Atrial Fibrillation

I am not feeling right.

Side track: I am thinking of starting to promote thisblog a bit. What do you think? (if there is STILL any response LOL)

Click. What can I say?

Watched "Click". Best choice ever.
Wonderful! Simply TOO good! I mean it is TOO great!!

Well I have to confess that I was never a fan of Adam Sandler. That's why this film wasn't really in my "view list" when I just learnt of it. It was until my friends told me that they cried during the movie (Big men) that triggered my curiosity. I mean, it was unimaginable that a film with Adam Sandler as leading actor can be tear-stimulating.

Anyway, I missed that film when it was on screen (damn, I am so regretful now~!). And now I watched it. It ROCKED my world. I mean... why it wasn't on screen like 10 years ago. It good. real good that I feel pity that I couldn;t watched it like 5 years ago.

This is the first time that I am happy about a ending of a movie claiming all the horrors were just a dream. It is my oridinary response by yelling "Oh No! Not this! What the hell! This is SO old!". I mean, what can be worse than to deny of what has happened on the screen for the last one hour or more and all of a sudden you told me it was nothing but a joke! That is not nice! But for "click" I was happy about that. It would have been one of the most alarming pictures that I have ever watched if it ended with with Michael's death. But with the "dream" trick, it became one of the most inspiring pictures I have watched. Ah.. Frank Coraci, the director, has really frightened me.

However, there is definitely a catch with this "idea". Unlike what happened in the movie, we , real humans, don;t have a second chance.

And, how pathetic!! (I have been yelling this all the time when I was watching the movie as the whole thing went downhill. I mean yelling inside coz my roomate was having a good nap). Many (if not most) people have that universal remote control!! And sadly, but gratefully now I know that, I am definitely one of those pathetic people.

I almost fell over when Morty (Christopher Walken) said whenever there is conclict between family and work. Work- one!. I hope I did not go to that extreme but I must say work has dominated most of my life that I have been spending little time on people around me. This is SO pathetic, isn't it? Working late /studying late for various projects/ activities/ anatomy/ powerpoints etc. but spent little if any time on real, living, warm people around me who are movingm, talking, caring. Gosh, This really makes me feel like an moron. What a pathetic guy! Well of course there is no wrong to dedicate myself in various stuffs: They are all good stuff and I am sure I would deeply regret if I miss any of these. But the point is: when work clashes with people, work-one. Argh, almost makes me getting sick of myself. Disgusting.

And ya. I think I am autopiloting myself sometimes too. Putting all the passion in work.. and then autopilotting my time with people around me. That is not nice.

Now, here is the management plan. I gonna put the VCD on my desk and make sure I am constantly reminded of the impotance to treasure people around... while keeping my passion alive.

Ahh... what a shock!!

Unsettled. What if?

M/20

Increased fine tremour X 2 months
Occasional palpitation w/ increaced frequency X 2 months
heat intolerance ?
Weight loss -ve
Anxiety -ve
Diarrhoea/constipation -ve
Good past health
Insignificant FH
NSND
ADL-I
NKDA

P/E:
Fine tremour +ve
Hyperreflexia (knee jerk)
P 88 Regular
Heart sound dual, no murmur
No palm erythema
Hands normal in temp and moisture
No pretibial myoxedema
No exothalmos, lid retraction, lid lag, proptosis, chemosis, ophthalmoplagia
Neck:mass -ve
No lymphadenopathy. Cervial LN -ve
No hoarseness of voice
Trachea central

I am really starting to get worried.
Should get my TSH tested.

Finger crossed

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Watched After This Our Exile earlier... Have thought a lot on the movie and on its meanings.. Hard stuff. Anyway, this is one of the critices which gave me some helped. I am trying to gether my thoughts and write something serious later.

