The off-season: Stoke City

Like Hull City, Stoke will be struggling to stay up this coming season. They were hard to beat in the Championship with the impregnable defence but in the Premier League they will need more than that to stay up. I really don’t think they will be able to stay up if they continue with the squad they currently have.

GK: Steve Simonsen, Thomas Sorensen

Getting Sorensen will help bring some solidarity in between the posts. This is a goalkeeper who has experience with Aston Villa, Sunderland and Denmark. Simonsen may have been given a chance but I think Sorensen will start in goal at the beginning of the campaign.

RB: Andy Griffin, Lewis Buxton

Griffin might be an experienced right-back with Newcastle United, Portsmouth and Derby but I don’t think he has the capability to be a Premier League right-back. Clearly Tony Pulis will need recruiting in the upcoming weeks.

LB: Carl Dickinson

I have never heard of Dickinson which doesn’t say much about his playing ability. Even if Dickinson is an unfound treasure playing in the lower leagues, Stoke will still require a back-up left defender in Dickinson falls foul to any injuries.

CB: Leon Cort, Ryan Shawcross, Andy Wilkinson

In Cort and Shawcross, Stoke have two up and coming centre backs. They maybe have fantastic ability but experience is still wanting. Tony Pulls will need to bring in another centre-back, preferably somebody with experience.

WG: Liam Lawrence, Danny Pugh

Not a great line-up - a Manchester United reject and somebody who couldn’t make the grade with Sunderland. I actually think Lawrence is underrated and shouldn’t have been booted out of the Stadium of Light by Roy Keane. I still think Pulis needs to recruit a natural winger.

CM: Glenn Whelan, Salif Diao, Rory Delap, Seyi Olofinjana

Probably Stoke’s strongest area with Premier League experience with Diao & Delap plus natural flair in Olofinjana and Whelan. I don’t think Stoke will require buying players in this area.

FW: Richard Cresswell, Ricardo Fuller, Dave Kitson, Vincent Pericard, Jon Parkin

Probably not the most impressive line-up in the Premier League. None of the players actually lit up the Premier League or are twenty goals per season strikers. Fuller is chronically injured whilst Kitson was not prolific in the two seasons when he was playing in the Premier League. It will require more goals to keep Stoke City up. Even Pericard, who has played for Juventus and Portsmouth, is not in the frame.

Summary

In: 1 x Right-back, 1 x Left-back, 2 x Centre-back, 2 x Wingers, 1 x Forward
Out: Buxton, Phillips, Parkin, Pericard

The off-season: Hull City

Hull City will be in the top flight for the first time in its history, which stretches back more than a hundred years. So forgive me if I state I know nothing about how the team play or what kind of players they have. Phil Brown, who used to be Sam Allardyce's number two at Bolton before going off to Derby and failing there, will have a hard time keeping them up. In the back of his mind he knows the team won't stay up. He will have to wait out this season, pick up the parachute payments and try again the season afterwards to consolidate themselves in the Premier League.

With that said, he does seem to be attempting to stay in the Premier League from some of his summer signings...

GK: Boaz Myhill, Tony Warner, Matt Duke

Bringing in Warner gives Hull City some Premier League experience between the sticks. Although Myhill is a keeper with international experience with Wales, he's still relatively inexperienced and will be facing top strikers every week. Don't be surprised if Warner starts to be in the goal during the middle of the campaign.

RB: Nathan Doyle, Bernard Mendy, Sam Ricketts

It will be a straight fight between Ricketts & Mendy for the number two position. Doyle may move on but he's still young.

LB: Andy Dawson

Dawson still is the only left back on the squad, so it won't be a surprise if Brown recruits a more experienced left-sided defender to back-up or even displace Dawson.

CB: Michael Turner, Anthony Gardner, Wayne Brown

Hull needed to bring in a defender with Premier League experience, so bringing in Gardner on loan was a good find. They still need to bring in another central defender.

WG: Ryan France, Richard Garcia, Nick Barmby, Craig Fagan, Peter Halmosi

This is where Hull have an abundance of wealth. With Nick Barmby being the experience they need, it will alow the likes of Garcia, Fagan & Halmosi to attack without fear. France is most likely to leave though.

CM: Ian Ashbee, Geovanni, Bryan Hughes, John Welsh, George Boateng

Brown has got the best idea of bringing two veterans in the likes of Geovanni & Boateng to be the centre of midfield. It looks like club veteran Ashbee will have to take a back seat whilst Welsh needs to rediscover the form he had at Liverpool.

FW: Caleb Folan, Dean Windass

If Brown doesn't recruit now, he won't be in the job come Christmas. Goals keep you up and he doesn't have any strikers of worth. It's difficult seeing where the goals will come from for Hull City at the moment. Folan didn't exactly light the Premier League up with his previous club Wigan Athletic whilst Windass will be used sparingly due to his age. Phil Brown will have to invest in a striker with Frazier Campbell, last season's top striker for the Tigers, staying at Manchester United for the immediate future.

Summary

In: 1 x Left-back, 1 x Centre-back, 2 x Forwards
Out: Doyle, France, Welsh

Running around like Mike the Headless Chicken

I'm really thank I have been posted to my current convalescence hospital. Compared to other hospitals, the workload is lighter. I don't have to admit many emergency patients which would require asking a proper history and performing a thorough clinical examination. Most of the patients I admit are transferred from the main hospital for convalescent care or are having elective surgery. Therefore most of their details are already on our electronic database and only requires a cut & paste approach. Of course for each patient I do ask how they are doing and assess their condition but it is much easier.

Most of the blood taking is performed by the nurses but I am proficient in taking blood, since I need to do it if the nurses can't, for example if they can't find a peripheral vein, for cross matching blood and when a blood culture is required. Most of the other stuff the nurses can do but usually require the house officers' signature. Interns do get ridiculous calls from nurses just to say what the blood results were and they require the interns to do nothing, just so that they are informed. Basically the nurses are covering their arses and shelving responsibility to the interns, in case something goes wrong.

Since I'm based around four floors in the current hospital, most of the time I'm running around like a headless chicken try to do all my tasks. One manages to sort out which is necessary and what can be left to a later time but I do manage to get off work at a reasonable hour, if you call six o'clock a reasonable hour. If fact I don't mind working to late. I don't have nothing much to do in the evenings. I'm just thankful I don't HAVE to revise or study when I get back in the evenings. Eventually I will have to study, since I can't remember how to read an ECG or what to do in particular situations but that will come later. Most of the evenings I'm bored to death now. Initially I had videos to watch on my notebook. Now I've run out of videos to watch and can't download any on the hospital internet networks. So I'll have to wait until I get back home to retrieve my videos. I can't be bothered to go out since that requires money and I can't watch a movie every day. So far I have resorted to buying some books and now am engaged in the fierce rivalry between Mr. Darcy and Elizabeth Bennett (prize to the first person who knows which novel that comes from).

At times I'm grateful I am busy and at other times I wish I had something to do... like now.

In need of a booty call

I had a good call night last night, with nobody calling me between 01:00 and 08:30. It's a bit of a coincidence that the calls I have without being called in the middle of the night, I'm attached to the same doctor. With that said, my day was busy with me having to certify the death of three patients and taking massive amounts of blood for microbiological work-up. I thought I can take blood well but I've still a long way to go.

********

As a constant horndog, I'm always seem to be looking out for a girlfriend. Unfortunately my options are very limited. I'll start with my largest group - patients. If I liked very old woman this wouldn't be a problem but I still want to stay with my age group. The only lady who came close was somebody who came in for thyroid surgery - she looked like an actress I keep seeing on Hong Kong TV.

There are a couple of cute nurses in my current hospital but most of them are too old for me or too Hongkie for me. I've been teased constantly how my hospital ID photo, which was taken about seven years ago when I was thinner, does not correlate with my present appearance. Probably for this reason I'm ruling out nurses.

So what about doctors? I've always maintained in the long term I don't want to be married to a doctor. I do want to talk about something other than medicine. I have a lot of doctor friends but when they gather, I'm usually bored stiff out of my mind when they start talking about exams, patients or anything else medically related. I know I cannot date somebody who's a medical officer now even though I may be older than her - I don't want to upset the social balance of this conservative society. I don't have many options within the intern pool since everybody seems to be paired up.

What I really need is a f*ck buddy. Somebody I can pay a booty call just for sex and have no intimate relationship or attachment to. Unfortunately the idea of a f*ck buddy in Hong Kong is a farfetched as free elections, so I have to give that up.

The off-season: Wigan Athletic

If Wigan had been relegated last season, I don't think anybody would have missed them. Like Middlesborough, Bolton and Fulham, they have pitiful attendance records and other bigger teams such as Nottingham Forest or Leeds United or areas where they are no Premier League team like the West Country or Yorkshire would pull in more fans. As it is they managed to stay in the Premier League by getting rid of a bad manager (why did anybody think Chris Hutchings would do a good job?) and getting a dire manager who was struggling with his own team, Steve Bruce.

