Sunday, May 31, 2009

hottest day everrr

don't worry, i know. as is apparent from my great cynicism on the matter. what i am trying to do is, well, actually, i'm not very sure. do the right thing at any one given moment i guess.

wrote lots of rather bad poetry and posted it on wb. the source of inspiration was the poetry review i think, koped from the journal shelves in the library.

praying for a safe trip back :) YAY LOTS OF BOOK READING AWAITS ME
j - you won't read this but i promiseeee you coffee when you get back. really!! coffee in what form only la... maybe i gift you nescafe instant coffee from the rj canteen.... haha. but i must say iiii would consider that a nice present

lovely people who helped me move stuff, you know who you are, merci beaucoup

SO EXHAUSTED. home soon.

Saturday, May 30, 2009



couldn't they let us enjoy our summer in peace?!! grrr

gd eg of not to take things at face value
in boys before flowers
monk, to ji-hoo: "that girl is going to make a family for you"
ji-hoo: !!!!!!!!

(he meant she's going to help ji hoo reconcile with his granddad)

this is like jun-pyo when he kept telling jan di "i'll take responsibility" when he meant responsibility for her staying out all night cos they got locked into the cable car. and when she thought "you're going to lose something" meant her virginity not her ankle charm that jun-pyo gave her. lol i love this show.

anatomy lab coat

..........i just washed my anatomy white coat with a pen in the same laundry bag............. so it's not really a white coat anymore... heh
funny pictures of cats with captions
see more Lolcats and funny pictures

Friday, May 29, 2009


here goes my fruitful day
wake up, have breakfast
fall asleep again


going running now, ta

utterly perplexed

who sent me the poem 'hello there' on 15th nov 2008..? i thiiink it's adam but i have no idea really. lol just that i don't immediately fix a name to it, so quite curious. trawling through all the stuff i've accumulated this past year.

halfway packed i'd say. :)

Thursday, May 28, 2009

today must be a thursday

After all is said and done, there is usually more said than done. - Anonymous
All things come to those who wait, but when they come they're out of date. - Anonymous
In any moment of decision the best thing you can do is the right thing, the next best thing is the wrong thing, and the worst thing you can do is nothing. - Theodore Roosevelt

douglas adams
I refuse to answer that question on the grounds that I don't know the answer.
You live and learn. At any rate, you live.
Today must be a Thursday. I could never get the hang of Thursdays.

gk chesterton
I believe in getting into hot water. I think it keeps you clean.
Art, like morality, consists in drawing the line somewhere.
There are no rules of architecture for a castle in the clouds.
The poets have been mysteriously silent on the subject of cheese.

just for today (and hopefully all the tomorrows as well)

The curious paradox is that when I accept myself just as I am, then I can change.~Carl Rogers~


Pep without purpose is piffle. - Anonymous
heh cute

Just for Today
I will live through the next 12 hours and try not to tackle all of life's problems at once.
I will improve my mind, I will learn something that requires effort and concentration.
I will be agreeable. I will look my best, speak in a well modulated voice, and be courteous and considerate.
I will not find fault with a friend, relative or colleague. I will not try to change or improve anyone but myself.
I will have a programme. I might not follow it exactly, but I will have it. I will save myself from two enemies:hurry and indecision.
I will do a good turn and keep it a secret. If anyone finds out, it will not count.
I will do two things I don't want to do, just for the exercise.
I will believe in myself. I will give my best to the world and feel confident that the world will give it's best to me.


When things go wrong as they sometime will
When the road you are trudging seems all uphill
When funds are low and debts are high
And instead of a smile you have a sigh
When care is pressing you down a bit
Rest in God's love and never quit
Life can be strange with its turns and twists
And many a failed man have turned away
When with God's help he'd have won the day.
Never give up though the pace seems slow
For you may succeed with another go
Success is the failure turned inside out
The silver line in the cloud of doubt
You never can tell how close you are
The goal may be near when it seems so far
So turn to the Lord and when you're hardest hit
Put your trust in Him and never quit

Wednesday, May 27, 2009


i am sitting in my room draining my coffee jar, realizing that
a) things dont change so easily
b) i am exactly the same as secondary school even

and that it's not my determination to achieve things, talent (haha), or intelligence (hahaha) that has brought me where i wanted to end up, it's literally God's grace.

it's not last minute mugging that gives good grades - the outcome varies shockingly widely no matter how i try. i can only conclude that, God has given me some things and decided that some other things are not for me.

it's always slightly depressing to pack the contents of your life up into suitcases and boxes no matter how many times you've done it. i must absolutely finish packing today. people's houses are filling up. there's something about finishing the coffee jars in my room that made me feel suddenly nostalgic for this place.

oh yes i've discovered a library inside chancellors court :) yays


this is a prime example of trying to please everyone and ending up pleasing no one, least of all myself. good job.

as always have to try though hai

i realise its easy to get angry at people you are close to. its hard to get angry at people you hardly know or even so it doesnt affect you that much.

Tuesday, May 26, 2009

sitting in the library writing poetry before swimming :)

today ive done laundry and run and run into many friends

life is not good good but there are some nice things about being alive.
thanks for that, really i mean it. it made everything all this time more than worthwhile. :)

im annoyed with myself for even broaching the issue, and i wont forget what spurred me to do it.

Monday, May 25, 2009

you see the thing is i know the things i have to do, but something always prevents me from doing them.

like j said, when you expect things to happen a certain way they invariably don't. it was about the most random smallest occurance, but it made perfect sense in that moment.

time seems to have slowed down now exams are over. ive discovered random libraries in the halls of residences. john grisham entertained me during boring studying, joseph keller is now :) not catch 22 though, someone else probably koped it

anyway it's been a nice few days! rainbow sushi, bella italia, drunken pantry parties (i had no part in the drinking just fyi), pizza farewells.


to the cf people, who probs won't read this,
i want to say thank you for being awesome friends, big brothers & big sisters to me and the rest of us this year. i know i have skipped countless bible studies for reasons both worthy and not (eg staying up all of the night before to chat to friends thus totally wiped out on friday, compared to dehibilating flus), and i have spent bible studies imparting my ah not very theologically grounded views of religion to impressionable friends, which is probably not the best way to go about converting people, also, have tried to convert them by example, unfortunately have about zero moral highground thus not sure if this worked at all...

but nevertheless, you guys have made friday nights fun and awesome without me having to succumb to clubbing or other hedonistic pursuits in order to find friends and fun here. you guys have brought me closer to God and showed me what fellowship really is like, something i'm not sure I'll ever find in my age group in my church back home. i look forward to friday nights after a long and draining week, and as my friends will attest to, i tussle with myself when i decide to skip it. it can only be because i know it WILL refresh me and because it's just such a fun and love-filled place :) so thank you for creating such a place in the middle of all the studying, drama, upsets, happinessess, weather changes this city holds.

First Year of Med School :)

I feel so happy to say that my first year of medical school is over! Honestly, there were times when I thought I'd never reach this day, ranging from when I thought I'd never even get to the first DAY of medical school to in the troughs of despair over exams. But it's over!! Please please let me pass, I'd really rather not go through all this again.. Haha.

Overall, I wouldn't say I've grown up a lot. Or at all. It's actually possibly more shielded here that at home because there isn't anyone here really TELLING you to grow up. Hopefully I have though, in some ways. I think I've become nicer. It's not THAT surprising because I have the happiness of being in medical school now. It takes the sting out of a lot of dissappointments to finally have had the one thing you've predicated a good part of your life upon. So I'd jolly well better be nice and not be an unhappy bunny. But I suppose there were definitely dissappointments. Apparently, there is no end to the number of times a single person can break your heart. Who would have thought huh? And the amount of self-hate one can incur through extended study breaks spent glued to the very small (laptop) screen is quite astounding. I will forever associate the pattern of my hall room's curtain with the thought "shit shit I'm going to fail must stop watching tv".

