Tuesday, August 5
Mathematics in french
We learnt simple mathematics in french today and it had been very very difficult. The process of thought just takes so long. In english, malay or mandarin, I can do 34-12 = 22 in 2 seconds. In french, it took me about 2 minutes to work out and say out the whole thing. I have to change the number from french to english, then calculate in english then translate the answer into french again. Seriously math has never been this hard for me ever...
Monday, August 4
Testosterone shift
I don't like working in psychiatry wards. The job itself may seem relaxing but I just feel mentally drained each time I finish a mental health shift. I was working in a male psychiatric intensive care unit (PICU) today. I was really scared when I first went in (but I was experienced enough to put on a confident face) because all the guys looked so strong and muscular, and they talked about how they want to kill each other all the time.
I had a good chat with T, who was charged with a criminal offence and held in for psychiatric review. He is just one year older than me and I hated him calling me 'miss'. Then D, a really muscular big guy, came along to chat with me. But then, I felt really uncomfortable when he wanted to share a chair with me and asked me to be his girlfriend. When D started putting his arm around my shoulders, I genuinely felt I wanted to get off, and the other two staff told him to keep his hands off me as well. He did, but he just wouldn't stop asking me to go out and give him my mobile number. At that time I was doing a 1:1 observation with T, but T walked away and went to talk to another staff. So I followed. Apparently he was upset about D's indecency towards me. He told me to keep on smiling and not let D get me down, but in fact it he who let D bring him down. He was at the verge of puncing D. I was so happy that he was able to control himself. However later on, they both nearly broke out into a big fight again because of this.
I felt slightly guilty. I suppose it's partly my fault. It wasn't because I was flitatious in any way (I do not wear make up, I wear conservative clothes and my hair is always tied on a pony tail. I take 5 minutes to dress). I am just never good at asserting myself. I am too nice to people. I said 'no' to D, but when he said 'come on.. why.. (blablabla)' I didn't reaffirm myself with another firm 'no'. But I was scared, the other staff said he has a problem with authority (and I can tell from interacting with him), what if he starts to be aggressive to me when I contradict him? I seriously didn't know what to do. I just tried not to react too much when he tried to get my attention. Anyway I finished my shift unharmed. What a relief...
Despite what I've said earlier, this has been one of my best shift. The reason being that I was able to have a proper conversation with T, not the usual patronising, 'pretending to listen but not really taking in' that I do with many patients. Maybe it's because we are of a similar age group, so we can relate to each other more. Today I've had a fantastic lesson listening to an experienced nurse talking therapeutically to T, and I really respected him for being able to speak so wisely. But I think I'm just too young to speak like that, for if anything like that comes out of my mouth it would sound more patronising than actual wisdom.
Finally I just want to mention that my favourite psychiatric illness is bipolar disorder. Extremely fascinating!
I had a good chat with T, who was charged with a criminal offence and held in for psychiatric review. He is just one year older than me and I hated him calling me 'miss'. Then D, a really muscular big guy, came along to chat with me. But then, I felt really uncomfortable when he wanted to share a chair with me and asked me to be his girlfriend. When D started putting his arm around my shoulders, I genuinely felt I wanted to get off, and the other two staff told him to keep his hands off me as well. He did, but he just wouldn't stop asking me to go out and give him my mobile number. At that time I was doing a 1:1 observation with T, but T walked away and went to talk to another staff. So I followed. Apparently he was upset about D's indecency towards me. He told me to keep on smiling and not let D get me down, but in fact it he who let D bring him down. He was at the verge of puncing D. I was so happy that he was able to control himself. However later on, they both nearly broke out into a big fight again because of this.
I felt slightly guilty. I suppose it's partly my fault. It wasn't because I was flitatious in any way (I do not wear make up, I wear conservative clothes and my hair is always tied on a pony tail. I take 5 minutes to dress). I am just never good at asserting myself. I am too nice to people. I said 'no' to D, but when he said 'come on.. why.. (blablabla)' I didn't reaffirm myself with another firm 'no'. But I was scared, the other staff said he has a problem with authority (and I can tell from interacting with him), what if he starts to be aggressive to me when I contradict him? I seriously didn't know what to do. I just tried not to react too much when he tried to get my attention. Anyway I finished my shift unharmed. What a relief...
