Go, Right Brain!

If someone had told me six months ago that I would one day be sitting on the sidewalk, painting shophouses (pictures of, not walls) on Emerald Hill Road, I would have been ROFLMAO, and thought that person out of his/her mind.

Well, that's exactly what I did today (paint shophouses, that is). I felt very Bohemian, sitting outside in 33 degrees (Celsius), 100% humidity weather, looking very artistic, sweating like a hog & actually PAINTING A SHOPHOUSE with my fellow students. Amazing.

The end result is not exactly pleasing to the eye, nor complete (yet)- I suspect it will go the way of my Abstract & sit in my living room till I get the inspiration to complete it.

Neverthless, I am very pleased with myself for how far I've come. I am no longer overwhelmed by the thought of doing an actual painting nor fearful of making mistakes. And I have my art teacher to thank; without her encouragement or kind words no matter how bad my art work looked/looks, I would have remained in my shell instead of gritting my teeth & attempting to stretch my creative wings!

Abstract-ion: complete

After leaving it sitting in my living room for a few weeks, I finally got down to attempting to finish my abstract piece. After a couple of revisions, here's the final result.





HOPE: (LIVING A LIFE FULL OF COLOR)


Nothing fancy, as you can see, but it just feels right.

Motherhood

Yesterday was Mother's Day.

I realise that I am only less than halfway through this journey through motherhood; and what a journey it has been...

The Beginning - I first fell in love with my child when I found out of his existence. Hard to imagine for some, but there it is, the strong maternal bond that can develop even before the child is born.

Giving Birth - done it both ways: C-section (because of breech presentation) as well as the normal way (if you can call pushing what feels like a watermelon out of one's body normal!). To all you mothers-to-be out there, the epidural is THE WAY TO GO...THANK YOU to whoever discovered/developed/invented the epidural procedure...you are a godsend!

The Trials & Tribulations - breastfeeding (actually just the initiation of breastfeeding with the accompanying sore nipples, engorgement & anxiety over whether one is producing enough or not :) ), sleepless nights (especially if one does not rely on a maid to bring up one's baby!), childhood fevers which sometimes seem neverending, the toddler tantrums, dealing with the sibling rivalry (still ongoing), worrying about the quality of education they receive...

The Cost - self-explanatory. This brings to mind an exchange between Homer Simpson (speaking in a very fatherly way) & his son Bart:

Homer: "Do you know why your mother & I share the same bed?"

Bart: "Because we're poor?"

Homer: "Yes...and do you know why we're poor?"

Bart: "Why?"

Homer: "Because we have children."

It had my husband & I ROTFL because it is so true!!!

The Rewards - immeasurable.

ISTJ

What do I have in common with George Washington, Joe Friday, Eeyore & Evander Holyfield?

I am, apparently, an ISTJ, according to this cool test I took.

Eerily accurate...

MOVIE MANIA

I was disappointed to learn that “The Da Vinci Code” movie has been rated NC-16 by the censorship board. Having read the book, I wonder at why the movie has been given this rating. Sexual content? Hardly any. Violence? Perhaps, but not anymore than some of the other movies which have been rated PG before. I suspect that it is to appease some of the groups, which have been protesting its release.

I wish I could sit down over a cup of coffee with the actual people who rate these movies & find out what they look for when they rate movies. There seems to be a disparity in how movies are rated. There is a huge gap between the NC-16 movies & the PG movies. For example, “When A Stranger Calls” has been rated PG. Now, I know that there will be kids out there who will be scared out of their wits after watching this movie. There needs to be another rating category in between, say, PG-13 where parental guidance is advised for those under 13, or where kids can only watch the movie with their parent/guardian.

Oh well, looks like our family will wait till we get to New York before watching the DVC movie. Pity...we had been looking forward to booking ourselves some Gold Class tickets & watching it in style.

COMING SOON

With the approaching summer also comes the season of blockbuster releases. Some movies I am looking forward to watching are:

• X-Men: The Last Stand - I think X-Men is one of the better movie adaptations of comic series, on par with Spiderman 1 & 2, Batman Begins and Superman… Hugh Jackman as Wolverine doesn’t hurt either (*drool*drool*).
• Superman Returns – sounds like an intriguing storyline; would like to see how Brandon Routh’s portrayal compares with Christopher Reeve’s.
• Pirates of the Caribbean: Dead Man’s Chest – enjoyed Johnny Depp in the first installment. He is usually so angsty, it is nice seeing him in a lighter, comedic role. Am also a fan of Keira Knightly, and I guess Orlando Bloom is OK as eye candy.

Politically (in?)correct

Well.

Elections are over & the PAP are back in power. I am quite relieved, to be honest. It's hard to support an opposition which doesn't seem quite up to par. The PAP have done a decent job of running the country so far.

Say what you may about the dictatorial methods of the government, & being a nanny state etc. etc. but I believe that the leaders had to do it this way in order to survive & to grow. They had to work with what they had. And now, they have to work with what they have.

Look at how far we've come since our independence over 40 years ago. There is much noise that has been & is being made about giving more freedom to the people, some of this noise coming from abroad, & some from within our shores. But I frankly do not think that the average citizen of this country is ready for this responsibility. I see the country as being a young one, just approaching maturity. The hardware is there but the software has yet to catch up. Many still look to the government to solve their problems. Social & civic skills are often still 3rd world despite our 1st world reputation where business & economy is concerned. We have a fine if you don't flush the toilet, for crying out loud!!!

I think change is needed but at the right pace. And until we see credible opposition candidates, the PAP should remain the incumbent party in government.

That's my two cents anyway. Enough politics for now.

MI:3

Watched MI:3 over the weekend. I thought it was pretty well-made, lots of action, incredible stunts & a surprisingly good storyline.

Thought that Jonathan Rhys-Meyers & Maggie Q were rather under-used though. Can't be helped I suppose...God forbid that they should upstage box-office draw, Tom Cruise!!!

One Big Happy Family

“Oh, East is East, and West is West, and never the twain shall meet…”
The opening line from The Ballad of East & West by Rudyard Kipling


One of the things which gets my goat & raises my hackles is when people start comparing Asian values with so-called Western values, praising the former & denouncing the latter. Having lived in both the East & the West, I realize that I may have life experiences which are unique & which the majority of folks would not have the chance to go through.

Before moving to the West, where I spent 7 years, I was rather apprehensive about settling in, being accepted, making friends in a foreign land. Being the shy sort, I was very uncomfortable about having to make friends with people of a totally different background & culture from myself.

However, I learned that wherever you are, the underlying values are very similar. We all want the best for our children. We value family time. We respect our elders & we teach our children to be respectful to their elders. Neighbours help each other when the need arises. We all try to earn a good living in order to put food on the table & ensure a secure future for our children. We laugh when happy, cry when sad, gasp at atrocities, celebrate achievements. Thanksgiving, Chinese New Year, Christmas, Hari Raya, Deepavali…different festivals celebrated by different cultures, but under it all, it’s all about family, love, togetherness.

I realized that whether you live in S______ville, PA in the USA or S_________ one degree north of the Equator, we are all the same underneath our differences. I finally got it. I hope we all get it one day.

I know that I may be too idealistic. But hey, what’s wrong with high hopes; I think the world needs it today.

“But there is neither East nor West, Border, nor Breed, nor Birth,
When two strong men stand face to face,
tho' they come from the ends of the earth!”
The closing lines from The Ballad of East & West by Rudyard Kipling

Religious Fervour

I read in the papers a few days ago that the National Council of Churches is protesting the release of “The Da Vinci Code” movie locally. Their reason is that they are afraid that the movie will spread misconceptions of Christianity.

It’s fiction, people!!! These are probably the same folks who stop the kids from reading the Harry Potter books. As far as I know, religion is about faith. No matter what you read or watch or see, the bottom line is still FAITH. I don’t think a movie or a book with its own interpretation of the history of Christianity will shake the beliefs of those who are truly Christians.

I am not anti-religion. Matter of fact, at one point of time, during the turbulent years of adolescence, I found some peace in attending church services & reading the gospels. I never had a dramatic moment of revelation in which I “found” Christ (or any other religious icon, for that matter). Contrary to that, I was turned off by fanatical evangelists who try to convert you every which way you turn, telling you that you will burn in hell if you don’t accept Christ as your Saviour THAT VERY SECOND!!!

To me, religion is a very personal decision. It cannot be forced on a person. Don’t get me wrong, I do believe in religion; it gives peace of mind to those who are troubled, & oftentimes, is the only thing that helps a person go through a time of bereavement. But when people become fanatical about it, the alarm bells start to go off.

One can be spiritual without being religious. I believe in the human spirit. I believe in miracles & the existence of things beyond our understanding. How else do you explain the world as it is? There has to be a greater Power at work. But religion & the rituals that go hand in hand with it, are things that are man-made, created to help society endure difficult times. Carry on, I say. Just don't force it down my, or any other person's, throat.

Ultimately, I believe that no matter how pious a person may outwardly seem, what is important is the goodness (or evil) in that person’s soul…I am sure that the Powers, whoever he/she/they may be, would know.

My Baby

My little cherub graduates from Middle School in a few weeks.





This picture was taken almost 14 years ago. He is now a strapping young man who has outgrown both my husband & me (in size), & probably knows more about IT related stuff than I do.

