Scenario: Emergency Dept in a small suburban hospital (refer to earlier blog on MM1) at the end of a particularly busy shift.
The hospital operator calls the A & E department to inform us of an incoming patient in labour being driven to the hospital by her husband. Note: this hospital has no O & G Department as it had been recently transferred to a larger maternity hospital. There were also no neonatology facilities.
I was the only doctor on duty that had experience in O & G as an intern, and had also done a rotation in the Neonatal ICU as an MO, so tired as I was, I gowned up in preparation for the patient's arrival. Fortunately, we were equipped with an obstetrics kit.
When the car arrived, I found the mother in the backseat, with the baby already delivered, and apparently healthy (to my relief), still attached to mum. Dad was understandably in an anxious state. I had to go into the backseat area to cut the cord so that mum could be transferred into the hospital where I delivered the placenta, and repaired the small perineal tear. Fortunately, I had delivered enough babies during my internship posting to remember how to check the placenta, secure hemostasis and do the repair.
Mother & child were both well, when we later checked with the maternity hospital which they had been transferred to later, and the labour ward staff were apparently very happy that I had done them a "favour" by repairing the tear for them!
As for the car, I have always wondered what Dad did with the amniotic-fluid-soaked backseat...
Thursday, September 29, 2005
A Doc's Life - Memorable Moments 3
Scenario: Health screening facility (same as in MM 2)
This is not quite medical related but it left a mark because it was my closest brush with the showbiz world so far :)
Celebrity 1 - a world renowned movie star from a country in Asia. Very pleasant lady, down-to-earth, with none of the airs one would associate with mega-celebrity-dom. She looked exactly like she does on the big screen. Pity that my fluency in Mandarin is so lacking, and my interaction with her was purely business (i.e. health screening related); it would have been nice to have chatted with her about life as a big-time movie star. But then I am not the sort who would fawn over a star (well, I might make an exception for Tom Cruise or Brad Pitt - hehe). The other staff WERE fawning, and posing for pictures with her etc etc.
Celebrity 2 - not so well renowned the world over; more on the local scene. Rather introverted but pleasant enough, I suppose. Can't blame her for wanting to keep to herself, given some of the crazy fans who can "stalk" their idols. Didn't really know her marital history too well (I am not a huge fan of the local Chinese dramas) so I think she was surprised when I asked her during history taking, what her marital status was. :)
Other "celebrities" I have come across during my time with the corporate practice included MTV VJ's & some local "stars" whom I had to do pre-employment checkups on. Some were more full of themselves than others - I think I probably put them down a peg or two with my ignorance of who they were until after they had left the clinic, my more star-strucked assistants enlightened me on whom they were and what shows they starred in.
I wonder if my reaction would have been the same if someone like Tom Cruise walked through my clinic doors for a consult...
This is not quite medical related but it left a mark because it was my closest brush with the showbiz world so far :)
Celebrity 1 - a world renowned movie star from a country in Asia. Very pleasant lady, down-to-earth, with none of the airs one would associate with mega-celebrity-dom. She looked exactly like she does on the big screen. Pity that my fluency in Mandarin is so lacking, and my interaction with her was purely business (i.e. health screening related); it would have been nice to have chatted with her about life as a big-time movie star. But then I am not the sort who would fawn over a star (well, I might make an exception for Tom Cruise or Brad Pitt - hehe). The other staff WERE fawning, and posing for pictures with her etc etc.
Celebrity 2 - not so well renowned the world over; more on the local scene. Rather introverted but pleasant enough, I suppose. Can't blame her for wanting to keep to herself, given some of the crazy fans who can "stalk" their idols. Didn't really know her marital history too well (I am not a huge fan of the local Chinese dramas) so I think she was surprised when I asked her during history taking, what her marital status was. :)
Other "celebrities" I have come across during my time with the corporate practice included MTV VJ's & some local "stars" whom I had to do pre-employment checkups on. Some were more full of themselves than others - I think I probably put them down a peg or two with my ignorance of who they were until after they had left the clinic, my more star-strucked assistants enlightened me on whom they were and what shows they starred in.
I wonder if my reaction would have been the same if someone like Tom Cruise walked through my clinic doors for a consult...
Wednesday, September 28, 2005
A Doc's Life - Memorable Moments 2
Scenario: Health Screening facility in the heart of the business. Patient A is a SYT (Sweet Young Thing) who is there for a medical check-up - part of her benefits from her company who has signed up for standard package deals for their staff.
As part of the check-up, PAP smears are also included for ladies who need them. I routinely ask them, during history taking, whether they are married or sexually active, before informing them of the neccessity of doing the PAP smear. Ladies who are VI(virgo intacta), I tell them that they don't need to have it done until they start being sexually active.
