Podcast with the Christian Medical Dental Association

I got a chance to do a podcast with the Christian Medical Dental Association talking about the challenges of medical training, particularly for the believer. Check it out and feel free to share your thoughts!


Baby update! (with pictures)

Again life happened and the resolution to post regularly died a sad silent death. It’s been so long since I last posted I forgot my username and password. Time for a life update and another attempt to revitalize this blog!

To say that much has changed would be a huge understatement. Let’s see, some highlights since my last post in December (of 2016??):

  • Found out we were expecting in January.
  • Transitioned out of my teaching role at Harbor-UCLA to go full-time at the Children’s Clinic in May.
  • Decided with the new baby coming would not have enough time/energy/money/fill-in-the-blank to continue with seminary so ended my time at Talbot early with a certificate in Theology also in May.
  • Moved into a new home mid August
  • Closed escrow on our old place mid September

And the most wonderful highlight of 2017:

  • Welcomed baby Cody Jackson Tsai on September 21st at 12:18 am, coming in at 7 lbs, 4 oz and 18 inches.

The whole delivery was ridiculously fast. Priscilla went in because of some light bleeding. She didn’t really have any contractions, but we just wanted to be safe. Checked in around 6:30 pm, contractions started picking up and becoming regular, and made a little change by 8:30 pm so hospital decided to keep her. She was admitted around 9:30 pm and close to midnight the baby was ready to come out. 2 pushes later, enter baby Cody!

She progressed so fast that there was no time for an epidural. Her primary OB didn’t even make it (I was ready to jump in there, but thankfully there was a backup OB). That was basically Priscilla’s worst nightmare, but she pushed through it like a super champ (yes on the pun!). I’m so proud of her and amazed at her strength. The end result?

Well, at least a week later after he has been cleaned up, fattened up, and most of the jaundice had gone away. 1st days he looked like this:

2017, and particularly the last several months, has been a huge whirlwind of activity and it took finally being on paternity leave to have some space and time to reflect. And sadly, very shortly after Cody was born, Ansley caught Hand Foot Mouth Disease from daycare, and unselfishly shared it with me (we’ve been working on this).

Thankfully she bypassed the oral lesions and her hand and feet lesions didn’t hurt. Luckily, I caught the whole package deal. And I have to say these ulcers and blisters hurt like a motor scooter. As the lesions spread from my mouth to my hands and feet, making each bite and step excruciating, I couldn’t help but think of Job 2:7-8

So Satan went out from the presence of the Lord and afflicted Job with painful sores from the soles of his feet to the crown of his head. Then Job took a piece of broken pottery and scraped himself with it as he sat among the ashes.

Now obviously it’s not that bad but it has been quite miserable this past week. And as much as these lesions hurt, what has been so much harder has been not being able to hold my new baby and be with Priscilla in these early days. Sorry Priscilla that I haven’t been able to be there for you. And I know how painful it has been for you to have to turn Ansley away too.

Not to all of a sudden get too preachy, but I think through this I understand a little bit more of the immense suffering of hell. Whatever physical pain there may be, I suspect it will not compare to the emotional pain of being separated for all eternity from our heavenly Father, with whom we have been created for deep, intimate relationship.

I’m off the soapbox now. Thanks for reading and would so appreciate your prayers for Ansley and my recovery, and for Priscilla’s and Cody’s continued health. Please pray for my anxiety too as I know what doctors do to babies less than 28 days old with fevers.

Some more pictures!

