So, I'll be sitting for my OSCEs exam come this Wednesday.
OSCEs are those annoying exams (actually crucial) that tests our clinical examination skills and history taking (that is eliciting a proper history of symptoms from a patient), which are in actual fact the bread and butter of our profession. And yes, they have to make an exam out of it, which I again totally understand But It is Still after all, an Exam.
To make sure we absolutely score, and NOT fail as NO one wants to come back to resit the exams when we can all be kicking back and eating char kuey teow in Malaysia while flipping through the twenty plus Astro channels while ordering our maids for another round of grilled satay,
we practice
and practice
and practice
AND practice
on each other.
Which brings us to a few new discoveries. So I've found out that one of my flatmates cannot externally rotate his shoulders. And a friend who lives upstairs has got a fixed flexion deformity of her elbow, which is also called a 'gunshot' deformity (basically means one cannot fully rotate one's wrist when the arm is fully outstretched). A splitting of a friend's 2nd heart sound is also heard (normal sounds should be just lub-dub, and a splitting means lub-d-dub). And of course, I've got a fantastic knee to be examined due to my past surgery but that is really rather old news.
Still, I will be incomplete and totally ostracized if I do not discover something new or rather, medically wrong about myself - and thank God for all the smart alecks and brainy people that exist around me. One single look - zero in and hey! another case to add on to my already expanding portfolio of medical problems that surely points towards the one direction -> AGEING.
I've got hallux valgus. Sounds like some Harry Potter enchantment, no?
A change of direction of my big toe which should normally be straight but is slanted, leaving an empty V in between the big toes of me both feet. Slight, but there all the same. It might be congenital though, or hereditary. And how does it happen? All time popular cause is the usage of heels (that's why women get it and men hardly) but hello, I stay in cobblestone Edinburgh where even walking down the stairs of my flat is treacherous. Not to mention planting my stilletos on the uneven pavement of the city as I walk 2 miles to my destination, precariously mantaining balance while tripping over every other step and ensuring that I still look feminine?
No, I hardly wear heels here!!
But I do have about 7 pairs of high heeled shoes sitting on my shelf now.
So?
Ignorance is bliss. And so is self denial.
Hallux Valgus
Dracunculiasis
Was flipping through my medical book that day looking for a description of "Typhoid Fever" and I just had to chance upon this word.
Dracunculiasis.
Captured my attention almost immediately. Sounds like "Dracula" doesn't it or "Dragon"? Uber cool.
What is it?
1. Is latin for 'little dragon'
2. More commonly known as the Guinea Worm Disease.
3. An infection by the parasite Dracunculus medinensis
4. Life cycle starts from larvae in fresh water, water fleas ingest it and they develop into its infective stage in these microscopic insects.
5. Humans drink the water, and stomach acid kills the water flea but not the larvae. The larvae goes to the intestines and gets into the body cavity.
6. A female worm copulates with a male worm and absorbs the male after he dies.
7. The female grows into 60-100 cm ( 1 bloody metre), looks like a cooked spaghetti noodle and her body cavity is filled with baby larvae.
Right up to now, the progression seems normal (except for the rather disgusting 'absorbing the male' part, hm and also the spaghetti part) . I was about to turn the page away - I mean all living things do mate sometime or other... but it was a good thing I didn't, as IT GETS BETTER.
8. So this female worm in the body now migrates to the cooler area of the body, usually the lower limbs.
9. She/It Ulcerates out of the human skin by causing a blister - which is extremely painful and has a burning sensation. About 24-72 hours later, the worm emerges OUT of the skin
!!@#$%^&*!!! Oh no, no... it doesn't come All the way out.
10. By this time, the human host is hurting and being human, soaks his/her leg in water to ease off the burning sensation and here, the female worm releases a milky white substance into the water, which contains about 100 thousand larvae.
11. By now the blister has become a unrelenting ulcer.
Eurgh!
How Incredibly, Utterly DISGUSTING.
12. The best way to treat is to slowly roll the worm round a stick and let it take its own time to emerge fully, as the least thing you want is for it to break off and leave half of its body in your body. This emerging process can take up to days or even weeks.
P/S: If surgical facilities are available, slice the leg open and get the bugger out immediately.
Shocker. Imagine walking around and living with a horrible worm dangling from your leg.
Like a piece of spaghetti - ahem, I mean, string.
Blood Groups
Blood group O - increased risk of getting H.Pylori infection, i.e. gastric ulcers
Blood group A - increased risk of getting gastric cancer
Which blood group are u?
