I was just browsing online and I noticed that Michael Jackson is still a trending topic on Twitter. Websites are still abuzz with the most recent rumour about him. Since I'm really bored and tired from revising and doing practice questions on MRCP Part I (yup, I'm specialising in Internal Medicine), I thought it would be good to see if I can support or debunk some rumours about MJ's medical history. Besides, it would be good for me to put some of my medical knowledge to use. As a trained physician, I tend to notice a lot of things from photographs of people - in fact, it is the very thing that medical schools train medical students to spot. It's called spot diagnosis, babeh!

Let's see how much I can spot from photographs.

Story/Rumour 1: MJ has vitiligo. - subdereality says TRUE!

I guess, one of the biggest rumours that has taken off for the last twenty years prior to MJ's death was that he wanted to be white man and decided to bleach his skin. In an interview with Oprah in 1993, MJ revealed that he had vitiligo - an autoimmune disease which destroys the pigment-producing cells in the skin basal layer. A lot of people are still skeptical to this very day. I, however, say that MJ was telling the truth. He was telling the truth when he said he was proud to be black.

Let me tell you why I'm so sure. About two years ago, I was absolutely horrified when one of my seniors came up to me and asked if I would like to see something odd. He said, *There's a spotted cow downstairs.* I was shocked when I found out that he wanted me to see a case of vitiligo in an Indian man. I told him that I took offence on the term 'spotted cow' because it seemed like a racist and cruel term to use. He simply shrugged his shoulders and said that the appearance of vilitigo in a dark-skinned person is very similar to Friesian cow. Ouch.



Which brings me back to MJ - my senior's way of describing the appearance of vitiligo in a dark-skinned person really brought home the pain which MJ would have felt when he was still alive. He was a singer, an entertainer, someone who spends most of his life on stage and in the limelight. To have such a disfiguring skin condition must have been terrifying, no wonder he probably developed body dysmorphic disorder. Besides, vitiligo is a lot more obvious in a naturally dark-skinned person.



Proof that MJ has vitiligo? Look at the photo above. There are spots of what was left of his original pigmentation. I doubt he bleached his skin, because the pasty whiteness would account for very advanced vitiligo. I have a feeling that his face would had been covered with vitiligo spots as well, hence the thick make-up to even out his complexion.



Also, why was MJ going around with an umbrella all the time? People with vilitigo are predisposed to squamous cell carcinoma (a type of skin cancer) because they no longer have the skin pigment to protect them from the harmful UV rays. The umbrella functioned to shield him from the sun. Perhaps, there is some truth to the news reports that MJ had skin cancer and the autopsy reports that MJ recently had a minor operation to remove a skin cancer.

Therefore, I don't believe that MJ bleached his skin. I don't think it's funny that people crack jokes about how he would use feminine make-up and carry an umbrella around.

Now after saying all that, I wish he had taken what nature dealt him in a better way. There are other entertainment figures who are very open about their physical disfigurements.For example, Seal wasn't afraid of showing his discoid lupus scars to the world. PLUS, Seal scored Heidi Klum.

Up next: Story/Rumour 2: MJ had lupus.

I'm not putting this behind a cut because the whole internet is abuzz with Harry Potter and the Half-Blood Prince and if you're so concerned about getting spoiled, it has been two weeks since the movie was released. Besides, if you have read the books, you can't get spoiled anyway.

I can't believe this: there are sexual innuendos in a Potter movie. I nearly choked on my diet Pepsi when Ron asked Harry: Did you and my sister do it? Brilliant moment there!

The whole movie was really dark, and I nearly squeezed out a tear when Harry was grieving over Dumbledore's body. It has really prompted me to reread Harry Potter and the Deathly Hallows. Lovely acting by teenage!Tom Riddle! Christian Coulson wasn't a convincing Tom Riddle in the second movie, but this current teenage!Tom Riddle certainly gives me creeps!

There were some unnecessary moments, but overall, the movie feels like a build-up to the final movie. The climax wasn't very exciting either, but I guess each and every Potter fan would be waiting for the moment when Harry triumphs over evil.

I want more Snape!

I know it has been nearly a month since MJ suffered a cardiac arrest and passed away suddenly, and for a month, I have been seeing news reports and tributes belted out to him. I didn't really want to post anything until now, seeing that the media frenzy over him hasn't died down. I don't remember the news going crazy over somebody's death. Perhaps, the closest I can think of was when Princess Diana died in a car crash in France more than a decade ago.

I have been a MJ fan since I was about 5 or 6. Although my fan-girling has died down after I went to medical school (mostly because I couldn't bear to watch MJ go on a downward spiral with the botched cosmetic surgeries), I still read about the latest updates in his trial and then-upcoming concerts. *Billie Jean*, *Thriller*, *We are the World* are amongst the few songs which brought back instant childhood memories. I remember my dad saying that there would never be another entertainer like Michael Jackson, and nobody would be able to combine the moonwalk with the music so well.



