Let your beauty not be external by the braiding of hair or wearing of gold jewelry; but by the inner person of the heart, the lasting beauty of a gentle and tranquil spirit that is precious is God's sight.
1 Peter 3: 3-4

This verse really impressed upon me a while back, and I chanced upon it again during service today. A thought provoking reflection on our relationships and what we strive for.

Geri is a humbling experience. You gain a deeper understanding that you cannot function alone and how much it takes from everyone to fight against institutionalization of the elderly. When I first started out, these social issues were very frustrating because I rarely approached them from the correct angles and always wanted conclusions too fast. Now I've begun to appreciate a little more how much effort is put into these intricacies.

These ahgongs and ahmas are frail and weathered on the outside, but they have a wealth of experiences and stories to share. As J and I always talk about, the privilege (or maybe somtimes curse) of working in the medical profession is that you feel and understand what matters to people who are reaching the end of their lives. Its hardly about the careers/achievement/possessions, but the relationships and the people they care about. As someone who is only a year and a half young into this profession, I still struggle to find that balance. You've got to decide what makes you happy. 

GS is a very trying period of learning how to be patient and meticulous despite the constant pressure of needing to be fast and efficient, to battle with fatigue at 7pm after exits with a thousand things to do, to be the better person despite the negative feelings. There are things to be thankful for; good friendships forged, learning little tidbits about fluid and electrolyte management, understanding more of myself and what I appreciate in a career. Sometimes, many times, these are overshadowed by a whole lot of jobs, changes to do, lists to update.

It's my first and perhaps last weekend off for a while; thankful for rest and a bit of time to be in thought. I really wish that I had a little more time to myself and the people I love, which is why leave is so very precious this posting despite the many an unfortunate circumstance ):

I guess we've all grown alot this year. Hope that as I look back I've learnt alot more than just how to discharge patients more efficiently or which duty radiologist to look for to beg for scans. It's always easy to brush aside the softer parts of medicine when you are crazy busy and talking to someone is the last thing on your mind. But these are the parts that stay the most. 

It's my first weekend off in a long while, and it's nice to just sit down and have a little time and some space to breathe and think about the months that have passed since we've started work. I must admit that especially in the month past, which has been very trying, I've become so embittered by the stress at work. Some days I feel like I'm constantly living in fear trying to meet expectations, or just to do things the right way to avoid getting scolded. And I pass some of this stress and bitter feelings unknowingly to the people around me.

It's not all bad. There have been days which have been so fulfilling. These are the days that I'm not trying to rush through the 1000 things to do, have time to slow down a little to think and to feel for the people I'm working for. These are the days I remember the most.

In the same way, let your light shine before others, that they may see your good deeds and glorify your Father in heaven.
- Matthew 5:16

The past few weeks have been nothing like that, and I hope I'll slow down a little to remember these important things. 

Thank God for His grace in bringing us through 9 papers thus far. Surgical long tomorrow; the last exam (hopefully) in medical school. I'm so excited for it to be over, it's been a long and tiring two months and I'm really looking forward to having time for myself and for people I care about. At the same time, I'm so scared. It's undoubtedly the scariest clinical exam yet, there are so many things that can possibly go wrong and that are out of our control. That's why they say; try your best and leave the rest to God.

Do not be anxious about anything, but in every situation, by prayer and petition, with thanksgiving, present your requests to God. And the peace of God, which transcends all understanding, will guard your hearts and your minds in Christ Jesus.
- Philippians 4:6-7 

We've finished medical school, are 3 weeks away from MBBS, and there are so many things on my mind. It's been a difficult week, there are moments when I am overcome by sheer fear, of being incompetent and ill prepared to take MBBS, and to practice as a doctor. Silly things like missing motor weakness in a patient because I was so fixated on his ataxia, for not being able to answer basic questions like the causes of dactylitis or the presentations of psoriatic arthritis. Grateful for our tutor who pointed out that I sometimes say or do things too fast and end up saying things that I don't mean. I should try to be more meticulous and more thoughtful in my work.

Time and time again, in moments when I am so imperfectly human, it's so easy to get snappy or upset at insignificant things. There's this self entitlement complex which is so unhealthy.
In reflection, I'm learning. Learning to love my family in times of need because I know they will gladly do the same for me. Learning to love my friends, to give a little more of myself. Learning to love through disagreements and frustrations when its easier to walk away, which I'm often so guilty of doing. Learning to love patients, irregardless of paying status/race/nationality or whether they express gratitude in return.

