Sunday, December 30, 2018

confidence/my hope is in the Lord

so i woke up this morning all ready to tackle EXAM STUDYING coz i only have ONE MONTH more left to this giant exam for which i am totally not prepared and which is really expensive. and someone remind me why i am taking the reg exam in yr 1 again? hahaha.

ok i know why, its becos i wanted to keep in touch with ed things during this 1 year away from ED, which is a really long time ok. but still. cant help feeling like ive bitten off ,more than i can chew (seems to be an eternal feeling hahah)

THEN i opened spotify and started playing my fav sanctus real songs and this popped up

the moment the music started i remembered all those days walking from the mrt to work (and nowadays walking down that long corridor into ot), feeling like i'm walking into the the lions den. the chords really make you feel like you're walking a long corridor at 6am into a lion's den HAHA

i'm definitely not a warrior, and altho i have mbbs (and pending mcem), there are definitely times i feel unqualified for what God calls me to do. although there are also times that i somehow got through a super rough call night and dont know how i managed to do what i did (cough SICU calls). and i know that it definitely was God helping me.

'so give me faith daniel in the lions den... give me a heart like david, Lord be my defense'
~

"Confidence" - sanctus real

I'm not a warrior, I'm too afraid to lose
I feel unqualified for what You're calling me to
But Lord with Your strength, I've got no excuse
'Cause broken people are exactly who You use

So give me faith like Daniel in the lion's den
Give me hope like Moses in the wilderness
Give me a heart like David, Lord be my defense
So I can face my giants with confidence

You took a shepherd boy and made him a King
So I'm gonna trust You and give You everything
I'll face my giants with confidence

~

my hope is in the lord - sanctus real 
Be still my soul, for the best is yet to come
Though the earth below is shaking
And I struggle to hold on
To anything that isn't bolted down
And I find that I am safe and sound
My hope is in the Lord

[Chorus]
And I am blessed beyond compare
To find my joy in things that last
Finding peace in who I am
Rather than my circumstance
I'd rather hear one simple phrase
From my Father's loving voice
Than to hear the praise of strangers
My hope is in the Lord


[Bridge]
So come and rest in the promise of His grace
That we are all just travelers
And our destination waits
For the pain you feel is temporary
But God is offering sanctuary
Our hope is in the Lord

~
"Changed"  sanctus real

I thought it'd be different
Was hoping by now
I would be closer
Have it all figured out
Been counting the reasons
Been feeling the weight
Of all of my failures
And every mistake

And though I cannot see
I know you promised me
You're making a new heart
Where the old one used to be

I'm gonna be changed
A little each day
Even when I fall I'll trust You when You say
I'm gonna be changed
By Your grace
You won't let me stay the same as yesterday
I'm gonna be changed

I look in the mirror
I see in my face
The pain that I've carried
Is being replaced
There's a brighter future
I see it in my eyes
There used to be darkness
But now there's a fire

'Cause the One who began a good work in me
Is faithful to make me complete
You're the Author, Perfector, my Hope and my Healer
The reason that I believe
I can change, oh I can change

~
10000 things to be improved, and it starts NOW.
how do i know i can change and become a better person - 'cause the one who began a good work in me/ is faithful to make me complete/ you're the reason that i believe/ i can change'


Tuesday, December 25, 2018

of christmas and fruitcakes

learnt alot from this christmas. in the middle of stress and lookin for spinals and gas induced dreams, there are presents under the christmas tree, tinsel, baubles, lots and lots of roast chicken and moments of fun and cheer. but there is also alot of stress, and not enough spinals, but ITS OK lets forget it all for one day or two. 
~
also been thinking of poetry now and then... the show YOU WHO FORGOT POETRY is most apt to describe this. sometimes, we forget poetry not becos we WANT to, because life comes at us in waves and on boats shouting lots of things and the poetry gets forgotten by the beach. but i dont think it is a BAD thing per se. (ok maybe one day i will need to defrost my heart and love again. but UNTIL THAT DAY, i think, i think, i opt out of the poetry. yes. sometimes i can write really nice poetry with good metaphors. but is it worth it, for the poetry? my artistic side says yes my brain says no there are a million other things to do). 

that being said, there is still alot to give thanks for, like my 5TH SPINAL (am very happy now still). and i know what i need to keep on doing (not slacking off like now). 

merry christmas guys! :)

Sunday, December 23, 2018

In the sea of doubt/keep your sails high/and ride it out

The wind will take u where ur meant to be
And when its over u will clearly see
~

Ive spent many hours pondering what is happiness and joy and such

And one thing i am certain of is that most things are just transient. not to sound jaded or what but it is true!! 

