Chapter end (9)

Part IX.
Word came to pass.
Took me some time to get my result using the enrollment/result email service. I submitted a request at around 3pm but it was still too early, and then again at 12.20am after coming home. I checked my portal email lots of times and decided that if it didn't come by 3am, I'd go to bed first.

I was woken up by my friend's phone alarm. Went to the bathroom while letting my laptop turn on. Then logged on to Student Portal. And got my results.

Really thanking God for this great journey that I've been on. Last night, I've decided that whatever the result is, it actually isn't as meaningful as the adventure itself, because it is during the long, sometimes arduous process that I've learned about what God desires out of my life.

Well, He came through and fulfilled His word! I achieved the highest excellence prophesied to me. And really, I found the journey (the process) to be more meaningful than the result itself (the single point in time). And you know what, this story is really more about Him than me. Seriously.

That's the close of this semester's chapter. Next up, Sem4 Neuroscience.

Picture credit: Daniel Mencák

Final 1 Hour (8)

Part VIII. CRL Practical, 1 hour, 50-MCQ, 15%.
Never Stop.

We learn from out mistakes. Agree? Well, after my last exam paper, here are three things I just learned:
1. When talking about lymph nodes, Bronchopulmonary = Hilar
2. The neutrophil's job
3. Coagulative necrosis - not fibrosis!

Also, as always, the prac exam has a few questions where the wording makes it ambiguous (at least to me). One thing I remember:

"The muscle associated with the structure pointed by the white arrow..."

It's as if the "muscle" and the "structure" are completely different, or somewhat different, or somehow related. I couldn't tell (so that's my problem). In the end I decided that the structure was part of the muscle, and made my answer choice.

I ended with about 18 spare minutes. Whew. What I feared the most were those long, PBL-style questions where you're told the patient's symptoms, history, body temperature, heart rate, etc., and give a diagnostic answer. And this is an MCQ test! Anyway, we didn't get any of that in the Prac paper, so it's a relief.

Last thoughts, despite the extra revision time that we had before this paper, I still don't feel the "readiness" feeling that I used to have before this. Could be a bad sign that I'm not preparing myself well enough. Or, could mean how much more I'm denying self-reliance, taking instead the understanding-that-is-higher-than-ours. And that's what I wish.

Big Surprise (7)

Part VII. HP3 OSCE, 7 minutes, 20%.
What should have been the last.

I totally did not expect it. The patient presented with cough. For the first 30 seconds while reading the case intro, before going into the consulting room, the word cough didn't ring a bell loud enough in my head. I expected sudden onset, central crushing chest pain (angina or full blown AMI), where I can then ask about the risk factors, etc. Heart attack is, in fact, the global #1 killer.

Thankfully, I have on the night before done a read-through of all the presenting symptoms in the ICM book, and sort of made links between their associated features. Cough goes with sputum (phlegm, kahak), haemoptysis, chest pain, breathlessness, wheeze, smoking, and fever. I reckon I did well with the cough, phlegm and coughing up blood. The ICM video on these were very interesting to me (thanks to Syarul), and all I did in the exam was copycat-ing the doctors and the way that they asked questions to find out more about the symptom.

What stressed me out was that I missed asking about chest pain and breathlessness! I realised this during the 3-hour lock-in after finishing my session, when I checked my workbook and found out that they are also associated features with cough. Surprisingly there's no feedback session with the doctor and patient this time around.

The reassuring thing for me is this thing posted online on LMS by our coordinator just 2 days ago:

On the whole I was impressed with the performance in this examination and the communication skills and interviewing skills were of a high standard.

Normally the OSCE (interview) is the last of our exams - which I see as the "pinnacle" where we utilise our medical knowledge to care for a person - but that's just me sometimes being over-dramatic. Our Prac Exam got the last slot this time.
OSCE=Objective Structured Clinical Examination, ICM=Introduction to Clinical Medicine
AMI=acute myocardial infarction, LMS=Learning Management System
Were you looking for something else?

So happy ~~ (6)

Part VI. HP3 Exam, 2 hours, 6-SAQ, 50%.
The most enjoyable.

Of all the papers I sat for this sem, I found this one to be the most encouraging. In fact, it's also the best Health Practice paper I've done in 1.5 years. You know, when you have such confidence while answering the exam questions?

I knew I wasn't alone and helpless. Because of the word in my ears.

