Dec 28, 2012

Princess's antenatal check up


Cloudy day on the last antenatal clinic day of the week

I glanced at the mother's name and prepared myself.

An African couple came in.

They were fluent in English. Thank God.

Full check-up and everything explained to the couple.

Couple reassured and delighted.

All smiles.

As they were at the door, my curiosity taken over and exchanged few words with the hubby.
Just wondering, I notice there's a "Princess" in your wife's name.
Yes, I am actually the Prince. (sport a sheepish smirk) 
Wow. So that makes me the royal physician.
Sort of. (more of a smile)
Alright, see you.

Perhaps they were just pulling my legs. But who knows.

Dec 22, 2012

Pain of inertia


Trolled by pain. Sigh!

I was in a sombre mood and pain score of 10 having to make the move - a change in my workplace.

It was an anticipated move, yet life changes in more than 360 degrees and my expenditures rises to the similar figure in percentage.

After 3 weeks here, absorbing whatever comes along the way, I am lucky not to be sucked into the black hole of unhealthy working environment.

See Explanation.  Clicking on the picture will download
 the highest resolution version available.
Black hole: Look pretty much like main interest in my line of work,doesn't it?

My fellow batchmate summarized it beautifully as
"It's freaking tiring like that, mentally and physically. Blaming game is one, defensive medicine is another, hierarchy system is another killer. Basically before getting the apple(credentials ) one has to get raped by everyone" 
Or perhaps my time have not come yet.

Still have not properly understand the natural history of such pathological phenomenon.

Yet, I should consider myself really effing lucky to start of my posting with such nice and dynamic team, especially the 3 senior colleagues who are always there for us, the 3 newbies, including me.

Dr S is informative and resourceful.
Dr N is funny and dynamic.
Dr Z is disciplined, pushy and things always get done - quick.

Lecturers are good teachers and sets fine examples to follow.

It is always nice to be in the junior pool again. Relief.

Horror stories had caught my ears. It isn't nice if one is caught with senior colleague who is lacking of the sense of teamwork.

My fellow Master batchmate was forced to the point of using the four letter work with the -ing suffix.
Four letter word would have been bad enough, but in continuous tense, it is definitely worse.

Now my pain score had gone down to 6-7.

P.S. the free usage of FB and blog in the hospy helps in reducing the pain score even further.

Dec 19, 2012

Penang's PalaGate




THE FACTS.


2004:The state govt (under Gerakan) approved the sale of the land of Kg Buah Pala to Koperasi Pegawai Kerajaan Pulau Pinang for RM6.42 million.

2005:On the recommendation of the then Deputy Chief Minister, the premium of the land was halved to RM3.21 million.

2005: The residents did not know about the sale but realilized something amiss when the state govt stopped collecting rent for the Temporary Occupation License in Kg Buah Pala.

2007: Eviction notice was issued to them, and they were offered a 850 sq ft three-bedroom low-medium cost flat or RM90,000 progressive payment...which they refused to accept.

2008: The residents were manipulated by certain parties, hence protested and DAP, the new state government was accused of mishandling the Kg Buah Pala issue.

2009: The court ruled with the developer and ordered the residents to vacate the land. 24 families came to an agreement and accepted offer by LGE and the developer. 9 other families refused to accept the offer.

April 2012: The 9 house owners who refused LGE's offer were given new home keys from PM under humanitarian grounds (not compensation). The houses are valued at RM220,000 each and are located at Taman Sejahtera Indah, Teluk Air Tawar)

Dec 2012: 24 house owners who accepted the offer from the developer received a compensation of a double-storey house of 1,400 sq ft (worth RM500k) along with RM8,000 in shifting cost.

______________________________________________________________

Guan Eng Terus Malukan BN- Serah Rumah Mewah RM500K Kepada 24 Penduduk KG Buah Pala

Seramai 24 penduduk Kampung Buah Pala menerima rumah teres dua tingkat yang bernilai kira-kira RM500,000 selepas kemelut yang melanda kampung itu dua tahun lalu.

Ketua Menteri, Lim Guan Eng berkata, pemberian itu adalah hasil kerja keras banyak pihak termasuk Kerajaan Negeri yang sentiasa prihatin terhadap hak penduduk kampung berkenaan.

“Kita bukannya menganiaya mereka seperti yang dituduh pihak tidak bertanggungjawab. Kini penduduk tidak perlu risau kerana sudah dapat hak mereka dan ini juga bukti kita tunaikan apa yang dijanji.

“Saya bersyukur kerana Kampung Buah Pala masih kekal di sini bersama penduduknya walaupun namanya kini ditukar kepada Taman Buah Pala. Keadaannya juga seperti dahulu cuma rumah yang dibina lebih selesa.