In the early 90's, I remember the shock I had when I read in the papers that MJ had married Lisa Marie Presley, and I remember thinking that it was a really odd match. Nevertheless, I was happy for him, and it was then I noticed that MJ's appearances had started to change very radically. There were even rumours in the local papers that MJ had plastic surgery to give him a six-pack. It was heart-breaking to see such a handsome young man from the Thriller era transform into a zombie-looking middle-age chap.



He was smoking hot during the Thriller era. Fair enough, he was diagnosed with vitiligo in the mid-80's.

In 1996, MJ performed in Malaysia as part of the HIStory world tour, and there was a huge media circus surrounding him. There was once when I wanted to go to Toys-R-Us, but was told that the store was *closed for a V.I.P.*. I wondered who the V.I.P. was, and there were reports in the newspapers the next day that Michael Jackson went to Toys-R-Us to shop roughly the same time I was there. I remember how the local television channels reported MJ's shopping trips and sight-seeing tours on prime-time news.



Everyone knew who MJ was. All of your friends, your cousins, your teachers. Everybody.

Then, the 2000's rolled along, and I went to medical school. I didn't follow MJ closely anymore. All the events surrounding him was obscene at best - his apparent wedding to Debbie Rowe, dangling his baby son over a balcony, that horrible child abuse trial, the allegations of him going broke, etc. I couldn't bring myself to watch the Martin Bashir documentary until a couple of weeks after his death, and it was so different to the MJ that I remembered from his interview with Oprah Winfred in 1992. He was emanciated, frail-looking and sad.

On and off, I still heard MJ's songs being played. When I went clubbing during the 1st year of med school, I used to enjoy going to the 70's nights in Creations (now called Liquid) Tuesdays. I was a big fan of the BeeGees, and the DJ used to play Jackson 5 as well - *I Want You Back* was a particular favourite, and the crowd full of young doctors and medical students would go wild.



I think, the last time I heard MJ was during my finals celebration when the security guard in Goscote House played some of his tunes on the stereo. It was alright, but I was too exhausted to enjoy the music properly.

When the news broke that Michael Jackson died, I was sitting in front of my laptop watching a movie. I had just went on annual leave, and I was in total shock. MJ was supposed to perform in London, and some of my work colleagues even took annual leave to buy concert tickets. I was tempted to buy tickets, but I didn't have any spare annual leave to take, so I just left it. I was hoping that I might be able to get some later on.

So yeah, when news broke that MJ died of a cardiac arrest, I had my suspicions that it was all due to drugs. When more news came in about how doctors administered Propofol to MJ, I was shocked. Propofol is hardcore stuff - only anaesthetists are allowed to use Propofol, and you need to be able to intubate and ventilate patients on Propofol because the risk of respiratory depression is very high. Then, when I read about how many doctors prescribed him all sorts of painkillers like pethedine (used by women in labour, that's how hardcore it is), I was saddened by the amount of professionalism those doctors showed.

All things considered, he had a sad life - horrible accusations of child molestation, physical abuse by his father, never had a chance to enjoy childhood, dysfunctional relationships with women, perceived dying fame, etc - and no wonder he turned to drugs for comfort. We saw that cycle with a lot of tragic talented actors and singers. I mean, yeah, MJ had money, and he probably give those doctors a lot of money to prescribe him those drugs. However, as a fellow physician, I felt terrible when I read those reports about how star-struck those doctors were, and how they exploited MJ's tendency to score drugs. When we took the Hippocratic Oath after qualifying as doctors, we swore that we would do no harm to our patients, and those doctors did the exact opposite. They gave him drugs and performed unnecessary cosmetic procedures.

I will neither give a deadly drug to anybody if asked for it, nor will I make a suggestion to this effect. - Hippocratic Oath.

I just wondered how many more cases are there to come.

Even after his death, there is still a media circus going on - issues about his children and will, issues about him being the biological father of those children (and possible 4th child?), his impending toxicology results, etc. I guess, if you look at the bright side, only legends like Michael Jackson could inspire the curiosity of many. I guess, the bit which I admired most about MJ (other than his singing and dancing abilities) was that he wrote his own songs, and it takes innate musical talent to do that. He wrote Billie Jean and Thriller. How many current singers wrote their own songs, produced their own cds, choreographed their own dance to the track and directed their own music videos?

Now, I'll just end this post with a music video of my favourite Michael Jackson song: Billie Jean - the most wicked bass line ever written in musical history.

So I've jumped onto the Twitter boat.

http://www.twitter.com/subdereality.

