Aug 31, 2009

Merdeka | Murky Day kah?

It all falls down to today.
31 Aug. Independence Day.
Big bang. Fireworks. Concerts. Sales.
Thank this. Thank that.

Looking at what currently haunting our nation (Teoh BH, Kugan, the Perak political impasse, Cow head in Shah Alam, 1Malaysia), perhaps 'thank' isn't the best word for it.

Jimbo has a long list of them.

Merdeka, perhaps, is a gloomy day not worth celebrating.

Are we really free from jajahan minda ciptaan kerajaan UMNO?
Is this just another black Merdeka?

No matter how dirty our Malaysian scenery are looking at this moment, at least, everything is being blew wide open. No dirt under the carpet.

Now it's time, to clean up the filth. One step at a time.

I believe the awakening is a blessing. It is something worth celebrating about.

It may not be easy, it may not be in the close future, but if the appropriate political front toe their path carefully, in good times, our differences will be our strength and together we will leave our political and racial minefield far behind.

Maybe the last paragraph sounds so gay. Maybe. Just maybe.

Anyway, any occasion with an off day is worth celebrating, right?

As for now, knock yourself out with The Tree.

Happy Merdeka!!

Aug 30, 2009

Jam session

i used to have this dream. not the ambition, cita-cita kind of dream. it is the regular, after tired of on call, and fall down to mattress to sleep kind of dream.

now, it's a reality.

Aug 27, 2009

suck-it kePALA

http://www.greenwithglamour.com/editorial/images/nutmeg.jpg

I’m not a big fan of politics, neither am I, a big fan of Chief Minister.
But as a Penangite, I am gladly to say I am really proud of our Chief Minister



After reading that piece of prime news in Page 3 of NST on 22 Aug 2009, detailing how one Gerakan small fry, Mr Oh-something criticizing YB Lim acting like child throwing tantrums in handling Kampung Lorong Buah Pala issue, it made me want to throw up. Not just the usual food-and-gastric-juices throw up, but the all out projectile, full momentum vomit with some vomitus actually going into the nose and beyond.

He even suggested CAT Competency, Accountability and Transparency be changed to ‘complaining, accusing and twisting’. WTF.

Let us just look at the whole big picture.

The Indian villagers were pushing up racial cards, saying the Malay company wanted to take the land, and the Chinese government is condoning it.

To begin with the right story, the land belongs to the government and the villagers were trespassers on the settlement.

The land was sold during the previous administration when the CM is Gerakan big head, alienated to Koperasi Pegawai Kerajaan Negeri Pulau Pinang with their developer Nusmetro Ventures.

And now, as YB Lim took over Penang, recognizing his role to protect the villagers had pushed a good deal for the villagers, whereby every house demolished, the company will compensate with a double-storey house. Yes, for every papan and zinc old house, they’re being compensated by A DOUBLE-STOREY HOUSE. Not something that any average Penangites can afford, especially at this time of economic crisis.

Which part of this effing effort is equivalent to complaining, accusing and twisting?
Brighten up, Gerakan. You’re already grounded; don’t start digging your own grave.

For whatever reason, the villagers turned down the offer. But at the current moment, I gathered about half of them accepted.

Whatever reason they give for turning down such a good offer sure baffled every Penangites who work their asses off every day and night and even weekends, but even so, were struggling to pay housing installment for a single unit of house in the flat.

I was thinking:
Could it be greed?
Could it be their ‘maruah’?
Could it be their homes have too much sentimental value?
Could it be probably their eyes are simply being covered with too much of shit?

Another hypothesis would run in the veins of the delusional decisions influenced by some political puppeteers. Puppeteers who go all out to make those villagers pawns for their own political mileage, who egg on the children of the villagers go all out and amok whenever demolishment unit came for their settlement, while they sit behind in their comfortable homes and try their best to brand the current Penang administration as racist, and anti-Indian.



And my sympathy goes all out for everyone, especially the children and ladies, who suffers mental and physical stress, whereby a peaceful transition of home is an option in front of their eyes.

