Community and clique - part one

I wrote this in March after attending an annual camp with my favourite church. Perhaps most of them, being at least double or triple my age, have grown in maturity and love for God, for their neighbours. What an inspiring example!

Recently, in my M church, the speaker talked about how we share meals with those we love. And how the pharisees must have felt when Jesus was eating and laughing with those who were considered sinners, outcasts, of the community in his time.

When the Pharisees saw this, they asked his disciples, “Why does your teacher eat with tax collectors and sinners?” On hearing this, Jesus said, “It is not the healthy who need a doctor, but the sick. - Matthew 9:11

There are many things to learn here about God's love and mercy, our self righteousness and tendency to judge others. But here is also a mirror of how we close the doors of fellowship with those we feel uncomfortable around. Maybe they sometimes say inappropriate things, their sins seem greater than ours; or maybe they aren't as educated, not as smart, give "weird" answers in Bible study, not well dressed, aren't pretty enough, don't speak fluent English, have accents, different skin colours, different background, too senile, too childish, to be a part of our comfortable social circle.

My brothers and sisters, believers in our glorious Lord Jesus Christ must not show favouritism. Suppose a man comes into your meeting wearing a gold ring and fine clothes, and a poor man in filthy old clothes also comes in. If you show special attention to the man wearing fine clothes and say, “Here’s a good seat for you,” but say to the poor man, “You stand there” or “Sit on the floor by my feet,” have you not discriminated among yourselves and become judges with evil thoughts? ...If you really keep the royal law found in Scripture, “Love your neighbor as yourself,”you are doing right. But if you show favouritism, you sin and are convicted by the law as lawbreakers. - James 2:1-4, 8-9

Say I was a guy (because guys are normally superficial, so are girls to be honest, but less obviously so) and showed special attention to the pretty single female, slim, a lovely dress and expensive handbag, just the right amount of makeup, perfectly permed hair and manicured nails, and from the same country as me.  Then I ignore the slightly awkward guy, who doesn't dress fashionably, standing in the middle of the crowd by himself, and worst still, talks like a "FOB" (fresh off the boat for those who are kind enough not to use the word). Is that loving my neighbour? Or is that like the pharisee trying to pick the neighbours he'll show love to by asking, "who is my neighbour?" Not to mention, are you getting side tracked about why you're attending church or fellowship?

In S I really learnt what it meant by "it is more blessed to give than to receive" - Acts 20:35

Favourite paeds resources

Edit: how could I forget! I shouldn't forget to thank Wikipedia and Google Search for their invaluable contribution to my education in medical school (and beyond).

Before I delete them from the "Favourites" bar!

1. Pedscases: cases, podcasts, quizzes and MCQs. Cases were my favourite - you answer MCQ/select  options questions about what to do next and read a digestable chunk of clinical reasoning before moving to the next part.

2. Merck Manual of Patient Symptoms: there's really good paediatric ones on common conditions (constipation, cough, diarrhoea, fever etc)! Clear, concise, always the same format every podcast so it's great repetition.

3. University of Arizona - Podcasts: a few more paediatric podcasts. Less medical (but still relevant) topics such as injury prevention, interviewing adolescents.

4. The Children's Hospital at Westmead - Fact Sheets: an alternative to parent information pages from RCH.

5. RCH Clinical Practice Guidelines: last but not least. It reflects well on a hospital to provide good CPGs that are widely used. RCH does a much better job with theirs than RWH does for women's health.

Good morning beautiful

I love you, your gloomy darkness, and how you give me the perfect excuse to never venture out of my warm room for days on end. With you, I don't need bottles and bottles of water a day, and I have forgotten what exercise or sweating feels like. The delicious bowls of hot ramen, and warmth of hot bubble tea, and how you never dictate when I should be asleep or awake because the days just become one long night.

I thought we were a perfect match, W & W, my mood and yours. But I tire of you. Waking and leaving the house in dark, and returning when it's darker. Never feeling quite safe, walking down my quiet street wondering who is lurking in the shadows.

Then, there was a day that I woke up to a brightness foreign to my eyes. Walking out of the house just before noon, the sun beamed brightly at my face and I squinted and squirmed like a vampire. There, I finally understood their obession with the sun. "What a beautiful day it is," they would say, lying under the stinging sun as I quickly found myself a patch of shaded grass. Growing up with non stop summer and a sun that boils, I didn't understand what they meant by beautiful. Or how anyone could become vitamin D deficient.