Only in God that one has even got the possibility of finding true happiness.

Well pple come and go that is true. But i also shld do my best to keep my friends around, not be a terrible friend as i know my younger self was. That being said everyone has ways of communication haha. For me i think whatsapp is easiest coz people are like all over the world or doing strange shift hrs (mainly me). 

Anyway, this past yr or so, d, a and bchow have been such a blessing to me seriously. (D and a for so many yrs alr!!). Eye was a slightly traumatic posting tbh coz of the massive learning curve and then the massive crowds but bchow made it so much more survivable. No one else can ever understand what we went through in that posting, coz they are all soooo pro at it haha. Eye noobs to the end haha. 

Anyway, all this is to say that, i shld be more worried abt exams in jan but im not because?! No idea why. I think im just super jaded and numbed out haha. Thank God i finished most of the other exams alr so there isnt like time pressure. Just super malu and expensive to not pass it. THAT'S all. That being said i still need to pass it by nov 2019 omggggggggg. So jan 2019 wld be infinitely preferable

I am trying to study but so tired everyday
Thank goodness for all the snrs tutorials if not i wouldnt study at ALL

Okok one month i have a small smodgen of hope

As i go back to emed next mth too, must keep my eyes on the endgoal - ie be a good doctor that God would be proud of, never leave any stone unturned, do my best for every pt. Its not abt the exams, not abt the quotas. Its the feeling that you have done the Right Thing

I know what i have to do to achieve that level of zen, get into that zone

And doing the right thing also includes seeing pts efficiently, i acknowledge. No point seeing 5 pts a shift but everyone else is battling massive crowds. If i have to stay back late to hit quota, ill do it! I mean i alr did that for 1.5yrs. Whats 4.5 yrs more. Hahahahaahah. It was defo worth it ok. Everyone kept telling me to get a life, get a bf, nurses tried to matchmake me with regs in an attempt to make me spend less time in hosp. But it workedddd and God also helped me to achieve my dream

Its like when i worked super duper hard as a ho and mo to thank God for helping me to pass med sch. The same thing applies! For granting my prayers FINALLY, i vow to be the best emed resident that i can possibly be. 

Thank you God, i promise to try my very best
And for the last week of anes, i will try to be the best anes mo i can be. I acknowledge my 100000 shortcomings but i can still try hahahaah

And dear God, please help me to get 4 more spinals...

~
You're here, you're here
I will never be alonee
In the same small room
Staring at the life ive chosen
Hopin the door's still open
Anywhere you are is sanctuary
You were paying cab fare making sure i made it home
I believed in my worst fears
You were never moving closer
You were only always here
You're here- nicole nordeman

Sunday, December 16, 2018

reflections on 2018

this edited version expresses rather well how this crazy (but intermittently fun) year has been haha. its funny how perspective of the same thing changes between my midyear reflections and how the year pans out at the end of the year. this version better appreciates the nuances of my waiting in the beginning of the year, not dissimilar to waiting for Godot, which turned to joy and rejoicing, and then back to real life - watching ecg rhythmns on steroids dance across the screens of life. but still very much depending on divine intervention to fix everything, through it all.
~

jan 2018
just plodding along in this time and place
bleary eyed mornings, taking the train home in the evenings like a quashed tuna sandwich
dreaming of mountains with wide open expanses, the first snow crunching underneath my feet, footprints in the snow, the salmon leaping up the rivers in the summers

feb 2018
I once saw a peek of the way in a taxi post night shift but since then I think I've fallen off the road so far and so hard and the winds and desert storms and life just came in and I haven't been able to find my way back

mar 2018
Indeed it is true... man can make his own plans, but in the end it is the Lord's way that prevails... and usually God answers our prayers in a manner FAR FAR BETTER than we could EVER EXPECT. (it also took a long time as when i was reading back my old posts, some of the posts were written like nearly 300+ days ago. that is a LONG TIME of waiting and i wont lie the time felt really long too haha

april 2018
two months more to go and i know God is with me. He is always with us in the darkest times, when we feel like we can't hold on anymore. He is with us through the night "you and i we will make it through/ make it through"

