To Sit at the Feet of Christ

2020 has not been a good year for anyone, and I don't think any of us saw this global pandemic coming our way.

In the midst of it all and the fears of continuing to work in ED as things escalate, I am still immensely grateful for a stable income and a great team to power through together. I am blessed to know my family is safe, and above all that God is still good and almighty.

I read this in my devotions this morning:

"Now it happened as they went that He entered a certain village; and a certain woman named Martha welcomed Him into her house. And she had a sister named Mary, who also sat at Jesus' feet and heard His word. But Martha was distracted with much serving, and she approached Him and said, "Lord do You not care that my sister has left me to serve alone? Therefore tell her to help me.

And Jesus said to her, "Martha, Martha, you are worried and troubled about many things. But one thing is needed, and Mary has chosen that good part, which will not be taken away from her."

- Luke 11:38 - 42

...

In this season, I feel like I'm becoming more and more like Martha - spending hours reading the news, going through work drills of intubating a COVID positive patient, checking and re-checking the national tallies.. what a timely reminder this is indeed that I can pause, breathe, and take a moment to sit at the feet of Jesus and let Him rejuvenate my soul.

In every circumstance, He is a good, good Father, and His grace will carry us through. We may not understand it now, but one day, we will see how He never left our side through every tear and heartbreak.

As Spurgeon put it, a Jesus who never wept could never wipe away my tears. 

How blessed I am indeed to know this Jesus. <3 div="">

My First 3 Days at Kudjip

I arrived at the Kudjip Nazarene Hospital in PNG late Monday evening after a day of travelling, and this is where I will be spending the rest of 2019. It has always been my dream to do medical missions in some form or another, and this all worked out so perfectly by God’s grace that I was given time off from work to be able to partner with World Medical Mission for two months.

I knew life here would be very different, so let me share with you a bit more about my past three days. (Apologies in advance for the medical jargon ahead)

It always takes me a while to warm up to my accommodation whenever I do missions, but this view and the cool air definitely helped me fall in love with the place!

My morning view outside my house

Day 1 (half day since I spent the morning doing a month’s worth of groceries from town) was a bit more of an orientation for me. I got a tour around the hospital grounds - we have five wards (paediatrics, medicine, surgery, obstetrics/gynae and TB), an outpatient department, an emergency department as well as a pathology lab and pharmacy. Here, doctors are expected to do a bit of everything - they work flexibly between different wards in the morning and then see outpatients in the afternoon.

This day, I shadowed Dr Nathan who has worked here for a number of years. Our first patient was a woman who had fallen and sustained a dislocated shoulder, which we reduced under ketamine sedation. An interesting note as I observed the open boxes of ketamine lying on the trolley - there’s no need to keep addictive meds in lock boxes to be signed out by two nurses, namely because we face very different problems here than back at home. I digress. Anyways, apart from that, we also saw a man with oral cancer barely able to open his mouth, a young boy who likely had a brain tumour based on a good story and the finding of evident papilloedema but unfortunately there are no CT or MRI scanners here (and the issue is even if we get the diagnosis, we don’t have neurosurgical capabilities), several pregnant mums, a woman with recurrent skin infections thought due to the locally-prevalent MRSA (a resistant bacteria), a man with post herpetic neuralgia complicated by amnesia from his pain medications and a few more patients who have escaped my memory as well. 

We have recently limited our outpatient attendees to 100 people per day due to being short staffed, but even amongst 4-5 doctors that is still a huge amount!

For the rest of this week, I would be doing morning ward rounds with Dr Susan in the paediatrics ward, followed by helping out in either ED or the outpatients department. 

Day 2 - We had only just started our morning ward rounds when Dr Susan got called to ED about a woman who was very short of breath. We went to ED and found this incredibly cachectic woman with a very distended abdomen - she suffers from liver cancer and recurrent pleural effusions (fluid build up in the space that contains the lung). She has a poor prognosis and only had the fluid removed 4 days ago, but it’s already re-accumulated. For comfort measures, we decided to remove the fluid again. 

My first time performing a thoracocentesis with guidance from Dr Susan

We head back to the ward after that, and saw a few more patients.