This may seem like a minor achievement to all you non-parents out there, but for parents (well, for me anyway), every step they take, no matter how small, is a milestone. Each milestone marks the end of one phase of your child’s life, & heralds the beginning of a new one. My son goes into high school come August & I know that the 4 years will fly by in the blink of an eye & off to college he will then go. Each milestone brings the child closer to the day when he (or she) leaves home, which I know will suddenly feel incomplete without my baby (& eventually my babies) there.

Once, my younger son said to me, “I’m NOT a baby” in response to something we were discussing regarding childish behaviour (I forget the details ... age, you know.). My response to him was: “You may not be A baby, but you & your brother will always be MY babies no matter how old you are.” That pretty much silenced him!

My message to the mothers out there: cherish the time you have with your little ones now…because time DOES fly & you will need to let them go sooner than you think.

Great Expectations

Watched "West Side Story" (the musical play, not the movie adaptation) over the weekend. I don't know....maybe I expected something more magical, more stunning...but it didn't really move me the way I thought that it would.

The vocals were good, as was the dancing; however, perhaps because I couldn't really identify with the story, or maybe the accents were sometimes a bit hard to catch (I think the actors were trying a bit too hard to put on a Puerto Rican/New York accent), I just didn't feel as caught up in it as I did with other plays I've seen like Chicago or Mama Mia or Grease or even Cats!

Art imitating Life

I wrote about colors in my life last Sunday. On Wednesday, I had my Art lesson, the theme being "Abstract" Art. To help us along, to challenge our brains, and to get our creative jucies going, my art teacher gave each of us a card with artwork & sayings about life created by an artist.

She walked from student to student, holding out the cards for us to pick. When I picked my card out of her stack, mine said: "Living a Life Full of Color."

Almost gave me goosebumps...how weird is that? Someone somewhere out there is trying to tell me something...

Abstract-ion

Abstract art is tough to do! That was the theme for today's Art lesson. We were supposed to clear our minds of images, & draw from our emotions & translate them on to our canvases.

How many of us have, while wandering through an Art museum or exhibit, exclaimed, "Even I can do that." over a seemingly simple piece of abstract art? I plead guilty to having done so before. It's not that easy, I realise now.

First of all, it was difficult for me to "visualise" my feelings & translate them into a painting. I am too used looking at things "just as they are". Everything looks like Still Life to me. My right brain hasn't been exercised enough.

I ended up taking home an incomplete piece of Art (I hesitate to use this word to describe it :)). I am hoping that I will feel inspired to finish it at home - not sure how long that will take...keeping fingers crossed...

Coloring Outside the Lines

My foray into the art world, taking painting lessons, has really taught me a lot about myself. It's strange how art reflects the artist's personality, background, & even upbringing.

In my first class, I tried to paint "within the lines"; I kept my brush strokes as even as possible; it was hard for me to let go of what I had previously been taught since toddlerhood. Remember the coloring books we used to have as kids, & how our teachers & parents would tell us to color within the lines? I realise now that that has how I have been living my life. Always coloring within the lines. Not making a "wrong move". Doing what is conventional & expected. Not upsetting the balance of the universe.

My art teacher told us to forget all that we have been told about what art should look like. It's OK to have uneven brush strokes. You don't have to color within the lines. The sky doesn't have to be blue or the grass green.

It's still an uphill battle for me to use my right brain, and to try to perceive of the world around me in a totally different way than I am used to. I have been so used to seeing the world in black & white & gray, that I had forgotten about the other colors in the spectrum.

With Art, I am starting to open my eyes, & to stimulate previously slumbering neurons in that area of my brain that has been left idle too long. I see a long journey ahead, but one which I look forward to with relish.

Random Thoughts on...

AI - ...and he's finally out! Never quite enjoyed Bucky as much as the other finalists. He always seemed uncomfortable performing on stage. Katie McPhee needs to go next...she likes to shout her songs.

Rumsfeldt - ...read about the comments & opinions made by retired Generals from the US military who say that Rumfeldt needs to go...makes sense to me...if you don't have experience in the field, how can you, with good conscience, make decisions that will affect thousands of troops?

LKY - ...our esteemed Minister Mentor is getting old...I saw him speak at my kids' school during a special ceremony celebrating the diamond anniversary of the school. He seemed more frail & his voice was softer & less forceful than I expected, & his speech seemed rather rambling, like he was trying real hard to stay on track but not terribly successfully.

Good Grief

"I am amazed that men of higher education can commit such stupid crimes."
Lt. Mac Taylor to a doctor who conspired with his medical colleague to commit insurance fraud in last night's episode of CSI:NY

I ask myself the same question after the recent weeks' very public revelation of cheating, perverted, drug trafficking doctors. WHY???

Oy vey.

Weirdos

Today's letter in the newspaper from a patient requesting a waiver for the need of a chaperone for her acupuncturist during treatment, triggered memories of certain kinds of patients which left me (& my female colleagues) rather uncomfortable.

The need for a chaperone when a male doctor does an examination on a female patient is pretty much standard practice, not only to protect the patient, but also to protect the doctor from allegations of inappropriate behaviour. However, when it comes to chaperoning a female doctor examining a male patient (specifically if said patient has a complaint related to his genitals), there hasn't been much discussion over this issue.

Usually a male patient who has a complaint like urethral discharge, or penile rash or testicular swelling would request to see a male doctor, especially in the local context where Asian sensibilities tend to be more conservative. Hence, when I get a male patient who specifically asks for a FEMALE doctor to examine him for such complaints, alarm bells start to go off! Fortunately, such encounters are rare. But my female colleagues & I have compared notes & each of us had our own "Penis Guy" (different patients but similar complaints, each time requesting to see us specifically)who would come in complaining of a rash or some other malady that has affected his organ. And when you examine the affected area, there really is nothing obviously wrong with it. When the same guy comes in repeatedly for the same problem, we would try to redirect them to our male colleague to handle. This usually would put a stop to further unneccessary consultations for non-existent problems.

We have been fortunate that these patients did not exhibit any drastically inappropriate behavior during our non-chaperoned consults (although there was a case that was publicised fairly recently about a male patient who masturbated in the presence of the female doctor while consulting her for a supposed traumatic injury to his groin). Worst that ever happened to me was my Penis Guy trying to invite me out to dinner DESPITE the fact that I was wearing my wedding ring, & did not give him any indication whatsoever that I would even remotely be interested! The gall of some people...

Talent

JAMES BLUNT

James Blunt was on Oprah yesterday. This young man impressed me with his talent (he performed 'You're Beautiful' & 'Goodbye My Love' on the show) & his self-deprecating humor. Before his current gig, he was a soldier in the British army & brought his guitar with him (strapped to the side of his tank) on his rotation through Kosovo. He has also served as one of the Queen's guards, & include "prancing on a horse for Japanese tourists to take pictures of him" on his resume.

When he sings, look into his eyes & you can see that the music & words truly comes from his soul. My husband bought his CD a few months ago, & I never really listened to all the tracks. I will now...

AMERICAN IDOL

Country music was the theme yesterday. I can't say that I am a huge country music fan. Apart from Shania Twain & Faith Hill, I can't think of any other country performers that I would listen to on a regular basis.

The final 9 gave a rather lacklustre performance; even my favorite, Taylor Hicks, singing Take Me Home Country Road, sounded like he was (to use a Simon Cowell-ish analogy) at a campfire trying to get people to join him in the song. The two idols who are supposedly the most comfortable in this genre, Kelly Pickler & Bucky Covington (question: what reason on this good earth would a parent have to name their twins Bucky & Rocky???!!!) failed to impress me - they just didn't seem very comfortable on stage.

And Kenny Rogers - gosh, I didn't recognise him without the full beard that he used to have....he should have kept it...

Hats Off

I salute this bunch of doctors for what they are doing.

I can honestly say that I don't think I could do what they do, mojo or no mojo...

Room with a View

This is the view from the balcony of our cabin on a cruise to nowhere last weekend, a much appreciated birthday gift from my mom (thanks, mom!).

Why go nowhere, some may ask. For the uninitiated, these cruises cater to the casino goers. Singapore has no casino (I should use the politically correct term coined by the government: Integrated Resort, or IR) yet. For some reason, Chinese people like to gamble (not being racist, but based on observation). So the cruise ship is a convenient & comfortable way of doing so without the hassle of having to go all the way up to Genting Highlands in Malaysia or flying to casinos in Australia/Europe/USA.

I am curious to see how the IR wil turn out. I hope it won't be seedy like Reno, or tacky like Atlantic City. I'm actually hoping that it can capture some of the glitz & glamour of Las Vegas, with top-class entertainers (in the calibre of Elton John, Cirque Du Soleil, David Copperfield)& family-friendly venues (think MGM's theme park, or Venetian's indoor water canals & gondolas, or New York New York's roller coaster that goes through & on top of the hotel!). It'll be tough bringing in those stretch- & super-stretch-limos though, seeing the limited space available for parking here.

Did I win any money on the cruise? No, because I don't enjoy gambling. I enjoyed the cruise, though, because the sea calms me - the sound of the waves & the soothing breeze makes me forget all my troubles & stressors. I love sitting by the ocean with a good book & can spend hours doing just that. Forget about the casino, & the multitude of activities planned by the cruise director. I am happy with just my book, thank you very much.

Pride & Prejudice (again)

OK. I am officially a Jane Austen(more specifically, Pride & Prejudice) groupie.

