We've a Long Way to go

This article was in The New Paper:

"CRUEL LIFT HOGS
Sick woman rushed to ambulance on ground floor. Ugly S'poreans squeeze in and make it stop on their floors
THE NEW PAPER, July 15, 2006

AN elderly woman, 60, collapses in a crowded shopping centre. She is seriously ill and needs to get to the hospital urgently.

Paramedics rush to the scene, place her on a stretcher, and get into a lift to take her downstairs to the ambulance.

But to the horror of the anxious family members, some shoppers refuse to give way. Instead, they decide to squeeze into the lift.

That's not all. They then press the buttons for all the other floors where they want to get off.

That's what Singapore Civil Defence Force (SCDF) paramedic Carolyn Low, 28, encountered recently at an Orchard Road shopping centre when trying to transport an unconscious cancer victim down from the fifth storey.

UPSET

She said: 'The lift ended up stopping at every floor. One of the relatives was so upset, she shouted at everyone in the lift.'

The incident highlights a new breed of inconsiderate people who think nothing of blocking the work of rescue personnel despite years of public education.

As SCDF personnel attend to more emergency cases in highrise buildings, they recall having brushes with a new breed of ugly Singaporean: The lift-hoggers.

While the SCDF says that most Singaporeans are helpful and considerate toward emergency personnel (see report on facing page), some are just too selfish and insensitive.

Given the serious consequences that could arise from a lift hog's actions, even one delay could be one delay too many.

Ms Low, who has been with the SCDF for seven years, recounted another incident in a HDB block in Serangoon last year.

She was trying to transport a woman in her 70s, who had a heart attack, to the ambulance downstairs.

She was trying to give the woman CPR inside the lift, but that didn't stop some 'uncles and aunties' who 'die die' wanted to squeeze into the lift. Not only did they get in her way, they also delayed the transfer to the hospital.

Mr Muhd Milhan Shah, 23, a medic and NSF, encountered another group of ugly Singaporeans last month.

Together with a paramedic and ambulance driver, they responded to a 995 call at a second storey HDB flat in Toa Payoh just past 7am.

Because the patient, a man in his 20s, was suffering from back pain and had to be immobilised flat on his back, the paramedic and driver had to carry him down the stairs using a special device.

Mr Milhan was left to transport the regular stretcher, the 10kg automated external defibrillator used to shock patients, and a large 'trauma bag' containing medical supplies, by himself.

But when the lift arrived, there were four people already inside.

Said Mr Milhan: 'I asked them, 'Can you let me through, you can use the staircase, it's only the second floor.''

But one women in her 50s said instead: 'No no, I'm late for work.' Then she tried to close the lift door.

Shocked, Mr Milhan pressed the lift door open and asked again - this time stressing that he was with the ambulance service and there was a patient downstairs waiting for him.

But he was turned down again.

In the end, Mr Milhan pushed open the door, and squeezed himself and all the equipment into the lift.

He said wryly: 'They nagged at me a bit, but I just kept quiet.'

Besides lift hoggers, emergency personnel also have to deal with the ubiquitous Singaporean kaypohs.

Said Ms Low: 'Sometimes they crowd around to kaypoh, see what we are doing. But when we need help, like carrying the patient, they don't offer.'

There's also the bochap shoppers: 'We are in shopping centres, trying to get access to the patient. But they don't give way until you shout, 'Excuse me, excuse me!' ' she said.

Singaporeans can also be inconsiderate in indirect ways.

Said Mr Milhan: 'Sometimes when I push the stretcher down the corridor, there are a lot of big vases (flower pots) obstructing our way. Slippers - we can still kick aside. But vases, bicycles, we have to carry aside one by one - especially early in the morning when they (the owners) are still sleeping.'

Anyone who voluntarily obstructs any public servant in the discharge of his public functions can be jailed up to three months, fined up to $500 or both.

Cpt Siti Afzan, assistant director of the SCDF Medical Department (emergency medical service), said: 'During emergencies, our paramedics are trying to assist those in distress and quickly rush them to the hospital. Help from the public, such as giving way to responding ambulances and giving priority to paramedics using the lift, can help us in our life-saving mission.'"



Smile Singapore 2006 indeed.

Singapore Idol...NOT!

Don't get me wrong.

I had hoped with all my heart that we would see come credible talent on SI.

But after the dismal showing on the first show, these hopes have come to nought. These were the top 12 out of the thousands who auditioned??? I shudder to think what the others who didn't make it were like.

Apart from a couple of potentials like Paul & Mathilda, I watched the other performances with a grimace of pain on my face (note: this was an involuntary reaction to the sight & sound; my son bore a similar expression). This was the first time that I was watching the entire top 12 in action.

"Give them a chance, why not?" I thought. I had missed the first 3 episodes cos I was away then. Then I saw the wildcard show - grimace of pain there too.

Then I thought: "Maybe the top 12 will be better."

High hopes.

I really don't know how the judges can bear it; at least Ken Lim has some substance in his comments. As for Ja...err...most of the time I wonder what the heck is she trying to say...

I am all for supporting local talent...if you can find it.

I think I will watch Rockstar: Supernova instead.

A Little Book with a Big Heart

I read "The Secret Life of Bees" by Sue Monk Kidd in just one day. I just couldn't put it down.

It's a story set in the South (of the USA) during the fledgling days of the Civil Rights Act, when racism was rampant against the African-Americans. It tells of a motherless girl, Lily, who discovers that family ties can transcend man-made barriers like differences in skin color, and can form even between non-related individuals. She discovers the strength of the human spirit through trinkets of advice from black beekeeper August Boatwright.

Here are some excerpts:

"Well, one time Big Mama told me she went out to the hives on Christmas Eve and heard the bees singing the words of the Christmas story right out of the gospel of Luke...

...What I mean is that the bees weren't really singing the works from Luke, but still, if you have the right kind of ears, you can listen to a hive and hear the Christmas story somewhere inside yourself. You can hear silent things on the other side of the everyday world that nobody else can...."

"You know, some things don't matter that much, Lily. Like the color of a house. How big is that in overall scheme of life? But lifting a person't heart - now, that matters. The whole problem with people is-"
"They don't know what matters and what doesn't," I said, filling her sentence and feeling proud of myself for doing so.
"I was gonna say, The problem is they know what matters, but they don't choose it..."


Cynics may find it cliched...but I found it inspirational.

Soul searching

Been feeling kinda restless lately. Not that I don't enjoy my free time & being, somewhat, a 'lady of leisure', as some might put it. But perhaps its the guilt complex in me, or the work ethic that's been drilled into me from school days, through med school & internship & through my working life that in order to be a productive citizen of society, one has to work & contribute to the economy.

