TGET 7 - Pisa & Pompeii

Pisa was a place that I've been looking forward to, ever since i saw countless photos of people pushing the Leaning Tower of Pisa.

That's what I did, boring!!~

This is what brother did, hilarious!!!~~~ too bad the photo was ruined. but you get what he meant. =)

Lonely Planet says we probably just need to spend half a day there. That was what we did, stopping there while on route to Rome from Florence. The city is kind of like Florence, with the small lanes, typical Italian old buildings, with the exception of lots of constrcution happening everywhere.

By the way, while at Florence train station, we paid the most amount of money to use the toilets in my life. It costed us 0.80 euro, which is equal to 1.60 australian dollars, and more than 4 ringgits!!!~~~~~

From the train station, we walked to the Centro Storico, where the Leaning Tower of Pisa, the Fields of Miracles, the cathedral, the cemetery, as well as the batistry are located.


The first thing that caught my eyes was actually the green green stretching Fields of Miracles.

And then there's of course the Pisa Tower. First thing that came out of my mind was "How come it looks so much shorter that what I expected?" hahahhaa...

and then "WOAH!!~ it is really very obviously slanting on one side!!~~" apparently, there's a displacement of 4 metres from the edge of the top of the tower and the base. freaky...

The tower is really white, marble stones... felt very clean and pure. There was some restoration going on when we visited the tower, some painting going on, getting rid of the blackness & corrosion, replacing some of the columns etc.

we paid 15 euro to climb the spiralling steps to the top of the tower. The most interesting point of the tower was observed when we were climbing towards the top. Because the tower is slanted at an angle, when we climb the stairs, people tend to step towards the side of each steps that leans towards the slanting side. So what you can see is with one side of the stairs, the indentation marks lean towards the right side, and on the stairs on the other side of the tower, the indentation marks lean towards the other direction!!!~~

the views from the top of the tower was awesome. It is soooo beautiful. we could even see the alps from a distance. and of course, the slanting of the tower was quite obvious from the top too!!~


We then went to the cathedral. as with many others, it is huge and glorious as well, with gold plated ceiling/dome.





The exterior of the batistry is quite unique, i thought. it looks like a layered cake to me for some reason. hehehehe...

And the cemetery has the serenity and peace, without the eerieness of some other cemetery has. It felt weird to walk inside, knowing that some famous persons were lying under us. hehe...


Also saw many tiny cars in the city. and then i r ealised the reason small cars are so popular in Europe is that the lanes and streets and parking lots are so narrow and small all over there. That's why...

Pisa felt like a day trip. A pleasant one nonetheless.
Next stop Rome.
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We visited Pompeii as a day trip from Napoli, with an Aussie couple we met in Napoli, Nigel & Shannon.
(Note: this is after spending a few days in Rome. I will write a post on Rome next.)

for me, Pompeii = volcano, tragedy and ruins.
and that's what the place delivered.

Pompeii is huge!!~~~~ half a day is definitely not enough!!!~~~ it's hard to imagine a volcano eruption destroyed and blanketed the whole city. the eruption must be humongous then!!!~~~ the site was discovered 200 years ago, imagine how long it must have taken the archaeologists to uncover and dusted out the whole area.

Mount Vesuvius looms behind. It's presence is felt all the time we were there and in Napoli. It is still an active volcano, and apparently, it has already overdued for an eruption. Nigel joked about what if there's an eruption and the site is covered again with ashes, then all those effort put in by the archeologists to uncover the site is wasted again. imagine that! haha~~~~ doing it all over again!!~~






What's interesting though, is that the eruption allows the preservation of how the Romans lived more than 1500 years ago. The roads, the houses, the amphitheatres, the water supply, the baths, etc.





the most interesting thing, however, was to see the plaster casts of the victims of the eruption. The whole day brother had insisted on seeing the so-called 'dead bodies' before we leave. After looking around for a while, asking people here and there, we finally found the little corner in Pompeii. All excitement put aside though, it was a profound moment for all of us. The posture, the way people behaved, and even the facial expression of these people at the moment of death, the moment they were covered by hot lava were all haunting reminders of how powerful nature is.

the technique to display these casts though was interesting. While they were discovering the site, they found out some spaces with human remains within, which actually represents the spaces left by the decomposed bodies. So one of the smart one thought about pumping plaster into those hollow spaces, and hence what we see today.

another interesting thing was pumice, the really light-weight volcanic rocks. they are very light because of the air bubbles within when the frothy lava solidifies. We learned this via Shannon, who is a science teacher back in Australia, and she took a few as souvenirs and teaching materials for her students.