I bought the Pride & Prejudice DVD, watched the movie again (which makes it a total of 3 times within a span of 4 months), watched all the bonus bits (even the tour of the homes used in the movie shoot), swooned over Mr Darcy (again), now wish that the men of today still stand up & bow when ladies walk into the room and that a man dressed in a cravat, coat, breeches & riding boots can be sexy (especially if he is Matthew Macfadyen).

Sometimes You Just Have To Listen To Your Gut

You wake up & have this bad feeling in your stomach (& you know it’s not the curry you ate last night). Things just go downhill from there. The car has a flat. Or the traffic is horrendous. You’re late for work. The F-O-N patient you usually try to avoid turns up & ends up in your consultation room. The waiter gets your dinner order messed up.

You also read about people with close calls who didn’t get on a plane because of a “bad feeling” & the plane ends up crashing with everyone on board losing their lives.

This sixth sense (no, not the I-see-dead-people variety) that you get sometimes is inexplicable, and unexplainable. I don’t know if it’s a gender-biased characteristic (the so-called “women’s intuition”); maybe the guys have a different name for it.

Whatever you may want to call it, this gut feel that you get can sometimes be a life-saver for your patients. I remember a few cases I encountered…

Patient A was a Malay gentleman in his early 40’s, who presented to me with mild gastric pain. Medical history & physical examination were unremarkable & he had only had the symptoms for a few weeks. Usually, I would prescribe an antacid and/or a H2 blocker with some lifestyle advice & review the patient again after a week or two, depending on the severity of symptoms.
However, in this case, something made me feel the need to refer him to a tertiary center for further investigations. 2 months later, I received a reply letter from the specialist who saw him at the specialist clinic giving me an update on his condition. Turns out that endoscopic examination revealed a gastric ulcer with very early malignant change. Fortunately, it was early enough that the patient did not need a total gastrectomy & just needed the affected area to be resected. I can’t begin to describe the feeling of relief (& some incredulity) I felt that we had caught this in time, thanks to my gut feel.

Patient B was a Chinese gentleman in his early 30’s who complained of a persistent cough of 2-3 weeks’ duration. He was not a smoker, & had no significant family or medical history of note. He had previously been prescribed cough mixture & lozenges by another doctor in the practice, without any relief. When I saw him, there were no physical signs to suggest any infection or malignancy. But again, gut feel made me order a chest x-ray…and to my horror, I saw a suspicious looking mass in the right lung. The radiologist report had daunting words like “suggestive of malignant change” & “infiltration”.

I referred him to a tertiary center. He returned to see me two months later to let me know that after undergoing a bronchoscopy & biopsy, the mass was not malignant, neither was it tuberculous (tested negative for acid-fast bacilli); even the specialists were puzzled by the diagnosis & thought that is was some unusual mycobacteria strain that had caused the infection. They ended up treating him empirically with what I believe to be a combo of Rifampicin & Streptomycin (patient was unclear as to the name of the drugs used). Happy ending – the treatment worked, & the patient was eternally grateful that number 1, the illness had been picked up, & number 2, it was NOT cancer.

Patient C was a Chinese lady in her early 20’s whom I saw as a health screening patient. During history taking, she revealed that she had a history of colonic cancer (!!!)& had a partial colectomy done. Apparently, she had seen her personal GP for (get this) epigastric pain (!!!), & the GP became suspicious & immediately referred her to a specialist for further investigations. Colonoscopy revealed early Ca Colon. I suspect that this GP had a gut feel too, that something was not quite right in this patient.

So the moral of the story is: don’t ignore that niggling voice that comes from that gray area between your conscious & subconscious, which sometimes makes you do things which you otherwise would not do. That strange feeling in your gut may not be indigestion, but your intuition telling you that things may not be what they seem to be.

Brrrrrrr

I think the older one gets, the lower one's tolerance level is towards the cold.

Cases in point:

We spent the 2004 Christmas holiday visiting my MIL in New York City. The night we arrived, the city received its first snowfall of the season. Needless to say, the kids were ecstatic - they were jumping for joy, sticking their tongues out trying to catch the snowflakes. As for me, I was chilled to the bone...the windchill factor was something like -20 Farenheit...at least it felt like it to me. As I desparately clutched the neck & hood of my parka close to my body to prevent the cold from creeping in, I thought: I don't think I will want to retire in any place that is not tropical or at least, sub-tropical!

Today I went swimming in our pool with my 2 boys. Now, we live in the tropics right on the equator (alright, maybe we are one degree north of the equator, not that it makes much of a difference) & the ambient temp today was something like 33 degrees C, humidity felt like it was in the high 90's if not 100. And yet, when one of my feet went into the pool, the water felt D**N cold (to me, anyway)....cold enough to curl your toes & make other unmentionable parts of the body shrink/pucker/retract.

But my boys? They went right in, initially went "Ooo it's cold" and within seconds (literally) were doing laps & somersaults in the water.

As for me, I stayed seated on the side of the pool with just my legs dipped into the water (up to the knees), to 'allow' my body to gradually accept the sudden change in temperature. Took me at least 10 minutes before I was able to totally submerge myself in the "icy" waters.

42

Today.

Me.

Winken Blinken and Nod

Insomnia hits me occasionally. Often, it is due to unresolved issues, running through my brain although the body is exhausted, preventing Sleep from taking over.

Tonight, there is no reason why I should not be fast asleep in bed right now. I can't think of anything that is bothering me, which may be keeping me up. My eyes are falling shut even as I type this. And yet, when my head touches the pillow, sleep eludes me. The harder I try, the further Mr Sandman seems to run from me...

Maybe I should try counting sheep...

Hugs & Kisses

As I read an article written by Linda Baker for the New York Times titled "When a mother must muzzle the nuzzle", about her attempts at weaning off the physical bonding she has with her children, it struck a chord with my own childrearing experiences.

I have always been a touchy-feely type of parent to my two boys. Hugs & kisses have always come freely from me to them & vice versa. Maybe it's a rebound phenomenon of my own childhood in which, as is typical of Asian upbringing, physical expression of love was not exactly a norm.

They still give me hugs & goodnight kisses. But I miss those "cling-to-your-neck-&-nuzzle-their-face-against-my-shoulder-&-neck" type of hugs which they used to give me. Something happens between the ages of 10 & 12. They develop a reserve that prevents them from giving you that all-out expression of affection. I guess it is a first step towards growing up. Perhaps this gradual weaning off process is a natural way to prepare for the day when they eventually leave the nest to make their own way in the world. I don't think it would make it any less painful, though.

Ahchoo!

Been sneezing up a storm. My allergic rhinitis has been acting up the last few weeks. Must be something in the air - mould, or the haze from Indonesia. Let me tell you, sneezing is very strenuous activity. It really drains your energy. I wonder how many extra calories I burnt up because of my allergy attack.

Those who suffer from VMR can empathise with me. Before the days of steroidal nasal sprays, one would wake up every morning with runny noses, sneezing fits, & oftentimes, clogged up sinuses. I think I spent most of the first half of my life breathing through just one nostril. Those of you who are not cursed with this affliction, don't take for granted this luxury of being able to use both nostrils at the same time.


Signed up for an ENT CME symposium this weekend. One of the topics being discussed: Allergic Rhinitis - A new Look at Immunotherapy.

Whoopee. Very timely indeed.

Blown Away

Wow.

What a concert it was last night. Mr A-Z (Jason Mraz), performing with percussion & vocal support from Toca Rivera gave a mesmerizing performance showcasing his vocal & guitar-playing talents.

I was amazed by the versatility of sounds & melodies displayed by a simple acoustic guitar with the accompanying percussion instruments (a small standing cymbal and a drum - not sure of the exact type, but it had a very Caribbean sound!). Even my boys, who are usually fans of heavy metal music a la AC/DC/Deep Purple/GunsNRoses, were suitably impressed (& hopefully inspired to add Mom's type of music to their repertoire of songs!)

I was blown away by how effortless he made it seem, with his improvisations, and his vocal acrobatics. The casual bantering with the audience was the icing on the cake.

This is what I call Talent.

Arty-Farty

Circles of Life- Angst

The Person

In the latest episode of Grey's Anatomy, Dr Christina Yang reveals to Dr Meredith Grey that the clinic she has gone to to "take care" of her unplanned pregnancy needed an emergency contact in case of unforeseen circumstances. And Christina has appointed Meredith as "The Person".

Scene

Meredith puts her arm around Christina's shoulders & leans her head against her in a show of support of what she is about to go through.

Christina (in her usual acrid tones): "You do know that this constitutes a hug?"

Meredith:" That's OK...I'm your Person."

This poignant & wonderfully written scene, which was brilliantly acted out by the two actress (Sandra Oh & Ellen Pompeo respectively)showed the friendship, trust & loyalty between the two friends.

I am lucky that I have a Person in my life. Someone who may not neccessarily be from within your family, or even your spouse, but whose relationship with you is such that he/she accepts, respects & supports you & your decisions at face value, no questions asked.

I hope everyone has their own Person too.

So Many Places, So Little Time...

Planning our summer vacation now. We have to make the obligatory trip to visit my M-I-L in New York City; this will make it our gazillionth time in NYC (no offense to NYC but I really would like to see other places in the USA as well :)). We'll probably have to limit ourselves to road trips on the Eastern coast of the USA within reasonable driving distance from Manhattan. Anyhoo, am looking at Martha's Vineyard (seems pretty enough on the websites that I've seen but don't want to end up going to a tourist trap), Providence (am attracted by the town from what I saw in the short-lived but excellent series a few years ago), Newport (hubby trained there while in the US Navy, & says it's a pretty town). Maybe I should also look south & see what's there.