A hard fight (5)

Part V. CRL Paper 2, 2 hours, 100-MCQ, 25%.
The Boss.
Perhaps because I expected a multiple-choice paper as do-able as last semester's, I found this one to be really difficult. I used all the combat skills I knew, like answering during the reading time, and speeding up at all times, yet still I feel that it's tough. Maybe I didn't have as much sample question drilling as last semester.

Yet there's one question where my last-minute answer switch was really worth it. It was a question on the A-a gradient (Alveolar-arterial PO₂).

P_aO₂=55 mm Hg
P_aCO₂=28 mm Hg
The formula for P_AO₂=150-(P_aCO₂/0.8) (simplified because it's an MCQ)

P_AO₂
=150-(28/(4/5))
=150-(28/4*5)
=150-35
=115

A-a gradient=P_AO₂-P_aO₂
=115-55
=60
I at first answered 30 because I used 55 instead of 28 for the P_aCO₂!

That's one of the good memories I had with the paper. Bad memories are numerous. I remember how I kept telling myself, must finish 50 questions in 1 hour! Quick! There were so many clinical/PBL-style questions! It comes with a short passage of the patient's case and follows with about 3 questions. Even the lecture based questions (pharmacology!) were ultra-specific!

Yet I believe that hard times are there to build us up. In the middle of the exam, at about 1 hour plus, I felt so frustrated I just wanted to explode and scream! And I screamed in my soul and spirit - I cried to heaven asking for wisdom from the Ancient of Days. It doesn't change the fact that the paper was a hard one, but it reassured me because I have the Unshakable Foundation.

And to this day I pray that a miracle happens for this paper. God gave me a dream to achieve the highest excellence this year---and that means that it's impossible. Only He can make it happen. I ask for favour over my exam, that He raise my grade, bump it up, miraculously. Though it's an MCQ paper marked by a machine, I pray that God will tell the machine to boost the marks. I want this miracle from God! In Jesus' name I pray! Because PRAYER IS POWERFUL.

Picture credit: thetorchonline.com

p/s: I was in uni south lawn the other day, talking with God. And I sensed that it's another one of those no-turning-back moments in my life. To start with, I think it's almost natural for people to take up stuff, to do something new, whether with a good motive or not. And we talked about my Top Secret Project, the excel spreadsheet in my laptop, and the ungodliness that it has brought into my life. He showed me how information or knowledge on its own is not necessarily good or bad; when applied righteously, it manifests as wisdom. When applied unrighteously, it's a gateway to sin, disobedience and rebellion. So I decided to delete this piece of information. I choose to not have access to it. Instead I choose full trust and obedience to The One and Only, because I look only unto Him - my vision fixed upon my Lord and Saviour.

Battle time! (4)

Part IV. CRL Paper 1, 3 hours, 12-SAQ, 35%.
"The Speed of Thought"

It was 10 days into SWOT VAC from the Saturday when it began. More than 50% of my time was spent in uni, rotating between Frank Tate and ERC. I like the background music in the reading room. My bedroom was only for sleeping.

One of the most useful equipment I recently bought is the earphones from Harvey Norman. Media Player + imeem = a new study method for me. Audio stimuli helps memory. But when I'm sleepy and tired, even Lectopia isn't that useful.

Other ways of studying:

• Test drive - doing the actual past papers. I surprised myself the 1st time by doing the 3-hour paper in 2 hours. And did it again a few times after that (2004-2007).
  
• Discussion - letting ideas bounce off from head to head. Good way to approach the PBL-style questions (30 marks each), and to get the minute details I don't remember that others might. Joined Brian and gang once upstairs in Frank Tate, and with Syarul and gang for a couple of sessions at uni and at home.
  

The test day was a Tuesday morning. If I had a philosophy for this paper, it was: Write at the Speed of Thought (sounds a bit like Bill Gates' book). No time to waste. Because I'll only get marks if I get the written ink down on the paper! Not good enough to think of the answer to a question, gotta write it out.

I felt happy with the questions on the pressure-volume loop, vitamin D3 activation and lung anatomy. The ones on the smoking patient, including the differential diagnosis, and the "neuro-related changes" of sarcopenia were a bit challenging. But overall I felt satisfied with the paper. It could have been harder (glad it wasn't).

Best part was, I was ahead of time, with 30 spare minutes at the end of the exam. This preparation felt better than semesters before this, though it probably could have been more productive. Regardless, I can't really talk about making preparation without giving credit to God, who directed my path throughout the study break, from the beginning until the actual paper itself. It was a real battle with decent practice sessions.

Very Quickly (3)

Part III. 3rd midsem, 3rd assignment.
All over the place.

