This Year Gone

It's crazy how in the blink of an eye, it is August already. 

Where the heck did the last 8 months of 2016 go? 

I recall the days of being a high school student : giggling with Manda about nonsense amidst classes, as with the days of being a carefree college student worrying about what to wear everyday so as not to recycle my wardrobe. I vividly recall the days of medical school and of my F1/F2 days where I was so much more driven and of my bright-eyed enthusiasm. 

In this last year since I commenced residency, I have come to terms with a few things: 

1) Why the previous residents I have met have been so jaded halfway through their career 

- I used to muse aloud as to why these guys would get so jaded halfway through or at the end of their third year and just throw in the ropes and call it quits. 

Sad to say, I now see why. Because I have found myself teetering on the edge of feeling so freaking fed up many times over the last year. 

Looking back now, it is difficult to pin-point down as to what drove those feelings, but I dare say that a big part of it possibly was driven by the culture in this part of the world and how I sometimes just get wronged for everything under the sun - even if it wasn't entirely my fault. If I did something brilliantly, no one ever actually acknowledged it, but the moment I made a mistake, I was given a look like I was dust. 

2) Why some people have just given up pursuing their dreams, because honestly, some things are just not worth it

- Honestly, people who have known me for most of my life will know that I have wanted to be a cardiologist for a good part of the last 5 years of my life at least. It's always been about how I need to be a cardio god: and that's all that matters. 

But truthfully, amidst the days of clerking 30 patients in the middle of the night, to 30 hour on calls that stretch into 33 hour on calls because I leave at 3 pm the next day, to days when I stare at myself in the mirror and wonder just when did I become so haggard: I question myself. 

And truth be told, I have been hesitating this year - ironically - about pushing forward with the cardiology dream. It was all I had wanted before becoming a trainee and all of a sudden, I find myself pausing at the crossroads and wondering whether this is the correct decision. Mainly because I realise that I will truly be ruining my own life in more ways than one and possibly be really museum-bound as a Cardiology reg. 

Heck, is life really worth sacrificing this much energy and my youth over a couple of ECGs and a stupid hospital where everyday I find myself getting more and more angsty with a zillion and one unnecessary things. 

3) How I have changed into someone I don't really get anymore

- Looking back at my blog entries of the past , the Gmail chats / text messages and my pictures, I realise what a different person I have become. It is difficult to put a finger down on it, but it is almost as though the 'me' of the past has faded into someone who just doesn't give a crap. 

I no longer care what people think of me. Neither do I care if I get into trouble for not doing the teeniest of things and if people hate me because I have raised their voice at them. I have ceased to care as much about my outfits and my sense of style daily. And to be honest, it is sad to say that I can no longer recall the last time I really felt happy and contented. 

Perhaps it is because I have managed to perfect the act of putting on a front after years of rigorous training. But it doesn't really matter, because I can tolerate a lot of things but it is difficult to define moments that actually bring joy to my life. Or rather, it has been so long since I have met someone I can truly connect with that I'm not sure what it feels like anymore. 

So almost a whole year of 2016 has gone by. I have yet again achieved nothing much in life. And a whole year of residency has flown past me, with little to add to my medical career besides just jumping through another hurdle. 

I guess to look at the glass as half full, there are a further 4 months to make this remaining bit of time left really count. 

Wonderland

It seems hard to imagine that 2014 is drawing to an end and again, my whole year has almost passed by without me achieving much in life. I suppose I imagined myself living in a sort of Wonderland before moving back, and then I took a whole month and more to get used to this job that I had loved so much before. 

Each day when I open up my various pages of social media, besides seeing this person getting married, that person getting engaged and this other person winning some kind of top-notch award, I drag myself on to my feet and realise that I have nothing much to share with the world besides trudging to work before it is barely light.

I suppose I can't complain much. I don't live at the other end of Singapore and am lucky enough to be able to get to and from work easily. I am also lucky that now it has been almost 6 months since I started work, I am less at a loss with the different abbreviations and I know how to get to A&E back to the ward without losing my way. I have also done countless 30 hour on calls now to the point that I know how it feels like to survive without sleep for 2 days. 

However, I do find myself questioning myself over and over again if this is what I really even want. 

How distant those days of bonding with my favourite cardiology registrar over coffee in the echo room or my cardiology consultant heaping praises over my winning the audit award to everyone in the hospital seemed. Here, I am less than dust. Not that it really mattered. I had at least gotten over the fact that if I got through the day without being shouted at, I should count my blessings. 

But I hadn't realised until recently how exhausted I was doing back to back 30 hour on calls until a few days ago and it made me wonder. If this was really what I wanted out of my entire life. Running around the hospital at top speed, getting angsty at stupid A&E referrals and snapping at everyone else. 

I wasn't that kind of person and I wasn't willing to be. 

These days, the thing that makes my days is listening to Taylor Swift and 1989 on repeat, gawking at her amazing outfits and how amazingly skinny she is....how I could never ever be this skinny despite my efforts (sporadic, yes, I know...) at gymming. 

And I think back to this time last year and the days of eyelash-batting at Mr Crook and gossiping about nonsense seem so so far away. 

This year I will spend boxing day on call, NYE post 30 hour on call and the rest of the month slaving through the usual routine of work + running around the wards + getting used to this life. 

It seems that when I was so inspired and so determined to achieve this cardiology dream in the UK, the dream has never seemed to distant to me until now. 

Back for good

Back when I had first announced my decision to leave the UK for good in March, it had seemed so far away then. On top of studying for my MRCP Part 2 exam and tearing my hair out amidst consecutive on calls and questions, the one thing I proclaimed daily was that I just wanted to go home for good. I couldn't wait. Later on, when these exams had been passed and done with and there was no longer any real stress, I ranted about how I hated surgery and ENT daily. That I couldn't wait to leave this place forever. 

