Blog

What I learnt from 6 months of Orthopaedic Surgery.

I have recently just finished my first 6 months of Orthopaedic Surgery. It has been such an enjoyable experience and I have learnt so much from it. Starting the rotation, I was quite apprehensive. I have never worked in orthopaedics before, and my knowledge and understanding of orthopaedics were limited, to say the least. My only exposure to orthopaedics was 6 years ago when I had a 4-week rotation as a medical student. 

Initially, I had every thought of swapping out of the run. Now that we are 6 months in and about to move on to another rotation, I believe that one of the best decisions I made in 2024 was to stay in orthopaedics for 6 months. During this period, I have learned so much about a very interesting specialty and also learned so much about myself. Amongst these are 3 main takeaway lessons that will continue to guide me in the future. 

1. You can learn anything. 

This was so true in orthopaedics. Having never really known anything about the specialty, I had to learn quickly.  When there is no other choice, you either sink or swim. I am glad to say I learnt to swim quickly. 

With the internet at our fingertips, learning new information has never been easier. Rather than trawling through textbooks manually, a quick Google search brings up a plethora of excellent resources. God knows how many times I have looked up an unfamiliar pathology and followed the recommendations on Orthobullets, an online wiki for orthopaedics.

By the end of 6 months, I had become comfortable with most acute orthopaedic presentations and could manage them safely; I even overcame my fear of spinal pathologies. Starting out, whenever I got called about back pain and spinal injuries, my heart would sink. Now, I can approach it with the system I have learnt and practised over the past months.  

Being surgically inclined, I am also very glad to have expanded my surgical skill set and can independently fix ankle and hip fractures.  On my last 2 days on the run, I even had the opportunity to spend all day in the Acutes operating theatre, even running one by myself, where I was able to perform ORIF (open reduction internal reduction, i.e. fixing bones with metal screws and plates) alone, the only assistance being a phone call or question to a senior who remained unscrubbed or operating in another theatre.

As my long term goal is to do volunteer surgery for organisations such as Mercy Ships and Doctors without Borders, I believe that the more skill I have, across a broader range of surgeries the more useful I can be in those settings. 

Going forward, I can now trust myself to learn anything quickly. The secret to it is to remain inquisitive - find ways of discovering the answer. If you are unsure, find someone who has the experience and knowledge to teach you. When they see that you are keen to learn, most people are more that happy to share what they know with you!

2. Confidence builds competence, and competence builds confidence.

Starting the run, while I did not have much experience, I have done the registrar job in other specialties. With 12 months of General Surgery and 12 months of Plastic Surgery under my belt, know how registrar job works. This gave me confidence in my abilities to cope with the workload. Not only that, I have enough basic understanding of surgical principles that helped me some confidence despite not knowing much orthopaedics. 

Having come off another rotation where I was significantly more stressed for many reasons, I set myself the goal to be more calm, collected and confident in this run. This meant I must still be well held together even when I feel like I know nothing. And surprisingly, this worked. 

I found that the intention to remain considered and relaxed helped boost my own confidence. Doing so allowed my seniors and consultants to trust that I had things under control and helped me to gain more confidence in myself. It also helped me to perform well in situations that pushed my abilities, allowing me to build my competence in managing orthopaedic issues. This quickly became a positive cycle. When I became competent and knowledgeable, I was, in turn, able to be more truly confident and push myself in even more demanding situations. 

So, how do I ensure I continue this in the future? I believe that it is very much mind over matter. No matter what comes your way, stay calm and trust that whatever it may be, you will survive and be better because of it. This calmness and trust will help you navigate the problem with confidence, and ultimately, you will increase your skill and abilities, or at least your tenacity!

3. No matter the opportunity, with the right attitude, there is always something to learn. 

As I mentioned earlier, I believe staying in orthopaedics was one of the best decisions I made in 2024. However, I must admit that there were countless times before the rotation when I had thought about swapping the rotation or quitting the job so that I didn't need to do something I thought was irrelevant to what I had intended in my career.  However, after some encouragement from my seniors, I carried on, and I am so glad that I did!

