Maturity.

- Warning: a crazily TL;DR philosophy-heavy post, be sure to take toilet breaks and always wear a seat belt. -

Lately I've been grappling with the above. Once upon a time, me and my friends were all just little tots, exploring, and trying to makes sense of the world. Now, many of them have grown up and left the cot behind. Many more have found jobs and are in all means of the phrase, standing on their own two legs. Despite yes, living on my own and having to look after myself, and yes, working much of my holidays, I still don't feel mature. I'm as immature as ever. Why am I not mature? How does one become "an adult"? Surely its not something people become by default. Its not like once we hit the all mighty age of 18 we are suddenly thrust into the big bad world as mature beings. No, thats definitely not it. Is maturity even age related? I seriously doubt it. Look at all the man-childs (men-children?) out there; Charlie Sheen and other such unconsolable arseholes. Are people who get addicted to substances immature? From a certain point of view, it seems as if addicts of any sort have yet to shed or control their childhood impulse for having a good time. I don't know, is that even what maturity is? Thus this wanderous and ponderous post, HMMMMM *strokes beard*.

So the crux of my conundrum; what defines maturity? I have a strong feeling whatever I'm going to write is self-defeating because it will be deemed "immature". Whatever - I'll do it anyway.

Maturity is... (in no particular order)


Knowing when to fold (or along similar lines; picking and choosing your battles, learning to let go) - I haven't always admired people who admit they are wrong, my parents never seem to do it. But now I realise how difficult it is to swallow your pride, especially when you are so sure you're right. I can credit this revelation to Medicine; after spending hours and hours rote learning half a page of neuroanatomy, by God you want to be right. Self-confidence takes a very real battering when you realise everything you know is wrong. And when the stakes are high, Pride becomes much harder to swallow.

Accepting that shit happens - Einstein once said "God does not play dice". That is bullshit. Ok, ok, so not complete bullshit. (Only because I'm slightly less credible. Jokes.) But I DO think that there's a reason for everything. Nothing to do with fate or destiny or anything hocus pocus like that, we're all rational beings here, but reasons as a result of consequences.  I am here because my parents had sex. (D=) My parents are here because my grandparents had sex (Dx, I feel dirtied... ) The reason their parents blah blah blah blah big bang or God, depending on your beliefs (which themselves can be explained by consequences). The only problem is that we cannot fully understand every step of the chain of consequentialism because frankly, we don't know anything. Or more specifically, we don't know EVERYTHING. When I wrote this, I was particularly thinking about romantic relationships. Seriously, how often does one know what the significant other is thinking? Even more startling, how often does one know what your subconscious is thinking! All the tiny, minute nuances of human nature - personality, upbringing, random spontaneous thoughts - found within yourself, and within your friends, and your friends' friends, all that most of the time subletly, sometimes not so subletly, affects your thoughts and your mood. It wouldn't be preposterous for me to say that it affects the very fiber of your being. (Background: I believe that people are dynamic and that they change all the time. Like a river, with moment brings new experiences, changing the entire composition of "a person".) pervade your life. Ever heard of the butterfly effect? Its basically chaos theory and talks about how tiny, tiny changes accumulate to create massive events; a butterfly that beats its wings in London could in theory, cause a hurricane in the US. 


Basically what I'm trying to say is, there are too many factors when it comes to consequences for us to understand, so we may as well take it at face value - as chance. And as with all chance, it doesn't give an rats anus about how hard you work, or how much money you have. In the end, shit happens. And you have no control over it.

Getting your priorities straight - self explanatory I think. All the friends that are in my eyes "mature" know where they want to go, and are hell bent on getting there. They have direction in life, something I would like. The other side of the coin is learning to balance work and play. Movies and such keep telling us to value our relationships, but such lessons should be taken with a grain of salt (or more). Films are, after all, nothing more than flights of fancy, designed to win our hearts and break the banks. Other related subjects (because I'm so cbs right now, 4 hours into writing this post) include maintaining motivation, being serious when it counts, doing what it takes to get what you want, and not procrastinating. Hah. Imagine, me not procrastinating. Not gonna happen.

Wisdom (a.k.a experience and learning from your mistakes) - I have a personal belief that all old people are walking encylopaedias on living. They are, after all, old people. They've probably made the same mistakes you and I are going to make, only 50 times over. Old people are in the best position to impart great wisdom upon us. All old people, except for my parents. Guh parents, shudder.