I thought that I had gotten over it last year in the first few months of non-working life. But I guess I haven't. This feels slightly different, though. I know that there has to be more to life than lounging by the pool, reading novels, having foot massages/facials, watching matinees in a non-crowded theatre or going to The Sale Worth Waiting For at Robinson's at off-peak hours. There are probably tai-tai's out there who would disagree, but I'm not one of them. (I do appreciate the luxury of being able to linger over a leisurely lunch with a friend without having to worry about rushing back to the clinic to clear the post-lunch crowd.)

However, the thought of going back to clinical practice is still quite abhorrent to me. In fact it evokes a rather unpleasant fluttery feeling in my stomach just thinking about it. I'm just not ready yet. I need to find something to do other than Practise Medicine. What that something is, I have yet to discover.

Huh???

I was quite confuzzled by an editorial in today's Straits Times "S'pore health system 80% fine but fix the 20%" by Ms Chua Mui Hoong. In it, she highlights what is right about the local healthcare system but emphasises that we should not ignore what needs improvement. She gives as examples of the latter, cases in which miscommunication between patients & healthcare providers resulted in death of the patients.

She says:
"A punitive culture where everyone fears making decisions in case a mistake is made is paralysing and counter-productive."

A promising attitude, I thought.

Then she proceeds to say in following paragraphs:
"The system must be exacting enough, and the auditors or senior doctors stern enough, for those down the line to fear the consquences of making a mistake sufficiently to keep them on their toes."

A bit of a contradiction, eh what? Isn't she advocating a punitive culture here?

I wonder what message she is trying to bring across in this article.

Ladies Night Out

Actually, it was more like a "Ladies Weekend Away".

I just returned from a long weekend in Hong Kong with two of my oldest & best friends - no kids, no husbands, no stress!

The relationship between girlfriends is a unique & special one. When we are together we can talk about things we would never discuss with our husbands/children/parents. There is a comfort about being with someone whom you have grown up with, through the angst of adolescence, through the teenage crushes, through shared experiences of school/university/relationships.

So this time away was a much appreciated one by all three of us. Not just the shopping or the eating, but more so, the company one was with.

Sidenote: Singapore needs to take notes from Hong Kong as far as customer service is concerned. HK has come a long way from as recent as 5 years ago. The sales persons at the retail stores are incredibly helpful. Even if you walk out without buying anything, they say a cheerful "Have a nice day" as you exit.
Oh, and one more thing: for the best "dou hua" (bean curd dessert) in the world, go to Sweet Dynasty...you won't regret it. I am still thinking about the tub of dou hua we ordered....yum...

A glimmer of hope?

"LEARNING FROM MISTAKES THE BEST WAY TO BETTER PATIENT CARE - by Salma Khalik, Health Correspondent, The Straits Times Friday June 30, 2006"

I was pleasantly surprised to read this editorial in today's newspaper, as it gives a viewpoint which does not damn the doctor, quite unlike previous writings which tend to do the opposite.

This was written in response to a recent case in which an elderly lady died after having been prescribed with the wrong dose of digoxin. This error had not been picked up & at the time, no checks had been in place to prevent this error from happening. This has since been corrected & new systems are now in place to, hopefully, minimise such errors in the future.

She says:
"Who among us has never made a mistake? Doctors to are human, and it is unrealistic to expect them never to make errors.
That is why it is important that system checks are in place as a safety net to catch mistakes."

Big revelation. About time for the public to realise this.

She ends off with this paragraph:
" Singapore has a great public health system. Far from perfect but constantly improving. And it is this willingness to admit mistakes and to learn from them that has led to better patient care.
As patients, that is all we can ask for."

It is indeed optimistic of her to say so, although I wonder whether this is true in practice or not. I have a feeling that the fear of blame is still preponderant enough in our hospitals & clinics to prevent the admission & reporting of medical errors & near misses.

Who knows, maybe this little nudge from the media may prove to be the first teensy weensy step towards a change in the mindset of the medical community where medical errors are concerned.

There is hope yet.

Not that Super

Despite the good reviews, I honestly was not terribly impressed by "Superman Returns"; I preferred "X-men : The Last Stand".

First of all, Brendan Routh, despite good looks & buff physique, is not that good of an actor. Very wooden...maybe he was overwhelmed by the shoes he has to fill... The special effects & action sequences were great but it seemed like Bryan Singer was letting all the action do the talking, leaving not much dialogue for the man himself. And the kid who plays Lois's son? No chemistry there either (I especially did not see the mother-child thing happening).

Overall, a bit disappointing. Perhaps part of it was due to the fact that:

a) the audience was full of kids with indulgent parents who do not know how to tell them to shut the h*ll up during the movie so that the paying patrons around them can actually hear & appreciate the conversation between the characters of said movie. It was Corporate Night for a couple of large organisations, & for reasons beyond my comprehension, the cinema operator sold tickets to regular patrons as well for the SAME theater; so probably a lot of people who were there went because it was free & didn't quite appreciate the fact that THERE ARE OTHERS THERE WHO ARE PAYING $9.50 A TICKET TO WATCH THE MOVIE.
Hello??? Gracious society...where are you???

b) the temperature was set at 'Arctic' & I had gone wearing shorts, t-shirt & flip flop Crocs (yeah, so smart, I know) so the latter half of the movie was spent trying to reduce heat loss by diminishing exposed body surface area by huddling one's body into as small a lump as possible - not an easy feat in a movie seat. This probably detracted from the enjoyment of the movie as well. (Note to self: movie attire in future should consist of ski pants & parka in order to avoid frostbite)

Anyhoo, I plan to rent Superman 1 & 2 to "complete the picture", so to speak, as I found myself trying to remember how Superman 2 ended (Superman Returns supposedly continues where that let off). Then maybe I'll watch it again (late night session = no brats) & hopefully, enjoy it more.

Smile Singapore?

Good grief.

I saw an ad in today's papers which basically campaigns the virtues of being gracious & being good ambassadors.

Reason? September is a big month as far as international meetings are concerned: the IMF, the World Bank, and a host of other biggie seminar/meetings/forums will be held here.

I find it sad that we have to be reminded to be on our best behaviour.

Holiday Highlights

On the day we left for Orlando from New York, we walk out to the street to take a limo to the airport & this is what we see...



...these white trailers are lined up along the street outside my MIL's apartment building.

Then I see these things stuck on lamp posts along the same street...



THEY WERE GOING TO BE FILMING SPIDERMAN 3 ON LOCATION RIGHT OUTSIDE THE APARTMENT BUILDING WHERE WE WERE STAYING!!!

My younger son & I had half a mind to stay behind & forego Orlando just so we could watch the film-making process...sigh...but we didn't as plans had been made months ahead of time & we didn't want to spoil it for everyone.

