My hands were sticky and smelt like a bar-top counter, which reminded me of the loud music banging at my ears and the numerous hi-bye greetings in a club. The club isn't a very nice place to be. And so is the hospital.

The entrance slide open, and a depressed grey sky greeted me with a cold slap of wind. I took a deep breathe in, and suddenly was whisked in a puff of cigarette smoke. The smell of irony.

Living a Lie

Ever lied so much about something (be it to cover your tracks, shy away from embarrassment, or whatever your rationale was), that you forgot what was the truth?

Will you lie, because you know the truth hurts?

Dancing With The Dead

Ever thought whether doing too much of something you love causes it to fade away?

I've met a bunch of interesting people. I call them my silent teachers. Most of them are pretty elderly, grown to their full riped age. The winkles on their skin all so oddly similar, yet they all came from various walks of lives, different backgrounds. Language is a big problem. You see, they don't really talk. Shy, calm, yet cold, they lie there, all prepared for the lessons. Doesn't matter if you are late though, they don't really mind. Afterall, they are usually locked up in the room, so company is fine.

Our first meeting wasn't the best. I was taken aback, not knowing how i should respond. One of their representatives came to show us the tricks and trades, on how to optimise our learning. They were there to help, with open arms, or sometimes just one arm.

As alike many things in life which requires time to nuture, our relationship grew. I felt more comfortable mingling amongst them. With every visit, they impart invaluable knowledge which strengthens my understanding. At times, i wish to ask why they were so sacrificial. I wanted to say a word of thanks, but that was silly. Afterall, they were dead.

NOT an accurate depiction of the teaching table

The path i have chosen makes Death, a familiar face. Right from the beginning we learn from those who nobly given their flesh to transcede into knowledge. And through the years, the emotional scale gets heightened. From the cold steel tables, to the fading warmth of the hospital bed, even the strongest hearts will ache.