Me: " I see that you are single; are you sexually active?"
Patient A (bashfully):"No."
Me:" OK, so you don't need to have the PAP smear done today."
Patient A (anxiously): "But isn't it included in the package?"
Me:" Yes, but only married ladies or ladies who are sexually active need this test done. Since you are neither, you are not at risk. Moreover, you are a virgin and doing the test would be extremely uncomfortable or even painful."
Patient A:" But since it's included, I might as well do it."
Me:" You really don't need to, you know." I follow on with a short explanation about the discomfort & possible bleeding that can result from the smear.
Patient A:" Never mind - I want to do it since it is paid for already."
After noting in the case notes that the patient insisted on the test being done despite explanations, I proceed with the procedure at the end of the check-up. Needless to say, it was not a terribly pleasant experience for Patient A...I will leave the nasty details to your imagination...
Sigh...a fine example of the Singaporean trademark of kiasu-ism.
As part of the check-up, PAP smears are also included for ladies who need them. I routinely ask them, during history taking, whether they are married or sexually active, before informing them of the neccessity of doing the PAP smear. Ladies who are VI(virgo intacta), I tell them that they don't need to have it done until they start being sexually active.
Me: " I see that you are single; are you sexually active?"
Patient A (bashfully):"No."
Me:" OK, so you don't need to have the PAP smear done today."
Patient A (anxiously): "But isn't it included in the package?"
Me:" Yes, but only married ladies or ladies who are sexually active need this test done. Since you are neither, you are not at risk. Moreover, you are a virgin and doing the test would be extremely uncomfortable or even painful."
Patient A:" But since it's included, I might as well do it."
Me:" You really don't need to, you know." I follow on with a short explanation about the discomfort & possible bleeding that can result from the smear.
Patient A:" Never mind - I want to do it since it is paid for already."
After noting in the case notes that the patient insisted on the test being done despite explanations, I proceed with the procedure at the end of the check-up. Needless to say, it was not a terribly pleasant experience for Patient A...I will leave the nasty details to your imagination...
Sigh...a fine example of the Singaporean trademark of kiasu-ism.
Tuesday, September 27, 2005
A Doc's Life - Memorable Moments I
Scenario: 7 year old boy, admitted to the Emergency Department of a small suburban now-defunct Hospital on a sweltering Saturday afternoon.
This little chap had the misfortune of catching his unprotected foreskin in the zipper of his shorts. Now, I don't know why, but in the local situation, many parents do not seem to see the wisdom of having their young sons put on underwear thereby exposing their nether regions to the hungry teeth of zippers.
Anyway, usually, with such patients (& I had seen a few, young & not so young), I'd apply some topical LA (for what it's worth :), probably more for its psychological benefits than anything else) wait 1 minuntes, then yank the zipper loose and "Voila", the member is free with nothing more than a mild abrasion. The patients would then be sent home with some topical antibiotics without further ado.
In this case, however, and exceptional large piece of foreskin had been caught by the zipper (sorry guys, I can imagine the winces and thighs clenching together) and the aforesaid method did not work. I must admit that this patient was extremely brave and did not cry a tear.
Undaunted, I asked the nurse for a pair of forceps, hoping that I would be able to pull off some of the zipper's teeth, hence freeing the patient's organ. Now, this was a particular busy Saturday afternoon, with many patients and staff outside the treatment area (separated by a curtain). There I was, sweating buckets, trying my damnedest to loosen the darn zipper, and the boy yelling at me,"Don't touch my penis!!!" repeatedly, and me responding," I am NOT touching your penis!". I wonder what the other patients must have been thinking...
Unfortunately, my attempts proved unfruitful, and the boy had to be admitted to the Surgical Department, where, apparently, even under GA, the surgeons were unable to remove the foreskin from the zipper. The patient ended up with a circumcision.
This little chap had the misfortune of catching his unprotected foreskin in the zipper of his shorts. Now, I don't know why, but in the local situation, many parents do not seem to see the wisdom of having their young sons put on underwear thereby exposing their nether regions to the hungry teeth of zippers.
Anyway, usually, with such patients (& I had seen a few, young & not so young), I'd apply some topical LA (for what it's worth :), probably more for its psychological benefits than anything else) wait 1 minuntes, then yank the zipper loose and "Voila", the member is free with nothing more than a mild abrasion. The patients would then be sent home with some topical antibiotics without further ado.
In this case, however, and exceptional large piece of foreskin had been caught by the zipper (sorry guys, I can imagine the winces and thighs clenching together) and the aforesaid method did not work. I must admit that this patient was extremely brave and did not cry a tear.
