best patient

The best kind of relationships begin unexpectedly. When you get that astonished feeling and everything happens so suddenly. That’s why you don’t look for love. It comes to you just at the right time. The time you never thought it would have.
MBTI Playlist Series - INFP

Playlists hand-crafted by yours truly based based on the 16 mbti types!

Vol. 1 - INFP

(listen here on spotify)

Rocket Man - Elton John

Prey - The Neighbourhood

Snow - The Red Hot Chili Peppers

When The Day Met The Night - Panic! At The Disco

Lovely - Twenty Øne Piløts

Always - Panic! At The Disco

Despair In The Departure Lounge - Arctic Monkeys

Daft Pretty Boys - Bad Suns

Mad As Rabbits - Panic! At the Disco

The Run and Go - Twenty Øne Piløts

Mad Hatter - Melanie Martinez 

Sing - My Chemical Romance

Life Lesson - Dodie Clark

Paris - The 1975

Light the Sky - Grace Vanderwaal

The Ballad of Me and My Brain - The 1975

No. 1 Party Anthem - Arctic Monkeys

Wild Things - Alessia Cara

I Wanna Be Yours - Arctic Monkeys

Tiny Dancer - Elton John

My Propeller - Arctic Monkeys

Underdog - Imagine Dragons

Blue - Troye Sivan

Announcement! New holiday schedule!

There will be no pages this weekend, since I am still concentrating in my studies and social life!

However… I will have an almost two-week holiday starting this April 13th! And it’ll last until this April 24th!


During those days, I will upload one page each day, and twice as much on weekends! That’s 16 pages! How does that sound~? After that, we’ll return to the regular schedule. Thanks for bearing with me!

Comfort Prompts

“I’m here, I’m not gonna leave you.”

“Don’t say that you love me more than I love you. Trust me, you are the glorious sun to me, my everything and I love you with all my heart.”

“Repeat after me; I am worthy, I am worthy, I am worthy…and believe it, ‘cause you are.”

“Darling, perfect is just a word. Perfection is impossible and chasing after it will lead you nowhere. Just do your best and accept that the result is good.”

“When the most broken put themselves back together, they become the most beautiful angels. It’s okay if it’s sloppy or if a crack is still left open, you’re even more ethereal to me.”

“The longest and most difficult roads in life end in the best places. Be patient and keep going.”

“So what if the world is complex and overwhelming? So what if you can’t do it all, can’t be the best? Stop focusing on your image and focus on yourself. You have these years on this earth, enjoy them, don’t overthink it. “

“I’m love with your mind, soul and body.”

“The best thing you can do in life is to love yourself and let your passion help others to love themselves too.”

“I know you may feel alone right now but just remember how big the world is. How many souls will love you for who you are. They’re out there, don’t worry. Just get through, explore and you’ll find them. Just don’t forget to find yourself.”

“Can I kiss where it hurts?”

“Hey, it’s going to be fine. We’ll get through this together, hand in hand, okay?”

“It’s all about the little things. Your favorite tea, good stories, sparkly eyes, beautiful skies, the thrill of adventure, passion, the feeling of home. Enjoy them.”

“You’re not broken. Your mind is just built differently, get to know it, have a little chat with yourself. The most complicated minds tend to be the most beautiful ones, just don’t let it use you, learn to cooperate with it.”

“Hey, beautiful, you okay?”

“You’re amazing, did you know that?”

“I think I’m going blind from your beauty.”

“Everyone’s different. Everyone’s beautiful. You’re the most beautiful human I’ve met, and I’ve met myself!”

“Breathe, darling, breathe.”

“I’m sorry, I didn’t know that triggered you, I’ll never do it again.”

“Here, I’m going to make you some tea and we’ll watch a movie, that sound good?”

“ Magic is real. It’s not spells and cauldrons, no… it’s more subtle. Like, when the air seems electrified, when eyes speak more than words, when you sense something none of your normal senses detect. If you stop for a moment and look beyond, you’ll find it.“

“I know you don’t want to, but in the end, it’ll pay off. Just breathe, keep your head up and you’ll be fine.”

The Sun

Glyph ( ☉ )

Ruler of Leo
Exalted in Aries
Detriment in Aquarius
Fall in Libra

Time Spent in a Sign: A month (about 30 days)

Mythology behind the Sun
There are countless of versions of how the Sun came to be in astrology, but most commonly known and told is that of the Greeks. Helios, seen as the Sun God, would ride on a golden chariot across the sunset making his way home everyday. He is often associated with Apollo. Apollo is not only God of Music, but also God of Sun and Light (and many more).