Truth be told, my departure from the UK was more uneventful than anything else I had ever experienced in life. It had been completely drama-free, perhaps aided greatly by the fact that we were in a mad rush to lug back my 28492 outfits and shoes that I had collected over half a lifetime in a country I had come to know so well over these years. There was no longing and bitterly missing my life in the UK after coming back here. In fact, I have almost forgotten what it was like back there - and this is what I'd like to think is what it is like to feel settled. That this decision to move back for good was none other than the right one all along. 

When I had first told my consultant of my decision to leave a few months ago, he pointed out that I had spent so many years in the UK that I was probably more 'anglicised' than I had thought over these years. Which I had to agree was slightly true and slightly not. I had come to find myself to be someone who was neither here nor there since I had left home at the age of 17. Amongst my English friends, I found myself to be 'more Chinese' than I had ever thought with my principles and yet back home, the tag 'UK Girl' never seemed to have left. Living abroad brought me the freedom and independence that made me grow into the person I was today, and this, amidst a myriad of both good and bad things that transpired - McD runs in the middle of the night, getting so wasted on 80% strength liquor, trudging 2 miles to the train station in ankle-deep snow clad only in ballet flats, coupled with short interludes of winter / easter / summer holidays gallivanting in Europe or being pampered back home....I would never have traded in for anything else ever. 

And then the one big party that was 'student life' ended, and the real world loomed ahead. Friends started to leave....one by one. For different parts of the UK, for Scotland, for the East. Boys came and went and sadly, none were here to stay. On call rotas started to shape our lives, followed closely by the pain of studying for post grad exams. There ceased to be a 'Club 168A' or a 'Daisy, Minnie and Coco' and meeting up for short European breaks  / weekend breaks seemed to be the only thing I lived for. And as much as I had professed that the past 2 years of my medical career had turned out with me having nothing to show for besides an amazing ability to multi-task and churn out discharge summaries at top speed, I had to admit that the only bit of meaning to my life was probably connecting with medicine and reinstating my faith in what I had already known - that I was a medic through and through. That it had been insane I had actually considered Colorectal Surgery and Ob Gyn for one brief point in medical school.

It feels strange to be leading the most unproductive life ever when I had hardly stopped to even breathe for the whole of May with my back to back on calls. Truth be told, there is alot of soul searching that I have been left with to do at the moment. Whether or not my incessant desire to live the Cardio dream and put up with a lifetime of stress and exams was what I would really want in the future, if life would really become as empty for me as being only about constantly struggling to keep abreast in this rat race that is medicine with no knight in shining armour riding along in a cloud of dust in the distance, if I was really cut out to be the best of both worlds in the future or if I could just handle one at a time.

But I reckon pondering never really did anyone any good, and I have come this far to achieve my fierce childhood dream of becoming a doctor. We only move forward from where we go, and hope for the best.

And for the moment, I'm optimistic that I can make it. 

A New Era

It seems like yesterday that I was young and fresh. Now, I say this like I am a grouchy middle-aged lady, but the truth is that the early and mid twenties are long over, and it feels even longer ago that I was a wide-eyed teenager. Where had all the time gone in the blink of an eye? 

I see myself evolving from day to day. And at this point in time, in my late twenties, sometimes I wonder if I have gained anything in life besides a medical degree, more lines, thinning hair and a ton of weight. 

The one thing I am sure that I have gained, however, is a tasteful sense of style. Don't get me wrong, I may not be Tatler Magazine's Woman of the Year or Fashionista of the Month, and not everyone shares a similar taste in my clothes, but I pride myself on not being tacky. 

Or, perhaps, it is just that I am probably 5 kg heavier than I was when I was 16, and there is no way a person of my height and weight and well past the age of 18 could pull of micro minis, plunging halter tops and strappy sandals any longer. These days, it makes me uncomfortable to appear in a hemline higher than above my knees, and I rarely appear in anything strapless or a halter neckline. My wardrobe is completely obsolete with any tops that need a zillion stringy bits tying together and it makes me uncomfortable when a hint of cleavage starts showing in any tops. 

It also helps that these days, I am meant to be a professional who is busy saving lives and nobody would want their doctor to turn up looking like a hooker. 

Last year I was obsessed with lace. I still am, don't get me wrong. 

This year, I discovered the wrap dress. 

I have long been a fan of Diane von Fursternbug. The only problem was that I could not afford anything from DvF because I was no lady of leisure and a poor aspiring doctor who has yet to pass the membership exams could never afford DvF on a regular basis. 

So I surfed. And made a mental note to hunt down high street alternatives. 

I love how this brightly coloured piece is demure yet striking at the same time. Totally screams power dressing all over.

I LOVE this piece. The take on a short sleeved wrap dress is something that I have yet to see and it screams versatility all over.

And finally, who can resist mesh sheer polka-dotted sleeves? 

Sigh. Sometimes I wonder if I would have been better off as a personal shopper or some kind of fashionista who had her own clothes boutique rather than the struggling aspiring cardiologist that I am now. It makes me wonder how my flair for piecing together outfits comes so naturally even when I am late for work and rushing to just throw on the first few pieces I see, whereas in contrast it takes so much for me to remember medical facts, tiny details, make sure I don't mess up at work....and on top of all that, claw everyone out of my way to the top. 

If it takes so much for me to even pass my membership exams and stay focused, I wonder if my whole life is going to filled with stress, a feeling of emptiness and dreariness AND still not be able to reach the top or even fulfil my distant dream of being a Cardio God. 

Why couldn't things be as simple as I thought they were when I was 16? Why couldn't I just have all the things I thought I would when I imagined myself at this age? 

