Showing posts with label I Failed My Finals. Show all posts
Showing posts with label I Failed My Finals. Show all posts

Friday, September 12, 2008

It's Over


Feeling lame. (Well you can tell it's an angmoh, so it can't be me.)


And so it's over. 

I don't feel exhilarated though. The feeling is just lame. 

Long case was a breeze, and was told i did really well. Short cases was not as great but i guess it's good enough. 

But the anticipated emancipatory joy is just not there. 

I guess i did not feel vindicated. The long case was simple, too simple to feel satisfied for doing well, while my performance at the short cases was wanting*. 

Wanting simply because i had a high expectation. So don't get alarmed. 

The short cases were a ulcerated papilloma, adult polycystic kidney disease, hallux valgus, and a plain AXR showing gas under diaphragm. Apart from the hallux valgus, the other 2 weren't the run-of-the-mill cases that we frequently get examined on. 

All the templates of perfect approach and answers gone down the drain just like that. 

Why do we even bother with short cases? What does it tell about a student? 

Zilt. 

Wednesday, September 10, 2008

Updates

And so the theory papers are all over now. Now what's left is the make-it-or-break-it clinical examinations on friday, with a day of break before the final hurdle. 

The past 3 days have been good. So don't worry. I just hope i won't get cold feet before the clinicals. You know, once bitten, twice shy. 

It's rather weird to worry about exams. 

Nevermind, i shall take refuge in the knowledge that i have identified my weaknesses and had taken measures to improve on delivery. 

Time to go back to study. 



Monday, June 30, 2008

J.K. Rowling's Commencement Speech at Harvard 2008


* I guess one day other medical students who fail their finals would stumble across my blog, and if you do, don't miss reading her speech

One of the things that i cherish most about running my own blog is that now there exists a means for me to easily share the gems that i come across everyday. 

Had a briefing with Prof Dean Koh this morning on our remedial general surgery posting, and he told us about this must-read speech by J.K. Rowling, the famous author who brought Harry Potter to life.

She was being conferred an honorary degree at Harvard University this year, and was invited to give a commencement speech to the graduating class as well. Her complete script below. 

Thanks to Joo Wei for promptly finding the article and sharing with all of us. 

---

The Fringe Benefits of Failure, and the Importance of Imagination

Harvard University Commencement Address

J.K. Rowling

Copyright June 2008

As prepared for delivery

President Faust, members of the Harvard Corporation and the Board of Overseers, members of the faculty, proud parents, and, above all, graduates, 

The first thing I would like to say is 'thank you.' Not only has Harvard given me an extraordinary honour, but the weeks of fear and nausea I've experienced at the thought of giving this commencement address have made me lose weight. A win-win situation! Now all I have to do is take deep breaths, squint at the red banners and fool myself into believing I am at the world's best-educated Harry Potter convention. 

Delivering a commencement address is a great responsibility; or so I thought until I cast my mind back to my own graduation. The commencement speaker that day was the distinguished British philosopher Baroness Mary Warnock. Reflecting on her speech has helped me enormously in writing this one, because it turns out that I can't remember a single word she said. This liberating discovery enables me to proceed without any fear that I might inadvertently influence you to abandon promising careers in business, law or politics for the giddy delights of becoming a gay wizard. 

You see? If all you remember in years to come is the 'gay wizard' joke, I've still come out ahead of Baroness Mary Warnock. Achievable goals: the first step towards personal improvement. 

Actually, I have wracked my mind and heart for what I ought to say to you today. I have asked myself what I wish I had known at my own graduation, and what important lessons I have learned in the 21 years that has expired between that day and this. 

I have come up with two answers. On this wonderful day when we are gathered together to celebrate your academic success, I have decided to talk to you about the benefits of failure. And as you stand on the threshold of what is sometimes called 'real life', I want to extol the crucial importance of imagination. 

These might seem quixotic or paradoxical choices, but please bear with me. 

Looking back at the 21-year-old that I was at graduation, is a slightly uncomfortable experience for the 42-year-old that she has become. Half my lifetime ago, I was striking an uneasy balance between the ambition I had for myself, and what those closest to me expected of me. 

I was convinced that the only thing I wanted to do, ever, was to write novels. However, my parents, both of whom came from impoverished backgrounds and neither of whom had been to college, took the view that my overactive imagination was an amusing personal quirk that could never pay a mortgage, or secure a pension. 

They had hoped that I would take a vocational degree; I wanted to study English Literature. A compromise was reached that in retrospect satisfied nobody, and I went up to study Modern Languages. Hardly had my parents' car rounded the corner at the end of the road than I ditched German and scuttled off down the Classics corridor. 

I cannot remember telling my parents that I was studying Classics; they might well have found out for the first time on graduation day. Of all subjects on this planet, I think they would have been hard put to name one less useful than Greek mythology when it came to securing the keys to an executive bathroom. 

