Sunday, February 21, 2010

Thursday, February 11, 2010

Medical Medical Student Burnout and the Challenge to Patient Care

by Pauline W Chen, MD, writer and consultant surgeon
This will be worthy to those studying medicine in Pm4

Not long ago, I read a paper titled “Burnout and Suicidal Ideation Among U.S. Medical Students” in The Annals of Internal Medicine. It brought back a flood of memories.
Skip to next paragraph
Well


Medical school was not easy for me. I knew that I wanted to become a doctor to help people, but I had given little thought to the process. I was poorly prepared for many things: the pressure to excel in ways that seemed so far from caring for people; rapidly mounting debts I signed off on every semester; a roller coaster existence from chronic lack of sleep; hazing from the more experienced students and residents; and the realities of patient suffering despite my best efforts.
Even surgical residency, despite the relentlessly long hours, seemed so much closer to what I wanted to do.

Some of my professors tried to “humanize” the process. They invited us to dinner in their homes, supported our extracurricular efforts to set up health screening clinics in low-income neighborhoods, and tried to make our basic science courses more relevant to working with patients. But sitting where I am now, as someone who teaches medical students and who loves helping others as a doctor, I can understand the challenge they faced. Given the fire hose of information medical students must learn in just four years, how does one ever gently take a sip?
Despite my teachers’ efforts, I was about as miserable in medical school as I had ever been. I felt alone. Neither I nor my classmates could admit to failure, and the last thing I wanted to do was to let anyone but my closest friends know just how unhappy I was. Success in medical school was the first step to a future of helping others, and I was not about to jeopardize that.


Last week I had dinner with two former classmates from that time. We had not seen each other in over a decade, and after catching up on personal news and reminiscing about gross anatomy lab and our first nights on call, one of them said quietly, “I hated med school. I wanted to quit.” The elephant in our collective memories had broken free.


With that elephant now running loose, and the three of us more comfortable with our own professional accomplishments, the conversation grew more honest. “If you look over my entire lifetime,” my other friend said, “those four years were the lowest point in terms of self esteem.” He held his hand out in the air, plotting an imaginary line that dropped precipitously to his knees.


It took nearly 20 years for the three of us to learn that we had each been miserable as medical students. It has taken even longer for researchers to discover the extent to which such feelings exist among American medical students.


In 2006, Dr. Liselotte N. Dyrbye and her colleagues at the Mayo Clinic found that nearly half of the 545 medical students they surveyed suffered from burnout, which they defined as professional distress in three domains: emotional exhaustion, depersonalization and low sense of personal accomplishment. Moreover, the researchers found that each successive year of schooling increased the chances students would experience burnout, despite the fact that they had entered medical school with mental health profiles similar to those of their peers who chose other career paths.


More recently, in the paper on burnout that had first caught my eye, Dr. Dyrbye and her colleagues widened the scope of their research, analyzing survey responses from 2,248 medical students at seven medical schools across the country. Again, nearly half of the students surveyed met the criteria for burnout. But the investigators discovered an even more ominous finding: 11 percent of all the students surveyed also reported having suicidal thoughts in the past year.


Dr. Dyrbye notes that we are just starting to learn about the high levels of distress in medical students. “It’s incredibly disconcerting,” she said. “What are the causes? And what can we do as educators to facilitate their well-being? We need a better understanding of the causes of stress to design interventions that will help improve student wellness. Students, just like doctors, need to take care of themselves in order to take care of their patients.”


Medical schools have more recently recognized the importance of this issue. For example, the Liaison Committee on Medical Education, the accrediting authority for medical schools in the United States, now mandates that all schools have a program for student wellness in place that includes “an effective system of personal counseling for its students.”


But beyond the personal implications, what are the ramifications of medical student burnout for patients?


