A Guide to Taiwan for Foreigners V

Excess of tourists!

I felt like a tourist in my own birthing country. Apart from the familiarity of relatives, Grandparents, and their house that I grew up in, most of everything else has changed. Going to shops and restaurants, people could tell that I am a 'foreigner'. I've never felt more like a Banana (perhaps I am more of one than I realised). The most striking observation while frolicking around tourist attractions was the prolific numbers of Chinese tourists. They came in busloads and busloads, traveled in groups, led by guides who would hold up their little flags high to direct the swarms of obnoxiously loud, camera donning (most complete with tripods) tourists. Like a plague of locusts: upon emerging from the buses, they would sweep hurriedly through the place (even in the museums or exhibitions), into the souvenir shops on the way out, devour the shelves clean of anything expensive (they are unimaginably loaded with cash), and back on the bus to the next stop. They stood out with their accent, their fashion, and behaviour; you can pick one straight away. On the other hand, the financial stimuli has allowed many of the tourist attractions to update and upgrade their hardware. I was much impressed by the organisation, presentation and even the marketing of these renovated tourist spots.

National Palace Museum

This is definitely the highlight of the trip. The museum reinstated the significance of Taiwan in the geopolitical importance of the area, but more so the status of Republic of China in the history of Chinese civilisation. When the exodus government retreated, one of the priority was to ship the contents of the Forbidden City to the new capital, so as not to fall into Communist hands. Which is fortunate, because much of this will not have survived the Cultural revolution.

The museum contains over 680,000 Chinese artifacts and art works, the collection encompasses over 8,000 years of Chinese history accumulated over the dynasties. It is simply put, The Chinese Civilisation. The collection was inherited by the succeeding emperors and dynasties, whoever ruled, was the owner of the treasure. From Wiki: “Today the museum is said to house some 93,000 items of Chinese calligraphy, porcelain, bronzes, landscape paintings, portraits, figurines, ancient manuscripts, books, carvings, coins, textiles, jades and precious stones. With a collection of this size, only 1% of the collection is exhibited at any given time." To see the complete exhibit would take a person 60 full years!

The most impressive artifact to me was an ivory ball of about 15-20cm in diameter, sculpted all from one piece of tusk. The surface of the ball is carved to minute details of dragons playing in the clouds, but when you take a closer look, there's a smaller ball inside, and a smaller layer, and another..., there are 15 layers of balls right down to the core of the tusk, each individually free from one another. It must have taken the sculptor decades to complete.

This tiny little boat (1.6x1.4x3.4cm) is sculpted from one single olive shell. The windows and doors on-board can be opened and closed. There are 8 people on-board, 3 poets and their respective servants, two boat-handlers. There's a little table in the centre showing a small banquet underway, with plates and cups. the bottom of the boat has a poem sculpted on it, all 300+ characters. It's eye-opening.

My visit brought back the heritage that I haven't thought much of for years. I had been an avid reader as a kid, the sense of pride in Chinese civilisation had rooted in me deeply early on. It always appeared to me though that the Old ways (the Confucian ways of Moderation) had died long ago, much like the grieve over the death of Chivalry in the West. However, seeing the history and the culture in its physical form, it's revived the pride and reminded me of the traditions that had evolved from the thousands of years of Chinese civilisation, that I am and always will be a descendant of the Dragon.

---Index---

We don't really consider ourselves 'travelling' unless it's to a destination different from the usual definition of home. That's why many experienced travelers often never visited another city in their own country. Many of the Mainland Chinese went to Taiwan to see the product of divergences: the democracy, the cultural differences, and the places they've heard so much of from the years of propaganda. To gain a travel visa, they are required to deposit $10k Yuan (Chinese Dollar) as security to the government, which is equivalent to over 50% of an average annual wage for an urban Chinese (or two years worth of income for an average rural Chinese wage). However, their itinerary was often filled with horrible 3-star hotels and expensive crappy food. Many resented with the saying: Never seeing Taiwan is a regret; but once there, you regret ever making the trip. If Taiwan is just another province, would they have gone through the same trouble?

The issue of Taiwanese sovereignty stems from the composition of its population, and the history of its inhabitants. I feel that a short breakdown of this confusing history is necessary, and according to my understanding this is how it goes. The first record of Taiwan in Chinese history dates around 800AD during the Three Kingdom Period. It was a hotbed for pirates and rebels, and throughout Chinese history there were mentions of military actions to suppress the piracy in each dynasty (funny I have always hated growing up among the descendants of criminals and pirates, now I'm living among them again (...I jest...)). Even with several attempts of rebellion in Ming and Qing Dynasty, Taiwan was so far away from the power central of Imperial China that its geopolitical importance only became a reality in the recent centuries. The indigenous population arrived in Taiwan thousands of years before the first Han Chinese arrived and the Hans were mostly migrated from South Eastern Chinese coastal provinces. These people would go on to identify themselves as the first settlers of the island, and regarded the later-comers as foreigners.

The Republic of China was founded a democracy on the grave of Imperialistic China in 1911, while still a fledgling, it was thrown into the fires of war with Japanese invasion (Second Sino-Japanese War from 1936-45). In the midst the war, the communist party ambushed the young democracy and started a civil war which would end with the Nationalist government retreating to Taiwan. The exile left the Mainland for the Communist party to consolidate its powers, who eventually established the Chinese Government today; whilst the Nationalist government regrouped in Taiwan, it would never regain control over the Mainland again, resulting in the stand-off today. These exodus of ex-military and government officials stayed and settled, but would be regarded as foreigners. Due to elections in recent years, politicians inflammed the division between the two groups, fueling the country into renewed heights of disgust towards each other, all for political gains. Much like the Bush administration dividing US into the Blue and Red states in his second election. I am a descendant of the exodus, born to the land and never felt like a foreigner, until recently that is.

A Guide to Taiwan for Foreigners IV

Excess of Temples

The small island is filled with temples. The primary religion is a mix of Buddism and Taoism, but most other religions have found themselves here. These places of worship aren’t just humble, old broken buildings where one goes to pry and clear thir minds. Some temples are so rich; they are gargantuan in size, immensely detailed features decorate the architecture and many of them centuries old.