“Pada 2009, Mahkamah Persekutuan memutuskan bahawa penjualan tanah kampung ini adalah sah dan pemaju berhak meneruskan projek mereka. Suka tidak suka, kita perlu terima bagi menghormati undang-undang.

“Namun Kerajaan Negeri mengambil inisiatif berunding dengan pemaju untuk mendapatkan pampasan buat penduduk dan kita bernasib baik kerana mereka menerima cadangan Kerajaan Negeri.

“Setelah berunding, seramai 24 keluarga bersetuju untuk menerima pampasan yang diberikan namun sembilan lagi tidak mahu menerimanya. Mereka mengatakan kita buat janji kosong dan menipu,” katanya.

Sementara itu, seorang penduduk, Annie Rose Micheal, 75, berkata, dia lega penantian selama dua tahun akhirnya berbaloi apabila diberikan sebuah rumah teres dua tingkat yang selesa untuk didiami bersama anak-anak.

“Selama ini saya hanya menyewa di sebuah rumah berdekatan kawasan ini selepas rumah saya dirobohkan dua tahun lalu,. Saya gembira dengan pemberian ini,” katanya.

Pada majlis berkenaan, Guan Eng menyampaikan kunci rumah kepada semua penduduk kampung itu termasuk sembilan keluarga Melayu
PalaGate.now they actually have gates for their homes.
This is the real deal of Janji Ditepati.
Not promise to build a new house after being voted in.
50years of being voted in, nothing being done.
After being voted out, you have the bollocks to vote you back in by promising the moon.
As the Federal Government, it is pretty obvious you don't give a damn about the rakyat in some States.
Why do you think we should give a damn bout voting you in. Grow up.


Dec 13, 2012

Crimson tide

The 'best' thing about the new hospy that I am working right now is all deliveries to be conducted by doctors.

All deliveries to be conducted by medical officers or house officers under medical officers supervision.

It does bring back good memories of the time when I first conducted my first delivery, which is in the same hospy but different labor room.

Now, the labor room is new and so-called advanced.

Computerized partogram. Data through computer. CTG centralized view.

Maybe it's inertia.
Maybe it's adjustment disorder.

The installed system has less pros and more cons.

Browsing through the computerized data takes a lifetime and the previous records still need to be traced manually on paper technology.

Although one may argue the invincibility and economics in intrapartum care records as its prime and sole raison d'etre, I beg to differ.

Files can be corrupted, hacked, stolen, altered and destroyed with good computer programming skills.

Plus, the poor record-keeping using the not-so-user-friendly system will work against the medical institution.

Feedbacks from Prof J on the review of the documentation can be summarized in one word - Rubbish.

When I had complicated third stage and documented in length in the 'remarks' column, the senior nurse partly 'censored' my entry because when printed out, it doesn't look 'nice'.

Lack of triaging also renders serious conditions do not get immediate attention.

When a preggie lady came with per vaginal bleeding, as I am busy, I instantly ask a loitering house officer to attend to the lady for brief history.

The house officer just ignored me and walked away.
When I confronted him, the nurse in charge backed him up, telling me about how the whole system works. Patients to be registered by the clerk. Then, reviewed and vital signs be taken by the nurse, before the lady can be clerked.

Probably there is a reason why a lady came with massive abruptio but was seen only after 15mins later.

All victims of technology, or rather victims of common sense deficiency.



Dec 8, 2012

Lameness of Jib Gor

http://m.malaysiakini.com/news/216200

Perdana Menteri Datuk Seri Najib Tun Razak hari ini berjanji untuk memberi dua hadiah besar kepada rakyat Pulau Pinang iaitu pembinaan 20,000 unit rumah mampu milik dan perkhidmatan monorel jika  Barisan Nasional (BN) diberi mandat semula untuk memerintah negeri itu.

Dear PM,

This is not 'Janji Ditepati'. It's 'Ugutan Untuk Undi'.

Are you threatening us that Penangites will lose 20,000 homes and the monorail if we don't vote for you?

Are you using YOUR own money or the PEOPLE's money for those 'Hadiah'?

This is cheap and lame. Mostly lame.

Don't bother to reply.

Yours truly,
Pilocarpine

Dec 7, 2012

Updates...

Reviewing a post delivery patient.

Medical Officer: Houseman, please update the baby.
Houseman: update the baby?(scratching head)
Specialist: Yeah, update the baby about the mother.

Sarcasm of the day.

Dec 1, 2012

A melody that I will complete

restecpe. yup. dat's how Ali G would have spelled respect.