副刊 > 星期日副刊 Our Cinema，Our Times﹕《父子》 渴望Happy Ending

【明報專訊】《父子》(導演譚家明)結束時，兒子BOY已是少年人。鏡頭帶我們去看他找父親。他站在河的一邊，看見彼岸的父親，跟一個女人手拖手慢慢走過。然後，一個騎單車的男孩子在BOY身邊駛過，男孩子回頭向他微笑。BOY看他﹕也許他是父親跟那女人生的兒子，細想自己的童年往事。也讓我想起，在遠處看見親人走路、上行人電梯、在果攤挑蘋果，都容易從心裏滲出近似哀愁的感覺。在凝望的一息間，這個親人的一切：對與錯、成功與失敗、期盼與失望，都失去了意義，變得完全不重要。跟所有人一樣，他挑蘋果要用手，走路要用雙腿，先提右腳再提左腿。如果他曾經遭遇過什麼事情，走起路來有點不方便，那他將要繼續一拐一拐的走下去。
《父子》的結局令我記起杜魯福的《四百擊》(1959)。安坦但奴(Anton Doinel)逃離教導所奔到海邊，眼前茫茫大海，是他將要單獨面對的自由。那時候，他也許還不知道，他可以做夢，可以風流，甚至選擇糊裏糊塗地過日子。但生命剛剛開始，他必須戰戰兢兢地試探它。BOY在《父子》片末再出現時，已是17、18歲的青年，卻好像對生命的自由，再沒有恐懼或期盼。他8、9歲時因為入屋行竊被關進教導所，其間發生了什麼事，電影沒有交代。他上路尋找父親，到昔日兩父子住過的旅館打聽，一併向店東買回那隻多年前偷來的手表，送還給物主。他的畫外音告訴我們，他探望過兒時鄰居的太太，她說已很久沒有跟他媽媽聯絡，倒知道他爸爸有了新家庭，而且日子過得不錯。然後，他站在河邊看對岸的父親，眼神像是充滿憐憫。
遭父母離棄
但他那個年紀的人應該做夢，對生命的憐憫可以交給時間慢慢滋生。但BOY很早便要背上責任的擔子。小時候他信賴的兩個人，爸爸和媽媽，都背棄了他。媽媽想過好日子，離家改嫁，卻沒想過要帶他一起走。之後他去過找她，媽媽也沒叫他留下。爸爸是個意志薄弱的賭徒謊子，他的擅長是利用人家的善意。兒子見自己家窮，去同學家玩時牽走一隻手表，爸爸看見，只說一句﹕「你偷來的？」然後，他「訓練」兒子入屋行竊。幾次失敗後，兒子說﹕「爸爸，我們別偷東西了。」爸爸說好，但話還未了，轉頭看見一戶人家熄燈，便趕兒子進去行竊。兒子遭抓住被打，他自顧慌張逃跑了。兒子被送到教導所，他去探望，卻只知求兒子原諒。小孩子怎懂得原諒出賣自己的成年人？BOY哭罵，撲過去咬破他的耳朵。
憐憫與憤怒
然後，差不多十年過去。我們不知道BOY遇上過什麼人，相信過什麼宗教。BOY的少年期是一片空白。他去尋找父親，其間還要彌補自己多年前、無知無邪地犯下的錯誤。我們不知道他為什麼去找父親(卻可以肯定父親沒有探望過他)？想跟他建立什麼關係？是他很需要「父愛」？還是真的在遠看父親的那一息間，明白了憐憫？他也會去找媽媽，「原諒」她嗎？但他還那麼年輕！世間萬物皆有時，憐憫有時，憤怒有時……
《少年》更無情
大島渚1969年的《少年》(BOY)和《父子》有些相似。兩個孩子都沒有名字，都只叫「BOY」，都有不長進的父親逼他們犯罪，剝奪他們的自由和尊嚴，而最後他們都選擇「接受」父親和家庭。
《少年》卻憤怒和徹底得多。大島渚針對的目標清晰明確﹕日本的父權和家庭制度。《少年》裏的勾當是先讓男孩假扮被汽車撞傷，然後由父母向司機勒索。一家人最後落網，孩子卻什麼都不肯跟警察說。
這個殘忍冷酷的家是他的所有，外面的世界只會更無情，他的唯一歇息是做白日夢。大島的鏡頭和剪接是疏離的：長鏡頭、事件經常在畫面的最右邊或最左邊發生、插入黑白的段落；畫面常見日本國旗，要不便是紅色的鮮血落在白雪上；抽象的音樂是聲音多過音樂。
失去童年夢
《少年》的情感是憤怒，並要求觀眾理智的去看去想。《父子》是另外一回事。《少年》的背景是北海道，《父子》是南洋；一個冷，一個熱。《父子》以浪漫悅耳的音樂、夕陽餘暉般的金黃色燈光、旖旎的影機活動和剪接，把我們放到一個殘酷世界的悲哀感情裏沐浴，感慨年輕生命被逼趕快長大，失去做夢的自由。這有泡溫泉的舒服，可以消除勞累，但之後終要回到外面冬天的世界。
文﹕王慶鏘
策劃：王慶鏘 李焯桃
編輯：葉旺文