Time in Eternity
Time passes by. Ever so slowly. And ever so quickly.
Just sitting there, looking into his eyes. The sclera was white when he came in. But now it is slightly red-tinged.
And his dad. His dad looks like how a dad should be. Graying hair, wise eyes. Slim, soft spoken, walking without a stick - a rare sight to see indeed in places like these, places like this where the elderly is usually ravaged with so many complications.
They are planning a holiday to Spain this weekend. A true family holiday. And daddy comes in here to get expert advice.
Daddy wears a sweater. A sweater that holds a lot of secrets. Scars of the past, present, future. Scars that can be seen and that cannot be seen. Clothes hides a body's secrets well. And so can accessories of all kinds. Like him, accessorising his dad. Complimenting each other. The picture of health and happiness.
But once all clothes have come off, once all pretence put down, the dark, ugly monster rears its head. It's obvious. Even to my untrained eyes, it is quite big. But I am inexperienced. Incompetent.
But we have the Expert.
And so daddy puts on his clothes and sits back down next to him. And now the Expert talks. Does not say much. No exact words are mentioned. But the subject is approached apprehensively. Dread fills the room. Trepidation hangs in the air, choking, bitter, unpleasant. Every sound is amplified, fear and hysteria threatens.. just beyond the horizon.
Now, a slight hint of red at the corners of his eyes.
But daddy is still calm. So soft spoken, still keeping his composure. He insists that what he wants is to go on the family holiday. But they need a 'Fit For Travel' note for the insurance company. Daddy refuses any tests. As tests in this place, any test of any kind will tell us things we want to know, information that is essential in our field of study, pieces of the jigsaw to be fitted together. But once the picture is complete, it might be a picture beyond your comprehension, a sliver of the promised future that you will never see, an image of the person you once were, a snapshot of Hades. And sometimes, it is better to throw the pieces away, to keep only the beautiful parts to yourself, where you can stilll harbour hope for the unknown and undefined.
When daddy drew a ragged breath, the redness grow darker. It spreads its firey fingers into his eyes, turning white to blood red.
Still the Expert does not mention it. It is taboo in my field. Daddy asks what he should do but the expert advises daddy to do what he Wants to do. And daddy still says he wants to go on this holiday. So go. Go and do what you want.
Go Go Go.
But be advised, you might not come back.
For the cancer lesion is enormous, the left half of daddy's liver has enlarged to the size of a fist, protruding out of his stomach, obvious to the naked eye. No imaging is needed, the diagnosis is unshakable. Unmovable. Undeniable.
Go and be happy and do what you want, go.
Make an appointment in a months time to see me.
'Will I be around,' asks daddy and my Consultant says 'Just make the appointment.'
But he knows and now we know too - that in 30 days, daddy will not live to see the rising sun, not wake up to the birds' morning call and never will make it to the appointment; not next month, not anymore.
Champions League 2007: AC Milan vs Liverpool
So it's d time of the year again, where all people out there with the XY gene hog the bars and pubs or mamak stalls, where all tv screens are suddenly turn green with miniscule figurines moving about, where money flows in and out due to bets placed on the wrong (or right) team, where tears are shed and voices are yelled hoarse (more visits to the doctor -heh), where beer glasses are smashed and mamak plates are broken/dropped clanking to the floor due to Mister's hand slam show off, and also where eatery merchants and sports shops make their windfall of cash.
The time of the year where the XX earthlings donate money to all the bars/pubs/mamaks just to please that certain someone, where they sigh as they miss their favourite Wah Lai Toi show, where they suffer the endless 'GO GO GO!! AIYO, STUPID LA U!' and the drone of the commentator that could honestly draw all flies, mosquitoes and moths to tv screen.
All in the name of 'football' or 'soccer' (if you please)
Of course, we shall not forget the few people that are off the normal distribution graph, people that belong to the ends of the bell shape graph - those that do not follow the norm. The boys who don't watch football and the girsl who Do watch football.
So what am I? XX who is bang, smack in the middle. Don't watch it if I can help it, but do enjoy it when I am actually absorbed into the game.
Which leads me back to 2 years ago, 2005.
What: Champions League 2005: AC Milan vs Liverpool
Where: In our luxurious apartment in Brussels, Belgium
Who: My friends and I
Watching the final match of the League between AC Milan and Liverpool.
Talk about Deja Vu
Posted by Rachel at 4:52 AM
Wasting My Life Away
Today.
