Life as a medical student #7 Empty Promise, No More

When you look back on your life, is there anything you wish you'd done, had done differently or had never done at all? I believe most of us would say yes. Guilt feels terrible. But the worst thing about guilt is that it sneaks up on you. You are filled with regrets and ''if onlys'', and what you did keeps playing and replaying in your mind. Today I have a confession to make. For if I were given another chance, I would act differently.

She was 42 years old, with underlying long-standing Diabetes Mellitus for more than 10 years. One of the most potentially serious complications of high and uncontrolled blood sugar in the body over many years would be neuropathy, which at its most severe can lead to amputation. This lady just had both her legs amputated. Up until the knees. She was lying on her bed when I see her, eyes staring at the ceiling, almost expressionless. She needed help to cut her fingernails, so I offered her help since I was free in the ward.

I had experience cutting fingernails for my mum but it was slightly different in this case. This is because diabetes and wounds are a dangerous combination. There is no such thing as a minor wound - even a small cut can turn into an ulcer, which is what happened to her legs. I have to make sure I don't cut her skin, not even a single bit. I held her hand up gently and slowly, I started to cut her fingernails, one by one. The lady thanked me, and while I was cutting her nails, she told me none of the nurses in the ward willing to cut her fingernails for her. They scolded her because she requested this and that. Her mum just got robbed of her money which was supposed to be her medical fees. She has no medical insurance. Her husband doesn't like her and finds her a nuisance. She couldn't stop crying after the amputation. The pain was unbearable. The only thing she knew was that she lost her legs. No legs. Cannot walk. Cannot run. Cannot go to places. No, nothing. All gone. Shattered dreams. Unfulfilled promises. Her life was totally changed.

I can't feel anything but pain. I am better off dead. 

I paused for a second, holding back my emotion. I wish I could pretend that I was all focus on cutting her fingernails, but no I had to say something. So I told her that with her hands she can still achieve a lot. She has perfect eyesight. She can still see the beauty in this world. She can still eat all the good food. She can still breathe. She is not alone. You are not alone.

She looked at me with gratitude. I guess it has been a while since someone spent time to talk to her and listen to her. She started to cry when she knew that it was my last day in her ward. I promised to still come back to her ward to visit her after my surgical rotation. Meanwhile, the nurses came in to clean her wound, so I left the lady, and I said, ''I will come back later.''

I didn't realise how much this sentence would mean to a patient the moment I said it. I continued with my work and at the end of the day when I was about to leave the hospital, I suddenly remember I made this promise to the lady. I knew I had to go back, but it was a Friday, laziness got the better of me and I thought I could just go back to the ward on Monday. So I left the hospital. But very soon after that I knew I made a wrong decision. I began to feel guilty for not going back. The lady might just be waiting for me to go back! How could I make an empty promise to a patient? The thought of the lady waiting and thinking that another person in this world cheated her and abandoned her again.....I can't believe I could be this cruel.

For the first time ever in my life, I don't look forward to weekends. All I want is to go back to Surgical Ward 11 on Monday. To fulfill my promise.

Life as a medical student #6 Just a touch of a hand

Dear Mrs E,

We didn't know each other well. You might recognize my face from ward rounds, I was the girl in the corner holding my books, looking at the ground or out the window. I occasionally asked you how you were, and you always told me the same thing - pain, so much pain. I didn't know what to do. I wanted to hold your hand and tell you you will be okay, but something held me back. Because there is nothing I can do to cure you. I am just a medical student, and even if I was a doctor, there is no medicine to make you better. We can give you pills and injections and fluids. But they can only prolong your life. All they gave you was just more and more pain.

I was there when your family was told the news. I saw how they reacted to your prognosis, did you see it? Did you see the pain they were in? Did you realize just how loved you have been. I looked at them, unsure of what to say, knowing that no words could take away their sadness and their grief.

As your condition deteriorated, you couldn't even tell me that you were in pain. I still went to your bed every morning and asked you how you were. But you could only stare at me, mouth wide open, no words coming out from your mouth. You started to lose appetite, you didn't even have a look at the food they served. Your son, who is a great chef who owns a restaurant brought you your favourite food. But yet, you turned your head away.

My heart aches for you.

Finally it was my last day in Ward 23. I came to your bed and said good morning to you. And as usual I asked you how you were. You looked at me, as if you knew that I won't be there with you anymore starting from tomorrow. You reached out your hand to me. I thought you wanted to tell me something so I bent down. Your fingertips found my skin, then you touched my face, gently.

Until today I don't know what it means. But I wish for a miracle - that this illness which haunts you will be gone one day. Stay strong.

Life as a medical student #5 What I learnt from Ward 23

Two weeks in Ward 23, Hospital Kuala Lumpur.

I wish I could tell you stories about an impressive tracheostomy, or how I performed chest compression on a patient and brought her back to life. Nahhh. But I can't. All I can tell you is the little things that happened - what Ward 23 has taught me.