Dolce Vita

Today had a day-off. Did some studying in the morning and went to Festival Walk in the afternoon.
The Christmas Tree was great--always the best you can find amongst the big shopping malls--Although I think the tree of 2004 was better.

Anyway, had a haircut and bought some CDs and VCDs for my enjoyment. Splendid.
DOLCE VITA!

After hairciut:
Before:Photo from PWH surgery:
Wah... I must have been mad by posting 3 self-portrait in a row :P
Freezing...

Success. Ambition. Life. Evita

Watched the VCD of EVITA this evening. First time watching it seriously from beginning to the end.

Evita had a glamorous life. And glamorous death. But speaking in terms of life and as a person. Her death was bitter.

Due to unfair treatment by the middle class family of his father by birth, her early life was sheltered under bitterness and hatred to the privilaged. She had always wanted to take revenge to the privilaged by over-ruling, over powering them and "be a part" of the upper class.

In shadow of such mentality, most, if not all of her life was themed under the sole target of becoming the top in the "big apple". She betrayed people around her and used whatever means she could to reach her goal. She "represented" the peasants not due to her idealology but because she would like to take revenge by overpowering the privilaged class by overthrowing them on behalf of the less previlaged. She extablished charity and visited people not out of her kindness but becuase all in her life she was heading for the goal of becoming the cream of Argentina. That was why the lyrics kept saying Eva wanted more and more. It is true that it is "not the money and fame", but it was a mentality from childhood that created her character and her tregady.

But Webber and Rice are after all not ordinary musicians/artist. They gave Evita a bitter ending. What beat her down at the end was not her enemy, but her own body. Webber gave her a very sacarstic ending by beating her by physical illness.

Ar, this is so true. No matter who you are and how good you are, after all, you will suffer from your own body. No matter how glamorous you look, how good an actress you are, you die one day! So why all these revenges? Why all these hatred? Che, the story teller of the whole thing, has actually spoted very precisely and accurately that: But that's all gone now/As soon as the smoke from the funeral clears/We're all gonna see and how, she did nothing for years. No matter how rich her life may seem, no matter how glorious her life looks, she did nothing for years that ("But in the end you could not deliver").

Dunno why the image of Pricecess Diana and a lot of other prominant public figures jumped out when I was watching the film. I thought the whole thing brought up a very hard yet very true message: You gonna die anyway, so instead of spending your life glamorously and leave like an ash, do something that is self-satisfying and makes a difference--that you will not regret, and people will remember you for the difference you have made.


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On this night of a thousand stars
Let me take you to heaven's door
Where the music of love's guitars
Plays for evermore

In the glow of those twinkling lights
We shall love through eternity

On this night in a million nights
Fly away with me

I never dreamed that a kiss could be as sweet as this
But now I know that it can
I used to wander alone without a love of my own
I was a desperate man
But all my grief disappeared and all the sorrow I'd feared
Wasn't there anymore
On that magical day when you first came my way
Mi amor

On this night
On this night
On this night of a thousand stars
Let me take you to heaven's door
Where the music of love's guitars
Plays for evermore

-- Nice lyrics :P

Photos.

