Writing about writing

"I don't understand, how can anyone write so much?"

I love writing.
Making sense of life. Sorting, shaping thoughts, feelings, views.
Stopping them from crazily and endlessly spinning in my head.
But you have to be careful with what you share with the world.
Careful not to write about people you know, offending them.
Careful not to name people, not to say too much about yourself.
Careful, so you think you are safe but maybe you are not.
Even in a convoluted way, there is depth in sharing who you are.
Never thinking, how abstract words, could surprise you.
Colliding with a mirror of your inner world, painfully. In tangible reality.
Writing to touch others, never imagining how profoundly it would touch you.
Writing about what was learnt; not seeing the start of a new lesson.
How could questions and uncertainties be so intertwined with writing.
Not knowing what to think, say. Not wanting to say anything at all.
Food was scrumptious. Blissful. Cannot hurt, or turn insane.
For a time. But sickening after a terrible evening. Hate it.
For a time, wanting to never, ever, write about it again.
So here I am again, resuming drafts on what I really love to write about.

What if your blessings come through raindrops?

Blessings - Laura Story

We pray for blessings, we pray for peace
Comfort for family, protection while we sleep
We pray for healing, for prosperity
We pray for Your mighty hand to ease our suffering
And all the while, You hear each spoken need
Yet love us way too much to give us lesser things

We pray for wisdom, Your voice to hear
And we cry in anger when we cannot feel you near
We doubt your goodness, we doubt your love
As if each promise from Your Word is not enough
And all the while, You hear each desperate plea
And long that we'd have faith to believe

Cause what if Your blessings come through raindrops
What if Your healing comes through tears
What if a thousand sleepless nights are what it takes to know You're near
What if trials of this life are Your mercies in disguise?

When friends betray us
When darkness seems to win, we know
That pain reminds this heart,
That this is not, this is not our home
It's not our home

What if my greatest disappointments,
Or the aching of this life,
Is the revealing of a greater thirst this world can't satisfy.
What if trials of this life,
The rain, the storms, the hardest nights
Are your mercies in disguise?

God, why?

I think it will take me a long time, if ever, to understand. But I see now why I loved this song and thought so often about what it meant, since I first heard it on the radio that frosty morning. What beautiful words of sorrow and hope, truth and clarity.  How did I not see it before - there is no true antidote in anyone, any distractions, anything, but God.

The hardest things

Assignments. Midsemester tests. Exams. Assessments. Tutor marks. Not being able to answer questions. Not knowing doses of medications. Not remembering pathophysiology. Not being sure of clinical signs.

A classmate was saying that the thought of the physician training exams terrifies him, because of what he had heard about the low pass rates. I laughed and replied, you can always take it again, and if you fail too many times, maybe you're really better suited to doing something else. I hear of students in science, pharmacy, arts, architecture, engineering, law, each talking about how stressful it is to have weekly assignment, midsemester tests, or exams coming up. Each, including medical students, sighing and not so subtly implying that their course is harder than everyone else's.

I guess I don't completely understand. Not that I don't feel the stress of assessments. But for many years that type of anxiety has not progressed beyond a useful prompt to open my textbooks and get on with work. So with a tad of arrogance, and disdain, I frown in scepticism when people around me rant about how hard everything in university is. I can't help wondering, which part of writing an essay, even if it's several thousand words in length, is difficult when you only have ten contact hours a week? Which part of medical school is difficult, and how much does that first class honours really count, especially when, being old and grey one day, you look back at your life? How are clinicals overwhelming? We keep learning, and have many years ahead to learn. Plus with so many iPhone apps (what a serious disadvantage, not having one yet!) what does it matter if we don't have encyclopaedic knowledge on every topic?

Lately, in my possibly excessive hours of self reflection, I found that the hardest things in university, in medicine, in hospital rotations, have little do with the studies, or even the clinical work itself. Not saying there isn't much to be learnt as a junior doctor. But, being a scribe/secretary/PA/intern for a team during ward rounds, writing scripts, filling in pathology slips, making phone calls - these are not difficult tasks, and hardly deserve the respect bestowed by the "Dr." title.