YB Lim did suggest to the villagers to ask those puppeteers to give them each something more than a double-storey house.

I think majority of Penangites would really want to see what those puppeteers can really do for them, instead of cooking up so much of smokes but no fire at sight.

YB Lim did mention that as he was devastated that the villagers turned down the offer, most Penangites were disappointed, too. Who wouldn’t be?

And this piece of pariah shooting-from-the-hip sarcastic condemnation on YB Lim, I guess in a way, when it hits YB Lim, it hits us all.

Aug 21, 2009

privileging praevia

I had really interesting EOD (every other day) on call with Dr. C recently. I got really really, seriously busy and tired, but in the midst of all this tiredness and jonahness, I had several new experiences.

Thanks to Dr Haznita, covering specialist from Penang, I was given the chance to fly solo in knifing down a bleeding posterior type III praevia while she was completing the rounds. So far, I had never been going all surgical unto praevia, except for that one time I accidental operated on that lady with praevia, which was missed antenatally. My heart was beating so fast prior to the op that the thoughts of popping a beta blocker crossed my mind. I kept her number on top of the list for speedy contact, just in case.

I went in all calm and focus, while all the scrub nurses around the OT were hilariously making comments about how lucky I am to have a pretty assisting intern that day. It was a bad moment for jokes. After wading through the abdomen, finally, I reached the uterus. Dr Haz’s words crossed my mind, “Don’t cut the uterus if there’s a nest of vessels on it.” There were only 2 vessels on it, the calibers of Aedan’s little fingers, both on the far left, which doesn’t really fit the definition of a nest of vessels.

Imkansiz Ask

And so, hands on blade 20, waltzed through the lower segment in the locus of smiley and incision on the uterus widen with the tissue scissors. It wasn’t the baby’s head. It was the placenta, probably nearing its anterior edge. With blunt force, I scrapped through the placenta with my right index finger and searched wildly for the baby’s head. And with my left index finger, I widen the exit for the baby as I scooped the baby’s out with a little help of fundal pressure from my assisting intern. Everything just happened in a split second. That split second. I reconfirmed intraoperatively – it was posterolateral type III praevia. I removed the placenta and sutured like crazy. I was lucky, the bleeders were secured and I was truly relieved I did not paint the house red that day.

The baby went all crying and good, thanks to my wonderful Paed colleague.

Kayaking

The second new experience would be to operate for an unfortunate mother with intrauterine death. She was devastated with the news 3 days ago, gone through 3 days of induction and finally went to labour room with 4cm os and though on maximum pitocin augmentation, her os remained stubbornly unchanged from sunrise to sunset. To make things worse, the soft bodied body of the fetus turned from cephalic to tranverse. Factor in the stubborn cervix, with informed consent, the mother insisted for surgical delivery.

Reload

I delivered the baby by breech extraction via the uterine incision. The baby was expected to be soft and floppy. I made small incision, contemplating some cosmetic compensation for the traumatic mother, but somehow I regretted it later when it was kinda difficult to extract the baby – all soft and you know, very soft. I was worried.

waterman

The idea of as I pulled the body out, the head might just get detached. How scary that thought was.

Luckily that gory scene didn’t materialize.

That lifeless baby boy came out in one piece and in the most solemn atmosphere, the maternity nurse let the unfortunate mother kissed him for the first and last time. Not one sound in the room, except for the ECG bleep on the machine.

Aug 19, 2009

H1N1 death and me

Someone actually tell me if he hears anyone (anyone including me) talk about H1N1 again, he’s going to freaking kill that person. Well, if he’s so freaking bloody nuts about sending someone 6feet down under, he shouldn’t be reading further. This entry touched a bit about H1N1, but mostly it is about something else. Anyway, technically, I am not ‘talking’ about H1N1, I am just writing it.

In the middle of the night, as I was just about to lie down in that lousy bed in my on call room after a heavy morning, noon and evening of Caesarean marathon, my phone rang. Yes, most of my clinical story began with the phone. That’s why we’re on CALL.

