Saturday, 24 December 2011

My abnormal life

In my last post, I sounded rather appreciative of the whole anesthesia/critical care thing. While it's certainly not a lie, I have to admit that it's not the complete truth either. Here's the other side of the story:

This rotation drains the life out of me. I'm starting my 3rd week and already I'm surprised at how strong I turn out to be. But, Friday morning, my body totally gave up inside the changing room. I slept for half a day that day. I vaguely heard sounds of people coming in and out of that room, some wondering why I was where I was (sprawling on the floor), and at least one saying to her friend that I might be ill.

I hadn't caught the flu or ebola, so by that definition, I wasn't ill, thank you very much. But I did feel like a walking dead. For almost 3 weeks now I live an automated life. I complete my SOAP notes, I do whatever the nurses tell me to do, I march to the lecture room and sit through the entire lecture wide awake like a good student, I prep all my OR patients,... basically I still work effectively. And yet I'm isolated in the triangle of OR-ICU-changing room, and when you get isolated, you can't help but change. I change. Now, planted in my consciousness, is the new duty to be awake at the most ungodly hours. And the rising sun is a sign that the day has ended, and that it's my turn to sleep. Strange.

When I finally got some days off this weekend due to Christmas, I slept for 18 hours, with around 4 hours of medium-level wakefulness and aimless internet browsing in between. So I've noticed, to make up for, say, 6 hours loss of sleep, you can NOT just take another 6-hour nap. This thing is not mathematical. The amount of time you need to recover is MORE than the hours lost.

This cycle is made more vicious with the fact that my med school had not delivered anesthesiology lectures separately. Anesthesiology was spread out in pulmonary system, pharmacology, and surgery lectures. Before, this trick worked out nicely---my teammates and I had quite a pleasant sail through other rotations, because we are accustomed to integrating different stuff together. But in anesthesia rotation, it doesn't work too well. The logic in anesthesiology is somewhat different. So here I'm trying to combine studying from scratch for the [what shaky] foundation and cramming everything I've got for the bricks. Coupled with the currently abnormal biological clock, I'd say it's pretty hellish.

Sunday, 18 December 2011

An update, finally

Pushing away the almost convincing sense that nobody is reading this anyway, I'm gonna say that I'm happy to be back in the blogosphere.

My dentistry rotation went okay, despite the fact that one team member quit in the middle of it. Also, we (I, especially) had had a little tension with one of the dentists regarding our papers. In all honesty she wasn't the most knowledgeable dentist. I mean, she even got upset when I [politely] asked for some reading recommendations since we were running out of references. Thought we were lazy, I guess.

I quickly learnt that we should leave her alone and asked the other dentists instead. There's this oral surgeon whose knowledge about general medicine is quite vast; it was very enjoyable to discuss things with him. And then there's a forensic odontologist who is also a police Colonel. She's a bit like Professor McGonagall; stern-looking, but somewhat motherly and very considerate. She was behind-the-scene middle ground between us and the upset dentist.

All in all, dentistry is not my favorite rotation and definitely not my thing, but I did learn one or two handy stuff in there. I learnt a lot about odontogenic focal infection, and the anatomy of the jaws and surrounding structures. Everything else was nonsense to me.

Right now I'm starting my SECOND week of anesthesiology and critical care. Things have been fun, not to mention enlightening. I used to have a negative image about operating rooms. An OR in my mind had been associated with a lot of yelling and tremendous stress and a demand for impeccable attitude (and cleanliness). After spending everyday in the OR though, I manage to develop a surprising fondness for it. The environment isn't that stressful. Not much yelling going on. Maybe one or two surgeons swear to themselves when they see something outrageously strange about a patient's body (like during one case where a plate was screwed too tightly to the ulna, requiring the orthopedist to re-break the bone to release the plate), but it stops there. And only some spots have to be sterile, otherwise it's a normal floor, normal walls, normal ceilings.

So that's my little personal achievement.

Plus, I like the green. Or the blue. Is it an unwritten rule that the OR has to be either green or blue? I hope so.  The colours are very relaxing.

We do our night shifts in the ICU. It's a unique 7-bedroom place. Most patients here can't hear you, can't understand you, and can't react much. On the first days, our job is to make ourselves familiar with objects and instruments and where they're stored and how to use them. I have successfully located commonly used items such as the suction tubes, urine bags, gauzes, cotton balls, alcohol sprays, epinephrine auto-injectors, syringes, essential drugs, and examination gloves. The ICU is a simple four-sided room but some objects are so typically placed that you have the learn it in order to quickly find them.

What I dislike the most about shifts is the paperwork. But so does the greatest diagnostician in the world.


Well, until next time!

Tuesday, 15 November 2011

People are like Bertie Bott's


People are like Bertie Bott's Every Flavor Beans. From school kids to school professors, everybody loves Bertie Bott's! We all know eating Bertie Bott's is both fun and frustrating because we never know what bean we pick up. They are ambiguous from the outside. Some look pretty, some look daring, a handful look plain, some look yucky, and a few look suspicious.

The flavors are even more surprising Some beans taste as pretty as they look. Some appear rather extravagant or evil but they are actually quite plain. The plain-looking ones may taste like delicious milk or sweet birthday cake. The yucky ones may really be yucky or taste like nothing. It's all confusing yet exciting.


How many times do we get disappointed by someone we are close to? How many times do we think we know somebody, just to realize that we don't? And yet, we hear stories about people falling into the same relationships over and over again with the wrong people. Tales about folks who once gave up love or friendship but then willingly bond themselves to someone.

It could also be the other way around. Maybe we think we would never get along with this particular person, only to find a few years later that you and him/her click perfectly like a lock and its key. It's true that we never know what we have until we lose it, but it's also true that we don't know what we are missing until we find it.

Are the yucky beans addictive? I guess not. It's not the beans themselves. It's all in the knowing that the whole experience is, eventually, rewarding. We fail a few times, victorious in others. We learn from mistakes, we move on, we cherish memories, we work on the new stuff. Some may say that love is bull, or that we cannot trust anybody... But I beg to differ. Sure we must exercise cautious in many instances, we must be ready at the strange flavors that the beans in our hand may contain, but that doesn't mean we can, or should, completely detach ourselves from others.

Life has its ups and downs. But it's all part of an ultra-exciting experience.

