A year of wilderness - part 1

 

'For God gave us a spirit not of fear, but of power and love and a sound mind.'                    2 Timothy 1:7                                                                                                                               

It took me a while to realise that I am in the wilderness. 

I finished 2019 on a high. Passed my fellowship exams, had a great time in Prince Charles Hospital functioning almost like a consultant doing most operations independently, spending more time with my wife and kids and just being relaxed most of the time. And then I started the transplant fellowship at the Princess Alexandra Hospital in February this year. That's when I started on a slippery slide toward stress and anxiety, depression, relentless self introspection and scrutiny, constant feeling of inadequacy and failure. 

I had thought that this job is many years in making - how God has guided me to PAH since I was a resident in Sunshine Coast, assisting in my first ever retrieval with Prof Fawcett and Nick Butler (he was SET 5 then) when they came up to Nambour Hospital, assisting Andrew Robson when he came up to Cairns for retrieval and then again at Royal Brisbane Hospital, meeting Kellee Slater in core course and forming a connection, driving past PAH everyday on my way to work in the past 2 years and having a prompting in my spirit that God would lead me there one day. I had heard that PAH is tough place to work in, like a modern day 'Babylon', where the culture is toxic and unfriendly. I would never have imagined that I would one day work there, if it weren't for the assurance I had in my heart that that's where God wanted me to be. 

I must admit that before I started, I had thought that I would be like Daniel in Babylon in the bible, experiencing triumph in a hostile environment because I believe in God. I thought I was 'good enough' for PAH. After all, I did excel in Royal Brisbane. And all the stories I have heard about people failing in PAH, I thought it must be because they just 'weren't good enough'.

Ah.. What a naive thought. I could not have been more wrong in my life.

Six months into the job, I was more depressed than I have ever been in my career. I have never felt so lousy about myself. I found myself very fearful of certain individuals, fearful of what they thought of me and the influence they have over my future. Whenever I was with them, I became paralysed. The skills and gifts that I have just became dormant and inoperative, and I looked like a dead chicken in front of them, which further fueled their distaste of me. So many times I ended up saying yes to people when I really wanted to say no, because their approval matters so much to me. Often when something happened which triggered painful memories, or something that someone said, my entire soul just goes into a messy tangle and downward spiral which would take days for me to get out from.

For the entire time, I could hardly focus when I was with my family because of my preoccupation with myself. I was worried about my future. I thought my career is over. Dr Kanagarajah had told me many times: 'this is meant to be a fun year for you. You have just finished your exams, you are not planning to do transplant so everything is learning exercise for you. You should enjoy.' 

But I could not.

I did not realise these were all symptoms of a bigger spirit at play. And now I realised what it is -  the spirit that's at work behind all the symptoms.

It's the spirit of intimidation.

Just imagine a really nice big house with brand new furnishings in it. But there is a hole in the roof. When things are going well, the house is a really nice place to live in. But then there is a thunderstorm, and everything in the house gets soaked and dirty. And then you have to spend all the energy and effort to clean everything up and replace the furnitures. When it's all done, the next storm comes, and the house is in a big mess again. And you clean everything up again. Only for the next storm to undo everything. You just keep cleaning the house and fixing the damage. At some point you are going to become depleted, spent and exhausted. You might even lose hope on the situation. 

You see the root problem here is the hole in the roof, not the dirty furniture. If only you would fix the hole in the roof, none of the above would happen. Likewise, the root problem in my life was the spirit of intimidation. I felt intimidated by certain toxic individuals at PAH, and in doing so, I gave them the power and authority over me. But all I did for the problem was trying to fix the symptoms (the dirty furniture) - the negative feelings, the fear, the depression and anxiety. I tried to exercise more, sleep better, read my bible, fast, practise positive thinking, visualization etc. And all the while, I ignored the root problem. So each time when I think I have got over it, the next storm comes, and everything gets undone and I go into depression. The cycle continues. 

Next I will share about how i got myself into a mess and allow the spirit of intimidation to get a hold of me. 