In a third study, Dr. Dyrbye found that when tested for empathy, medical students at baseline generally scored higher than their nonmedical peers. But, as medical students experienced more burnout, there was a corresponding drop in the level of empathy toward patients.
“What do they really need to know before graduating from medical school, and how could they most efficiently learn?” Dr. Drybye asked, reflecting on one of the central challenges of medical education. “All the information we want to share with them is not necessarily what they really need to learn.”


By the time my dinner with my former classmates last week had ended, we had made plans to stay in touch and to do something I had never been sure I would ever do: return to my medical school in two years’ time to celebrate our 20th reunion. Over the course of our dinner conversation I felt strangely connected and nostalgic about medical school; I was deeply moved by what my two classmates had chosen to do with their education. One is a well-loved community obstetrician/gynecologist; the other is a psychiatrist devoted to teaching, working in a county medical clinic and caring for severely traumatized Hmong refugees. And both love their work as doctors.


As I listened to them talk about their work, I was reminded of one other thing Dr. Dyrbye had told me. “We need to change things,” she had said, “because maybe the students who are most vulnerable are the ones who are most empathic.”

Sunday, January 3, 2010

HAPPY NEW YEAR!!

Ah, Nyoke Lee's Family!

Wherefore art thou abandoned?

What has become of your family?

All busy with their new lives, as it seems.

We have the largest group in IMU - Chia Yew, Michelle, Shin Yee, Hui Chuin, Marcel, with Ko, Tim and Beng Ying due to join them in two months

The next largest group in the UK. Sorta.
London - myself, Kim and Li Wei
Edinburgh - Su-Ern and Ken Vin
Nottingham - Roshan
Cardiff - Jason
Sheffield - Chiun Min

Then there are those scattered elsewhere
Sharon in Harvard
Kai Lun in Russia
Aly in HELP
Joanne in PMC
Daniel, Aussie-bound
Leelian the activist
Shin Yi still MIA

Not forgetting the devolved ones,
Jamie in U Penn
Geetha in Indonesia
Poh Hui about to leave to Aussie soon-ish
May Suen and Esther still in INTEC
Sue Wei in Cardiff
Hwang Yang just finished his A-Levels

And the pseudos!
John in Nilai
Hui Ning in St Andrews
William to start in IMU

Oh yes, all leading very busy lives as we each embark on our own journeys of life.

Still, we have the Book of Travelling Secrets, keeping us all together.

It is now due to pass from the hands of Charles to that of Ah Lek Ken Vin.

And I am certain that despite the apparent lack of activity on the blog's part, or the Facebook group, PM4 is never far from our minds.

I know it isn't for me.

What lies ahead for the Family?

Only time will tell.


Friday, December 11, 2009

R.I.P.?

Please say no....

Sunday, October 25, 2009

Drawing the Line

I have forgotten birthdays, forgone gatherings, denied the existence of group lunches, made up false excuses and turn the opposite direction - all in the name of objectivity and time efficiency. I didn’t use to be so. I used to be able to while away hours, talking about nothing, with no tangible result at the end of it, except maybe a warmed chair. Now that chair is unoccupied, but I have papers and certificates of better academic performance. Also now, if I were to sit in that chair, I) not many will occupy that chair next to me ii) I would fidget in that seat thinking that I’ve got more important things to do.

Should this be so? There seems to exist this very delicate balance between friends and work. In my quest to improve my studies and my knowledge on American politics or ‘serious’ issues such as laws, I have neglected friends and even family. Even though my absence is felt and sometimes even hurt, I do nothing to stop that. I can defend it by saying I’m striving for a greater good. That though this may suck temporarily, I’ll make up for it with better grades and with more information in my head how to talk ‘informedly, and without bias’. On the other hand, I do not want to defend myself. There is no way I can justify not spending more time with my parents and siblings when this could be my last year with them before going overseas. Nor can I justify my paper accomplishment and my ambition to be successful in an occupation to be more important than making the woman that raised me for 18 years, regardless of hardships, happy by just agreeing with all the disagreeable things she might say. Or that friend who sacrificed her own time for me, but I would not accord the same to her.

