Wednesday, April 30, 2008

It's been a Remarkable 2 Weeks

It has been 2 weeks since 16 April. The day i stumbled in life. 

It's been 2 weeks of disbelief, denial, anger and despair. Acceptance eventually comes, providing the episode a closure. 

But it's remarkable. 

No, i do not mean my 2 weeks journey. It's but a little blip in my brief existence.
What is remarkable is the support that has been thrown my way, so great that i am humbled. 

I have never been a particularly amiable, or pleasant guy. I do not always do the right thing. 

My Mum and my Poodle, Lucky

Many a time i have been less than a good son to my mum. I did not always have her best interest in my mind when i made decisions in life. I had not been a great brother to my elder bro too. I kicked him in the nuts when i was young. 

My Bro and I 

Sorry i just can't help being cheeky

I was headstrong in choosing to come to pursue medicine in Singapore, even though i already had a place in UKM (National University of Malaysia), which was so close to home. Little did i realise the magnitude of the decision that i so recklessly committed to, without giving much thoughts of what would become of my family and me. 

I was naive then. Why was everyone making so much fuss when all i was doing was to choose my own tertiary education? 

One day i just weeped, the full weight of the sudden realisation crashing down on me. The decision was really on my life, not just tertiary education. 

Bonded to the government, I am obliged to work in Singapore for 7 years on top of the 5 years spent studying medicine.

It's 12 long years that i will merely be a presence on the other end of the telephone. I will not be able to share fully the pain that my family goes through. I will not be able to savour completely the joy that my family experiences. I will not be able to tend to my mum when she falls sick. I will not be there to see my nephew/niece taking his/her first step, muttering his/her first word. I am missing so much that it hurts. I want to be part of their everyday life so badly. 

Now, I can only conjure their journeys from imaginations. That will have to do. 

Leaving all that was part of me behind, I arrived in Singapore to start a new chapter of my life. 

I must have sowed plenty of good karma, for i am blessed with so many great friends in these 5 years. Those who went through medical school with me, those who stayed in KE, and all others whose life paths somehow crossed mine. 

Many a time i leave so much to be desired in my dealings with friends. I am brunt, inconsiderate, full of myself, ignorant, impatient, and the list just goes on and on. i am really sorry. 

For all the moments that i was being a good friend, there were many more that i felt so deficient. For all the joy that i brought to my friends, i caused more sorrow and trouble. 

Despite all these, you guys forgive my shortcomings and when i fall, lend me your support so willingly, and in such abundance. So many of you have cared for my well being, in all manners possible for the past 2 weeks. 

I am really touched, really grateful for all of you. 

Dear friends all, both in Singapore and Malaysia, thank you so much for being here with me. 

Dear mum and bro, thanks for never doubting me, and provide me with a haven that i can take refuge in, both emotionally and physically. 

Life has been good to me, and it's indeed a remarkable 2 weeks. 

Tuesday, April 29, 2008

Just for Laughs #1

Jewish Peppers

I JUST have to show this to you guys, haha.

Monday, April 28, 2008


The View from My Room
The alarm heralds a new day. I heard it used to be roosters but i probably like them better for curry than waking me up. 

It's still early. Let's sleep for another 10 minutes. 

The stupid alarm rings again, all too soon. 

Still in the comfort of the bed, my hand reaches out for the water bottle. Pushing myself up i sat with my back against the wall, i gulps down 2 mouthful. Nesa, my roommate, is still deep in slumber. I will wake him up after i have showered. I always take longer to get ready. 

The early morning breeze buffets against my face, gently bringing me further from my sleepiness. Level 8 is blessed with generous winds, and i am really glad to have stayed here for 4 years. 

Untangling my slippers from Nesa's, i slip it on and walk down the corridor, and down the stairs. The bathrooms are empty. They always are, at this hour of the day, and i find that welcoming. 

The sound of water gushing out of the shower, and the cool water that bats on my head finally brings me completely out of my sleep. 

I wake up Nesa. He always respond promptly by sitting up over the edge of bed, but whether he truly wakes up or not is another matter. I will not be surprised to find him snoring on the bed one second later. Haha. 

I know Rags won't have woken up yet. 