That's the cool thing about being in a city like New York. There's always a movie being made somewhere. During the time we were there, apart from Spiderman 3, 2 other movies were also being shot there (one was called "Enchanted", the other "The Spring in Her Step").

Be that as it may, I don't think I would want to live in NYC. It's too in-your-face for my liking. I prefer a more laid-back existence, preferably somewhere where I can appreciate nature in all its glory.

We did visit the Metropolitan Museum of Art which houses an amazing collection of art & historical pieces from around the world.


The place is huge & you could spend a whole day there & not finish viewing everything. Our poor feet could not tolerate the pressure so we only spent 4 hours there, seeing selective areas.



THE HAPPIEST PLACE ON EARTH

Honestly speaking, I think most adults can only enjoy the Disney theme parks if they go with a young child. I remember enjoying them more when the kids were younger.

We did Epcot Center & Animal Kingdom. Epcot was good for the most part, except for the fact that Hurricane Alberto brought along torrents of rain while we were there so we spent half the time trying to stay dry in our rain ponchos (unsuccessfully).



I was disappointed with Animal Kingdom as I kept comparing it with our local zoo (which is pretty darned good as far as world-wide zoo standards are concerned). The Living Tree attraction seemed too contrived for me to really enjoy it. The best part of this park was the Dinosaur ride, but that was about it.



UNIVERSAL STUDIOS & ISLANDS OF ADVENTURE

My boys (as well as A & I) enjoyed these parks more so than the Disney ones. Probably because it catered more to teenaged & adult patrons. The rides & attractions are developed so that one feels like one is part of the fantasy, with the help of a combination of 3-D technology, animatronics & live action stunts.

My favourites were the MIB: Alien Attack (you get to shoot at "aliens" with a laser gun while your vehicle brings you through a haphazard ride through the "streets"); Terminator 2 (a stunt show/3-D experience which amazingly meshed live action with film starring Arnold himself); and Spiderman (a ride combined with 3-D technology so that you actually feel as if you are being attacked by Doc Ock, the Green Goblin, etc & then rescued by Spidey himself).

The boys & A enjoyed the Revenge of the Mummy ride which I decided to sit out of, as my vestibular system was still reeling from the Alien Attack & the ride Back To The Future!

Now, I just need to recuperate from the vacation!

I Hate Flying

You could probably tell from the title that I'm back from our vacation.

My idea of torture: a 20 hour FULL flight in economy seated in the back cabin of the plane, suffering from a cold & a stomach virus, unable to sleep or eat, feeling queasy the whole time & watching the time go by, EXTREMELY SLOWLY. I seriously was considering asking the flight attendants if they had a drip set on board, so that I could IV myself as I could feel the effects of dehydration setting in.

Will post more when I am less groggy...

Checking in...

A quick post from the Big Apple since I have managed to hijack a wireless signal :)

Two weeks away from home...am ready to go back but still have a few more days before we leave.
New York is, well....New York.
The sights, sounds & smells are unmistakable; you are inundated by them night & day. It is truly a city that never sleeps. I hear sirens from ambulances/police cars/fire trucks even in the wee hours of the night.
The hustle & bustle hits you from all sides as you walk down the streets, be it in Chinatown, or Park Avenue, or Broadway. People of all shapes & sizes, speaking a multitude of languages, of different colors, a true melting pot.
The site of the Two Towers still stands bare when I look towards it from Broadway; I visited the site two years ago. Sad. I don't want to go again...no need to. We see the results of terror everyday in the media. Time to move on.
Food - honestly, I miss the good ol' hawker food of
singapore! Tah mee, wanton noodles (not the kind you get here in Chinatown - too bland for my singaporean palate), curry chicken, nasi lemak. Went to Carnegie Deli, famous for its various kinds of sandwiches. Ridiculously large portions...sandwiches 6 inches high (I'm not kidding you). I thought it was over-rated, but then that's just me. Food here in the States in great abundance, but much of it terribly unhealthy. Eg. on the menu in a Cracker Barrel: Fried steak - steak dipped in batter & deep fried, served with mashed potatoes & gravy. Choice of vegetable sides: Turnip greens (Taylor Hick's fave...I tried it; tasted like pickled cabbage...yeech), mashed potatoes, potato wedges, french fries (see the trend here?), apple sauce(!!!), corn (the only remotely healthy vege I found). No wonder the high proportion of morbid obesity here...


Time for breakfast...bagel with cream cheese...sigh...no mee pok...

More later...

On Hiatus

Heading for here...

...and here...

...and maybe here if time permits.

Be back soon. Check back in 3 weeks...

Proud Mom

Warning: the following post contains material that is maternally braggadocious in nature!





My 8th grader graduated from Middle School yesterday. He also received a President’s Educational Award for Academic Excellence. The certificate came with a letter signed by George Dubbya himself (printed, not handwritten; but I reckon it’s still pretty “awesome”, as my son would say!).

Surprisingly, I didn’t get all emotional like I did when he graduated from Kindy, though I did feel a prickling of tears when the school choir sang “Because You Loved Me” by Celine Dion.


You gave me wings and made me fly
You touched my hand I could touch the sky
I lost my faith, you gave it back to me
You said no star was out of reach
You stood by me and I stood tall
I had your love I had it all
I'm grateful for each day you gave me
Maybe I don't know that much
But I know this much is true
I was blessed because I was loved by you

Excerpt from “Because You Loved Me”



My little boy is growing up…

Back to School

Ha! Scored a 6 out of 10 for a Math (Algebra) Quiz today.

No, I didn’t go back to high school ☺; it was one of those student-parent-teacher conference thingys with my 8th grader today. And his Math teacher thought it would be a novel way for the parents to see what the kids have learnt in Math this past school year.

My son does Algebra. (They split the kids up according to ability: Pre-Algebra, Algebra & Geometry with the majority of kids doing Pre-Alg while Algebra & Geometry are considered faster-track courses). So I had to do an Algebra quiz.

Here are some of the problems I had to solve, starting with the easiest ones first:

David has 83 coins in nickels (5 cents) & dimes (10 cents). He has a total of $6.95. How many of each coin does he have?

----------------------------------------------

Simplify:



----------------------------------------------

Solve the equation if possible:



-----------------------------------------------

Factor by grouping

rs – 6r – 5s + 30


Here are some I couldn’t do:

Write an equation in slope-intercept form for the line described below:
Containing (4,8) and (-2, -1)

-----------------------------------------------


Solve:



-------------------------------------------------

Graph the system of inequalities and state the solution:




(it’s been eons since I’ve drawn graphs from equations….!!!)



Considering the fact that it’s been more than 20 years since I’ve worked on mathematical formulae and that my brain has been used for memorizing medical facts more than anything else in the last half of my life, I was not too disappointed with my score ☺ .

