Intimacy

There we are, chilling with the “Chicago” soundtrack flirting around in the background as we munch on Co-op’s delectable cheddar bites. And like the culmination of any double-digit nighttime having sprawled-all-over-the-bed sorts of talks, the giggly topic of innocence is inevitably brought up — more as a passing defiant comment, I mention the Rice Purity Test.

Seriously. NOT a bucket list.

This popular test was originally published in 1924 by Thresher, Rice University’s official campus newspaper. Historically, kids would complete the Purity Test as during O-week (read: Fresher’s week, if you’re not from across the pond); the more you tick off, the more you’ve done – or, in line with the test name, the less ‘pure’ you are. Not only a light-hearted activity meant to bond students, the score is meant to gauge your maturity throughout freshmen year. Read more about the historical context of this test on, well, Thresher itself. 

I’ve done the Rice Purity Test before (yeah, go give them more traffic – you know you want to). An excited “You’ve never done it before?” “Right, I’ve got to try this out!” exchange later, my friends and I are squeezed around a laptop reading each item off the list, occasionally stopping to justify a tick with an embarrassingly hilarious story. The questions range from the relatively more demure “Kissed for more than two hours consecutively?” to “Used a drug stronger than marijuana?”, and to the extremely eyebrow-raising “Engaged in bestiality?” Note that once you get into a relationship, your score will basically drop from 90 to 70 like an anchor to a seabed.

My score is unapologetically high. My friends’ scores are unapologetically low. Is anybody more promiscuous or inherently immoral relative to the other? Is anybody more of a conservative prude, eliciting a high-pitched “Ew, yucky!” outcry when sex is brought up in conversation? A gigantic, slap-in-the-face no, no, and no.  The test was such a good laugh, and reminded us how we’ve all come into university with vastly different life experiences. It’s harmless, but think any more of the score than it is, and the test transforms into a long tightrope across a valley of heckling, slut-shaming, and off-limits interrogation. The view isn’t ever worth that sort of assault, and quite frankly, is offensive to be distilling experiences down to a simple number.

Nonetheless, the large number of questions involving intimacy did get me wondering about my own reservations with physical touch.

I’ve never been a hugger. It’s evolved from petty “Ugh, don’t hug me because I’m not clingy and am playing hard to get” teen rebellion facade, into now near-instinctive hugging whenever I believe it suits social customs; but underneath it all was simply my timeless inability to make intimacy feel natural. Resting your head on someone’s shoulder, lying on someone’s lap, linking arms with a friend — to me, it’s like being Cameron Diaz’s character desperately trying to cry in “The Holiday”.  Don’t get me wrong, it’d sure be lovely to get cosy with Noah Centineo in a hot-tub (yes please), but I’m a big fan of compartmentalisation. Partner dances, patient examinations, massaging – I’ll give it my all; strictly professional. But as soon as weird, fuzzy emotions intertwine with the intentions of intimacy [~that lull in conversation as the night draws to an end when his gaze lingers on your lips~] a foreboding “Oh no no no no”  Titanic-sinking moment vividly plays in my head.

A plethora of reasons pops up as to why some people may find physical intimacy harder than others: you’ve grown up with parents who avoided or evaded intimacy; perhaps the fear of intimacy stems from childhood abuse, and such experiences make it hard to trust anybody. Apart from the familial side, you could simply be an unending workaholic, feel it to be unexplored territory, experience anxiety, or could even just be down to plain immaturity. Maybe the lack of touch doesn’t mean that somebody isn’t comfortable with you, but quite simply, that physical intimacy is not their primary method of showing affection. Words are. Making time to see you. Actively listening to you. The lack of touching itself, I’d even argue, is a form of respect that speaks volumes.

And of course, we cannot forget culture. Oh boy. You’ve seen the endless memes and YouTube videos (“No dating until marriage!”), which are obviously dramatised parodies, but dramatised off of a very real ideology nonetheless. Coming from an Asian background, there is no denying the enormous influence tradition plays in the reservations when approaching intimacy.

Mate selection itself is a process heavily determined by cultural and social factors, differing between an individualistic and collectivist culture (my my, nothing more sexy than cross-cultural psychology and anthropology research). Here’s a crude rundown: individualistic cultures embody that revised plotline where the main protagonist (i.e. you) dramatically assumes the Thinker position and profoundly contemplates, “I need to figure out who I am”;  it emphasises a more autonomous exploration of relationships, to gain more experience in love and sexuality, cultivating love upon this intrinsic desire for passion.