Regarding Birmingham City who were relegated, Bruce has raided his former club for players but hasn't done really much that would satisfy Wigan fans, if there are any. He still needs a major recruitment drive soon, otherwise it will be another tough season for the Latics.

GK: Chris Kirkland, Mike Politt, Carlo Nash

With Politt recently signing an extension, it will look like Nash going as he has been on loan other a few Championship clubs already and will no doubt interest many.

RB: Mario Melchiot, Ryan Taylor

With Emmerson Boyce more likely to shift to centre-back, Bruce will allow Taylor to revert back to his usual role as right-back but to be second choice to Melchiot's experience.

LB: Erik Edman, Martin Figueroa

If Bruce can tie down FIgueroa to a permanent deal, he won't have any issues in this position.

CB: Emmerson Boyce, Paul Scharner, Titus Bramble

Everybody knows what will happen here - Bramble has to leave. He's the worst player to grace the Premier League. He's the reason why we have so many foreign players in the Premiership. After Bruce has finally got rid of Bramble, his main priority is getting a couple of decent centre-backs.

WG: Luis Antonio Valencia, David Cotterill, Daniel de Ridder, Kevin Kilbane, Jason Koumas, Rachid Bouaouzan

With Bruce bringin in de Ridder, Cotterill's days are numbered at the JJB Stadium. Also Bouaouzan will be looking for a new club after doing sod all. There have been rumours of Kilbane and Koumas leaving but that would be suicide by Bruce. They are two exceptional footballers who can keep Wigan in the Premier League.

CM: Wilson Palacios, Michael Brown, Oliver Kapo

After recruiting more players from his old club, I think Bruce will stop here. He may recruit another central midfielder but he has priorities elsewhere.

FW: Antoine Sibierski, Henri Camara, Emile Heskey, Marlon King, Amr Zaki

Only Heskey and new recruit Zaki are guaranteed to at Wigan come August. King has been shopped around despite being recruited in January whilst Camara and Sibierski have fallen out of favour with Bruce. Expect at least anothe forward coming to Bruce's squad in the next few months.

Summary

In: 2 x Centre-backs, 1 x Centre-midfielder, 1 x Forward
Out: Nash, Bramble, Cotterill, Bouaouzan, Sibierski, Camara

Movie Review - The Dark Knight

I used to write for a movie site called "The Trades". The writers were a group of amateur enthusiasts covering the world of entertainment, covering box office grossings to TV shows. Whenever I had the chance I would write movie reviews for the site, especially if the film was opening in Hong Kong before it opened in USA, where the website is based. I stopped writing a few years ago - mainly because I didn't have time to go to the cinema to catch the first screening of a movie and then immediately write about the quality of the acting but mostly because I started to become more dispassionate about the quality of films. I would constantly hype myself up about a film only to be disappointed. I should stop watching too many Hollywood films and turn my attention to other world areas but it is difficult to find these films.

On Wednesday I finally found a film that lived up to its hype - "The Dark Knight". You may have heard it broke all box-office records but it doesn't say anything about the quality of the film. It is one of those films I would go back to see in the cinema again. Christopher Nolan has broken all the rules - he's made an action film with intelligence, a sequel far superior than its predecessors and a summer blockbuster which could vie for best movie of the year. Forget about Oscar nominations for Heath Ledger, you could start dishing out nominations for the film itself as Best Picture and Christopher Nolan as Best Director.

Much has been lauded about Heather Ledger's performance as the Joker. A very deep psychotic performance compared to the wacky, insane approach by Jack Nicholson, Heath Ledger totally dominates the movie. Forget Best Supporting Actor, Warner Bros. could seriously push him for Best Actor. It's a good thing they didn't try to explain the Joker's origins, which helps with the mystery.

That's not to say the other actors performances were poor. In any other film, Aaron Eckhart would be lauded as Harvey Dent whilst Maggie Gyllenhaal was radiant as Rachel Dawes. Christian Bale continues to represent Bruce Wayne/Batman well whilst you cannot fault Morgan Freeman and Michael Caine when they were on screen.

With "The Dark Knight", Christopher Nolan has truly flexed his muscles and shown he can direct and write well. The plot and storyline are intelligent down to the finest details whilst the dialogue and directing are spot on, with nothing too cliched.

See this movie, because it is the only good movie out there.

The off-season: West Ham United

Last season West Ham United were the most average team in the Premier League and probably in the world. Too good to go down but too crap to vie for European places, there season petered out by February. With the recent takeover Hammer fans should be expect to challenge for Europe. Yet the money has been tighten and Alan Curbishley needs to sell before he can, which has lead him to shed some excess weight already.

GK: Robert Green, James Walker

After Richard Wright was sold back to old club Ipswich Town, it will be just two keepers battling it out. I don't know why Green has been ignored by McClaren and now Capello in the England reckoning. He clearly is better than most English keepers around.

RB: Lucas Neill

Now with Pantsil having gone to Fulham, Curbishley will probably need another right-back but he still has the option of playing Spector here.

LB: George McCartney

West Ham United seems to be lacking full backs, with only McCartney being the only left-back. And he's not that good either. There has been rumours of Nicky Shorey at six million pounds but with purse strings being tighten, Curbishley has to look elsewhere.

CB: Danny Gabbidon, Anton Ferdinand, Matthew Upson, Jonathan Spector, James Collins, Calum Davenport

Probably a well packed area but with too many inferior players. Gabbidon, Collins & Davenport are surplus to requirements whilst Ferdinand has been shopped around since his off-the-field behaviour has been overshadowing his performances. It only leaves Upson & Spector as the real centre-backs likely to keep their places.

WG: Fredrik Ljungberg, Julien Faubert, Kieron Dyer, Matthew Etherington, Luis Boa Morte

At one point Curbishley had too many right-wingers but after getting rid of Norberto Solano and most likely to payout Ljunberg to go somewhere else the number and quality of wingers is just right.

CM: Scott Parker, Mark Noble, Hayden Mullins, Lee Bowyer, Nigel Quashie

After hopefully getting his worst buy in the form of Quashie, it is most likely Curbishley will just consolidate in this area.

FW: Dean Ashton, Craig Bellamy, Carlton Cole

After selling Zamora (which I think is a bad idea) and not keep Henri Camara, there is a need for a striker, especially with the injury problems of Bellamy and Cole's uncertain future. There haven't been any names flouted around, since it will require a considerable amount to pay for somebody decent.

Summary

In: 1 x Right-back, 1 x Left-back, 1 x Forward
Out: Collins, Davenport, Ljungberg, Quashie

Post-call + taking it on the chin

I'm currently post-call. I don't know why doctors have to differentiate between pre-call, call & post-call but they just do. My call last night was relatively good. Only had to be waken in the middle of the night once at 03:00 for fever which I should have dealt with early at midnight. That's all part of the learning process.

********

I had a relatively long weekend. When I write 'relatively' it means that - doctors don't have long weekends like other professions. My long weekend was from Saturday afternoon to Sunday night, meaning I could go home and sleep overnight. I do what I normally do at home - eat, drink & sleep plus bake. Since my dad is away on business, I can get to cook dinner which I'm not normally entrusted with, despite being quite good at. I enjoy the cooking process - creating something that other people get pleasure out of. Whether it is baking carrot muffins or baking fish in lemongrass & curry leaves, I enjoy the end result. Also it was nice seeing my dogs around and playing with them.

********

I was in the lift the other day with my supervising MO, a doctor friend of mine, when this obnoxious couple started commenting about her appearance. To give you a background I live in the most conservative society in the world where burns patients have more skin exposed than girls/ladies. This ignorant couple started commenting on my friend's dyed hair, dress sense, stockings & high heels. They regarded it as "inappropriate" for a doctor

Let me just say she was not provocatively dressed at all. My friend was not wearing a see-through low-cut top or a short skirt. She was not wearing red, three-inch, f*ck-me heels. She wears her make-up beautifully (unlike most Hong Kong ladies) and she has dyed her hair. She was dressed smartly But does this has nothing to do with her performance, her attitude or her professionalism as a doctor.

We could talk back since we don't a dreaded visit from the public relations officer, so she had to take it on the chin and just stand there whilst this couple continued their inappropriate barrage on her, just half metre away. There is always this phrase that the customer is always rights but it is wrong. Most of the time the customer is ignorant and doesn't know what he truly wants, whereas the business/service has a much better understanding of the customer needs. The customer is blinded by hearsay, rumours and dodgy advertising, so his/her view of perspective is clearly distorted.

We don't doctors in flip-flops, shorts and a tank top. But calling somebody inappropriately dressed when she clearly isn't may say something more about the caller than the target.

A good on-call day/night

I had a nice call day yesterday, what is described in my profession as "complete bed rest". You need to be a doctor to understand that type of humour.

The day didn't start off that well. I was admitted patients when I heard one of the health care assistants shouting one of the patients had collapsed. Since I was the only doctor around, I raced over to check what was going on. The patient became unconscious whilst walking to the toilet and fell forwards, banging her head & cutting her lip. I checked to see if she was responsive (no) but if she was still breathing & had a pulse (yes to both). I didn't know the patient that well since she's not on my team but had to do a quick assessment. It felt unnecessary since one of the medical officers was going to document her condition anyway but I felt as the first doctor there that I at least should write something.