Besides, two other parents there who took the PRE-Algebra quiz scored a ZERO and a 5 out of 10, respectively....hehehe...

Freaky

I am usually pretty oblivious to paranormal occurences. Put me in a supposedly haunted house & chances are I'd probably sleep the night through with no disturbances from the resident ghost/spirit/poltergeist.

However, two days ago, something kinda freaky happened while I was web-surfing. I usually turn on my i-Tunes while I am on the computer. Well, on this instance, I was looking at pictures from the GhostHunters website (I'm a fan of the series) and then on a local paranormal website. These were pictures of "orbs" which are supposedly collections of energy manifested literally as circular objects in photographs. (There is debate on the how these orbs are formed).

Everything was fine until, while viewing pictures taken at various locations in Changi, the volume control on my computer just kept increasing to the max! My fingers were not on the keyboard, & neither were they on the mouse. I tried reducing the volume using the keyboard control but that didn't work. I had to turn off i-Tunes to turn off the music. Thinking it was a technical glitch, I turned on i-Tunes again. 10 minutes later, the same thing happens again. I was still on that same website looking at the pictures.

Now, thoughts of what-ifs start running through my mind & I decided to turn off the computer. When I later checked with hubby if this has ever happened to him before with i-Tunes, he said no. And it hasn't happened again since, although I still occasionally visit that same website.

I'm no techno-geek, & for all I know, it was some weird technical short circuit or whatsit that happened.

But it WAS weird though.

X-Men: The Last Stand

*************Spoiler Alert**************







“X Men: The Last Stand” is REALLY, REALLY GOOD. Really.

Apart from the fact that Hugh Jackman returns as the angsty (my favourite word of the year) Wolverine, the storyline which touched on issues like genocide, terrorism & intolerance was an engrossing & thought-provoking one. There were also a few heart-wrenching scenes including main characters who (*gasp*!) die, (yes, die!) & also lose their powers (*gasp* again!).

The aptly cast actors included return performances by Patrick Stewart as Prof X, Ian McKellan as Magneto, Halle Berry as Storm, Famke Janssen as Jean Grey aka Phoenix, James Marsden as Cyclops, Anna Paquin as Rogue, Rebecca Romijn as Mystique & Shawn Ashmore as Iceman. Kelsey Grammer & Ellen Page gave impressive performances as Beast & Kitty respectively. I was especially surprised by Mr Grammer whose long tenure as Frasier in the TV series had him stereotyped, in my mind, as a square, slightly wimpy academic sort. His turn as Beast has certainly corrected that. Well done, indeed.

The special effects with (literally) earth-shaking sound effects were spectacular & made the movie experience all the more intense.

This is, supposedly, the last of a trilogy…but is it? (Hint: stay till the END of the credits, & you’ll see what I mean).

Way To Go, Taylor!

YES! Taylor is the new American Idol....whew!

AI Fever

Tomorrow is the finals of the American Idol competition. I sincerely hope that Taylor Hicks wins. Something about Katherine McPhee annoys me.

Maybe it's the way she tries to oversing a song.
Or the way she likes to bounce around.
Or the lack of something in her eyes which somehow don't possess the soul & passion that Taylor has.

I don't know what it is, but I just don't get her.

I really hope Taylor wins it.

On Mediation

In another letter to the papers today:


CJ right to urge aggrieved patients to talk to doctor rather than sue

INDEED, it was heartwarming news - 'Getting aggrieved patients to talk to doc, not sue' (ST, May 20).

Occasionally, precious lives are lost due to hospital mismanagement and doctors' negligence. Sadly, many people do not have the financial resources and knowledge to take legal action against health-care professionals and medical institutions.

With Chief Justice Chan Sek Keong's new protocol, many people will find solace, and closure of their grief so they can move on with life.

From my observation, consultation time allocated to each patient is relatively short and doctors rarely have enough time to conduct proper patient examinations and assessments/examinations. Owing to time constraints, they may be in a hurry to move on to the next patient, leading to oversight or dismissal of obvious symptoms.

Therefore, to protect the interests of both doctors and patients, the Ministry of Health should review and improve the present practice in medical institutions.

The new protocol will pose a great challenge to mediators, and all parties concerned.

One kind doctor shared with me the following:

As doctors we can only pray that God guides our hands to do the right thing. And, if we do wrong, to have the courage to admit it. And pray that the patient's relatives will be forgiving. What more can be done? Not all people we meet or deal with are forgiving.

There are some (fortunately a few) who make excessive demands of compensation. The world is like that. Fortunately, the majority are willing to close the chapter without 'killing' the doctor.

Lee Soh Hong (Miss)

**********************************************************


I wish I was as optimistic as Miss Lee. Being the skeptic that I am as far as human nature is concerned (especially in the local context, where materialism seems to be so prevalent), and having spent some time dealing with such cases, I really do not think that “the majority are willing to close the chapter without 'killing' the doctor”. Not yet, anyway.

Don’t get me wrong, I think mediation is a great idea. But you will need a drastic change of culture for it to succeed. Right now, with the culture of blame (on the patients’ part) & the culture of shame (on the medical professionals’ part), there will need to be a lot of careful meandering through the landscape of medical jargon & potential litigation, peppered with emotions like grief, anger, & even the occasional desire for vengeance. Even in the first paragraph of Miss Lee's letter, one can see that the assumption made when something goes wrong & a patient dies, is that it is due to "hospital mismanagement and doctors' negligence".

The process of mediation will have to involve a team comprising of medical professionals (be they doctors or nurses), lawyers & highly skilled counselors/psychologists to help both parties through a difficult process. Let us also not forget that the victims are not just the patients & their kin, but also the healthcare worker who has been implicated in any case of alleged negligence or wrong doing. The resulting guilt (whether real or implied) can be devastating & may even impact their ability to carry on with what they have been trained to do.

I don’t mean to belittle the anguish which a patient or his family go through when an adverse event occurs resulting in disability, injury or even death. But I hope that both sides of the story will be presented – after all, isn’t that what mediation is about?

On raising a child

It was heart-lifting to read this letter in today's newspaper:

Young adult thinks parents should take responsibility for their children rather than rely on 'the authorities'

I REFER to the letter 'Kidz Bop spreads wrong values' by Mr Nicodemus Ching Cheok Hui (ST Online Forum, May 20).

As a young adult, I have yet to experience parenthood and am unable to share my sentiments with Mr Ching, but letters to ST Forum by parents showing concerns over their children have given me an image of 'modern' parents in Singapore.

All too often, there are letters from parents with concerns or complaints about contents in the media or issues their children have to deal with in and out of school. Almost always, a reply is expected from 'the authorities'. This raises a question in my mind: 'Are parents fulfilling their roles as parents?'