Bertie Bott's wouldn't be so loved if it didn't have the odd beans. If all the beans are sweet, they would give you diabetes.


Thursday, 20 October 2011

18 Unique Identifiers You Want To Avoid (or 3, if you were here in the equator)

From the Health Insurance Portability and Accountability Act (HIPAA).

The following are 18 unique identifiers that you want to avoid when publishing case reports, stories, anecdotes, anything that concern specific individuals, especially patients.

1. Names;
2. All geographical subdivisions smaller than a State, including street address, city, county, precinct, zip code, and their equivalent geocodes, except for the initial three digits of a zip code, if according to the current publicly available data from the Bureau of the Census: (1) The geographic unit formed by combining all zip codes with the same three initial digits contains more than 20,000 people; and (2) The initial three digits of a zip code for all such geographic units containing 20,000 or fewer people is changed to 000;
3. All elements of dates (except year) for dates directly related to an individual, including birth date, admission date, discharge date, date of death; and all ages over 89 and all elements of dates (including year) indicative of such age, except that such ages and elements may be aggregated into a single category of age 90 or older;
4. Phone numbers;
5. Fax numbers;
6. Electronic mail addresses;
7. Social Security numbers;
8. Medical record numbers;
9. Health plan beneficiary numbers;
10. Account numbers;
11. Certificate/license numbers;
12. Vehicle identifiers and serial numbers, including license plate numbers;
13. Device identifiers and serial numbers;
14. Web Universal Resource Locators (URLs);
15. Internet Protocol (IP) address numbers;
16. Biometric identifiers, including finger and voice prints;
17. Full face photographic images and any comparable images; and
18. Any other unique identifying number, characteristic, or code (note this does not mean the unique code assigned by the investigator to code the data)
There are also additional standards and criteria to protect individual's privacy from re-identification. Any code used to replace the identifiers in datasets cannot be derived from any information related to the individual and the master codes, nor can the method to derive the codes be disclosed. For example, the unique code cannot include the last four digits (in sequence) of the social security number. Additionally, the researcher must not have actual knowledge that the research subject could be re-identified from the remaining identifiers in the PHI used in the research study. In other words, the information would still be considered identifiable is there was a way to identify the individual even though all of the 18 identifiers were removed.

A bit of a cultural perspective:

As a medical student now doing clerkship, I am well aware of the rules on patient privacy. I'm not sure if my country's medical council / boards has this kind of list that explicitly states which items are not for public consumption. Maybe we rely much on conscience? [It works, though!] After all, not a lot of these stuff are relevant to the average Indonesians. Items #4 down to #18 are certainly irrelevant. Well, item #8 is acceptable, but trust me, nobody here cares or understands what it means save for health professionals. Those who know their rights come from medium-upper class society, and this community constitutes around... uh, I dunno, less than 50% of the entire population. Possibly much less.

In other words, we can say that most of these patients are practically invisible. I daresay, if a careless / delinquent / just plain evil med student sells away a piece of patient's information, as long as the patient comes from a lower class / is uneducated / is not a public figure, the med student can easily evade lawsuit. Heck, the patient himself would be too [forgive me] "unenlightened", to understand his own rights, let alone to sue!

This is the phenomenon that exists in a developing country with one of the densest population in the world. If you are lucky enough to be born or to live somewhere where all its citizens actually exist and are busy defending their rights to death, remember that you are the minority here on dear ol' Earth. Most of us are just vapors in the wind.

Tuesday, 18 October 2011

The End

Owners of the world and empty hope
      in vanity head for the downward slope
Theirs is the crown of fool's gold
      with nothing but sulfur it withholds
Bedazzling though, to the minds so lame
      in the fiery lake it will be put to shame.


Yet the blessed, who live up unceasing
      to the name bestowed
      by the Spirit Most Hallowed
              they are obedient on His golden road
              faithful on His trail of blood.
These will share the glory of the King,
a crown, so bright, it forces the sun to sink.




18.10.2011

by: Anna Elissa

Monday, 17 October 2011

The attending is always right.

1. I was wrong to use the term "subcutaneous layer" because I had been referring to the the other layers as "epidermis" and "dermis". He said I was supposed to say "subdermis" instead.

2. Polycyclic and herpetiform are lesions (not configurations of a lesion), just like a macule, papule, or vesicle is a lesion.

3. A wheal is a secondary lesion when it is caused by an external source, for example, an insect sting/bite.

4. Since what we think and what the textbooks think as right are actually wrong to him, so we all have to agree to him. "Because there's no absolute truth," he said.


People? Enlighten me. Before my head goes polycyclic.

Thursday, 13 October 2011

For St. Anna


Allow me to dedicate this one post to Saint Anna (Ann, Anne), mother of the Blessed Virgin and grandmother of our Lord. Last month, I asked for her help as the patroness of women, wives, and fertility. I was having irregular periods for a while; my body is apparently very sensitive towards things like disturbance in sleep cycle and stress (thanks, med school!), and it manifests as, among other things, problematic menses. I had never invoked St. Anna's name before, but I'm glad I finally did. This month I get my usual 28-day cycle, strangely without any nasty prodrome, so it came as quite a [nice] surprise. This is important for me because, who wants to be bothered with irregular periods when you're working hard to save the world? :p
Although my scientific side still wants to wait for several months to see if it's permanent, my less-Einstein truly believes that this is St. Anna gladly interceding for me. I'm sure her daughter also helps, because I've also been praying the rosary.

Thank you, St. Anna. Happy to have you as my patroness.
Grace

is getting what we don't deserve.


Mercy

is not getting what we do deserve.

Wednesday, 12 October 2011

I Paint You

I paint you in water
A blue crystalline saucer
Unreliable though it is
You disappear at first kiss


I paint you in the sand
Where the first fish approached the land
The sea, though, is jealous
It creeps in and steals you senseless


I paint you with the branches of the tree
that carve the sky a wisp cloudy
But nature, bitter, would tear you apart
As in time the tree dies and departs


Finally, I paint you in my dream
A place where everything ought to be
In it, your image shall be breathed
And my tears shall find redeem


by: Anna Elissa


"I dream my painting
and then I paint my dream."