In the end it didn't really matter. Three hours later the patient passed away. Her condition deteriorated very rapidly. I'm just surprised at how patients can go from being good & walking around to being comatose and near death.

********

The medical officer that I was on-call with last night was a good friend of mine. Whatever people say about her, she's a nice girl. It is slightly awkward having a friend as your senior. In the presence of other people I would call her "Dr. Chow" but if nobody is around I would call her by her first name. I know it aggravates a lot of people but in this situation she's not my pal but my superior. She's the one who tells me to do things, whether to write up discharge summaries or consultations. I just have to remind myself she's doing her job and so am I.

The off-season: Tottenham Hotspurs

We knew Ramos will do a clearout of some of the players in his squad. It is surprising that only a few players have left so far, with Cerny only the one that springs to mind. By August most of the peripheral players and even some stars will have left White Hart Lane with new players joining in.

GK: Paul Robinson, Ben Alnwick, Heurelho Gomes

With Robinson culpable of many mistakes last season, Ramos needed a more reliable goalkeeper. In stepped Gomes Gomez from PSV but will he be enough to propel Spurs to a top four finish?

RB: Alan Hutton, Pascal Chimbonda, Paul Stalteri, Chris Gunter

We all know Chimbonda is an arse and wants to leave to greener (i.e. richer) pastures. With Stalteri also likely to go, it will lave Hutton and Gunter fighting out for the number two shirt.

LB: Gareth Bale, Gilberto, Lee Young-Pyo, Benoit Assou-Ekotto

With far too many inadequate left backs, surely a few must leave during this summer. Players from the former regime such as Lee & Assou-Ekotto are set to depart White Hart Lane whilst Gilberto may stick around for another season. Ramos will want to use Bale more in his most ideal position of left-back

CB: Ledley King, Jonathan Woodgate, Michael Dawson, Ricardo Rocha, Younes Kaboul, Anthony Gardner

There have been rumours of King leaving Spurs this summer due to his constant injury plights but it will be difficult to replace his quality. More likely to go are Rocha, Kaboul (who maybe going to Portsmouth) and Gardner. That leaves a slot free to fill.

WG: Aaron Lennon, Steed Malbranque, Teemo Tainio

This is where Ramos might consider investing a lot of time and money in. He really doesn't have many natural wingers. Malbranque and Tainio are wide attacking midfielders, leaving only Lennon as the only out and out winger. He may consider playing Modric or dos Santos in the wide areas though.

CM: Didier Zokora, Jermaine Jenas, Kevin-Prince Boateng, Adel Taarabt, Tom Huddlestone, Jamie O'Hara, Luka Modric, Hossam Ghaly

We all know Ghaly was expected to leave and maybe followed by Boateng but I'm surprised that O'Hara and Taarabt might be on their way. They are both technically gifted playmakers who will do well in any Premier League team. That said there are far too many midfielders at Tottenham and to make room some have to go.

FW: Dimitar Berbatov, Robbie Keane, Darren Bent, Giovani dos Santos

Even though Bent was worthless last year, it will be difficult for Spurs to shift him to any other team if they want to recoup any of the 16 million pounds they paid for him last summer. But they did get a good bargain on dos Santos, For just 5 million pounds, he has got to be bargain of the season already.

Summary:

In: 1 x Right-back, 1 x Centre-back, 1 x Winger
Out: Robinson, Chimbonda, Stalteri, Lee, Assou-Ekotto, Rocha, Kaboul, Gardner, Tainio, Boateng, Taarabt, O'Hara, Ghaly

Settling in...

I'm finally settling into my job as a lowly intern. 90% of my job involves paperwork - filling up the drug chart or writing a discharge prescription; writing up admission management orders; booking follow-ups; writing admission notes or discharge summaries. The only thing that differentiates me from a nurse is my signature. Most nurses I know are experienced enough to know the bureaucracy of our health care system and how to navigate through it but require my signature for the authorization to do anything. I get through 90% of my paperwork without any mistakes but it is nice there is somebody like a nurse to correct me. Unfortunately none of the nurses at my current hospital are sexy.

All this mind-numbing copying of previous notes and orders has left my brain dull. Most of my clinical sense has gone out the window and I'm afraid without it I might kill a patient. I nearly did on Sunday. A patient developed a fever at 6 am. I diagnosed it as pneumonia and did what I normally would do - take blood for culture and laboratory tests plus gave her oral antibiotics. At 9 am she developed a low blood pressure. I ordered IV fluids & antibiotics for her and basically was about to leave before somebody reminded me what her blood pressure actually was. After looking at her blood pressure and nearly freaking out, I eventually called the medical officer on call. Before long the patient was sent to the Special Care Unit because of septic shock. I just hope I develop back my clinical sense so I don't kill another patient.

Doing procedures is starting to become much easier for me now. I almost proficient in venous blood sampling but my arterial blood sampling is still in need of practise. I had to take an arterial blood sample from a patient today. I'm fortunate the patient was in a state of stupor, since I had to poke her a few times before I could take enough to perform an arterial blood gas. I'm also relieved I could catheterise a patient's bladder without any major hitches, even though the last time I performed an urinary catheterisation was a year ago... on a dummy.

What surprises me most is the number of deaths I had to certify. In a convalescent hospital , we don't get many emergency cases. However we do get a number of terminal patients with "Do Not Resuscitate" orders. Yet it seems my luck that I had to certify three deaths in a four day spell, all of them when I was on call. Compare this to the other interns in the hospital, who haven't had any, and you start to think you have a black cloud following you.

I'm not looking forward to my next call on Friday if this keeps happening.

********

Yesterday I had afternoon tea with two of my best friends at the Peninsula. I was quite surprised that we had to queue for something like this. The food was actually very good. I loved the scones with clotted cream and strawberry jam. How I miss English food! And the tea was very good - it didn't need milk to be enjoyed. I was disappointed they didn't have any cup cakes or french fancies but you can't have everything.

Of course I'm going to whine that I could all that at home - serve tea with scones and everything else. But I have to realize not everybody could do that and sometimes the experience is more important than the food itself.

The off-season: Sunderland

I'm in the middle of my lunch break right now, so excuse me if this entry seems a little truncated.

I reckon Sunderland were fortunate to survive last season. Roy Keane is a good motivator and coach but his prowess in the transfer market is a little less desired than most. He needs to make more astute signings over the next two months to consolidate the Black Cats' position in the Premier League.

GK: Craig Gordon, Darren Ward, Martin Fulop

Even though Gordon had a slippery patch last season, he's still considered the No. 1 at the Stadium of Light and most likely Ward will back him up. Fulop has been courted by many Championship clubs so he is most likely to leave.

RB: Phil Bardsley, Greg Halford

Roy Keane should cut his loss on Halford and just sell him instead of loaning him out. He doesn't need a back-up since he has many players who can also play in the right back role such as Whitehead & Nosworthy.

LB: Danny Collins

After letting Ian Harte go and playing a centre back in this position, Keano will need to get a left-back as one of his priorities.

CB: Nyron Nosworthy, Paul McShane, Danny Higginbotham, Russell Anderson

With Anderson most likely to go, I think Roy Keane should go an experienced centre-back to balance the back line.

WG: Carlos Edwards, Roy O'Donovan, Kieran Richardson, Ross Wallace

Keane has already stated Wallace can go, despite the fact he's not bad and versatile. With Richardson and Edwards spending most of last season in the treatment room, this is another area Keane needs more numbers in.

CM: Dickson Etuhu, Dean Whitehead, Liam Miller, Greg Leadbitter, Dwight Yorke, Andy Reid, Graham Kavanagh, Arnau Riera

Everybody knows Riera, Kavanagh and Miller have fallen out of favour with Keane. So you won't be expecting them to be at Sunderland in August.

FW: Anthony Stokes, Daryl Murphy, Michael Chopra, Kenwyne Jones, David Connolly, Martin Waghorn, Rade Prica

This is where Roy Keane has the most trouble with. He seems to buy hopeless strikers and even his best striker Jones has trouble scoring. I'm sure he will keep everybody apart from Connolly but I still think he needs another striker.

Summary

In: 1 x Centre-back, 1 x Left-back, 1 x Forward
Out: Fulop, Halford, Anderson, Wallace, Miller, Kavanagh, Riera, Connolly

Many firsts

Everybody seems to remember their first time for everything. The first time they kissed a girl or boy for example. It is suppose to litter your life with memorable events that you look back on when you're older. In my short lifespan as a slave to the Hospital Authority, I've experience quite a number of firsts. Not all of them were great but some where.

I had to deal with my first difficult patient in the General Clinic, who insisted having a colonoscopy despite there was really nothing wrong with him. Yeah, he was a bit constipated and was reliant on medication to take a dump but the guy was in his late fifties and most people are starting to depend on lactulose or senna to prevent constipation at that age. Thankfully the medical officer in charge stepped in to save me from the hassle of dealing with this patient. I was eternally thankful, having been arguing with the patient for more than ten minutes. I'm just grateful these people are a minority.

