I dread

I'm not bad at blood taking and cannulation, so I do get called a lot to help out especially with difficult ones. But who knows my hidden hatred for such patients? The sorts of patients that i hate are: 

1. Nephro - cannot use one hand because needed for AVF formation; needs blood taking daily to monitor renal function and VBG, stays in hospital for ages because they just don't get better. Worst ones are when AVF failed on one hand already, another hand not allowed to use, leg veins already ruined by other house officers - how and what do you want me to do?

2. Obesity - Obese patients should be barred from coming into hospital. Do you have any idea how difficult it is to see or do anything through those thick subcutaneous tissue? Same applies to oedematous patients.

3. Relative - who refuses to go out, who peeps through the curtain when I specifically asked you to go out and wait faraway. Yes, torture session of your grandmother in progress and I don't think you would derive any pleasure from seeing me poke her for 10 times and I asked you to go away for good reason.  

4. Patient - who tries to be helpful by moving around, thinking that they are smarter than me, who demands for left leg instead of right when I have another 5 new patients to clerk in, who kicks and jumps, who has ridiculously low pain threshold, who moans and groans non-stop when I am doing you a service and trying to save your life (be informed that any plea, prayer or piss would not stop me from doing what I do, which is usually to persist until I get it, even if I have to poke you 20 times). 

I value my relationship with my colleagues. I try my best to be a good team player. I am usually willing to help out with anything whenever I can, but doesn't mean that I don't dread it. But sometimes I wish I'm not, so someone else can be called to help, because I am spending ages to deal with these difficult bloods. A difficult cannulation will take at least 20 minutes and I'd much rather be doing something else. As well as a pair of good hands, I think I have good brains as well and I'd like to use it more often rather than just spending so much time picking up other people's mess.

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Throwing in the towel

Yesterday was one of the worst days since I have started working.

 

On call the night before was not particularly heavy. But one of the new patients had a seizure requiring urgent CT brain, and another was vomiting and bleeding fresh blood (with other issues like extremely difficult vein and relatives who refused to let me poke her to save her lives. Acutely ill patients like this takes up a lot of my time and energy, leaving less for the rest of the jobs. As well as that, I had to deal with two of my usual patients in my ward – one wanted to discharge himself and another wanted me to write letter of a summary of his condition for financial help (which was not urgent in my book, can wait). Also at the beginning of the oncall, no one could contact the other HO – so I ended up doing several jobs for him as well. I did finally get a chance to have my dinner at 3:30am. My last 3 admissions arrived after 5am. Usually if I am still having lots of unsettled jobs by 6am I start to panic because it is my experience that if I don’t start my usual ward job by 6:30am, everything will be delayed in the day. After clerking the last patient at 7am, high dependency (HDW) started calling to ask me to take blood. I only finished the new patient clerking by 7am. Imagine the shock when they tell me that I have to take blood from all of the patients there. HDW patients’ bloods are not easy to take as they are usually very sick. I was still doing bloods there at 8am. Really really stressed up then thinking that I still have to shower, morning bloods at wad warga and 2 hours late for my ward work, and I just couldn’t hold back my tears and snouts while actually poking a needle in the patient. Luckily Debbie and the medical students were super efficient that morning to have finished all the bloods by the time I arrived. Such is the usual arrangement that the oncall person has to do the morning bloods for HDW and wad warga (as well as CCU, CRW sometimes) as they don’t have house officer there and I feel really being taken advantage of. Do they not realize on normal days we have to start our regular morning blood taking as early as 6:30am to avoid running behind?   

 

Prof was in a bad mood yesterday. Everyone got some bullets from her, from the medical student right up to the registrar. Even I was unusually alert (normally I am half asleep in rounds post-call). So many new patients. My registrar was amazing and helped me out and didn’t take forever to review the patients. One of the patients was from Debbie’s side – so many things not done – so I had to pick up the pieces and answer when prof and the other specialist demanded to know why things were not done. Usually my MO follows round on my side but she left half way today – so I had to be totally in charged of all the jobs for the patients on my side.   

