Saturday, July 07, 2007

I just had to post today, for the date

Yet another protracted absence from this blog, and I haven't been updating my twitter either. Well school life isn't exactly exciting, and in addition to the general boring nature of life I have also been extremely lazy, with regard to both studying as well as blogging, heh. To make up for my sloth, though, I bring you a super long three-part post today, so take a look when you have the free time (half the class is starting SIP on Monday, so I wonder how much free time they'll have).


Part One: Of the geriatric medicine posting

I thought Geriatric Med was a pretty good start to the year, especially since I was still feeling the after-effects of enjoying myself (i.e. leading an extremely lazy, self-indulgent life) during the post-exam break, electives, and subsequent June break. Geri at SeeJeeH is quite relaxed, and there aren't a whole lot of new things or skills to learn, especially since we have been exposed to some bits of GRM here and there through clinical years, and it was just a matter of learning the main things in greater detail, and trying to recollect the things we have done before (I still can never remember the 10 items of the Abbreviated Mental Test). It felt like a warm-up posting, to get the body used to the earlier waking hours and time spent standing during ward rounds, and the mind more accustomed to actually having to remember things and mug after a long rest haha.

SeeJeeH is also a nice place to do GRM, since most of the consultants are pretty nice and friendly, and each ward is split into three teams of doctors so the MOs don't really seem very overworked (but there are exceptions, which I shall explain later). During the allocation of ward teams on the first day I ended up with a really nice consultant (also the HOD) who was absolutely one of the most effervescent doctors I've seen, and almost effusive in her praise for doctors and patients alike, and also very sweet to the old people, so it was really great doing ward rounds with her. She also keeps asking questions during rounds whenever she thinks of something, so I got to learn a bit also.

Ward rounds in GRM ended up being a mini-SIP, because my consultant started getting me to write the daily entry in the case notes while she examined the patient, or to examine the patient and report my findings to her. This was when I realised it's not enough to just be a scribe, because when she asked me about the plan for some patient a while later I found that I couldn't remember a thing. A bit embarrassing, that was. After rounds she also asked me to help the MO take bloods, and it wasn't long before I had this sneaking suspicion that the GRM department is quite happy to have students to use in the place of HOs since they didn't have any (i.e. slave labour).

The second week was when things started getting a little hairy in my part of the ward, as one disaster came after another. My consultant went on leave, and the main MO (who is very good at what she does, almost like Reg level) went to another ward, leaving an MO who had just been posted over from another ward, as well as an MO from the Phillipines (very new, and .. well, I won't say more). The registrar and consultant from the other two teams in the ward were supposed to cover the patients in my team, but by the time they finished their own rounds it was really late and then they came over to look at our patients, making my rounds end even later, and I still had to do bloods after that, so I ended up leaving much later than everyone else. This wasn't all, because on Tuesday even the Filipino MO had gone to another team (I will never understand how that worked out), leaving the other MO (who didn't really know the patients) alone with 14 patients on his hands.

Basically it was disastrous, and it didn't help that the consultant that was covering our rounds was someone with an obsessive attention to small details, to say it kindly. At every patient he would think of some strange question to ask, for example regarding the patient's history of ventricular tachycardia he would want to know the changes made to the dose of amiodarone, and why the medication was stopped briefly - was it because it didn't work, and if so, why are we still using it? He effectively made the MO trawl through volumes of notes on several patients, when the poor guy already had a tonne of work on his hands and no one to help him. It also didn't help that we had two very sick patients that the consultant spent a lot of time seeing every morning before he went to see the other patients. We'd be lucky if the rounds ended before 12 (in fact, they didn't).

It was amusing in retrospect that I grew increasingly miserable over the course of the second week, with features similar to what our senior J mentioned during the M5 SIP briefing. Every time I went to take blood after rounds I would wonder why I was here doing this crappy job, and how in the world I had ever been enthusiastic about taking bloods when I was in year 3 - no wonder those seniors always advise us to lay off the enthusiasm for bloods because "when you're a HO you'll be taking so much bloods you'll get sick of it". I even started getting a bit nauseated by the smell of latex that stays on the hands after removing gloves. At least the patients didn't complain too much, and would staunchly subject themselves to my poking after a little persuasion; I think it would have been the last straw if I had to take bloods with someone screaming and cursing at me. I really didn't like doing it, but the MO seemed to really depend on me to help in that small aspect, so I did as much as I could to lessen his workload. I don't think it was an enjoyable week for either of us.

Well, for all the misery of the second week of the posting it still ended on a good note. On Friday the consultant had to go for clinics so he did a very quick round - we ended before 11 for once, to the delight of both MO and I. And the test wasn't too bad also, though I left a fair number of blanks due to uncertainty (no point gambling when there is negative marking) which paid off also, since there were quite a number of questions I would have gotten wrong if I had guessed.

I think I enjoyed GRM as a discipline, because most of the patients I met during the two weeks were really very nice people. I used to think old people would be grumpy, difficult, oath-spewing fogies (must be PTSD from some of my grandparents whom I don't have good relationships with haha), but the patients I encountered were mostly very sweet and obliging, and genuinely pleasant when you sit down and talk to them (even the demented patients are cheerful). There was this old lady who was quite memorable - she was on NG tube feeding and restrained because she would pull out her tube, and the restraints made her rather cranky so she would scream and curse the ward staff, and every time someone walked by she would call out to the person to release her restraints. One day she kept calling me "Uncle" and the MO was all "My goodness, a 94 year-old lady is calling you an uncle! How insulting!", which was amusing. Another day when she was calling for help I asked her what was wrong and she told me the back of her hand was itchy, so I scratched it for her and she was happier after that, but that led to her calling me every 10 minutes to scratch her hand. Sigh. Anyway eventually her restraints were removed when they tried to feed her orally, and she was smiling beatifically after that. Such an amusing patient.

