9.26.2005

for the greater good

it really is the luck of the draw if you believe in karma and reincarnation i suppose. it makes all the difference in the world to be born as a lab rat or as a human, yet even as a human, you still need a bit of luck to have it a bit better than the next person.

'twas the conversation with L, Nuls and Abs over coffee at the Lotus a few weekends ago. (it's locate at The Junction. modern, hip interior with open kitchen concept serving up scrumptious brekkie spread with plenty of vegetarian choices and mouthwateringly large portions. would lay off on the milkshakes tho ~ their supershake still can't rival that of McDonalds' if that means anything) anyway, we were musing at little twists of fate. how L's mom narrowly missed out on getting an education had her father listened to his older brothers challenging his decision to send a girl to school. why how absurd! they exclaimed. wasting money sending her to get educated. had her mom been deprieved of her education, L wouldn't have been sitting here that day enjoying a glorious morning of laughs with us. we're not sure she would've even have been born.

yeah, yeah.. a ton and a half of what ifs...
tis not really the point though. i digress, but hey.. what else is new?

i've ploughed through a year's worth of journal articles from Pediatric Research in the hopes of materializing an idea of Dr I's... who knows. he was hoping to present it at some international conference in november if things get done on time =) despite having an interesting research topic, the trawling of articles has now become a tad tedious and maybe even monotonous. it's also depressing to realize that all these animals are born just so they can die. to die for the greater good that's supposed to be mankind.

phrases such as "blood samples were obtained by decapitation, within the first 24 h after birth in nonfasting condition" and "1-day old newborn rabbits were killed and the lungs were recovered" leave a queasy feeling at the bottom of my tummy. i don't know if that's worse.. to kill off these little baby animals as soon as their born or to modify them with "permanent ligation of the right carotid artery with subsequent exposure to an episode of hypoxia... thereby producing a cerbral infarct" ~ in plain english, they had a major artery in their neck cut, then was suffocated by breathing in air that was 92% nitrogen to make their blood vessels in their brains bleed and produce a stroke.

after the scanning of my mere 250+ articles, i now kinda understand why people would have such strong feelings against animal testing now... let alone animal research. i just wish there was some other way to obtain the answers... =(

9.24.2005

another helping of strings around my finger


more "notes to self" to add to the previous list. but before that... here are some totally unrelated gookiness...
this is for firefox fans ~ a series of firefox-themed wallpapers brought to my attention by dkxeon. i like =) for those who lean towards books rather than electronic animals, but are at a loss at what to read next... well, enter the name of a book that you've enjoyed and they will suggest other books you may like. should you suddenly feel like Lady Macbeth, you may want to invest in this ring la spice from the spiffy people at iluren.com. if you do like electronic animals, maybe you might want to settle for some pixel blocks and make your own. all this too geeky for you? =) chill out with some caffeinated lip balm! well.. actually, you might get more pumped up than usual with it but it'll put you in the perfect mood to test drive pergeot's moovie or 20cup. rest assured that although they have odd names, we are talking about cars here! if you prefer to sit down after all that excitement, the scooterdesk may be perfect for cooling down as you catch up on all the backlogged work you need to do with the help of your ringpen in your office-in-a-bucket.

and now, for some strings:
  • string #5 ~ respect the nurses. just because you're a doctor doesn't mean you're superior (although some doctors with overinflated egos may beg to differ). in the words of one of the ED nurses as she imparted her wisdom to my friend... "you guys should respect nurses you know. ["of course! everyone deserves respect no matter who they may be!" interjects my friend] we may not know as much as you guys, but we sure as hell know enough to make life hell for you if you don't." wise words indeed. duly noted!
  • string #6 ~ along the same vein, never call some "just a [insert profession]"... it doesn't go down very well with the recipient of the message, no matter how frustrated you may be. the poor, misunderstood and short-tempered dr. acidophilus was mistakenly thought to be a lazy wanker by the midwife on duty. she mouthed "wanker" over his shoulder at me, so there was no mistake about what she thought about him. all he wanted to do was give me experience by letting me handle the morning antenatal clinics by myself. i loved the idea and couldn't wait to be calling patients into my own room with my own desk and nobody to look over my shoulder! the midwife was concerned about my mental health and thought it wasn't fair to push me, "just a student", into such a situation. she stood her ground, dr acidophilus stood his. he got frustrated and spat out to the midwife that "I'M the doctor here. YOU are just the midwife. go away! no, go. away. now. ...go. away." with a wave of his hand. oooooooh boy..
  • string #7 ~ do not get swayed, learn to stand your ground. it doesn't always mean that one needs to be an arrogant prick but sometimes, you have no choice. like how dr acidophilus was to the midwife. anyone else can tell you their opinion, but once you make a decision, you need to be held responsible for that decision. if things go wrong, your head rolls... not that of the midwife who nagged you into changing your mind. that passing intern's head stays put even though you listened to him at the time. you can't tell people "but the nurse told me so!" and expect to be freed from bearing the responsibility of an unwise decision... so stand your ground. if it's shaky, at least stand on the ground you most likely will believe in.