Respect is a very simple thing.
It has nothing to with money or status.
It has nothing to do with a great amount of time or sacrifice.
It has something to do with being sincere and open.

I may not have fate with that person for a long period of time.
May have seen that person 3-4 times.
But from that person, I had received the great motivation from that person.

That person have given me a simple mindtrack and mindset that I must project myself to be.

That person's ultimate victory has allow me to respect that person's rightful success.

That person also kept reminding me who is the person behind what he had achieved today.

Incidentally, I bumped into that person during dinner tonight and was re-motivated again.

And a song came into my mind.

Listen,
To the song here in my heart
A melody I start but can't complete

Listen, to the sound from deep within
It's only beginning
To find release

Oh,
The time has come
For my dreams to be heard
They will not be pushed aside and turned
Into your own
All cause you won't
Listen....

[Chorus:]
Listen,
I am alone at a crossroads
I'm not at home, in my own home
And I've tried and tried
To say what's on my mind
You should have known
Oh,
Now I'm done believing you
You don't know what I'm feeling
I'm more than what you made of me
I followed the voice you gave to me
But now I gotta find my own..

You should have listened
There is someone here inside
Someone I'd thought had died
So long ago

Oh I'm screaming out, for my dreams to be heard
They will not be pushed aside or worked
Into your own
All cause you won't
Listen...

[Chorus]
I don't know where I belong
But I'll be moving on
If you don't....
If you won't....

LISTEN!!!...
To the song here in my heart
A melody I've started
But I will complete

Oh,
Now I'm done believing you
You don't know what I'm feeling
I'm more than what you've made of me
I followed the voice you think you gave to me
But now I gotta find my own..
My own...





Nov 26, 2012

Outstation, UpNorth


A mountain of footware...




Boots doesn't really sell footware.




Great sense of security...


Ministry of Trade actually approves this...


Drawn to the weightlifting Tshirt.


Oddly drawn to pork-based fastfood, though I think Chicken tastes better.

Nov 25, 2012

The meaning of green

eyewitnessed...

Road's entrance blocked off.

Drawing public attention. The flag indicates the place.
 
Officers with videocam and camera. Documentation, perhaps.

Nov 22, 2012

desperate moments before the great fall




Screen shot from Dr. H's phone. He asked: Is this lame?
For me, I was getting them at least once a week. Initially, I thought it was just a random thing, but after a while, it started to become a pain.

Dream Job?



Everyone have their own definition and criteria for a dream job.

Or perhaps, dream job is sort of an oxymoron.

Dream is the unconscious thoughts arising in slumber, without any work being done.

Job requiring work being done and compensated by returns, usually monetary gains and rarely satisfaction.

Therefore, it actually depends on what people like to do or enjoy doing.

For instance, I could say that I like to watch movie.
I like to watch latest movie.
I like to watch all the series.
I like to sit all day and do nothing but watch movie.
I want to watch all types of movie, including banned movies, with all the R rated scenes.
Dream job?
Join the Censorship Board.
But then, it will come with its own sets of problem and nightmare, doesn't it?

I was told that I am having a dream job.
I thought that I am having a dream job.
Once a while, at difficult times, I have my doubts.
I tell myself, it is common to have doubts.

But these doubts are dangerous.
They will eat into the subconscious mind.
Slowly eat into the conscious mind.
Until even the best of life seems like a piece of thrash on earth.

Maybe I am lacking in something to look forward to.
Maybe I am having quarterlife crisis.
Maybe I really need is to find back

to find back that DREAM in my dream job again.

P.S. Wish me luck. And the video above has nothing to do with my dream, just so there are no strayed ideas.

Nov 11, 2012

AES or ass?

A panel of doctors was asked for their opinions concerning AES.
This was what they said:

*The Allergists voted to scratch it.
*The Dermatologists preferred no rash moves.
*The Psychiatrists thought it was madness.
*The Radiologists could see right through it.
*The Gastroenterologists had a gut feeling about it.
*The Neurologists thought the administration had a lot of nerve.
*The Obstetricians stated they were labouring under a misconception.
*The Ophthalmologist s considered the idea short-sighted.
*The Pathologists yelled, "Over my dead body."
*The Pediatricians said, "Grow up!"
*The Plastic Surgeon said, 'This puts a whole new face on the matter.'
*The Podiatrists thought it was a step forward.
*The Urologists felt the scheme wouldn't hold water.
*The Surgeons decided to wash their hands of the whole thing.
*The Anesthesiologists thought the whole idea was a gas.
*The Cardiologists didn't have the heart to say no.