I got up at 8 am for a 9.30 am class.
And we waited til 9.45 am - no one turned up.
Went to bleep our tutor and she said she forgot. Ok, fine, I mean, I know you are out there saving people's lives and what not... (in actual fact she was on a ward round - a ward round is the time when doctors go around the wards to check on their patients with their whole team) So here said Very Important Tutor asked us to wait til 10 am. Which is perfectly acceptable (since she is doing good for the world and all).
10 am came, a No Show.
But being incredibly understanding medical students, we decided that she is probably intubating that one last poor soul who is close to being braindead due to lack of Oxygen or pushing 3ml of adrenaline into that patient who's heart had just stopped on its own whim and fancy...
But 10.15 am came and still a No Show.
Being the incredibly Knowledgable medical students now, we know that she is Not going to come, Because she just does not want to. I mean, some people cannot handle teaching a group of medical students in fear of finding out that the students knows much much more than them. I so totally understand. But u can still call the ward we are in, where we sit waiting in vain to hear your footsteps and see ur lovely face cos it will bring such light and hope to our lives - you can still Call and let us know you are not coming. There are 100s of telephones littered all over the place, no excuse. Bitch.
And at 10.15 am, there is really no point going home and coming back for a 2 pm class.
So I go to the library to sleep (while managing to appear extremely intelligent with Davidsons Principles and Practice of Medicine in front of me).
2 pm came and went.
And once again, no blardy tutor turned up. People went out to bleep the tutors again, but to no avail.
Should we go?
But we have another tutorial at 2.30pm. Any level headed twit by now would have left the room and never come back.
But being over eager, ambitious and should i say kiasu medical students, we said, 'Ooooh welll, we have another tutorial at 2.30pm. Let's just wait.'
2.30 pm came and went.
That's it. Time to use good old bleeping again. No one answers. I think they are deliberately avoiding us. Like I said, you never want to tutor over smart students.
But as assertive and resourceful medical students, we whip out our new up-to-date mobile phones and attempt to contact our tutors on their mobiles.
And I think we have come to a conclusion that they hate us that much to give us the wrong numbers.
So I came back at only at 4 pm. A good day put to waste. When I can actually be working my way towards 99% in exams.
Posted by Rachel at 9:53 PM
Labels: Life's Not Fair, Medicine
And I STILL Can't Run to Save My Life
Went to my physiotherapist today and she put me on the Biodex, this humongous machine that measures the strength of all limbs and muscle groups in your body. I was to compare my good leg with my bad leg (for the uninformed, I underwent a knee ligament reconstruction last October) and decide from there whether I could start running again.
The last time I did it , which was 2 months ago, my bad leg lacked in 75% muscle strength compared to my good one. At most, the deficit allowed is 20-25%. SO CANNOT MAKE IT.
Now, 2 months down the road, I did the test again, and Hallelujah! Much Better says my physio. A deficit of *ta-da* 30%!!!
But, according to the graph, my leg muscles (quadriceps) are slow in uptake, meaning they do not reach their maximum strength immediately like my good one.
And the verdict remains - no running.
Not that it really matters, (short of not being able to play sports) but not being able to run is hell Annoying when I see the free shuttle bus that's bring me to the hospital in front of me and I can't run to it. Buses do not wait for people here in the UK and I could probably be in front of the bus door in half a tick should my legs be normal, but NO they bus will be about 100 m in front of me, taking in its last passenger and bam! the doors close and it moves off.
Which means I have to pay 1 pound to take the normal bus. (with 1 pound I can buy something nice from the 1 pound shop ok). I can go on to being very 'sui' on that particular day, encounter the same problem, miss the pay bus, hence making me late for my teaching, leading my tutor to think I am incompetent and lowering my feedback marks considerably. Which matters a lot when you are score 99 and need that one measly mark to get 100.
Appreciate your working limbs folks.
Posted by Rachel at 1:42 AM
Labels: Life's Not Fair
My Roman Holiday 3
That aside.
Rome is a busy city with ruins situated all around and in it. Rather weird to be exactly honest but if they took down the ruins, they would run out of business in tourism pronto.
So the essential things to cover would be:
1. The Coliseum

If you look behind Ven Gee.. do you see Angelina Jolie??
Street artists selling their waresBut let's not forget our main focus - the Pantheon. That was built in 19-- and has 16 pillars on the outside. On the inside, it has a hole on its dome, built to let in natural sun rays and 28 holes punched into the ground to drain water away when it rains. That is about as much as I can remember about it.