9.22.2005

four days into the obs/gyn rotation and i feel like i've obtained enough "moments" to last me a lifetime or two. i'm being lazy by compiling a list of things again, but you gotta believe me when i tell you i'm pooped. obstetrics and gynecology... i love and hate you all at once =(

List of Things Done and Gone
  • my social life has been more happening this week than any other week ~ i managed to go out and meet an old friend over a bowl, yes bowl of white hot chocolate. mmmm!
  • in terms of academia, i've clocked more hours per day, well even per week, than the private obstetrician when she's in the operating theaters. i worry for my legs, especially varicose veins and my back is killing me. kinda sad to realize that i'm not cut out to be the surgeon i wanted to be =(
  • on the upside, i almost fulfilled that little bit of gossip going around about my doctor boyfriend. almost is the imperative word here. obviously, i have a soft spot for strays ~ this registrar just moved up to newcastle for 2 months, didn't know anyone and was willing the previous surgical team to hurry up with his "aiyaaaaahh!"-ing about having to do the last caesarean outside the OTs as we waited for the xraying to finish. we didn't stay in the OT cuz well.. i don't exactly fancy having my gonads fried...
  • also on the upside, i saw my first 2 babies being delivered for the first time. gross i tell you.. they come out with a layer of white moldy fungusish stuff covering them and look absolutely hideous until they're wiped and swaddled. a face even a mother couldn't love, i tell you! i'm having second thoughts about having kids after seeing the pain and surgery involved... i'm petrified. i also saw my first hysterectomy and got the chance to assist, zapping a blood vessel close with the diothermy and exercising my muscles by retracting the bladder. i even saw my first set of ovaries, one of which was cystic and decided to burst halfway through the surgery when the doctor accidentally brushed it. *squirt* it went. a stream of straw*colored clear fluid shot across the room. it got stuff about a foot away... mighty impressive, i must say!
  • more happy news ~ my "survival kit" that A customized and put together arrived yesterday. wow.. flabbergasted!! it was so pretty with all those mini milo bars sprinkled all over the box and the instructions were jaw-dropping. i wasn't expecting anything near what i got at all! i still don't know why i got sent a survival kit, nor think that i deserved some of the stuff in there but i really appreciated the spontaneity of the whole thing and i'm glad to hear that A had a lotta fun putting it together =)
  • in other news, i somehow gave myself a huge bruise on my knee and i only noticed it today ~ 'twas the first decent bruise in several years really. it's as big as a flattened mothball-sized piece of play*doh! go me!
List of Things to be Done
  • catch up on sleep
  • remember to eat
  • send car to the bodyworks shop to be fixed under warrantee
  • sleep
  • drink more water
  • catch up on paperwork
  • catch up on emails
  • catch up on sleep
  • try not to polish off my stash of cookies, chocolate and nutella
  • have i mentioned that i needed some sleep?