Wanna write up something about "A Litre of Tears"...Another drama that triggered some thoughts... Will write that up later after I have thought over the issue more in depth

Today, wanna share some photo I took in team 2 and firm 3:


by florencechong111_6

Florence, Lilian, Dr. WT Siu, Jessie, Me (Sigh... could not get hold of other doctors...)


by florencechong111_6

Florence, Jessie, Lilian and Me--Formal look



by florencechong111_6

Playing around in the seminar room



by florencechong111_6

Jessie, Florence, Maggie, Kevin, Dr. Susanna Ng, Lilian, Christina, Me
(what happened to our faces?!)


by florencechong111_6

Apparaently very sleepy that day haha. Prof. Thomas Chan in the middle. He is such a nice professor.


by florencechong111_6

Firm 3 + Dr. HN Tse (Tui Gor Gor). He is such a funny doctor. :P



by florencechong111_6

Firm 3 + Dr. Anne Chan. I still remember the doalogue

Dr. Chan: Do you know the common differential diagnosis of hypoglycaemia?

Students: Insulin overdose, neoplasm......... (dead air)

Dr. Chan: Do you know the word EXPLAIN?

Students: (oh my god, she is going to be harsh..) ....umm.... yes....

Dr. Chan: EX stand for exogenous insulin, P stand for....... N stand for neoplasm...

Students: Phew...

Make a Difference. Make a Splash

Too much to say. Can;t put them in works.

In short, AMSAHK, you changed me.

Exhausted. Let me go.

Ah, I am so tired of the whole incident. Please let me go and let me go on with my life. I just want to concentrate on what I am doing rather than to dwell on a past problem which I have already reviewed thousands of times and blamed myself.

Fresh air needed.

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Sorry for this low quality entry. I just need somewhere to vent out.

Doctors and Execution

Haven't been writing for a while again. Well, I am lazy, I admit that.

Yesterday was the last day of service by the old "Star" ferry pier. (Anyone notice that the habour was named 'The "Star" Ferry"? Note the quotation marks! I never understand why. I would be real glad if some history nerd can educate me on that.) I admit that I did have a sense of loss. Star ferry has been really a part of my Hong Kong memory and it is definitely something that make you think about this special city. I would always remember those special rails and stairs in that pier.

Although I did have that sense of loss, I do see the necessity of going forward. What I mean is that I am not a fan of the current atmosphere of protecting every single structure that makes people think about their past. Preservation of history and architecture is important, but does it simple mean to preserve every single piece of building? I mean, other then the desire of preserving the memory, the preservation process needs to give the monument a new life. Otherwise, the preserved building would be nothing different from an abandoned flat. However, it seems to me is that the current atmosphere was that people only cared about the preservation but not the re-newing part of the monuments-- which is pathetic in my own opinion.

Anyway, today's society is distorted and strange.

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The above was really sidetrack of what I want to write today. Two weeks ago, Joe emailed me asking for my opinion on a pretty interesting matter. He was saying that doctors are hired as executor in capital punishments in the US and he was asking for my thoughts on whether this was an violation of the doctor's ethics. For those who know me well, you must know that I could not wait to answer that question. But in light of coming examinations, I had to put that question down in pain. Now, with examination passed and with life back to normal, it is time for me to hand in this piece of homework to my dear friend.

This is a complicated question and it took me some time to think how I should approach the question. After some thoughts, I think I would structure my answer as follows

a. Doctor's Ethics
b. Doctor's role in capital punishment
c. The conclusion

I must stress here that the following discussion is based on my personal knowledge and experience rather than scientific evidence or well established data/papers. This was because this question was largely pointed towards my personal opinion and also I dun intend to take the trouble in searching everywhere for papers and data (although I am pretty sure that there must have been high quality discussions on the matter). Secondly, I also need to point out that the following discussion is largely based on humanities as this issue should have no room of suspicions in the ground of law (law people please voice out if otherwise!!)

a. Doctor's ethics.

