HALLOWEEN!

Here is my GaGalicious outfit I wore for Halloween! My boss made a bow in my hair out of my own hair and I didn't need to wear my ugly wig! It was so cool! My boyfriend dressed like Hannibal Lector. Here are pix of us! 

 

         

Kaori Ishii show gymnastic skill

G.S.

If it falls on your lot to be a street sweeper,

sweep streets like Michelangelo painted pictures,

like Shakespeare wrote poetry,

like Beethoven composed music;

sweep streets so well that all the host of Heaven and Earth will have to pause and say,

"Here lived a great sweeper, who swept his job well".

- Martin Luther King, Jr.

They are revered in public, but sometimes jokingly reviled behind the closed doors of medicine. They have a cocky air about them, only because an extra, maybe even seemingly unecessary dose of confidence is necessary for the very thing they were born to do. They can be rough, brash, and demanding, because of what systems, people and the world-at-large demand of them.

General Surgeons. They're one of a kind.

So I've been in denial. Until lately, I didn't realise how much I enjoy Surgery, far more than any other internal medical specialty. Because of its crazy lifestyle (think 630am to 7pm working hours and 36-hour calls once or twice a week), its seemingly bad reputation and the persuasion of others for me to try something a little more "female-friendly", I had sought my solace elsewhere, exploring Obstetrics, Ophthalmology, Orthopedics and other surgical specialties offering friendlier working hours.

Then came SIP. It's the Surgery Internship Programme, where they work you, as they say, "like a dog" to prepare you for the gruelling life of a house officer/junior doctor right after graduation.

It was then that I found out, that after rotating through all the different specialties, my heart beats in a different way in General Surgery.

I guess sometimes, you only realise how much you love something when you see how much you are willing to give up for its sake. It can be quite scary, especially if you have been in denial for a long time.

Before entering medicine, I never knew surgeons worked 7 days a week. I never knew of such things called Calls, which are 30-over-hour marathon workshifts where one works from 6 or 7am in the morning till 2pm the next day, with hardly a wink of rest in between. It involves continually seeing new patients being admitted, interviewing them, examining them, speaking to family, ordering lab tests, taking blood, preparing them for operations and if you're senior enough, actually doing the operation itself. I never knew they were bad-tempered not so much because they're unreasonable but because anybody sleeping those number of hours would be a little cranky too. I never knew surgeons had to operate through the night, that sometimes, they don't sleep for more than 30 or 40 over hours.

Last night was one such night. It was Saturday. We started work at 6am. Today is Sunday, we ended work around 2pm. On call, my team and I went without any sleep between the 2 days. There were not one, not two but three open laparotomies through the night. A laparotomy is an operation where the tummy is barbarically opened up and one's guts are all dug out to explore and repair the abnormalities.

Someone had suffered multiple stab wounds from assault. The knife pierced his liver, his lung and his diaphragm. The operation was brutal. The scar was a huge crucifix emblazoned across his chest and abdomen. The main surgeon, together with my seniors, deftly and swiftly rummaged through the mass of injured organs to stop the vicious bleeding. When the operation was over, I caught a glimpse of the patient's face. It was bruised, haggard. He looked thirty or forty.

Outside, a wailing family of almost twenty members burst into hysteria when my senior broke the news to them that even after a heroic rescue effort by the team, the patient collapsed just minutes after the harrowing surgery. The patient didn't make it. He was only 19.

More surgeries through the night kept the surgical team awake. My senior, Dr. N, did not have dinner perhaps till 3am in the morning. Dr. D and Dr. U slept for 20 minutes during the night. They are very senior already, they could have gone into private practice. Still they choose to slog it out because of their passions, because of their desire to train better and because of a fiery desire to pursue excellence in a field they could call their own. They laugh and joke and talk in the operating theatre not because they take their work lightly, but because the tension is so high that they have no choice but to do so.

At 5.30am in the morning, as I held a surgical retractor for the surgical wound of a patient who had to have her almost-burst appendix removed, and I realised that I had slept only for 20 minutes since 6am the previous day and had been running around seeing patients with my seniors, running in and out of operating theatre with them, and that I was dead tired but happy, happier than when I had far easier hours and yet the days seemed like eternity in other specialties, that I realised that it's really, really true when they say your passion can and will take you further than you ever thought possible. People always ask how we manage to stay awake in those hours of the night- it is God's grace and something I believe called Conviction and Passion.

Passion is what keeps you up at 4am in the morning when every fibre of your body is screaming for rest. It is what keeps your legs running to the next patient because you know it is an impending emergency. It is what keeps you asking your seniors questions without fear of ridicule. Passion, is what makes you want to excel, and do the littlest thing well. A consuming love for God, then, can enable one to desire to pusue excellence not only in work, but in relationships and life too.


"Last's night call was normal, Wai Jia. Welcome to GS (General Surgery)," said my senior doctor.

I asked the surgeons what made them give up so much of their lives, their evenings with their wives, their weekends with their kids, their energy, and all they said was, there was nothing else they would rather do. General surgery saves lives. It is direct. It requires teamwork. It is exciting. It is bloody, gory and in-your-face. But it is also tiring, does not pay as well as other more comfortable, more glamorous subspecialties, and it is downright demanding. There're a lot of jokes made about surgeons in the medical fraternity, even more about female ones. We jokingly say they're narrow-minded, that all they think about is cutting people up. We joke that it is a field predominantly owned by testosterone-filled males who're stuck-up, impatient and grumpy. The female surgeons must be odd, single or childless, or all the above.

