Saturday, October 25, 2008

Wisdom in one night

Bhaddekaratte (Pali wisdom in one night). That's the name my master gave me when I was a novice. It was originally the name from a sutta, with a quote like this:

You shall not chase after the past or place expectation on the future
The past is left behind
The future is as yet unreached
Whatever present, you clearly see
right there, right there
Not taken in, unshaken

It is an idea which develop from the Buddha's teaching: nonself. There is no self, or there's no me. The self didn't exists. With no self, there's no feeling, no future, no past. I'm just a coumpound of chemical compositions, using the eyes of this body to look things in presence. There's no neceesary to distinguish who is me among people around me. Because whatever I do, I'll die one day.

This is a little hard to digest for me at first. But, recently, recovering from my massive depression attack, I seem to appreciate this more...give up or not give up. I don't have to decide. Because everything is determined by kamma...I just have to observe what I'm doing right now, without myu minds thinking of competing or passing exams...just be mindfull.

Thursday, October 23, 2008

放弃

放弃,真的放下成为the person后,真的轻松很多。
跟着自己的脚步读剩下的书,
反正读完读不完就这是这样了,
成王为寇一早是注定的,
再强求也没用。

无聊时就跑到GSC看场电影,笑一场;
闷到发狂时就在部落格写写文字。
我没有情人,没有朋友,
一个人有点孤单,但真的觉得很轻松。
人生不需要快乐,轻轻松松作回自己就好。
听听歌,幻想一切的如果...
原来放弃,真的可以潇洒得很快乐。

不再想和任何人争,
就算得到天下第一又能怎样?
平常心面对一切,真的很轻松。
周遭的人都不分昼夜地读书,
我时间一到就看戏,
看到累了就睡觉。
这才叫生活嘛!

人生活到几年算短,考试只有更短。
短短几十年的人生,如果每天都在想着成为第一,很累的。
有人说,只要付出过,就算得不到,而此生无悔。
我付出过吗?
是的,我付出过很多,也得不到很很多。
如果不再有欲望,真的很轻松。

我放弃了。
既然命运安排我在这里读医生,就让它船到桥头自然直吧!
我今生既不会再有朋友,亦不会再有对手,也不会再有情人。
了然一生,潇潇洒洒走一回吧!

Saturday, October 18, 2008

说好的幸福呢

爱上不该爱的人,
我真的痛了。
爱上她时,我不懂自己爱的多深;
原来爱的深浅是当爱过后的痛来了解的...
我真的深深的懂了...当我痛到不能自己的这一刻,
我懂一个男人一旦不顾后果的爱上一女人,
哭得时候会比女人还惨。

不懂是周杰伦了解我,
还是方文山太懂我,
《说好的幸福呢》完完全全是我的爱情写照。

爱一个换一个,
我曾经爱得那么潇洒,
没想到我也会有这么的一天。

痛...真的真的很痛。
我不懂谁能拯救我。
抗忧郁药换了两次,
心理医生看了三个,
也医不好一次爱一个人的那一种痛。

一年半来辛辛苦苦告诉自己为什么要当医生,
只需要一首4分钟17秒的歌来否认一切。

用心理学角度,
我现在的感觉完全是self-fulling prophercy;
用药剂学的角度,
只要我服用SSRI就能不再犹豫...
为什么我还是那么的痛呢?

怎么呢?你累了。
说好的幸福呢?

你不等了,说好的幸福呢?

我每天都因为要让你看见我地努力着,
一个人背负着做一般的梦继续向说好的幸福的方向攀爬...
一起要当医生,一起浪迹天涯行医...
剩我一人...
让时间经过,错过你的时间慢慢的累积,
我痛苦的过着每一天...
我都忍,干了的泪流了又流...
手上的伤一道道的流着血,
结疤后又割...要提醒自己这种痛。

我会继续作个医生,
而且是很厉害的那个,
人人羡慕的那个,
就连你都很难不注意我的那个...