9.19.2005

i don't like it...

in the words of the brave little 4 year old boy who sat there quietly on his mommy's lap, processing and assessing his feelings towards that needle going into his right arm as he was getting his immunization shots... "i don't like it...!"

today.. well yesterday actually... i didn't like it much. i don't like it at all...

a culmination of a lot of things tainted an otherwise very nice mooncake festival day.
  • having my didi ("little brother" in chinese) breaking the news a few days ago that his mom passed away suddenly ~ he sounded distracted, prolly distraught and said he'd call the next day. he didn't call, i don't want to call.. i'm not sure it's a good idea but at the same time, i'm worried about him
  • hearing about a good friend of mine finding out her dad being diagnosed with cancer and then speaking to her on the phone today ~ not only did it leave me in shock, i was also left with this big gaping hole in my heart. a sinking feeling in the pit of my stomach. i really wanted to help in some way, but i didn't know how. i've never heard her sound this way and it kinda tore me up inside after putting the phone down
  • learning that another friend's sister lost her boyfriend to an accident prior to talking to my friend about her dad ~ to hear how helpless he felt at not being able to comfort his sister, to hear of all the stuff he had to go through during the years i've known him and not have a clue about it... i wish i had known back then so he would've had one more person to lean on at the time
  • having a ghost from the past message me on msn to wish me a happy mooncake day today ~ that pretty much set the tone for the rest of the day.
  • to grapple with the reality that my mom now has a computer and has my msn... and is signing on and off every few minutes after complaining that her cousin "turned her internet off" and now she can't "turn it back on" ~ well obviously, she figured out how to "turn it back on" with all that signing in and out. she also spent the whole night trying to start video conferencing with me, except she kept cancelling it and telling me she can't "get in" so don't bother waiting up for her, i can turn off my computer now. or that she sent me an email... a blank email mind you, but her first email nonetheless. tech saavy parents aren't part of my vocabulary, so you'll understand why it's a very disconcerting feeling.
  • to know that today is the last day of my one week break and that my 8 - 5 day starts tomorrow, in less than 6 hours actually... that i haven't even touched my pediatrics material and that the only thing i've read for obs/gyn is that the uterus is normally 7.5cm tall by 5cm wide. (OUCH! can u imagine a baby in a 7.5x5 enclosure.. man, that thing must stretch a lot. *looks down at tummy* owie...)
and so, i'm left with a bitter aftertaste to an otherwise good non-mooncake day...

9.16.2005

an abundance of mothers

i think i have a knack of picking up surrogate mothers...

3 god-mothers to date, 2 sets of friends' parents that have taken me into their fold, 1 extremely doting aunt (the kind that gives you your own cordless curling iron when you turn 8, your own phone/cassette player/radio thing when you turn 9 and a puppy when you turn 10 among other things) and today, i picked up another surrogate family at my GP placement.

i don't know what possessed Dr. MM to invite me over to her house for dinner after spending just 4 hours with her on our first meeting this morning, but invite me she did. i thought i adored Dr. R at my last placement but MM is slowly climbing up my personal ladder of idols next to Dr. R. (well, for lack of a better word. i don't exactly feel strongly enough to idolize anyone) small world it is, to find out that Dr. R used to be part of this clinic that i went to this morning before going solo. surely it couldn't be due to the fact that the two GPs i've gushed about were both newcastle graduates... that 150 year old clinic must have some secret recipe for producing such awesome doctors.

MM made it her personal crusade to make sure i'll be introduced to all the little towns and retreats the "locals" visit around the newcastle area before i graduated. she also sent out my dinner invite before knowing my life story in a nutshell. i don't know whether to be slightly well.. not offended, but i feel a little like an orphan or a stray puppy. she insisted that i have to go to dinner at her place, to act as a surrogate family for me and to take her seriously when she says not to hesitate if i should need any sort of help or support from her. she emphasized seriously three times. sigh.


what is it with motherly instincts and kids out in the world alone? the last time i had a dinner invite from one of them (as opposed to one of us, or one of my friends) was from two of my junior college teachers upon learning that i was home alone for that week as my mom gallivanted around taiwan. you should've seen the horrified looks they each sported on separate occasions, as if they were ready to call the SPCA.

how much is that doggy... originally uploaded by thoughtwax.


oh don't get me wrong... i'm very flattered that they would even consider inviting me to their home for dinner. i don't know about you, but i think it's a rather personal thing to allow what technically constitutes as a stranger into your private life so to me, those invitations are an honor in a way. i just don't like the bit where i feel like that doggy in the window..