And there was a surprising amount of ah drama and interesting occurances this past year. Which is all very good for interest sake but sometimes you REALLY don't know what to do. I'm just glad I became a nicer person for it rather than a more horrible person. Although I've definitely learnt that I have a clear anti-social streak, and I tend to run away from things. I'm sorry guys. But I made it for everything really important right? And I -hope- I'm always there if you reaaally needed me and sometimes erm even forcing help when I thought you needed it heh. I hope I helped. Thank you all for being so lovely and understanding, esp about the drinking thing, about my red balloons, when I blew up at you guys over a thousand things. Thank you for making me a nicer person, it could have gone so many ways. Thank you for sheltering me this one year I spent living away from my family, I don't feel like I've struck out on my own actually lol, rather that I've been living in a really comfortable bubble full of friends and fun heh. But next year in flats I'm sure it'll be more independent living and stuff... I'll miss hall life!! Looking forward to going to all your flats for dinners and everything :)

<3 me

ps: dear med school, i love you muchly but i'm sure you knew that! will love you more if i get a good grade, hint, >90 is good for starters.... but worst come to worst PASSING IS PARAMOUNT

Sunday, May 24, 2009


Looking at what I so wanted then is such an interesting experience in itself. The scary thing is I wouldn't want it now. I'm looking back at who I was then and the things I liked and coveting with a sort of fascination the way you would read someone else's personal diary or check out their room to see what they're like. (mine's like a hurricane btw. lol)

Words cannot convey the feeling of realising that friendships are like soap bubbles, that loves are like the pots of gold at the end of rainbows, that kindnesses are fleeting as the seasons, that the only thing that seems to be real is the drama playing out on your computer screen.

Okay lol sorry, must be the post-traumatic stress disorder... coupled with new addiction to korean dramas... plus the thing I am now trying to commit to hilarity, with no success. The only good thing is knowing that it is good God didn't want to give me what I so wished for last time, and thus, this is for good too.

Saturday, May 23, 2009


Finally!! I hope I pass my exams though......

Tonight - Do laundry. Run <3 <3 , Eva's birthday dinner
Sunday - Church, Academic family lunch at chocolate soup :) (as in the year 2s and us) Academic family (j, r and me) dinner? at, well, somewhere.
Monday- Friday paaack and put stuff at people's places? Return books to RIE. Watch korean dramas (my new obsession). Run/ Swim/ Play badminton.

Then soon... home :)

Friday, May 22, 2009

Thursday, May 21, 2009

i really feel like crying. everything i didn't know came out and everything i knew didn't come out. seriously when i think of the word maraviroc, and all the confounders that i knew the answers for like the drug that inhibits phosphodiesterase, and all the nonsense i was writing instead........................................................

life goes on, luckily.

but still. it's just awful.

there were some right answers presumably. just many more wrong ones. oh God please let me pass? please please please

Wednesday, May 20, 2009

nothing is perfectttt lah
101 things to finishhhh

1. as much of s2 unit 7 (experience of illness) as i can esp those bits on pain, chronic illness...
2. random s2 unit 8 stuff... community care... global burden of disease
3. immunology
4. stuff i photocopied for respi fr crash course..
5. read thru b&j, respi...
well done, well done

nooo words

just really tired, more than ready for it to be over, yet far from ready. all i can do is literally to hope i pass at this point. i feel so bad for letting my past self down, my past self who so enthusiastically professed love for anatomy and biochemistry and drugs (no love for you physiology or bacteria...). my past self who would prioritize revision over other fun things like watching tv (but watch tv anyway... ok that's not the point.)

i do feel quite argh about that. but at least i tried. right? to be so tired at this point means i must really have earned the tiredness. this is not very consoling of course and the fact stands that i must stillll do a whole ton of workkkk. oh well one good thing about exams is you get to eat chocolate slightly more guilt free heh. cos errr it gives you energy!! yes! i had a kitkat just now :)

that being said, after exams (before flying back)
1) everyone outing
2) eva's bday thing!
3) acad family dinner? :)
4) go to south queensferry (?? sp?) (gill says it's pretty!)
6) library. storybooks. everyday.
7) watch allllll the television serials and get started on korean dramas.

at home, oh the possibilities are endless.

thank you to everyone who has encouraged me and been nothing less than kindness and awesomeness thus far. sorry j for being sucha talkative person to study with hahaha i hope i was more entertaining than the computer screen heh.

dear goodness i hope i manage to pull this off.

if any of you lacks wisdom

Prayer Before an Exam
Dear Lord,
Sometimes I feel a little strange praying
to you because of an exam.
It doesn't really seem all that significant
when you consider the "big picture."

But right now, the test looms so large
that it is all I can see before me.
I pray to you for three things:
- the strength to handle the pressure that I feel,
- the confidence to feel secure
in my knowledge and preparation,
- and the ability to keep an appropriate
perspective on it all.
Help me to keep in mind what is really important,
even as I focus all of my time and energy
on this test in the immediate future.

If any of You lacks wisdom, let him ask of God, who gives to all liberally and without reproach, and it will be given to him.
James 1:5.

Tuesday, May 19, 2009

very sleepyyyyyy
absolutely must compare ra/ oa/ op todayyyy
and strand 2
but i just wanna sleep and watch tv.........

oh well :)

Greg Laswell - How the day sounds

Oh who would have ever known this?
Could be this easy
I was a long, long way off
Then just like that it was over

And I think I like how the day sounds
Like how the day sounds through this new song

Thank you for opening the window
The sky is clear as my mind is now
I was a long, long way off
Join me in welcoming the sun in
It's much brighter than the night I hid in
I was a long, long way off

And I think I like how the day sounds
Like how the day sounds through this new song
And I think I like how the day sounds
Like how the day sounds through this new song
From a long way down.

Yeah, it's well worth the time that its taken to get here now
Yeah, it's well worth the time that its taken to get here now
And the lines have all been drawn
I know where I belong, where I belong,
Where I belong
imagine it as little presents not as creepy beetles
or maybe like the story of the girl who thought there was a mouse in her room
but it was a fizzy drink

it was a great present. funny wrapping paper, maybe the whole purpose is for comic relief. goodness knows we all need some. hahaha. very very relieving. -_- well at least, it's amusing now & brightens up the day. it depends on how seriously you take it. and i know now that i can't take it seriously at all. it does sometimes seem rather sad, that no matter how much i do my best, it just never seems to work out. well yes of course probably the fundamental connecting bridge across the crevice just isnt there. should be glad for what is there, ie lots of chocolate that can be thrown over the ravine...

the fact is that chocolate is chocolate but i just want to have the rainbow for once. i know i can't, goodness knows why. but i don't regret it, not at all. i treasure every single bit of sunshine even if i can't have the full range of colors. green grass is enough for me, and i can find all the other colors in everything on this side here - purple engorged sky, red apples, blue ants creeping along my note paper, orange highlighter, the browness of coffee.

and so... against all my conscience, it is okay. well not okay okay, obviously. but you can't argue with the pure happinesses that sometimes find you, and it is ok, sometimes, to gift exchange a little happiness for the knowing that there doesn't exist a guiderope.

more exam prayers...

Undertaking Exams
Loving God
be with me now,
as I prepare for my exams.

Thank you for the many talents and gifts you have
given me and for the opportunity of education.

Calm my nerves and anxiety, help me
to remember all that I have studied,
to express it clearly and to answer the questions
the very best that I can.

Holy Spirit, sit with me in my exam-
and always.
In Jesus' name
and part of a prayer that i have always liked very much

Prayer of Saint Francis
Lord, make me an instrument of your peace.
Where there is hatred, let me sow love;
Where there is doubt, faith;
Where there is despair, hope;
Where there is darkness, light;
and Where there is sadness, joy.
isn't that beautiful :)

today - bones & joints ALOT OF QNS, finished up acid base once and for all, quite a lot of respi qns, rheumatoid arthritis

9-10 osteoarthritis
10-12 mechanical role of skeleton, hand surg, paed ortho finishh up, connective tissue & intro lect stufff think that should be it right

morning: immuno mugging & qns
afternoon: strand 2, pathogenesis of infection, oa ra op comparision
lung cancerrr
night: REVISE

i dont know at alll if this will work. i guess the only way to find out is to try. lol. i really hope it works.

Monday, May 18, 2009

God of history and today, we pray that you will bless each one of us working for exams with a sense of value; that what we do should be our best because that is part of who you made us to be. When we get depressed, tired and want to be somewhere else remind us that what we do is part of the message of who we are. At the end of this time give us the contentment that says ‘I did my best...’

Exam Prayer (as exam approaches)

O God of Wisdom, I thank you for the knowledge
gained and the learning experiences of this year.

I come to you on this day and ask you to enlighten my
mind and heart.

Let your Holy Spirit be with me as I prepare for
exams, guiding my studies, and giving me insight so
that I can perform to the best of my ability.