At this point in time, it looks like I will end up looking as haggard as a rag from the exhaustion of mugging for my MRCP, stressing over on calls and work AND I would still end up not being a Cardio God and NOT having a Prince Charming of any kind to prevent me from drowning under all this pressure. 

Oh well. 

From Surgical F1 to Orthopaedic SHO

Hi, I am your Orthopaedic SHO. 

Firstly, I know nothing. Secondly, the only thing I like about Ortho is looking at ECGs. 

Wow, that's helpful isn't it? 

I finished my last day of FY1 12 hours later than everyone else by covering my fellow F1's night because he had to move to a different location whereas I was still in the same trust. 

It was uneventful. I doubly played a role as a Medical F1 on call as well because the medical SHO (whom I swear I have fallen in love with after last night) was struggling but remained so pleasant, each time telling me that he was okay when I repeatedly offered to help him even clerk new admissions, and kept thanking me when I helped him do odd jobs. Unfortunately, the sickest chap died despite my heroic efforts at catheterising and ABG-ing him...but an inoperable CA and an ischaemic bowel with a Lactate of 8.6 would have unlikely interested the surgeons in a laparotomy. 

It is true what the Med Registrar was saying - there is such a difference now retrospectively standing back and looking at the events that had unfurled this past year. How much better I am now at the end of my FY1 career than at the beginning. Even if it is just small things like working the system or telling the nurse to just forget it when there is minimal urine output in a perfectly well patient overnight. Hello, nobody pees at 4 am when they are asleep for God's sake! 

So it is with a tinge of emotion that I bid my first year of my career as a doctor goodbye. 

It has been full of ups and downs and it has been such a steep learning curve and despite it all, I am proud that I have come this far with the following to be proud of: 

1) I made it through all my F1 on calls and normal days without shedding a single tear. Yes, I have had my fair share of being treated unfairly and being shouted at for no reason, and making mistakes that could potentially endanger a person's life but I had refused to cry. Not once. 

2) Actually gained some knowledge clinically. Or at least I'd like to think so. At least now I clearly know what dilated loops of small bowel look like and what to do when someone is in ileus. NG Tube for God's sake. I Don't care whether the patient likes it or not. 

3) As much as I was afraid of surgery, I actually learnt some surgery from the few sporadic bouts of being a surgical house officer and actually doing something useful besides a ward bitch. I am only looking forward to learning some Orthopaedics because let's face it, I know nothing and we all know that we just have to man up and face our fears sometimes. 

4) Learnt to read ECGs properly. I suppose that was one of my better areas in medicine anyway. Nowadays if something looks weird I just holler for the Cardio reg and force him to come over and take a look even if he gives me grief. That's because I have also learnt that despite all his swearing, he isn't all that fierce and I'm not the least fazed by him taking the piss out of me. 

5) Can successfully totter around in fairly high speed in heels/wedges. Fashion comes first, regardless of your job. 

6) Am hopefully one step closer to being a Cardio God. 

It's been a good year, F1. Despite the fact that my days on Elderly Care almost did my head in and made me lose all my hair, Cardiology was a dream and Colorectal was great fun mainly because I had the best registrar in the world who even gave me a present when I left. 

And now on to embrace the world of Orthopaedics. My first day tomorrow and I am scheduled in theatre. The Consultant is not just going to throw his hammer at me, he might drill a hole through me and throw me out the window eventually. 

Good Luck. 

So you think you can doctor

As this academic year draws to an end, it amazes me how fast time flies. Perhaps the word 'academic' isn't even right in this context because I have certainly been doing nothing remotely 'academic' since I graduated from Medical School last year.

This time last year, I remember starting out as a wide-eyed house officer, clueless to so many things. Starting a weekend day ward cover less than 2 weeks into my career as a junior doctor, I did not sit down for 12 hours that day and became hypoglycaemic. I remember going up to my SHO and helplessly asking him for help because I could not cannulate someone who needed IV Fluids. I remember someone going into acute pulmonary oedema on me into Day 2 of my career. The only achievement I can hold my head high to is that I *touch wood* did not burst into tears during any of my medical on calls or nights, even when faced with the most horrendous situations.

This time in 2 weeks I turn into an Orthopaedic SHO. Perhaps I had made too many snide jokes about my wanting to be an Orthopod in the past, that this is payback time. Perhaps I might actually want to be an Orthopod after this 4 month stint, who knows.

At this point in time, it is one year of my career as a doctor down....an indefinite number of years to go.

Don't get me wrong, there are times like now when I am on my set of nights with my nose dripping relentlessly and feeling rotten, that I wish I did not have to do night shifts, and I question my obsession (or ambition) to be a Cardiologist as such. I do think that it would be nice to have a job where I had normal working hours and did not bear such huge responsibility of whether someone lived or died just because of the mistakes I made.

Recently, I notice myself losing my temper all too quickly and my impatience mounting by the second when things are slow and don't go my way. I am uncompromising and demanding and I get annoyed when people are slow to understand things that I say.

And then I check myself right there. I detest stereotypes and the typical stereotypical female doctor lusting after a high-flying, stressful job is one of a Tiger Alpha Female who makes everyone else shudder from head to toe as soon as she turns her eye on them.

The role of a female surgeon or a high-flying, competitive medical specialty such as Cardiology paints the exact same stereotypical picture. As with my entry before on sense of style in the work environment, I refuse to conform to such stereotypes just because the 'norm' is such.

And yet there are days when I find myself so excited about ECGs and chest pain and heart failure and PCI's that it is sad. Even when my days on Cardiology were as a glorified secretary, sitting at my favourite spot on the ward typing on the computer furiously and doing referrals for CABG surgery to Southampton, I missed it when I was away and on call. With the same pace on Colorectal Surgery which I once loved and actually wanted to do, I feel no such attachment to my job and in fact, got so bored towards the end of my normal days on surgery that I was becoming rather cavalier about stuff.

