Truth

What are the questions that fill people's minds?
I wonder if they are the same as mine?
I wonder if they are searching for truth

What is the meaning of life? Forty-two?
What purpose does my life serve here on earth?
People devote their lives to many things...
Science and research - looking for that cure
Philanthropists, pacifists - doing "good"
Hedonism or asceticism?
Heaps for the former, few for the latter
Success and fame...how many know your name?

What if choices were simply black or white
And replaced all of the grey around us?
Like who would I vote for? Who can I trust?
Why does it matter? What really matters?
Who should I believe? Who's telling the truth?
Can I base my opinion on the news;
Second-, third- or tenth-hand information?
Dig deep and you'll find dirt on anyone
Everyone is flawed and everyone lies
So how can we possibly find the truth?

I find myself looking for guarantees
Money-back, satisfaction or lifetime
A guarantee for love, relationships
Happiness and a family of my own
A guarantee of work, food and shelter
Simply the basic needs for survival
But these are not guarantees we all have
Some of us are luckier than others
Death seems to be the only guarantee
Even taxes are evaded by some

When my understanding is incomplete
I have nowhere to turn but towards faith
Faith that my car will start in the morning
Faith that the plane won't crash when I fly home
Faith that justice and mercy will prevail
One day, for all those who suffer right now
In an imperfect, unjust, unfair world
A faith that there is more than meets the eye
Faith I hope grows into mustard seed size
A rational faith that is based on truth

The truth is that people matter a lot
I wish I made more time for those I know
Family, friends, and people who are in need
To share about life, to explore the truth
To help because I'm called to and I can
Would having thirty hours a day help?
Probably not - I’m great with excuses
Historically, that seems to be true
Maybe I should just make my wish come true

I guess I want to uncover the truth
Because where there is truth, there is freedom
Doesn’t everybody want to be free?

John 14:6 (NIV)
Jesus answered, "I am the way and the truth and the life. No one comes to the Father except through me."

John 3:1-21 (NIV)
"Now there was a man of the Pharisees named Nicodemus, a member of the Jewish ruling council. He came to Jesus at night and said, "Rabbi, we know you are a teacher who has come from God. For no one could perform the miraculous signs you are doing if God were not with him."

In reply Jesus declared, "I tell you the truth, no one can see the kingdom of God unless he is born again."

"How can a man be born when he is old?" Nicodemus asked. "Surely he cannot enter a second time into his mother's womb to be born!"

Jesus answered, "I tell you the truth, no one can enter the kingdom of God unless he is born of water and the Spirit. Flesh gives birth to flesh, but the Spirit gives birth to spirit. You should not be surprised at my saying, 'You must be born again.' The wind blows wherever it pleases. You hear its sound, but you cannot tell where it comes from or where it is going. So it is with everyone born of the Spirit."

"How can this be?" Nicodemus asked.

"You are Israel's teacher," said Jesus, "and do you not understand these things? I tell you the truth, we speak of what we know, and we testify to what we have seen, but still you people do not accept our testimony. I have spoken to you of earthly things and you do not believe; how then will you believe if I speak of heavenly things? No one has ever gone into heaven except the one who came from heaven—the Son of Man. Just as Moses lifted up the snake in the desert, so the Son of Man must be lifted up, that everyone who believes in him may have eternal life.

"For God so loved the world that he gave his one and only Son, that whoever believes in him shall not perish but have eternal life. For God did not send his Son into the world to condemn the world, but to save the world through him. Whoever believes in him is not condemned, but whoever does not believe stands condemned already because he has not believed in the name of God's one and only Son. This is the verdict: Light has come into the world, but men loved darkness instead of light because their deeds were evil. Everyone who does evil hates the light, and will not come into the light for fear that his deeds will be exposed. But whoever lives by the truth comes into the light, so that it may be seen plainly that what he has done has been done through God."

Neuro Mnemonics

Hurray for mnemonics! Here are some of the good ones I've come across recently during my neuro revision...

