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.

Medicine posting in 500 words

I grinned when that laborer told me that the precipitants of his migraine included ejaculation. And I was wondering if that's coital cephalgia. He must really hate sex then.

I chatted with the stubborn lorry driver with Crohn's disease complicated with perianal fistulae who refused to quit smoking. I sorta sympathized with him when he talked about her wife's infidelity and his recent unemployment. I saw hopelessness in his eyes. Could these have caused his flare up?

I examined the cute, hunky farmer who suffered from pleural effusion secondary to pulmonary tuberculosis.

I examined that pitiful woman with bulbar palsy with very beautiful tongue fasciculations who had dysarthria and a very clear carotid bruit. Carotid stenosis. She had the look of an elderly ill woman who'd been abandoned by her children. For some reason, my heart ached.

I examined the girl with Down's syndrome who had missed the boat for a surgical correction of her ventricular septal defect. I wondered why she had digital clubbing and cyanosis. And I later found out she had developed Eisenmenger's complex. Poor girl.

I talked to the hot fisherman with decompensated Child's C liver cirrhosis secondary to chronic Hepatitis B infection who could recall every single detail of his variceal bleeding. And I couldn't stop ogling at his son who was so damn hunky and muscular.

It's nice to meet the medical lab technologist with cholangiocarcinoma who was admitted due to liver abscess. She was able to give me a detailed history with medical jargons. She's the sort of patient you hope you can get in exam. You'll know how frustrating it is when you meet someone who can't even tell you the medications he'd been taking for the past 10 years. 

I realized how devastating the complications of haemophilia A can be when the hematologist brought us to see the guy who'd suffered from a subdural haematoma.

I like the friendly girl with myasthenia gravis who talked to me about her bilateral ptosis, double vision and how she progressed to the stage where her respiratory muscles were involved and required intubation. 

The gastroenterologist mentioned something about gay bowel syndrome during a discussion on inflammatory bowel diseases the other day. And I found that very relevant. Never knew such a syndrome existed. Gay bowel syndrome. Interesting. Speaking of this, did you know that AIDS was actually known as Gay-related Immunodefiency Disease (GRID) in the early 1980s?

I saw a diabetic with all the macrovascular and microvascular complications. Diabetic retinopathy, nephropathy, neuropathy, peripheral vascular disease and coronary artery disease. You name it, he has it. That was the day I decided to reduce my sugar intake. 

I saw a young father with systemic lupus erythematosus (SLE) in the rheumatology clinic. SLE rarely affects guys. But, when it does, the prognosis is bad. Does he know that SLE patients have a lifespan 10 - 20 years shorter in comparison to the general population?

I felt bad when I talked to patients who didn't know they were actually dying.

It's fun to appreciate the pansystolic murmur of that chap with severe mitral regurgitation. And to see the spider naevi of that chap with alcoholic liver disease and electrocardiogram of that man with sick sinus syndrome.

But, when exam comes, it's not that fun anymore.

I have to be prepared. For the battle next week. 

Tuls, thank you

I'm really really tense.

My last class today ended at 8pm. My mind could barely absorb anything when someone was going through some of the inconsequential details of the management of hepatic encephalopathy based on the American Association for the Study of Liver Diseases.

I feel so tired. I feel like crying. I feel like collapsing.

I've got so many things to do. So many things to read up on.

I have to present a case of Crohn's disease to the head of the medical department tomorrow. I've got a case report which I've completed due to procrastination. I've just rejected a girl very politely by coming out to her. It was a spur-of-moment decision which I hope I won't regret. Apart from that, my beloved car is still being hospitalized. And I'm still waiting indefinitely for it to be discharged.

I texted Tuls out of desperation and frustration, compelling him to say something nice that would soothe my soul.

To my surprise, he did, very obediently.

I smiled.

I really did.

I wish I had my own boyfriend (instead of someone else's) whom I can exploit when I'm in such a predicament.

But, for a moment, I could forget the saddening fact that there'd been nothing really significant in my sexual history and grinned as I read his SMS-es for the second time.

Thank you, Tuls.

No way

I think I'm on the verge of falling for a straight guy again.

The same guy Alicia used to fall for.

Damn it. I need to rationalize.

The worst thing is, he's homophobic.

I don't know how I managed to conceal my sexual preference so perfectly. Sometimes, I feel guilty having to make a few white lies to avert suspicion.

I cannot afford to let this happen. No way!

An accident

We were jerked forward by the inertia brought on by the sudden impact. I could hear a deafening thud simultaneously with the sound of shattering glass which completely dumbfounded me. The collision had already occurred before I could successfully bring my car to a halt.

Fear pervaded the air. Staying calm seemed to be an absolute impossibility. By the time I regained my composure, I realized that my heart was thumping erratically. I was perspiring profusely. The crippling hunger I felt during my lecture an hour ago had vanished. I didn't know how long my sympathetic nervous system had been activated. But, I did know we weren't catapulted out of the car nor injured.