9.14.2005

classic amy moment #1

i booked my hotel rooms in sg! i was so excited i blurted it to my girliefriends.. i got even more excited when one of them said she could stay over. a few minutes later, another one said she could too. slumber party's in the making!! there was one last friend to contact. i haven't seen her online for the past 2 years. i believed she still had her icq account so i sent this msg off to her:

i dunno if u still use icq but here goes.. i hope you get this message. i'll be in sg from dec ** - ** and i'm staying at the *** hotel. hope you'll be free during that time. lu is gonna stay over on the ** and i've asked liz, but no reply yet. it'd be great if u could come too.. then we can have a sleepover! =)


it was only after sending the msg that i decided to check her user info to search for an email address. this is what greeted me:

ICQ Number: 129-***-***
Name: ali baba
NickName: *e*n
Address: Singapore
Gender: Male
Birth Date: 9/20/1939
Age: 65

going by that info, we're gonna get a 65 year old ah pek coming to join us for the slumber party. i hope it's just S being a dork... i really should stop assuming things!

9.12.2005

word of the day

should anyone need educating on the meaning of late, please travel back in time and spend today with me. keeping to the spirit of today's theme, by the time this entry is blogged, it'll be tomorrow. yay!

it was one of those days where i wish i had a rewind button just so i can go through it the way i had meant to the first time around. i woke up late this morning, meaning i had to run out to the foyer in my pjs, messy hair and morning breath to grab printerless L's flashdrive and print out her assignments for her. meant i couldn't go hand in my assignments with her as planned. ah well, i used the time to get ready for the expedition to sydney that was meant to commence mid-morning. at the sound of the bell that was the phone, i jumped and was raring to go. heart sank to hear the words "i've been naughty" ~ L had been sleeping for the past few hours. we'd be running late. i had a 1pm lunch appt in sydney and at the time, i thought i could make it with half an hour to spare. one hour later with no L in sight at the parking lot to pick me up, i had to shove lunch into the dinner slot.


it literally turned my plans upside down. i had planned to meet up with B for lunch and do shopping afterwards. what ended up happening was me, trudging up and down george street in various modes of transportation with 4 boxes of krispy kreme donuts. we all ended up meeting B for the first time after half a dozen phone calls and telephone tag. we met over coffee, or lack of because with my luck today, all the coffee places in the area had already closed by the time we met. gawd, what an awful way to hold a first meeting. i swear i'm usually not this disorganized!! i hope his box of krispy kremes make up for some of the bad first impressions =( dunkin' donuts indeed...

apparently, i wasn't the only one running late all day. the two other people the shuttle bus had to pick up on the way up to newcastle were on two different flights that were both nearly an hour late. meant my pickup time was nearly an hour late. meant i got home nearer to 11 than the 7pm slot i had planned.

ahh i'm at least alive and well, but very late. please.. i've learnt what the word late means and i've learnt it well. please don't arrange for anymore follow-up sessions! and so, with these misadventures, i begin my one week holiday!

9.09.2005

alternate realities

besides having conversations about nothing as a kid, i often challenged people with the notion that life as we know it might actually be the proverbial hell people are so afraid to end up at when they pass away. for that matter, how do you know that we're not living in the afterlife and that this is death, that when we die, we actually go to that other place in the land of the living? how can we be so sure that the earth, the solar system and heck, the milky way aren't inside some giant's stomach... or in the eyeball of a squid for that matter? that the universe as we know it is actually the black void in some orifice of some other giant being, that we aren't the very bacteria that we study?

parallel lives, parallel realities..

watching one of the 4400 episodes sparked it off. it was a neat concept but i was bursting with frustration because i was just as confused as the main dude who was stuck in his alternate universe. i had to drag it out of A to tell me what happened so that i could finish watching the episode in peace. i promised to give back her pastry brush for the info, but i didn't keep up my end of the bargain *grins* instead, i got some scrumptious cinnamon sticks & accompanying frosting + apple cinnamon swirled toast for my lack of cooperation... how good was that?! =)

· ¤ · ¤ · ¤ ·

i grew up visiting M's house in san marino every weekend ever since i was like 6 or 7. our parents would yak, i'd sit there and read my ramona quimby or latest nancy drew from the library if M and his brother and sister weren't around. if they were, i was shoved into their care.. these strange grown up people that weren't quite proper grownups because they weren't as old as my parents, but were much older than me.

best bonding moment was when all 4 of us were plopped on their parents' bed watching some tennis final. they were rooting for agassi. A asked me how old i thought she was. i shrugged and avoided answering "old" just so she wouldn't get upset. they forced it out of me in the end.

