Clinics

What a perfect day on urology, despite the freezing frosting early morning start. A few patients on morning rounds, followed by outpatients clinic. Sitting in with consultants who were friendly, great teachers, and had impeccable patient manner. Seeing lots of common cases of kidney stones and benign prostate hypertrophy. Followed by coffee in the hidden garden area of the cafe opposite the hospital. Last week was similarly pleasant. These mornings are worth climbing reluctantly out of bed for. I would consider urology, if surgical training wasn't involved.

Out of all hospital activities, I enjoy clinics the most. I saw my first patient in medical outpatients for the first time in the first few weeks of clinical school last year. Just starting to learn how to take a full history at that time, I felt like a doctor in a room alone - well, an imposter one, still it was fun. Since then I still love sitting down in a quiet room, and being able to talk in without interruptions. If we're with consultants, it's great how clinics usually happens at a pace where you can ask questions and be asked questions.

In our first semester of medicine, we had a few sessions of clinical placements. I remember my first one was at surgical outpatients in N Hospital, and the first patient had pilonidal sinus, and the second was a man who had been circumcised at an age of sixty or so. Back then we looked away awkwardly when those first two patients had to take off their trousers to be examined. That doctor saw patients at an astonishing speed of thirty patients over two hours. So we thought that's how fast patients are usually seen by doctors, haha. That was until we went for our second placement at a private specialist clinic at M Hospital, with the first consult running for over one and a half hours - we were really struggling to stay awake. Time use to pass so slowwww during those placements because you didn't know enough to understand the conversations or learn anything useful.

Living within books

I hardly touch novels during semester, because the irresistible desire to keep reading and reading, and reading until I finish a book overrides the sensible prompts to sleep and be awake for school the next day. So each holidays, I pay a visit to the local library and borrow a stack of books and slowly churn through them with great enthusiasm.

I love classics in particular. Wuthering Heights, Jane Eyre, Pride and Prejudice, Little Women, and even that Tess of the d'Urbervilles we all dreaded studying in high school. There is a quirkiness and mystery of a time and era past, and people who have such distinct ideas about women, about class, that fascinates me. These text have a richness - patient descriptions, colours, references to Biblical ideas or other popular texts at the time (undoubtedly, these are the elements which make them substantial for study by high school students over generations). Unfortunately, this art of painting a world and immersion into the character's lives is stripped to a bare minimum in many of today's popular novels, whose fast paced scenes, and flurry of dialogues, serve better as film material. But for all that I'm an impatient reader too, and for each classic I named above, I've had to start these books many times before I succeeded in passing the first one or two chapters.

A list of my holiday adventures:

A Tale of Two Cities - I remember the vivid references to this book from Sara in A Little Princess. Last holidays I managed two chapters before I gave up. This holiday I persevered and was rewarded with a story of love, of the terrible savage nature humans are capable of in times of desperation and of a mob mentality reminiscent of that scene in To Kill a Mockingbird. I've heard of but never studied the French Revolution and the novel gave life to this overthrow of aristocrats, and the impacts of this on daily life that I could never have gleaned from history books.

The Conversations at Curlow Creek - dreamy, poetic writing that was difficult to follow but I enjoyed the stories that ranged from a bushranger, to the childhood of a soldier from Ireland, on a backdrop of the harsh and wilderness of the "cursed" Australian land.
Anne of Green Gables - re-read, probably for the 30th+ time. I laughed at such lovable, comical characters. How come as a child I've never noticed, nor felt the twitch of irritation at how much Anne talked and talked. How is it that I didn't see Marilla's dry humour and sarcasm sprinkled throughout the novel. Being older, I could also smell the developing romance of Gilbert and Anne from miles away.

North and South - ah the stubborn Margaret and Mr Thornton. The strange commonplace practice of ladies "fainting" at shocking news. The contrast of north England with its factories and bustling cities, to the the south, with its idyllic landscapes, farms and small villages. The symbiotic relationship between masters and "hands" during the industrial revolution.

The Curious Case of Dr Jekyll and Mr Hyde - I can see how such an improbable story would nevertheless resonate with each of us. The fascinating coexistance of our good and upright self, and our ugly and hateful being.

Others - I picked up a true story of a translator working for the inmates of Guantanamo Bay. The accounts spoke of such dehumanisation of individuals, and physical and psychological cruelty. Without the accounts of these detained men and the wives and children waiting for them at home, I would never have given much thought to the injustice of the whole operation. Another story I read was the autobiography of a schizophrenic man and the gradual paranoia that everyone was whispering about him, and all things were signs that linked to a grand plan to exterminate him. How horrible it would be to really be convinced of such things, as unreal as they are.

When we study symptoms of disease, the doctors tell us what you don't consciously think about, you won't see. I guess when we look at history, at our world (at the injustice, the divides, the hate, the mentally ill), what we don't learn to think about, we won't see either.