However, we are humans. We adapt. We find little pieces that amuse us, crack a joke to relief the tension, harden our hearts, or just cry. I signed up for this because I love humanity, but will the process rob my humanity instead.

~~~~~~~~~~~~~~~~~~~~~
"When they pick up the coffin, you must look away"
Version Grandma, "Or your spirit will get sucked in and trapped"
Version Mother, "Cause it is scary"
Version Me, "Signs, Symptom, physical examination..."

Don't let me fall the stereotype. Don't be labelled "heartless".
I want to fear death, as much as i want to embrace it.
I want to waltz amongst my silent teachers, as much as i want to cry with their loved ones
For in death, there is life.

Exams

“Good afternoon, my name is Yang Chan, and I’m first year medical student”

No more I’m not! Exams are over, and I am now 1/5 of a doctor! Exams are a very interesting phase that we all have to go through, and hate it. During these periods, all sought of personalities arise. Some huddle up in their rooms, scurry into a secluded and quiet study spot, while others gather. I feel that I am a very independent learner, who doesn’t pay as much attention to lectures and details. So when a discussion pops up, I try to join in the debates but always find myself lost, as though I can’t remember anything. But when it came to revision, what took my friends almost a week for a topic (or system), took me 4 days. That only happens when the exams are here. Then, was I able to join in intellectual arguments :P

I am very pleased that I managed to discover a suitable study style. However, there is SO MUCH to learn in medicine, studying alone is very difficult. As much as I prefer to go at my own pace, I decided that it was necessary to sit down with friends and simply, trash out everything we knew. Most of the time, we get lost in a cloud of confusion and conflicting knowledge. But in the end, it helps to cover more ground. There were things that I could teach them, and vice versa.

The sun setting at 10pm, and rising at 4:30am, was a new challenge. Having optimal studying when the sky is dark has worked for me since O’s. Now, I find myself totally knuckled when I study through the whole night. Sleeping after breakfast, at 8am, was by far the most ridiculous sleeping habit I had.

Bad sleeping habits, terrible catered food, midnight snacks or starvation. So, I had to fall sick 2 days before the exam. The fever and sore throat kept me awake all night. I managed to sneak an hour of sleep before the first paper. Thankfully the first paper was not the most demanding. Still, once the exam began, my head cooled and nose plugged. Maybe it was the adrenaline.

In retrospect, the academic year was a very eventful one. I had many opportunities to travel: Loch Ness Hike, CNY in Glasgow, Acapella in St. Andrews, Conference in Manchester, and now heading to London with Uzzy. Aberdeen Medical School is an awesome place, and I have no regrets coming here. Top notch teaching quality, with amazing lecturers and a very well planned course.

Now, just to await for the results in 2 weeks, so that I can official conclude the year.

Adventure along the Loch Ness

How did the idea came about?
We were initially planning to head down (or west) to the Cairngorms National Park for a hike. Suddenly, Martin gave us a bunch of Sainsbury's discount coupon for ScotRail. With a return trip on the train just for £19, the Singaporean in me said, "Free discount, must use!" The thought of Gabriel's desire to visit Inverness (the city by Loch Ness, and also the capital of the Scottish Highlands) came to mind. So, one random day in the library, when i should have been studying, a number of googling and web-browsing was done, and the plan was conceived.

Hike the Great Glen Ways, a beginner's long distance route which spans alongside the Loch Ness for 117km, estimating a 5-7days hike. We decided to modify the trekking by starting halfway. Hiking and camping in the Spring, sounds great doesn't it? We were so wrong. We just threw ourselves into my greatest adventure thus far.

Day 1
We started off with our usual style. BEING LATE, to the extent that we had to call a taxi, and being fashionably on time for the departing train in the early 0715H morning.

Drumnadrochit view of the Loch Ness

A gorgeous bus ride down the Loch Ness. The funny thing was that we were gonna be going through the same route again, but instead on foot, and somewhere up in the hills. The view was pretty familiar, having travelled along the same road with my parents. As I reminisced about how 8months passed so quickly, Liz & Gab were busy struggling with car-sickness. They should try visiting China, the bus-drivers and terrainns are even more ruthless!

1st Stop - Fort Augustus!

Fish & Chips (Chippies) by the Loch

We decided to make camp in a designated campsite, just 5min of the town. They had a nice empty for both campers and caravans, equipped with shower facilities AND hot water. But for a whooping £8/pax?! That's a rip-off! Nonetheless, we wanted to be comfortable for the first night before we threw ourselves into the wild.

Typical attempts at Jump Shot

Our failed attempt to start a fire. Without any dry wood, we ended up soaking the cans in hot-water from the toilet

And the night wasn't comfortable, at least it wasn't for the rest. With a nice clear starry night sky, the heat waved goodbye along with the setting sun, leaving us freezing in our tents. In the middle of the night, the couple disappeared. And the apparent story was that they were in the toilet for 5hours, trying to thaw themselves. Rightttt...

Day 2
Everybody's motivation level dropped to as deep as the Loch Ness (at 260m, that's deeper than the North Sea in average!). I wasn't ready to give up, not right at the beginning! Maybel was really initially quite adament to the idea of going on, habouring on a non-existing Plan B (something that i never plan for). By now, the sky had become overcast, and the weather forecast was telling us snow was coming. Thankfully we went on, because the next ~15km was a treat.

After a continuous uphill, our first checkpoint!

Next checkpoint, luncheon meat for lunch (with bread & beans)

As we got closer to the next town, Invermoriston, we noticed a tree marked with an orange arrow, with a sign "Norwood Camp". We decided to check it out.

Orange arrows leading the way into the forest

We ended up at Norwood camp, a large plot of land in the middle of nowhere. We stood outside the gate, deciding on our next step. Suddenly, a scottish man (maybe a farmer?) and his can of Irn Bru (scot's soft drink) appeared from one of the buildings and began walking towards us. How did he know we were there?