 

Half way during the round, a nurse from the other ward called me. In a very fierce tone, she demanded to know why had I not prescribed the medication for a patient admitted last night. Really? When she told me the name, it didn’t even ring a bell. I left the ward round and went down to that ward anyway. The specialist in that ward started questioning why have I not clerked the patient, and the nurse started asking if I’ve not clerked the patient who was it who wrote in the notes? Looked at the notes – no one clerked the patient; in fact the nurse did not inform me that patient had been admitted. They called the nurse on duty the night before – indeed she admitted to have forgotten to call the on-call doctor to clerk the patient in. OK. Scolded for nothing of my fault, but nevermind. I hate nurses in this ward.   

During round also, the patient from the night before who wanted the letter for social welfare became really angry and shouting around saying that I have not given him what he wanted. The registrar kindly sorted out the problem for me, and the patient apologized (all very civilized after), but still didn’t stop me from feeling very incompetent and that all was my fault. 

 

Then in the evening I was doing a discharge at the other ward, Debbie called me and spoke to me and Mandarin, asking if I have made a referral to gastro, which I did, and said the MO told me to come back here immediately because he was very angry. I rolled my eyes. OK OK I made a late referral. Nevermind there was a 2 hour Friday prayer break, nevermind that I was given passed around 3 people before being passed to the right gastro person for referral, nevermind that I had 1000 other more urgent jobs to do including helping Debbie with an extremely difficult blooding taking, nevermind that whenever I tried to do referrals nurses or some other people would snatch the patient file away from me, nevermind that the phone is constantly being used. It’s my wrong. Always. Stressed out, I cried again. I told the nurses my eyes were red only because I was tired.     

 

Looking after 12 patients (from yesterday 16) may sound easy. Sometimes, but usually not. There are always so ill that they shouldn’t have been in the general ward. A patient on BIPAP (breathing support) needs bloods every few hours. There was once when three doctors were spending 3 hours inserting an IV on one patient. Do you know how much work could have been done by 3 doctors in 3 hours for the rest of the 27 patients? As houseman we are the ones responsible for the unpleasant job for poking people, and I just get so much complaints and abuse every time I approach some of these patients. It is not me who want to poke, I am nothing but a slave. And because I am around all the time, relative comes to me to discuss about the patient just when I am rushing to finish through all my discharges. And nurses would call you to ask about insulin doses, prescribe drugs, do IV lines, see acutely ill patient etc etc. I know it is important to know the progress of the patient for the relative and attend to ill patients, but it is even more important that I get through my 7 discharges this evening without interruption.  

 

So yesterday was a really bad day. I went home at 11pm (40 continuous working hour in hospital) and still there were 4 referrals not done, one phone enquiry not done, many forms not filled in, 2 blood cultures not taken etc etc. Patients are staying in hospital unnecessarily long because the houseman is too incompetent to sort out all the jobs in time – and I do deserve to be told off sometimes. Making referrals and requesting for radiological scans especially, we needed to be very clear of the patient history and progress, and know exactly why we are referring a patient and have the necessary investigation – trouble is I don’t always know. The workload is so heavy that I needed to work at bullet pace. There is no time to think or discuss why things are happening or needed to be done, no time to read or check things up. That’s why I’m still so blur with regards to the management of common medical conditions. I have been working for 6 weeks now and I am still so unorganized – I really doubt that I would ever be up for the job.

 

It is nice when my senior says things like ‘Of course she’s good, she’s my houseman’. Yesterday a sister said ‘O… you are Dr Tan. One of the senior doctors said you are very good’, and I told her ‘OK. But I don’t really care.’ Now I have started not to believe people when they tell me I am doing a good job or anything like that. I don’t want to be complacent even for a bit. Can’t afford to because I know I am not.