But the warmth and soft rays falling gently onto trees, people, and everything it touches, is beautiful. Maybe I love you after all. The sun never scorches in your presence, and I would never have anticipated eagerly for it, if you didn't hide it in your gloominess.

Reminds me of the song that's been in my head this morning. See What a Morning - what an apt song after reading Isaiah 53:

See, what a morning, gloriously bright,
With the dawning of hope in Jerusalem;
Folded the grave-clothes, tomb filled with light,
As the angels announce, "Christ is risen!"

See God's salvation plan,
Wrought in love, borne in pain, paid in sacrifice,
Fulfilled in Christ, the Man,
For He lives: Christ is risen from the dead!

My growing head

I have several long posts in draft that I've been thinking about. But the inspiration to write came like a wave, and faded away today.

Before these few weeks I didn't realise how heavy the head is. I don't think my brain is getting bigger from studying, but it certainly feels more difficult to support each day. Is that a legitimate medical condition? I don't know what to do with it - flex, extend, lateral flexion, neutral position. Sitting, it hurts. Lying down, on my back, on the side, on my face, it hurts. Hello insomnia. Maybe I need a thicker neck to hold up the mass of my growing head.

Time to see a chiro? Or a shrink?

Paed's scribbles

Happy paediatric pictures.

Behavioural problems. Temper tantrum, food refusal, sleep problems:

Delicious MacBook cover:


Exam stickers (edited, you don't really want to know my student number, do you?) each character is a toy someone brought into the exam yesterday:

And our favourite game - draw something. Else.

There are more scribbles and more draw something pics too.

Women's scribbles

Sorry, women's isn't very inspiring. Unlike psych and children's. Scribbling in class, or during sermons (which has been my recent outlet for scribble energy) is a high compliment. It means I am really paying attention, and interested, in what you're saying. Really.

Ziph this is my new creation after I got tired of drawing kidney man (what an awesome year & how fun it was to see you guys every day, I miss B) and uterus woman:

Hello, I am your friendly gynaecologist:

Unhappy heart and a disturbing fetus:

Oops it's a bit messed up anatomically, and not very women's related. I think the correct term is "abstract". Go ahead and psychoanalyse me:

Dreams - part 2

Sometimes I ask myself whether God speaks through dreams. Certainly, we have accounts of God speaking to Belshazzar the king in Daniels, we read of the prophetic dreams Joseph "the dreamer" had, the dreams he interpreted for Pharaoh's servants, and even in the New Testament, the wise men were warned in a dream to go back to their country via a different route to avoid Herod, who wanted to kill Jesus.

Although I'm sure God still speak in dreams, in visions, through signs and miracles, it is sort of worrying and suspicious when someone is always claiming to be hearing directly from God. I was given a book after my baptism called "Conversations with God" - it reads as a Q&A not unlike the conversation the humans in Prometheus hoped to have with their "Engineers". Though certain sections correlated well with the Bible, and it was very appealing to have direct "answers" from God on the difficult questions of life, it probably didn't belong in a Christian bookshop. Also, after hearing a few psychiatric patients speak of bizarre end of the world theories, claiming to be special persons in God's plans, we have reasons to be extra cautious.

The Lord said, “Go out and stand on the mountain in the presence of the Lord, for the Lord is about to pass by.” Then a great and powerful wind tore the mountains apart and shattered the rocks before the Lord, but the Lord was not in the wind. After the wind there was an earthquake, but the Lord was not in the earthquake. After the earthquake came a fire, but the Lord was not in the fire. And after the fire came a gentle whisper. - 1 Kings 19:11-12

When we make a decision, want to understand our purpose, when we want to know whether God is really there or not, we want something spectacular, extraordinary, and preferably instant. "God, show yourself to be real!" or "what choice do you want me make?" I had asked, and was often disappointed with the lack of dreams, writings on the wall, special encounters, or even a warm tingly feelings inside. Oh well.

