Anyway, managed to dig into a comfortable little corner in the bar's courtyard and surround myself with some friends and chatted about our long case exams while sipping champagne, which is the most expensive drink from the bar and given our free-flowing drinking ticket of A$26, its the most value-for-money alcoholic beverage! Haha. What a cheapskate. But it is nice though. Never had champagne before. 

It's funny how I've always avoided such occasions because of the fact that I prefer not to waste my time (and not to mention money!) to "socialise" with people whom I even don't want to socialise with, given that the group that I hang out with think pretty much the same way as I do. But this time, because of, you know, the fact that it's gonna be our last year, yadda yadda yadda.... so all of us decided to go and see what's it like, plus to catch up with friends at the other 2 clinical schools. It was good in that aspects. To see old friends again and find out their plans for next year. 

The other interesting thing was - I finally see why people who enjoy doing this so called pubbing/clubbing thing like it so much. You see, when you consume alcohol in amounts more than your liver can metabolise, it has this somewhat "refreshing" effect on your brain such that when you find yourself having to talk to people whom you would usually avoided, you actually don't feel as difficult to make small talk as you would if you had been sober! Its like, oh yeah, whatever. Verbal diarrhoea man. Talking and talking and not giving a damn at all! Goes in one ear and out the other and smiles all around. Cheers! The downside to this is that my head felt really heavy. And wobbly. 

It was a good experience all in all. But not again. 

I've gotten a diabetic patient with chronic leg ulcers and recurrent falls for my long case. Unbelievable. I know many of my peers are already screaming out unfair! I probably would have too. It was almost the same case I had for my long case back in fourth year. What are the odds of that? Hmmm. Except this time, my patient was pretty vague and slow to speak. So by the time I felt like I have adequately covered the history, 40 minutes out of the allocated 1 hour has already passed. Major panic mode activated. I still have the physical examination and synthesis of issues to do! Did manage to do a rather haphazard examination. Thought up my opening and summary statements while walking back to the examiners' room. Very very bad. The actual presentation was still ok I thought, although I did take too long and some bits seem rather disjointed. Got cut short in my physical exam findings, which is a good thing since I didn't do a good job for that. The 2 examiners were pretty nice. We discussed about my history, examination and ulcers and falls management. Silly me, the first thing I actually said was MRI when I got asked "what tests would you do to see if there's osteomyelitis?" I can't believe those 3 letters popped out from my mouth. Whatever happened to plain old good X-rays? Doh! Anyway, otherwise I think I did a decent job. Managed to answer most of the questions and the reassuring nods and smiles seemed to be coming in quite wholesome amounts. The 25 minutes of discussion just seem to fly by almost instantaneously! I was actually expecting more questions when they said: oh, we'll have to stop here now coz time is up! Phew! Well, either that or they're just hungry for their morning tea. Must be very boring to be listening to medical student presentations the whole day! 

So there you have it. The final assessment of my competency to practise as a doctor. The assessment that's supposed to make sure that we will be safe doctors who won't kill too many patients on our 1st year out on the wards. Honestly, I say this test is probably 50% luck and the remaining your own knowledge. And I am so lucky oh boy. Ready or not, here I come! Hahahhaha.... 

What a mess of a contradiction I am in.  

Right now, if the exams were truly over, I could have been totally enjoying myself when I'm slacking off and just idling the time away, be it with games or TV or just chatting on the phone, etc. But they are not. And although I'm still engaging in these activities nonetheless, I hate the fact that I'm not able to get the maximum enjoyment out of them because I still have that bloody long case exam this Wednesday! It's like my exams are over but they're not! 

Things to look forward to in Singaland:

What's the point of studying so hard (relatively!) for your exams when all that you are going to say, in respond to a simple question put forth by the examiner there and then during an OSCE, is gonna sound like something that has randomly popped into your brain and dribbled out like a bad case of incontinence? All the systematic and structured format that has been repeatedly droned into my head has abandoned me in my time of need. This may well mean that I was never a systematic person to begin with in my approach to clinical problems/management. Or perhaps it was due to the anxiety and stress of being in an OSCE. But you would expect someone to get better over the past 6 years right? I just can't seem to get it right. 