-Vincent Van Gogh

Tamarillo

I'm slightly obsessed with drinking tamarillo juice lately. Indonesians call it terong Belanda, or "Dutch eggplant", probably because it was first introduced in the archipelago by the Dutch. It's very rich in vitamin A and vitamin C (antioxidants!), and low in calories. When blended and mixed with milk, it's a pink awesomeness.


Source: Wikipedia

This is how the fruits look like. You can just eat them by scooping the flesh out. I haven't tried that.



A tamarillo juice.

There's a recipe online that says about removing the seeds before blending. Not sure if that's possible, though. The seeds are attached to the flesh, much like kiwi fruits. I prefer to leave them in the drink; they add a pleasant crunchy effect. Drink the juice slowly, like you would a bubble drink, and pause here and there to bite on the seeds. Man, it's so satisfying!



The tamarillo fruit in my hand.

The boy seller was generous enough to let me take one home. Shame on me, I had never seen such a fruit before! Have you?



An example of how good God is.
And also of how worthwhile it is to go out on a limb and try something new.

{I don't like eggplants. The idea of making them into a juice was scary at first.
But this, this changes everything.}

Sunday, 9 October 2011

Col 3:23




"Whatever you do, work at it with all your heart, as working for the Lord, not for men."


Colossians 3:23


Col 3:23 is my #1 favorite verse from the Scriptures. I label all my academic notebooks with this verse. It's my comfort and my inspiration, and here's why.

Ever heard about God sanctifying the uniqueness in each and every one of us according to His purpose, instead of making us all the same (and boring)? St. Peter was a fisherman, St. Matthew was a tax collector, St. Mary was a young virgin, St. Monica was an old widow, St. Helena and Elizabeth of Hungary were queens, St. Augustine was a delinquent rascal, St. Thomas Aquinas was a brilliant philosopher, St. Benedict was a monk, and the list goes on. Each of us is given a different personality, a different role, a different calling. The essence stays the same, though: "Whatever you do, work at it with all your heart, as working for the Lord, not for men."

I feel that the above verse is the reassurance I need. I've always been the little perfectionist (although as an adult I've relaxed a bit). I couldn't put my work down before I feel satisfied with it. I like both to plan the bigger picture as well as attending to details. But the bitterness comes when other people doesn't seem to appreciate what I do, or when my work seems useless anyways. My peers can get the same or even better grades / awards / etc. with half-hearted efforts, or even by cheating. I come on time just to see nobody else does. I do the "unimportant" assignments when others do not and get away with it.

With this verse in mind, now I have a sense of purpose; I can direct my vision towards Someone who will appreciate what I do and He will make it even more fruitful. The fruits may not be directly visible, but they're there. Placing God as our Ultimate Master, higher than our worldly masters, automatically motivate us to give the best that we can, in whatever we do, with honesty and love. If we are to present our works to the King of all kings, we would definitely present only the very best, wouldn't we? The judgement from peers and human masters is no longer relevant.

Saturday, 8 October 2011

October's theme song, for the Blessed Virgin

A music video I created to the hymn "Immaculate Mary" and its Indonesian version "Di Lourdes di Gua". Dedicated to the sweetest Mother Mary. Enjoy!

video

Wednesday, 5 October 2011

When you forget this aspect of life

Once in a while I feel helplessly sick of medicine and the medical life. It's not the kind of feeling that makes me want to reconsider my chosen path (at least not seriously). It's more like, the feeling of loneliness, the feeling that no one understands you. You can still get by, but the flames that you thought would always be there to keep your strides spring, are gone. Which is odd, I know, because as a medical student doing clerkship, I'm surrounded by exactly the "right" people, the people who should share a lot of similar experiences and similar thoughts.

Truth is, there are times when I feel like everything is automated. People move like robots---efficient yet heartless---and they merge into the very walls of this big old hospital. Existing but not quite. In a field that deals with life, there is no life. In a field that deals with humans, there is no humanity. In a field that wants every sick person to be normal again, there is no normalcy. Thus, the loneliness. [and this emo thought]

And so in a day like these, it's a relief to be able to read about real people in medicine. That's why I subscribe to so many blogs by med students and doctors. They are essentially telling the same thing: Hey, we're in this together. We're gonna be fine. YOU are gonna be fine!

Also, the great thing about these bloggers is that, they are all so infectious in their zeal, their humor, their perspective. This is what I seldom get. Too many people whine and complain and cry over trivial stuff. Granted, some people may thrive on stressful atmosphere, but not me. I like eustress. But not distress. I get frustrated easily when surrounded by whiny stressed out folks (especially those who think that they need to broadcast their distress so that everyone will know about it, and consequently become distressed too).

Have you tried taking a break from yourself? Trust me, a few hours of that is worth it. It has helped me reduce unnecessary preoccupations, helping me to not take myself too seriously. Once in a while, just pause and step back and see the bigger picture. Get things into perspective, learn what it's really all about.



For all medical bloggers out there, keep blogging! You have no idea that even while blogging you can save someone from committing suicide, do you? (not that I have contemplated suicide myself)

Tuesday, 4 October 2011

Serenity Prayer


God grant me the serenity
to accept the things I cannot change;
courage to change the things I can;
and wisdom to know the difference.

Living one day at a time;
Enjoying one moment at a time;
Accepting hardships as the pathway to peace;
Taking, as He did, this sinful world
as it is, not as I would have it;
Trusting that He will make all things right
if I surrender to His Will;
That I may be reasonably happy in this life
and supremely happy with Him
Forever in the next.

Amen.

Sunday, 2 October 2011

"Sorry, your angel wasn't too angelic, was she?"

From Twitter:

Baby: "God, if you send me to the earth now, tell me my angel's name."
God: "You'll simply call her, Mom."

Sweet. But wouldn't be so sweet if the scenario continues like this:
Baby: "God, why did my angel kill me before I was even born?" 

Oops.

Saturday, 24 September 2011

Most awaited movie: "The Raid"

Alright, I'm gonna unabashedly promote this new Indonesian action movie "The Raid" (Serbuan Maut in Indonesian). No, wait, scratch that. This movie has got all the press it needs. Even Hollywood wants it. So I'm doing nothing here. Besides, I haven't actually watched it except for the trailer, which sold me in seconds.


