Ah Ma, you've got to be strong!

Jamie and I sat outside the oncology clinic, patiently waiting for the arrival of Dr. Teh.

Suddenly, the gynae-oncologist, Dr. Mary, who isn’t really fond of medical students, called us into her clinic. She needed us to be translators and convey her messages to a 75-year-old lady with recurrent endometrial carcinoma (cancer of the uterus) and her daughter, who understood only Mandarin and Cantonese. Heh. That’s when the ability to speak multiple languages stands you in good stead.

The patient was pale (probably anaemic) and emaciated. The tumour was growing at an alarming rate. In view of the advancement and aggressiveness of the cancer, the prognosis of the patient’s condition was rather poor. It had spread to her vagina, it seemed, and was on the verge of distant metastases to other parts of the body, namely the kidneys, bones and lungs.

Surgeries and radiotherapy had previously been done. And the patient was given 2 choices – giving chemotherapy a try or rejecting any sort of medical intervention and let nature take its course. She had reached a stage where the disease was incurable. Chemotherapy would merely have a 20% chance of shrinking the tumour and delaying death. Meanwhile, it’d torture her with such adverse side effects as cardiotoxicity, nephrotoxicity, myelosuppression, nausea and vomiting. And eventually, she’d still die.

Cruel huh?

“Ah Ma, cheer up, ok? Don’t think too much la. Just do whatever you want now. Eat whatever you want. Be happy lo. It helps lessen your pain de.”

“ 顺其自然咯!” lamented the old lady.

Tears pooled up in her daughter’s eyes. She tried to put on a smile that failed to shield the utter grief and helplessness in her. My heart was filled with sorrow and sympathy.

The length of the remnant of the patient’s life is now entirely in the hands of God. Nothing can be done at present, I guess, other than praying for a miracle to occur.

Nevertheless, Ah Ma, you’ve got to be strong, no matter what happens !

Dirty thoughts in the clinic

Dr Teh: So, what’s the case just now?

Me: Ovarian cyst. Scheduled for laparascopic cystectomy. Right?

Dr. Teh: Hmm. Tell me the complications the woman might develop.

I was not the least flustered. When I was in 2nd year, I computed the complications of ovarian tumours into my mind, using a mnemonic. Confidently, I answered.

Me: Erm. Torsion. Rupture. Haemorrhage. Malignant change. Infection.

Dr. Teh: Tell me a few things that are suggestive of malignancy.
Me: Elevated serum levels of CA 125? Loss of weight and appetite?

Dr. Teh: My dear, you don’t jump. When you want to present things, present them in order. Firstly, history. Secondly, physical examination. Then only you come to investigation and so on.

Me: Oh! Ok lor.

I spent the session allocated for ward work today in Dr. Teh’s clinic with another course-mate. It was indeed an honour to be with him. The 2-hour session was educational and absolutely entertaining. He taught us lots of stuff, which was something not every specialist or medical officer would be willing to do. Can’t blame them. Perhaps their workload is so heavy that the sight of a bunch of inquisitive medical students disrupts their mood.

And guess what? Dr. Teh attracted me. Hehe.

He is an obstetrician and gynaecologist in his mid 30s. A little bit fleshy, but neither too slim nor too fat. Someone with the body mass index (BMI) of 26.5 Kg/m², I would say. Just nice. He is not stylish. His hair is neatly combed, just like other geeky- and nerdy-looking doctors in the hospital. Yet, that does not obscure the authentic beauty of his face. He’s handsome. His smile mesmerizes me. And I bet he will look damn appealing if he were a little bit slimmer, or muscular. I actually fantasized about making out with him when I was in the clinic.

Apart from that, he does not speak Mandarin. A typical banana. Only did I realize that when he was removing the ring pessary from the pussy of a Chinese woman with uterovaginal prolapse and started conversing with her in Malay. And I was asked to explain to him a few Chinese words which he did not understand.