FACTS:
1. According to MoF, cost for AES project is RM717k
2. Beta Tegap S/B and Ates S/B were awarded the AES project.
3. Beta tegap S/B sealed a deal with Australia's Redflex Traffic System to supply the cameras for RM151 million.
4. Ates S/B sealed a deal with German's Jenoptik Robot to fix the system for RM160million.


*scratch* *scratch* is my calculator not working or doesn't the amount add up?

Nov 9, 2012

Datuk Lee CW, the unfilial son?

But Chong Wei is never the one who likes to discuss his complicated family affair, telling Red Carpet in a previous interview that “I’m not a celebrity. I’m a very private person.”

from red carpet

 

面書貼文“傷心父親”‧沒受通知出席‧李亞財飆淚

  • 李亞財:我只能在大山腳家鄉收看電視直播兒子婚禮。(圖:星洲日報)
(檳城‧大山腳9日訊)大馬羽壇一哥拿督李宗偉今日大喜在即,父親李亞財昨晚卻突然在面子書上載“傷心父親"貼文,隨即引來諸多臆測。
李亞財坦承,他是因為沒有出席兒子李宗偉與媳婦黃妙珠在吉隆坡的婚禮而難過。他接受訪問時更一度忍不住飆淚。
李亞財說,自己並沒在婚宴受邀名單內,所以週六隻能獨自在大山腳家鄉收看電視直播,並在300多公里外的檳城,遙寄祝福給在吉隆坡的兒子和媳婦。
“之前我一直等家人通知,安排我出席婚禮,不過一直等到本月6日都沒有人通知我,我也不知要穿甚麼禮服……之前大兒子還有帶我去試穿西裝,不過不合身,婚紗店說要修改,不過到昨天婚紗店的人都沒有聯絡我……"偉珠婚是城中焦點,婚宴今明兩晚在吉隆坡國際會展中心(KLCC)隆重舉行。
Google translated:
Lee Chong Wei today overjoyed imminent, father, Li Ya Choi last night suddenly on the face book contained "sad father" (Penang ‧ Mertajam Bernama) - Malaysian badminton a Ge Nadu post immediately attracted a lot of speculation.
Ya Choi admits he did not attend the wedding in Kuala Lumpur, the son of Lee Chong Wei and daughter-in-law Wong Mew Choo sad. Biao tears once more could not resist when he interviewed.
[Trendy] the hearts of many men will avoid the marriage thing, or divorce, messed up, do not know how to clean up the mess after only know to evade responsibility and Chief avoid you.

Ya Choi said, he was not in the wedding invited list, so Saturday only to watch live television alone in Mertajam hometown Send a blessing to his son and daughter-in-law in Kuala Lumpur and Penang over 300 kilometers away, away.
"I have been waiting for family notification, arranged for me to attend the wedding, but waited until the 6th of this month, no one informed me, I do not know what to wear dress ...... before the eldest son there to take me to try on a suit, but does not fit , bridal salon that you want to modify, but yesterday bridal salon did not contact me ...... "Wei beads marriage is the city's focal point, the wedding and next two nights was held at the Kuala Lumpur International Convention and Exhibition Centre (KLCC).
http://www.sinchew.com.my/node/267763?tid=1



user posted image


http://forum.lowyat.net/topic/2582920/al
Gmruleme: got a lot of ppl say abt lcw father issues in fb..gambling and even bring a china chick back home until lcw mom move out frm the house?? sad.gif
Balaclava: despites all sin done, he's still LCW father. so i dont see why don't invite him over. just ask him behave.
Mois: Nothing to disgrace about. Politician as friends gonna make your life easier next time when you are in business. Get better contracts, cheaper land for Chongwei Binajaya. With this, he can provides his family fortunes and more travelling or even all the luxuries for his family members. In this case, perhaps his father gold ring and rolex. 
LCW cant last long in badminton. Time is catching up. He certainly does not want to end up like misbun or rashid sidek. He wants to be a businessman.

Seather: from wut i heard from his Berapit neighbours... the tea ceremony will still be held in Bukit Meratajam... his father is invited la... LCW oso not totally anak derhaka...

as for why his father not invited to KL dinner.... alot of rumors flying around.. but all hearsay la....

btw... LCW bought a house for his father to collect rent as his living expenses smile.gif
___________________________________________________________________________________

My take on this matter:

Our national shuttler, Datuk Lee CW received a lot of media coverage this few days mainly for his lavish wedding dinners.

But beside the positive ones, negative news was circulating as well, mainly focus on the absence of his dad from the wedding dinners and watching his gala from home.

Lots of netizens, mainly keyboard warriors, lashed out extremely hurtful comments based on assumption that Datuk Lee CW is an unfilial son based upon his dad's abscence.