By sticking with it, I discovered a new specialty that was incredibly fun, filled with excellent people and great banter. It has got to be one of the most enjoyable surgical rotations I have done in my career so far. Thinking back, I can only imagine what I would have missed out on if I had taken another path. In the 6 months, I have expanded my clinical and surgical acumen, acquired competency and independence in more surgeries, learned some lessons for life, and made new friends that I otherwise would not have met!

So, if you ever find yourself in a situation where the road ahead seems uncertain, challenging, or maybe unsure how it relates to your goals and aspirations, crack on and give it a try. You never know what you may find or learn in the experience. And if you approach it with the right attitude, nothing is ever wasted!

Returning to the blog.

Wow! It has been over two years since I last wrote a blog post. So much has happened and changed in that time. At the time of my last entry, I was still a House Officer in my second year of working. Since then, I have stepped up to become a registrar. This has meant my workload has also increased significantly, hence the slackness in my writing. 

I have also since moved to Auckland. While I absolutely loved my time in Tauranga and would go back there in a heartbeat, I really did have to move to a bigger city to gain the experience and training required to become a specialist in my field. I am keen to pursue a career in Plastic Surgery, and the only hospitals that provide the scope required are in large tertiary hospitals.

Going forward, I am hoping to continue with weekly blog entries. This may encompass something I am learning, a book I have recently read, or some reflections from work or training for an Ironman 70.3 race.

3 months of ED: What I loved, and why I will never do it again.

Bells ringing. The radio announcing the next ambulance to arrive. 

Friday Five (Issue 3)

1. Find your purpose

2. Do the work

3. Building relationships

4. Create better systems

5. Serve others

My Purpose in Life

There is one area that I know I will be serving, no matter where I end up, or what I do. 

My life's direction is to serve others and to help them achieve the best of their abilities. 

Whether this is through teaching; helping students achieve the results so they can apply for their program.

Surgery: curing patients of cancer or at least giving them a fighting chance to re-enter society, and continue to chase their dreams.

Friday Five (issue 2)

1. Make learning a habit

Create systems that help you build knowledge and understanding. Whether that's a podcast, and bookmarked website, or having a book by your bedside. Decreasing the barriers helps you learn something new every day. Imagine that! By the end of the year you would have learnt 365 new pieces of information if you just learnt one thing every day.

2. Envision who you want to become

A clear vision of who you want to become helps you prioritise your efforts to achieve your goals.

Where do you see yourself in 10 years time? Now, what do you need to start doing to help you become that person?

3. Address your weaknesses

Constantly reflect on your own abilities. To solve a problem, you must first understand it. 

Only by knowing yourself can you become actively work on your weaknesses and become a better person. 

4. Embrace your strengths

Knowing your weaknesses is important, but you must also know your strengths. What are you good at? Use your strengths to your advantage, and maximise them. Become good enough and you can lead others in your area of expertise. 

Know yourself.

5. Did you know 3 dogs survived the Titanic?! 

Belonging to first class passengers, they were taken into the lifeboats by their owners. 🐕

Ironman got cancelled!

Today would have been race day - if it was not for Covid.

That's right, covid-19, the disease that started over 2 years ago, that is still wrecking its path across the world in what has got to be the most global pandemic to date.

The past month saw a surge of omicron across New Zealand. Our old approach of isolate and eradicate has been thrown out the window to embrace a new strategy to live with this terrible virus while minimizing strain on our health system.

In saying that, gatherings are still significantly limited in order to restrict spread of omicron, and hence large scale events like the international ironman competition had to be cancelled.

Friday Five (Issue 1)

From this week I will be starting a Friday blog series entitled the 'Friday Five', sharing 5 of the top things lessons I have experienced in the past week.