我会一个人站在我们曾说好的幸福终点站,
然后,我会问你:说好的幸福呢?

Monday, October 13, 2008

屌的背后




每当天空洒下这寂寞的颜色,

把这个水泥森林都笼罩在孤独的空气里,

代表我想你又过了一天,

也代表我和你分手多了一天,

更代表你给我的痛在我心里又深了一寸;

但,欣慰的是,你想着另一个他又过了一天,

也意味着我距离死心靠近了一点,

不再想你的死亡之日也接近了一天。


时间一秒一秒地过去,

回忆一幕一幕的消失,

爱情一分一分地蒸发,

伤痛一寸一寸的累积;

当所有事情都从分手那天开始失控地变化着,

唯一不变的是我们的距离。


我不懂如何描述我们的距离。

明明你和我在一个擦肩的距离,

我的手却怎么都我不到你的手。


有人说失恋会慢慢习惯的。

真的吗?


我怎么都不能习惯眼泪替代你亲吻我的脸,

我打死都不能习惯空气取代你吻着我的唇,

我到死都不能习惯大雨去换你拥抱我的人...

我不能习惯...我不能!


看回自己在这个blog不断欺骗自己没有你坚强活下去的谎言,

我到底在欺骗着谁?

我可以以冷酷的外表欺骗全世界,

我可以用超屌的个性让自己和全世界隔离,

我就是不可以再次欺骗自己不可能再“携子之手,与子偕老”。

看着自己洋洋的用英文告诉自己多么的特别,多么的坚强...

解下这个不属于我的战甲,我只是一个被女生抛弃的男生。


我不懂自己在这个医学的战场在干什么。

我不懂谁是我的敌人,不懂该砍谁;

我只管挥剑砍死周围的所有人,

让和我无缘无仇的血溅在我那虚假的战甲,

让我的背后不断被讨厌的小人攻击,

我只想把这战场上的所有人打败,

不是因为我想成为医生,

只是我要到最后让你看见只有最强的我活着。

尸遍满野的战场上,我是最后活着的。

到了那时候,你是否就会注意到我呢?

Friday, October 10, 2008

要怎么形容黄之浩呢?
国大医学院里,最特别的人非他莫属。
一开始的第一学年,很少人见过他 -- 因为他从来不上讲堂的课。
正因为越少人见过他,他越出名。
有人说过他是医学院的高手之一,却没有人正确地知道他的成绩。
如果他在校园里出现时,见到他不用惊讶。
经常戴着一幅黑眼镜,脸上不带一丝笑容,独来独往地穿梭在医学院生里。
长得不怎么帅,却叫人很难忽略他的存在。
如果你有机会仔细地看着他的右手臂,你会看见几道你很难忘记的刀疤。
据宿舍里的男生说,他的右上臂有更多的刀疤,似乎是他自己割上去的。
正因为手上的刀疤的关系,黄之浩的黑色S&K外套也成了他的象征之一。

2008年的2月,黄之浩很突然的,却没多少人发现的,每天出现在讲堂里。
每天一早,他就出现在讲堂里,一个人地坐在最高的一排座椅,听着耳机一面翻着厚厚的课本。
有时候,他的听课专著程度真的让人惊讶;
也有时候,他的书本打开在桌上,人却不见了,直到教授快废完时,他就会变回在座位上收拾东西,准备离开。
黄之浩这样的转变,成为了医学院里一时轰动的话题。
有人说,他准备追求医学院里的另一个女生;
也有人说,他忘不了他的前女友--静芬,也是本医学院之一的学生。

说到黄之浩有这么的一个前女友,就不得不提他曾经为后者自杀的那么一件事。
据知情人透露,浩曾经在matriculation时期,为了她服下过量的paracetamol而紧急入院洗胃。
两人曾经在KMPh时期曾为一对令人羡慕的情侣。
就和其他KMPh出产的情侣一样,他们一起被国大的医学院录取了。
但后来却不知什么原因,开学不久,他们就这样分手了。
浩成了医学院里的话题人物,而芬被封了“冰山美人”的这么一个称号。

