Thoughts (July 24 2010)

1. It's back to reality pretty soon. But then again, the post exams was never a holiday for me. No honeymoon, no traveling, none of the stuff people do before starting work as a houseman. Every day, it was 4-7 hours of driving. If you think driving is not tiring by itself even though it burns no calories and chronically breaks people's backs, I'd love to have you as a personal driver.

I had to survive on pretty high doses of caffeine. There were several times when I had to just sleep in the car because of severe fatigue. Once my wife and I had dinner at 1.30 AM with work on the next day (I cooked of course, she was already fried from work and slept until food was ready). The day was spent helping my mother with errands/Abah's health issues. The only thing keeping me sane was the progress in the gym, which I could only go at night and ended up with coming home late, exacerbating my caffeine super-dependence. For references, to survive the induction I drank almost 6 cups/day of coffee/tea. That equaled 2 strong cups of coffee from Dunkin Donuts every day. I also kept my typically high levels of reading during the holidays, which at least kept my mind a little bit sharp. No studying though.

The recently ended induction program for housemen was supposed to be a holiday. But then I ended up as the participant leader. Luckily, other than an incident of a "lost" laptop and handling money-collecting duties, it wasn't too hard. But the chance for a mental break was lost. And housemanship starts next week.

I really envy the people who have been having fun during the holidays.

2. Next week I'll start work at HKL. Will it be that hard? I'm really not sure, after feeling exhausted already before starting work. Maybe it'll be the same level of tiring life as now, but in different ways. After all, I did say that the medical exams were harder and more stressful than the akad nikah (wedding vows).

What's really getting into me is the need to find a house. It's no longer feasible to go to KL every day from Bangi, especially if the aim is to reach there by 7 AM. The preferred places are Sentul/Ampang/Cheras as there are LRT stations there. A sleepy houseman is a dangerous houseman. But Sentul is super expensive, and the other two are jam centers on days that we drive. Other choices are Keramat & Gombak, but those options mean that driving is the only option to work. But as it stands, going to work from Bangi has been hell for both of us.

3. Will need to find another gym when I move. I'll make sure I get a lift, even during housemanship. But nothing will be as cheap as Kaki Gym/TLS/Try My Gym in KL. And it's utopian to get as many sessions as I could before, even during the peak of Abah's ills, when I did two a week, combing days into long sessions, sparing the weekends. Being strong has been quite useful and I don't want it to go away.

4. I'm a bit torn as regards to my future. My plan has been to go to a government clinic after housemanship, followed by pursuing studies in sports medicine. But there are several issues. With whom do I want to work? KKM, MSN, or MoHE? Do I want to be attached to a sport, or in a clinic setting? When the time comes, do I want to open what I have in mind: a comprehensive physical/sports rehab clinic, catering for sports and general public needs? I really would like answers.

But if all that fails, emergency medicine and internal medicine are fallbacks.

5. Lastly, Abah is back in the wards, this time for overwarfarinization, bleeding gums, INR of 8. Unsure of the cause though. Sigh.

Stuff on My Google Reader

I borrowed my mother's credit card for a few ringgit well spent on installing Reeder (a Google Reader client for the iPhone); the worth of it is 100 times more than the amount paid. With Google Reader, I'm able to subscribe to tons of news feeds, and scan them all in rapid time: what I need to read I can open up and expand, what I think it's not worthwhile I'll just ignore and mark all of them as read altogether. In 1 day I receive up to at least 200 entries of news. The only skill you need is fast reading. And using Reeder on the iPhone is a delightful experience, just as using Google Reader on the computer (ask Jusnimar/Nu'aim, both whom regularly use my (Abah's in actual fact) iPhone for news browsing).

Lemme just share with you what I subscribe to; maybe you might be interested in at least a few subscriptions. The only thing unavailable are my Sinfest and Girls Without Slingshot comics, as they don't provide RSS feeds (another prerequisite).

Google yourself folks these feeds, as some are subdivided into sections, making linking inconvenient in a way.

News:

The Economist - This periodical (with many blogs as well) divides its news into many sections, and I subscribe to most of them. English debaters, especially those familiar with the Asians, British Parliamentary style debates must be familiar with this staple source of information. Some stuff might be too heavy (as I found out as well) for normal every day people.

NYT (Global Home) - World news of various topics. Subscribing to this makes subscription to any other "World" news sources redundant.

The Star Online - The best mainstream English Malaysian paper.

The Malaysian Insider - An interesting online English Malaysian news-site. I read this most for it's opinions, as news items in the Star may be identical.

Apple (I used to read eWeek and PCMag but no longer) & Tech:

Daring Fireball - The mainstream Apple news analysis with commentary.

Mac Rumors - It is what it is.

Macworld - Interesting articles from time to time.

The Macalope - Mythical creature with dark humor regarding the industry.

Sports:

ESPN.com (golf, tennis, NBA, Soccernet) - Whether it's Wood's comeback attempt or Chelsea's possible meltdown in London for the last game, where else should you go?

Health, Fitness, Strength Sports including Powerlifting:

Alwyn Cosgrove - He doesn't blog much about fitness, but his insight into life is enlightening. A two-time cancer (leukemia) survivor.

Amped Training - Of Matt Perryman. Politically incorrect, and hence likable.

Bill Hartman - A physical therapist, co-owner of one of the top 10 gyms in America. Read for his knowledge on rehab.