 

Now my parents are also angry at me because I am leaving home earlier and earlier and going back home later and later everyday. And they get upset if I tell them that I haven’t been to the toilet all day or haven’t eaten anything all day (especially when oncall, can go by without lunch, dinner, breakfast and lunch on the next day). So, I avoid telling them anything of this sort now. It is physically and emotionally draining to be parents of houseman.

 

Stages of bereavement: Denial – Anger –Bargaining – Depression – Acceptance  

I am still at the denial stage.

 

Finally learnt how to apply for leave yesterday. Might get a day off or two soon.

 

 

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A House Officer in a Teaching Hospital: Week 2

Monday

Don't remember what happened on Monday. Probably nothing significant. A group of 10 final year medical students came to join us in the ward. Their job is to make me happy. I am their boss. I am so grateful they are here. Dr Andrea gave me a pen and a notebook (to write down my jobs) - that's very nice of her and I am grateful for the presents (hope I won't lose them because of the past few days I nearly had).

Monday night to Tuesday morning I was oncall. It was horrible. Luckily the two MOs were kind enough to help me out. I was so slow to do everything. Bloods that needed to be taken, cannulas that were to be inserted, patients that needed to be clerked in were only done, on average, two hours after they were supposed to be done. One major delaying factor was that I had to go down to MR scan 3 times to sedate this lady, which was a scary experience on its own. When clerking patients, it's such a pain when you cannot read the previous person's clerking, and having to ask around the nurses. The nurses... what shall I say... were just not being supportive during the night. I felt so useless not knowing how to manage anything and having to phone my MO for everything. Call call call coming non-stop. The lady gaga ringtone of my phone got more and more irritating as the night went, and I thought for a few moments that I was having auditory hallucination of the sweet romance ringtone. I need to revise my medical emergencies management and learn how to priorities better.

Tuesday

I was so tired post call that all I could think was can I please go to sleep stat? All I could recall was a really long teaching ward round which lasted until 3pm. The peak of my sleepiness came about during the discussion of renal tubular acidosis in a young patient. I don't care how interesting the physiology of the disease is. I want to get this over with and go home and sleep. I ended up doing discharges until 11pm that night. Working continuously for 42 hours in hospital. Can you imagine my exhaustion?  

Wednesday

I made a patient cry today because I have poked her too many times for ABG. I really cannot understand - this is the second patient that I have encountered that I just simply cannot get any ABG. I did it the usual way which I can proudly say, yield rather good success rate. I tried for about 10x before giving up.

I suddenly had a sense of how meaningful my job is. There's this patient whom I really wish not see everyday. He has chronic renal failure and pulmonary oedema, and it is my job to take blood from him everyday. Unfortunately, he pulls up a 'tak-nak tak-nak' show every single morning. Come on... I haven't got time for this: I have 27 other bloods to do! What I normally do is to leave him alone for a while and come back after I have finished everyone, by then he would normally be in a better mood for me to poke around. I had a really important job today, which was to sort out his social welfare. His son and his life has been in a mess for years but no one had bothered to properly get the necessary help for him. The registrar had assigned this important job for me. I helped him write support letter, get the social worker to see him, get help for dialysis etc. I was proud that I was able to put aside my vengeance on how he has made my life difficult every morning and rise above to understand that he's only acting like that because he is ill. I am really determined to do this part of my job well.

Thursday

I really hate relatives surrounding the patient when I am trying to take blood or put in cannula. It's ok if it is easy and requires only one shot. But if I have to try 5/10 times before I get it, I feel the pressure as the relatives get distressed for seeing the patient getting distress. Normal people are just not emotionally numb to patient in pain like doctors are. I am considering if I should ask the relatives to go away while I do these next time.

Dr Andrea made everyone wear pink today. We took a group picture. That was really sweet.

Dr Yusniza, my registrar gave me two of her white coats today. Aghr.... now I have no excuse for not wearing it anymore. 

Untraumatic radiology scans requests today. HAHAHA!!!