"It's £4 per person for the night. You can use our toilets."

"Lovely! We will head down to the town first. And if we decide to come back, how can we find you?"

"Don't worry, I will find you."

*And the sound of chainsaws growled in the distance

No thank you! We are moving on!

Endless trekking...

Never too tired to set-up the tripod for a photo

After ~7hours, the river beside Invermoriston.

By the time we got to Invermoriston, it was apparent that we had missed the bus to the next town (the new Plan B that was devised while walking). Not a mistake on our side, but apparently the bus frequency on Sunday were much lesser. Damn the pamphlet for not mentioning that. The next bus was 2hours later...

We killed time in a restaurant, who were kind enough not to chase us out into the cold. Still, the bus was 20min. Next stop was Drumnadrochit!

The plan was camp at another designated campsite, Borlum's Farm. By the time we got there, night had fallen. No one answered the doorbell. So we decided to explore the farm a little, maybe we could find the owners... Instead, we found the toilet. And since it was apparent that no one was going to entertain us, we used their toilet and quickly scurried off to find a place to camp.

Our 'campsite' - At a road junction & beside the river

'Camp'-whoring! (The couple took the other tent)

Day 3
We had to conjure up a new plan for the day. Everything was not going according to plan. With the incoming weather forcing us out of the hiking plans, we were skipping to the major towns. We had a whole day to spend in Drumnadrochit. So we headed down to the Tourist Centre, picked up some brochures and was back to hiking up a random hill.

Taking the more difficult and steeper path

Sitting by the edge of the viewpoint, overlooking the town & Loch Ness

Using the dry branches that we collect along the way for a nice warm meal

Despite the fog and utter randomness of the hike, the climb was worth it

We walked along the main road towards the next checkpoint, which was the only area of interest that was planned for. Urquhaut Castle had the winning formula to make it a worthy visit. It had some history (though not epic), a magnificant view over a famous scenery, and most importantly - It was in ruins. I greatly dislike Castles which are refurbished and turned into a museum.

What makes a nice castle to visit - Destruction

We waited for the bus, which was yet again, was not arriving at the stipulated timing. It was a Weekday, so no excuses! Figured that the pamphlet timing was not updated. When we wanted to head back into the castle's reception to enquire, just 15min after its closure, the building was already pitch dark. Surely, they left very promptly. This time with no place warm to accommodate us, we battled with the constant drizzle as the temperature dipped to zero.

Jumping (or floating) to keep warm

Keeping warm with the exhaust of another bus

We did eventually get on the bus for Inverness, after more than an hour of waiting in the cold. It had began to snow. We headed for Travelodge (the hotel that i booked while at the viewpoint of the hill), and walking in the cold & snow without knowing the distance was exciting. I enjoyed the uncertainty.

Inverness - Snowing in Spring!

Day 4
We watched a good WWII movie till late. And finally had warm proper sleep. We could finally leave our backpacks behind and had a comfortable walk to Inverness town. There, we convinced ourselves that since we were on holiday, we shall be spendthrift and embark on a food rampage! We visited coffee shops, had ice cream, cakes, sandwich and soup. I also had my first 'atas' chocolates!

SG$1.25 each

Dessert frenzy

 With much time to kill, we visited the public library. Soon, we were tired of sitting around. Hence, we walked to and across the motorway, over to the Black Isle (Eastern Highlands). The highway spans across Moray Firth, the opening of the Loch Ness to the North Sea. I felt pretty stressed walking it, as the cars zoomed passed and the wind blew strongly in ever-changing direction.

Along the highway, with Beauly Firth & Inverness behind

In the distance, we saw a snow cloud approaching. We thought we could out-walk it, but halfway on the bridge, we were showered by heavy hail. So much snow/hail that I was collecting 'Ice Kachang' in my hoodie. Then the snow cloud passed us, and showered over Inverness. And it was sunny again...

Caught in the snow cloud

Dinner was in a nice pub called Hootananny's. Thai cruisine, drinks and live music.

Day 5

Ice cream in the cold. Brrr~

River Ness running through Inverness

Inverness Castle

Haggis, Neeps & Tatties - Sheep's inards, mash turnip & potato

Sticky Toffee Pudding w/ custard

As we sat in the train station, I felt that the ending of the trip was kinda anti-climatic. Said it too early.

A man came into the waiting room, and started chatting up Liz & I. It didn't take us long to realise that he was intoxicated / confused as he started repeating his questions. He lit his cigarette in the enclosed room, started singing aloud, and was receiving his audience of judgemental stares. Gab did come along at a later time, and the couple left at the sight of him, but i sat through all the way (with all the baggage). He was amusing. He reeked of alcohol, the smoke was unbearable, but i wanted to see the outcome.

I did finally manage to inform the train staff about him, who weren't very worried as they were familiar with such people. The trains had all arrived at the platform, and i was alone with this stranger. So i asked,

"Do you have somewhere to go tonight, like home?"

"I hate the British Government."

"But why so, sir?"

"They killed my family"

Taken aback by that statement, I sank into an awkward silence. Then he broke it,

"You are a very good man. Promise me something."

"Sure thing. What is it?"

"Promise me, that you would study hard. And when you finally get married, be good to your family. Be good to your wife and your children."

He handed me his phone, and requested for my number. I wondered whether should i simply fake a number. Or i could give him my actual number, not that he would remember anything. I checked, turns out he had no credits left. I left my real number under his recent call list.

We exchanged a hug. While he stumbled off, he suddenly burst into a momentary fit of rage and hollered at a passing train staff. Then he calmly walked into the distance.