Undaunted, I asked the nurse for a pair of forceps, hoping that I would be able to pull off some of the zipper's teeth, hence freeing the patient's organ. Now, this was a particular busy Saturday afternoon, with many patients and staff outside the treatment area (separated by a curtain). There I was, sweating buckets, trying my damnedest to loosen the darn zipper, and the boy yelling at me,"Don't touch my penis!!!" repeatedly, and me responding," I am NOT touching your penis!". I wonder what the other patients must have been thinking...
Unfortunately, my attempts proved unfruitful, and the boy had to be admitted to the Surgical Department, where, apparently, even under GA, the surgeons were unable to remove the foreskin from the zipper. The patient ended up with a circumcision.
Friday, September 23, 2005
The Force is With You
Patients, my young Padawan, will prove to be both the reason AND the bane of your existence. They will be the ultimate test of your abilities to resist the Dark side.
You will face the challenge of remaining calm when faced with a storm of demands from multiple patients and their families.
You will face the temptation of profiteering by selling generic drugs at brand name prices.
There will be times when you will feel the urge to succumb to the Darkness called MHCs.
There may even be times when you will feel overwhelmed by Anger & Frustration as you try to deal with these entities called Patients who will test your endurance to the limits with their unending questions about their ailments, and demands for cheap and immediate treatments for their illnesses.
Remember to take a step back, breathe deeply and focus on the reasons why you took the steps towards becoming Medi Masters at the Beginning of your Journey. Find strength from within and from the Force of the Hippocratic Oath and remember the Medi Masters of the past who have had to deal with greater Patient loads than you.
May the Force be with You.
You will face the challenge of remaining calm when faced with a storm of demands from multiple patients and their families.
You will face the temptation of profiteering by selling generic drugs at brand name prices.
There will be times when you will feel the urge to succumb to the Darkness called MHCs.
There may even be times when you will feel overwhelmed by Anger & Frustration as you try to deal with these entities called Patients who will test your endurance to the limits with their unending questions about their ailments, and demands for cheap and immediate treatments for their illnesses.
Remember to take a step back, breathe deeply and focus on the reasons why you took the steps towards becoming Medi Masters at the Beginning of your Journey. Find strength from within and from the Force of the Hippocratic Oath and remember the Medi Masters of the past who have had to deal with greater Patient loads than you.
May the Force be with You.
Friday, September 16, 2005
"Must-see TV"
LOST
This series is like quicksand: it sucks you in bit by bit, week by week, till you are stuck and enmeshed in its sometimes complicated plots & flashbacks. My favourite character is Locke - the ex-paraplegic with an astounding knowledge of weapons & the art of survival, who mysteriously regained the function of his legs after the plane crash. I can't get away from watching this!
CSI (the original series)
Somehow, the characters from the original CSI (based out of Vegas) are more appealing with their quirkiness & idiosyncracies, especially Grissom. I must admit that it took me some time to get hooked to the series.
Las Vegas
A light drama, not terribly imaginative with its stories, but its fast pace & unique camera work & editing is addictive. Plus its characters are appealing, with eye candy for the guys as well as the girls (Josh Duhamel - yum).
House MD
The latest medical drama, which I believe has garnered a few Emmy nominations. Appealing to me as a doctor because its main character voices out loud what many doctors keep inside...their true feelings about some of their patients and the practice of medicine today. Hugh Laurie does a great job in the lead; it is hard to believe that he is actually British.
Gilmore Girls
This much ignored series has wonderful dialogue with lively exchanges between Lorelei & Rory Gilmore (mother & daughter). It makes me wish for a similar relationship with my own mother...
This series is like quicksand: it sucks you in bit by bit, week by week, till you are stuck and enmeshed in its sometimes complicated plots & flashbacks. My favourite character is Locke - the ex-paraplegic with an astounding knowledge of weapons & the art of survival, who mysteriously regained the function of his legs after the plane crash. I can't get away from watching this!
CSI (the original series)
Somehow, the characters from the original CSI (based out of Vegas) are more appealing with their quirkiness & idiosyncracies, especially Grissom. I must admit that it took me some time to get hooked to the series.
Las Vegas
A light drama, not terribly imaginative with its stories, but its fast pace & unique camera work & editing is addictive. Plus its characters are appealing, with eye candy for the guys as well as the girls (Josh Duhamel - yum).
House MD
The latest medical drama, which I believe has garnered a few Emmy nominations. Appealing to me as a doctor because its main character voices out loud what many doctors keep inside...their true feelings about some of their patients and the practice of medicine today. Hugh Laurie does a great job in the lead; it is hard to believe that he is actually British.