Even just thinking about the last 4 weeks of semester is daunting till now. Have you ever heard someone say, "it was really stressful, but I felt very satisfied with it"?

First off, it's the Age of Anatomy for me, the one I've always thought of when I was younger. Example: Some Lovers Try Positions That They Can't Handle. It's a way to remember the 8 wrist bones, going from the 1st row to the 2nd, from the thumb to the pinky side: 1st-Scaphoid, Lunate, Triquetrum, Pisiform. 2nd-Trapezium, Trapezoid, Capitate, Hamate (proximal, then distal; from lateral to medial on supinated hand).

Coupled with that are the musculoskeletal diseases, osteoarthritis, rheumatoid arthritis, Paget's disease, osteosarcoma, Duchenne muscular dystrophy, etc. I had much more trouble getting interested in these than the lung diseases.

Of course there were other stuff to busify me. Two AMS interviews. Physical Exam OSCE, where I felt that the cardio exam went in 5 minutes or so (total given 9 min). Day 6, and the box-hunt, including Zi's random but generous helping hand. Monday neuro lectures (I slept in several of them, and made a PlanetUni call during 1 of them). Twilight Concert, where we did Let it Be and Chasing Cars.

HP3, meanwhile, was all about critical appraisal, which I was initially unable to appreciate at all! Thankfully there was the assignment which I speedily drafted, and then put aside, then revised, then discussed, and then finally revised again before submitting it around midnight before the due date (as I always did with assignments...=).

Finally done with 15% of CRL (5% per test) and 30% of HP3 (10% per assignment). Honestly I felt very happy with the marks I've got. You know, like when you get more than you deserve?

It went very quickly. After the final 15-minute test on Monday, week 14, I did my best to transform that last week of semester into an extra SWOT VAC week, conditioning myself to the routine of revising. Maybe that's why my SWOT VAC experience this time around felt different from before. What's different? It's very fruitful.

Picture credit: physioweb.org

Going Uphill (2)

Part II. 2nd midsem, 2nd assignment.

The energy. The fast. The sacrifice.
It was a fast-paced period in my life. I tried to keep up the momentum I've gained. We had PlanetUni Market Day, Run for the Kids, and Planetshakers 2009 Conference "One". Thankfully Daylight Savings Time gave us 1 extra hour to sleep.

I didn't want to slack. I fasted from midday food (lunch, tea & snacks) for fourteen days, seeking The Lord. If I have a life message from this semester, it would be: basic, stripped down, streamlined life. My biggest life-change is that I've left my old habit of a bad addiction. I've never thought it could be done, though for ages I've always wished that it could. You know what's even more awesome? It was prophesied to me last year during DNA encounter, and again during one of the church services just before conference.

A life truly focused on The Maker's blueprint, I discovered, requires another sacrifice: the girl. I liked her since knowing her when I was 12, and secretly kept this passion for her until recently. And the The Creator's voice was asking me: Who's #1 in your life? And I decided that I must give her up.

In uni, the test and assignment came soon enough. Test was on the heart; and I still think I was much better prepared for the first one than this. Assignment was on (medical) statistics; glad to make use of MathType again!

Picture credit: Thomas Langenberg

Recollection (1)

Part I. 1st midsem, 1st assignment.
Initial heat.

I intend this to be a series of reflective writings on MBBS Sem 3, one posted per day, as my result day approaches. Gee, I've been doing 1 post/day for the past 5 days...
If you could graph my enthusiasm level, it was still up high early in the semester. It was five weeks on, with a variety of random stuff like going to the Allans Music warehouse clearance sale, MoMu BBQ in Flagstaff Garden, buying chicken for home stock, etc.

My diary entries were also still very up-to-date, with each of the 5 tute cases of lung diseases recorded neatly. And I didn't miss any of the AMS info sessions.

I didn't know what to expect for the test, but I revised extensively regardless. Stayed up till almost 5am to cram for the Monday test. The fact that I was leveling up my Facebook Mafia didn't help.

The assignment was due that Friday. For the first time in 5 weeks, I finally revised my epidemiology/public health lecture notes!

Allowance money came in on that week as well, so that probably was some source of motivation too =)
Like the pink text?

Backfire!

A taste of my own medicine...

Just today I had a bit of a feel what it's like when you wanna study at your own pace--and then there's the girl who's sitting next to you--this probably isn't what you're thinking

OK, I have a confession to make. Oftentimes, I come to my lectures having pre-read the lecture notes; to my dissection pracs, having tried memorising the names of the bones, ligaments and muscles; and so on. So here's my confession, I'm uncovering this thing: I actually like the "wonder" aura that I get when people see how I'm not lost in those classes. It's not 100% of the time that I do this, mind you, but still I realise how much I've been dwelling on what other people think of me.