In Ward 23 we have our General Medicine rotation. Patients are from diverse cultural backgrounds and have different life circumstances. Some have been relatively healthy and it was their first hospital admission. Others were chronic disease patients who probably have twenty years of long standing hypertension and diabetes. This is my first opportunity to meet real patients in a hospital setting - it is a much less structured learning environment than I have experienced up until now. A lot of self-directed in my learning is needed, which is a challenge for me as I am used to be spoon-fed -  we all are. On the first few days, I entered the ward and not knowing what to do or who to speak to. All I did was standing there watching the specialists and doctors discussing cases which I don't understand. The busy environment was intimidating, I almost started doubting my decision of becoming a doctor again.

But as I started to talk to some of the patients, things changed. I remember one woman in particular. I was walking from one bed to another, reading their charts. Then she started to make sounds. I knew she was trying to gain my attention. So I closed my files and walked towards her.

''Kenapa mak cik? Mak cik okey?''

She started to complain to me about her calf pain and how it affected her sleep. She frowned talking about the pain like a little kid. She told me how she hated staying in the hospital and her children never came to visit her. I looked at her lunch plate and realised she only ate the fruits. I asked why didn't she eat the porridge, the vegetables and the chicken. She said she had no appetite. And that she only likes fruits, especially the watermelon selling at the cafeteria downstairs. But she is wheel-chair bound and it is difficult for her to go down to the cafeteria. So I offered to buy her the watermelon. 

She was all happy when she saw me coming back with the watermelon. She had one bite and told me the watermelon was sweet. The juice of the watermelon was dripping everywhere on her neck and shirt. I helped her to wipe them away.

I made a promise to myself to always remember the sparks that she had in her eyes and the smile on her face when someone in the ward finally willing to listen to her and satisfy her wish.

Ward 23 taught me something -  that patients are always our best teachers. I am grateful for patients who are happy to let me talk to and examine them. Thank you for seeing me as a member of the medical profession - although I am just a medical student. It reminds me to behave in a professional manner at all times. I know that my rotations will have even more to offer me in terms of interactive, hands-on learning. Finding real life connections between the diseases I learned and the presentations I saw in my patients is interesting. But it is going beyond the disease presentations of my patients and getting a glimpse into their lives that really are the heart of medicine. Thank you, Ward 23.

"Medicine is learned at the bedside and not in the classroom”

Sir William Osler (1849 - 1919)

Life as a medical student #4 Sweet Revenge

From left: Abby, Chern Meng and I

Have you ever met someone that just weren't very nice to you? It wasn't because of anything you did - or maybe it was - but they just weren't very kind or friendly. I remember writing about how I embarrassed myself in front of my supervisor and how it made me think and reflect on my own performance. (You can read about it here) After some time, I realized there were only two possibilities - either I really performed badly or he was trying to pick on me. I wish it was the first one. Worst comes to worst, I have to be the type of incompetent people who know that I am not good, instead of those who are clueless about their incompetence. It is never too late to learn. 

Last Friday, we ended our Student Selected Component (SSC) by having oral presentation in university in front of the examiners, and most importantly - in front of my supervisor. It was a day I have long anticipated, I probably secretly hoping to prove him wrong or something. So of course I made sufficient preparation. We rehearsed the presentation for countless times, we even colour coded our outfits. But most importantly, I was all ready to present to everyone what we have done in the past six weeks. Because from the very beginning, I am proud of what my SSC is all about and am really glad that I was given the opportunity to be a part of the team. (Will be posting here about my 6 weeks attachment at Yayasan Chow Kit soon)

The presentation turned out pretty good, the response from the floor was out of my expectation. People were impressed by the findings and how it would benefit the street children. One of the lecturers from Dublin asked if we would like to publish our papers. I mean, what an honour! Publishing papers is the dream of every researcher. To receive such feedback is the best one could ever get.

I wish it was from my supervisor though. He didn't make any comment after our presentation. No dramas like patting on my shoulder saying ''Well done'' or ''Keep up the good work''. But nah it's okay. Maybe my supervisor is just cool like that.

I dip my fist in sugar before I punch my enemies in the face. Sweet, Sweet Revenge.

记我与慈济的一段缘 #3 来，一起做黄梨酥！

为了《陪伴我长大》学生助养计划的募款，Perdana的大家继See Green See Lives之后又再聚在一起集思广益动脑筋。

“要过年了，一起做黄梨酥吧！”

下定了决心，有了目标，大家都兴致勃勃。采购原料，安排时间，招集人手帮忙 - 事前的准备非常充分。但当面团真的在自己的手心里，我们才发现制作黄梨酥一点也不简单。第一天，只有三位伙伴来到劲顺爸爸的家，其他人都抽不出时间。在劲顺爸爸和Amy妈妈的指点下，从准备面团，均匀地分配黄梨馅，将黄梨馅小心地包进小面团里，捏形，涂上蛋浆 - 每一个步骤需要许多的耐心和细心，一点也不得马虎。材料少一点多一点都不行。再加上这些黄梨酥将会是我们本着助养同学的名义在售卖的，所以我们更加力求完美。就这样，三个人在厨房里忙啊忙的，一整个早上才做出了一点点的黄梨酥。我们打算在大型的207爱心晚会上售卖我们的黄梨酥，来达到最大的收益。但是以现在的进度，怎么做到很多很多的黄梨酥来满足当天出席的五百个人呢？