'Eh Rags wake up d?', i ask anyway. 

Nesa drags his feet to Rag's room next door. Opening the door that probably isn't needed at all, as it is almost always left unlocked, we see a baby sleeping like a, as we medical students instinctively say it, prawn. 

'Hey rags wake up!' Nesa breaks the silence in the room that envelops Rags. 

Like a guard who falls asleep on duty, Rags jumps. The blanket is all over the place except on himself, while the standing fan rotates lazily at the head of the bed. He stares at us with reddened eyes that are as widely open as humanly possible, yet conveys unmistakable sleepiness. He still manages to look puzzled, after we have woken him up the exact same manner for countless times since he moved up to E8. 

It takes him almost 5 seconds before he comes to his senses and loses that puzzled appearance. But i will not be surprised to see him sleeping like a baby prawn (cooked) in a second too. That reminds me i have yet to video that amazing wake up routine.

I can never understand how i take so long to get ready. While i get dressed up, and pack up my bag, Nesa and Rags have already finished washing up, maybe poo-ed as well, dressed up and all ready to go. 

Descending the stairs to E4 on our way to breakfast, i realise we forgot about Lydia. Walking back up to E5, the three of us speculate whether she will be ready to go. 

Through the glass pane on top of the door, the room appears dark. That can only mean the blinds are still down, and she's probably further down in some dream. I tapped on the door, and Nesa started, 'Lydia, Lydiiiaaaa, Lyyyddiiiiaaa...' like my old ringtone that gets louder progressively. My ringtone had a nice melody to it though. 

After probably 15 seconds, i hear a rustling noise, telling me she's climbing out of the bed. A few dull thuds of footsteps later, the door lock crackles (extremely loud and low pitched, unlike bronchiectasis) and turns. The door opens slightly and she peers at us with a bedhead that any hairstylist will be proud of. Her sleepiness permeates the very air that we are breathing, and i want very badly to yawn in spite of myself. 

'You guys go down first la, i will join you all there,' she mutters, in an infectious sleepy voice that makes me wonder if i am doing the right thing being awake now. Sleep deprived, we all are. 

Walking down more stairs and we crack a few jokes. The usual bad and not too tasteful jokes. But that's us la. 

Queuing for breakfast, i tap my matric card at the card sensor. Contented that they are still the same old familiar array of food, i pointed to the fried rice. Carrying my plate on one hand, i collect 3 sets of cutleries, raising them up to show the 2 tall black guys i have taken for them. 

Putting down my plate on the table, i walk back to get myself a cup of soy milk. 

Nesa forgets and gets himself another pair of utensils again. Haha. 

As usual, Nesa finishes before me, while Rags lags behind. I have never had anyone eaten faster than me before coming to university. Now i have my match as my roommate. 

With no more fried rice to chew on, the three of us stare out at the view in front of us. Nothing great actually, just a huge block of beige flat that blocks what used to be a view of the seaports. 

Lydia always amazes me at how fast she gets ready. Just as we wonders if sleep has reclaimed her, she hurried into the dining hall in small shuffling steps, with a face that is so focused i surmise it must be for something other than the bread that she's heading for. No one can be so bent on getting food, can they? 

We exit the dining hall through the new door next to the counter. It's one of the few additions in Hall that actually improves quality of life. No more long detour. 

Walking up the slope leading to the carpark, Rags passes Nesa the padlock key. The carpark was recently padlocked to prevent outsiders hogging up parking space of privileged Keviians (KE VII is the Hall's name, for King Edward VII) who drive. The carpark is underutilised, most of the time though, unfortunately.

I volunteer to stay with Nesa next to the metal bar, while Rags drives down the car. It serves no real purpose to not get into the car first, and Nesa needs no company for the brief one minute waiting for the car to come down, but i do it anyway. The camaraderie of roommates i suppose. 

The car creaks to a stop. Nesa lowers the metal bar and inserts the padlock, but it does not click. He tries a few times, and resigns to asking me to do it. Somehow the stupid lock likes me better, and clicks to engage after only one try. 

We climb into the car, and immediately wind down the windows. 

'Naga hasn't arrived,' Rags noted. 