I am not close to him. I just know he is our national shuttler and he had always worked hard for the country. At some point, he was our national hero, by struggling to come back from his injury to gain a gold for the country. He failed and he apologized to the whole country.

I do not even know his family. I bet 99% of people commenting badly about him does not know either.

Anyway, it is unfair to him and utterly appalling how 'self-righteous' netizens like to be behind their own keyboards when they don't have an inkling what is happening.

I came from a complicated family and I knew people who have much more complicated family.

Having a wedding to be shown on live television is not something you want to really exclude your own father from.

Yet, Datuk Lee did it for real reasons only he knew best and he did not even try to be a hipocrite.

If you read back the first row of this entry, Datuk Lee CW did not wish to discuss his complicated family affair because I believe he still want to protect the possible ugly side of his father, parents or family from the public and swallow the bad 'image' by himself.

It is not our business to poke into his family affair, as well.

As for the media who strive and popularise his father's absence, I believe the media knows more than what was reported. Come on lar. You expect me to believe the media only knows that his dad not being invited and crying at home and does not know the whole background of Datuk Lee CW's family including his father's background.

Anyway, even before the wedding, media had been at the wrong side of the fence, thanks to his publicity company who arranged for a string of media conference (I believe it is six) without the certainty of him attending any of it. Plus, the publicity company already approved limited media quarters to cover the wedding, yet they still calling up all the others for the string of media conference which appear like a waste of time.

Enough said, perhaps we should mind our mind business and not assume anything based simply on an absence before we really know the whole truth. And it is just simply a sick thing to do to keep prying on our national shuttler's private life.

I can attest to how amazingly ridiculous some people can be when they became judgemental and not even bother to find out the real truth.

Nov 8, 2012

Congrats, President Obama!



Okay, jokes aside.

His victory speech is truly enlightening.

He decided to thank every citizen and his political rival before his own wife and family.

I want to thank every American who participated in this election. (Applause.) Whether you voted for the very first time or waited in line for a very long time -- (applause) -- by the way, we have to fix that. (Applause.) Whether you pounded the pavement or picked up the phone -- (applause) -- whether you held an Obama sign or a Romney sign, you made your voice heard, and you made a difference. (Applause.)

I just spoke with Governor Romney, and I congratulated him and Paul Ryan on a hard-fought campaign. (Applause.) We may have battled fiercely, but it’s only because we love this country deeply, and we care so strongly about its future. From George to Lenore to their son Mitt, the Romney family has chosen to give back to America through public service, and that is a legacy that we honor and applaud tonight.

full transcript here

But deep down, in his victory tweet, there was this picture.



I am sure one can feel the warmth, relief and that special feeling with this picture.

I agree with Salvatore.

Obama is more than just the leader of the free world. He represents more than that. He made the world less racial. He represents the blurring of how people are treated badly because of the colour of their skin or where they are from. Although far from supporting GLT rights outright, the Democrats is the better of the two. It is a more enveloping and compassionate platform.It embraces.

Nov 6, 2012

Culinary of vaginal discharge

Nasi kangkang.... ewwwww....



Ewww....

Here's a rough guide on vaginal discharge when you see such colors on the 'nasi'...

Clear and Milky
 
The normal colors of vaginal discharge are clear or milky. It depends what time of the month your body is going through. Most women will experience both clear and milky colored vaginal discharge in a given month. These changes are nothing to worry about.

Cottage Cheesy White
White, cottage cheesy vaginal discharge can be a sign of a yeast infection. Yeast infections are simply an extra abundance of the yeast fungus. This condition is extremely common in women who are pregnant, have diabetes, or are on any type of antibiotics.

Grey Vaginal Discharge
Another condition of the vagina is bacterial vaginosis. This is detected by a gray vaginal discharge, itching, and a fishy smell. It is nothing to be worried about because it can easily be treated by taking antibiotics. Usually this is in the form of a pill.

Green or Yellow
A sign of a more serious condition called Trichomoniasis is a green or yellow vaginal discharge. This is also accompanied by a nasty odor. This disease can be caught from a sexual partner without using a condom. Unfortunately, women can have this condition for quite a while without knowing. Many times, a characteristic of the vaginal discharge associated with Trichomoniasis is a bubbly quality.
 

Nov 4, 2012

Anti-anxiety FAIL


Trying to calm down couple of medical students before the exam.

They looked super nervous. Either that or they are suffering from caffeine withdrawal.

Me: Relax. Hold your breath and count to ten.
Med Student: If I do that, I scared I will pass out.
Me: (=,=")

Oct 30, 2012

Examining exam

Frankly-speaking, I was feeling rather quesy having to be included to plan the long case exam for the medical students.

