DAY 1675-1689

Apr 4 - 18

1) The eyes are the windows of the soul. From one specialty to another, our group has moved on from radiology to ophthalmology - the branch of medicine and surgery that deals with the diagnosis and treatment of disorders of the eye. Out of all the five senses, vision is undeniably the most important. We are unique in our reliance on sight as the dominant sense and this is reflected in how complicated our eyes are relative to other creatures. Also, while most of us could probably make do with a reduced sense of smell (i.e. myself as I have a congested nose most mornings), the same cannot be said for vision loss. 

2) Anyway, it's two weeks of ophthalmology and two weeks of ENT (otherwise known as otorhinolaryngology) for us. Unlike the previous two rotations that we had (emergency medicine and radiology), there will actually be an end-of-rotation clinical assessment for both eye and ENT postings. For our current rotation, the clinical exam is mainly to assess our ability to properly use the direct ophthalmoscope (a handheld device that allows the doctor to look into the back of the eye at the various structures). 

3) The past week has been well spent clerking patients and examining them in the wards. We noticed quite a few patients who presented with cataracts, either age-related or due to trauma (e.g. motor vehicle accidents). Other conditions included thyroid eye disease, inflammatory orbital cellulitis, intra-ocular foreign body (another way of saying "external object lodged in the eye"), and sixth nerve palsy. Suffice to say, we've learnt a lot in the short span of a week, with one more week to go before exams. Hopefully it'll be another fruitful week ahead.

4) With that, I'll end this edition of my blog here. Thanks very much for tuning in as always, and have a great week ahead. Cheers! 

So we celebrated Melissa's birthday on Friday!

(l-r: Esther, Myself, Jason, Melvin, Melissa, Girvana, Ice

@ Soul Cafe)

Spaghetti carbonara

Cappuccino in a rather curious-looking cup

Chocolate birthday cake as hand-picked by Girvana

What a decadent and moist chocolate cake it was!

It was lovely meeting up with you guys again!

(All the best for finals! :)

DAY 1670-1674

Mar 30 - Apr 3

1) X-rays were first discovered by Wilhelm Roentgen in 1895, when he discovered that the cathode radiation he was experimenting on passed through human tissue, leaving bones and metal visible. Fast forward to today, and X-ray radiography remains one of the cheapest and fastest non-invasive imaging techniques available. We use X-rays for a variety of diagnostic purposes, as a screening tool to exclude fractures or foreign objects, and to visualise the proper placement of various lines and tubes. The reason for this brief history of the origin of X-rays is because, for the past week, we have been posted in the department of radiology, at Seberang Jaya Hospital.

2) There are four commonly used imaging modalities in the current hospital i.e. radiography (X-rays), ultrasound (US), magnetic resonance imaging (MRI), and computed tomography (CT). Each imaging technique serves a different purpose. For example, X-rays are really cheap, fast, and convenient, and can easily detect most bone abnormalities e.g. deformities, fractures, and some tumours. Ultrasound and MRI are more useful at detecting soft tissue abnormalities e.g. specific organ damage, tears, and ligament injuries. They also do not expose the patient to any radiation, compared to X-rays. Regardless of their strengths and weaknesses, each imaging modality has a role to play, and the expert radiologist only selects the test(s) based on what is absolutely necessary to answer the clinical question.

3) In radiology, each one of us was assigned a different station each day, such that by the end of the week, we had covered all the imaging modalities in the department of radiology. In addition, we had afternoon lectures/tutorials to consolidate all that we had seen in our practicals. I was indeed fortunate as all the doctors and technicians that I observed were very happy to teach, and as a result I was able to learn a lot. Fun fact: when I was quite a bit younger, I had somewhat of an aspiration of becoming a radiologist - as that would mean secluding myself from everyone, interpreting scans and just writing up radiology reports. Having been through the rotation, however, I realise that radiology, much like other departments, is very much a team-based effort, in the same vein as emergency medicine.

4) For the past week, I observed as medical officers, radiographers, and technicians worked together to coordinate the entire process of preparing patients for imaging. For example, someone has to set up the X-ray machine and place the patient in the correct orientation (e.g. standing or lying down) and at the appropriate distance away. Someone else has to key in the patient's details, select the correct body part to be analysed (e.g. chest), the view and orientation, as well as ensure the appropriate level of radiation exposure, including any precautions (especially for children). Next, someone has to interpret the test results, and write a radiology report with the impression of what the scan shows. This would sometimes involve discussion with the specialists if the case was more complex. As you can see, a lot of people are involved in the wellbeing of just one patient. And there would be a long line of patients from morning till lunch time. 