Conversely, the collectivist culture attitude towards mate selection can be summarised quite simply: “If you date her, you date her family.” The process of finding a partner is a tricky business that your entire family unquestionably embarks on, too; in these cultures, only until marriage does physical intimacy and sex become acceptable with a romantic partner. Rather than focusing on the ‘sparks flying’ connection between individuals (every single 12% Rotten Tomatoes rom-com movie), its encouraged to focus on the more pragmatic qualities like economic assets, social status, but most importantly, a positive relationship between the two families. 

Of course, these ideologies are inevitably dynamic and fluid when applied in the real world – social attitudes are always so political. But there is no denying the cultural influence on behaviours towards physical intimacy, and the unimaginable weight of importance placed on family in all life matters when it comes to those of Asian descent. It’s a tad different in my case, as my siblings and I have grown up in a Westernised household in Asian countries – we’d enjoy watching Little Britain when I was a kid (and all innuendos were understood…), I grew up watching Disney Channel religiously where the shows set my expectation of dating to always involve lovey-dovey hand-holding and kissing at the end of the night (PG touching at its finest), and thirst tweets about Ryan Gosling or Mark Ruffalo don’t make me uncomfortable in the slightest. Despite this, despite intimacy making so much sense in my mind as a natural thing to do, actually carrying it out in my own life simply hasn’t ever been. Maybe it was that discrepancy between the individualistic exposure and collectivist real-life. 

So, yes – love can be the hopeless, blissful kind, a passionate fervour that makes you pen a thousand songs to never let the world stop knowing. But love is also putting food on the table, working abroad to earn family income, or giving your first ever earnings in a new job to your parents as a thank you. Love is much more than just Versace on the floor; love is also practical. 

With love, a 90+ Rice Purity Test scorer. Always aiming high.

©TMK

The Introvert (or Extrovert) ‘Hangover’

“Go hard or go home!”

I definitely go home.

In these past couple weeks, I have never felt much more blatantly aware of my introverted self. Having begun my intercalation year in physiological sciences, I’ve essentially become a fresher again, but not without an unattractively scornful attitude. It’s highly likely to have arisen from the premise of “This may be my third year here, but I still want the privileges of a fresher to justify my lack of boldness with”, but boy has it made me ponder. 

The introvert hangover makes such profound sense as to why I feel utterly drained and exhausted after any kind of context involving people, but it’s upon the assumption I’m an introvert myself. I’ve taken those 4-hour long personality tests every Asian tutoring school seems to offer up to the ubiquitously crude Buzzfeed-style quizzes that have tried to bedazzle by defining who I am. Like a ping-pong match, the results cast me back and forth — you’re an introvert! You’re an extrovert! “You are such an extrovert!” “Are you an introvert, too?” And it’s only gotten much more absurdly complex: in parade the ambiverts, the extroverted introverts, the social ambiverts. Typical perennial human obsession flaunting to the world a justification for their attributes.

However, I’m no exception. During middle school, I unashamedly went through an addictive phase of doing online quizzes – but beyond visionary extrapolation, vanity and harmless fun, I was a superbly low self-esteem teen much too worried and much too serious about the future. Personality quizzes were a fork-lift out of the rubble of imploding thoughts; they’d get me out of my own head. See whether my experiences levelled with how others perceived me. And funnily enough, there was almost this sense of awe and wonder to every buffered result – this psychological need for self-reflection, a paralleled OASIS avatar of everything I can be.

Because there, you are assigned an identity, and everybody’s a winner. ESTJ? The performer. INFJ? The advocate. An inborn sense of morality and idealism,” 16personalities.com writes. Hogwarts House: Slytherin. “You possess a remarkably unique blend of imagination and reliability,” some random job recruitment service site spews. Because there, everybody wants to believe they possess some remarkable personality trait, as if it grants them VIP access to unlocking the secrets of society and reality.

Because there, you bask in a sense of innate superiority, in which the world simply must acknowledge and validate. It’s flattering, but probably more to do with the Barnum effect.

So here I am, after a whirlwind of several taster sessions, social events, and meeting new course-mates, and I quickly realised how great of a proportion I spent my 5-month summer engaging in serene, single-player activities. And I’ve also become consciously aware of what a convincing pretence I can muster up in the headlight moment somebody catches me cautiously roaming the room’s perimeter to ask if I’m enjoying the party. Too many introvert hangovers have I experienced from the over-stimulation of social environments (and the only kind of hangover I can relate to, for that matter).