Ethics is a fluid issue with its continuous changes with time, culture, scientific development and human values. Ethic is different from law in that those who violate law will be punished by means as stated by law. Professional ethics is however a bit different from general ethics as vioation of professional ethics may lead to punishment by professional organization in forms of condemns to termination of liscence. Moreover, professional ethics usually required from its member a higher level of standard.

So why professional ethics and not professional laws? Ethics is also different from law in that it gives more room to its executive arm in determining whether there is violation of professional ethics. As a result, professionals can act according to the continuous change in public expectations.

The public require more from pressionals-- this is well established. Doctor is one of the professions that have been highly regarded and respected by the society as a whole. As price of that kind of respect, the public has the right of requiring more from foctors in the ground of ethics.

Doctors learn medicine. And in medicine, doctors learn way to heal, as well as way to kill. It is therefore of utmost important that people who are liscenced as doctors must have high standard of morality. Medicinal knowledge, as required from the days of Hippocratic Oath, should only be used to heal/cure/comfort rather than to harm/kill. Doctors are people who learn to help people in maintaining their life with quallity, doctors do not learn medicinal knowledge to "rule" life. In other words, doctors have no right to determine whether somebody should live or die, but only have right to help people in keeping themselves alive and healthy, or to help people die with dignity and quality of life.

b. Role of doctors in capital punishment.

As stated in his email, Joe mentioned that the rationale behind the hiring of doctors as executioner was that they needed somebody to certify the death of the prisoner. In other words, doctors actively participates in the induction of death of that prisoner.

What if doctors are only hired to certify the death by not the execution of death? In modern and ancient medical ethics, it was required from doctors that they should prevent the death of any human being within their power, no matter whether they are responsible for that patient of not

c. Conclusion.

In conclusion, I do think the participation of doctors in any form an violation of medical ethics. However, since his action was granted by law, there is no ground that such doctor can be condemned by exisiting medical regulations for doctors.

It may be argued that the concerned doctor does not act in capacity of doctor when he/she is overseeing the process of execution. However, it is necessary to note that by getting the liscence of doctor, it means to act in limit of doctor's ethic at any time and place.

In short, there is no problem with that doctor to become an executioner in terms of law. However, I would have strong reservation of regarding that person still as doctor.

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Life is hectic, but passion is growing.

Joy. Fulfilling

Had an extremely joyful beginning for the day. Thank you for that message..(L)

Hehe..

Had been having the AMSAHK Executive Committee Interview since yesterday. Today it lasted from 1745 and we finally left CUHK at 1 am.... Very late indeed. But very fulfilling indeed. The spirit must pass on!!!

Had some thoughts on my way back. Anyway, I gonna write this later. It is almost two and I definitely need to get some rest.

Responsibility and Honour

I never thought a TV series could be so thought provoking.

Lately, I have been indulging myself on Sunday night for the TV drama of 女王的教室. Very provoking indeed.

I originally thought it would be another old fashioned primary school melodrama which makes every one cry at the very last episode (haha, unfortunately, I do have special interest in these old fashion stuff. Why? Perhaps it always remind me of the bright things around). It turned out that this drama had basically the same plot. But unexpectedly, this drama has proved itself to be not only very thought provoking, but also sacarstic to the examination centred modern education which over protects children from challenges and obstacles in life.

