Ken's blog

Before I started university I had one clear goal that I wanted to achieve during my time here. No, it was not getting a medical degree, passing with a honours or having epic amounts of fun. It was all about getting into the University Challenge team and have that familiar voice call out “Imperial College Wu!”. The advantages of studying medicine is that you essentially have 6 years of attempting to get in to the team. Therefore even though I have failed in 3 attempts, there are still 3 more years left to try. I have even considered doing a PhD purely for the sake that I will have 3 more years of hearing those infamous words, which my friends have described as “one of the best reasons I’ve heard of doing a PhD!”

Personally I love trivia and general knowledge, whether it be the weekly pub quiz, the annual school quiz or passionately shouting out answers whilst watching back University Challenge on iPlayer (yes I am THAT dedicated!). However I think trivia is actually something that is enjoyed and loved by everyone, especially at university. I tend to find that in lectures, the piece of information that everyone tends to remember afterwards is usually told with some clever anecdote/background which is generally quite interesting. In fact at the exact moment when a piece of trivia is told, you can hear a distinct, hushed murmur of everyone going “aaaahhhhh…that’s really interesting” accompanied by a slight smile and nod of the head. That piece of information is all your will remember and talk about and, as my friend Nia will know all too well, you will want to share that absolute gem with everyone around you. In fact, the most senior, memorable, and knowledgeable lecturers, consultants and professors (in fact the ones most likely to get a good SOLE!) tend to just casually throw out pieces of inane information that is vaguely related to medicine. Even though it may be a completely useless piece of information that you will never use, especially in exams, it does give you that indescribable warm feeling you get inside when you felt like you have genuinely learnt something.

General knowledge is also strangely memorable. Learning medicine often involves the painstaking process of learning an insane amount, especially when it comes to lists of drug names, muscles and molecules. It is very similar to learning a whole new language with their dreaded ‘vocab’ lists. Learning these pieces of information tend to be via repetition, much like practicing endlessly to perfect a piece of music. However, pieces of trivial knowledge tend to stick in your mind after just one mention and they are emphatically memorable since if you think of anything associated with that particular topic, that piece of general knowledge suddenly jumps out over any other knowledge. One of the best examples of this is the reason why all screws are sunk in clockwise. Basically supination of the arm (turning your hand clockwise) is a lot stronger than pronation (turning your hand anticlockwise) as the biceps muscle is the most powerful supinator. After learning this, I have suddenly found that every time I use a screwdriver, this piece of trivia jumps into my head!

General knowledge can of course be learnt and mastered in the usual way. In preparation for a pub quiz, my friend tried to learn all the knowledge in the world by learning the whole of Wikipedia! I tend to find that the beauty of trivia lies in the way you acquire it. When you are told a piece of general knowledge that is just completely random and out of the blue, not only will you enjoy that special feeling when you are told something that is ‘interesting’ but you will easily remember it. My fondest moment is when my friend Emily, who is from Salisbury, somehow mentioned in a lunchtime conversation that Salisbury Cathedral has the tallest church spire in the UK. 2 weeks later in a pub quiz the very question ‘which cathedral in the UK has the tallest spire?’ was asked!

The paradox of trivia is not to seek it out, but let it find you. Make yourself vulnerable to trivia and embrace it so that one day you might hear the words “Imperial College Wu!” spoken by that infamous voice.

It is often said that doctors make the worst patients. However, I think the worst patients are actually the would-be doctors of the future. Medical students are by far THE worst patients anyone is likely to ever come across, and I can personally vouch for that with my recent experiences of being ill.

The reason why doctors make quite bad patients are quite self-explanatory. It’s like saying lawyers are lawyer’s worst clients or teachers are the worst students. They essentially have the inside knowledge of what they are being subjected to, and hence they cannot have the feeling of ‘leaving it to the experts’ as they themselves are the experts and thus view every step of the process with an extra layer of cynicism. It’s like working behind the scenes at a movie set. Everyone, me included, tends to watch the DVD extras and the ‘behind the scenes’ sections of a movie that they really like and then wished that they themselves could work there, and see the REAL action of how a movie is made. However, once you have been behind the scenes, it ruins your perception of the show as you know that some scenes are shot with a stuntman and some scenes are done using computers. It’s probably much better to be ignorant and believe the illusion that’s sold to you. It’s also why I have never come across anyone who’s worked at McDonald’s or KFC and wanted to have some fast food after they’ve worked there!

Now we come to the species of medical students that I’m a proud member of. The reason we are THE worst patients is that we don’t actually have the inside knowledge, only we THINK we do. That, coupled with the fresh arrogance, enthusiasm and fearlessness that defines medical students, creates a very dangerous precedence. Medical students, especially once you hit the clinical years, tend to delude themselves into thinking that they know everything, can do a spot-diagnosis of some insanely complicated patient and stroll into the operating theatre and do a procedure, all the while thinking that they are exactly like House. This feeling tends to intensify when you are amongst other students. However, once they meet the ACTUAL doctors, then we tend to split into 2 groups: those who are still that confident and get rinsed by the consultants for looking like arrogant students with a God-complex when in fact they don’t know anything, and those whose confidence instantly evaporates the moment they meet someone who is more qualified but still get rinsed by the consultants for looking like scared students with a inferiority complex.