“Patient in HDW with ILI (influenza-like illness) asystole. You’re the primary unit. You gotta come”

“OK.”

I reached there all tired, weary and exhausted like Meredith Grey of Grey’s Anatomy, and pulled a full scrubs and face masks before I entered that isolation room. One of the nurses was heavily pumping unto the patient’s chest. The attending Anaest colleague was bagging and shown me the bilateral fixed pupils. My medical colleague informed the medical specialist on call. The patient, a Day 6 post Caesarean mother, clearly didn’t have any hope to survive, her heart beating without any perfusing pulse completely dependent on the chest compressions and the multiple doses of atropine and adrenaline pushed into her. I finally called it as per protocol, and I calmly sat down gone over her thick medical record briefly and signed the death certificate. Her husband who was previously counseled about her poor prognosis accepted my final word of confirmation of her passing away. He had bloodshot swollen eyes, probably had been crying whole day and night. Just probably. I double checked. Her infection of H1N1 was still pending.

After that entire ordeal, I was called to attend another obstetric patient which the houseman informed me as ‘the patient came in all anxious and headache and BP 200/120 by machine reading’, not even knowing the patient’s age, gravidity, parity and gestation. Obviously, nowadays, economy wasn’t the only thing in crisis.

“You need to review and summarize the case history of the deceased patient and type it out to be presented” bugged the nurses at such ungodly hours, while I was reviewing that patient with impending eclampsia.

“I had a LIVE patient with emergency I need to attend to. You understand what I am talking about?”

“OK, later.”

“Yes, but this is maternity mortality review. I believed the specialist should be called in to analyze, not some small fry like me. Comprehend?” (In Malay, of course)

Next working day, the nurses called again. This time, she pulled in the Matron, for more weightage, power and all. I am totally like ‘Duh’.

Matron K: You need to type, review and I need to save in Pengarah’s pendrive to be sent to KKM

Me: Usually maternal mortality, needs specialist review, I am just small fry. I don’t think I have the priviledge to do it. I can do it then get specialist double check, can I have the records?

MK: you need records? You can’t just write?

M: Huh?!?!? How to write?

MK: Your department so mar fan (troublesome)… [mumbled something]

M: I will pretend I didn't hear that. Please get us the records, my specialist will review it. That’s the protocol, and how things are being done CORRECTLY. (didn’t raise my voice, just highlighted it)

MK: What ever. [Shut down phone]

For the record, that was the first and the last time I saw the patient, I didn’t know head and tail about that unfortunate mother. All I heard was that her oxygen saturation was hooked on 60% on air and 80% on high flow mask for several hours without any intubation as her conscious state ‘doesn’t correlate’. Thereafter, repeated and repeated ABGs shows severe acidosis and low oxygen saturation but still, she wasn’t intubated till her GCS dropped and collapsed. Only then, the Anaest team decided to tube her. There must be a solid professional reason why intubation was withheld earlier. I have yet to find out that exact reason.

Secondly, to send in report about ILI deaths urgently without any professional systematic review is just plain pathetic and irresponsible with total Malaysian-style apathy. If all deaths were reviewed in this cincai manner, no wonder our H1N1 battle strategies are becoming laughing stock.

On top of that, countering own childish unprofessional demand by insulting my department’s professionalism is beyond doubt the most horrendous medical attitude of all time.

DANG! Should have recorded that piece of ‘fine’ conversation for my personal library.

Aug 18, 2009

facebook MD

And yes, I am pimping someone else article. But thanks to Ben, this piece is really an eye-opener, especially for a medical facebooker like me.

Practicing Medicine in the Age of Facebook
Sachin H. Jain, M.D., M.B.A.

In my second week of medical internship, I received a "friend request" on Facebook, the popular social-networking Web site. The name of the requester was familiar: Erica Baxter. Three years earlier, as a medical student, I had participated in the delivery of Ms. Baxter's baby. Now, apparently, she wanted to be back in touch.