Friday

Started the day with one of my patients collapsed. Thank goodness she was found before I arrived in hospital, or else I'd be clueless on what to do. Abi, who was oncall, dealt with it impressively. I did my first successful femoral stab for her (with all the surrounding nurses cheering). Unfortunately, we arrested not long after, and we did CPR for 50 minutes - unfortunately she did not survive. Quite sad.

There's another reason for me to be proud of myself today. One of the patient needs cannula for blood transfusion. She's been ill for so long already, she's literally skin and bone. She needs a pink one, but all her veins were of the blue size. The medical students and I had tried so many times - left hand, right hand, left leg, right leg - nothing went in. I was already on the verge of giving up when I thought I felt a small vein on the leg. Went for it, and hurray - it's in. I'm so proud that I persisted and did not go asking for help without trying my best. (at the expense of the patient suffering of course).  

Saturday

Dr Andrea gave me a day off. Will grab the opportunity to study.

Sunday 

It started ok. 4 discharges. Before my ward round finished, my already getting calls. It was only a tidy bit better than my on-call last time. I still haven't finishes the discharge by 8pm. Luckily there was a very very kind medical student to help me with 2 discharges, or else I'll be stuck with discharge and delay the rest of my on-call work by another 2 hours. 

I have still not learnt the art of prioritizing yet. There's new patients from emergency and admitted electively to be clerked in - supposed to be seen as soon as they arrive in ward (take history, examine, take blood, and prescribe medication so the nurses can give them out asap as a minimum) . Also in patient who suddenly has problem like shortness of breath, chest pain - some of which, obviously I need to drop everything and go as soon as they call as it could be a matter of life and death. Finally, there's petty jobs like take blood, insert cannula - not unimportant either because the patients who usually need blood have dengue or electrolyte imbalance who need regular monitoring, and patients who need cannula would have needed it for IV antibiotic or blood transfusion. Many a times when I'm trying to sit down and do something, I get called to do something else, which fragments my job. So 10 jobs becomes 30 jobs because I have to go back and forth 3 times to complete the unfinished work. Of all the jobs amassed during my oncall, only about 50% have been done. I feel so bad because the patient don't get the treatment they need. I've also really not been having time to document everything I've done - this could well come back and bite me in the future (really, of so many jobs I have during oncall, documenting is the least of my priority. But I need to make it the priority to cover my ass). So far, my MOs (more senior doctors) had been very supportive, but I feel the support has gone to the point of burden. Like last time oncall, I skipped lunch, dinner, breakfast and lunch next day just because all these were not my priority compared to clerking new patients and attending to acutely ill patients. Was absolutely totally exhausted. Didn't finish oncall work until 9am next day.

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A House Officer in a Teaching Hospital: Week 1

Day 1

Reported to the hospital at 9:30am. A big pile of forms to fill in. Met another new house officer (HO), Sara. We were supposed to go to another four places to settle the admin stuff: the department of medcine, general admin, security and white coat. Didn't manage to do the latter three because our head of department wasn't around on that day, whose signature is required to complete the latter three things. Allocated to the department of medicine.

Met Abi, the house officer leader. She was so happy to see us because medicine has been very short of HO that she was working oncall every 2 days. I was allocated to work for ward Med5 with Abi, while Sara will be working next door with another HO, Izni. 

I tagged Abi until 10pm that day. Oncall is crazy. Say I am oncall for monday, I will come to work as usual on 7am monday, start oncall at 5pm until 7am the next day, then resume ward work from 7am until 5pm - 36 hours non stop. Jobs include clerking new admission which could be up to 28 overnight, covering the 6 medical wards, cardiac care unit, cardiac rehab unit, high dependency unit and a semiprivate ward all on our own. 

Day 2

Already given half a ward to be in-charged of. Aren't we supposed to be just shadowing on the first week? So scary to be on my own. The routine is we take blood, ward round, request scan, make referral and prepare discharge summaries. Luckily the medical students were around to help out with the jobs - such angels. I was particularly anxious of having to request for scan and make referrals over the phone because my medicine has really gone a little rusty and I don't know the patients well thus didn't always know why the scan was requested. 