But in jarring contrast, I’m a big fan of initiating conversations with total strangers outside of lecture theatres – I despise small-talk, but because I crave authenticity, I’ll tolerate it and can most certainly conjure small-talk with genuine enjoyment when it’s expected of me. At a totally different birthday party, you can find me wildly busting out the dance sequence to “We’re All In This Together” in front of people I just met. And possibly the most convincing example of extraversion for you Bristol medics out there, I auditioned for CLIC last year (and proud to say I did not get in; 10/10 will definitely go again this year).

That being said, I’ve always known myself to be more of an introvert at heart. And despite everything I’ve said, whatever the consensus on the whole introvert/extrovert faff, I experience introvert hangovers all the time. At the end of the day (quite literally), I’d much rather be doing laundry whilst listening to the “Horizon Zero Dawn” soundtrack instead of clubbing with Nick Grimshaw on a Thursday night. Oddly specific? That’s because it is precisely what I did.

Like a brick-load of things in life, ambiversion is a spectrum. I can’t deny having binged on Buzzfeed quizzes, because let’s admit we’re all a little bit narcissistic and need nonsense in this stupidly stressed life; my issue lies with those quizzes or tests claiming they’re the real deal with a prediction of your future career, relationships and goals. We’re all wired to seek out ways to reflect on who we are — and fair enough, yet this vulnerability is exactly what those companies, tuition centres and other organisations exploit. There’s no denying the very real need people seek to figure out the mess of who they are, but who I am is not a calculation, nor is it a summation of what we know. You don’t need some overpriced test result to articulate your own identity as if you were hearing about if for the first time. The way quizzes guide you through with a nurturing hand, as if a momentous self-discovery process?  It’s an illusion of truth; a botched pseudo-science that rarely tells you anything you didn’t know before, but simply articulates who you know yourself to be. 

You know yourself better than anybody, and more importantly, you know exactly what you don’t know. So, Heaven forbid you sincerely believe your complexity of an existence can be contained by four tiny letters, but please, by all means go right ahead and make a pizza to decide if you’d survive a zombie apocalypse.

©TMK

Put Up Your (Manic) Defence!

I distinctly remember that middle school phase where inspirational sayings overlying a natural landscape was a staple of every social media timeline (i.e. highly stylised memes for the gullible); suddenly, you were the righteously self-titled “deep thinker”, reflecting much more than a mirror ever could. Admittedly, many pseudo-intellectual Tumblr quotes were saved to my camera roll despite its mild insult to great sayings by actual influential figures of history. Anyways, that was a much longer than anticipated trajectory to this wonderful quote by Oscar Wilde: “To do nothing at all is the most difficult thing in the world, the most difficult and the most intellectual.” And, sir, I can finally truly appreciate your words.

Being idle and content with doing nothing is something I’ve aspired to for years. Curated by Disney’s “School’s out, scream & shout!” ideology and agonising exam periods, it’s bizarre to think how relaxation can be difficult. It’s almost been a month since I’ve touched down in Bangkok, where I resolutely told myself, “Now, I can finally relax.” However, I’m still periodically plagued with Raven Baxter-like precognition (except it’s a stabbing pain in my temples, not a vision, and I have that hideous look of a sneeze). I mean, my goodness – exams are over. Pre-clinical years have finished. I’m back at home for the summer holidays with limitless hugs from my family. So, why do I still feel like I’m subconsciously pushing ridiculous deadlines and complicating personal projects to unnecessarily create stress? Stress withdrawal symptoms, is this what this is?

Do I like being stressed?

An infuriating no! resounds, but even the immediacy in this response seems defensive. Maybe my whack hormones enjoy the high of stress, but my mental health does not find satisfaction in reaching a new high score on the scoreboard.

I guess I never really conceptualized it before, but holidays are weird. What are these short periods of unstructured time, and how does one simply do…nothing? My childhood summers filled up with personal projects that began as plain fun, which rapidly escalated to the infuriating high school summers where the same projects caused my eyebrows to furrow thinking, “What’s the point of this?” Because if the sole point was just to unwind, guaranteed I’d find it a waste of time. 

It’s partially my own values and personality, but it’s also partially the environment we surround ourselves in. “Taking breaks is so important in avoiding burnouts!” numerous teachers, friends, and Business Insider articles have stressed (ha). What a load of flapjacks, my body always thought, though never consciously. My helpless and despairing mind engages in warfare, grabbing pitchforks and desperately charges towards this utopia of nothingness, but it’s too late – once again, omnipotent control and overwhelming stress has won. The go-to war strategy has always been manic defence, especially in the predominantly Western mindset that there is supreme nobility in sprinting from one task to the next. Relax, but then the next person will beat you to whatever you were trying to accomplish. Demands of daily life are intense, never-ending, and relentless; thus, the guilt of relaxing really is a guise of your inability to master your agenda despite the ambition. It makes sense why when we stop, stress doesn’t. It would explain the scene of me shuffling pathetically through Suvarnabhumi Airport with a luggage in better condition than me, feeling absolutely battered and broken not from the 12-hour flight, but the 5-month fight, because it still isn’t over.