All in all, Pompeii is like a daytrip of history, culture, science, geology and humanity.

recently

10 weeks into fulltime hospitals, i'm still surviving. Yay!~

barely though. 2 more weeks and then i shall have a week of holidays.
really looking forward to it.

hospitals are emotionally and mentally and physically taxing place. at time, it's awesome, other times, it just makes you want to leave the place as soon as possible.

i shall reflect more when i have that one week break.
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on another note, friday was one of the good day of the year. I got to play competitive volleyball for a day in a national competition among Malaysian students in Australia!!~~~


i've come to realised how much my setting has improved since high school. a lot of the things that i did that day, i wouldn't be able to pull it off at all 6 years ago. It's a funny concept to understand cos i haven't been playing much volleyball after leaving KL. i guess there's truth behind the older you are, the more experienced you get, the better your skills are?

and of course, i miss my volleyball mates heaps!!~~ the cohesiveness that we had, the togetherness, the understanding among us without saying a word. I wonder when we can all gather again and had a game or two again.
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on another note again, i've gone back into earning money from working. well, not exactly yet cos i'm still in training. but 2 weeks after, i shall be earning money on at least a fortnightly basis, working as a medical receptionist.
So yes!!!~~~ i'll have the money to go travelling again!!~~~~ wahahahahhahaa~~~~~

the next task is to find a travelling buddy. hehe...

anyone interested in going to Tasmania or New Zealand with me end of this year/early next year?

on well, i shall enjoy my sunday.
take care peeps!

random cuteness?

I have been thinking about what foolish or funny things i did when i was young in primary school. And one of the things that i still find funny is my huge little crush on my friend. I've decided to write this down, if not i may forget one day... or maybe not. =P

the cute funny things i did include:
- carved her name with a coin onto my bed headboard (another crush's name was on it too! LOL)
- learned some new words through her name, & the meaning of the words
- wrote the date that we first met on my wardrobe door
- wrote the date of her birthday on my wardrobe door
- always looking forward to tutorials because that's the only time we were in the same class (normal school days, she was next door)
- always tried to see where she was while walking past her classroom
- always tried to spot her amongst the sea of student during assemblies/public speaking competitions etc.
- always looked towards the street that she lived in whenever we drove past
- always waited for her at the end of the tutorials so that we could take the bus home together after
- always tried too so hard to make her laugh
- always tried too so hard to make her talk more (she was a really quiet girl)
- memorised her phone number so well that if you write it out now, i would still find the numbers familiar
- got very nervous everytime I called her on the phone
- took many many many many photos of her on our graduation trip
- those photos are carefully ordered and placed in a special photo booklet
- was so nervous when I had a photo taken with her
- got to hold her hands while taking that photo too! haha... (this sounds sooo dorky!)
- read the things she wrote & looked at her photo she put on my graduation booklet soooooo many times
- had a list of the countries she had been through in the back of that booklet (wth?!)
- wondered countless times about how come we didn't meet sooner
- so crushed when I had to move to KL for high school, not being able to attend the same high school as her (we would have been in the same class!)
- so crushed when letters stopped flowing a few months after high school started

We lost contact after graduation.
Never met/heard of each other for nearly 9 years after.

and one day, out of nowhere, i decided to google my full chinese name.
(I know, i had nothing better to do that time! Turned out to be one of the best thing I've ever done.)

and guess what? I bumped into her blog!!
She wrote a post on primary school friends, and I was so surprised that she still remembers me!!!~~

and we kept in touch ever since.