说完了黄之浩过去的这么一个大秘密,黄之浩还是这么一个迷一样的医学生。
他的性格,没有人知道。
但,很清楚的是,现在的黄之浩绝对和中学的他不一样。
据他的中学同班同学Connie,浩在中学的时候成绩是日新名校全五名之一,
其纪律问题的程度也绝对不在他的成绩之下。
当面与日新纪律老师干架,被传到校长室训话 -- 日新优秀生里,就算他最特别。
在日新的他绝对不是独来独往的。
他有一班学业和他一样好的朋友,也有另一班和他一起找纪律麻烦的兄弟。
曾经很健谈的他,有时还会说笑。
脸上总是有点邪气的笑容,曾经让他迷倒过不少....对不起,只有两个女生。
所以,拍过两次拖 -- 不多,但他曾干过的事情绝对让你跌破眼镜。
比如?-- 他曾经在巴士--载满者日新学生的学生巴士上,强吻一个小他一年的学妹。
后来,那女生没有告他非礼,反而成为他的女友。

所以,肯定的是,中学的浩和之前描述冷酷酷的浩简直就是判若两人。
如果你再观察第二学年的浩,你会怀疑他到底是受过什么刺激而变成这样的一个人。

你若认为戴墨镜 + 穿S&K黑灰色外衣 + 一头金发 + 嘴里衔着烟 @ 嚼着口香糖 的黄之浩已经够屌,那么你就大错特错了。
从第二学年开始,你不会再在讲堂的最高座位看到他 -- 因为他如今都是坐在第三第四排的前座。
又据浩第二学年的同班同学透露,进入第二学年后染金头发的浩从“特别”进化成了“怪物”。
上PBL时,他不怎么回答教授的问题;如果当他打开金口回答问题时,那绝对是没有人会回答的问题 -- 正因为这样,许多奇奇怪怪的case都是他发现diagnosis的。
这还不用紧,每一次的小组讨论,他似乎什么都没准备就来上课了。
当他发表他的research资料时,是不看纸的 -- 因为他从不把东西写在纸上;他只看着同学和教授了脸上,好像答案都写在他们的脸上似的。
上lab时,情况也是大同小异;很多时候,他说的答案全班只有教授听过这么样的东东。
这令和他一起上课的人很不爽他的屌。

这么屌的一个医学院生,真让人猜不透黄之浩究竟是怎么样的人。
那孤单的背影和不带笑容的脸下,到底是怎么样的一个人呢?
不用猜,也猜不到。
只是,有时候当你发现他一个人走在街上,一个人吃东西,一个人看电影时,
你会发现悲伤一直紧紧跟随着他,不肯放过他似的。
他被宿命拖着,走向你所谓的“成功医生”的道上,你永远不会了解黄之浩的这么一个人。

2008年10月10日
23:36

注:你看过黄之浩用流利的英文其他英文教育的人交谈,你会以为他是个ABC。再加上你看过 / 听过他在English Night 的辩论赛最后一场压倒性的辩论演词,你深信不疑他真的是个ABC,绝对不会用中文写下这样的一篇blog...你应该还不知到黄之浩也有自恋的一面吧!

XOXO
Reno (黄之浩是也)

Sunday, October 5, 2008

Clincal Skill - relfection

This is an assignment I was required to do for my Clinical Science Learning (CSL) module. Well, I prereleased it here, before I hand in to my mentor tomorrow.

Ooi Zhi Hao A116684
Clinical Skills Learning 5 (CVS3) Reflective writing

On the 5th session of Clinical Skill Learning, I, as with my other colleagues, were required to perform skills that we learned from 2nd till 4th session, which including general and cardiovascular system examination on a standard patient. We were informed that the particular session was going to be a mock OSCE, just like what is going to be in our real final examination. As differ from 1st year standard patient session, this time, we were not only be tested our clinical examination skill, but we are also going to the particular cubicle in order and solo, without other colleagues watching what we were going to do. During that session, I offered to be the second person to be tested.