I would like to make it clear, in parenthesis, that I do not blame my parents for their point of view. There is an expiry date on blaming your parents for steering you in the wrong direction; the moment you are old enough to take the wheel, responsibility lies with you. What is more, I cannot criticise my parents for hoping that I would never experience poverty. They had been poor themselves, and I have since been poor, and I quite agree with them that it is not an ennobling experience. Poverty entails fear, and stress, and sometimes depression; it means a thousand petty humiliations and hardships. Climbing out of poverty by your own efforts, that is indeed something on which to pride yourself, but poverty itself is romanticised only by fools. 

What I feared most for myself at your age was not poverty, but failure. 

At your age, in spite of a distinct lack of motivation at university, where I had spent far too long in the coffee bar writing stories, and far too little time at lectures, I had a knack for passing examinations, and that, for years, had been the measure of success in my life and that of my peers. 

I am not dull enough to suppose that because you are young, gifted and well-educated, you have never known hardship or heartbreak. Talent and intelligence never yet inoculated anyone against the caprice of the Fates, and I do not for a moment suppose that everyone here has enjoyed an existence of unruffled privilege and contentment. 

However, the fact that you are graduating from Harvard suggests that you are not very well-acquainted with failure. You might be driven by a fear of failure quite as much as a desire for success. Indeed, your conception of failure might not be too far from the average person's idea of success, so high have you already flown academically. 

Ultimately, we all have to decide for ourselves what constitutes failure, but the world is quite eager to give you a set of criteria if you let it. So I think it fair to say that by any conventional measure, a mere seven years after my graduation day, I had failed on an epic scale. An exceptionally short-lived marriage had imploded, and I was jobless, a lone parent, and as poor as it is possible to be in modern Britain, without being homeless. The fears my parents had had for me, and that I had had for myself, had both come to pass, and by every usual standard, I was the biggest failure I knew. 

Now, I am not going to stand here and tell you that failure is fun. That period of my life was a dark one, and I had no idea that there was going to be what the press has since represented as a kind of fairy tale resolution. I had no idea how far the tunnel extended, and for a long time, any light at the end of it was a hope rather than a reality. 

So why do I talk about the benefits of failure? Simply because failure meant a stripping away of the inessential. I stopped pretending to myself that I was anything other than what I was, and began to direct all my energy into finishing the only work that mattered to me. Had I really succeeded at anything else, I might never have found the determination to succeed in the one arena I believed I truly belonged. I was set free, because my greatest fear had already been realised, and I was still alive, and I still had a daughter whom I adored, and I had an old typewriter and a big idea. And so rock bottom became the solid foundation on which I rebuilt my life. 

You might never fail on the scale I did, but some failure in life is inevitable. It is impossible to live without failing at something, unless you live so cautiously that you might as well not have lived at all – in which case, you fail by default. 

Failure gave me an inner security that I had never attained by passing examinations. Failure taught me things about myself that I could have learned no other way. I discovered that I had a strong will, and more discipline than I had suspected; I also found out that I had friends whose value was truly above rubies. 

The knowledge that you have emerged wiser and stronger from setbacks means that you are, ever after, secure in your ability to survive. You will never truly know yourself, or the strength of your relationships, until both have been tested by adversity. Such knowledge is a true gift, for all that it is painfully won, and it has been worth more to me than any qualification I ever earned. 

Given a time machine or a Time Turner, I would tell my 21-year-old self that personal happiness lies in knowing that life is not a check-list of acquisition or achievement. Your qualifications, your CV, are not your life, though you will meet many people of my age and older who confuse the two. Life is difficult, and complicated, and beyond anyone's total control, and the humility to know that will enable you to survive its vicissitudes. 

You might think that I chose my second theme, the importance of imagination, because of the part it played in rebuilding my life, but that is not wholly so. Though I will defend the value of bedtime stories to my last gasp, I have learned to value imagination in a much broader sense. Imagination is not only the uniquely human capacity to envision that which is not, and therefore the fount of all invention and innovation. In its arguably most transformative and revelatory capacity, it is the power that enables us to empathise with humans whose experiences we have never shared. 

One of the greatest formative experiences of my life preceded Harry Potter, though it informed much of what I subsequently wrote in those books. This revelation came in the form of one of my earliest day jobs. Though I was sloping off to write stories during my lunch hours, I paid the rent in my early 20s by working in the research department at Amnesty International's headquarters in London. 

There in my little office I read hastily scribbled letters smuggled out of totalitarian regimes by men and women who were risking imprisonment to inform the outside world of what was happening to them. I saw photographs of those who had disappeared without trace, sent to Amnesty by their desperate families and friends. I read the testimony of torture victims and saw pictures of their injuries. I opened handwritten, eye-witness accounts of summary trials and executions, of kidnappings and rapes. 

Many of my co-workers were ex-political prisoners, people who had been displaced from their homes, or fled into exile, because they had the temerity to think independently of their government. Visitors to our office included those who had come to give information, or to try and find out what had happened to those they had been forced to leave behind. 

