Beautiful to love the ordinary...

Anyone can love a rose

























but it takes a great deal to love a leaf. 


It's ordinary to love the beautiful


but it's beautiful to love the ordinary

"Anyone can love a rose, 

but it takes a great deal to love a leaf.  

it's ordinary to love the beautiful, 

but it's beautiful to love the ordinary."

Unorthodox breastfeeding position

From the Daughter of the Sun. the Newspiece.

Reminds me of the time at the age of 2years plus,
when my Dearest wife asked my little Genevieve whether she still want breast milk.
Little Genevieve requested: Can you pour them out?

(=,=")

...

The falling star

Morning round started with the specialist who came in early.

The lady in front of us was pale and obviously in slight distress, mildly gasping.

As the medical officers and specialists quickly did a run-through examination on the unfortunate lady in almost plain white, I ran and took a branula trying to secure a running line into the vein.

And the house officer, oblivious to all the emergency steps we're doing still in her own world, standing on the foot of the bed.

She wrote "S/B (seen by) Dr XXX (the name of the specialist)" and below written "Case and progress noted".

She didn't budge a single inch from her place of writing. Possibly was doing some kind of exorcism or external healing from writing on the medical case notes while her superiors all busy fluid resuscitating the lady.

Such is the quality of future doctors the whole innocent world are up against. Sadly.

A brief review of the case note revealed that she was being operated the night before for bilateral large endometrioma and currently suffering from hypovolemic shock possibly due to the underestimation of blood loss from the operation the night before.

Unfortunately, she was seen by the gynae medical officer on call but was not being fully assessed or scanned.
She was referred on table by the Surgical team after the glaring perineal findings came into the light (the laparoscope light).

Something that is very dishonorable about this whole incident is the lack of professionalism in the initial assessment.

The unfortunate lady would have been diagnosed correctly if she was being assessed with massive apathy because the bilateral endometrioma was as big as two ostriches' eggs.

She would have undergone an elective operation after good pain control and exclusion of the minute risk of malignancy.

Under a better controlled elective setting, it would possibly end up with reduced blood loss and dismiss the need for transfusion.

It would be less taxing on the on call team and the on call team can focus on other more dire emergency during the on call.

The gynae medical officer, Mr B was reprimanded only with a few words - I know you have brain, but you're purely lazy.

If this was the first time, then maybe it could have happened by chance, but it isn't unfortunately.

Mr B is a foreign student under training with our Master training programme.
They do not have salary as they paid for this programme.
Thus, his concept is that since the local students from Ministry of Health are being paid, therefore we should work harder than him.
And fair enough, our superiors (not all) conformed to the similar thinking, which I beg to differ.

We are paid salary but we're also being tied up for 5 years working for the government after we graduated.
Technically, we are also paying for the programme, similar to them.

Secondly, in an esteemed centre of training, I do not comprehend how can we let certain standards slide away just like that.

He is always missing from the wards and clinics.
What happens to the maximum 2 weeks of leave of absence for every 6 months of training?
If it was more than 2 weeks, isn't it a person need to be extended in his/her training?
Why lady trainees has to be on their toes and return within 2 weeks post delivery to assure non-extension of the Master training, yet some people just go missing more than 2 weeks without substantiated evidence of their absence?

There was just no team work in him.
He even can tell his teammate that he is not coming for ward round because he was invited the other day.
Do you actually need to be invited to ward rounds?
What kind of specialist are we breeding in this centre of excellence?

When there was shared and scheduled operation theatre hours, he refused to enter operation theatre.
And he boasted on how he could do a certain surgery by himself with supervision of lecturer, but end up his intraabdominal drain got stuck and required a relaparotomy.
Maybe it's just a rare unfortunate occurence, or perhaps it is due to lack of experience in assisting.

My eyes welled up with tears during ward round that day, knowing the clinical circumstances leading to the emergency endometrioma removal.
How could such a appalling and disgusting performance be accepted in the institution?
Even if he is a smart student, he is an excellent protege, he is possibly the exam top scorer, is that how we should accept the birth of a specialist who lacks professionalism and proper attitude for life and patient?

The saddest of all, his infamous role model for delinquency is well known by all the lecturers and Consultants but yet there are no formal response to such a shameful attitude, only table talk about him over meal time.

This inaction will only breed more to follow in his footsteps.

It is really unforgiving for this institution to allow such a candidate to be honored with the recognition of a specialist at the end of program without any correction of his current appalling attitude.

Is our institution still ardent to be stars of the sky or are we letting ourselves reduced to a falling star?

The fitting things for fits

Calm Sunday morning.

