Treasures

These are some of my work-related treasures. Nothing of value to most; notes, cards and tidbits I've gotten from patients in the last few years. Nothing you can put on your resumé, costing perhaps a few cents for the card and stamp, but if you've ever received them before I'm sure you know what I mean when I say they're almost priceless. On bad days, on days when you feel pretty insignificant and think you're making no damn difference at all in a patient's life, getting and reading one of these lifts you up like little else can. It's easy to forget when you see so many patients, that you sometimes do help. And though you might see 20 patients that day and details begin to get fuzzy, that one patient might just appreciate your reassurance, or kindness or smile, and remember you for it. Perhaps even for years. I recall that patient I had seen 2 years earlier who picked me out from a crowd in Macaroni Grill that New Year's eve. These things are nice reminders that you're appreciated.

I'm not saying I'm wanting patients to reward me, no. It's just nice to know that you did things right.

This card arrived at my clinic the other day. Some random stranger heard or read my radio interview with NPR when I was in New Orleans, and decided to send this to my hospital. And it found it's way to me. Though this was just a card, I must say it made me kembang the whole day, and then somemore. Whoever you are, Cathy of Fort Meyers, thanks for the kind words.

300

If there's ever a movie that makes me want to run out in my loin cloth, skin covered in oil, and to eat meat raw and dripping in blood, Lake House 300 has to be it.
The cinematography (background all CG, apparently) was brilliant. The battle scenes eye-popping and so very, very gory and graphic. Body parts flying everywhere like it was a Texas Chainsaw Massacre highschool reunion. Slow-mo in the right parts, though a decapitated torso would have spurted blood way higher than that from a severed carotid artery. Blood was definitely not lacking in the show. And the movie was positively oozing with sexuality. From the oracle's R-rated dance that would make a Vegas pole dancer blush, to the oh-so-prominent nipples (women AND men)(don't ask me why I noticed the men too), to the muscular, well-oiled bodies of the Spartan warriors (good thing my girlfriend wasn't there. She would have gone into shock from the salivary dehydration). And if that Spartan queen isn't one hot MILF, I'm not sure what is.

I'm pretty sure they took some creative liberties with the show, but then again I'm not cultured enough to appreciate the accuracy of history.
My favourite part, really, was the scene of the first battle. Not sure if the Greeks really fought like that, but I thought it was cool.
My verdict: Go watch the show, especially if you've had one pissed-off, need-to-kill-someone week. And forget the pirated Chow Kit DVD; spend the miserable 6 dollars and watch it on the big screen. Now excuse me while I go hunting for moose.

I said 'No anchovies', dammit!

PMS, Part III

Warning, content includes strong language unsuitable for children

Questions regarding my research protocol should have been brought up when the protocol was initially written up years ago. Not when my 21-page manuscript is being tweaked prior to submission for publication.
It's amazing how some senior consultants can be so hands off and not lift any finger to help you problem-solve or give ideas, but after you've done all the work, the same people can be so fucking picky and fussy about details.
And it's also amazing how some cibai consultants, on smelling blood, or in this case possible publication material, suddenly hops on the bandwagon wanting to be co-authors. Kanineh chaucibai.... sang chai mou si fatt! (translation: you really don't want to know what it means. Trust me)
It's a game I guess.
You know it's helpful to have experts on your panel of authors to give the paper more credibility. One can call this a simbiotic existence; they get a free ride on your paper to add to their 200 publications, while you have some powerful names as co-authors.
Except in this case, the very same people who hopped on at the last minute are questioning my study protocol and validity of the results, and are talking my other consultants in to scrapping my manuscript. So, in a nutshell, I'm getting ass-fucked. And people ask me why I hate research.

Ed note: This has been the 3rd and final chapter in our PMS series. We hope you enjoyed the show. After our author has simmered down a bit, our regular broadcast of sex, lies, blood and medicine in general, will return.

PMS, Part II

Since I'm still in my mood swing, I'm going to be unreasonable, regress 25 years and vent a bit more. I have had it for today with thyroid biopsies from the 10 hours of seminars today, so I'm just gonna talk crap.

Some things really irritate me. Pet peeves.

One, cellphones ringing when they're not supposed to. You'd think that anyone with some sense of decency and at least half a gram of brain material would remember to turn off (or to silence) their cellphones at meetings or the movies. But without a doubt, whether in the USA or Malaysian (10x worse back home), there's always bound to be some idiot who's not able to read the pre-movie notice 'Please silence your phones'. Worse are those damn ahbengs who have the nerve to answer their phones and then proceed to converse. Fucking morons. Here, you'd think that being in a hall with 200 highly qualified subspecialty trainees, it would be different. But no. Even after one or two phones had gone off, some people were too retarded to remember to shut their phones up.

My second pet peeve, and I know it's going to hit some of you out there in the face so be forewarned, is medical students who call themselves doctors, or who sign up for email addresses that begin with dr...@hotmail.com. I mean, WTF? That's stupid, that's arrogant, and bothers on boasting. And it's almost as stupid as having Vagus@hotmail.com as your email nick. First of all, buddy, getting in was the easy part. Surviving medical school is a different thing. The graduation rate amongst the Malaysians at my medschool was only 70%. So, don't be so sure you're gonna get that title in front of your name. Not that there's anything special being called 'Dr. Vagus'. I'd rather be called studmuffin or tripod. You might say that you're free to use whatever username you wish, then again this is my blog so I'm allowed to throw temper tantrums like a 5 year old who just crapped in his diaper.

