Stranglers + My First NGT + Random Updates

Dunno why but I find it hillarious! Heh.

I finally got to put in a nasogastric tube a few weeks ago. It's all these super simple procedures that keep eluding me. I know, I know, it's an idiot-proof proof thing and even a monkey can do it, but I don't feel satisfied until I've done it hands on. Same goes with assisting with delivering a baby. Didn't feel like I completed my O&G rotation until I did at least one. Anyway I got the scare of my life la with this patient...

She was in ICU with sepsis. Asked the registrar if I could do it for him and he said OK. Slid the thing in, auscultated to check if it was in the stomach, aspirated gastric contents. Registrar was happy. NGT was taped in place, patient sent for chest X-ray to double check. 2 hours later, the consultant was going through the X-rays during the round. She looked at that patients chest X-ray and said: "The course of the tube is very odd. I think the NGT is in the lungs..."

I was like!!!!!! Internally going "SHIT SHIT SHIT SHIT SHIT SHIT SHIT SHIT SHIT SHIT SHIT SHIT SHIT SHIT SHIT SHIT SHIT SHITTTTTT!!" How could I screw up something so simple? I was pretty darned sure it was in the stomach. So consultant asks nurse to check the NGT aspirate. Looked like gastric contents. pH test scored a 7. Wah that time I even more panic... After a few minutes of debating between the consultant and registrar, it was discovered that the patient was on proton-pump inhibitors. Maybe too much of it. That caused the ridiculous gastric content pH.

....so the conclusion was, the NGT is in the stomach and working fine. Cease PPIs. *PHEW*

Haha handed in my Geriatrics and Rehabilitation Medicine write-ups today! One stone off my back for now. That medication review and management planning for my patient was giving me white hair. My patient was on 16 different medications. My report ended up being 20 pages of crap no thanks to that.

Am finishing up my week with pain presentations tomorrow. Can't wait 'cos the weekend's here!

My Current Obsessions (all the things I can't wear to hospital!!! *SOBB*):
1. Denim dresses
2. Vests
3. Skinny Jeans
4. Tartan

No Bravery - by James Blunt


There are children standing here,
Arms outstretched into the sky,
Tears drying on their face.
He has been here.
Brothers lie in shallow graves.
Fathers lost without a trace.
A nation blind to their disgrace,
Since he's been here.

And I see no bravery,
No bravery in your eyes anymore.
Only sadness.

Houses burnt beyond repair.
The smell of death is in the air.
A woman weeping in despair says,
He has been here.
Tracer lighting up the sky.
It's another family's turn to die.
A child afraid to even cry out says,
He has been here.

And I see no bravery,
No bravery in your eyes anymore.
Only sadness.

There are children standing here,
Arms outstretched into the sky,
But no one asks the question why,
He has been here.
Old men kneel and accept their fate.
Wives and daughters cut and raped.
A generation drenched in hate.
Yes, he has been here.

And I see no bravery,
No bravery in your eyes anymore.
Only sadness.

Voices of a Distant Star

...we are far, far, very, very far apart...
but it might be that thoughts can overcome time and distance.

This short film touched my heart in a special way. Maybe it's because I can relate to film's theme: Distance.

Voices of a Distant Star (ほしのこえ, Hoshi no Koe) is a Japanese anime OVA by Makoto Shinkai. It chronicles a long-distance relationship between a teenage couple who communicate by sending emails via their mobile phones across interstellar space.

Hoshi no Koe was written, directed and produced entirely by Makoto on his Macintosh computer. Makoto and his fiancée provided the voice acting for the working dub. Makoto's friend Tenmon, who had worked with Makoto at his video game company, provided the soundtrack. This half hour OVA also represents the "long distance" relationship between Makoto Shinkai and his wife, as Shinkai spent often long hours in the studio and communicated with his wife via text messaging.

A middle-school girl named Mikako Nagamine is drafted to the UN Space Army in a war against a group of aliens called the Tarsians, named after the Martian region (Tharsis) where they were first encountered. As a Special Agent, Mikako pilots a giant bipedal robot or mecha as part of a fighting squadron attached to the spacecraft carrier Lysithea.

When the Lysithea leaves Earth to search for the Tarsians with Mikako on board, Mikako's friend, Noboru Terao, remains behind. The couple continues to communicate across interplanetary, and eventually interstellar space via the e-mail facilities on their mobile phones.

As the Lysithea travels deeper into space, the e-mails take increasingly longer to reach Noboru on Earth, and the time-lag of their correspondence eventually spans years.