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Part Two: Of Ken's Noodle House

I finally got around to trying the ramen at Ken's Noodle House at Orchard Shopping Centre, as recommended by plhu. Went there with G on the Saturday before school started (23 June) and luckily it was open this time - I had tried going there 3 times previously, all on Sundays, and the store was always closed (guess I'm not Liu Bei haha). I realised during this visit that the store is closed on all Sundays. -__-;

I got a Chashu Ramen, while G had a Chashu Ramen with extra ramen and extra chashu (which would make it chashuchashu ramenramen?). It was quite regrettable that they didn't have any stewed egg that day - the serving staff said something like "we're out of eggs", how do you run out of eggs when there are supermarkets all around you? I will definitely have to go there again another day to try the egg.



It's difficult to say if I prefer the noodles here or at Marutama Ramen, because each has its own surprises and gems, and also little bits I didn't really like.

Starting from the noodles, the ramen here was definitely full of bite and springier than Marutama's, and also the serving is larger and more satisfying (don't need to ask for extra ramen actually). As for the soup it was clear compared to the oily richness of Marutama's, though definitely not lacking in aroma, taste, and flavourful-ness. I guess both soups are comparable depending on how your preferences lie. The chashu at Ken's was really quite a bit tougher than Marutama's, possibly because the pieces are so big it's probably quite difficult to get them to be tender; the consistency is also variable with some pieces being tough and others tender. The tender pieces of chashu were quite enjoyable, mingled with just the right amount of melt-in-your-mouth fat. It also didn't have the strange smell that Marutama's had, so I think I'll go with Ken's for the chashu, at least for the pieces that weren't tough. In terms of garnishing, I liked the fried garlic at Marutama, though adding a handful to your bowl will give you garlic-breath for the whole day, and in Ken's ramen there were these pickled bamboo shoots, I think, that were quite delicious.

Yeah, so like I said, difficult to say for sure which is better. I quite enjoyed the ramen at Ken's, though like Marutama they also serve ice water and not Japanese tea; I really have to try the egg, it will probably be the deciding factor between the two, though I suspect another draw may be quite likely also.

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Part Three: Of anime

I finished watching Bakumatsu Kikansetsu Irohanihoheto (always such a handful to type) on the second day of GRM posting, and thoroughly enjoyed the entire anime. The artwork and animation were above average, and I especially liked the kabuki scenes with the costumes and amazing stage backdrops and effects (wonder how they achieved things like that in that time), and the soundtrack has to be mentioned for its greatness in accompanying the anime - goes to show how an already good anime can be catapulted into breathtaking awesome-ness by good accompanying music. I loved the opening theme song (Kouya Ruten) and how it has those twanging strings worked into the song (shamisen?), and when I found out the performer was FictionJunction YUUKA that explained things. FictionJunction YUUKA sang Akatsuki no Kuruma for Gundam SEED, which to date is still my all-time favourite anime-related song which I can listen to for ages without getting sick of it, and Kouya Ruten is a song much in the same vein. FictionJunction YUUKA rocks!

Iroha (as I shall call it for short) contains also a fair bit of Japanese history, being itself set in the Bakumatsu period which is the time when the shogunate rule of Japan came to an end, leading to the Meiji Restoration, a tumultous and hence very interesting period of Japanese history. The anime works the story of the protagonist and the supernatural plot (of an evil force called Hasha no Kubi - "Conqueror's Head" - that causes chaos and tumult in the human world by possessing people and inducing general warmongering, and the protagonist is a swordsman whose destiny is to find the head and seal it) quite well into the whole historical timeline, bringing in real historical characters and their course though that time. It was quite an eye-opener for me because, for all my interest in Japan, I've never actually read up much on Japanese history, and I can probably call this a crash-course for me, because my interest in the history grew after watching Iroha and I went and read quite a few Wikipedia articles about the Bakumatsu period.

I thought the supernatural plot got slightly ridiculous after a while, though, when futuristic city armour appeared out of nowhere, and a city started floating in the sky. It sort of spoilt the plausibility of the anime as a story set in reality but with the air of a myth that no one can verify - when you have floating cities, it's no longer a myth, it's a fantasy story. Otherwise the pacing was quite pretty good, and the ending is also quite satisfactory, though it would have been nice to find out the motives of Ibaragi Soutetsu, the main villain. I liked him, he was quite the interesting baddie in terms of being the kind who orchestrates events to his master plan from behind the scenes (he's the scriptwriter for the kabuki group in the beginning of the anime, true to his nature), and who gives the feeling of being himself a person who is controlled by something else, his destiny, perhaps, because he is not a malicious person. Very intriguing villain heh.


Also finished watching Death Note last week; somehow things weren't as exciting after [spoiler] L died [/spoiler], and the ending also wasn't as thrillingly genius as I thought it would be - the movie ending seemed more clever actually - but it was still pretty good watching. I think my mind got thoroughly confounded with the mental gymnastics the characters were doing sometimes, so it switched itself off.


Currently watching: Jigoku Shoujo (interesting premise, but hoping to see whether there's more backstory to the characters); Code Geass (like Death Note on mecha heh, also fun); Claymore (very nice, promising); Bleach (crappy fillers, and they just got Hitsugaya to do an Edward Elric-esque "Who are you calling a super chibi?!?", extremely amusing [the joke comes from the fact that Paku Romi, the voice actress for Hitsugaya, is the same as for Edward Elric])

Avaris / 7/07/2007 10:22:00 PM

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