A Nightmare

I had a nightmare the other day.

I was sitting in the back row of a maths class in my high school. It was a classroom of about 40 students. As usual, at the front was a maths teacher who was rambling on some basic principles nonchalantly. He was also making some random irrelevant political remarks.

The air was as stale as last week's white bread. It was so boring that I was staring blank into the space. Some people were taking notes of what the teacher said. Some copied it verbatim. I couldn't be bothered.

As if realising the staleness of the air itself, the teacher suddenly decided to stir up the air by running a spot-check on our notebooks. With raised eyebrows he inspected our notes, barely giving any appreciation for those who jotted down his excellent political remarks word-by-word. You just can't expect him to do that.

Then he came to me. And my book was blank.

"HOW DARE YOU not paying any attention in my class. You are so disrespectful. You will be deducted five points from the final maths exam for your conduct!"

I was absolutely horrified.

Flushed with indignation, I retorted,

"You were just teaching basic things, why should I copy down what you said? If you said one plus one equals two, should I copy that down too?! Give me back my five points!"

He ignored me. I sat down trying to contain my pent-up anger.

Ten minutes later the class went on as usual. I continued to not take any note and the girl in front continued to write down everything.

And then he decided to do another spot-check.

He came to me.

And I woke up.

Image Credit: Teachers happy to get more work, responsibilities for Teachers’ Day « Nose4news

p/s: This is a real dream. And for some reasons that teacher is En. Ilias for those who know him :P

[Video] If the Earth Has Rings Like Saturn's

Do want!

[Photo] Peeking Through

What's beyond the blind?
1/80s - f/3.5 - ISO 400 - 50mm

Big Boob Blooper - A Story on FAIL Journalism

This is about a news article in The Star (published on November 12, 2009) that turned out to be a fake news fabricated by a supermarket tabloid 6 years ago.

To save myself the trouble of telling the whole story again, let me attach the complaint letter I wrote to The Star here:

Dear The Star Editor,

I am writing with regards to the news on  "a study in the US showing that women with bigger breasts were found to be smarter". For your information, this is a fake news which was reported in World Weekly News back in Nov 4, 2003. Yes, from six years ago. The original news is available here. You can verify that this "news" is identical to the one reported in The Star.

Evidence that this news is fake:

1. World Weekly News is a supermarket tabloid renowned for its outlandish cover stories often based on supernatural and paranormal themes and an approach to news that verged on the satirical.
   
   
2. Note the informal language this article is written with.
   
   
3. Read the previous and subsequent pages. Note the trivial and exaggerated writing.
   
   
4. A search in Google Scholar (Google's academic journal search engine) for published articles by Rossdale in chicago returned no matching result. Google Scholar is a comprehensive academic search engine so the lack of matching result implies the non-existence of the study.
   
   
5. A search for "yvonne rossdale" in Google shows only copies of the original article from World Weekly News. If you browse through some of the results, there are many websites in which people have pointed out that Dr. Yvonne Rossdale does not exist.
   
   
6. A search in Google News for "chicago breasts" shows that only The Star and Hindustan Times (which in turn copied The Star I believe) are reporting on this news. No other major news outlet is picking up on this "study".

I am absolutely appalled by The Star's negligence in verifying the authenticity of the news before the publication. This fake news has now been disseminated widely over the Internet, and your company's negligence is responsible for the misinformation. It is mentioned that this news is compiled from Sin Chew Daily which in turn is quoting from a Singaporean paper, but I have not been able to find the articles in Sin Chew or any Singaporean paper. I would like you to point me to the original article in these papers, so that I can forward this email to them as well.

More importantly, I would like The Star to publish a correction in a conspicuous corner as soon as possible. I fervently hope that in the future your employees remember to verify all news with primary sources (isn't that in Journalism 101 by the way?) before publication lest your reputation deteriorates.

Thanks.

Regards,
Chang Yang Yew

Let us see how The Star responds to the hoax story they have published.

Kill The "Do You Want to Restart Now" Nag

I am sure this is not new to geeks like See Hua, but I discovered this convenient trick to get rid of one of the many annoyances in Windows. If you have spent some time with Windows (any of the recent versions including XP, Vista or 7), you would most likely have come across this lovely dialog:

You click on "Restart Later" hoping that it would go away; but no, it keeps coming back to you like a nagging aunt. Some days your machine gets more impatient, and it shows you this version instead:

Sometimes it's even worse, where the option "Restart Later" is grayed-out and you can do nothing except to watch your computer restart in horror.

Now, imagine that this happens in the middle of watching your favourite movie, or presenting your powerpoint slides. Should we let Windows take us hostage for its "restart now" compulsion? Of course not. There's an easy way you can kill off this nagging dialog when it appears.

Here's what you do. The following instruction is for Windows XP only, for Windows Vista or Windows 7 please refer to this page.

1. Go to Start --> Run
(for those who like keyboard shortcut, you can also use the combination "Win + R")

2. Type net stop "automatic updates" then Enter.

3. You will see the Command Line window for a brief second and voila, the nagging dialog would be gone. You don't have to worry about the update not being installed because the Windows will still install it automatically the next time you restart your computer.

That's it, a public message by CY.

10 Things About Melbourne Cup

1. Melbourne Cup is an annual horse-racing event held in Melbourne on the first Tuesday every November. The first Melbourne Cup was held in 1861.

2. It's widely known as the race that stops a nation. It's also gazetted as a public holiday in Victoria state.

3. About 100,000 people attend the cup day every year. 100,000 dressed-up people.

4. Fashion is a main focus for the attendants at the Melbourne Cup race. Apart from their best dresses, women often wear elegant hats or fascinators (pictured above) as an accessory. It's quite a sight to behold. However, many of these people get drunk and the ground is full of rubbish after the event. It's an eyesore not to behold.

5. 80 percent of all adult Australians population are said to place a bet in any given year's race. The total bet often goes up to 100 million dollars throughout Australia. Australia's population is 20 million, so it comes up to everyone in the country placing an average of 5-dollar bet in the race.

6. The winner this year, Shocking, came first at a 11-1 odd. It means that if you bet $10 for a win, you would have earned $110 at the end of the day. One punter took home $440,000 on a $40,000 stake. If you bet one of the other 22 horses in the race you lose all your money. Apart from winner you can also bet for places (top three), quinella, trifecta, first four, big 6 and so on.

