Moving on

"For My thoughts are not your thoughts,
Nor are your ways My ways," says the Lord.
"For as the heavens are higher than the earth,
So are My ways higher than your ways,
And My thoughts than your thoughts.

Isa 55:8-9

Things have not been smooth going lately. I was tied down with struggles for a while. Oh Lord, there must be something that You're teaching me.

Grandma is demotivated to carry on life lately, so am I with work. Let's press in once again! It's time to move on, life still goes on.

Shall we?

P/S: It's working ONE year anniversary today!

一年游子

猷记得离家前的家庭聚会正是中秋。光阴似剑，离家背景也快一年。古晋的工作依然繁忙，对三、四天一次的 oncall 煎熬虽已麻木，但却越来越筋疲力尽，不像刚入行时那样的兴致勃勃，也许我老了...

逢佳节我会想家，这个中秋也不例外。我怀念诸圣堂的弟兄姐妹，以往一起筹备的每个晚会、每个细节。想念家庭温暖，想念与弟妹谈天说笑。也想起了孤苦伶仃的外婆和她那受伤了的脚...

今年中秋不一样，我们偶然地参与了古晋福音堂的晚会。能够忙里偷闲，再次感受团契生活让我有所感触。

再坚持一个月吧，我下个月能回家了！

祝大家：中秋节快乐、佳节蒙恩！

You raise me up

You raise me up, to more than I can be.

The little artist

I am in Paediatrics Surgery, a posting which I am entertained more by the kids than the subject itself. Rather slacked and lazy nowadays as things move in a slower pace compared to that of in General Surgery. Having to relax once in a while is good.

Recently discovered a talented artist, who draws unceasingly without an eraser. A 6-year-old's copyright masterpiece:

Impressively creative isn't it?

Pencil

May God continue to strengthen us in time of the painful sharpening.

And God is faithful; He will not let you be tempted beyond what you can bear. But when you are tempted, he will also provide a way out so that you can stand up under it. - 1 Cor 10:13b -

A solved mystery: Surgeon Vs Physician

He was in his late fifties, a known case of vitiligo for the past 12 years who was admitted to surgical ward for dysphagia for 10 days. More difficult on swallowing solid than fluid. It wasn't preceded by abdominal pain and there was no constitutional symptom. No family history of cancer. Neither does he smoke nor drink.

It was unlikely oesophageal carcinoma in such acute presentation. Reflux oesophagitis or ulceration causing stricture is possible but there was no symptom pointed towards it. So oesophageagastroduodenoscope was indicated to look for the direct cause of dysphagia. Barium swallow was arranged too but patient would have problem in swallowing.

Here's how the story starts...

He refused to lie down in scope room claimed to have shortness of breath in supine position. Oh well, he had been sit sleeping for the past 4 days. Medical referral made but work out elicited no cardiac or pulmonary related dyspnea. He appeared comfortable and oxygen saturation was always perfect under room air. His big bunch of family members were around everyday and they take turn to massage him. So I, evil enough, put him a PSY label - feigning and attention seeking.

One fine day, another medical referral was made. This time around, a physician came to review instead. He solved the mystery just by a sentence:

"Pakcik, tengok saya!"

Slowly, the patient lifted up head with much struggle, and dropped down again shortly. He had droopy eyelids and proximal myopathy on examination.

Yes, he was in head-nodding position most of the time, which I didn't bother to find out why.

"So what's the diagnosis?" We were asked.

"Myasthenia gravis..." We stared dumfoundedly. It never even cross my mind.

Further history was elicited that his muscle weakness started months ago, worst towards evening. And his son is diagnosed myasternia gravis too on treatment!

Thinking about it, everything seems to be co-related:

Vitiligo
Head-nodding position
Massage
Dysphagia
Shortness of breath

I feel a bit dumb.

Lesson of the day:
1) Think wide! Surgery posting doesn't mean diagnosing only surgical related problem.
2) Do not judge!

Simplicity

Postcall weekend off and I am having my all time favourite kaya butter toast and teh c ping special. Simply enjoying!

I had a good call. And I can go to church today!

Happy~