5) Having finished yet another rotation, we have a one-week break for "self-directed learning" before continuing with the next two rotations in this multi-specialty block - ENT and ophthalmology. That would lead to the final rotation of fourth year which is obstetrics and gynaecology. For now, however, we get a break. And it couldn't have come any sooner. Thanks very much for visiting my blog as always, and have a great weekend. Cheers! :D 

Trying out the hospital cafe (Aariz Cafe) for lunch :)

(l-r: Myself, Wen Hui, and Jia Min)

Study session with my good friend Kuhan ended with a wonderful lunch

Indian-style lunch @ Arati Villas

(That's biryani rice with curry chicken, cucumber, and hard-boiled egg)

Seberang Jaya Hospital

(the seminar room where we have our afternoon tutorials)

The sunrise in Penang is to die for :')

(What a lovely view to end the rotation!)

DAY 1661-1669

Mar 21 - 29

1) And just like that, our group is done with Emergency Medicine! It has been a hectic week, doing morning shifts and evening shifts for the past week, but we definitely learnt a lot. Throughout the rotation, we were attached to different "zones" within the department. Essentially, patients presenting to the Emergency Department (ED) can be classified into trauma vs non-trauma cases. Most trauma cases would involve road traffic accidents, although falls are quite common too. Trauma cases need to be assessed for severity, and priority is given to the patients that are in the most critical state, followed by those in semi-critical condition, and finally those that are in stable (non-critical) condition. Patients in the most critical state are sent to the "red zone", those in semi-critical state to the "yellow zone", and finally stable patients to the "green zone" - this is the definition of triage. 

2) In addition to the three "zones", the ED houses an observation ward, where patients are monitored quite similarly as in a medical ward, before being discharged. Finally, unique to the hospital we were attached to (Seberang Jaya Hospital), there is also a Medical Emergency Coordination Centre (MECC), where emergency calls are handled. I was attached there for a day, and I learnt a lot about how emergencies are coordinated by region. For example, Seberang Jaya Hospital is the only public hospital that handles emergency calls throughout Penang. So if anyone dials "999", the call is transferred to this centre, where the operator confirms the details and the nature of the emergency.

3) An important point to note (which I suspect not many are aware of) is that the call taker and the ambulance dispatcher are not the same person. Sometimes, callers may be worried the longer they continue talking with the operator, the longer the time taken for help to arrive. This is not the case. Immediately after an emergency call is answered and the location confirmed, an ambulance is dispatched from the nearest available hospital or health clinic. The reason the operator continues asking further questions is to ascertain the extent and severity of the injury/condition, to check if more than one person is involved, and whether there are other hazards in the vicinity. Also, certain procedures can actually be taught over the call, for example how to perform CPR, or how to tie a wound to stop bleeding, or even how to perform or assist an emergency delivery!

4) I really enjoyed my time in emergency medicine. We managed to sit in on two CME (continuous medical education) sessions, where we learnt about primary and secondary surveys (done on patients presenting with polytrauma), as well as stroke management. CME sessions are intended for house officers and medical officers alike, as a means to keep up to date with the latest guidelines. Furthermore, I noticed that everyone in this department worked very well together, like a well-oiled machine. We would see medical assistants, nurses, house officers, and medical officers work together, each doing separate tasks, all working to stabilise and monitor the patients in each zone. What struck me the most was how relaxed these people were - they were doing things that would in any other setting cause a lot of chaos and panic, but instead they remained calm and collected. 

5) Next week onwards, we will be switching to the department of radiology, also in Seberang Jaya Hospital. I hope that radiology will be just as interesting as emergency medicine has been. Until then, I'm just going to enjoy whatever "free time" I have left haha. Thanks for visiting my blog as always, and have a great week ahead. Cheers! 

Post-rotation dinner @ Saigon Bowl

(l-r: Myself, Sharifah, Rachel, Siti, Jinny)

Pho (Vietnamese noodle soup) with a very unique drink - egg coffee!

