(T - 2) days

I went for a run this evening. I felt much better and refreshed after the run. It wasn't that I was able to straighten my thinking or come to some sort of enlightenment about the interview during the run. In fact I achieved neither. It was just simply being able to get out there, getting my mind off the interview, and doing something that I love that helped me feel better.

Why am I so worried about the interview?  My colleague made a casual comment this week saying: 'Ah jimmy, don't be so stressed. I am sure you will do fine.' I thought to myself. Of course I will be fine. But the point is not about being fine. The point is about having a perfect interview. Only a perfect interview would give us a reasonable chance of getting into the programme.

I am sure i am not the only person thinking of it this way. And here lies the source of all stress and anxiety.

Stressful times like bring me closer to God, as it always does. When i have come to the end of myself, the only person i can go to is God. Obviously there is a hypocritical component to this, in that i only go to God when i am in deep need. Other times, i just lead my own life the way i wanted to. It feels like i am only 'using' God to help to advance my career. But this is, of course, not entirely true. I also go to God for comfort, for guidance, and to find rest when i am heavy-laden. Like a little child who has lost his way, or has nowhere else to go, I run to God.

I think the thing i need to be most concerned now is not the final outcome, neither should i be worried about things like: Will God bless me? Am i holy enough for God to bless me? Or should i spend more time with Him so He would bless me? These questions, while valid and are very human, focus on me utilising God for my own purpose rather God using us for His purpose.

I need to focus on a few truths instead.

First, God loves me and has given His Son to die for me. (John 3:16)

Second, God has a plan and purpose for my life, plans to prosper me and not to harm me. (Jeremiah 29:11)

Third, God's timing is perfect (Ecclesiastes 3). If i don't get on, it will only be because i am not ready, and that there are things God wants me to learn and experience He wants me to have before getting into the programme.

Fourth, I can go in His confidence and do my best for His glory (Philippians 4:13 & 1 Corinthians 10:31).

I surrender it to Him.

They keep me going

SET interview (T - 4 days)

Next Tuesday I am attending an interview for the surgical education training (SET) programme. This is the final hurdle, after curriculum vitae scoring (15%) and referee report scoring (60%). This is where trainees are subjected to a series of questions in a broad range of topics to decide suitability and aptitude for the programme. During the interview, you come face to face with very experienced surgeons, where you can't hide your defects in knowledge, nervousness and lack in experience. 5 stations. 10 minutes in each station.

Last year, around ~500 people across Australia applied,  ~400 people were short-listed for interview, and 54 people were selected into the programme. This year, approximately ~300 plus applicants across Australia applied, 150 were short-listed for interview, and eventually only 50 people will be selected for the programme.

It's been an extremely difficult week for me. Somehow I just felt I am not in a good mental shape to attend the interview. I have been doing some reading and practice with friends, and my answers always come short. I am not able to think of an intelligent answer on time, much less structure my answer properly in a concise and clear manner. What comes out is usually just a random ball of mess.

I just don't believe I belong there. I felt like I don't deserve the interview. I felt others who have worked hard deserved more than me. I am frightened. I am frightened by the fact that i will be staring at the interviewers with my mind go blank on the interview day.

Time is running out. I have 4 days to get my shit together. 4 more days to D day. I am still in a mess. I need a breakthrough in my mind and spirit. Lord, I desperately need You to come through for me.

Devotional run

I just came up with a tentative race calendar for this year. Part of the reason for planning ahead is to give myself motivation to train. I was scrubbing with my boss one day (who also happens to be my running buddy) and commenting to him that I struggle to wake up in the morning to run. He said just sign up for one race and you will find yourself getting up when the alarm clock goes off.

For this year I have intentionally chosen to stick with the shorter races. Nothing more than a marathon. With increasing responsibility at work and home, I just don't have the time to train for the longer stuff. So I hope to run more shorter races and participate in cross country series or park run to get my leg speed up. This all accumulates till the end where I am hoping to run a fast marathon in Malaysia (either KL marathon, Putrajaya Marathon or Penang Bridge Marathon).

For the past week or so, I have been able to establish a routine for morning devotion and running - two of the most important activities in my life to keep my spirit nourished. I usually get up at 5am and head up for run, I would also put on my iPod and listen to sermons/short messages at the same time, I just find it really refreshing to listen to God's Word while running. Whereas in the past, my mind would be blank or thinking random thoughts when I was running, now I find my mind more active and alert to take in and meditate on God's Word.