Thought of waking up  - naturally.

Naturally basically means sleep till late late, but kids are already jumpy and going all over the bed like baboons in the zoo.

My wife and I craved for the beef noodle near the old town.

We forced ourselves up and got dressed up for that awesome morning meal.

By the time we were there with my 2 little angels, the whole place was packed with people from all walks of life.

That shop was hidden away into small alley and without any signboard of the shop's name.

Frankly-speaking, it doesn't need a name.
Everyone seems to know this place.

As we sat down and began to order, the dried a.k.a. gravy version, mee and koay teow had already finished... at 845am.

Only left were the noodles with soup version.

Still a good enjoyable dish.

The next table was filled with a group of youngster, possibly in their early 20's.
A few of them started to light up a ciggie each.

It annoyed me a lot as my kids were there exposed to those toxic fumes.

Intermittently, I stared at them, the few who lighted up, giving them my infamous crazy eyes stare.

Luckily the nicotinic aroma did not travel to my table as the fan was directing the wind away from my table.

Out of sudden, a sudden crash was heard.

The soup of a youngster who sat just behind me were splashed all over the place.

My initial thought was they were playfully fighting or playing, but as I turned over, I could see above my shoulder, a young man was basically fitting on his chair.

All of his friends, in their stylish half-blonde and semi-redhead hairstyle, were stunned and tried to hold him down and tight as if their strength will stop him from shaking.

I quickly ordered my wife to bring my children to the other side of the table.


With the help of his friend, a plump guy with less clothing or hairstyle sense but more senses in everything else, we brought him down to the floor slowly and put him in left lateral position.

All his other friends just stood there, indulging in their own anxiety, puffing away more ciggies and basically blowing those smokes to their fitting friend and to my face.



I asked them to go away and provide more air for his friend and the plump friend (let just call him fatso) was suddenly on the phone.

While holding the phone, Fatso pinched on the fitting friend's nose and obliterating it, as I was holding his cheek turning him left lateral.

I was shocked, surprised and practically speechless.

Fatso revealed he was talking to the fitting friend's mother and that was fitting boy's mom's order.

I quickly slapped that hand off the nose as I saw the lips slowly turning cyanosed.

At that point, I had to declare my identity as doctor and I know what to do.

The fit aborted spontaneously but he was still drowsy and breathing in deeply.
The blueish discoloration of the lips went into a crimson shade of relief.

I asked for help to fan the fitting guy and someone volunteered to do it with the newspapers folded into two.

On and off, there will be people, mostly looks like those who survived Japanese occupation, coming over my ears and trying to convince me to shove a spoon into his mouth or do something to prevent him from biting his own tongue.



One actually suggested putting in a finger.
I smiled at them, although, I could not tell you how much I wish to laugh out frantically and suggest to them to volunteer their fingers.

I explained that it is important not to put as if foreign body broken off it may cause choking.
I also explained turning to side will prevent the tongue from falling back and block the airway.

Fatso continued to talk to the mom, telling the mom, I was pressing on the fitting man's neck.

"Helloooo.... This is cheek and not neck lah."

Anxiety-induced visual illusion.

"Please call for ambulance." I ordered.

Fatso asked me "Mister, do you have the phone number of ambulance?"



My mind was yelling "WTF!" but my words was exactly "Call 999 and ask for hospital".

I was not sure if it was education failure or community failure or just purely another anxiety-induced morbid panic, even as a young chap when my legs were short and my shorts were small, I always knew 999 was for police, firemen and ambulance.

The ambulance couldn't come because they don't know where were we.
Really couldn't blame them, this place was pretty hidden away from the main streets.

That person slowly regained consciousness and I asked him if he knew who he was.

I asked Fatso what was the fitting boy's name. "Yxx Hxx"

As if in a deep slumber, he answered "I am Suai Ker Xing (Handsome Xing)." and fell back to sleep.

All his friends quickly brought him into their "sport car", modified version of our local car and they sped off to the nearest hospital.

It's been quite long time since I last seen any fits.

The last fit that I encountered was the 5 seconds eclampsia that spontaneously relieved, too fast for my eyes. This was like 5 years ago.


Wifey was impressed and sort of figure out I am not just another lame fanny doctor.

It was an eye-opener to my kids and they are still trying to digest what exactly was happening.

All my cute daughter told me was "That uncle is sick."

As a whole, I think my medical and public health colleagues still have a lot of grounds to cover as even the epileptic's mother do not know how to administer the correct first aid (WTF, pinch nose and obstruct nasal airway) and the general public as a whole in the misperceptions in attending to person with seizure.

Here's a good read about seizure treatment.