first week of surgery has gone by just like that. i can hardly believe that i was in medicine last week! there's been so much to see and learn, here at the chalet hospital. my tutor has so far been very amiable and approachable, and is willing to teach. i'm on the hepato-biliary team, so there's been lots of pancreatitis (ranson's blah blah blah) and gallstones and colon CAs. several drug addicts too, especially since there's been a clamp down on subutex. one patient had injected the drug near his groin and now there's a bilateral thickening of his inguinal region which feels like a tube under the skin. he also has the same thickening in the armpit area. we asked him about other possible sites and he told us that he once sent the drug up his neck! there's also the top of the ankle site (above the part where you'd expect to feel the dorsalis pedis pulse) and anywhere in the arm. this patient also talked about how expensive the pill has become on the black market (from $20 per pill in 2002 to $80 for half a pill now) and how badly he wants to quit. he's got a young kid and he hasn't been able to hold down a job recently. let's hope he never will turn to drugs again.

haven't had a chance to scrub in yet (seems that others got their chance during e clinics but i didn't) but i do suppose there'll be plenty of opportunities in the weeks ahead. the team is an interesting mix of characters, and counts the chief of surgery as a member. he's the stereotypical chief - tall, stout, with a deep, booming voice to boot. heh. btw, surgery morning rounds are the best way to wake up because we're forever running after them and flitting from patient to patient.

i was walking along city link mall the other day when i overheard an ang moh excitedly telling his girlfriend, "hey they've got square over here!" i hope he wasn't too disappointed.

anyway i was at city link cuz i was on my way to bs. had to go alone as no one else could make it and i had something planned for friday evening. when you walk alone in a busy shopping mall like suntec, you become acutely aware of things, of people, of the atmosphere. because a large part of the day is spent with people it's quite a refreshing feeling to be in a crowd by oneself.

the minister's talk was...well, more or less as i expected it to be. the questions raised were relevant and i applaud the four brave souls who stood up. this coming tuesday will be the dean's talk. hope there won't be any surprises in store for us. ha.

surgery posting starts tomorrow! i'm quite looking forward to the change of subject, and am interested to discover the magic of surgery which missA has been raving all about. heh. i wish we had a bit of a break between the postings though. yesterday the gang of us met up at city hall to celebrate the end of posting #1. we couldn't decide on a place for dinner so we ended up going to mos burger for some good ol' rice burgers and delicious gossip. then it was on to new york, new york at city link mall to chill out. i must say that the ambience there is excellent. they have large couches and booth seats where about ten people can be seated comfortably, pictures of the nyc skyline all around and great lounge music playing. i finally got a chance to try their hot chocolate ($5.90), which i long for every friday night when i walk past. it's very sweet, and is worth the price. the service was brisk, though i would like to say that the waitresses were better than the waiters. haha.

anyway, the minister is going to give us a talk regarding the future of the healthcare system on tuesday evening. i find it quite amusing that the first email we received informing us of the talk started with," you are cordially invited to..." and the subsequent emails all had the line," it is compulsory for you to attend the talk..." not being very cordial here are we. they're issuing us tickets, and we have our names printed on them. how impressive.

and breaking news, there are no more tickets left for this year's medicine dinner and dance. i wasn't intending to go, but considering there wasn't any publicity for it, save for the few posters i saw the last two weeks, it's pretty strange that it can be sold out. i remember last year's campaign went on and on, and even attempted to reach the clinical years. now we've been left out. boohoo.

surgery starts in eight hours' time. tata.

the local tv station is filming under my block of flats, so there's lots of shouting and screaming. they have been filming here quite a bit over the past two weeks. what's so special about my block?

in other news, our hilltop university has been ranked one of the top 50 in the world by newsweek. here's some of the schools we "outranked":

• nyu
• mcgill university
• brown university
• vanderbilt
• purdue
• emory
• carnegie mellon
  

well, i guess we can be proud, since singapore, hongkong and japan are the only asian countries represented. but to be ranked higher than the aforementioned schools is nothing short of surprising.