This happy little bubba got to go home cause he’s all better

Then I went to ED and saw a woman for wound review post C-section for eclampsia, a man with malaria, a woman who was kicked in her chest by her abusive husband, an accident victim who suffered a terrible clavicle fracture, a severely underweight baby who was born preterm at home and mum is not producing enough milk (picture below), another man needing a thoracocentesis for recurrent symptomatic pleural effusions, and an elderly woman in septic shock from pneumonia. Being so new here, it was extremely daunting to see this woman alone while the other doctor was on a break. I was told she wasn’t doing too badly, and then I got a manual blood pressure reading of 65/30, hypothermic 33C, hypoxic saturating 80% on 4L of oxygen, listened to a horribly crackly right lung and saw blood results - haemoglobin 6.1 and white cells 24.6. Unfortunately once again I am reminded that this is a rural hospital in a third world country - there’s only so much we can do. I give her fluids, antibiotics, oxygen and organise for a blood transfusion. Here, our blood bank will usually only release blood once a relative of the patient agrees to donate blood in exchange; namely because we have such a shortage of blood. Eventually we decided she was not for a trial of inotropes (intensive medications to raise blood pressure) partly because it is very difficult to execute here for multiple reasons, and due to her advanced age. We admitted her to the ward, and I’m not sure what has happened since. 

Day 3 today. Soon after I arrived to the paediatrics ward, I noticed a flurry of nurses heading for a very sick young child who was admitted overnight. He was unconscious but vomiting dark “coffee-ground” material through his nose and mouth despite a drainage tube put in place. I read the notes - this child has been unwell for two days, had fevers and seizures yesterday and is now unconscious. He was treated for meningitis (extremely common here) and all we could do next was wait and see. I could see the absolute devastation in mum’s face as she sat quietly praying by his bedside, while he lay almost completely covered by a blue UNICEF blanket to ward off the flies around him. I later learnt that he went into cardiac arrest in the afternoon and passed away.

In my three almost four years being a doctor, this is my first time experiencing the death of a paediatric patient under my care. Sadly though, I am certain he would not be the last in my time here. The harrowing sound of his mother’s wails from the morgue as she grieved the loss of her child will remain in my thoughts for a long time.

And yet.. the day continued, for there were still numerous patients that needed to be seen.

Happier parts of today - I ended the day with a lovely patient Mama Rachael who was soft spoken but had the biggest smile in thanking me for looking after her today, so much so that she insisted to bring me fruits next time. Also I had such a wonderful interpreter today named Jenny. She was very pleased that I was trying to pick up Tok Pisin and we had great conversations around faith and God as well, I was even blessed with a home grown cucumber from her garden after lunch today!

I would upload photos of them both but my blogspot and Digicel 3G are not keen to work together much longer. Also I just wanted to note that all these photos were taken with patient/parent consent.

All in all it’s really been a whirlwind of emotions and experiences, and I’m only at day 3! There’s truly so much to learn and so many people to love on while I have the opportunity to. I am so grateful that God had brought me here for this season, for such a time as this and I pray that He will continue use my hands and feet to do whatever good I am able to do. 

Dr Mark Smith

I remember wondering if I should text him when I found out our study group got cancelled, and eventually decided it would be better to say too much nice things than to regret never saying anything at all.

I didn’t realise those words would be the last thing I ever said to him.

Thank you sir, for how much you’ve sown into us. You will be so, so dearly missed.

The Waiting Place

"Be kind, for everyone you meet is fighting a difficult battle."

...

On a busy night shift a while ago, I picked up the next longest waiting patient to be seen. Before I left our staff base to speak to him though, I was warned by a colleague.

"Be careful, that patient looked really angry earlier."

I walked into the cubicle and was coldly greeted by a middle-aged man. The conversation escalated quickly as he was extremely unhappy about having to wait over two hours in the ED prior to being seen by a doctor, despite being given intravenous pain relief fairly early on. He had come in with abdominal pain and an intestinal stoma which had stopped functioning on a background of multiple complex abdominal surgeries for cancer in the past.

Whilst standing (generally a good sign that they aren't critically unwell), he looked me in the eye and said to me seriously, "If anything happens to me, it will be your fault. Maybe not you specifically Candice, but this hospital. It will be negligence, because I am a sick man, and I am not just someone with a broken leg or a mental health issue."

More than halfway into this demanding night shift where I had been working as hard as I possibly could, (let me be real here and say that) I was not very impressed in that moment. I did not appreciate the threats upon introduction, nor the sarcastic sighs and demands that followed.