We sat in the car and stare ahead of us again. 

Rags' sms alert chimes, and with the swiftness of an accomplice of bank robber waiting on the sidewalk, he ignites the engine and kicks on the gas. The car leaps to the front and make a sharp turn into Kent Ridge Road. 

Enjoying the gusts of air that comes along with open windows of a moving car, i look at the people walking along the pedestrian's path. Where are they going to? That girl seems a little too overdressed (or too 'under'dressed if we take the plunging neckline into consideration) for a lecture. 

The car swerves into the link road to AYE (Ayer Rajah Expressway), and stops at the bus stop. Naga looks up from her book, gets up and hurries to get in the car. I wonder if she listens to music streaming in from the earphone more or study more today. 

Lydia gets out of the car and Naga jumps in, wedged between me and Lydia at the backseat. Everyone greet Naga at once. I guess it's her saintly aura that compel us to always greet her immediately. 

Rags kicks on the gas again, and the car lurches forward. Looking to the back, i see the bus driver eases the bus to a stop without too much of a displease on his face. We did not get in the way. Good. 

I wind up the window as it is no longer gentle breeze that comes in, it's howling strong guts of wind that deforms my yet-to-be-dried gelled hair, and the noise is deafening. 

The car gets into the tunnel after endless rows of beautiful shady trees. I look around, Rags and I are the only 2 still not sleeping. I decide to dump him and sleep too. Poor Rags. 

This part of the journey to Changi General Hospital is always a blur. I will wake up somewhere in PIE just before we arrive for another typical day at hospital.


Today is not a typical day. 

I did not wake up Nesa, or Rags, or Lydia. I am the only one going down to NUH today. Today is the first day of O&G posting, unfortunately still as a student. 

It feels weird to go alone. After spending almost 24 hours everyday with these people for the past one year. 

I walked out of Shepherd's path, and down the Green Staircase alone. I arrived at the office, seeing not the familiar faces but faces that belong to poor souls who have the misfortune to fail Surgery Finals. It reminded me that it really wasn't only competency that was the key of the exam. Luck was at play also. 

It's not that difficult. I will just have to get used to a life without these close friends studying together, or rather, doing everything together.

It's 11.32am now. It does not feel too bad. 

Don't worry, i will be fine. I am tough. You dare say no? 

Sunday, April 27, 2008

The Last Lecture

I spent this Saturday with Pacey and 2 other friends. After we had lunch in Raffles City, I saw MPH on my way to toilet. As always, i was unable to resist going in, only to come out clutching 3 books in my hand, and 40 bucks poorer. 

I really have got to stop this bad habit of impulse purchase now that i am getting more cash-strapped. 

Anyway 'The Last Lecture' is a really good read. Like 'Tuesday with Morrie', it is about a dying man. But unlike Morrie, Randy Pausch was a man at the prime of his life when he discovered he had pancreatic cancer, probably the cancer with the worst prognosis. To make the matter worse, his kids were all really young. The eldest boy was barely 6. The youngest toddler was so young that she probably would not have any recollection of what her father was like. 

He needed to leave a legacy for his kids. One day his children will grow up and yearn to know who their father really is. 

There is a tradition of professors in Carnegie Mellon giving their last lecture of their lives. 

He knew immediately that was what he needed. He gave his on 18th September 2007, his wife's birthday. The last one that would ever have him around singing Happy Birthday. 

His story was just so magnificent.  

It made me feeling foolish to be mulling over my failure all these days. It made me realise that there were more pressing matters in life than to mourn my failure. I was being so petty.  

Reading the book was like immersing myself in his wisdom, and i did so in awe. 

Below are a few excerpts that i would like to share. They resonated with my being. 

It has not always been easy to stay positive through my cancer treatment. When you have a dire medical issue, it's tough to know how you're really faring emotionally. I had wondered whether a part of me was acting when I was with other people. Maybe at times I forced myself to appear strong and upbeat. Many cancer patients feel obliged to put up a brave front. Was I doing that, too?

Too often we feel it necessary to put up a brave front. I certainly am guilty of that too. 

He remembers me telling him:"I know you're smart. But everyone here is smart. Smart isn't enough. The kind of people I want on my research team are those who will help everyone else feel happy to be here."