(a Vietnamese drink traditionally prepared with egg yolks, sugar, condensed milk, and robusta coffee)

All smiles after being told to go have breakfast first XD

DAY 1652-1660

Mar 12 - 20

1) Finally, after several delays due to extension of the movement control order (MCO), our group (Group B) has completed the family medicine rotation! This means there are two more major rotations to go - the so-called "multispecialty rotation" (consisting of emergency medicine, radiology, ophthalmology, and otorhinolaryngology), and obstetrics and gynecology. After that, we have a week of written papers and a soul-draining 20 station OSCE. For each station, we get 1 minute to read the question, then 6 minutes to perform whatever task needs to be performed. The task could be anything from history taking (asking patients about what brought them here), communication (breaking bad news to patients, or educating patients about certain medications/procedures), physical examination, or practical skills procedures. Bottom line is none of us are really looking forward to it...

2) Reflecting on the current rotation, I have found family medicine to be a unique experience. This is due to a few reasons. Firstly, the opportunity to compare and contrast both the public and private aspects of medical practice. During our time in family medicine, we got a chance to visit a different clinic each day. This meant that some days we were attached to the public community health clinics, and on other days we went to private GP practices. Some of the main differences between the private and public settings include the availability of medications, continuity of care, and cost. For instance, government health clinics would usually have certain types of medication only, while in the private setting, the only limiting factor would be whether the patient could afford the medication. In terms of continuity of care, in a private setting, the patient would see the same doctor/specialist, which means they would develop good rapport over time, while in the government setting, they might not see the same doctor each time for follow up. Finally, the most important factor - cost! While a private GP does have a set consultation fee, this is still many times more expensive than the equivalent government health clinic, where each consultation costs a mere RM1. 

3) Another reason I found family medicine to be unique is that we had the opportunity to see a patient managed from start to finish i.e. from the moment they walk in until they leave. Whereas in other settings, such as the medical or surgical wards in hospitals, we only see patients at a particular time, perhaps before their surgery, or after their surgery. In the GP setting, we learnt how to take a history of the patients' complaints, perform necessary physical examinations, order relevant investigations/blood tests, prescribe them the appropriate medications, and follow them up as required. This made me realise how important the primary care consultation is for patients. The primary care physician is the first point of contact for patients, and they see undifferentiated cases (meaning patients which have not been seen by any other healthcare professionals before this). Their duty, among other things, is to ensure that no "warning signs" are missed. As an example, for every 100 patients who come in with the common cold, perhaps 95 of them do indeed have the common cold which will resolve by itself, while another 5 may have more serious underlying medical conditions that require further investigating. By looking for warning signs, the physician avoids misdiagnosing these five patients with a simple common cold.

4) Throughout the rotation, I found all the doctors (in both private and public settings) to be phenomenally nice and helpful. Each of them had their unique style of teaching, for example, by asking us to examine patients in the waiting room before presenting it to them, or by testing our book knowledge about common medical conditions encountered in this department. Generally, we would see a lot of patients with a history of diabetes, hypertension (high blood pressure), and dyslipidemia (high cholesterol). Others would present with more acute conditions, such as diarrhoea, rash, joint pains, or headaches. Regardless, we saw our fair share of cases during our time here.

5) Having finished our exam today, we have two days of "free time" before our next rotation (emergency medicine) starts on Monday. For both emergency medicine and radiology, our clinical attachment will be at Seberang Jaya Hospital (not the usual Penang General Hospital). I look forward to a fruitful and enriching experience in the coming rotations. And on that positive note, I'll end my blog post here. Thanks so much for visiting as always, and have a nice day. Take care and stay safe, cheers! 

Look who I bumped into post-exam @ Gurney Plaza - Melvin and Melissa! :D

Lunch with friends on the day we had practical skills session at the Clinical Skills Unit

(l-r: Afifah, Jia Min, Jinny, Myself)

Practising those suture skills XD

Initially I took these pictures for study purposes, 

but now I see they can also be used as blog material XD

(this is the medication given to patients presenting with sudden breathlessness due to an asthma attack)

That's how you measure the amount of medication needed

That's normal saline solution (basically it's 0.9% sodium chloride)

That's how you measure out the required volume of normal saline

This is the nebuliser machine

(it converts the liquid medication from just now into a fine mist for easy inhalation into the lungs via the face mask below)

That's a nebuliser face mask 

(the patient with an asthma attack may need to breathe through this 

to relieve their symptoms of breathless)

Got my haircut two days before our exam :)

DAY 1637-1651

Feb 25 - Mar 11

Night has arrived, 

Another day survived,

The medical student returns late.