"old!" they sniggered. "how old is old to you?"

i stared at the tv, trying to figure out which white-clad dude was agassi.

"c'mon! we won't get mad!" they egged.

i stared at the tv, trying to figure out why they all liked agassi. hey forgive me, i was 7...

in the end, i told them that i thought anyone above twenty was old. they burst out laughing and i only remember someone telling me they were 16. i heaved a great sigh of relief. at least i didn't insult anyone by calling them old.. 16 was still younger than 20 so they must still be young.

10 years later, M and R were taking me out for coffee when i visited them in taipei although it was a tad forced. R snuck off, claiming he couldn't find a parking spot and left M with me. or me with M. A had quit med school after one year and was now a blossoming director based in japan. tack on another 6 odd years.. A now has a taiwanese movie starring Lin Yi Chen and Anita Yuen under her belt, M is a chief psychiatrist at a taipei hospital and R is the head of the emergency dept at another hospital. you could say they're a bunch of overachievers =)

now comes the weird part..

their mom apparently blurted out her true plans during my last visit back to taiwan early this year. she wasn't drunk. she meant every word she said and repeated everything to another set of friends the following day. in her exact words, "do you mind if i make amy my daughter? if i can't have her as my daughter-in-law, then by god i'm having her as my god-daughter."

*hears a pin drop in the room as the awkward moment lingers. my dad slurps his noodles to break the silence*

he's a freaking 9 years older than me!! he's supposed to be like an older brother!! eeeeeeeeewwww!

tonight, my mom calls. this random phone call from my mom sparked off more of that parallel universe stuff.. she was calling from M's wedding dinner reception. i could hear my dad in the background. the call seemed misplaced as she asked if i wanted to speak to M. "what for??" streaked across my mind.. i forgot it's friday today. i forgot she said she'd call today. i forgot i was supposed to be out partying today. i forgot i had to finish my case report today. *sigh* for my mom to drag M away from his duties as the groom on his wedding night just so she can pass the phone to some kid-sister figure of his whom his mother tried to set him up with, so she can congratulate him... i couldn't do it. it was too weird. his poor wife. i hope his mother doesn't think she's me. it got me thinking tho.. what if things went according to his mother's twisted plan. she had been planning this ever since i was visiting their house in cali as a kid!!!


what if though... what if.
what if i never left cali.
what if i went to cate and boarded there to finish high school.
what if i still had jimmy.
what if i had found that letter i wrote in 6th grade to a certain somebody.
what if i had given that letter to that certain somebody.

a million and one what ifs that i'll never ever know the endings to. i guess the bottom line is that life is what you make of it. for me, it meant having fun at the pediatric dinner last nite with L and L. L and I were drunk with laughter. the other L on the other hand was hilariously but quite decidedly drunk. after all.. all roads lead to the same point, don't they?

9.07.2005

all done!

just got back from my pediatric long case ~ it could've been better, well.. i could've done better but med school just breeds mediocrity so i'm just glad it's over and done with. just pass me dammit! is the slogan nowadays... a far cry from the amy of yore. the stereotyped asian whose heart sank and felt truly ashamed for getting a 98% instead of a 100%. funny how i was just as happy with a 99% but not those 98%s...

i can't believe how fast that hour whizzed by... "hi, my name is amy. i'm a 4th yr med student and i was wondering if it's ok with you to have a chat and then examine the birthday girl afterwards?" before i knew it, it was time to go. "one last thing... i just need to get your head circumference so i'm just gonna wrap this silly piece of paper around your head and give you a temporary princess crown ok?" then i was off to skye's office to sit there in silence for 20 minutes, furiously scribbling down what i'd present to murray and ian whilst almost forgetting to plot the growth parameters against the charts. then came the presentation and the questions. those who're interested can read more about the birthday girl below.