The reason I mention this is that I have been (and still am a bit!) ill for the past week or so. Now being of the medical student breed, I have at various times tried to clerk, examine, present, diagnose, treat, refer myself as a patient…to other medical students (yes I’m THAT cool!). It involved me trying, unsuccessfully, to percuss and auscultate myself, and then getting my housemate Dave (who’s also a third year medical student) to percuss and auscultate me. Now for those of you who don’t know what auscultate means, it is basically the act of listening-to-someone-with-your-stethoscope-whilst-hearing-some-undecipherable-noises-and-answering-yes-when-a-consultant-asks-you-did-you-hear-the-crackles. I also tried to get some final year medics to diagnose me during orchestra rehearsals. However, I think the epitome of my self-diagnosis is being grilled by the registrar on my ward whilst jokingly trying to present my own history. What actually happened later is that I rested for a couple of days and took some Lemsip and now feel a lot better – basically what any normal person would do.

It’s quite peculiar why I decided to essentially be my own patient and doctor at the same time. It highlights the flaw of medical student – they are so excited by their newly acquired knowledge that they are ready to apply it to everything, and then feel immensely proud of themselves for actually using their knowledge, no matter how trivial the case is. It’s why a medical student patient is probably one of the worst patients there could ever exist. Meanwhile, I’m near the end of my illness, but my housemates are just starting theirs…cue more ‘patients’ to examine and clerk, ending with the inevitable phrase of ‘go and see a doctor!’

It is often said that life is full of guilty pleasures. I’m sure you can think of some classic ones: the tub of Ben & Jerry’s ice cream, that collection of 90s pop music or some ridiculously long Starbucks order you can get (uncyclopedia reliably informs me that it’s a Double Ristretto Venti Half-Soy Nonfat Decaf Organic Chocolate Brownie Iced Vanilla Double-Shot Gingerbread Frappuccino Extra Hot With Foam Whipped Cream Upside Down Double Blended, One Sweet’N Low and One Nutrasweet, and Ice). However for me, the guiltiest of all pleasures, especially for a university student, is the simple act of doing absolutely nothing of any value whatsoever and ashamedly it’s something I have recently experienced, and one I’m sure most of you will have experienced especially in the long summer holidays.

Taking a break and having ‘chillax’ time is good, and in fact very necessary especially after a long 10 weeks at a hospital that I have to commute a total of 50 miles every day for. Added to that the additional pressures of performing in 2 concerts, editing 3 issues of a newspaper, giving a tutorial to second year medics, marking keen A-level students’ BMAT essays and the numerous 21st birthday parties that comes with the 3rd year of university it is no surprise that you can feel a bit burnt out. A huge sense of relief comes after getting ‘signed off’ by your consultant for your first hospital attachment and mentally and physically, you are ready for holidays. Then you find out that you have 3 more weeks of lectures left…oh dear. The good news is that there is a weekend between the end of firms and the start of lectures: perfect time just to ‘take a chill-pill’ and have some good old relaxing time.

Now, having been on the insane warp-speed driven conveyor belt that is a medical student’s life, it is quite a surreal feeling to step off the belt and walk at normal speed for once. You are so used to everything going at such as fast and furious pace that the sudden slowness of a day off literally hits you like a door that you’ve just ran into, expecting it to open but only to find that it opens the other way (something I definitely…err…haven’t done before). Once you’ve recovered, you become an stationary observer, witnessing all the other people rushing about and trying to stay on the conveyor belt. To start with, you stand there and look back at the conveyor belt with some satisfaction. The satisfaction that comes with being on, surviving and being able to jump off the belt all in one piece. The satisfactory feeling gradually subsides, only to be replaced by a sense of envy. You start to miss the rush, the pace and the frenzy of life on the belt. You secretly wished you were back on the belt, although you are grateful that you’ve managed to escape it. Suddenly, an internal battle starts within your mind of whether or not to rejoin the belt: you really do NEED the rest but it looks like so much fun there! Finally, a massive wave of regret hits you. You DO really want to throw yourself back into the life that you’ve escaped from. In fact you actually feel guilty at having left it in the first place and what’s even worse is that the people who’ve stayed on the belt have move that little bit ahead of you, and you have to work even harder to catch them up. You feel even more regret at taking the time off especially since university students are at the very peak of their human condition, both mentally and physically. It is such a shame to see this time wasted on a day of doing absolutely nothing at all.