Let us face the harsh reality. The influence of media is growing exponentially and the environment around us is ever changing. There is no way to put a stop to 'undesirable' materials being displayed via any medium, nor can we choose what experiences we want our children to go through.

Please do not seek solutions from the authorities or the Government. You, as a parent, chose to have a child, and it is your responsibility to bring him up to be an upright person.

One may argue that I am still too young and inexperienced to put forward any comment on how a child should be brought up, but I beg to differ. One simply needs to move outdoors and observe parent-child interactions to see the seriousness of this problem: for example, children showing disrespect to their parents and parents taking no action to correct their children's behaviour.

Perhaps parents today are too soft-hearted and resort to other means to teach their children. It is time for parents to reflect and take the responsibility of teaching their children rather than spend time and effort trying to get a solution from 'the authorities'.

Eric Ho Wee Kim



Parenthood is a hands-on endeavour. This seems to be an oft forgotten fact by many Singaporeans. Because of easily available & affordable domestic help here, much of the parenting has been left to the maids. And having husbands who are mostly hopeless on the homefront as far as childcare, & housework is concerned, doesn’t help either, thanks to their mothers who think that their darling sons should not be allowed to lift a finger to help out at home. I know of people whose husbands have not even touched their own children’s diapers. And these are mostly guys who have grown up locally, and not had the experience of living overseas & having to take care of their own household without Mummy or a maid to help. (Note: I am not saying that ALL local guys are helpless; this is the impression that I have gotten from my encounters).

Giving birth is probably the easiest part of parenthood (or perhaps the creation of the child ☺). After that come the sleepless nights, the dirty diapers, the messy emissions from various orifices, the childhood illnesses with the accompanying anxieties, the tantrums, the adolescent angst, teaching your child right from wrong, school choices, school grades, colleges choices…the list is never-ending.

Parents should take it upon themselves to raise their children & not rely on the government or their maid to do so. Oh sure, have someone help out with some of the housekeeping chores. But for heaven’s sake, discipline your own child, & teach them to behave in a civilized manner instead of relying on your maid to do so. Speak to your children about the birds & the bees instead of blaming the schools for not giving proper instruction on sex education. Help your children make the right decisions instead of asking the government to ban certain books/music/movies/TV programs because of questionable content (be it religious, moral or ethical).

We, parents, are the grown-ups, and our children look to us for guidance. It is OUR responsibility that they grow up to be well-rounded individuals, who are able to make wise choices in their own lives.

Da Vinci

Watched the movie last night. The theatre was full to the brim despite it being a Sunday night. I think all the hype surrounding the book has spilled over to the movie adaptation, & no matter how bad the reviews are, people will still go watch it.

I found it entertaining enough, although, I think Ron Howard could have done a better job with it. There was something missing especially in the first half of the movie, almost like the players & director didn't quite have their hearts in the project. I didn't quite feel the thrill of the chase though I could see that the potential was there.

Tom Hanks was also rather stiff throughout & sounded like he had a sinus infection for most of the movie.

Ian McKellan stole the show with his portrayal of the seemingly-normal-but-actually-demenented Sir Leigh Teabing. Jean Reno also did a decent job as Captain Fache.

There were some nice additional touches which were not in the book eg. the ending when Sophie (Audrey Tautou) playfully attempted to walk on water then smiled & shrugged at Robert Langdon. Cute.

Go, Right Brain!

If someone had told me six months ago that I would one day be sitting on the sidewalk, painting shophouses (pictures of, not walls) on Emerald Hill Road, I would have been ROFLMAO, and thought that person out of his/her mind.

Well, that's exactly what I did today (paint shophouses, that is). I felt very Bohemian, sitting outside in 33 degrees (Celsius), 100% humidity weather, looking very artistic, sweating like a hog & actually PAINTING A SHOPHOUSE with my fellow students. Amazing.

The end result is not exactly pleasing to the eye, nor complete (yet)- I suspect it will go the way of my Abstract & sit in my living room till I get the inspiration to complete it.

Neverthless, I am very pleased with myself for how far I've come. I am no longer overwhelmed by the thought of doing an actual painting nor fearful of making mistakes. And I have my art teacher to thank; without her encouragement or kind words no matter how bad my art work looked/looks, I would have remained in my shell instead of gritting my teeth & attempting to stretch my creative wings!

Abstract-ion: complete

After leaving it sitting in my living room for a few weeks, I finally got down to attempting to finish my abstract piece. After a couple of revisions, here's the final result.





HOPE: (LIVING A LIFE FULL OF COLOR)


Nothing fancy, as you can see, but it just feels right.

Motherhood

Yesterday was Mother's Day.

I realise that I am only less than halfway through this journey through motherhood; and what a journey it has been...

The Beginning - I first fell in love with my child when I found out of his existence. Hard to imagine for some, but there it is, the strong maternal bond that can develop even before the child is born.

Giving Birth - done it both ways: C-section (because of breech presentation) as well as the normal way (if you can call pushing what feels like a watermelon out of one's body normal!). To all you mothers-to-be out there, the epidural is THE WAY TO GO...THANK YOU to whoever discovered/developed/invented the epidural procedure...you are a godsend!

The Trials & Tribulations - breastfeeding (actually just the initiation of breastfeeding with the accompanying sore nipples, engorgement & anxiety over whether one is producing enough or not :) ), sleepless nights (especially if one does not rely on a maid to bring up one's baby!), childhood fevers which sometimes seem neverending, the toddler tantrums, dealing with the sibling rivalry (still ongoing), worrying about the quality of education they receive...

The Cost - self-explanatory. This brings to mind an exchange between Homer Simpson (speaking in a very fatherly way) & his son Bart:

Homer: "Do you know why your mother & I share the same bed?"

Bart: "Because we're poor?"

Homer: "Yes...and do you know why we're poor?"

Bart: "Why?"

Homer: "Because we have children."

It had my husband & I ROTFL because it is so true!!!

The Rewards - immeasurable.

ISTJ

What do I have in common with George Washington, Joe Friday, Eeyore & Evander Holyfield?

I am, apparently, an ISTJ, according to this cool test I took.

Eerily accurate...

MOVIE MANIA

I was disappointed to learn that “The Da Vinci Code” movie has been rated NC-16 by the censorship board. Having read the book, I wonder at why the movie has been given this rating. Sexual content? Hardly any. Violence? Perhaps, but not anymore than some of the other movies which have been rated PG before. I suspect that it is to appease some of the groups, which have been protesting its release.

I wish I could sit down over a cup of coffee with the actual people who rate these movies & find out what they look for when they rate movies. There seems to be a disparity in how movies are rated. There is a huge gap between the NC-16 movies & the PG movies. For example, “When A Stranger Calls” has been rated PG. Now, I know that there will be kids out there who will be scared out of their wits after watching this movie. There needs to be another rating category in between, say, PG-13 where parental guidance is advised for those under 13, or where kids can only watch the movie with their parent/guardian.