I've been approached by my first drup rep during my shift in the Breast Centre. I don't know why they put a guy in the Breast Centre but they did. Probably more disappointing was the gender of the drug rep - it was a guy. I know most the drug reps in the industry are women, just to entice the male doctors into buying drugs they don't need to prescribe. Thankfully he was courteous enough to explain the drug trial I knew nothing about, about a drug I knew nothing about and gave me a free gift - a placemat for your car to prevent items like your keys and mobile phone sliding all over the place. I know it must sound daft to some people to think this is your highlight for the day but it just reminds you that you're a doctor and these people are giving you a bit of respect for what you are.

The last 'first' I'm going to write about is one 'first' I didn't expect to be doing. I was on call last night and after having done the night round, I was settling in for an episode of 'Bones' before I got a call from the nurse. I had to certify the death of a patient. My mind thought, "Jesus Christ! Isn't this suppose to be a job of a medical officer!" I was going to ask the nurse to phone the medical officer instead to certify the death. Yet I thought I will eventually have to do this. So after getting changed quicker than an adulterer who hears the partner coming into the house, I whizzed to the ward and at the same time brushed up on my knowledge on how to certify the death of a person. I had seen it done before but I had to make sure since this was somebody's life (or death as it was).

After reaching the ward and asking the patient's sisters to wait outside the room while I conducted the examination. It just dawned at me at that point this was no longer a person but just a body. I know it sounds harsh and cold but it is true. I just had to get this over with, with respect, dignity and professionalism. After making sure I had all the signs to confirm death and double checking just to make sure, I told the relatives that their brother had passed away and I was sorry. I had to get down to the business of writing all my findings and documenting everything. I had to call the medical officer on-call just to inform her what I did.

Probably what scares me most is that I don't know the patient's name - even now after 18 hours post-mortem. I think it is easier for me to not know, to actually detach myself from the event and not to personalize it. The patient (whoever he was) was from a different team which I'm normally attached to during the day. I just so happened to be the house officer on call who had to perform the necessary duties. It just is a fact of life.

I just hope that I don't encounter too many of these incidents in my career.

Week 1 out of 52

I'm one week into my intern life and I'm learning quite a lot. I'm not learning much medicine as it is. The life of a house officer is basically to learn the mundane bureaucracy and protocols that come with daily life in a hospital structure or within a health care system. You learn to know which drugs to prescribe, when you can book a follow-up clinic, how to write up discharge summaries and which people to consult for particular patients.

Perhaps I'm being too harsh since I'm based at a convalescent & rehabilitation hospital. Most of the patients I admit into the hospital have already been assessed a number of times by more senior doctors. So when they come into have surgery there is really no point asking them a history or performing a physical examination since it does really help his/her management and more important it wastes my time. Most of the time I feel I'm treating a laboratory result or a finding, which I know I've got to stop. Every time a patient has low potassium levels, I should be stopping myself prescribing potassium chloride syrup and actually go to the patient, assess his/her status and then think about some management. I hate to say it but I think my mind is being numbed. The pay off is that the work is not that taxing and my calls are not that harsh. I will probably miss having a good night's sleep when I'm on call in the admission ward but I think my mental thinking will benefit a lot more.

After this week I know which doctors and nurses are nice and who is a real bastard or bitch. Fortunately those are a minority but it does make your life hell. Thank goodness I've only got five more weeks of this. The doctors and nurses who I don't like expect you to know everything and when you don't they give you a really hard time about it. They don't know about insight or putting themselves into other people's shoes.

For once I'm really glad I have my evening free. I'm glad that I'm not revising my exams and being under pressure. I'm glad that I'm just reading for my benefit and not for the benefit of somebody else. I'm glad I have the evenings to sleep and watch episodes of "House" and "Bones" that I have (illegally) downloaded off the internet before my internship.

The off-season: Portsmouth

It's been a long time since I did an analysis on a Premier League team. Since the last time there have been many changes and a lot more transfers. I won't be going back to revisit my past analysis despite the movement.

After winning the FA Cup, Portsmouth will be needing to maintain this form otherwise they will be going backwards. This will be dependent on who Redknapp brings in.

GK: David James, Jamie Ashdown

Having the best English goalkeeper, Portsmouth doesn't need to bring in an extra goalkeeper and Ashdown is adequate enough as back-up.

RB: Glen Johnson, Lauren

With Johnson rediscovering his form, there is no need to reinforce in this area.

LB: Hermann Hreidarsson, Djimi Traore

With Traore seeming to go, hopefully Redknapp can keep Aubey to keep two left-backs.

CB: Linvoy Primus, Sylvain Distin, Noe Pamarot, Martin Cranie, Sol Campbell

Distin & Campbell are great and tough to budge, so Redknapp might want to consider getting some young back-ups since Primus and Pamarot are ageing whilst Redknapp doesn't seem to have faith in Cranie. However he won't be doing it this summer.

WG: John Utaka, Glen Little, Franck Songo'o, Sulley Muntari, Niko Krancjar

With Songo'o effectively out of the picture, I still think Redknapp will like to bring another winger. Muntari's best position is in left central midfield rather than an out-right winger. Bringing in Little reinforces the right side.

CM: Lassana Diarra, Papa Bouba Diop, Richard Hughes, Sean Davis, Pedro Mendes, Antonio Mvuemba

The best area for Portsmouth, so much so that many of the players will leave. Only Diarra and Bouba Diop are certain to stay. I think Hughes is the most likely to leave and Davis won't be far behind.

FW: Nwankwo Kanu, David Nugent, Jermaine Defoe, Ben Sahar

By bringing in Sahar, I think Nugent can effectively say goodbye to his career at Portsmouth. I don't know why Redknapp bought him in the first place. I think the leap was too far for the one-cap wonder but he's still young enough to recover.

Summary:

In: 1 x Left-back, 1 x Winger, 1 x Forward
Out: Traore, Songo'o, Hughes, Davis, Nugent

"You know, you come from nothing - you're going back to nothing. What have you lost? Nothing!"

Today is my last day of freedom. I spent most of today at the hospital where I will be doing my first rotation as an medical intern. Most of the morning was spent listening to our intern co-ordinator giving the overview of what was expected of interns and following the intern I will be taking over. After a dim sum lunch, more work was done (which I will further elaborate on) ending with a census meeting and journal review. I was at the hospital from 09:00 to 19:00 and that should be a NORMAL day for a doctor.

So how am I spending my last day of freedom? I should be spending the night learning how to perform resuscitation, how to perform a chest drain and all the other malarkey that goes with being an intern. But I have decided to spend my time by watching "Top Gear" and surfing the Internet. I want to spend the final hours of having no responsibilities just doing sod all before I have gained power come July 1st. One of lecturing doctors during pre-internship likened us to Spiderman - "With great power comes great responsibility." Essentially what the doctor is say is true. We medical students have been given powers we never had before - performing procedures, giving out drugs and doing resuscitations.

On that last point I should state I watched and participated in my first resuscitation. It was awkward, exhilarating and saddening all at the same time. It was 15:25 and my house officer got the call that a ninety-one year old patient had suddenly suffer from a cardiac arrest. We raced up three flights of stairs and already there were already two medical officers and numerous nurses there resuscitating the patient. For the first twenty minutes, I was there doing nothing, feeling stupid (not knowing what to do) plus felt being in the way. I tried to stay back whilst everybody was doing something - chest compressions, bag inflation, intravenous access, blood taking. I should also say that I also felt a bit guilty. This was a patient I admitted in last Thursday and I was wondering if I did anything wrong or did I miss anything. Even though it was five days ago, there have been numerous checks beforehand and she was well before, there is always some nagging part of your brain that tells you might have done something wrong.

After about twenty minutes, all the nursing and medical staff were getting tired. I was given the chance to perform chest compressions. It is not as easy as in practices on dummies. Getting enough strength to perform chest compressions and not being tired is very hard. I also think I broke a few ribs during the process, hearing the familiar cracking sound during my compressions. Yet it is all part of the process of learning and experience. I know it sounds terrible but that how everybody learns. It also part of the educational process to deal with death, as in this case as the patient could not be revived. We were also performing resuscitation whilst the relatives were just a few feet away balling their eyes out. Once the medical staff knew the patient could not be revived, we made the patient look presentable to the relatives. This is all part of the grieving process, since I don't think anybody wants to see their beloved one in that state.

So how did I personally handle the situation. I did feel slightly guilty that I couldn't save the patient. I think everybody does in those situations and you wish you could have done more. Yet I felt strangely numb that somebody has died in my hands, that I'm not feeling anything. Is it because she's so old that I think her time has come? Or is it due to my depression, that I feel apathetic towards everything including death?

Sometimes I wish I could feel something, even if it is bad, rather than feel nothing at all.

The off-season: Newcastle United

Even if the Messiah has returned, Newcastle United still needs to turn things around player-wise. Too many big names being paid oodles of moolah and not doing much for it. The Magpies need both quality and heart in their team and who better than Kevin Keegan to do it.