Please grant me the strength to handle the pressure of
these final days of the term,
the confidence to feel secure in my knowledge,
and the ability to keep an appropriate perspective
through it all.

Help me to keep in mind what is truly important,
even as I focus my time and energy on these exams in
the immediate future.

Finally, may I sense your peace in knowing that I
applied myself to the challenges of this day.

I ask this through Jesus Christ our Lord.

The Student's Psalm (v cute!!)

The Lord is my shepherd, I shall not flunk;
He keepeth me from lying down when I should be studying.
He leadeth me beside the water cooler for a study break;
He restores my faith in study guides.
He leads me to better study habits
For my grades' sake.
Yea, tho' I walk through the valley of borderline grades,
I will not have a nervous breakdown;
For Thou art with me;
My prayers and my friends, they comfort me.
Thou givest me the answers in moments of blankness;
Thou anointest my head with understanding,
My test paper runneth over with questions I recognize.
Surely passing grades and flying colors shall follow me
All the days of examinations; And I shall not have to dwell in this university

A prayer about exams

O God, I come to you because I feel overwhelmed by all the deadlines that are before me. My mind is full of information but my spirit is tired and afraid. Help me study for my exams by giving me a calm heart and mind. Let not my fear of failure and bad grades undermine all the things that I have already accomplished. Give me the wisdom to know what is important and what is not. Let not so many distractions keep me from my goal. Let me also always remember that you love me for who I am and not for what I do. Finally, God, let me be honest with myself and face up to the challenges that are before me in truth and grace. In Jesus' name I pray, Amen.

for my own reference (read: make myself feel better about the nap i just had)

yesterdayy did gram negative bacteria, antivirals, revised respi physiology- asthma etc
this morning was uber productive haha woke up at 8+ to go kilamajaro, did acid-base, revised respi physiology - the fev/fvc graphs, surfactant, lung compliance etc, came back and finished oxygen therapy in the comp lab.

then read through some bones & joints stuff, and was completely wiped out by 5pm+, slept until now -_- i might as well have 8 hours of sleep every night instead of randomly wiping out during the day......

*new plannn
9-10 random anat revision
10-12 BONES AND JOINTS stuffff (2 intro lectures i never did)
12-1 random bones & joints lectures i havent done yet?/ slp

wake up at 8am for rie lib to get books back by 10++ hopefully!
10-12 gas exchange revision
12-1 lunch/ test
1-6 kilamanjaro? heh hopefully. bleeding disorders, body fluids, endocrine reg of vascular bed, biochemical markers & fn, lung cancer (1 hr for each)
after dinner
random bones and joints lectures

chiong s2
pathogenesis of infectious diseases

still really really sleepy
on a happier note i tried a chai latte today and it was really nicee

Sunday, May 17, 2009

thank you God for these wonderful wonderful people

i really, honestly, don't know what i would do without them. you know who you are :)

please help me to concentrate, to not do anything too off. i know i have failed to do so many things so many times, i have failed you in so many ways.... please give me the chance to make amends after the exams. please show me the right thing to do at the right time. never let me lose my God. Amen.
from now on i am going to live my life only for blackadder and the prospect of being on call in a&e. absolutely nothing including social interaction is worth it.

no idea why i suddenly feel this way could be the weather or dust mites.

i just asked j
hey what's squalene? is it the enzyme that makes squalor?


Saturday, May 16, 2009

Invictus by William Ernest Henley

Out of the night that covers me,
Black as the Pit from pole to pole,
I thank whatever gods may be
For my unconquerable soul.

In the fell clutch of circumstance
I have not winced nor cried aloud.
Under the bludgeonings of chance
My head is bloody, but unbowed.

Beyond this place of wrath and tears
Looms but the Horror of the shade,
And yet the menace of the years
Finds, and shall find, me unafraid.

It matters not how strait the gate,
How charged with punishments the scroll.
I am the master of my fate:
I am the captain of my soul.
this has carried me through countless difficulties
i thank whatever gods may be for my unconquerable soul
my head is bloody, but unbowed

From an Atlas of the Difficult World by Adrienne Rich

I know you are reading this poem
late, before leaving your office
of the one intense yellow lamp-spot and the darkening window
in the lassitude of a building faded to quiet
long after rush-hour. I know you are reading this poem
standing up in a bookstore far from the ocean
on a grey day of early spring, faint flakes driven
across the plains' enormous spaces around you.
I know you are reading this poem
in a room where too much has happened for you to bear
where the bedclothes lie in stagnant coils on the bed
and the open valise speaks of flight
but you cannot leave yet. I know you are reading this poem
as the underground train loses momentum and before running
up the stairs
toward a new kind of love
your life has never allowed.
I know you are reading this poem by the light
of the television screen where soundless images jerk and slide
while you wait for the newscast from the intifada.
I know you are reading this poem in a waiting-room
of eyes met and unmeeting, of identity with strangers.
I know you are reading this poem by fluorescent light
in the boredom and fatigue of the young who are counted out,
count themselves out, at too early an age. I know
you are reading this poem through your failing sight, the thick
lens enlarging these letters beyond all meaning yet you read on
because even the alphabet is precious.
I know you are reading this poem as you pace beside the stove
warming milk, a crying child on your shoulder, a book in yourhand
because life is short and you too are thirsty.
I know you are reading this poem which is not in your language
guessing at some words while others keep you reading
and I want to know which words they are.
I know you are reading this poem listening for something, torn
between bitterness and hope
turning back once again to the task you cannot refuse.
I know you are reading this poem because there is nothing else
left to read

there where you have landed, stripped as you are.

some things in life are pretty :)

pretty flowers

Friday, May 15, 2009

hamlet on fb
omg this is so amusing

no man's land

sorry on a blackadder goes forth kick now...
oh yeah that song into the dark was sent to me by abby :) it's really really nice!!
i especially like the bit about "now i won't be stuck on qns" or something hahaha

i think next yr i shall buy a super big desk from ikea or something with ALOT ALOT of space.... highlighters and flashcards keep falling offff

yeah we're also going to buy gamess like jenga (heh surgery hand stability training) and a wiii and a piano?! hahaha well i don't minddd at all! my flatmates can fill the flat with beautiful music no probs at all :) and oh yeah a COFFEE MAKER. NOW I JUST NEED TO PASS FIRST YR.

only in the dark

In The Dark
The raindrops fall incessantly
Each time I think the sky's letting up
There seems to be another cloud
Bringing the dark
Coming right at me.

So often I can't see the road ahead
the blinding headlights round then go round again
Suddenly I fight back
Don't need to strive
And I realise I am rising and flying

It's only in the dark when I can seem to see
I learn to hear your whisper that's been guiding me
Reach out for the handthat bears the light
So my step is right
Only in the dark
Only in the dark

Now each day's a step that's lighted up
and the questions asked won't make me stuck
cos I know no matter how I feel
that this is real
and I'm slowly getting to a place where

it's not only in the dark where I can seem to see-chorus-
so let the shadows come
let me run into your arms
where I can feel the warmth of your touch
leading me on

oh now it seems to be that - chorus-
last night only did millenium development goals and some social care waffle. oh and comparing the nhs and the pluralist private insurance scheme in the usa. (which is gd cos no waiting lists but bad cos u only have choice if you can pay and over medicalization or something due to increasing litigation) the nhs is comphrehensive universal & free @ the point of use. excellent it wasn't a total waste of time sleeping at 4am... unfortunately today has been really slow like a snail having bradycardia or sth.

oh yes happy birthday adam!! if you read this! :) may you have an amazing year doing lots of outrageously cool things if you are so inclined.

today - doing really random bits of unit 8... technically i'm on schedule since I WAS supposed to do unit 8 today heh but everything in between... urgh. ok I did the cancer in africa thing, and some steve platts lectures

okay for the funding thing, it all comes from the scottish parliment, from westminister or something... there's a scottish health executive, and like the minister of health will divide up the funds and check that policies are carried out?! and there are scotland wide things like NHS 24, NHS social care, ambulance services. and then there's the dunno how many, either 12 or 24 NHS Health Boards (i think Lothian is just one of them) and they are more regional. something like that anyways.

priorities - there's macro meso micro. meso is like the lothian-wide thing. like the lothian joint fomulary. regional at any rate. macro is like national. micro is departmental or case by case.