Didn't tag oncall but still stayed until 10pm to prepare the next day's discharge so I would have less work tomorrow. Unfortunately it would benefit someone else tomorrow.

Day 3

There was a crisis today. One of the medical HO did not turn up for work and wouldn't answer his phone. Abi said he's been depressed for a while because of the job. So I had to go upstairs to ward Med1 to cover for him. What an experience being the only HO in the ward. With no medical students and another HO to help out, I spent the entire day taking blood. I felt so useless taking such a long time, like a headless chicken going back and forth the trolley. And to make it worse, Abi still wanted me to go downstairs and manage half of the ward. I did go down for a while but was sent back upstairs by the specialist again. 

I have fallen in love the team upstairs here. The specialist is called Dr Andrea. She's amazing. She said there's no hierarchy in this ward, that I can ask anyone anything. Finishing blood so late, by the time I started the discharges it was already 4-5pm already. She and the MO sat down to help me do the discharges - I was so moved! (The first three days were a bit of a shock and I was constantly feeling emotional, I really could have shed the happy tears). It turned out that I needed to call her mobile at 9pm about some discharges and she was happy to help me out. 

My first acutely ill ward patient today. This lady who was suppose to be discharged suddenly complained of shortness of breath. I forgot to think ABC, but I briefly asked the patient some question and examined her, then asked the nurse to do a set of obs and called the MO straightaway. In the mean time she didn't look too unwell so I carried on doing discharges while waiting for the MO. A repeated set of obs was done in 20 minutes - the heart rate had shot up to 133! Just as I began having palpitation and cold sweat, the MO arrived. She asked me what's wrong, and I said I wasn't sure. Then she asked me for differential diagnosis for shortness of breath. That's easy - pulmonary oedema, MI, PE, pneumonia, pneumothorax, asthma etc etc. She said if I knew why didn't I work out the problem myself? Why indeed? Busy panicking perhaps? Then she reminded me that I'm a doctor not a clerk, and taught be how to deal with problems like this in the future. Opps, nearly forgot about that. A good lesson. 

Didn't have time to go to admin.

Day 4

Back to the downstairs ward with Abi. Today I had a strict MO - no mistake allowed. I very quickly get taught how to run the ward round and I learnt quite quickly. There were quite a few jobs to do but I was getting much more organized and was actually finished before 8pm. I then helped out Abi who was oncall again with blood. I spent an hour in high dependency with two very poorly and veinless patients.

Abi broke a bad news to me: said I won't be working in Med5 with her anymore. It was because Sara, the new HO, who was sent to cover the ward Med1 upstairs today could not cope alone, and Dr Andrea was more comfortable with me (I'm so flattered). Abi was quite upset that I was going. I was too. :(

Still didn't have time to go to admin.

Day 5

Yes! Back in Med1. Came at 6:30am today as I don't want to spend the entire day taking blood for the whole ward like the other day. It all went well as planned until about 9am the high dependency kept calling me over to do bloods, cannula, consenting their patients, interrupting my organization. 

The evil plan was that there were 9 discharges today! Luckily the team of my seniors was kind enough to help me with 6, or else I would be staying in hospital overnight. Well, nearly... I finished everything and went home at 11pm.

Still didn't have time to go to admin.

Day 6

Sadly, Malaysian doctors of all levels, from house officers to specialists have to work on weekend. Maybe I did push myself too far yesterday. Felt completely drained, was so slow to do the blood and kept missing when I normally wouldn't. I informed Dr Andrea and Aida about the 2 impossible patient who needed cannula. Today I saw how brutal and heartless doctors with many years of hard training are. In each patient, we poked about 20 unsuccessful cannulae before giving up, ignorant to the patient's moaning, involuntary jerks etc. I am not that cruel yet - I would try up to only 5-6 times before stopping. Again, I'm so moved that they are willing to help me do these house officer's jobs. They inserted proper central lines in them eventually. Managed to escape just before dusk today. Yeah!!!