Read other reviews here:

Alex's Toronto Review
Bloody Disgusting Review
Slashfilm Review (with 2 HD trailers)
Red and White Review (in Indonesian - with a trailer and 6 character posters)

IMDb rating: 9.0 / 10

To be honest this is not my type of genre, because fighting movies, especially the ones with heavy weaponry as opposed to traditional martial arts, usually do not have any real aesthetics---just violence, and some cursing. But when "The Raid" is released, I MUST see it. This could be one of the first Indonesian movies that, finally, get it right.

Thursday, 22 September 2011

Chipmunk face

Pictures of human paranasal sinuses used to scare the crap out of me. I simply couldn't imagine having such BIG holes scattered all over my face. Maybe this is what made me highly uninterested in learning ENT-related anatomy in the first place, and that gave me some problems in my ENT rotation. I'm sure this wouldn't have happened if only the first picture of paranasal sinuses I encountered was something like this:



That is certainly the most adorable coronal section of the face I've ever seen, unlike the stupid-looking hollowed out face that similar pictures usually portray. This one happens to cut through four front teeth of the superior dental hemi-arch, so that the final image looks like... well, a chipmunk.

Speaking about chipmunks, thanks to the fantastic team of five attendings (especially Dr. Chip (!), a brilliant but laid-back surgeon and a self-proclaimed Apple expert), I learnt pretty quickly and surprisingly a lot. Of course, I'd never dream of boasting my knowledge, though I can't help feeling rather amazed at how much you can accomplish even in a field you dislike, if you have strongly motivational peers around you.

And cute pictures also help.

Wednesday, 21 September 2011

By each hurting step

Once again, in my usual rather careless excitement, I slipped on the wet floor. I fell in a curious kneeling position, my left knee bent and thumped the wet tile, and my right foot is inversed inwards. I really, really hate it when it does that. Inverses inwards. Typically it only results in a little jolt as the sudden falling sensation triggers my reflex to readjust my body position. But not so much pain. Or even no pain at all. But today I got the worst of it. It's not a sprained ankle. It's a very annoying, button-sized hematoma on the lateral side of my right dorsum pedis, strategically located so that every time I extend or lift that foot, it hurts.

I have always take pride in my feet. They're small (EUR size 37), they look fragile, but they're quite strong. I'm able to walk miles without being easily fatigued, I run fast, and I like to hike. My feet have accompanied my journey around the world, from north to south, from east to west, from the highest of mountains to the deepest of jungles. I have climbed stairs, ladders, bunk beds, trees, hills, sand dunes, horses, all impossible without the help of my feet. The problem is, my heart often runs ahead of my feet, and I almost always need my mum or other people to remind me to be careful. Of course, in my pride, I tend to let that warning just float by. Besides, I can take care of myself!

But even my feet are not invincible. I am not invincible. As I walked the rest of today, limping, I discovered the sickly feeling of being slow and powerless. People who walk ever so slowly while being busy with their phones annoy me. And yet here I am, unable to take my strides steadily without grimacing. This is the kind of pain you experience when you realize that the world still goes on without you. That when you disappear, there will be very few people who notice. That when fate strikes you, you can be thrown off and left in the dust. I felt somewhat humbled when I had to hire an umbrella kid and that cheerful little fella had to slow down for me. Poor me and my right foot. And rain continued to wash the earth.

So many other things, too, must slow down or stop. I got very frustrated, because I knew I could have done a lot more. Today I didn't get to scan a picture for my friend, send two important e-mails, and do some reading for upcoming exam. Today I only accomplished one case report and one blog entry, and also some frantic messages to and from my mum and dad who, as always, got more panicked about me than I did (is that how I'm gonna be when I become a parent?).

And then there are things that do not change. I got tagged in a Facebook photo and as a result, endless comments about the photo (which is not of myself) filled up my notifications. They were all good-natured and happy, but in my condition, they became far from pleasing. Meanwhile, a friend kept sending me messages, intending to spark a conversation. Exam will still be held the next two days. The sun still sets. The food catering still sends dinners to everybody. Tom & Jerry still plays on TV. Foot is still swollen.

I don't like being slow, or being slowed down. It's such an alien idea to my very existence. I always want to be speedy, effective, efficient. By each hurting step, I am reminded that, while pride is good for confidence, extreme self-importance can be destructive. When one of our supportive legs is broken, either literally or figuratively, we might find ourselves robbed of our prominence. Are we even that great to begin with?

Saturday, 17 September 2011

Journey - "Don't Stop Believing"

This song has been dominating my head lately.


And of course, the Glee version; they are the one who introduced me to the song in the first place.

Monday, 12 September 2011

Mini heart attack (thank you, ENT)

The ENT rotation is supposed to last for 5 weeks.

Okay.

Then the Islamic Eid holiday took over the second week. Which means a week off plus ketupat and sleeping all day! *grins*

Then began the new week.

And the ultimate question in our heads was: did we get an extension to replace the one week lost? We speculated among ourselves that yes we did (and we should, shouldn't we??).

But now it looks like the answer is no. So right now we are already well into our 4th week, NOT 3rd week, and obviously we really need to... err, start studying. You know, to make sure that we know more than otitis media and epistaxis.




(Actually, I had wished for this in the hope that the overall clerkship time would not be longer than planned. Lesson learned: Be careful of what you wish for, because it might come true.)

Saturday, 10 September 2011

Bangsaku, negeriku


Katanya, orang harus bangga pada bangsa sendiri.

Katanya, orang harus bangga pada negeri sendiri.

Nasionalisme. Patriotisme. Kata-kata agung yang kerap didengungkan terutama menjelang perayaan kemerdekaan. Kata-kata yang pernah ditakuti. Kata-kata yang kini terdengar naif.

Mengapa naif?

Karena setiap kali saya menyinggung mengenai keinginan untuk memajukan bangsa, atau mengharumkan nama bangsa, atau memamerkan kekayaan budaya bangsa, biasanya reaksi yang saya dengar hanyalah cibiran, pandangan mengasihani, dan gelengan kepala.

Hare gene mikirin bangsa.

Begitu terpuruknyakah kita? Bukankah dasar sumur pun masih mendapat cahaya matahari betapapun jauhnya ia di atas sana? Atau mungkin saya telah menanyai orang yang salah? Karena jujur saja, kebanyakan jawaban demikian keluar dari mulut orang-orang minoritas. Berbagai alasan dikemukakan: minoritas tidak dihargai, minoritas tidak mungkin berprestasi, minoritas tidak layak berkarya. Jadi sebaiknya menetap saja di tanah asing dan melupakan segala identitas ke-Indonesia-an kita.