in rationing, either you give
- all services to a limited number of people OR
- a limited number of services to all people

principles of rationing
1. needs - on basis of medical & health need not ability to pay
2. equity - equals - pple in same situation --> treated equally
- no discrimination on grounds of employment status, family circ, disability, age, race, sex, social/ financial status/ religion
3. effectiveness - extent to which intended effect achieved? additional length of life, contribution to well being pt of, urgency of treatment.
4. cost-effectiveness/ efficiency - compared to resources used eg time labor equipment material. impact/ unit cost. value relative to other treatments
5. QALY's - estimate extra life of yrs gained from intervening BUT adjusted for QoL in these years
6. pt choice - gets to choose btw treatments of sim efficiency

5 ds of priority rationing
1. denial - like refusing to give an elderly person treatment (well personally not really ethically right right? the chinese story about the rope of ash as well! hai ok nevermind can argue this forever. from hnop we learnt that old people definitely experience discrimination in hospitals too and that's just NOT GOOD *cough rice bowl story*) or refusing to give ultra - orphan drugs (helps <1000>10o,000. eg herceptin
2. delaying like waiting lists for hip operations
3. deterrance -social/ economic/ psychological barriers like charges for prescriptions, centralization for some treatments - deter pts from seeking medical care (?!! that's quite odd, maybe they mean for those pple who are like the wellworried or sth, who incidentally make a lot of use of health checks in health promotion ;p)
4. deflect - gp as gatekeepers, refer old person for local authority services instead of keeping him longer in hosp, self care, like over the counter medicine, cam
5. dilution - shorter hosp stays, less skilled nurses, cheaper drugs (personally this doesnt sound tooo awesome but i'm sure they know how to do it properly)

yeah i know no one wants to listen to me regurgitating facts anymoreee so i am forced to do it here haha. sorry to anyone who came here wanting a break from exams lol. if i continue telling pple random facts i will have no friends anymore heh.

ok anw i cheated and half of this is typing to remember, ie it's not all me pulling rabbits out of a hat, and the facts dont live in my brain yet. THEY WILL SOON though, or at least for the duration of the papers hopefully...


i'm stressed beyond imagination, feel like i don't know anything and there's no time
i dont know how best to plan my time between now and the exams
i don't know how or what i can do to help myself, i cant even SCHEDULE a way to finish everything

the good thing is, i do know -some- things
lol. im really sorry if i seem to be showing off btw.... i dont know its just my way of remembering stuff...i'm sure u guys understand right?

gah i dont like staying up late cos i always eat alot. everyone's gone back now and i've eaten 2 apples and bought a drink from the vending machine. good one. oh well the run just now was awesome. seriously the weather was good and i did interval training and it was just really nice :)

i really don't know where to go from here.
on a separate note, bones and joints is a really interesting module. if only it didn't have to come with so much random exam stress...

no idea how or if i'll pull through this. no idea if i'm going about it the right way. it's so cliched to angst about exams by now, saying it has no effect. the person i'm saying it to won't know if i'm really expressing my true feelings or saying it cos i have nothing else to say and everyone generally is stressed now so it is like a Common Factor.
equally, everyone is stressed so say for what.

i don't know lah.
maybe tomorrow will be a better day, but i wouldn't count on it.
tonight i'm going to try and finish the millenium development goals & then sleeeeep
tomorrow - revise anatomy, the horrible bleeding disorder thing i had no idea about today, plus finish s2. hilarious.
saturday - revise respi ESPECIALLY microbio

Thursday, May 14, 2009

in no man's land

Blackadder: Now, where the hell are we?
George: Well, it's difficult to say, we appear to have crawledinto an area marked with mushrooms.
Blackadder: (patiently) What do those symbols denote?
George: Pfff. That we're in a field of mushrooms?
Blackadder: Lieutenant, that is a military map, it is unlikely to list interesting flora and fungi. Look at the key and you'll discover that those mushrooms aren't for picking.
George: Good Lord, you're quite right sir, it says "mine". So, these mushrooms must belong to the man who made the map.
Blackadder: Either that, or we're in the middle of a minefield.
Baldrick: Oh dear.
George: So, he owns the field as well?


Baldric: "You know, the funny thing is, my father was a nun."
Blackadder: "No he wasn't."
Baldrick: "He was so sir, I know, cuz when ever he was up in court, and the judge used to say occupation? he'd say none."

- typed up trauma and half of paeds ortho lectures
- read whole of unit 7
- lots of cartilage, cv anat, cv physio discussion...

ok it looks like quite little. it probably is.
- aim to do shoulder anat (i completely skipped over it last time...)
- unit 6 - occupational health etc
- unit 7 (getting a little too ambitious here...)
- discuss cv with the rest
- ventilation-perfusion & ecg discussion during pbl was really good i felt :)
- and the sporting injury lecture was quite interesting!! at least the 2/3s of the lecture i actually made it for...

so so tired.
haha just feeling contemplative today, it seems like a day for slowing down and thinking, not by choice but i think my mind is just needing a break from thinking about studying, very very badly..

so tired ><

with some luck, the things i've underestimated will sort of balance with those i've overestimated, and everything will be fine.

i want chocolate coffee beanssss

something has to be said

but WHAT is another thing altogether. All I can say is, it's really nice to feel friendship and love (platonic) enamating from people. It really is. It's nice to laugh about things and be able to go to people with your problems even when we're all stressed out enough as it is. It's lovely to stay up til 5am and groan and moan over studying and quiz each other, to walk to school late together =p But for every good thing, there will be some bad stuff. I don't like talking about the bad stuff, cos it's bad.

But oh, it is so very bad. For every good friend who cheers you up and whom you can attempt to cheer up by listening to them, buying them chocolate, etc, there are some surely who dissappoint you. It's happened so many times to so many people, me included, that I don't even bother to count anymore. It isn't irreversible. Thank goodness for that. There are people I have fought fiercely with (heh like with ZMY over projects... and just even random arguing in the canteen right before a's...), but whom I now get all excited to talk to, but there are people who used to make me insanely happy, whom I have blocked on msn, sent angry emails to, thought unspeakably angry thoughts about.

There are people not worth even thinking about that I have written poems for, lyrical poems befitting beautiful situations that were only created when I looked back with hindsight. There is a bus-stop at home that I cannot fail to cringe inside whenever I pass it, because it has been like a conch shell on the beach, an empty shell, a bombshell to me. Obviously, none of these are what I refer to. But I won't refer to what I am referring to.

I just want to say for myself and for anyone who might be sad in any way, that it's cheesy and wrong half the time, but the good friendships make the bad ones worthwhile. That sometimes a friendship might hit the rocks, but when it is reignited it can do great things. The person who helped me get through a lot of my junior college years is the same person I sent angry emails to. Okay this is grossly out of context, but it suffices. And if it just gets snuffed out like a lousy candle from the bargain store... then honestly, does it even matter? It obviously wasn't made to be a relightable candle. It obviously wasn't meant to set off any fire alarms. And sometimes too, you're not willing to go out in the cold at 2am just for someone. But if you think it might be worth fighting for, then you have to do everything you can, everything in your power, to set things right. Either that, or wait for time and circumstances, so that everything falls into place.

Wednesday, May 13, 2009

Anatomy Memorial Service

In the middle of being unable to remember anatomical structures and the brachial plexus (If I can't remember it in the exams I think I'll just draw a tree and label the roots, trunk....), today at least we remembered the people who gave us the opportunity to learn from their bodies. I won't say too much because I don't want to detract from the solemnity of it, and any disrespect is sorely unmeant. But really, it is a great gift, and I am extremely grateful for it.

Today reminded me all over again of the amazingness of medicine, what an honour it is to be allowed to study it, and that I should stop whining and put my nose at least slightly near to the grindstone. It also made me think quite uncomfortably about mortality, and send up many many prayers hoping that I can achieve things in life other than "slept in every class" and "made lots of lame jokes" and "likes coffee", and that I will hopefully be able to give life (if it is God's will) as a doctor in the future, and to relieve pain (give years to life, health to life, life to years, equality in health... aims of health promotion =p).

Tuesday, May 12, 2009

fragments of poetry

if you like my poems let them
walk in the evening,a little behind you

- ee cummings

the fish by william butler yeats

happy with coffee

How I feel at the moment

2 types ofbone growth actually... endochondral, like what's in this pic i think, and intermembranous. intermembranous is like just after birth/ during fetal development. eg between bones of the skull? endochondral is pretty much longditudinal as illustrated... starts with primary ossification after birth then secondary can happen any time later randomly (more or less)

random pretty picture. doesn't it look so serene.