GK: Shay Given, Steve Harper

Hopefully Given will stay for Newcastle's sake, otherwise finding another quality goalkeeper is difficult and especially attracting them to the desolate area of the north east.

RB: Habib Beye

With Stephen Carr gone hopefully Keegan will bring a young exciting right-back to the side. I was thinking they could bring Nicky Hunt from Bolton so he can resurrect his career.

LB: Jose Enrique

Enrique waxed and waned last season, so I'll think Keegan will give him another chance. Keegan will still bring in some back up since he can't keep playing Charles N'Zogbia out of position.

CB: Cacapa, Amdy Faye, Steven Taylor

The most vital area where Newcastle have to invest in. Only Taylor deserves to be considered in the line-up but he needs somebody to partner him. At least two centre-backs are required.

WG: James Milner, Damien Duff, Charles N'Zogbia

Hopefully Newcastle can keep their young wingers, with Aston Villa chasing Milner and N'Zogbia saying he wants to leave.

CM: Joey Barton, Geremi, Nicky Butt, Emre

With Emre definitely going and Barton in jail, they need to bring in more central midfielders.

FW: Michael Owen, Mark Viduka, Obafemi Martins, Shola Ameobi, Alan Smith

Probably the best area for Newcastle United but they're still going to get rid of Ameobi. Smith might go or be played in central midfield.

Summary

In: Right Back x 1, Left Back x 1, Centre Back x 2, Winger x 1, Central Midfielder x 1, Forward x 1
Out: Cacapa, Emre, Barton, Ameobi

Getting desperate

I'm sure every guy does this but whenever I meet a girl I am attracted to, I subconsciously start to 'hit' or 'flirt' with her. I hope every guy does this because it will give me an excuse, otherwise I feel desperate and sick by my behaviour. I'm suddenly more polite than I'm usually am if it is a waitress or a barista, not that I'm not rude before. I'm more open to any girl I like the look of and I'm not shy like I'm usually am.I suddenly notice this when I was attaching to the intern this morning at the admission ward. When I noticed the house officer I thought, "She looks cute."

I'm so desperate for a relationship my criteria for women is now by exclusion. Any lady within in a suitable age range - not jailbait to not much older than me. The girl has to be reasonably good-looking but she doesn't have to be drop dead gorgeous. If she speaks fluent English and has had a Western upbringing, then she is within range. Other basic criteria such as not being a lesbian and not having a boyfriend/husband/partner have to be fulfilled. Unfortunately this intern did have a boyfriend and she dropped off the radar. Essentially I'm back to square one.

Why do I torture myself like this? Why can't I be patient and just wait for a girl to come to me? I just know having been single all my life my choices are dramatically falling down to zero and I won't have a lot of time to look for opportunities. I don't want to date nurses, since most won't get my upbringing, depression and sense of humour. I can't date patients and most of them are way too old and near death for my liking. Basically I'm running out of options and not liking the situation I'm in.

********

I often commentated before on how religion sometimes doesn't fit with reality. I recently read a BBC News article how this is true. A Romanian girl of 11 years old is allowed to have a 21 week foetus aborted as she was raped by her uncle. Usually the limit in Romania is 14 weeks but the court has ruled this is an exceptional circumstance. Typically the Christian Orthodox church is up in arms about the prospect of a foetus being aborted.

I should state why I feel strongly about this. Your religion should not affect or govern the policies a country makes. This amounts to imposing your religious views on the population. Not everybody in your country follows that religion, especially if it is Western countries with Christian backgrounds. There are other religions in those countries. Nowadays more and more people say they are Christian but are not really. Even more people are become atheist or agnostic.

Personally I do not believe in abortion. I can not sanctify a termination of policy - one of the reasons why I didn't want to go into obstetrics and gynaecology. Yet I do not believe I should impose this view on the rest of the population of the world. A woman has a right to choose whether or not she should have an abortion or not. There are exceptional circumstances, such as rape, a medically affected foetus or the pregnancy threatening the life of the mother, where a termination of pregnancy should be allowed. This is why I am infuriated at the Romanian Christian Orthodox church for throwing a fit at this story and for British MPs voting to lower the limit of termination of pregnancy based on religious and not based on scientific fact given by an expert panel for the Human Embryo Bill.

I wish people act with a little more sense and a little less religious belief.

The thrill and the rush

I finally understand why people go to watch horror movies and ride rollercoasters. Before I just didn't know why people would want to frighten themselves by watching "Scream" or going to Alton Towers. They were always saying it was for the adrenaline rush but I always thought that adrenaline rush was just false, nothing like the real thing of dying or falling out of an airplane. Yet after my first attachement with the house officer I'm taking over, I finally understand what that adrenaline rush is.

After some delays with a previous engagement and weather, I finally was following around the doctor I will be taking over at a convalescence and rehabilitation hospital. She has been very nice, teaching me everything I need to know, not passing judgement if I did anything wrong and telling me all the nice places to eat in the local area. Did I mention she didn't pass judgement when I did anything wrong, when I didn't chart the drug allergies correctly. Yes, I was given some duties such as copying drug charts, getting consent for investigations and doing some admissions. That is when I got the same feeling as people riding rollercoasters and watching scary films. It was very frightening doing those duties but also very thrilling and exhilarating as well. It was the first time I really felt like a doctor and that was the rush I was getting. I know it might sound weird, perverted and even wrong to some people. Yet it was just thrilling knowing I was making a difference in somebody's life for the better.

The final stretch

We had more pre-internship during this week. For the past two days my timetable has been filled with lectures, filling out forms and re-acquiring skills on the practical aspect of my life for the next year. It has been a non-stop barrage of information which will require time to process and develop into skills. I just hope I don't kill anybody along the way and don't screw up too much. That is all I ask for.

My eyes have certainly been opened by one person in this pre-internship block. I think this person is the most remarkable person in the world. Her name is Rachael and she came to Hong Kong from UK to perform an internship. According to what I know she has already done her internship in UK and been practising for quite sometime before coming to Hong Kong to take the licensing medical examinations.You might be thinking a lot of people do that and you are right. The most remarkable thing is she 100% English and doesn't know a single word of Chinese. She's coming to Hong Kong for her boyfriend, who is working here. How romantic is this situation? Can you think of anybody willing to give up their comfortable life in a place they know and move halfway around the world to a place you don't know that well, a language you cannot speak and into one of the most difficulty jobs in the world. All of this takes courage, commitment and love. I really wonder if anybody I know would do that and I can't think of anybody who would. I just hope that everything is easy for her and everything turns out alright. I just hope I can help her in any way I can.

********

I haven't been commenting much on the news lately. I have a lot I could talk about but I think most people get bored if they hear too much on politics. One story I think is important to my heart is the withdrawal of Morgan Tsvangirai from the Zimbabwean elections. It is disappointing that he is giving into intimidation from Robert Mugabe and his cronies. On the other hand he needs to consider the lives and safety of his party, with about hundred supporters being killed so far. I know people should stand up to dictators like Mugabe and think democracy will live on. However we all live in the real world and people die in these situations - fathers, breadwinners. You can't ignore that fact and neither can Tsvangirai.

It's also a pity the outside world cannot do much. All the other nations on this Earth can do is impose sanctions on Zimbabwe. It's not like we can invade the country and put in a person we think could do the job better. It will be just like Iraq and Afghanistan all over again. I have these views about Burma, North Korea and many other countries but dabbling in other countries matters is a direct violation of their sovereignty. Yet there must be a limit to what we can accept.

The off-season: Middlesbrough

The Boro are a strange team. They are too good to be relegated but don't have the quality to challenge higher up the table. Most fans will be hoping they can get some pot luck in the cup competitions because that is the only way they will get success.

GK: Brad Jones, Ross Turnbull

Southgate has made a good decision in trusting the remaining keepers after Schwarzer left for Fulham. Both Jones and Turnbull both have sufficient quality and experience to excel as a No. 1. If both don't fulfill expectations during pre-season, Southgate can always recruit another goalkeeper (which will be expensive).

RB: Luke Young, Anthony McMahon

I've included McMahon since he made an impact on the team a few years ago. However injuries have left on the sidelines for the past two seasons and the team will be hoping he can recapture that form and provide suitable back-up for Young.

LB: Emanuel Pogatetz, Andrew Taylor

With Taylor coming through the ranks, Southgate had to slide Pogatetz into central defence to accomadte the emerging left-back. Jonathan Grounds is also making an impact.

CB: Robert Huth, Chris Riggott, David Wheater, Matthew Bates, Seb Hines

Boro have enough good players in this department but they do lack experience. They were also hindered by injuries, especially to Huth and Bates. I don't think Southgate will recruit any more centre-backs but he must keep everyone fit.

WG: Gary O'Neil, Stewart Downing, Adam Johnson

With the threat of Downing and Johnson leaving, Southgate will definitely ponder bringing in some attacking players over the summer. Unfortunately funds will be tight and he will be forced to use them wisely. No big names have been linked so it might a unknown entity heading towards the Riverside. Southgate will also consider bringing Aliadere or Tuncay on to the right flank.