The drama has succeeded in bringing up a theme of "Responsibility" which has cery much been neglected in the society nowadays. No matter how much we are trying to pretend, the modern society, no matter in Japan or in Hong Kong, very interest oriented. Children HAVE to study hard so that they can have good results and go into a good unicersity, and finally get a good job. Adults have to go to class after work so that their boss would consider them hardworking and promote them. Politician organizes protests (but without solution) so that their voters know that they are doing something and re-vote them in the next campaign. Indeed, few children really study since they want to accmulate knowledge. Few people study after work since they want to do better at work. Few politician would work for their ideals in spite of pressures. I am not denying the few people who indeed have thought about that, but I must say the world in general is pretty interested oriented today.

What about responsibility? I guess the adults of my dad's and mum's age do have much better idea on that. They have in fact been trained to take responsibility of themselves since they were small. The failure of their parents to take care of every details of their life (because of hardship in everyday life) have trained that generation to be very independent and responsible people.

The new generattions have received much better attention with more available resources. But at the same time, few attention was given to "responsibility" i.e. You don't do something becuase somebody tells you to do it, but becuase you are taking responsibility of the action and consider you SHOULD do it. In other words, we study not because we are told that we will have a better future, but because you are taking responsibility of your own life, and subsequently, you make out that you have to have the knowledge from school in order to achieve what you want to.

This value is very simple indeed, but it is very easy for people to get loose and forget about these big principles when they get too tired or too busy. I am thankful that I am reminded from point to point.

In fact, being a medical student is no easy task. The ocean of medical knowledge is too big and it is expanding exponentially that you never learn enough to practice the best of medicine. On the other hand, you get very desperate since you understand that the more you absorb, the better you can practice in your job. This made me annoyed from time to time-- there is a feeling of getting drown and it seems that you never see the coastline. And that is a very desperate feeling when I flip through the books and relized how little I have read-- and among those which I have read, how little I could remember. From time to time, I just wanna throw away everything and enjoy myself. (of course I DO throw away books and enjoy myslef, I am human after all). This is not the evil. The evil is that sometimes I just lose the motivation to study.

"He may be just one of the few thousand patients in your career, but to him, you are all his remaining hope" I know I have already mentioned this quote in my previous entry. But this lecture was really so moving that I cannot emphasize this quote more. I am not only studying to become a doctor, but I am studying so that when people are in need, I can offer support and hope. This always give me motivation to continue my study.

Today is the national day. Watched the firework in the evening on TV and I must say this is one of the best shows in these few years (Dede, you are missing something nice). National day always reminds me of my ambition to become a "useful person in the society" (since kindergarten!!). Today, my responsibility is to remain energetic, caring and loving; and study hard for the benefit of people in need!!

Today is an inspiring day.

A deficient End. A Fresh Start.

Haven't been writing here for some while due to various reason. Academics mainly as the forma excuse. The hard fact: Coz I am lazy. and because I am confused.

Confused till now--i.e. the last day of my attachment at Ward 9AB. How much I really get from this medical rotation. A lot. Really a lot. More than I actually thought I would. Too little. I am still extremely far too deficient that I am really shameful to call myself a third year medical student. Ya I mean it. That perhaps explain my episodic blue today. I am far too green, or the preferred word by MOs: EMPTY.

Yes, I know it really takes time. Yet, it is really painful to realize that in 2.5 years time, people are actually going to put their lives in your hands-- and I am not confident at all that by that day I am 50% capable of doing so. So empty.

Enough of blues. Well, the good thing is, after this rotation, I know I am feverishly falling in love in medicine. I mean medicine in general. The confusion between medicine and surgery is still here. Though I am not worried about this. Like Charles said one day, it is so hard to find a job on earth which you have so much satisfaction in spite of the long hours and hard efforts. I know this is the right path I am pursuing on-- no matter how deficient I am.

I still remember the first day we went up to the ward, I was really anticipating a lot from this rotation. Now, I think I got more I could expected. Yet, at the same time I really understand myself all. It is truly a harsh but rewarding rotation that tame a nearly arroggant beast into a modest man.

