Pot of gold.

The worst thing about having EOPT today was snapping awake at 6am with a funny feeling in my stomach. Not in the past few years, I think, have I woken up at 6am on Saturday. It’s even worse than med EOPT. This is on top of knowing that Patho CA is soon, and having to watch enviously as others skipped out of SGH, almost every day this past week, with their EOPTs over.

The stars were aligned. I had a nice young (English-speaking!) lady who gave me a straightforward history. My examiners were very friendly (and also very late), which allowed me to think through things properly. I had time to write down nearly everything I know about acute pancreatitis.

Someone should have mentioned that vascular cases are so popular in NUH. 3/8 in my CG. I will miss CG13, they are all great ppl, who laugh at my jokes. Sometimes.

Dead leg.

There’s a lot of luck involved, running around the wards.

For example, lipomas are supposed to be fairly common. In 7 weeks of surgery, I have seen one – a 1cmx1cm lipoma on a patient’s foot. I tried to elicit a slip sign and that leetle lump just buried itself out of sight.

This is not for lack of trying. I’ve been going to clinics and scouting the pre-op lists when I can. The closest I came was when I went down to ASC to see this lady who was supposed to have a lipoma on her back. Talked to her for a bit, asked her for some NS advice since she works in CMPB. She said the lump was quite large and was bothering her a lot. I nodded sympathetically and told her that the surgeons here are excellent. Inside me, that depraved medical student was doing cartwheels because she has a big lipoma! Wow!

So I asked her if I could just examine the lump quickly before the op. Sure, she said, why not. I wandered off to get a chaperone, and when I came back… she was handing over her valuables and prepping for op. This is where you submit your story to the “FML” website and people vote and tell you “you totally deserved it.”

This other time, I was in HPB clinic. My reg was seeing a lot of follow-ups so I thought I’d pop over to the consultant’s clinic for a while. I waited outside and walked in after this pleasant-looking Indian gentleman walked out.

He had Dercum’s disease.

Argh.

So, luck. Or Murphy’s law or whatever.

But it’s ok. There are other things that make up for it. Last week during rounds, we passed by this guy who looked like he had a paraumbilical hernia.

Cool, I thought. Never seen a paraumbilical hernia before.

So we went back to look at him after that. Not only did he have a paraumbilical hernia, he also had hepatomegaly, a colostomy bag, bilateral ballotable kidneys, asterixis, and a grade III PSM.

After 7 weeks in surgery, it’s so good to hear a PSM again.

Today we spent the day in OT! It was a histopathology day. Followed a pelvic mass specimen sent for frozen section and got to see how the pathologists work – ended up being a ?dermoid cyst / teratoma. Then they let me cut open a resected colonic segment and GB. Really cool.

I think we’re incredibly lucky to be in SGH surgery.

Perspective.

“If the main purpose of your life is to study hard and be a good doctor, then studies are hard, but life is easy.

But if your life’s calling is to know God and make Him known, then life is hard, and studies are easy.”

- Ninja S, 3rd year medical student

Coconut trees.

I still wonder what would have happened if I’d done surgery first. Mostly because there’s this nagging feeling that I should have worked harder and learned more during gen med. I slept through that first posting.

Still, there would have been no coconut trees. And no life lessons or interpretations of the true import of death. That alone makes it worthwhile – and there’s always electives.

This past week in urology has been eye-opening. The first day we stayed back for exits, which comprised 2 patients. Yes, 2. Next week more than half the department is going on leave. I mean, in which other specialty are you able to function at less than 50% manpower?

Urology is awesome! They really spend a lot of time with each patient, in the ward or the clinic. The diagnosis is straightforward – stones, infection, or CA. And there are all these cool trans-urethral procedures they do.

Past 2 days especially have been great! Thursday turned out to be an accidental hernia day. Everyone else had decided to crowd up at the OT to watch a radical cystectomy, so I had the clinic to myself in the morning. Straddled 2 rooms and popped by to procedures every once in a while. I bumped into the incredible Dr HH at a cystoscopy, and it so happened the guy had an inguinal hernia as well, so I got an impromptu hernia tutorial. Then went to follow Dr T on call, and it just so happened that she was seeing an incarcerated hernia at A&E.

Yesterday a tutorial was pushed back so I went to the OT early. Watched the last part of a TURP, then hung around as the next patient went under. The anaesthetist was awesome, he let us pump the bag. It was terrifying in the best possible way. I have never felt so acutely before that someone’s life was in my hands.

There is our IHD therapeutic seminar to prep for, case write-ups to do, colorectal to study for next week, patho to mug, script to write, letters to draft… so many things and so little time.

Peaked caps.

My brother came back Saturday from playing in 74/08. A batchmate just posted some videos on facebook. 3 years, 12 batches later, the first thing that comes to mind is that feeling of weight on my shoulders as my hat started to spiral downwards. Haha.

Burning coals.

Totally by accident, now I think I understand a bit better. Humbled and contrite again.

In the company of giants.

Surgery at SGH has been extraordinarily awesome so far. P & I did night call last night with our team. It was fun! Watched them clerk the new admissions; felt a few livers, a spleen, a thyroid; moseyed around A&E for a while trying to appear useful.  Most memorable moment was talking to the poor young lady with a needle phobia.

Our tutor seems a little perturbed that we insist on sticking to her like leeches… but I think she’s resigning herself to it. Sometimes you have to be a bit thick-skinned. She’s great, really.

I can’t get anything done nowadays. There’s something happening every weekend, and on weekdays sleep > studying. And still haven’t found a COFM patient. And there’s still patho.

Doing OT3 has been like uncovering an iceberg.

The long and short of it.

Today was the first day of auditions! I must really hand it to all those ppl who showed up. It takes guts to stand up there and try to sing, in front of your fellow students no less.

And it is HUGE fun to sit behind the desk. Hahaha.

Med EOPT was a thyroid day. There were these 2 stone-faced examiners for long case. Totally expressionless. If you could peel the skin off their faces you would probably find a switchboard underneath.

Ok maybe I am being a bit harsh, especially on the lady. She did laugh, once (at my dumb answer). But that guy… man, it must be difficult to go through life with so much seriousness. Haha.

I don’t think I did that well! I would probably fail myself, so if I pass it will be by the grace of God and my 2 lovely long case examiners.

We were very blessed to have med posting at TTSH, and even more so to have Dr. Chia as our core tutor. He chose to teach us less about medicine, and more about life, and I think he was right to do so.

So many things left to do… so little time.

Managed to play golf with A, finally. Out of desperation we went to Eng Neo, early in the morning. Highlight of the day was watching as he chased his runaway trolley down the slope – straight out of America’s Funniest Home Videos.

Also managed to play with dad at MBGC for the first time. Very nice course. There is this overhead shower in the locker room that is totally unnerving. I would like to see my shower faucet in front of me, if you please.

I’m happy with the break – the surest sign that my standards are dropping.

The promise in store.

An evil man with a dastardly plan.

We have a title! Finally. It’s been a bit clunky but at least things are moving. So far it’s been kind of fun! No regrets.

It’s less than 2 weeks to EOPT. I have this sinking feeling.

We sat in front of the TV waiting for my brother to make an appearance yesterday, but apparently the MDC was more interesting than the trumpets. Still, proud of him.

Green.

Went for White Coat on Wednesday. Personally I think it serves its purpose admirably. It made me proud to be M1.