But when I live within the world of novels and imagination, I feel less and less connected to the reality of my physical existence. I should be careful not to slip too far. I've spent enough time over there and it's time to come back.

Difficulties about prayer

The trigger

The current theme for sermons at my home church is on prayer. I have such difficulty praising God when I hear anecdotes about God healing people miraculously, or when God opened a path for them to study a prestigious course, or when God saved their life and so on.

I can't forget the true account of the pastor's relative, whose son was kidnapped together with another child and held ransom. The father prayed fervently, the son was unharmed, and amazingly the criminal actually repented and turned to God. Praise God, they said. Then another member of the pastor's family who sat next to me that day turned to me and whispered, that was my uncle, and by the way the other child was killed. I felt sad.


The problem

Oh God it hurts to hear about one person being protected, but another, who may have prayed just the same is harmed. It hurts to hear people speak of being healed because I remember the emotions and darkness of some of those faces at the hospital. And because of this confusion, I have real difficulties especially in praying for victims of natural disasters, and praying for those with physical illness.

I read a book years ago called Prayer (does it make any difference) by Philip Yancey. The honesty in which he addresses the issues and doubts of praying would fascinate Christians and non Christians alike. When I talked about my doubts I was encouraged to re-read the book. He coins this the "inconsistency problem":

I hope by now I have made it clear that I believe in prayer and its power to change both people and events. Nevertheless, when I hear a person describe a remarkable escape from a plane crash, I cannot help thinking about the people who died in the same crash, many of them praying just as fervently. And although I rejoice over reports of miraculous healings, I also remember with a pang the filing cabinet drawer in my office bulging with stories of those who have not been healed. I do not doubt that God answers prayer. Rather I struggle with the inconsistency of those apparent answers. - Philip Yancey


"Faith and doubt" (borrowed from the title of a good book.)

So I've been reading that book about prayer, then the Bible about prayers of Jesus, of prophets, of Paul's letters that mention prayer. And ironically, praying about understanding prayer. Here are some thoughts:

1. I too "believe" in prayer because I believe in the Bible - that demonstrates the nature of God as one who delights in communicating and having a relationship with us, who loves us and listens to us (but am still unsure about how he answers and responds), I believe God as the almighty creator and king and as such:

Surely the arm of the Lord is not too short to save, nor his ear too dull to hear. - Isiah 59:1

2. I believe in prayer in that it transforms my character. For example, the times when I pray consistently I find a care and love for those I'm not even that close to, that I would never have otherwise. Along with the Word, prayer helps me to forgive, reminds me to apologise, gives me hope when I'm feeling dark etc. The effect of prayer on myself also transforms my relationships as it changes my interaction with others. I do occasionally wonder if it's self deception or "sanitised" self talk, but I would also be adamant in declaring that there is a difference between prayer and self reflection (which I've also done much of via diary writing for years and years).

3. Phillip Yancey's book on prayer begins with the quote:

The reason why we pray is simply that we cannot help praying. - William James

I thought that was a little cryptic and exaggerated, but perhaps its true. Many people (myself, and also those without a faith as such) pray when they're sick, when they face danger, when they want to score well in exams, when something terrible happens and we ask God why?!

4. However, the questions still remain. Why does God require us to be persistent in prayer? How can our prayers actually change events? Do they? If God knows our hearts why do we need to ask for it? If God knows, why pray at all? Why does God "answer" some prayers and not others?

I still pray with some faith and conviction though the questions are still there. By and by I will gain understanding and experience of God, but I don't expect there are concrete answers in this lifetime.

Like death

I'm not sure I can do it ever again. I've known nothing worse than its sharp grief and lingering consequences. I hope and pray that I never have to know it again, but maybe, just maybe, I might face it once more. The abrupt cutting off gives a taste similar to what death would bring. And it is metaphorically a death, an unbridgeable chasm. But perhaps it's worse than death because it comes through conscious choice, and is stained by your own errors.

And if it does happen I would need plenty, plenty, plenty of therapy.

My life is my own

"Few Christians are audacious enough to say this out loud, but many live as if that were true", said our visiting pastor on Sunday. On Saturday night I thought where will I go, what will I do and was in the process of making many plans about electives - without much prayer or conscious consideration of God, what would you like me to do?

Now listen, you who say, "Today or tomorrow we will go to this or that city, spend a year there, carry on business and make money." Why, you do not even know what will happen tomorrow. What is your life? You are a mist that appears for a little while and then vanishes. Instead, you ought to say, "If it is the Lord's will, we will live and do this or that." As it is, you boast and brag. All such boasting is evil. - James 4:13-17

We come again to this passage in James. We've heard this passage preached so many times that I was honestly surprised by the following insights:

1. The passage is addressed to Christian traders, who live as if their life is their own (instead of belong in to Christ to do his works).