The Sun in Astrology
The only way we identify ourselves, normally, is through our Star sign aka our Sun sign. It’s who we are when we are first getting to know someone since it’s our most basic personality. It’s purely our sense of self. On a deeper level, some argue that the Sun sign is your life purpose. This makes sense since our Sun sign is who we are at our very best. But in order to become our “very best”, we must accept ourselves for who we are and work with that. Trying to be someone you are not only confuses your life’s purpose and you are not staying true to yourself. You are not showing your Sun sign at its best, but only a reflection of what you want it to be.

Sun in Aries
The Sun is exalted in Aries. At their best, Arians are self-aware and they strongly project their own personalities. At their worst, they can be selfish and aggressive.

Sun in Taurus
At their best, Taurus’ are reliable, patient and firmly hold their ground no matter what. At their worst, they can be materialistic, lazy and quick to anger.

Sun in Gemini
At their best, Gemini’s are intelligent, social and capable of handling multiple tasks at once. At their worst, they can be liars and massive manipulators.

Sun in Cancer
At their best, Cancer’s are protective, nurturing and self-aware (especially of their emotions). At their worst, they can be prone to terrible mood swings and being somewhat of a guilt-tripper.

Sun in Leo
The Sun is domicile in Leo. At their best, Leo’s are confident, proud and they teach others how to be as self-aware as they are. At their worst, they can be bullies, dominating and overly dramatic.

Sun in Virgo
At their best, Virgo’s are intelligent, resourceful and willing to lend a helping hand. At their worst, they can be overly critical, highly judgmental and insecure yet believing they are the “perfect human”.

Sun in Libra
The Sun is in fall in Libra. At their best, Libra’s are considerate, fair and have a strong sense of justice. At their worst, they can be critical and may not have a voice or be stepped on constantly by others.  

Sun in Scorpio
At their best, Scorpio’s are observant, intuitive and capable of exploring human depth. At their worst, they can be manipulative, obsessive and might have a stalker tendency.

Sun in Sagittarius
At their best, Sagittarius’ are optimistic, philosophical and able to overcome many obstacles. At their worst, they can be arrogant, insensitive and exaggerating their personality traits as superior to others.

Sun in Capricorn
At their best, Capricorn’s are driven, prideful and always striving for better. At their worst, they can be inconsiderate of others, bossy and demanding.

Sun in Aquarius
The Sun is in detriment in Aquarius. At their best, Aquarians are humanitarians, innovative and genius. At their worst, they can be aloof and careless towards others including their loved ones.

Sun in Pisces
At their best, Pisces’ are selfless, creative and adaptable. At their worst, they can be psychologically manipulative and may not be self-aware at all, taking on the personality and opinions of others.

Personal hygiene is important.

Patient: DOC I’VE BEEN WAITING HOURS MY TOENAIL IS BLACK.
Emergency Registrar: Sorry, we’ve been a little swamped tonight. Tell me about your toe.
Patient: IT’S BLACK.
Registrar: okay, let’s look at it.

Patient puts his foot up on the bed. There’s black fluff on his toenail.

Registrar: … did you have a bandaid on the toe recently?
Patient: YES
Registrar: and do you wear black socks?
Patient: …how did you know?

Registrar calmly removes an alcowipe, and cleans the patient’s toenail. It is no longer black.

Patient: …I waited two hours for that?
Registrar: yep.
Patient: … … can we tell my wife it was really serious?
Registrar: I’ll tell her you were really brave.

GUYS PLEASE

I’ve just got the 10th message this month asking me how to watch Book of the Atlantic online :/

You can’t watch it online because BotA is a movie and it’s still running in cinemas in Japan.

The release date for the DVD/BDs hasn’t been announced yet, so I don’t know when you’ll be able to watch it.

Please ask Funimation or Crunchyroll or whoever is in charge of the official Kuroshitsuji anime in the US when they’ll release the English dub/sub version.

How To Be A Good Med Student In The Clinical Years

A doctor once told me that the best instrument we have is medicine is the retrospectoscope.  Basically he was saying that often it is easier to make sense of things when looking back from the vantage point of the future.  This is true of life too.  After being an intern for two months I suddenly understand what things make for a strong med students, and what things do not.  Unfortunately, I feel like I lacked many of the qualities that would have made me a helpful med student.  Though I cannot rectify my own mistakes, perhaps I can pass my advice on to future generations of third and fourth year medical students.  I now present, how to be a good clinical med student:

  1. Show up.  This seems obvious.  When you are there to work, then be there to work.  It is so frustrating when medical students are mysteriously absent all the time (only to be found later in the cafe or cafeteria) or when they are there but totally disinterested in what is going on.  I understand that sometimes as a medical student things get slow - like when the interns are putting in orders and notes or when there is a slow call day.  But at least bring something to read.  Don’t play Pokemon Go.  Don’t spend all day on Uworld.  Make an effort to learn real clinical medicine.
  2. Take initiative to learn.  When I was a third year I would wander the hospital to find learning opportunities.  I made friends with the telemetry nurses and they started a folder of good tele strips to give me each day.  I would go to other teams and see if their patients had good exam findings.  I found the cardiology fellows and asked if they had good patients with murmurs.  There is so much learning that can happen if you are willing to experience it.  Now, referring back to number 1, make sure you always let your residents know where you are.  Personally, I would be ecstatic if my students went to hunt down murmurs rather than playing Pokemon Go. 
  3. Read your patient’s chart.  This can be very helpful and will make you look like a star.  Residents are busy taking admissions and sometimes don’t have the time to hunt down records that are three and four years old.  You can stand out by doing that  Look at a patient’s past hospital notes or their specialty clinic notes.  For example, you might be able to alert the resident that an old echocardiogram demonstrated a below normal ejection fraction, which in turn might change how much fluid the patient is given.  Or perhaps you found that during a hospitalization in the past the patient became delirious and needed a one-to-one sitter.  Find ways to add information in a helpful, non-prescriptive, non-judgmental way.  I guarantee your reviews will benefit.
  4. Read about your patient’s condition.  Even if you just browse Medscape, UpToDate, or some other curated source, make sure you understand the basics of your patient’s primary diagnosis.  If they are there for heart failure, read over the basics of treatment.  If they have autoimmune hepatitis look up some info on diagnosis and prognosis.  These things will get noticed, especially when you ask intelligent questions on rounds.  Do not be like a med student I had who, when asked, reported for 4 straight days that he had not read about his patient’s disease.  He instead responded he was too busy with Uworld so he would get a good shelf score.
  5. See your patients.  I literally had students who, on rounds, tried to present without actually having seen the patient in the morning.  This is a huge no-no.  Get to work early enough to see your patients, review their labs, and their overnight events.  
  6. Practice your presentations.  Even if it is on your own or with other medical students, spend time working on your presentation skills.  Heck, even ask the residents to watch you.  I would be happy to do that for any of my students.  Unfortunately, none have taken me up on that offer and instead bumble through their presentation each day making the same mistakes.  By the end of medical school you need to be able to make a good presentation. 
  7. Spend time working on note writing.  Compare your notes to your residents’, your attendings’, and the specialists’.  Everyone has a different style.  Look at lots of notes to determine a style for yourself.  
  8. Forget all the step 1 stuff you learned.  I find many students perseverate on the terrible stereotypes and patterns they see on step 1.  Not all black people with cough have sarcoidosis.  Not every patient with acute kidney injury needs urine eosinophils.  These are good associations, but realize that step 1 has little overlap with real clinical medicine.  Take those associations with a grain of salt. 
  9. Don’t just look for zebras.  I cannot tell you how many times students opt not to follow a patient because the case “doesn’t seem that interesting.”  The majority of medicine is made up of mundane and common diseases such as heart failure, pneumonia, COPD, cirrhosis, etc.  It is pretty rare to get the exciting cases, like disseminated histoplasmosis or a crazy paraneoplastic syndrome.  A lot of learning can happen on cases that are “bread and butter” medicine.  Make sure you follow those cases too. 
  10. Be gentle to your interns/residents.  The transition from 4th year to being a doctor is swift and brutal.  It is easy to criticize when you aren’t the one taking 5 admits.  Find ways to help your intern/resident, because in return they will help you.  I learned this lesson the hard way my 4th year, when I unintentionally threw an intern under the bus while trying to look smart.  Afterwards she took me aside and reminded me that she controlled much of my fate while I was a student under her.  I learned my lesson and we went on to become very good friends.

The clinical years of medical school are daunting.  You constantly feel like a tap dancing monkey, trying to impress people you barely have time to get to know.  But personally, I am not looking for someone who knows everything about everything.  That’s why you are in school.  The best thing you can get out of third and fourth year is how to do a good history and physical, how to write good notes, and how to triage patients.  The best students are interested, willing to learn, and know their patients well.  If you keep that in mind, the clinical years are much simpler.  I promise, if you follow your patients you will learn much more than just doing qbank questions.   

Best of luck on your clinical rotations.  Don’t make things too complicated.  At the end of the day have fun, treat your patients right, and keep an open mind.  The learning will happen whether you recognize it or not.