So be it if I must voluntarily delude myself in “You miss 100% of the shots you don’t make” quotes to help unstrap the belt around my head, to practice the art of doing nothing. Who would’ve guessed, that years later, my name is enrolled in a fight I never thought I’d sign up for: learning and practicing what it all means to simply relax, just like finding happiness.

©TMK

Year 2 Bristol Med School | Summer Exams

It has only been a few days since completing the final summer exams, and you bet your sweet bippy I’m still experiencing severe withdrawal symptoms. These episodes are of an unfortunate recurrence after every exam season, and leave me chaotically conflicted. I’m gonna call it…post-exam subjection trauma (PEST). You know what I mean; how every little ordinary detail in daily life triggers this automatic all-out regurgitation of lecture knowledge where you completely blackout, before snapping back into reality dry-heaving “May 16th please be kind to me”.

*sees a mother breastfeeding her baby in public*

Okay oestrogen = ductal system, progesterone = secretory system? Ooooo but don’t be fooled since progesterone & oestrogen actually inhibit lactation. Nice one. And then, what was it? Oh, dopamine inhibition due to suckling relieves restraint on PRH, prolactin release causes milk production, oxytocin causes that weird “milk ejection reflex”…that reminds me of the “viscous fingering” mechanism in the parietal cells of the stomach, omg that lecture was kinda weird, ha ha ha *still staring at the breastfeeding*

Sigh. This is what PEST does to you – you only see science, not people. 

Anyways, I did a similar review last year of the Year 1 summer exams. Thus, as a sucker for continuity, here’s another.

Systems of the Body 2: Paper 1 (April 23rd)

Structure: 70 best-of-five questions | 1 hour 45 mins

What: Gastrointestinal, respiratory, renal

Remarks: Because we had January mocks on Systems 2, this was just a smidge less terrifying than the others. I have to say, it was much more clinical than I prepared for, but I was definitely expecting it. There was one question where it said a man came in with fever, diarrhoea, etc. and we had to figure out which bacteria he is most likely to be infected with. At this point, it could be any of the options. But then, the vital bit of information is that upon history-taking, it is learned he works in a lab…with lizards.

…so, okay. I get medical school is all about lateral thinking, but the lizard thing was just a little bizarre. Can’t get over it. Lizards.

With drug names, I can safely say this on behalf on all of us: we don’t remember them entirely, and just commit the first syllable to memory. It’s best-of-five, after all. For example, one of the cysteine leukotriene antagonists for asthma is montelukast, but I just think its that Monte Carlo drug, or the synthetic analogue of PGE1 protecting the stomach mucosa for peptic ulcers is misoprostol but I remember miso soup. And then, we all have our idiotic tactics of remembering a list of drugs. Anti-emetics, for example: the 5-HT receptor antagonists. One of them is Nabilone, which sounds like Naboo, that planet in the Star Wars universe, so extraordinarily picturesque it’s almost euphoric (one of the side-effects of the drug). Or furosemide is a loop diuretic; I remember this by the thinking “fur” = dogs, one of my favourite dog breeds are shiba inus, and they have curly tails (“loop” diuretics)…

A lot of the tactics used are incredibly crude, linking up selective information required for exam purposes only in a strange way. And then for others, you go over and over them again, until they just suddenly give way. Like, for me, I didn’t want to just accept the definitions of SaO2, CaO2 & PaO2 – we’re told it’s saturation, content and partial pressure, respectively. I never really properly understood this in relation to the equations given, but one day, it just randomly fell into place for me: SaO2 = the oxygen binding to Hb, PaO2 = the oxygen actually dissolved in plasma, and CaO2 = summation of SaO2 & PaO2. Highly likely I’m just really slow, but I never really got it until I kept staring at it.