Rather the hardest things are to wake up to an alarm clock, or worse still, long before the alarm clock sounds. Day after day, after day. It's waiting for trains on a chilly morning, or cold afternoon, and attempting to use the vending machines at the platform to barricade against the wind, only to realise that it's impossible to do so because the wild wind constantly blows where it wills, in multiple directions. It's uncomfortably shifting weight between the collapsing arches of two feet in uncomfortable shoes, and pouncing on opportunities to sit on ledges, lean on benches, kneel on the floor whilst leaning on patient beds to write notes on. It's driving home at night blinking constantly, feeling like there is glue trying to close my eyelids shut. It's being too tired to asleep, or when insomnia lingers. It's when too many early mornings make the days of the week blur into one another, until I score a patient wrong on the mini mental examination, when it was really me who had the days and dates mixed up.

It's being easily upset, fiercely angry, and excessively sad and teary. It's wondering whether it would be better if I live alone forever so that no one else needs to deal with these emotions. It's when the monsters pay frequent visits, when gradually the sorrows of the night spill into the morning, yet there is still the obligation to get ready for the day, be functional, and deal with the grief of others. It's when grief spills into the unconscious world, manifesting in restless dreams with deaths of loved ones, hurtful words, being attacked with a ballpoint pen, lost friendships - waking up with palpitations, elevated heart rate, hearing my own voice cry out, and starting the day with a discomfort that is difficult to describe. It's when, working next year, staying home to sort myself out for non physical illnesses is no longer an acceptable option. It's being physically unwell and feeling guilty for resting at home for a minor illness. It's being disheartened at the room with suitcases, bits of paper, bags, shoes and clothes strewn over the floor. It's at the end of a day, being reluctant to be at home amongst another family's world of hidden but palpable sadness, conflict, uneasiness, which I feel for almost as much as if it were my own. Yet having no real alternative, unless I wish to wander from restaurant to restaurant, bubble tea to bubble tea stores, taking long strolls around the city, or purposely making the train journey home longer, every evening.

In writing I realise, perhaps it's not that I hate medicine, but that I use it as a scapegoat. What is hard is the weariness of functioning reliably, and managing the difficult feelings that come with daily life, both personal and those which arise from clinical encounters. I think that's what my Boggart would be shape shifting into, if there was a physical, tangible, pictorial representation of that fear. I shouldn't scorn at others for what their Boggarts turn into, for them finding their greatest fears, the hardest things, to be other aspects of life.

Day by Day

Day by day, and with each passing moment,
Strength I find to meet my trials here;
Trusting in my Father's wise bestowment,
I've no cause for worry or for fear.
He, whose heart is kind beyond all measure,
Gives unto each day what He deems best,
Lovingly its part of pain and pleasure,
Mingling toil with peace and rest...

God, help me to walk with you through each day, through everything I find difficult. In toil and rest, pain and pleasure, finding strength and purpose in you.

The cold city

It's been awhile since I've heard bits of a song that seem to reflect my mood perfectly. Even if the song itself is talking about something completely different.

那年夏天 - 许飞

长大以后现在的我常常会寂寞 
偶尔缱绻 星星闪烁剩最亮一颗
往事如风 划过夜空 你的歌
跳动音符 熟悉旋律谁来和

长大以后现在的我忘记了快乐
人来人去 留在身边的朋友不多
那些天真 纯纯的笑 哪去了
洁白翅膀 美丽天使不见了...

Is it because I've been on four plane flights in two weeks? Is it that I've met new and old friends, family, just starting to be part of their lives again, only to be saying goodbye? Or is it that I had once again began to slip away from my life here and now, being lost in mysterious Obernewtyn, the complicated family ties within the single Korean drama I've half watched all these years (because I stumbled across it during my hotel stay overseas), or the dark world of Batman where everyone on screen seem to get killed, and where heroes and villains alike love to use blazing guns? Is it because I've packed and unpacked countless times and will be living in two homes for the following weeks, being confused where my belongings are here or there? Is it because I had lost my voice without singing and felt too tired to go grocery shopping and find something to eat?

I can't see why the first few days back were so hard. Over the semester, in a layer of busyness, of meals, of catch ups, I always forget. But each time I come back, I find something terribly cold about M, and it has nothing to do with the weather. It's a place of solitude, as it always has been - reminiscent of a time many winters ago when I arrived in a cold room, with tired walls, at the end of a corridor in which I knew no one. That semester I was way more sick than now, lying on my bed, half awake, half feverish. Didn't appreciate the college "friends" who made fun of me disappearing for days rather than just dropping by and seeing how I was.