I suppose, there is a grain of truth in each of the statements. With such working hours, one feels chronically tired and yet pumped up, all the time. When I saw my seniors doctors seeing patients on a Sunday morning after an entire night of non-stop surgical emergencies in the operating theatre, and took in that this was what they did on a normal basis, I began to respect them in a different way altogether. Say what you want, but this, is a superhuman job. Imagine going in and out of surgery in the middle of the night dealing with wailing families when the last wink you had was more than a day ago, and the last meal you had was more than ten hours ago.

What can you do? It's life and death for someone else.

My question for myself is, is the sacrifice worth it? If I were male and single all my life, my answer would most definitely be a resounding yes. But life poses its realities.

Is it wrong to want to settle down and have a normal life where I still have time to cook and paint and serve at church? Yet, isn't it also wrong to settle for a job I don't enjoy simply because of the better hours? I'll be upfront- I don't enjoy Family Medicine (aka GP work) or anything without an element of surgery. Yet, is the sacrifice to pursue this passion worth it? 7 days a week. Patients fall ill on Sundays too.

Right now... I've not met anyone to sweep me off my feet, and if that doesn't happen, do I then pursue surgery? But why should I even need to wait? But if I don't, would I then regret it? Ten years down the road, all alone while my friends have all married, with eyebags and a sleep deficit so huge it would take a hundred years to rouse me from slumber, would I look back and hate myself for my guts. Or would I look back in anguish and regret my sacrificial decision after marrying someone who turned out to be a scum of a man. I hate scums.

A senior told me this week, that for a woman to be a surgeon and to have a family life, a very unique set of circumstances must befall her. I suppose, very few men would tolerate that sort of lifestyle, fewer would tolerate a spouse with a higher salary, possibly a higher status. It is not impossible. But how, without her family and spouse feeling neglected, I do not know.

I don't know what it is about me that enjoys challenge so much, and I don't mean it in a good way. To quote my folks, "Why do you have to choose such difficult options? Why surgery, not family medicine? Why triathlon, not just simple running? Why liking to travel to developing countries to visit the poor, not just community service here?"

I don't know. It must be the adrenaline that my mini-me craves for.

God, what would you have me to do? Give me wisdom and give me strength.

And I know it's crazy for me to say this- that I'm really glad that I didn't apply for any specialty or residency programme this year because I suspected this would happen. I suspected that somewhere down the line, in the most unexpected of places, at 5am in the morning when I'm sleep deprived and hungry and dehydrated and shivering in the operating theatre holding a retractor for a surgeon, I would discover what made my heart leap, what gave me grit and what gave me enough stout to say I liked something enough to miss a comfortable life because fulfillment is an elusive word which has no reason.

I'm still not sure what kind of doctor I will be. I'm not even sure what kind of woman I will be. I'm not sure if I will still enjoy surgery after feeling chronically tired and grumpy from long working hours and a lack of sleep. But I know one thing for sure-

-that for now, I really like General Surgery. And that scares and excites me, still.

Vocation is the place where your deep gladness meets the world's deep need.

- Frederick Buechner

Warrior Princess.

When they told me you had left, I didn't cry. I only felt like the news I had been half-expecting was now here. I felt a little guilty, even, because we were all praying that somehow, God would reverse this bad dream and make you all better again. And you didn't. I somehow felt defeated, lost.

But I think you never did. I think you never allowed yourself to.

Yours, was the most beautiful funeral I'd ever been to. I just want you to know that. You're a very special brave little girl to us all, and I just want you to know what a champion you've been. We were at your funeral, but it didn't feel like we were mourning as much as we were celebrating your short life with us.

There were balloons. There were lots and lots of Balloons! And Colourful! Flowers! Everywhere! Snow white, Winnie the Pooh, Beauty and the Beast... and castles and sprinkles and shiny things everywhere. Your daddy came up to say how death... did not win, even though it may seem like it did. Your two best friends, 7 and 12 years old respectively, came up to share a minute's worth of who you were to them. One of them, like you, was from my Sunday School class. I was so proud of her. Just like how I was and still am proud of you that even when the tumour took you away, you refused to let it win.

When it paralysed your right hand, you wrote with your left. When you could not walk straight, you used a handrail. When you could not swallow and they had to put a tube through your nose into your stomach, you joked that you looked like a little mouse. And when they shaved your hair for the brain biopsy and it totally shattered you and drove you crazy and made you cry ( I would, too), you said it was okay. You coped courageously. Your family triumped. You drew a cross on a piece of paper, you said God was good, in spite of your illness. You lived life bravely, till the very end.

How could death have won? Surely, it only produced the circumstance to which your courage shone through, the way stars do in the dark.

I don't know why I cried when we sang at your funeral. After all, I should know, you're a in a better place, a place where you had always wanted to go anyway. But I guess I cried still, because... I miss you.

When we went to see you in the coffin, it gripped me to see the medal I gave you folded neatly next to your body. It was the medal my overseas friend (who had liver cancer when he was 11 and then went on to do an Iron Man event later in life) had mailed to me to encourage you with. It gripped me also to see a stack of heart-shaped cards at your feet- they were they art and craft letters which I had taught my sunday school children to make, for a friend they wanted to encourage. Some of them made them for you.

And if anything, I guess I just want to say I miss you. Thank you for living life in a way that would not let death triumph. Thank you for living in a way that puts life in all of us my dear.

Love you. You're our brave little warrior princess.

Jesus said to her,

"I am the resurrection and the life.

He who believes in me will live, even though he dies;

and whoever lives and believes in me will never die.

Do you believe this?"

-John 11