As Ven Gee and Victoria disappeared to goodness-knows-where (AGAIN), we took advantage of the lighting to make up for the album-cover-quality shots that were lost in my camera.
3. Italian Coffee

4. Fontana De Trevi
my 6th gelati:
At San Crispino. The best in my trip! Honey flavour and banana flavour. Honey flavour absolutely rocks.
5. The Palantine and Roman Ruins


Spent about 2 hours just wondering among the ruins and taking pictures. The weather was good, the place was good, aah...
Returned to the San Crispino again for my 7th gelati! Took the Honey flavour (can't get enough of it) and tried Meringue and Chocolate flavour too. Absolutely heavenly.
While walking down the shopping streets of Rome, we chanced upon this street artist. She spray painted the entire picture under 5 minutes, and her performance always ends with a round of applause from the crowd. They are sold for 10 euros per piece. Makes me wonder why I am paying RM 1 mil to study in university when I can just sit by the road side, Wow people with my fantastic talent and earn loads of tax free cash.

7. Don't know what it is called
It is the fortune teller thing you find in shopping malls across Malaysia. So now I know.. the real one is in Rome. and it is barricaded off and certainly does not tell any fortunes at all. I've been cheated my whole life. Not that I have used the fake ones in 1U before BUT...8. Villa Borghese
A large garden. Situated north of Rome. Pretty indeed. We then decided to rent the 3 seater bike. It was fun. Truly relaxing and enjoyable. That is until we found out that it was extremely difficult trying to cycle up a small incline. Despite 2 people pedalling with all our weight. However, the landscape remained pretty. Until we decided to make a final turn downhill before returning the bike. And found ourselves at the metro station entrance. Which is way, way off from where the garden is. Then things weren't as pretty. We had to push the bike uphill as we cannot, even with all our weights combined, cycle up the slope. And things got uglier as Victoria dropped her shades and it got run over by a car.Mm. Not pretty at all. But, we survived. And the garden, not us with our sweaty faces, remained as pretty as before.
my 8th and final gelati of the trip!7 am worked, 8 am worked but things stopped working just about there. The bus was late, the train was late and we met an American student who was travelling to the Vatican too and claimed that she knew the way by bus. The latter should be just about better news, as our original plan was to take the metro to San Pietro and find our way from there. But since said American girl mentioned that someone told her the fastest and best way is by bus, us being the submissive Asian followed her to the bus stop. Only to discover she was about as clueless as we were on which bus to take. Upon boarding the bus, we realised that we were going the wrong way a few stops too late, and when we finally reached the Vatican it was 11 am.
So we queued for about 40 minutes in line to enter the Dome only to find out that the Vatican Museum closes at 1.30 pm. Left the line and made our way to the Vatican Museum instead where we stood for 2 hours (I HATE Qs!!!) until we were finally permitted entry.
Absolutely worth it.
You cannot go your own way and pace, the crowd moves as ONE. So do you. We entered countless rooms decked with paintings and drapes etc that were magnificent!! The end of the museum is the Sistine Chapel where Michaelangelo's painting "The Last Judgment" stands. I totally recommend the Vatican Museum after the Louvre in Paris.Posted by Rachel at 12:52 AM
Labels: Gallivanting Across the Globe
My Roman Holiday 2
The Piazza Duomo with it's green and pink facadeThe eurostar which cost us a whooping 30 euros (damn, it's expensive) brought us to this city which is my favourite. It is small, everything is within walking distance and it is really pretty too. Our hotel was located onthis rather dodgy street, sorta like Petaling St back in KL but no, we did not run into any kind of trouble at all. We were the only occupants in the hotel at that time and man did we make loads of noise.
Our first stop was the Piazza Duomo which in my opinion looked weird from outside with its green n pink walls. Inside was even better, it was starkly bare. However, according to Lonely Planet, the Duomo is well known for its pink n green facade; which kinda skewed my impression - i have to like the exterior now.
Spent over an hour in it, and at the gift shop, the shopkeeper came up to us and told us to keep quiet when the best part was, we weren't even talking. Not to mention we just only entered the shop. The noise was from the crowd that was jostling around the whole place. !#$*. Ungrateful woman, we are bringing business to ur drabby place!
