Please Behave!

I was doing my clinic today. 

I called out for a patient's name, "Mrs V please?"

Mrs V stood up, and walked towards my clinic room. She had a confused look on her face. 

The first thing she said to me was, "Oh I thought I was seeing Dr Y?"

Dr Y is of course my consultant, and runs the clinic. I am his registrar. 

"Well, I am his registrar.  Dr Y is here today, but we do the clinic together. If you do not want to see me, I am more than happy for you to see Dr Y," I replied.

"Oh, but I have many questions to him."

"I can help answer them if that's ok with you?" I asked.

 

After a big mouthful and disgruntle, she sat down and let me review her. The environment in the room became rather awkward.

She began by asking me a question, "Dr Y said I was going to be listed into a trial for my condition. I have not heard anything about it. I want to be involved in any trials to get treatment for my condition."

This patient unfortunately has an untreatable degenerative condition. I read through the notes again, and read that Dr Y was thinking of recommending her into a few trials but didn't mention which one. 

So I told her, "I do not know which trials Dr Y has suggested. I will have to check with him. But I do not think that there is any trial that we are involved at present."

"Oh right, you see, that is why I want to speak to Dr Y because he knows what I am talking about." 

"Ok. I will speak to Dr Y. How else can I help you?" 

She asked me about an alternative medication for her leg problems.

I said, "If that does not work, why don't we try drug X? You can taper the current one, while we gradually increase the dose of the new tablet."

"Oh, are you sure? Would that be ok with Dr Y? Shouldn't you ask him first?"

By this point, my patience have reached its limit. I wanted to ask her to just stop fucking around, and just piss off.  

But, no, of course I didnt do that. Otherwise, I would be struck off from the medical council!!!

So I simply smiled and said, "You are more than welcome to check with him. But he will most likely agree with me. The side effects are A, B and C."

She wasn't too convinced but went along with it in the end. I had to get Dr Y to see her. He told her exactly what I just explained to her. 

It certainly made her happier. But I mean, come on, this behaviour is so NOT ON! How could you assume that I do not know what I am talking about?? 

I know I am petite, I know I look like a teenager, I know this is my first year into specialty training, and I know I am not a caucasian, but that DOES NOT mean you can judge me just like that. You have to give me a chance! 

30 years on...

Happy Birthday to me!

Just realised how long I haven't updated this blog. I have been busy and too lazy to type anything!

It has been 6 months or more into my new job. It's going ok. I am slowly learning, getting more confident in giving advice over the telephone. Hope I continue to grow as the days go on. However, I am still rather intimidated by the weekly Neurology Grand Rounds. It is frightening, and makes one feel very very inadequate. I will share my experience of the grand rounds later in another post.

30 years sound like a loonnng time. I guess to a certain degree it is, but I think these past few years, in particular, is flying by!

Reaching 30 years old is considered a "MILESTONE", however, I think it is not so much the number that is the milestone. All my life experiences and life changing decisions so far have been my milestones.

Think about it.

Going into primary school was a big step.

Passing UPSR and going on to secondary/high school is yet another milestone.

This was subsequently followed by 2 major public examinations; PMR and SPM.

Successfully obtaining certificates for both these exams was a major life achievement.

Then it was decision time.....A-levels? University? What do I want to do?

Dunno if many knew, but I actually wanted to do actuarial science (coz of my love for mathematics), or civil engineering. And of course, there was medicine in the background.

I was fortunate enough to be offered a place in the local university to do civil engineering. However, after much thought, I turned it down. I do not why I turned it down, I think I was still rather unsure, and felt that engineering might be a wee bit boring. I was not successful in applying for actuarial studies which was disappointing, because I really love mathematics. Having said that, I did not try to hard to apply for it. I only send an application to one tertiary centre.

So I decided that I should pursue A-Levels and then apply for med school.

Ever since young, I have told everyone that I wanted to be a doctor. There was no reason given. It was just one of those things when you were in primary school, and asked my your teacher to write an essay about your ambition. I recalled writing about wanting to be a doctor. But when it was decision time, I was unsure about it.... I was scared about the difficulty of it, worried about having to deal with people's lives, and also the need to spend so much time studying like a geek.