Looking back, Ansley was probably the most contagious here…

“When Breath Becomes Air” Reflections

           I finally got chance to read Dr. Paul Kalanithi’s memoir “When Breath Becomes Air” over Christmas break. It really was a heavy punch in the gut, and it couldn’t have come at a better time. It was such a needed reminder of the brevity of life, the sacredness of the medical profession, and the immeasurable value of our human relationships, particularly those between physician and patient.
          Early in the book, Dr. Kalanithi asks the question, “If the unexamined life was not worth living, was the unlived life worth examining” (31)? In Dr. Kalanithi’s life is an example of both a profound reflection coupled with an active and intentional engagement of people, even at great personal cost.
          I was particularly challenged by his view of medicine, and of his patients. Regarding his work, he writes, “People often ask if it is a calling, and my answer is always yes. You can’t see it as a job, because if it’s a job, it’s one of the worst jobs there is” (151). He was referring to his field of neurosurgery, but I think this can be said of the medical profession as a whole. Sure the pay is substantial, whatever field you pursue, but the personal cost is steep, even after the training is done.
          And let’s not forget the enormity of assuming the care of a person. For Dr. Kalanithi, he was responsible for not just his patients’ physical health, but the entire weight of the whole of the individual. His call was to “protect life—and not merely life but another’s identity, it is perhaps not too much to say another’s soul…” (98). He understood that “all of medicine…trespasses into sacred spheres. Doctors invade the body in every way imaginable. They see people at their most vulnerable, their most sacred, their most private” (49). It is a high calling , and a tremendous privilege to become a physician.
          What hit most poignantly was the stark contrast of the sense of purpose and urgency reflected in Dr.Kalanithi’s life, even before his cancer diagnosis, to where I am at now. Sadly I confess that 2016 has slowly drifted into a complacency where personal relationship (both with God and people) and my own personal calling have become obligations, and entertainment designed for rest and renewal has crossed into the realm of numbing escape. This was a much welcomed wake-up call.
          God, forgive me for mistaking physical presence with connection, thinking competency and efficiency was enough, and treating the sacred as ordinary. Grant me conviction and courage, by Your grace and through Your Spirit, to make 2017 different.
Be very careful, then, how you live-not as unwise but as wise, making the most of every opportunity, because the days are evil. Therefore do not be foolish, but understand what the Lord’s will is. Ephesians 5:15-17

Made in God’s Image

It’s been one of those weeks…

Two patient deaths, a patient stabbed right outside of clinic, and the regularly scheduled patients still waiting to be seen. And it’s only Wednesday.

Today I spent some time talking to the daughter of one of the deceased patients who called from out of town. They had been estranged for some time so she had many questions, particularly about how he looked before he passed. Apparently his body had decomposed too much for her to see, so all she had was my general description. My heart was heavy after that call.

Talking to her reminded me that this patient was not just another homeless man, another name on my schedule, or another disease to treat. But he was someone’s father, someone’s son, someone’s friend.

It’s so easy to lose track of the person in the endless list of patients that need to be seen. I’m ashamed to admit that there have been days where I can’t remember a single patient name, but I can tell you their diagnoses and treatment plan.

It’s been a tough week. But it’s been a good reminder that each person has intrinsic worth. That was God’s design, making each person in His image. God help me to see and treat each patient that way.

To my patients who passed away…

Sorry for the super long no update. Life has been busy (but good!). Having a child really does change your life…

I found out this week that another patient I had gotten to know pretty well at the homeless clinic passed away. They say the average life expectancy of the homeless is around 50 years old. Sadly, I have found that to be true.

Some of these deaths were pretty expected, but this last one caught me completely off guard. I had just seen him a couple weeks ago, and I expected to see him in a couple of weeks for his monthly narcotic prescriptions (and usually some brand new complaint).

It has been hard finding the space and time to mourn. After finding out through an inbox message the very first thing in the morning, I had a full panel of patients waiting to be seen.

Medical school and residency didn’t teach me all that much about coping with patient death, and I have found that it has been much easier to just set it aside and forge ahead. After all, there are still living patients who need my immediate attention.

This morning as I took my daughter out for a walk, I realized something that made me sad; I am beginning to forget. I was thinking about the patients that I had gotten to know who have passed, and even now I can’t remember some of the names.

Well Bob (fictitious name), I don’t want to forget you. Here’s to your memory. I’ll try to do this for the patients I have gotten to know, but we’ll see how it goes. Hopefully it wouldn’t be too frequent.