To recognize pride, expectations and selfishness and to cast these aside.
To love in spite of, because Christ is such a perfect epitome of love as depicted in 1 Corinthians.

To recognize that as daunting and consuming as MBBS may be, that it doesn't close the chapter. That we will be dealing with people and lives. That we should be responsible and know that though our knowledge will always be deficient, we should strive to be humble and keep learning so as to be better doctors for our patients and their familes. 

I must say that the prospect of going on call tomorrow is pretty daunting. I wonder if I'll ever get used to it during housemanship :( Gen med has been tiring ++. The learning curve is so steep and there are so many knowledge gaps to fill. Feel exhausted and inadequate at times, but grateful to be learning and to leave a little wiser every day. 

Jesus, joy of the highest heaven,

Born as a little baby

Under a wondrous star.

Like us, crying he takes His first breath

Held by His mother, helpless

Close to her beating heart.

Jesus, laid in a lowly manger,

Facing a world of dangers,

Come to turn me a stranger

Into a child of God.

Jesus, King of the highest heaven

Learning to take His first steps,

That He might bring us life.

Like us, knowing our smiles and sorrows,

He showed the way to follow,

A way that is true and right.

Jesus, take away every darkness,

Steady my simple footsteps

That I might in your goodness

Live as a child of God.

I was moved by this lovely hymm, sung on Christmas by a group of children. A beautiful reminder of the true meaning of this season (:

It's the last Sunday of 2013, and I'm reminded of God's goodness and providence all throughout this year.
Thankful for electives and the chance to explore general medicine.
Thankful for patients to learn from and inspiring mentors.
Thankful to have spent an exciting month in London.
Thankful for family who stand by me, for their acts of service and words of encouragement.
Thankful for friends to learn with and grow with, who bear with my grumpiness and understand my need for coffee.
Thankful to have met someone dear and to learn to love.

2014 holds MBBS and the prospect of starting work, both of which I face with some fear.
Now that we're almost nearing the end of this long journey, I remember what I wrote in my personal statement in my idealism at the start of medical school. I think some parts still hold true, that it would be nice to end a day knowing that I've made a difference to someone, however small. I pray that this will be something I will hold on dearly to. 

Studying for Dermatology is rather frustrating . So I've decided to take a break and write about my thoughts after visiting Mr T yesterday evening, one well spent (:

He's someone we met in year 3 of medical school. After that encounter, he had a major surgery and we lost touch for the last 2 years until he contacted one of us again. His disease has since progressed, and management has turned palliative. Spending some time with him and his wife yesterday just reminded me of how we once made time to listen and to be a friend, and also how nice it is to have friends who care. 

Med school has been a time of tremendous growth, in knowledge and in understanding. Knowledge will always be deficient; we get so caught up in learning the thousand and one manifestations of chronic liver disease or the causes of ascites, that we sometimes forget to recognize how privileged we are to be sharing in the lives of people and to learn much more beyond the books. It is a recurring theme that at the end of the day, all these material things that we fight for when we are young - career, wealth, material comforts - become secondary. And the things that matter the most are not things seen or said, but felt with the heart. 

Talking to someone who has months to live puts what is important in perspective. It evokes so many complex emotions that I feel, but cannot fully comprehend.

"Do not ask your children 

to strive for extraordinary lives. 

Such striving may seem admirable, 

but it is the way of foolishness. 

Help them instead to find the wonder 

and the marvel of an ordinary life. 

Show them the joy of tasting 

tomatoes, apple and pears. 

Show them how to cry

when pets and people die.
Show them the infinite pleasure 

in the touch of a hand. 

And make the ordinary come alive for them. 

The extraordinary will take care of itself."

- William Martin 

How this poem resonates (: 

It's beautiful to be happy with less; to find something extraordinary in the colours of a sunset, tranquil waters, companionship, a cup of coffee, a warm smile that costs nothing to give. 

It's beautiful to be human, to know hurt because you have loved. 

On a restful Sunday after church, these conclusions are easier to arrive at. The challenge is to remember this even during the imperfect moments when you're tired and grumpy and frustrated, which I fail terribly at. 

I pray, for the wisdom to see the beauty in ordinary things. To never lose sight of what is important and to make time for it. To choose to see the good in every situation and learn from the bad. To have more faith, to care more generously. 