7. Melbourne Cup is one of the races where a handicap is placed on the horses based on their previous performances. The handicap is in the form of weight they are stipulated to carry during the race. For example, if a horse has recently won a race, it might be "penalised" and be required to carry an extra one kilogram. This is meant to "equalise" the winning chances of all participating horses.

8. As a result of the above, jockeys need to be extremely light. Since the stipulated handicap weight is usually around 55 to 60 kilograms, and this includes the jockey's weight, the jockeys have to weigh in at somewhere in the low 50 kilograms. As part of the job jockeys would do almost anything to keep their weight down. Some turn anorexic, restricting their diet vigorously and purging routinely to lose weight. In fact some racecourses have specific "heaving bowls" in its toilets for the purpose of purging. Amongst other drastic methods to lose weight include the use of illegal drugs, diuretics, wrapping themselves in a hot bag and sweat off the weight. All these are detrimental to health and can cause death in severe cases, and they can make jockeys look older than they are. It's an ugly scene not widely known behind the glamour of the whole industry.

9. In exchange the jockeys can earn a considerable amount of money if they are successful. A top jockey can earn more than one million dollars a year.

10. I went to the 2009 Melbourne Cup and burned my ears and nose.

More photos will come later. This photo is courtesy of Wee Loon.

My Favourite Story

A day before his 15th birthday, the son of a wealthy family was asked by his father, “Well my son, what would you like for your birthday?”

The son hesitated a moment and his father’s thoughts leapt ahead to a new computer and similar things. However, his son had had a new computer only recently and could have a new one any time he wished.

Finally, the son said, “Father, I have everything a boy could wish for, but there is one thing I would really like. I would love to have a pink ping pong ball.”

The father was rather astonished at this wish, but said, “If it is a pink ping pong ball that you want, a pink ping pong ball you shall have.”

And so, the next day, the son was given as his bithday present a pink ping pong ball.

The boy took the ball to his room and the next morning the pink ping pong ball was gone. The father was mildly surprised but decided not to say anything. The pink ping pong ball, however, was never seen again.

——————————

The next year, a day before his 16th birthday, the father asked his son what he would like for his birthday.

“Father,” replied the son, “I have everything a boy could possibly wish for, but there is one thing I would really, really like. I would love to have a tenpack of pink ping pong balls.”

The father was more surprised than the year before, but kept his curiosity at bay, for he knew that his son had a right for privacy. he said therefore, “If it is a tenpack of pink ping pong balls that you want, a tenpack of pink ping pong balls you shall have.”

And so, the next day, the son was given as his birthday present a tenpack of pink ping pong balls.

The boy took the tenpack of balls to his room and the next morning, not a single ball remained, merely the empty husk of the tenpack.

The father wondered where ten pink ping pong balls might disappear to, but decided not to say anything. The pink ping pong balls, however, were never seen again.

——————————

The next year, a day before his 17th birthday, the son was asked by his father what he would like for his birthday.

“Father,” said the son to this, “I have everything a boy could wish for, but one thing would make my happiness complete. I would dearly want a carton of pink ping pong balls.”

The father was beyond surprise, but decided to make sure he had not misheard. “A carton of pink ping pong balls?”

“A carton of pink ping pong balls,” the boy confirmed.

“I can’t understand your fascination with pink ping pong balls,” said the father, “but if it is a carton of pink ping pong balls that you want, it is a carton of pink ping pong balls that you shall have.”

And so, the next day, the boy was given as his birthday present a carton of pink ping pong balls.

The boy was delighted and took the carton to his room. The next day, miraculously (as if by magic, even) the pink ping pong balls had all disappeared.

“Dear son,” said the father, “I must ask now, what do you do with all those pink ping pong balls?”

The son, however, was reluctant to tell him. “Please humour me, dear father.”

The carton of pink ping pong balls, however, was never seen again.

——————————

The next year, it was clear that the son would get a car, but the father felt that, perhaps, his son also had some other wish apart from the obvious. So, one day before the son’s 18th birthday, the father asked him whether he had a special wish for his birthday.

“Dearest father,” the son started, “I have everything a young man could possibly want, but there is one craving in me. I would, more than anything, want a warehouse full of pink ping pong balls.”

One of these years, his father thought, I should get to the bottom of this. However, he decided to humour his son’s wish. At least he had been wise enough to buy shares in a pink ping pong ball factory.

The next day, the son was given the address of a warehouse where all his new pink ping pong balls were stored. The son was delighted and decided to spend the next night in the warehouse rather than at home.

The following morning, the son stepped out of the warehouse, but it seemed to be empty otherwise. The father had a closer look and indeed, apart from empty cardboard boxes, nothing was left inside the warehouse. No pink ping pong balls were left.

——————————

The following year, one day before the son’s 19th birthday, the father braced himself for another warehouse of pink ping pong balls. He asked his son what his deepest desire was and he had not been entirely wrong.

“Father, you have made me very happy these last years and this year I ask of you a shipload of pink ping pong balls if at all possible.”

It was possible, if only because the father had by now bought each and every factory of pink ping pong balls in the country.

The next day, the father took his son to the harbour and showed him a huge tanker and told his son that there were millions, billions, trillions of pink ping pong balls in there.

“Father,” the son said, “You’ve made me very happy yet again.”

That night, the son spent on board the tanker.

The next morning, not a single of the pink ping pong balls could be found, but the son was happy.

——————————

A few days before his 20th birthday, however, the son had a terrible road accident and was taken to the hospital.

His father visited the young man in hospital. “My dear son! Can I bring you anything to make you feel better?”

Weakly, the son sat up in bed. “Father, dearest father, grant me this wish; just one tenpack of pink ping pong balls.”

The father held his son’s hand tightly. “Whatever you wish my son, but I have to give you one condition. Even if it may be embarrassing, I must know what you did with all those pink ping pong balls.”

“Very well, father, but please indulge me first. I will tell you whatever you wish to know after you have given me the ten pink ping pong balls.”

The father thought that was fair enough and the next day brought his son the ten asked for pink ping pong balls. The son smiled weakly but seemed too weak to talk.