Part of me wanted to retaliate. The truth is, he did not see the young woman I looked after while he was waiting. She was practically blue, struggling to breathe despite having the highest possible concentration of oxygen being delivered via a face mask. He did not see the crying woman who was miscarrying her unborn child and was bleeding large blood clots. Nor did he see the elderly woman dropping her blood pressure and becoming more and more unwell despite the machines we had her connected to to help her breathe.

Still, professionally and spiritually, I knew better than to fight fire with fire. I chose the wiser - I held my tongue and continued trying to defuse the situation.

"I'm very sorry for your inconvenience, but I can assure you that we are all trying our best to care for everyone in this department while being short staffed. Now, how can I help you? Tell me more about this pain."

He lay back down onto the hospital bed and started telling me about what had happened. His caring wife stood by his side and gently added information as he went along.

As he spoke, his anger dissipated slowly, revealing a very raw and vulnerable.. fear.

He was diagnosed with metastatic bowel cancer months ago and had been told that he had under six months to live. He explained that he was so scared of his bowels perforating after the intense surgery he had, and that he wanted to see a doctor quickly because he was afraid of this being the end of the road for him.

"I did the surgery because I wanted more time with her," he said tearfully while holding on to his wife's hand. She too wept softly while listening to him speak.

The initial tension in that room was long gone by now.
All that was left was, peace.. God's peace, I dare say.

Long story short, after taking a proper history and looking at his XRay, I figured out that he was actually constipated. His stoma was not working because it was blocked by hard faeces. All that needed to be done was to essentially "unclog the pipes". The three of us got to work manually clearing it bit by bit, even laughing together in that little cubicle that it still smelled like papaya instead of being malodorous. He began to feel much better once all that faecal material was removed, and his pain improved significantly too. I checked him over once more and satisfactorily told them that they could go home.

Their faces upon getting discharged were completely different that the initial glares I was introduced to. Their eyes were soft, the frowns replaced with an unmistakable peace, and they kept thanking me for taking care of him that night.

They offered me kind, large smiles of gratefulness as they waved goodbye to me and slowly walked out the ED together.

...

Be kind, for everyone you meet is fighting a difficult battle.

These words came to mind as I reflected on that encounter later in the morning. I remembered also a Bible verse that was prophesied over me in the past - "when treated with slander, you respond with kindness." That was from 1 Corinthians 4:13.

How grateful I felt really, that we got to have an ending like that after all that had happened. They truly were beautiful people, and it would've been a shame if I had missed out on seeing that because of my preconceived ideas, or if I chose to remain blinded by my own anger.

I write this story not to boast in any way.
I write this because it was a powerful reminder to myself to not judge people too quickly.

People will have reasons for their actions, and from the outside looking in without getting to know their battles, our judgments can too often be incredibly unfair and incredibly wrong. After all, we're all running our own challenging races in this life.

Perhaps all we need to do to see the beauty and magic all around us, is to take our eyes off our own pity parties, show a little kindness, and try, really try, to ease the sufferings of our fellow men, even if only in a brief encounter. 

Finding Peace

”Work can’t be your only thing. You’ll go mad within the week! I must admit, this really took its toll on me at one point too.
Do you feel like you have an outlet outside from work?”

The overwhelming kindness from my older colleague was completely unexpected; little did I know that my venture into his office to talk about a patient would end up in a short deep-and-meaningful talk.

There are days when it gets too much - unfair comments being made by other inpatient teams, manipulative aggressive patients, those I could not save, those I want to save but will not save themselves, the unending pace, the care that goes unnoticed and the emotional toll it takes on us all. There are days when I leave work and all I feel is defeat.

Ray’s been encouraging me to get more exercise to clear my mind.
Two thousand steps up a mountain later and some good quality time with Papa, I must say, I feel so much better, and ready to try again.

I think of the middle aged man whom I crossed paths with three times today, and on the third time as I was on my second lap up 1000 steps, he gave me a big grin with bright eyes and said, “Good job!”

I’m slowly learning to find my feet again in the midst of it all, to understand what it meant to be a disciple on the same boat as Jesus when the storm rages on. I’m thankful that His peace is attainable at any time, and that not for a moment was I forsaken. I’m thankful for the kindness of strangers, or rather friends I have just yet to make.