(Read more at http://en.wikipedia.org/wiki/Voices_of_a_Distant_Star)

Though only 25 minutes long, the film delivered so much bittersweet emotion that I couldn't help but cry. The dialogue was simple and earnest, and that made it even more heartbreaking. The animation is... for lack of a better word: stunning. For Makoto Shinkai to single-handedly create such beauty on a humble laptop is amazing. The music complimented the story perfectly and the song for the final scene was painfully melancholic. I've also watched his most recent film 5 Centimeters per second which also revolves around distance. The animation for 5 cm is like 10 times more breath-taking than Voices. Seriously. I think Hayao Miyazaki is the only person I'd rank above him.


Towards the end, the messages between Mikako and Noboru take 8 years, 224 days and 18 hours to arrive. Imagine waiting that long for just a simple "I am here.", let alone her returning to Earth. Would you have the strength to love and wait for someone who may never return? Would you?

Rejoice in the little things in life...

...like stir-fried garlic + ginger + spring onion + wine mussels. Made this for dinner and it really made my day.

30 Days of Night Comic Series

The origin of the movie. The movie was ok la, not terrible but not the best vampire movie ever. Still can't beat Interview with the Vampire which had Brad Pitt and Tom Cruise in it (I prefer Brad over Tom anytime, though!). Don't even get me started on bad vampire movies. Remember Queen of the Damned, anyone? Any self-respecting Anne Rice fan would cry bloody tears.

Ok anyway I love love love the art in 30 Days of Night: Eben and Stella. Lots of playing around with shadow and diffuse light. The story was a bit short and action scenes in the last bit were kinda confusing, but oh well. I'm a sucker for vampire romance. :P:P:P

This is some hillarious but depressing shit. Not to mention invariably true...

From DOCFILES.blogspot.com:

Malaysian Govt Doctors Criteria

Criteria for becoming a Malaysian Govt Doctor. Theres no need for an aptitude test. Students should consider these requirements:

1. No life outside medicine; this includes dating, sports, clubbing, chores for your parents and visiting the toilet

2. Not to live with your parents. Move out ASAP as they will never understand the ludicrous working hours that u go through. Furthermore, chores are not suitable for u as to rule No. 1.

3. Not to be married until completion of all 4 years of Govt Compulsory service as u will be transferred left and right to some of the most remote Govt clinics in Malaysia. Having wife and kids to follow you to your new working area may increase high level of stress on all parties. Furthermore, if your spouse is a Govt Doctor, he/she will also be transferred away from u and no matter what appeal is made, KKM will put up a deaf ear (unless u have big cables or of a certain skin color).

4. If married, no to have children until u finish all 4 years of Govt Compulsory service, as to which u and your spouse will not have much time for your child/children or they end up not recognizing u and refer the Indonesian maid as their mother (change in language patterns commonly follow).

5. To obtain life insurance once your govt service begins as there is not many claims for accidents during work. Don't be fooled, Doctoring in Malaysia is hazardous.

6. Able to withstand 36 hours of non stop work and stress without mistakenly labeling Left for Right or uvula for vulva (or Volvo S40)

7. To buy a car with complete safety features (like I'm doing) which includes multiple airbags, ABS, EBD, side-front-rear-top-parallel and diagonal impact bars and seat belts to ensure survivability if u are involved in an accident because your driving resembled a drunkard maniac after working in the hospital for 40 hrs non stop.

8. Constant supply of coffee

9. Nicotine Patch as u will have the urge to start smoking due to overwhelming stress

10. Interest in watching medical sitcoms such as House MD, Scrubs, ER, Grays Anatomy and Chicago Hope to inspire u to continue your life as a doctor as the exciting things u see on TV does not resemble the real life of a Malaysian govt doctor.

11. Not to have any pets or plants (not even cactuses) as u will have no time to feed or care for them and eventually all will end up in your mortuary.

12. Able to endure the stench of your own sweat as to when 36 hours "on call" does not permit u time to bathe or freshen up.

13. Able to carry on working without food or water over 15 hours. ( I was in OT for 16 hrs without food, water or bathroom breaks). If during fasting month, able to break your fast with “water for injection” as u had no time to buy food.

14. Able to come to work with fever/cough/illness or physical disability (sprained ankle etc) as to which doctors do not deserve MCs. (My MO was on crutches during rounds)

15. Able to stand scolding, destructive criticism, kiss ass behaviors, racial bias, finger pointing, scape goating, and in competency from your superiors.

16. Able to withstand the jealousy when your friends call u up for some fun and ur stuck in the hospital during on call.


Also see Doctor jobs Malaysia - Looking for Doctors.