Being serious, sometimes. I pray to God that this is the case, and not having to be serious ALL the time. I think that is what I'm afraid of most. If you know me well, then you'll realise that a lot of time, I'm just a massive retard, as in I do many many what I think is inconsequential, immeasurably stupid, most of the time, innapriopriate things; for example, burst into song, make lame puns, break out in dance, and generally make a fool out of myself. I realise this is probably the department in which I am most lacking in maturity. But I hope I don't have to shut down the entire department altogether. Being a retard is thoroughly enjoyable afterall. 

I think knowing what is appropriate and what is not (mainly not) is a big part of being mature. Giggling whenever a patient mentions haemorrhoids is NOT being mature. Nor is it professional. But the problem with being a pioneer of any sort (for example inventors, surgeons) and entertainer (am I not entertaining? pleasedon'tanswerthat) is that there's an urge to push the boundaries of normal and expand whatever it is you do, be it the field you work in or human rights. And I do have this urge to push boundaries, its a form of curiousity ingrained into my personality. I usually experiment with my own boundaries, but sometimes the constraints of society become collateral damage - it's not so much as an act of rebellion, but more exploration. And therein lies the problem; many, MANY people don't appreciate having their comfort zone pushed, and the mature person would realise this and recognise where a particular person's boundaries lie. But I am no mature person and I enjoy bending boundaries, it makes life so very interesting. So all it is a giant balancing act, and with wisdom and experience, you can only get better at determining what is innappropriate and what is okay. I tried desperately to wikipedia some wisdom, but to no avail. Sigh~

To be honest maturity is probably not having to define maturity. Hurrah, Kevin 0 - Kevin 1.
 

Maturity is not...
Golf
Being too old to have fun
Sophistication (in the shallow sense of the word) - basically trying to look sophisticated because you're old and people assume that you're "mature". 
Always being serious.


Final thoughts - I think maturity is the future. By "future" I don't mean, the forever unreachable (and always packed full of plans) tomorrow. What I mean is that its something we always strive towards. Perhaps its something like being "a good" person. Once you're there, there's always better. And so you don't actually get there. (How depressing.)

You know, it would cause me great despair if someone told me I was mature... I hope for the sake of mankind that I am not. If this little MedKid is mature then the world is seriously fucked.

I wish I look as good as this dude when I'm mature.

By the way, I'm actually on term mid year holidays for those who don't know, have been for the past almost 4 weeks. Its only because of the holidays that I've been able to blog at all. So since its nearing the end of my break, I'll probably be hard at work again very soon, meaning that this will probably be the last post for a while. 

Adieu for now, my fellow time travellers.

Part two! (of something or rather)

In my last post, I promised you a couple of things. And now, I plan to break them in true Medkid (yours trully) style. By breaking my promise to break my promises. Yeah!~

So the question was, "How exactly are you spending your time Mr. MedKid???"

Let me see.

1. gurlfran
2. procrastinating
3. gaming (Oh Diablo II, how I have missed thee~)
4. parkouring
5. studying
6. taking pictures

(like here! can you spot my sisters?! There are two of them, I think.)

And the things I SHOULD be doing?

1. studying *duh*
2. earning monies
3. blogging more often sighies 

Yeah!

So this was one of those posts where I had a great idea, wrote a bunch of awesome dotpoints, and prayed to God that the idea would stick in my head. Or even better, perhaps even ferment a bit and blossom into a nice, well rounded, well written post. But it was not to be. Soz, blogger, I have failed thee. But no! There was something important I was supposed to rage about... but I forget what... huh. 

Another QUALITY POST, by MedKid!

So I should blog every once in a blue moon eh?

Soooo its been a while yeahhhhh...

Indeed it has. Stuff tends to happen over time. In terms of this blog however, its quite the opposite. Since I haven't written anything original over the past half year or so (?) I'm gonna get down and dirty. And regurgitate everything that's happened in the life of this little MedKid since my last post.

Get ready. Get steady. Go!

Second year vs. first year - I may or may not have said this before (I ceebs rereading my posts right now), but 2nd year is a piece of noobcake with pwnage-icing topped with a slice of pro-ness compared to first year. Study is seriously chill. Reasons; 1) the workload is lighter - naive little MedKids go into first year thinking they know everything there is to learn. Unbeknowst to them, BAM! Cecil (refer here) ninja's in from nowhere and smacks them in the face, causing frontal bone fracture with concomitant coup and contre-coup contusion, leading to cerebral oedema, mass effect, central herniation and ultimately, the end point of all the best mechanisms, death. Whiiippeee! That was first year. In second year, you actually know stuff. You no longer quake in your boots when you see the words "clotting factor" or "parasympathetic stimulation". "Cytokines!" isn't your catch phrase anymore for any immune system related question. And now, you can actually read an ECG. (Hell yes baybee, hell yes.)