Oh well, looks like our family will wait till we get to New York before watching the DVC movie. Pity...we had been looking forward to booking ourselves some Gold Class tickets & watching it in style.

COMING SOON

With the approaching summer also comes the season of blockbuster releases. Some movies I am looking forward to watching are:

• X-Men: The Last Stand - I think X-Men is one of the better movie adaptations of comic series, on par with Spiderman 1 & 2, Batman Begins and Superman… Hugh Jackman as Wolverine doesn’t hurt either (*drool*drool*).
• Superman Returns – sounds like an intriguing storyline; would like to see how Brandon Routh’s portrayal compares with Christopher Reeve’s.
• Pirates of the Caribbean: Dead Man’s Chest – enjoyed Johnny Depp in the first installment. He is usually so angsty, it is nice seeing him in a lighter, comedic role. Am also a fan of Keira Knightly, and I guess Orlando Bloom is OK as eye candy.

Politically (in?)correct

Well.

Elections are over & the PAP are back in power. I am quite relieved, to be honest. It's hard to support an opposition which doesn't seem quite up to par. The PAP have done a decent job of running the country so far.

Say what you may about the dictatorial methods of the government, & being a nanny state etc. etc. but I believe that the leaders had to do it this way in order to survive & to grow. They had to work with what they had. And now, they have to work with what they have.

Look at how far we've come since our independence over 40 years ago. There is much noise that has been & is being made about giving more freedom to the people, some of this noise coming from abroad, & some from within our shores. But I frankly do not think that the average citizen of this country is ready for this responsibility. I see the country as being a young one, just approaching maturity. The hardware is there but the software has yet to catch up. Many still look to the government to solve their problems. Social & civic skills are often still 3rd world despite our 1st world reputation where business & economy is concerned. We have a fine if you don't flush the toilet, for crying out loud!!!

I think change is needed but at the right pace. And until we see credible opposition candidates, the PAP should remain the incumbent party in government.

That's my two cents anyway. Enough politics for now.

MI:3

Watched MI:3 over the weekend. I thought it was pretty well-made, lots of action, incredible stunts & a surprisingly good storyline.

Thought that Jonathan Rhys-Meyers & Maggie Q were rather under-used though. Can't be helped I suppose...God forbid that they should upstage box-office draw, Tom Cruise!!!

One Big Happy Family

“Oh, East is East, and West is West, and never the twain shall meet…”
The opening line from The Ballad of East & West by Rudyard Kipling


One of the things which gets my goat & raises my hackles is when people start comparing Asian values with so-called Western values, praising the former & denouncing the latter. Having lived in both the East & the West, I realize that I may have life experiences which are unique & which the majority of folks would not have the chance to go through.

Before moving to the West, where I spent 7 years, I was rather apprehensive about settling in, being accepted, making friends in a foreign land. Being the shy sort, I was very uncomfortable about having to make friends with people of a totally different background & culture from myself.

However, I learned that wherever you are, the underlying values are very similar. We all want the best for our children. We value family time. We respect our elders & we teach our children to be respectful to their elders. Neighbours help each other when the need arises. We all try to earn a good living in order to put food on the table & ensure a secure future for our children. We laugh when happy, cry when sad, gasp at atrocities, celebrate achievements. Thanksgiving, Chinese New Year, Christmas, Hari Raya, Deepavali…different festivals celebrated by different cultures, but under it all, it’s all about family, love, togetherness.

I realized that whether you live in S______ville, PA in the USA or S_________ one degree north of the Equator, we are all the same underneath our differences. I finally got it. I hope we all get it one day.

I know that I may be too idealistic. But hey, what’s wrong with high hopes; I think the world needs it today.

“But there is neither East nor West, Border, nor Breed, nor Birth,
When two strong men stand face to face,
tho' they come from the ends of the earth!”
The closing lines from The Ballad of East & West by Rudyard Kipling

Religious Fervour

I read in the papers a few days ago that the National Council of Churches is protesting the release of “The Da Vinci Code” movie locally. Their reason is that they are afraid that the movie will spread misconceptions of Christianity.

It’s fiction, people!!! These are probably the same folks who stop the kids from reading the Harry Potter books. As far as I know, religion is about faith. No matter what you read or watch or see, the bottom line is still FAITH. I don’t think a movie or a book with its own interpretation of the history of Christianity will shake the beliefs of those who are truly Christians.

I am not anti-religion. Matter of fact, at one point of time, during the turbulent years of adolescence, I found some peace in attending church services & reading the gospels. I never had a dramatic moment of revelation in which I “found” Christ (or any other religious icon, for that matter). Contrary to that, I was turned off by fanatical evangelists who try to convert you every which way you turn, telling you that you will burn in hell if you don’t accept Christ as your Saviour THAT VERY SECOND!!!

To me, religion is a very personal decision. It cannot be forced on a person. Don’t get me wrong, I do believe in religion; it gives peace of mind to those who are troubled, & oftentimes, is the only thing that helps a person go through a time of bereavement. But when people become fanatical about it, the alarm bells start to go off.

One can be spiritual without being religious. I believe in the human spirit. I believe in miracles & the existence of things beyond our understanding. How else do you explain the world as it is? There has to be a greater Power at work. But religion & the rituals that go hand in hand with it, are things that are man-made, created to help society endure difficult times. Carry on, I say. Just don't force it down my, or any other person's, throat.

Ultimately, I believe that no matter how pious a person may outwardly seem, what is important is the goodness (or evil) in that person’s soul…I am sure that the Powers, whoever he/she/they may be, would know.

My Baby

My little cherub graduates from Middle School in a few weeks.





This picture was taken almost 14 years ago. He is now a strapping young man who has outgrown both my husband & me (in size), & probably knows more about IT related stuff than I do.

This may seem like a minor achievement to all you non-parents out there, but for parents (well, for me anyway), every step they take, no matter how small, is a milestone. Each milestone marks the end of one phase of your child’s life, & heralds the beginning of a new one. My son goes into high school come August & I know that the 4 years will fly by in the blink of an eye & off to college he will then go. Each milestone brings the child closer to the day when he (or she) leaves home, which I know will suddenly feel incomplete without my baby (& eventually my babies) there.

Once, my younger son said to me, “I’m NOT a baby” in response to something we were discussing regarding childish behaviour (I forget the details ... age, you know.). My response to him was: “You may not be A baby, but you & your brother will always be MY babies no matter how old you are.” That pretty much silenced him!

My message to the mothers out there: cherish the time you have with your little ones now…because time DOES fly & you will need to let them go sooner than you think.

Great Expectations

Watched "West Side Story" (the musical play, not the movie adaptation) over the weekend. I don't know....maybe I expected something more magical, more stunning...but it didn't really move me the way I thought that it would.

