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Medical Examinations

“To cure sometimes, to relieve often, to comfort always”

Medical exams come in two types. The first type, which involves over two hundred people exhibiting tachycardia (increased heart rate), shortness of breath, cold clammy hands, shivering, and signs of rabies (impending doom) – all clearly systemic, alarming symptoms, is not particularly comforting nor curative. The only thing they manage to cure would be delusions of grandeur.

The second class would be the physical examination. This usually involves a set sequence of things to observe, starting from the hands, then the face, neck, and then the abdomen/ chest, depending on the system examined. The actual order of things is not too complicated, but having to perform it on a stranger (or an actual human being, really), in front of an eagle-eyed audience, really sets on an attack of the nerves.

The neurological examination is rather endearing. It involves raising your eyebrows, puffing out your cheeks, and showing your teeth. If you can do that, you must be neurologically intact!

A friend was excited about the per rectal training today. “The breast exam is on Friday!” I told him. “Nah, too clinical” Was his response. And truly, we need to be professional about these things. No-one wants to imagine a bunch of giggling university students, as they sit, shivering on the doctor’s couch. My first experience with the breast examination was something I will never forget. After being drilled not to say “I want to feel your breasts”, I duly went into the cubicle, introduced myself, and said “I want to do an examination of your breasts”. The elderly lady regarded me dubiously, demanding “And what will you do to them?” “Errr… I will…. Feel them…”. After the ensuing shouting, the tutor actually ran after me to check that I was not traumatised for life.

I have heard interesting tales from seniors. One actually fell asleep in the middle of taking a patient’s history (of narcolepsy, perhaps?). Another, after expertly reassuring the mock patient that his chest pain was perfectly normal, thinking it was a communication skills station, realised to his horror after the bell had rung that he was supposed to have had diagnosed peritonitis – quite a serious condition.

Nervousness aside, it isn’t all fun and games. A classmate, being the sixth person to examine the simulated patient, asked to skip the vocal resonance part of the respiratory exam to save time. The tutor replied “that may save you time now, but if you miss a sign, the patient will waste lots of time later”. In that moment, I realised that our bumbling through this learning process now has some Greater Meaning, somewhere else. The disjunct of watching myself and my classmates, who usually spend our days like slugs sleeping in the lecture theatres, or parasitizing off the wise words of professors, dressed up like mini-doctors, voices trembling mildly as we ask patients for their kind co-operation, is far from comforting. But in a way, everyone has to grow up. We can’t be Peter Pan forever.

People often ask: what is the meaning of life? I don’t know, but the meaning of that day was that we all remembered to not miss that step in the exam. In the exam itself, and in the future, where the test is someone’s life hanging in the balance, and not just that of depressed medical students. The thought that the trade-off of my momentary pain will potentially be able to allieviate someone else’s in the future makes me, at least, feel relieved.

On Studying Abroad

I know a place where the grass is really greener –  Katy Perry, California Gurls

Despite having never visited California, it is quite true that the grass really is always greener on the other side. Many students spend their formative years dreaming of going overseas and being free as a bird. Well, as Margaret Atwood said in the Handmaid’s Tale, there is freedom to, and freedom from.

There is definitely more freedom to do what you like in a foreign country; you don’t need to let a soul know when you go out, you can walk on the streets without being recognized by someone you knew in primary school, you can explore new territory, and most of all, there is this feeling I can’t quite put a finger on – of buoyancy, of independence and adventure. But freedom from – that is less easily achieved. Everyone has their own issues, and strangely enough these tend to stick with you wherever you go.

Of those who study overseas, many make the conscious choice to mingle more with non-Singaporeans, whilst many others simply stick to the familiar bubble of the Singaporean Society. There are pros and cons to both, but who’s to judge the decisions of someone flying the coop for the first time?  Furthermore, some manage to straddle both cultures nicely, by joining in societies where the differences are mitigated by a shared interest, for instance in sports or music. No doubt, those who are able to mix more capably have a different, and perhaps more interesting set of experiences.

Whichever it is though, most people will eventually find themselves missing Singaporean food, looking forward to flying home for the holidays, and finding they have some sort of common history with random Singaporeans they meet. This usually manifests itself in the questioning about which JC and secondary school you came from, and so on. People usually say that people overseas are more friendly, which one may assume to refer to the Caucasians. This is true, but you might find that Singaporeans overseas tend to be more friendly too.

Some even pay exorbitant amounts for Singaporean food, for instance 6 pounds, which is around $12 for nasi lemak. Those more culinarily-disposed can even go to great lengths to replicate the food, down to the perfect chicken rice chilli sauce. All this may seem silly in light of the fact that there are probably juniors still in Junior College dreaming of fish and chips, and there are definitely exchange students who are probably currently exploring every nook and cranny of Europe that they can.

However, my opinion is that there’s  nothing wrong in finding that you treasure something more than you’d expected. In fact, to have something worth missing, in fact, is a beautiful thing in itself.  I found myself making an extra trip to the supermarket for oranges near the Chinese New Year season, and eating yusheng as a forfeit during games, where I had felt mutinous about all the spring cleaning and preparations for the past 18 years. I even acquired an accent. In short, becoming more Singaporean just by studying abroad. You can take the girl out of Singapore, but…

I returned to Singapore some time ago. After some time, I began to miss the UK. Rustic cobblestoned streets, majestic castles and waking up to the whole world turned white, breakfast with a hodgepodge of people. The one ceilidh (Scottish dance) which I went for, which fit my mental image of Pride and Prejudice-type dances quite neatly. Coming home to find my friends standing on top of the bed, jabbing at a pair of jeans with a broom in order to find an errant rat. Fire alarms taking on a whole new meaning at 5am, when you forget to bring the winter coat out with you.

Feelings of alienhood are not always congruent with actual continents. I probably have nothing on the legions of diaspora and displaced people in the world, but my first day feeling as alien in my class of Singaporeans as in an all-British class having to take a patient history in a put-on accent, was quite eye-opening.

Perhaps no matter where one is, things will always be better somewhere else. Freedom isn’t really about the physical location you are at, barring jail cells.  It’s about whether you can ignore naysayers and gossipers, and whether you can live with the voice in your head. Or voices, in case of schizophrenia. And finally – that in order to know where you belong, perhaps you need to go someplace else first.  It’s only then that, not belonging anywhere and to anyone, will you be truly free.