The past 2 days have seen me going through 9 OSCE stations. I don't know why but I seemed to have become too slow for my own good. Wasn't able to finish a couple of them. It's like my brain is put into slow-motion mode when under stress. Need more time to read, to make sense of the whole question, to think, to retrieve the information, if it's there in the first place. And I think it's so unfair to be judged on your competency (which you have painstakingly acquired for the past 6 years) based on these pockets of 9 min-long stations. But I have got no better alternative solutions to offer and I would rather have OSCE any day than to have a written paper, which we don't so I should be lucky eh? In the meantime, I have just gotta learn to play the game. 

Long case this coming Wednesday. Will probably only be bothered to revise on common conditions like CCF, AMI, COAD, liver failure, etc. And by revise I mean quickly glean through and deluding myself that I have mastered them. Can't be bothered with any other rare entities. Not like I'm gonna make any significant difference from now till then in my history, physical examination and presentation skills. Battle plan for long case: walk in, smile, talk to patient, get a decent chronologically correct story, test out a few differential diagnoses with relevant positives and negatives, obtain the other necessary sections of a medical interview, perform a basic physical examination, pick up some signs if possible, and finally regurgitate it all back to the examiners while shouting out a few keywords like "my differential diagnoses are...", "my management plan includes...", "this patient has 3 main issues..." - all to make me seem slightly more intelligent than a 4th year medical student and thus earning a pass on my marking sheet! Yeh! 

So, this means I have actually got quite a bit of free time from now to then to start playing! Actually, I should say continue playing. Heh heh. I have some star trek videos, manga, and of course, Raven shield game! Let the fun begin!

I have officially finish med school today. It's a somewhat liberating sensation. More of that to come when I finish my exams by the next 2 weeks. No more "I'm just a medical student" crap anymore. Well, except one last time at my exams that's all. Six years of study (most of it was anyway) gone by like that. It's been an enjoyable journey overall that I can't deny. Congratulate me people! 

I must be crazy - no, actually more like overly-presumptuous to think that I have graduated when I haven't even passed my exams yet! Ok. I'll hold the champagne for now.  

I'm feeling a lot better now. The weekend has been good to me. Other than getting cheated out of 1 hour of my time that is. Stupid daylight savings thing. Can never understand how it works. 

Spent my Sunday with Hogan - and got reminded of how I have managed to shove away the friends in my life who are possibly the best ones that I will ever have. I'm glad. I feel thankful. I feel nostalgic. About a long time ago when I was only a first year medical student. How I had been miserably moving along the first semester feeling like I'm the only person in the whole course who is so aloof from the rest. Until I got to know him. I have always been relatively guarded when it comes to making new friends. Not so much because I'm shy or what but more of being way too cynical about people's motives. Getting to know Hogan for the first time back then was like scratching away on a lucky draw scratchie card and repeatedly finding the winning symbols one after another! I just keep discovering nice bits about him. The profoundly similar characteristics and outlook on life that we share. Your heart palpitates while your mind takes a while to force yourself to accept the fact that it's true, as unlikely as it seems. It was kind of like the time when I found Huiyu too. In a world of strangers, finding someone like that is almost as difficult as than striking lottery. And I have been such a fool to neglect such a gem while I stick myself in the company of lesser acquaintances. 

Now, what we did yesterday was just fantastic. I guess you can call it a well-balanced day. In the morning, we went to RMH to practise our long cases. Seeing a patient each in pair and then presenting to each other, looking at lab results, x-rays... It was all good. Especially when I take Monday to Friday off virtually every week. Then we had a yummy lunch in the city. Then an OSCE discussion session with some other friends for about an hour. Then we (me and Hogan) came back to my place and we relived our childhood! Or actually, I should say - I relived my childhood while he was given one - spoilt Singaporean brat VS strict Taiwanese upbringing. Haha. We played SNES games on my PC! In my opinion, emulators are the best software ever coded. We went through Contra, Super Mario World, Mario Kart, etc. It was all so good! 

But I feel really sad. About having to leave this place soon and leaving a friend like Hogan behind. Next year means starting work in the local medical world and having to make new friends all over again. I had an epiphany just the other day while I was in a tutorial (yeah, I daydream a lot as you can see). Even being in a supposedly more friendly society like Melbourne, doing medicine here is already hard enough with the couple of hardcore freaks in the course. The horrific realisation is that when I get back to Singaland (I love this term, Reminisce!), wouldn't I simply be surrounded by a flood of the same hardcore freaks that I have come to detest here, but even more hardcore! I really hope that won't happen. As if the 90 hours per week workload isn't enough to stress me out. 