2. We often make plans and resolutions depending on our strength and abilities (assuming that they will do this and that to make money), under the premise that time is in our own hands, that "I can sustain my own life". Such planning leaves no room for God.

3. Guarding against such presumptions - we do this by recognising we do not know what will happen tomorrow, accepting our fragile and transient existence (mist that appears for a little while), and acknowledging it is God who ultimately determines our steps.

In his heart a man plans his course, but the Lord determines his steps. - Proverbs 16:9

4. However, making plans are not a bad thing - Paul made plans about his ministry, his visitations to the different churches, but he said "I will come back if it is God's will." (Acts 18:21) God-willing. I know a pastor who literally includes that phrase when he makes plans of any sort.

Thank you for the timely reminder. May I remember this when making plans and decisions, big or small.

Therapy

I'm angry and am in the process of writing short stories about you, and you, and you.

Writing is a "real" form of therapy, for a range of psychoneurotic disorders apparently. I quite like the quote below - obsessive ruminations in the small hours of the night describes me so perfectly and poetically.

"Quite what happens when near-obsessive ruminations, which frequently take place in the small hours of the night, are committed to paper is difficult to describe. It does feel as if the trap door of a mental treadmill has been opened to allow persecutory thoughts to escape. Though the accompanying feelings may persist for a time, the thoughts begin to integrate or dissipate or reach some constructive resolution." - Anonymous

Flames and burning coal

Once upon a time the highs and lows came in abundance. The excitement of getting to know each other, the conversations that drag late into the night, having (or perceiving to have) so much in common, the fluttering heart and butterflies when you "accidentally" meet each other in the corridor, the ecstasy of just holding hands, and the purring contentment of simply being near the other person. On the other hand there were the tears of parting, even for a ridiculously short period of time, the uncertainty of what he really thinks, and the endless angst of waiting for messages or phone calls. The first flames, infatuations, are deceptive, you're adamant that the person is so perfect when you've only known them for a few days. How hilarious. (It's ok, I'm mocking myself too.)

Familiarity changes relationships - from sweet words to hurtful arguments, admiration to contempt. Fine, let's not be cynical, there are good changes too. The rollercoaster ride of romance turns into a valuable friendship, someone with a deep understanding of your thoughts, feelings, tone and moods.

A parallel to my relationship to God. The first time I started understanding the words of the Bible, saw depth in the layers of meaning, listened to God's words spoken and realised how true! how relevant to everyday life! how wise! - do you know, that was as refreshing, as fascinating as the start of a new relationship. Once in awhile I really saw God's words as his "love letter" to us. The first experiences of God's presence in times of turmoil, opening my eyes to God's grace when I've sinned, experiencing changes in my character that even my family were surprised to see - that left such a deep, moving impression on my spirit.

Yet now, I'm finding the enthusiasm harder to come by. Hate to say it (because it sounds disgustingly arrogant) but sometimes I read and think, well I've only read about the Christmas story, the account of the crucifixion, the letter to the to the Corinthian church like a million zillion times. What can I possibly learn. Then, when I think about which book of the Bible to spend my reading time on I sometimes can't help think - if only there were new books in the Bible I haven't read before, that would be so much more exciting.

I've always loved church and fellowship, and couldn't understand why some Christians avoid it when loving, learning, and serving together with fellow believers is clearly how God wants his family to live. And not only that, meaningful fellowship is such a blessing. Yet this week I thought, I am so tired I don't want to go to church. Why do I have to go. These months I often have problems listening with my heart in sermons because I sigh and think I know this passage well, I've heard the concepts and teachings before. (But yes, as long as I haven't put everything perfectly into practice, I would do well to listen attentively.) Then when I went to fellowship the other day prayer made me groan inside "oh no, why is this so long, boring and repetitive."

What did Jesus say to churches who endured life threatening persecution but lost their "first love"?

You have persevered and have endured hardships for my name, and have not grown weary. Yet I hold this against you: You have forsaken the love you had at first. - Revelations 2:3-4

I know your deeds, that you are neither cold nor hot. I wish you were either one or the other! - Revelations 3:15

But I know (or doubt sometimes, but I still believe more than I doubt) you are God, you are real, your words have power. I know you give me purpose, joy, mental stability. It troubles me deeply to be lethargic towards something that is my passion, but enthusiastic or not I will try to honour my commitment to you, seeking you as you have sought me.

"We shouldn't expect a relationship with God to remain on a constant plane all the time. Not long ago I celebrated my sixty-fifth wedding anniversary. Believe me, when you've been married that long, you don't stay on a plane of ecstasy all the time. Romance starts as a blazing bonfire - you know, 'You light up my life.' After a few decades it settles into something more like a heap of glowing coals. Sure, some of the heat dissipates, but coals are good, too; you can roast marshmallows, or warm your feet. A different level of companionship opens up." - Vernon, in Prayer by Philip Yancy

Indeed, in front of the fireplace is a good place to start contemplating about the changing flames in a relationship.