Despite what I've said earlier, this has been one of my best shift. The reason being that I was able to have a proper conversation with T, not the usual patronising, 'pretending to listen but not really taking in' that I do with many patients. Maybe it's because we are of a similar age group, so we can relate to each other more. Today I've had a fantastic lesson listening to an experienced nurse talking therapeutically to T, and I really respected him for being able to speak so wisely. But I think I'm just too young to speak like that, for if anything like that comes out of my mouth it would sound more patronising than actual wisdom.
Finally I just want to mention that my favourite psychiatric illness is bipolar disorder. Extremely fascinating!
Stripping yourself naked, emotionally
S is a driver of the nursing agency I work for. He brings us to and from hospital which is miles away. I am not much of a chatter in a minibus especially as I feel sick really quickly. So I've not really know him much eventhough we've met on quite a few occasions now, but I know he's a really nice fella. Today he picked me up first and we spent about 20 minutes waiting outside another place for the other carers. I thought it would be awkward to just keep quiet, so I started chatting. We talked about the journey, the agency and our jobs. Then he said something unexpected. He told me about his low mood, about problems in life and how this job is just to force him to get out of the depressive mood. I didn't know how to react. If I were with my patient, I would sit down and have a proper chat to find out more. Yet just now I wasn't sure if I should dwell in at all. It just didn't feelt very natural - would you tell someone about things like relationship problems to a stranger? I wouldn't. I just listened. Our conversation abruptly ended as people started getting onto the minibus. It has given me a lot to think about. He has certainly hidden his low mood very well as I'd never have guessed that he's just barely coping. It challenged my judgement on people's mental state based on their behaviours.
But why did he tell me those things? In my last GP placement, I had the privillage of sitting in with a clinical psychologist in one of her therapy sessions. I can tell that these sessions were very painful for the patients because they relive their terrible ordeal. I personally am quite an expressive person, but I (and everyone else I suppose) have bad memories that I shall never ever want to think about. Making me think and talk about them would be akin to stripping myself naked. It would make me feel extremely insecure and allow others to invade me. So what made a S tell me about things so intimate to a stranger like myself? Was it normal? Was it an outburst? Was it because I was in my nurse uniform and I told him that I'm a medical student? Was it not really stripping himself naked emotionally after all, or was he simple not an emotional virgin anymore?
But why did he tell me those things? In my last GP placement, I had the privillage of sitting in with a clinical psychologist in one of her therapy sessions. I can tell that these sessions were very painful for the patients because they relive their terrible ordeal. I personally am quite an expressive person, but I (and everyone else I suppose) have bad memories that I shall never ever want to think about. Making me think and talk about them would be akin to stripping myself naked. It would make me feel extremely insecure and allow others to invade me. So what made a S tell me about things so intimate to a stranger like myself? Was it normal? Was it an outburst? Was it because I was in my nurse uniform and I told him that I'm a medical student? Was it not really stripping himself naked emotionally after all, or was he simple not an emotional virgin anymore?
Tuesday, July 22
Asking money from God?
I don't believe in god. But if I do, I would ask god for things I have no control over. I would ask god to keep my family and friends to be safe and sound, strong and healthy, happy and enjoying life. Sometimes I would ask god to take the rain away and give me a sunny day, or let me do well in an exam. I won't ask god for money. But would anyone do that?
My relatives do. Some of us chinese pray to many deities, gods and goddesses. Different gods are in charge to different things. For example in my old house, we had four gods: The three main buddhas, a 'de zhu gong' (the god in charge of the land), a kitchen god and another one outside the house (I think its the god in charge of guarding the house). These are the standard altars of a chinese family home in Malaysia. But other people have more.
Many of my relatives are very obsessed with money, and very superstitious. Bad combination. They spend lots of time, effort and money praying to gods in charge of finance, so they can be rewarded with more financial luck. I remember once when I was in primary school, I followed one of my aunt to a temple to ask for a lottery number. The ritual was weird, involving throwing coins, rubbing the idol's face with taufu, writing stuff with chinese brush then burning it and bringing the ash home to mix with tea and drink it. I didn't remember how did the miracle numbers pop out and had my aunt won. But I remember my aunt putting quite a big sum of money into an angpau (red packet) for the old lady performing the ritual. Very good profession to go into for anyone who wants to earn lots of money by performing peculiar entertainment since my aunt couldn't be the only greedy person in the world.