Note I used 'experienced' not 'learned' because I believe you can superficially 'learn' something without truly understanding what it means. Therefore it is my endeavour to 'experience' the lesson so that I can really apply the gold nugget as I continue to navigate my way through life.

Here goes, the first Friday Five.

1. Take more daring action

You won't know what the outcome will be until you have taken the action. There is no added value by worrying excessively. 

If you are even 80% sure that what you are about to do is the right thing, take the action. Even if it turns out wrong, you will learn invaluable lessons you would not otherwise experience.

2. Rest and recovery is vital to success

Any athlete would be acutely aware of just how important rest is. It allows the body to recover from all the training, and is vital in helping consolidate the hard work you've put in, and turn that into fitness and muscle.

Similarly, in life it is important to have sufficient rest. This enables the mind to recover from mental strain, keeping your thinking sharp. It also has ample physical benefits - keeping you energised, and maintaining your immunity.

As Stephen Covey would put it, remember to 'sharpen the saw'.

3. Find honest supporters

We all need back up as we navigate life. People who will be by our side even when the going gets tough. However, mere supporters are great, but not enough if you want to truly exceed your current limits. 

An honest supporter is someone who goes beyond cheering your accomplishments and sharing your sorrows. They dare to point out your flaws, help you realise what you need to change in order to reach your goals, or just remind you to be a better person. 

Find someone you trust to give you feedback, even when it may be a tough pill to swallow. When you do find someone like that, take the time to recognise what they are doing - its not always easy to speak the hard truth - and take their advice into account as you decide on your next course of action. 

4. Pray and plan - always, for all things

As a believer in God, I trust there is a greater purpose and design in life. This does not mean things already have a set pre-determined outcome.  It just means that there is something greater and better that is destined for your life than you can comprehend. However, the only way to get there is if you dutifully complete your half of the puzzle, and trusting God to do the rest. 

Through prayer we can bring the tasks beyond our capabilities to our omnipotent God. Alongside this we must also plan our own actions, in accordance with what is right by Him. 

5. Live to serve

We live in community. If we exist alone and care only for ourselves, then life is meaningless. Only through service do we truly realise our potential, and build a meaningful legacy through the lives we touch. 

The most inspiring people are those who have it all, yet still have the humility to care about the weakest and most vulnerable. 

Be inspired to serve, and my your service inspire others. Together is how we make the world a better place.

Reflections; a life well lived?

Context: written during a memorial service for my recently deceased grandmother. Composed as we reflected and reminisced on the life she had lead.

A life well lived?

Adventures explored, and places been

To experience and dare

To dream and to share

To live, to feel, to love

And to care.

For alone we are nothing

Meaningless. Dust, none other.

Yet together, new spirit alive in vigour

After all matter is but dust to gather.

When a tree falls in a forest, and none is to hear

Then did it fall?

Even if so, when? where?

Who cares for the silent?

Who care for the dead?

Memories belong to those of the living

Memories. To be shared.

A petal floats

from spring to fall

Sweet remnant of a blossom been

A song resounds

around a valley vast.

Sensation felt, and heard, not seen.

Gone past - still present

soft fading fate

A glimpse of reflection

in flowing stream beyond the silver sheen.

Getting back into studying

Every year comes with a new set of challenges. That is both exciting and daunting at the same time. 

For me 2022 is the year I need to pass my surgical primary exams. This is a difficult exam that assess all of human anatomy, and physiology, as well as some pathology. Basically the foundational knowledge that all surgeons need.

However, I have never been a great 'study-er'. Throughout my education thus far, I have succeeded on the 'cram-and-dump' technique.  For the majority of tests I would have up to 1-2 weeks of cramming, sometimes as little as 2 days. But I have been told that the surgical primary exam takes most people ~6 months to prepare, and even then not everyone passes.

In the coming months I will be experimenting with various study techniques, and see what I enjoy the most, which methods are most effective, and how to maintain study motivation. Hopefully through my experimentation, not only will I successfully pass this exam, but also be able to create some real content that might help fellow students and budding surgeons get through the challenge of exams.