This has always been a minor irritant to me. But I guess the thing that pushed me over the edge was this medical student who is a total stranger to me who sent me an email asking for advice, who began his email with 'Hey Brother....'. And get this, he not only has drsomething for his email address, but his email profile has his name listed as Dr. So and so. Talk about being presumptious.

Not sure who reads my blog anymore these days aside from the FBI, but if you, the medical student I refer to happen to read this, here's some advice: it really IS rude to start an email to a total stranger like that, especially if you're asking for career advice. Now let me go and PMS somemore.

PMS, part I

Blogging has been sporadic of late. Have been extremely busy with paperwork, concurrent research projects and meetings. And am now attending a week-long 7am-8pm seminar hosted by my division. Also have been troubled by some career and financial issues the last few weeks. But anyways, I'm back now. And do I ever need to vent.

You have been warned.

Maybe I'm just stressed. But the one thing that bugs me is how this career in a place like this, can be so very demanding. Medicine in general is tough enough, but medicine in an extremely academic institution, brings it up a few notches. Take this, for example.

There are smart smart people. And then there are dumb smart people. I consider myself one. I'd call myself a dumb dumb person, except I know you're not going to believe me just coz I'm a physician and so by default I have to be smart (oh how wrong can you be, naive readers). So for simplicity I'll use dumb smart.

You see, being a doctor at a big institution, aside from seeing patients, you're expected to be up-to-date with current medical treatments. To be able to quote research papers from the top of your head. You're also expected to be a productive academician. Research.

I started my research year last July. In the meantime, I've published 2 papers (one of which an abstract), have another 2 manuscripts accepted for publication, authored a textbook chapter, and have another 2 manuscripts 80% ready for submission to a journal. I've also had 2 abstracts accepted for presentation at two national meetings. Maybe in another world, I'd feel satisfied, perhaps even pride. But no, I kid you not.

Being here, it's not only about publishing papers, but also what papers you publish (case reports vs metanalysis), how high the impact factor of the medical journal that accepted your paper, research grant money.

And when you're working alongside consultants with over 100-200 publications in their names, with R01 million-dollar research grants falling out of their pockets, who are world experts in their respective fields, it's easy to feel insignificant. Or lost, being in a lab full of PhD types. Made more apparent when even your good friend laughs at your lack of publications.

Put people together, and all they can talk about is their research and how they're going to be publishing some ground-breaking data. Me, talk about research makes me sick. If I could have it my way, I'd watch TV and relax on my weekends. But if I do, I feel so damn guilty not being productive. Really. I wish I could remember when I last slept a weekend away without feeling guilt.

Normally, I'd feel somemore pride, having run a free clinic at the local Salvation Army fortnightly for the last 2 years. Or having performed disaster relief work for a week. You'd think that that should amount to something. But sadly, it means squat to your career. It might mean the world to the patients you treat, but it usually elicits nothing more than a hmm, interesting to a professor. Not something that would get people to hire you.

And so, I plod along at this place. Blessed to be here, but really, feeling so extremely stupid or insignificant at times. Never been the type of person who remembers the exact month and year some paper was published, or understood biostatistics (ironic, seeing that I co-authored a book chapter about evidence-based medicine 2 years ago), or is able to grasp the subtleties of lipoprotein metabolism. Heck, half the time I don't even say the right things, and constantly suffer from the foot-in-mouth syndrome. If I didn't know better, I'd diagnose myself with dyslexia or ADHD or something.

Really, there are times I ask myself how on Earth did they mess up to let me into this place?

Like riding a bike, I guess.

You never forget.

Gene & Nate, friends from home, Kris and I went snowboarding the other day. Though I've talked about wanting to do it again, it's been almost 7 years since I last snowboarded. I figured, I was used to the magnificent slopes of the Canadian Rockies, where I first picked up this sport. Banff, Lake Louise; world-class ski resorts. I did it because a cute Japanese-Australian medical student wanted to go skiing. Almost killed myself learning how to snowboard.

How on earth can I ever get used to snowboarding in Minnesota?

It's like comparing a ripe Tanner stage V Jenny McCarthy to a Tanner stage I Kate Moss.

But in the end, I went. I'm glad Gene dragged me along. Initially, I had reservations; after all, I haven't the foggiest idea if I could remember how to snowboard.

Images came to mind of me rolling into the ER, right into the hands of trauma surgeons, with my leg wrapped in cloth inside a bag of ice. I had O-positive scribbled on my forehead, just in case. And I told Kris that if anything happened, I want to be cremated (you readers out there shall bear witness to this) and have my ashes scattered over Playboy Mansion. None of that Anna Nicole courtroom saga.

True, the ski 'resort' here was miniscule compared to the unbelievable slopes of the Rockies, but it sufficed. Enough trails to give you 10 minutes of board-time per run (compared to the 1 hour on some of Lake Louise's trails). Snow was perfect powder. And my body quickly remembered the smooth, gliding swoosh you feel when boarding. I remembered to how to put on the boots. How to turn. How to stop. Even remembered the mandatory robot-like gait a person assumes, walking with the boarding boots. Your ankles are fixed in a semi dorsiflexed position.

It was exhilirating! We spent 4 hours on the slopes. And aside from a few minor face-plants I made while looking at ski-babes while snowboarding, I had no other mishaps.

I'll be back.