We even met up 1.5 years ago once.
BUT I forgot to take a photo with her!!!~~~
ARGH~~~~

oh well... good fun reminiscing!

ah~~ such a good weekend so far~~~
take care.

breathe

Breathe in, breathe out.

I can stop and relax, and take in as much fresh cold air I can for this 2 days or so.
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Past 6 weeks have been hectic.
My very first rotation, full-time in hospital.

I don't like the politics.
I don't like the bureaucracy.
I don't like people unreasonable attitudes.
I don't like failing.

But,

I enjoy talking and getting to know the patients.
I enjoy doing the procedurals (not enough!).
I enjoy apologising for my cold hands while doing physical examinations.
I enjoy feeling a wee bit more like a doctor.
I enjoy learning new things.
I enjoy challenging myself, putting myself out of my comfort zone.
I enjoy the sense of purpose after a long day's work.
I even enjoy staying in the hospital for 12 hours straight.

But most importantly, I enjoy feeling alive.

This is what I want.
Bring it on!

Take care.

TGET 6 - Florence & San Gimignano

Florence (Firenze) is very much a city full of history and culture. Afterall, they have 2 of the most visited galleries in the world here.
Sculptures everywhere in Florence!

We reached Florence in the afternoon and was amazed by the bad traffic and 2nd hand smoke everywhere. But also, many many people walking all over the place, small roads, small buses, and boutiques everywhere!!
Argh!~ Cute little bus!!!~~~~~

the weather was still grey, BUT the temparature is good, not very cold at all. Walked for a long distance before finally found the hotel we've booked. It's rather an odd place, it's placed inside an old multistorey building with huge and heavy doors, right in the middle of everything, great location indeed!!~ But if only they are less stringent on turning on the heater at night.

anyhow, 1st stop, we went to Duomo, famous for its cupola. It was really beautiful! very high up inside the building, with drawings of heavenly figures as well as devils, very real and all. If only we knew the biblical story, i had no idea what figures they are, haha...
Duomo in Florence

1st dinner there was Chinese food!!~ surprise surprise! hahaha... we actually craved for rice! good place, nice price, just feeling at home. For once, we know what the people around us are talking about, haha...
Chinese for dinner!!!!~~ miss it!

Next morning for breakfast, shared a sandwich between me and brother. Awesome panino ever!!~~ freshly made, cheap, and great ingredient! Lonely planet never fail!!~ We kept going back for more panino until the guy actually recognised us when we are there... so good!

the glorious statue of Michelangelo's David in Galeria dell Accademia is one of the best statue i've ever ever seen!!!~~ it was amazing! the attention to details, the size of it, every single muscles, every single feature, such grace, such beauty and strength!!!~ the knowledge of anatomy made it even more interesting! hehe... but yea, i was dumbfounded for a long time. No wonder it's stated as the most perfect sculpture in the world. Perfect, that's the word.

Then we went to Uffizi gallery, one of the most famous gallery in the world. I must say though, i didn't enjoy it as much, but more because of lack of knowledge from my part. Maybe i shall go back again one day when i know more, hehe...

rewarded ourselves after with the best gelato in town!! had a pistaccio one, which is not green, but nutty colour, sooooooo authentic!

as with most of the major cities in the world, there's a river - which is yellow in colour, must be the rain washing all the mud away. We walked to Vecchio bridge, famous for the jewellery shops. Yes, i'm not rich enough to get anything yet.
River - yellow-ness....

Old building everywhere!

Multiple bridges!!

another highlight in Florence was the walk up to Piazzale Michelangelo, there stand a bronze statue of David. and the view of Florence (lots of old building), and surrounding the town is the green/yellow/brown hilly region. Beautiful scene... i wondered how Tuscany gonna look like. hmm...
Walking up to Piazzale Michelangelo

Walking walking
walking walking again?

Bronze David!!

Florence!

FLorence

Greeneries surrounding Florence

Beautiful eh?

I want to live there!

Final day in Florence was planned got a day trip to San Gimignano, and behold, it didn't rain!!!~~~ blue skies all the way to the final destination!!!!~~ passing through the valleys and hilly region of Tuscany, i was surprised that there were still patches of green and yellow!!!~~ beautiful place...