Stay tuned to follow my journey in studying!

Ironman 70.3 Countdown: 9 weeks

Start of a new year! Blasted it off with a 90km ride on new years morning, followed by a 30 minute run. 

It was so hot by the time I got to the run that I struggled so hard to keep my heart rate within zone 2 (aerobic) zone.  

Regardless of how the training went, I am glad to say that I have started the year pursuing my personal aspiration. Who needs new years resolutions - its much better just to get out there and start living whatever the resolution might be!

Ironman 70.3 Countdown: 13 weeks

This year has been a year full of training. Sometimes consistent, and others sporadic maybe even lazy. 

We are currently 13 weeks out from race day. With only 3 months to go, I do not have anymore wiggle room to be slack on my training. It is imperative that I abide by my training plan to ensure I make the most out of the build towards the race, and perform at the peak of my abilities on race day. 

Over the past few weeks, I have been doing some Ironman training already, however have been particularly slack on some workouts - namely the long weekend sessions. Those have been particularly difficult to motivate myself to do, mainly because it just takes up so much time!

I have also been spending a lot of my time looking at gear and buying what I need - especially on the cycling and swimming fronts. Running if fairly straight forward - just a good pair of running shoes, which I have recently purchased during my marathon training (unfortunately the race was cancelled due to the COVID delta variant lockdown).  For now the swimming is covered, I have bought a new wetsuit that should serve me well in the race. Biking is my biggest concern.

I have just bought a second had road bike - but am now faced with the challenge of learning to ride in cleats. Having now purchased some riding shoes and cleats this weekend, I am practicing clipping in and out of the pedals. Surprising, it was more difficult than I had anticipated. In the moment of an imminent fall, it is so hard to make your foot do what it needs to and complete the rotational motion to release it from the clips. 

Prior to getting a road bike and cleats, I have just been practicing on a mountain bike with flat pedals - as you can imagine, this is quite a different experience from riding a road bike. Being an alloy mountain bike, it is also significantly heavier - and therefore I would like to think it is much slower. I do hope my speed will improve significantly once I can ride on the lighter carbon road bike.

Gold Nugget: Stop for Coffee

Doctors are well known for drinking lots of coffee.

And I must admit, I am a bit of a coffee snob. To me a cup of coffee is so much more than just a delicious hot drink, with a kick of caffeine to get you on your feet. It has layers of flavour, fragrance, tastes and textures. 

But there is something even more important about coffee than any of that!

In the hospital, oftentimes teams would stop for coffee at some point during the day - if time allows. Some teams might have it every day - sometimes more than once a day. While other teams may only enjoy of cup, once in a blue moon.

On my surgical rotations especially, the team would often stop for coffee after ward rounds. 

A code name often used for coffee is Mr Brown. So we would finish seeing all our patients, and then we would collectively decide that we also need to go see Mr Brown and include them in our ward round. Besides operating in theatre, or seeing a patient get better because of what you have done, seeing Mr Brown is my favourite part of the day.

I think there are 3 things in particular that makes stopping for coffee so beneficial.

1. Team bonding. 

• Over coffee you get to know your colleagues a little better. 

• You’re not just talking about patients, surgeries or work, rather you get to know what other people do in their free time, what hobbies they enjoy, and maybe even activities you can do together.

2. Rest and reset. 

• By stopping for coffee, you also get some time to remove yourself from the business of the wards. 

• You get to take a step back and relax a little. 

• Just like cutting down a tree you need a sharp axe, stopping for coffee is like sharpening that axe, so that when you get back to work you are more relaxed and can be more focused on the tasks at hand.