Kids & husband don't really care as long as they get to make their pilgrimage to Matt Umanov (a guitar store that has been in the Village area forever). Of course, Woodbury Commons (factory outlet stores!!) is a must. Maybe a Broadway musical (been trying to get Lion King tickets for the longest time....seems to be perpetually sold-out...I guess I should start trying to get tickets NOW).

There are soooo many places in the world that I'd love to visit - horseback riding in the Canadian Rockies; cruising down the Nile; riding a camel to the pyramids; a safari in Kenya...these are some of my dream vacations. Oh well, one of these days...

It's Not About the Money

There has been some discussion lately about the economics and business of Medicine and some of the ethical & moral issues surrounding this. Oftentimes, these issues get lost in all the rhetoric.

In my POV, I don't think the debate is over whether doctors should make a lot of money from their profession. I don't begrudge highly skilled surgeons and well-respected, knowledgeable physicians earning large amounts of money for services rendered in practising good solid Medicine. Many have & still do make a lot of money for much needed services mostly in the private sector, to cater to people who can afford it (hopefully!).

I think most of us in the medical community have no qualms about denouncing the doctors who prescribe addictive drugs like benzodiazapines or Subutex or codeine-containing cough mixtures inappropriately. This is clear-cut inethical behaviour.

However, when doctors start to perform aesthetic procedures on teenagers, prescribe weight loss medicine to non-obese patients, or order a gamut of largely unneccessary tests under the auspices of Health Screening, I start to wonder at the motives of these "healers". I don't feel comfortable with doctors pandering to the vanity of the masses, the way they do now, with the numerous ads one sees in various publications expounding the availability of aesthetic services. They have become glorified beauticians. The LASIK procedure is also being aggressively promoted (not as bad as in the US but still...), and now that the competition is heating up, I wonder about the decision making process both for the doctors (in patient selection) and for the patients (same day service - eye assessment + procedure done on the same day...does that leave time for the patient to actually go home and think through this???).

It is all these gray areas which we should question ourselves about.

The Business of Medicine

Ooo...angrydoc is really angry today...

Like it or not, Medicine is a business now.

Young At Heart

I turn 42 in a few weeks. I certainly don’t feel 42 in my head, although my body & its various parts beg to differ & remind me of that fact constantly. And I sometimes need my sons to help me read the date on my watch :).

I can still appreciate contemporary music & don’t limit my selection of listening pleasure to songs from the 70’s & 80’s. Matter of fact, the radio stations that are “memorized” in my car’s stereo system play contemporary & rock music. Michael Buble, Linkin Park, Green Day, Maroon 5, James Blunt, count among some of my favourite musicians to listen (& even sing along!) to. Admittedly, I don’t do research into these artistes bio-data & memorise their dates of birth, favourite food, names of pets etc. like I used to do as a teenybopper screaming over Donny Osmond’s purple socks.

I occasional drool over hunks like Brad Pitt, & enjoy looking at nicely toned 6-packs (& hubby is OK with it. Really.)

I can still empathize with my teenage & pre-teen sons, nephews & niece. I know all the angst (ha! One of my favorite words!) that they feel during this hormone-filled phase of their lives.

Just the other day, my husband commented amusedly, “You’re still such a kid!” when I almost jumped up & down with excitement upon seeing a documentary on ‘How Star Trek Has Affected Technology ‘ on the Discovery Channel. During one of hubby’s usual channel surfing sessions, I had caught a glimpse of William Shatner narrating while clips from the various series of Star Trek played. I forced him to stay on that channel while I watched the two back-to-back episodes that night. I am a closet Trekkie (actually just ST:TNG or Star Trek: The Next Generation for the uninitiated; & to a lesser degree, ST Voyager); in fact, only my immediate family (i.e. hubby & sons) knows that I have watched every single episode of ST:TNG thanks to syndication in the US ☺, have actually attended two Star Trek conventions while living in the US (and no, I did not dress up as a Klingon nor a Ferringhi☺) & went to the Star Trek exhibition in Suntec City when it came to Singapore a few years ago.

Yeah, I still feel like a kid sometimes. I am not going to conform to society’s perception of what a woman approaching middle age is supposed to look like or be like. My motto in life now is "Live & Let Live". That’s the great thing that comes with maturity, life experiences & growing older – self-confidence and a greater appreciation for life.

Oh, and one more thing…I don’t need reading glasses yet. Really.

Just Being Random

angst

noun a profound feeling of generalized anxiety or dread.

ORIGIN German, ‘fear’.

(Definition from askOxford.com)


Don't you think the word "angst" is so apt in describing the emotions that one goes through no matter how old you are? It is so much more versatile than "anxiety" or "fear", don't you think?

Childhood separation anxiety, teenage hormonal-induced mood swings, puppy love, first love, broken hearts, pre-marriage jitters, maternal worries, empty nest syndrome...it's all so angsty.

At the Crossroads

In today's papers, Dr Huang gives us his take on the practice of Medicine today.

He writes: "The tragedy with the mantra, 'Medicine is now just another business', is that some among us are beginning to believe that it is true."

Let's be honest here...if one were to take a poll among medical students now on why they want to become doctors, what proportion would indicate "Want to earn a good living" as a major reason? I suspect a large percentage would.

Realistically speaking, being a doctor is like "having an iron rice bowl" (鐵飯碗 - a Chinese idiom referring to an occupation which guarantees job security & a steady income) - you would probably not end up among the statistics of the unemployment rate. Quantum of income would vary, but I sincerely doubt that any established, fully trained doctor would be classed in the lower or middle income groups. Unfortunately, the "business" end of Medicine has become, in many instances, the bottomline for many doctors & the "companies" they own or have a share in.

He also writes: " Many now strut around like some centrefold media superstar in the most unlikely magazines. 'Glam' sells and these coffee-table tabloids naturally fly off the racks."

I think he probably refers to the (mostly) aesthetic physicians/surgeons who are featured quite regularly in magazines targeted at the female population, as well as the well-heeled. Let's hope that we won't end up with the local version of "Dr 90210" (an American TV series on the gossipy E channel which features real-life cases of plastic suregeons in Beverly Hills).

Dr Huang also states that "The challenge facing us is how the medical profession is going to harness the tools that modernity affords us and, by self-regulating moderately, ensure that the 'outliers' in our profession do not tarnish the good reputation that our forebears had so painstakingly built over the centuries."

A challenge indeed. I anxiously wait to see where & whether the Powers draw the line with some of the more dubious practices we see.

If Only They Knew

The recent spate of letters related to high cost of medicine, alleged wrong prescription of medicine, & expectations of how doctors should practise medicine, have me reflecting again, on the varied reasons why I decided to take a break from clinical practice more than a year ago.

I see how patients' expectations have become so unrealistic (their ignorance is not entirely their fault, I have to add; it's just that their idealistic views have not changed with the times) that many expect their doctors to be at their beck & call, at the expense of the doctors' personal lives.

I see how money plays a huge factor in how doctors practise medicine. Unfortunately, the advent of managed health care, and medical groups becoming publicly listed, or bought over by listed companies which have to answer to their shareholders, have resulted in the dollar sign becoming a top priority when running a clinic. I know that there are ways of practising medicine (NOT negligently) which can improve profits for the company, and oftentimes, these methods are encouraged so that profit margins look good for the shareholders. However, some of these methods go against the grain of one's soul as a doctor (and no, you don't have to be negligent to practise "profit-geared" medicine).

It's a vicious cycle really, since the average patient expects that a doctor is there to look after his/her health, not thinking that the person whom they have placed on a pedestal would try to squeeze extra dollars out of him/her in doing so. Extrapolate this to corporate clients with some of these expectations who sign contracts with medical groups or managed health care companies (eg. some end up with packages which include unneccessary health screening tests with huge profit margins)- you are looking at potentially hundreds of thousands of dollars ( and I am only referring to primary care, not even specialist care here). And there ARE other ways of "making more money" which I will not mention here...

So there it is. The disillusionment sets in. Maybe eventually, the mindset of the patients will change & they will start to really question whether their healthcare needs are being taken care of cost-effectively or not ( I stress - "COST EFFECTIVELY" - not CHEAPLY). Maybe eventually the patients will also realise that doctors are far from angels (we'll gladly relinquish that image to the nurses *GRIN* who really do deserve that accolade) & are not gods & actually do have personal lives too :).

One day. Maybe. But not soon I think...

Hear, hear!

Some quotes from letters in today's newspaper in reply to a recent complaints from patients regarding doctors not seeing patients if they go to the clinic close to closing time, & high prices charged etc...

"I believe that doctors have a duty to attend to medical emergencies at all times but I'm afraid I will have to disagree with the assertion that I'm obliged to deal with any patient with any kind of complaint at anytime." Dr Sim Sze Keen

Well said, Dr Sim!

"There is currently no strain of pathogen causing the influenza or common cold that's acutely present just a few minutes before midnight. Most of the patients would have been experiencing symptoms in the preceding hours and there is no reason for them to be attended to when they decide to turn up at the clinic at closing time." ">Tan Shian Ming

I wish more patients had the consideration & common sense shown by Mr Tan.

