Debrief: One Night In Emergency

He was a likeable fellow, early thirties, very thoughtful and humorous, and kept me smiling with a constant stream of jokes the whole time I was treating him.

That night, he had come in with a painful left foot that needed X-Rays and a cast.

We built good rapport with one another fairly quickly, trading stories and chemistry jokes. He even got to hear the circus arts vs medical school dilemma from my early teenage years. He then told me of his journey as a professional clown for years, touring the world, eventually being an individual act, and then exploring acting as a career and now, writing. Amused, I assured him that I would purchase his novel if ever I saw it in a bookstore. What an exciting journey he portrayed indeed!

I glued his wound back together, bandaged it and put his foot in a plaster cast.

Hobbling out of emergency with his crutches, medication and a brand new plaster cast, he quite loudly announced in front of the whole department so that I could hear from our staff base where I was sitting, "Your compassion and healing has been exemplary!"

With a cheeky grin spread across his face, he left the department.

...

Later that shift though, in stark contrast to that experience, I encountered her.

This girl, who was just about as old as I was, had come in for "self-inflicted lacerations to her lower legs". 

I hadn't yet met her at that point but I heard what all the staff were saying about her.

"Did you see the number of scars on her arms and her legs?"
"She's done cuts with a razor blade in a crosshatched manner this time, it's not going to be possible to suture that up."

I knew she was coming to short stay for the rest of the night, where I was in charge. A plan was put in place for her, she was to be reviewed by plastic surgeons in the morning, and for me this meant that I didn't really have to see her at all or manage anything at this stage. So she was moved, and I tended to my other jobs instead.

7.30am, I get a call that plastics didn't think she needed surgery, that the wound could just be cleaned, steri-stripped and bandaged, and that the nurses could easily deal with it if I had other jobs to do. I relayed this to her nurse, who accepted the job without complaint.

I went back to the staff base and sat in front my computer again.

"Self-inflicted lacerations to her lower legs."

To be honest, triage doesn't give patients much of a personality with the 4-10 words they use in their descriptions on our tracking list.

All night, she had been just a name on my screen, which is something I must admit has occurred a lot more frequently now that I am a "busy" intern. Third-year-medical-student me would have been so ashamed of how I allowed this to happen. Third-year-medical-student me would not have been put off by frequent presenters to hospital and was always innocently bright-eyed, looking to bless a struggling patient at whatever cost. 

I hesitated for a moment as I read that once more, and finally got up to tell her nurse that I would dress the wounds myself. 

As I set up to dress the wounds in her cubicle, I got to have a good glimpse of her arms and her legs. Believe me, that I am in no way exaggerating when I say that there was no part of her limbs that was not covered in some sort of self-inflicted scar. There were countless slashes all across her arms and legs, in different lengths and depths, healed into a myriad of colours - some a deep purple whereas others were as white as snow. 

I cannot imagine anybody being able to take a good look at her, gaze at her skin that was so far beyond what it ought to look like, what it once used to look like, and not feel a deep pang of compassion for her. 

I gently asked her if she wanted to talk about why she did it this time. 

She quietly shook her head, continuing to observe my actions in the cubicle. As I looked at her and waited to see if I would get any further response, she had this look in her eyes that spoke more clearly than anything she could have audibly mentioned. 

"How could you understand? Young, well-dressed, happy doctor like you, how could you ever know anything about my pain?"

And to be honest, she was probably right. 

I wasn't born into a low socioeconomic area. I grew up with great opportunities before me to attend a private school and pursue any university degree that I could get myself accepted to. Even now, I often receive compliments to further boost my self-confidence regarding the way that I look and the way that I act. I come from a loving and supportive family. I know that there are people I can call right now who would immediately attend to my needs if I was struggling with even half of what she was going through.

I have never walked in anything close to the shoes she had been walking in all her life. 

And for the first time since I started work, I felt so inadequate as a doctor not because I didn't know enough academically compared to my peers and seniors, but this time simply because I just could not fix her problems. I hated that I would eventually send home a bandaged version of a girl that was just as broken as the one that walked into emergency bleeding all over her trousers in the middle of the night. 

I regretted not being someone who was more inspiring, who was courageous enough to look her in the eyes and really tell her that she was so precious and important, and that it was not too late to be who she dreamt she would be. I wished so hard that I was bold enough to tell her about the reason I am who I am today - a God that know her by name, adores her so much and whose heart broke each time she cut herself like this. 

