“… Even in the greatest of odds, there is something in the human spirit – a magic blend of skill, faith and valour – that can lift men from certain defeat to incredible victory”
Adapted from a quote on the Battle of Midway by an American write, Walter Lord, inscribed on granite at the Pacific War wing of the World War II memorial in Washington DC
To anyone of you who’s facing moments of bleakness, let this quote be your guide and motivation.
Spain and I seem to have an affinity of sorts. In my first undergraduate year, I spent my summer break visiting five Spanish cities/towns within a span of 10 days – Barcelona, Madrid, Cordoba, Toledo, and Segovia. My most recent trip has brought me back to Spain, this time to Mallorca, the largest Balearic island off the southern tip of Spain. Having spent four days and three nights there, I can attest that the total hours and intensity of sunlight during that trip was more than what I could get back in ye olde England, and more specifically Cambridge town, in a whole academic year.
Mallorca is a truly beautiful island, with plenty of sunshine, beaches (both sandy and rocky ones) and brimming with tourists, with some areas of the island dominated by Germans and some English. Incidentally, the places in Mallorca that we visited were mainly filled with German tourists, so much so that the shop signs and restaurant menus were in German. In fact, some hotels even had the German flag waving, aside the Spanish and Mallorcan flags!
In my first Spain trip, the Malaysians completely outnumbered the lone Singaporean 6 to 1. This time around, I found myself in the minority, with two other Singaporean Churchillians in the group – Yifan and Rus. In spite of that, there were plenty of jokes stereotyping Malaysians and Singaporeans exchanged between the three of us.
The places we visited were Palma (the capital of Mallorca and the only (and by default, biggest) city in the Balearic islands), Cala Ratjada, Port d’ Alcudia, and Soller. Port d’ Alcudia was not originally in our list of places to visit in Mallorca; rather, we planned to visit and spend a night in a monastery in Lluc. However, due to a mis-reading of the bus schedule, we missed the last bus of the day to Lluc, and decided, instead, to head off to Port d’ Alcudia.
I intend to post pictures up from the trip, but will have to wait for the pictures from Yifan and Rus because my camera was giving me problems during the trip. Stay tuned!
One thing which has always intrigued me is the statement that ‘medicine is both an art and science’. Having completed the two years of my preclinical medical sciences and one year of pharmacology as a natural science subject, I have come to understand the second part of the statement – medicine as a science. And now, on the threshold between the preclinical and clinical phases of my medical training, I feel it is timely to ponder upon the ‘art of medicine’.
What exactly is the ‘art of medicine’?
Well, according to Eugene Braunwald, MD et al. (2006):
[quote]
When a patient poses challenging clinical problems, an effective physician must be able to identify the crucial elements in a complex history and physical examination, and to extract the key laboratory results from the crowded computer printouts of data, in order to determine whether to ‘treat’ or to ‘watch’.
Deciding whether a clinical clue is worth pursuing or should be dismissed as a ‘red herring’ and weighing whether a proposed treatment entails a greater risk than the disease itself are essential judgments that the skilled clinician must make many times each day.
This combination of medical knowledge, intuition, experience, and judgment defines the art of medicine, which is as necessary to the practice of medicine as is a sound scientific base
[/unquote]
So, basically, all the amount of textbook medical knowledge will be worthless if a clinician fails to exercise prudent judgment in evaluating the clinical signs and symptoms. Thus, a competent clinician is one who has mastery of BOTH the science and art of medicine.
But does this de-emphasize the importance of having a sound knowledge in the medical sciences? The answer is a resounding ‘no’. In fact, the opposite is true. Without a good grounding in the sciences, the physician is analogous to a person with visual agnosia (well, not literally, but figuratively) – in that, one is able to observe and extract the signs and symptoms from the patient, but fails to relate them to a coherent body of medical knowledge.
Done! A checklist of the essays I attempted in the exam:
Day 1 : Pharmacology of Integrated Systems (3 essays – 1 hour each)
Reverse Cholesterol Transport – a feasible therapeutic target?
Current and future pharmacotherapy for asthma
Blood brain barrier: roles and function
Day 2 : Pharmacology of Integrated Systems (2 essays – 1.5 hour each)
Discuss, with examples, angiogenesis as a viable therapeutic target.
The roles and regulation of nitric oxide in cardiovascular diseases.
Day 3 : Molecular & Cellular Pharmacology (3 essays – 1 hour each)
What do we know about the activation gate of voltage gated ion channels?
Discuss the viability of aquaporins as drug targets.
Activation and inactivation of trimeric G-proteins.
Day 4 : Molecular & Cellular Pharmacology (2 essays – 1.5 hour each)
How do transcription factors decode second messenger signals?
Protein-protein interactions in the regulation of voltage-gated calcium channels
The exam was a rollercoaster ride, to say the least. And I don’t think I’d survive this grueling week, if not for the support from my family.
More updates coming soon. It’s post-exam celebration in Cambridge!