The vocals were good, as was the dancing; however, perhaps because I couldn't really identify with the story, or maybe the accents were sometimes a bit hard to catch (I think the actors were trying a bit too hard to put on a Puerto Rican/New York accent), I just didn't feel as caught up in it as I did with other plays I've seen like Chicago or Mama Mia or Grease or even Cats!

Art imitating Life

I wrote about colors in my life last Sunday. On Wednesday, I had my Art lesson, the theme being "Abstract" Art. To help us along, to challenge our brains, and to get our creative jucies going, my art teacher gave each of us a card with artwork & sayings about life created by an artist.

She walked from student to student, holding out the cards for us to pick. When I picked my card out of her stack, mine said: "Living a Life Full of Color."

Almost gave me goosebumps...how weird is that? Someone somewhere out there is trying to tell me something...

Abstract-ion

Abstract art is tough to do! That was the theme for today's Art lesson. We were supposed to clear our minds of images, & draw from our emotions & translate them on to our canvases.

How many of us have, while wandering through an Art museum or exhibit, exclaimed, "Even I can do that." over a seemingly simple piece of abstract art? I plead guilty to having done so before. It's not that easy, I realise now.

First of all, it was difficult for me to "visualise" my feelings & translate them into a painting. I am too used looking at things "just as they are". Everything looks like Still Life to me. My right brain hasn't been exercised enough.

I ended up taking home an incomplete piece of Art (I hesitate to use this word to describe it :)). I am hoping that I will feel inspired to finish it at home - not sure how long that will take...keeping fingers crossed...

Coloring Outside the Lines

My foray into the art world, taking painting lessons, has really taught me a lot about myself. It's strange how art reflects the artist's personality, background, & even upbringing.

In my first class, I tried to paint "within the lines"; I kept my brush strokes as even as possible; it was hard for me to let go of what I had previously been taught since toddlerhood. Remember the coloring books we used to have as kids, & how our teachers & parents would tell us to color within the lines? I realise now that that has how I have been living my life. Always coloring within the lines. Not making a "wrong move". Doing what is conventional & expected. Not upsetting the balance of the universe.

My art teacher told us to forget all that we have been told about what art should look like. It's OK to have uneven brush strokes. You don't have to color within the lines. The sky doesn't have to be blue or the grass green.

It's still an uphill battle for me to use my right brain, and to try to perceive of the world around me in a totally different way than I am used to. I have been so used to seeing the world in black & white & gray, that I had forgotten about the other colors in the spectrum.

With Art, I am starting to open my eyes, & to stimulate previously slumbering neurons in that area of my brain that has been left idle too long. I see a long journey ahead, but one which I look forward to with relish.

Random Thoughts on...

AI - ...and he's finally out! Never quite enjoyed Bucky as much as the other finalists. He always seemed uncomfortable performing on stage. Katie McPhee needs to go next...she likes to shout her songs.

Rumsfeldt - ...read about the comments & opinions made by retired Generals from the US military who say that Rumfeldt needs to go...makes sense to me...if you don't have experience in the field, how can you, with good conscience, make decisions that will affect thousands of troops?

LKY - ...our esteemed Minister Mentor is getting old...I saw him speak at my kids' school during a special ceremony celebrating the diamond anniversary of the school. He seemed more frail & his voice was softer & less forceful than I expected, & his speech seemed rather rambling, like he was trying real hard to stay on track but not terribly successfully.

Good Grief

"I am amazed that men of higher education can commit such stupid crimes."
Lt. Mac Taylor to a doctor who conspired with his medical colleague to commit insurance fraud in last night's episode of CSI:NY

I ask myself the same question after the recent weeks' very public revelation of cheating, perverted, drug trafficking doctors. WHY???

Oy vey.

Weirdos

Today's letter in the newspaper from a patient requesting a waiver for the need of a chaperone for her acupuncturist during treatment, triggered memories of certain kinds of patients which left me (& my female colleagues) rather uncomfortable.

The need for a chaperone when a male doctor does an examination on a female patient is pretty much standard practice, not only to protect the patient, but also to protect the doctor from allegations of inappropriate behaviour. However, when it comes to chaperoning a female doctor examining a male patient (specifically if said patient has a complaint related to his genitals), there hasn't been much discussion over this issue.

Usually a male patient who has a complaint like urethral discharge, or penile rash or testicular swelling would request to see a male doctor, especially in the local context where Asian sensibilities tend to be more conservative. Hence, when I get a male patient who specifically asks for a FEMALE doctor to examine him for such complaints, alarm bells start to go off! Fortunately, such encounters are rare. But my female colleagues & I have compared notes & each of us had our own "Penis Guy" (different patients but similar complaints, each time requesting to see us specifically)who would come in complaining of a rash or some other malady that has affected his organ. And when you examine the affected area, there really is nothing obviously wrong with it. When the same guy comes in repeatedly for the same problem, we would try to redirect them to our male colleague to handle. This usually would put a stop to further unneccessary consultations for non-existent problems.

We have been fortunate that these patients did not exhibit any drastically inappropriate behavior during our non-chaperoned consults (although there was a case that was publicised fairly recently about a male patient who masturbated in the presence of the female doctor while consulting her for a supposed traumatic injury to his groin). Worst that ever happened to me was my Penis Guy trying to invite me out to dinner DESPITE the fact that I was wearing my wedding ring, & did not give him any indication whatsoever that I would even remotely be interested! The gall of some people...

Talent

JAMES BLUNT

James Blunt was on Oprah yesterday. This young man impressed me with his talent (he performed 'You're Beautiful' & 'Goodbye My Love' on the show) & his self-deprecating humor. Before his current gig, he was a soldier in the British army & brought his guitar with him (strapped to the side of his tank) on his rotation through Kosovo. He has also served as one of the Queen's guards, & include "prancing on a horse for Japanese tourists to take pictures of him" on his resume.

When he sings, look into his eyes & you can see that the music & words truly comes from his soul. My husband bought his CD a few months ago, & I never really listened to all the tracks. I will now...

AMERICAN IDOL

Country music was the theme yesterday. I can't say that I am a huge country music fan. Apart from Shania Twain & Faith Hill, I can't think of any other country performers that I would listen to on a regular basis.

The final 9 gave a rather lacklustre performance; even my favorite, Taylor Hicks, singing Take Me Home Country Road, sounded like he was (to use a Simon Cowell-ish analogy) at a campfire trying to get people to join him in the song. The two idols who are supposedly the most comfortable in this genre, Kelly Pickler & Bucky Covington (question: what reason on this good earth would a parent have to name their twins Bucky & Rocky???!!!) failed to impress me - they just didn't seem very comfortable on stage.