Doing Anaesthetics this week. How exciting. I'll learn the art of the ninja and try to disappear most stealthily! 

Hiyah!!  *Johnicology throws a smoke bomb and vanishes!* 

After such a long break away from comicking, I have finally felt like drawing MM again! Yeh! I guess this shows that at least I could be bothered with doing something, even if it's not academically-related! Otherwise it could also mean that I'm sick of watching all the Star Trek videos that I borrowed from the Rowden White Library. But they were good while they lasted. I miss being a trekkie. I miss imitating Picard's voice and giving out commands like "Make it so", or "Engage", "Not good enough dammit, not good enough!". Not forgetting all the nerdy geeky technobabble like "configuring the main deflector array to emit a tachyon pulse". 

Gotta try and get my hands on a patient for a presentation on Thurs. In case you're not aware, trying to do that during this near-exam period in a tertiary hospital swarmed full of self-serving medical students (some whom you call your friends), this could be harder than trying to squeeze blood out of a stone. 

Which reminds me - at the end of the day, people only look after their own self-interest. Which shouldn't be a new concept to me. It's just that somehow along the way, I've let my guard down and stupidly think that there's such a thing called good friends. Hah. Selfish fuckers. 

"Beneath all those smiles lie a hidden knife" - Chinese proverb

Me: I don't know. I just can't be bothered with doing anything. I feel like its too late already. The exams will be here in another 2 weeks time and I'm still so terrible at presenting long cases!

Voice in head: What? Don't be spastic. What's there to stress about over the final exams? You've already got a job, there's no written component, and you should know your stuff by now right? 

Me: .....

Voice in head: Shouldn't you? 

B: Well... I think I do, but I just haven't got enough practice! Have only presented like, three times this semester? And it's not that I don't want to but there's just so many factors that make it difficult for me to present! It's hard enough to get a case in the first place, having to find one who is able to speak English and not demented, and hopefully that they haven't already been seen by 10,000 other medical students, all as eager as beavers to clerk patients! Argh! Then there's the fact that I often can't even get a complete and thorough history and even when I do come close, I'll just self-destruct at the presenting part. 

Voice in head: How so?

Me: It's like, I become dysphasic during presentation. Fluency of speech is completely gone and I can't seem to even string simple sentences together. And I lack the confidence too. Jason says that when I'm presenting, I just keep looking at the examiner and seeking for his nods and reassurance that I'm doing fine. He says that I have to press along and keep going regardless! But this isn't something that I can change overnight and probably won't ever either! Perhaps if I am more competent in my medical knowledge I might feel slightly more confident about myself. But now it just seems hopeless to even try and study hard and cram my brain with information because there won't be enough time! I just can't accept how everyone else is so damn clever and knows so much. Actually that's a silly statement coz in fact I do know why everyone else is so smart. They actually study whereas I don't. But I don't care! I don't want to be the dumbest person in the group! I feel so frustrated!!

Voice in head: You know what's your problem? You are such a whiner. Stop your moping and actually open up your books and study you lazy ass!!! 

Me: .... GO AWAY, you're not helping  

Was just doodling and resulted in this sketch. Quite representative of the general feeling I have regarding next year when I start work. Heh heh... Need an adaptor man.

Please.. let the time pass faster. 

Oh, and I got Austin hospital for my long case exam. PHEW. Thank god and all my lucky stars that I didn't get St Vincent's. PHEW, or whatever that sounds like an extreme sound of relief to you. 

Plus I'm having this really weird feeling inside me. A feeling of something being not-quite-right. And if I were to take a guess at what it is, it would most probably be the fact that I having been having adequate sleep on most nights this week - despite the fact that I'm supposed to be doing surgery. That's not right isn't it? I mean, am I not supposed to be complaining out loud about how tired and wasted I am by now? It should be like that, but its not. Conclusion? I have been too bloody slack. Haven't been getting as involved with the team as I should. That's right. I can't seem to recall having seen any patients this week. But I know I must have. With Jason I think. Everything's so vague. I can't remember much of what I did this week, academically-related or otherwise. It's like looking back with a pair of spectacles smeared with Vaseline (for achieving soft focus in photography). 