第二天，依然只有四位伙伴来帮忙。我们心想，能做多少就多少吧！虽然因为有过经验，所以做起来比第一次更得心应手，但是奈于人手有限，我们的进度还是非常缓慢。到了晚上，救星终于来了！欣颖带了一群刚上完课的伙伴们（辛苦了！）来劲顺爸爸家帮忙了。

谢谢家齐，Isaac，Jason，Abby，昌伟（不在照片里）和政铭特地过来帮忙！
当然还有凯勋和欣颖，感恩 :)

人多力量大。爸爸看到慈青们齐心努力，也下手帮忙大家一起做黄梨酥。一瞬间，劲顺爸爸家的厨房变成了一个迷你工厂，大家分成不同的小组，各司其职，黄梨酥的产量突然间提高了好多。烘炉不见断地飘来黄梨酥的香气，一盘又一盘的黄梨酥也随之出炉。看到烘得金黄色的一个个黄梨酥，内心好满足。大家一边做一边谈笑，每一个，都是想要替募款计划出那么一点点力量的人 - 我想，这就是一起做黄梨酥的幸福。

累倒的凯勋

做完黄梨酥，包装又是另一门学问。黄梨酥非常脆弱，每一个都要小心地装进袋子里，才不会把它给压碎了。每一个黄梨酥都是我们的心头宝，我们也懂得将来要细细地品尝新年的年饼，因为一切的背后都不是理所当然。

Perdana's Bakery传递的新年祝福，你有收到吗？:)

黄梨酥的反应非常好，207当天更是供不应求，90包在一个晚上一售而空。想到有好多的人尝到我们亲手做的黄梨酥，心里好开心。大家期盼着下一次再一起制作年饼。

而我，又再一次感受到付出的法喜。

过日子比过年重要

好好耕耘心田，分秒不空过

Life as a medical student #3 Let's go jogging

Picked up my old habit of jogging in the evening today. And it feels so so good. I smiled to strangers. I admired the flowers that people grown outside of their houses. I realised that the family who had a cute rabbit as their pet, was no longer living in there. I have forgotten how beautiful the sunset is.  The sky is so blue, the clouds are so fluffy. Why didn't I think of doing this earlier? When I was all stressed up last semester, why didn't I go jog? I jogged when I was in IC1, like everyday, but not even a single day in IC2. What have I missed out?

Yesterday was a bad day. Got screwed by my supervisor, which, I think he was right. With just passion is not going to pull me through medical school. I am just....not capable enough. Whatever you have in your head, if you don't speak up, if you don't speak to impress, you are just one dumb idiot. But, almost all the time, I have thousands of thoughts running in my head - should I say this? No I shouldn't. People will laugh at me. Is this correct? No it could probably wrong, I better don't say it. My thoughts are scattered. Only by writing, I can sort out my mind and say myself best. Maybe, just maybe. I need to speak up for myself. I am terrified of something, which I have always wanted to avoid. And yesterday, it just exploded. And I could no longer hide it. I wish I could be perfect in everything I do, I never thought that I could be that weak, and stupid, in front of people. 

I would do anything, to get out of this shit.

Had a bit of thinking today when I was jogging. So I was thinking, maybe one day I would thank him for this. What doesn't kill me makes me stronger anyway. I sat on my favourite swing, had some time to myself. I really, really love this. It calms me down. It makes me think. And I don't have to do anything to please anyone.

Because my thoughts are stars I cannot fathom into constellations.

记我与慈济的一段缘 #2 承担的幸福

518营队后，Perdana University多了一群很有理想的年轻人。他们开始聚在一起，想要一起做点什么来让这个世界有那么一点点的不一样。所以，他们有了See Green See Lives。

See Green See Lives

凯勋伙伴向我提起See Green See Lives，问我要不要协助他做协调方面的工作。当下没有多想，马上就答应了。第一次承担，满腹的理想，满脑子的点子，我感觉到自己有很多的力量可以去改变，可以去影响。同时很高兴自己找回了那股热血，距离上一次自己这么地有干劲是多久以前的事了？我仿佛看到了中学时期那个因为办活动而笑得很开心的女孩。主动接下了制作结缘品晴天娃娃的这份工作之后，我忙着帮助凯勋处理协调其他事物，直到活动的前一天我才恍然 - 我还没有开始动工做晴天娃娃！

眼看满桌子已准备好了的材料，我对自己说：既然接下了这份职务，就有义务把它做好。好吧就拼了。做，就对了！于是开始用心准备静思语，剪布料，包裹乒乓球，为一个个晴天娃娃画上笑脸。为了让每个娃娃都漂漂亮亮的，我拆了又包，包了又拆。然后，其中一个娃娃上的静思语吸引了我的注意力。

愈能忍受艰难的花
愈能有甜蜜的果 

A blossom which can endure the toughest conditions
will bear the sweetest fruit.
 

的确，活动当天，看到同学们领到结缘品的那份喜悦，真的是最甜蜜的果实。一切的一切，都是值得的。

承担，辛苦也幸福。

但也因为承担，我更爱慈济了。