When it was my turn, I walked towards the cubicle and was told to read the question. During reading the question, I committed my first mistake as I was spending too much time to organize chain of question I was going to ask about history of presenting illness. Till my examiner / mentor reminded me of the limited allocated time, then I started to panic and began my history taking by greeting the standard patient. During the first question of taking history of presenting illness, I ended my question 2 minutes before time up. My examiner broke the silence by reminding me about asking patient’s symptoms at night. Before I could asked further question about patient’s paroxysmal nocturnal dyspnea, it was time up and I had to present my history taking. After my history taking presentation, my mentor told me that my history taking wasn’t impressive as the biggest flaw in my HPI was the lacking of any childhood disease that would suggest rheumatic heart disease.

Next, I was required to perform a cardiovascular examination on the same standard patient. This time, I couldn’t stop myself by thinking my mistake during history taking. This distraction caused my performance worse than I used to be during usual session. Couple of things I missed during my CVS examination, included radio-radial pulse, collapsing pulse, carotid pulse etc. With this poor performance, my mentor finally pointed out in her feedback that I was behaving nervous during the whole mock OSCE, and I will need a lot of practices to be more professional next time, which I couldn’t agree more with that.

As my reflection on my mistake during history taking, I realize how important it is for a medical student / doctors to be well prepared anytime with any situation of how the patient might be. Organizing chain of though when the patient is in front of me is surely not an impression I want to be in front of a sick person who might need emergency medical treatment. Patients seeking our help because of trust, hence, any delay in approaching to patient is not a good thing to do, but in fact, causing patient to doubt our professionalism. In more serious level, delay in approaching a patient because of “organizing chain of though” is not an excuse, as time is very precious especially patient attend to us with a serious medical problem which might be life threatening. A fast response and well-react to a patient’s medical problem can sometimes mean saving a life. Be well-prepared anytime is the first lesson I learn in this session.

In order to improve my approach of history taking, I realize that I was missing the part of nocturnal symptoms and childhood history is because I wasn’t formulating differential diagnosis in the process of asking history form the patient. Making use of clinical manifestations of various diseases I learned from books, I should be able to form a provisional diagnosis after knowing chief complaint of the patient. Based on this case, patient was young and presented with shortness of breath. I should have suspected rheumatic heart disease, on the ground of its prevalence among young population, and hence it would lead me into probing any history of rheumatic fever during childhood. From here, I learned that conversation with the patient and simultaneously making provisional diagnosis in my mind is a multi-task ability I should practice a lot. This is a big step from history taking in 1st year when there weren’t many diseases that we learned which limited our differential diagnosis in first year, but it shouldn’t be in second year right now. With our maturation during this year, it’s time for us to make differential diagnosis during history taking, and not after.

In the physical examination part of this mock OSCE, I should learn to overcome my distraction next time as it would influence my performance. From here, I realize that steadiness is very crucial when we are going to approach a patient physically. Steadiness would mean making sure oneself is not influenced by distraction, no matter what. With a clear thought, we will be able to complete all things that we need to do when we were examining particular system of a patient. Lacking any step would sometimes result in missing a sign that might suggest a particular disease. Furthermore, steadiness also enables us to appreciate some clinical signs even more, e.g. heart murmurs, apex beat etc., which is very fundamental to make every our action merely action, but an investigation.

Lastly, I should keeps reminding my weakness always, but not allowing them to influence me when attending a patient. I should also keep my mentor’s advice in mind, which the only way to perfectionism is through practices, and lots of practices.

Thursday, October 2, 2008

My Way

Shit!

What a good word to start this blog. Shit because I spend two days in revising anemia, which was only one hour lecture + two hour MES (meet expert session). Shit! (again)

Why was I spending so many time? After comparing what I read from books with lectuer notes ... it's like comparing a kindergarden maths exercise and a pre-U one. What the fuck! Isn't that medical school suppose to train doctors who are going to save some lives in future? And this is the fucking lecture notes and are going to teach these bunch of people to handle lives of people in future. Well done, Dr Azma from UKM! (Okay, I confessed that I missed the lecture because I was sick that day, though part of me intentionally...)