Dinner has gone to waste,

For they only long to taste, 

That warm embrace of their own bed.

In stress they thrive,

In sickness they strive,

For attendance equates to proficiency,

From dawn to dusk, 

They put on a mask,

To shield others from their own deficiency.

Exams are a priority, 

So say the majority,

The mindset of a student is resolute,

Like modulus in mathematics,

Or temperature in thermodynamics,

Their conviction is thus absolute.

From students to doctors in a flash,

From scratching their heads, to treating the rash,

Repeating to themselves that old lie,

That this will all be worth it before they die.

Years of stress have taken their toll,

The once bubbly figures have lost their soul,

The cost of their dreams was their own health,

Have they never learnt that health is wealth?

Pre exam week lunch with my friends @ Baby Sumo Restaurant

(l-r: Rachel, Myself, Sharifah, Afifah)

Dinner with my cousin Eo @ Arashi, Gurney Plaza

Thanks so much for the wonderful meal!!

DAY 1623-1636

Feb 11-24

1) These past few weeks have been rather uneventful, as might be expected given the current pandemic climate. Seeing as there is not much going on in my day-to-day life right now, I thought I might write on a topic that is clearly on everyone's minds right now i.e. vaccination. Specifically, I want to briefly discuss the reasons behind vaccine hesitancy, and how one's decision not to vaccinate may affect the wider population. 

2) Vaccines train your immune system to create antibodies, which are useful in fighting off infections (i.e. bacterial or viral). They consist of either killed or weakened (attenuated) forms of germs, so they do not cause the disease or put you at risk of its complications. As the saying goes, prevention is better than cure. However, not everyone wishes to vaccinate their child, hence the recently-coined term "vaccine hesitancy". As future healthcare practitioners, it is important to understand some of the driving factors behind vaccine hesitancy or outright refusal, so that we may be better prepared to educate the patient and their families.

3) One of the main reasons for vaccine refusal is due to alleged safety concerns. It is no surprise that in the age of the internet, information regarding vaccines is readily available at the click of a keyboard. Moreover, when we consider that the mass media (TV, radio, news), as well as hearsay from family and friends, could also deliver information about vaccines, it is easy to see how the public could be bombarded with information - making it difficult to make a well-informed decision regarding vaccines. One of the main challenges in promoting a healthy discussion on vaccines is the effect of mass media sensationalism. News outlets are much more likely to report and sensationalise a rare, unforeseen side effect of a vaccine, than they are to report the countless other patients who are protected from the disease as a result of that same vaccination. 

4) Let's consider the infamous example of scientific fraud - the supposed association between vaccines and autism in childhood. One faithful day in Feb 1996, now-disgraced ex-doctor Andrew Wakefield was hired to write a journal article on "vaccine damage" in young children (google "Lancet MMR autism fraud" to learn more). His study used just 12 (!) children to "prove" that the MMR vaccine caused them to develop autism. Not surprisingly, he lost his license to practice as a doctor in the UK. Sadly, the damage had already been done. Widely considered "the most damaging medical hoax of the 20th century, it led to a sharp drop in vaccination rates in the UK and Ireland. Following the initial claims made in 1998 (when the results were published), multiple large epidemiological studies were undertaken. Reviews of the evidence by the Centres for Disease Control and Prevention (CDC), US National Academy of Sciences, the UK National Health Service, and the Cochrane Library, all found no link between the MMR vaccine and autism. Physicians, medical journals, and editors have described his actions as fraudulent and tied them to epidemics and deaths worldwide. 

5) So why was his fraudulent research so impactful? Two reasons - firstly, because people generally prefer a good conspiracy theory. There is real science behind why conspiracies are so widely believed - namely i) the desire for understanding and certainty; ii) the desire for control and security; and iii) the desire to maintain a positive self-image. A thorough discussion on this can be found via this link (https://www.psychologytoday.com/intl/blog/talking-apes/201801/why-do-people-believe-in-conspiracy-theories) Secondly, because we are pattern-seeking mammals - we look for patterns and associations where there are none. A popular saying in the field of biostatistics is "correlation is not equal to causation". Just because two things happen at the same time, does not mean that one causes the other to happen. For example, if research were to show that during the summer months, there was an increase in ice-cream consumption, and during this same period, the number of people struck by lightning increases - can we reasonably say that eating ice-cream is a cause of getting struck by lightning? Similarly, if you did a study on children who have autism and you found that they did indeed get vaccinated as a child, can we reasonably say that the vaccines must have caused them to develop autism?