• Not to mention you also get a caffeine boost

3. Breaks up your day

• Adds a bit of variety to your day, 

• In medicine, it is inevitable that you will be faced with a particularly challenging day - or week, sometimes even an entire rotation. So even on a day when its particularly stressful, or maybe your even contemplating why you ever decided to do this profession in the first place, you still have something that you can enjoy during the day - it may be all that’s needed to make the day that much more manageable.

Now medical students, here is a situation you might find yourself in.

The team is going for coffee, and someone is offering to buy coffee for you. Now some students might feel bad that they are always being bought coffees, and feel like they can’t contribute.

But that’s totally OK. In most cases, student’s aren’t expected to pay for coffees, and the majority of doctors I have come across are more than happy to buy their students coffee!

Think of it as paying it forward. The doctors are buying you coffee now, and one day, when you are in their position, you can pay for the coffees of your team and your medical students.

So whenever I grab coffees with my students, I always tell them just to pay it forward and remember to buy coffees for their future medical students. 

Some of you might also be wondering - what if I don’t like coffee, or don’t want it?

Firstly - I don’t understand, you are missing out on an essential experience of the human life. Its like being able to breathe, but in a brown liquid form, that gently caresses your mouth and warms your soul with every sip.

That makes me sound like a coffee junky - I love coffee, but not to be addicted - more on that later.

Second - that’s totally OK, have a hot chocolate, or a tea.

You will almost certainly get roasted for it at some point in time, but hey, we roast you out of love, like we love our coffee beans to be roasted.

So evidently, I love coffee, but I would say there is one thing that I am careful about when it comes to coffee, and that is to never be dependent on it. Actually this doesn’t just apply to coffee, I have a pretty blanket rule for my life that I can’t be dependent on anything. 

Because I love coffee, I want to enjoy drinking it because I want to - not because I need to. 

In order to do this, I make sure I don’t get coffee every day. It might happen that we go for coffee every day as a team, in which case I would keep my weekends coffee free - and enjoy some proper Taiwanese green tea instead. 

Something a surgeon once said to me - in the context of a complex surgical procedure, but I think also applies to various areas of life is - you want to be in control. In an operation, you want to be able to control any bleeding so the patient doesn’t suffer from it. And in the case of coffee, I want to be in control of my physiology. I want to be able to do good work - without having to rely on a caffeine fix. 

Another upside of this is that when I do drink coffee, I truly get to enjoy it, and if I can’t access good proper coffee, I wouldn’t cave in to drinking a poorly made cup of coffee just for the effects of being caffeinated. 

So this sums up my expression of love for the wonderful, deliciousness that is coffee.

I’m off to enjoy a flat white, see you next time.

Back into lockdown

Badumbadumbadum. My heart beat resounded inside my skull. My feet sore again and again with each step on the treadmill. Adrenaline pumping, dopamine rushing throughout my system. Upping the speed, then relax, then up again, and relax.

As I did my tempo run workout, my eyes shifted towards to television screen above the gym. "Community covid case in Auckland". Oh... ok. I kept running. "Prime minister announcement at 6pm". Sure, why not. After all, I'm in Tauranga, and the case is up in Auckland. We'll be fine.

I looked down at my watch - 5:50pm. Oh right, 10 more minutes until the announcement. My brain didn't really acknowledge what was showing up on the TV screens. Apparently the Taliban have taken over Afghanistan, and chaos everywhere. Half of Australia is living in lockdown. Another screen showed some red bull sponsored extreme sports. Cool bananas. 

I kept running, pushing through the pain to complete the training session. After a while I looked up again, and there was the prime minister. I didn't really know what she was saying - the TVs didn't have any audio. So I kept going, I ran and I ran. Then my eyes focused on the bottom of the screen - "Lockdown". 

More words scrolled across the bottom banner - "Nationwide lockdown in level 4 for at least 3 days, starting 1159pm." That's when it gripped my attention, and my feet pattered away at their own accord, fading into my subconscious mind. 

Alright then, here we go again.

People matter

What matters? 

Everything you do affects others. Remember that; leave a positive impact.

Serve people.

Rules give us more freedom!