It is making me wonder: whether all I'm doing right now worth? I have been puting so much effort persuing a different path from others. While others are making lecture notes thier bible, I'm struggling to understand text from a 1.5 kg pathology which is only secondary source for others. Other people's lecture notes are beautifully highlighted and jotting foot notes in every corners, mine are as clean as unsed toilet wipe (this metaphore is just intend to make more sense how I feel lecture notes are nothing more useful than a toilet wipe). The keyword of survial in UKM Medic: DIGEST YOUR LECTURE NOTES and you'll pass the exam. This is a proven fact seeing how my friend was making diagnosis of the last question based on excluding other already-choosen disease in lecture notes. (What a good way to save lives!). But, I don't want to survive, I want to LIVE! (quoted from WALL-E). That's why I have been choosing different path from others... the question now is: is this all worth?

Doubts and uncertainties are always exist in no matter which path I would have choosen. Time is allocated equally for every contestors in this Medic game. If I'm going to walk on this path I chose, I need to work harder to reach to the same progression as others. This is like a gamble because the final is just in less than one month. After all the humiliation of first year, I'm not going to humiliate myself more. Back to the same question: is it worth what I'm doing right now? Neglecting lecture notes and reading mostly textbooks? ... ... (moment of silence) Out of sudden, I think about a shoutout which I wrote on my MSN two years ago (I don't know why my memory still so clear about this)... ...exactly the night when I decided to reject matriculation offer (but in the end, I still went there and experienced a hell of life)... the shoutout was (not is) the reason why I wanted (not want) to stay in Form 6:

A person who follow the crowd will never be the person.

I tell myself again tonight, "A person who follow the crowd will never be the person". That was the Zhi Hao I was in secondary school. I lost myself during matriculation, and I need to find myself back. This path of becoming a doctor is about finding myself again and continue the principle of my life before I gave up two years ago and let myself deteriorate in matriculation. Becoming THE person. There's no replay or restart in this non-return life. I had two options: follow the crowd or be THE person. (Note that I use "had") I already made my choice, I want to be THE person. For once and the last time of my life, I want to be THE doctor, and not a doctor like others. This is the difference of me from others, and my path as well.

Life keeps screwing with me. Being born in a broken family, entering matriculation, poverty ... My shrink told me that all my background have been working synergically to contribute to my depression today. Growing under the best medium of cultivating depression, how can't I not develop depression. I've been having depressional breakdown since I graduated from matriculation (thanks to my triggering factor ex-girlfriend). I'm not going to let life screwing with me. Fuck the life! Screw the fate! I'll be THE person.

It doesn't matter whether I can achieve it or not. Because the worst scenario is: I die with the dream just steps away from me. I rather die this way than never begin step my foor on path to be special. Even if the worst case, I wouldn't just merely die, I die HARDER.

I think I can answer my doubt of the worthness of my current effort right now. It is not the matter whether it's worth or the other way. This is the matter that I have nothing to loose. If I follow the crowd and read the lecture notes, I lost many important things, top of the list: the ability of making differential diagnosis as a doctor, and the opportunity to be special as an ordinary human beings. Conversely, I lost nothing if I work harder (and die harder) and read the textbooks. The conclusion is: I have nothing to loose, so, continue what I have started these two days -- screw the lecture notes and read the textbooks.

Before I continue to work on digesting "bleedind diatheses", here are some quotes that I want to tell myself tonight and share:

做医生,就要当第一的医生;因为没有病人会想把生命交给第二第三的医生。
-- 蓝泽耕作《Code Blue》(日剧)

被嘲笑的梦想才有被实践的价值;即使跌到了,姿势也会很豪迈。
-- 九把刀 (台湾作家)

A person who follow the crowd will never be the person
-- Reno

Hence, the name of my blog -- My Doc Path.