I wanna thank all the patients for being our teachers. You have been patient with our stupid and clumsy question and have bare our slow and unfamiliar physical examination. Thank you for cutting your sleep and rest short to educate this group of timid youg people-- who although looked bright, are very unsettled inside. Thank you for teaching us in spite of all the discomfort we have caused you. And thank you for those who have told us what they expected from the medical practitioners. What you have taught is is beyond book stuff.

I wanna thank all the doctors are professors who have been teaching us through ward rounds and bedside teaching. Thanks must especially go to Dr. S. Ng, Dr. HN Tse and Dr. YY Chan whom we have been following round with most of the time. Thank you for teaching us although that have caused you extra time in doing the ward round. Thanks must also go to all the tutors who have taught us a lot and have so many expectations on us. We have definitely learnt to become a doctor, rather than a medical nerd, from you as a role model.

I also need to thank Prof. Thomas Chan, who have been a patient teacher, and as far as I know, the most involved coorindator of all medical rotations in PWH. Thank you for not only teaching us medical bookstuff, especially drug stuff, but also for being caring with our lifestyles and attitude towards life. Thank you for your sharing-- although it is unlikely that I can practise what you have taught us, I am truely grateful and touched.

Finally, I gotta thank all the groupmates in M3. I have learnt a lot from our medical/academic talks, and I have had a lot of fun with you. I really look forward to out next medical rotation.

In midst of the current blue-- because of my deficiency, and also because of the forthcoming exams, life must go on. Going to start my first surgical rotation in QEH next Tuesday. And frankly, I am excited (though the comeing assessments are killling me). I have really been "planning" to be a surgeon all these years. In the recent 2 years, internal medicine has become more charming to me because of the rapport extablished between doctors and patients. But of course, I still love the decisiveness and effectiveness of surgery. What is my fate? Perhaps I will have a better idea after my first surgical rotation.

Now, every one has flew.... somehow have some sense of loss.

Inspiration

Today, had an extremely inspiring out patient clinic teaching by Professor Thomas Chan. Very inspiring and touched. Felt pretty ignorant, naive and guilty after class though...

Anyway, it is late now. I wanna join the MO ward round at eight. So may be I will write about this later.

Impact of death

Today, the second day in ward, a patient passed away. Should be a case of respiratory failure after long term chronic obstructive pulmonary diseases. The first patient since I started the rotation.

The family cried at that moment-- I think most relatives were with the patient when he left. They cried. But pretty strangely, I think that was pretty a relief--for the patient and for the family members. In fact, the patient's condition has been so bad that his family has been called to be with him since yesterday. The family members were obviously very depressed and stressed since yesterday. But more importantly, the patient was already on Bilevel ventilation for pretty long time-- Which essentially means that the obstruction was too severe for the patient that each breath takes a lot of effort. The patient became too weak that a machine has been connected to him to assist his breathing. And today, after uncountable number of miserable breathes, his respiratory muscle finally given up. The suffering ended. The patient has signed for no intubation which essentially offers no help other than to prolong the suffering. I think this is a relief to the patient and the family from their sufering.

But this comes back to a question-- is there such a thing called good death? This is difficult. Death is more a process, a process that leads us to the end of our life. To this special process, it would be inapprorpiate for by-standers to comment on this last journey for the traveller himself. But yet, what by-standers can do, and esp. what we, as medical professionals, can do, is to assist so that the patient may have a respectable, self-controlled death. This comes back to the goal of the medical sector: to cure, to safe life and to improves quality of life if possible. If not, we try to reduce patients' suffering and let them go with self-respect, self-control and self-independence.

What is death? What is death like? Will death be painful? How long will be the death? This sort of questions are always posed to medical doctors. But perhaps, death is more a process that no one can determine/explain except the traveller himself-- just like our lives, no one is a better narrator than the person him/herself.

A Whole New World

So this is my first day to ward.

The morning started with Prof. Chan's briefing. He turned out to be a much more humourous guy than I had thought. Strict but nice + a bit of balck humour. Nice.

Then we proceed to the ward to clerk cases ourselves.