Time away heals, but old troubles, new sorrows, quickly return. The city suited my melancholy moods during those earlier years, especially the mesmerising dark beauty of the river reflecting the city skyscape at night. But I'm content to do without the artistic emo-ness. No matter how many years later, each time the loneliness and sadness welcomes my arrival. And each time, it becomes a bitter reminder of how I handled those feelings when I first came. When I visit these places afresh I see the ghost which are so intertwined with the cityscape, familiar routes through which our footprints have long been covered by layers of leaves, dust, rain.

This is the place like no other, where love has turned into hate, where my high school best friends have become cold strangers, not because they were far away, but for the very fact that we lived in the same city. The superficiality of relationships in this city perlexes me, whether at school or church. Even the friends I have here now are mostly a remnant of my life away from this city. In all my travels I've yet to find a place which matches this city's culinary quality and diversity. But despite that, and despite M being the place where I've done much growing up, crossed the milestones of my young adult life, I doubt that I can make my home here. Many years will not change that.

But even being in my favourite town is sad. The same old nursing home student accommodation, but the people living behind the same doors are long gone. The brilliant red jars of quince jelly we made, knocking each other's doors, the vegetarian Peking duck rolls, the Rockband sessions in a crammed room, late night talks, racing to the hospital, walks and runs along the lake, weekly badminton - these have faded from reality into mere memories. At least our friendships are still reality.

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.

Give and take

Loving others, is a blessing, and a command. That means caring for that stranger, listening to that person whether they give a hoot about you or not.

However. A one sided love is a crush, an unrequited love, rather than a real relationship. Then, what do you say of the one sided friendship? What is friendship? I would think that, by definition, it implies give and take. Of care, of listening, of encouraging.

There is a place for investing in someones life without expecting return. But I assume as humans, we also need solid, two way, mutual friendships to keep us going, through the flat, the ups, and downs of daily life.

I find that you can't expect much (I've been told that I'm demanding), especially when you have a need. When the answer is always, I'm really really busy. Sorry, instead of listening to your packed schedule, what I'm really hearing is something about your priorities (I've also been told that I should hear what is said, rather than feeling the undercurrents).

After a long day, a quick impromptu meal and chat will be great. Openly sharing "matters of the heart", without needing to describe who's who would be good. On the weekend, it would be nice to go for a short drive, explore somewhere. Being able to ask without hesitation, without wondering if the answer would be too busy, or too far, would be amazing. Not doing the asking would be better. Just knowing that the friendship is mutually sought, enjoyed and appreciate.

It's tiring. It's not that I have all the time in the world and am exempt from whatever university students worry about. And neither is it that I'm bored out of my brains and can't entertain myself. It's an offer of friendship, to spend time together. This garden doesn't seem terribly conducive for plant growing. Ooo, we were talking about Jesus' parables involving growing seeds just today, maybe I accidently plagarised the ideas.

The fourteen year old wrote:

Friendship

The plant of two,

Blossoming under tender care,

The alive and ever true,

Are sadly very rare.

The seeds are planted,

With a smile and nod,

The two are enchanted,

With each growing pod.

As the plant grows,

Towards the vast sky,

A wind of sin blows,

A shrilling and ugly cry.

The two grows apart,

The plant withers dry,

They grieve in their heart,

Not wanting it to die.

The two may arise,

From their petty feud,

And grow increasingly wise,

In granting the plant food.

Other plants are buried,

Under newfound flowers,

The results are not varied,

Destroying works of hours.

Tall and lasting plants,

Succulent in loyalty,

Lovingly grants,

An envied life in royalty.

Four o'clock

I thought today was an improvement.
I wanted to thank God.
But, tossing and turning in bed.
Thinking about waking up tomorrow.
Getting more and more agitated.
I suppose, no one can be expected to keep you company.
Not at 4am. So I sit here and talk, to myself.
Maybe double digits is a bad year,
I hate birth. Days. Not to be ungrateful to my family.
And the friends who wrote me thoughtful messages.
Or C, who always has a lovely word and card.
But they're distressing. Days.
I hoped for quiet, familiar, company.
Instead I dined and talked with a stranger.
A nice stranger doesn't take away the bitterness.
Really. It's been building up for longer, beyond that day.
M, the city of distant ghosts, cold faces.
A place I loved, or a bad and lonely place?
The cars. Deadly trucks. Angry cyclists knocking angrily.
The closer proximity, the heightened expectations.
The distateful mess. The fatigue. And a poisonous aftertaste.
Pointing. It's your fault. No it's your fault.
The inability to say a caring word. How sad.
Sadness is irritable. And sadness. Is isolating.
The episodes makes functioning. Rather difficult.
And sleep. Rather difficult too. Don't think DSM.
I thought there were old friends and new friends.
On good days there are. Opportunities to love.
But on bad days I see the popular, shunning the unpopular.
And lament that it happens at church. Of all places.
It could be seasonal. You know, summer and winter.
The lense needs a cleaning. Dark in darkness dwells.