Anyway, I really do appreciate him for his humility and willingness to teach. And I’ll find out whether or not he is married.

They make the ward a beautiful place

As I draw near them, some of them pretend to sleep. Some of them give me a derisive smile and the please-fuck-off look upon learning the fact that I actually am just a student. Some of them appear to be delirious and uninterested without bothering to answer any of my questions. Some of them get fed up when I am already halfway doing the history taking. These, are what happen in the ward. It is typical of the patients to be impolite to medical students.

It hurts at times, to be scorned and treated with hostility. Really.

Nonetheless, there are patients who make me feel damn great about myself. They are people who guide me how to insert my 2 fingers into their vaginas, people who greet me with an encouraging smile despite my failure in taking their blood (by venipuncture), and dying patients with valvular heart disease who allow me to appreciate their cardiac murmurs…and so on.

I still remember that pleasant and friendly woman with cervical carcinoma in pregnancy who died 3 days after I took her history. I still remember that 46-year-old nulliparous woman with an ovarian mass the size of a football and whose malignancy had yet to be confirmed, that agreed without a second thought to become the subject for our bedside teaching. That warm and chatty lady immobilized by paraplegia in the orthopaedic ward. That amiable boy with atrial septal defect complicated by thalassaemia major in the medical ward.

These are people to whom I feel eternal gratitude and who make the ward a beautiful place I enjoy going.

What I'd tell an angel

My mom called last night.

Me: Why am I so big in size? Did you have gestational diabetes mellitus (GDM) when I was in your womb?

Mom: I don’t know.

Me: Did you give birth to me by Caesarean section?

Mom: No. You came out from down there.

Me: Was it painful? The obstetric patients in the hospital look so painful when they’re in labour.

Mom: Of course it was!!

Me: You still remember?

Mom: Of course!! If you ever treat me badly in future. I will….

The hospital is a living hell where people go through immense sufferings, emotionally and physically. They say it is a place where you pay off your debts that you owed and get punished for the sins you committed in your previous incarnations.

Cancers devour your flesh, make you cachexic, deprive you of your zest for life and eventually dampen your determination to move on. Renal failure makes you a candidate for haemodialysis and significantly deteriorates your quality of life. Chronic diabetes mellitus puts you on a higher risk of developing stroke, decelerates the healing process of your wounds, blurs your vision and so on. Stroke may rob you of your ability to speak and lead to contralateral hemiplegia and sensory loss or visuo-spatial deficit, depending on where the infarcts in your brain are.

My mom plays a vital role in making who I am today (except the gay part).Had it not been her unconditional love and support, I don’t think I would have survived all the hurdles I have come across. I’m scared that someday, my mom will end up in the hospital too, crippled by diseases and haunted by the fear of dying. I hope that she’ll always be blessed with good health and if possible, longevity. This, is what I would tell an angel, if he offers to honour a wish of mine.

Mummy, I love you. :)

A token of appreciation

I forwarded an sms to Leo last night. He replied.

Leo: Di ar. So late still haven’t slept yet ar?

Me: I liked someone. But he got bf ady. I feel a bit sour. About to sleep lo.

Leo: Oh. Too bad. Don’t worry. I always face this problem. In the end just forget it lo. Or else it’ll make u really hurt. Really…

Me: Your msg makes me smile at least. =) Looks like u r much unluckier than me. Hehe. Anyway, thanks, Leo. Hugs

Leo: No problem. You can always share with me if u need somebody. Ok la. You sleep early la. Nitez o. Muacks.

Me: Aih. Pi**y oso got new target dy. Aih. Gor, u so nice. Next time I treat u yum cha.

Leo: Don’t worry. Still got me accompany you to be single ma. If you come back for sure will let you treat me de. Kekeke…

Me: Remind me lo. I’ll treat u (only during happy hour wor). K la. Nite. Hug Hug.