Yeah. That's sums it up nicely. That's why I'm feeling so weird about this entire week. I think there's a component of guilt in there too. The guilt of a slacker. Ok. Enough self-reflection for now. It's 1928 and my non-stop TV viewing session is about to begin. First up is 2 episodes of Raymond and then it's Galaxy quest! I love that show! I love anything remotely to do with Star Trek! Woo hoo!

Anyway, I'm back at RMH for my 5 week surgery rotation and boy, it sure feels good to be back here. It's been what? 1.5 years since I was last based here. So sad. When you choose the RMH clinical school you shouldn't be misled into thinking that you will be here all your clinical years. Damn. Got cheated haven't I? Got sent out to rubbish places like Sunshine so often (that's 5 weeks for med and 6 weeks for psych and 4 weeks for paeds! Bastard!). Gotta learn to do the dance man, if you wanna be able to stay in RMH (sorry, esoteric comment).

Surgery is fun. It essentially boils down to: (1) being spoken down to like complete retards, (2) having the excitement of not knowing when your scheduled tutes and lectures will actually happen or not, (3) developing lovely eye bags and transforming into a panda, and (4) trying your hardest to escape the obligatory theatre sessions!

Otherwise, the other highlight of the week - look who's finally made her debut with her own blog (not without a lot of persuasion on my part of course)! Take a look at The Jelly's Still In The Pot! 

Otherwise, that seem to be the general flavour of the kind of patients that's lying around on the medical wards at Sunshine. Most of them uncooperative and looking really grumpy or psycho. But I guess I can't blame them coz if I were sick and ended up there, I would be sad too. But what really saved the day was this really nice old man who let me and Jason clerk him and do physical examination and listen to all the wonderful crepitations in his lungs. Its funny coz initially I was very apprehensive about clerking him coz it says on the patient's list that he's got dementia. Turns out to be the complete opposite. Really dunno what the people in Sunshine are doing man. Maybe for them dementia is defined by age... 

I don't think there will ever be the day when I can say to myself that, yeah, I am capable of doing a good and thorough history and examination on patients. There will always some screw-up or brain malfunction leaving this gaping big hole in my case. Which of course I will only realise when I am finished with the interview. That feeling of knowing that you are actually not as good as you think you are really sucks. It sort of brings your nice comfortable world crashing down and shattering into a million pieces. It's funny how I thought that I've always considered myself to be just an average student but paradoxically and unconsciously hope to be better than that. Today I realised that I am truly mediocre. Thanks for all your consolation guys. But I'm not delusion nor lacking insight. It's painfully obvious. Remember what the consultant said? "Your presentation is boring. This is like a fourth year presentation" (at that moment, I didn't think I have ever been more humiliated than that). Another thing that made me felt even worse was the fact that I have completely wasted everybody's time. Today we basically have nothing on other than that presentation tutorial. So there goes everyone in my group dragging their asses to the Western Hospital to listen to the piece of shit presentation that I have to offer and get absolutely no value and learnt nothing from that. Wasted everyone's time, Danny's petrol, and carpark ticket. Should have let someone else present and then maybe we all could have at least learn something. (btw, the case I presented was on AF - we had only had a tute on AF last week and even the questions that the consultant asked me were all too basic, given my level, for the others to learn anything useful) Argh. I hate being a medical student. 

Furthermore, what makes this incident worse is that you would think that after such an event like this, I would be driven to better myself, to become more hardworking. And personally, I wished it was the case too. But what I did after getting home was just to escape away from the fact that I'm a medical student. And a lousy one at that too. Which kind of explains why I'm online writing this blog. And also the 2 hours of Simpson's cartoon that I watched, and the 1 hour of GT3 that I've played. I don't understand why I can't be more like the others. Be more motivated!!!!!

Meanwhile, it's back into the daily competition of finding patients to clerk first. Yet another thing I simply detest about my life right now. I don't want to have to compete... cos I don't like losing.  

My weight seems to be stabilizing at around 76kg. Its becoming harder and harder to abstain from food as I get nearer to my goal. Complacency seeps in easily. Doesn't help especially when I'm getting sian of playing GT3 as well. Also no time to play it even if I want to. Have to get up at 730am every morning!