Bob, I have to admit that I did not look forward to our appointments. Narcotic management is one of my least favorite things, and you certainly made it difficult. For the longest time it felt like a wrestling match of sorts, you always pushing for more and me trying to hold my ground. I confess that there were times I gave in because it was too much to deal with and I had too many patients waiting.

I’m happy to say that it has turned into much more of a partnership this past year. But still, I would always want to get out of the room as fast as I could because there was always “one more thing.”

You were a tough guy, and you have endured much. And you certainly looked the part: big, perpetual scowl, multiple tattoos. Yet you showed me a side of you that very few have seen, even shedding some tears. Thank you for that privilege.

Thank you for sharing with me one of your favorite Bible verses the last time I was with you, Proverbs 3:5-6. That’s one of my favorites too, so hopefully I will never forget about you.

I didn’t know I will never see you again (this side of eternity, anyway). Thank you for the reminder that tomorrow is never guaranteed, that no matter how difficult the patient encounter, that might be my last so I need to be present completely instead of already having one foot out the door.

I do hope to see you again one day. May you rest in peace.

“Trust in the Lord with all your heart
    and lean not on your own understanding;
  in all your ways submit to him,
    and he will make your paths straight.” Proverbs 3:5-6

Question from the Reader: Was it Worth it?

This past semester the book was used by a pre-health class at Point Loma, and the students submitted questions as part of their assignment. I got a copy of that list, and they were great questions! I’m going to try to answer a question every couple of weeks, so here’s the first! 

“Looking back on your journey into medicine, what aspect of medicine made it “worth it” (worth the time, money, energy, many hours of studying, etc.) to pursue for you, and how has your view shifted (or remained the same) today?”

Now that I am done with my training and have been in working for a few years, I can say that the realities of medical practice is definitely much different than what I expected as a pre-med, and even as a medical student. To answer the second part of your question first, the two major frustrations I have encountered as a physician are the 1) the brokenness of the medical system impacting the type of care I can provide, and 2) the non-medical nature, or components, of complaints I get from patients. 

As for 1), the sad reality is that medicine in the US is a commodity, and healthcare a business. Of course there should be appropriate checks in how doctors should practice, but unfortunately, it really comes down to maximizing profit which means seeing as many patients as you can. In the underserved community clinics where I work, there is less of that, but then there’s the problem of less resources available. And now with the expanded healthcare coverage, which is great for my patient population, even underserved community clinics are pushing to see more and more patients since they can finally be reimbursed for the care they provide. So, in the 15 minute time slots, doctors really only have a fraction of that time for direct patient care if they don’t want to stay after hours to finish all my charting and other admin work. 

Not only is the system broken, 2) the nature of healthcare has changed too with primary care being mostly about chronic disease management. The most common conditions I see are diabetes, hypertension, and high cholesterol with all its complications. Sadly, these are largely preventable diseases and largely related to lifestyle choices. While people want to feel better, they don’t want to change the way they live (sometimes they can’t change because of socio-economic factors like no access to affordable healthy foods or safe places to exercise). There’s nothing quite as defeating as spending extra time counseling patients and coming up with a game plan to find out at the next return visit that things are worse. Going into medicine, I thought I was going to come in and change everyone’s lives, impacting them like Jesus did. But even in Jesus’ time, there were people who didn’t really care for true healing, but just wanted the miracles.  

So real-life practice is not what I expected going into medicine. But, as frustrating and infuriating (at times) medical practice can be, I will say that it has been and still is worth all that it took to get to where I am. And that is because I constantly come back to the realization that my pursuit of medicine would not be just about my own fulfilment, but about God’s kingdom. If me being in medicine was simply about being happy that I get to help people and make a good living, then no this would not have been worth it.

Without the kingdom perspective, I would have burned out long ago (and I haven’t even been practicing that long!). You don’t have to search very hard to find articles about physician dissatisfaction and doctors leaving medicine. But with God and His kingdom purposes in the picture, I still see that being in medicine is so strategic in pointing people to the realities of heaven where there is no sickness, death, and suffering. 