YAY I PASSED THE FRCEM INTERMEDIATE!


may 2018
i dont know why it takes so long for me to feel human after each call. last night was up at strange hours watching zdoggmd lol
and his tedmed talk on feeling like a zombie wearing a steth REALLY RESONATED WITH ME
but sadly as i stalk the corridors at 1am with my portable slit lamp... i dont even wear a steth LOL.
at least he has a steth filled with bacteria. i dont even remember when is the last time i took my steth out of my bag

june 2018
the me now knows - it is God that dragged me along in the snow all these years, to this start line. and He won't leave me here now. this is just the beginning and He will be with me for the next 5 years too.

i still believe in the goodness of God and yes it is amazing that after all these yrs i never lost my God. so going for a 3 call week now. see you guys on the other side! God will bring me through safely. i TRUST in Him.

~
july 2018

first week of emresidency!
~
So, I step to the edge and I take a deep breath
I believe that one day I will see Your kingdom come
And I wanna hear You say, "Welcome home my child, well done"

aug 2018
Its national day and im actually leaving hospital in warm sunshine!! Very very rare.
Grateful for the bosses peers nurses and rts in icu who have guided me through the 1st week. Esp for the rts!! Super invaluable. When the rts are nervous abt an airway u know its really a difficult airway...

sept 2018
walking out of cgh after literally living there for 6 mths felt very strange and epic for some reason - for a few mins - then i was too shag and sleepy, couldnt philosophize anymore then got into the cab and slept all the way home.

not forgetting, running to codes with D. Who would have thought we would level up from those nights spent at serene center mcD studying maths, to running to codes?! God's amazing grace and his foresight in providing me friends for the way never fails to amaze me. Thank u for being there and helping me to never lose my God.
~
All my life I longed to be a hero
My sword raised high, running to the battle
I was gonna take giants down
Deep in my chest is the heart of a warrior

~
something abt the first paragraph makes me think of running to code blues. #borntobeED


oct 2018
the most important lesson i learnt from anesthesia is this: being kind to the people around you, IS the most important and best thing you could do. i'm not sure if that is the lesson they meant me to learn, but i am very grateful to that one consultant who guided a stressed out, baby mo through an adult LP

nov 2018
the life well lived doesnt have to be a life well examined only through poetry. you can examine your life in a dimly lit atmospheric japanese hole in the wall restaurant surrounded by sake bottles  with copious amounts of green tea to wash away all traces of stress. and then the week will start again with gases, machines to be checked, or machines that self check. putting the whole ot to sleep inadvertently because of the way you hold the mask.

dec 2018
(on sicu calls) shant talk about how my innergeek ocd traits made me sit in front of the monitors all night staring at the strange ecg rhythms flying across the screens. that even the computer gave up reading and started calling it UNKNOWN ECG RHYTHM. you are telling me, computer.

something i have learnt from my 29 yrs of existance is that... humanly trying doesn't help very much, it's boats beating against the current but staying still. what usually works is pure DIVINE INTERVENTION

~
And when it's over you will clearly see
That the storm was only there to show you what it takes to believe

decompression

my precall prayer before my last sicu call: 
so dear God, please may my patients survive my last upcoming SICU call, may i do the right things, may i hand over accurately the things we ponder about all night. its impossible to have human considerations COMPLETELY out of the picture but at least, just help the pts survive the night. THANK YOU, very much gratitude, my prophylactic prayer.

did it work? UHHHH. well. i guess the patients all survived the night. me and my reg? not sure abt my reg but i woke up today post post call feeling like i had just run the stan chart marathon ytd. it was a very uh action packed call but somehow we managed to crawl out of it alive, so that is good, i guess.

yesterday also marked my last day of sicu, i had been really nervous prior to it starting, and worried about alot of things. but it turned out to be very similar to micu in some ways. i was also very lucky to get a nice team and had 2 really nice and friendly consultants. i also managed to set 1 central line and 2 intubations (bringing my logged intubation count to 16, think i did abt 20 so far since starting residency but didnt really start logging the anes ones until after the first week or so).

i still think i need abit more icu/critical care experience, which some can get from ed, and some from. ccu and maybe electives?? much much more to learn, this is barely scratching the surface

next up: back to OT, then christmas + new year, then back to ed!!
im a bit worried TBH since i havent done ED for 1 year, which is the secret reason why i have been torturing myself with all these exams - part b and c hehe so as to not forget ed stuffs! but at the same time, also really excited to be back for obvious reasons. and now i can intubate a bit more confidently, set central lines, set ventilator settings, set IA lines, do chest tubes, am totally way more useful in resus than just being an iv plug setter and computer documentator haha.

something emed taught me is that when we finally start following God's little nudges and soft voices telling us what is the right thing to do, then everything finally starts working out.