Because when I sit and still my heart, I know, that I have been blessed beyond measure and have much to be grateful for.

...

“I look to the mountains, from where my help comes from, my help comes from the Lord.”
- Psalm 121:1-2

“Courage is not that it didn’t make you cry.
Courage is going back again after it did, because you know that what you do is important.”

The Left-Behind Ones

A few nights ago, I was at work when I heard the emergency buzzer for Resuscitation Cubicle 5. I hurried along with several other medical staff to find an elderly woman lying unresponsive on the bed.

She was in cardiac arrest.

Everyone quickly found a job to do - start compressions, give medications, get more intravenous access, ventilate the patient, suction the vomit. In the midst of all that was happening, I heard my boss' voice say, "Has anyone contacted the family yet?"

The next thing I know, a phone was tossed at me whereby her unsuspecting daughter was on the other line. The ward clerk had contacted her for us and escalated the job of speaking to her to the doctor in closest proximity.

"Hi, this is Candice, one of the doctors in the hospital. Your mother has gone into cardiac arrest and we are attempting CPR at the moment. You need to come in now."

In that moment, she responded with this incredible, loud, heart-wrenching wail over the phone.

It's days later yet I can still hear that sound in my head ever so clearly.

"I'm coming in right now," she cried, just before she hung up.

Unfortunately, it was a matter of minutes later that a time of death was finally called.

...

If there's one word that I can use to describe the Emergency Department as I reflect on this memory, it's anguish.

I think also of the teary wife of the man who had successfully poisoned himself in his suicide attempt.
I remember the grieving husband travailing by the darkened bedside of his deceased wife.
I reflect on the son who had held back his tears in front of his mother and sister, and wept alone in the quiet corridor.
I look back at the woman who sobbed as she told me stories of her late husband who had passed away years prior.
I remember the daughter whose heart broke as she realised her father's time was finally coming to an end.

Week in week out, I'm there in the midst of that anguish, and I see the left-behind ones.
I may not remember all their names, but I remember their faces, and I remember their sorrow.

And deep in my heart as I walk away, I suppress a heavy recurring burden, this immense fear; that one day it would be my turn to be left behind and so carelessly abandoned in that place of utter anguish. 

Feels

It felt like a burden, but once I could grasp it
You took me further, further than I was asking
Simply to see You, it's worth it all
My life is an altar, let Your fire fall

If you say it's wrong, then I'll say no
If you say release, I'm letting go
If You're in it with me, I'll begin
And when You say to jump, I'm diving it

If You say be still, then I will wait
If You say to trust, I will obey
Teach me how to follow in Your way
I'm done chasing feelings

Spirit lead me
I'm gonna let Your Spirit lead me
Spirit lead me
Spirit lead me

Spirit lead me

Precious Encounters

"See these scars on my arms? It's from shrapnel. They happened in 1956 during the Hungarian uprising. I was working as a nurse back then and we got attacked by people who wanted to hurt doctors and nurses. One doctor lost his leg and another nurse lost her arm."

After that story, she gives me a big smile and asks, "Now tell me dear, where are you from?'

...

A few days ago, I was lamenting to my dad over the phone about the long drives I have to work now that I've been placed somewhere rural, and my fears about falling asleep on the drives home after a night shift.

He sighed, and said to me then - "Well, I really hope you enjoy what you're doing."

The truth is.. I do. Very much so. I often catch myself feeling very grateful that I am blessed with this job I have now and the opportunity to meet people from all walks of life. I think back to the years I spent dreaming of making it through medical school, and I can't help but feel so amazed by how faithful God has been through it all, carrying me through step by step to where I am now.

I'm thankful for the elderly patients I get to meet, particularly those who share their stories with me - stories of a completely different era and world. What an honour it is  really,  to be transported in time for a brief moment and be reminded of how truly blessed we are to live in such different seasons now.

23:44

Her last words were ,"Ooh, that's just lovely". She sighed contentedly at the warm blankets placed on her shivering body.

Shortly after, she went into cardiac arrest.

The buzzer was alarmed and a flurry of people came rushing in, each filling a role that needed to be done in this critical situation. I stood at the edge of the bed and forced oxygen into her lungs periodically with a bag and mask. Chest compressions were underway to the chorus of "1, 2, 3, 4.... 30."  In between mandatory breaths, I was fixated on suctioning her secretions and inserting a Guedel's adjunct for her airway protection.