This sounds like a good piece of advice for all of us who are too full of ourselves. 

Start-up companies often prefer to hire a chief executive with a failed start-up in his or her background. The person who failed often knows how to avoid future failures. The person who knows only success can be more oblivious to all the pitfalls. 

Maybe there's a purpose to my failure after all. I was, after all, not looking out for pitfalls often enough. 

All in all this is an invaluable glimpse into Randy's wisdom and optimism as he faced his terminal disease. Especially for us who will be/are medical professionals. 

Saturday, April 26, 2008

It's the 16 minutes

The verdict is out. 

My short cases were the cause of my failure. It was really a surprise, as i thought i did reasonably well enough to pass, and i still couldn't fathom what actually went wrong. Granted that short case was never my strength, but i never had an inkling that i was actually weak enough to fail. Guess i was wrong.  

But well, at least i have found out the reason of my failure, and it's something that i agree that i am not particularly good at. 

I will have to shed my mindset that short case is just a show that has little usage outside of exams. It has, already caused enough havoc in my life. 

I will improve on it, and I will triumph in that 16 minutes this time. 

Friday, April 25, 2008

Waiting for the Verdict

Waiting for the Verdict
Waiting for the Verdict, by Abraham Soloman, painted in 1857

I will find out what happened in my finals in a few hours time. Can't stop my mind from racing everywhere and my heart from pounding away. Gotta find something to distract myself now. 

Thursday, April 24, 2008

To Kill a Mockingbird

The cover of the version i have

My dad wanted me to study in Mandarin school, while my mum was more fond of English education. She even told me once that it would be ideal to have one kid (my elder brother) studying in Mandarin School, and another kid to 'tak ang moh chek' (study in English-medium school,in hokkien). My dad was adamant though, and in the end mum relented, sending me to Sum Sun Primary School.

Sek Ren is short for Sekolah Rendah, Primary School in Malay. The centre of the flower contains  the characters 三山  which means three hills literally, and where the name anglicised Sum Sun was derived from. 

I wonder how different my life would chart its paths had mum persisted. 

Lang Tengah, a pristine island resort adjacent to Redang. Could be where the founders were inspired to call my school Sum Sun, heh. What if there were only 2 peaks? Twin peaks sounds awfully female....

Anyway i had digressed, rather severely. All i wanted to say was that being brought up in a Mandarin language school my exposure to English classics was really wanting. I was totally absorbed in Enid Blyton's Secret Seven, Famous Five etc when i was in primary school, but those weren't the classics that i meant.

Reading 'To Kill a Mockingbird' was such a pure joy for me. I wouldn't even try to describe how beautiful the book is; just read it if you haven't. 

'Shoot all the bluejays ceejays you want, if you can hit 'em, but remember it's a sin to kill a mockingbird'  
-To Kill a Mockingbird, Harper Lee

Beautiful, isn't it?

Tuesday, April 22, 2008

Where would You Jump to?

I have just watched this movie, after being delayed by my finals for many weeks.  

Jumper is one of those movies that captures your imagination. The Invisible Man is another such movie.  

While the movie is not spectacular, it did provide me decent entertainment as long as i watch mindlessly. However the imagination that runs wild after watching easily trumps the movie itself. 

Where will i jump to?

I asked myself the similar question after watching The Invisible Man. That answer was too easy, almost like a reflex arc. I would, as most other guys would, hehe. Let's just leave it as that. Sorry guys for incriminating all of you, but deep down under inside, we share the same anatomy that shortcircuits our brain right?  

So back to the question about where i want to jump to. 

David (Main guy, played by Hayden Christensen) wreaks havoc in the library each time he jumps there (first he flooded the place in water, and in the finale he brought a whole freaking apartment unit into the library with plenty of sea water too). I will be wayyyy more appreciative of the libraries that are as accessible as my bookshelves. Sweet. 

While flooding libraries doesn't really make him a criminal, this certainly is. 

How could that guy jump into a Japanese kitchen just to walk out like that!? Not even the courtesy to take a few bites of sushi or sashimi? What kind of jumper is that?!