Differential Diagnosis: VITAMIN C & D

V - vascular
I - infectious/inflammatory
T - trauma
A - autoimmune
M - metabolic/toxic
I - inherited/iatrogenic
N - neoplastic
C - congenital
& - other/unknown/idiopathic
D - degenerative

Coma Etiology: AEIOU TIPS

A - acidosis/alcohol
E - electrolytes/endocrine
I - infection
O - overdosed drugs
U - uremia
T - trauma to head/toxins
I - insulin (too little or too much)
P - psychotic episode
S - stroke/shock/space occupying lesion/subarachnoid hemorrhage/seizure

Seizure Differential: SICK DRIFTER

S - substrates (sugar, O2)
I - isoniazid (overdose)
C - cations (Na+, Ca2+, Mg2+)
K - kids (ecclampsia)
D - drugs: CRAP (Cocaine, Rum/EtOH, Amphetamines, PCP)
R - rum (alcohol withdrawal)
I - illnesses (chronic seizure disorder, other chronic disorder)
F - fever (meningitis, encephalitis, abscess)
T - trauma (epidural/subdural/intraparynchymal hemorrhage)
E - extras: toxocologic (TAIL = Theophylline, Acetylsalicylic acid, Isoniazid, Lithium) and the 3 Anti's (Antihistamine overdose, Antidepressant overdose, Anticonvulsants [too much dilantin, too much tegretol, benzo withdrawal])
R - rat poison (organophosphate poisoning)

Differential Diagnosis for Headache: "MM...IT ACHES!"

M - migraine
M - meningitis
I - increased intracranial pressure
T - tension headache/temporal arteritis
A - AV malformations
C - cluster headache
H - hypertension
E - eye disorders (refractory errors, glaucoma)
S - sinusitis, subarachnoid hemorrhage, systemic illness

Headache Red Flags: SNOOPS

S - systemic symptoms (fever, weight loss)
N - neuro symptoms (confusion, altered level of consciousness)
O - onset (sudden, abrupt or split second)
O - older patient (new onset or progressive, especially if >50 yrs)
P - previous history of headaches (1st headache? New or different? Change in attack frequency, severity or clinical features?)
S - secondary risk factors (HIV, systemic cancer)

Diagnostic Questions for Migraines: is it POUNDing?

P - pulsatile quality
O - over 4-72 hours
U - unilateral
N - nausea/vomiting
D - disabling intensity

Migraine Diagnosis: SULTANS

Need 2 or more of following...
S - severe
U - uni
L - lateral
T - throbbing
A - activity provokes

Need 1 of following...
N - nausea
S - sensitivity to light/sound/smell

Etiology of Delirium: I WATCH DEATH

I - infectious (encephalitis, meningitis, UTI, pneumonia)
W - withdrawal (EtOH, barbiturates, benzodiazepines)
A - acute metabolic disorders (electrolytes, hepatic/renal failure)
T - trauma (head injury, postoperative)
C - CNS pathology (stroke, hemorrhage, tumor, seizure disorder, Parkinson's)
H - hypoxia (anemia, cardiac failure, pulmonary embolus)
D - deficiencies (vitamin B12, folic acid, thiamine)
E - endocrinopathies (thyroid, glucose, parathyroid, adrenal)
A - acute vascular shock (shock, vasculitis, hypertensive encephalopathy)
T - toxins (substance use, EtOH or EtOH withdrawal, sedatives or sedative withdrawal, narcotics like morphine, anesthetics, anticholinergics, anticonvulsants, dopaminergic agnets, steroids, insulin, glyburide, antibiotics like quinolones, NSAIDs)
H - heavy metals (arsenic, lead, mercury)