“Son, I leave these pink ping pong balls with you and shall come back tomorrow to ask of you what you have done with all those pink ping pong balls.”

The son nodded weakly.

The next day, less than surprisingly, no pink ping pong balls could be found in the son’s hospital room.

“Now, my dearest son, apple of my eye, treasure of my life, please tell me what you did with all those pink ping pong balls,” the father requested.

The son nodded and the father gripped his hand tighter.

“I-” the son started and sat up a bit, swallowing with a dry mouth.

“I- I-”

Then he died.

Credit to Suhaimi.

[Story] What Do Retired People Do All Day

This is a story I read on one of the hospital notice boards.

Working people frequently ask retired people what they do to make their days interesting.

Well, for example, the other day my wife and I went down town and went into a shop.

We were only in there for about 5 minutes.

When we came out, there was a cop writing out a parking ticket.

We went up to him and said, "Come on, man, how about giving a senior citizen a break"?

He ignored us and continued writing the ticket. I called him a Nazi turd. He glared at me and started writing another ticket for having worn tires.

So my wife called him a shithead. He finished the second ticket and put it on the windshield with the first. Then he started writing a third ticket.

This went on for about 20 minutes. The more we abused him, the more tickets he wrote.

Personally, we didn't care. We came into town by bus. We try to have a little fun each day now that we're retired. It's important at our age.

Source: Maryborough Hospital notice board and throughout the Internet.

A Visit to the Zoo (Part 2)

Note: Continued from here.

We came across the meerkat. Meerkat is one of the most popular animals in all Australian zoos I have been. They are just so small, so hairy and so cute. Being one of those hyperactive animals, they are also quite difficult to shoot because they just don't stand still most of the time.


Despite sharing the name "kat", the meerkat is not at all related to the cat. On the contrary, the big fella here is quite a close relative to the cat. The tiger is one of the four so-called "big cats", the other three being lion, leopard and jaguar. Interestingly, the Chinese nickname given to the tiger is the "big worm" (大虫）. The reason is that "worm" was used as an umbrella term for all animals.


In Melbourne Zoo, we have an even bigger resident. This mother elephant here is pregnant, and she's probably going to be pregnant for quite a while - an elephant's gestation period is 22 months. The white stuff on her is not dandruff, it's water droplets from showering.


On the other extreme of the dimension, we have the very tall giraffes. This fellow here is drooling in the public. Not a very good demeanour indeed. By the way, we all know that each of us has seven bones in our neck; but do you know how many neck bones a giraffe has? Surprise, surprise - Seven!


The range of human-like behaviours amongst animals is fascinating. We can occasionally observe what seems like deep affection (the not-so-romantic truth: they are cleaning each other's beaks),


or thoughtfulness;


but more often than not I see an expression of boredom


and depression.


I have probably been pretentious in the last few pictures and made them more "meaningful" than they really are. However, this hand here carries an entirely different dimension of emotional content. What do you see in it? A struggle? Determination? Imprisonment? Or just a hand?


The last few shots of our fellow primates must have bored you out. So let's take a short break to enjoy some flowers


and leaves.


I must apologise though that I have to end this series of pictures with my favourite shot of the day. This orangutan is just soo cute.

A Visit to the Zoo (Part 1)

On a beautiful day, a group of Fotoholics brought their gears and headed to the Melbourne Zoo for some shots. (Photo courtesy of Brandon)


Photography in the zoo is a tricky business. Since visitors are usually kept a fair distance away from the animals, a good quality telephoto zoom lens is very useful in photographing the animals up close. For the unfamiliar, telephoto zoom lenses are those that are able to "zoom in" a lot and give you a magnified view of subjects from a distance. Here Lynn is seen holding a piece of expensive glass (Canon EF 70-200mm f/2.8 L IS) that happens to be the same glass this picture is taken with.


The difference between a "standard zoom" lens and a "telephoto zoom" lens is this,


and this.

Like the previous pic, the second shot is also shot from behind the wired fences; however the telephoto zooming and the high aperture value (f/2.8) have rendered the fences invisible. Furthermore, the second pic is shot from a further distance away from the first pic. Also noteworthy is the pleasant "bokeh" (the blurring of the background) in the second picture.


Despite the obvious advantage offered by a telephoto lens, all is not lost when all we have is a standard lens. In the zoo there are still many other interesting things easily captured with a standard lens like unsuspecting kids,


lizards that are sniffing the morning air,

br /> and naughty little turtles.


I am not too much of an animal lover, probably because I have not really visited many zoos when I was little. Growing up in a small town in North Malaysia, the nearest Zoo to me is some three hours drive away. Before coming to Australia I have probably only been to the zoos two times.


Compare that to Melbourne. Melbourne Zoo is just a 30-minute walk from my house, and there are two other zoos just one hour's drive away (Werribee Zoo and Healesville Sanctuary). The zoos here are quite children-friendly. Here a girl is seen patting a giant tortoise while having picture taken by the zoo staff - an up-close package sold at a price of 20 dollars.


Meanwhile, this boy is saying hi to an orangutan for free.

[to be continued]
[Continued here]

My First CPR

When I joined St. John Ambulance eleven years ago and learned CPR (cardiopulmonary resuscitation) as a thirteen-year-old, I never imagined that one day I would be doing it for real. Back then I always thought that one day when I come across someone with cardiac arrest I would probably just stand there, do nothing and look like a fool. Walk away before someone yells "Anyone knows CPR here?!". Or perhaps a combination of the above.

Seven years later, I became a medical student. I was to save life in the future and I can't walk away from a CPR.

When I learned basic life support (= CPR) and advanced life support (CPR plus a few advanced measures including electric shock and adrenaline administration) on a high-tech mannequin, I imagined that I would not need to do this for real for at least a few more years.

One week later, the unimaginable happened.

It was the last day of my three-week rotation in the emergency department. The ED, contrary to the public perception, is not a place where people die every minute from horrible diseases and injuries. Instead, ED is a place where minor diseases come up everyday (minor being a relative term of course) and severe conditions are thrown in for good measure every once in a while. The reality is, most people who come into ED don't die. At least they don't die in the ED itself. In the three-week rotation I have not seen one death nor a single case of CPR. There were not too many "emergencies" after all, even after allowing for the fact that major trauma cases in Melbourne aren't usually sent to my hospital.