At some point into the routine we had adopted in our efforts of resuscitating her, her family was led in. I remember clearly the tears that poured down their red cheeks and the sound of the wail that was released, the absolute fear and horror embedded in that one cry.

Focused on the task of ventilating this elderly woman, I lost track of everything else. Time flew by as we ran through cycle after cycle of CPR. It was only when I looked up and noticed that no one was compressing her chest anymore that I realised what my boss had said.

"This is an irreversible cause for an asystolic arrest - we'll call time of death here."

...

These past few months as an emergency registrar have been extremely rewarding, and when asked about my job, I would often say that this was what I was meant to do, I truly do love it.

However, for many reasons, it has also been extremely tough.
Good long cleansing cries after work are not an uncommon thing.

Firstly because there are haunting situations such as these - where the sudden loss of a good person is felt so deeply and the immense grief of close ones reverberate through to us staff members too. Apart from this patient's family members tonight, I have the image of an elderly man sitting by his wife's bedside in absolute fear that tonight would be the night he lost his wife of over fifty years. She had suffered a catastrophic bleed in her brain. I also carry with me the memory of the son of another patient who had been so strong through the extensive family meetings for his dying father today. In the presence of his tearful mother and sister, he remained calm, comforting and collected. I later encountered him on my way out from work  - he stood in a quiet corridor crying alone.

And then there is the overwhelming politics of emergency medicine as well, having to juggle the advice of different specialty teams and health professionals and ultimately make the final decision for the patient based on what we felt was best for them. Inpatient doctors aren't always happy with how things work out but, I'm starting to learn that you can only do your best in this job and even then, you can't please everyone.

It's been a steep learning curve too, and I have learnt so much this year. Often, I learn by being thrown into the deep end of having to manage a condition I have never managed before. My seniors have been supportive, but inevitably, mistakes are made at times. The outcomes of those mistakes can be painful despite the lack of significant clinical consequences- be it the yells that come from other treating specialists or the yells from angry patient families or the immense guilt that comes anyways.

On top of that, our ED seems to attract a lot of very violent people who are drug affected. The loud echo of profanities towards staff members is not an uncommon background noise, and if I'm honest, it does get quite tiring when we are in that situation too often.

Lastly, I've found in my time this year as well, that emergency training is probably one of the least respected training options amongst medical doctors. Oh the kind of criticism I have sat through from doctors of other specialties, even those closest to me, about how terrible and hopeless ED is. I hear annoyed remarks regarding the lack of faith they have in us. It becomes very demoralising and disheartening, especially when I know that I've worked to my fullest capability to try and do right by the patient with the resources that I have.

...

A while back, I was led to this article directed at young ED doctors written by a famous emergency physician - https://lifeinthefastlane.com/a-letter-to-a-young-emergency-doctor/ . After another difficult shift a few weeks back, I re-read the article and felt this resonate with me.

"Your ED colleagues get it. No-one else does. Others can imagine, they can listen, they can sympathise, but they don’t get it. Don’t expect them to.

When you feel a failure, when you think you have let someone down, when you think you’re no good and never will be, balance it up. Think of someone you helped, something you did well, a person whose life you touched even briefly and left better off than before they met you. If you’re doing this job right, there are far more of those."

My bosses kindly remind us - "You always tend to remember the one 'bad' thing you did, but not the hundred other good things you've done for people. Remember those."

I close my eyes and think of the other patients I have worked with who have gotten better, or who have been helped in some way.

I think of the patients we couldn't save today, but at the very least could offer a dignified, comfortable death. I think of how I was privileged to comfort family members in their greatest time of sorrow as they battled with the reality that we have truly come to the end of the road.

I close my eyes and remember the good days, the happy stories - and accept the.. wholesomeness of this burden I have chosen to carry upon myself.

...

I'm thankful though, for how Papa has so faithfully carried me through.

As I sat in my car today after another overwhelming night, I was put to peace once more by the soft tune and encouraging words of  "Glorious Ruins" playing in the background.

"Where my courage ends, let my heart find strength in Your presence."

Today I rest, and I debrief.
And tomorrow, by God's grace, a new day begins, with a new set of challenges, joys and work to be done.  