Gathering, persuading, calling and confirming patients for long case exam, then making sure the students and patients at the right place at the right time is really sucking the energy out of me.


Of course, everyone in the team worked very hard as well and made it an exciting and good experience.

Still couldn't get over the 'bad' joke of asking one of my colleague going in as a patient with primary amenorrhea. I am sure there will be quite a lot to be discussed given her physical appearance. My bad.

There were two nerve-wrecking moments. Firstly, when the airconditioner in one of the examiner's room not starting and we had to take over another dept's house officers' on call room as a substitute. Of course, with blessing of the other dept's Consultant. Yet, something puzzled me. I always thought house officers are all running shift system right now.

Secondly, it was the major black out for a good 10mins. Basically, no electricity in the entire building. Sunshine substituted the artificial light that went off. The room temperature remained cool, heavily upon the residue air-conditioned air of the close room. Presentation to examiner and clerking of patients continued in the semi-dark condition.

Reminds me of the time when I had to perform C-Section in the dark when the lights went out in the Maternity theatre. No emergency lightings. So much for developing country and first world facilities.

I am pretty sure Bryan Mills won't be holding up Marko of Tropoja here. No constant continuous electrical current.

I wasn't in the room when the examiners drilled and grilled the students. Thus, no exam bloopers to brag about.

Yet there was an awkward moment when a student was clerking a patient.

Med student (MS): Hi, can you take the BP? (She was speaking to the house officer who is co-invigilating the exam)
House officer (HO): (Bring the sphygmomanometer to the MS) Here.
MS: Can you take the BP?
HO: (Stunned and speechless for 10secs) Err... No.
MS: (Took the sphygmomanometer and appeared lost for a while)

I told the HO. Perhaps you should have asked the MS: How much?

I am not surprise at all that this incident happening because I used to have referrals from house officers in their sixth posting, meaning 4 months away to being medical officers, telling me:

"The BP is 163/95. I swear I took it manually with the BP set"
"Pardon, what is the BP?"
"THE BP is ONE SIX THREE over NINETY-FIVE"
"And that's a manual BP?"
"Of course."
"Well, you see manual BP only shows even number."
"But it is really 163/95 manual. Really. So how, admit or not?"
"Admit, then." I put down the phone and whispered to myself "Admit to re-check BP."



Oct 28, 2012

Partially impartial

Frankly, in perfect contrast to public perception, we do not treat all patient equally.

Reason being, some patients are more important the others, due to several factors ie.

1. Age. Young patients have greater life span ahead of them compared the old patients, therefore, they get prioritized. If there were a single ventilator for both patients with similar severity of disease, it will go to the younger patient because they have 'better prognosis' and the older one will be considered as 'waiting for his/her time' to come. No one really takes into account how much the older patient had contributed to the society in their youth.

2. Status/Royalty-link. YBs, VIPs, Sultans and family members, political figures will trigger the red carpet treatment. Some even coined the term 'social' ward rounds when ward rounds felt like a cocktail party where the high society people mingle.



3. Preggie. If you're pregnant or even just delivered few weeks ago, you're in the radar, you'll get prioritized. Preggie or pregnant ladies is being given priority is not because the noble value of upholding the sanctity of conception, pregnancy or the 'two lives in one body', but because people just wanted to save their asses from potentially being screwed in maternal mortality meeting which will be held at district level up to national level.



4. Complaint freaks. Surprisingly, our system do not allow us to be objectively providing treatment effectively and equally. Most of times, we reduce ourselves to lap dogs for anyone who threatened to complain. Sad, but true. Personally, I just do not give a d*mn and I will personally help him/her to write the complaint if needed to if they insist to make a fool out of themselves and their parents who fail to educate them.



Sadly (and pathetic), our system do not allow objectivity in treatment of preggie simply because they are preggie.

An unfortunate lady, delivered vaginally uneventfully a week ago, slipped and fell. Suffered loss of consciousness and possible symptoms of cerebral concussion. Ambulance call. She was shipped to the maternity hospital, instead of going to the General hospital, a separate building across the street with imaging facilities and the Surgical team. Time wasted further to bring that mother out of the ambulance to the triage for assessment and referral, plus putting back her to ambulance and send her over to General hospital. If needed, Gynae team is available in General Hospital.

The utterly appalling scene repeats itself again with another mother.

Delivered well 5 days ago. Slippery floor. Fell and hit her back. Couldn't walk. Sent to Maternity Hospital.

I think anyone with IQ of 70-100 without any medical knowledge would have known the mother with back ache do not need an OB consult.