So on this day, I found myself following this kind doctor when he was told that a 71-year-old post-cardiac-arrest patient was on the way to the ED. He was absolutely enthusiastic.

"This is the exciting bit about ED, this is what you'd signed up for! Come let's get ourselves ready!"

Unlike what happens in TV dramas, the ambulance doesn't usually barge into the ED door out of the blue wheeling people in a puddle of blood or other serious life-threatening conditions. Instead, they notify the ED prior to their arrival using a high-tech gadget called a telephone. As soon as they get a truly urgent case, the ambulance staff will call the ED before they arrive so that we have time to get ready for resuscitation.

So prepare we did. While the doctor prepared the heavyweight stuff like airways, defibrillation pads etc, I made myself slightly useful and prepared some equipments for intravenous cannulation. Besides the fact that the patient had an arrest (the stopping of heartbeat), not much else was known at the moment. We were just doing whatever we could and waiting for the patient to arrive.

And we waited. It was the longest ten minutes ever in my life. Would the patient be "dead on arrival"? Would he already have been revived and stabilised when he reaches ED? Is he in a pool of blood, badly mangled in an accident? A deluge of thoughts overwhelmed me.

Palpitation.

A commotion was heard outside the resuscitation room and a team of paramedics whisked the patient in. The patient's face looked flushed and slightly blue. He's as still as a log. He's lifeless.

"He had another arrest on the way here, we have been going for 10 minutes," someone reported.

After a quick transfer to a firm surface, the resuscitation recommenced. The nurses quickly hooked up monitor cables while the doctor listened to the report from the paramedics. Ventilation machine. High flow oxygen. Adrenaline infusion. IV fluid. ECG. Sodium Bicarb. Feeling for a pulse. Shining lights into the patient's eyes.

The resuscitation room became a flurry of movements.

Meanwhile, a tall male nurse started compressing the patient's chest vigorously, as fast as he could ^{[see note 1]}. Awkward mechanical sounds were produced. The patient's pot belly was protuding and retracting synchronously with the compression. Nobody laughed.

I stood in a corner and watched as the unreal scene unfurled, perhaps living up to what I envisioned myself as a thirteen-year-old St. John member. The resuscitation room was crowded. There were five ambulance staff, four doctors, three nurses, and a clueless medical student. I had to shift a few times to get out of people's way. I was just a spectator.

One of the doctors in the room asked me to go to the left hand side of the patient.

"You should go and do it. It's an experience."

I forgot how I responded to that. Within seconds, I was standing next to the tall nurse who was already four minutes into his compression.

"You ready? On the count to three. One. Two. Three."

He moved away swiftly, and I stood in. Keeping my arms straight, elbows fully extended and wrists placed right in the middle of the chest, I started the chest compression.

The first thing I felt was the resistance of the chest wall. I have never pressed on a human chest, not to mention pressing it at a high speed. All we did for St. John was to fake the motion. So the resistance was fully felt.

"Good, you are doing it right."

Well of course I am doing it right - I have known CPR for eleven years!

As I was compressing, I went into a transcendental state of mind. Reels of old memory started playing before my eyes. The intensive first-aid training I went through before high school St. John competitions. My decision to choose medicine as a career. 100 beats per minute. Staying alive by Bee Gees ^{[see note 2]}. The CPR mannequin.

I could feel it.

Then I took a glimpse of the patient's face. His eyes were closed. His face was dark red. I felt responsible. I pressed even harder.

Fatigue soon got the better of me and I was struggling to keep up with the compression. I must have gone on for two minutes. Someone offered to take over, and I moved away after a count of three.

The compression went on for a while, pausing occasionally to check whether the heart started producing pulses by itself. There was no defibrillation because the patient was having pulseless electrical activity ^{[see note 3]}, a rhythm that can't be shocked.

The patient's wife came to the resuscitation room. Upon seeing the chest compression, she immediately let out a loud cry and ran out wailing uncontrollably.

His son came in later. He said he wanted to watch. The big man was shedding tears. A nurse asked him to hold the patient's hand.

"How long now?" A doctor asked.

"30 minutes since arrest." Answered a paramedic.

"We should let go."

A nurse turned off the monitor and detached the cables. Spectators walked out. Some nurses were tapping the shoulder of the inconsolable family. We removed our gloves. And I walked out.

"What? Is he dead now?!"

These were the last decipherable words I heard from the resuscitation room.

I felt a sense of loss upon leaving the scene. The cry in the distance certainly did not help with the sombre mood. I didn't even know that patient, and I knew 90% of CPR are unsuccessful. I thought I am a level-headed rationalist who's immune from unreasonable emotions. But there was this feeling of emptiness, or even a bit of grief, that filled me. I felt a bit off.

I have seen many patients gasping for air, coughing bucket load of sputum or looking so orange they look like they were going to die. But despite their suffering, they were alive. This man here was lying there looking peaceful, yet his heart failed him.

A doctor can sit in front of the computer all day looking brilliant and important. A medical student can read textbooks all day learning the finest details of every single disease looking smart and knowledgeable. But at the end of the day, and at the end of the life, everything boils down to keeping the heart pumping and the blood moving. Despite all our presumed brilliance, we are still using the most rudimentary mechanical compression in our attempt to revive a dead person.

There was an indescribable sense of irony that I couldn't quite fathom.

I am not even sure what I have really learned in this process, but the two minutes of chest compression changed me. The glimpse I took of him during the CPR will stay with me forever. The transcendental feeling will, too. The doctor wasn't lying when he said "It's an experience". Indeed it has been.


Note:
1. In fact pressing too fast is counter-productive, as the heart does not have enough time to fill up with blood in between the compressions. The recommended rate is 100 per minute.

2. Bee Gees' "Staying Alive" is recommended by American Heart Association in conjunction with CPR training due to its tempo of 100 beats per minute. I am sure the song title is the biggest reason for the recommendation.