It may not happen with every patient, and may even happen very far and few in between, but if we are open, God does arrange for divine appointments where we can have more than just physical impact. This looks different for each patient, and for each specialty, but the opportunities are there if we have the sensitivity to the Holy Spirit, and the courage to act on those promptings. And the really cool part is that we don’t have to try to love people in our own strength. As long as we are abiding in Christ and receiving from Him, God will continue to strengthens us for His kingdom work.

Medicine opens up so many doors to be used by God in powerful ways. My prayer is that as you continue in this path, you would make choices to put God first starting now so that when you are done with your training, medicine can still be about Him, rather than just about yourself. 


SD visit!

Wow sorry for not updating for so long. I have a pretty good excuse though, it was March Madness. Just kidding, I didn’t even watch a single game entirely. Incidently, I was third in my church bracket. Not bad for just picking randomly.

Life has been very much different since the new year! It has been so much fun being a dad. That’s because Priscilla is doing most of the work =P. Since I am back at work now, she let’s me sleep through the night. It is crazy how fast she is growing up. Here’s a fairly recent picture, and one of my favorites!


Absolutely adorable. We’ve been so bless, she’s done so well. Just this week she went on her first overnight trip! I got invited to speak to a pre-health class at Point Loma University so we made a family trip out of it. No melt-downs or anything, she was quite the trooper. It is crazy how much we have to pack though just for one night.

It was a really fun trip. We got to spend time with some old church friends, as well as with Dr Nick, which is always an encouragement.  The day of the talk Priscilla and I enjoyed brunch at the Mission Restuarant in PB (can’t believe I never been there before), and then exercised the spiritual discipline of bargain shopping at the Carlsbad outlets.

Speaking for the pre-health class was such a privilege as well. It was so good to be with these students whose heart for patients has not been hardened by the trials of training and the frustrations of the realities of patient care. Even though I was supposed to be ministering to them, I was blessed and encouraged by them. I needed to be reminded of convictions God placed on my heart when I was in their shoes, and that I need God’s spirit to start softening my heart up again to love.

So, to the pre-health class, thank you. I will be praying for you as you continue to seek God’s calling for you. And if that happens to be medicine, I pray that God would strengthen and guard your heart as you go through your training and beyond. Dr. Choung and Dr. Buzzell, you are doing a great work. May God persevere and bring to completion the work that has been started!


Breast Engorgement and the Love of God

It’s a little weird writing about breasts in a Christian-themed blog, but I am a doctor so I can get away with it. Plus you can’t see me giggle and blush.

Throughout pregnancy, a woman’s breast can increase 1-2 cup sizes as the tissue changes in anticipation for milk production and breastfeeding. It’s quite remarkable really what the body is capable of to care for the new life on the way. Sometimes though, if breastfeeding does not go well, they can become painfully engorged.

While my breast tissue has remained the same (thank goodness), I feel like my heart has undergone an engorgement of sorts. I’m not talking about a cardiomyopathy of pregnancy (which could happen to moms), but it seems like in emotional capacity, and even ability, my heart has grown. It’s a change both in quantity and quality.

Quantitatively, there has been just a huge surge of emotions, especially after the delivery, but even in the months leading to the big day. A couple weeks ago I was reading a children’s book to Priscilla’s belly, and right in the middle I started to cry. And not a burning-behind-my-eyes manly cry, but tears actually broke free, sliding ever so tenderly down my cheeks. Where in the world did that come from? I can’t even remember the last time I had real tears. Just looking at Ansley doing nothing but sleep, I am sometimes overwhelmed by how much I love this little thing.

And this love is different. Qualitatively, it’s a different form– a purer form — of love than I have experienced. The love I have for my parents and for Priscilla comes close, but even that love has been influenced by their actions towards me. Of course I love my wife, but I didn’t love Priscilla the first time I laid my eyes on her. If I did, it would have been quite creepy since she was just a junior higher. For sure I love my parents, but much of that I think has to do with the care and love they have shown me. That’s conditional love.