I put myself up for the challenge (yet another milestone!)....and here I am now.

I must admit it required a lot of hardwork, dedication and perseverance! But I am loving it!

Well, after graduation, I thought that is me! I'm all sorted...can be a fully fledged doc, and work myself up to a be consultant. However, little did I know that there were more challenges ahead of me!

First it was to decide whether I want to be a medic, surgeon or paediatrician.
Then applying for that particular specialty.

Again, my decision changed...and so did my life. I knew I am not a surgeon in the making, coz I dislike standing long hours in theatre, and I preferred the medical side of things. I was rather interested in paediatrics since uni days...however, doing the job itself, really put me off it.

So being a medic was my choice. Even in medicine, you have to choose whether to be general medic or specialise in a certain field, ie cardiology, respiratory, gastroenterology, diabetology...etc..

You know the rest of the story....I was planning to do endocrine/diabetes...but after another life changing decision....I am now training to be a neurologist!

I sometimes wonder how my life would be if I had taken up the civil engineering course or worked harder to apply for actuarial science.

See? It is interesting isn't thinking/reflecting on all past events?

These are major milestones for me, not so much, turning 16 or 21 or 30.

So happy birthday to me once again!!!! :D
No celebrations planned really. Family and close friends are not nearby. And I am not one to have big parties...just like to keep it quiet.
But, I will bring in some goodies for me colleagues :)

wow...what a rant today! haha.

I have only a few wishes on my bday:
1. to be loved
2. to be blessed with good health
3. and wish that all my loved ones (family and friends) will be blessed with good health, and happiness.

What's coming next??

Well, I hope that I will get married and build a beautiful family in the future.
I hope that I will be able to complete my training, and maybe spend some time to do research or a fellowship...

Watch this space!

xx

All New People

Last weekend, I was fortunate enough to get tickets to watch a play written and directed by Zach Braff, called, "All New People."

Zach Braff is one of my favourite actor/writer. Of course, we all know Zach Braff as Dr John Dorian or J.D in Scrubs. Yes, he is the dorky geeky one! :) But he is also very funny. I could watch Scrubs every day, and will not get bored of it. I just love that all the characters are so different, and also the fact that they create banter in the hospital.

Ever since Scrubs, I have been sort of stalking Zach Braff....so I've watched his first ever movie, "Garden State," which starred Natalie Portman. It was an excellent movie. Zach also starred in "The Last Kiss," another movie that was written about the struggles in life as one gets older. They were all brilliant movies....so when I heard that Zach was coming to UK to perform his play, "All New People," I got really excited, and bought the tickets asap.

I got tickets for his performance in King's theatre, Glasgow. It was a sold out performance!

The play was about a 35 year old man attempting to commit suicide, after making a big error in his career....he didnt manage to end his life as he met 3 new people in his life, who changed his mind.

I love that the play was dark yet hilarious. I love that they played recorded clips in between the scenes of the play.... I love that the casts worked so well together, and the chemistry between them all was so good.

There were 2 minor glitches towards the end of the play. Apparently, at the very last scene, it was meant to be snowing, but the machine holding the fake snow failed to operate, and also made a loud grinding noise....but that aside, the play was fantastic.

At the end of the play, Zach Braff held a short 25 min Q&A session. One of the questions that made me smile was this, "Zach, have you tried the fried Mars bar yet?"

For those of you who have never heard of the famous fried Mars bar, I would not recommend it. The fried Mars bar is a delicacy of Scotland. Basically, it is a Mars bar.....deep fried.

Zach replied, "Yes, I've heard about it. I do not understand why one would want to make something already unhealthy, even unhealthier."

=) You can check out the website for the play here: http://www.allnewpeople.co.uk/

The Making of Pineapple Tarts

Following on my previous entry on baking for CNY, I decided to be more adventurous and attempt something I've never done before......The Pineapple Tarts.

Yeap....."pineapple tarts" in Malaysia do not look like typical tarts. The dough, when baked, is not flaky and crispy, and the filling is not made from custard or filled with fresh fruits. Pineapple tarts are basically biscuit filled with pineapple jam....i guess, you could say it is almost similar to fig rolls in the UK, just that the biscuit tastes more buttery.