Chung Tai Monastery, you could see it from kilometres away as you approach it in the small country winding roads. Only built in 2001, the scale is breath taking; it was the tallest Buddist temple in the world for a couple of years. The monastery is one of the most important one on the island, not only in religious sense, but political as well. The campus includes various Halls and quarters, monks, accommodation for the pilgrims, restaurant, and its own museum! The museum has a huge collection of thousands of statues of deities in stone, wood or copper sculptures, some of which dates to hundreds of years BC. It’s even got its own website

One of the four guardians in the main hall, it’s about 5 stores tall. The Budda is of course, more impressive still.

This is one of the oldest temples in Taiwan. It’s been there for at least 300 years when the first settlers founded the port-side city. One of my uncles grew up around the town and gave me a nice tour of it. The rich details of the architecture showcase the arts of Chinese sculpture and masonry. It is treasured and protected as a heritage site now.

A Guide to Taiwan for Foreigners III

Excess of Work

This is a land of miracle based on magnificent feats of hard working. Its economy became a powerhouse in Southeast Asia in the 1990’s, the abundance of ‘Made In Taiwan’ goods gradually put the small island on the map. But the economic boom of the 80’s and 90’s did not come by chance, with no natural resources, the people worked with good old-fashioned hard work and long hours. As a kid, I seldom see my dad at home. He would have left for work before I get up in the morning, and arrive home after I’ve long lost in dreams. A 12 hour working day is a norm here. While I was there, my aunt who is a sales/market manager at a software firm, worked 14 hours almost everyday, 6 days a week, not including the constant ringing of her phone with clients on the other end of the line. When my 15 year-old cousin did her Highschool Entry exam (for High achiever classes), the amount of study materials piled up to two 160-cm high lots, each as tall as she was. My aunt has a pic of it. A typical child studying in secondary schools would leave by 7AM for school, and come home around 9PM after after-school tuition. For the medicine-aspired girl, she would have to obtain top grades in her bursary exam in all the 15 or so subjects comprised of both humanties and science topics. Not including all the other activities she’s meant to have on her CV, preferably with publications. Who the hell expect Highschool kids to have publications?

Excess of Services

Another excess was the services provided. In restaurants, there are waiter/waitresses that serve you as if they are your slaves. The cup would never go half-empty for longer than 5 minutes. They respond to your ever call within seconds. We went to a steak house famous for their services; from the door opening, to pulling chairs (even for men), you were treated like a prince. When my steak came, the waitress offered to cut mine up for me! The desert was served with the standard introduction as well as suggestions on how you would go about eating it. The exuberance is shown ultimately in the luxuries of department stores. The malls in Australia are grand in size, but in terms of variety, choices, brands, there is no match to a department store.

The concentration of brands, variety of goods, and the sheer scale of it makes you wonder how we manage to save on average much much more than Western countries. The shop assistances are almost aggressive in terms of service though. Soon as you step in the vicinity, the amount of attention paid to you, they might as well be your personal fashion advisor. Sorry, I am just a poor student taking a look, probably won't end up buying anything.

I don’t normally like shopping, but I do have a soft spot for bookshops. Large bookstores can be found to operate 24/7. The one I went to had several floors of display dedicated to stationary alone. There were gadgets you'd never even dreamed of needing but once you know that it exists, you can't go without. We've come a long way since the days of brushes and ink bottles. We went to one of the bookshop one night at 10PM and didn't get out until 2AM. I totally lost track of time. But that was a common occurrence, and never fear, cause supper was just around the corner, with freshly made soymilk (you have never tasted soymilk until you've had it from TW, the stuff here are just...disgraceful) and dumplings fresh off the frying pan. And the thing is, at 2AM, the place is packed.

Read on...

A Guide to Taiwan for Foreigners II

This is a land of excess and passing fads. The standard attitude is: you like this? Great, let me get you 10o’s of these until you’ve had so many that you absolutely loath it, then let’s move on the next hip thing. It’s like that new hit song on the radio played over and over, day in and day out. The people are very hospitable, often too hospitable that they forget there’s a limit to how much goodness one can take. This way of living is shown in every aspects of life: food and wine; work and play.

Excess of Food

The food is sensational not only from its taste but, it’s economical as well. Being an Asian country, a gourmet meal comes cheaper than a dodgy hamburger from McDonalds here. From Grandma's home-cooked banquet where my plate is constantly being refilled, to posh all-you-can-eat buffet that address quantity without sacrificing quality. The gastronomic pleasures never cease to be fulfilled here. When I said posh all-you-can-eat buffet, I mean 5-star hotel restaurant serving lobsters, oysters, and other expensive seafood. When did you last see gourmet chefs behind the counter making your dish to order in a buffet?

What do you do with your hands while roaming the Night-markets or commercial districts? You fill them with snacks to stuff your face with of course! The street food culture here is comparable to Hong Kong or Singapore. Vendors populate a whole district in some places, hundreds of stands as far as the eye can see. They are mostly easy to eat finger foods: grills, fried stuff, anything and everything braised in master stock, pastry, takoyaki, Chinese pancake, various dumplings, buns...etc. A huge fried chicken fillet of 30cm in diameter, much like a chicken parmie without the cheese, would cost about $2 AUS. I walked around with food in my hands while checking out other stands. Of note, smelly tofu is the equivalent of Blue Vein Cheese in terms of strong smell and taste. Fermented tofu that is fried till crispy on the outside, and soft and squishy on the inside; usually served with pickled vegetables. Whole streets permeate with smells that flirt with the nostril, the sound of frying and the clanging of woks, then the mouth-watering presentation of the colours, the variety of choices, and all obtainable quick and cheap with just one shout of order away. It's a hellish nightmare of a place for anyone on a diet.

Taiwanese cuisine has branched off the traditional Chinese route and taken on more Japanese and Western influence than any other Asian cuisine. Japanese restaurants are everywhere to be seen, as well as other Asian cuisine. One thing I can complain about is that due to the American influence, most coffee places serve filtered coffee. The sparse Italian Espresso cafes do not do it justice. Many Western cuisines takes on local twists though, and acquire a taste that fits the locals.