3. Pulseless Electrical Activity is the phenomenon where due to various reasons, there is an observed ECG (electrical tracing of the heart) that should be producing a pulse, but is not. Defibrillation (= shocking) is not effective in this role as it only works in cardiac arrest due to certain types of non-pulse-producing electrical chaos in the heart circuit. And here's a popular myth: you can't shock a flat line. So most TV shows including House MD are wrong.

Happy Birthday

Happy Birthday to you! Miss you heaps. :)

[Photo] Walk Here

A random scene just next to where I live.

[Photo] The Darkroom, The Lightroom

Just a random shot of my room with a cheapskate starburst lens filter :P

Michael Jackson - Man in the Mirror

Gotta make a change
For once in my life
It's gonna feel real good
Gonna make a difference
Gonna make it right

As I turned up the collar on
A favorite winter coat
This wind is blowin' my mind
I see the kids in the street
With not enough to eat
Who am I to be blind
Pretending not to see their needs

A summer's disregard
A broken bottle top
And a one man's soul
They follow each other
On the wind ya' know
'Cause they got nowhere to go
That's why I want you to know

I'm starting with the man in the mirror
I'm asking him to change his ways
And no message could have been any clearer
If you wanna make the world a better place
Take a look at yourself and then make a change, yey
Na na na, na na na, na na na na oh ho

I've been a victim of
A selfish kinda love
It's time that I realize
There are some with no home
Not a nickel to loan
Could it be really pretending that they're not alone

A willow deeply scarred
Somebody's broken heart
And a washed out dream
(Washed out dream)
They follow the pattern of the wind ya' see
'Cause they got no place to be
That's why I'm starting with me

I'm starting with the man in the mirror
I'm asking him to change his ways
And no message could have been any clearer
If you wanna make the world a better place
Take a look at yourself and then make a change

I'm starting with the man in the mirror
I'm asking him to change his ways
And no message could have been any clearer
If you wanna make the world a better place
Take a look at yourself and then make that change

I'm starting with the man in the mirror
(Man in the mirror, oh yeah)
I'm asking him to change his ways, yeah
(Change)
No message could have been any clearer
If you wanna make the world a better place
Take a look at yourself and then make the change
You gotta get it right, while you got the time
'Cause when you close your heart
(You can't close your, your mind)
Then you close your mind

(That man, that man, that man)
(That man, that man, that man)
(With the man in the mirror, oh yeah)
(That man you know, that man you know)
(That man you know, that man you know)
I'm asking him to change his ways
(Change)
No message could have been any clearer
If you wanna make the world a better place
Take a look at yourself then make that change

(Na na na, na na na, na na na na)
Ooh
Oh yeah
Yeah yeah yeah yeah yeah yeah
(Na na na, na na na, na na na na)

Oh no
Oh no, I'm gonna make a change
It's gonna feel real good
Sure mon
(Change)
Just lift yourself
You know, you got to stop it yourself
(Yeah)
Oh
Make that change
(I gotta make that change today, oh)
(Man in the mirror)
You got to, you got to not let yourself, brother oh
Yeah
You know that
(Make that change)
(I gotta make that make me then make)
You got, you got to move
Sure mon, sure mon
You got to
(Stand up, stand up, stand up)
Make that change
Stand up and lift yourself, now
(Man in the mirror)
Make that change
(Gonna make that change, sure mon)
(Man in the mirror)
You know it, you know it, you know it, you know
(Change)
Make that change

Please DON'T Call Cardiac Arrest A Cause of Death (3)

[Continued from here]

CNN has a good conversation between Anderson Cooper and Dr Sanjay Gupta about this topic:

Please DON'T Call Cardiac Arrest A Cause of Death (2)

[Continued from here]

More about the cardiac arrest business.

When I say it's silly to say someone "died of cardiac arrest", I am not saying that it's *wrong* - in fact it's absolutely true that a lot of people die when their heart stops. What I am saying instead is that calling cardiac arrest "the cause of death" is quite meaningless. It's almost like asking "Why was TDM hospitalised?" only to hear the answer of "The doctor asked him to stay". Absolutely accurate, but absolutely not answering the question too. I want to hear what illness he had that made him stay in the hospital; not whether the doctor, the surgeon or the physiotherapist asked him to.

It's technically correct to say someone died of stopping of the heart, but we shouldn't call it "THE cause of death" without knowing what caused the heart to stop in the first place. Cardiac arrest, or "the stopping of the heart", can be due to thousands of reasons.

• Being immersed under the arctic ice cap for one hour.
• Being electrocuted.
• Dumping shit load of potassium ion into one's circulation.
• Being born with a heart with screwed-up wiring.
• Being born with thickening of certain parts of the heart (how many young athletes have sudden death).
• Getting overdosed on drugs (which is currently one of the top hypothesis in MJ's case because he has been getting opioids from his doctor).
• Having a massive heart attack.
• Having a sick heart from a previous heart attack.
• Having a huge clot in the pulmonary aorta.
• And the list goes on.

In fact, almost any disease process or injury would kill you by stopping the heart in the end, with the exception of brain death due to brain injury. In brain death, even though their heart might still be beating, we also consider them dead because there is no longer a person in that body.

*****

What about calling it a heart attack, some might say. THIS is another peeve of mine in the whole media report. Yesterday all the Fairfax newspapers in Australia reported that MJ has died from a heart attack when the official sources said NOTHING about a heart attack. It appeared to me that the Fairfax journalists have equated a cardiac arrest with a heart attack, which is to me as atrocious as equating bacteria to virus.

And NOW you see why I am so worked up.

Heart attack is a specific entity, and we say someone's got heart attack when his coronary arteries (which are the arteries that supply the heart itself) got blocked off by clots. Heart attack can cause death, and when someone dies in a heart attack they often die via cardiac arrest (i.e. when their heart finally stops). But in the process a lot of things could happen, their heart wiring may run amok, their heart walls may rupture, their heart will beat out of synchrony. And so on. And all that could be the precipitant for the eventual cardiac arrest.

In MJ's case, the current official word is cardiac arrest, and no official word has said he's got a heart attack. But I can see that some Australian media has automatically translated cardiac arrest to heart attack, which is quite misleading. In the early hours BBC also used the word "heart failure", which was also another term with a specific meaning in medicine.