Thank you so much, this is the best thing that's happened for ages, you have no idea. The affirmation was sorely needed I think. Even though it doesn't affect me directly directly, I can't help but feel all happy and cheery about it. YAY!!

True should not gripe in difficulties and only praise God when things go smoothly of course... but gah well it's human to not know how to cope with life when it stultifies you, and to look at the blue skies with renewed hope when happy things happen... I'll sort this out philsophically another time. Also despite great distresss, Strand 2 Unit 5 ie Health Promotion is progressing very slowly but surely. Something akin to the drift of the glaciers.


I'm reading my respiratory physiology notes now, they make me feel like i'm in alice in wonderland. SERIOUSLY. My logic is SO warped and roundabout -_- what time in the morning did I write these notes, 8am after not sleeping all night?!!

Right now the highlight of our lives is.... the prospect of studying in the meadows this weekend. Lol.


is probably the most positive emotion i can conjure up atm...

between lectures - osteoporosis & drugs to treat it (bisphosphonates - alendronate, oestrogen replacement therapy/ HRT, raloxifene - a SERM , parathyroid hormone (or rather a fragment of it, teriparatide) , calcitonin, vit D )

after lectures, took bus to the lovely hospital library, had rather cool yoghurt granola thing

finished anti-bacterials. it was quite a painful slog.

now, just woke up from a nap... it's 8pm and looks like the middle of the day.
need to do, in the Very Near Future ie 8pm to 10pm
1. finish up the heparin & warfarin things - like indications for them, side effects, low molecular weight heparin etc etc
2. revise physiology of breathing, obstructive & restrictive disorders
3. start (and finish?!) lung cancer notes
4. draw diagrams on cardiac excitation notes, readdd cardiac output

then shower & go microlab to reviseeee with the others... and hopefully do strand 2 unit 5 also.

1. run YAY 8-9am
2. breakfast, pick up my parcel :) 9-10am, do laundryyy
3. random stuff like a) hand surgery b) mech role of the skeleton 3) antimicrobial resistance
4. s2 unit 6
go pbl
finish pbl (hahahah)

Monday, May 11, 2009

D-Ala - D- Ala

am i the only one who finds this highly amusing?!! haha. i shall dapao pancakes more often, just swapped pancakes for a banana & apple.

the days are getting longer

LITERALLY as anyone on this side of the world knows. It's now 9pm and it looks like 6pm. But more sun = good, though HIGHLY DECEPTIVE. It honestly sometimes looks like you can wear a tshirt and shorts out. But of course...

Today - finished all the ECG minutae I was supposed to have finished goodness how long ago. Revised asthma drugs when I realised I couldn't remember any of them at all. Last night was discussing them with someone, and I proudly boasted "i know i know! for asthma you use beta blockers right!" person: "........." nah sorry folks it's bronchodilators, quite the opposite. Beta blockers like atenolol - BAD for people who have asthma!! Ran :) It was a really nice day out, wasn't too cold, and the run itself was superb. Some days you feel like you're running through concrete, but this was completely effortless (ok maybe I was running quite slowly at some points is why. but anyway... sometimes I run slowly and still feel like I'm moving through a swamp...)

Then made it for mass. I feel I must share the amusing sermon.
on the grapevine
"... he says he is the true grapevine, which means there must be a false grapevine. Or at least, a grapevine that wasn't up to very much"

Ohhhh wow I love this priest hahaha. but well on a more serious note, sometimes I feel rather like a grapevine that isn't up to very much lol. That just describes it perfectly. When he said that I immediately had this mental image of a really cute grapevine just bumming around suntanning (as all grapevines technically do but ohwells) and not I dunno doing greater things. Whatever the greater things are that grapevines can do, I presume become grapes and wine. Well anyway. Absolutely cute.

Oh and then there was this part about bad grapes - "sour grapes, if you will". LOL. Just LOL. I think I must have commited all the crimes that can possibily be metaphorized by way of grapes. Whoops.

The singing was really really good too. I know I've said it many times but hearing the same hymms I've heard all my childhood, that don't depend on catchy drum beats or pop song hooks, but just rely on beautiful choral harmony, lyrics that come from psalms or from amazingly prayerful nuns/ monks/ priests/ whoever else writes these things.... there's something in it, you know? Don't get me wrong, I like Hillsong, Casting Crowns, Lifehouse etc etc just as much as anyone else. But when you go right to the center of it.... I love all the rituals of the Catholic Church. I love how it stays so true to how Christianity began, how the hymns are so simple and pure and yet manage to evoke the same as the catchy pop songs do; maybe even inspiring awe. I like Christian pop quite a lot too, and it speaks to me, and is probably better than Linkin Park singing stuff like how when you're gone no one will care etccc emo stufff that I nevertheless listen to.

But really... please go listen to some hymns if you've never ever done so. They're just really beautiful and calming. And especially the sung parts of the mass.... I won't say anymore because truly I cannot do it justice. But I would just like to let it be known that I was happy today, singing all the Alleluias and Hosanna to the Highest and all the parts integral to the mass. And that despite my childhood rebelliousness towards Sunday School and my peers in it, perhaps mutual perhaps self-inflicted, I will never know, I am glad for my Catholicism, because it fits me and the way I relate to my religion. That said, I'm also really glad I found a place I can study the Bible, with lovely people who are God-fearing and love God. I did experience some fellowship in choir of course, which probably made me want to continue doing bible study... but it was just really random I think. It's good that I've finally found both fellowship and peace.

treatment of asthma (and really lame ways of remembering drugs)

Hi world, for your edification:

There are two main ways to treat asthma - quick relief for during attacks, and long term control medications
1. Quick relief
- short acting bronchodilators eg salbutamol, terbutaline (i guess Sally was at a mall and Terry went line-skating when they both got asthmatic attacks...)
- oral/ iv corticosteroids eg prednisolone (the treatment of asthma is predicated on this =p)

2. Long term control meds
- inhaled steroids - beclomethasone (oh how the meth beckons to be inhaled) , budesonide, fluticosone (i guess budding flutists need to inhale before playing a note...) it takes reaally long to get off meth/ learn to play the flute :)

- leukotreine inhibitors: monetelukast, zafirleukast, zileuton (monty & zafir weigh a zillon tons)

- long acting bronchodilators - salmeterol, eformoterol - open airways (takes v long to make sales/ write out forms)

- cromones - chromoglicate, nedocromil, ketotofin sodium (pple who live in glided cages don't needto get toto. instead they eat sharks fin soup)

- xanthines like aminophylline, theophylline - not used so frequently now(i give up)

to treat copd - bronchodilators, sometimes theophylline

oh dear. hahaha. sorry to have to subject anyone to that.

Sunday, May 10, 2009

Ok. I have now finished most of strand 1 at least once. Unfortunately, the stuff I did at the beginning was so long ago (like when the sem after Christmas started), that I can't remember any of it at all. like some parts of ecg. It's really painful like sorting through my half-made notes and trying to figure out what I understood and did not, what I now understand or don't, and what I remember.

AND I have not touched Strand 2, but I really need to revise Strand 1. The ETERNAL TUSSLE. When one feels GUILTY for studying and to deal with the stress needs to do all manner of random things. It would be amusing if I could say I finished off all of Blackadder whilst studying for one exam alone. Shame I watched most of Gossip Girl for last exam and can't brandish that trophy-like as well...

thoughts at 3 a.m

it may be contrary to everything to be so angry at some things. like go round being all love peace joy and then suddenly it just comes out in some pointed comment that makes what i truly think quite obvious. not that it isn't already, of course, but. seeing as it would be best erased and not flogged like a dead horse. but am i not entitled to these sentiments?

i don't actually think i could stand pretending on this count. i can pretend many things, apparently to very little effect, but how much effect won't ever be known unless i say ok here are all the times i told jokes but really felt like putting my head in the sand like an ostrich and people say, oh yeah, it was perfectly apparent. i don't think it's all that often actually. if i feel like sitting in a hole in the sand i'll usually go do it.

revision today thwarted by all manner of things, mostly my own dissipation. absolutely no idea why. i did do some drugs revision, learnt the drugs for tb, sorted out some random ecg stuff, so all is not lost. just a very big part of my soul, but i had to let it go. i thought i had come to terms with it, but apparently not. absolutely fantastic run after pbl on friday, i felt like i had all the time in the world to run so that was really freeing. of course, it was a delusion, and i hadn't. oh well.

i think it's all very good to just study for the love of medicine, but the love of something won't keep you going when things get tough. what will is the shining idea of doing well. but i am tired of chasing that impossible ideal all these years and beating myself up about it mentally if i didn't meet that, which is quite often actually... i just want to enjoy studying what i love studying. but oh goodness it gets tough so often. tough as in... you just want to go chill out. not really like impossible to grasp concepts. just impossible to grasp them until the exams come around. they keep slipping out like eels that know they're going to end up on a dinner plate soon -_-

Saturday, May 9, 2009

wrestling with amazing amounts of sleep debt (slept at five this morning...), and trying to decide whether i should force myself to cosy up to bugs (and even so, the positive ones, or the negative ones?) or delightful drugs? they're quite useful drugs actually. but my mind is just SATURATED with thinking. i need to unwinddd and not think for a while.