Differential Diagnosis for Dementia: VITAMIN D VEST

V - vitamin deficiency (B1, B9, B12)
I - intracranial tumor
T - trauma (head injury)
A - anoxia
M - metabolic (diabetes)
I - infection (postencephalitis, HIV)
N - normal pressure hydrocephalus
D - degenerative (Alzheimer's, Huntington's, Creutzfeldt-Jakob disease)
V - vascular (multi-infarct dementia)
E - endocrine (hypothyroid)
S - space occupying lesion (chronic subdural hematoma)
T - toxic (EtOH)

Some extracranial causes of acute confusion: HIT ME

H - hypoxia (respiratory failure, heart failure, carbon monoxide, poisoning)
I - infectious (septicemia, pneumonia, UTI)
T - toxins/meds (EtOH, benzos, BB, anticholinergics)
M - metabolic (hepatic/renal failure, electrolyte imbalance, B12 deficiency)
E - endocrine (hyper/hypothyroidism, hyper/hypoglycemia, hyper/hypocorticism)

Things to ask in Hx for dementia: DEATH SHAFT

Ask about basic activities of daily living (ADLs):
D - dressing
E - eating
A - ambulating
T - toileting
H - hygiene

Ask about instrumental activities of daily living (IADLs):
S - shopping
H - housekeeping
A - accounting
F - food preparation
T - transportation

Signs and Symptoms of Parkinson's: TRAP DGEMMS

Major:
T- tremor (classic "pill-rolling")
R - rigidity (cogwheeling/ratcheting, smooth/lead pipe)
A - akinesia/bradykinesia (slow, difficulty initiating)
P - postural instability

Minor:
D - dysphasia, dysphagia
G - gait abnormalities (slow shuffling, short stride, less arm swing)
E - eye abnormalities (wide eyes)
M - micrographia
M - mask-like facies
S - subcoritcal dementia

Discipleship Revolution

I thought today's sermon was great. There was a guest pastor by the name of Paul Butler and he spoke about his passion - helping to bring about a discipleship revolution.

Pastor Paul used three three-word mnemonics to help us join in on this discipleship revolution. He spoke from 1 Thessalonians 1:2-10 and reminded us all that we should be living as disciples of Christ, not merely believers; we should live in a way inspired by Jesus Christ with our works coming by faith, our labor prompted by the love of our God (who sent His one and only son to die on the cross for our sins), and have endurance inspired by the hope of eternal life. Faith, love and hope.

One truth that Pastor Paul brought up was that it is the Holy Spirit's work that leads people to repentance and ultimately salvation. Too often I think that the words that I use, the well-contrived arguments and my rational thinking can sway people when it comes to the truth - the truth about life, love and what purpose we serve being here on earth. Wrong. We do our best but it's by God's grace and by the Holy Spirit that people are saved. The apostle Paul makes it very clear that the power of the gospel lies not in the words that we use to present it. It comes through power, deep conviction and joy given to us by the Holy Spirit. Power, conviction and joy.

I don't like being wrong about anything - nobody does. This is especially true when it comes to worldviews. When I claim to be a follower of Christ, what does that mean I think about all the other religions out there? Jesus said, "I am the way and the truth and the life. No one comes to the Father except through me." So basically, this means that if God indeed exists and Jesus turns out to be God (as he claimed to be), then any other worldview that claims to have an alternate way to heaven/God/enlightenment/nirvana/whatever is wrong. I didn't make up the rules, God did - the author of life and truth. Unfortunately, this comes across as exclusivism and rubs a lot of people the wrong way. We can and should do our best to plant the seeds and water them but ultimately it's up to God and the Holy Spirit to soften hearts...

The last bit of the sermon today was focused on how to kick-start the discipleship revolution. He spoke of Jamie Oliver and how he has taken his passion for food and cooking and written a book on the "Ministry of Food". Basically, Jamie has started this "pass it on campaign" to teach people how to cook that follows a discipleship method. You learn how to make something like spaghetti bolognaise, you invite a couple of your mates over for dinner, and using the book you talk both of them through the recipe. Once they've got it down, they can each go and teach two of their mates the same recipe and the result is a powerful, exponential explosion of people who can now make this dish.