God can choose to come in powerful earthquakes and blazing fires, but he can also speak gently and quietly, in ordinary ways. Ordinary is not better (or worse), but it is often what we neglect when we want to hear from God. Maybe because it's not very impressive, and takes long term effort on our part to diligently read the word, understand the Bible, pray, attend church, fellowship with others, seek counsel, have God as our priority in everyday things, and live in constant obedience to him. Yet, the ordinary ways are what we can reliably turn to every day, and what we need to be familiar with to recognise God's voice should he choose to speak through dreams and visions. And it is also what we need to run far away from false voices.

When he has brought out all his own, he goes on ahead of them, and his sheep follow him because they know his voice. But they will never follow a stranger; in fact, they will run away from him because they do not recognize a stranger’s voice.” - John 10:4-5

Dreams - part 1

Dreams. The dreams you have at night, and the dreams you have about your future. "I wouldn't dream of..." and "as if in a dream...". Nightmares, recurrent dreams, vivid dreams. The topic did happen to be the latest lesson available on BBC English. But, I didn't tell my class why I really chose that topic.

It was because I had a vivid dream which was lingering as I thought about what to teach that week. A vivid, also recurring, and not nightmarish, but certainly disturbing, dream. That's okay. They have reduced significantly both in intensity and frequency. Medical descriptions are pretty handy, for all sorts of things.

When I wake up, I always wonder what to "do" with the dream. Does it mean something, is it trying to tell me something, is it reflecting my inner psyche? Do I try to not think about it so that it will fade into oblivion? Take it as a prompt and act on it? I do a bit of both. Dreams are just dreams. But, they can and do have tangible effects, depending on what you do with them.

In this case, my dream and our brief exchange of words that followed, has led me to be disappointed, and colder.

Out of my collection of whacko friendships, or non friendships, you are the one who I never got angry at. I never portrayed you unfairly, or even written negatively about you at all, really. I never failed to correct nasty or uncalled for snide remarks against you. I never echoed your coldness, cynicism or sarcasm. To you, I've only communicated genuine, warm, offers of friendship, in various ways, over years and years and years. I didn't give up on you because long ago, we expressed a common sentiment that it's sad if we can't even be friends.

You've always been surprising. Surprising in how long you can stubbornly clutch onto a cup of poison. Surprising in your maturity and generosity at the least expected times. I had always hoped that time would heal sufficiently, to allow us to start over anew as friends. "Maybe we're a bit better now," you remarked not too long ago. Then you seem to change your mind depending on the season.

Thinking back, we can sum up our interactions by the same questions we've been asking  each other all these years. Why. Why shouldn't I hate you, ignore you. Why do I need to let go of anything, why shouldn't things remain the way it has been, why should I have anything to do with you. And my answer all along has been, because. You don't have to, but you could, and why not? You could never give an answer to that either.

Sometimes I think you're ungrateful. I come across your photos, and see that you're happy to be normal and happy with our mutual friends. Why should I be any different. When I see your confident smile I want to ask you, do you remember how you used to be awkwardly hiding your face or giving a blank look in photos, until I sweetly suggested to you to just smile? Look at your earlier photos if you don't believe me. I think about you graduating and wonder if you remember how I helped you with that year, how I encouraged and believed in you when you said you felt like a failure. Or how I cooked and washed up so that you could study. And did you forget how many assignments and essays I patiently edited for you? It's no wonder that I know the course material so well, though I've never done it myself. Of course it's your own work and achievement in the end, that you scored well and entered into a course which you've always wanted to do.

In the time that followed, what more could I have done to demonstrate my constant friendship, or how else could I have done better in giving you the space you required? Yes there are other areas in which I could have done much much better. And although I can't change what's passed and am unwilling to change where I am now, I don't see how I could apologise more sincerely, and try to understand your point of view any more than I have been trying to do for the past years. I tried to keep out of your way when I knew it would be unsettling for you to see me wandering down your corridor. When you don't appreciate my light hearted comments, I give you a serious answer. When you wish to speak in cryptic codes, I play along with you. When you are drawn back into reflecting, thinking, I haven't ignored you. Hey, why should you pick out the worst aspect of me, and remember me based on that particular season, never looking back, never looking ahead? Unfair, I say. I have always remembered the good in you. Although I am still learning to deal with the consequences of the scars you have left in my life, I have never held it against you, or hated you for what you did. You probably don't have enough insight to realise what they are, or what their effects are.