Systems of the Body 2 & 3: Anatomy & Histology Spot Test (April 25th)

Structure: 80 MCQ questions | 45 seconds per station (1 hour exam) | Includes topographical anatomy, case scenarios, pathology cases, clinical examinations, radiology, and histology

What: Gastrointestinal, respiratory, renal (Systems 2); nervous system, endocrine & reproduction (Systems 3)

Remarks: Right, so this was the exam I was more disappointed at myself in compared to the others. Anatomy tends to be the slightly (better subject for me than the written papers (keyword: slightly), but I walked out feeling absolute dismay; it didn’t feel like the dozens of hours spent revising, especially on the topics you make an extra effort to understand, paid off. Things that we spent a lot of time in the DR learning (“You need to know this!”), like the various strictures of the oesophagus & its multi blood supply or the lumbosacral plexus roots, didn’t even come up. We had a whole practical dedicated to ears & eyes, and only 2 questions max came up in total for both. My friend said she only knew the answer to another question because she happened to overhear someone directly ask the demos; so unless prompted, there would be no explicit answer that wasn’t even in the booklet (but apparently on the exam).

The questions came at obscure angles, like the innervation of the ureter (only PSNS, only SNS, both PSNS & SNS, etc.) – not even joking when I say it’s this tiny, vague statement at the bottom of the renal booklet “Nerve supply via autonomic plexuses”. There was one station displaying a radiograph of the thorax, and the right lung clearly showed pleural effusion. The question was, “What is the pathology in the left lung?”, in which the correct answer was simply “Normal”, which I didn’t even realise was a trick question until somebody asked me after the exam, “Hey, that trick question though, right?!” I think what irks me is that the formative spot questions in the sessions give the wrong impression of the style of questions that actually came up. But then again, this was just my experience; a lot of people came out feeling pretty good, and that it went better than expected, so I could just be an unpopular opinion (story of my life).

Systems of the Body 3: Paper 2 (April 27th)

Structure: 70 best-of-five questions | 1 hour 45 mins

What: Nervous system, endocrine & reproduction

Remarks: Held in the grandiose Will’s Memorial Great Hall, it was a pretty adorable way to finish the gruelling pre-clinical years. Most of us were tremendously jittery beforehand, because of the fact we have handbooks the length of your average 3.5/5 Goodreads YA novel and tedious 9-5 lectures that happily shoved us off the cliff into anxiety. So, it was a shocker to say the paper went much better than anticipated for the majority of us. Once again, a rather clinical paper – there were quite a few questions on contraception applying theory to legitimate context useful in practice, which I appreciated (though mind-boggling at points). The first question threw everybody off – “How does alcohol cross the blood-brain barrier?” For some reason, I thought drawing the molecule for ethanol would help me decipher the answer (it didn’t). Ask us about the basal ganglia pathways in relation to Parkinson’s disease, and we’ll give you this immaculate answer all backed up with Vancouver referencing. But a stupidly easy question about alcohol’s solubility properties? Well-played, examiners, you’ve caught 228 med students off-guard. My favourite question asked how a patient with mania would present at the GP – one of the options had convoluted SAT words with way too many vowels, but the real star answer was “Staring at the wall and counting”. Not the right answer, but just…right.

There were other little bits I picked up on, like how there were equations the lecturers specifically said to commit to memory, like % ionised, that they just straight up gave in the paper anyway. Then various pathways, including the motor & sensory tracts, auditory & optic pathway, or the spermatogenesis & oogenesis processes, barely made appearances, if not at all. Embryology was absent. It was a little frustrating, because with those topics,  it actually took a substantial amount of time to methodically learn them step-by-step. Then there were those one-off questions, like what the uterus fundal height is by 20 weeks – it’s this tiny sub-bullet point on a slide amongst 37 others, let alone in a booklet of 225 pages. Or which condition can cause increased feet width; intuitively, most would choose acromegaly anyway, but this information was in a video the lecturer showed, not on the actual lecture slides given.

••••••••••

I know a lot of this was nit-picking and complaining about parts of the paper, but overall, I understand exams will always be like this. The really wishy-washy, extremely unpredictable questions that you’ll feel are unfair, but you gotta play the game whether you like it or not. What I’m basically saying is, no matter how much you revise, it’ll never be enough – the learning isn’t necessarily harder than IB or A-levels, but probably down to the sheer quantity and conceptualisation of certain ideas (e.g. the reticular formation or the basal ganglia). It’s learning how to cover everything effectively (but not beating yourself up if you don’t, either), preparing to accept there isn’t always a correct answer, but most importantly, being able to not always want to know why. I say this with a conviction suitable only in this context; this is a mindset that our high school curriculums set us up to think, that there is always some kind of explanation for every question-mark – it’s the whole “big fish small pond” syndrome shaking up the high-achieving kids who tumble down the pyramid. Falling isn’t the issue, but trying to climb to the top again purely out of familiarity, most definitely is. Whether you agree or disagree, hopefully it’s something to think about.