Leo: Wa. Got time limit tim ar. Erm. Ok lo. Good nite.

I have crushes on guys all the time, and get disappointed in the end. William has always described me as being “inconsistent”. I’m not at all feeling upset. Or gloomy. Yet, his little effort to cheer me up coated my heart with a layer of honey. It felt damn sweet. =) Thank you, Leo.

Life and death

I was on call for the first time last night.

I managed to conduct 2 normal deliveries under close supervision and with the assistance of a staff nurse. It is an enchanting experience, to pull out a baby from his mothers' pussy and hear his cries, which herald the journey of an entirely new life.

Besides, I happened to witness an obstetric emergency too. It was announced that there was a red alert in one of the OTs. When Jamie and I arrived, cardiopulmonary resuscitation (CPR) was being done. Things were dramatic. The obstetricians, anaesthetist and medical officers tried their best to bring the patient to life, but to no avail. We were later told that the patient died due to primary postpartum haemorrhage following a lower-segment Caesarean section (LSCS).

When I was browsing around in the delivery suite at midnight, I was told that CH had got a boyfriend. A bombshell that depressed (not clinically) me for several minutes. Felt kind of demoralized. Demotivated. Sigh. 怎么办?

I left the hospital at 5.50 am, fatigued and down, because of that.

Anyway, life moves on. I have encountered much worse predicaments in my life than that.

Caesarean section

I've just returned from the ward. Last night was action-packed.

I got the opportunity to observe a Caesarean section (an operation performed to deliver a baby via the transabdominal route) which started at 11.35 pm. The procedure was indicated as the patient had premature preterm rupture of membranes (PPROM) and the amniotic fluid index (AFI) was low. Besides, the baby had a breech presentation, meaning that the foetal buttocks (instead of the head) occupied the lower part of the uterus and this would complicate normal vaginal deliveries.

CW and KH accompanied me. It was our first time entering an operating theater (OT) and watch a surgery. Needless to say, we're ecstatic and jubilant. We're required to change into the blue suits ( I don't know what they call them. Surgical gowns?), masks and green caps provided. Even that was enough to make us exuberate. Our laughter permeated the entire changing room. Heh.

The surgeon made a transverse suprapubic skin incision and cut open the abdominal wall, layer by layer. The urinary bladder was reflected inferiorly and the uterus incised. Finally, the baby was taken out. The procedure was much simpler than we thought. It looked kind of quick and easy to our untrained eyes.

It was enjoyable being in an OT for the first time. The 3 of us took tons of pics before changing into our formal attire (at 0035).

Random thoughts

At times, it surprises me to realize the fact I've actually spent 99.9% of my entire life to date with straight guys. We do basically everything together. Having meals. Travelling. Clerking patients. Polishing our clinical skills. Doing physical examination on one another before an OSCE. Playing DotA and basketball. Watching movies. Hanging out. Helping one another in preparation of an exam. Staying united in times of happiness and hardships. The list goes on. Yes. Basically everything, except jerking off and watching porn, as straight porn isn't really my cup of tea.

I know, for certain, that someday in future, each of them will get a girlfriend and have a world of their own. I don't really have a strong network of gay friends, except for a few whom I got acquainted to when I slutted in KL. Some of them did leave beautiful footprints in my heart. But do they actually give a damn about me? I don't know. Hence, it really pains me to think of the possibility that I'll be left alone and lonely, with suicidal thoughts invading my mind subsequently.

I feel helpless and worried. The academic pressure I'm facing, somehow, does help in numbing and anaesthetizing me to all these pessimistic thoughts. But then, the effect is not permanent. Many a time, I'm soaked in fear, not knowing where my life leads to and what the future holds for me. And the something bigger and tragic -- coming out to my parents-- has yet to come. Aih. I really don't know how to deal with this sort of calamity that's imminent and bound to happen.