Re-Encountering Love

In the stillness, I find You there, waiting to meet me once again.
Never once did You leave me. Never once did You give up on me.
And always, always, You welcome me home into Your embrace.

Matt

"This is a really good thing that you're doing for her."

He turned away from me and was quiet. With his back turned to me, I could just see the corner of his face turn red and that telltale quiver of his lower lip. He covered his face with his hand, attempting to hide the tears spilling from his eyes.

For the past two and a half hours that I've known him, Matt had been a rock for Lila - extremely patient, kind and reassuring. He held her hand when she was afraid, listened as she spoke endlessly and sat with her in the busy ED just to keep her company.

"I just feel so... helpless."

He started to sob as if a dam broke within him, releasing the incredible weight upon his shoulders in the few peaceful moments of respite that we had.

...

Lila was well into her ninety-s and still living at home on her own. In the past few weeks, Lila had become more confused, paranoid, delusional and suspicious of people around her. It was very likely that she had undiagnosed dementia as well as other ongoing medical problems that may be contributing to her symptoms. She had also had two falls in this time, sustaining moderately large bruises to her face.

Today, she had been brought in by the ambulance under an assessment order, whereby she needed to be seen by a psychiatrist before being cleared to be safe to go home.

Glancing into her cubicle prior to meeting her, I saw a well-dressed elderly woman with a shopping trolley sitting on a chair in the company of a man who appeared to be in his mid-sixties.

Matt introduced himself to me. I had initially assumed that he was her son, but as it turned out, Matt was her next door neighbour.

Lila was not an easy person to hold a conversation with as she remained fixated on her paranoid ideas and needed to be interrupted frequently due to her tendency to tangentially go off topic. She was certain that we were trying to do harmful things to her and separate her from Matt. I even had to obtain more information via telephone from Matt's wife Susie, because the latter knew what medications Lila was on and what her doctors had said about her health.

After some time with great difficulty, we managed to get Lila to agree to a CT scan of her brain and for me to take some blood from her. Through Matt's gentle coercion she would reluctantly agree to allow us to do what was required as long as he stayed by her side. Matt even successfully managed to persuade her into allowing a nurse to assist her in the bathroom for a urine sample while he and I waited outside.

It was in these few moments alone that we were able to speak freely.

In between sobs, Matt admitted to me, "My wife and I want to help her because she's our neighbour and we care about her, but how much can we do? She's not our mother. It's so difficult, but underneath all that's happening, Lila really does have a heart of gold."

I was extremely moved in that moment. I immediately thought of how Jesus commanded us to love our neighbour as we love ourselves, and pondered upon the sacrifice that both Matt and his wife had chosen to take upon themselves because they genuinely loved their neighbour.

How many people in our world today would do for our neighbour what Matt and Susie had been doing for Lila?

Lila came out the bathroom shortly after, causing Matt to wipe the last of his tears off his cheek and put on a good face for her once more, as if nothing had happened at all.

...

Today, Matt taught me a powerful lesson with his life. He showed me the beauty of our humanity in his choice to sit with an elderly lonely woman in the emergency room while she got the medical help that she needed even though she did not want it. He demonstrated an extreme kindness that went far above and beyond the call of duty, exemplifying "whoever compels you to go with him one mile, go with him two".

Not all heroes wear capes. Truly.

I don't think you'll every come across this Matt, but I want to thank you for inspiring me today to love others more selflessly as Christ does. Thank you for your generosity, and for showing me just how capable we are of doing something powerful in the midst of the broken world that we live in, making it better one cause at a time. 

You Meet Me Here, Right Here

Lift your eyes! In the midst of all that's going on, lift your eyes, look to heaven and remember it is a mighty God you serve!

Surrender

”I have held many things in my hands, and I have lost them all, but whatever I have placed in God’s hands, that I still possess.”
- Martin Luther

Just How Far I've Come

I remember sitting in the meeting room of our emergency department for registrar teaching when I was a timid final-year medical student. I thought of the sandwiches that were provided each time, the presentations that were taught there and the emergency registrars that always seemed so cool and put-together. I remember how the director of ED spoke to his team of registrars, encouraging that they were the army that was the real lifeforce of this emergency.

I remember wishing that one day I could be one of them too.

..