Despite certain reservations, I clicked "confirm," and Ms. Baxter joined my list of Facebook "friends." I was curious to hear about the progress of her baby girl, but I wondered about the appropriateness of this interaction. Was Ms. Baxter simply a grateful patient interested in sharing news about her child — as a follow-up to our professional interaction — or did she have other motives that weren't apparent to me? In confirming this patient as my "friend" on Facebook, I was merging my professional and personal lives. From my Facebook page, Ms. Baxter could identify and reach anyone in my network of friends, view an extensive collection of personal photographs, read my personal blog, and review notations that others had left on my "wall." The anxiety I felt about crossing boundaries is an old problem in clinical medicine, but it has taken a different shape as it has migrated to this new medium.

Over the past 5 years, social-networking sites have evolved from a preoccupation of high-school and college students to a mainstream form of social interaction that spans divisions of age, profession, and socioeconomic status. At the hospital where I'm in training, medical students, nurses, residents, fellows, attending physicians, and service chiefs can all be found linked to one another as active members of social-networking sites. The technology facilitates communication, with personal Web pages that permit users to post information about events in their lives, advertise social activities, and share photographs. Users are prompted by Facebook to carve out a digital identity by disclosing their political affiliations, sexual orientation, and relationship status. Those who do so can readily communicate and associate with other users who have similar interests — a feature of these sites that facilitates collective action across spans of geography and time. In the 2008 presidential campaign, the group Doctors for Obama used Facebook to rapidly mobilize thousands of doctors to communicate their views on health policy to the Obama headquarters. This group of physicians continues to have a voice in the Obama administration, largely on the strength of its Facebook-created network of members. Similarly, Facebook networking groups have been created with a focus on specific medical specialties or diseases. Doctors or patients can interact with one another in groups such as "Diabetes Daily" and "I Support Cystic Fibrosis Research and Awareness!," each of which boasts thousands of Facebook members. Hundreds of thousands of philanthropic dollars can be traced back to initiatives publicized on social-networking sites.

By creating a new environment for individual and group interaction, social-networking sites also create new challenges for those who work in clinical settings. Take, for example, the MICU nurse who blogs about her experiences in dealing with a difficult patient, forgetting that one of the patient's family members — a recent addition to her network of friends — has access to her blog. Or the dermatology resident who is asked on a date by a clinic patient after he learns from her online profile that she is single — information that he would have hesitated to draw out of her in person. Or the medical attending whose clinical judgment is questioned because of photographs posted online, showing him in progressive stages of apparent inebriation at a department holiday party. Although many Web sites allow users to choose higher privacy settings and to control which personal content is available to whom, it is clear that there is no longer a professional remove between many clinicians and their patients.

Physicians, medical centers, and medical schools are trying to keep pace with the potential effects of such networking on clinical practice. In an e-mail to students and faculty of Harvard Medical School, Dean for Medical Education Jules Dienstag wrote: "Caution is recommended . . . in using social networking sites such as Facebook or MySpace. Items that represent unprofessional behavior that are posted by you on such networking sites reflect poorly on you and the medical profession. Such items may become public and could subject you to unintended exposure and consequences." At the Drexel University College of Medicine, medical students are warned about the possibility that information placed on social-networking sites might influence the fate of their applications for postgraduate training: "Programs/employers are increasingly gaining access to social networking sites such as Facebook and MySpace to see what they can learn about candidates." Although legal questions surrounding the relationship between clinical medicine and social networking are as yet undefined, there are obvious concerns for individuals and institutions, since their Internet presence makes clinicians' attitudes and activities increasingly visible.

The issues raised by access to online media are in many ways similar to issues that physicians and medical institutions have dealt with for generations. Physicians, after all, are members of real-life communities and might be observed in public behaving in ways that are discordant with their professional personas. During medical training, the importance of maintaining professional distance — however much one desires to have a close, meaningful relationship with one's patients — is taught by educators and reinforced by the use of beepers and paging services meant to shield physicians from their patients. What is different about the online arena is the potential size of the community and the still-evolving rules of etiquette.