Where is the middle line drawn between these two extremes?
Where does focusing on goals stop?
How does it fit into making others (but not necessarily, yourself) happy?
When does social obligation compensate for being selfish?

It’s easier to say balance than to actually stand on that trapeze’s rope itself.

Note : Class Dictator takes this opportunity to apologize for any hurt feelings caused by her. She is currently on a caffeine high and yes, she realizes this is her first post here *slaps hand*. I hope you don’t mind sombre, reflective and somewhat philosophical :)

Saturday, October 10, 2009

Inner Medial Femoral Trauma: Etiology and Treatment (CY Kong, 2009)

Inner Medial Femoral Trauma or Inner Thigh Trauma (ChiaYewnian Syndrome) was first described by Kong CY in 2009 in an isolated case involving a patient named Chi Ko Pek*, a 19 year old male . Chi Ko Pek presented with numbness of the inner thigh and distinct post traumatic stress disorder. After further inspection of the site of trauma and interview, it was found that Chi had presented with a disease that was never reported before in Medicine.







Etiology:







This trauma is humanovector borne. A humanovector in this case Ah Piang the Garang*, an 18 year old female, had inflicted trauma by touching the inner thighs of Ko with her phalanges. This disease will only manifest with cranial (upward) progression of phalangeal stimulus onto the medial inner thigh. Trauma is remarkably more marked if phalangeal stimulation proceeds to the pubic area. Humanovectors of Chiayewnian Syndrome have exhibited abnormally high amounts of oestradiol in females and testosterone in males and very pronounced levels of pheromone secretion. They however curiously are rarely sexually active. This an be explained by the fact that their celibacy actually drives them to out put any suppressed sexual needs to committing Inner Thigh Trauma. Inner Thigh Trauma has a higher incidence in females than males. Patients almost always are atrichomic (hairless) in the lower limb.







Diagnosis:







The signs and symptoms include the universal sign of embarassment- the obsessive adduction of the lower limbs. The adductor magnus muscles of the legs are in a contracted and stimulated state for a prolonged period of time. This can be considered biopsychosocial manifestation of the trauma to prevent further stimulation of the site and to protect from any more trauma. There is marked pathology of mindset in the patient, with vasodilatation especially in the facial area, indicating a sympathetic response (from stimulation by cervical outflow). There is marked numbness indicating sensory fatigue of touch receptors in the medial inner thigh. There is marked psychological trauma: post traumatic stress disorder has been reported in many such patients with Inner Thigh Trauma.







Treatment and Prevention:

The Adductor Magnus muscles



The best method of preventing such incidents are strengthening of the adductor magnus muscles of guys. Posture when sitting is also important. Sitting with legs closed (aductor magnus muscles contrated have shown to significantly reduce levels of Chiayewnian Syndrome.





When patients have exhibited symptoms, there is nothing much health care givers can do. It is as much a psychological disorder as it is a somatic pathology. The first thing to assess is as to the extent of the trauma. It is classified below





1 cm- 0 cm from pubic region: Highly SEVERE (needs immediate psychological intervention)





5 cm- 1cm from pubic region: SEVERE ( counselling)





More than 5 cm from pubic region : No intervention needed, surveillance recommended





Numbness in the leg usually subsides within a day while massage with deep heat on the adductor magnus muscles relieves it from contraction and promotes relaxation.





Stress medication should be prescribed if needed.




Published in the Peeamfourianic Journal of Medicine October 2009.

*All names have been changed in accordance with medical ethics.

Monday, September 7, 2009

PM4 on Taylor's Website!

So because this blog is in dire needs of resuscitation,

look what Taylor's published on their website!

A picture of some from PM4 & our very own Mr Suresh, with the caption "Happy graduates sharing a light moment with their physics teacher, Mr Suresh Muniandy (fifth from left) "



(Ignore the first half part of the report & just go see the PM4 picture!)