The mishap took place at a roundabout in the heart of the city which immediately led to a traffic thrombosis. I'd always had the inclination to mercilessly curse people who got involved in an accident during peak hours which congested the already very stagnant traffic. The time for karmic payment had come, I thought.

A middle-aged man emerged unscathed from the Kembara I'd just rammed headlong into. The situation looked as if I was entirely at fault. But, thanks God, he didn't look barbaric.

My roommate, the only passenger, and I alighted the car. The driver of the Kembara alleged that I shouldn't have driven too fast. I shrugged my shoulders and didn't even bother to initiate an argument. I have to clarify here that although I can confidently defend a diagnosis I've made for a patient with justifications, generally speaking, I'm never good at arguing. I'm always the one who loses in an argument or quarrel.  Guess I just wasn't born with the fundamental qualities a criminal lawyer must possess.

His mechanic arrived while we're busy making phone calls to seek others' opinions as to how the situation should be dealt with. And his mechanic was hot, damn it. He unintentionally lifted his shirt in front of me. I could see his beautiful six-pack and treasure trail. Or did he do that intentionally? How does he know I'm gay? Is this some sort of strategy to dupe me into giving in to his baseless accusation and to pay the unjustifiable compensation he had demanded for?



To be continued.

Why?

Allow me to sound immature. Just once.

I feel extremely stupid today.

Isn't medicine supposed to be a noble profession?

But, why does everyone seem to have his or her own hidden agenda?

Why does everyone seem so self-centred?

Shouldn't knowledge be shared?

Why are brilliant people so difficult to mix with?

Why do certain people who seem so benign and friendly can suddenly become so selfish?

Why am I always among the  unfortunate who're victimized?

Am I being too sensitive and kiasu?

Am I being too naive?

Now, I believe that there ain't no one in this world who'll stand by you and always look out for you like your mother.

Let me anger and hatred consume me. For today.

Let me translate my grudges and negative emotions into voiceless words here, the only place I can express my frustration without the fear of being judged.

I will grow emotionally stronger from tomorrow onwards.

But, I do not want to be like them. I do not want to lose my innocence and naivete.

I want to be remembered as the naive boy who's so enthusiastic about weight loss but invariably becomes orally indisciplined on seeing appetizing food and extremely remorseful after the reactionary binge.

If I can how my concern to patients without expecting any sort of reciprocation, I believe I can do the same to my colleagues.

子曰：“君子周而不比，小人比而不周 。”

学业上的竞争及现实生活中不必要的尔虞我诈， 真是令人筋疲力尽。

我决定把心胸拉阔。缩小自己。不在乎那么多。就算是吃了亏，也无所谓。尽了力就好。

DotA

As far as I can recollect, I started playing DotA when I was still in the pre-university phase of my life.

There's a bunch of hot hunks from Jit Sin High School who're all DotA freaks. Well, I guess what kindled my interest in playing the game was self-explanatory. When you're a teenager, your peers have a colossal influence on what you do because you want to fit in and not be the social outcast everyone shuns. I even played futsal with them. However, it's a harrowing experience. I must admit that ' atheletic ' is not exactly an adjective I'd describe myself with.

Nevertheless, playing DotA has inconceivably become one of my most favourite pastimes at present. It's not just the game or the ecstasy you experience when you kill an enemy with skills and tactics that develop only after years of practice for noobs like me. Or the recuperative powers it promises after an exhausting examination week. Apart from the indisputable fact that it's the cheapest entertainment you can ever get, it fosters good relationships between my friends and I.

Similar to most guys in general, I'm just another colonial animal incapable of functioning well socially on a solitary basis. The complications that invariably arose in my history of befriending straight guys necessitate no further explanations here. Therefore, DotA, to me, is the equivalent of a friendship lubricant which has played a crucial role in helping me establish a good rapport with my friends in university. Friends whom I can walk with in pride, sending an implicit message to others that we're a group of buddies indispensable from one another. Furthermore, it has also helped me reconnect with my old friends.

Playing DotA is somewhat analogous to drug intoxication. You can momentarily forget about the abysmal fact that you just gained a pound or that the hunk you've been stalking online is officially ignoring you. You become engulfed in euphoria and rapture. On top of that, you feel a deep sense of togetherness and comradeship which stems from the team work that naturally exists among your teammates when the game is going on.

Thanks to DotA and Garena, I've become a regular patron of cybercafes. We can literally spend a century in them, especially those with an interior similar to that of a spaceship. One thing I like about cybercafes is the sight of thuggish twinks with ear studs, tattoos and ludicrously dyed hair, often heard yelling at one another with profanities.

The exciting thing is, many of them are appallingly hunky and hot. Which is the part that totally trumps my fear for my unnecessary exposure to passive smoking that increases my risk of suffering from bronchial carcinoma.

Gang fights are not uncommon. As risible and infantile it may sound, a defeat or loss in a virtual war can fuel anger and dissatisfaction strong enough to induce a gang fight. I personally witnessed one in a  a cybercafe in Genting Klang a few months back. One from which Keng and I almost suffered collateral damage from had we not fled in time.

May the game always be in vogue.