Day 7

My best day yet. Came in at 6:45, managed to finish blood round by 8:30, even had time to read about the new patients and update the blood results. Joined the round properly for the first time in Med1. It was fun actually. They taught me how to write and I picked up very quickly. Not very dissimilar to the UK, I've been writing round notes since third year. Dr Aida, my MO was such an efficient partner - while I write, she went around doing all the jobs, so they'd be no jobs left for after the round (apart from bloods, cannula, discharge, in other words my job). Dr Andrea complained that I wasn't wearing white coat today. I have to wash and I only have one... And then she said she would give me hers. No no no please forget it. And then she said she would give me hers. No no no please forget it. It's so filthy, people coughing TB, Strep and all sorts at me everyday. Now I am having some cough now. Hope I don't have to take MC. Another fun thing was that my cannulae all went in the first time round! Satisfying. 

Dr Andrea told me that from tomorrow I would have a group of medical students to help me out. In fact, they were already here today to clerk in their patients. Asian medical students are so hardworking - they come in at 7am, weekends and does overnight oncall. I love medical students. 

Went home at 5:30. Bliss.

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This week I am so grateful for my colleagues for giving me the support I need - my specialist, registrar, MO and fellow house officer for giving second opinions on cannulae, helping and training me up for the job, attending to my calls about sick patients, answering my query at 10 o'clock or simply asking if I am coping alright - meant so much. Says who that junior doctors in Malaysia do not get support?

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When she is angry

She is the coolest and the hottest lady in town. An outright extrovert, she expresses whatever she is feeling. Mainly through body language. Because of this, I think she is cool. Sometimes, I sing to her and ask her how was my singing, she would say 'Good, very good...' with a smile while carrying on with her kitchen work and I carry on singing. I really enjoy helping her with her housework because she gives me with a big 'THANK YOU' with the sweetest tone. I thought I was her favourite, but she claims that she has no favourite, and I believe her, because sometimes she always gangs up with the other sisters or even papa against me. But it's ok, I still love her to bits.

She is like the sun. This is very important because when she is happy, everyone else around her miraculously are drawn into the jovial mood. Ever so popular like a hot star, everyone wants to be around her. Even I, the ultimate family loudspeaker cum joker have to bow to this special talent of hers. I'll tell you the biggest secret. I am happiest when I catch her singing, as if I have found gold. Even though her vocal power is nowhere nearly as good as mine, I know that she must be in her own heaven, and I am happiest when she is happy. 

But when she is unhappy (it is very easy to tell, she makes no effort to hide it) mysteriously everyone around her become quiet and uptight, as if a preparing for a stormy night. There are two faces of unhappiness in her. One is of shouting, another is of the silent treatment. Off her wide range of vocabulary, she picks the most cynical words. Fresh off the boiling volcano, her sentences are high in volume, low in tone, furiously dark on her face and completely mad in emotion. The impact seeps into every cells of everyone within 20 feet. It is hurtful, like freshly sharpened knife stabbed straight into the chest for 1000 times. I would not wish of them any upon my worst enemy. 

When this phase dies off, comes the long, silent aftermath. This is a dangerous time because she looks as cool as the black charcoal sitting quietly amongst the woods, but a small wind would set off another raging bonfire. It is at this time that we realize how important she is in making decisions at home. It is during times like this the rest of us at home instinctively want to help around the house, hoping that it will dim her inner fire. However, it is also when we realize we don't know too many of the menial routine at home. We dare not ask her because we fear it would start another fire. and the task remains unfinished and left for her to do, which will make her angry anyway. So, unfortunately, this coping mechanism had long been abandoned. Instead, during this silent phase, we try to stay out of her way as much as possible, until she finally cools down and start talking to us. 

