Right. After that disastrous flash flood episode that ended off with me and poor Maria moping up all the water on the floor. I'm not nasty; she insisted on helping. And explaining to my sis why she can't use the computer for another 15mins while I make sure everything is nice and dry before I switch the mains on again. And thereafter, I decided to make one FINAL attempt tomorrow. Going back to the hardware store I guess. =( This time, everything will be done meticulously. Proper PVC glue, switching off ALL water outlets, and wearing slippers for insulation.

Spent this morning at the computer trying to do my writeup discussion, at the rate of 2 small paragraphs per hour. Had a lovely solitary lunch, then went about with HS, EW, Derrick, Radziah and co. (all 7 of us) to do some short cases. We examined a case of myasthenia gravis, but eye signs could not be elicited due to total opthalmoplegia. On hindsight, we really should have examined him for proximal myopathy. Then we saw a very nice lady with ascites, palmar erythema and ?hepatosplenomegaly.

After that, Radziah and I went to do a long case on Grave's Disease. The poor man had a huge bulging eye, and was slightly grouchy when we spoke to him. It's not his fault; he was as nice as I had a right to expect, but I guess it's the thyrotoxicosis that's making him irritable. Anyway, it was a good examination - goitre, tremor, eye signs (diplopia! and the usual stuff ... exopthalmos and proptosis) but no bruit. Prospective patient for a writeup, but alas - when I went to look for him, he was gone. Went to the Eye Centre.

Dr. Tien gave a mass tutorial today and as usual, totally whacked the poor presenter. And here's the "5 Cardinal Signs of Dr.Tien" :

1. Always ask if the patient has pets. He always suspects toxoplasmosis.
2. Always ask for sexual history. He's always highly-suspicious of elderly single men who visit Batam and Thailand.
3. Always ask for intricate details. He's always interested in the time interval between the onset of symptoms.
4. Always examine every single organ system. Do a PR even if it's a case of breast cancer.
5. Always include a haematological condition in the differential diagnosis. Even something as innocent as occupation (working at a petrol kiosk!) can end up in bone marrow suppression.

I very much pity the poor students who will get him for the end-of-posting test. They won't know what's hit them.

Not a bad day in school, not an excellent one either. Must do better. Having short case tutorial with Dr. Hsu tomorrow, hope it goes well.