©TMK

Term 1 • Year 2 Bristol Med School | Reflection

 

So, I don’t do these much – a solid year has passed since the last one. Well, here I am, giving you my less-than-wise perspective on how I found the last few months. So, it’s rumoured Term 1 of Year 2 is objectively the most leisurely time of your entire medical school experience in Bristol, to which is a statement I do not object – but it’s not saying much compared to everything else.

Let’s skip over explaining all that standard lecture curriculum stuff you can read on the website; what’s differed from Year 1 is that after finishing a lecture-based teaching block studying a particular system in the body (i.e. respiratory, gastrointestinal, renal) lasting between two to three weeks, we all get placed into a hospital in or around Bristol. Our stethoscopes slung proudly around our necks (£90 worth of the hypocritical attitude “Just don’t ask us to properly use it”), it’s the ultimate committal point-of-no-return investment.

I’d really like to point out how it positively warms my heart to watch my medic colleagues take a history and do clinical examinations on actual patients – everybody slowly emerges with their little personality quirks. Like that intimidatingly buff dude who got in Clicendales last year who is actually adorably soft-spoken and displays great open body language. Or that girl always rocking denim overalls you’ve never really properly talked to who unconsciously leans very far forward, engaging far more with the patient. Or the legend card guy on nights out, who consistently makes sure to repeat back the information to put the patient at ease she/he is being actively understood. I’ll even say it’s humbling to being a part of the beginnings of my peers’ medical career – sappy? Yep.

Aside from that, you’d think medical students would find the clinical environment extremely exciting; and don’t get me wrong, we did desperately yearn for those hospital placements after living in E29 (groggily waiting as the clock ticks a few minutes after the scheduled hour before somebody shouts “LECTURE CANCELLED, CHECK YO EMAILS!” which unfortunately happened far too often). However, there was a surprising collective thought a few of my fellow colleagues had about the 3-day formalities:

“I’ve realised people are just…so tiring. Is that bad?”

We’re still figuring it out. Even myself, I found the weekend leading up to ICS Placement was a bit of a dreaded countdown – it’s the culmination of having not finished going through the Respiratory Element and then we’re expected to know Gastrointestinal pathologies for the following Monday; exhaustion from everything else in our lives not medically-related; fear of the much-too-real insight into the lives we will lead in the many years ahead…

I guess it’s some mild form of empathetic burnout – honestly, actually sitting down with patients is always incredibly humbling and we would never be insincere about it. And yet, at the end of the day, you flop onto your bed in bare-below-the-elbows attire with the lanyard uneven around your neck, utterly exhausted. And I swear, if I met somebody new during that period, I would’ve immediately blurted out the preprogrammed “Hi-my-name-is-Holly-I’m-a-second-year-medical-student-etc-etc-etc”

Anatomy was chill as always. Top tip: no matter how weird your question, ask. Really. As long as you use anatomical terms, you can practically ask anything whilst sounding vaguely intellectual – the demonstrators will possibly be the more openminded people you’ll meet, given the niche nature of their job. And even though your friends (you know who you are) are cackling at your sincere curiosity of the science behind certain, ahem, activities, you’ll certainly thank yourself for not needing to do an uncomfortable Google deep-dive without UV protection from the bare exposure to everything but the science.

And now, January exams have ended (before I hightailed into London – what is it with me escaping to that city after tests?) and Term 2 has begun with the highly anticipated neuro (negatively rumour-drenched from older years). A brief review of Week 1 so far? Let’s just say, I’m seriously enticed to do work rather than celebrate my birthday next week.

’til next time.

©TMK

I Wore A Heart Monitor For 24 Hours

Spoiler: I’m okay for now.

Approximately three weeks ago, I went for my regular health-checkup routine. There was nothing spectacularly negative about my results – my total cholesterol level increased compared to last year, but it was due to an elevation in good ol’ HDL; my TSH level was 1.960 uIU/mL, smack-bam in the middle of the hospital’s normal range; my hematocrit percentage, usually presented with a taunting “L”, was surprisingly normal for the first time in years. It’s safe to say, living on my own in Bristol the past year has made me much healthier on the micro scale.

Ah, but the results came with a little more excitement than anticipated.

Last year, my EKG result stated: “Sinus bradycardia with sinus arrhythmia; borderline prolonged QT interval; otherwise no pathological findings”. It wasn’t necessarily denial, but an unimpressive knowledge about ECG/EKG interpretation that allowed me to shrug nonchalantly about the situation. But this year, my EKG result stated: “Sinus bradycardia with junctional escape beat and bigeminy premature ventricular complexes”, and after having crammed an outrageous amount of information about various cardiovascular system abnormalities (I’m panicking as the phrase “Quick lids flecking at amiable dilettantes” scrolls across my vision), well, what can I say…I still shrugged nonchalantly about the situation.