"Why am I gay?" I asked myself this when I discovered my sexuality 10 years back. I started to deviate further and further from the straight path ever since. Nevertheless, the same old question never ceases to resurface and trouble me even until now. Sigh.

---

The weekend was pretty great though. Got to see the new juniors. Had several wars against them on DotA which actually plays quite a vital role in boosting the senior-junior relationship in our faculty.

Ankle sprain

I sprained my left ankle and fell while playing basketball. An inversion injury which involved twisting of my plantarflexed foot. Some of the fibres of the ligaments might have been torn, I suppose.

Now there’s a localized swelling on my sprained ankle. And the 5 cardinal signs of acute inflammation – rubor(redness), tumor (swelling), calor (heat), dolor (pain) and functio laesa (loss of function) – are becoming more and more obvious. Besides, my gait has been affected too. It hurts when I walk.

Hope it’s not God’s punishment on me for fantasizing about the cute, hot, muscular, athletic and sweaty guys with six packs in the basketball court. Ha.

Juniors

Last night, I got the chance to see my male juniors who just came in. They were gathered in a very secluded area of my residential college by the second-year students. It's just a session to get to know the freshies. The ragging will take part later on, during the orientation day.

Most of them are high scorers from prestigious and pretty well-known high schools all over Malaysia. Chung Ling. Malacca High. Chung Hwa, Kota Bharu. VI. Sam Tet. Keat Hwa. VI.

I despaired of not being able to find my type as I carefully scanned through the guys. Among the 35-odd bookish- and studious-looking guys, there's one who actually caught my eyes. Hehe. A guy from Klang whose name I've forgotten. Slim and lean and sort of cute. A straight STPM scorer. But that's not what attracted me. When asked why he chose medicine, he lamented that it wasn't really in list. He wanted to do actuarial science and went on blaming the Ministry of Higher Education and bla bla bla.

He looks messy, brilliant and has the mannerisms similar to that of CH. He displays a tinge of arrogance and indifference in the way he talks and stands. Some, I'm pretty sure, would find him irritating. Annoying. Cocky. However, I'm strangely drawn to him.

I'll find a chance to get acquainted to him. I thought of bribing him with lecture notes and past-year questions. But he doesn't seem to be a kiasu person who hankers for any of these. But if I'm not mistaken, he plays DotA too. At least, I know we have something in common. This will make matters a lot easier and my motives less obvious.

And hopefully, he's gay. Heh.

As it squeezes out....

I've been very busy lately.

For yesterday alone, I witnessed how a Pap's smear was done, 4 spontaneous vaginal deliveries (SVD) and 3 episiotomies and their subseqent repair as well as an ultrasound scan of an obstetric patient with antepartum haemorrhage. I did a vaginal examination and 2 venipunctures, one of which wasn't very successful. A lot of pussies, and blood.

It's the 4th day today. Our knowlegde regarding basic patient care is very limited, let alone obstetrics and gynaecology. Sometimes, I need to poke the one of the veins in the antecubital fossa several times just in order to take a blood sample. I don't know where the cervix is when my fingers are already 20 seconds in the vagina. I stammer when the medical officers bombard me with questions. I don't really know how to measure the symphysis-fundal height (SFH). I feel lost when palpating the fetal poles. I don't know what I'm looking at during an ultrasound scan. Feel stupid at times.

Watching babies being delivered, nonetheless, is something I find very rewarding. It kind of phagocytoses all these feelings of stupidity which seem to undermine my confidence and self-esteem when I'm with my brilliant coursemates.

The labour pain that a mother, especially a primipara, has to undergo is immense and indescribable. There's plenty of fresh blood and bodily fluid here and there. In an event of difficult birth, an episiotomy has to be carried out and when the incision into the perineum is done, the pain looks so excruciating that it sends shivers down my spine. I do count my blessings for being born with a dick and not having to experience child birth in my current life.