Back to what I was saying: The girl next to you, obviously much better prepared, starts telling you everything that she knows about the subject. You start feeling nervous. Anxious. Stressed. Intimidated.

Hah, what I just realised is that I'm the one who has been doing this to all my friends all along! Those poor enough to be sucked into my presence just when my megalomaniac ego is bursting forth! And sad enough to be bashed when I sometimes deliberately and knowingly criticise, "What have you been doing in class all along?"

I repent from this. I had a taste of my own medicine. Backfire!

Truth is, we gotta esteem our friends better than ourselves. Better be building up than breaking down.

A Moment Captured

What's happening when Creski says he's studying...

It's the first time I've taken a screenshot of the PC in ERC ground floor. These "study sessions" have been my routine for the past 2 weeks plus, ever since SWOT VAC started on 1st June.

If you look carefully, you can see:

1. Media Player - Now Playing: 2009-03-12@0905 (CRL 4.6 Superior and Posterior Mediastinum by Dr Jenny Hayes). Speed: 1.6X.
2. imeem - Playing: IvyFocus G2 (by iMusic). Website says it can improve brainwaves for focus, absorption, stamina and mental acuity. Don't know how true that is.
3. Firefox - Welcome to your Student Portal. To get Lectopia, lecture notes, email, notices, etc. Of course there's the distracting bit like Gmail and Facebook opened in multiple tabs.

So I'd have my printed lecture notes in front of me, my earphones plugged into my ears, and I'd spend 1-2 hours doing this. Two reasons: I won't study as efficiently in my own room, and even if I do, I'll use up the Internet download quota to get my lectures and the iMusic mp3's. Gotta make good use of our resources =)

It's a new way of studying for me, so it's pretty cool (although it's becoming a little bit mechanical/repetitive/robotic now that I've been doing it day in, day out for almost 20 days).

And I cherish the way that music/sound is augmenting my study. Here it is, a moment captured.

Can't wait for exam to be over.

Time for physical exercise.

Success

What leads to it?




Short and sweet. And meaningful.

Thanks to:
Chang Yang's blog post (where I found it)
www.TED.com

Word in my ears

I'm so happy I can't contain it!

The 100-MCQ exam I had last Tuesday was seriously difficult--on most questions I could tell that A and D are wrong, but between B, C, and E, which one was the correct answer? From question to question, it was just really, really hard.

Then it was hermit mode for me again, until this afternoon's paper.

Ever met a little kid so happy after an exam? Well, I'm like that now.

The 2-hour written exam had various kinds of stuff in it: Epidemiology, Statistics and Critical Appraisal. I learned from previous exams that I can't waste time at all. 1 mark means 1 minute. Quicker=better.

And all along, I was writing almost at the speed of thought. My mind flowed like a river. Like my ears were hearing a word behind me saying: "This is the way." Must have been the Helper's voice.

YEAH! None of the questions could stop me! None! Why, because I'm smart? No, it's because I'm prepared. And I wanna honour the One and Only who's with me throughout the whole ordeal of preparing.

Discipline is a hard thing--my housemates have their Travian empires calling out to them every half hour, every day. Then it's trying to call out to me as well. That would be bad preparation. Oh, how we need wisdom and might! I found them from the Owner, for they belong to him. The word in my ears keeps saying, this is the way, walk in it. If it's anything more than just reward for good works, I've found that it's unmerited favour.

And that's my reliance.

Come OSCE.
Come Prac Exam.
You can't stop me.

Picture from HP3.07: Stats 1 - "Being Right on Average"
(Thanks to Dr Katrina Scurrah)

Why do People Die?

...Perhaps what I meant is "What do people die from?"



Based on 2004 records, more than 85% of the people who died in that year are from middle- and low-income countries.

And what kills most people?

• Coronary heart disease
• Stroke & other cerebrovascular diseases
• Lower respiratory infections
• COPD (chronic obstructive pulmonary disease)

Mostly heart and lung diseases - the stuff that we've been learning in 3rd sem. Cleverly integrated with public health concepts like National Health Priority Areas, QALY, DALY etc.

On another note, why do people die? I really agree with Alex Seeley when she said that we're never really meant to die (Think: Why are we so sad when someone close passes away?). It goes back to the beginning of history. The fall of humanity. Disobedience. Rebellion.