It's probably the public health educator's fault that many people are unable to tell the difference between a heart attack and a cardiac arrest. The difference might not be that crucial for laymen, you might argue, and you are probably right. However, in the case of journalism, I don't think it's acceptable for a journalist to substitute "cardiac arrest" with "heart attack" without any verification and disseminate the information to millions of people. This is a count of irresponsibility.

[Continued here]

Please DON'T Call Cardiac Arrest A Cause of Death

What would you think if you come across a conversation like this:

A: Hey do you know why Mr. Rockefeller was rich?
B: Oh of course, he's rich because he had earned lots of money.
A: Ahh thanks for telling, that's helpful!

Sounds dumb, no?

Well, what about this conversation.

A: How did he die?
B: He died because his heart stopped.

Sounds dumb, no?

Now time for some pseudo-medical-jargon 101:

Cardiac - adjective - related to the heart.
Arrest - noun - Stopping.

YES when you read a paper that says "Michael Jackson died of cardiac arrest", they are telling you "Michael Jackson died of the stopping of his heart".

And they irk my nerd-sanity big time. Too tired to write more right now, I will update this post tomorrow.

[Continued here]

RIP Michael Jackson

Michael Jackson died.

I am not really a huge fan of his but at various points of my life I have been touched by his music and inspired by his performance. Who amongst us have never been touched by some of the works like "we are the world", "heal the world", "man in the mirror", "strangers in moscow" or "you are not alone"? Who amongst us have never been electrified by or danced to "beat it", "black or white" or "remember the time" or "thriller"?

I know I have - and for that I mourn the loss. Yes he has his eccentricities and sins, but let's leave it for another day, or for someone above if it is there.

A Hospital Sign

The swine flu panic. Australia is now officially the limelight in this swine epidemic, and Victoria, the state I am in, has the world's highest swine-flu-per-capita ratio.

And my exams are two weeks away.

No Auto-Play Music Please

Sometimes I wonder whether people who put auto-play music in their blog actually visit their own blog at all. Because if they do, they would know how annoying it is. :P

Of course I have no right to ask people to remove their favourite musics. But at the very least, please make it play only on request, or give us an option to disable it. Thanks.

Just Like Crossing the Road

Learning medicine is not unlike learning to cross the road.

When we were little, our parents held our hands to cross the road. When we were young, our parents told us to always cross the road when the traffic light turns green. We should look right, left, and right again to make sure there's no car. And then we cross. After growing up, we learned to jaywalk when there's no car. We even learned to cross a busy road just before the speeding cars could hit us.

When we were a medical student, the doctors carry our hands to see patients. This is how it goes: First you inspect. Then you palpate. Then you percuss. And you auscultate. As we grow up to become doctors and become more experienced, we start to go for only the important stuff and skip the irrelevant bits. As for the consultants? They are the jaywalkers.

I don't mean they are haphazard or reckless, of course. They know where all the cars are.

Of Using Thesaurus Could be Dangerous

Note: This is again a collage of my posts in ReCom, so it might appear incoherent. This post is dedicated to my fellow juniors who are facing the struggle I once faced and is still trying to overcome.

Writing in English is a common struggle faced by most students from Chinese education background. Being unacquainted with the language, many of us have difficulty finding the right expression for our thoughts, and some people end up doing literal translation from Chinese language, often resulting in embarrassment.

In improving our language, one of the tactics often employed is to read thesaurus and do what I would call "find-and-replace". What happens is, instead of using simple words like "beautiful", "ugly" in our writing; we look up the fancier version of the adjectives in thesaurus and replace them with "idyllic" and "grotesque" instead.

While this tactic could work if we do it with care and complement it with improvements in other aspects of the language, I would like to remind people to resist the temptation of doing simple "bombastic-vocab substitution" without considering the context. I have seen many people who learn vocabs through thesaurus and end up writing sentences like,

• Yeah I am trying to ameliorate my english
• He is a bona fide guy
• I reckon vehemently that you are of the right opinion;

when they actually mean

• Yeah I am trying to improve my english
• He is a genuine guy
• I strongly agree with you

After some find-and-replace process, we end up with either sentences that sound awkward or are totally wrong. And worse of all, we don't even realise it, as some of us think that thesaurus means "the book of synonyms".

Just some explanations.

Ameliorate is "improve", but it's usually used in the context of "ameliorate the condition". I am not sure whether it's correct to say "ameliorate english", but the fact is that it's seldom used in this context, so when you simply use it this way it sounds awkward. It would be much better if you just say "improve my english" or "brush up my English".

Bona fide means genuine, but it only refers to the genuine in the sense that it's not counterfeit. E.g. a bona fide Malaysian, a bona fide van Gogh painting, a bona fide offer etc. However, it doesn't have the meaning of "genuine" in "a genuine guy". By a genuine guy we don't mean this is not a pirated-version of a guy, but we are referring to his sincere, truthful personality. And "bona fide" is not often used in this context.

Reckon means think, vehemently means with passion / emotion / zeal. That last sentence was simply improper and awkward. "Of the right opinion" is technically correct but it's not what you would say in daily conversation. It's a cumbersome phrase.

I hope that it's obvious from the examples above that if we simply learn our vocabs off thesaurus, thinking that we can substitute improve with ameliorate or genuine with bona fide indiscriminately, we will probably end up doing more harm than good to our writing.

At the end of the day, using good vocab per se is not a bad thing. Obviously all seasonal writers have a good repertoire of vocabulary, and the vocabulary fluorishes their writing. However, when the other aspects of our language is not as good as the vocab we are using, the whole thing will just feel absolutely awkward. For someone who is not too well-versed in the language, he or she might be "impressed" by our mastery of vocabs without picking up the other glaring errors; but for a native speaker, seeing improperly used vocab interspersed with glaring grammatical errors and non-flowing sentences is a major eyesore.

Or to put it the other way: vocabulary is to a language as icing is to a cake. If you put the icing on a great tasting cake, it's gonna make it even better; but if you simply put icing on a burnt cake or on a bowl of noodle, it's just yucky.

Of Living in the Past is Not Necessarily Better

Recently there was an interesting casual discussion in ReCom where people talked about why they prefer living in the past or the present. It was intriguing that a lot of people prefer the past with the general sentiment being that it was more serene, peaceful and fresh. I beg to differ with this generalisation.