The other night, when she was at the peak of her unhappiness, I was so upset. I wonder if I am selfish, if I only want her to be happy in order for me to be happy. Maybe. However, it truly pains me to see her unhappy. I toyed with the idea of suggesting that we visit the temple (but at the end I chickened). I could only pray in my heart. I pray that she rids herself of this suffering, all those negativity driving her towards unpleasantness. I pray that never again would she set foot into this realm of unhappiness. I love her happy side too much that I would never do anything to make her unveil her unhappy side. But everyone becomes unhappy once in a while and when she is, I pray that she finds a better way of channeling it out of herself, whether it is taking a breath, or just telling me that her temperature is rising is would like to be left alone for the day, a way that does not raise her blood pressure. 

She is my mummy, and our sunshine. We will always love her to bits.

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I love home

Teaching basic life support to Wan Teng.

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Half asleep

The worst nights are the ones when you are sleeping but actually half awake. The worst days are the ones when you are awake but actually half asleep. I had such a day yesterday. I knew the first thing in the morning that it was a bad day. I just couldn't concentrate on anything. I went to Bristol for a surgical conference. I nearly miss my morning train to Bristol. And then at Bristol, I told the bus driver to give me a shout when we arrive at 'The Triangle' but he didn't and I only alighted a few stops after. On the return journey, I got lost walking from the university building to the train station, and therefore missed my train and had to fork out an extra 18 pound.

Before yesterday, I was really looking forward to enjoying the conference. I usually do, I love seeing and get fascinated by all the research and innovation presented. But I don't know what poison got me yesterday. I was just in the totally wrong frame of mind. Maybe because I was presenting, and I knew I was amongst the people competing for the prize. I was saddened that so many posters and presentations had fresher ideas and were more eye-catching than mine. Suddenly I felt my poster was so uninteresting, unappelling and there is no chance I would win. I was also disappointed that some of my friends were selected for oral presentation for really low level stuff like case report whilst mine, a higher level research and involved much more work was only asked to present a poster. I was unhappy because case report is so easy as they only had to pick a clinical case and do some textbook reading (and obviously they have only bothered to present to enhance their CV), whereas study like mine involved thrawling over 100 casenotes, statistical analysis, collaboration between researchers etc etc, i.e. at least 10x harder than a case report, especially when compared those undergraduate level ones they have presented. The negativity overcame me so much that I was neither meeting new people nor looking at other presentations which I usually do. I was just stood by my poster with my arms folded for a few hours in the morning. Is this a classic case of 'kiasu-ness'? I was very aware of this and I kept on telling myself that it was no use feeling like that because a) I was just going to give people a very negative impression of myself b) I was not going to enjoy anything. Later on in the day it became a little better - I was interacting and even had a smile on my face. But I was still desperate to get over this and arrive at Aunty Sheena's place to commence a relaxing weekend asap.



Had I woke up fully awake, I would have been so POSITIVE even if exactly the same things happened:


- I nearly the train to Bristol, but I didn't. Isn't that lucky?

- The bus driver didn't shout me to get off at the stop I wanted to, but the walk to the building from the next stop I alighted from were actually shorter compared to had I got off at the previous stop that I first intended. Saved me 5 extra minutes of walking.


- The nice ticketman at the train station suggested that I buy the ticket to Bristol-London, and then get another one from London-Watford Junction when I arrive at London (rather than Bristol-Watford Junction) because it would work out to be cheaper. I should thank him because on the train, I realized that I didn't even need to buy the second part at all because this part of the ticket for the train the I had missed was still valid as it was not time restricted. Saved 10 pounds.


- My abstract was accepted. And I had a chance to showcase my work. That in itself is an achievement already.


- Questions from other participants in the conference have given me more ideas for me to write up in my publication for this research.


- Is poster presentation inferior to oral presentation? Debatable, but I don't think so. Some who won the best presentation prize were posters.


- I had really enjoyed designing the poster. I have put in a lot of effort into this and I am very proud of it.

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