After becoming my Facebook friend and exchanging a few friendly e-mails, Ms. Baxter divulged the reason she had gotten back in touch. Having tired of her job as a fitness instructor, she had decided to apply to medical school and wanted some advice. Relieved to be back in a semiprofessional realm, I began a correspondence with her and shared a few thoughts and suggestions. Among other things, I recommended that she carefully consider her online identity.

The name and identifying characteristics of the patient have been changed to protect her privacy.

No potential conflict of interest relevant to this article was reported.

Aug 14, 2009

bedtimes stories

Being with a mischievous son can be pretty taxing. It had been a while since I last talk about my dear Aedan.

Part of the growing process, kids as kids are will become very hyperactive and tried to be involved in everything.

Similarly, my little Aedan is very active and sometimes just bite off more than what he can chew.

He had two baskets of toys for himself, and yet, he only spent a few minutes on his own toys. Most of the time, he will be helping out in the housework.

After hanging all the washed clothings, Aedan would happily help carry the empty pail back to the bathroom

Then when all clothings well dried and collected back, he will help to fold them into the basket. Now he is doing quite a decent job of folding his own clothes and hankie.

If he sees you mopping the floor, he will gladly want to take the mop and do it! If not allowed, he will blast his own vocal cord into full volume. Nevertheless, in view of the sloppy job he will be doing and he may end up injuring himself, he will be left crying, till I can find a mini mop in the Toys’ Department.

When I was small, the world of stories was never a stranger to me.
I read them up in the books. I watched those stories in cartoon. I even can tell or two in the story-telling competition, and actually won something in primary school. At this point, I couldn’t really remember the ‘award-winning’ story at that time, probably because it wasn’t a common story and it is related to ‘fart’.

My dad didn’t read story to me during my bedtime, but I hope to do so for little Aedan. Hence, I am re-summoning back my story-telling ‘talent’ to tell bedtime stories to my little Aedan. I bought few pictorial books, and I tell the story to him in my own words.

It was a difficult choice of which story to tell to my son. But then, fortunately, I got myself reading the right FIRST bedtime story to my son.

It was ‘The Ugly Duckling’.

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For those unaccustomed to this story, it is basically about the hatching of an ultra-ugly duckling together with other golden yellow duckling. The ugly one got shun by its own mother and other animals. But, finally, it grew up to be a beautiful swan.

Through the story, I hope that Aedan will grow up, not being blinded or discriminate against colours and superficial beauty.

Aug 13, 2009

Aug 9, 2009

amusing flu clinic

2 days ago, I was post call. A bit tired. But then again, I registered myself for locum in A&E, looking forward to learn new things beyond what my department has to offer.

Yet, for my first session, I was pretty stuck in the 'flu clinic' - in the Green Zone, where the resident A&E MOs would gladly give it a 'pass', to give others the fair share of opportunities to gain some 'active immunity'.

For those who are pretty healthy all their life, and so far never been to the Accident and Emergency... here's the thing
Zones of A&E is colour-coded, and if I am not mistaken
Green zone - for the walking ones
Yellow zone - for those groaning in pain
Red zone - for those way past the 'groaning' part, and now playing 'dead'
Black zone - no such zone. One floor down - mortuary.

Okay, there I was sitting there, baffled at my assistants, a nurse and a medical assistant. Both of them with a surgical mask on. Feel like punching myself in the face.

Punch Face

Not because I was stuck in the viral loaded room, but simply because these professionals who work day and night here, couldn't get a decent N95 mask to protect themselves. Come on lar.

And when I asked for one, they told me, "Department only gives us the surgical mask"

Get real, man. Even the our Malaysia's H1N1 protocol by DG stated that all medical staff handling flu patients to be given N95 masks in black and white.

I had to make my way into Yellow zone and into some admin office to get it myself, with a little help from some much-wiser medical assistant.

Then the long line of patients, I was thinking I would be punching myself for the second time, but then, I was over amused by the range of patients that I was seeing.