But of course you don't have to remain fallen. You know why?

Credits: WHO (World Health Organisation)

Ex*m

3rd semester ending.

Didn't realise how quickly one semester passes. Back in KMB before starting uni, one of the things I've always pondered was, how on earth would I be able to perform at my best continually semester after semester? I had 4 semesters back then, and by the end of 2nd, I was already slacking a lot. EE, ToK, WorldLit, IA...LoL. I seriously was overwhelmed. In class, I already lost some enthusiasm, and I bet my classmates noticed it.

So here are some of the ways which I've found to be effective in raising my motivation:

1. Have a dream
What we see now always begins with what we didn't see in the past. In other words, have a vision. A goal. A target. An objective. And you know what doesn't work? I wanna be #1. Because there's only one first place, and it's really out of your control! What works better would be: I want at least all credits. Or I wanna get H2B and above for all subjects. Or I wanna score at least 90% for these 3 subjects this sem, and 85% for the other. Then commit to your goal and do your best.

2. You're always getting better
At the very least, you're better today compared to last year. Otherwise what are you working on? What's truly within our control are our thoughts, actions and behaviour. Ourselves. You're leading at least one person: you. So start looking at how far ahead you've progressed. This means so much to me because I've always compared myself to others. I'm designed with specific capabilities (specifications), for a specific purpose, so I should be the best that I can be. Not the best that Einstein can be, because I'm not Einstein.

3. Group study can and does work
One rule: The expectation is that everyone would individually be better. Requirements: discipline, unity, and humility. Discipline means making the effort to prepare for the session, more so for the person facilitating/leading it. Unity means not leaving anyone behind (think: why call it group study?). But perhaps humility is the most important factor. Otherwise it's just an ego-show where people demoralise each other. And that's violating the one rule.

4. Who's your reliance?
A great king said: Lean not on your own understanding. We seriously need to understand how life means nothing unless we know what the Designer made it for. I remember a boy who in Grade 6 always humbly said, "Unto you I rely." I'm not sure about you, but I still am inspired by that voice, and yearn to depend more on that understanding that is far higher than my own.

5. Keep your eyes on The Big Guy
If I can do it on my own, then I need to realise that I'm born for the impossible. And that 'impossible' is not the same for every person. My impossible is not yours. So if I'm trying to fulfil your impossible, I'm not doing the right thing! So how do I find out? Simple. I ask and seek the Author of Life, and fix my eyes there.


Picture credit: gatesofacademe.wordpress.com

Happy SWOT VAC.

All the best for you with exams!

...Broken

Bits from "Romance touches"

On one hand is the desire to “own”, to “be loved”, “be cared”, or whatever passionate words are used to describe that feeling of being in a relationship. That’s pampering myself. It’s self-centredness. What about her life? For goodness’ sake, she has tonnes of male fish in her sea of bachelors. Tonnes. And what about her future? What about setting her free? Her liberty? Letting her have all the opportunity to best develop herself as fully as possible, fulfilling her potential? And what about my future?

Lot’s of deep questions there. Abstract and futuristic questions of personal and interpersonal development. Not just mine, but also hers.

I find it interesting how I've always held on to some ideals when it comes to romance. Illidan always wanted Tyrande, and he lived for ages with that desire. The fact that his own twin brother Malfurion was the one for her must have driven him crazy. As for me, the ideal I held was loyalty to one.

It stems from a pure motive. But when it is held on to in a strict, rigid way, almost ritualistic, then I must ask myself: Why? Why hold on? Will there still be a reward to this loyalty? In fact, who to hold on to? If the Giver of Life came to do exactly what his name says, then why should I hold on to another?

I know someone who had always been single all his life. He had a few casual, temporary crushes here and there, but nothing serious. I asked him:

"So you take pride in your singlehood?"
"Yeah, I won't fall for any girl."

"*Sigh* Well, that's the pride of life." (and Illidan's pathetic story again)

But you know what I recently learned about him? Well, last year he liked a girl, more so than any previous ones. It probably went on for about 3 months. He told her nothing, but told his Counselor everything. He said, now it's different. I'm not holding too tightly anymore. A release, you know? Like no control. For the first time, I'm broken. Broken to my Maker.

I went, wow. I feel what you feel. Why not be broken to the girl first? You know why not? Because humans fail. Illidan found that Tyrande fails. But I've found that The One I'm broken to doesn't.

And there's no other way I'd have it.
OK, Illidan was an imaginary demon hunter, a Night Elf (not a human), but you get what I mean.
Picture credit: DeviantArt