" Let us not publicly complain or accuse without a clear understanding of doctors and the constraints they face. We should also refrain from giving comments to the media on certain medications and their prices without clarification." Miss Adeline Ng Su Mei

Thank you, Miss Ng, for voicing your support & understanding. Your sentiments echo what many doctors feel, and goes to the heart of the cause of many complaints - lack of communication or misguided reluctance of patients to speak directly to their doctors/nurses regarding their concerns. For some reason, they think that writing to the newspaper, or even their MPs & Ministers will solve their problems.

An Open Letter

Dear I.M. Sik:

First, let me say that I understand you are not feeling too well, & can empathise with your feelings of anxiety over your medical condition. I hope that you will be able to take the sentiments expressed in this letter with an open mind, and hopefully be able to appreciate that practising Medicine in the modern world is not as easy as you may think.

Doctors go to work everyday with the hope of making their patients feel better. I don't think anyone of us have intentions of killing/maiming/injuring their patients. In a perfect world, everything would come up rosy & everyone would live happily ever after. However, as you know, this is not a perfect world, & unfortunate things do happen, often beyond the control of us mere humans (yes, even doctors are human & not gods!). Whenever possible, safeguards & contigency plans are in place to try to minimise or rectify these unfortunate incidences, but not everyone can be saved due to factors like age, concurrent medical conditions & just sheer bad luck.

In this material world, the question of cost often comes up. Everyone expects excellent medical care with minimal cost. But surely you must understand that logically speaking, that is not possible. There will always be trainee doctors, who will eventually take over the role of their senior & more experienced consultants & professors. If they are not given the chance to learn (under the supervision of their teachers) how will they ever achieve the expertise needed in the future?

It is also not possible for everyone to be under the direct care of a consultant otherwise these poor doctors would not even have time to take a meal let alone do ward rounds, or surgery or spend time with their own families!

Ultimately, there needs to be a relatively fair way of distributing the healthcare needs without compromising on healthcare standards nor on the morale of the healthcare workers. And one way which the institutions have done so is to allow the subsidised patients to be seen by Medical Officers with supervision from their superiors. You have to admit that the amount of subsidy given by the government is not small, and the amount that each subsidised patient has to pay for consultation, drugs, investigations, surgery etc. is a small fraction of the actual cost! It is hard to fathom that many people don't blink an eye about spending hundreds & sometimes, thousands of dollars on slimming treatments, massages, facials etc at the spa & yet gripe about the cost of seeing a doctor when they have a health problem. I sometimes wonder if they have their priorities right.

I hope that you will also understand that doctors have personal lives outside the hospitals and clinics. They have spouses, children, and even hobbies to even out the balance of an otherwise stressful life. So please do not begrudge a doctor for closing his/her clinic on time if it's not a dire emergency or urgent condition. Do take note that locally, we are, indeed, extremely fortunate that there are clinics open 24 hours even on Saturdays & Sundays & public holidays. (Doctors often spend their evenings & weekends with their patients instead of with their own children.) Not so in some of the developed countries. They open from 9 to 5, Mondays to Fridays. If you catch a cold or a flu outside office hours, you can jolly well get your own medicine from the local supermarket. Urgent cases & emergencies would go to the ER. Locally, we are actually spoilt for choice; unfortunately, this is largely unappreciated.

Finally, a humble word of advice - take charge of your own health. Know your medical history & the drugs that you are taking or allergic to, so that when you next see a doctor, he doesn't have to guess or trace records which would take time away from the consultation. Don't be shy to ask questions about your management, your condition, and your treatment. If in doubt, get a second opinion. Most of us wouldn't mind (this is not a matter of losing face; it is your health we are talking about). Remember that risks are inherent in everything we do, including crossing the street! Same thing with medical procedures - do not take for granted that risks are non-existent. Risks vary depending on the treatment/procedure/surgery. Ask your doctor what they are & what are the chances of developing complications; know what the possible complications are. Success rates are also variable depending on the medical condition; and although we would like to be, we are in no way, miracle workers! Discuss all this with your doctor. In this way, you would be able to make an informed decision on how you want to be treated & managed.

Wishing you all the best,

Sincerely,

Doc MD

Boys are ALSO from Mars & Girls from Venus

My 14 year old son recently suffered a bout of viral GE, with fever, nausea, abdominal cramps, vomiting, diarrhea, the works. Threw up all over the bathroom except the toilet bowl (must be a guy thing, trying to will himself not to vomit or suppress the feeling till he couldn't tolerate it anymore, hence, did not make it in time to the aforementioned receptacle).

He went back to school & described his illness to his friends. I believe the words "Projectile Vomiting" were mentioned, probably with a rather graphic description of the state of his bathroom in the aftermath.

The reaction from his female friends : "Eeewww!!!"

And from his best friend (a guy): "Awesome, dude!"

Go figure.

Happy Valentine's Day!

Here's a cute poem my son wrote for his Math Valentine's Day assignment:

You are the coordinates of my coordinate plane,
Showing me the way so I don’t go astray.
You are the equal sign of my equation
The exponent of scientific notation
You’re also the parentheses that keep things together
A binomial we shall be forever.
If you were mine,
I’d be just fine,
Will you be my valentine?



Happy V Day, everyone!

True Colors

Self esteem.

Something that all of us struggle with. From childhood, especially through adolescence & even as mature women, self-doubt & poor self-image affect the decisions we make & how we live our lives.

Watch this.

Drugs!

Hah! The wonders of medicine...say what you may about the COXIBs but within hours of ingesting the first dose of Celebrex, the pain had reduced by 90%! Hallelujah, I don't have to hobble around the house like an old lady anymore!

One of my pet peeves is the misconception by patients that analgesic drugs (more commonly known as "pain-killers") are bad for you & makes you rely on them (I'm not talking about the opiates even). Some are averse to taking even Panadol, let alone 'stronger' NSAIDS like mefenamic acid, ibuprofen or a COXIB.

More often than not, I have to explain to them that pain is caused by inflammation, & if you make the inflammation go away with the above mentioned drugs, voila! the pain disappears too. So the drug is not PURELY a pain killer, but it acts on the inflammation causing the pain. Of course, at the same time, you would need to elucidate the cause of the inflammation, & address that problem at the same time.

I am not advocating prescribing analgesics or anti-inflammatory left, right & center, but if indicated, the results can be wonderful (as personally experienced recently *GRIN*), & leaves one with a much better quality of life.

Now, back to my softball game......

My Left Foot

Man...I did something to my left foot. Since starting softball 3 weeks ago, my left heel & base of 5th metatarsal has been tender. I know, probably a bad case of plantar fasciitis. But the pain on the lateral part of my foot is a bit worrying...I hope it's not a stress fracture.

I know, I know, I should go see a podiatrist or an orthopod or at least get an X-ray done. But I hate going to see doctors. Yeah, sounds strange, me being one & all.

Maybe it's just me but it feels awkward when I consult a doctor. It's like, I feel like I should be able to diagnose myself already (sic). Even the other way around, if I happen to see a doctor who has come in as my patient for something as simple as an insurance check-up, I feel uncomfortable.

They say doctors make the worst patients & I think I am a classic example. Sigh...if the pain goes on much longer, I'll have to call up one of my orthopaedic colleagues for a consult.

Memoirs of a Geisha (which I think, should have been renamed Memoirs of Bitchy Geishas)

Just caught the above movie tonight. Haven't read the book yet, so maybe that's why at the end of the movie, I didn't quite get the point of the movie. That geishas have hard lives? That love triumphs in the end but you still may not get the guy? That women can be real bitches? (I think the last point stood out the most, with all the catfights & backstabbing shenanigans that was going on throughout the movie).

Zhang Ziyi did a great job, as did the young actress, Suzuka Ohgo, who played the younger version of Chiyo. Felt that Michelle Yeoh's performance was lukewarm, and she sounded rather out of place with her semi-Japanese semi-Singaporean accent. Gong Li as THE bitchy geisha also played her role well. There was also a hodge-podge of other Asian actors (my husband & I call them the recycled Asians, as they take turns appearing in various movies & TV series as the token villian/Asian gangster/gung-fu master/wise old man, such is the sad state of affairs for Asian actors in Hollywood)). Ken Watanabe, as Chiyo's love interest gave a credible performance. What stood out for me, as far as the acting talent was concerned, was that it was understated, which was refreshing; many Chinese/Asian movies tend to have overly done, melodramatic performances by its stars, & this was a nice change.

Was it a good movie? Yeah, I think so - wonderful cinematography, costumes & make-up, which should garner it some Oscar nominations in their respective categories. Didn't think too much of the storyline though. In any case, it was interesting watching an ex-patient star in her first BIG Hollywood production...

Now I need to decide whether the book is worth reading or not...

Patient Safety

Thank you, Dr Kee & Dr Lee for voicing so eloquently, their views about changes that need to happen in order to improve clinical quality. I wish that these letters had been printed in the newspaper, with a greater audience, instead of just on the online forum. It would be one small step towards a greater understanding by the general public that medical errors do happen but a great deal can be done to reduce risk of these errors happening.

It will take a nudge from the people to get The Powers That Be to get things moving in the right direction where this issue is concerned.

Stee-rrrike!

I put on a softball glove, & picked up a softball bat today for the first time after a lapse of almost 20 years. I can already feel my muscles protesting & I dread tomorrow morning when I am SURE that I will have trouble crawling out of bed...groan.

In medical school, I played softball for my year (remember the FMS shield? Hmm, I wonder if the annual competition is still being held, with the grand finale of a play which made up a huge chunk of the total score!), & also for the faculty. It was always the same group of people taking part in the various sports. I, myself, not that I am a great athlete, did softball, tennis, squash (go figure) and basketball, in addition to lending a hand in making the props/costumes for the play.