The novelty factor also plays a big part. One of the new fad while I was there was egg tarts that come still in the eggshells. They carefully crack the egg at the top, makes the filling, pour it back into the shells and finish with the tarts in the original eggshell. You eat it with a spoon. An example for the passing fad culture: couple of years back some celebrity combined egg tarts and Portuguese tarts into a new breed of Portuguese egg tart; it turned into a rave overnight. Specialty bakeries that make only these tarts opened one after another, hundreds of them took the whole island by storm. But when the trend dies down, the whole hundreds of shops close down within a couple months.

Then there's the pressure to innovate. We went to a winery that had everything ranging from sausage, ice blocks, cake, pastry, sweets, jelly, and crackers with the wine in it. Not all ideas work of course, but I did learn a lot about rice and barley based Chinese wine as oppose to grape-based Western wine. I don't know much about beer, but we had 'raw beer' over there that expires within a couple of weeks. It tastes lighter on the tongue, more refreshing and not as bitter than the average pint. There are even flavoured beers of various fruits.

Read on...

A Guide to Taiwan for Foreigners I

The past 6 weeks had been my holiday term at uni, the last long holiday I will have as a medical student. So while my colleagues slaved away in their respective rotations playing doctors, I went home for a month. Where is home? When I tell people that I am going home, I typically have to explain which one I meant by it. I went to NZ for a couple of days, then off to Taiwan for 2 weeks where my dad and most relatives are. The point of this post is actually, my observations of Taiwan. It may be strange for a person to 'observe' his own homeland. A land that I was born in, lived for 13 years, and left without much thought of the place. I did of course have many attachments, but as a child dealing with constant departures of loved ones, I quickly learned to deal with those emotions. Since then, home to me had been the century-old Victorian villa in Auckland until recent. This trip gave me a new perspective of Taiwan. Somehow being away for so long gave me a somewhat neutral disposition from which I observed, things I never really saw or thought about before.

Republic of China (Taiwan) circled in red. Short of putting glitter around it, it was hard for the world to pay attention to this tiny island half the size of Tasmania. Until about 19'70s and 80's most maps do not have the detail to include Taiwan. But then it became an economic powerhouse, goods and electronics 'Made In Taiwan' eventually put it on the map.

The confusion

To begin, we should address the elephant in the room, it's not part of China (...let me finish). In the sense that Taiwan has its own Government, Parliament (for entertainment really), Military, Constitution, Laws, naively funded Health Care System (with both Western and Traditional Chinese Medicine)...etc. Despite the same cultural lineage and similar ethnic background (Hans is the majority in the population, and indigenous minorities who share the same ancestry as Maoris and other Polynesians) as Mainland China, the last century of political turmoil, WWII, and civil war has driven the two sides substantially further away from each other than the narrow Taiwanese Straight ever could. Heavily influenced by the surrounding countries and Globalisation (especially Americanisation), the Island had transformed into a cultural chimera with an identity very different from the Mainland. The Taiwanese people today resemble so very little of Chinese people from the Mainland. In fact, the distinction is so great that Taiwan has become one of the most popular travelling destinations for Chinese (I will explain that point in later paragraph). On the one hand, the country wants to celebrate its achievements in politics, economics, and cultures independent of China; but on the other, it cannot separate itself from the ancestral ties which governs the Chinese values that fundamentally affects every Taiwanese. It's like a teenager, eager to declare his independence, but not quite ready to leave home. To better understand the issue of sovereignty I included a short history paragraph at the end, one could argue that ROC is the rightful ruler of China...but let’s avoid the politics for now.

This is a land of excess and passing fads. The standard attitude is: you like this? Great, let me get you 10o’s of these until you’ve had so many that you absolutely loath it, then let’s move on the next hip thing. It’s like that new hit song on the radio played over and over, day in and day out. The people are very hospitable, often too hospitable that they forget there’s a limit to how much goodness one can take. This way of living is shown in every aspects of life: food and wine; work and play.

Read on...

Sober Irish

I know, the racial slurs. I get them all the time and can't say I enjoy the malicious ones. But sometimes, harmless jokes get everybody laughing.

We met a old Irish gentleman in ward round this morning, who was fortunately well enough to chat socially. So while the cardio reg was trying his hardest to obtain a history, an Irish consultant budded in and started making small talk. It didn't get any better when our consultant turned up cause he started telling jokes. Anyway, part of the history taking is asking for alcohol consumption, and the patient said he doesn't drink anymore, he's allergic to alcohol. He had been drinking all his life, but developed an anaphylaxic reaction while drinking with his brother one night and all of a sudden he has an allergy to alcohol. "can't touch a glass of whiskey," he said. And this is funny cause, well, an Irish who's allergic to alcohol.

The consultant started telling jokes and another Reg came to find the team in a sea of laughter, this is the joke the consultant told:

An Englishman goes to his doctor and said he wanted to become an Irish. His doctor says "alright, but that means we will need to do some radical operations on you; we need to perform a lobotomy, cut out half of your brain." The Englishman really wanted to become an Irish, so he agreed with it. When he wakes up from the operation, the doctor was there looking worried. The doctor says to him, "I am sorry sir, but the operation had bit of a complication, and we took out much more than half of your brain." To which the patient replied "she'll be right, mate!"

My new consultant is a very approach person, it's a nice change, and it feels pleasantly strange. He's the type of person that smiles with his eyes and coupled with a really easy going attitude, which really reminds me of Robin Williams without the crazy babbling impersonating part. You know the type of people with a quirky and genuinely infectious smile, whose looks at you straight in the eye during those prolonged laughter to see that their tickles has also made you giggle?

Perfume de Mujer (scent of a woman)

Music affects our emotions, there is no doubt about it. My poor brain is so easily influenced by music that it can lead me off a cliff like a rat following Pied Piper of Hamelin. It's just as well that we link our memory to a piece of music, the synapses between the limbic system and prefrontal cortex is perhaps more powerful than the logic and reasoning of our frontal cortex.