It seems there is such a long path ahead to trudge on in this competitive journey of pushing everyone out of the way en-route to clinching that training number - it makes me wonder if I really have what it takes to become a Cardiologist.

Or more importantly, do I really want to....that badly?

But for the moment, let's live in the present. Now that I am fully GMC-registered as a fully qualified medical practitioner, I can doctor.

Or at least let's hope so.

2013: BOOM!

So 2012 came and went SO SO quickly that it took me the whole of today for it to sink in that I am now at Day 1 of a fresh new start.

This year's NYE celebration was as different from last year's as night from day. I spent the day time in a comatose state, completely exhausted, having finished on night shifts. The irony was that my night before had been a state of boredom beyond words. The Surgical F1 and I sat at the mess looking at each other, he having offered to do as many cannulas for me as he could (simply because he was bored as well!) before he finally decided to sleep, and me, having watched him and the Surgical SHO snore away for every single night before this, decided to cave and join them as well. The funny thing is when you DO sleep, compared to when you don't, you wake up even more exhausted than usual each time you are interrupted to do the most stupid jobs. 

I then decided to attend a costume party with my usual outfit - a pretty dress. Unfortunately I was the only other person in the whole place to not be dressed up as something, so my constantly repeating over and over again that I was there as a 'pretty girl' could only get me as far. 

Counting down to 2013 was a bit anti-climatic to say the least. We spent ages trying to find this person or the other and when we finally did, I was already sober beyond words. It didn't help that the bartender at the club rejected my debit card and I didn't have enough cash on me, and that we had to drag my drunk friend back home in a taxi at the start of the night because she was almost wasted beyond words. We did, however, manage to have quite a bit of fun at the end of the night, despite the series of events that prevailed, with me being utterly confused at 3 am in the morning amidst deafening music and having a flashback of an unfortunate scene that had happened a few years ago. 

At that time, having a whole week off post-nights AND having the directorate forget to take my request into account that I wanted to cancel it off the rota seemed like a good idea. But with my Microsoft Office not yet arrived in the post and my wandering mind unable to concentrate on reading any book for long, it makes me despair and wish that I was actually back to the manic conditions of the elderly care wards tomorrow. It doesn't help that I started the morning of my new year with the most intense conversation ever at 5.30 am in the morning and that I was so tired today that I fell asleep at 6 pm only to wake up with a start at 8 pm. Aye, messing up my own sleeping patterns indeed. 

It is possibly slightly sad that I am spending my first day off lamenting about the fact that I wish I was going back to work rather than be left with nothing to do and to fester with a zillion thoughts in my own head, and it reminds me of the dismal times in the midst of Final Year when I was going through emotional turmoil and had nothing to distract myself from apart from the fact that finals were looming and I had to pass them by hook or by crook. 

But this is why I like my job. I like the fact that I am constantly on the go and always called to do things left, right and centre. I like that nothing is predictable day to day. I like that I am so busy all the time and when I look up it is suddenly 5 pm already. And I love the fact that my life is routine as such, and at the moment there are only important things ahead to dwell on: successfully completely F1, focus on taking postgrad exams and make the most of this damn career. Because it is possibly the only thing in my life that I can control at the moment and the only thing I can make sure doesn't go pear-shaped.

My new year's resolution, apart from learning to be a better doctor, however is to be this girl:

My figure is no 5'6" (I am only 5'4") but I sure as hell can have that bag. I will be sure of it :) 

And as Kel says, it is only another 3 more months before I am on home soil and catching up with my beloved chums again! I absolutely can't wait!! 

For the moment, I need to reignite the positivity that I had when I embarked on the start of 2012 - that this will be one hell of a year and I will take down every single lemon that life hurls at me. Because I know that this will be an even better year than the last. And I will make sure that I become every inch of a kick-ass doctor to measure up to it. 

BOOM! 

Just Because

There are only a handful of people in this world who actually know me inside out. That in all truthfulness, I look stronger than I really am. 

But since I have started this job in August, I have only gone upwards and forwards from there. Much to the point that I feel I have such good control over my emotions these days, I have almost talked myself into NOT feeling. Or rather, not actively feeling anything. 

But I am human. Just because I don't cry doesn't mean that there aren't days when I feel like work is sucking the energy right out of me. 

Just because I don't say anything does not mean that my heart doesn't break when I see that old lady tottering around the ward, being denied that cup of tea she can't have because she isn't safe to swallow.

Just because I hold my tongue and smile certainly does not mean that I feel any less impatient towards the lack of insight and initiative some people have. 

And just because I am remaining positive about my new job in Geriatric Medicine and the amount of general medicine I am hoping to gain out of this sure as hell does not mean that I miss Cardiology any less. 

The strange thrills that I get from diagnosing and managing someone in heart failure OR talking about pacemakers OR managing fast AF make me wonder at times whether I have just anchored myself because I dislike change, or perhaps...

Perhaps that I just like things that I cannot have. 

So this is what I signed up for...

A life of continuously rushing around the corridors of the hospital, being bleeped in every single direction and having a seemingly endless list of jobs to complete over each stretch of 12 hours. And when I say 12 hours are not enough, I mean they are not enough. 

First weekend of ward cover being on call - check. 

Horrendous ward cover oncall experience - CHECK. 

I am not much of a Drama Queen, but last night, I was on the verge of exasperation. I had to hand over a list of stupid jobs to the Nights F1 simply because 12 hours was not enough for me to run from one corner of the hospital to another in between getting bleeped every 5 minutes and sprint down to A&E for TWO cardiac arrest calls. So amidst watching two ppl die and watching a guy I had clerked in slowly deteriorate right in front of my eyes with the most deranged blood results ever, I had to mentally psych myself aloud into bringing on another day of ward cover without buckling. 