Everyone gets those days where you literally answer everything, both mentally and verbally with ‘cba’. It is a standard part of the classic ‘allow/CBA’ culture that is a student’s life (see blog post ‘Allowing it’ http://www2.imperial.ac.uk/blog/studentblogs/ken/2011/07/12/allowing-it/).The regret of having been so unproductive is clearly evident the day after, where an additional layer of madness is added to an already manic day through you trying to make up for the day before. The regret is even worse when your day was intended to be productive but in fact ends up with an Youtubing binge. However, the guilt is dampened when it comes with a day of intentional rest. Breaks are good and it is a pleasure to be enjoyed, albeit guiltily. Just remember that after the rest, the relaxation and the recuperation, in the words of President Bartlet on the ‘West Wing’: “Breaks over” (http://www.youtube.com/watch?v=KZvgSgpjkWU).

In the run up to Christmas, my housemates and I are attempting to cook a full Christmas dinner. Even though the four of us are…satisfactory cooks, we’ve never actually done a full roast dinner before. Making the old student favourite of spag-bol, maybe a bit of stir-fry and the occasional shepherd’s pie seems pretty simple now, and I don’t even need to look at a recipe for them. However, the full roast, and not any old roast but a full-on Christmas roast, is literally (as my friend Rahul likes to say), the ‘next level’.

Having taken some time to mull about this immense challenge, it is actually a lot less daunting than it sounds. Taking it to the next level is in fact a natural process of learning and a by-product of ‘growing up’. I came to university having cooked nothing more than a fry-up and boiled some rice (yes I’m THAT Asian!). When faced with making my first proper meal in halls, I was a bit scared, to say the least. Of course I took the standard necessary safety precautions before cooking my first meal, namely: making sure no-one was in the kitchen, making sure I was only cooking for myself and making sure that I had a pizza ready to shove in the oven in case anything goes wrong. Cooking for yourself is a lot less pressurised, not least because it relieves you of a responsibility that you are in charge of someone else’s meal but it also means you are saved from further embarrassment in that if you do inevitably mess it up, no-one else needs to know! 2 and a half years later, I can’t believe why I was so scared of making such a simple meal such as spag-bol. In those years of trying and failing, my cooking skills have slowly developed and now, I’m even confident enough (just about!) to actually not be afraid of the responsibility of cooking for other people. Therefore in 2 weeks time, it’s comforting to know that at least this attempt at a Christmas dinner won’t be as bad as if I made it 2 years ago (although this time, the 4 of us are cooking for other people as well…so no pressure then!).

Reaching for the next level not only applies to cooking, but to almost everything else. It is only by trying for, failing, then repeating until you eventually succeed that you can actually achieve the next level. In other words, this whole process can be aptly described by the phrase ‘man up!’. Now manning up usually applies to ‘downing’ some form of alcoholic concoction but it is also a great mantra for approaching medicine. If someone asks you to take blood, or put in a cannula, or to hold a clamp in surgery, there are several processes that occur in your mind. ‘Wow I’m being asked to do something!’, ‘I have stuff to do!’, ‘I feel useful!’, ‘I’m being recognised as a person rather than a spare part’, ‘Oh crap! I have never done one before’. These thoughts come in quick succession, and it’s product is the classic ‘eerrrrr’ noise that medical students tend to make. The turning point of the process come immediately after the noise: you either man up, do the cannula, fail, then learn how to do it correctly so at least your next response won’t be ‘I’ve never done one before’ but it will be ‘I’ve TRIED to do one’, or you don’t man up, in which case you will always be the one who has ‘never done that before’.

Building on knowledge is an extremely important part of learning, and that comes with the strength to step into the unknown. I’ve already written about stepping literally into the unknown in the ‘Inferior’ blog post (http://www2.imperial.ac.uk/blog/studentblogs/ken/2011/01/16/inferior/) However, you can also step into the unknown in familiar territory, and that can seem even more daunting at times because you can no longer fall back on the ‘I have never’ cushion. My friend Geraint is taking a giant leap into the foray of conducting, the ‘next level’ of musicianship. An absolute brilliant pianist and singer, he has decided to take up the baton of ICSM orchestra. Conducting may seem a lot easier than learning and playing an instrument but believe me it is a lot more difficult (I have never seen someone with so much visible stress as Geraint has shown in one particular rehearsal, admittedly it didn’t help that most of the orchestra were hungover!). It is even more difficult when you are both an accomplished musician yourself and are conducting fellow accomplished musicians because you AND they KNOW if it isn’t going well. If it hopefully all goes well on Thursday in the ICSM autumn orchestra concert, then it is another success at climbing to the upper echelons and I recommend you all come to watch the concert. It might inspire you to try and climb to the next level. Once you reach the next level, it is again another immense high (http://www2.imperial.ac.uk/blog/studentblogs/ken/2011/03/04/searching-for-a-high/) and you can look below and be proud of your achievements and look up and aspire to be even better.