But then, the moment the baby squeezes its way out of the birth canal, my heart melts, like the butter under the sun. The staff nurses will insert tubes, which they call suction catheters, into the its airway. And then, the baby, so fragile but full of live, cries incessantly. Feels like it has been held captive in the womb for an entire 9 months and is eventually set free and comes alive.

I almost shed tears the first time I observed an SVD. I watched in awe, with the zest of a 3-year-old who sees an ice-cream for the first time. My feelings were a mixture of satisfaction, amazement and pleasure.

We're required to perform at least 5 vaginal deliveries in this posting under supervision. And I really do look forward to it. Hehe.

A dream

CH: Hey. Let's go out for supper.

Me: Huh? It's already 0035 wor. Want meh?

CH: Faster la.

Me: But I have a 11pm curfew. I'm not allowed to enter the campus after 11pm.

CH: Nvm de la. Don't worry.

Me: Ok lu....

I boarded CH's white MyVi and off we went.

Well, it's a dream. A sweet one. That's the only part I can vividly remember. Am not sure what happened next.

The world seemed to be more beautiful when I woke up this morning. =) It's my first time dreaming of CH after I realized I was infatuated with him. I was filled with excitement and an inexplicable sense of satisfaction despite the fact that deep in my heart, I knew he's a star that I'd never be able to reach, at least for the time being.

The O&G posting officially began today. Went to class in high spirits. Attended some boring lectures on the embryology and anatomy of the female reproductive organs. And I realized I'd forgotten almost everything I learnt in 1st year. Aih.

CH lingered on my mind the entire day.

Feel so high, although it's merely a dream.

:)

Coming clean

"If you like someone, make sure you take the first move. Don't just wait and expect to be noticed coz if you are like that, then forever people won't notice you."

Darren wrote that.

All of a sudden, my mind is deluged by memories of the days when I was in love with KS. A straight guy. Back in high school.

I was secretly in love with him for 2 years until one day, I finally decided to come clean with him about my feelings for him, no matter how catastrophic the consequences might be.

So, a few months before the SPM examination, I came out to KS and told him that I loved him.

And he said he truly appreciated me for my bravery and veracity but apologized for he didn't feel the same towards me.

Somehow, I wasn't really disappointed, perhaps because I never expected my feelings to be reciprocated.

Nonetheless, I'm glad that our friendship wasn't affected. We're, in fact, still good friends. Heh.

ObGyn

My first posting came to an end last week. Coming up next is O&G (Obstetrics & Gynaecology/妇产科）.

8 weeks.

I don't know what to expect. Lots of pussies, I guess.

But then, the posting will be in another hospital, which means I won't be able to see Dr. Aaron (for 2 months). Sigh.

Distance

I got his number today!!

:)

I met CH when I slutted in KL for 9 days (during which I got to meet 15 guys whom I previously chatted with on mIRC), right before I embarked upon the third year of my university life.

The day I arrived at KL, Pikey brought me to Wing's cafe in Kuchai Lama where a few of his friends were already waiting.

CH caught my attention immediately.

Then, for the next few days, I had the opportunity to meet him several times, with the presence of Pikey's friends.

He's messy. Straight-acting. Manly. Short ( barely reaches my shoulders). Slim and lean. Boisterous and blasting with energy. Childish, in a way that attracts me. Craps a lot. Funny. Fun to be with. Cute and adorable, in a way that makes me dyspnoeic and my heart arrhythmic.

I have a great liking for him. Images of his sensual eyes and his captivating smiles appear on my mind every now and then.

He made my slutting trip very memorable. But the fact that we're separated by the South China Sea really saddens me.

Today, I mustered up my courage and asked for his cell phone number when we chatted online, which I'd wanted to do for so long but didn't have the guts to. Feel very glad, though I know this means nothing more than having a guy I like in my contact list whom I'll never have the chance to be in love with, chiefly because we're so far away from each other.

But still, I've got something to say. CH, I like you. =)