If there is one thing that my debaucles with matters of the heart have taught me over the years, it is to be stronger. And in moments like these, it has never proved to be more useful. 

So today, I cruised into 3 pm in the afternoon thinking that all was completely under control. And then things started to spiral the other way. Each time the Med Registrar saw me, he would take a look at me and go: 

"Alyssa, have you eaten all day?"

"No."

"Oh my God. Please. Go and eat something." 

And proceeded to drag me into the Doctor's office to force me to eat a doughnut. 

And just as I was leaving tonight, he took one look at me and said "Alyssa you look absolutely knackered. Are you okay?"

Yeah, maybe not. After I was bleeped to see someone who turned out to have a Pulmonary Oedema on my way to Handover at 8.55 pm. After not eating anything before 10 pm for the past three days. Maybe not. 

Not to mention all the stupid questions that I have had to ask the Reg over the weekend and how my heart just lurches each time I am faced with a really sick patient. 

I have so much to learn still. It makes me really wonder if I will ever make it to be a Medical Registrar. Or any kind of Registrar at all. 

We'll see how I feel in three years or so. 

Hello, Cardiology F1 speaking

Because that is all I say these days when I get bleeped left, right and centre to prescribe this person Clopidogrel, rewrite that person's drug chart or please come and review Mr. X who is suddenly complaining of chest pain. 

And each day, it is almost amusing when my fellow F1 and I are notified of yet another new admission into CCU, and upon asking the question "What's the story with this new patient?", it seems our telepathy skills have improved drastically because I could almost put my money on it being Chest Pain. Or Shortness of breath. Or a collapse. 

When I was a Final Year doing my Medicine and Surgery placements where I was shadowing the F1, I was positive that I wouldn't have any trouble adapting to the job the following year, simply because much of the feedback I received revolved around me being 'really efficient' or 'too useful to discard' on the wards. Yes, my knowledge was hardly there. But I didn't like wasting time and I liked making sure that everything was sorted before I called it a day. 

Now that I am a junior doctor in Cardiology for real, it seems that I had imagined myself to be better than I really was. It took me a while to grasp the Trust's IT system, almost making the then F1 whom I was shadowing frown many a time in exasperation when I asked one stupid question after another. When I finally got my mind around that, the number of errors I came up with was astounding. I would cringe each time a weird look came across the Registrar's face when I had to explain yet again why the angio images from Salisbury had not yet arrived, or the look of astonishment on the Consultant's face when I could correctly give an answer to "What are the signs of Pericardial effusion?", as though it was amazing that I actually knew something. 

So my knowledge as a doctor remains close to obsolete. And I apparently am not as 'valuable' on the wards as I had imagined myself to be. The Registrar is always one step ahead and it seems I still lack the initiative to have everything perfectly in order at each start of the day. 

Today I told my Consultant that I wanted to be a Cardiologist. Fortunately for me, he was as encouraging as one could be. Whether or not it is a feasible achievement, that is a matter for the near future, but for the moment, I have this to work towards. 

Don't get me wrong, I might be dense. And my medical knowledge might be 1/100th of a Cardiology SpR's, but I enjoy my job. I enjoy the adrenaline it brings each day from rushing around chasing stuff in between having to clerk in Primary PCI's from Cath Lab. It gives me a sense of fulfillment when I know my patients so well that I can give an accurate summary without having to refer to the clerking proforma. And it makes me proud when I manage to successfully beg the Physiologist to squeeze in an echo for my patient who is hanging on a very thin thread of patience because she has been waiting for days just to have an echo. 

I love the fact that working hard everyday helps me take my mind off everything else and that I don't even have time to be bored or exasperated with my life, or rather a lack of it. It helps me take my mind off my homesickness, how much I miss my friends and the life we had in London as med students, of how much I have suffered one blow after another to my heart in recent times, and the uncertainty of my future. Without work, it seems I feel almost empty and at the verge of withdrawal symptoms. Knowing me, it is just like me to get hooked on something else to get my mind off the issues at present. 

And at the moment, I am determined to get myself hooked on the job. 

Who knows, as far as Cardiology as career is concerned, this could be as good as it gets. 

So here's to hopefully making the most out of my 4 month Cardiology stint and stepping up to the job. They are big to fill, these boots. But I never say never. 

Vamos Shing! 

Sudden Cardiac Death

A Registrar once said to me, "This is why I like Cardiology. Everything just makes sense, you know. I'm not very bright."

I can't say I echo that remark completely for now - the stark differences being that I am no where near being a Cardiology Registrar yet, and I am sure that her definition of being 'not very bright' was vastly different from mine.

But I do see every now and again. That my overt preference towards Cardiology was never just an anchoring heuristic to begin with.

The term 'Sudden Cardiac Death' was almost foreign to me prior to my Clinical Medicine years. And now that I am approaching the end of my last EVER placement in Med School, I am being hurled with the terms 'Sudden Cardiac Death' and 'Cardiomyopathies' almost every other day. With all the hype about Fabrice Muamba collapsing in the middle of the pitch a couple of weeks ago and having to be resuscitated in public, I was introduced to the term of 'Non-Sustained VTs'.

Non-Sustained VT's : Ventricular Tachycardia of less than 30 seconds.

We were always taught to recognise the Ventricular arrythmias as the dangerous ones. VTs being no less so. 'Non-Sustained VTs' could progress into 'Prolonged VTs' and then eventually there was the risk of the heart arresting.

There you go. It could be Sudden Cardiac Death all over again.

I've never had an ECG in my life. I am sure that Fabrice Muamba never did regularly either. Who would have thought that a Premier League footballer would arrest for no reason in the middle of a football pitch. So in all essence, I could pretty much be at risk of Sudden Cardiac Death for all I knew. Lol. OK, I kid.