Friday, August 21, 2009

Hikayat Amanat Awaang Kolo kepada Jason Chai

This poem is telling of how intrepid Pm4 girls can get. Awaang Kolo paints a poignant satire of the adventurous girls of Pm4...


Wahai Jason Chai, berhati-hati la kau dengan gelagat gelagat si perempuan PM4.

Adapun mereka yang gatal, suka merenung abs lelaki.

Adapun yang suka jejaka lampai tinggi berilmu bergunung ganang

Adapun mereka yang berhikayat berperihal skandal berlarutan bermula pagu hingga ke larut malam.

Wahai Jason Chai, tutuplah telinga kau bila tergugat,agar jiwa minda dan kau terselamat

Dari kawan jantan kau yang terancam dan solo,

Encik Awaang Kolo

Jika mana mereka bertanya pendapat,

Apakah kuasa seseorang si mamat itu,

adakah abs buntut dia padat dan jitu?

Jawablah kepada insan-insan ini,

Harap-harap dia dah ada bini.

Jikalau mereka mengucapkan Hot Hot

Keluarkan lah sebarang kentot,

Biar mereka terkejut,

Biarkan horniness mereka mengecut,

Biarkan hormones mereka susut.

Jadilah Panglima Garang Amy,

Jadikan diri bagai seorang penjual kolo mee,

Buanglah pheromone mereka,

Supaya mereka kurang terseksa

Amanat ini patut dijadikan warisan pustaka

Bagi kegunaan generasi depan, kini, dahulu kala

Saturday, July 11, 2009

To the Family's Thymus Gland,


Ever patient, ever caring, ever dedicated,



Always making sure we did our work & knew our stuff,



HAPPY BIRTHDAY :)


___________________________________________________

P.S.: We are currently receiving birthday dedications for Ms Ko. If you have anything to say to Ms Ko (I know you can do that on Facebook but putting it altogether in one blog post is more meaningful lah) please send it to nyokeleesfamily@gmail.com & we shall post it here.
If we gather enough meaningful messages, we shall spam her FB asking her to come check on our blog. ;)

Thursday, June 25, 2009

Charle's Day Out

Wednesday was a very funny day.

Two aims were fulfilled on that day.

1) the answering of the question; Where is Jamie ah?

2) the entertainment of Charles Ng Chiun Min, depressed from inactivity and dormancy.

We went to Midvalley: Allyssa, Charles, I and Jamie

we saw 17 again and then went to Starbucks to chat, do you-know-who impersonations, and talk about the years to come, and to further fulfil the clauses of the Jamie-Lohsoh Agreement. No, the clause on throwing chemical models at old ladies was yet to be ratified in action, but i dare say we came close

It was a strange day. From the start of Ally and I coming up to Midvalley,

I recorded 9 times the enchanted question,

Eh, where is Jamie ah?

We even called her on phone finally and asked

Where are you ah?

Even up to where she was in sight, Ally asked once more

Where is Jamie ah?

And once or twice a message came from Charles that asked

Where is Jamie ah?


Clearly the question was answered She was right with us all along.

Mirrors the "you have to get lost to find yourself' tagline.

When after what 2 hours hogging the chairs of Starbucks Gardens, and spending 1 hour buying a book for the sake of buying one,

I bought Hanif kureishi's Buddha of Suburbia by the way, (amid stares of the three "oh yea the buddhist fanaticism thing :P)

But it's a book of literature a British book ( I like only British fiction, but both British and American non-fiction, the latter as a lighter more fun reading material, the former as more of an itellectual challenge- very complex reading habit)

It's a book that examines escapism from dysfunctionality ( that Mark haddon also pokes around with)

It uses such nice vocabulary as f*ck, prick and cum


enough said.

But after Jamie left and thus left us asking

Where is Jamie ahhh? again

Charles took over.


He led us on an eating spree first, practically shortgunning orders
in a Sushi restaurant at Gardens.