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14/06/17 EKG Results (For You Keeners Out There)

A follow-up was required a couple weeks later. I was *this* close to napping face-down all day listening to the ironically motivational movie soundtracks of Rupert Gregson-Williams, but thankfully dragged my lazy bum off the bed due to post-exam hopelessness (I hope today all you IB kids got the results you wanted – remember, there’s always a pathway for you!). So there I was, in the doctor’s office – not to be worried about at all, she said. It’s common for people under 40, and it’s very rare for it to be serious. Two things would happen: I’d get an echocardiogram done, and then wear a Holter monitor for 24 hours.

I remember watching one of the demos talk about echocardiography during an anatomy session, and this image was put up:

echocardiogram
Source: http://www.cardiachealth.org/sites/default/files/2011/echocardiogram.jpg

Um. I mean, what a truly wondrous photo. Find a person who’ll look at you the same way the patient and sonographer look at each other, am I right? (I swear I learn in anatomy sessions).

Anyways, that didn’t happen in my case (painfully grateful); I faced away from the sonographer and counted the number of vertical stripes per coloured block on the wallpaper (seven, if you wanted to know), and there was barely any talking. Despite being half-nude and having this transducer basically kneading my left boob, it all felt incredibly systematic. I almost fell asleep. But by hearing sudden spitfire beatboxing by my heart, occasionally being asked to hold my breath, and catching a glimpse of the Doppler echocardiography’s explosion of pretty colours, I just managed to stay awake.

After swiping away the ultrasound gel, I was then suited up with the Holter monitor: five electrodes plastered on, and a little pouch that held the ambulatory device itself. It’s basically just a piece of tech that records heart activity continuously for 24 hours (or 48, depending on the doctor’s suspicions of the final diagnosis) – since ECG/EKGs are performed only within a short snapshot of time and abnormal heart rhythms/cardiac symptoms come and go, the monitors are pretty great for doctors to evaluate irregularities, severity and patterns over an extended period.

I left the hospital feeling like an amateur espionage agent (watch out Agent Cody Banks!1!!). Here are a couple of images to show the Holter monitor itself and where the electrodes were placed – the former displays a countdown of the exact amount of time I had left of the 24 hours, and shut down once it reached zero; it was like a microcosm of every dystopian novel ever. 

So comes the next day, after having slept as still as a log (subconsciously afraid I’ll roll onto the Holter monitor and suffer the pricey consequences), and they go analyse the data. Here are my results in brief.

Echocardiography Summary: function and anatomy normal albeit mild tricuspid regurgitation (TR). Seeing the real-time videos of my heart beating made me oddly vulnerable – I mean, if you think about it, nobody will ever have the privilege to set eyes on your beating heart (with the exception of those lucky enough to partake in open heart surgery). I’d feel more naked posting a snippet of the echocardiogram than a revealing swimsuit photo of myself.

Holter Monitor Summary: The doctor said if I had 10% or more ventricular ectopic beats in the total number of heartbeats in the 24 hours, I would be sent for treatment. If it was 5% or below, I’d be alright. Luckily, I only had 4.1% – whilst she did appease my mother by stating there was nothing to worry about (“All you need to hear is that her heart is completely normal”), she turned to me and asked me to be more aware of my body. That is, if my palpitations become more frequent or if the tight squeezes I feel in my chest increase in severity, I am to go back to see her.

“How many hours of sleep do you get?” she asked in the middle of history-taking.

“Well, 7 hours on average, now that it’s summer.” I think back to how my heart rate was only 48BPM just before the appointment; that armchair was really quite comfortable…

With a small smile, she casually said, “Ah, wonderful – when you get to clinical years of medical school, you won’t get nearly as much!”

Honestly, I really like this doctor.

Anyways, I got this incredibly exciting full report with an hour-by-hour analysis (I can sense what a funky, wild Friday night I’ll be having).

You can see how the number of PVCs vary during various times of the day; a few examples of the activities I was engaged in included:

8:00PM = delicious dinner at MK with the family + a McDonalds cone (the simple pleasures of life)

10:00AM = extremely fervent Kyle Landry piano-playing; I even got a cramp in my left hand (watch this space for a cover…)

3:00PM = serious car talks in traffic

It’s extraordinary to actually see the direct play between the physical environment and the electrical activity of my heart – the times with high PVC frequencies correlated with some form of intense emotion; “Strike fear into the hearts of your enemies” “With a sinking heart” “Eat your heart out” idioms suddenly became exceptionally reasonable to me. It should be blatantly obvious that everything you do cascades upon your inner mechanics, but I previously could only resonate so much so as if watching a devastating BBC News segment from the comfort of my own home. It just further highlighted the stark opposition of medicine being both routine practice and blindly grasping in the dark.