Guidance for next year

'All that I have done today has gone amiss. What is to be done now?' Aragorn

I will lead the blind by ways they have not known, along unfamiliar paths I will guide them;
I will turn darkness into light before them, and make the rough places smooth.
These are the things I will do; I will not forsake them.
           
                                                                                                                                               Isaiah 42:16


Lord I am hoping you will speak to me about plans for next year. I don't have a job. What should I do? Should I actively go look for one? Or should I wait? I feel like if I were to do it my way, I would charge into the world, and fight for my own dreams and passion. I am so used to figuring out life on my own, solving problems, fighting battles. But I am not sure if this is the way God wants me to live. Well, life is not meant to be lived like that - on our own. I am meant to walk in intimacy with the Lord, to seek counsel from Him - the wisest and kindest and most living person in the universe.

So Lord, what should I do next year? My options are

1) HPB fellowship at PAH or RBH. These positions have both been taken...

2) HPB fellowship at Mater or Gold Coast.

3) Upper GI fellowship in RBH

4) General Surgery fellowship

5) HPB fellowship in Interstates

6) Take a year off. Be house daddy, do research, finish my masters, private assist, travel etc.
 
Well option 1 has pretty much been decided for me. Both positions have been taken. And unless if one of them pulls out, I would have no chance.

Personally I am not so keen on option 2. These fellowship positions are not as established as option 1. I know this sounds arrogant, and I am aware of the fact that 'no job is a waste of time', but in an ideal world, I would prefer to do 2-3 years of solid HPB training in reputable units like RBH, PAH, Royal Prince Alfred in NSW, Fiona Stanley Hospital in Perth or Austin in Victoria.

Option 3 is a very lucrative option for me. Because my aim is ultimately be a minimally invasive HPB surgeon, spending a year in Upper GI in RBH is great because it helps develop advanced laparoscopic skills. The problem is, Dr Finch has offered the job to a good friend of mine - Kevin Lah, who is the current Upper GI fellow. Because his year has been affected by Covid-19, Finchy offered for him to stay for another year.  Given his current circumstances, it is quite likely that he will remain in QLD for another year.

Option 4. This is not bad a option to keep my general surgery skills up and help to feed the family, except that I don't have interest to do it. The nearby Gen Surg fellowship positions are Caboolture, Redcliffe, QE 2, Logan and I don't feel particularly drawn to these positions. I also don't feel they would significantly contribute or 'value-add' to my ultimate goal to be a MIS HPB surgeon. Yes it is a good way to kill time and maintain my general skills, but I don't feel like this is an area I am lacking in.

Option 5. Well, we are having our third child in October so that makes traveling interstate very difficult, almost impossible. My wife is not keen to uproot the whole family to go to a new place with a newborn. While my wife is happy for me to go on my own, and she will remain in QLD with 3 kids, I don't think that is the right thing to do. I cannot imagine being away from my family for that long, even if I could travel back on some weekends to see them. It's just not the same.

Option 6. If all the above options are out, this is likely what i would be doing next year. It is actually not a bad option. In fact, it is pretty tempting. To finally not have a 'stable' job, to be able to spend more time with the family and do what i like and pursue my hobby of running, write a few papers and do my Masters etc. Besides I can privately assist David Cavallucci, Nick O'Rourke, Richard Bryant or some of my PAH bosses eg Shinn Yeung, which would be a great learning opportunity for me. Yes finance would be a bit tight, and the year of 'no formal training' does not look good on my cv, but hey, it's still fun !