6) As with all medications and surgical procedures, there is a possibility of unwanted complications. For instance, when you take Panadol (paracetamol) for that chronic headache, there is an increased risk you might develop kidney and liver problems, and at higher doses, it may precipitate massive stomach bleeding and severe, life threatening skin reactions, including Steven-Johnson Syndrome, or toxic epidermal necrolysis. Yet we are quite happy to continue taking Panadol, and other over-the-counter medications on a regular basis. So what gives? The answer is simple - we weigh the risk-to-benefit ratio of these medications. The above complications I mentioned are incredibly rare, and usually occur in really high doses. So let's now compare the risk-to-benefit ratio of vaccinations.

7) Vaccines are no different to other medications - they come with their own side effects. Most of these are self-limiting, meaning they resolve by themselves without any further treatment. These include local symptoms, such as swelling, redness, and pain at the site of the injection, as well as general symptoms such as a headache, fatigue, and a mild fever. Quite a lot of people get worried when they see their child being feverish and less active after getting a vaccine. This is understandable, but at the same time, we must remember that having a temperature is a sign that the body is improving its immune defenses! At slightly higher body temperatures, our cells and enzymes are able to work more efficiently, producing more antibodies and at a higher rate, to fight off infection. Now let's consider anaphylaxis, which is a severe, life-threatening allergic reaction that rarely occurs after vaccination. In the US, a grand total of 10 cases of anaphylaxis were reported after over 4,000,000 doses of Moderna COVID-19 vaccines were administered (https://www.cdc.gov/mmwr/volumes/70/wr/mm7004e1.htm). No deaths were reported. This means that your chances of getting an anaphylactic shock after vaccination are quite literally a million to one (to be exact, it is 2.5 per million population, but I'm not about to argue semantics here). Now before someone says even a million to one odds is still too high when it comes to human lives, let's consider the alternative - not vaccinating. Based on the same report, there have been a total of 24,135,690 cases and 400,306 deaths due to COVID-19 in the US. When you compare 400,000 deaths due to COVID-19, against the 0 deaths attributable to the vaccine, then perhaps vaccines may not sound as bad as some people make them out to be...

8) One of the main reasons to vaccinate your child is to provide herd immunity. You may have heard of this before, but basically it's the idea that when a sufficient percentage of a population is vaccinated against an infectious disease, the whole population (including those who are not vaccinated, for various reasons) will be protected against the disease. So why should we care about providing immunity to others who would not vaccinate? To put it simply, there are a group of individuals who simply cannot receive a vaccination as their immune system is too weak (we call them immunocompromised). For example, individuals who have cancer, full-blown AIDS, or are on radiotherapy, chemotherapy, or are transplant recipients. These patients are sadly more susceptible to infectious diseases and yet are ineligible to receive the very vaccines that will provide them protection against these diseases. Instead, they rely on you and me to vaccinate ourselves, so that we may collectively achieve herd immunity, thereby indirectly protecting them from the disease.

9) Some parents may also wonder why vaccines do not completely prevent the infection - i.e. you can be vaccinated against tuberculosis (via the BCG vaccine) and still develop pulmonary tuberculosis in later life. So what's the point of vaccines then? Well, I like to use the analogy of a seatbelt. A seatbelt on its own does not prevent an accident from happening, but in the unfortunate event of an accident, the seatbelt could well save your life, by preventing you from getting hurled out of the vehicle. Similarly, vaccines may not be 100% effective in preventing a dangerous illness from occurring, but it i) significantly reduces the likelihood of it happening, and ii) in the unfortunate event that you do contract the disease, it reduces the severity and duration of the illness. Having said that, vaccines in general are highly effective. For instance, after receiving the second dose of the MMR vaccine (which protects against measles, mumps, and rubella), 99.7% of vaccinated individuals are immune to measles. Similarly, the varicella (chickenpox) vaccine is between 85-90% effective in preventing all varicella infections, but 99.9% effective in preventing moderate to severe chicken pox. 