Which is to be expected. You were always selfish. This time you respond like this, because it is an inconvenient, busy time for you. To even give a civil answer. I hate to compare but am almost certain that I have better reason to be too busy to be friendly to you. Back then, every time exams came around, it was inconvenient for you to discuss or face anything. Often, you were so engrossed in your constant physical and emotional ailments, that you could not bring yourself to recognise, much less help me deal with mine. Always saying that your love was one sided, I think the truth is that you're too self pitying and ungrateful to even recognise love when it was in front of you.

Look, it doesn't what you were like before and hopefully you've matured since then. After all, I was taken aback when I calculated your age this year, ha. This dream, your response, my reflections, might just be what I need to wholeheartedly acknowledge God's wisdom, thank him for his grace in a time where I ignored him, thank him for where I am today, and move onto a new stage in this healing process.

Writing and speaking

I wish ideas for every letter flowed so easily, took as little time to write, as the one below. I didn't expect it to be such a time consuming task. It took me at least a full day of concentration, to write each letter. Full days of concentration are hard to come by, so that really means many days. Fortunately, I had less than a handful to write. I shouldn't be complaining. I chose to play this game. Also, I feel deeply for those international classmates students who are applying to >10 hospitals in this state, and more elsewhere.

Having a previous year applicant's letters in front me, I felt I couldn't send in a piece of writing (even if you substitute it with the relevant career aspirations, achievements etc) that wasn't "me". Is that arrogant? The letters were well constructed, they just weren't an accurate representation of the way I express myself. Then, although I complained about every hospital being similar in values education and support, I felt too dishonest to give the same generic praises in each letter. So that stopped me from copying and pasting paragraphs of text. When looking for something specific to say about the hospital, I found it hard to write down that I was interested in a education program, or specific specialty rotation, that I was actually not very interested in it. No wonder it took so long.

Same sentiments as the fake letter, but the product was very different. But even if I sound interested on paper I wonder if I can muster up any real interest in face to face conversation. I'd happily talk animatedly about B, but that's all. Monotonous, you need to be more interested, you mumble. What unfortunate but probably not untrue phrases people use. Pah, this discussion has taken us to dark and distateful territories. I don't feel like writing anymore.

Need a cover letter?

"Just see it as a way to test your acting / creative writing skills."

Dear most incredible hospital in the universe,

I am writing to apply for the internship position in 2013 with you. I care about patients, becoming a competent doctor, and having a good experience during my intern year.

However, I don't know what to write on this letter. I don't understand why you want me to regurgitate your values. Every hospital has similar values of excellence, compassion, respect, and teamwork anyway. Of course everyone is going to say that these are values they uphold - whether we do or not, you will find out in due course. Ha. Ha. Your information session came across as arrogant, elitist, and I don't care for your application process.  Your rotations are nearly the same as the other hospitals I'm applying to. You give the same spill about being supportive and providing great teaching. Why lie, I am apathetic about working with you and you are not even my first choice. However, I did not forget the abundant refreshments during your open day. This is a good sign of your generosity, and indicates that I will be well fed at your hospital. I am a very hungry person and food makes my world go round. You and I might actually make a perfect match.

Before you lose interest at my application... wait! I'm absolutely *amazing* and well rounded. I communicate well, and am both an excellent leader and team player. I've done a million extra things that I have no interest in to pad out my CV - conferences, volunteer work, committees, sporting, music and have even taken a course in rocket flying. I juggle my time so well that I have straight high distinctions and have worked full time, continuously, for 12 months, of at least 50 hours a week. I never sleep, I love waking up at 5am to go to ward rounds, I get a huge buzz from performing cannulations and writing discharge summaries. Don't you see? I'm a good doctor and I'm good at everything else. I am superhuman. So basically, I'm pretty amazing!

Okay, I stretched the truth. I'm not that amazing. And I'm terribly bored of writing this letter. I've run out of ideas. Oh here's one - you do employ some hot doctors driving fancy cars. I promise to come into work early so that I can spy on them early every morning. Alternatively, I can be enticed with a colourful breakfast of thick delicious yoghurt, croissants, raisin toast, cut fruit, tea and coffee. To conclude, my dearest hospital, it will be an absolutely incredibly unbelievable honour and delight to work slavishly under your rule. Thank you for your time and consideration.

Yours sincerely,

Very bored and insincere applicant

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