Thursday, December 27, 2012

Year in review

One thing about the UK system, they way everything starts in the middle of the year - is that the end of the calendar year doesn't really feel like the end at all. I don't feel like it's a new dawn or anything like that - just the lingering, haunting thought of finals on the same week as Valentine's day, feeling much like an inherited debt from the previous quarter. I'll probably do the countdown thing and all, and get straight back to books and practice as soon as the hubbub is over, no fooling around with resolutions and reflections. Time is of the essence.

But since I'm here, I'm going to have a look at the past year and all the trimmings that came with it:

School
Started off with a continuation of my psychiatry posting (god, was it this year? Feels like ages ago.), followed by Healthcare of the Elderly and then Speicals/SSM, which saw me hopping around QMC, West Bridgeford, Mansfield, Lincoln, and City Hospital, before taking and passing the final 4th year exam which meant I was liberated from psychotic patients foreverrr (well I will definitely encounter psych patients in the future, only I'll just have to 'refer to Mental Health' instead of spending hours arguing with the liaison nurse about anti psychotic drugs).

HCE, with its reputation of being a drag, has only come to that because of those essays we had to write, I believe. Practically, HCE is probably one of the most important postings we could have as medical students, what with the aging population and all. With and set of ageing grandparents at home and the increasing ailments that come with being 'blessed' with a long life, I really came to appreciate how things like falls and polypharmacy and rehab could affect the older patient, and their immediate families. As a lecturer said on our first day - 'Those who want to be paediatricians stand up. The rest of you sitting down will be dealing with old people, no matter what specialty you are in.'

Specials was mildly interesting the way I find most things mildly interesting, and Lincoln was a quaint little town to be living in for 4 weeks. All that dermatology, ENT and opthalmology knowledge is becoming quite useful in the GP setting, which I'm in currently. I think I liked derm least - I know no specialty is lesser than another but a lot of conditions seemed really trivial, like little lumps and bumps and acne. I also think derms are like radiologists, they have an eye for things ordinary people like you and me can't see, like 'that suspicious mole' that looks identical to the 5 others on the patients back.

I did my SSM in Upper GI Surgery, under a surgeon who was as quiet and stoic as he was tall and burly. He probably spoke less words to me than there are words in this post, so half the time I didn't know whether I was pulling my weight satisfactorily or if he was simply unimpressed by my lack of boldness. It didn't help that I was the meek asian student conditioned since the harsh chinese Primary School days that YOUR SUPERIORS NEED NOT PUT UP WITH YOUR SHOCKING INADEQUACY! SPEAK NOT UNLESS SPOKEN TOO! DO NOT MAINTAIN EYE CONTACT, WHO DO YOU THINK YOU ARE??

Um yeah. But nontheless it was a pretty good attachment. Saw some operations involving esophagus to rectum, and I do admit, I have a thing for upper GI surgery. I felt like I got to understand surgeons a little better too. But as time passes I don't think surgery is the right thing for me. I mean I could probably do it if the pathway were handed to me on a platter, but only the opposite is true. I don't want it enough to fight for it, so why not withdraw from the game and hand it to the gunners.

Career wise, I'm still like that proverbial plastic bag just floating wherever the wind takes it. I have no idea what I want to do, and while some schools of thought say it's perfectly fine to be a final year medical student and not have any idea, I get the sense that time is running out fast. Already the surgeon wannabes have enough conference attendance certs and suturing competition prizes to add another page to their resumes. Even though I'm not gunning for surgery or anything in particular, sometimes I feel that this passiveness will bite me in the arse one day.

But anyway, 4th year finally ended after what felt like forever, I got a well-deserved month-long holiday which I wasted no time hopping on a plane and getting home as soon as possible. But of course it all flew by too quickly and before I knew it I was back in the land of 20 degree summers.

Fifth year kicked off with a bit of rar-rar pep talk and 8 weeks of surgery in Derby. And then another 8 weeks in MDD (Ortho&Rheum), 8 weeks in medicine (Derby is the best place to do it, honestly) and now GP, which I am currently doing in Hyson Green, a migrant area. The surgery (GPs here are called 'surgeries', don't ask me) sees more far Pakistani, black, and Eastern European patients than whites. My GP himself is from Pakistan and despite studying and working in the UK for the most part of his life, is still fluent in Urdu and Punjabi, which quite a few consultations are held in. I don't mind, as long as I get to clerk and examine a fair share of patients. He himself is a lovely guy, with the sort of calm wisdom that comes with a quarter century's experience of being top of your game.  

But medicine in Derby kinda takes the cake - they'd put in place a free hopper bus (yay!) that I was so thankful for, despite it only leaving at 2 hour intervals. Meaning that if I wanted to be in for 9am and had a teaching till 4pm, I would be taking the 7.45am bus and leaving on the 5.25pm one. It would be nearly six thirty and dark when I got back, and I did that nearly everyday throughout the 8 weeks. I did put in a lot of effort to be proactive and see patients on my own etc, but at the end my consultant decided I needed more work on my 'communication skills', which was vaguely upsetting. To add salt onto the wound, a friend of mine, who spent the 8 weeks whining about how his consultant wanted him to be in everyday and how he'd rather not be here, got a glowing end-of-attachment report from said consultant who must have been blind to all the foot-dragging! But overall it was a positive experience, learnt loads, heard more murmurs and crackles than I've ever heard.

I'd been doing regular OSCE practice with a bunch of friends since the start of fifth year, it usually goes well (until the stress of managing a circuit gets to us) and I do hope it'll pay off come February. I know people keep on saying as long as we're practicing the way we are, we should be fine, but as an exam-taking student I live in eternal fear of 不怕一万,就怕万一.

Only time will tell.