Inferiority complex.

Tetapi izinkan saya bertanya: bangsa apa yang kita sebut "bangsa saya"? Negeri apa yang kita sebut "negeri saya"? Apakah menjadi jaminan bahwa kita akan langsung melebur di tanah asing daripada di negeri sendiri? Bukankah dengan melanglang ke seberang lautan berarti kita semakin memperjelas identitas kita sebagai "orang asing", dan kemungkinan besar, "minoritas"?

Di zaman globalisasi ini, batas-batas telah mengabur. Anak-anak hasil perkawinan antar-ras ada di mana-mana. Anak-anak ini adalah warga dunia, namun anehnya, seringkali mereka bukanlah warga negara manapun. Ambil contoh saya. Mungkin ada orang "asli Indonesia" yang menganggap saya tidak cukup Indonesia. Tetapi jika saya kembali ke tanah kelahiran ayah saya pun, orang-orang sana tidak akan menganggap saya penduduk lokal. Apalagi jika saya pergi ke negeri di mana saya tidak memiliki hubungan darah sama sekali.

Saya pikir, nasionalisme adalah mengenai pilihan. Toh nasionalisme atau patriotisme itu salah satu bentuk cinta. Cinta negara, cinta tanah air, cinta bangsa. Dan cinta adalah urusan kehendak bebas. Saya telah memilih bahwa di manapun saya akan hidup, tinggal, dan berkarya nantinya, hati saya akan selalu Indonesia. Darah saya akan selalu berdesir jika nama Indonesia dipuja. Saya tidak mengandalkan hubungan darah atau takdir yang menyurati di mana saya waktu itu dilahirkan.

Saya mengandalkan pilihan secara sadar. Ini bukan persoalan politik. Ini masalah cinta.

Wednesday, 31 August 2011

Book Review: An Exorcist Tells His Story

Title: An Exorcist Tells His Story; Seorang Eksorsis Menceritakan Kisahnya
Author: Gabriele Amorth
Publisher: Ignatius Press; Marian Centre Indonesia
Country: Italy
Pages: 205 pages (paperback); 259 pages (paperback)
Genre: Catholic, true story, angels and demons, exorcism


This book is NOT:

1) a collection of horror stories. If you want such stories, go see The Exorcist or The Exorcism of Emily Rose. Granted, this book presents an assortment of possession stories, but does not go into great gory details. And if present, the stories mainly serve as illustrations for the theological/pastoral descriptions. If you're expecting a freak show, you'll be disappointed;

2) a recollection of an exorcist's day-to-day life. It's not even a recollection of an exorcist's job!;

3) an anthology of exorcism ritual texts;

4) a detailed explanation on demonology or angelology;

5) a fairytale-natured book aiming to sow the seeds of false optimism and arrogance about human's power over the demons.


What the book IS:

1) Catholic and Christ-centered. Definitely!;

2) an honest (neither exaggerating nor underestimating) description about the nature of demons and demonic activities;

3) an "Exorcism 101".


What I mean by "Exorcism 101" is that Fr. Amorth's book does not place a special emphasis on just a single aspect of exorcism. Rather, it touches on many factors: the nature of Christ, the angels, and the demons; forms and characteristics of diabolic activities; and the basic theories of exorcism---what it is, who can do it, when should it be done, why it should it be done, and how it should be done.

Although not by any means extensive, readers will be pleasantly fulfilled, and believers especially, will likely to have their faith renewed. Fr. Amorth's book is powerful indeed; it serves as a reminder (or warning?) for us that the force of evil very much exists and is very active.


This review is also available on Goodreads.

Book Review: Of Bees and Mist


Title: Of Bees and Mist; Kabut Masa Lalu
Author: Erick Setiawan
Publisher: Simon & Schuster; GagasMedia
Country: United States of America
Pages: 404 pages (paperback); 507 pages (paperback)
Genre: Literary fiction, magic realism, fantasy


There's a lot to say about this fascinating book. First of all, if this is your first magic realism, the story may come off as rather messy at first. You'll see curious things thrown at you at seemingly random places and time, and these things don't just pass by; they actually move the story forward. Secondly, you must have an open mind, somewhat a high imagination to suspend your disbelief and accept Setiawan's world. If you can do that, you'll get a charming household drama that is both familiar and otherworldly.

The basic premise is quite straightforward and rather soap opera-ish. Mainly it is about a female protagonist who is caught in a feud between two houses. In the first few chapters, when the protagonist is young, it seems that her enemies are her own house—her parents, and the house itself. But as the story progresses, with her marriage with Daniel of the other house, it turns out that her true nemesis is her almost-satanic mother-in-law.

What makes it different from soap operas is, you guessed it, the use of magical elements. In Setiawan's world, magic is commonplace, and is both utilitarian and superstitious. There are ghosts in the mirrors, there are colorful mists at the doorstep, there are mysterious bees and fireflies that seem to have an impact on the people they're surrounding. The wording of many of the sentences is deliberate, so as to give you a sense of magic even without the presence of actual magic. But Setiawan manages to stay true to reality, despite the surreal environments. Although strange juxtapositions are everywhere, they all have certain meanings once you get used to it. Of Bees and Mist is not an adult fairytale. Sometimes it's heartwarming, sometimes it's heart-wrenching. Characters are three dimensional, actions are believable, motives are understandable.

The pace of the story varies; sometimes it is fast and exciting, sometimes it is slower, but never dragging. It's definitely rather slow at the beginning, which, combined with the feeling of "strangeness" especially for readers new to magic realism, can produce either a big question mark or a big ho-hum, both leading to giving up early. My suggestion is: be patient, and bear with the author a bit more. You will quickly keep up with what's happening.

It can be a bit confusing to describe this book in mere words. I say just give this book a go. But keep in mind that magic realism is not everyone's cup of tea. Objectively, I think Of Bees and Mist is a great story. Yet I also can see why some people would dislike it.


This review is also available on Goodreads.