The way Jamie Oliver is spreading the joys of cooking and food to countless people is the same way that we as Christians should be spreading the gospel of Jesus Christ - through a mentorship/discipleship scheme. In fact, we should be probably be telling more than just two people because the gospel message will determine how we spend all of eternity. Food is great and everything but most of us can't even remember what we cooked or ate a few days ago. It is such a temporary and fleeting experience and within hours (or minutes for some of us) we are hungry yet again. How must more desperate should we be to teach others about the truth of Jesus Christ so that the church can grow exponentially and fulfill the great commission? Pastor Paul told us to remember three words for discipleship (which I forgot and had to be reminded of after church LoL) from a mentorship perspective:

Intentional - it needs to be proactive; we must initiate the process or it won't happen
Investment - commit to meeting once a week with someone to talk about one thing that Jesus teaches us in the bible and how to apply it to our lives today.
Imitation - we should imitate the example set by the apostle Paul and, in doing so, imitate Christ

We need to develop a passion for people through...
Faith Love Hope
Power Conviction Joy
Intentional Investment Imitation

Was just listening to a song I really like called "Revolution Cry". I believe it was originally written by Jason Wade of Lifehouse while he was with a band called Blyss. Steve Fee did a cover of it on the Passion Worship Band album "Sacred Revolution". Have a listen below =)

Next Stop: RBWH

Dear student

The numbers for each Clinical School for Year 3 2009 are now fixed. If you wish to change Clinical Schools you may only do so by finding someone to directly change places with you. Students will have to organise this exchange themselves and must inform both Clinical Schools in writing. No exchanges will be accepted after 31st October 2008.

Congratulations you have been allocated to: RBWH Clinical School


This is great news as it means I will not be forced to find a new place to live (as I have done each year so far here in Australia). Now all I have to do is pass... x_x

Contraception Effectiveness

Some methods of contraception are pretty good and some just suck. Here's a list of a few from worst to best...
(stats taken from Toronto Notes 2008. For more details about each method, go here)

Chance
- nothing used...just flying by the seat of your pants and rolling a 10-sided dice every time = 10.0%

Female condom = 75.0%
Withdrawal method/coitus interruptus = 77.0%
Rhythm method/calendar/mucous/symptothermal = 76.0%
Spermicide along = 82.0%
Diaphragm w/ spermicide = 90.0%
Condom alone = 90.0% (assuming proper use which often doesn't happen)
Condom w/ spermicide = 95.0%
NuvaRing (once-a-month hormonal contraceptive) = 98%
Depo-Provera = 99%
Hormonal skin patch > 99%
Oral Contraceptive Pill = 98.0-99.5% (depends on compliance)
Tubal ligation = 99.6%
Vasectomy = 99.8%
Abstinence = 100.0%

What I don't understand is how the surgical methods (tubal ligation and vasectomy) aren't 100%? If you tie off the tubes and do a little snip-snip, how can the sperm still get there and induce a pregnancy 0.2-0.4% of the time? Another category I didn't include are the emergency postcoital contraceptive (EPC) methods, also referred to as the "morning-after pill". By taking a large bolus of progestin or combo estrogen/progestin after the fact within 24 hrs, they will terminate any potential pregnancy 98% of the time (you can take it up to 72 hrs after I think). I wouldn't say they prevent a pregnancy because technically fertilization may have taken place in the uterine tubes at that point - they just do a very good job at making sure it doesn't progress any further. I think there are some serious ethical implications of EPC methods that separate it from the other classes of contraception.

If you don't want to be starting a family anytime soon, maybe it's time to consider how effective your chosen method of contraception is and make changes as necessary...