Had a nice chat with a good friend over Christmas lattes over this lazy post-posting weekend. Was just sharing about how troubling this entire residency exercise was, and how I wish I wasn't so affected by it. I guess it really boils down to getting caught up with how society defines success by; that I would feel incompetent if I was left behind and didn't get into residency. Perhaps it's a fear of never being good enough, and a matter of personal pride.

She asked me why success should be dictated by people's standards and expectations. Shouldn't success be a personal measure of self attainment and fulfillment? There's so much truth in that. It's so easy to lose yourself, and to forget that happiness and contentment are often choices.

I read this interesting article on the way home today about George Price, a man who wrote about a theory that altruism is self interest in disguise. People will be willing to display altruistic behaviour to those who are genetically similar to themselves because by nature of self selection, we want to preserve our genetic heritage. Unfortunately, after writing about this theory and trying to prove this theory wrong himself by giving money to the poor, he committed suicide.

It's a controversial topic, I remember reading extensively around it while preparing for GP. It is difficult to believe that people are motivated solely by self interest, and to reduce every decision made into a mathematical calculation of benefit and cost. I believe that it is way more complex than that; that altruism is beautifully humane, and things such as love cannot be adequately represented in equation or in words.

I've had a few of these reflective moments on the journeys from the east. These few weeks have been tiring, I think that the really long journeys home, compounded with the fact that # is really not my cup of tea, contribute to this. From this posting, I'm reminded more about the things that I really appreciate in Internal Medicine :D But, things to be happy for include a cheap and fast drinks stall in the canteen with good kopi, yummy waffles for $1.50, and traveling to the sunrise in the morning haha! 

Comfort on difficult days
Smiles when sadness intrudes
Rainbows to follow the clouds
Laughter to kiss your lips
Sunsets to warm your heart
Hugs when spirits sag
Friendships to brighten your being
Faith to believe
Confidence for when you doubt
Courage to know yourself
Patience to accept the truth
Love to complete your life

Caring for a person, is about being selfless, and putting his/her needs above your own. About genuinely rejoicing for the triumphs, being there for the not so good days. About understanding that no one is ever perfect, but you can choose and learn to love an imperfect person.

As I have loved you, so you must love one another.
- John 13:34

Still learning how to do that, every single day.

This is my prayer in the fire
Through weakness and trial or pain
There is a faith proved of more worth than gold
So refine me Lord through the flame 

Back from a month long stint in London and Italy, sad to leave but at the same time glad to return home. I've been incredibly blessed with the opportunity to experience London like I did. The chance to be inspired by the medical culture there; how doctors are so humble and unassuming, and how patients are educated about their disease and accept the limitations of medical care. The chance to soak in the culture of cafes and parks and musicals. The chance to have great company in a foreign environment which was so special. I really enjoyed my weeks there; the introspective moments in the parks and over cream teas/coffee, the musicals experienced, the markets, the walks along Thames. Too many fond memories (:

Spent 6 days in Italia with Laine, the most memorable bits of which were this small fishing village Cinque Terre a few hours away from Florence, and the days in Rome. Cinque Terre was beautiful, beyond words I can use to describe. I'm a huge fan of water and the tranquility it brings, and just taking in the waves crashing at the coast and the endlessness of the ocean was amazing. Rome was a different experience. If I had one thing to begrudge it would be that it's too touristy and crowded. But walking the streets filled with monuments, fountains (with potable drinking water!) and historical sites was really enriching. I love Rome for its rich history and religious value. And of course, the food! The pastas and gelato were really yummy.

I've learnt how beauty can be found in the unlikeliest of things if you would just open your eyes to look.

As we start year 5 in barely a few days, I am sometimes fraught with uncertainty on what the year ahead may bring, how priorities may change and how I might lose myself along the way. May we take heart in all that we do, and continue to remind ourselves that we can do all things in Christ who gives us strength.

During worship, we sang a song that I used to sing as a kid in Sunday school (:

My Jesus, my saviour
Lord there is none like You
All of my days, I want to praise
The wonders of Your mighty love

My comfort, my shelter
Tower of refuge and strength
Let every breath, all that I am
Never cease to worship You

Shout to the Lord, all the earth let us sing
Power and majesty, praise to the King
Mountains bow down, and the seas will roar
At the sound of Your name

I sing for joy at the works of Your hands
Forever I'll love You, forever I'll stand
Nothing compares to the promise I have in You

There have been many ups and downs over the past 2 weeks. There were difficult moments, moments of doubt. But there were also moments of blessing, moments to encounter. It is easy to be thankful for the roses in our lives, but we forget to give thanks for the thorns.