Monday, December 10, 2018

salmon

exhaustion post call, nothing new. i shant talk about how my innergeek ocd traits made me sit in front of the monitors all night staring at the strange ecg rhythms flying across the screens. that even the computer gave up reading and started calling it UNKNOWN ECG RHYTHM. you are telling me, computer.

or the whirl of morning activity to screen all the pts do the morning entries and present the entire icu, IT'S HARD, ive repeated that ad nauseum. i have no idea how everyone else does it so effortlessly. well its an open secret that i am not the fastest energizer bunny out there but dudes, it is IMPOSSIBLE unless u have really uninterrupted timing from 6am to 8am to prepare to do all that. if any major thing happens at that time then all bets are off.

anyway, call last night went a smidgen better than my first call. maybe experience helps, maybe my fervent, last minute, desperate prayers were heard last sunday and God helped to smoothen many things. like rather yummy salmon samurai and bubble tea. being on call with friends! lucy (giving me pantry advice on ecg rhythms), km, jane hehe. the best and sweetest ED con to the rescue when i needed something. (even the anes reg when i told her said OH MAN HE IS SUCH A SWEETHEART. haha). a nice reg who didnt scold me for calling her nonstop (i really thought abt what can i solve before i call the reg, sometimes, there is really just no choice.). i mean there was plenty of desperations and sweating and so forth but there were some salvageable parts of it and i managed to present my morning entire icu pts in a ???relatively coherent, non garbled (???) manner, or maybe the morning con was just nice.

so anyway now doing a million admin things.
part of me wants to learn languages and paint and watch kdramas
another part of me wants to buy all the books in the novena bookstore and learn all about icu and watch amal mattu ecg videos nonstop (hypomattuism hehe). and practice for exam all weekend with my friends "~i get by with a little help from my friendssss"

so its a bit of a disjunct but anyway something i have learnt from my 29 yrs of existance is that... humanly trying doesn't help very much, it's boats beating against the current but staying still. what usually works is pure DIVINE INTERVENTION

so dear God, please may my patients survive my last upcoming SICU call, may i do the right things, may i hand over accurately the things we ponder about all night. its impossible to have human considerations COMPLETELY out of the picture but at least, just help the pts survive the night. THANK YOU, very much gratitude, my prophylactic prayer.

Saturday, December 8, 2018

Post post call

Im having severe post post call syndrome. Practically crawled home after icu call ended yesterday. Prob becos the call literally went off with a bang and then i had to do all the morning entries n screen all the pts and present all the icu pts. Which i have to say i did not do with exactly perfect eloquence but at least the listeners were nice abt it. And the reg was SO nice all night, i was so incredibly lucky to get her.

Ok at least all my pts survived, i also made it out alive (i seriously wondered about making it out alive at 755am when i was rushing thru my prep for am rounds). And i know how to prepare better for the next call! The medical bit is ok. Micu taught me really well for this. Heart cgh micu!!! Its the having to present the whole icu and magically know all the am blds when i spent 5am to 730am firefighting and all the bld results come out at 7am that was difficult but UH hopefully next call will be marginally better (??).

Got a spot for exam in jan. Which omg!!!! 2 mths more to prepare OMG. How is it gonna be possible i havent the faintest clue. But i am grateful to the mock osce the other day for making me mug at least a little bit and the snrs for tuts. At least im not completely clueless.