Some expressive music are so inviting and strong, that my mind surrenders and allow itself to be led onto the dance floor for a tango; I love letting myself wallow in these melancholic tunes so much that a string of simply constructed notes like Chopin's Prelude in E minor (Op28, No4) can bring water to my eyes.

The title is a piece of old tango music written in 1935 by Carlos Gardel. He was perhaps the most prominent figure in Tango, although prior to this point, I had no idea who he was. According to Wiki, he died in an air crash at the height of his career, becoming an archetypal tragic hero mourned throughout Latin America.

Anyway, I heard this in a Itzhak Perlman's CD today, and immediately recognised the piece that was used in the opening scene of Schindler's list. I never knew the name of the piece, but it's made such an impression on me that I've never forgotten it. Now I finally put a name on it.

This is one of my favorite scene of all times, in my mind, this is just the persona that I have always wished to be.

We start with the camera following a waiter who makes his way round the place, setting the location in a fine diner club with a live band playing perfume de mujer in the background, drowned by the social chatter about the place. Then it freezes on Schindler (Liam Neeson) as he make his appearance. Well-groomed and dressed to the nine, with an air of elegance. This got the waiters talking, who is this man? The camera focuses back on Schindler as he scans the room with his sharp piercing gaze, studies his opportunities. A pretty woman looked his way, looked away acting disinterest, but stole a peek back at him. Schindler smiles as he knows he's won the game. As the first violin solo of perfume de Mujer comes on, the camera moves to two SS officers on the other end of the table. Camera flashes on the badges, there's the reason why he came tonight. But no, there's a reserve table, someone higher up, someone more important. The SS commander officer enters the restaurant with his escort and a beautiful girl. There, his real prize of the night. Schindler makes his move.

He's handsome, well presented, graceful and elegant. Later in the scene he reveals his charm and unstoppable charisma. All class. Sigh, I don't think any of this can be learned.

50th Post!!!

50th post! Wow, that's a milestone right?

Reading some of the stuff I wrote last year, it brings me right back to the day, the situation, right then and there. I guess that's why people write these things, partly to entertain themselves, others, and to record a part of life, a memory, and a moment that can be retrieved and relived.

Just looked at the stats, my most popular post by far is Surgical Fetish. I had notice its popularity for awhile now, but it doesn't make sense. The post is about a simple surgical procedure, surely there are many better written treatises out there than my half-assed attempt. Then it dawned on me that the reason why it is popular, particularly in US, is probably due to the word fetish on the title. Given that 90% of internet traffic is for pornography, one can put two and two together and make a incredibly saucy porn regarding some disgusting but not too weird fetish.

See what I did there? This post is gonna double the traffic to this blog, if not triple. Soon I can build my own Playboy mansion. It's not that I have no faith in humanity, I just don't think it's worthy of my faith. If only I get a dollar for everytime someone stumbles onto this site looking for porn.

An oldman's rant about Remix

Is it just me or does anyone else think that "Remix" songs are incredibly insulting?

I consider myself generally open minded, mostly accommodating to new ideas, I may not agree with everything anyone says, but I can mostly appreciate their point. My taste in music does not follow the mainstream, sure, but I can tolerate most crap that comes on the radio. I can enjoy Creed and Nickleback despite the fashionable notion that they are utterly worthless and uncool...they do have good songs.

But I can't stand remix. Now it may be that I am getting old and doesn't get what's hip about these techno headbanging beat. No, headbanging is cool, just listen to any Nirvana songs. What I am talking about is the monotonic repetition of a melody no longer than 2 bars long that is played over and over and over and over. What's worse is that the melody is usually ripped straight off some original songs. Most of these remix songs can pass off as an artistic creation because of a descent backbone melody, which goes to show that the original is fine, there's no need for 'remixing'.

What really bugs me is the simplicity. Listen to any remix and it's not hard to pick out that they are made of very few, simple note constructions are are pretty much, primitive. More scales rather than music. It would not take any effort to write it. All you need is find a backbone melody, turn on your metronome and set the beat, add a twist every 16 bars, then back to the metronome.

Why would people want to listen to it? It has no complexity, not inspiring, it doesn't wow you with technical difficulties nor offer your emotions and imaginations for a ride. It doesn't require any thought processing. Perhaps that's it, it doesn't require any brain nor heart to listen it. No efforts required. Such a degrading genre.

Oh man, I sound like an oldman.

There's nothing exciting about Mt. Gambier IV

Let's finish off with my day advanture to Wannon Fall in Victoria. So I checked out the sinkholes around the city one morning, and heard that there's a beautiful waterfall just outside of the city, having the beautiful sunny day ahead and fueled with caffeine, we set out to find the illustrious waterfall. Soon after leaving Mt. G, we crossed the Victorian border, which was rather exciting I thought. I was waiting for the signs pointing to the waterfall but it never appeared, and after about an hour drive, we came to Casterton, home of the Kelpies! There weren't much to see in town, but we stumble into a bakery which I later learned was run by the family of a scrub nurse back in MGH, small world. There was also an art gallery of this local artist, whose work based mainly on settlers theme, has a real talent on drawing horses. Anyway, we were given direction to the waterfall "just 30 minutes out of town, you will see the sign", and way we go.

Then we came to Coleraine, an even smaller town with nobody in it. We finally found a old man who told us the quickest way is not to take the highway, but through these convoluted, tortuous roads in the mountains. I was adventurous and so was my car. With a high sense of doubt and a full tank of petrol, we gambled with this little path. He turned out to be right!

The waterfall itself is only as impressive in the sense that it's a water feature that you don't see everyday in the back of your garden, so in other words not a whole worldly exciting. It is disappointing in terms of the scale, and you cant really get very close to it. Following the same river upstream we found Nigretta Fall, which is a much lusher reserve with a campsite, and you can get right up to the water where the fall is. I'd imagine a rather popular spot for camping in the summer, what with the swimming and fishing in the water, hiking and hunting in the woods, roasting marsh mellows and sacrificial rituals and whatever people do while camping.

To my surprise, I had a very exciting 6 weeks in Mt. Gambier where I had done many 'firsts'. It was as much a learning medical rotation as a holiday away, and I certainly felt the adventurous spirit. I guess life is like flour, plain and dull on it's own, but what you do with it makes all the difference in the end.