But Ansley has existed for less than a week and has done nothing but eat, sleep, poop, and cry all night. Yet I know I love her and will love her no matter what (check back with me in her teenage years and I hope this is still true). It’s the closest thing I have come to experiencing pure, unconditional love.

They say that the love of a parent for his or her child is the closest thing we can get to understanding the unconditional love that God has for us. It’s no surprise, then, that one of the major pictures of God in the Bible is that of God the Father, and we as His children. Unfortunately, because of our fallenness, there are many broken families. As a consequence, there are many broken pictures of God.

Christian parents, we have the task of redeeming the picture of God’s unconditional love for us through our love for our children. A professor said in class once, “Our role as parents is to give our kids the most appropriate picture of God so that when ‘God comes around,’ they will recognize Him.”

By the way we love our kids, our kids will be introduced to their heavenly Father, and those around will catch a glimpse too. When they read about the amazing love of God, that love will seem familiar, inviting, because they have already felt it from you. John 3:16 would not just be a cliche, but an experience based in reality. Parenthood really is a high calling, your prayers are much appreciated.

To all my recently married Christian friends, do take some time to enjoy marriage and build up your relationship before the babies come. But don’t wait too long though. The world needs more examples of God’s unconditional love.

“For God so loved the world that He gave His one and only Son, that whoever believes in Him shall not perish, but have eternal life” (John 3:16).

Home Sweet Home (A recap of this past week’s excitement)

Wow what a whirlwind of a week this turned out to be. During my sermon last Sunday I half joked that when we met again for service we might be new parents. I have to be more careful with my words.

Even though we are a full week early, the timing could not have been better. The baby turned out bigger than anticipated, and the doctor even said that if the baby stayed until her due date, Priscilla would have needed a c-section. Looks like Someone knows what He is doing.

These last several days are just a huge blur. Now that we are finally home, I have a chance to process it all. More for my own sake, here’s a recap how our little miracle came into this world. If you don’t care for the details, you can scroll through to see the pictures. It all started about 9 mos ago after a romanti… just kidding we won’t go that far back.

Tuesday morning (12/30/14) while I was getting ready for my last week of work, Priscilla mentioned she had a small amount of discharge that was more watery than usual. She hadn’t had much in terms of contractions, but after an extensive review of medical literature on Google, we decided to just go in to be safe. Turned out to be a good call.

Around 8:30 am we arrived at Labor and Delivery, and they sent off a sample to the lab. Thirty minutes later, the nurse confirmed that Priscilla was leaking amniotic fluid. Even though it was a very small amount, they decided to admit her to induce labor since she was at a higher risk of infection (GBS + for the medical people) and told us that the baby will come in the next 12-24 hours.

Hearing that, I went into panic mode since I thought I still had one more week to prepare. While Priscilla got admitted, I went home to tie up what seemed like a million loose ends for work, church, and just regular life before disappearing for at least 3 days.


Turned out I didn’t have to rush since her induction lasted quite a long time because other than the fluid leaking, Priscilla was not at all in labor. They started the medicines around 10 am, and by 10 pm she was only about 3 cm dilated. We spent the day chatting, watching movies/shows, and hanging out.

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Originally we had wanted a natural delivery without too much meds on board, but by that time Priscilla was exhausted from being in the hospital all day. We decided to go for the epidural to help her relax more, and that turned out to be another good call.

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Around 10 pm, the epidural went in and early AM 12/31/14, things started to move, but even then it was still painfully (pun intended) slow. The rest of her water broke, and the contractions started to come on stronger and stronger.

After around 4 am, she finally reached 10 cm and was ready to start pushing. Unfortunately, the baby didn’t seem to want to come out. 2.5 hours later, Priscilla was pooped out (not literal), and the baby only progressed a small amount.