I am not sure how long this will last. I may one day find that family and work get so busy that I don't have time to head out for a devotional run in the morning. I hope this won't happen of course. But i don't know what the future holds.

Already God has spoken so much to me in the past week during my devotional runs. I have been listening to Rick Warren's sermons on building financial fitness and realised that I really have not been very prudent with my money. So this week I have put up my new Salomon sense pro and inov-8 race ultra 290 (which I purchased last year bcoz I really liked them) up for sales in eBay. I don't need them really. I just thought it will be cool to 'have' them.

I am looking to hearing more from God in the coming days and weeks.

True friend

Four days ago, one of my best friends Jeremy Boy came over to hand me some running gear that i purchased from the US. He stayed for  dinner and we ended up chatting till midnight.

It's so important to have true friends in life. Jeremy Boy - a friend i have known for almost 10 years, has been with me through many trials and challenges. At many low points of my life, he was there. His insight into life, and more specifically my life, allows me to share my thoughts freely with him without any fear of rejection. I was able to share with him what i have suppressed or hidden in my life for so long. Thoughts and attitude which i didn't even know existed in me, were all articulated and vented during our sharing.

I realised that all these years of living and working in Australia, my heart has turned cold. People's life stories no longer interest me anymore. He told me of two people he met in Darwin, one is a Iraqi doctor whose father was murdered by Sadam Hussein, and the other was 76 year old man who used to sell sex to other man when he was a 8 year old boy just to earn a living. He was trying to convince me that everyone has a story to tell, if we were to listen. And whilst that's a belief that i held firmly to when i was younger, now my hardened heart no longer subscribes to it. I insisted that no, not everyone has an interesting story like that. Some people have incredibly boring or selfish story, where their life's greatest achievement is posting selfie on Facebook to get as many likes, or acquiring the latest Apple gadgets in the market, or decorating their 8 weeks-old baby to be like a super model. There is nothing interesting about such self-centred achievements.

This is truly a far cry to the person that i was before. I was shocked to hear these words coming from my mouth. But i could not deny, that these words have been residing in my heart for a long time, slowly growing in force, infecting and infiltrating into other areas of my thought life. I remembered listening to an elderly Christian couple sharing about their little 'miracle' of gathering supplies and donation to send to Fiji a few months ago. The sense of excitement was evident on the man's face as he recounted God's faithfulness in arranging the circumstances. As i listened, i was nodding in agreement and and saying Amen on the outside. A small part of me was genuinely happy for them. But at the same time, my 'old cynical self' just refused to rejoice. It went like: ya ya ya, another of those Christian stories of God-helped-me-so-i-succeed.

All these years of not tending to my soul, or burying myself in work and running, have finally had its toll on me. My heart has become cold toward God and people. It's not that i dislike being with people or talking to them. It's just that I find it hard to derive a sense of joy and curiosity in knowing people, and because of my pride, arrogance and pre-occupation with my own problems, I find it hard to place myself in their shoes to understand them. The Bible says: rejoice with those who rejoice, weep with those who weep (Romans 12:15). But I have lost this heart of compassion.

So everyday I put on a facade, pretending to be nice to people when i really don't care about them.

It's easy to go for a good run in some exotic place, achieve some results, post a nice photo with a big smile on Facebook, and still pass off as being a nice guy. It's easy to make people believe that we are better than what we really are, show off nice photos of our babies as if parenting is such a bliss and our babies could sleep well and eat well and never cry.

But when rubber meets the road, when our friends call us at 2am needing a listening ear, that's when our hearts are revealed. I pray that as I seek God this year,  He will give me a new heart and a new spirit. He will take out my heart of stone and give me a heart of flesh (Ezekiel 36:26).

Elusive Time

As i sit here waiting to board my flight, i realised that i don't get much opportunity like this, just to sit here and have nothing to do. When i say having nothing to do, there are still of course a million things which occupy my minds - where to bring my wife for our wedding anniversary, what gear to buy so i could bring Jonas for a hike and cycle, when to start writing the male breast cancer and unusual hibernoma case report, which books should i read, when and how should i start running and training for marathon, how to be better in my work to impress my boss, what movies to watch etc. My brain just never stops. 

Life just kinda feels like i have arrived at a movie thirty minutes late. Everything i do, there are always 600 other things waiting to be done. I feel I am constantly behind, trying to figure out the story plot, chasing deadline, trying to fulfil my promise and commitment, and hoping at the end of the day, things will work out. 