Sunday, December 2, 2018

shooting star





You by the light
Is the greatest find
In the world full of  wrong
You're the thing that's right
Finally made it
Through the lonely
To the other side
You said it again
My heart's in motion
Every word feels like a shooting star
I'm at the edge
Of my emotions
Watching the shadows burning in the dark
And I'm in love
And I'm terrified
For the first time
In the last time
In my only life
And this could be good
It's already better than that
And nothing's worse
Than knowing you're holding back
I could be all
That you needed
If you let me try
You said it again
My heart's in motion
Every word feels like a shooting star
I'm at the edge
Of my emotions
Watching the shadows burning in the dark
And I'm in love
And I'm terrified
For the first time
In the last time
In my only
I only said it 'cause I mean it
I only mean 'cause it's true
So don't you doubt what I've been dreaming
'Cause it fills me up
And holds me close
Whenever I'm without you
You said it again
My heart's in motion
Every word feels like a shooting star
Watching the shadows burning in the dark
And I'm in love
And I'm terrified
For the first time
In the last time
In my only life
Life
Life
In my only life

~

fall for you - secondhand serenade 
The best thing about tonight's that we're not fighting Could it be that we have been this way before? I know you don't think that I am trying I know you're wearing thin down to the core This is not what I intended I always swore to you I'd never fall apart You always thought that I was stronger I may have failed, but I have loved you from the start ~

hahah terrified describes it best
what is IT is another question by itself
i only knew these words and music are beautiful
even the words itself without the music has a lilting quality to it

the secondhand serenade song is beautiful too but it has a quality of a past tense to it. a sense of feelings i might have felt in a past life too far away to remember. i think that in that mythical past life, i might not have fully understood what it meant to love, i think i understand it a little better now. to be very honest with myself, i have never really properly loved someone as per below. but if ever i love again (if my imperfect loves are counted), i will choose a love where i can do this a little better.

"Love is patient, love is kind. It does not envy, it does not boast, it is not proud. It does not dishonor others, it is not self-seeking, it is not easily angered, it keeps no record of wrongs. Love does not delight in evil but rejoices with the truth. It always protects, always trusts, always hopes, always perseveres." 

whereAS the song terrified, apart from perfectly summing up what i feel everyday on the eve of new postings, every new posting, no matter how many pgy +++ i become haha, also seems to sing of new things.

You by the light
Is the greatest find
In the world full of wrong
You're the thing that's right
Finally made it
Through the lonely
To the other side

~
at the end of it all (what is IT), i think life is like one big video game. clearing each level, each battle. battles yet to fight, i'll deal with them when they come. for the battles fought and won, for the companionship, thank YOU and YOU and YOU (too numerous to name). thank God for sending various people at various times. 

thank YOU for the continued shared PTSD ramblings (not sure if its a good thing whahahaha) and for keeping me updated on my fav topic of helis. i knew from the start that anyone who loves gatsby is a friend to keep for life hahaha

Memories

Memories of the alhambra the newest kdrama on the block is making my weekend!!

Also having learnt spanish for a few mths i actually understand some of the train announcements. And spain is sooo beautiful. It really feels like im playing a virtual reality game in spain

That said bicu and nicu (real life) has been alternatively fun and chill, much thanks to the nice cons and peers and nurses! Hahahaha meeting old friends is a plus too. Altho it also reminds myself of my past self which... i think i ?levelled up ?evolved alot the past eight years, something which i realized very acutely this past week, which is fantastic! Evolution yo.

Alot of this is thanks to emed. Emed has made me a much better person and made me much more proactive, independant, efficient, a team player, and reccently with all the resus sims and osce practice, team leader skills. What makes me most confident is that i know my team members are my friends so ive got backup always hehe. Like in my weekly ed basemend premed sessions then im always chilling with z and i was telling her all abt our exam resus sim practices and how i guess leading resus is a difficult skill to learn but its fun and we are getting better with practice and she said "dont worry! Just be firm! We will listen to u! Cant wait for u to be reg leh" hahahahaha so kind of her, it is at least 2.5 years more though. Anyway it removes alot of the fear for me, that pple will take it the wrong way if u are too fierce or sth. And we had an icu sim with nicu nurses which was fun coz got to know them better!! And ok i wasnt the leader coz it was an anes icu sim but ended up helping a lot and realized that i can sound firm and yet not like a dictator and also firm enough for my teammates to follow my instructions hahaha. It was great fun and great knowing the simulation practice is working somewhat hehe.

Ok off to do some very delayed admin things oops. And then revise icu stuffs (stresssss). And study for exam. What exam?! *ignorance is bliss

my hope is in you

my hope is in you - aaron shust I meet with You and my soul sings out As your word throws doubt far away I sing to You and my heart cr...