I shall never forget the African torture victim, a young man no older than I was at the time, who had become mentally ill after all he had endured in his homeland. He trembled uncontrollably as he spoke into a video camera about the brutality inflicted upon him. He was a foot taller than I was, and seemed as fragile as a child. I was given the job of escorting him to the Underground Station afterwards, and this man whose life had been shattered by cruelty took my hand with exquisite courtesy, and wished me future happiness. 

And as long as I live I shall remember walking along an empty corridor and suddenly hearing, from behind a closed door, a scream of pain and horror such as I have never heard since. The door opened, and the researcher poked out her head and told me to run and make a hot drink for the young man sitting with her. She had just given him the news that in retaliation for his own outspokenness against his country's regime, his mother had been seized and executed. 

Every day of my working week in my early 20s I was reminded how incredibly fortunate I was, to live in a country with a democratically elected government, where legal representation and a public trial were the rights of everyone. 

Every day, I saw more evidence about the evils humankind will inflict on their fellow humans, to gain or maintain power. I began to have nightmares, literal nightmares, about some of the things I saw, heard and read. 

And yet I also learned more about human goodness at Amnesty International than I had ever known before. 

Amnesty mobilises thousands of people who have never been tortured or imprisoned for their beliefs to act on behalf of those who have. The power of human empathy, leading to collective action, saves lives, and frees prisoners. Ordinary people, whose personal well-being and security are assured, join together in huge numbers to save people they do not know, and will never meet. My small participation in that process was one of the most humbling and inspiring experiences of my life. 

Unlike any other creature on this planet, humans can learn and understand, without having experienced. They can think themselves into other people's minds, imagine themselves into other people's places. 

Of course, this is a power, like my brand of fictional magic, that is morally neutral. One might use such an ability to manipulate, or control, just as much as to understand or sympathise. 

And many prefer not to exercise their imaginations at all. They choose to remain comfortably within the bounds of their own experience, never troubling to wonder how it would feel to have been born other than they are. They can refuse to hear screams or to peer inside cages; they can close their minds and hearts to any suffering that does not touch them personally; they can refuse to know. 

I might be tempted to envy people who can live that way, except that I do not think they have any fewer nightmares than I do. Choosing to live in narrow spaces can lead to a form of mental agoraphobia, and that brings its own terrors. I think the wilfully unimaginative see more monsters. They are often more afraid. 

What is more, those who choose not to empathise may enable real monsters. For without ever committing an act of outright evil ourselves, we collude with it, through our own apathy. 

One of the many things I learned at the end of that Classics corridor down which I ventured at the age of 18, in search of something I could not then define, was this, written by the Greek author Plutarch: What we achieve inwardly will change outer reality. 

That is an astonishing statement and yet proven a thousand times every day of our lives. It expresses, in part, our inescapable connection with the outside world, the fact that we touch other people's lives simply by existing. 

But how much more are you, Harvard graduates of 2008, likely to touch other people's lives? Your intelligence, your capacity for hard work, the education you have earned and received, give you unique status, and unique responsibilities. Even your nationality sets you apart. The great majority of you belong to the world's only remaining superpower. The way you vote, the way you live, the way you protest, the pressure you bring to bear on your government, has an impact way beyond your borders. That is your privilege, and your burden. 

If you choose to use your status and influence to raise your voice on behalf of those who have no voice; if you choose to identify not only with the powerful, but with the powerless; if you retain the ability to imagine yourself into the lives of those who do not have your advantages, then it will not only be your proud families who celebrate your existence, but thousands and millions of people whose reality you have helped transform for the better. We do not need magic to change the world, we carry all the power we need inside ourselves already: we have the power to imagine better. 

I am nearly finished. I have one last hope for you, which is something that I already had at 21. The friends with whom I sat on graduation day have been my friends for life. They are my children's godparents, the people to whom I've been able to turn in times of trouble, friends who have been kind enough not to sue me when I've used their names for Death Eaters. At our graduation we were bound by enormous affection, by our shared experience of a time that could never come again, and, of course, by the knowledge that we held certain photographic evidence that would be exceptionally valuable if any of us ran for Prime Minister. 

So today, I can wish you nothing better than similar friendships. And tomorrow, I hope that even if you remember not a single word of mine, you remember those of Seneca, another of those old Romans I met when I fled down the Classics corridor, in retreat from career ladders, in search of ancient wisdom: 

As is a tale, so is life: not how long it is, but how good it is, is what matters. 

I wish you all very good lives. 

Thank you very much. 



Tuesday, June 3, 2008

You’re A Failure? You’re Not Alone.




Just to share this website. There's actually a metablog of blog entries related to failure. Even my entry about every woman needing to carry a condom. Hah. 

Quite interesting. 

Monday, May 26, 2008

Scream


The Scream by Edvard Munch. Recently back on display in a Norwegian Museum, complete with a stain at the lower left corner. I will be restored in 3 month's time too, albeit with a stain too. 

After so many weeks, i still harbour the hope of waking up from this nightmare, to find that this is nothing but a protracted horror-filled dream. 

Yes i will wake up screaming, but i would have passed my finals. 



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. 







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. 

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...