There's nothing exciting about Mt. Gambier III

One of the GP-anaesthetic reg, P, has done it all. He is definitely my new hero and idol. Before getting into medicine, P worked as a policeman for years, he was a high-ranked detective in narcotics and stuff around SA, made a couple of busts of drug trafficking and smuggling (Close to Port Mac where the smugglers would land). He's a amateur diver who is quite well-known in the diving circles, who had doubled for films and movies. Most of all, he's a rock star. He has his own band, they perform regularly in local pubs, and they did a couple of gigs while I was there, so of course there was no way I'd look pass it. I went to two of their gigs, old school classic rock music, P on the vocal, great guitarist with ripping solos, and a solid bass. Problem is they have no drummer, and they are all very shy about showmanship. A timid guitarist looks just weird especially when doing solos. Nevertheless, it was right up my alley. I must have embarrassed him with the loud cheering and excited beyond control when they played Sweet Child o Mine, but who goes to a live gig and just sit there?

Anyway, we were in RSL where they were playing. I was surprised to find how friendly the locals were and how easily you can just strike up a conversation with anyone there. Apart from a cute girl who turns out to be the daughter of the guitarist, I randomly met a French guy whose name is Guy. He's a sculptor, with a reservoir of knowledge on cheese, women and all things artistic. Because he does body sculptors, he studies people's body language, and being trained in psychology he studies people in fascinating details and accuracy. Some conversations interest you, some makes you smile and nod while screaming in your head hoping for it to end. This was definitely one of those where you know you've met a like-minded person. I went to visit him in his gallery the following weekend, we sat down with wine and talked about arts and his adventures as a Ballet Dancer working around the world, and how he found a liking in the small town of Penola and stayed. He invited me to stay for dinner, and he was able to rustle up a delicious meal for 4 people just like that, with the little groceries that his girlfriend came home with, it was quite impressive. Don't you hate how some people just 'have it'? It being the flair of excellence in everything that they do.

Snorkeling in freezing water of less than 10 degrees isn't exactly my description of a lazy Sat morning, but I had never done it before, and the Adelaide uni kids I met (these two are actually quite nice) were doing it, so I thought, why not. We drove for about 20 minutes to Port Mac, then further couple of minutes out of town to a local dairy that has a shed at the back of it for wetsuits hire. From there it was another 20 mins drive on the bumpy gravelly road to Ewen Pond. Diving into the freezing water and looking through the goggles, the world underwater is surreal. The water was clear, but tinted by the grey sky that day, and it was greenish blue all the way to the bottom of the pond couple of meters deep. It felt like we landed on a strange planet.

It took a little of climatising, but once you are comfortable you start to enjoy spotting things in the pond. There are three main ponds with interconnected waterways paved with golden aquatic grass, so we were able to navigate from one pond to another. The waterways were very pretty as shown in the pic, you glide through the water just touching the grass, and pass the fish hiding in it. there were huge yabbies dotting here and there, and underwater spring bubbling out of little cones at the bottom of the pond. I think I understand the attraction of snorkeling the Reef, if I get a kick out of this freezing, rather lifeless pond.

Continue next post...

There's nothing exciting about Mt. Gambier II

I had imagined life in Mt. Gambier would be quite boring and brough a library of books with me, but as usual, I didn't read any of it. The combination of ease of commute, plentiful parking, and welcoming interns meant that I had a more active 'social life' than in Adelaide. We weren't spoiled with choices, but the limited selection of cafes and resturants actually simplifies dining out. The cafes in Mt. Gambier were friendly and unpretentious, simple food and great coffee as you would expect and just as desired. I really see no point in restaurants that charge a premium for some fancy-named 'reinvented' dish 'with a modern twist' that actually just means they cannot get the basics right, and parades it under the false banner of creativity.

Plus there were specials every week night at most places, soon we worked out a routine. It did not take long for Wednesday night steak and wine at Sorrentos to become a tradition. The waitresses there were quick to notice the newcomers, and soon we were ordering our 'usual' before even sitting down. There's $10 pizza at the G (Mt. G hotel) on thursday night, as well as $15 shinny at the Southern Aussie; although we thought about it, never ventured into the Southern Aussie, and the locals would understand why. The cafe in the city library has free wifi, so does most cafes in town. It's hard to comprehend why it is so hard to find a nice little cafe in Adelaide with free wifi and good coffee. Oh and the supermarkets open till 10, every night.

Then there was the Happy Hour on Friday night at Sorrentos with the Intern Boys (I am not kidding about the 90s boy-band reference, that's what they call themselves) and girls. With house wine for $2.50 a glass, it sets you comfortably tipsy and merry to start the weekend.

On Saturday morning, Metro cafe is The waterhole in town. It's like the Big Table in Adelaide. Nice selection of affordable breakfast menu and best coffee in town. Perfect way to start a Saturday morning, much of my CV was done on chilly Saturday mornings with a satisfying warm coffee in hand. It did nicely to feed my now well-established coffee addiction, we'd find ourselves there after morning wardrounds and before surgeries start (credit to the theatre staff, there is always at least 30 minutes before they can get ready even when they call you). Unfortunately they don't open on Sundays.

My adventure continues...

There's nothing exciting about Mt. Gambier I

I have put off writing this post for 6 weeks. My right brain is feeling particularly awake today, so I will get this done.

First off, the drive down was long and arduous despite plenty of caffeine and loud rock music. Even taking the 'scenic' route along the Great Ocean Road, the trip qickly became monotonous and boring. When you are driving, you can't really look out the ocean anyway. Interestingly I found the sights much more picturesque once the highway turned inland. You are confronted with the vast steppe of grassland with a sea of green nothingness and no proof of civilisation anywhere, apart from the lonely winding road, worned down and stretched far up the end of the horizon, disappearing beyond the eyes can see.