Why oh why did I miss all this reflection, when I was happy and carefree not too long ago? When all I had to think about is whether I should go for this dinner or that dinner or if I should go running in the Meadows or should I come back and watch tv on my laptop? When the major decisions were like, which color highlighter to color my anatomy drawings with, or which tv show I should watch? Okay obviously all this is gross exaggeration. But you get the idea. I was beginning to think my life was vapid and simple and I was forgetting how to think. The only thing I had forgotten was the angst that comes along with thinking. Why is it not inseparable?!!

Forgive any inanity please. I write what occured to me as I waited by the traffic lights outside the gym. That's quite symbolic isn't it. Traffic lights. They did eventually turn green, btw. Evidently I should take that as a positive sign. lol.

From blackadder the third:
"Your father now thinks he is a small town in Lincolnshire."
"I wish my son to marry this rose bush"

[in reference to McAdder, Blackadder's Scottish cousin]
Baldrick: He's the spitting image of you.
Blackadder: No, he's not! We're about as similar as two completely dis-similar things in a pod.

Blackadder: Oh, God. Fortune vomits on my eiderdown once more.

Baldrick: Morning, Mr. B. Blackadder: Leave me alone, Baldrick. If I wanted to talk to a vegetable, I would have bought one at the market

[Referring to a suicide pill they have both been given, after being captured by French revolutionaries]
Baldrick: I'm glad to say you won't be needing that pill, Mr. B.
Blackadder: Am I jumping the gun, Baldrick, or are the words "I have a cunning plan" marching with ill-deserved confidence in the direction of this conversation?
Baldrick: They certainly are.
Blackadder: Well, forgive me if I don't do a cartwheel of joy; your record in this department is hardly 100%. So what is it?
Baldrick: We do nothing...
Blackadder: Yup, it's another world-beater.
Baldrick: No, wait. We do nothing... until our heads have actually been cut off.
Blackadder: And then we... spring into action?

Blackadder: Stick the kettle on, Baldrick
Baldrick: What? Aren't we going to France?
Blackadder: Of course we're not going to France! It's incredibly dangerous!
Baldrick: Well, how you gonna win your bet?
Blackadder: Simple, Baldrick. By the use of the large thing between my ears.
Baldrick: Ohhh. Your nose.

Prince George: Perhaps this disgusting fellow is some sort of blessing in disguise.
Blackadder: If he is, it's a very good disguise.
Prince George: After all, did the Lord not send Moses a lowly earthworm to comfort him in his torment?
Blackadder: Nope.
Prince George: Well, it's the sort of thing he might have done.

Friday, May 8, 2009

ok although it seems like i have done NOTHING all day, i have done anat of the elbow & knee in the morning and osteoperosis after anat finisheddd

tomorrow - type up hand surgery & the skeleton (is there even anyth to type up -_-) and finish flashcards for anti-coagulants etc

anti-arrhythmics, antimicrobials

forgot what i wanted to do

Thursday, May 7, 2009

today was good because
1. breakfast was nice - muesli, grapefruit, eggg
2. i like hand anatomy
3. am touched by concern coming from so far away
4. i managed to go running!
5. bernice's email :) :) was nice to read that my tone is warm and lovely or sth like that hahaha thank you bernice!! you cheer me up in the most random times in the most random ways, like hiding behind the library shelves er discussing people's characters and agreeing on certain observations (ie bitching la oops but it was justified!! then that is, now the person is perfectly fine ahhh oh well lol. then was a bit annoying.) and like angsting about our h3 chem endlessly.

1. well, you know.
2. am having the WORST stomachache in all of history. this ranks up there with the time i had gastroenteritis and forced david to go with me to a&e at midnight coz i thought i had dengue (lol)
3. hardly any study done, waaay behind schedule. note: its not really just -that- also the stomachache and general exhaustion
4. didnt go for expected nice lunch i was rather looking forward to. i know it was my decision but even if i had gone i dont think my morals would have forgiven me. yes self-righteous but sometimes you just have to put your foot down, some things are just unforgivable.
5. people are upset :( i don't know how to cheer them up and i really feel very very bad for them
6. __________________ which is rather -_- well i tried. but really there is only so much you can do while having fish thrown in your face.

all this in one day is quite. erm. yeah. even one of them would fell me on a usual day.
6 is particularly upsetting because, hi universe, some things are uncalled for, i can live without this truly i can. ok i can live without all the others eg stomachaches, horrible inevitabilities, but these are logical progressions - everyone's got to face the final trial and i guess pms - cramps/ maybe i drank water from a tap that wasn't that clean or something, hence the horrific pain, who knows, at least there's basic logic there. its not great but better than like say flying fish coming out of clouds...

i should stop here and drag myself through some more anat, then sleep. sincerely hope tomorrow will be better. but - it could definitely have been worse today so i'm thankful for what little good there was, really and truly.

Wednesday, May 6, 2009

that said

songs really can move people so much. i want so much to post this set of lyrics, but i can't for fear it would expose too much of my soul. honestly i don't even know why i bother with this faux subterfuge since it's not like it's the best kept secret in the world, and in any case it no more existed than Cotton Candy Fairy Land did. but.... I guess I do still retain a shred of pride and equinamity. Everytime I hear that song time just literally stops. Cheesy, but true. Hahahaha tonight the pasta was really cheesy. OK ANYWAY. Lol.

Apart from the angst I've taken to flogging like a dead horse reccently, there is literally no motivation within my being at all. I looked inside my soul today and I saw no incentive to study, beyond that of, the timetable says do this then. Oh. Ok do it. I see my friends brimming with enthusiasm, forcing themselves to stay awake to meet their targets... me? I'm sitting in quiet nooks and crannies of the campus trying to recapture the kind of quiet panic, but maybe just the quiet part of the panic, that I used to know so well. I'm trying to isolate myself in the middle of friends, for no reason other than that, the last time I did it, it worked wonders for my grades, well yes, but that's also because I STUDIED last time, I don't think the temporary friendlessness was the reason for doing well.

Anyway, it wasn't total isolation, I remember M and B and the paper ball fighting guys and S and N and so many people lighting up the darkness. And any isolation was only coz I couldn't study with them without talking hahaha.

Quite ironic that today Adam reminded me of how I basically locked myself up in the tower and ah 'did not want to party' heh. Symbolically I guessss. It was ironic coz as I was telling him I wished I had 'partied' more, I was sitting in this quiet computer area above the cafe, trying to find back what had worked once. But anyways. I'm partying quite a lot here, depending on how you define the word, haha. Yes if you count hanging out with friends, going out for dinner, etc :) No to mad drunken nights, obviously.

But whatever you're doing, whoever you're with, you need to find the motivation within yourself to go all out, meet time targets, shove facts into every orifice. I can't find it. All I can think of is how I want so much to run it all away. I used to find comfort in my running, used to motivate myself in my struggles by reminding myself that if I could run 21k I could do anything. Now it's just round upon round of green field that I must conquer or suffer dehibilating guilt. Every sunny day that passes by is a day I should have run but didn't. It's probably symbolic of something I don't know.

I need to study, I need to find back my groove. I'm so unmotivated it isn't even funny. Shouldn't have done so well in first sem :( But then I'd have spent the whole year bogged down by depression and feelings of inadequacy, rather than telling everyone how I don't mug I watch tv!! Well of course, I do watch tv heh, but I do like revise a bit. Unfortunately I've forgotten it all, except the contents of the tv serials. (DARN). So I might as well have spent ALL the time watching tv. heh knew there was something i'd regretted.

