discussions

yesterday was not a good day. had pediatrics clinical exam. messed up the order of my differential diagnoses. was really pissed off, mainly because the examiner said she was "worried about patients' safety" in my hands. quite insulting especially because i DID think of the possibility of a surgical abdomen but i threw out viral gastritis anyway as my primary diagnosis because of how the patient reported his history. don't think it was that wrong, especially since he was lying there so peacefully and claimed not to have had painkillers or surgery since being admitted. BUT APPARENTLY HE WAS ON MORPHINE. apparently kids don't know shit, even 13 year old ones. yeah really insulting cos i thought of surgical abdomen and i got the management and all that correct. just really difficult when you have a really shy boy telling you a strange, atypical history that doesn't really fit here nor there, and you have examiners who are on one track and you are desperately trying to second guess them and give them the answers they want to amazingly open questions. eg. what blood tests would you give if this boy needed a transfusion? group and cross match. ok. what else? HUH WHAT ELSE? if he needs a transfusion he needs a transfusion what. anyway they were looking for hemoglobin levels. WHICH REALLY DOES NOT HELP the fucking management in any way. it's in fucking g/dL, tells you concentration, and not blood volume, which is the important thing in blood loss right??? which is what i told them and they said GOOD. then why the fuck you keep poking me to make me say full blood count? you told me the kid was tachycardic, hypotensive, thready pulse, pale. QUITE FREAKING OBVIOUS RIGHT. aiyah. damn annoyed la. feel so misunderstood. so hard to get them to understand your thought process when all they're interested in is their own. have to keep guessing. and one of them even said she was worried if i would be a safe doctor. I DID THINK OF SURGICAL ABDOMEN KNN JUST THAT YOU NEVER GIVE ME CHANCE TO EXPLAIN MY DIAGNOSIS AND GIVE DIFFERENTIALS RIGHT. anyway i hope i pass. got the management part pretty much correct though. knnccb. insulted. but i guess i must learn to control the examiners more in future. make them think what i want them to think. must learn must learn.

anyway later that night went to this jazz bar at regent hotel, and what ensued was this REALLY prolonged discussion about creation vs evolution. i'm too lazy to write out everything here, but anyway cuong(aussie exchange student) was talking about theory of irreducible complexity, how that makes macroevolution so freaking unlikely it's impossible. and that evolutionists really have no concrete proof. greg(singapore med student) was basically saying that there is SOME evidence SUGGESTING evolutionary theory is correct, and that lack of evidence doesn't disprove a theory. ya anyway they went on and on but come on, we all just talking theory here right. you're never going to be able to win. maybe what we're thinking is all wrong? maybe our idea of logic is bullshit? maybe what we perceive is not what really is? how do we know our minds are not lying to us? when we see an apple, is it really an apple? maybe our mind tricks us into thinking that some pears look like apples. there's just too much we don't know la. and everything is theory. but anyway one interesting point that was made is that science is so incomplete and flawed, it's amazing how many people take it for gospel truth. alot of things that are done in medicine actually don't have very robust evidence supporting them, maybe just based on years of experience or some studies that were done within the limits of our current knowledge or even our ability as humans to comprehend how the universe works. take the law of thermodynamics. it's a misnomer. it's a theory, not a law. but the guy who coined it was probably pretty clever. he got to create a natural law. no body can really prove or disprove it. hence, my new law is that i am greater than you. suck it.

haha and cuong is quite funny. he was saying that the US have got it all wrong. they should deal with terrorism by threatening to kill terrorists families. 3 generations up and down. you know, like in those period dramas where the emperor orders your entire clan to be executed. but seriously, he has a point. it would work wonders as a deterrent. "you dare bomb my subway station, i'm going to go down there, to the little shithole you call home, and nuke your fucking village off the map. wanna try me?" that would really work. assymetric warfare no more. apparently that's what the viet cong did in vietnam after the vietnam war to keep the peace. cuong is from vietnam, and he has alot of stories about crazy vietnamese with guns and grenades, and also about his previous involvement in the vietnamese triad and drugs and shit in perth. some of his stories sound so out of the world though, hard to believe they're real. interesting though.