Word of caution: ECG machines mad baaaad alarm clocks.

And now, because you know your foundations, other stuff is a whole lot easier to learn. Also, the admin like pounding in the basics, so you oft get the opportunity to redo first year material to make sure it sticks in your head, which, for those that havn't forgotten everything, makes for easy studying.

Reasono numero two-o) you sort of know how to study medicine. The coursework is less, but the material is still just as difficult, if not more so (*shudder* brain anatomy */shudder*). Even so, you're so used to rote learning lists of random names (such as the muscles of the limbs) that beating out the obscurest names of the obscurest structures in the depths of the brain that no one really ever talks about is no big deal. (Example, the crus of the Fornix and the Habenular nuclei and whatever. I don't care anymore, I did my exams.) But anywho, as I was saying.. uhmmm yeah. By second year, you will have honed down your studying skills to a scapels edge allowing you to cut through swathes of boring junk without a single bead of sweat. That's the theory anyway. In practice, it certainly does help to have good study habits, but mine are nowhere near perfect aka I cannot blow up a mans head with my mind just yet...

3) Our mid-year medical exams were formative - meaning they didn't count. Need I say more?

4) Less contact hours. Instead of the deadly jungle that was my first year timetable, this years timetable is relatively desolate. Most days (Mon, Weds, Fri) I have afternoon CBL (refer here this time) meaning that I can sleep in until about 10 o'clock. On top of that, I've just been a naughty boy and have been skipping some of the more useless lectures. So instead of my almost impeccable attendance record last year, this years attendance record is only slightly more than a stained square of 2-ply toilet paper. Sigh. The reason for this ceebsness? Most of it stems from the fact that I know I don't need to work as hard as first year. I sort of regret putting in the amount of effort that I did. And now I have a feeling I'm going to regret not working hard enough this year. But that shall be reflected in the exam grades. In terms of clinical skills and CBL assessments however, I've been doing pretty good so perhaps that's what's been causing my false sense of security. Gah, we shall see...

And now for some random gratuitious picture! The caption: "Hugs keep us alive"

If only this were a T-shirt design... guess what, it is!

All this means MORE TIME TO CHILL AND STUFF. Chilling how I hear you ask? Read the next instalment of the Chronicles of a MedKid and you will find out!

Ugh

"If it were a two or above I wouldn't be able to answer because it would mean a pause in the screaming."

Ahh, xkcd. 

I'm such a faggot.

Medical charts

The following are actual, unedited, notes written by doctors on
patients’ medical charts:

1. Patient has chest pain if she lies on her left side for over a
year.

2. On the second day the knee was better,
and on the third day it disappeared completely.

3. She has had no rigors or shaking chills, but her husband states
she was very hot in bed last night.

4. The patient has been depressed ever since she began seeing me in
1993.

5. The patient is tearful and crying constantly. She also appears to
be depressed.

6. Discharge status: Alive but without permission.

7. Healthy appearing, decrepit 69 year-old male, mentally alert but
forgetful.

8. The patient refused an autopsy.

9. The patient has no past history of suicides.

10. Patient has left his white blood cells at another hospital.

11. Patient’s past medical history has been remarkably insignificant
with only a forty pound weight gain in the past three days.

12. Patient had waffles for breakfast and anorexia for lunch.

13. Between you and me, we ought to be able to get this lady
pregnant.

14. Since she can’t get pregnant with her husband, I thought you
might like to work her up.

15. She is numb from her toes down.

16. While in the ER, she was examined, X-rated, and sent home.

17. The skin was moist and dry.

18. Occasional, constant, infrequent headaches.

19. Patient was alert and unresponsive.

20. Rectal exam revealed a normal size thyroid.

21. She stated that she had been constipated for most of her life
until she got a divorce.

22. I saw your patient today, who is still under our car for physical
therapy.

23. Both breasts are equal and reactive to light and accommodation.

24. Exam of genitalia reveals that he is circus sized.

25. The lab test indicated abnormal lover function.

26. The patient was to have a bowel resection. However, he took a
job as a stockbroker instead.

27. Skin: Somewhat pale but present.

28. The pelvic examination will be done later on the floor.

29. Patient was seen in consultation by Dr. Blank, who felt we should
sit on the abdomen, and I agree.

30. Large brown stool ambulating in the hall.

31. Patient has two teenage children, but no other abnormalities.

32.  By the time he was admitted, his rapid heart had stopped, and he was feeling better.

33.  Patient was released to outpatient department without dressing.

34. I have suggested that he loosen his pants before standing, and then, when he stands with the help of his wife, they should fall to the floor.