CM: George Boateng, Julio Arca, Mohamed Shawky, Lee Cattermole

Another area where Southgate will consider reinforcing where Boateng has considered leaving. Southgate needs to bring a midfield enforcer to help protect his young backline.

FW: Mido, Jeremie Aliadere, Tuncay Sanli, Alfonso Alves

I'm sure Southgate will allow Alves more time to settle in at the Riverside, so I don't think he'll reinforce during the summer. In the winter he may consider dipping into the transfer market if none of the strikers are firing.

Summary

In: Winger x 1, Central Midfielder x 1
Out: Riggott, Boateng (Downing, Johnson)

The pursuit for companionship

After achieving one of my life's ambitions by graduating with a degree in medicine, I now want to pursue my next goal - having a romantic relationship. My goals in life are now simpler. That is what happens after some many years with depression - your expectations become lower.

Unfortunately I seem to view every viable woman as a potential target. Examples include a waitress at Fat Angelo's where I was having dinner with friends and the attendant behind the deli counter in Three-Sixty (a high-class supermarket). My mind starts to wander and think, "Could she be the one? She looks reasonably nice." Then my mind tells me it will never work since she won't accept your depression.

This way of thinking applies just as well to my friends. When meeting up with my friends last night at a housewarming party for another friend. One female friend says she looks older and less beautiful but I didn't think so. She's sweet and nice. I always wondered why she is still single (to my knowledge). The same thoughts applied to another female friend of mine. She's beautiful, the most kind-hearted person I know and (to my knowledge) is single. Yet the same thoughts apply to them as they apply to any other viable lady - I don't think they will accept my depression.

********

On a slightly related note there has been a recent phenomenon to employ beautiful ladies to read & report the news for TVB Pearl. This should not be the case. It shouldn't matter how beautiful or ugly you are, just as long you can report the facts. Yet men won't be able to help themselves turning over to the news at 7:30pm just to see some eye-candy. At the forefront of the beauty parade are Emma Jones, Nicole Tsang and Priscilla Ng. There are other ladies who are also good looking such as Donna Mok and Mona Lam. I know it is wrong just to watch the news just because nice looking girls are reading it but they are very good at reporting the news as well. I think in the interest of balance I should mention Jimmy So, who is a young male newsreader who may attract the attention of female viewers.

It's just a pity I cannot find more information on them. They aren't many screenshots on the web and there is far less information on the TVB website. In more advanced countries, all the newsreaders & reporters have biographies posted on the station's website.

The off-season: Manchester United

How can you improve a winning team? That is the question Sir Alex Ferguson has to ask himself over the summer. After winning the Premier League in consecutive seasons and his second Champions' League title, Ferguson wants to consolidate his position. Yet when you look at the Man Utd team you find very little fault in the players.

GK: Edwin Van der Saar, Tomasz Kuszczak, Ben Foster

With Van der Saar continuing on for at least another season, Kuszczak and Foster will be deputising for at lot longer than they anticipated. It might be one of the young goalies will go out on loan.

RB: Gary Neville

Although Wes Brown played most of last season as right back, he is most likely to revert back to his favoured role as central defender. What is more important is finding a back-up or even a replacement for Neville. Before Ferguson leaves he will recruit a young player to take over from Mr. Man Utd.

LB: Patrice Evra, Mikel Silvestre

With Evra signing a new four year contract, Silvestre might be looking elsewhere for playing time. He's already has offers form Bordeaux and Lyon but they need to match his wage demands. He's 50-50 on whether or not to stay or to go. Keeping him would not cause any disadvantage for United - he's versatile and a capable defender.

CB: Rio Ferdinand, Nemanja Vidic, Wes Brown, Jonny Evans

With Ferdinand and Vidic occupying the central defence, it seems unlikely Ferguson will recruit any central defenders. His opinion might change if Evans joins Sunderland but even then any player coming in will be fourth choice.

WG: Cristiano Ronaldo, Park Ji-Sung, Ryan Giggs, Nani

With Ronaldo rumoured to be going off to Real Madrid, the most important piece of transfer dealings for Manchester United is not selling this Portuguese wizard. His best seasons have been the previous two, coinciding with Manchester United success. If he goes, most of Manchester United's goals go as well since Rooney and Tevez haven't been as prolific as they should be.

CM: Owen Hargreaves, Anderson, Michael Carrick, Paul Scholes, John O'Shea, Darren Fletcher

The central midfield is the strongest area for Manchester United. The only transfer dealings likely to happen is Fletcher going.

FW: Louis Saha, Wayne Rooney, Carlos Tevez, Manucho, Dong Fangzhuo

Probably Alex Ferguson's prime concern, the forward line-up will be revamped this summer. Saha is most likely to move on whilst another forward will be recruited.

Summary

In: 1 x Right-back, 1 x Forward
Out: Fletcher, Saha, Chris Eagles, (Silvestre, Ronaldo)

Religion gone mad

I have a lot of issues I like to write about but I don't anticipate writing many blog entries in the upcoming weeks due to my internship work. One topic I really want to express my views about are religion. I have commented many times about religion but certain events have happened since I ranted about religion that I need to rant again.

Whilst mentioning ranting about religion, one honourable mention should be Marcus Brigstocke's rant about religion on the BBC Radio 4 program "The Now Show". It is the funniest and most accurate rant about religion I have ever heard. If you want to hear what Brigstocke talks about or want to read the transcript, you can find it here. What I like about the rant is that is not entirely focussed on Christians. Marcus Brigstocke also directs his views towards the Jews and Muslims as well

On the same program I heard the Vatican issued new sins which include:

1. "Bioethical" violations such as birth control
2. "Morally dubious" experiments such as stem cell research
3. Drug abuse
4. Polluting the environment
5. Contributing to widening divide between rich and poor
6. Excessive wealth
7. Creating poverty

I'm sure all these sins are very valid and should be applied in the modern era. Yet it was pointed out the Vatican said about polluting the environment, "We should be listening to the science and facts. We should not be basing our actions on erroneous beliefs." I think at this point it started to snow in Satan's home and certain porcine creatures demonstrated vertical flight. It's similar to Adolf Hitler asking us to be nicer to Jews.

Also very hippocritcal is the sixth sin - excessive wealth. For those who have been to the Sistine Chapel or seen Godfather Part III know the Roman Catholic Church are not short of money. By accumulating all that money, you are indirectly committing sins 5 and 7 at the same time. Why don't they just sell all those paints by Raphael and Michelangelo, using the proceeds to help children in Africa who have been orphaned due to the spread of AIDS, thanks to the Roman Catholic Church policy of not endorsing the use of condoms to prevent the spread of HIV for Christian-based aid agencies.

After the list of sins were produced, many paedophiles and sexual abusers were relieved to hear that kiddie-fiddling was not one of the new seven deadly sins. If paedophilia had been on the list, most Catholic bishops and priests from USA and around the world would have been booked on a one-way trip to Hell already.

The off-season: Manchester City

Probably the most important signing for City has already been made. Recruiting Mark Hughes from nearby Blackburn Rovers was a coup for the team from the Eastlands. Now they have other signings waiting to rival the other team in Manchester.

GK: Joe Hart, Andreas Isaksson, Kasper Schmeichel

Even though Hart finished the season as the top goalkeeper, nobody's place is secure with a new manager. If Hughes keeps everything like Eriksson did, Hart will continue as No. 1 whilst Isaksson and Schmeichel will leave. This will leave space for a back-up goalkeeper.

RB: Vedran Corluka, Sun Jihai, Danny Mills

With Corluka cementing the right-back role, Sun and Mills will look elsewhere for playing time. However with Mills injured until October he will most likely be backing up Corluka until at least the New Year.

LB: Michael Ball, Javier Garrido

No immediate problems with this position but if City are to challenge for Champions' League places they will need a better left back as Ball and Garrido are not Big Four material.

CB: Micah Richards, Richard Dunne, Nedum Onuoha

With the confirmation of Hughes as manager, that news will hopefully be enough for Dunne to stay with rumours of him going to Tottenham. Yet they will still need back-up. They struggled last season with injuries having to use Ball and Corluka in this position.

WG: Stephen Ireland, Martin Petrov

Another area where reinforcements will be required, with Ronaldinho being heavily touted. Ireland is not a out-and-out winger whilst Darius Vassell has been used as a right-winger. It has been left to Petrov at times, who's form dipped during the middle of the season.

CM: Michael Johnson, Dietmar Hamann, Gelson Fernandes, Elano, Geovanni

Geovanni is most likely to go whilst everybody else is likely to stay. Reinforcements are less likely in this department

FW: Emile Mpenza, Rolando Bianchi, Darius Vassell, Paul Dickov, Felipe Caiceido, Benjani Mwaruwari, Valeri Bojinov, Nery Castillo, Georgios Samaras, Bernardo Corradi

The term 'clear-out' is what one thinks when looking at Manchester City's forward line-up. Basically they should blow it all up and start all over again.