Soon after, we left and headed to Piazza Signoria where the Uffizi Museum was situated. Waited in line for about 30 minutes and then VenGee and I decided to go right up front to see if we can purchase the tickets first. Mr Right In Front of the Q told us he has been waiting in line for 3 hours. THREE HOURS?!!? and the line is less than a 100 m in length. Mental. However, we were given a choice to purchase advanced tickets at a higher price of 9 euros(normally 6 euros). If money can solve a problem, then the problem is Not a problem.
my 3rd gelati!
Next stop on was Piazza Dei Pitti where we bought the 11.50 euro ticket to enter the Palazzo Pitti. In utmost truth it was like any other museum and a rather boring one too.. as it had too many rooms and pictures. The gardens looked fantastic from the windows though and soon we were itching to get the heck out the the building and onto the sunny lawns.
Hiked up to the Piazza Michaelangelo to watch the sunset though the sun was hidden behind clouds - I know.. what sunset??!?
Pisa
We actually spent about 1 1/2 hours in Pisa as we had to rush back to enter the Uffizi (10 euros return train ride from Florence to Pisa). My 5th gelati was in Pisa (just after the bridge, in Lonely Planet). No pictures unfortunately as we were in a terrible rush, but it was of Peach and Cookie n Cream(I think) flavour. The best ice cream so far as the Peach one had bits of peaches in it which made it really really lovely. Made the train just by the skin of our necks and reached Florence in time for our 3 pm Uffizi date.
Uffizi was pretty. That is if you get the audio guide or guide book to tell you about the important pictures to see. We saw the famous Adam and Eve painting and the Birth of Venus along with the works of Leonardo Da Vinci and Carravagio, to name a few. After Uffizi, I decided to return to Palazzo Pitti in a last bid to find my camera. Went up to the security personnel to explain my predicament (I gotta applaud Italy as they can at least understand English, not like the French/Belgians) but no one turned in my lost camera. They then directed Dan and I across the square to a gate on the opposite.
"Ask for Carabinieri" - what the...??
So we wandered across the square and gate crashed a party that was going on next to the gate. A woman came out and demanded our presence, to which we replied " We are looking for.. em.. ca..va..er..nie-ri?" (Obviously the word Carabinieri was not retained in our memory.)
"Ah, it is over there." And pointed towards a set of shut, forbidding looking gates.
We inched up to the gates and boom, it opened with another woman asking us what we wanted.
"Cava - thingy"
"Oh. Upstairs."
"Er, what is it may I ask?"
"It is the police."
"Ah. Er. I see. Ok, but thanks!" And we left double quick.
Rather fun though, asking around people just using a word that we had absolutely no idea about. Everyone should try it at least once in their lifetime.
Posted by Rachel at 11:13 PM
Labels: Gallivanting Across the Globe
My Roman Holiday

Sforzesco Castle
Unfortunately, Darren and I got cheated in Milan in front of the Duomo. 2 men came up to us and almost forcibly put some corn into our hands while whistling for the birds to come. And come they did. I walked off and one of them came up to me asking for 10 euros. I refused and he asked for 5. I refused again, and I finally offered him 3 euros for both Darren and I. However, they swooped down onto Darren next and tried to force him to pay 5 euros too. After much argument, they walked of with 2 euros that he gave. Do NOT in any circumstances allow these idiots to put anything into your hand. In fact, Do Not accept any sort of things at all from anyone in Italy.
and my first gelati of the trip!
Tiramisu Flavour
City of water and canals
A whole orchestra made entirely from glass. and the figurines are TINY
An entire garden made of glass. Glass Museum in MuranoThen made our way back to San Marco which was the main square in Venice. It was once again beautiful but there were tonnes of people shoving, pushing... ergghh... and way, way Too Many Birds. This time around, there were street vendors selling a packet of corn each for 1 euro. Makes me feel like neutering the 2 wankers in Milan.
Ven Gee, Darren and I bombarded with BirdsWhat's this? As bad as Petaling Street!. In the end, we went to a gondola operator that had their prices printed on the board. It was still 80 bucks overall but I guess we felt less cheated.


San Marco Square
30 euros worth of vege which consisted of carrots, cucumbers, aubergines, potatoes and peas that I can get from Tesco at 30p. Blardyyyyyy.... eating gold - 食金啊???.
In one of the churches that was on an isolated island in Venice. Ven Gee and I intellectually contemplating the ceiling's paintings.
Pistachio and chocolate flavourTbc
Posted by Rachel at 12:10 AM
Labels: Gallivanting Across the Globe