Imagine a game where the goal is to get the ball from one side of the court into the opposing teams basket. Let's call the game ball-basket. Besides getting it into the opposing basket, there are no rules. The court does not have any boundaries marking out the playing area. There are no rules dictating what is and isn't allowed by the players in the game. Players can kick, bite, throw, punch, run, whatever they choose really. Imagine how well that game will play out... it would be chaos. And that is why we have basket ball, where players must abide by a commonly agreed set of rules - and if you break them, you incur some sort of penalty. There is a limit to the size of the playing.

We all want more freedom, however, having too much freedom can actually be a problem in itself. 

The same applies to our lives. 

Recently I experienced a rather stressful week of work. I was exhausted and not loving my job. Now I must admit, I like to enjoy a nice glass of alcoholic beverage at the end of a long week. However, I also have a rule I've made for myself - I will never be dependent on any substance. Why? Because I don't want to be controlled by something else, especially if it will be detrimental to myself and others. Thus from this came another rule - I will never drink, or use any potentially addictive substances/activities when my mood is especially low. I don't want to create a negative cycle where an addictive behaviour becomes my coping mechanism.

Now some people may say rules are unnecessary, but I'd beg to differ. The aforementioned rules I have set for myself around substances doesn't take away my freedom from enjoying a nice pint of beer, or glass of vino. Instead, because I have this rule I am not dependent on the substance, and on the occasions I would like to treat myself to a nice drink, I have the liberty of doing so. I am freed from worrying about a one off drink becoming a regular habit - because I have rules in place to prevent that from happening. Moreover, it saves me the stress of thinking I might be getting overboard with drinking. It also facilitates developing better and healthier coping mechanisms for dealing with stress. 

Rules can also apply to other aspects of life. For instance, I will always spend less than half of what I earn - including any living expenses. As my income increase, this percentage will likely decrease. I am not allowed to have caffeine every day - this way I can enjoy the pleasures of a good coffee, without the withdrawal symptoms when I cannot get a caffeine fix. I must do some sort of exercise first thing in the morning - even if its only 30 seconds, so long as it gets my heart rate up. This allows me to be warmer for the day, and helps we make up, giving me more energy to tackle the day, unrestrained by brain fog.

There are definitely still areas of my life where I need to consider placing rules around. For instance, studying. Despite having survived medical school, studying is still a weakness of mine, so how can I create a rule that will help me study, and open doors for me to pass exams and become a surgeon?

Rules give us parameters to work within. And it removes the mental effort of deciding where your boundaries lie. Everything has been already decided; you just need to focus on taking action of the moves that fall within your courts. 

Experiment with different rules. Create your own rules for life. See for yourself if you live more freely with them in place.

Make Daily habits

One of the most difficult things about doing anything new is sticking to your commitment. New habits are a common commitment we promise ourselves. However, they can be so difficult to stick to. 

I have found when I try to incorporate something into my life as a 'sometimes' option - for instance doing an ab workout 3 times a week - is more difficult than doing it every day.  When you set out to do something every day, there are no excuses - you will need to do it every day so might as well start today. However, if it is every other day, it becomes so much easier to just do it tomorrow. The problem is tomorrow will always be tomorrow. 

Moreover, when something is laid out as every day, it means you can automate it into your day. You no longer have to think, it just exists as part of your routine. On the other hand, if it is more irregular, then you have to exert mental energy to decide which days to do them on. It also gives you the unwanted opportunity to delay the task to another day, should a particular day become busier. And you won't feel guilty, because you still intend to fit in those 3 workouts a week... but just not today... and more likely will turn out to be never. If you miss a daily task on the other hand you will have to be accountable for your action (or lack thereof) - and you will know by not completing it, you have failed for that day. 

From now, whenever I want to make something a new habit, I will try to do it every day. Currently, I am trying to do stretches and core exercises in addition to my pre-existing push-ups first thing in the morning. Today is day 1 over many more daily stretches to come. 