I remember in our final year, everyone was very "boh chap" about taking part in the FMS games because we were all panicking & busy trying to revise for the finals. So not surprisingly, our year was at the bottom of the scoreboard once all the games had been tallied. All that was left was the final play.

24 hours before the day that the plays were supposed to be performed, the "usual" group of us decided, what the h***, this is our final swansong, might as well go for it. A very talented classmate put together a play, inspired by the successful British comedy "'Allo 'Allo", with music & lyrics even. We rehearsed into the wee hours of the night, put together a medley of costumes (some loaned from the Franciscan monks!), & used minimal props for the performance.

Well, guess what? We won the Play section of the competition! Quite unbelievable, eh? I think our juniors must have been pretty pissed off! Unfortunately, because of our "poor" performance in the sporting events, our overall score only managed to get us 2nd place. But we were happy anyway. Nothing beats the euphoria of putting together a successful performance.

Come to think of it, I think the most enjoyable times of med school were actually the extra-curricular activities!

S, M, L, XL

God.

I hate clothes shopping in the local stores. Talk about a blow to one's self-image. Most of the clothes seem to be made for stick-thin models. Looking for new clothes for Chinese New Year here is an annual nightmare. The "Women's Plus" sections have clothes seemingly designed for the fashion impaired. The "Normal" sections have clothes which would probably fit just one limb on my body.

Not that I am morbidly obese - I shop in the "Regular" sized departments in the US. I guess being born with a genetic disposition to being "big-boned" in Asia is a real detriment as far as trendy clothes are concerned.

Oh well, come summer, Woodbury Commons, here I come!!!

simple pleasures

~ hugs & kisses from your child/children

~ finding life in a rock pool at low tide

~ the smell of a freshly bathed newborn

~ reading a good book while enjoying the ocean breeze & sounds of the waves crashing

~ discovering the first daffodil shoot peeking through the soil in between patches of snow in the waning days of Winter

~ coming home to your own comfortable bed after a vacation

~ laughing till tears roll down your cheeks

~ a girls night out with your best friends in the world, reminiscing about school, teachers & life in general

~ the first snow of Winter

~ the long days of Summer, when you can still enjoy daylight at 8 o' clock in the evening

So romantic, can die

Call me crazy, but I sat through a second viewing of "Pride & Prejudice" today, and liked it even better the second time around. Matthew Macfadyen as the dashing Mr Darcy certainly grows on you, as I had said before. There's just something about the Mr-Darcy-striding-through-the misty-meadow-towards-Elizabeth-Bennet scene that stirs my innards. *YUM*

After the last couple of weeks, I needed a "feel good" movie, and nothing lifts the spirits up like a good old historical romance with a happy ending.

Footnote: They showed the "Coming Soon" trailer of "Casanova" starring Heath Ledger & Sienna Miller- hmm...looks like my cup of tea :).

Hormonal Swings

Well. So much for the life changing event. It’s not going to happen after all. I must admit that I am a bit disappointed. This seemed like the last chance for us after all. Oh well. C’est la vie, as they say. At least I won’t be peri-menopausal, and post-natal at the same time. I am sure that many women out there will agree with me that hormones are powerful things & can produce all kinds of strange emotional reactions/responses/behaviour when they ebb & flow like the tides.

When I saw that second stripe appear on the test kit two weeks ago, my heart truly felt like it sank into the toilet bowl upon which I was sitting at the time while waiting for the result. It was a total shock. Why did I do the test? Well, any self-respecting doctor would tell you that one of the first things one has to test for in a female of child-bearing age who is overdue (no matter which end of the spectrum she happens to fall into!), is for pregnancy. So, as per my own medical know-how, I dutifully went out & bought one of those generic tests, not expecting to see a positive result at all. After all, I have been experiencing what I thought were peri-menopausal symptoms on & off for the last year (although I am rather “young” relatively, but still…) or so I thought. But this particular episode of amenorrhoea had gone on for a bit longer than usual, and hence the saga began.

In my mind, my family is complete. Hopes of having a third child had diminished after a prior blighted ovum & with advancing age. I had given away all the baby stuff, which I had stored & carted all the way from the USA with the intention of re-using them one more time. We have two great kids, had started planning for college for them, & had just gotten rid of the MPV.

So when the positive test came about, it really threw me for a loop, to say the least. It was a conflux (read: conflict + flux) of emotions; I was shocked, petrified, happy, anxious, cautious all at the same time. Thoughts of night feeds, diaper changes, strollers, weaning, toddler tantrums came flying through my mind simultaneously…with the associated flash of panic & depression. I was then cautiously happy but not hopeful, as the symptoms did not feel the same as when I was pregnant with my 2 boys. Much like with the previous failed pregnancy, I didn’t have the hyperemetic feelings, though there were fluctuations of appetite loss & occasional nausea. There was also the strange hypersensitivity to the smell of garlic (!!!).

I think when you, yourself, are the patient, being a doctor is a curse. You know too much. You know & can research into the risks & possibilities & complications of whatever medical condition you have (in this case, being an elderly multip – yeah, sounds awful, but that is the term used for pregnant moms above 35). And true enough, subsequent scans showed a non-viable pregnancy. My gynae said that most commonly at my age, this is caused by a chromosomal abnormality like trisomy 21. It was probably better to lose it now than to have to go through amoniocentesis & find out in the 2nd trimester.

I know it may sound cold to some, but I have tried to remain detached emotionally from what has been happening, in preparation for the ultimate diagnosis. Call it intuition, a “feeling”, a sixth sense, but deep down inside, I just knew that it wasn’t meant to be. So, no, I don’t feel depressed by what is happening. Admittedly, I’m a bit sad for the baby-that-never-was, & for unfulfilled hopes that have been re-awakened. But I know I will get through this. We, women, are resilient creatures!

Eating Wind

To those who have been wondering if I have dropped off the face of the earth, please be assured that I am still around & have not gone over to the Dark Side :). This especially so after my last rather cryptic post.

Reasons why I haven't been around are:

a) Have been chillin' out on a nearby Indonesian island for the last week;
b) Been dealing with a potentially life-changing event which caused
c) Writer's Block

Thankfully, I think I am over (c); (b) I am still dealing with & may write more about in a later post if I feel up to it.

As for (a), I admit that I would have enjoyed it more if I were still working full-time :). I think it is true that we don't appreciate what we have until we don't have it, in this case, leisure time - to just laze by the pool/on the beach/in the spa. Eight months ago, I would have enjoyed this holiday a lot more, eager to leave the hectic deadlines & rat race of work & just doing absolutely nothing. I know that my kids enjoyed themselves just being in the pool as they had worked hard all semester in school. Hubby the workaholic was happy just hanging around the hotel, & having aromatherapy foot massages, and not having to answer phone calls & emails.

Maybe it's time for me to start looking at going back to work....well, at least on a part-time basis...I guess a "tai-tai"s life is not for me.

GREY'S ANATOMY

I taped the 2nd episode of this new series & just watched it tonight. I must say that this was definitely a more uplifting episode than the 1st one. Seeing Meredith Grey turn around from drawing lines between herself & the rest of the world, to drawing people into her circle was refreshing. This episode certainly reminded me that the practice of medicine can do some good after all, especially if we practice medicine for the sake of the patients.

flux

balancing on this knife edge of uncertainty
i want to fall off the precipice
which side doesn't matter
as long as I fall
to end this state of confusion
and emotional torment

Memories

Watching the first episode of "Grey's Anatomy" brought back memories, both good & bad, of my own internship. The busy calls, "Nazi" residents, wonderful consultants who actually treat you like a person who is there to learn instead of just a grunt worker...these were so real to me. I wonder how laypersons reacted to watching how some of the interns were treated (made to look like fools). Doesn't seem too humane, does it? But it happens (unfortunately).

This looks like a promising series - I look forward to watching, and remembering, more.

Pride & Prejudice the Movie (*Spoiler Alert*)

Die-hard Jane Austen fans would hate this movie. Not only did they change & condense bits of the story (especially Darcy's explanation to Elizabeth about Wickham's past behaviour), but the screenwriters also modified some of the dialogue of the characters.

Me? I liked it. I especially liked the lead actors playing Elizabeth (Kiera Knightly) & Mr Darcy (Matthew Macfadyen); Donald Sutherland also did a superb portrayal of Mr Bennet & the scene in the study where he asks Lizzie about her true feelings for Mr Darcy brought me to tears. Judi Dench, as Lady Catherine De Burgh, did not fail to live up to her reputation.

The emotional angst & passion in the story were turned way up compared with the mini-series starring Colin Firth, & will satisfy the ladies who will swoon over Mr Macfadyen's Darcy. The scene in which he strides through a misty hazed meadow towards Elizabeth before they finally declare their love for each other, did for me, what the scene of Colin Firth in a sodden white shirt at Pemberly, did for Bridget Jones. Sigh...

I survived my first Teenage Party

No, not as a participant (I had my fair share of such do's eons ago), but as a Supervising Parent (God, I feel so old as I type that). My older son celebrated the end of the semester, as well as his 14th birthday this past weekend at our condo pool.

Having sixteen 13 & 14 year old boys & girls all in one place is no joke, man, I tell you... All those adolescent hormones raging, one boy was literally almost climbing the wall by the pool till my panicked husband stopped him! They were chasing each other around the pool, in the pool, out of the pool, singing songs, girls screaming/dancing....my poor neighbours...