With a head full of thoughts, I cleaned her wounds slowly, praying quietly for the peace of a young girl and the healing of her emotional wounds as my hands were laid upon her. I bandaged up her injuries, and sent her on her way afterwards. 

Expressionless and numb, holding on to what was left of her bloodied belongings, she left the department.

...

"Stir in me a love that's deep

A love that's wide, a love that's sweet

And help me Lord to never keep it to myself

Cause there's no fear in love."

A Debrief: What Being Dr Candice Toh Feels Like

I spoke to my parents after finishing my midnight shift tonight, and daddy told me of how my sister recently found a small, folded piece of paper that I wrote in as a child.

In it, were these words -  "I want to be a doctor. I want to help people. I want to change the world."

...

I've come a long way since then. 

This job that I have now - it's such a testimony of God's grace upon my life. I've been meaning to write that testimony out for a while now, but just never found the time to do so.

Second-priority job offers (for international students) were supposed to come out in August. I remember being on yet another God-led mission trip to Pos Gob for a government mobile clinic then, and feeling God whisper to me amidst the lack of connection to the outside world - "Frankston". I felt it over and over again that I was so sure I would get the job.

When the offers came out though, I didn't get the job.

It was hard, but I knew, that the same God that has been so faithful to me all my life, the One who never left my side through trial and pain, that same God would do exactly what He has promised me He would do.

And so I called Frankston. I called and I called, and often doubted myself - that my grades probably weren't impressive enough, this year was extra competitive for jobs due to the increasing number of medical students, my CV lacked medical research... I just was not good enough for this.

I started considering going home to Malaysia instead. And after all the time I spent at the Gombak Aboriginal Hospital in Malaysia, I was quite okay with the idea of it.

One day though, in the midst of worship, I felt God clearly say to me - "Your willingness to give this up is not making you any stronger, nor is it giving you more power over Me. In fact, it is your faith that will see this promise through to fruition."

Fast forward to October - still no job. My last placement of the year was at a rehab in Frankston. I did work hard then, but truly more than anything else, I am so thankful for God's favour upon my life. Having built good rapport with my consultant, he offered to help me with my references, and ended up writing me a really nice recommendation letter about the work I had been doing on the ward, my approachability, knowledge and dedication. My intern was so pleased with the help I had been that he too called medical workforce on my behalf. And to my delight, on the last week of placement, I was told that I had been moved to the top of the waiting list.

The next week was back-to-base week at uni, and the Monday was incidentally my birthday as well. B2B week was like a reunion, the whole cohort gathering together again and catching up, and one of the first few questions that would get asked usually is, "So where are you next year?" Needless to say, it was a pretty awful day for me having to explain over and over that I was still unemployed.

The next day, I found out that a friend of mine who had a spot at Frankston had received a job offer interstate where she wanted to go. This meant a spot had become vacant, and if what I was told was correct, it would be for me. We agreed to call workforce together the next day, and to my surprise, my employment wasn't as confirmed as I initially thought.

After a long and arduous wait, I decided to email workforce a day later to respectfully ask if the position had been filled.

Turns out, I didn't get the job.

I'll be honest, I went home and cried that day. I didn't know how much longer God wanted to keep me in limbo, I didn't know if I really heard Him right or not. I started to regret not calling anywhere else, for not trying a rural location instead.

I've always felt though, that my time in Melbourne wasn't up. Somehow, God still had(has) destiny in store for me right here in this season. I remember telling Papa, "If I go back, I'm gonna forget Melbourne for good and the promises I felt from You that are related to here. If I get to stay though, I'll know You still want me here, I'll stay in ministry because I'll know that's important to You."

Friday, I decided to take matters into my own hand and get an academic transcript. I would apply interstate, and call up all rural hospitals as well. I didn't want to just go on by faith anymore. Still, it was already evening, so any calls would have to be made Monday morning instead.

Come Monday morning, I couldn't do it. I couldn't bring myself to intentionally stray from what I knew God wanted for my life. I started asking for more prayer from those around me instead. I started writing declarations of the promises God has confirmed in my life. And, I made peace in my heart for what would happen if God didn't come through - I would go home to Malaysia, work hard and continue to chase my dreams of becoming a medical missionary. I love Malaysia anyways, life would be harder for sure, but I believed I would survive.

Wednesday, in my sister's apartment, with a clay mask on my face preventing much facial expression - the email came.

After months of waiting, I had finally been offered a job at this very hospital.
Two weeks before graduation, I was no longer unemployed.

God really did come through for me. 

Wow. Just.. wow.

