Tuesday, July 25, 2006

BMT...

Has been a hectic few weeks... almost getting used to waking up at 5.30 am in order to be able to start rounding at 6.15 am. Learning lots...
Funny how different people face challenges so differently. Have had quite a number of patients on the service who had the same disease, same conditioning regimen, same chemotherapy side effects, same complications and yet have such a different outcome... one stays in the hospital for 5 days and the other 15 days...
The emotional, psychological state is so important when facing a life-threatening diease. The right attitudes, approach, mental fortitude can often make a difference between recovery and illness...
The WHO defines health as...

Health is a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity

.
I must admit, as physicians we are often so focused on the physcical that we forget the mental, emotional and social aspects of health.
Interestingly even this definition under debate, in fact, there have been various attempts to modify, edit this definition. Found a paper recently by Sussela Bok a senior visiting fellow from the Harvard School of Public Health which discusses the historical context of the definition, as well the various efforts to 'update' this definition. Found it to be of a somewhat interesting read. Included here is the link to the PDF.
http://www.hsph.harvard.edu/hcpds/wpweb/Bok_wp1407_3.pdf

Saturday, July 15, 2006

Day off...!

Day off today... didn't do much today, slept in, watched TV, surfed the net, emailed, napped...

Looks like a we are going to get hit by a heat wave here in minnesota...

Got to go to bed... early day again tomorrow... 6.30 am...

Wednesday, July 12, 2006

Medical Oncology / Hematology Fellowship

I am tired... only 3 days into my clinical fellowship and I am already tired... not a very auspicious start huh??

Starting out on the BMT (blood and marrow transplant service) has been tiring... taking call from home, and since the BMT service does not have inhouse coverage so all the pages get directed to me at night... sigh... I suppose to put a positive spin on things, at least I get to sleep in my own bed at night, between pages anyways... The BMT service can be busy... we do more than 300 stem cell transplants a year... that usually equates to a lot of sick patients...

(BMT = aggressive treatment for diseases like blood cancers, stem cells are collected from either the bone marrow or circulating blood and infused back to the patient after intense chemotherapy / radiation that is intended to wipe out all the cancer cells. The stem cells then repopulate the bone marrow to produce good blood cells. They can be either stem cells collected from the patient or from a donor.)

Actually, complaning aside, I am quite excited at starting my fellowship... looking forward to learning much about oncology and hematology... starting off with 6 months of hematology, it will be a steep learning curve the next 6 months... will be rotating through BMT, Inpatient lymphoma and leukemia services, Hematology consulting service, Transfusion medicine and Coagulation service.

Anyways, got to go get some sleep before I get paged...

Sunday, July 09, 2006

Sense of wonderment

Been wanting to starting blogging for some time now.. just didn't know where to start. Never really kept a journal growing up, not consistently for any real length of time anyways..

Anyways.. Just as I am about to embark on a new phase in my training (a clinical fellowship in Medical Oncology / Hematology), a sense of wonderment came over me.. 'What am I doing here?' I suppose the real question is how did an ordinary guy from a small town in Malaysia end up working as a physician in one of the largest academic medical centers in the US.. I wonder myself..

'Was I smarter..?' I don't think so.. 'Was I more hardworking..?' Definitely not.. 'Was I lucky..?' I don't believe in luck.. 'Do I deserve it..?' No.. then 'What was it..?', I asked myself..

I am blessed.. blessed with parents that were willing to make sacrifices that allowed me to make it to medical school abroad.. Not just financial sacrifices, but lifelong sacrifices from the day I was born.. The sacrifice of time, finances, career, energy.. etc.. The time spent to nurtue, support, teach, talk to, advise, encourage, play with, travel together and role model was not spent in vain. Big and small sacrifices that through the years molded and shaped my thoughts and character.. Because of it all, I have become the person I am today, and I look back at my formative years with gratitude..

I am blessed.. blessed with friends that were willing to help, support and encourage me to achieve my dreams, even though they may have seemed a little out-of-reach.. friends that I have turned to for comfort and advice, for companionship and friendship..

I am blessed.. blessed with teachers and mentors who could see beyond the obvious to look for potential and were willing to invest the time to provide guidance and good advice..

I am blessed.. blessed with God's grace and good health that has allowed me to devote my energies to pursuing my dreams..

In summary, I am where I am because I have been blessed.. I do not know the reason that I was blessed with this opportunity, but one day I will find out.. and I pray that at that time of reckoning I will be found adequate.. and willing to put all the sacrifices that my parents, family, friends and teachers to good use.. and that their investments in me will be fruitful and worthwhile..