Pineapple tarts come in different shapes. Some looks like cylindrical fig rolls, some looks like sushi (as in a roll filled with pineapple jam in the middle), and the others look like raspberry jam biscuits.

I grew up eating pineapple tarts. We have them as treats during Chinese New Year. I recalled watching mum making the tarts, and I all I have to do is to eat them! They tasted divine. I haven't had a pineapple tart for such a long time....and obviously, I have developed a sudden craving for them. So since I can't get any pineapple tarts at home, I shall make them! :)

I used mum's recipe. I was meant to make them last week, before Chap Goh Meh (the last day of CNY), but unfortunately, I fell ill at that time, and was not in the right state of mind and energy to make them. However, I recovered quickly, and decided to give it a go last weekend.

The most time consuming part of the process was making the pineapple jam. I grated fresh pineapples, and then, boil them slowly with sugar in a pot for more than an hour. The end result being a thick sweet sourish pineapple jam. I added cloves and a bit of grated nutmeg into the jam just to add some extra flavour. The jam was made the night before I made the batter for the biscuit, as it needs to cool down fully.

Pineapple Jam! :)

The next morning, I made the dough. Mum would usually use a mould to create a nice flower shaped biscuit with a small hollow in the middle to allow one to fill it with a tiny portion of pineapple jam. As I do not own one, I decided to make the ones that look like fig rolls. So the idea is to wrap some dough around a small portion of pineapple jam. I also made the rolled ones too.

This is how they looked before popping them into the oven.

I baked it in the oven for about 20-25mins....and here they are:

Don't they look like cylinder shaped fig rolls?

The end result! :D

Not bad for a first timer....But the looks can deceive you. It looks nice and brown...but I think I might have over baked it a little as the biscuit tasted a tad too crunchy for a pineapple tart. Nevertheless, the pineapple jam was brilliant! :D

In The Spirit of The Lunar New Year

Celebrating Chinese New Year (CNY) in a foreign country is pretty boring. There isn't any CNY atmosphere here. The day goes on as usual. There isn't any red lanterns hanging around, and there aren't any loud cheesy CNY songs playing in the background when you enter the shops. The only CNY-related event is the "Buy 1 Get 1 Free on Chinese Sauces" in Tesco and Morrisons, or the "10 pound meal deal" for Chinese food in M&S. Well, at least, they have us in mind.

CNY away from home also means missing the ang pows. And it would also be extremely difficult (or impossible) to savour the usual delicious goodies one can get back home.

I miss my grandmother's reunion dinner dishes. She would make a big pot of "ham choi" or preserved vegetable duck soup. Her "lo-bak" is to die for. "Lo-bak" is basically fried bean curd skin roll filled with pork. Then, her acar is so good....hmmm.... Thinking about them ismaking me hungry!

The other lovely thing about CNY is the traditional biscuits that we only eat during this festive period. Kuih kapit, peanut biscuit, kuih bangkit, spicy prawn roll, ribbon biscuits, pineapple tarts....I could really some right now!

So....because I'm missing home, and dreaming of all those goodies, I decided to usher in the Water Dragon New Year, by baking the famous Dragon biscuit. My mum managed to persuade my aunt to share her recipe. Her Dragon biscuit is, by far, the best I've ever tasted! She does make them to sell, and undoubtedly, they sell like hotcakes! Therefore, her recipe is super top-secret.

This is my first time baking the Dragon biscuit, and I was really enthusiastic. Halfway through mixing the dough, I realised that it is not as easy as it seems. It involved quite abit of mixing action with just a wooden spatula. My arms were aching, and I decided to use my fingers instead.

In order to get the dough to resemble a dragon, I have to put the dough into a piping bag and squeeze it out with a star-shaped nozzle. This is where I failed miserably! My dough was not soft enough to go through the nozzle! I decided to add a wee bit more of my leftover beaten egg to it....My dough became wetter, but I was still unable to squeeze it! I was frustrated. In the end, I used my fingers to try to create the "dragons." I also used red colouring to dot the eyes. And the result is ..........ttaa-daahhh.....