after cramming for the clinical test (causes of clubbing? causes of hepatomegaly? causes of splenomegaly? causes of hepatosplenomegaly?) i now have an aversion for talley's. had to refer to it while going through the medicine mcqs, and i had to hold it at arm's length and quickly push it out of my sight after i was done with it. it'll be a looong time before i'll pick up any of the medicine texts again.

while studying neuro however, i found this queerly named condition called witzelsucht, which is due to lesions in the orbitofrontal cortex. according to wiki, it is "characterized by the patient's uncontrollable tendency to pun, tell inappropriate jokes and pointless or irrelevant stories at inconvenient moments. the patient nevertheless finds these utterances intensely amusing." (in german, witz means joke or wit and sucht means mania or addiction.) somehow i feel as if we all must know someone in our midst who fits that description. heh.

whew. i think i passed. rather, i hope i passed. it really was a harrowing experience, and it's amazing how easily one can forget simple, basic signs and symptoms when being grilled. (is there a term for it? symptomanemia?) was tested together with mr b, and we both took turns to mumble and flounder (haha mr b, what happened to our bang1 chance pact huh?). our tester was a stern-looking consultant who had the sense of humour to point out that the person -not- doing the test always has all the answers, but not the one who's being grilled. heh. i was totally freaking out during the semi-long case and i could almost hear the theme of "jaws" playing in the distance, but i think i did much better on the shorts. esm indicating aortic stenosis which led to patient fainting, and a parkinson's patient. he was nice enough to go through points in taking history and other various learning points, so at least we took away something from this test. yay.

while at the hospital i met an ex-schoolmate who was being warded for two slipped discs. after my test i popped by to talk to him, and although he was in pain, we still managed to chat. hope he'll be out by the time i start my surgery posting there next week.

have to go mug for the mcq test now. will probably post about my 8 week stint at the not-so-wild-wild-west hospital later.

heard at a party last night:

Q: what do you call a group of medical students following the consultants on ward rounds?


A: shifting dullness.

had to go up on stage with miss j and dance to madonna's Hung Up. suffice to say, there wasn't very much of a dance, but i did have a lot of fun and the food, especially the soup, was excellent.

i have been posted to a hospital on the other side of the island for my test on wednesday. can't wait for everything to be over!

it's national day. whoot. a day for sleeping in and just to jalan jalan with friends, which is what i did today. woke up at nine and met my secondary school choir friends for lunch at eleven. it's been awhile since we all met up, and i've always felt blessed that after eight years, we're all still going strong and can talk about anything under the sun. heh. really must treasure my social life (or whatever little i have of it) because it doesn't seem like i'll have very much in the near future. bleah.

the patient who had neuroleptic malignant syndrome has been discharged. i think his stay was the longest of all the patients i've talked to. he came in one night at the beginning of my posting, now he's finally going home just before i sit for my end of posting test. am really glad he's so much better now.

this end of posting test is irritating me. there's so much to know that i don't know where to start. there are questions and answers, and questions about those answers. it never ends. the good thing about the posting is that i've grown to like medicine quite a bit, and that's it's been nice knowing the seniors. -grin- during csfc, surgery was so my thing and i couldn't understand why people could like med at all! oh well it's back to studying now i guess, and will probably take a hiatus from here until the end of my posting, unless something extraordinary happens.

latest news from the deanary: my batch will be having a super long electives posting at the end of fourth year, a total of sixteen weeks because they're combining the third year electives with the fourth year ones. the intention seems to be to encourage us to do research. hmmm. at the end of this year we will instead be doing one of the three long postings to replace the electives. wow-wee.

anyhoo, this morning when the docs were doing their rounds, a few of us examined this old lady who seemed pretty weak and kept complaining of giddiness. we didn't think very much about it until we returned to the cubicle one hour later for a tutorial and found the docs busy resuscitating her. it's the second reminder in as many days of what we are -really- dealing with when working in a hospital.