The main reason she was being sent to Maternity Hospital is simply because of the General policy of Ambulance Call: If pregnant or near after delivery, all patients MUST be sent to Maternity Hospital.

Thus, can't really blame the people for fulfilling their faithful duty of 'saya yang menurut perintah'.

Perhaps such policy should be reviewed urgently before the delay actually kill someone.

I have no doubt that it will one fine day.


Oct 27, 2012

Killer Lifts!!

The lift in C Block of my hospy nearly dislocated my Specialist's shoulder as he walk in to the lift and the door came in closing even with me pressing on the '< >' button.

Even as I pressed the usually middle bar of the door of the lift, it does not stop it.


It came closing and unstoppable.

Security guards had already alerted the supposedly 'On Call' technician, but the lifts continue to have their killer edge up till the night time.

Instead of closing/barring usage of the killer lifts, the security guards just went around reminding everyone who is using the lifts.

A staff nurse told me, once upon a time (not fairy tale, mind you), someone actually got her fingers fractured because banged by the lift's door.

Freakishly dangerous. I was imagining a scene from Final Destination.

Oct 25, 2012

Aedan's first 2 trophies !!

Last year, he went to the Annual Concert as the happy bee without any bling-bling to keep...



This year... he won 2nd prize in Malay story telling and consolation in Easter Egg coloring.


And it is only natural for a father to brag about it. LOL.

But it was not all talent, but wifey's dedication and sacrifice (almost to the stage of developing hematemesis) in helping him getting this award.

Even his teachers were telling us how close he was in getting First.

He found mastering Malay easier because of the simple, straightforward 'Bahasa Baku'.

Perhaps people may look up to other languages such as English for its global use or Mandarin due to China's growing strength.

I got slightly annoyed when Malay patients insisted to reply in English, even when I started the conversation comfortably in Malay.

Personally, I adore Malay language slightly more because it is the simple empowerment of this language is one of the things that set us apart and made us unique as Malaysians.

Grateful for the services


One of the best thing about this profession is the moment
that few milliseconds or more
our heart totally melt down
patients who came in being ill or mashed up like a potato 
and now went home walking like a professional footballer 
as they took their steps heading to the exit
they express their gratitude to you...
But one took it further and present a personalized trophy/award...
You're awesome, Siow Jin!

Oct 15, 2012

House Officer Trolling Level: MAX !!

From LohHS:

Heard from a doctor friend ~ "A Paeds MO asked his houseman to get consent as he had planned to do a procedure on the baby. After a while, the houseman came back with the consent form in his hands, very satisfied, and showed it to the MO. There was a little thumb print belonging to that baby on the signature line".

Apprehension of the apprehend

My dearest and me was sitting idle, enjoying our late lunch of the famous vegetarian curry mee at around 3pm. We indulges in small talks, basically in our own world. Happy in our own moment while both the kids soundly asleep.

*Bang*

Three motorcycles fell down in front of a row of cars neatly parked in front of the adhoc vegetarian stalls built especially for the 9 days of religious celebration.

3 plain-clothed men was obviously on to each other like football players hugging each others after a goal.

One of them broke out of the 3-men hug and jumped in between of the Kancil and lorry, breaking off the small car's side mirror.

His quick motion was stopped in the next seconds as the other 2 men responded aggressively and held him down as if he was holding the ball in a rugby game.

Everyone in the stall held their breath. Totally puzzled until they saw a shining handcuff held high above and applied to the shabby looking man in his twenties.

Another man showed his badge briefly to the apprehended man.

Another handcuff was being applied to the back of the motorcycle and to the handcuff of the 'criminal' as he rode on the motorcycle in the pillion seat.

They left the scene after 5 mins of drama after speaking to the Kancil owner in 2 motorcycles.



Not full of fanfare as portrayed by TV series, but just as effectively and without much of violence.

But my dearest reminded me that all the violence will probably be behind the four walls of blue silence.

I couldn't have agreed more.

We both agreed the police officers risk their life everyday, especially after what we had witnessed today. The 'suspect' may have a gun with him, who knows, right?

Thank you, Mr.Police for keeping the neighborhood safe.

Oct 12, 2012

Smallest penis wins iPhone5!

Condoms usage that is not suited to the appropriate size increases slippage or breakage leading to unwanted pregnancies and sexually transmitted infections.

Luckily somebody invented a fit kit, available here.

Evidently, recently there's another benefit of measuring your naughty bit as you may stand to win iPhone5 if you have the smallest!