A sushi restaurant that charges Rm 12.90 for a slab of fish that can fit in your palm... :p


Then he transported us to an ice cream joint (cant remember the name)

Tried ALL the flavours

made the people working quite nervous that the used testing spoons bucket was filling up fast.

Thank God (PM 4's version or any other version in fact) he bought something.

To mask the embarassment, I and Ally bought also.

Entertaining Charles proved to be a very demanding task.

he then walked into the wine store which purpotedly gives free samples.

Fact: They did not.

Charles actually asked the person to give a tour around the shop: which was no bigger than any chicken rice shop you can find. He was waiting for the owner to offer him some good stuff.

Allyssa and I started laughing

which more or less eliminated all chance of us getting free booze.

The alcoholic he is, Charles, disappointed and wounded dragged us into Isetan Gardens,

where we had to sit on stools as tall as a 1 year old baby and play LEGO

For roughly one hour in which we built purposeless structures while Charles built a tower.

With a window to add to its tower-y glory.

A child was invited to play with his father

to which the child said.

Don't want.

Ok...

when it was time to go home, Charles almost relented saying "Wanna go for a drink?"

Seeing as Alyssa's stomach had reahed critical bursting pressure. Critical in bolded font.

WE pulled him to my car.

And my car was in deep shit.

The sewage tank just next to my car overflowed and there was the overwhelming smell of oh... how do you describe it?

HUMAN SHIT




So My poor Vasa Acini's tyre's and my feet and flip flops got bathed in liquid gold.


such Fun...






Wednesday, June 24, 2009

On Miss Yoong

Miss Yoong has a boyfriend:

Malcolm

PM4 wishes her every luck and happiness and is proud of the fact that

every teacher who teaches PM4 has had relationship luck when teaching us.

Miss Yap had us...

Miss Shoba got married

Miss Ko had a baby

Miss Ho had Daniel's blog

Mr Suresh had Ko Yan Rui

Mr Arivom threatened Poh Hui to kiss her to the maximum

Anyways we hope wedding bells will ring soon...

lol IMU people then can attend and then the overseas people will agonise at not being able to attend it

Muahahaha

Saturday, June 20, 2009

what defines us


Lol looks like i was biting tang shin yee's hair...

Sunday, June 14, 2009

Lowya Buluk at a loss for words

I cannot adequately sum up my emotions over the past one week, what more the past 18 months. I told myself that today, I must wake up early & write a detailed account of Redang on the class blog, & if time permits, my experience in PM4. I told myself that I will finish writing about Redang, before I head to Sarawak for 13 days & Redang becomes a secondary memory, no longer fresh in my mind. But the words fail me.

I have experienced this dilemma before, after my first PKTR. On one hand, there is such a full treasure trove of memories that must be recorded before they fall prey to the erosion of time & the fallibility of the human brain. But on the other hand is the unwillingness to do so, because the act of putting all those memories down in words would signify that yes, it has come to an end, & this is all we have left to remember it by. Which is the last thing I would ever want.

I don't feel sad. I am still unable to fully feel sad. I know I have been relatively more emo over the past week than I have ever been throughout the 18 months you guys have known me, & I apologize for leaving an emo picture of me as the last memory you would have of me in PM4, but it is not sadness I feel. Rather, it is nothingness, for lack of a better word to describe this state of limbo I am in, of wanting to linger in these moments a little while more, refusing to move on to the next stage of life.

Who am I kidding? As I write this, a few of us have already left Subang. I am loathe to go back there. What charm would the streets of SS15 hold anymore? Nothing but ghosts of a time when we used to walk from the main campus guardhouse to Madam Joyce's, laughing at whatever it was that had our attentions at that time. Faint imprints of 23 silhouettes in the classroom, poking fun at each other & exasperating our lecturers. Shadows in the corners of the rooms that used to house friendly faces, always welcoming a weary friend who just needed to rest. I envision myself back in Taylor's now, only to find buildings which represent empty husks of a life I once led. There is no more comfort or warmth in that place.