10) "So what if I do not vaccinate my child? It is a risk I am willing to take." Well, let's consider some of the aforementioned diseases. In the neonatal (newborn) ward, one of the saddest cases to come across is a baby born with congenital rubella. Typically, these babies are born blind in both eyes (due to bilateral cataract) and deaf (bilateral sensorineural deafness) in both ears. They have a 50% risk of heart abnormalities, including a "hole in the heart" (patent ductus arteriosus), and are prone to infections of the layers surrounding the brain (meningoencephalitis). When you consider that this disease is completely preventable (by ensuring that everyone including the mother is vaccinated with the MMR vaccine), perhaps it's easier to understand the pain that healthcare workers go through when they see yet another implication of vaccine refusal. 

11) Also, let's try to remember that it was barely fifty years ago when patients with polio, most already paralysed due to the disease, were strapped for the rest of their lives to huge industry-sized horizontal cylinders called "iron lungs" (just google it), with their entire body up to their neck encased in this metal contraption with only their head sticking out - just to be able to breathe. Since being eradicated (in the US at least) due to the success of a nationwide vaccination programme, polio has since made a resurgence in other countries, including Malaysia, the Philippines, and most of sub-Saharan Africa. Similarly, measles, once considered eradicated in the year 2000 due to mass vaccination, has seen a resurgence in the United States, with over 1,200 cases confirmed by the CDC in the year 2019. 

12) So what can we do to educate the public regarding vaccines and their use? First and foremost, as healthcare practitioners, do not brush off the parents' concerns. Acknowledge and empathise with them. Try to understand how they must feel, overburdened with information and a sense of guilt and uncertainty in deciding what is best for their child. Secondly, do not demonise or condemn those who refuse to vaccinate their children. Instead, point them to reputable and verifiable sources of information, such as the Centre for Disease Control and Prevention (CDC), World Health Organisation (WHO), and your country's own Ministry of Health. Thirdly, as a parent, talk to your healthcare provider. They will have firsthand experience in counselling parents regarding vaccinations, so they should be able to answer most of your questions. 

13) Given the current situation, we are in desperate need for mass vaccination against the COVID-19 virus, so that we may return to a semblance of normalcy once everyone develops immunity. Let's all do our part to ensure that we remain protected, and by extension, that we protect our loved ones, and those around us, from this pandemic. I would like to leave you a quote by Jeffrey Kluger, editor-at-large for TIME magazine, " Vaccination saves lives. Fear endangers them. It's a simple message parents need to keep hearing". And with that, I end today's blogpost. Thank you for visiting, take care, and stay safe. Cheers! 

DAY 1607-1622

 Jan 26 - Feb 10

1) It has been a good while now since my last post. Usually, I would have quite a lot of interesting material to share on my blog after such a long period of time. However, due to the fact that we are all in lockdown, and clinical sessions have not yet resumed, there is nothing really exciting going on in my life right now.  Meanwhile, we have received news that clinical teaching will resume on the 22nd, which gives us some time to relax revise.

2) I have been spending the past week revising data from my previous dissertation. It has been a long week for me, having to sift through and conduct further analyses on what seemed to be lines of never-ending data. Thankfully, I have managed to complete the bulk of the analyses, and I shall now wait to discuss the next steps with my supervisor. 

3) At the start of the new year, a lot of us would been led to believe that we would witness a sense of normalcy from the current COVID-19 pandemic. That has very clearly not been the case. While numbers have been dropping in most countries, it is clear that mass vaccination will take a while to implement, and even longer to build up immunity in the general population i.e. herd immunity. This could take anywhere from months to a year. Therefore, it is important to maintain social distancing, practice good hygiene, wear a mask, and obey local public health guidelines. 

4) Having said that, the situation in local shopping complexes and other small businesses is really quite depressing. Just the other day, I walked to Gurney Plaza to get some groceries and stock up for Chinese New Year. Around 80% of non-food outlets were closed, and of the food outlets, no dine-in was permitted, with takeaway being the only option. For added measure, all the chairs and tables in these outlets had been tied up to prevent any dine-in customers. In general, the whole complex looked empty, safe for the  Grab/Food Panda delivery drivers who were queuing to pick up items for home deliveries. 

5) It is quite clear now that I would not be returning home for CNY. There is just too much uncertainty with when I might come back for clinics. At the very least, I will be fully occupied with things to do throughout this continued lockdown - mostly revision if I'm honest haha. That's about it for this edition of my blog. Hopefully there will be more exciting posts in the weeks to come. Have a great week ahead, and stay safe and healthy. Cheers!

Beautiful Chinese New Year decorations @ Gurney Plaza :)

Too bad there were so few visitors to admire the lovely decorations...