They had to let out steam I guess, 8th grade is hard work, & it's been a strenuous Semester for the kids with almost no break since Aug (apart from a couple of days over Thanksgiving) till now. If I were them, I'd be screaming too.

But well, I survived to live another day. Don't ask me when I will organise another one of these things again - I need to recuperate first...I have another 2 years before my other son turns 14, so that should give me some time...

Christmas Spirit (or the lack thereof)

My son commented that I had lost the Christmas spirit this year. This was triggered by the fact that till today (count:10 more days till Christmas!) I have yet to put up a single Christmas decoration, let alone buy a tree!

"Why?" you may ask.

Well, first of all, I think that in the local context, getting a real tree is such a hassle, as there are no garbage trucks that pick up the used tree for recycling when the season is over.

Secondly, I have not felt that Christmas magic in a number of years. This is magnified by the fact that in the local context, the original meaning of Christmas has pretty much gone down the drain... I thought that Christmas was the celebration of the birth of Christ? For many (especially kids), it's just another excuse for giving (getting) presents. Oh, I know that there are Christians out there who know that there is more to Christmas than the presents & the tree, but I would hazard a guess to say that if you go out on the streets & interview one of the many shoppers thronging O. Road asking them what Christmas means, 8 out of 10 will tell you "Getting Presents".

I plead guilty to being one of those indulgent parents who tried to bring the magic of Christmas alive, with the tree & the stockings by the fireplace (we actually did have a fireplace while living in the US) & the cookies/milk for Santa etc. etc. Moving back to this tropical clime, this was hard to maintain (how does santa come down the chimney if we don't have one???). Believe you me, I tried to delay the inevitable Truth About Santa from my kids (they believed till they were 9 & 7 respectively!).

Sadly, with growing up also comes the loss of that faith in the magical (there goes the Tooth Fairy). And being caught up in the rat race of life has also resulted in a certain jadedness & a realisation of the hypocrisy over the whole Christmas rigmarole.

Perhaps I need to dig down deep inside & examine what Christmas has really meant to me all these years. Perhaps it has become more than just a religious celebration. Perhaps it is also a chance for us to celebrate the love & togetherness of a family, and a willingness to give joy & happiness to our loved ones. This does sound like it is getting all mushy, isn't it? Perhaps it means that I am starting to feel some of the Christmas spirit after all...

Elitism?

This letter to the editor in today's newspaper gives a different perspective on the difference between the "elite" and "neighbourhood" schools locally. I have heard of similar views from a friend of mine whose child goes to one of these "elite" schools.

I had been grousing to her about my dissatisfaction with the education that my kids were getting in the local system, and had thought that perhaps, it was because they weren't in one of the "elite" schools that the quality was lacking. She then replied that the only difference between these schools & a neighbourhood school was that most of the kids in the elite had the resources available to them to go for extra tutoring & "enrichment" courses; hence they managed to get better grades in their exams.

It was certainly an eye-opener for me that the education system has changed so much from the time that we were in school till the present time. Come to think of it, I remember getting a phone call from my son's Chinese teacher when he was in Pr 1, asking if he had anyone tutoring him in Chinese. At the time, being newly from the US, I had naively thought that putting a 6 year old child through extra classes outside of school was ridiculous, so had resisted doing so. The teacher had been shocked when I said no, & insisted that I should engage a tutor for him, as it was not possible for her to bring his grasp of the language to the acceptable standard without outside help.

Which brings me to the next question: if the teachers themselves think that they are unable to teach a child adequately & requests for the child to get extra tutoring, and if schools ROUTINELY schedule remedial/supplementary classes in addition to the normal school hours, does that not mean that something is not right with the system???

And another thing...I wonder why these "elite schools" tend to be grouped in districts where the affluent live? I know of at least 3 "neighbourhood" schools which have been displaced from their previous locations within these affluent districts (they still maintain their original names a couple of which were taken from the street names where they were located), & their sites taken over by the "elite" schools. Another form of social engineering, hmmm?

Lessons Learnt

Why do you want to become a doctor?

This question has been asked countless times to potential medical students during their pre-admission interview.

Standard answers probably include things like
a) "I want to help people"
b) "I think it is a noble profession".

More realistic reasons would probably include
a) pleasing the parents;
b) thinking that doctors lead glamourous lives (as portrayed on medical TV dramas),& are like the white knights of the days of old, charging in on their gallant steeds to protect patients and slay the disease-dragons
c) wanting to achieve a certain standing in society (doctors have historically been placed on a pedestal by society).

In rare cases, a student truly feels that it is his/her calling to become a physician.

The truth is, yes, you do get to help people -and this is invaluable. What they don't tell you is that you also get a lot of crap in return. And also, that white knight on a steed? Well, sometimes they have to deal with a blunt sword or being able to afford a steed at all; their king may also close off short cuts leading to the patients, & instead decree that they have to take the path that is laden with strewn logs & brambles.

So do I regret the decision I made of becoming a doctor? No. The decision was made according to the circumstances surrounding my situation at that point of time.

And do I think it a waste that I have stopped working as a doctor (for now)? Again, no. I believe I have put in my share of blood, sweat & tears; I do believe that I have saved countless lives, or at least improved the quality of life of many of my patients.

And in return, my experiences & knowledge gained during these years are priceless. I have learnt of the fragility of human life, and the resilience of the human soul to survive seemingly insurmountable setbacks. I have learnt that underneath all that skin, no matter what color it may be, we are all the same. I have learnt not to take life for granted. I have developed "thicker skin" so that ill-meant remarks don't cut as deep (thanks to certain 'senior' doctors during the houseman days). I have learnt to be a (hopefully!) better mother who doesn't panic at the slightest whimper of my child (thanks to postings thru neonatal ICU & pediatric surgery). I have also learnt that this is not a perfect world, and that sometimes, wanting to do right & actually doing it right are two entirely different things altogether. And lastly, I have learnt that politics is inherent in everything you do in this society; no matter how good your intentions are, you still have jump through the right hoops to achieve what you want to achieve - not an easy task if you are one who is not politically-inclined (read: good at brown-nosing).

So to all you potential doctors out there, don't let my rantings & the rantings of other doc blogs discourage you from becoming a physician. Just make sure that you don't go into it with rose-tinted glasses, like some of us did, & you will be fine.

Learning English

This letter in today's newspaper reiterates the point I was trying to make in a previous post.

Learning a language (be it English, Chinese, Malay or Tamil) is more than just filling in the blanks or multiple choice questions. Let's hope the folks in the Education Ministry realise it soon...

Gimme a Break!

Ever since I started my self-imposed sabbatical away from the world of medicine (both clinical & non-clinical) 6 months ago, people I meet, be they family members, friends or even newly acquainted persons, ask me why I stopped working & when I will be going back to work.

My much repeated answer to the first question is, to summarise it: disillusionment, dissatisfaction, re-prioritization of my life.

Why disillusionment? I must admit that this started way back in the first years of my residency, when I was posted through the then-compulsory outpatient rotation (in my case, a polyclinic posting). The workload back then was just as bad (if not worse) than it is now. I remember my personal record of seeing 100 elderly patients with chronic illnesses on a Saturday morning from 8.30 am to 12.30 p.m.!!! It was literally come in, sit down, measure blood pressure/pulse, listen to heart/lungs, repeat prescription & out they went. Not quite the ideal situation for consults, as you can imagine.

Another eye-opener for me was the lack of scruples in our fellow man. My inherent (& perhaps naive) idealism in the goodness of human nature took a battering when I came across numerous malingerers (especially those NS guys -sorry, but this was based on my personal observations) hoping for MCs.

And in more recent times, I have grown increasingly disillusioned with this so-called "noble profession" as I see the dog-eat-dog world of corporate medicine, fighting to get contracts with companies, with undercutting and fancy packages (with sometimes dubious value) geared to attract HR managers. Doctors have become assembly-line workers, churning out patients from their consultation rooms. The higher the number of patients they see, the better it is for the practice since more consults = more $$$. I know that this is not reflective of all doctors, & that my skepticism & jadedness is a result of my personal experiences, but I am sure there are many fellow physicians out there who feel the same way.

And then there are the patients. Period. I am sure angrydoc's blog will give you many examples of doctor's dealings with patients which can be rather, ahem, challenging :). I have also recounted some of these experiences in some of my previous entries.

As for the 2nd question, the answer is simply: I don't know. I have yet to feel the urge or the calling to resume clinical practice. Whether or not I will ever feel it again, I don't know...I may still go back to practising part-time or as a locum, just to keep the neurons firing, but not just yet...let me take a break first.

What a Classic Line!

"I was born naturally, but brought up Caesarean." - Adrian Monk from the series Monk

I heard this line last night on the latest episode of Monk & cracked up! I think it will be a classic. I had to think deeper after my initial response (i.e.ROFL) to its superficial comedic delivery by the talented Tony Shalhoub to figure out what Monk meant when he said that. My personal take on its meaning is that Monk was born, like most everyone else, a normal baby. But subsequent "interventions" (i.e. situations which occur , and people he interacted with during his life) - hence the term "Caesarean" upbringing- resulted in the neurotic person that he is now, with all his oddities & quirks.

I love the analogy & I think it applies to all of us, as each & every one of us have our own distinctive neuroses & dysfunctionalities (to different degrees!).