Our only hope now lies in three things: the Facebook group, this blog, & most importantly, the Book of Travelling Secrets. I pray with all my heart that these will always keep us connected, that the Book will actually work, that we will all still play our parts as PM4ians, because I refuse to allow this to become a mere memory of my life.

I cannot adequately sum up my emotions over the past one week. But I can adequately sum up my emotions now - writing this made me cry. I still am crying. & I don't know when I will stop.

Wednesday, May 13, 2009

Surat Pekeliling No. 18.5 Kerajaan Berdaulat PM4

Berikutan pengumuman darurat tanpa pengetahuan diktator Kerajaan Berdaulat PM4, di bawah merupakan arahan kepada angkatan tentera PM4 yang mest dipatuhi, seperti yang dinyatakan dalam Akta Darurat PM4 2009.

Diktator Kong U-B - menunjukkan kehebatan U-B nya

Lau Bu - membuat impersonasi Simon Cowell, Meryl Streep, Amy, dan sesiapa lagi yang relevan

Komando Jason - 'show abs'

Jeneral Ko - meng'nger'

Leftenan Marcel - senyum dengan lebih lebar lagi

Korporal Michelle - menggoda the Dark Lord

Sir Charles - ketawa dan tidur

Tok Kong Bomoh - teruskan pencarian untuk cara penyelesaian melalui teknik mereka cerita nonsesikalnya

Tuan Daniel - minum lebih banyak chocolate milk

Cik Muda Beng Ying - 'slap' sesiapa yang patut

Sergeant Kimberly - 'act cute'

Presiden Lek Ken Vin - membuat stail rambut yang lebih dahsyat lagi

Kolonel Roshan - memakai tali leher hodoh

Private Hui Chuin - membeli kasut imitasi Jimmy Choos untuk seluruh angkatan

Duchess Shin Yee - memandu tank

Count Li Wei - makan di Madam Joyce

Kapten Sharon - mengawal pengaliran wang PM4

Viscountess Su-Ern - mengamplifikasikan komand yang diberi

Lady Zhen - meloyakan arahan the Dark Lord

Baron Kai Lun - bersama Leftenan Marcel menambahkan kuasa senyum

Admiral Shin Yi - menanya soalan atau memberi jawapan yang tidak berkaitan

Marshal Joanne - gunting rambut

Major Alyssa - ketawa seperti hyena

_______________________________________

Dengan kerjasama seluruh angkatan, Kerajaan Berdaulat PM4 yakin bahawa kita boleh mengalahkan the Dark Lord!!

Sesiapa yang tidak menjalankan tanggungjawab seperti yang dinyatakan di atas akan diberi hukuman "chee gei chap sang"

Majulah Negara Untuk Sukan

Friday, May 8, 2009

THE BOOK OF TRAVELLING SECRETS IS NOW WITH MISS YAP NYOKE LEE

Jamie Lohsoh Day

I have started the social experiment of asking in my class

"Where is Jamie ahhh?"

as if she had never left and she was just absent due to a dis-ease.

when in fact she left after the ratification of the Jamie Lohsoh Agreements for INTEC.

It has elicit responses that has really made me burst out laughing.

Loh shin Yi,

was asked in an sms about the PM4 people's scattering the same question

Lol she paid no attention to all the sentimental stuff in the message but just answered the questionby saying

I'm Sorry.... i don't know where jamie is...

I burst out laughing naturally.

Celebrate Jamie Lohsoh Day every 2nd of june


When the sambil lewa attitude stops, the killing can too...

Cumberlek's Jouney in Peeam 4

Dear PM fourians.

I shall start by saying my Peeamfoourian terminology is horrible. (so do forgive me for it. =p)

Well, i't's been awhile since i've written anything anywhere, joined group events with you guys and actually had a decent chat with generally a lot of people in the class. Yet, class had officially ended, and i'm left here wishing it wasn't over.

I shall declare a few of many things.
1. You guys were the most awesome classmates i ever had in my entire life. By far. You were all so welcoming to one another, always open to helping one another and cooperative.