San Gimignano is a small town in the Tuscany (A place where i can actually breathe comfortably, not much traffic and smokers!!!~~). It's famous for the towers, seen erected everywhere within the medieval town. Apparently, in 14th century, the height of the tower signifies wealth and power, they had a total of 72 towers back then. Now only 14 towers left. Still, they are everywhere, and the place is called the Medieval Manhattan with its high rise buildings!~ hehehhee...
San Gimignano - Medieval Manhattan!

Entrance to the town centre

Ancient well.

and from Grosso Torre (Great Tower), the tallest tower in San Gimignano, comes the panaromic view of Tuscany!!!!~~~~~ It was BEAUTIFUL!!!!~~~ just breathtaking!!!~~ vineyards, greeneries, medieval building, and blue skies top it off!! I WILL go to explore Tuscany in summer/spring again one day, and cycle through the region would be awesome!!!~~~~ It was sooo good!!~~ The travelling was worth it!!~
Tuscan Valley 1

Tuscan Valley 2

Tuscan Valley 3

Tuscan Valley 4

Tuscan Valley 5

Olives!!!!!~~~ found them while walking around San Gimignano

Medieval town!

The essence of Tuscany?

Essence of Medieval town?

At that stage, i'm starting to fell in love with Italy! hehehe...

med blog?

I know, I haven't been writing heaps lately.

I did posted a few short blog entries on MedMusers, the joint med blog with my med mates.

here's a few:

Of BMIs
just to refresh your memory, BMI equals weight divide by height twice.
< 18 = underweight
19-25 = normal
25-30 = overweight
> 30 = obese
> 40 = morbidly obese (i particularly like how they use the term ‘Morbid‘)

today i saw a patient, 38 year old female with a ridiculous BMI.

BMI = 64! –> Superobese? (’Super‘ doesn’t actually sound too bad. hmm…)

nope, my phone calculator is not malfunction. i can still do maths very well without using a calculator. yes, the formula is correct. and yes, my endocrinologist had double-checked with me by calculating the BMI again herself, after seeing the number on my mobile phone.

and she can still walk, didn’t really have any significant illness, can lie down fine for a GIT examination, BP is normal. basically healthwise she’s still ok, which is so different to what we would expect in the hospital.

just one of those things that make you ponder.
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Remember
We see so many patients on the wards all the time in hospital, sometimes I forget that it is actually a big deal being admitted into the hospital. Their family often required to take time off work to stay with the patient, take care of the patient etc.

Everything has to stop.

I was reminded this today when I heard the news that one of my previous supervisor has taken long service leave because her partner is admitted to a palliative care unit. I was reminded for the past few days in the wards when I kept seeing the husband of a patient around the hospital grounds. I was reminded again and again by patients who have so many doctor appointments to attend, each of them with the support of their family, not easy nonetheless.

We only spend 10 minutes or so of our time with these patients everyday, but their family are the ones who have it hard, dealing with them 24/7. So compared to them, our job is actually relatively easy.
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Interesting
“Can I kill her?”
“I swear I’m going to kill her after this.”

So, I had a patient saying this to my fellow buddy while I was doing a Mini Mental State Examinaion on her. She was of course implying about me.

Hear me people! Asking someone to do maths or subtract 7 from 100 for 5 consecutive times makes people crazy.

Hmm… That’s funny. I’ve never thought the first person to threaten me would happen in the hospital. Why am I doing Med again?

BUT, she’s also a patient who laughed and giggled hysterically when the 2 pentagons she drew looked like a guy’s “dick” (in her own words).

She wasn’t stoned. (Probably has some sort of toxicity from gentamicin.) She also likes to watch Inspector Rex (in French), and nope, she wasn’t serious. Or so I hope. haha…

Ah!~~ Colourful patient keeps the day alive!

EDIT: I've since know that she has also been sexually disinhibited to male staffs. Eek!
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People

“So, you are our mystery man!”

“Am I? Maybe I should keep on being one.”