Pictured above is the cover of the Indonesian translation. The cover for the original edition published in the USA is:



Wednesday, 24 August 2011

Book Review: Garis Batas

Judul: Garis Batas
Penulis: Agustinus Wibowo
Penerbit: Gramedia Pustaka Utama
Negara: Indonesia
Tebal: 528 hlm (paperback)
Genre: Travel

Waktu kecil, saya pernah berangan-angan pergi ke negara-negara Stan. Ini gara-gara saya menemukan gambar bendera aneh berwarna biru muda bergambar elang dan matahari kuning (ternyata bendera Kazakhstan). Bendera yang warna biru halusnya mencolok di antara-antara bendera-bendera negara lain yang biasanya berwarna cerah dan berani. Tetapi seiring berjalannya waktu, saya melihat sepertinya negara-negara Stan ini tidak ada di dalam daftar tujuan turis manapun. Pun, tidak ada buku-buku travel yang sibuk menjajakan negara-negara misterius ini.

Terima kasih kepada Agustinus Wibowo, kini saya boleh mencicipi impian masa kecil saya meskipun hanya melalui lembar-lembar kertas. Catatan perjalanan Agustinus ini sungguh lain dari yang lain. Tadinya saya menyangka akan melihat daftar harga hotel, rumah makan, dan daftar tempat-tempat wisata yang tak boleh dilewatkan, seperti dalam banyak buku travel lainnya yang lebih banyak narsis daripada informatif.

Tetapi buku ini lain. Agustinus bertindak lebih jauh daripada sekedar mengumpulkan informasi teknis dan menjadikan bukunya just another Lonely Planet. Agustinus mengangkat bukunya menjadi sebuah karya sastra, sebuah "literatur perjalanan", bukan hanya "buku jalan-jalan". Kisah-kisah kesehariannya sebagai seorang perantau di tanah Stan, dijalin secara apik dengan pengetahuan agama, sejarah, dan budaya, baik setempat maupun dunia. Bagi yang tidak suka digurui, buku ini tidak menggurui. Buku ini justru mengajak kita untuk membuka mata serta pikiran terhadap sekumpulan negara Islam bekas Soviet yang kini menjadi bangsa-bangsa yang enigmatik, tidak terjamah, tidak terwakilkan dalam pentas global, namun ada dan bersikeras untuk hidup.

Alur cerita Agustinus cukup mampu membawa saya (dengan sukarela) masuk ke sudut-sudut terbaik dan tergelap dari tiap negeri. Di beberapa tempat sedikit tersendat, dan pada awalnya agak membosankan karena penulis sepertinya berputar-putar terus di sekitar Sungai Amu Darya (teriak saya: "Iyaaaa... saya tahu sungai itu indah, sungai itu hebat, sungai itu agung, sungai itu pemisah yang kejam, tapi lanjut dooonggg..."). Untungnya Agustinus cepat-cepat "mengungsi" ke daratan dan memulai petualangannya. Saya juga suka cara Agustinus melihat masyarakat, keadaan kota, politik, agama, dan budaya dari berbagai segi. Rasa humornya yang kering ("dry wit") cukup berhasil menambah bumbu kemalangan dalam kisah-kisahnya. (Jangan heran, buku ini memang dipenuhi dengan kemalangan, kesederhanaan, kesialan, dan ke- ke- lainnya yang membuat jantung berdebar)

Tidak akan menyesal membaca buku ini. Saya memang belum pernah melihat sendiri negeri-negerinya, tetapi saya pikir, Agustinus has done them justice :)


This review also available in: Goodreads

Thursday, 18 August 2011

The "Hail Mary" in Afrikaans and Indonesian

A South African friend of mine taught me this version of the Hail Mary in Afrikaans.


Wees gegroet, Maria, vol genade, die Here is met u.
Geseënd is u onder die vroue 
en geseënd is Jesus, die vrug van u skoot.
Heilige Maria, moeder van God, bid vir ons sondaars,
nou en in die uur van ons dood. Amen.




I want to use this opportunity to also share with you the Indonesian version of "Hail Mary":

Salam, Maria, penuh rahmat, Tuhan sertamu
Terpujilah engkau di antara wanita
Dan terpujilah buah tubuhmu, Yesus.
Santa Maria, Bunda Allah, doakanlah kami yang berdosa ini
Sekarang, dan waktu kami mati. Amin.



Well, Twitter time well spent!

Do you have your language's versions of Hail Mary and other Catholic prayers? Feel free to share them with the world!

Saturday, 16 July 2011

The price of a dream


Everyone has dreams. I have dreams, you have dreams. Most of us are excited not only to nurture those beautiful images in our minds that are called dreams, but also to make them actually happen. We are all trying to transform dreams into reality.

For the most part, the process of dreaming is easy. We just close our eyes, and pop!---there come pretty balloons and smiling rainbows and a majestic castle on a foreign wonderland. Dreaming can be as simple as picturing oneself in a new dress, driving a new car, standing in front of a new house. It can also be as complex as dreaming about oneself studying in a certain college to get so and so degrees and to work here and then there. Walt Disney reportedly said, "If you can dream it, you can do it!"

I believe that no dreams are ever too big and no dreamers are ever too small. But---there's a but in this---there are prices to pay. Dare to dream means dare to change. A change from comfort to uncertainty. A change from laid-back life to hard work. A change from familiar relationships to strange bonds. A lot of people are not aware of this fact. They go running after the sun without being prepared for the brewing storm behind them.


I started to think about such a price when psychiatry rotation came to an end just last week. 99% of the patients in the psych ward are female domestic workers. They are women, young and senior, who have left their homes to search for some fortune in foreign countries. They are not well-educated, and they are of limited means, but their dreams are higher than the sky. So if they're good dreamers, then why do they end up in a psych ward?

The types of mental breakdown these women experience are quite similar: paranoia and depression. The trigger is an old classic: domestic tortures by their masters. To put it simply, they are treated like a bunch of Old Testament slaves, and it's obvious that they are not prepared for it. They don't think things through; all they see are: 1) they are Muslims, 2) their prospective masters are also Muslims, and 3) their prospective masters live in Muslim countries. Ergo, it must be convenient to live in a familiar environment with a familiar faith among familiar believers. Simple logic. Right?

Sadly, reality speaks otherwise. Sameness of faith does not equal automatic warm welcome. And so these soft-spoken naive ladies must learn about the price of their dreams the hard way. It is literal that they have lost themselves in the effort of seeking and finding. Instead of gaining some cash to help with the family's economy, they lose more than just happiness; they lose their minds. Some have also lost their lives.