And this afternoon, I came up with a new term altogether: 'Gradual Cardiac Death'.

Clearly, I am becoming more and more insane with the manic mugging for finals than I thought. Because for a moment today, I thought that I would rather be a victim of Sudden Cardiac Death than a gradual one altogether. Although it seems that it is a little late to reverse things now.

Keep Calm and Carry On.

Vamos, Shing!

Lost Without You

Hello, my name is Alyssa and I am a Smartphone addict.

It seems, if a stranger were to chance upon my blog, that I could be pictured as having an addictive personality of almost every possible kind! After having confessed a while ago that I was a sucker for buying accessories, I now have to grudgingly admit that it doesn't stop there.

Yes, I suppose admitting it publicly is the first key to acknowledging the problem.

There was a time not very long ago, that I was absolutely hooked. My battery life suffered terribly as a consequence, and I would freak out the very moment my 3G stopped working.

Here is some photographic evidence. Good times those were. Note: I have changed for the better. MUCH better.

Not particularly voluntarily though. Unfortunately. My sturdy HTC Desire S, which I had been enthusing about since I got last year, decided to die on me recently, and I was left in a bit of a state making multiple panic phone calls to the Orange helpline and to their store to source out a solution.

I must say, Orange is in dire need of some brushing up of their communication skills.

"Wow is it THAT dead? Sorry, we can't do anything for you."

"What?? You can't even find help me repair it even if I paid?" *lower lip trembles and tears almost start welling up in my eyes 'Puss-In-Boots style' at the thought of being phoneless....possibly forever"

The salesperson, not picking up on any of the cues at all: "Sorry, I can't do anything for you."

WHERE was the empathy?? I mean, seriously!!

Thank Goodness HTC sort of made up for its faulty device by offering good customer services. Currently my phone is off to some corner of the country to be looked at by the people who will hopefully repair it.

And in the meantime, I get to finally come to terms with my addiction by going cold turkey. No smart phone for at least 10 days.

*lip starts to tremble again* I have felt so different since. So.....empty. Meh. So....lost.

OMG someone give me a medal already!!!!

NB: All in good fun. But on a serious note, will not be on Whatsapp for a good amount of time. Text my UK number / Email / FB msg me if anything urgent beckons!

More Walking and More Remembering

As yet another year draws to a close, I feel pressured to write a customary year-end post reflecting on the good and bad times of the year gone by.

It's difficult to focus properly at this moment when my mind is not really on track considering how my holidays have come to an end and I pack up tomorrow to head to Chertsey for my next placement. But I will say that I am eternally grateful for all my friends and family for making 2011 one giant of a year, and I have never embarked on the beginning of another year as optimistic as I am now.

They say that with the grey moments, there is a silver lining folded inside every raining cloud.

And with the good moments, even if they pass on eventually, I am one who believes in actively savouring moments and MAKING things happen :) Hence my excitement to hit the ground running this year. I have a life list to pursue, and I will take on every downfall that tries to barrage my way.

Manda and I share inside jokes and fond memories of our 'infamous' (i.e. fun in characteristic ways) NYE celebrations in Kch. This year was a first for me spending it on Greenwich Meridian Time (GMT).

Coco and I 'co-hosted' (I use the term loosely, because it was at her place) a NYE Dinner Party / make-shift karaoke (SingStar) party / failed attempt at watching fireworks on TV, that turned out to be heaps of fun and a personal achievement (i.e. our meagre culinary skills produced quite good results in the end)

And all in all, this was definitely one celebration to remember. Although I miss the wishy washy plans usually made with the Kch people before each 31st December night arrives, mostly ending with an 'I dunno lah' or 'See how lah'. Well, hey....new year, new beginnings right??

So 2012, BRING IT!!

Almost Clockwork

I will admit that the past two weeks of my life have been particularly unfamiliar ones.

For one thing, it had become increasingly frustrating to be continuously on the end of being an F1's personal lackey. At first, it was alright. More of an 'I don't mind' mentality to being ordered up and down - taking bloods, faxing letters, being a postman to bring referral letters to clinics for referral. Simply because I was fast and it was pretty much routine. Clockwork, to be exact. No second thoughts needed.

Then it got worse. It started dawning on me how disastrous it would be to work with people who were disorganised or irresponsible or just plain blur in the future - and I wasn't referring to medical-knowledge wise but just plain common sense. It started getting to the point where I felt plagued with a sense of dreariness going to the stuffy ward office and sitting in front of computers doing endless discharge summaries. And then it got worse when the other med students on my firm became increasingly annoying and started asking me every single blur question under the sun. It got worse when I became expected to pick up alot of people's slack and even got the blame for things I didn't do just because I wasn't up for arguing and defending myself. And most of all, I felt that my brain had come to a standstill. It was terrible. It was bad enough that I wasn't the smartest cookie in the jar to begin with, but this had started hitting all time lows.

And then today, everything changed. At the risk of sounding dramatic, I suddenly felt alive again. My lack of tolerance for the haphazard fashion that ward rounds had been carried out drove me to go in at 8 am to sort out the notes and check all the obs for the patients, simply because Consultant teaching at 8.30 am would mean that everything would not be in place for later if I didn't take any initiative to do it. Who knew that a tiny gesture like that would have earned me multiple praises from the people I least expected them from, and even being labelled 'Star Student of the Day'.

But more importantly, for the first time in 3 weeks, after a useful bedside teaching session, I finally felt in touch with medicine again. I was finally thinking laterally and using my bank of differential diagnoses to work up a patient systematically. I was learning new things, revising my CXR presentations and mentally going 'Ooohhhhh' in my mind because my brain was finally working. I had forgotten the thrill of getting things right and realising that there are some things you actually had no idea that you actually knew.