i can't believe how fast these 8 weeks have whizzed by... "hi, my name is murray and i'll be your course coordinator for pediatrics." before i knew it, it was time for the pediatric dinner. "one last thing... how did you think you went? we always like to ask students how they think they did before we tell them if they've passed or not." then i was off to bara to sit here in silence to type up my long case, blog and then face those awful assignments that are due by 5pm friday afternoon. but not before preparing to go out for a catch-up dinner with nuls and abs and a few others. not before getting ready for the rotational pediatric dinner tomorrow night with our tutors and such. not before making a hella lot of little trinkets out of that shrinky dink stuff i just got in the mail.. wheeeeeeeeeeeeeee! ~

yearly ritual

here's my long case on Tee as we'll call her. poor little girlie had to celebrate her 6th bdae at the hospital. apparently, she celebrated her 5th bdae at the hospital with a broken collarbone last year. ian joked that we should book her in for the same time next year at this rate, hee.

Sooo...

I saw Tee, a 6 year old little girl with pneumonia who presented to ED 2 days ago on the advice of her GP and has since been admitted to the wards.

She's had a slew of symptoms since last Tuesday, about a week ago, that included fevers, vomitting, diarrhea, abdo pain, cough, sore throat, coryzal symptoms and hallucinations. I'll go through each in more detail..

Her coryzal symptoms started late Monday night with what her mom described as "the sniffles." By Tuesday, she was having fevers in the high 39s to 40 degrees and this lasted through the rest of the week despite being given panadol and panamax. Tee also hallucinated Tuesday night, mistaking bead curtains for the plaits of a little girl and she got agitated, whining that the little girl shouldn't be allowed into bed with her. This was prolly attributed to her high temperatures. She's had 2 episodes of vomitting since admission, bringing up thick clear phlegm. no blood, particles or food and there was no pattern to the vomitting; she didn't vomit after every meal or anything like that. Tee's had 1 - 2 bouts of diarrhea but her bowel motions have since returned to normal. Her abdo pain was her major complaint. It started out generalized but localized into left hip pain 4 days ago. A day later, it had become left shoulder pain. pain so bad it caused Tee to scream herself to exhaustion everytime she had an "attack" of the pain. Throughout all this, Tee has had a dry persistent cough and a sore throat that developed a few days after the initial fever. She has seen 3 different GPs throughout the week and was prescribed antibiotics by the 2nd GP, who suspected pleuricy. The first GP thought it was a viral self-limiting illness and the 3rd GP sent her to ED when her mother wanted a referral for an xray of Tee's shoulder.

Tee's been more tired and listless than usual. She's sleeping 3 - 4x during the day but is also sleeping through the night unless she's woken up by the pain along her left side. Her appetite's been less than usual, eating only jello and light snacks. She's well hydrated with her choice of water, juice and sprite with her mother making sure she's sipping one of them everytime she checks on her.

Besides breaking her collarbone last year at this time, Tee's had no other relevant surgical history. According to mom, she's had bowel problems since she was born and had to be on parachoc. Nowadays, she gets abdominal pains about once a month and these are relieved by a dose of parachoc. Tee's been also seeing a counsellor at the Wallsend branch of Kaleidescope regarding separation issues ~ she had trouble adjusting to the seperation of her parents about 12 months ago and refused to leave her mother, becoming clingy. Her mother didn't elaborate, stating that she didn't want to talk about this in front of Tee so I didn't pursue this any further.

The pregnancy was uneventful. Her mother was involved in a motorbike accident when she was 5 weeks pregnant and was given oral painkillers and IV morphine for a few days. No other medications were taken during the rest of the pregnancy and no complications such as gestational diabetes or pre-eclampsia developed. Tee was 10 days overdue and had to be induced. Forceps had to be used to aid in her delivery but she was well. Her mother didn't know her Apgar scores but remembers that Tee passed her baby check. (i forgot to ask for birth weight even though i had scribbled it down and circled the thing). Tee's not normally on any sort of medication, has no known allergies and her vaccinations are up to date. She's currently on IV penicillin and oral antibiotics 3x a day while in hospital.

Tee's now attending first grade and is near the top of her class. She gets along fine with her classmates and there haven't been any reports of disruptive or abnormal behavior. At home, she lives with her mom and younger sister who's 4. She sees her dad during the weekends.