Dream is a great temptress. It pulls, invites, seduces, attracts everyone. Dream is also elusive. It takes the sharpest mind and the most valiant heart to win it. While dream keeps the wheels of life turning, it may also become a cancerous growth. One must treat it with cautions and great respect. Even dream is not free.

Saturday, 2 July 2011

A world all its own

This is by far the most comprehensive tourism promotional video about Indonesia. It's a bit long for an ad, and the music, although very nice, is not as epic-sounding as we might expect from ambitious tourism videos. But what can I say--a standard several seconds ad is really not enough to describe this glittering archipelago. There is definitely more to Indonesia than Bali.

So, enjoy this video (don't forget to full view), and see you in Indonesia!

video

Thursday, 9 June 2011

Oh hey, I'm a Bachelor of Medicine!

Please excuse the lack of updates on my blog. I've just passed two most overwhelming weeks of the month, and one of those two weeks led up to my graduation on Saturday May 28 (oohh yesss!!).



The graduation batch for medical school was the afternoon batch. It means two things: 1) I could spend the entire morning perfecting my makeup, hairdo, and kebaya (hey I'm a woman!), and 2) I could have lunch first and not thinking about a hungry stomach during the ceremony. I was lucky to have my mum's employee as my makeup and hair artist; she attended a beauty school so she was able to give me some "academic" inputs regarding the art of makeup. Her name is Eka and she is terrific! (and a great chat buddy as well)

We (my dad, my mum, Eka, and I) then headed to Lomoto, a photography studio owned and operated by my friend Owen. The studio is conveniently located quite close to my student housing and even closer to my campus. I had five great shots with Owen. As a trivial bit, we knew each other after he offered himself to massage my sprained ankle during one retreat up in the mountains. At that time he was a final-year Visual Communication student, but even now he still retains the same broom-like hairstyle.

And then the commencement ceremony. The campus yard was a sea of flowing red. There were spots of other colours of students' kebaya and long dresses and batik shirts and black suits. The graduation robe (that's the red) was one heavy article compared to anything else I've worn, or maybe it was the heat that made it feel heavy. Remember, it was one afternoon in one packed place.


Me on the bench. I wore a gorgeous blue kebaya (so my colour!)
and a jarit (traditional Javanese sarong) made of batik with truntum motifs.

The ceremony went smoothly and everything was so well prepared. Of course, nothing could go wrong with an ultra-comfortable, air-conditioned, 5000-seat Grand Chapel. We the med folks were probably not as excited and proud as students from other majors because they have actually completed their education. We... well we completed the basic science years but not yet the clinical rotations. We still have work to do, man. We might have walked out of the Grand Chapel with a new title as Bachelors of Medicine, but no, you cannot legally call us doctors just yet. Just saying.

But hey, I think the commencement was still worth attending. I got nice pictures.


Me and Pamella in the basketball court, after class photoshoot.


Me and my best friend Yiyin. We did our rotations in different hospitals, so
I'm glad we could catch up with each other.


Me with Prof. Budhi (left) and Prof. Bambang (right).
Prof. Budhi teaches medical ethics and blood chemistry. Prof. Bambang teaches 
epidemiology and public health.


Medicine class of 2007.


The "party" also took place on the cyberworld. Facebook was full of friends around the world congratulating us. It is times like this that make me think how fortunate we are to live in a strongly connected era. Virtually every corner of the world is accessible and we can share happiness and blessings with a greater number of people.

Now back to work.

Wednesday, 25 May 2011

Book Review: Room (a novel)

Title: Room
Author: Emma Donoghue
Publisher: Little, Brown and Company; Back Bay Books (international edition)
Country: United States of America
Pages: 321 pages (paperback)
Genre: Literary fiction


The one word I'm going to use to call Donoghue's Room is: different. It's different in many ways. Room is actually a terrifying story about imprisonment and its damaging impacts on the victims. Unlike most books about adult crime, however, the story is told from a 5-year-old's point of view, which makes the horror look falsely innocent, and the violence look like some sort of a fleeting nightmare. Room offers a rare insight into the mind of a small boy born and bred in captivity; the way he views and treats the world around him that we often take for granted puts things into perspective and will certainly move your heart.

The book is not about the glaring, dramatic sensation often projected by the media when covering the news of such an unfortunate event. Rather, Room is simple; the author focuses more about what it means to try to live a normal life, and to raise a child in the most normal way possible, in abnormal circumstances. It also teaches about how strong a woman can be, especially a mother, without having to be outwardly aggressive. It's a love story with low-profile heroism.

Room is incomparable to other books. It's one of those rare gems that have many facets and can scratch many hearts.


This review also available in: Goodreads

Friday, 20 May 2011

Radiology - knowing ahead

In the literary world, it's called the "dramatic irony". It is when you, as the reader, knows a particular information about a character or an event that the character knows nothing about. Consequently, you know what is coming whereas the character has to suffer from not having the same knowledge.

Spending four weeks in radiology rotation granted me the pleasure---and the irony---of knowing ahead. A radiologist is the first person who knows exactly what is happening with a patient. A radiologist could also be the first person who is prepared to see a smile fading and hope losing.

Of course, sometimes we can only suspect. After all, imaging is only supportive of clinical presentations. Results may still be inconclusive, and maybe, maybe it's all just some technical errors or a very bad dream.

But other times, radiographic images can be as glaringly obvious as the screen you're staring at right now, Consider the following images:

Multiple metastases to the lung. (Image source)

Staghorn calculi. (Image source)

A CT image of a holoprosencephalic brain. (Image source)


We know these conditions. We are aware of the dangers and the consequences. We know what is imminent.

What do you do when you have the knowledge? Keeping it to yourself? Telling that person? Secretly trying to cure / repair / reverse the situation while still pretending to be ignorant, just to be sure that you have done some Samaritan good?

Unfortunately hospital management system doesn't work that way. The most Samaritan you can get if you're working as a radiologist is to write the best imaging interpretations to be sent to the referring physician. That's all. Then it's that physician's job to find the best way to inform the patient about what's in store for them.

When I was presented with an old X-ray of metastatic cancer in the lung taken of a man 12 years ago, I immediately wondered: Did he survive? How has he been doing? Where is he now? Is he still eating his favourite food, watching his favourite TV show? What would he be now if this all had not happened? The X-ray displayed a silent horror more morbid than any other creep show. It was real, it was a human being, and it kind of reminds us about the similar endpoint we all have.