It was quite hard to stay awake driving by yourself. I had to stop by a couple of towns to refuel myself with greasy meat pies, energy drinks, and much needed rest; including one 20-min snooze at a resting station along the highway. It certainly did not help that I had a splitting alcohol-induced headache from the previous night, half of which had blurred into vague oblivion. I am pretty sure I had embarrassed myself and my friends, but that happens a lot anyway.

Some of the towns along the way were rather nice. Robe was a small sea-side town that I found out later as the holiday-house filled destination for a lot of Adelaideans and Mt. Gambier locals, being half way between the two. The famous gigantic sculpture of the red crustacean at Kingsington was the most exciting thing to see among the small town scenes.

The accommodation was nothing impressive. The stock standard 3-bedroom house with everything that you would need to sustain life, but at a bare minimum. It was no luxury mansion. The dribbling shower drizzles fluctuating hot and cold water was the bane of my stay. But, it did come with a roaring gas heater in the living room (the fan can be rather noisy), and two good housemates. Linens were provided by the hospital, and sure enough, it's the same hospital linens that they use for patients, so I slept in my sleeping bag for the 6 weeks.

The hospital is a portion of the size to its previous incarnation. It was a glorious 400-bed regional hospital built in the 50s, but as the demand unable to live up to the supply, the hospital was running a big loss. As medical technology improved, the hospital required to be upgraded. It'd have made more sense to tear the building down, and rebuild on the same site as it was prime location, but the asbestos in the building meant that it'd cost millions just to tear it down. It was thought to be cheaper to rebuild a new smaller hospital on the other side of town, and so they did, without the foresight of extra room for future expansion, now there's problem with a small hospital unable to meet the demands of the quickly expanding population, and no room for expansion.

The old hospital is left standing by the lake, abandoned, overlooking the town like an old guard still manning its post. One walks pass it as part of the trail around the Lakes. It now looks like something you'd find in a movie set in the post-war Soviet era East Berlin. It's the place to go if you are looking for hard drugs at night, among other transactions that still take place there.

Continues next post...

Easily satisfied

Couple of days ago a patient on the ward had a tumble, came away with a laceration on his forehead.

He was a charming old chap, led an extraordinary life. He was a sergeant in the British SAS commandos, been to a couple of tours around the world. He even did the sniper duty for the Queen's Coronation back in the days.

I volunteered to stitch him back up. To my surprise, my reg agreed; and even more surprisingly he agreed too, having only tuned down a surgical intern the previous night. Anyway, I gave a pretty good performance with a big audience of a reg, a RMO, a nurse and the patient's wife.

On the consultant ward round the next morning, he greeted each of us as we come in. When he saw me, he welcomed me warmly, "ahh! my plastic surgeon!"

Hehe...he made my day. I'm easily satisfied.

2 minute silence

Two patients passed away on the ward today, the sight of two families grieving made the atmosphere very very heavy.

My reg took me to do a physical exam on the deceased so that we can officially declare death. This is more or less a formality as 'an experienced nurse can tell you that with a glance.' But only

doctors can declare death, and this is one diagnosis you don't want to mistake.

On approaching the patient, they may appear to be sleeping peacefully. But when you look into their eyes, you realise that there is no life there anymore. It's quite distinct, something I've never seen up close before.

To look for signs of life, firstly you try and get a response from the patient with voice, then pain, check that the pupil is dilated and does not react to light. Then you put your stethoscope on the patient's chest and listen for heart and breath sounds, or the lack of any sound really. You listen for 2 full minutes.

This reminds me of the 2 minutes of silence when we pay tribute to those who passed away. Officially, as doctors, we are the first ones to pay the 2 minute tribute.

Sooner or later every story ends

Unplugging oneself from the modern civilisation is surprisingly liberating. For 3 days, I deliberately stayed away from the internet, turned my phone off, used my laptop only to watch movies; and instead of being constantly buzzed by Facebook updates or Gchat, I filled it with helping out with random odd jobs around the farm, watching stars, and made exciting excursions around the place with a little black dog trotting along. Most of all, I freed my mind, let go of the reign and it took a nice long nap.

Life is full of contrasts. As I sealed myself off from the city, and connections to the world; I spent half a night looking at the stars and wonder what is out there.

A pile of dry wood of 5 meters in diameter fed a scorching flame that stood 3 meters high. We lit one end of the pile with the help of some gas, and the fire soon grew to consume the rest of it. The most beautiful and most savage of the primal elements; It was red with anger, orange with warmth, blue with calm, and yellow with passion. Its tongue snakes, its claw swings and sways, and it danced. it danced on the dead branches that was once brimming with life, and it celebrated the transfer of one energy to another. The bonfire filled my limbs with warmth, my body with adrenaline, and my mind with primal impulses. I wanted to dance, with the dancing flame, spin in circles and around the fire, but as I got close the heat slapped me on my face. I wanted to fly, spread my wings and let the hot current take me up to twirl and whirl and glide gracefully back to the ground. I wished, that I had my violin in my hands, that I could play like a gypsy around the campfire, without method, without rules, carelessly luring the curious in the nearby woods.

The Red violin is a movie I've wanted to watch for a long time. Problem with anticipation is that it elevates the expectation, leaving you disappointed regardless of how good the experience is. Don't anticipate anything in life, that way, everything is a nice surprise. It also doesn't help that someone tells you the twist just before you watch the movie. Nevertheless, it did remind me of my love for violins, and now I miss mine.

The legend of 1900 is another movie that I have wanted to watch for years. It turned out better than I thought. It tells the story of a man who was born on a cruise ship, who spent his life performing on the ship as it sails across the Atlantic. He never sat foot on dry land, and when the opportunity came, couldn't.

"Land? Land is a ship too big for me; it's a woman too beautiful, it's a voyage too long, a perfume too strong...It's music I don't know how to make..."

It also gave me the title for this post.

It's scary how limiting our world can become when we stay in the comfort zone. If we don't expand the horizon, push the boundary, scare ourselves; we then become settled, and even fearful of the outside world. At the same time, knowing your limits can be an asset as well as an excuse not to explore beyond the eyes can see.

The highlight of the weekend, is of course, an introduction to leatherworking. I am now a proud owner of a leather belt and a keyring that I made myself, tooled, and stitched by hand. It's immensely satisfying to make use of tools and your hands, and walk away with a product of your labour.