I spoke to Cav and Nick - two of my bosses in RBH this week, and had a long chat with them about the future. Nick recommends that i do option 5 and Cav reckons options 1, 3 or 6 are good. In fact, Cav mentioned about Tan Tock Seng Hospital HPB fellowship job in Singapore, coz it's the only unit in Singapore that is recognised by ANZHPBA. Besides the head of unit - Terence Huey, used to train under Nick and Cav in RBH in early 2010s. If they put in a word for me, and if the position is still vacant, I should stand a good chance. I have also been thinking for a long time to move our family back to Singapore/Malaysia for a year for the kids to spend some time with their cousins and get cultural education, so this seems like a great opportunity. I left Singapore since 2006 for my university education, and it still holds a special place in my heart. I looked up the HPB unit in TTSH, and it appears that they do a fair bit of MIS HPB as well. So it is in fact a really good job to do with high case volume. Plus our family and the newborn can be close to both of our families. Except i am not sure if the position is still vacant.

Not having a clear plan and being at the mercy of other people is hard. It's almost the end of June. Most people would have figured out their fellowship plans for next year by now, or started making effort. I feel like that I am not making progress, and I am waiting for things to happen. Waiting is hard. It sounds like a passive thing to do.  Do nothing. Be vulnerable. Thus I am getting stressed out - which then hurts my ability to discern what God is saying to me. Which only increases my desperation to hear, and the whole thing is spinning into a tight, little Gordian knot. I have to pause, back up and consecrate myself and the matter at hand. I have to let go of my constant attempt to 'figure things out'.

Lord I don't want to decide this matter on my own. For I know I will almost definitely act on this based on my own selfish ambition, even at the expense of my own family. Teach me to hear Your voice, in the midst of some many competing noises and priorities. I want to do Your will. It is fruitless for me to seek your counsel while being privately committed to one course of action over the others. I must surrender my agendas and my 'best thoughts' on the matter. I must surrender my secret desires. When I do this, i will be in a much better place to receive His thoughts on the situation.

Laurence Webber, my HPB fellow last year, who is a great role model for me

Assoc Prof David Cavallucci and Nicholas O'Rourke, two of my HPB bosses in RBH. So much to learn from them!

My naughty wife tied both of our boys' hair up

Jeremy Boy's and Ethel's newborn - Matthias Cheah

New addition in Oct 2020!

Missing the grandparents !

Coming back

It's been so long since I last visited this blog. I guess this reflects how hectic the past few years have been, and writing has really taken a backseat in my life amongst many other competing priorities. But lately, I have been feeling the urge to write again. I like to write. About anything. It's not that I think I have any interesting things to share, or that my life experiences are important. The reason i write is simple - to connect with another human being. You may ask: why publish your writing in a blog where everyone can see it? This is where things get prickly, but i think most people aren't being true to themselves if they don't agree at least a little but with what i am going to say next. There is no reason to post one's life on the internet other than to feel as if you have some sort of agency as a human being. That is, that your actions - and posts - are meaningful to someone other than oneself and that they affect other humans in some way: to inspire, comfort, invoke joy, or inflame etc. The blog allows others to see you, provides an audience, and that helps tremendously to validate one's existence.

This started as blog to describe my journey in running - the highs and the lows, the lessons, trainings, victories and defeats. But I don't run as much anymore. Now other things have taken priorities: marriage, children, surgery, friends etc. Each aspect takes up huge proportion of my time. I intend to only write things that i think will be helpful and meaningful to share, not only for other like-minded people, but also for myself when i look back many years from now.

My dream is to write a book. People ask me what I intend to write. I think writing about my own life is going incredibly boring, selfish and bordering between self-aggrandisement and narcissism. The book has to be bigger than that. It's going to be about a collection of stories about people i have come across, people who have impacted my life in a deep way in different areas, that i believe will inspire other people. Many years ago i read a book titled - Soul Survivor by Philip Yancey. It's about how 13 unlikely mentors helped his faith survived the church. He interweaves the story of his own struggle to reclaim his belief with inspiring portraits of people who have succeeded in the pursuit of an authentic faith. I have not quite thought about the exact theme of the book i am going to write yet, but  it will be something along this line.

I thought the best way to start is revive my blog again, and start writing about things - anything. This way, at least i get to record the significant events or lessons in my life.  And this will all contribute toward my dream to writing a book. So here we go!

Family. Celebrating Rachel's Birthday

two boys practising yoga!

Camping during covid lockdown period