Thank God as well for the random Vascular surgeon later on who came by our ward to review a patient and randomly started giving me an impromptu teaching session on Mononeuritis Multiplex and the different types of Anaemias that could present in a Rheumatoid patient. Despite my wariness with his brandishing a pair of surgical clamps excitedly around (don't ask me why he brought it with him) while he asked me questions, I was truly intrigued. And grateful. At the very least, my brain was yet again given the chance to function for once.

And most of all, despite the slight dampening in the end to a great day, with my patient deteriorating rapidly in the afternoon and going into Septic Shock, at the very least, I was back in touch with my long-lost self again. I was reminded again that I had compassion as a healthcare provider, and a human being. That I was doing Medicine for all the right reasons as much as I had doubted my resilience greatly from time to time. And most of all, that there was no way in hell I would trade all the lack of seeing sunlight, trekking more than an hour to and from the hospital, and pulling my hair out due to the fact that none of my time would really be my own in the future. Because at the end of the day, the message was clear....

There's really no other place I would rather be.

Kung Fu Fighting

Everyone knows that I am pretty much a gym junkie.

NB: That statement was dripping with sarcasm, just in case you guys didn't notice.

Yes, I go to the gym once in a blue moon, at the most. In the past year, I could probably count the number of time I have been to the gym with my fingers. And each time, in the midst of each workout session, I would be on the verge of arresting on a treadmill and proclaim aloud in my head that starving was MUCH easier than the pain I was going through. I would think back to the days of gymming with Pei Hua where the two of us would overdose on Body Combat, Body Pump and Yogalates. Unfortunately, the ULU Gym had none of these, and when it comes to leaving Shing to devise a workout session for herself without the guidance of an instructor, there is only one thing she does: she cuts corners. The lightest weights possible for all resistance training and well, the occasional crunch or two.....you know, when she feels like it.

And then this year, Coco, Daisy and Minnie switched gyms. It initially came as a bit of an impromptu decision, but I must say that two months into this routine (in which 90% of the encouragement comes from Coco, I must admit), I am loving life!!! Saturday mornings are much looked forward to because of this:

Oh Body Combat, how I have missed thee!!

Falling back into the routine of Upper Cuts, Cross Jabs, Roundhouse Kicks and Spinballing brings about a kind of euphoria of its own....not to mention that it is particularly therapeutic to be punching the air as hard as you can (+/- the option of imagining an opponent that you are really in combat against).

And really, besides the awkward hours I will possibly be anticipating in my next two weeks of Emergeny Medicine, at the moment, life cannot get any better than improving my cardiovascular fitness and strength.....at the very least.

(I have resigned to the fact that it is a tad impossible to actively wish any amount of weight loss upon myself when not much effort has been divulged on my part. Hellooooo water diet?!)

Perhaps it would be time to invest in a pair of combat gloves after this? :) Depending on how long I can keep this habit up for.

A is for Airway....and Anaesthetics

I had had several apprehensions before starting Anaesthetics....and I had experienced EVEN more doubts prior to this when I had heard more than one individual proclaim their love for the specialty.

Perhaps it is true when they say pleasant surprises happen when you are least expecting it. Because my first week on the placement so far has been anything but unpleasant. Fair enough, I did come across a fair bit of grilling on my very first day and very first theatre session, but the amount that I took away from it surprised even myself.

And, taking into account the fact that I was still pretty much riding on my wave of vacation fever when I started last week, I had to say that the patience and effort that these wonderful beings poured into helping me grasp the core points around the topic was definitely much appreciated. At the end of last Friday, I had reverted from a Cardio Fangirl to an Anaesthetist Wannabe. Pretty much sold. No further persuasions required.

Okay, I kid. The door is pretty much still open to me, and at the moment, the anchoring heuristic in me still sides the matters of the heart (pun intended) strongly. But it was moments like last Thursday where Lynn and I had had a very productive afternoon session brushing up on our Gen Med knowledge and our systematic approach (or maybe lack of) in handling emergent situations, that struck a significant chord in me and made me realise.....that moments like these...moment like these are what drove me to endure the hours of trawling the hospital, of being ignored or chastised as liked, of tearing hair out prior to exams.....and of potential identity crisis when work commences....and that at the end of the day, there is nothing else but this that I could imagine myself possibly doing.

I will miss Anaesthetics when it is all over. And maybe in another 3 weeks or so, I will have reverted back to the broken, bitter, ill-tempered med student scurrying around A&E when you next check this space.

But for the moment, in customary ABCDE approach, let me just say.

A is for:

- Airway

- Anaesthetics

and - Alyssa being strangely happy for the first time in ages.

WIP - Work In Progress

It has been a while since Meredith's narrations rang out clearly in my mind, amidst all the new and upcoming drama that Greys spurts out each week.

This particularly stuck, and reminded me why she was my favourite character to start of with years ago.

"I always thought I'd be happier alone.

Not because I like being alone. But it's easier to be alone.

Because what if you learn that you need love and then you don't have it?

What if you like it....and lean on it?

What if you shape your life around it? And then it falls apart....."

Likewise, I am a piece of work under construction.

But at the moment, with Korean dramas, tennis, coffee and friends, who needs to dwell on the grey bits of it all?

C'est la vie :)

Dear 16-Year-Old Self...

In between some random surfing of the web and procrastinating, I came across some blog posts that then inspired me to write one of my own: a letter to my 16-year-old self, a stroll down memory lane to reassure that teenage girl back then about the ups and downs that had seemed larger than life again.

Dear 16-Year-Old Shing,

When December finally swung around and Form 4 finally ended, I know it seemed like all too much of a relief because that ridiculously long and tumultuous year felt like it would never end. Firstly, I wish I could have given you a good shaking in the beginning back then when you started off the year taking Form 4 for granted, just because you thought topping the class for the past 10 years before was a sure-win even though you knew very well that you were being placed in a highly-pressurised environment with all the other straight A students from the other classes.