Secretly, I was giggling beneath the N95.

I was wondering what's really cooking inside their brain.

Cook in brain

One
An uncle came into the long flu queue just to reach me after 4hours of waiting with only some throat dryness. No fever, no flu symptoms, no contact history. Clean as a whistle except for probably poor fluid intake. Then he asked me how to avoid H1N1.

My answer: Don't go near people with flu. Stay out of crowd, especially the crowd in hospital with variety of bacterial, and always wash your hands. Drink more water. (In Bahasa Melayu, of course)
What I really want to tell him - Pack your bags, grab all the essentials including portable modem, and hike up the mountain to a secluded area. Stay there alone, plant your own vege, hunt for your meat, and keep yourself updated. Come back to civilization when everything cleared up.

Two
A mamat came in all jacket and looked tired, or tried his best to look tired. Almost an 'Oscar-award winning' show. No fever. Started to have cough yesterday. As he told me he had cough, he coughed a bit. No runny nose. No contact.
I told him: Now, I will give you some cough medicine.
Mamat: I don't need medicine. I need some rest. My work very stressful.
Me: Don't worry stress is good for your cough.
Mamat: I think I need rest.
Me: I think I am not going to give you M.C.
Then as I was leaving hospital, I saw him puffing away the old Marlboro's cig sticks. WTF. (WTF = WonDerFul?)

Three
An ah beng bang the door loudly and rushed in.
Ah Beng(AB): WOOOOOOOOOOOIIII!!! I waited so long, so tired. cannot breathe. why no doctor to see me. How can you let me wait so long. . I waited 3 hours since 12noon. Haven't even eaten lunch yet...(fluently full sentence spoken)
Me: oh. (turn to the pakcik that I am seeing) Pakcik, kamu datang pukul berapa?
Pakcik: Pukul sebelai stegoh...
Me: (look back at the Ah Beng) So...
There was slight hint of Ah Beng's balls shrunk few mls and he went outside.
Then I told the nurse: If he really breathless and going to collapse, bring him into Yellow Zone.

Four
A mother brought her 2 years old daughter.
Me: how is she?
Mother: she's ok
Me: have fever?
Mom: No.
Me: have cough?
Mom: No.
Me: have runny nose?
Mom: No.
Me: have shortness of breath?
Mom: No.
Me: have contact with H1N1 patient?
Mom: No.
Me: err.. why you come?
Mom: I brought her along to Tesco, and someone coughed at the payment counter. Not very near, but it was in the same queue. I just wanna screen for H1N1 just to be sure.
Me: err... okay, come back if she had any flu symptoms.

All this amusing experience, definitely boost my immune system through endorphin.

Aug 2, 2009

senseless street protest


fail owned pwned pictures

Senseless street protest.

Catchy title. You'd probably be thinking I am going to blog otherwise.

No, it is senseless, as much as I hate to agree with this fella, read my lips: S-E-N-S-E-L-E-S-S!

But I am glad, everything is calm back in KL again.

Although I believe, government offering a venue to hold peaceful demonstration is just so hard to believe. It sounds as if it is something that you say retrospectively just to look good, or in chinese, we called it the cannon behind the horse (if I'm not mistaken). It sounds like Khil Toyol offering commission of 50% of the massive price tag on his Balinese Mansion and simply doesn't want to offer the keys up to keep his bullshit on.

There's no doubt that ISA is draconian. At the moment writing this, I should probably be worried of being detained under ISA. But then again, with my personal blog entry just a read for myself and just few friends around me, I guessed they won't waste their prison space for me.

Nevertheless, to march with 10,000 people to Palace, and causing major chaos. Shops closed, traffic down, casualties brought to hospital. As if H1N1 was enough to keep the medical staffs in KL busy. Even someone trying to get into the action lost RM 18,000.

All this unnecessary chaos and coercion is equal to spitting to the sky. As a result of this, probably we'll be scaring away investors and shot down a few figures in our tourism sales.