I'm running on empty now. I live in hope that if I run, clarity will come to me. New inspiration and encouragement will come to me as the wind blows through my hair. But everyday is thwarted by sleeping late in a huge effort to study, that usually fails miserably, or rain, or goodness knows what, just plain exhaustion. WHAT is exhausting me, too much tv?!

Ok gah angst. I must finish some of haemostasis before I sleep, hello again viscious cycle -_- Lols.

Tuesday, May 5, 2009

I have resolved to make this place worthy of coming back to to relieve happy memories. While this is rather contingent on the memories being happy, I'm sure I can supply some details to jolt rememberance, rather than clicking the back button to find the usual "i dont waaant to study any more... it's raining... i really really don't know what to do", UH, do I REALLY wish that to be all I remember of these halycon days?!

In any case, the Teviot cafe bar people must love me, I've visited them like three times today, GRR studying makes me snack. Well this is good, probably means my brain cells are working heh. Studying upstairs of Teviot, it's really nice! Doing coagulation which is thoroughly messy. Lunch at Vittoria tomorrow yay :)

dear world

if it doesn't rain today, i promise to go running!

last night, really could not tahan, so finished nob and nobility from blackadder the third, then watched house's three stories which i've been wanting to watch since FOREVER. then had 8 hours of sleep and bagel for breakfast :) still going to fail but life is good.

quite interesting to watch hugh laurie first be a fop of a prince and then a really smart and cynical doctor. lol.
zzzzzz i think i can forget about running until after exams. unless i become magically efficient between now and then, which is quite impossible

some drugs, lest i forget, making the not-running quite un worthwhile
heart failure
- ace inhibitors - captopril, enalapril, lisinopril
- angiotensin II --> AT2 inhibitors - losartan, valsartan
- aldosterone inhibitors - spironalactone, eplenerone
- beta blockers
cardioselective B1 - atenolol, metaprolol
B1 B2 non selective - propanolol - GIVES BAD DREAMS
- cardiac glycosides - digoxin
- diuretics
thiazide (bendrofluazide) , loop (frusemide, bumetamide), K+ sparing - spironalactone

- nitrovasodilators like GTN ie glyceryl trinitrate, isosorbide dinitrate
- hydralazine

ischemic heart disease
- better diet, no smoking, balloon angioplasty, stent, CABG

lower lipids for preventation (insert drugs for hyperlipidaemia, but for ihd they usually just use statins & fibrates)
1. statins - simvastatin, atorvastatin/ fluva/ prava/ rosuva (inhibit HMG CoA reductase, the rate limiting step in cholesterol synthesis)
2. fibrates - ciprofibrate - agonist for PPARalpha --> more transcription of gene for LPL-C thus LDL uptake more, also increased HDL formation cos helps apo AI, AII production
3. inhibitors of cholesterol absoption - ezetimibe, plant sterols/ phytosterols
4. nicotinic acid - decreases lipolysis --> less free fatty acids released. hdl goes down goodness knows why

stable angina
- statins to treat underlying a/s
- decrease cardiac work & o2 demand - nitrovasodilators - gtn, isosorbide dinitrate sublingual
- prophylaxis for chronic management
a) antiplatelets to prev thrombosis - asprin cox 1,2 inhib + clopidogrel - ADP antagonists
b) beta blockers - decrease HR thus o2 demand on exercise
c) Ca2+ entry blockers - prev ca from entering - less muscle contraction.
--> verapamil most cardioselective
--> nifedipine smooth muscle selective
--> dilthiazem intermediate

what's left (for cv drugs that is) - hypertension, alll the thrombosis stufff. but hypertension is pretty similar
if i'm not from its
a - ace inhibitors
b - beta blockers
c- ca2+ entry blockers
d- diuretics right?

thrombosis is arghhhh though

ohhh and nsaidss which we did today
basically aspirin inhibits cox 1 & 2, diff is the cox 2 receptor has a binding pocket at the side or sth about aspirin most decreases production of PGE2, PGI2 --> most impt in pain
other nsaids
- paracetamol
- diclofenac
-celecoxhib (cox 2 selective)
- prednisolone
- hydrocortisone
- betamethasone - potent
- beclometasone - gd for ezcema, asthma
- budesonide
- fluticosone
inhib where phospholipids become arachidonic acid w/ help of phospholipid A2

oh yeah dmards
initially - sulfasalazine
+ gold
+ hydroquinolone/ antimalarials
immunomodulators - methtrexate
tnf inhibitor - infliximab

........... i prob won't remember all these by tomorrow, oh well. thrombosis drugs tonight SO looking forward to it... luckily tomorrow is just disability workshop & pbl (1st session so no need to do any work for it whoo) and my day starts at 11am yay!! ok i am SO GOING TO RUN TOMORROW.

tomorrow - finish up thrombosis stuff/ hypertension? start pbl
wednesday - antiarrhythmia drugs
thursday - do ecg properly + sequalae of MI
friday - well i'm sure i have something on the timetable but can't rmb at all lol. oh yeahhh get anti-microbial notes back from j and do those...

TOO MANY DRUGS. next wk - cardiac output/ etc etcc, basically heart physiology

apparent im very methodical when it comes to notes hahaha thank you thank you. i'm just copying out lecture notes though in pretty colors lol. i give up, tonight = house episodes :) with luck it'll be something to do with bleeding disorders heh

Monday, May 4, 2009


what doesn't kill you makes you stronger. and as i dissociate everything from it absolutely nothing at all can hurt me.

1. don't read too much into anything

2. very long lasting sore throat

3. you don't need to prove that you are right to be right all the time.

4. choose people you go to for advice carefully. ie, the whole world is generally a bad idea.

5. when you do get good advice, try not to forget the epiphanies you get.

6. when you buy people chocolate, dont eat it. failing that, don't tell them you ate it. failing that, insert a strategic dramatic pause
me: hey i bought you chocolate!! -go to check out the scenery-
person: yay thank you!!
me: oh but i just ate it ah sorry
person: ....

me: heyy guess what i bought you chocolate
me: but erm i just ate it
person: HAHAHA

7. stop sleeping at 3am!!!
8. running everyday keeps you sane and should be done more often

prescription to cure allergy to life: run 8k everyday :)

Sunday, May 3, 2009

my friend just popped up on msn saying hey look at this song
which is called 'let go' -_-
to believe in the thing about no coincidences? that if someone comes up to you & for not lots of reason tells you something, it must mean something more?

recently i was trying to comfort a friend/ encourage the person to pray/ ask God for an answer. i said 'maybe God will say not tomorrow, wait 1 month'. my friend said oh wow hey maybe he's speaking though you maybe it'll happen in 1 month's time. hahahaha welll erm i would love God to speak through me but not sure to what extent i can promise that he is lol. in that case my only prob in life would be, when i talk to myself to find out what God is telling me, people would think I'm slightly nuts for talking to myself... haha

i think what i mean is it's really really hard to say what comes from where
oh but if one month's time then.... then pls remember me k! hahah.

anyway, more ruminations to come during HOLIDAYS, this is sooo not the time. on a brighter note i've discovered yummyy bagels from sainsburys, for like 69p?! omg omg i know what's going to be my lunch for the next few days already. it's like raisin and cinnamon yum. and on the way back from church saw the people doing the bupa run FELT SO JEALOUS DFLGHDFLH should have signed up i waaant to run. but is extremely ex for 10k?! like i can totally run 10k myself. but still. running is awesome.

oh sermon was pretty good. we are like sheep cos we keep on wandering off the path and need to be called back. TELL ME ABOUT IT man. ok ok cv drugs during dinner. don't do drugs, guys. they are thoroughly depressing. find your happiness elsewhere. trust me on this.
WHY are all my breaks so tiring

omg, it feels like i've been studying since FOREVER. i am SO ready for my four month holidayyy. but two weeks of torture + horrible exams left. argh. anyway for some reason going out and doing fun stufff is more exhausting than sitting in my room and watching tv on my comp with my notes spread out in front of me. now I WONDER WHY

lol that said, it was nice having birthday noodles yesterdayyy and catching up with everyone! if i can finish heart failure notes today i will be a happy girllll and alll the time spent on relaxing will be truly relaxifying instead of a point of stressss

the lameee flu joke
what do you get when you cross bird flu and swine flu?

when i told gill this
gill: oh geez
me: you mean, oh geese
gill: .....
me: prob the person who came up with it had a bird brain

LOL sorry to the person who did come up with it... its quite funny!! i couldnt resist. birds on the brain, at any rate?