Easter Holidays

UK universities seem to have a rather unique term system. The 2nd semester is much long than the 1st (Jan to May, compared to Sep to Dec). Year 1 medical school is pretty generous with their breaks. I'm currently having 3 weeks easter holiday, a much needed break after continuous mugging. Thereafter, 3+ weeks of project work, without any other lessons. Then another 3+ weeks of study break before a barrage of exams...

So technically, year 1 cirriculum has finished. And it ended off on a good note.

My last lesson was a ward session. In pairs, we headed out to our assigned wards, to our allocated patients, to practice all the clinical skills we have learnt thus far.

It was my partner's turn to take the patients history, and it flows like this:
Presenting complaint
History of presenting complaint
Past medical history
Drugs & Allergies
Family History
Social History
Systematic enquiry
Ideas, concern, expectations

Our patient was so chatty that I didn't get a chance to do the 2nd part, physical examination. Unsatisfied, i headed back to the hospital after our debrief, while my classmates strided off into the early spring for their holidays.

B.S was sitting in the vascular wards, her left foot bounded up. A visible black marker drawn across her shin, though the ulceration and red tender skin was creeping superiorly. Her ulcers are progressing upwards. Now with all the time i had, i pulled a chair beside her bed, and started chatting with her. She shared the hardship and adventures of her life. And like a jigsaw puzzle, piecing the stories together in my mind, she felt like more than just a patient, and more like a friend.

We spoke till the sun was no longer shining through the windows, and the seagulls were back to their routine and irritating squawkings. It was time to go. So i wished her all the best; afterall, that's all i had to offer.

Medical school has loads to offer. But admist all the structured learning and clinical session, we need to know how to recognise and sieze an opportunity when it arises. B.S was my patient, but through the additional time i had with her, she unknowingly become my teacher. There is so much information u can gather from simply observing and listening, rather than diving straight into clearing the checklist for history taking, and the procedures of physical examination. For example:

When she shook my hand, her grip was loose and her fingers cringed - Osteoarthiritis
As she spoke, she occassional pause to catch her breath. The muscles in her neck and shoulder tensed, meaning she needed additional effort. - Chronic obstructive pulmonary disease
Swollen ankle - Heart failure? Vein blockage?
Large number of bruising - On steroid medication? blood-thinners?
Cloudy rim around the iris, and excess skin deposits around the eyes - Corneal arcus & Xanthelasma = High cholesterol

I'm grateful that Aberdeen medical school starts clinical from year 1. Clinical skills require time to develop. In the end, that's what makes us doctors.

Reflection Essay

So... We are made to do a reflection essay every once in a while. Just thought i share what i had written / typed. It felt more like a story though:

My first ward experience

I was fortunate to have a regent who was willing to have me shadow him on his ward rounds, even though it was only our first visit. At that point of time, I have yet to have the official ward opportunity, so that was my first contact with real patients. As I trailed behind my consultant, it was a mixture of both excitement and uncertainty. This was the reason why I came to medical school, and it was starting that very moment. Yet I was feeling inadequate as a 1^st year medical student, who had barely any clinical knowledge.

“Follow me, and do as I do,” the first advice the cardiothoracic surgeon gave me before he proceeded to apply the alcohol hand sanitiser. I jumped onto it instantly, proud and relief that I knew how to perform the first task. Hand-washing never felt that good before. By then, we were gathered before an elderly man, propped up comfortably on the bedside chair. My consultant began the conversation with an update on the patient’s upcoming surgery. Soon, I got lost in the many new jargons that were used. Keeping a straight-face, I attempted to keep up with the case summary of the elderly man. It was all panic from within. I constantly hoped that my regent would not throw a question at me and stun me. And thankfully, he did not.

My regent started with the auscultation of the heart, and had me follow-suit. I inched towards the patient, trying to look confident; in hope that it would compensate my incompetency. A smile, my first greeting, all seems well as the patient gave me consent to have me examine him. Still confused as to what the patient’s condition was, I mimicked my regent’s actions. And the moment the stethoscope was pressed against the patient’s chest, my eyes lit up. It was the sound of saw against wood, preceding the ‘lub’ heart sound. Containing my excitement, I calmly described what I had heard. Thereafter, my regent taught me how to use a stethoscope, such as how to amplify the sound or how to hold the bell.

As we took our leave, my regent began explaining the details to the patient’s condition – Aetiology, pathophysiology, clinical features, management and treatment. Everything felt much easier to understand as I mentally pieced together the information with my personal encounter.

In retrospect, I had a very eventful first ward experience. The patient was very cooperative, and it did not seem to bother him that a medical student was examining him. In fact, as I listened to his heart a couple of times thereafter, his assuring smile conveyed a form of satisfaction; that he as a patient may also be a teacher. Being able to put into practice clinical skills was satisfying. I can only imagine that without them, I would have been much more ill-prepared and nervous. Furthermore, a very patient regent who was keen to teach made the whole experience a very fruitful and memorable one.

Presently, we are on the topic of Cardio-vascular system. And the moment ‘Aortic Valve Stenosis’ appears on the slides, the distinctive sound of blood flow turbulence preceding S1, ringed in my mind. Moreover, I picked up on skills on how to use the stethoscope effectively, and I had been practicing and imparting them on to my fellow colleagues. In addition, I have decided to bring a little notebook for documenting new information whenever I visited the wards; for experience is the best teacher.