Halfway

50% completed or 50% left to go? Time 'til freedom or time left to study? There should actually be another 11.5 hrs added to the timer because I won't be done until 11.30am on Wednesday. AND, there will be only be pseudo-freedom (or short-lived at the very best) after my exams because I'm going to be busting my balls to try to prep for the USMLE Step 1. x_x

Created by OnePlusYou

Goodbye My Friend

Dear Ronnie/Pomaron/Ronstars,

It's been a while since we've had time to catch up. I still remember what a pleasant surprise it was to see you at S.N.O.W. last Christmas. Ever since you left for Edmonton to do pharmacy, it's been tough to keep in touch. I wish I could have met up with you before I had to jet off to Australia again. You've got me in this deer-caught-in-headlights shock man and I don't know what to do. I don't know what to write or what to say but I can't help but remember our time spent together...

Much of my time yesterday afternoon and evening was spent looking through some old photos that Nathan had uploaded from the good 'ole days at Evangel Alliance Church. We were the 'Evangel Boyz'. What a memory explosion and how thankful I am that Nathan was so good at diligently photographing everything throughout the years. I don't know how I would have survived all those years without you there. Not officially, but you were the leader of that small handful of us that made up the EAC youth; and not just by default either but deservedly.

You were so cool and mature. As a teen I thought you were so lucky to live with your sister and have your level of independence. I remember getting into Gran Turismo 2 because of you and giving the Final Fantasy games a shot (never really caught on to the FF series). Remember that choreographed Matrix-style fight scene you had with Gabe at EAC's 10th Anniversary celebration? I wish I knew karate or kung-fu or some form of I-can-kick-your-ass-art like you.


There weren't many people I looked up to but you were one of them. You were the closest thing to a goh-goh or "older brother" that I had. It was awesome having you a couple years ahead of me to light the path ahead of me in many ways. Asking you about school stuff like whether I should take IB in high school. Bugging you about university and eventually choosing to major in biochemistry - just as you did - and then realizing how freaking hard it was to memorize all that crap and spend all that time in labs (I didn't realize that because you were so stinkin' smart and chill playing foosball throughout uni - you made it look so easy). I still have your chem 201/203 and bio 231/233 labs and notes in my room back in Calgary. Wouldn't have gotten A's in those classes without your help.

I remember how we were the first of the next generation to get baptized at EAC. I wish I had a copy of your testimony saved somewhere.

But by far the best memory I have is how we both started really getting into worship music. Neither of us were satisfied with the simple piano accompaniment our church had been using for years and years and we wanted more...we wanted to start a revolution that would introduce guitars, drums and just a modern sound into our church music. And so we set off to learn the instruments ourselves...starting with the guitar. I still remember how nice your guitar was (a Simon & Patrick) compared to mine (my uncle's old Yamaha SJ-180 that I was borrowing - no offense uncle!!). We set out to teach ourselves chords and for the purpose of playing in church. You were the sifu and I was the todai trying to learn whatever I could from you.

Do you remember the first song we led together on the guitar? I remember this set that we led back in June of 2001. I was playing keys and you were on the guitar. I'm pretty sure we did "Open The Eyes of My Heart" and "Every Move I Make" among others. I remember Every Move because we were trying to teach people the part that goes "La la la la la la la la la la la..." and when we got there nobody knew how to time the 'las' and nobody could sing it LOL. At that point I had managed to learn the chords for "Lord Most High" and that was the one song we both played the guitar for - you leading and I struggling along with you trying to keep up.

It was so cool to see you this past winter and to see that you were still passionate about worshiping God through music (and through the rest of your life). I'm still playing the guitar now and I thought I'd play that first song we learned together. It sounds a bit empty without one of us singing the echo parts or maybe doing a bit of harmonizing during the chorus. But that's okay as long as God gets the glory. If I close my eyes I can almost hear your voice singing in the background...

You were a true friend and I count myself blessed to have known you. I'm going to miss you heaps. Your selfless, caring attitude will never be forgotten. I look forward to seeing you again when my time here is finished. Rest in peace.

Your brother in Christ,
Matt