To begin with, I think we should make a good distinction between rural rustic life and the past. Many people equate the past with what it is like in rural area today; but this is a gross misrepresentation of the past. Yes the modern men may look at insulated villages for a glimpse of olden days; but that doesn't mean that life in the past is rustic, peaceful and wonderful. Not everyone in the past lived in small villages - towns and metropolitans have existed way before our grandparents were born, and people who lived in big towns definitely did not enjoy the serene life some of us conjured to be the typical life of the past. Our past was riddled with endless warfare in most corners of the world, and though we continue to face military conflict in many places today,  an unprecedented majority of the world population is currently enjoying the most peace at any point in history.

The proponents of living in the past also propose that relationships in the past was more lovey-dovey and close-knit in general. While there is some truth in it, it does not mean that inter-personal relationship today is inferior to the past in all regards.

Yes on average most people today don't spend the same amount of time at home or close to home compared to before. But guess what, last time if people were to leave their hometown they might not see their family for months, years or decades. But now we have the phone, Facebook, MSN, Skype and what not. And we have airplanes. We tend to forget that the very things that bring us apart easier, bring us together easier too.

Yes it might appear to us that most people today spend a lot of time on the phone, in the office, in the car, attend endless conferences and meetings and ignore their kids. But it would be simplistic to think that there were fewer busy people in the past - there were lots of people spending time farming, mining, brokering at Wall Street, travelling on steam train, and arguing with their bosses. Therefore, whilst working life were drastically different from today, and despite the irrefutable fact that urbanisation has made more people busier today; it doesn't mean that most people were free people who had all the time to spend with their kids and form great bonds with their neighbour's grandchildren.

There are certain things that are undeniable. It's undeniable that an urban dweller today is less likely to know their neighbours as well as a villager in the last century knew their neighbours. It's undeniable that there were less people who led a hectic city life in 19th century compared to today.

However, it's also undeniable that we form bonds in ways people would never have thought possible. People DO find their life partners online. I make friends in ReCom as electrons travel through servers, cobble wires and personal computeres. I get to see my parents regularly from 6000km away and Skype's voice quality is so clear it sounds like they are just talking in front of me. I know that there's no place on Earth which is too far to get to.

As with most things, there are gives and takes when we progress as a society. Some things we lose; some we gain. It's how we make use of the things we gain and salvage the things we lose that makes all the difference. In this post I haven't even mentioned the World Wars, the Great Depression, colonisation, Spanish flu, the Black death, typhoid fevers and many others. All considered, I propose it's not easy to make the case of the life in the past being better than the life today, as frivolous as all this talk may sound.

Note: This is a collage of a few posts of mine in the ReCom thread, so pardon me for the incoherence and lack of comprehensiveness.

Image Credit: L'Arte - Where Everyone's an Artist!

[frank2c] The Lottery

The yearly begging practice is starting to sound like a broken record

If you are an invited reader, read it here.

If you have no idea what it is, read more about frank2c here.

[Photo] The Light, The Light!

Boroka Lookout, Grampians National Park, Victoria
1/125s - f/6.3 - ISO 100 - 13mm (HDR with 3 exposures)

Small talk: I have been relatively busy recently so there hasn't been much inspiration or time to be spent in this blog. Exams are gonna happen in 8 more weeks. The shot above was taken during one of the trips in Easter break last week.

A Foggy Morning

The Secrets of Success

I believe that through our journey of growing up, all of us must have come across self-help motivation books and speeches where the authors and presenters claim to give you the key to success. They enabled us, they made us dream. With time, however, we gradually forget most of the contents from those books and speeches. In fact, we come to the ironic conclusion that the only successful people seem to be the very people who make money from publishing books and giving speeches about being successful. Like Lillian Too and her Feng Shui tips. However, this video is a bit different. It managed to encapsulate the good old "secret of success" succinctly (it's only 3 minutes long) in an engaging way. I found it highly enjoyable and inspirational. I hope you feel the same too.

Thanks to my brother for the recommendation.

Of The Maturing Maturity

I believe that we all go through a stage of life where we start to ponder the question called "Am I mature?". We set criteria for maturity which we often conveniently fulfill. We cherry-pick the "immaturity" of our peers to highlight our blossoming thinking faculty. And we are secretly happy.

Eventually, everyone goes through that phase and slowly we stop doing this mental exercise of "maturity criteria". We stop caring whether you are mature enough. I guess that's when the real maturity begins to set in. Or at least we hope.


**
Note: Yes it's the Easter holidays! Two trips, can't wait for them!

[frank2c] I Thank Abdullah

Inevitably history will judge Abdullah as a weak and ineffective PM, one whose tenure is embarrassingly amongst the shortest in history. In fact his tenure would have been the shortest if not because he managed to delay it so that he has more than one month longer in record than Tun Hessein Onn.

If you are an invited reader, read it here.

If you have no idea what it is, read more about frank2c here.

[Photo] Thrill

Thrill Ride at Lonsdale St, Melbourne
1/250s - f/4 - ISO 400 - 153mm

[Photo] Grip

Port Campbell, Victoria
1/1250s - f/3.5 - ISO 100 - 26mm

How to Stop The Buzz in An Earbud

So your earbud / earphone produces annoying buzz when it plays low frequency sounds? This is what to do:

... gently place the earbud to your mouth and suck, taking care not to get the earbud wet.

Worked like a charm. Saved me a trip to the Apple store.

A Medical Student's Apology

We wander around the ward corridor
Chirping, chattering, cheering, conniving
Stealthily we peeked at you
And we thought you would be interesting.

You are awake, you are not sleeping.
You don't have any pain, you are not eating.
You are not demented, and you have got no one visiting.
You look okay, in fact you look welcoming.

We come to you, and start to greet you
The greeting is always the same
Official, boring, and impersonal
And we always go like this

"Hi Mr. Smith my name is Yang,
I am a fifth year medical student.
Do you mind if I spend a few minutes with you,
to talk about your recent condition?"

You agreed to that because you are nice,
But deep inside you let out a grunt.
"Those students again"
"How many of them are out there lurking?!"