On physical examination.. well when I first saw Tee, she was a well.. well-perfused looking girl who was sitting up in bed playing with all her birthday presents. She was obviously better from what her mom had described her to be last week because I saw her get up several times to answer phone calls bearing birthday wishes throughout the interview. Her vitals... they were all normal. BP was 96/68, pulse was 96bpm, last recorded temp on charts was 36.2 degrees, resp rate was 20. Her hydration status was normal ~ no signs of dehydration like sunken eyes and her capillary refill was less than 2 seconds. Her height and weight were both between the 50th and 75th percentiles, showing normal and symmetrical growth. Her head circumference fell just below the 50th percentile for her age but that's also considered normal.

I started out by looking at her hands ~ no clubbing that would indicate some sort of chronic disease, palmar creases normal, weren't pale so she's not anemic. capillary refill was normal as I've said. Then I moved up to her head. Eyes were fine ~ red and pupillary reflexes present. Then I looked in her ears ~ no signs of inflammation seen to suggest otitis media. She also hadn't complained of sore ears so OM is unlikely. Her nose was fine.. no deviated septum or anatomical abnormalities. When I looked in her mouth, I could see whitish stuff on her tonsils but couldn't get a good look because she was trouble keeping her mouth open and tongue out and was also coughing. Her parotids and lymph nodes weren't swollen, she had no tracheal tug, accessory mm use or other signs of respiratory distress when I looked. Her trachea was midline, chest was normal ~ no structural abnormalities. When I percussed, I could elicit an area of consolidation on her lower left lobe at the back. On ausculatation, I heard bronchial breath sounds at her upper left lobe in front. Air entry seemed to be decreased on her lower left lobe when compared to the right lobe. No vocal fremitus or resonance could be elicited.

Next, I had a quick look at her abdomen. It was soft, non-tender and wasn't distended...

by this point, murray had to cut me off and tell me to summarize cuz we were running out of time. so in summary, I saw Tee, a 6 year old little girl with pneumonia being treated with IV penicillin and oral antibiotics who is now on the mend.

9.03.2005

the banshee saga

it's funny how things often come a full circle...

it started with a 7-month long saga of incessant noise problems coupled with complaints on my part about a particularly heavy family of elephants living in the room next to me. i've since dubbed the couple the banshee and the vampiress. the guy looks like your typical ah beng, except he hails from hong kong rather than singapore. the girl is as pale as your pressed and starched lab coat, complete with long stingy wispy black hair. all she really needs is that blood red lipstick to complete the look and it'll be halloween all year round next door. i think the girl would literally sizzle and shrivel up if sunlight touched her. anyway, after much angst that culminated into a series of complaints by those of us living directly next to them, above them and one up, one over on top of them two nights in a row, they've stopped gaming with the friggin sound turned loud enough to imitate slow rolling thunder. headphones people, headphones!!

other than reverting back to the original stomping problem, they've shut up. maybe the threat of meeting with the head of college worked.. or not. time seems to work differently over here.. it's as if the air's too thick of muddleheadedness at times ~ too thick for even time to travel through and hence, time seems to sometimes slow down as it tries to fight its way through the tangle of madness. things basically never get done efficiently. people get fired for being too efficient over here, literally. people learn to underachieve and it dulls even the best of us down after being submersed in such an environment after a length of time. (icantwaittoleavethisplace!)

anyway, i found it slightly cheeky of fate to have the banshee and the vampiress see me in my flustered glory, bag on shoulder with bits and pieces hanging out, one strap off my shoulder as i struggled to replace the house phone in the foyer with one hand and grappled with my mail and three shopping bags full of soda and toilet paper in the other. you'll have to excuse me when i tell you that these are really nice people, deep down inside those rolls of callous selfish behavior. i tend to be a horrible judge of human character. i only got 11 out of 20 right when i tried to tell a fake smile from a real one.

as i sauntered through the foyer door, appearing to struggle much more than i really needed to... i grinned inwardly. what irony it is, to hold the door open for the same girl that complained about you for the past 7 months and wrote you into the dorm's blacklist. the same one that hopefully made your life hell with all those phone calls imploring you to "please turn it down just a little?" because you certainly made life hell for her, to make sure that she was fully through the doorway before shutting the door quietly behind her and catching up to your girlfriend. thank goodness for my anonymous status.

sigh of relief's not there for long tho... the banshee's gone, the elephant's back.