This is going to be a short blogpost of what I’ve been up to thus far, which is definitely anything but profound! (and I’m referring to both the blogpost and the things I’ve been up to…)

From April until June, I completed my General Medical & Surgical Junior Clerkships at Southend University Hospital. The hospital was great, but the sand and sea were better!  

During one of the Bank holiday long weekends, I escaped from my hospital work and travelled up north to Scotland to visit the IMU gang in Edinburgh. Glen was there too. Visited loads of tourist attractions in the Lothian city, did lots of touristy stuff etc. etc.

Right after the clerkships, I returned to London for my end of year examination. Kudos to the Dawson Hall transfer crew for for our effort in practicing for the OSCE exam! It was good fun. Really.

I returned to Muuuutherland on 17th August. The gym junkie in me ensured that the first thing I did when I arrived back home was to join the local gym. In between burning off calories, I was piling on the carbs, and to this end, Malaysian food pretty much hit home.

I originally had quite a lot of things lined up for the summer, but somehow, ‘administrative work’ and a lot of unexpected turns in my life seemed to get the better of my time. The things I had to miss out: white water rafting in Gopeng with Amanda et al. (sorry Amanda!), and trip to Bentong and Genting Highlands with David and Nicholas (sorry guys!!) 

The things I did do:

1) Annual ‘pilgrimage’ to Penang (a.k.a. late nights out, sleepovers, and generally, bugging the hell out of Yew Ewe and co. at Penang Medical College). This year’s Penang trip proved to be much more eventful and fun compared to previous years. (*nudge* *nudge* *wink* *wink*). It felt really refreshing to reconnect with people from my past.

2) 2nd UKEC Malaysian Students Leaders Summit (MSLS)2008 in KL. I had my (not-so) little sister joining me for this event. Some of the talks/forums were compellingly engaging, while some were just downright bo-ring. I sometimes felt a bit out of place, due to the fact that an overwhelming majority of the participants were either undergraduates or pre-university students(OK la.. I’m NOT that old…). But the post-MSLS BBQ in PJ was good fun, and gave me the chance to get to know more people. Thanks to Chen Chow for letting me in on this!

(Productive) Things that I’ve trying to do:

1)Read up my pre-course notes on animal surgery and anaesthesia for my upcoming UK Home Office Animal License training course in London. 

2) New developments in the area of my research project that have taken place in the last three months. I’ve been trying to learn 3D mathematical modelling in order to understand the work of a rival group from Oxford working on a similiar topic. Not fun. It amazes me what four years of medical school can do to deteriorate one’s mathematical acumen. I swear I knew more when I was studying for A-level math, whereas now, I can’t even do simple trigonometric differentials to save my life! (There’s always the scientific calculator, no? )

3) Deutsche Sprache learnen. On my own. No classes. Just from books. And have I ever told you that German grammar is insane? No? Well, it sure is. Thus far, I cannot yet string a proper sentence beyond four words. So much for DIY language-learning.

********

(Not-so) Little Sister is coming back from KL today. I’m looking forward to see her again! Yay~

Time: Late February 2007

Place: Royal Free Hospital, Camden, London, UK

Occasion: Interview for entry into Royal Free & University College Medical School

Friend: Shen-Han, do you know what is the best way to predict whether you will be accepted into a school or not?

Me: No, I don’t. How?

Friend: Very easy, actually. Just look around you when you’re in the school. Do you feel at home there? Do you feel like you’re welcomed there? Do you get THAT feeling, just by being there?

Me: Whoa… really? Man, I don’t really feel nice in this place. And I don’t think the interviewers liked me. Must be something I said….

Friend: Whoops…..

Me: Shite.

True enough, three days later, I got a nice, succint one-page R-letter, nicely signed by the Faculty Tutor. Blergh. In hindsight, it was a good thing to happen. Instead, I got accepted by Barts & The London School of Medicine.

Scene 2

Time: February 2007

Place: Cancer Research UK Cambridge Research Institute, Li Ka-Shing Centre, Cambridge, UK

Occasion: Lunch at the Cafeteria

Me: Whoa…….. this place rocks. Sparkling new research centre.

Friend: Shen-Han, you’re so superficial.

Me: Tell me about it…..

Friend: It’s the research going on in this place that counts la…..

Me: Don’t care. It’s nice. That’s all I care. You’re lucky to be able to do your Part II project here, dude. Man, I wish Iwas doing a cancer-related Part II project at this place.

The strangest things do happen. And sometimes, you get more than what you bargained for.

Scene 3

Time: December 2007

Place: Dawson Hall, Charterhouse Square, London, UK

I had an epiphany.

A sudden realisation.

It occured to me that I was still in love with her. Science. I cannot forget her, no matter how much I try. The excitement that she stirs in me is just too intense. Passionate. Full of life and energy. We first met when I was an impressionable young student. I admired her in her many forms. Physics, Chemistry, Biology & Mathematics – each of them representing different parts of the perfection that is her.