Close to heart

Three weeks of psychiatry and I've had enough. The conditions are interesting and I wouldn't mind talking to more of the patients (consumers?) myself, but sitting in with psychiatrists during those long interviews I've come close to nodding off to sleep so many times. Which always makes me laugh because it reminds me of the referral letter I read about a patient having issues with his previous psychologist who often fell sleep through therapy.

Sometimes I go through a psych lecture thinking, I don't want to be reminded. We had the talk about suicide. Oh... is it unusual to be preoccupied with thoughts of death, and plan how you might go about it? If society made it easier to access easy, painless, non-gruesome, high "success" methods, I would be long gone. Is a risk assessment forming in your mind now? I've learnt to throw out those thoughts into oblivion whenever they appear. And walking with God these years, there isn't the thoughts of everything being empty, meaningless, weary - that is the most life draining thought of them all.

Still, when my mood and sadness overwhelms me sometimes I wonder why I have to be stuck in this world I don't feel like I can live in. It seems that small things can tip me into a dark place with this drowning sorrow and thoughts that's painful and hard to shake off. It makes me wonder how I will deal with the bigger issues in life - if I have problems with marriage, if someone close dies, if I get a serious illness. At these times I wonder, why am I going to be a doctor (or, why am I talking to psychiatric patients) when I can't deal with my issues. Physician heal thyself.

Maybe the plus side of all this is that I'm constantly conscious aware of promoting my mental health. Often reflecting to understand why I feel and respond the way I do, consider how I can interact better with other people, talking to a good listener (friend, not a psychiatrist yet), praying and fellowship, getting out of the room even when I don't feel like it, caring about other people even when I don't particularly want to care, write or draw to deal with my feelings, make sure I get enough sleep, have a regular schedule, eat something nice when the appetite comes back, don't try to use alcohol to deal with mood problems.

I recognise that they are people loved by God, they often had a tumultuous upbringing, and well, they have an illness. But I find it seriously hard to respond with compassion and patience at angry, threatening, accusatory patients. Just you wait. I'm going to kill you. I don't know how psychiatrists take it.

I can't make my mind whether I really hate Psych, or if I can grow to love Pysch. I'll have a good think about Psych's effects on my psyche at the end of the rotation.

Psych is following me around. Personification, paranoid delusions. Today's topic at Christian medical fellowship was on psychiatry. Part one covers secular and Christian models for mental illness, and part two covers psychiatric therapies from a Christian perspectives, whether voices are demonic. Part two also briefly touches the question "are Christians delusional?"

Monsters

Just a story. So it's fictional, maybe. I didn't write it today. Not suitable for children.

Once upon a time there was an institution, and a girl lived there. There was also a Monster, a hideous shadow whose name was Pain. At night, when silence and darkness prevailed, he would visit her room, sometimes sneaking up without a sound, sometimes entering rudely with a loud bang. He would reach out those deformed claws and hook them tightly into her chest, tugging and tearing the flesh. Then standing back, he would watch the splatter, drizzle of blood, the cough and the fear. She barely had the strength to call for help, and even if she did, he made sure there was no one was close enough to hear. She would hide under her sheets, and hug herself tight, closing her eyes so that she would not see his formless face. She cried and cried and he would collect tears as if he was collecting gold. Eventually Pain would be satisfied and leave. Miraculously her wound would disappear without a trace. She felt a lingering throb and twisting of her insides. But there were no physical injuries and scars, and the healers were unable to offer any help.

When Pain left, his good friend Loneliness always followed. He was a pale, solemn looking man with a neat suit and briefcase, with no particular features to distinguish himself as one of the Monsters. Loneliness never raised his voice and was always polite, as if he was paying a social visit. And he would talk. He would come up close to her and whisper in her ears and chill her insides with his cold breath. He was a professional liar, or was he brutally honest, she couldn’t tell. He convinced her that no one understood, no one cared and Friends did not exist but were illusions. They all hate you, he would say, don’t you remember when they said this to you, and my, did you notice the tone they spoke to you in? Then Loneliness would lay a cold hand on her shoulder and say, that’s okay, I will stay with you for the night. Occasionally though, a fellow inmate, a Friend, would walk in while he was talking to her. The girl would turn back to Loneliness and retort, hey, you are wrong! He would shrug, then bow, and excuse himself and leave.