That's the contest proposed by Singlesex.dk, a sex dating site in Denmark. Its owner, 45-year-old Morten Fabricius, has asked men to send photos of their penises to win a free iPhone 5. The one with the smallest penis wins.Talking to Agence France Press, Fabricius says that "it's a competition which is at the core of manhood, the most important thing for a man. There are so many unhappy men out there who think you have to have a giant penis, but it's not normal to have a huge one. Everything has to be bigger, and bigger, and bigger. It's incredible how the media has frightened people from showing themselves as they are."It's not only about size: the female members of the site will also vote their favorite.
P.S. wondering if certain ethnic group stands a higher chance to win the contest.. 

Oct 11, 2012

Rich dad, poor dad, bankrupt dad.

Just learnt that Robert Kiyosaki had filed for bankruptcy after a district court dropped a judgement. He was being re-branded as an ungrateful writer and defaulted his payment to the company that made his book into a brand worldwide.

Kind of irony, that the writer of a book who supposed to teach you to attain financial freedom is now having freedom from any finances.

Probably he's going to make a come back later on and write a new book titled "Bankrupt dad, Grateful dad"

Oct 10, 2012

Abbreviated intelligence

This conversation just made my day.

A junior doctor was presenting about a surgery that he did not even bothered to check as he copy and paste whole thing into the PowerPoint presentation. I think he trusted technology too much or he's just conserving his own brainpower.

There he was presenting about the 27years old patient with PMB who had underwent hysteroscopic. PMB, a well-known abbreviation for post menopausal bleeding.

My very attentive colleague (unlike me- half asleep because having toasted brain as clinic stretched to 130pm) quickly raised the question of the day. It was probably question of the year.

"What is PMB?"

"Post menopausal bleeding" presenter rebutted.

"You mean a 27years old is having POSTMENOPAUSAL bleeding?" (capital letters for deepening of tone to stress the word, and not shouting)

The presenter answered confidently with a smirk.

"Then, it is Pre Menopausal Bleeding!"

I nearly fell off my chair laughing.

P.S. Here is the list of the approved abbreviations by our lovely Ministry.

Sep 29, 2012

Timely fat!

http://www.fasebj.org/content/26/8/3493.abstract
Timed high-fat diet resets circadian metabolism and prevents obesity
    1
  1. Oren Froy2
+Author Affiliations
Institute of Biochemistry, Food Science, and Nutrition, Robert H. Smith Faculty of Agriculture, Food, and Environment, The Hebrew University of Jerusalem, Rehovot, Israel
  1. 2Correspondence: Institute of Biochemistry, Food Science, and Nutrition, Robert H. Smith Faculty of Agriculture, Food, and Environment, The Hebrew University of Jerusalem, Rehovot 76100, Israel. E-mail: froy@agri.huji.ac.il
1 These authors contributed equally to this work.
Abstract
Disruption of circadian rhythms leads to obesity and metabolic disorders. Timed restricted feeding (RF) provides a time cue and resets the circadian clock, leading to better health. In contrast, a high-fat (HF) diet leads to disrupted circadian expression of metabolic factors and obesity. We tested whether long-term (18 wk) clock resetting by RF can attenuate the disruptive effects of diet-induced obesity. Analyses included liver clock gene expression, locomotor activity, blood glucose, metabolic markers, lipids, and hormones around the circadian cycle for a more accurate assessment. Compared with mice fed the HF diet ad libitum, the timed HF diet restored the expression phase of the clock genesClock and Cry1 and phase-advanced Per1Per2Cry2Bmal1Rorα, and Rev-erbα. Although timed HF-diet-fed mice consumed the same amount of calories as ad libitumlow-fat diet-fed mice, they showed 12% reduced body weight, 21% reduced cholesterol levels, and 1.4-fold increased insulin sensitivity. Compared with the HF diet ad libitum, the timed HF diet led to 18% lower body weight, 30% decreased cholesterol levels, 10% reduced TNF-α levels, and 3.7-fold improved insulin sensitivity. Timed HF-diet-fed mice exhibited a better satiated and less stressed phenotype of 25% lower ghrelin and 53% lower corticosterone levels compared with mice fed the timed low-fat diet. Taken together, our findings suggest that timing can prevent obesity and rectify the harmful effects of a HF diet.—Sherman, H., Genzer, Y., Cohen, R., Chapnik, N., Madar, Z., Froy, O. Timed high-fat diet resets circadian metabolism and prevents obesity.
all Greek to you? 

Timely high fat diet better than untimely low fat diet = 12% thinner, 21% less cholesterol
Timely high fat diet better than untimely high fat diet = 18% thinner, 30% less cholesterol

Conclusion, if you eat on time, you can eat as much as you like... If you're a mouse?