I used to hold dearly to the motto of the University of Michigan. Artes Scientia Veritas. And yet, I held strongly to the rhetorics of the German pathologist, Rudolf Virchow who argued against ’science for the sake of science’ (Virchow believed that everything in science is applied, and there is no merit in pursuing ’science for the sake of science’. The purists might disagree…).

Yet, I was still commited to my first love. Medicine. For as far back as I could ever remember, I have always longed for her. She was the one thing that brought light to the destitute, and hope to the despaired. She was the one that everyone turned to when they were at their bleakest hours of their lives. She gave, selflessly, without discrimnating creed or color.

What if I wanted both of them? Could they co-exist in harmony? More importantly, was I able to envision myself spending the rest of my life with the both of them?

(pardon the romantic personification of science and medicine. *how nerdy can I get, huh?*)

I thought long and hard. It was a moment of existentialism.

Follow your heart.

Follow your heart.

My mind was flooded with flashes of conversations that I had earlier that day, with a few different people, one being the abovementioned friend and another medical school-mate in the same hospital. (Refer to my previous post on ‘An Epiphany’)

On one end of the spectrum:

‘A good scientist can never be a good clinician’

‘A doctor who spends too much time with his patients can never produce ‘world-changing’ scientific work’

On the other end of the spectrum:

‘The thought of finding something new everyday gives you a reason to live’

‘Some of the clinician-scientist I’ve worked with are the best clinicians in the hospital’

Fast forward to present time.

As I am typing this post today, I can  only ponder with bemusement at all these events that have transpired over the past year. Certainly a lot has happened since then. I am only glad that I’ve finally made up my mind. There is some truth in what my friend had said. The thing about that good feeling you get when you’re applying to a school for admission.

I came to myself in a dark wood

For the straight way was lost.”

Translation from the first canto of the first cantica Dante Alighieri’s The Divine Comedy

Much have been going through my head lately. Apart from my work. About life. About what I really want to become in life. A doctor? A scientist? Or, perhaps, both? (and I haven’t even begun to think what field of medicine I would like to specialise in!)

Pondering aloud has begotten me a wide spectrum of response from the people around me.

On one end of the spectrum, one of my hospital colleague is of opinion that the excellence in both fields are mutually exclusive. That to achieve excellence in one requires the sacrifice of the other.

“A great scientist can never be a good clinician, while a doctor who spends much time with his patients will never produce world-changing scientific work. Are you willing to quit medicine? Are you able to imagine yourself stuck for long hours in the lab for the rest of your life?”

(I should have clarified with her what she meant by ‘world-changing scientific work’…)

On the other end of the spectrum, an old friend of mine feels the other way around.

“The thought of finding something new everyday gives you a reason to live. You don’t want to spend the rest of your life doing the same thing, do you? You only live once, you know?

In the USA, each year, about 1000 of 17000 medical students do an MD-PhD, and go on to become great scientists. And some of the clinician scientist that I have worked with are some of the best clinicians in the hospital.”

(No prize for guessing correctly whether this guy is an MD-PhD student)

A crossroad.

Two paths to follow. One filled with hurdles. The other filled with hurdles, and extra hurdles.

I think I will try my best to prove to the lady-colleague of mine that she is wrong. Even if it takes a lifetime to do that. There is truth in words of the MD-PhD friend. Yet, words from both parties have invoked a deep-rooted determination in me.

 Lots and lots of it. *cough*

(In the UK, it’s called Powerade. So, it seems that USAN not only covers pharmaceuticals, but also sports drinks. ) 

Oh, also, it might be possible to drop dead from viral-induced septic shock in front of the Emergency Department of one of America’s finest teaching hospitals -which I shall not name - and nobody will attend to you if you can’t pay the co-pay fees that your medical insurance didn’t cover – something to the tune of $ 100 per emergency admission out of office hours, without an appointment. And in case you didn’t have a medical insurance, you’ve to fork out the full fees – $1500. Great. Just great.

Thank God for the NHS!

Well, that’s a bit of an exaggeration, really.

My undergraduate gown is still with me, and I didn’t get any white coat (in fact, British doctors have long discarded the white coat tradition).

I’ve now started my clinical course at Barts and The London Medical School, and although I’ve finished three years in Cambridge, I’m technically a 3rd year at Barts, since the Cambridge Part II year doesn’t count towards my medical degree proper. Things have been going *relatively* smoothly since I shifted into the student halls on September 3rd.

The area which I’m living in, Barbican, is a picture of geniality of its Victorian past, most notably that of the West Smithfield meat market, coupled with visible signs of modernism, as exemplified by the giant gray behemoth that is the Barbican Centre. Not too far from my hall is St Bartholomew’s Hospital (affectionately known as St Barts), which dates back to 1123 – making it supposedly the oldest hospital in existence in England. This is one of the two major teaching hospitals that make up Barts & The London Medical School, the other one being The Royal London Hopsital (most of the time, simply referred to as The London) in Whitechapel. Whitechapel is, for the want of a better word, referred to as the ‘culturally-vibrant’ heart of East London - quite simply, an euphimism to describe the plethora of (mostly) South Asian community that populate that quarter of the city. Not surprisingly, we get a good mix of patients.