Around 6:45 am, the doctor came in and decided to give it one last go at pushing. If baby didn’t come out, then it was to the OR we go. Praise the Lord it didn’t come to that. With the help of a vacuum and some extra encouragement, Ansley entered the world at 7:06 am!

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Almost 24 hours after going in for a quick check just in case, we had a brand new baby girl. The next two days was setting into a routine of feeding, resting, and showing her off to visitors. We have had so much support and love from those around us, thank you! I have never gotten so many Facebook likes with any other pictures/status updates.

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All the leftover time, we just hung out and enjoyed the gift God has given to us. We were sad we weren’t able to be with family and friends on New Year’s Eve, but we had fun celebrating as a new family. And by celebrating we mean feeding and changing poopy diapers past midnight.

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Your eyes do not deceive you, that is a steak dinner they give for new moms! As for the rest of the stay, it was pretty uneventful. Ansley had some jaundice that needed additional blood tests, but those turned out fine. Friday 1/2/15 in the morning we were discharged home!

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It really is a miracle, this whole birthing thing. As I watch my daughter move and squirm in her new bed, it’s surreal to think only days ago it was her that was making Priscilla’s stomach move. God really has knit her from the womb, and as I have loved her before she came out, I know that God has loved her even before she was conceived.

It’s crazy that as exhausting as these last couple of days have been, it is just the beginning. We are in totally way over our heads, but surrounded by friends and family, and with God’s guidance, somehow we trust that it will turn out alright.

A big thank you again to all who have come alongside of us in this journey, and a thank you ahead of time for walking with us. It’s going to be an eventful 2015. Happy New Year!

“For you created my inmost being; you knit me together in my mother’s womb. I praise you because I am fearfully and wonderfully made; your works are wonderful, I know that full well. My frame was not hidden from you when I was made in the secret place, when I was woven together in the depths of the earth. Your eyes saw my unformed body; all the days ordained for me were written in your book before one of them came to be.” (Psalm 139:13-16)


A Different Christmas Experience


It is long overdue for a post, sorry. Life has been pretty crazy getting ready for the new year, and for the new addition to the family! Thanksgiving felt like just last week, how is it Christmas already??

This year, Priscilla and I wanted to do something different for Christmas. Since we already have so much, we decided not to give each other gifts. Not that we are against gifts, but we wanted to try to recapture at least a little bit of what Christmas is about by not making it all about us. After all, we are celebrating the birth of our Savior Jesus, who, “being in very nature God, did not consider equality with God something to be grasped, but made himself nothing, taking the very nature of a servant, being made in human likeness” (Phil 2:6-7).

For Jesus, Christmas is about emptying Himself for the sake of others, ultimately dying for our sins. Obviously there is nothing we can do that can come even remotely close to that, but we wanted to take the time to bless someone else as Christ has blessed us. There’s a homeless man that I drive by almost daily on my way to work that God had been prompting me on more than one occasion to talk to, but I never mustered up the courage to obey. We decided to make a simple care package and share breakfast with him.

It was a really cool time just chatting with him and learning a part of his story as we ate some Jack-in-the-Box breakfast. He has been on the streets for three years ever since the factory he was working at shut down. We didn’t spend a long time together, but enough for me to realize that it is much easier to ignore someone in need when you don’t know anything about him.

I write this not to say we did some amazing thing; it really wasn’t much. It took a major Christian holiday to get me to do something Christians really should be doing on a regular basis. But I write this as a reminder to myself of how much more I still need to grow to love others as Christ loves.

Charles Spurgeon writes, “Immanuel-God with us in our nature, in our sorrow, in our daily work, in our punishment, in our death, and now with us, or rather we with Him, in resurrection, ascension, triumph, and Second Advent splendor” (Morning and Evening). Just as Christ left all the comforts of heaven and entered into our world to give us hope, we are called to step out of our comfort zones and enter into the lives of those around us to be God’s hands and feet to point to the living hope.

Merry Christ to all, and I pray this new year can challenge us and grow us to love as God loves.