I for a change will make sure i drop by the cold room to bring home each day fresh succulent salmon and tuna and yellow tail and scallops and squid, not forgetting some nice sake to wash it down too.... 

Life's a bliss that way. And every time hunger pang strikes, i can just jump to a Japanese restaurants with conveyor belt sushi. Jump in, grab a bite, and jump out. Simple as that, and with Japanese restaurants being so popular, i have restaurants in every timezone to choose from! Isn't that wonderful? 

Best still, I do not have to worry about renting a flat near any mrt station or at an accessible location. Any crap location will do. I can jump to work, and back to relax. No time lost in transit! 

No more bus, no more mrt, no more car, no more pollution, no more....

Now you have just gotten to know me a little bit better - bookworm, glutton, always hungry, hate to travel long distance, and incredibly mundane and boring too!

Now where would you jump to?

Monday, April 21, 2008

When the Fat Lady Sings

The room is empty. 

Nesa is now at some ACLS seminar (Advanced Cardiac Life Support), probably getting quite bored at the lecturers ranting on and on about handling emergencies. Not that it's not important, but interesting lecturers (lectures well i mean; but if they look interesting that will do too, but won't be for long) are really hard to come by. I can even see Rags dozing off right under the nose of the lecturer. Heh. Either that or he is passing some crude, inappropriate but deviously funny remarks about the lecturer to Nesa and Pam and Lydia and Naga or some poor soul who has the misfortune to try his/her hardest stifling every giggle or snort that threatens to come loose. 

It feels so different, to be left out of action when everyone i have studied with is either attending some lectures to prepare for housemanship, or shadowing the housemen in the department that they soon will be working at. 

Yet here i am, sitting in the comfort of my room, listening to a potpourri of tunes, enduring the unpleasant but bearable heat, reading 'To Kill a Mockingbird'.

An excellent book no less, but something's missing here. 

A wounded US soldier in Iraq, left out of action. Fortunately i only have a psychological injury to mend

I long to be in action. I don't want to idle around. 

Some genie please take pity in me and send me two fan-holding Greek goddesses in their awesome yet unbelievably economical costumes, and an endless supply of grape. 

I know she's not a Greek Goddess, but this is what i mean ok?

Ah.... Cool gusts of air with each flutter of the fan, nice melodies from iTunes, and manicured fingers putting one fabulous grape after another into my mouth, not to mention the awesome SIGHT that i will be enjoying. I should ask for vintage red wine from the genie too. 

That will do for the moment... Except that i just have remembered what Rags told me last night, that all the Greek ladies he encountered in Athens were unbelievably fat, and unbelievably naked. Haha. 

When the Fat Lady Sings. (Can't put a naked pic here la, wait till i branch into adult blogs, hehe)

Saturday, April 19, 2008

The Other 'War Dead'

A monument commemorating the war dead of Japanese Occupation in Air Itam, Penang

Many have fallen in Finals this year.
I hope everyone is coping well and not taking it too harshly upon themselves. 

We need to pull ourselves together and be ready for the many challenges ahead. I do not know nor possess the wisdom to foresee what future has in store for us.

I guess we just need to toughen ourselves up and brace for, especially unintentional damaging remarks that will sear through our self worth and reduce our egos to dirt. 

I don't know if any of the other 11 M5s will visit this blog, but in case they chance upon it, will everyone please leave some encouragements here for them? 

Friday, April 18, 2008

What's the big deal about failing finals?

Yes, it's a rather big deal, by any measures. 

The worst part of failing finals is never about one self. It's about hurting all those who i care.

Let me attempt at enumerating the adverse SIDE EFFECTS of failing the finals. 

Retarded my life by 6 months

I thought i have paid my dues as a student. (2+6+5+2+5=)20 years of education has been a really long journey. I couldn't wait to start working, to be financially independent, to be in a position to give. To be able to start materializing long term plans. 
To be really an adult, not just by age but by my worth to the society. And most pressingly, to start paying off that huge mound of debts piling on my back!!! 

Giant 25 year old leech that i am now

Financial burden on my family
I am sort of a scholar, living on the generous partial loan/grant from Kuok Foundation, and more loans from OCBC all these years. However they do not have provisions from any extra time needed to complete my degree. And it certainly didn't help that i have never budgeted for failing my finals, being cocksure that nothing would prevent me from passing my finals. Serve me right. 