I used to be able to sit down in silence in my devotional time with God, where i lost track of time and just enjoying close connection and spiritual intimacy with my heavenly Father. But now, when i sit down for more than 30 seconds, my mind starts racing and thinking what to do next. Even when i set aside time to read the bible or just for prayer, i always set a time that i must 'finish' my quiet time. If i don't, I won't be able to finish all the tasks for the day. 

It seems like life has become such a rush for me. Having said that, i probably can't recall a time when i actually have free time. Ever since high school, I have always packed my schedules real tight such that there is minimal free time. All through high school, college and university, it has always been studies, church, christian fellowship, Boys' Brigade, infinity milers, friends, running. Now I am working full time on a job that demands so much of me, and having a family and a new baby that need constant attention, my free time is essentially non-existent.  

This is not the way i want to live. At this rate, I am bound to crash at some point or head toward burn-out. I remember reading a book when i was 18 titled - 'Ordering Your Private World' by Gordon MacDonald. The book warns against the barrenness of a busy life and urges us to build a strong inner world and spirit with God so we are able to face the challenges of the external world. It encourages us to live from the centre, from the inside out, instead of the other round. 

I need to remind myself that every new day is a gift from God. He is our heavenly Father who desires to spend time with us, fulfil us, give us joy, hope and peace, guide our everyday decision, and supply us with the strength and wisdom for the challenges that lie ahead. God is not that angry or sulky-looking guy up there who is always disappointed and dissatisfied with us, who always says no to our every request. He is the very essence of  Joy itself, and His heart is for His children.

Each time i start my day chasing deadlines and goals, I neglect the very source of life and strength and wisdom that i need for the day ahead. It's driving a car without replenishing the fuel, or going for a multi-day hike without bringing food and water.

For this new year, I really don't want to live the way i used to live. I want to begin each new day with my heavenly Father, and build a strong inner world with Him. I want to derive my sense of self-worth and identity from Him, rather than from achievement or men's approval. I want to live from the inside out, with a strong spirit and a godly purpose. I know my heavenly Father feels the same. His heart just can't wait to bless His children. He doesn't force Himself on us, but is always there, with arms wide open, waiting for us to return to Him. 

3 weeks from now

3 weeks from now and I will be free!

My generic surgical science exams (GSSE) is 3 weeks from now and i really can't wait to finish it. I have spent the better part of last 7-8 months preparing for this exams. It has been weighing on my mind for too long and the stress that accompanies it. The last 3 weeks is just about going through the materials and the question bank again and trying to recall the core concepts of each subject.

There are so many things  i would like to do after i finish my exams.

First thing is to bring my wife out for a good celebration. She has been so supportive of my endeavour in this preparation period and frequently let me off my parental duty so i could sneak in more hours to study. She understands how important this exams is for my future career and always reminds me to look after my body, eat well and not to be too stressed. I cannot thank her enough and i really hope i could make it up to her after this exams. We are planning for a Europe trip some time in June-August, and i can't wait to start planning for it.

Second thing I would like to do is to spend more time with Jonas, our baby boy. He is growing so fast, and he is becoming more active and emotionally aware of his surrounding. My heart always melts when he looks at me with an expectant looks in his eyes hoping for some cuddle or play. I definitely want to bring him out more often for a walk, a run with baby jogger or a hike in the mountains after my exams.

Work-wise, i am so looking forward to greater responsibility at work this year and more operating time. God has been gracious in placing me in Nambour Hospital to learn from some of the best surgeons in the region. Dr Michael Donovan, Dr Ratna Aseervatham, Dr Sandy Grieve, Dr John Hansen, Dr David Colladge to name a few. They are all very influential figures in my life and i really hope to learn from them. I am very excited to start the first 6 months in Vascular Surgery and the next 6 months in General Surgery.  I want to use the knowledge that i have acquired whilst studying for the exams and apply that in clinical setting.

Another thing i want to do is the USMLE step 1 exams. Not to divulge too much here, but i am hoping to go to the States after i finish my surgical training in Australia for 1-2 years of fellowship. The medical technology, advanced surgical care, and amazing landscapes really fascinate me and i hope to bring my family there to live for a while.