Where there are still lots of people and children without food, shirt and clothings, yet, people chose to spend their money to buy anti ISA shirt rather than help out their fellow suffering Malaysians.

And the vids actually shown one of the demonstrator actually shouted out that the gathering is blessed by the God. I think He is all for peace.

Somehow I felt this mass gathering may be secretly instigated by the one to appear to have more sense than the political opposition.

If you'd seen an old Chinese movie, 'Black Gold' starring Andy Lau and Tony Leung Kar Fai, then one would see that the politician that Tony portrayed, was the one who purposedly started major chaos in the city, then stepped out in his pyjamas, to calm everyone and solve the commotion like a hero and then gained massive political mileage.

If one is not familiar with Chinese movie, the recent 'Angels and Demons' will put some perspective in the possible conspiracy behind the whole mass gatherings.

There's another famous chinese sayings: Gods is you, Ghost also you.

If you really think do not like the current government, remember them, and vote them out.

Peacefully.

P.S. Don't give them chance to look good.

Aug 1, 2009

Intel Inside

Ever heard of Intel?

Yes, the silicon giant that pretty much dominate the computer world. For now.
If you really do read news from abroad, there is actually a new invention of computer with bacterial (yes, those microorganism) that successfully solve complicated mathematical problems faster than the conventional computer. An innovation still at its infancy stage.

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If you’re really accustomed to computers (who doesn’t nowadays), there’s this famous logo of Intel Inside which is the pride logo of Intel.

And someone went a step further, and came up with the parody of this logo, by adding few words outside, making it.

With my hospy pretty much pushing forward into the world of IT, we’re treating more computers than patients. Probably computers doesn’t complain as much as the patients.

Few weeks back, I was on call and I almost fainted when I was in the middle of the “Intel inside, Idiots outside” scenario.

And here goes the real story about how the smartest people do the most stupid thing. Ever.

“Ring, ring, ring.”

I received the call from my colleague. I went to OT immediately, waiting to perform a C-Section for a mother with her dearest baby in distress.

As I changed to the OT blues, I received another call. This was from the house officer conveying to me that my specialist was actually also suspecting that unfortunate mother having placenta abruption as well, which means bleeding from the placenta. That could mean the baby would probably be in worse prognosis.

I went to the nursing counter.

“Yes, Dr, the patient is already at the door.”

I waited for 10mins. Another 5mins. Another 5mins. Then everything got weird. A simple OT entry checklist doesn’t require a freaking 20mins.

I actually was pretty worried and I peeked into the ‘transition’ room.

In front of my eyes, the nurses, almost 4 of them, kept on clicking on the computer, refreshing the OT slate, waiting for the patient’s name to pop up.

“Why patient can’t come in yet?”

“Nama dia takde dalam komputer lar..”

“Eh, ini fetal distress dengan abruptio. Jika ini anak kamu, kamu nak tunggu lagi ke?”

“Ini matron punya order la… Kena ikut”

Immediately, I was totally baffled at such an idiocy and pushed the patient into the OT, awaiting my anaest colleague rapid pre-op assessment. Postoperatively, indeed there was 200cc of retroplacental clots. The baby was admitted with some good degree of respiratory distress. In my personal opinion, could have been better.

Matron, supposedly the chief of all head of nurses, came up with this so-called I-D-E-A after received complaint that operation performed in the OT was not entered in the computer. Every now and then, if it was a life-saving procedure, surely there should be some sensible allowance for the delay in entering the name into the OT slate. And for the nurses, the so called medical professionals, of whom, the public trusted their life with everyday, followed the I-D-E-A without a single hint of intelligence or conscience regarding the possible morbidity that the delay may cause.

A classical tale of “Intel inside, Idiots outside” telling us how mankind slowly loses our human touch and wisdom in the companionship of the computer.

The tyranny of machine and artificial intelligence in The Terminator may be a fiction. But somehow, fiction can’t be too far from the real thing.

Frankly, I crossed my fingers with hope that this incident isn’t just the tip of the iceberg.