Summary

In: Goalkeeper x 1, Centre-back x 1, Wingers x 2, Forward x 1
Out: Isaksson, Schmeichel, Sun, Geovanni, Mpenza, Bianchi, Vassell, Dickov, Samaras, Corradi

More on internship

Due to a last minute change (instigated by me) my final internship placements are finalised

I couldn't change the paediatric placement, so I swapped it for a less busy hospital.

It's slightly weird and frightening being in pre-internship. There is a lot we don't know and have forgotten - blame the post-exam syndrome of failing memories - but it's weird for me having probably set the Guinness world record for the longest time being a medical student. Frankly I have to get to grips with the real world - insurance, taxes, etc. It's not a prospect I look forward to but I know I have to do it.

The off-season: Liverpool

In my opinion Liverpool have not progressed under Rafa Benitez. This will irk some Liverpool fans, including my father and brother. There is evidence for this. I know underneath him they have won the Champions' League & the FA Cup. Most Liverpool fans will want to win the Premier League title the most, after eighteen years and counting without lifting the top division trophy. In the four years with Benitez at the helm, they have finished fifth, third, third and fourth. He has money to spend on players and he bought some truly awful players who don't fit in. If Benitez doesn't fix the problem soon, he will be the next manager out of the door.

GK: Pepe Reina, Charles Itandje, Scott Carson, Nikolay Mihaylov

With Reina cementing his place as the No. 1, everybody else is playing second fiddle. This has irked Carson who wants to go but can't because of the ludicrous price tag Liverpool has placed on him, Mihaylov is at FC Twente for next season, leaving Itandje to back-up Reina. There has been some reports Reina needs more competition as his form has dipped slightly but I doubt Benitez will recruit another goalie.

RB: Alvaro Arbeola, Steve Finnan, Phillip Degen

A problem area for Benitez, he may finally have recruited the right-backs he needs in Arbeola and Degen. Finnan will go which will be a disappointment as he has improved and been consistent in Benitez's years as manager.

LB: John Arne Riise, Fabio Aurelio, Emiliano Insua

Since the right-back position SEEMS to be finished, Benitez can focus on the left-back position which has been gradually falling apart. Riise's form has dipped, especially last season, and seems to be moving on (presumably). Insua is too young to play a major role whilst Aurelio is probably going to play back-up to whoever Benitez brings in.

CB: Jamie Carragher, Daniel Agger, Martin Skrtel, Sami Hyypia

Hyypia's Liverpool playing career was only prolonged due to Agger's injury for most of last season. With Agger coming back to fitness, Hyypia appears likely to move on.

WG: Jermaine Pennant, Yossi Benayoun, Ryan Babel

The whole of Liverpool's wingers are completely useless, meaning Benitez will require at least two wingers during the summer. Pennant just fritters in and out of games; Yossi Benayoun was a great player in an average team but now is an average player in a great team; Ryan Babel is more suited to playing upfront behind the main striker. Out of the three, Pennant is most likely to go whilst the rest are staying behind.

CM: Steven Gerrard, Xabi Alonso, Javier Mascherano, Lucas

The transfer saga regarding Gareth Barry is ridiculous. Liverpool already have four top quality central-midfielders, so why do they need a fifth? Even if Alonso leaves, Barry still has to rotate with Mascherano. He should stick with Villa, since they can equal or overtake Liverpool in two years' time.

FW: Fernando Torres, Andriy Voronin, Peter Crouch, Dirk Kuyt

With Torres likely to be in every match, everybody else is just playing as his partner. Voronin and Kuyt, although crap, seem likely to stay with Crouch going.

Summary

In: Left-back x 1, Winger x 2, Forward x 1
Out: Carson, Finnan, Riise, Hyypia, Pennant, Crouch (+ Antony Le Tallec, finally)

The off-season: Fulham

It's amazing what Roy Hodgson has done after the dour affair with Lawrie Sanchez. With relegation almost certain last season, the veteran manager extracted safety from the jaws of relegation. Hodgson can now look forward to rebuilding his team in his own style. He's already started by being the most active manager in the transfer market, release quite a number of players with a lot of free signings coming into Craven Cottage.

GK: Mark Schwarzer, Antti Niemi, Kasey Keller, David Stockdale

The revolution at Fulham is very obvious just by looking at the goalkeeping section. Normally a safe haven for players, not even the likes of the reliable Anti Niemi or Kasey Keller are immune from being put on the transfer list. Niemi has lost his form over the past years but still has the class to be picked up by a good team. Keller has indicated he won't get a new deal and will retire. It was a major coup to sign Schwarzer, whilst Stockdale will be used as the secondary goalkeeper.

RB: Moritz Volz, Chris Baird, Elliot Omozusi

Even with three right-backs at his disposal, Hodgson still recruited Paul Stalteri from Tottenham, saying a lot about his faith in those players. He will likely give Omozusi a chance, since he's still young, but failures like Baird will move on. I don't know about Volz - his versatility is a great asset but I think he might return to Germany to get regular playing time.

LB: Paul Konchesky

Konchesky is reliable and no-frills, able to get forward to support the attack. With Bocanegra going Fulham will require a secondary left-back

CB: Aaron Hughes, Brede Hangeland, Defan Stefanovic, Toni Kallio

I reckon Hodgson will get rid of Stefanovic & Zakuani and bring in some younger players. He has already had the established pairing of Hughes and Hangeland - all he needs is some reliable reinforcements.

WG: Seol Ki-Hyeon, Clint Dempsey, Hameur Bouazza, Simon Davies, Lee Cook, Zoltan Gera

Fulham have a bevy of wingers but will getting rid of most of them. Seol, Bouazza and Cook will be leaving. The Cottagers managed to recruit Gera from WBA but they still require one more winger.

CM: Alexei Smertin, Andranik Teymourian, Steven Davis, Danny Murphy, Jimmy Bullard, Leon Andreasen

With Teymourian coming in, the likes of Smertin and Davis are most likely to go.

FW: David Healy, Diomansy Kamara, Eddie Johnson, Collins John, Erik Nevland

It's a pity Fulham's best forward, Brian McBride, is departing and leaving behind not one forward who can score goals. It's is definite John will be leaving whilst the rest will be given one more chance but how long will Hodgson's patience last?

Summary

In: 1 x Right-back, 1 x Left-back, 1 x Centre-back, 1 x Winger
Out: Keller, Niemi, Baird, Volz, Stefanovic, Zakuani, Cook, Seol, Bouazza, Smertin, Davis, John

The calm before the storm

Today was the first day for the pre-internship block. To me it was a bewildering barrage of knowledge concerning what it is like to be an intern and it has already left me dreading being an house officer. There are people already concerned about how to get their residency NEXT YEAR by placing their rotations for their internship in an order favourable to them, apply for all the post-graduate exams and already smooching up to the people who will be making those decisions. I'm just worried about getting through pre-internship - applying to the Medical Protection Scheme, the Hong Kong Medical Council and the Hong Kong University Medical Alumni Association, getting a name tag with my name and 'Dr.' on it.

I know it is not all great for some people as well. To the people who have failed and still have to take the exams yet again they still have to turn up to the pre-internship block. I know they feel inside when they hear the words "Congratulations on graduating!" spoken by every doctor who had given talks during the day. I really want to reach out to them to say, "I know how you feel and if you want to talk, just contact me." but I don't because I'm shy and pathetic plus I don't know them very well.

One thing I am glad of is that I can use the email address I have been saving for the last few years. I will be gradually phasing out my Yahoo! email address and will be using a Gmail email address. For those who want to contact me, start using dr.kenneth.leung@gmail.com.

The off-season: Everton

Since Derby County are now out of the Premier League, the next club undergoing my analysis is Everton. I will also be leaving the promoted clubs to the end, since I need time to study their team.

Everton are like Aston Villa and Blackburn, the clubs who are constantly improving and vying for the top spots behind the Big Four. They are constantly in the hunt for UEFA Cup places, the FA Cup, League Cup and maybe even for the last Champions' League place. However they still need more investment and players to take the extra step to challenge the Big Four clubs.

GK: Tim Howard, Iain Turner, John Ruddy

David Moyes has stated he needs another goalkeeper to back up Tim Howard and that maybe right. He has lost faith with Iain Turner after bringing in Stefan Wessels last season and it won't be surprising to see this goalkeeper go during this summer. Currently John Ruddy is still too young to be considered but he's highly rated, so Moyes will keep him around or send him out on loan.

RB: Tony Hibbert

Hibbert is a reliable, tough-tackling defender but he lacks the extra quality (particularly on going forward) to be a great right-back. Moyes needs to invest in an excellent defender in this position. He has enough players to cover in this position, with Philip Neville capable playing here, but to progress to the next level, Everton needs a more attacking-minded right-back.

LB: Leighton Baines, Nuno Valente

I think both players will be given more opportunity to exert themselves in this position, after Joleon Lescott played most of last season on the left side of defence. Baines & Valente were blighted with injuries and when they were fit, Lescott was playing too consistently good to be budged.