Hm... Should I be using Twitter?

Are you using Twitter? What are your experiences of Twitter?

Show me your Twitter pages!!

Hm, can't believe that I've made a profit from selling my Twilight books. Seriously.

I've found the love of my life (at least, when it comes to shoes). The biggest challenge in the medical profession is to find a pair of shoes which are comfortable enough to be in all day long but yet look professional. For female doctors, it's even worse. It's virtually impossible to find anything which doesn't look frumpy and ancient.



And I found Skechers. They are so sneaky (excuse the pun)! Those shoes are virtually sneakers disguised as casual/formal flats. The tough bit is: they are really expensive at £45-£50 a pair.

However, I managed to get my first pair of Skechers at TK Max - a clothing/fashion store selling branded goods at discounted prices. Then, I managed to get a second pair online for £15 (including delivery). Good stuff! My feet loves me now.

I honestly don't get why Twilight has such a big fandom.

The movie was mediocre at best. Robert Pattinson was good eye-candy, but his acting was so wooden and his American accent was really distracting. Bella didn't grow on me. I just liked the baseball scene and the fight scene. Otherwise, there was no chemistry between the two main (oops, I nearly typed *male*) leads.

I've bought the book last year, but never got around to reading it. I bought it because I heard rave reviews about it, and it was going for £2.99 at Amazon. I thought I'd give it a try since there are a lot of people comparing the Twilight series to the Harry Potter series, which I love to tiny bits.

I'm halfway through *Twilight* (the book) now. The book is slightly better than the movie, but I'm not very attracted to the series. I couldn't put Harry Potter down, but I could put Twilight down to do other stuff.

Is it a sign that I'm growing older?

Merry Christmas everyone!

I know I haven't updated in ages, but yeah, I'm still alive and kicking. I might do a large round-up in a couple of days.

I have been reading a book by Phillip Yancey: What's So Amazing About Grace, and this paragraph hit me:

In one of his last acts before death, Jesus forgave a thief dangling on a cross, knowing full well that the thief had converted out of plain fear. That thief would never study the Bible, ever attend synagogue or church, and never make amends to all those he had wronged. He simply said, "Jesus, remember me," and Jesus promised, "Today you will be with me in paradise." It was another shocking reminder that grace does not depend on what we have done for God but rather what God has done for us.

Beautifully written.

Beware: the incidents detailed below may only be understood by doctors/nurses.

Last Thursday was the most stressful day in my working life as a doctor.

My entire team was away/on-call/in another hospital/in operation theatres. I was left all alone when I received a fast bleep.

Nurse: Mrs U has a pulse of 150 and a systolic blood pressure of 60. She is pyrexic too.
Me: How long has this been going on?
Nurse: Since this morning.
Me: Didn't the other house officer notice this?
Nurse: He said *patient's ok, just continue.*
Me: O...kay. I'll be up shortly.

Ten minutes later... After assessing the patient, doing all the basic stuff, and waiting for the ECG to be done. Patient was obese and immobile with a long list of cardiac complications, diabetes and a laparostoma. PLUS, she doesn't speak/understand English. Recruited a Gujerati-speaking janitor to help with the translation.

Me: Ask her if she has chest pain.
Janitor: I'm in charge of feeding her, you know.
Me: JUST ASK IF SHE HAS CHEST PAIN. NOW.

Me: *starts to panic* ****** ****.

ECG showed supra-ventricular tachycardia, most likely fast atrial fibrillation. Heart rate was 200/minute. Patient looked like she was about to expire anytime. Shouted for the nurses to push the arrest trolley down from the end of the ward and tried to ring my reg on his mobile, but he was scrubbed up in theatres with the patient opened up already. I grabbed the ECG and ran down the Emergency Medical Unit to get help. Fast bleeped the medical registrar. Medical registrar turned up in record time.

Med reg: Where are your seniors?
Me: They are not here.
Med reg: Are you all alone?
Me: Yes.
Med reg: This is unacceptable.

Recruited the janitor again to translate. Med reg thought that patient has had a massive heart attack. Reckoned that patient only had hours to live. Started discussing 'Do Not Resuscitate' orders and who to ring the family with me. Suddenly, the janitor who was listening to the discussion butted in.

Janitor: I have an important question to ask.
Med reg: Go on then.
Janitor: Should I still give her lunch?
Med reg and me: ....
Med reg: If you're hours away from dying, lunch would be the last thing on your mind.
Janitor: But lunch is very important! I'm in charge of handing out lunches!

At the point, the med reg and I just walked away. The story didn't end there, but there's already a lesson to be learnt.

Moral of the story: Horror stories of janitors feeding dead patients tea ain't very far-fetched.

So, I have been working as a proper doctor for the last 10 days.