To leave a legacy - a stream of consciousness account

My life goal is to live an enjoyable life, and leave a meaningful impact that will last years, and maybe even centuries after I am gone.

The eulogy exercise is when you think about what your friends and family will say about you at your funeral. It may sound morbid, but it is a very useful tool in helping you find your life direction. 

As I write this account, I am currently also thinking about what I would like to leave behind when I die. For me, life is more than just a meaning less existence amidst the expanse of time and history. Instead, I see it like the drop of water in the ocean, while seemingly insignificant, its energy nevertheless ripples and shakes the water. The right energy, in the right place, at the right time can have a phenomenal impact. You can be the butterfly, whose flap of a wing can stir up a thunderstorm.

Yes, this does sound a bit narcissistic I admit, but hear me out. We are each allotted a limited amount of time and energy - from the moment we are born until our dying breath. Every second that ticks by, every ounce of energy - physical or mental - can only be used once and then its gone. Over the history of human civilisation there has been millions of people. Most people would have probably used a reasonable amount of that time and energy in service of the people immediately around them - and that is good. More than good, in fact, I would say incredibly respectable. One should pour dedicate their energy in service of those they love. But for the majority of people, once they die, their influence may ripple for a little while, maybe in the memories of their family, and the friends they have influenced, but after a few years they are forgotten, and their wave fades away into the ocean. A select few however manage to leave their mark. Despite being but another drop of water in the abyss, their impact echoes and resonates for years or even centuries.

So if you are going to be a fleeting moment, why not make the most of it? Why not strive to leave the greatest impact? Why not build a legacy that can stand the test of time and echo down the generations?

Because it is incredibly difficult. Not just difficult, but also unpredictable. Even if you play all the cards right, how can you even know that the legacy you struggled to build is the one that remains - if it even remains at all?

But it is doable, and we all know people who have achieved this level of continuance. They are the historical figures we learn about. The Martin Luther Kings, the Mother Teresas, as well as the Hitlers and Stalins. The saints and heroes, but also the devils and villains. They have all left a legacy, and shaped the way our society exists today. The flap of their wings stirred up storms that reformed the way we perceive and interact with the world.

So how did they do it? To be honest, most of the great historical figures probably weren't even aware their legacy will last for centuries. They merely poured their hearts and souls into pursuing what they believed was valuable. And for our heroes, their values improved upon the lives of others - so much so that we can still feel its warmth til this day. We look up to these titans of history, and they inspire us to be better, and push us to do more. If anything, I believe that in itself is an incredible legacy to leave - the legacy of inspiring generations of young people to rise up and strive to create a better world for the future. And that is what I want to achieve. I want my story to be told in a way that motivates, inspires and invigorates others to take action in making the world a better place. 

So what do I need to do? I need to go out and be intentional in serving those I interact with. And in doing so find unmet needs that can be filled with a heart of service and lots of hard work. If I do all that, then I can only hope that my story will be told, and my life will inspire others, even beyond the grasps of death.

Life is a series of problems - and you are the solution

Challenges are an essential part of life. Without them, life would feel empty and meaningless. Yet how often do we want to shy away from the difficulties that come our way?

Believe that you are the solution. It is what the human race has been doing for eons. Solving problems was the foundation that enabled us to create civilisation, invent incredible technology, and all in all the answer to living a fulfilling life.

Problem solving is about service. It is filling a need that you have identified. Whether that problem in question is a personal failure, a business setback or an entrepreneurial opportunity, it exists because something is missing. Now because you have identified the problem, you can either be part of the solution, or be a coward and hide from the responsibility of doing something. 

Be brave and courageous, everything that you face in life is perfectly positioned as something that you can overcome. Otherwise it's not a problem, it's a fact of life. 

