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?"
"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.


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.