I remember the time I got to assist in stabilising a patient who had overdosed on a hundred slow-release potassium tablets. Registrars were busy giving her medications and putting in big needles into big vessels to prepare her for dialysis as per the orders of the overseeing consultant. My special job as the medical student was to fill 1L of laxatives every hour and push it through her nasogastric tube to wash out the rest of the tablets from her gut. For three hours at least, I diligently did that, syringe by syringe. It took me close to an hour to reconstitute and push 1L of fluids in through this small tube, which meant by the time my hourly task was completed, it was time to start all over again. I remembered the blisters on my hands that day from forcefully pushing the plunger of a 60mL syringe over and over.

I remember looking at the bag attached to her rectal tube after, and the crushed up tablets within them. "Look at that. You saved her life," came the encouragement from the kind consultant in charge.

I remember wishing that one day I too could carry that kind of confidence and grace into such a critical condition. 

..

I remembered all these as I sat in the same meeting room a few days ago, in my scrubs after a night shift. My lanyard no longer said "medical student" and I didn't have to be as timid in this room anymore because I knew most of the people there now.

I thought of these things because now, finally, I am one of them.

..

Emergency doctors get a lot of criticism from the rest of the hospital, as I've learnt a long time ago. At times that can be discouraging, but I know that there isn't a perfect specialty out there, and it pushes me to keep trying to do the best that I can. A lot of non-emergency people give me a face when I tell them that I have decided to pursue emergency medicine, and they ask me "why?".

Because I love the variety.

I love the stories I take home from work every day - the resuscitation that went on for several hours in emergency, the traumatic amputation, the foreign items in places they shouldn't be, the pus leaking profusely out a man's shoulder.

I love the different kinds of people I meet each shift - the brave wife who helped hold the mouth of her husband open while I stitched within it, the elderly woman giving me relationship advice while both her broken arms were in slings, the little boy running up and down the department because he was feeling much better after the right medication for his infection.

I love the camaraderie in ED as we tackle the list of patients waiting to be seen, and how every shift always comes to an end.

And I am so blessed where I am to love the place I work in and the people I work with too.

And on top of that, I love having more days off to live and focus on other important things in life too - family, church, friends, people, exercise, adventure.

..

God, You have been so, so good to me indeed. Thank You Papa. 

Keep On Pushing Back The Dark

Things haven't been the easiest lately.

Many thoughts.. many responsibilities, disappointments, fears, worries.. heaviness.

It's all part of growing up, I know, and in the midst of it all I hear Papa saying to me,
"Now is where you test and see that I really am enough for you. This is your training ground, and I am preparing you for bigger battles."

Bill Johnson once said that when his spirit was in despair, he would read the Psalms until he found one that resonated with his spirit.

...

Psalms 34 - A Psalm of David when he pretended madness before Abimelech, who drove him away, and he departed.

"I will bless the Lord at all times;
His praise shall continually be in my mouth.
My soul shall make its boast in the Lord. 
The humble shall hear of it and be glad.
Oh, magnify the Lord with me,
And let us exalt His name together.

I sought the Lord, and He heard me,
And delivered me from all my fears. 
They looked to Him and were radiant,
And their faces were not ashamed.

The poor man cried out, and the Lord heard him,
And saved him out of all his troubles.
The angel of the Lord encamps all around those who fear him,
And delivers them.

Oh, taste and see that the Lord is good;
Blessed is the man who trusts in Him!
O, fear the Lord, you His saints!
There is no want to those who fear Him.
The young lions lack and suffer hunger;
But those who seek the Lord shall not lack any good thing.

Come, you children, listen to me;
I will teach you the fear of the Lord.
Who is the man who desires life,
And loves many days that he may see good?
Keep your tongue from evil,
And your lips from speaking deceit.
Depart from evil and do good,
Seek peace and pursue it.

The eyes of the Lord are on the righteous,
And His ears are open to their cry.
The face of the Lord is against those who do evil,
To cut off the remembrance of them from the earth.

The righteous cry out, and the Lord hears,
And delivers them out of all their troubles.
The Lord is near to those who have a broken heart,
And saves such as have a contrite spirit.

Many are the afflictions of the righteous,
But the Lord delivers him out of them all.
He guards all his bones;
Not one of them is broken.
Evil shall slay the wicked,
And those who hate the righteous shall be condemned.
The Lord redeems the soul of His servants,
And none of those who trust in Him shall be condemned."

Selah.

...