With the tap running dry on that side i will have to turn to my family for support. Sighs, i am approaching 25 and i still have to burden my family financially. Shame on me, shame on the 25 year old leech. 

Disappointing my family
My mum had once said she wanted to get a tailor-made cheongsam for my commencement.  I squirmed at that idea of such an elaborate costume, after all it's just a bachelor degree that i am earning, and it's a dime a dozen these days. But that's beside the point, it shows how much pride she feels to bring up a son to graduate as a doctor, singlehandedly. Therefore it was really heart-wrenching for me to tell her that there won't be any commencement this July. She will have to wait longer... 

Delaying my filial responsibility for another 6 months
Ever since my dad passed away not long after i started primary school, my mum had been playing the roles of father and mother and breadwinner and maid and cook and driver and ATM and counsellor and friend and (PET?, heh). 

I have always liked to imagine being able to provide for her, to finally begin to repay all that i owe her. Treating her to fancy restaurants that we could not afford, bringing her to visit places that she didn't have time to travel to, giving her the peace of mind that she never had. Well, all these too have to wait. 

That's not me. My chest is not at all hairy... 

Dented self worth
That's the least of the problem. Ha, fellow buddhists will concur with me. Non self. 

Wedding band

Making my girlfriend wait another 6 more extra months
Tonight we would have been together for 2 years and 8 months. It used to be x months before i would propose. Now its x + 6 months. I am sorry, darling. 

I wonder if any examiners would have given any thoughts about what it means to fail a student and take away more than just 6 months of his/her life. 

It really is not just about an exam. 

Thursday, April 17, 2008

I Failed My Finals

'No matter what you do now, you will end up passing your finals anyway, so stop worrying about it. '

I can't even remember how many times i have repeated this line to all my friends who worries about the final hurdle of our medical education. Some got rather annoyed with me, asking me how could I be so sure of this. I just shrugged them off all the time. Never had i thought it will come back to haunt me. 

Well, I always have always managed to pass my exams. To me, it's a constant. No worries. The only variable is the grade. It has been like this all my life, almost (there were exceptions, but I shall leave that to another post). I have even stopped worrying about grades after getting admitted to university. At the end of the day everybody is conferred MBBS (Singapore). Only the few exceptional students who score distinctions in all 5 years get a mention of honours. That's beyond my reach. However I have been conscientious enough to make sure that every step i take, it is towards becoming a competent and safe doctor.

All these years, I have always assumed that I will graduate along with everyone else in the class. 

So when Naga called me 2 mornings ago, I wasn't at all prepared for the cruel irony that follows. That I have failed my surgery paper felt so unreal, so unreal that i kept on hoping that i would wake up and realise that this is nothing but a dream. I never woke up from the nightmare. Still haven't, i last recalled. 

I was so confident that i would pass my surgery papers. 

Apart from the Slides examination that i mistook the allocated time for 2 hours instead of 1.5 hours (I was left with a lot more questions than i should at that juncture but thankfully I managed to finish answering them all with my sympathetic overdrive), there was hardly any hiccups at all. I thought the clinical examination were a clear pass. I had very simple short cases that I could perform very well. Long case wise, it was less than stellar but i managed to present my history and physical examinations succinctly and coherently, giving the correct diagnosis with appropriate differentials, and the discussion went smoothly from investigations to managements. With every statements i gave supporting findings and reasonings; likewise for things that i ruled out. 

Unfortunately there were also instances that i could not answer well. 

"How do you test for L5?"
"By testing the EHL sir, according to the American Spinal Injury Association"
"How else can you test for L5?"
"Err.. Tibialis anterior, sir"
"Good. How do you ISOLATE tibialis anterior?"
"Err i am not sure how to isolate tibialis anterior from the other muscles that dorsiflex the foot" (Eversion is the answer i think, but that really is a bit chim, isn't it?)