On the nights of their visits, the Monsters would enter some rooms in the institution, but not others. No one really knew why that was so. The girl guessed it was because she was weak and did not kick them out, or run fast enough. Or that she and the Monsters grew mutually familiar with each other’s company. Or was it that she was stupidly feeding them something they hungered for. Or perhaps, they merely came to remind her that there was no space, no room available, no place suitable for her in the institution – telling her she had to leave. Some inmates saw and felt the attacks, while others were oblivious. Some were strong and defeated the Monsters. However, others grew weary of seeing the Monsters on many dark nights, and eventually agreed to negotiate with Despair, who was the master of Pain and Loneliness. The girl hated Despair and prepared many knives to throw at him. Since she forged the knives, he had stopped visiting her. She grew very angry and upset when Despair tried to offer her Friends a deal. He told them about the land where there were no Monsters. In exchange for their room in the institution, he could offer a one-way train ticket to that land beyond the hills.

Solitude

By Lord Byron

To sit on rocks, to muse o'er flood and fell,
To slowly trace the forest's shady scene,
Where things that own not man's dominion dwell,
And mortal foot hath ne'er or rarely been;
To climb the trackless mountain all unseen,
With the wild flock that never needs a fold;
Alone o'er steeps and foaming falls to lean;
This is not solitude, 'tis but to hold
Converse with Nature's charms, and view her stores unrolled.

But midst the crowd, the hurry, the shock of men,
To hear, to see, to feel and to possess,
And roam alone, the world's tired denizen,
With none who bless us, none whom we can bless;
Minions of splendour shrinking from distress!
None that, with kindred consciousness endued,
If we were not, would seem to smile the less
Of all the flattered, followed, sought and sued;
This is to be alone; this, this is solitude!

A beautiful poem, a memorable poem. One that comes to mind from time to time. I pasted it on my last blog too.

Cold is...

(yup it's a long and totally pointless post, because you all know what cold is)

an unfamiliar, large empty room with high ceilings. An eerie line of light from a gap where the blinds don't quite meet the width of the windows. The deepest winter night, wrapped up in a thick blanket with the heater on full blast and all windows closed; but still freezing.

chilling winds gently rocking a lift chair suspended high above the slopes. Sitting with no assurance that the heavy skiis attached to your boots will not plummet into the (deceptively soft) white snow below. Hands numb from wet gloves, clasping tightly to the metal rails.

sitting on a lone bench in the middle of a park with stretches of grass on all sides. A park from which, in the distant horizon, a row of high rises can be seen. Not believing that the vast spaces are empty, wondering if anyone hides behind the night cover. Shivering uncontrollably inside a fur coat.

breathing out a magical ball of mist with every puff you let out. Marvelling at it like a child; knowing it's condensation but being fascinated nonetheless.

Art

Once upon a time an artist completed a painting. He was mesmerised, delighted! A scene rich in harmonious colours, with exquisite details, with life. (The rainforest. Grass green, dark green, dull green, crisp green. Fine rays of sunshine shy through the rustling leaves. A fresh scent lingers, the dampness seeps through the canvas, the birds are gliding out of the page...)

He continued to paint. But none matched the one he had completed. His skills and techniques were unchanged, but in light of his masterpiece, they were mere shadows, without colour, without magic. After numerous failed attempts, the joy of art was lost to him.

The artist was contented with his works before the painting changed him. If by some power you could decide, would you have let him create this masterpiece?

Twinkle twinkle little star

Every evening the sun falls and slams into the horizon. Light turns to dark. Droplets of tears hidden behind the blue day sky begin to appear as thousands and thousands of shimmering stars, forming a stream. The tale of a star is only unveiled to gazing eyes, patiently track her journey. Their mysteries are forever hidden from indoor eyes, busy eyes, eyes that see yet quickly forget - indifferent eyes. At the break of dawn a wave of energy sweeps the little stars away; faded and forgotten until night rises once more. The cycle is constant, never ending, eternal.

But today the sun died. The splendor of the stars will hang, not with joy, but shyly and with great sorrow.