2. I do wish class never ended so fast.

3. I can tell you TAYMUN would not have been a success if i was placed in any other class other than PM4, simply because i wouldn't have got 90% of the class to join the club and i also wouldn't have gotten such commitment from a huge group of people. Never did i imagine when i wrote that petition letter requestion you guys to join TAYMUN that i would receive such an encouraging feedback in return.


While i was spending my last day with all of you guys i realized how much i've missed out on in the last couple of months for i was so sucked up with myself and my personal agenda. You can pretty much say my presence in class was almost just to attend classes and to do nothing else. I failed to strengthen my friendship bonds with many of you, failed to come across as a warm and friendly guy as i once was and definitely failed to even seem like i was part of the class. For that i sincerely apologize.

Since it is all over now, i guess there's no point looking at the past but instead look towards the future. All of us wil be scattered across the world but hey, in addition to that wonderful idea of that "BOOK", i'll offer my suggestions. ( i may no longer hold any presidential posts to advocate and have the final say over stuff, but i still can suggest. =p)

1. A once a year class meet is definitely very possible. Especially between the months of June- August during our summer holidays. And hey, it's just a day. It's really possible. I can almost assure you that in 10 years time, most of us would be so busy with our lives that we would hardly remember each other, or even make an effort to meet up knowing very well that some of us might not return to this country.

2. the Facebook group to me is the most VITAL communicating tool. I mean come on, there's nothing that beats the internet nowadays, not even snail mail. =p. the one problem about the group which has made it such a lousy communicating tool is that posts on walls do not SAMPAI to the members. Instead, we should just publish a random event and invite all PEEAMFOURIANS TO GRAB THEIR ATTENTION TO CHECK the group once in a while. =p. Thus, the role of the officers of that group become very significant. As much as i like the idea of the book, i have a very bad feeling that it will one day go missing.

I will end by thanking all of you for being such wonderful people and personally sharing what i wish and hope to do in my future so that you will get to know me a little better than what you have in this year and a half.

To start with,
I will choose the road more often taken by PEEAMfourians that is to pursue medicine at Edinburgh. This decision came about after i had a personal revelation speaking with God. Quite simply, to do God's will. And how, it is by being the first one on the ground helping and healing those in need. I do plan to join the NGO Medicins Sans Frontiere when i graduate, go to places where people are living in poverty and do not even get proper healthcare. At the same time i would get to see the world, and see things from a different perspective of life.

And again, the road more often taken, i will choose to specialize. and a particular interest as of now, Neurology. haha. gosh. even talking about it sends shivers. (imagine the amount of time i would spend indulging in text books picking up this field). But yes, this is just something I am thinking of having been inspired by Oliver Sacks and his stories and realizing that this is a field with so much more potential to be tapped out of.(for the knowledge we know about how our brain functions is actually very shallow as of now)

Soon after, i will either choose to be a

i) WHO Director GEneral just like what Dr Margaret CHan is now. I definitely want to make a difference and when i say that, i mean a global difference. And it is by assuming such a high position that i believe we'll be able to do it. (she was the health director of HK who manage to curb avian flu prior to assuming that position)

ii) Get involved in Politics. Why? Because again, i come to realize that i want to bring changes to this country. I want to do something for this country i have lived in for 18 years. And again, it is by assuming such a position, you will have the power to do and bring major reforms. (of course, if i would like to do this, i would have to pick up many dilagues =p including TAMIL)

iii) Be the CEo of a health care company. If i were to do this, i would be looking at earning tonnes of money in which i would use to be a philanthropist myself. And what would i do with the money? Again helping those less fortunate than us (in our own country primarily) and those in poverty stricken regions like Africa. (this would require me to take up an MBA)

I end here.


p.s. It was a very emotional parting session for me today. I am glad i will still be able to see you guys a couple more times before we part ways. And i hope that whatever time we have remaining, we'll be able to make the most of it.

p.p.s it has been within this period of one and a half years i've grown and matured as a person in terms of thoughts more than i have ever done so in my life.

p.p.p.s one more post will follow this one in due time. =)

Your friend always,

Ken Vin Lek.