"What brought you to the hospital?"
"An ambulance, obviously"
"Tell me more about the pain"
"It hurts, doc"

Minutes dragged on to hours
Hours dragged on to days.
Your stay in the teaching hospital,
Is punctuated by endless visits by annoying students.

At times you see us on the corridor,
Laughing, sniggering, jeering and bantering.
And you probably wonder,
whether we realise we should be a bit more proper.

At times you accidentally hear us say,
"Mr. Smith is an interesting case, go do a long case on him"
And you probably wonder,
whether we realise you are not here for our exam rehearsal.

So an apology this is
For all the patients we have hurt,
For patients we saw as a long case or a short case,
And for patients who are not good for any type of case.

We don't mean to annoy you,
Although at times we probably do.
We don't mean to use you,
Although in reality we probably do.

We empathise what you are going through,
At the very least, we used to.
But after toiling for a year or two,
Even the warmest heart probably turn a bit cool.

My dear patients, we wish we really could
Be a bit less rude and do a bit more good
We are really sorry what we subject you to,
Hopefully, just hopefully, we will all pull through.


Image Credit: Lupus Comedy

[Photo] After the Rain

1/100s - f/1.8 - ISO 400 - 50mm
I am feeling much better now. Thanks for your concern!

Of Feeling Sick

It's quite easy to overlook the experience of illness as one progresses in their medical career. As we fret over how best to present our long cases or how best to study the Oxford Handbook of Clinical Medicine cover to cover, we often forget that we are not really there to study medicine; we are there to learn how to treat sick people, and how to make them feel better.

I had my share of illness today. It started this morning when I went to the Austin Hospital at about 8.30. Feeling unwell in the tummy, I immediately went to the toilet, and there I was flushing out some humongous amount of bowel content into the toilet. However, at that stage I was feeling alright, and the watery bowel motion didn't bother me at all.

At 9am, I went on to have a tute with one of the doctors without much problem. After the tute, I had to go to the toilet again. And again. And again. In the next three hours, I went to the toilet four times, feeling more and more unwell in the process. Come lunch time, I struggled to finish my tuna sandwich due to a lack of appetite.

I wanted to stay back to clerk some patients but my physical condition was deteriorating quickly. My tie started to strangulate me, and my anal sphincters were unforgiving. I could feel some chill overwhelming my body, and I immediately knew I was not gonna make it to the 5pm lecture.

With an ashen face, I braved the chill and physical weakness and walked to the train station opposite my hospital. What usually seemed like a short walk became an endurance race. Each step I took was harder than the step before, and I was in fear - I knew that there was a possibility I was going to collapse on the street. At that moment, weakness ceased to be a mere physical descriptor of the patients; it became a real entity, a thoroughly debilitating sensation. It became a fear.

The train ride back to the city was uneventful, but I was not feeling better. By the time I reached city, it was apparent how feverish I was. From the train station, I boarded a tram to head home. The tram was packed like a sardine. To worsen the matter, a girl in front of me kept on swearing bad words like 操你妈的 to her boy friends. She was making me nauseous.

Two minutes into the journey, I was on the verge of throwing up. They say that nausea is the worst feeling of all physical afflictions, and it can't be more true. I had a patient who developed some nausea due to morphine, and without hesitation she wanted to cut down on the morphine just to get rid of the sick feeling. I had to get out of the tram and get some fresh air.

I sat in the toilet of a shopping complex having the seventh bowel motion of the day, but I didn't vomit despite the continuous tug in my stomach. At that juncture, I started to wonder how I was going to get home at all. Am I going to take a tram home and risk myself vomitting in it? Or should I just wait in the shopping complex to get better? The loneliness and helplessness was killing me.

I decided to visit a pharmacy and shelled out some money to buy oral dehydration salt (at which Xuan Ni later ridiculed :P), paracetamol and water. Immediately I mixed the salt with the water to make up the rehydration solution. I guess the other shoppers must have thought I was mixing some illicit drugs.

Eventually I got home via a bus. I collapsed on my bed immediately and fell into a deep, warm slumber for the next three hours. Xuan Ni and Anthony (my current housemate) came home and visited me. I am very grateful for their care - Anthony cooked porridge for me (which I only ate a little due to nausea), and Xuan Ni was simply there for me. Social support is not just something that earns us extra points in long case presentation; it is something that truly helps.

Right now, the diarrhoea has stopped although there is still some lingering weakness and my temperature is still a tad up. The metoclopramide I brought to Melbourne four years ago worked wonderfully against the nausea. Today, as cliché as it sounds, I reminded myself of what it truly means to be sick, and hopefully, how to be a better doctor (or a better medical student, for that matter).

Of Learning in Medicine (1)

I enrolled in medicine in the most unusual yet not unexpected circumstances.

Since I was little, I have always been a maths and physics guy. I read popular science magazines, I read my dad's old Chinese maths textbooks (they ARE interesting). I have never picked up a Biology textbook with much enthusiasm, neither have I ever been attracted by the animal or human body documentaries in National Geographics Channel.

Throughout my high school years, most people expected me to go on to study maths, engineering, actuarial science and the sorts, and I kinda took up the expectation as my own goal too. At one point I was considering MIT as a goal, seeing that participation in the IMO could be a useful line in the CV. However, my procrastination and lack of motivation eventually reigned over my temporary ambition. I never got beyond reading the university brochure.

Eventually, I enrolled in medicine. You could probably argue that I was just following the footsteps of my sisters, and I can't deny that it did play a huge part in my decision. But beyond that, I chose medicine because of the satisfaction I thought I could derive from medicine in terms of intellectual fulfillment, job satisfaction, social status and monetary stability.

Besides, I chose medicine over the other aforementioned options because I thought that those paths offer less satisfaction, and that I don't want to be doing maths in a cubicle forever. That could be just an excuse, I don't know. Even today, I still suspect whether this line was a lie I obstinately hold on to, just so that I could justify my not pursuing paths in alignment with my interest and talents.

But I thought it didn't matter.

[To be continued...]
Image Credit: Vagus Surgicalis

[Photo] The Flyer

1/640s - f/5.6 - ISO 100 - 33mm
The Singapore Flyer, taken from a bus through a very weird posture

[Photo] The Young Pianist

1/400s - f/2.8 - 41mm - ISO 800
Yes, another random photo for Yee Pin