It’s all jovial and cheery in the beginning of the consult.

Then 5 minutes later, the whole situation turned 180 degrees around.

Metastatic disease of multiple vertebra.
Where is the primary malignancy? To what extent the cancer has spread?

It’s a huge shock. Not only to the patient, but also for us. If only we’ve read the MRI report before he came in, maybe it wouldn’t be such a drastic change of atmosphere.

To someone in his mid-40s, no major health concerns, not even back pain, referred to an endocrinologist for an incidental finding of sclerotic vertebra (?osteoporosis ?vit D deficiency) on abdomen CT scan, the last thing we expect is this.

Worse, he has to endure 3 days (damn you! long weekends!) of uncertainty, as well as trying to just digest the bad news, before getting further investigations done next week.

It’s all too easy when we explored ways of breaking bad news to actors acting as patients.

In reality, it’s devastating.
It’s one of those times that reinforces the humanity of medicine. Textbooks thrown out of the window.

And at the end of the day, it’s all about people.
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5 weeks into hospital. I'm having too much fun.

It's frustrating here and there with some of the politics. And even more disappointing when you are constantly reminded of how little you know, how you are the bottom of the bottom of the medical food chain.

BUT I'm loving every minute of it. Even those darn 12 hours day in the hospital.
This is what I want.
This is what I enjoy.

Life's hectic, but good.
take care people!

Hospital.. Finally!

it has only been 5 days.
What i’ve learned in the past 5 days is more than what i’ve learned medically in the first 12 weeks of Uni with Medicine in Context (MiC).
and i’m extremely happy!~

I’ve been spending time mainly hovering between endocrinology and ambulatory care unit. Both units are quite free, very community-based, run outpatient clinics, see patients that are not very acute, and so it feels like semi-MiC, with more Med stuff in it, which is awesome!

what i’ve done so far:
- cannulated my RMO on the 1st day – success! (haven’t done any since though)
- attended diabetes clinics and saw my consultant being ‘lectured’ by a patient about bedside manners O_O”
- seen many many pregnant women in gestational diabetes clinics and was surprised by how varied their sizes are eventhough they are at the same stage of pregnancy
- presented a few full histories and then felt such failure again and again – a long learning curve ahead!
- rushed down excitedly to the ED during lunch time when my consultant called us about a DM Type I patient – oops! no DKA. – and subsequently missed out on a ascitic tap (why do both unit called us at the same time?!) dang!
- seen a patient with chronic venous insufficiency with lipodermatosclerosis.
- realised the enormity of the antibiotics list – how am i going to remember them all?
- learned that the GI index of wholemeal bread is no different to white bread except more fibres. and 15g of carbohydrates = 1 serve. – Dietiticians are great!
- dreamt about hospitals and hospital wards and doctors and nurses and bloody patients for the past 5 days! – overactive mind!
- consultants/RMO/Registrar don’t eat, drink and pee.
- free food attracts medical students & consultants & Registrars & RMOs & Interns.

things will only get more interesting next week.
and i desperately need my weekends!

hmm...i’m also enjoying a bit too much about having my hospital ID on me. those retractable string are fun to play with indeed.
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on another note, i've been having my regular dose of caffeine volleyball lately too!

trying hard to get back into learning Japanese. and all my leisure reading is only from newspapers! i don't have time to read my feminist theory book!!~~ or other non-medically related stuff. such nerds.

but life's great. exciting. daunting at times. pushing myself most of the time in hospital. learning new stuff all the time. getting to talk to patients a lot. and really enjoying being a doctor medical student. hehe~~~

and we are nearly halfway. nearly.
take care people!
life's good!

new nickname?

Shihui = B2 = Banana 2

The story goes:
Our (Me and my fellow banana 1) consultant introduced us as “We got two new bananas here with us.”.

He was hungry, and the nurse in front of him was eating a banana.

and no, he was too hypoglycaemic to notice the accidental name-calling.

this just shows how important lunch and good glycaemic control is.
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Hospitals are AWESOME!!!~~~
and i've only been there 4 days!!~~
take care.