They look more like worms/snakes!! :(

I also made some squares, which definitely looked much better and pleasant! LOL.

Well, on a more positive note, they tasted quite yummy, but not as good as my aunt's. I think I will try a cookie press to squeeze the dough out next time!

I am pretty knackered now, having spent the whole afternoon baking these. The thought of going back to work tomorrow makes me even more tired!

Anywho, here's wishing everyone a very happy and prosperous new year!

Kong Hei Fatt Choy!

Wan Shi Ru Yi!

One Month Later...

One month into the job,

1. I am definitely more confident in managing epilepsy, migraines, Gullain-Barre, and myasthenia gravis.

2. I can perform a slick neurological examination.

3. I have survived all the on-calls so far, but still feeling stressed at the thought of more to come!

4. I have invested in a neurology textbook written by Brazis.

5. I am still quite slow and need to pick up my pace.

6. I have seen 4 "functional" disorders.

7. I really need to learn how to interpret MRI brain and spine images.

8. I really need to pick up a copy of Practical Neurology, and start reading it.

Am I coping?

Yes, I am. I am slowly finding my way up my learning curve...I am just at the beginning of the curve. I hope my skills and knowledge will continue to grow exponentially.

It's The Last Day of The Year 2011

Yes this is one of those entries where I reflect upon the year that is about to come to an end. So feel free to stop reading now as it may bore you.

I remember being really busy preparing for exams. In April, I sat Part 2 MRCP. This was quickly followed by a failed attempt at PACES in June. And as a result of my failure, I was unable to proceed to the next stage in my career. Fortunately, my 2nd attempt in October was successful, and because of that, I have completed my membership exams.

Should I say that obtaining full MRCP was somewhat life-changing for me? Well, I guess it was. I mean when I failed PACES, I felt really low. My confidence was down in the dumps, and I felt really embarrassed. The embarrassment was due to the fact that my junior colleagues passed theirs without much problem, and I seemed to be struggling with it. Yes, I have some ego in me. When I found out that I passed PACES, I was really super-duper overjoyed.

Then, it was time for me to choose which specialty I wanted to specialise in. I received 2 job offers; one in diabetes/endocrinology, and the other, in neurology. I chose the latter as I felt it was more interesting diagnosing the weird and wonderful neurological disorders. I am thoroughly enjoying the job at the moment, although I have alot to read up on.

Work aside, the only other exciting achievement for me was running and completing my first ever 10k. I was happy that I finished it in just over an hour. However, I regretted not training for it properly because I ended up with a very bad left knee injury, which left me inactive for a few months. I will definitely try to run it again this year, and aim for a better time!

My unhappiest moment in this year was when I was informed of my beloved doggie, Kiki's death in September. She suffered from septicaemia. I really do miss her alot, and think about her sometimes, especially, when I see other dogs walking in front of me with their owner.

This year saw me spending 2 holidays back home (which is unheard of since I came to the UK in 2004). =) Hopefully I would be able to repeat this next year. Nothing, absolutely nothing, beats spending holidays back home with my family and friends, whilst enjoying the comfort of being in the country where I grew up in!

2011 has been great. The 4 goals I set for myself in January have all been achieved; running 10k, travelling abroad (spent a week in Belgium in summer), passing exams, and going home. I am very grateful for what I have. I have also been very fortunate to have met new colleagues, who are now my friends, who have supported me while I prepared for my exams/job interviews.

What does 2012 hold for me??

I am looking forward to catching the London Olympics because I have tickets to watch badminton finals!! woohoo!!! Lee Chong Wei...dun disappoint me! I want to see you in the finals!! :P

I hope that 2012 will take me closer to my partner. I am seriously tired of the distance. I really just want us to be together everyday, that isn't too much to ask for, right??.... and deep down in me, I am hoping that we could settle down, get a house and slowly build a family.

I need to work hard and be geekier (is there even such a word?!) as I gradually build up my confidence, skill and knowledge in the field of neurology. It will be interesting to see how much I would have hopefully learned after 1 year.

Watch this space!

Happy 2012!!!

Cheers!!