35.  The patient will need disposition, and therefore we will get Dr. Blank to dispose of him.

36.   The patient expired on the floor uneventfully.

37.  She slipped on the ice and apparently her legs went in separate directions in early December.

38.  The patient experienced sudden onset of severe shortness of breath with a picture of acute pulmonary edema at home while having sex which gradually deteriorated in the emergency room.

39.  The patient was in his usual state of good health until his airplane ran out of gas and crashed.

40.  Coming from Detroit, this man has no children.

Medical school, round 2

Uni has started and I am once again up to my pits in work. Seriously, there's literally no space to move. But even so, I went to medcamp last night. Good drunken times were had. 

Also, Med tends to suck inspiration, time, and life dry. Who would have thought things could get worse than first year. In light of this, I'm not even going to promise that I'll post again anytime soon. Way too far behind in everything, especially sleep. 

$50 to anyone who invents a consumable form of sleep. 

Interesting Medical Cases: Unusual Foreign Body In Boys Bladder

(From ISPUB) Click here for the full text.
Below is the unTL;DR, slightly less medical version.

So basically, a 14 year old boy complains of pain, difficulty in passing urine with dribbling and subsequent urinary retention that is 24 hours in duration. On further questioning he told the doctor that while he was cleaning the fish tank in his house, he was holding a fish in his hand when he went to the toilet. When passing urine, the fish slipped from his hand and entered his urethra and he developed the subsequent symptoms.

An X ray and abdominal ultrasound were done, with the ultrasound showing a 1.5cm echogenic object found inside his bladder. 

For management a cystourethroscopy was done (i.e. sticking a flexible scope up his penis). A 2cm long dead fish was found inside the bladder. The medical team tried to remove the fish with forceps but was unable to due to its slippery surface. Instead, a rigid ureteroscope with stone graspers was used to remove the fish whole. 

Afterwards, the child was asymptomatic and was sent for psychiatric counseling.

This story begs the question, what the fuck was the kid doing with a fish in his hand whilst in the toilet in the first place.

The article itself then goes on about the Candirú or Canero fish, found in the Amazon river. Below is the extract. 

"One of the strangest stories from the Amazon was a fish that was urinophilic and could swim up the urethra or into the vagina who urinated while bathing in the Amazon. It was said that this fish, known as candirú [in Brazil; as carnero. Once inside it would eat away the mucous membranes and tissues until hemorrhage would kill it or the host. It was also said that even if one caught the fish by the tail, once in the urethra it could not be pulled out because it would spread itself like an umbrella. in Spanish-speaking countries], was long, thin, and capable of forcing its way into the body's passageways following the trail of urine."

 

Charming.

Sounds like the future

Reposted from a MedKids Journal - http://boards.medscape.com/forums?128@559.f7mYawOqGzD@.2a063f93!comment=1

I Am Only Human After All

Kendra Campbell, MD, Psychiatry/Mental Health, 12:41AM Jan 14, 2011

"We are human, after all. Flesh Uncovered, after all.
We are human, after all. Much in Common, after all.”
-Daft Punk

It's 1:00 a.m. I just got home from an 18-hour shift at the hospital. I should really be sleeping, not typing. But I need to put in my weekly post here at the Ink Blot. And I don’t know when I’ll ever get the time to write again.

I remember when I was a pre-med student and even a med student...looking around at some of the doctors and wondering how they could sometimes be so short with their patients. I saw docs who didn’t really seem to care much for anyone, especially their patients. And I wondered how they could be in medicine and have such little empathy.

And now I truly realize why, maybe for the first time in my life.

As I’ve said before, there is an inverse correlation between the hours worked and the level of empathy towards patients. And not only empathy, but compassion as well.

I started the day at full speed, diligently caring for my patients. I comforted a patient in excruciating pain. I took the time to talk extensively with my patient’s mother. I went the extra mile.

But after around 15 hours into my shift, my empathy and compassion started fading. I began viewing patients not as humans who needed my help, but rather as obstacles in my path towards gaining sustenance, rest, and sleep.

Why did my patient have to go into respiratory distress and require intubation? Didn’t he know how fatigued I was? Why couldn’t he have waited until I left the hospital to become such a time sink?

Why did my demented patient have to keep ripping out her IV lines and foley catheter? Didn’t she know how much I wanted to see my bed?

I feel like I’m really starting to understand the dark side of medicine. I now comprehend The House of God with a whole new appreciation.

I want to care. I want to have empathy. I want to have compassion.

I know it’s within me. I know I want to be the best doctor I can be to each and every one of my patients.

But the reality...the truth...

Is that I can not.

I simply do not have that innumerable capacity.

I am only human, after all.