I love Monk! More, more!!!

English Lit.

The movie adaptation of Jane Austen's "Pride & Prejudice" will hit the local cinemas in December. I have already asked a couple of my ex-schoolmates if they would be interested in coming along with me to watch this chick flick (hubby had resignedly said,"If you really want to watch it, I will accompany you." Sweet intentioned that he is - hee hee - I won't submit him to the torture of sitting through 2 hours of Jane Austen's dialogue).

Reason why I am so keen to watch this is because I remember reading this book for English Literature, one of my favorite subjects in Secondary school. What made it even more fun was that some of us were assigned "roles" (characters) from the book, & we read out the dialogue as if we were acting out the book in a play. Reading this book brings back many enjoyable memories of reading & learning to appreciate the beauty of words & what emotions some words can evoke in me. I remember reading Poetry which could stir up emotions in me that I never knew existed!

Admittedly, Jane Austen's austere & rather long-winded writing style frustrates me immensely at times; and yet, I am still drawn to reading her books (as a matter of fact, I have all her novels); perhaps I am a masochist! I even have some of the previous movie adaptations (Sense & Sensibility, Emma) as well as the TV series version of Pride & Prejudice in which Mr Darcy was played by a rather wooden Colin Firth (highlighted in Bridget Jones' Diary).

Literature is no longer a compulsory subject in local schools, which is a pity. It is a shame that many of our children will not know writings of Shakespeare or Bronte or Austen, nor the poetry of Yeats or Keating. It is obvious that the standard of written & spoken English locally has deteriorated tremendously in the last decade or so. Someone in the Ministry of Education should realise that the study of a language does not comprise solely of filling in the blanks of Cloze passages (what the h*** does Cloze mean anyway??? Can't find it in any respectable dictionary!) & answering multiple choice questions. Children need to be exposed to the different forms of writing & not only will they grow to appreciate the power of language, but at the same time learn so much more about the world around us.

When my older son first transferred to the international school system after spending 5 years in the local system, he struggled with Reading & Language. Yes - this despite the purported high standard of English in the local schools. He realised that what he had been doing previously was just skimming the surface. In his new school, he had to actually read books, analyse paragraphs, and learn to use different tools in writing. It took him a couple of months to change his mindset as far as learning the language was concerned. And it is only recently that I see a change & vast improvement in his language skills when he had to review a poem (below) by Langston Hughes called "A Dream Deferred".

Not bad for a 13 year old, eh?

A Dream Deferred:
Why it’s Memorable

“A Dream Deferred” by Langston Hughes is very memorable because of its vivid, detailed imagery. His use of pauses and hyphens causes the desired, unsteady beat to create stress in the poem. For example, he put “Harlem” at the beginning, asks a question, and he has an off-beat question at the end and they all don’t follow any steady rhythm like the middle of the poem does. He probably did these things in this poem to show that a dream deferred is random and out of place. Hughes also used harsh “st” sounds and “s” alliterations to create undesirable images and slithering, flowing sounds to show slyness. For instance, he wrote, “Or fester like a sore – And then run?” this creates an ugly or even painful image of a sore in the reader’s head. Another example: he wrote, “Or crust and sugar over – like a syrupy sweet?” which creates an encroaching, slithering manifestation of a rotting candy. Using all kinds of devices, Hughes creates a lasting impression in the reader’s mind.

Harry Potter & GOF

Watched Harry Potter & the GOF tonight. Have mixed feelings about it. Loved the special effects, and the stars of the show did a wonderful job, but somehow felt like the movie had a rather chopped-up-then-put-together-again feel to it. I guess the director was trying very hard to squeeze all the important elements of the story into it, without ending up with a 4 hour movie! I wish that some of the supporting characters like Cedric, Fleur & Cho had been given more screen time & allowed to develop their characters a bit more. Even Snape didn't get to show his colors as much this time around. And Sirius was reduced to literally ashes in the fireplace in just one scene.

A-n-y-hoo, I think it's worth a second look (we are such movie buffs that we tend to go a bit overboard sometimes!) to catch some of the minor bits & nuances which we may have missed the first time around. Hmm...maybe will try Gold Class.

Of Witches, Wizards, Magic & Hogwarts

What is it about Harry Potter that draws grown-ups into his world & his adventures? We bought advance tickets for Harry Potter & the Goblet of Fire last week when the tickets first became available for sale. I am probably more excited about the movie than my sons! I have even marked the date on which we are watching the movie in RED on my calendar, that's how excited I am!

I bought the first Harry Potter book (Sorcerer's Stone) out of curiosity about the hoo-ha that surrounded its popularity. My older son was not even old enough to appreciate it at the time. My husband soon got drawn into it by the time the 3rd book came out.

I guess part of the appeal is the fantasy world of magic, where bones can be mended with a potion, or time can be relived using a magical necklace. It's a form of escapism from the real & often mundane world. Something about living in a boarding school also appeals to the teenager in me, who used to read the Mallory Towers series by Enid Blyton, wishing that I, too, could do the same.

I know that come Nov 18 when we are watching the movie, I will be on the edge of my seat with anticipation as the scenes unfold and JK Rowling's words are transformed into the images on the big screen. I also know that I will wish that the movie will never end - that's how it's always been in all the Harry Potter movies- and that the magic will somehow continue...but it never does, and eventually, it has to come to the bittersweet end.

Must-See TV...NOT!

I was appalled at the standard of a local TV drama series which premiered last night called "Lifeline", which is about a group of paramedics & police officers. I am all for supporting local talent if it exists! I wonder if the TV stations have quality control people who screen through the programs first before they are allowed to make the cut into prime-time!

I was cringing through the 1-hour episode with the wooden acting, poorly scripted dialogue, unimaginative storyline; even when the credits were rolling, the background showed a scattering of what was supposed to be ECG tracings (I think!) which looked more like the scribblings of someone testing out a pen at Popular (a local chain of stationary/book stores).

Sigh...local TV needs to be revamped, especially the programming. For the last decade or so, prime time slots of between 7.30 pm to 9.30 pm have been reserved for mainly locally produced comedies, reality programs & now dramas, while award-winning TV programs like Desparate Housewives, CSI, & previously X-files, E.R., Chicago Hope etc were relegated to late night slots of after 10 or 11 pm.


SOAPs are like DOPE

Do you realise that soapy dramas like One Tree Hill have an almost addictive effect on its viewers??? I watched one episode of this series (targeted mainly at the teenage female audience)during one of my "nothing-better-to-do" moments & was reluctantly, slowly, but surely, drawn into the convoluted happenings of this small town called Tree Hill. The story revolves around characters from the local high school - two of them, Lucas & Nathan are half brothers on the basketball team. They share the same father (Dan) whose brother (Keith) is in love with Lucas's Mom (Karen). There is a plethora of other characters like Jake (a single parent to an infant girl), Brooke (Lucas's ex-girlfriend), Peyton (Brooke's best friend whom I think had a fling with Lucas but I am not sure cos I wasn't watching the series when it happened), Haley (Nathan's girlfriend & now wife!) & Jessie (???I think that's her name??? - anyway she is the mother to Jake's baby girl). Latest cliffhangers in the season finale has Nathan's mom (Deb) having a one night stand with Keith; Lucas leaving Tree Hill with Keith; Dan having a heart attack; Coach Whitey (basketball coach) on the verge of discovering the diagnosis of his eye condition; Jessie trying to find Jake who has run off with their daughter after she threatened to fight for custody; & Haley & Nathan finally consumating their relationship after a quickie wedding. Confused enough??? My husband begged me not to tell him about the story ("No, no more...enough!!!") when I was trying to explain it to him while I was watching the taped final episode of the season. I think I will try to cold turkey myself off this series even when the new season starts....

Something's Gotta Give

A renowned advertising executive, Neil French recently resigned after creating an uproar over a remark made about why women don't make it to creative directorship. He said something to the effect that because of motherhood, women just do not have what it takes to get to the top of the heap in the advertising world.

In my personal opinion, his remarks probably holds true for many other professions, including Medicine. The demands & time needed to, first of all, complete medical school, then internship, and then possibly traineeship, are arduous & draining, both physically & mentally. I know that there are thousands of ladies out there who have become excellent clinicians and heads of departments, or set up their own GP clinics working morning noon & night for most of the week and at the same time, have managed to start families, balancing work & family life with amazing dexterity. But one wonders if the quality of life achieved is satisfactory, and whether their families (especially the children) suffer as a result of this tenuous balance.

We may want to be Supermom & Superdoc concurrently, & there are probably some women out there who can be both, but I think that is the exception rather than the rule. Like it or not, women ARE from Venus & men ARE from Mars, and apart from our physical differences, the psychological and emotional make-up of the two genders are very different. Somehow, when men are at work, they are able to focus totally on their job - forget about planning for dinner or whether the kids have homework, or whether the kids are revising for their tests/exams etc. Women, on the other hand, often times have to multitask - seeing patients, planning what's for dinner, making up a grocery list, worrying whether the kids are doing their homework...

I told my ex-boss once after lamenting about the shortage of doctors in our practice: it's tough hiring female doctors, isn't it? What with maternity leave and going part-time once the babies arrive, and children's MC etc... He just smiled & said "You said it, I didn't!" I guess many people don't voice out what is quite obvious in their minds for fear of repurcussions (a la Neil French). But we have to admit that something's gotta give...

Flame on people (:::putting on my asbestos suit:::)