OH OH and on our way back from dinner last night, at the part where the group usually parts cos some pple live nearer the back gates of the halls, we saw a, get this, fork in the road
heh. as in LITERALLY, there was a fork in the road, just as the road forks!! like fork, spoon, knife, yknow

good to know life has a sense of humor

oh ya i'm quite proud of this last declaration. i bought 2 of my friends chocolate cos they're so awesome. then i ATE IT MYSELF. and then... as you guys all know, i have a penchant for confessing things... i then confessed it to them. GOOD JOB.

Saturday, May 2, 2009

on the bright side, now if i do really well, everyone will be quite astounded.
unfortunately, i highly doubt i can do that. even 80 seems like a hilarity. oh wells.

on why it is so hard sometimes

looking at the sunny day through raindrops on my window... it's quite like how it feels often

perhaps, what makes it so hard is knowing God condones this. it's like you want to say "huh?! why?!" but he's not here to tell you "just kidding" or anything. it's REAL and you have to live it out. that's what's so upsetting i think because of the relative finality of some things. you just have to accept that it's the best for you. and it may well be but.... you just want it. i know this sounds dumb but it's the unfortunate truth... maybe i don't have to achieve full understanding in the next five minutes.

being understanding of something i dont want to be understanding about really gets to me. its like someone steals your cappuchino and you just say "oh its ok i forgive you and i totally understand why you did it". but ermmm actually NO?! well ok, coffee, vaguely understandable. BUT STILL. its just very bo tai bo ji.

haha. actually after dissecting the happenings in my life for so long i might just have talked some peace into my life. anyways, hope i can run later. and... darn, it's just hard.

whatever it is hopefully it is pleasing to God eventually. like the way i coped with things *cough shouting at people...* erm and yeah just make sure the next time round i do the right things. with luck i'll know what the right thing to do is next time.

thoughts at 2.30am

"everything will be ok in the end. if it's not ok, it's not the end"

it's really scary how we affect other people around us. okay. these few days have been trying but on hindsight, essential. well. i could have done with much less of the angst factor BUT i think i have become a better person for it. it will take a long long time to say thanks for the trials because well... they are TRYING. but. i can say thank you for making me stronger.

i'm not sure sometimes if i become weaker or stronger for it... but sometimes i just understand that little bit more...

today during bible study someone was saying it's like a lamp, so every step you take you see a little more... it sure feels like that

and no matter what it is, you can still follow Him. ah. hopefully.

it was good to know that i was not quite mad
and also that the situation is laughable
these are good things! they dont make me cling on to any shred of hope, but they mean that i don't feel crap or nuts or whatever.

and yes, i think i really need to believe in myself. i used to have immense immense belief in myself particularly when i had least reason to. because it was like, if i didn't, who would?! and then absolutely no one would believe in me which is rather a depressing thought. so yes now when things are smooth sailing (RELATIVELY speaking), i can't stop believing....

i'm not sure if this is the best time to face everything. maybe i should have postponed it till after exams. but i might have carried the hurts for years... so yeah better sooner than later. and i think its good, not to reveal everything to all and sundry, but to one or two people, and lay out what you did and how you tried to follow God and ask if you suceeded to do so to some like... generally agreed standards... or if you had some kinda nut logical reasoning (q possible with me)

really tiring week with a lot of anatomy. drugs to come this weekend oh joy. i hope birthday planning goes welllll.

a new week looms ahead and i hope it goes well :)
and thanks you guys for waiting for me. i was truly prepared to walk home alone somehow hahaha. v touched!! sometimes you wish things would happen and good things do happen just not the way you imagined it to you know... i really felt quite down for various reasons reccently, just wanted someone to tell me i was doing a good job being a good student good friend etc etc but i just NEVER HEARD IT its all very well to have friendly ribbing etc abt randomm stuff, i like it, but sometimes you need plain encouragement not hiding behind something funny. although i didn't hear it directly, i realized that what i thought was insults... wasn't REALLY insult per se. it's just a diff perspective on things really. don't take everything as the gospel truth... unless it REALLY is the gospel (note to self, buy bible..)

i realised that its the small things people do *cough muffins* hahahaha or just waiting for you to finish telling long stories or i dont know laughing at unfunny things that sometimes mean a lot. i'm sure there are more but i can't remember them, they just encourage you in the moment then leach into the general continuum of things.

it's not perfect, by no means. but i think this might be the wave of peace for now.

Friday, May 1, 2009

in the spirit of this being a place where i write down epiphanies about life/ insights from what wiser people tell me

it is important to guard one's heart, i feel.

this reminds me of the ee cummings poem "i carry your heart" :) which is lovely. but anyway... yes. there are so many pathogens out there just waiting to colonize different bits of your heart leading to 101 diseases and pathologies.

life has its challenges and it's impossible, well, nearly, to do everything you would like to do. but there is nothing for it but to try. i hope in these few weeks, i manage to do everything i would like to do, while remaining sane, and retaining my friends. i hope i don't snap at everyone i love and treasure until they lock me up in the toilet or something. i hope i don't bang on about any obsession be it running, blackadder, or spout too many randomities. i hope i don't bore anyone to tears, or do anything so outrageous they all decide to pretend there is a pretty waterfall on the ceiling. i hope i finish covering everything, and actually remember some of it. i hope i will have time and determination to run, because it really does keep me sane, and not suffer from the condition of medstudentitis, which makes me fearful to run because i -might- get osteoarthritis or some unnamable condition i've never learnt if i do it too much. i would rather die from osteroarthritis than depression or insanity, i think. well that's contentious, but anyway...

i hope i make the right decision about how to spend my holidays, and where to spread my soul and what renmants of goodwill i have left towards the world. i hope i never go back to the hate and angstfilled existance that characterised the past, but most importantly, that i never have reason to do so. that i will face with courage any opposition or insults, and not deserve them. that i will smile in the face of people who do not care one bit about how anyone feels, and try not to commit the same mistakes as them, in as much as is possible. i hope i don't say anything that i shouldn't, but also don't fail to pass on information i should, or a funny story that won't hurt anyone, but will lighten up peoples' days.

i hope i don't get too affected by events beyond my control, or overwhelmed by the universe's decision to give me so many trials all at once, such that i can't even bear to face anyone sometimes. i hope that the people many miles away, or just even those slightly nearer, will never wish to throw me into the oceans because i talk too much, or get emo one time too often. i hope that they will never judge me too adversely or label me with anything other than just being -me-. because it really isn't worth it getting worked up over stupid events or people. it's stupid to get sad over things and mope about; one should do SOMETHING about it, whatever it is, studying for exams or rowing boats or even just wanting to feel the wind in your hair again. no one ever said it would be easy. but cheesy as it may sound, the alternative, which i know only too well, is far worse. that doesn't mean i should settle for less, just because i am doing what i wish, everything else is unimportant... i still have to pass my exams and fulfill all my roles and keep sane.

so... it's difficult, but i ASKED FOR IT. and i can't wait for the day after exams when i can slum around watching movies, reading books, and when i get back, fill the house with music and paintings and laughter (not angst or pretended glee or obscure jokes, at unearthly hours). when i can watch plays, attend concerts, walk down memory lanes, let these people who have supported me through so much know how much i appreciate it, say thank you to the people whose friendships will be the benchmark for all my friendships ever to come, and whose awesomeness i'd always somehow taken for granted.

and to run round the smelly canal which i always used to think looked somewhat like paris canals ;p to dodge maids and dogs and old people. to drift into the national library at bugis with its basement glass walls, to hear the terrible choir sing and see if they've improved. to once again read God's word, to shed everything that i no longer want and to look inside my soul to see if there's anything i've learnt from all this.

and i'm sure there is.
i'm sure this will pass. but just - GAH. no words really. not because anything particularly !! but just the general shittiness of life. just now art therapy heh doing campaigny stuff for a was fun fun :) i really should have gone church on sunday. good one. oh goodness. this is a good lesson to learn: even when you get your greatest desire, it won't be smooth sailing.

on that extremely optimistic note, i'm off to learn about osteoarthritis

God please help me, Amen.


3 more days of AL! a much needed break cant decide if i shld just sleep. or do research. or study ecg. omg how how or do the mountain o...