One month into Ironman 70.3 training

We are a third of the way through a 12 week Ironman 70.3 training. With 7-8 hours of training 

So far I have managed to complete every workout, and haven't missed a day yet. Injury free at the moment - and I intend to keep it that way. Although I haven't sustained any physical impairments yet, I can feel my muscles and tendons starting to get tight.
One of the things I have been really slack about is stretching. Despite knowing that this is an essential part of injury prevention, I often feel so tired after training that I forget the recovery is just as important. I've already had knee and ITB injury from marathon training in the past so I should know better!

8 more weeks to go. With regular stretching and intentional recovery, we can make it to the end unscathed, better and stronger than ever. Bring it on!

Controlled impulsivity - using peer pressure for self improvement

Sometimes all you need is some hype and a healthy dose of peer pressure to do something stupid. Sometimes that something stupid also happens to be something beneficial. It is times like this that we can employ peer pressure to help us push our limits, and increase the boundaries of our abilities.

The secret to commitment, is more commitment.

Committing to anything can be difficult. There may be things you really want to do, but never came to making the commitment with yourself to see it through. In my own life, this has happened far too often, and see me drift away from my life goals. 

So how do we become more committed to our hopes and dreams? While self discipline definitely plays a significant role in this, there are other ways that we can influence our own psyche to be more focused on completing a task.

One of the ways is to start by committing what you can. For instance, I want to start Ironman training, but have procrastinated for almost half a year. But today, I decided to commit. I went and signed up for a swimming pool membership, brought a pull buoy to help with my technique, and hopped in the pool straight away. 

Doing this tricks our brain in a number of ways. Firstly, we make a financial commitment. Coming from a conservative and frugal Asian family, nothing goes to waste. So by committing hundreds of dollars in a membership and gear, I am stingy enough to want to make sure I get my money's worth and make the most out of my membership, and use the equipment I have bought. This also plays into the 'sunk cost' fallacy; where the more invested in something, the harder it is to back away from it. Since I've already committed so much, I might as well see it through to the end otherwise all this will be for nothing.

The second thing was to start straight away. As soon as I got the membership I went for my first training swim. The key here is to start. There are a million reasons not to; I'm too tired, I'll start tomorrow, there's not enough time today, I don't have the right gear. If we give in to these reasons, we become faced with so much inertia and become paralysed in the present. However, by starting straight away - even if you don't have time and can only do a 10 minute swim - you are proving to yourself that you can commit. You have taken that first step and finally moving towards your goal. You start to push against that inertia, building a new momentum.

Start committing with what you can, and work your way up. As with everything, start one step at a time.

Starting my Ironman training 

One of my goals in my first year as a house officer is to complete an Ironman 70.3. 

This week I have finally made a start towards achieving this goal. Despite not having a bike, cycling gear, or a swimming wetsuit, I am making a start - and that is what matters most.

A few ideas that I've come across recently is "Start before you are ready" and to "Do what you can".

While I have had some experience in running, I have never really done any cycling or swimming. But starting before I am ready is important - if I never start, then I will never be ready. Only after you've taken the first step, can you take the second, then another, and another. You cannot do your 100th ride, without the 99 that came before it.

"Do what you can" is a thought that came to me while I was hesitating about training. The thought of preparing for an ironman has been on my mind for quite a while now. In retrospect, all that time I have been finding excuses as to why I can't start; namely the fact that I do not own a cycle. And since cycling takes up the majority of the distance and is one of three events, how can I even think about doing an ironman without owning one?

Well, the "Do what you can" rule applies to when you might not have everything you need, and so you have to make do with what you have. I don't have a bike, or open swimming gear, but I have a cheap gym membership, and a pool close to where I live. At my gym, there are cycles - while not identical to riding on the road, I can still improve my endurance and become accustomed to the movements and techniques involved in riding a bike. Even though pool swimming cannot fully replace open water swimming, I will be better prepared for when I do get into the ocean. Do what you can, and use what you have; something is always better than nothing.

So here we go, week 1 of Ironman training - no bike, no wetsuit, no problem!