Introduction

First impression lasts. The initial interaction is so hugely influential that it inevitably install some sort of expectation for either party and sets the tone of the rest of the encounter. As one progress through med school, you evolve from the timid first year asking a nurse whether it's ok to talk to a patient on the ward, to being mistaken as a Registrar answering their call of distress. More importantly, while observing in a clinical situation, the introduced is often made by the consultants to the patients.

Classically, you are introduced as the medical student, and the patient is given the option whether to let you sit in the quiet corner or to kick you out of the room. But sometimes, your introduction gives you more weight and thus appears crucial for you to be there. As one progress through the years, seniority and title changes.

"Hi Mr. Blah, This is our senior medical studnet, would you mind if he sits in with us for today?"

"Hi, this is our final year medical student, would it be ok for him to observe the consultation?"

"...This is our final year med student who is working as part of the team..."

"...this is one of our doctors in training..."

and my favorite so far,

"...This is a final year trainee doctor working with the team. he will be let loose to the public as a doctor in a couple of months time, and frankly, it's scary for us all..."

First Class Friends

This is the philosophy of one of my best friend from high school, It made a lot of sense when he told me, and so it's stuck with me ever since. He said that having friends is like inviting a whole lot of people onto a jumbo jet where you are the Captain. Like a commercial airliner, there are different classes of seats. The general friends and acquittance who make up the most majority of the people you will meet in your life, they get seated in the Economy class, where the services are standardised. There's the Business Class where closer friends hang out, and generally enjoy better catering and hotter air-hostess. But the most precious people in your life, you keep them close in the First Class, where upon opening the Captain's cabinet, you attend to them with most of your time and energy.

The curious thing is that you will never be able to write a set rule or protocol on deciding who gets to be in the First Class, it's instinctual. You meet someone, exchange pleasantries, then they start to seat themselves into the different classes. Most people will gladly stay in the Economy Class, but once in a blue moon, you will bump into another person who you will invite to the First Class straight away.

Sometimes when you arrive at certain airports in life, some of the passengers may depart and new ones will board. Even your First Class passengers may leave you in pursuit of their own destination, but you'd always reserve an empty seat for them. For you know that someday when they'd like to fly with you again, there is always a seat for them.

Blue Eyes

Bright blue blue sky, lightly painted with wisps of fluffy clouds. It sits just on the vast horizon where the sky meets the ocean, the blurry division faithfully guards the start of the canvas where the darker shades of blue are painted onto it. With the green undertone, each layer of the marine blue grow richer and thicker in colour, only to be broken by brushes of white as the wind forces the wave-tops to crush onto itself.

I looked around to find two different shades of blue; The iris blue perfectly circumscribes the sphere, whereupon folds of violet line in furrows along the circumference, and on approaching the centre, gradually give way to the radiant yellow-green that disperse in directions like the rays of the gleaming sun. In the middle, a vibrant sapphire blue, like the Great sinkhole of Belize, describes an alluring depth, a window to her mysterious soul.

She has fiery auburn hair that sways and flirts with the wind, yet the tame fringe rests comfortably on her forehead, half covering her alluring blues. Her pink lips framing the neatly displayed pearls, that when she smiles, the up lifting smirk brings the whole world smiling too. If ever angels be, for God's good purpose enthroned in mortal form, they may be, without impiety, supposed to abide in such as hers.

It was a sun shiny day at Victor Harbour, and I did not have a camera with me, so I took a mental picture. But trying to describe the image is a crime, for words do not speak the essence of her beauty.

Stupid grin

You know that smile? that exhibition of pure, unadulterated bliss? The stupid, mirthful grin that permeates out from within? It could only be convinced by a general state of content, induced not by any real material achievement, but by a worthless sense of romance? Sickeningly sweet to all observing, but nectar to the ones immersed in it.

The Plastics Diet

1AM in the morning, in the ED with my plastics Reg, who by the way is the nicest surgeon a student will ever meet, not to mention her charming English accents and lovely manners; I've decided that all English girls, like their emblem the English Roses, are made of elegance and grace, but that's a story for another time.

Anyway, 1AM in ED, talking to the patient while waiting for X-ray to come through, we realised that it's been more than 12 hours ago since either of us had anything to eat or drink. I had 20 minutes at lunch time to scoff down half a mini baguette and chomped on an apple on the way to clinic; then 5 minutes for glasses of water on the way to theatre at ~ 6pm. It's been a busy day, but that's the plastics diet.

Monday morning ward round (7:30AM) generally takes longer than usual as all the plastics consultants are present, so soon after 9AM when everything is done, we rushed down to clinics to start chipping away at the list of patients. Monday also means consultant paper round, theatre list review and pathological meeting. So by the time my Intern had a chance to shout me coffee, it was 12:45, then some odd jobs around the ward while stealing some down time for my baguette and back to afternoon clinic at 13:30.

It's actually been one of the most exciting day since I've started medicine. Cut out a BCC on a leg, sutured another one on the back, and saw 2 infected sebaceous glands that were dealt poorly. For my own benefit: in the first case, the RMO had cut through the gland without realising it is there, resulting in release of pus everywhere in the wound, it took quite a while to clean and debride everything soon as the Pandora's box is opened. In the second case, an infected sebaceous gland resulting in an abscess/haematoma. I think he should've ultrasounded it first, I would, to check the dimension of it. From experience of having pimples, the sebaceous gland go through stages of infection when at a 'mature' stage, the keratin top of it becomes weakens, then becomes ready to be 'poped' and released. This was much angrier than a pimple of course, but the principle should be the same. Anyway, a cut was made, not much came out, so another cut turned it into a hole, then the gaping hole grew wider and deeper as we frantically try to debride as much as possible. In the end, the deep wound is impacted with gauze, and patient given ABx. I have my doubts on whether that will heal at all.