Some days I still can't believe it, that He's been so, so real and faithful to me, and that He walks every step of this journey holding my hand so tightly. Thank You Jesus for being so so good to me. You never fail to humble and amaze me with Your incredible grace. :)

...

Fast forward a month or so later, and here I am, lying in bed typing at 3.51am after an evening shift and FaceTime with my family back home.

Many days it still feels weird to see the Dr in front of my name on my ID or the computer system.

Ask any medical intern, we wear our titles on bills, bank details and applications with pride and an almost childish kind of joy. It's just cool, and it's been a long time coming too.

However, the title 'Dr' has also carried the most enormous weight upon our shoulders.

After at least three years of clinical placement and "I'll get the (real) doctor for you dear patient" , suddenly I find myself in the shoes of the "real doctor". It is now my responsibility to give this patient the best medical care possible, to listen, to know, to explain, to try and understand their perspective, to not judge and to respect them, the way I would want myself or a loved one treated.

Knowledge is no longer a mere discrepancy between a credit and an HD any longer, it provides the ability to pick up on something serious that would have been missed otherwise.
Good clinical skills are no longer just to impress an OSCE examiner, but to really understand the clues that a patient's body is giving us to help us treat them.
Offering a crying patient a tissue is not just a means of getting an extra mark with a simulated patient anymore, it's a mark of respect, heartfelt care and genuine concern for the wellbeing of a patient.

So, I'll say it now. Being a doctor is hard.

There are the days you feel you're doing a fabulous job - busting discharge summaries at the speed of near-lightning, getting those cannulas in, picking up the diastolic murmur on auscultation, having patients thank you for your excellent care... and then there are the days where people yell at you for the decisions your superiors made, where you miss one thing in the list of ten things you were told to do and it turned out to be important, where patients get angry for having to wait so long, days where you just feel so completely, extremely, entirely out of your depth to be trusted with this job of saving lives.

But.. it's a journey.

Every time I reach a point of wanting to break apart for whatever recent stressor in this job happened, I remind myself of that.

"But it's a journey. "

And as long as I keep moving forwards and learning from my mistakes, I'll get better.

And in the midst of my fears of inadequacy and struggles to stay afloat, I feel God hold me and say "Hey, hey baby girl.. you're doing just fine. Everything is going to be okay."

He's brought me this far hasn't He? :)

...

I'll live to fight another day.

I've gotta live up to the expectations of that child many years ago who scribbled on a piece of paper. I've got to make her dreams come true.

So, for now, good night to you, dear reader. :) I pray that you are able to make your dreams come true as well.

With much love,
Just.. dice :)

The Power of Our Testimony

"in a few hours i will find out if i got into monash or not. man this feel SO surreal. for so long i've wanted this, and was so certain even that this is the direction God's calling me to. now all doubts rush in at my shortcomings, my ability to get a spot. yet, like my results, maybe, just maybe, a God-breathed miracle awaits me. a part of me is afraid of not getting it (like DUH!) cause for so long i have put monash as where i thought i was meant to go to, but another part of me doesn't really care, cause i know that God's still in control, and that He will open the doors needed to take me where He wants me to go. so putting aside my pride, my possible errors in hearing His voice, now it's just all about the revelation, of where He wants me to go. UNSW or Monash? despite the anxiety and maybe even "induced" fear, there's an underlying peace within me now for i know that.. in all things God works for the good of those who love him, who have been called according to his purpose.- Romans 8:28. so i'm just keeping my fingers crossed, and waiting. :) in or not God, i will still praise You, and i will always love You. thank You Daddy King! :)

...

after a year of anticipation and stress.....

I GOT IN! :)

praise the Lord for He is good and His mercy endures forever! :D i find myself once again in a place where i know, like REALLY KNOW, i could not have done this by my own strength. all glory goes to God! thank You Father Lord! :)"

- 12-13 January 2011

//

"My biggest testimony from all of this really, is having the peace of God with me throughout everything. I knew those dear to me were very worried, which made me wonder if I should be too, if something was wrong with me for not being afraid of illness, or even death. Now I know though, it's all Papa God just being like.. totally cool and in control of everything.

I knew I had nothing to fear because there had already been multiple prophecies made over my life at different times and by different people all resounding the same message, that there is a future for me to live out my dreams for the glory of God, to share His love to the poor and the broken.

Again I say, that my greatest joy was having His hand to hold through everything, the good and the bad. We are blessed not because we have nothing to endure, but because He remains by our side in every situation. Time and time again, He would overwhelm me with His love and assure me that everything was going to be OK.