Family
The usual I suppose, apart from the occasional Skype session and rambling email from my brother, things are pretty much normal. It was definitely good to see everyone again when I went back for summer. The whole family's coming up again in January to celebrate mum's graduation and freedom from academic work, ever. Looking forward to it of course, just not the inevitable exam stress that will pair up along with that time of the year.


Friends
As we get older, shred of innocence get lost, torn, pried away. I used to think friends were friends and that was it; a simple definition of people you knew and got along well with, and occasionally had a good time or two which served to fortify and preserve the relationship. But that bit of innocence may be gone forever I'm afraid. Certain things will happen and make you wonder, question, about everything, yourself, and why oh why. Not all friendships are a fluffy soft toy; some are just a double edged sword. All of a sudden, those relationship complexes in Evangelion make so much more sense.

Still, a moment for that piece of innocence that I will never get back, please.

Travel
Did a round of Central Europe for our one-week easter break, stopping by Budapest, Vienna and Salzburg all on my own. Traveling alone is quite nice, I like the idea of planning and preparing for my own thing, and having the freedom to decide what I want to do or how I want to spend. The 3 places we amazing in their own right, but Salzburg will always be the city I will rave about when describing these travels. What I missed most about Budapest was the chimney bread, and seeing a ballet and opera in the Wiener Staatsoper was nothing short of amazing.

Summer saw me home in Kuching for half the time, and frolicking in Perth for the other half. Kuching was awesome as usual, pretty much spent my days chilling (more like sweating, oh glorious 35 degrees and late afternoon convection rain!), eating and doing nothing. Perth was Perth as usual, spending time with the bf, hanging out with friends, meeting bro and cuz, eating good food and having an awesome time in general. I can never stop going on about how it was 19 degrees during winter there. That really brings out the Greener Grass Syndrome in me. 

Good times? Good times. :)

But there's just something about Perth. Not just the weather or the oodles of Malaysians who have made their home there or the comfort of seeing so many more asian faces - or even the fact most memories I have of it are of good times and not bad. Walking down Wellington street to get to the buses, going up the stairs to Utopia for karaoke, chinese at Uncle's, bubble tea stores everywhere, transperth buses and trains, trying out a new Japanese or Korean place - maybe I'm just hard-up for proper asiany things, amongst others. And well, the 6-monthly meetup with the bf. We had our fourth year together in September. Time flies.

Opera House

In September I hopped on a spontaneous-ish weekend trip to Norway - Oslo and Bergen to be exact. I'd always wanted to visit Scandinavia, having quite a romantic view of the area that regularly tops 'World's Best Place to .....' in all categories. Well the plane tickets were cheap - less than the average train ticket down to London, say. It is slightly more expensive than the UK in terms of food, but at 30kroners (3pounds) for a Subway six inch, I'd say stereotype was one that was basked in more than it should have been. Oslo was nice, for lack of a better description, but somehow quite ordinary- I'd go as far as to say it was quite boring. Everything was so proper, so in-place, it felt like Singapore without the malls, food, and culture.


Bergen would've been a great experience, if it hadn't been for the weather. Wet, grey and windy, Bergen made England look like a dry, sunny place, and that's saying something. I'd planned to go on a massive 7 hour hike across 2 mountain peaks, but had to cancel that due to the mist engulfing the peaks. It would've been beautiful if it weren't so gloomy. Still, I managed to try whale and reindeer meat, which was a definite highlight of an otherwise unremarkable trip. I'd like to think it was just a case of being at the wrong places at the wrong times.

Pic unrelated: Christmas dinner lamb shoulder! Brining works wonders. 'I'll have the supraspinatus, please.' 

Others (work)
Worked on a prn (as needed) basis in a Malaysian restaurant - they pretty much called me in last minute whenever they needed extra staff, I waited tables and served food, earned minimum wage at the end of the night (usually enough to pay off 2 weeks of groceries) plus tips if I was lucky/sneaky. Learnt a lot from working there - sounds strange but I'd always wanted to work at a restaurant, just for the experience. It's definitely different from my usual hospital-study routine, but thinking about it, there were a lot of similarities too. Whether in the service industry or the NHS, patients/customers were just there because they wanted or needed something, and your job was to serve them and make them happy (within boundaries, of course, especially medical ethics ones!), and there were just tricks of the trade that one picked up over time, like how to deal with an angry customer/patient, for instance.

The thing about being a 'fine-dining' place was that there wasn't a lot of room for student budgets to afford a meal out there (12pounds nasi lemak anyone?), but to my surprise quite a few customers we had were Malaysian doctors working in the UK. I struck up friendly banter with some of them (good rapport is important, of course!). Getting bungkus of random Malaysian food at the end of the night was no small bonus either. One day, when I deem it not too extravagant to spend 12pounds on a single dish, I will walk in and order myself some of that kickass beef rendang.

*********
So that somewhat sums up the year, althought somewhere along the lines of that endless student cycle of starting, slacking, slaving and supposed relief, I think Istarted to grow roots in this thing called the 'comfort zone'. I won't wax lyrical on how I've regressed like a kid with Rett's syndrome, but I do hope I can break it out of here and start creating things instead of passively accepting them.

So! On to another year, what have I got lined up in my tiny new Ryman diary/planner:
-family in the UK!
-finals (and oh god pleasee a passss)
-MASST (aka unpaid NHS slave)
-electives aka homeeeeee
-more traveling :)
-prep course (no idea what that is either...talks on 'how to be an F1' maybe?)
-shadowing
-starting work as a doctor on the first Wednesday of August (god willing)
-life as a working adult! Good bye 2 week long Christmas holidays for the rest of my life until retirement! I'll miss you!!

The year has been good to me. I have lots to be thankful for, and I am. However, exciting times, tough times, good times, bad times - all lie ahead. Take em as they come, take em as they go, I say.

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