My family, being quite middle class (we get what we want often but we are not spoilt) is naturally quite disgusted with my relatives' behaviour. I sometimes wonder what makes them so obsessed with money. Perhaps it's their poor upbringing. My grandmother had 12 children and she was a single mum who brought up all of them by tailoring. My mum told me they can only afford to eat chicken once or twice a month. Only one out of the 12 siblings made it to university. Many of the elder ones had to drop out of school early to help generate income for the family. Since they are unskilled by the time my aunts and uncles were married, their jobs bring them just about suffient income to pay for food, shelter and other basic stuff. It's really hard for them to fork out extra money for say, university fees. But I have seen poor people who are content with their simple life. Why can't my relatives be a little happier about who they are now? Are they just trying too hard to get out of the vicious circle of poverty, to the point that they lose sight of everything else in the world, that they have to ask for money from god? My aunt said people like me, who had sailed through life smoothly, would never understand their predicament. Perhaps I never would.
My relatives do. Some of us chinese pray to many deities, gods and goddesses. Different gods are in charge to different things. For example in my old house, we had four gods: The three main buddhas, a 'de zhu gong' (the god in charge of the land), a kitchen god and another one outside the house (I think its the god in charge of guarding the house). These are the standard altars of a chinese family home in Malaysia. But other people have more.
Many of my relatives are very obsessed with money, and very superstitious. Bad combination. They spend lots of time, effort and money praying to gods in charge of finance, so they can be rewarded with more financial luck. I remember once when I was in primary school, I followed one of my aunt to a temple to ask for a lottery number. The ritual was weird, involving throwing coins, rubbing the idol's face with taufu, writing stuff with chinese brush then burning it and bringing the ash home to mix with tea and drink it. I didn't remember how did the miracle numbers pop out and had my aunt won. But I remember my aunt putting quite a big sum of money into an angpau (red packet) for the old lady performing the ritual. Very good profession to go into for anyone who wants to earn lots of money by performing peculiar entertainment since my aunt couldn't be the only greedy person in the world.
My family, being quite middle class (we get what we want often but we are not spoilt) is naturally quite disgusted with my relatives' behaviour. I sometimes wonder what makes them so obsessed with money. Perhaps it's their poor upbringing. My grandmother had 12 children and she was a single mum who brought up all of them by tailoring. My mum told me they can only afford to eat chicken once or twice a month. Only one out of the 12 siblings made it to university. Many of the elder ones had to drop out of school early to help generate income for the family. Since they are unskilled by the time my aunts and uncles were married, their jobs bring them just about suffient income to pay for food, shelter and other basic stuff. It's really hard for them to fork out extra money for say, university fees. But I have seen poor people who are content with their simple life. Why can't my relatives be a little happier about who they are now? Are they just trying too hard to get out of the vicious circle of poverty, to the point that they lose sight of everything else in the world, that they have to ask for money from god? My aunt said people like me, who had sailed through life smoothly, would never understand their predicament. Perhaps I never would.
Thursday, July 17
Learning french
Bonjour!
I'm determined to learn french well. I met lots of patients from African countries who spoke french in my GP placement and I hated not being able to understand their conversations with the GP (who spoke very good french). Many other reasons to learn french: it's (one of the) language of love, it's one of the official languages within the UN and it is my secret ambition to work one of the African countries one day. I'd also like to visit France once my conversational French is up to the minimum standard.
We've just started with the alphabets, numbers, self introduction and some of the other basics. It was a real pleassure to learn a new language. Repeat after the teacher. Watch the spelling. I have almost forgotten how long did I took for me to feel comfortable using English. In lesson, I met my old self: feeling insecure, shy, reluctant to speak, and fear making mistakes, and envious of the other students who were better than me. But as I say I want to learn it well and I am revising it every day.
I really like pronoucing 'r' from the throat. But it's very hard, dismantling and rebuiliding the part of the brain which makes the connection between the visual 'r' and the motor action of the tougue to make the 'arrr' sound. Had to consciously stop myself and say 'r' from my throat each time I see the letter in a word.