Gilmore Girls
This much ignored series has wonderful dialogue with lively exchanges between Lorelei & Rory Gilmore (mother & daughter). It makes me wish for a similar relationship with my own mother...
Thursday, September 15, 2005
AGING SUCKS
I am beginning to feel more aches and pains these days. No matter that I didn't too anything extremely strenuous; it could be just from sitting or lying in one position for too long. The MCP & IP joints of the fingers are also feeling it. I tried playing the piano after long years of not touching a keyboard - my fingers didn't feel like my own. I used to be able to do scales & arpeggios like nobody's business. Sigh.
I played tennis with my boys a few weeks ago. OMG, when I tried to hit a ball overhand, I felt something pull on the right side of my back, snapping like a broken string of a guitar. Thank God the pain was only temporary. But it made me realise that my body is aging faster than my mind. Sometimes, I still feel like the teenager who used to play tennis for ECA.
The eyes are also starting to go. Reading the road directory is a chore now, especially the street names. And trying to read the lipstick color off the base? Fuh-get it. I can still read the newspaper...but I know I am fighting a losing battle & will need reading glasses in the coming year or two.
Sigh.
I played tennis with my boys a few weeks ago. OMG, when I tried to hit a ball overhand, I felt something pull on the right side of my back, snapping like a broken string of a guitar. Thank God the pain was only temporary. But it made me realise that my body is aging faster than my mind. Sometimes, I still feel like the teenager who used to play tennis for ECA.
The eyes are also starting to go. Reading the road directory is a chore now, especially the street names. And trying to read the lipstick color off the base? Fuh-get it. I can still read the newspaper...but I know I am fighting a losing battle & will need reading glasses in the coming year or two.
Sigh.
Friday, September 09, 2005
Circumstances
My niece has been groaning & moaning about school & the system. She wants to join a school that offers the more well-rounded IB program but cost is a huge factor as my nephew is already attending it. Her mum can't afford to put both kids in there, & out of her 3 kids, My niece is "the one most likely to survive the local system". Unfortunately, this will probably mean that she will end up in the local uni with its straight laced programs & parroting form of learning. Hopefully she will choose to major in something that will allow her to widen her horizons after she graduates.
I feel melancholy when I heard the phrase in bold above, not that I fault my sister at all. But I was in the same position as my niece during my schooldays. As the "brainiac" of the family, I made it into JC & then in NUS. Not so for my sis & bro. Because of their "lesser" academic abilities, they were given the chance to pursue their studies overseas & in "alternative" albeit more expensive methods. My parents could not afford to do so for all of us.
Ironically, I found myself trapped in a system that did not encourage me to explore & stretch myself, & subsequently, followed the safe & tried route of becoming a well-respected professional. I can't say that I made the wrong decision in my choice of career, as I made the best decision I could given my circumstances & what was available to me at the time. But I want & hope that my own children will be given wider choices as they develop & find themselves. Hopefully, they will end up doing what they love & have a passion for, and be able to earn a living doing so.
Hence all the sacrifices that A & I are willing to put up with, in placing them in an excellent international school with a curriculum & teachers which even the local university would envy.
I can't help but find myself wondering "what if"...if I had been given the chance that my kids have now, would I be doing something that I passionately believe in & love? I guess I will never know...
I feel melancholy when I heard the phrase in bold above, not that I fault my sister at all. But I was in the same position as my niece during my schooldays. As the "brainiac" of the family, I made it into JC & then in NUS. Not so for my sis & bro. Because of their "lesser" academic abilities, they were given the chance to pursue their studies overseas & in "alternative" albeit more expensive methods. My parents could not afford to do so for all of us.
Ironically, I found myself trapped in a system that did not encourage me to explore & stretch myself, & subsequently, followed the safe & tried route of becoming a well-respected professional. I can't say that I made the wrong decision in my choice of career, as I made the best decision I could given my circumstances & what was available to me at the time. But I want & hope that my own children will be given wider choices as they develop & find themselves. Hopefully, they will end up doing what they love & have a passion for, and be able to earn a living doing so.
Hence all the sacrifices that A & I are willing to put up with, in placing them in an excellent international school with a curriculum & teachers which even the local university would envy.
I can't help but find myself wondering "what if"...if I had been given the chance that my kids have now, would I be doing something that I passionately believe in & love? I guess I will never know...
Thursday, September 08, 2005
Human Nature
Watching the afternmath of Hurricane Katrina, human nature has reared its ugly head. Looters, rapists, murderers taking advantage of the catastrophe. And all the political finger-pointing which to me is pointless now. Get a grip, people! Use all that energy for more constructive purposes, puh-leese!!! Leave the blame fest till later!!!
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