At the end of the day, the treatment literally stated “reassurance” – drink lots of water, sleep for a minimum of 6 hours per day, no caffeine, stress less. Such basic courses of action to take, and yet so subconsciously overlooked by the generation of today. Anyways, I think as a medical student, having the opportunity to personally experience particular examinations/procedures you see portrayed via cringe-worthy stock photo compilations in lectures provokes the same level of excitement you have as you are about to watch one of the most anticipated block-buster films of the year (I am at this very minute on the way to watch Spider-Man Homecoming). And that’s probably the very reason I documented it all…I guess I’m just young at heart.

©TMK

 

Skull

Despite having examined juvenile skulls frequently in the past anatomy sessions, I am still always in awe at how breathtakingly light and fragile they are. And as I trace my fingers over the fontanelles in amazement, I’m constantly thinking to myself,

“This will never get old.”

©TMK

5 Social Media Tactics Freshers Deal With Homesickness

I’ve noticed quite a few ways freshers (including myself) communicate with their friends and family via social media, so here is an unstructured framework of that. Maybe a tad more geared towards international students. Specifically Asians. Maybe not.

  1. Facebook
    • Sharing friendship anniversaries “___ and ___ are celebrating 6 years of friendship on Facebook!” complete with the video no one watches that has the weird translucent overlapping coloured faces with “Hey __ &___” thumbnail
      • Warning: irritating when overabused
    • Tagging your long-distance pals in memes a couple times per week is enough to let them know you’re still thinking of them, or videos with those black bars:
      • Top bar (please notice the blaring caps)
        • WHO DID THIS
        • I FEEL BAD FOR LAUGHING
        • WAIT FOR IT
        • I CAN’T BREATHE
        • DYING
        • I DON’T KNOW HOW I FEEL ABOUT THIS
        • TRY NOT TO LAUGH
      • Bottom bar contains exactly 3 crying/laughing emojis – no more, no less
  2. Line calls
    • 90% of communication with family – extremely great for group conversations (unlike WhatsApp) but for moderately active members >10, mute conversation (e.g. society circles)
    • Effectively conveys exact feelings + mood because of the cute stickers
    • Includes scratchy video calls and poor connection, freezing up at the most unflattering facial expressions (which you have to subsequently screenshot)
    • Emoji expressions can be incorporated during video calls (I especially like the beads of sweat one)
    • Recommendation: calling family via Line in the mornings before lecture as you eat breakfast for efficiency
  3. Voice recordings
    • Incredibly useful for on-the-go communication
    • Best for use with close friends, either Facebook messenger or Line (though Facebook messenger has a 60 second limit, but Line is limitless)
    • For terrible texters (like me)
    • Expect awesomely awkward moments at the end of each Facebook messenger 60 second recordings including: “Um, yeaAAahh…” “Cool cool…” “So, yeah…”
    • …and equally as awkward beginnings of the next recording, or perhaps the last recording was cut off by the person’s excited speech: “My thumb got ahead of me”, “Oh I just got cut off”, “Oh whoops”, “LOL”
    • A Facebook conversation filled with seventeen recording bars is something to look forward to listening to while making dinner or on the toilet
    • Don’t feel obliged to reply as soon as you read the messages and don’t feel obliged to also plan what you will say (spontaneity is key)
    • Oh-so-exciting when you open a chat and see a page of long blue bars one after the other filled with the voice of a rambling friend you love
  4. Facetime
    • Less commonly used mode of conversation; more with pals in the U.S. or with conversations you know will last longer than 2 hours long (“Okay, so…” is a typical signpost)
    • Will eat up battery; best to do in your dorm/accommodation room near a charger so you can also put on speaker while you snack
    • Best on Friday nights (because so lit)
  5. Instagram
    • Occasional #ThrowbackThursday #TBT posts and if you’re in the U.K., expect photos from summer with captions concerning the weather (e.g. “Omggg I miss this weather and you” “Missin this dude”)
    • Personally not a fan of this method

Ignoring Skype in this list because that is a given, and is usually a secondary communicative device anyways since you organize the call via the methods listed above. Oh, and I don’t have Snapchat.

©TMK