"Is drug allergy important?"
"Yes sir, it is very important."
"Is it important in THIS PATIENT?"
(I thought I have just answered YES??!!)
i was told the golden rule in answering a question that was asked twice was to change course immediately. So without further consultation with my common sense i blurted out, "No."
I swore his eyeballs almost came loose from the sockets at that moment, and i immediately retracted my statement and apologized profusely. 

"Isn't blood pressure important in this patient? Why didn't you take the blood pressure?"
"Yes sir it is very important in this patient as he has a significant history of hypertension of x years duration, currently treated with 2 drugs, with no complications from the condition so far as well as no side effect from the medications. I did not obtain his blood pressure reading as the BP machine was faulty and i did not have enough time to hunt for another one down the corridor."
"Why didn't you get another BP machine?" he repeated. 
"I did not have enough time, sir. I thought I can refer to his clinical chart for his BP readings while i continue with my examination"
He does not appear appeased by my answer. 

"What else do you see on the X ray? Something you have mentioned just now?"
"Err.... secondaries?" (My differentials of neurogenic claudication from spondylosis or spondylolisthesi, vascular claudication from peripheral arterial disease, and secondary metastasis to the spine)
"Where is the secondary deposit?"
We were both peering very hard at the screen. It would have been a great photo if the screen captured our facial expression at that moment. 
"I do not see any, sir. They usually involve the pedicles and present as winking owl sign. I do not see any such sign here."
I think he was trying to hint at spondylolisthesis on hindsight, but i really did not see any anterior translation of any vertebrae. I did mention about wanting a oblique x ray for Scottie dog sign though, but he wasn't impressed. 

Other than that there was no more blunders that i can recall, apart from introducing Dr Suresh as Prof Thambiah to my patient. Haha. That surely wasn't that fatal a mistake, right? 

Anyway I came back to Singapore today. First thing i did after i put down my luggage in my room was to walk down to the Dean's Office to find out what's going on. Was told to approach the Surgery Dept instead. I had to wait for a week or two before they will finalize my appeal application, then the Head of Department or the Convener of the Final Exams will explain to me my shortcomings identified in the exams. 

That's a rather long wait, but the grimmer piece of news was that so far No One succeeded in their appeal. That the outcome always stay the same, makes me wonder what all the fuss about appealing is, why i even bother to appeal. 

Anyway I managed to talk to my previous tutor, and we discussed on what might have gone wrong. He reminded me of one reason that a student could fail - causing the patient pain. I recall that my patient was suddenly able to flex more than 70 degrees on straight leg raising when asked to demonstrate in front of the examiners, and i had to raise it to almost 90 degrees before he grimace. I then proceeded on to confirm with Lesague and Bowstring test. Was there any moment that i caused the patient pain without realising it? I really do not know now. I have a really uncomfortable feeling about this. 

I spent the last 2 days cracking my head on how i could have failed my surgery paper. I have mentally watched my long case being played over and over again in my mind, so many times that i was really exhausted at the end of the day that i could ACTUALLY sleep on both nights. Amazing feat isn't it. It's going nowhere, and it's getting unhealthy. Had been wearing a mask-like facies on both days that worried everyone at home sick, especially my mum. My best friend commented that i have sighed more times in the last 2 days than all the years he has known me. Even my dog stayed away from me. And for the first time in my life, instead of dropping me at the airport and drive off waving goodbye, my brother actually parked his car and sat with me for half an hour before urging me to board my plane. 

Now that i have realised how futile and wishful my appeal to the department was, i am more accepting of my failure. The change in mood came so suddenly that i found myself grinning and filled with optimism. (Hope it is not the first presentation of bipolar) Well, casting aside all the downside of a supplementary exam and the remedial posting that comes along, i actually get to be a student for another 6 months!!! Not that i really want it... But i am determined to make full use of the coming months. There were many things that i wished i had more time to cover and do when i was preparing for finals earlier on. There are other skills that i wish to acquire too. Suddenly it felt as if it wasn't too bad to fail. 

Now i sound more like myself. The endless supply of optimism. 

There's one HUGE regret though. The fact that i won't be able to graduate along with my close friends saddens me every time i thought about it. But then again, i can always borrow their gown and take photos together. Eventually my memory will fail and i will think i have graduated along with everyone. That is if my significant cardiovascular risk does not kill me before i grow THAT old...