And I didn't know there's even a french way of saying Malaysia! (Malasie)
Au revoir.
I'm determined to learn french well. I met lots of patients from African countries who spoke french in my GP placement and I hated not being able to understand their conversations with the GP (who spoke very good french). Many other reasons to learn french: it's (one of the) language of love, it's one of the official languages within the UN and it is my secret ambition to work one of the African countries one day. I'd also like to visit France once my conversational French is up to the minimum standard.
We've just started with the alphabets, numbers, self introduction and some of the other basics. It was a real pleassure to learn a new language. Repeat after the teacher. Watch the spelling. I have almost forgotten how long did I took for me to feel comfortable using English. In lesson, I met my old self: feeling insecure, shy, reluctant to speak, and fear making mistakes, and envious of the other students who were better than me. But as I say I want to learn it well and I am revising it every day.
I really like pronoucing 'r' from the throat. But it's very hard, dismantling and rebuiliding the part of the brain which makes the connection between the visual 'r' and the motor action of the tougue to make the 'arrr' sound. Had to consciously stop myself and say 'r' from my throat each time I see the letter in a word.
And I didn't know there's even a french way of saying Malaysia! (Malasie)
Au revoir.
Wednesday, July 16
Greenwich-Amsterdam-Bruges-Canterbury
I am back from the first round of my summer travel.
Thursday:
Went to London by megabus (surprisingly comfortable for £10). Then went to Greenwich and visited the the Royal Observatory and the Prime meridian, the Old Royal Navy College, the Queens house and the National Maritime Museum. The view was breathtaking! Spent the night at the Malaysian hall.
Friday:
Joined the tour group and travelled across the English channel, France and Belgium to reach Amsterdam. Went for a canal cruise ride, followed by a tour of the red light district, which was a little disturbing.
Saturday:
Excursion to a cheese and clog factories and took pictures at the countryside in Holland. After that we visited the Anne Franks house, a diamond factory and the sex museum. Also saw lots of other attractions from outside.
Sunday:
Spent some time in Bruges. Beautiful churches. Went to the chocolate factory. Stopped by at a alcohol warehouse in Calais and bantered a bit with some drunken men. Stayed in Kipps hostel which was fantastic.
Monday:
Saw Canterbury. Learnt about Canterbury tale, went into a castle in the UK for the first time and visited the Canterbury cathedral and the Eastbridge hospital for the poor pilgrims.
Tuesday, June 24
My GP placement
Some of you might be wondering why the long silence. The answer is simply laziness, specifically the post-exam laze, although at the moment it seems ages ago since I've had my last OSCE. Time really flies....
I'm now on the third week of my SSC attached to a GP practice. Unlike ordinary practices, we specialise in providing primary care for asylum seekers only. In February this year when I volunteered in an event organised by the Manchester Refugees Support Network, I met this GP (who is now my supervisor) who works here and I asked if I could do a placement with her, which she happily agreed. I was naturally looking forward to this placement as (many of you might have know) I am passionate about issues surrounding refugees.
It couldn't have been a better placement. We see lots and lots of patients with post traumatic stress disorder. Although it was quite boring for me to see the GPs prescribe antidepressants after antidepressants, I enjoyed listening to their stories. It was extremely rewarding to see a patient who started off obviously unable to trust anyone and almost mute, to start to give bits of eye contact on the next visit, to start talking, to joke and finally to trust us enough to tell us their horrible ordeal. I have seen the most terrible scars from torture while examining these patients, yet it is often the unseen scar deep in the heart which is even more worrying. The sufferings that the asylum seekers face make the biggest problem in my life so minute, so insignificant. Similarly, because the close knit staff here know what's more important in life, they never complain about petty things. They are the nicest people ever, like the buddha, they are always calm and smiling and I get along with all of them very well.