These have come so that your faith - of greater worth than gold, which perishes even though refined by fire - may be proven genuine and may result in praise, glory and honour when Jesus Christ is revealed. 
- 1 Peter 1:7-9

I always thought that being in healthcare helps one to accept death and dying as part and parcel of life. But when it happens close, no one is immune to the complexity of emotions that follow.
I believe that we fear death in one way or another because of what we leave behind. But you can only lose something, or feel hurt and pain and loss, when it has meant something to you. So I try to remember never to take anything for granted, and to appreciate and love more. Because there is no reason not to and life is more beautiful that way. 

Whether through little encounters or poignant conversations, bearing witness to what patients go through and yet being able to offer so little to their betterment in our capacity as medical students continually sheds new perspectives.

After returning to the wards for barely three weeks, it's still so easy to to get tired, grumpy, jaded. Easy to get carried away with the negativities and forget the blessings. So it's important always to remind oneself that happiness comes from small things. The seemingly insignificant things; a cup of morning coffee, greeting someone with a smile, offering a drink to a patient, witnessing acts of kindness, laughing over the silliest things, a moment of introspection on the train ride home, a reminder from a verse, taking in the beautiful colours that paint the sky at the end of a sunset or the stars that sparkle on a cloudless night.

I've struggled with faith, and am guilty of doubting love. We sometimes wonder if the things people do for us are for another reason, or we always feel that we need to give something back in return to earn our right to be loved.

This Lent has reaffirmed that God's love is so unconditional and abundant. There is much to give thanks for this Easter, but above all, I would like to give thanks for Love. And for all the people around me who love, and who allow me to love them in return.

For God so loved the world that He gave his one and only Son, that all who believe in Him shall not perish but have eternal life. - John 3:16

10 hectic, insane months of clinical postings over. We're more than halfway through medical school, and graduating in 2 years. It's crazy how time slips past your fingers. At the start, 5 years was just so impossibly long. But in the midst of it, knowingly or unknowingly, you're drawn into it faster than expected. Studying for our 3rd professional examinations was really despairing. There's so much more to learn and absorb, and I feel like I'm not ready to graduate and start looking after patients after merely 5 years of education.

 The holidays have been good. I busy myself with random things like exploring random nooks and crannies of Singapore, dancing, and learning Bahasa Melayu which is susah sekali! Learning a language at this age is definitely not easy. Even though Malay is not as pictorially complicated as Chinese, the words are so difficult to pick up. It's quite funny that the Malay slang that we use in everyday life like sekali/sama-sama/lagi, have very different meanings from the expressions we mean them to be haha.

 My legs are really sore from all the dancing, especially after doing endless amounts of pirouettes en pointe each rehearsal so that my legs don't fail me on stage. I enjoy it all the same; the time spent rolling around in the studio because we're just too tired to get up, going on spontaneous dinner/supper dates after class, fretting over pirouettes and fouette turns and developpes. I've been dancing as long as I can remember, and these moments are magical every time.

 I also underwent a tiring week of Cardiology with one of my friends. The doctor to whom we were attached to is intimidating in many ways, but yet after attending his clinics and observing how he interacts with his colleagues and patients, I was so inspired. After 1 year of shadowing doctors and being around in the clinics and wards, we've seen alot, been inspired by some, disillusioned by some. His practice, however, was how I envisioned medicine to be like at the start of medical school. Patience, sincerity and humility.

 It amazed me how dedicated this team of doctors were to their work. Cardiology involves many interventional procedures and it's similar to surgical practice in some ways. We were stuck in the cath lab until 8.30pm one day because we were asked to stay and observe a diagnostic cath procedure for one of our patients. I've always been interested in cardiology as a subject, but there are so many other considerations when it comes to pursuing it as a career. Well despite the long hours and standing/walking until my lower limb varicosities became prominent, I gained alot over that week. I love learning when it's not the school term and you can take your own time to understand and appreciate things.

We're flying off to India in 2 weeks! It's rather exciting, I hope to gain many new experiences and come back more enriched and humbled.