CB: Joseph Yobo, Phil Jagielka, Joleon Lescott

The most reliable and highest quality area for Everton. Whoever Moyes brings in will have to know they are playing fourth fiddle to established centre-backs. I don't think Moyes will bring anyone in unless he has more injury worries.

MF: Mikel Arteta, Leon Osman, Tim Cahill, Phillip Neville, Steven Pienaar, Andy Van Der Meyde

The Toffees characteristically don't play with wide-men and the only winger they have seems likely to go (Van Der Meyde). They still need some attacking players to play on the sidelines, since they are totally reliant on Arteta and Cahill. When the Australian midfielder was injured in February, Everton fell out of Champions' League contention. They will also need to replace Lee Carsley with another defensive midfielder.

FW: Andy Johnson, Yakubu Aiyegbeni, James Vaughn, Victor Anichebe

There are doubts of Andy Johnson's future but I'm sure Moyes will want to keep him. If Everton are to start getting into fourth place, Moyes has to play 4-4-2 at times with Johnson dropping off into midfield. At times they play too defensively and it can cost them goals against lower league opposition.

Summary

In: 1 x Goalkeeper, 1 x Right-back, 1 x Defensive midfielder, 2 x Attacking midfielder
Out: Turner, Van Der Meyde

Nine long years finally over

I've been in a daze since yesterday afternoon, when I found out that I have finally passed my last exam. It means I finally have a degree after nine long years and can be called a doctor - although I can't give out drugs just yet. You would think I would be happy, joyous or relieved to hear this news. To be honest I don't think I feel any of these things. I think after all these years my depression has left me emotionally numb, even when it comes to happy personal news like this. I more glad I'm not feeling sad right now.

So what have I been doing? I should be doing the homework the Hospital Authority has given us but I think I can afford myself another day of rest before I start doing it. I haven't been going out and getting plastered like most people would. I need friends to do that and most of them are out of Hong Kong or working, so that idea has been muted. Most of the time I have been spending at home indulging in my passion - cooking. Since I came back on Tuesday I have been cooking Thai green chicken curry and French onion soup. The recipes need to be improved upon but I'm sure most people will find them tasty.

I'm just going to enjoy the last few days of rest before I go into pre-internship.

The off-season: Chelsea

Even finishing second in the league and being a penalty kick away from winning the Champions' League is not enough for Roman Abramovich. This Russian oligarch wants to win everything and if it means sacking two good managers in the form of Mourinho and Grant, than that can be arranged. The most mportant signing for the Blues in the coming months is who becomes manager, since they will be under enormous amounts of pressure to deliver at least the Premier League title or the Champions' League trophy in their first season. I think most Chelsea followers don't care who comes in, as long as the manager produces trophies and exciting. Yet I know two true Chelsea fans who are a bit disgusted at the way Abramovich has treated the club and are wary anything the billionaire does.

GK: Petr Cech, Carlo Cudicini, Hilario

I'm sure whoever comes in will keep Cech and Cudicini. Hilario will go since Mourinho has already left but Chelsea will need a third goalkeeper.

RB: Paulo Ferreira, Juliano Belletti, Jose Bosingwa

I don't know why Chelsea signed Ferreira to a long term deal - he's crap and should have been sold this summer. Yet they will have three profile players competing in this position after signing Bosingwa. Yet another reason why Chelsea are a difficult team to understand.

LB: Ashley Cole, Wayne Bridge

It is amazing to see England's top two left-backs at the same club but there you go. After two seasons underneath Cole, I think Bridge will finally move on. I expect Villa and Newcastle to be top of the pile of clubs asking for him to play for them.

CB: John Terry, Ricardo Carvahlo, Alex, Branislav Ivanovic, Tal Ben Haim, Khalid Boulahrouz

It is inevitable Terry and Carvahlo are the top choices with Alex backing them up. It's just much harder to think of the fourth choice centre-back. Ivanovic has not played at all and you wonder if he ever will. Ben Haim and Boulahrouz are on their way out, leavng possibility of more space in Chelsea's locker room for another central defender.

WG: Shaun Wright-Phillips, Joe Cole, Salomon Kalou, Florent Malouda

Even though Chelsea do have enough wingers, some will be going and others have their futures in doubt. Definitely going will be SWP, whose career has stalled at Chelsea for the past few years. Malouda started last season off well but faded at the end but will be given another season to prove his worth. I think Joe Cole will definitely stay as he's too good and versatile to let go, plus no team in England outside the top four could afford him. Kalou is totally incompetent up front but as a winger he's fast and gets crosses into the main man.

CM: Claude Makelele, Michael Essien, John Obi Mikel, Frank Lampard, Michael Ballack, Steven Sidwell

Along with Manchester United, probably the best central midfield players in the world. The only blemish is Steven Sidwell, who should be punished by other clubs by not signing him until 2009 because he just took Chelsea's money to rot away in the reserves when he could have joined the like of Aston Villa or Everton earlier, played regularly and even could have made the England team if he wasn't that greedy like Ashley Cole.

FW: Didier Drogba, Andriy Shevchenko, Nicolas Anelka, Claudio Pizarro

Unlike Manchester United, Chelsea don't have a settled forward line-up. Their best forward Drogba wants to go AC Milan. Their most malaligned striker (Shevchenko) wants to go back to AC Milan. Pizarro is crap and Anelka is a whining bastard. You could see all of them staying or going, depending who comes in to manage this mess.

Summary

In: Goalkeeper x 1, Left-back x 1, Forward x 1
Out: Hilario, Ben Haim, Bridge, Wright-Phillips, Sidwell, Shevchenko

Paediatric supplementary exam and "Britain's Got Talent"

I took my supplementary written examination in Paediatrics this morning. It wasn't difficult with many of the short answer questions having appeared before in the past papers and none of the multiple-choice & extended-matching questions being very taxing.

The biggest scare of the day happened before the examination. When I was on the minibus going up to my destination, a man wanted to get on the vehicle with his mother. However the driver told him he couldn't alight the minibus as it was at a traffic lights and there was a designated bus stop with people already queueing just a few metres away. Then something happened I have never seen before - the man slammed the minibus door open, barged into the minibus and started to argue with the driver. At one point I thought the man was going to get physical. The driver rang the police and had to wait for them to arrive. I thought I was going to be late for my exam but, since the man walked away and the driver cancelled the police coming, we were soon on our way. Obviously that man has issues.

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To relax before my exams, I've been mainly watching "Britain's Got Talent" clips on Youtube and their main website. I know many people are familiar with the format but for those who don't know, it's basically a live talent contest with three celebrity judges giving their opinion.

I usually don't like "reality" shows on the basis it is not really reality. When do sixteen people get stuck on an island and have to perform tasks to win US$1000000? Real reality shows are documentaries, not programs as "Laguna Beach". Probably the worst reality show is "Big Brother" since it seems to make stars out of complete morons such as Jade Goody. I don't mind gameshows such as "Who Wants To Be A Millionaire?" or "The Weakest Link". Yet some of these gameshows are too easy (you have a 25% chance of getting the answer right in WWTBAM) while some are ridiculously too easy. "Deal or No Deal" is not a gameshow. The program is made for thick stupid people to pick boxes and it has been made worse by the Americans by putting models in. They obviously knew they needed some eye candy to attract viewers.

I don't mind "Britain's Got Talent" for giving people a chance to show the public what kind of talent is on offer in their country. I do have problems with other aspects of the show. Firstly one of the celebrity judges - Piers Morgan - is a totally dick. This is somebody you wouldn't trust and wouldn't want as a friend. People may think his persona is made for the cameras but I think he's genuinely like that, having seen him before in "Have I Got News For You" and before as sleazy tabloid editor for "The Mirror" and "The Sun". Secondly is the voting system. ITV (the channel which "Britain's Got Talent" is shown in UK) has been found guilty of rigging phone voting in many of their programs including "Saturday Night Takeaway" - hosted by the same presenters as "Britain's Got Talent". It has been pointed out the acts which performed last in the semi-finals have come first, something which is far too coincidental. They have also been complaints from the public that they couldn't get through to vote.

That said (or should that be "that written") nothing can be taken away from the contestants of the show. Initially I thought the winners were going to be "Signature" - two man dance group mixing Michael Jackson and Bangura dancing. They were totally electrifying in their audition and upped it during the final stages. However my favourite was "Kate and Gin", a shy sixteen year old girl with her six year old collie performing canine freestyle. You have to watch the videos to get a real sense of what they were doing and most of them can be found on Youtube or the "Britain's Got Talent" website. I knew it would be difficult to decide a winner but eventually it went to George Sampson, a fourteen year old breakdancer. I think many people voted for him because of his background - impoverished, busking on the streets of Manchester and doing it for his family instead of fame and fortune (well, he was doing it for fortune but to benefit his mum). However I think he deserved to win since he's great at what he does - think a younger version of Justin Timberlake and you're not even close.

I think many of the contestants will benefit from being on "Britain's Got Talent" with the added exposure. Here's to Kate & Gin especially.