And even though it was good that you finally gathered your wits about you and went on to maintain the straight A's that were so expected of you, but I wish you could have had someone like me to tell you back then that no matter how brilliant you were in High School, no matter how many straight A1's you scored in SPM later on, or during your A-Levels, no one could ever have predicted the slump in intellect and discipline when you entered Medical School....when you were in the same class as 300 other aspiring doctors who are 10 times smarter and sharper than you.

Having said that, Shing, it is no good to harp on the negatives. You should dwell on the positives while you still can. Amidst those chatting / note-writing sessions you had with your bestie Manda during Sejarah lessons, BM lessons and more, despite how many times teachers might have caught you guys out for not paying attention: believe me when I say this, you should have spent MORE lessons gossiping with Manda instead of listening to the Sejarah lesson drone on and on.

Because you would not have come to realise in those days of seeing her for 8 hours or more EVERY single day, that one day would come when the two of you would be half a world apart, and that the last time you saw each other would be 4 whole years ago.

And the same would apply for your other amazing girl friends. At this point you will not know it yet, but a time will come when you realise that everyone has moved on leading their own lives, turning into hotshot architects, lawyers, physiotherapists and doctors, but the one thing to be grateful for is that you have still been able to see Voon on an annual basis, for standard Kch-style NYE Celebrations that go down in history. And a day will come when you are thankful that this bond between the two of you.....this Best Fried - Best Boiled bond, has not wavered, thanks to the fact that she will one day move back to Kch to be that hot-shot architect that you always knew she would be.

Fast forward a couple of years down the line, and you will realise, that no matter where your life takes you, your heart will always stay in Kch. And that you would be eternally grateful for those God-given amazing friends that have been around to hopefully, last a lifetime.

Of course at 16, you would not know this, because you have worn that same freaking school uniform for the past 4 years or so and you can't wait to be rid of it. But that year of Form 5 after this would fly by as though it never had before, and you would take off to the UK, where you always knew you would end up. Parent biasness, what can I say? Lol.

And at 16, you would not anticipate the 2 years after that would be the most incredible years of your life. I wish I could have flagged it up to you now, so you could have been ready to make the most out of your CC days. Because this was where you would meet the best friends in your life, who would go on to touch your life in so many ways, and leave such a huge mark.... that although most of them would eventually move on and away....back to Malaysia or to Singapore to continue achieving great things in life: you know that these are friendships that are made to last. God knows what would have happened had you not crossed paths the first day with Jenn in the airport, and had not later met Hanna, Rex & Noemi....and eventually, grown closer to CK, WL and Munchkin.

And of course, the most important thing to say to you, at 16 years old, would be that you would eventually achieve that life-long dream of yours to enter medical school, and with God's will, finally become a doctor next year.

Whether or not you will become that Neurosurgeon that you aspired to be at 14, or the Cardiologist you later realised was potentially more realistic, that is a matter to be discussed years further on. I will update you again when I have hit 35, whether or not you ended up doing Internal Medicine or Surgery or *gasp* dare I say it.....Obs & Gynae!

At Med School, you would go on to meet a whole cohort of other amazing people. None of whom you could have travelled a journey this difficult and this far without.

There is no 'What if....' that comes along with what would have happened if you had not met Pei Hua, or Yuan Lih or LX, because it would be difficult to describe and imagine you without them. You see, you have yet to know it now, but they will go on to understand you in every way, be it to catch you when you fall into the darkest of holes, or laugh along at every lame attempt at a joke you make.

So nonetheless, my dear 16-year-old girl, I am sure it has transpired now that you needn't have worried about getting along with people and finding friends whom you can click with after leaving the comfort zone of Kch and Lodge. God is kind on you, and you will have a comfortable circle of friends through thick and thin wherever you go.

As for matters of the heart though, that is another page in the book. I wish I could have told you back when you were 16 that those minor 'heartaches' that you suffered from the random high school crushes, the moments when your heart would go into AF when you saw that one crush.....hard as it is to imagine now, is something that you would possibly have liked to hold on to more tightly. Because High School crushes were the days of being 'bright and shiny', and you would realise that when later on, many a guy was to cross your path and produce blow after blow to your heart that you wondered whether you could possibly feel again in this state of trauma.

You would not have known at 16, when your one major high school crush left school, that you guys would ever see or speak to each other again. Who knew that years along the line, you guys would be even better friends than before, and that he would ironically be the one constant 'guy' there for you throughout tears and heartbreaks from all those others. You might have wished you had taken more initiative to treasure the high school days spent with him then, but not to worry. You guys will continue to be friends for a long time coming.

For better of for worse, I would urge you to be fully optimistic, because there is surely one guy out there... somewhere in this huge world who is completely in sync with you, and when the time comes, you will KNOW without a doubt, idealistic as this might seem. But then again, at 16 you should be full of hopes and dreams. Cynicism will come later. Don't rush it.

I know this is a whole lot to take in, literally....and at 16, I hope your English is as up to par as it would be later on. No worries though, I think you would have read alot more at 16 to add to your vocab than you would later on when your brain is even failing to take in short excerpts of medical blurb.

But the end point is this: that at 16, you would not have known what the world beholds, 10 years down the line. And unless you had a Crystal Ball, the best way is to live every day to the fullest, and put in your everything to achieve whatever you aspire to do this lifetime.

In terms of growing up though, do not fret. I can assure you that you will mature year by year, as tedious a process as it might be, as painful a lesson as you might come across on the way, to eventually be a down-to-earth, worldly, 25-year-old young lady. Poised, grounded and possibly with a flair for fashion.

We will speak again another 10 years from now, perhaps. Until then, take care. Hang in there. You are in for one hell of a ride!