I don't mind the heavy emotion involved, instead I usually get quite excited about it. But I can't help but notice that many of the patients see the doctor not for medical reasons. Many of them come in for a letter from the doctor for various reasons, eg to support an legal appeal, for a bus pass, to complain against the housing provider, even to report a hate crime etc. I mean some of these things are not even a doctor's job, but I have never seen the staff here refusing to help a patient. These asylum seekers are really desperate people. Besides having to deal with the stress from previous trauma and leaving home, they have to deal the the painful process of applying for asylum in the UK, at the same time not able to speak English and not allowed work. If we don't help them they just have no where to turn to. Thus the staff in this GP practice spend lots of time making phone calls and writing letters to sort out logistic/practical day to day things for the patients. I have helped a patient write a complain letter and another patient write a claim letter for compensation of lost item in the post. They were just tiny favours but the patients were extremely grateful, which gave me much satisfaction in helping them. Medically, I learn a few useful stuff not seen in ordinary GP practices in the UK. For example in unexplained anaemia I have to think about tropical diseases like tape worm, which is a deviation from the standard differential diagnosis; or in generalised myalgia before I write off one as a heart sink patient I would remember to exclude vitamin D deficiency.
At the end of the placement I need to submit an essay related to a chosen topic. I thought about the people I have seen and helped, and I thought about why I became so passionate about refugee issues since the college days. It was because I have a great family, and a warm home, a place I can seek shelter in and feel secure no matter what happens. And I think everyone should have a good home No one should be left homeless. And if you must know, the house that asylum seekers in the UK are provided with are often of the lowest standard. So I have decided to write an essay on the housing problems faced by asylum seekers and how their health are affected.
I'm now on the third week of my SSC attached to a GP practice. Unlike ordinary practices, we specialise in providing primary care for asylum seekers only. In February this year when I volunteered in an event organised by the Manchester Refugees Support Network, I met this GP (who is now my supervisor) who works here and I asked if I could do a placement with her, which she happily agreed. I was naturally looking forward to this placement as (many of you might have know) I am passionate about issues surrounding refugees.
It couldn't have been a better placement. We see lots and lots of patients with post traumatic stress disorder. Although it was quite boring for me to see the GPs prescribe antidepressants after antidepressants, I enjoyed listening to their stories. It was extremely rewarding to see a patient who started off obviously unable to trust anyone and almost mute, to start to give bits of eye contact on the next visit, to start talking, to joke and finally to trust us enough to tell us their horrible ordeal. I have seen the most terrible scars from torture while examining these patients, yet it is often the unseen scar deep in the heart which is even more worrying. The sufferings that the asylum seekers face make the biggest problem in my life so minute, so insignificant. Similarly, because the close knit staff here know what's more important in life, they never complain about petty things. They are the nicest people ever, like the buddha, they are always calm and smiling and I get along with all of them very well.
I don't mind the heavy emotion involved, instead I usually get quite excited about it. But I can't help but notice that many of the patients see the doctor not for medical reasons. Many of them come in for a letter from the doctor for various reasons, eg to support an legal appeal, for a bus pass, to complain against the housing provider, even to report a hate crime etc. I mean some of these things are not even a doctor's job, but I have never seen the staff here refusing to help a patient. These asylum seekers are really desperate people. Besides having to deal with the stress from previous trauma and leaving home, they have to deal the the painful process of applying for asylum in the UK, at the same time not able to speak English and not allowed work. If we don't help them they just have no where to turn to. Thus the staff in this GP practice spend lots of time making phone calls and writing letters to sort out logistic/practical day to day things for the patients. I have helped a patient write a complain letter and another patient write a claim letter for compensation of lost item in the post. They were just tiny favours but the patients were extremely grateful, which gave me much satisfaction in helping them. Medically, I learn a few useful stuff not seen in ordinary GP practices in the UK. For example in unexplained anaemia I have to think about tropical diseases like tape worm, which is a deviation from the standard differential diagnosis; or in generalised myalgia before I write off one as a heart sink patient I would remember to exclude vitamin D deficiency.
At the end of the placement I need to submit an essay related to a chosen topic. I thought about the people I have seen and helped, and I thought about why I became so passionate about refugee issues since the college days. It was because I have a great family, and a warm home, a place I can seek shelter in and feel secure no matter what happens. And I think everyone should have a good home No one should be left homeless. And if you must know, the house that asylum seekers in the UK are provided with are often of the lowest standard. So I have decided to write an essay on the housing problems faced by asylum seekers and how their health are affected.
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