The afternoon started with ward teaching by Prof. Thomlinson,who took us to 9 C and also 11 AB wards (infectious ward) which we cannot go by ourselves. Then we went back to 9AB to ask about the ward round schedule. And also updated ourselves with a pt we clerked earlier on.

So Lilian and I clerked two patient. One with a very typical spontaneous penumothorax. One with COPD exacerbation.. and a mix of many other diseases. Pretty happy since this is the first time I see such a big tension pneumothorax. And for the second patient, I managed to pick up abdominal distension, hepatomegaly and ascitis although the histroy did not really point directly to that.

The ward is a totally new place for me--a whole new world. I mean I have been there before. But being attached to it, being a part of it, is a totally different matter. It is the first time I have the time and opportunities to feel the dynamics in the ward.

Hospital wards, are prehaps, one of the most complex places in the world in terms of emotion.

Today, a patient who has COPD was going to leave and his relatives and families were all staying with him. The family, although must be pretty prepared, looked depressed. Nurses go to them from time to time asking them to eat something, telling them that they will collapse and add burden to other family members if they don't-- a sort of alternative encouragement by the nurses I suppose.

In the nursing station and around the beds, nurses and assistants are buzzing here and there, busying handling the patient--some are cooperative, some are confused, some are annoyed. The nurses are pretty irritable-- yet, you can always sense the caring heart behind the shouting voices.

Students like me a idling around the beds and the X ray box.. willing to learn but sort of confused by the new atmosphere.

Curiosity, care, annoyance, depression, broken heart, ambition, smiles and laughter, tears... you can find all in a medical ward. What a place.

And yet, this is the place which we have chosen to stay for our career. Ah.. I really wanna mature quicker.

Finished today pretty early-- exhausted after standing a whole day on my leather shoes..sore! I was reading the relevant materials all night. YEAH, this is the feel that I need-- the feeling to relevance, the feeling of application of knowledge. Gosh, I love this!

New Beginning

Today (i.e. in 8 hours time) is a big day for me.
Since the first day I step into the medical school, today has been what I have been looking forward to-- Clinical Clerkship.

Yes, I am starting my Junior Medical Clerkship today. For those who don't know, clerkship basically means learning through rotations in different wards in the hospitals. Tomorrow, I will be a doctor-in-training in ward 9AB of Prince of Wales Hospital.

Though I have been looking forward to this for really long time, I don't feel pretty nervous now. Perhaps the previous occupation in the organization of the AMSC has been to exhausting that I do not have time yet to look at the whole clerkship thing seriously. And perhaps I am not fully prepared for the clerkship yet too.

Clerkship is an important stepping stone to a medical student (MS). It marks the conversion from a preclinical student to a clinical student. It embarks a learning process which MS have to learn by active participation in daily running of the ward, instead of passive sitting and recitition of lecture materials. It also means that your learning process will be actively monitored by MOs and Profs in the ward--and should we be not proficient enough with our knowledge, they will make sure that we feel ashamed of ourselves. Clerkship also remarks the beginning of interaction with patients in the wards. And this is what medicine is about after all-- we finally take the leap from lecture notes and tutorial papers to the real life. The real life is not going to be easy- and in fact, will be pretty tough and demanding. Yet, this is why medicine is so fabulous.

The blog is established to remember this transection-- from a medical student to a doctor to-be. Ward life means busy life. Yet, I am expecting inspiration and emotional challenge from time to time. And this blog is made for me to record these remarkable events that hopefully, finally, will train me from a naive MS to a mature house officer (if I managed to graduate, of course). This blod, unlike my another blog, will not be a record of my daily life/emotions, but rather inspirations of my daily education in medicine.

No. I am not planning to make a big deal of the establishment of this blog. I rather this blog to be a quiet place for those who accidently come across this by chance, and among those, people who decided to share my life experience. I thank you for your sharing in advance.

I am not sure if I will be a good doc., but I will be my best to be a caring, empathetic and holistic doctor-in-training.