Oh and..

Coming back from the doctor today, I am happy to announce that my bloods are now within the normal range and that my biopsy was all clear too! :) Praise God!"

- 05 July 2013

//

"Shortly after this photo was taken, I found out that my flight to Cairns had been pushed to 7am the next morning, which was an absolute disaster because my flight from PNG to Cairns was at 7am. I stood at the counter, flustered, anxious and despaired, thinking of the people I would be letting down who have prayed and financed my way there.

BUT, testimony taime! :) I thank God for an amazing Tiger Air counter person who searched out other options for me for probably 20 minutes. In this time I kept hearing God say, "Do you believe that I want you to go to PNG this time? Do you really think I would set you up to fail?"

Miracle of all miracles, he organised a transfer of my plane ticket to Brisbane and helped me purchase a ticket to Cairns from there. I'm sitting here at the Brisbane Airport awaiting to board now. 

God is so so good to me, ever faithful and a very present help in time of need! Just prior to this photo, I told Ron that a life of missions was so exciting, always having to rely on God for the next pay check. I didn't realize that extended to plane rides too. Still, I am so so thankful to see Him catch me just in time, and even give me a shorter stopover time through the night being homeless at the Cairns airport tonight. 

Lesson learnt: In times of chaos, do I still know who my God is? :) :) :)"

- 11 June 2014

//

"Dr Izandis said to me, "I guarantee you, you would not get this experience with any other hospital, not even if you went to Sabah/Sarawak." And numerous other people have commented too that my timing for my elective placement here was absolutely perfect because it was not often that they did trips like this anymore. What a successful mission this was too, for we managed to evacuate two sick children with their parents to tertiary care, and see a lot of patients in different villages around Pos Gob.

You may have heard the story of how God impressed the word Gombak on my heart before I even knew about this hospital, and nudged me to come home for this period when I wanted to go abroad somewhere exotic to do my elective instead. I didn't really wanna come here for I thought it would lack the adventure of missions I craved so badly.

Looking back now I can truly say, God's instructions are always the very best and that His timing truly is perfect. The past few months, I keep hearing Him say to me cheekily, "I told you so. :)" God has been so, so good to me. Whatever comes next, the good and the bad, I am so excited and thankful to do it all with Him. Puji Tuhan!"
- 13 August 2015 

//

How could I have ever thought that Papa God would not come through for me again?

Do it again Jesus. Come show off yet once more in my life. It's all You now. :)

Wholeness

"I actually attack the concept of happiness. The idea that - I don't mind people being happy - but the idea that everything we do is part of the pursuit of happiness seems to me a really dangerous idea and has led to a contemporary disease in our Western society, which is fear of sadness. 

...

Wholeness is what we ought to be striving for and part of that is sadness, disappointment, frustration, failure; all of those things which make us who we are.

I would like just for a year to have a moratorium on the word "happiness" and to replace it with the word "wholeness". Ask yourself "Is this contributing to my wholeness?" and if you're having a bad day, it is."

- Hugh Mackay

...

It's been a wholesome year for me. 

By no means was it only filled with the kind of bad days mentioned above, but it has definitely been a difficult journey nonetheless. Still, I must admit that I did have a large portion of sunshiny days as well.

This year has encompassed decent amounts of joy, sadness, hope, tears, laughter, family, heartache, precious moments, tiredness, love, promises come true, sickness, adventure and new challenges.

For this much, to have grown in the midst of all that, I am very grateful indeed. 

Happy Place

Bring me back to the laughter of children and the kindness of strangers. 

Bring me back to the ease at which I breathed and embraced each day. 

Bring me back to the joy I found in the works of my hands.

Bring me back to face-to-face conversations.

Bring me back to being unplugged from the technology that so often robs us of deeper relationships.

Bring me back to the beautiful, untainted villages tucked away from the rest of the world.

Bring me back to the nights we spent in worship on the deck, where Your presence was so tangibly with us. 

Bring me back to where life was simple, pure and filled with hope for tomorrow. 

Bring me back to that place where I knew that I knew that I knew.. that I was doing exactly what I was created to do.

Rest

"The Lord will fight for you, and you shall hold your peace."
- Exodus 14:14

Overwhelming Peace

That feeling.. that I am exactly right where God wants me to be.

That He will most assuredly do all He has promised to do.

...

"Let us become more aware of Your presence,
Let us experience the glory of Your goodness."
- Holy Spirit, Bryan and Katie Torwalt

Perhaps this is how those prayers are being answered.