Saw an old gentleman of 80 on my own, who had lacerated his index finger while curving ham. His finger had functions that are largely in tact and the sensations were absolutely normal, so on the surface it was an over-zealous referral, but exploration under local confirmed the suspicion that there were tendon involvement, and Kessler repair ensued. Interesting and rather stoic grandpa, we chatted about ancient legends and myths while I was allowed to suture him back up. One of his ancestors was accused of murder and some serious crime or rather, that he was locked up in the Tower of London in the 16th century for a couple of years. Now you don't hear a story like that everyday.

Theatre paged, it's preped and ready to go. A lady's wound from previous breast reduction operation had dehessed and became infected, the wound needed debridement and re-closure. wound edge debrided, sent for culture, closed. Easy enough. Hardest part was to remain inconspicuous and seem totally innocent while checking out the scrub nurse, I'm pretty sure it's unprofessional to hit on your scrub nurse.

Then a dude who's tip of index finger was bitten off by his partner. She had stabbed him a couple of weeks previously, and I guess he must've retaliated, because she's actually in hospital as well after being beaten up, and he was seen walking around the ward this morning with blood EtOH of 0.1. Anyway, too little flap left for an effective stump for the distal phalanx, so we took it off. Got to give my first ring block for the finger, and sutured the rest of his finger into a nice little stumpy index finger.

When we got back to ED, there were 2 patients who had already been waiting to be seen for hours. Both had fractures of the hands that needed to be admitted, but we didn't have time to fix either right on the spot. One had punched something and fractured his 5th metacarpal bone, which was funny cause we'd see another bloke with multiple metacarpal fractures from the same mechanism in a couple of hours time. Lots of locals (Ropivacaine; Naropin), manual reduction and hours later, it's 1AM in ED, my Reg and I sitting in a room talking to a patient who had punched a wall out of frustration. We are both looking forward to going home, have something to eat, and collapse in bed.

I Wiki'd it

Apart from last Thursday where there was no theatre list, I have been in theatre everyday since I started this year. It's both exciting and daunting to be on the table with the surgeon, be it with the Reg or the consultant. Exciting because I'm scrubbing in every time, not that I actually get to do anything other than cutting sutures or holding the hook, but you are an actual assistant to the surgeon rather than standing back and watch over the shoulder. Some surgeries can take a long time, and in these long hours, there are plenty of time for the surgeons to grill you to bits if they are feeling particularly nasty. Luckily, I haven't had that this year. Anyway, the point is, I am finding myself having to look up surgical procedures a lot, and as I don't really know many surgical textbooks, this is quite a challenge.

When you find that Wikipedia doesn't answer your questions anymore, it probably indicates that the knowledge you seek is so specific, that it will never have any practical value outside that particular field. Definitely won't help you in trivia at the local pub.

p.s. the surgical nurse was hot, I shall try and chat her up when I'm not covered in blood, infected green tissue slough and bits of fat.

TRAMtastic!

I started 4th year on plastic surgery 4 days ago, it has been a blast! I remember not being able to sleep on Monday night from the excitement and worry about the grueling grillings that the consultants may do to me. But so far the people had been friendly, the two regs I met on the first day are rather indifferent to my presence, but on the third day another reg joined our rank, and she has been nothing but friendly and approachable.

Apart from the early ward rounds, all-day clinic on Thursday, I've been living in the theatre. There were a lot of holding hooks and cutting sutures but eventually, hang around long enough, they throw you a scrap once in a while. I got to cut out a BCC on Tuesday, and today, sutured a belly button.

I got to assist in a free TRAM flap today. TRAM stands for transversus rectus abdominus myocutaneous flap. It means taking the fat and skin of the abdomen to reconstruct a breast for those underwent mastectomy. It is a major operation, took us from 9am to finishing at 6pm with about 30 minutes break in between. It took every bit of concentrations to dissect away layers of skin, fat and muscle, all the while keeping an eye out for the blood vessels as we were trying to harvest them. Then about 2 hours of micro-surgery anastomosing the artery and vein that were about 3mm in diameter with 9/0 sutures that were about 50% thinner than hair. Follow by urning the tummy flab into breast, and lastly stitch everything up.

Being a good boy that I am, I got to suture the new belly button for the patient. She was worried about whether she will still have a belly button yesterday when we saw her pre-op. I will have to ask her how she likes her new belly button when I see her next.

Dumplings, Houses and Marriage

That pretty much summed up my short holiday. Let me explain.

Since my family immigrated to NZ, we have gotten used to being on our own. We have always had a large, closely-knit family back home, with up to 20 relatives meeting up for dinner at my grandparents almost weekly. It was hard to adjust to the change. My mum, brother and I lived together, and dad came as frequently as he could, but medicine is one of those profession where vacation is both fleeting and scarce. With my departure to Aus, and my brother studying in South Island, mum had been on her own. So it became such a luxury to spend time with family, we sat down at the same dinner table for the first time in about a year.

Dad is a passionate self-taught cook and the keeper of family recipes. Besides golf, I spent my time this summer making dumplings. Making dough, hand-rolled with wooden rolling pin into little circular pastry dumpling skins, each dumpling is then made by hand. It is a fortunately complicated production that requires more than 2 people, and it was perfect for us to spend time together. While your hands are occupied, your mouth is freed up.

One of the things I did this summer was spend time with my family.

I met up with a close friend who had recently gotten married, one recently engaged, and another who is in a relationship where the wedding bell is about to toll. Naturally my state of freedom stands out and perhaps, cause of concern, because apart from mum's intention to introduce friends' daughters to me, my friends have joined the cause. It may be an interesting novelty, but these match-making efforts can hardly agree with me.

Just before meeting up with my newly-wed friend, I was reading a classics, The Adventures of Tom Sawyer. I was quite indulged in the world of the childish worry-free ventures. When I met my friend however, we spent the morning talking about buying houses, investing in properties and all these genuine grown-up stuff. Things I have never put too much thought into, but rather, left to worry for the future. It was quite a contrast. Here I am still at school, reading novels, and worry about which cafe I shall try before leaving for Aus again; when he spends his time reading investment books, looking up properties, and worry about providing for his new bride and coming family.

I remember at some point during the breakfast, I took a silent moment to lament over the lost innocence, last I saw him, he was telling me about the new phone that he bought. I am also glad though, that at least some of us are maturing and taking on responsibility.