My new boyfriend

I am so in love with my iPhone 4.

I really really do.

And I can't stop Grindr-ing. The guys on Grindr are so different than those on Axcest. At least, there're no kids. You tend to meet more mature and financially sound guys. And the interesting thing is, they're mostly hot.

I'm still waiting for one those with six-packs to buzz me. Which will always be a fantasy because I guess they only approach guys with similarly perfect bodies. Perhaps one you can take the initiative to?

It's kinda exciting sometimes when you realize there's a hot gay guy less then 500 metres away from you. However, as conservative as I've always been, I don't think I'll go beyond the 'boundary'. Not yet.

Today, something pretty embarrassing happened.

I actually missed the diagnosis of tricuspid regurgitation in a chap with decompensated congestive cardiac failure secondary to chronic rheumatic heart disease complicated with atrial fibrillation and prosthetic valve dysfunction. I should have referred to the echocardiogram before I presented the case to the cardiologist. 

Well, he impressed us with his ability to come out with the provisional diagnosis of tricuspid regurgitation just by placing his stethoscope on the patient's praecordium. Awesome.

Hmm. Why didn't I think of that when all my physical examination findings actually pointed towards that diagnosis? The pansystolic murmur at the left lower sternal edge? the tender enlarged liver (though it wasn't pulsatile) ? the elevated jugular venous pressure? the gross ascites and bilateral pitting edema? 

But then, I guess I'm excusable because that wasn't a very direct case. He'd had his aortic and mitral valves replaced. I could hear a cacophony of ejection systolic murmur and clicks here and there produced by the mechanical valves.

In medicine, you may know something theoretically. You may know all the manoeuvres to accentuate certain types of cardiac murmurs. But, when you actually see the patient, it's really not that simple. A lot of practice is needed. You may know everything in the textbook ( which I don't). Yet, if the patient is uncooperative or if you fail to present your findings confidently to the examiner, that's the end of the story. You've got to make an impression. That's why I feel so stressed, you see.

I learnt my lesson today. 

I will improve. =)

Exam's on Monday. No more Grindr-ing.