Thursday, May 7, 2009

WELCOME MISS YAP


Welcome Miss Yap to a world you have never known existed. You would have got this address from that very nice gift we peeamfourians got for you.


we would think that you would guess that we were already tak betul a little when we started playing dress-up


Jason getting pregnant


daniel having big assets and showing them off unceremoniously in a bathrobe



Timothy dressing up and making up as a 90 year old woman


This blogspot has been running for months but we knew the wisdom of keeping this very pleasant surprise from you until we all say our goodbyes.


From the start of this blog, we have always been theorizing whether you were aware of the existence of this blog ( Note: If you are one who is fond of googling yourself, then ... hint..hint...)


Anyway, without beating around the bush, welcome Miss Yap to the blogspot of a class who have not really got the right screws in the right places up there.


We have spun numerous tales of distant lands and fantastical circumstances throughout our 1 and a half years at Taylor's, of which unfortunately, only a small fraction (the milder ones : smirk) is documented in this blog.


We hope that this blog will only bring two things:


1) As a means of contact and fellowship among the peeamfourians and you. We will continue to update this blog, spinning either tales that don't quite make sense or more serious commentaries which are classified as "State of the PM4 Commentaries". We sincerely hope that you will continually check this blog, comment once in a while and pour attention on your 23 beloved hunks and models , especially those who need it the most... read: Ko :P


2) As a record of events be a truly awesome class, that will one day do great things. We want you Miss Yap, to open this blogspot 20 years later and see articles documenting each of the 23 models and hunks making this world a better place and then click on the archives to find in great horror the nonsense these 23 hunky and model-ly superheroes of the world once wrote and spoke of.
NOw, Teacher, be also proud that you have one more thing to show off to your colleagues :P



I am also proud to say that we have not deleted a single thing from this blog before presenting it to you (although we did practise discretion on what goes up at first :P)



I thus end with the hope that we will not break such endothermic bonds with such a fantastic teacher.

And we hope you do not find reason or enough energy to break those bonds too...





LOVE

PM4


PS: WE hope nothing is offensive on this blog. All the stories are borne out for our immense love for our class mates and lecturers. If at all anything is found to be offensive, we sincerely apologise. WE do not want untoward incidences of certificates being withheld afterall... (a grin and a smirk)




This Blog has been mainly contributed by





Lim WEi Zhen





KOng Chia YEw





Daniel Lee





ESther Lee





Lek Ken Vin





Jason Chai

Tuesday, May 5, 2009

Pemindaan Perlembagaan PM4

Berikutan Krisis Wei Zhen-He Who Must Not be named,

Diktator Tun Kong Lee Lian tanpa pengetahuan nya, memperkenan Pemindaan Perlembagaan seperti berikut.

Penambahan Klausa seperti berikut;

Klausa 564

Segala hal yang berkaitan dengan He Who Must not benamed dan kaitannya dengan Lowya Buruk atau warganegara lain adalah dilarang sama sekali di depan Lowya Buluk :P. Ia diberi takrif ISU SENSITIF di mana perbincanagnnya boleh dijatuhkan hukuman seperti berikut:

Hukuman ke atas pemegang Jawatan Kerajaan

a) Burettization
b) Pemberian makanan percuma kepada jason Chai
c) Pemakaian stail Timothy Kueks seumur hidup.

Hukuman ke atas Warganegara Biasa

a) Burettization
b) Kalau berwarganegara Lelaki, hukuman 'show abs' dikenakan di depan Michelle .

hukuman ke atas jarley

a) makanan percuma dilarang sama sekali ke atasnya.
b) Burettization


KONG CHIA YEW

Bagi Pihak

Relative dan Diktator

Tun Kong Lee Lian, AYNL