Funny story of the week:

*bleep (pager) goes off, and I answer the page*
Me: Hello, Dr Wong speaking. Somebody bleeped me?
Nurse: Yeah, Mrs XXX has a blood pressure of 80/50 (hypotensive) and not passing any urine. Can you please come down and see her?
Me: Okay, will be over in a minute.

*10 minutes later, and after assessing the patient.*
Me: I've written up some fluids for the patient because she's very dehydrated and she's also post-surgery. Can you please put them up stat (ASAP)?
Nurse: Okay, leave it to m.

*One hour later, I went over to check on the patient*
Me: *horrified look* Why is the patient still having a blood pressure of 83/50? Have you put the fluids up?
Nurse: Oh, sorry. I went for my break. I just got back.


Lesson of the day: tea breaks for nurses are more important than the patient's life.

THREE CAREERS YOU’RE CONSIDERING/YOU’VE CONSIDERED:
1. Doctor
2. Electronic/electrical engineer
3. Professional musician

THREE WAYS THAT YOU ARE STEREOTYPICALLY LIKE THE OPPOSITE SEX:
1. I don't like doing housework at all.
2. I don't like the colour pink. Refuse to wear pink if possible.
3. I crack disgusting jokes sometimes.

TWO TRUTHS AND A LIE, IN NO PARTICULAR ORDER:
1. I love food.
2. I want to be a surgeon.
3. I'm in love with a friend.

THREE WAYS THAT YOU ARE STEREOTYPICALLY A GIRL:
1. I love shopping, make-up and dressing up.
2. I can't resist a sappy romantic movie/book.
3. I enjoy receiving flowers, although I think it's a waste of money and I'm allergic to pollen.

Yup, I'm graduating in 6 days. :)

My folks have flown in from Malaysia, and I'm being pampered by mummy. :)

Life's good at the moment.

Wow.

Only a couple of weeks of doing poplocking properly again, I'm starting to see and feel the changes to my physical state. My arms are more toned, my abs are starting to feel firmer and my stamina/ muscle control/ flexibility have definitely increased.

I had a fitness level showdown with the guys over at church last Saturday, and I beat them hands down at flexibility and muscle control! And that is only after 1 week of proper crunches, push ups and hardcore poplocking foundation practice.

Poplocking foundations include hitting (as in controlling muscle tension according to the music beats) and muscle/joint isolations. Although poplocking isn't popular with girls (mainly because it's not exactly very feminine-looking), it's great for getting a toned and beautiful figure. :)

Watch this space! Photos coming up!

Since coming back from Malaysia, I got onto the weighing scale and realised that I have gained 5kg as a direct result of eating too much and bumming around too much. So, my mission before graduation is to lose the 5kg of extra weight. So far, over the past 1 week, I have lost 1.5kg and I'm working on losing the rest by the end of this month.

My current weight-loss programme:
(a) Diet
- cut out as much carbohydrates as possible. That means, no bread, less rice, no sugar in coffee/tea. Luckily, I don't have a sweet tooth and I don't like desserts very much. Therefore, cutting out sweets, chocolate bars, ice-cream and cakes shouldn't be too hard.
- Instead of carbohydates, I'm eating more protein. That means, more hard-boiled eggs. As opposed to traditional health myths, you can eat as many eggs as you want, and the cholesterol levels aren't as bad as eating a pack of fries.
- Drink more water so that I won't feel so lethargic and dehydrated.

(b) Exercise
- Loads and loads of walking briskly around. I am walking an average of 5-6 miles a day. :) It helps when the surgeons walk very fast when it comes to ward rounds.
- Plains ol' working out in my room with stuff like sit-ups, stretching, push-ups, etc.
- I admit I'm very rusty when it comes to dancing. Back in my 1st and 2nd year, I danced quite a lot and I had a pretty good figure (IMHO). I wasn't stick-thin, but I had curves in the right places and I could fit comfortably in a UK size 8 dress (that's a US size 4?). Last week, I even had problems fitting comfortably into a size 10 shirt. Thankfully, it's getting better. Therefore, I'm taking up dancing again - mainly hip-hop and poplocking. Hopefully, the girl living below me won't complain of the noise I'm making.

So there. I have the ability to make my weight balloon down if I really put effort into this. :) I can't wait to fit into a cheongsam by this date in July!

*jaw drops open* And I thought I was the only one who could do all those weird contortions and double-jointed moves for party tricks... You know, stuff like touching my forearm with my thumb. I have never seen contortions being incorporated into traditional popping and locking. This video is just sick.

Hugh Laurie (on Dr House): First of all, he heals people. That's attractive in its own right.
Craig (the interviewer): Yeah, that's sexy.

Can any other doctors testify to this? :p