Bret Contreras - An up-and-coming, using EMG to study and refute many myths of exercise.

EliteFTS - THE site for powerlifters, and has articles for strength coaches, bodybuilders and health enthusiasts. A bit ironic considering powerlifters are known to be fat, that's how we squat and bench well! I have my online coaching for my pullups from Harry Selkow, among the Q&A staff on the site, hence my Youtube videos.

Mike Boyle's Blog - Old-timer, functional strength & conditioning coach. Pretty controversial.

Mike Reinold - A physical therapist. Very scientific.

Robertson Training Systems - of Mike Robertson, co-owner of iFAST with Hartman. A corrective strength coach with a background in powerlifting.

The Fitcast - The premier contemporary S&C podcast, hosted by Kevin Larrabee

Tony Gentilcore - One of the coaches at Cressey Performance. A funny blog. Beautiful babes too. While I'm at it, I should mention that I subscribe to Eric Cressey's newsletters (via email).

Comics:

Brenda Starr - Dramatic reporter.

ButternutSquash - Irony.

Ctrl+Alt+Del - Gamer comics.

Diesel Sweeties - Pixel humor.

Dinosaur Comics - High level comics for the intelligent in you.

Flipside - A lesbian jester fighter with her swordswoman lover. NSFW!

Girl Genius - Steampunk

Indexed - Math has never been this funny.

Kukuburi - Fantasy

Least I Could Do - Comics for perverts. NSFW?

Looking for Group - Traveller elf and "friends".

Mystic Revolution - Gamer comics

xkcd - Geek comics.

How Hard Work Ends with a Fart

The only thing worse than getting no sleep to finish the hardest work in your group (editing video, inserting subtitles, production) is to see your 50 minute product shown only for 10 minutes because there wasn't enough time.

Sigh.

Indecisive Alert

If you're indecisive, don't make decisions. 

Especially when they affect others. You piss people off. That means you, Sunil. Fuck yourself with your motherfucking ass all the way down to hell.

To others: beware of such people, as they're dangerous. I learned this first-hand. It's better to be committed yet wrong, than indecisive and see-sawing back and forth. At least with the former, you can make a good u-turn early enough as you recognize the problem; it's much harder with the latter.

I declare war against people who are indecisive, a sub-group of people with messed-up decision making processes.

Offices and the Creative Zone

A good read about the disadvantages of typical office layouts in the creative worker's perspective.

It's not applicable to the medical practitioner, but still applicable to many from other fields who might read it. It's partially applicable to medical students too.

(via Daring Fireball)

Like a Wave Than a Wheel

This is probably my lowest point of my so-far clinical training.

Sleeping late.

Coming to the ward late.

Not going to the ward.

Not studying at home.

After being super hardworking during O & G, I'm currently extremely lazy during this pediatric posting. Sheesh.

I even had to offer friends money to motivate me to come early to the ward. This is really horrible.

I hope that I'll be in a wave with low amplitude, low frequency, and a high baseline. Currently I'm at a neutral baseline, but with a moderate frequency, and a huge amplitude. The trough is just crazy. This is definitely burn-out.

Lesson: Don't burn yourself out. Get a well-timed break, to keep you motivated for what you need to do. Learn to time your waves as well. Having the trough during the middle part of a clinical posting is...err...dangerous.

O & G: Experience in Perspective

Hm, after the hell of the busy New York City that is Obstetrics and Gynecology, I'm now in the peaceful meadows of Pediatrics. That's a picture of me at the beginning of Ped's, which is ≈ the end of O & G. Misery is an understatement.

But I like the training program in O & G. I think it employs the better methods of clinical training (Surgery is another) suitable for my personality.

1) No discrimination between Year 3 or Year 5 students. There is no topic for which the Year 3 students are excused from learning, just excused from exams. That's a good thing.

2) You learn to be independent. In surgery, you are constantly pressured & monitored by the lecturers. In internal medicine, you are left alone, but you have lots of bedside teachings. In O & G, you are not monitored by the lecturers, and you have no bedside teachings. None at all. The only exception are those conducted voluntarily by the lecturers themselves (thanks to Prof. Murad, Zalina & Hamizah). The only way to learn in the ward is by following the ward rounds, going to the clinic, labor room, screening room, etc. The formal CP's help, but only about 20% of knowledge at most. Added with the responsibility of presenting 10 CP's (sorry Ped's, but 1-2 is way too little), and you end up going for on-calls even when it's not your turn. You know that you can't run away from not going to the wards, not a single bit. The only difficult part is balancing between doing ward work and studying for the theoretical components.

3) You are really trained into becoming housemen. When presenting cases, we have to know everything: history, examinations, investigations, management, progress. Presentations are expected to be as "complete" as housemen's during ward rounds; specialists plan patients' management based on those presentations. If specialists decide to not listen to your presentations, and ask the houseman to present instead, that means that you really sucked.

I liked the training, but I don't like the field. So sorry Dr Azha, until I suddenly become disinterested in Emergency Medicine, or something else supersedes it as a speciality I'd like to be involved in, O & G will only be 2nd choice at most.

Witticism of the Day

"Eccentrics are always creative, but not the other way around".

Lesson: Always ask for ideas from that guy you think is a snobbish jerk. Just don't ask him to do any tasks; he is, afterall, a snobbish jerk.