Some people find solace in radiology because there's no need for an actual contact with the patients. Therefore they can be spared from the old dreadful thing called breaking bad news. In some ways it is nice. Ignorance is bliss, indeed.

But I feel a tad bit disturbed as well. Often times, a patient would ask me or my attending about the imaging result. Most of the time we just smile and say that the result needs an interpretation, and that he/she can check with the referring doctor later during the next visit. But God, we already know what's wrong at that very moment!

There are times when I cast a look at the patient, wanting to tell, but the attending usually hurries me to his office for yet another teaching and another writing.

That knowledge sometimes gives me pain. I want to just scream whatever's in it to the patient's face, as honestly as I could, but that's just not the way it works, is it?

To know first-hand precisely what is, earlier and better than most other people, can pretty much haunt your conscience.

Thursday, 19 May 2011

the wild horse


my hour. so long, vanity
i have chosen an exit
i shall run and run.
for a reunion
with the soul.
in a strange domain.
in an esoteric earth.
a cage was a cage
and a prayer answered
is a prayer answered.
so i shall run. and run.
and run. never to finish.
but to live;
to climb the sunray
to ride the moonbeam
into the milky way in me
i am the wild horse.

-by: Anna Elissa-

Wednesday, 18 May 2011

Seuntai Kangen Untuk Kamu


Hai, kamu di seberang lautan
Kemarilah kasih, sebelum kau bertolak lagi
Ini ada kalung. Kuronce dari bibit rindu
Yang pernah berderai dari ujung mata
Saat kita mencuri pandang dan mencuri hati,
     pikiran luruh dalam imaji.
Kasih, kenakanlah untaian kangen ini
Biar aku bisa mendekap kamu
     menempel denganmu, meski kamu sibuk
     berdansa di megamega.
Suatu hari nanti,
Saat kamu sudah lelah menjaring terik matahari
Kembalilah kamu,
      kepada selimut purnama.
Itu saat kangen kita jadi mekar
Lalu isinya membuncah
Dan lenyap
Dalam kecupan
Menjadi sayang
Ah, sayang
Rasa kangen yang telah mendewasa

-by: Anna Elissa-

Saturday, 14 May 2011

Jarak



Ada seceruk sudut kosong
Teronggok jauh di lorong kalbu
Bagai hantu ia memanggil-manggil namamu
Hasrat menangguk apa yang telah ditabur

Mari menunggu dengan gembira
Tahun-tahun yang akan datang
Tidak waktu, tidak jarak, tidak gunung ataupun palung
'Kan pisahkan milikku daripadaku

Sebab waktunya akan tiba
Para malaikat terduduk lelah
Saat laut tak lagi basah
Dan air menjadi merah


-by: Anna Elissa-

Sunday, 24 April 2011

What I learnt in Neurology


1. A whole lotta pathologic reflexes. The first days we were all flabbergasted at the tricks our attendings did. We know Babinski, Chaddock, and Oppenheim, but Schaeffer? Gordon? Gonda? Rossolimo? Hoffman-Trommer? Like, what?? And then we of course found out about the Babinski-like responses bunch and felt ridiculous. I mean, even Wikipedia knows more about it.

2. Turns out in addition to Brudzinski's signs I and II, there are Brudzinski III and IV. Brudzinski III is when you press the zygomatic bones to see if the patient will flex his/her upper arms. Brudzinski IV is when you press slightly above the pubic symphysis to elicit flexions of the hips and knees.
What I don't know is whether these signs are known at all in the Western world, because every time I Google them I always get Indonesian sources. Please help me on this. Do they exist with another name or what? I'm dying to know.

3. Tension-type headache can manifest as tightness of the shoulder and neck muscles.

4. Patients with myasthenia gravis should remain in a temperate environment. Extreme heat increases the destruction of the precious acetylcholine by acetylcholinesterase. On the other hand, cold temperature is reported to significantly improve the symptoms; however, even references to this matter vary in opinion.

5. Don't catheterize a delirious patient! He/she might try to yank it out.

6. The primary sources of metastatic carcinoma of the brain are prostate, lung, and GI tract carcinomas.

7. Stroke patients who develop dysphagia can get pneumonia. Two reasons:

  • Decreased level of consciousness in many stroke patients leads to "attenuation of protective reflexes, impaired function of lower esophageal sphincters, delayed gastric emptying, and the worsening of the coordination of breathing and swallowing."

  • While nasogastric tube aids the feeding in stroke patients, it is also controversial because it may actually precipitate aspiration pneumonia through "increased oropharyngeal secretions, impairment of laryngeal elevation, and disruption of the upper and lower esophageal sphincters."

8. Distinguish carefully between tetraparesis and double hemiparesis.

9. Yes, it's possible to have a monoparesis / monoplegia that is a UMN lesion.

10. Four cerebral lobes? Think again! There are five!

11. The degree of sensory aphasia can be measured roughly by giving two instructions, one simple and one harder. An example of simple instruction would be telling the patient to raise his/her left arm. A harder instruction is telling him/her to take a piece of paper with the right hand, fold it into half, and place it on his/her right side. A patient with mild aphasia may have some difficulties in following the latter.

12. Meningeal irritations and associated signs are not specific for meningitis. They can also indicate meningeal inflammation (as in the case of neoplasm) and hemorrhage (e.g.: subarachnoid hemorrhage). They can even be absent in patients with GCS <8.

13. MRI is more sensitive in detecting infratentorial lesions than CT scan.

14. Lactate is the base complement of lactic acid! This was especially confusing because the Indonesian word for lactic acid is "asam laktat", with "laktat" being a direct translation from "lactate". That's why Ringer's lactate is okay for stroke patients undergoing anaerobic metabolism!

15. Nimodipine is given to attenuate vasospasm in cases of subarachnoid hemorrhage.

16. A whole new world of hypokalemic periodic paralysis.


Also, our terrific attending gave each of us a copy of stroke guidelines. It contains EVERYTHING we need to know about the management of stroke and its associated conditions (hyperglycemia, hypertension).

We are very lucky.


EDIT on April 25, 2011:

One more thing: I have Hoffman-Trommer reflex! It is NOT pathological if it exists bilaterally in an otherwise normal healthy sane people.