And last but not least, running. I have been in a hiatus for so long. I went for a run this morning and it was truly refreshing. But i know it's going to take a while to build up my aerobic base again. 2:40 marathon is my target this year. To run a 2:40 marathon, i have to do a 1:16 half marathon, which means i have to do a 35 minutes 10km, which means i have run sub-17 mins for 5km, and so on. Whether it's possible to achieve that in this busy year remains to be seen. The more exciting thing is Rachel told me she would like to attempt a half marathon this year! I really hope she could do it and this gives us more reason to go for a run as a family.

But for now, i'd better stop writing to go back to finish my pathology questions!

Family time on New Year day

At the peak of Mt Coolum

Christmas 2014

More of this to come!

he has started feeding solids

Running with my surgical mentor and friend - Dr Michael Donovan

Bali trip 2014

Taboo time!

Family photo

Life in Surgery

I just finished a stressful night shift in the surgical ward. It's my 6th night in a row and the previous nights have not been easy either. There are a few sick patients who demanded a lot of time and resources from medical and nursing staff. At the beginning of my shift last evening, I also just found out that one of the patients i saw the night before was taken back to the operating theatre for emergency surgery yesterday morning and was found to have ~2L of blood in the abdomen. She didn't look that unwell when i saw her, just some abdominal pain which was present even before i came on. Her belly was soft, stoma was working, bowel sound present, good urine output and all her vital signs were within normal limits. The only thing abnormal was she had a markedly elevated APTT (test for blood clotting) whilst on heparin infusion (blood thinner) which we responded appropriately by withholding the heparin for 2 hours and re-commenced at a slower rate according to guidelines. The only I did not check at 2am was her haemoglobin. Bad mistake. In my mind, intra-abdominal bleed was not even considered because she must be my 8th or 9th patient this week who had markedly elevated APTT. All of them were fine and the APTT normalised the day after. Well, all but this lady. 

During the morning handover, I saw how the night registrar was being fired by all the seniors for the patients that he admitted. 'Have you discussed this with Dr H?', 'What did the urine dipstix show?', 'What was the reason for MRI cervical spine?', 'Can you get a normal lactate with ischaemic bowel?' Questions after questions. I imagine that must be extremely stressful and even humiliating at times when you could not answer your superiors'  questions.  It just re-emphasises that point that surgery is such a fine art of which the treatment, be it surgical or conservative, needs to tailored specifically, timely and appropriately according to patients' presenting complaints, clinical signs and investigation results. There is an old saying which goes: a good surgeon knows when to operate, a great surgeon knows when not to operate. Whenever bowels or organ viability and haemodynamic stability are in question, there is no time for delay. Definitive action is required and that's when most junior registrars run into trouble. Knowing when is a good time to ring your boss (mind you, i am talking about waking your boss up in the middle of the night to discuss patients and risk his/her wrath), having a coherent story and all the investigative results at hand, organising and liaising with members of other department to book a patient for surgery, and finally mustering the courage to call are certainly a challenge for every junior registrars doing night shifts. I am having anxiety and goosebumps even thinking about it. 

Last Thursday I just had my interview for the Surgical Education Training (SET) programme. It's the final hurdle to enter into the ever-competitive, much-coveted surgical training programme. The entry into the surgical programme is based on three things: curriculum vitae (which is based on work experience, research experience, achievement, awards and teaching), referee reports (you need five referees who can back you up) and the surgical interview. There is probably around 500-600 people in Australia fighting for 50 slots. So only about 1 in 10 would get into the programme. The interview consists of 5 stations, each station manned by 2 experienced surgeons, 10 minutes per station. 

The interview was very stressful. The time is so limited and the surgeons all kept a straight face. Throughout the interview, they either remain silent or they ask: anything else? anything else? anything else? It just gives you a deep sense of inadequacy that you are missing something. 

I think i did average. I was feeling reasonably confident and happy in some stations and doubtful in others. This year where only 1 in 10 would get a spot, average ain't going to be enough. You have to be extraordinary in your performance to stand a chance. 

One thing i am happy with myself though, that is i did not ask for the interview questions from those who had finished the interview. I felt God had spoken to me, to put my trust in Him and to do it His way.  One day before my interview, I saw my registrar in the hospital and he was telling me i would be silly not to know the questions beforehand. The interviewers would be more strict because they expect us to already know the questions and have come prepared. But I have made my mind to do it God's way. If i want His blessing and favour in my application to the programme, I must put my trust in Him, knowing that He would open door for me which no one can shut and close door which on one can open. 

Dead gut

Missing our days in Delaneys Creek

Running at the backyard of our house

Running - compared with surgery - is a so much more relaxing and free

Love the smile on Rachel's face :D