David stays opposite my room. Both our neighbours are ex-Oxonians. And our neighbour’s neighbours were from St Andrew’s. Interestingly enough, there’s also another ex-Cantabridgian living along our corridor who shares the same first name as David. (and oddly enough, we seem not to have a problem with differentiating the both of them). Call it a coincident if you want to, but I strongly suspect that this is a ploy by the higher-ups to lump all the direct clinical entry students (or ‘transfer students’, as they call us) in the same place. Possibly to avoid us integrating with the other Barts students? My suspicions were further confirmed when I found out that ALL the transfer students who had applied for student accomodation were indeed placed in the SAME student hall.

Academic-wise (you saw that coming didn’t you?), it’s a steep learning curve. That’s as much as I can say at this juncture, since it’s too early to judge.

*******

Summer break this year has been pretty fun, albeit the fact that this is my first full summer in Malaysia. Granted this summer has been relatively uneventful compared to my previous two summers, I feel that it has more fulfiling in terms of renewing old friendships and making new ones. Above all, the opportunity of spending this summer with my family matters more than anything else in the world.  

And what have I been up to for the past 5 weeks? I’ll save the answer to that question for another post till I get all the pictures.  Stay tuned!

On a different note,  another 3 weeks till I start my clinical school! I’m not sure whether to laugh (new life! new place! new course! new people! ) or to groan (this is my last long summer break:P). 

Whatever it may be, it’s definitely gonna be a start of something new! Clinical school, here I come! 

On June 29th, 2007, I was admitted to my BA degree from the University of Cambridge, with a Part I Medical & Veterinary Sciences Tripos (MVST), and Part II Natural Sciences Tripos (NST Pharmacology).

It has been an eye-opening three years thus far. And the fun part being that the journey toward becoming a doctor has only just begun.

To all of you (you know who you are), thanks for being part of my Cambridge years. Here’s a toast to our times together, and I wish you best in the long road of life ahead

As the Malay saying goes: ‘syurga di telapak kaki ibu‘. (translation: heaven is at a mother’s feet) Ok, not literally, but you get it.

And now, the fun part. Q & A time. Where the professors try to screw you over.
I stood in front of everyone in the theatre,  ready to be arraigned with a salvo of questions from the audience.

First question from Dr Barrand. Something about the receptor activation and downstream cellular pathway to which it couples. No problemo.

And then….

Prof Taylor and Prof McNaughton shot up their hands eagerly at the same time. Dr Hiley, the chairperson cued Prof Taylor to voice his question.

‘How do you explain the difference in magnitude of EC50 values obtained from your in vitro pharmacology experiments and Lindemann et al. (2005) that showed EC50 values within the nanomolar range?’

Half-expecting that question, I replied ‘Lindemann et al. expressed human TA1 genes in recombinant heterologous cell based assay, measuring cAMP production as an index of TA1 activity. In this study, I used human vascular tissues, measuring vasoconstrictor response’

‘Then why did you measure vasoconstriction? Are you sure that what you see is a result of TA1 activation?’

crap. Why did I measure vasoconstriction? Well, simply because my supervisor asked me to do it! haha. I thought to myself.

Then, Prof McNaughton interjected. ‘I think the vasoconstriction that you’re getting may not be an effect of TA1 activation.’

‘No professor. Earlier studies in our lab showed vasoconstrictor activity EVEN in the presence of classical biogenic amine antagonists. Besides, we used human umbilical veins, which do not have neurogenic innervation, thus precluding the effect of trace amine in displacing classical biogenic amines from the perivascular nerves.’

Shit. What am I saying? The professor is saying that the vasoconstrictor response might not be mediated via TA1 activation, while here I am, talking in a total tangent to what I’m trying to claim. And what I said actually didn’t do anything to rebut the professor’s suggestion that my results were crap. Too late to do anything.

‘Well, that is a well-founded…’

‘OK that’s all the time we have. Next.’ Dr Hiley interrupted.

Back in my seat, Dr Venter turned to me and said ‘I think you did well’.

Yeah, right.   Did well in giving a dumb answer to a good question.

-3 days before my research presentation at the Part II Students Departmental Seminar. [done!]
-10 days before my Final Honors Examination (a.k.a. the Tripos Exam!) [done!]
-4 weeks before I finally get something that I’ve been working for this whole three years. (if I pass my Tripos exams, that is)[graduated!]
Need to muster everything in my reserves in this last few weeks…
A quote from a can of an energy drink (well, I’ve been drinking, haven’t I? heh)

It’s GOODBYE to SHORTCUTS, HELLO to the GRIND

NOBODY ever said it would be an easy ride. Suffer for your art!

Hardcore, eh?

——-

Update: conditional offer states that place is subject to satisfactory performance in the Cambridge final exam.
My thoughts: Right. Nothing beats the fact that satisfactory is totally arbitrary.

I’m now officially a Cambridge BA graduate.  

And…… I’ve completed all the requirements to be a registered full time medical student at Barts & The London! Yay!