Tonight, in the midst of my thoughts, I felt Papa bring this song to my mind.

It's been blasting through my earphones on repeat for several times now. How truly grateful I am indeed, that where the spirit of the Lord is, there is freedom.



I'm not sure what it is that compels me to write sometimes, but more often than not, I think I write for me. I write as a means of releasing the burdens on my shoulders, a scream into a blinded audience, a story to only those willing to listen.

"The light shines into the darkness, and the darkness can never extinguish it."
- John 1:5

"In His presence is fullness of joy."
- Psalm 16:11

"In this world you will have tribulation, but take heart, for I have overcome the world."
- John 16:33

I'll keep pushing back the dark. Just watch me.

The Strongest Part of Me

"My heart beating, my soul breathing
I found my life when I laid it down,
Upward falling, spirit soaring,
I touch the sky when my knees hit the ground."
 - Touch The Sky, Hillsong

This song came on my speakers as I drove home from church today, and I felt God remind me of this photo someone took of me at church many years ago.

This is me at my strongest. 

I thought of all the battles I've fought on my knees, all the times God came through for me in the past, and how despite the circumstance - His embrace always makes everything okay.

It's been a challenging past few months, for many reasons. I've questioned my identity, my gifts, my purpose, my choices, my dreams - whether or not I had the courage to pursue it, my weaknesses and my worth. I've questioned the expectations that the people and the world around me had for me. I've questioned everything and some days it left me exhausted, broken and afraid of the future.

I've always had a pretty close relationship with God, but even that has fluctuated throughout the years - I have been the girl on my knees who would boldly pray "here I am Lord, send me" and I have also been the Sunday Christian whose relationship with God only went as far as attending church on the days my work schedule allowed it. And funny enough, when I look back at my life, it was at the toughest moments of my life that I was drawn closest to God, learning then to let Him carry me through and fight my battles for me.

Somewhere in this season, I found myself running back into Papa's arms again. And oh, how He loves indeed. When my heart is quiet enough to listen, he never fails to speak wisdom into my life with this unmistakable authority that is firm, yet gentle. He corrects the error of my ways, dusts me off, and gives me the courage to face tomorrow. He helps me to dream again and teaches me to activate my faith. And He always, always reminds me that I am not alone.

My heart is so blessed. Thank You Papa.
The road ahead may be long, but I look heavenwards and know that He's got me.
Everything's gonna be okay.

"The Lord your God will fight for you.
You need only to be still."
- Exodus 14:14

Acceptance

“Your love so deep, is washing over me

Your face is all I see,

You are my everything

Jesus Christ, You are my one desire

Lord hear my only cry

To know You all my life

I’m wide awake

Drawing close, stirred by grace

And all my heart is Yours

All fear removed 

I breathe you in
I lean into Your love”
- Sinking Deep, Hillsong

...

“Not that I speak in regard to need, but I have learnt in whatever state I am, to be content: I know how to be abased and I know how to abound. Everywhere and in all things I have learnt both to be full and to be hungry, both to abound and to suffer need.”
- Philippians 4:11-12

"I look to the hills, from where my help comes from
My help comes from the Lord."
- Psalm 121:1-2

Never On My Own

”God grant me the serenity to accept the things I cannot change, the courage to change the things I can and the wisdom to know the difference.”

Much Needed

"Lay down your hurts, lay down your heart;
Come as you are."

Perspective

What do you do when you realise your time is running out? 

...

In the past week, I've started a Cardiology term. We had a patient who had a major heart attack. Fortunately, he was rushed into the cath lab in time for a life-saving procedure to re-open his blocked heart vessels.

As my boss put it the next day - he was very lucky to be alive.

As a doctor, I see plenty of life and death situations each day. I see cancers, strokes, heart attacks, kidney failure, dementia.. the list goes on and on.
And as I age, I see it in the people around me - relatives, friends and their parents too.

Life truly is so fragile.

I am forced to question - have I become guilty of getting so caught up in routine and my own agenda that I have forgotten we aren't promised tomorrow?

Perhaps if I kept this perspective, I would live a bit more freely, perhaps I would forgive a bit more quickly, dream a bit more courageously, give even more generously, be more thankful for the abundance that I have, hold on to what truly matters, share of the joy and love Christ has given me more often and squeeze every last drop of goodness that today has to offer.