And Kenny Rogers - gosh, I didn't recognise him without the full beard that he used to have....he should have kept it...

Hats Off

I salute this bunch of doctors for what they are doing.

I can honestly say that I don't think I could do what they do, mojo or no mojo...

Room with a View

This is the view from the balcony of our cabin on a cruise to nowhere last weekend, a much appreciated birthday gift from my mom (thanks, mom!).

Why go nowhere, some may ask. For the uninitiated, these cruises cater to the casino goers. Singapore has no casino (I should use the politically correct term coined by the government: Integrated Resort, or IR) yet. For some reason, Chinese people like to gamble (not being racist, but based on observation). So the cruise ship is a convenient & comfortable way of doing so without the hassle of having to go all the way up to Genting Highlands in Malaysia or flying to casinos in Australia/Europe/USA.

I am curious to see how the IR wil turn out. I hope it won't be seedy like Reno, or tacky like Atlantic City. I'm actually hoping that it can capture some of the glitz & glamour of Las Vegas, with top-class entertainers (in the calibre of Elton John, Cirque Du Soleil, David Copperfield)& family-friendly venues (think MGM's theme park, or Venetian's indoor water canals & gondolas, or New York New York's roller coaster that goes through & on top of the hotel!). It'll be tough bringing in those stretch- & super-stretch-limos though, seeing the limited space available for parking here.

Did I win any money on the cruise? No, because I don't enjoy gambling. I enjoyed the cruise, though, because the sea calms me - the sound of the waves & the soothing breeze makes me forget all my troubles & stressors. I love sitting by the ocean with a good book & can spend hours doing just that. Forget about the casino, & the multitude of activities planned by the cruise director. I am happy with just my book, thank you very much.

Pride & Prejudice (again)

OK. I am officially a Jane Austen(more specifically, Pride & Prejudice) groupie.

I bought the Pride & Prejudice DVD, watched the movie again (which makes it a total of 3 times within a span of 4 months), watched all the bonus bits (even the tour of the homes used in the movie shoot), swooned over Mr Darcy (again), now wish that the men of today still stand up & bow when ladies walk into the room and that a man dressed in a cravat, coat, breeches & riding boots can be sexy (especially if he is Matthew Macfadyen).

Sometimes You Just Have To Listen To Your Gut

You wake up & have this bad feeling in your stomach (& you know it’s not the curry you ate last night). Things just go downhill from there. The car has a flat. Or the traffic is horrendous. You’re late for work. The F-O-N patient you usually try to avoid turns up & ends up in your consultation room. The waiter gets your dinner order messed up.

You also read about people with close calls who didn’t get on a plane because of a “bad feeling” & the plane ends up crashing with everyone on board losing their lives.

This sixth sense (no, not the I-see-dead-people variety) that you get sometimes is inexplicable, and unexplainable. I don’t know if it’s a gender-biased characteristic (the so-called “women’s intuition”); maybe the guys have a different name for it.

Whatever you may want to call it, this gut feel that you get can sometimes be a life-saver for your patients. I remember a few cases I encountered…

Patient A was a Malay gentleman in his early 40’s, who presented to me with mild gastric pain. Medical history & physical examination were unremarkable & he had only had the symptoms for a few weeks. Usually, I would prescribe an antacid and/or a H2 blocker with some lifestyle advice & review the patient again after a week or two, depending on the severity of symptoms.
However, in this case, something made me feel the need to refer him to a tertiary center for further investigations. 2 months later, I received a reply letter from the specialist who saw him at the specialist clinic giving me an update on his condition. Turns out that endoscopic examination revealed a gastric ulcer with very early malignant change. Fortunately, it was early enough that the patient did not need a total gastrectomy & just needed the affected area to be resected. I can’t begin to describe the feeling of relief (& some incredulity) I felt that we had caught this in time, thanks to my gut feel.

Patient B was a Chinese gentleman in his early 30’s who complained of a persistent cough of 2-3 weeks’ duration. He was not a smoker, & had no significant family or medical history of note. He had previously been prescribed cough mixture & lozenges by another doctor in the practice, without any relief. When I saw him, there were no physical signs to suggest any infection or malignancy. But again, gut feel made me order a chest x-ray…and to my horror, I saw a suspicious looking mass in the right lung. The radiologist report had daunting words like “suggestive of malignant change” & “infiltration”.

I referred him to a tertiary center. He returned to see me two months later to let me know that after undergoing a bronchoscopy & biopsy, the mass was not malignant, neither was it tuberculous (tested negative for acid-fast bacilli); even the specialists were puzzled by the diagnosis & thought that is was some unusual mycobacteria strain that had caused the infection. They ended up treating him empirically with what I believe to be a combo of Rifampicin & Streptomycin (patient was unclear as to the name of the drugs used). Happy ending – the treatment worked, & the patient was eternally grateful that number 1, the illness had been picked up, & number 2, it was NOT cancer.

Patient C was a Chinese lady in her early 20’s whom I saw as a health screening patient. During history taking, she revealed that she had a history of colonic cancer (!!!)& had a partial colectomy done. Apparently, she had seen her personal GP for (get this) epigastric pain (!!!), & the GP became suspicious & immediately referred her to a specialist for further investigations. Colonoscopy revealed early Ca Colon. I suspect that this GP had a gut feel too, that something was not quite right in this patient.

So the moral of the story is: don’t ignore that niggling voice that comes from that gray area between your conscious & subconscious, which sometimes makes you do things which you otherwise would not do. That strange feeling in your gut may not be indigestion, but your intuition telling you that things may not be what they seem to be.

Brrrrrrr

I think the older one gets, the lower one's tolerance level is towards the cold.

Cases in point:

We spent the 2004 Christmas holiday visiting my MIL in New York City. The night we arrived, the city received its first snowfall of the season. Needless to say, the kids were ecstatic - they were jumping for joy, sticking their tongues out trying to catch the snowflakes. As for me, I was chilled to the bone...the windchill factor was something like -20 Farenheit...at least it felt like it to me. As I desparately clutched the neck & hood of my parka close to my body to prevent the cold from creeping in, I thought: I don't think I will want to retire in any place that is not tropical or at least, sub-tropical!

Today I went swimming in our pool with my 2 boys. Now, we live in the tropics right on the equator (alright, maybe we are one degree north of the equator, not that it makes much of a difference) & the ambient temp today was something like 33 degrees C, humidity felt like it was in the high 90's if not 100. And yet, when one of my feet went into the pool, the water felt D**N cold (to me, anyway)....cold enough to curl your toes & make other unmentionable parts of the body shrink/pucker/retract.

But my boys? They went right in, initially went "Ooo it's cold" and within seconds (literally) were doing laps & somersaults in the water.

As for me, I stayed seated on the side of the pool with just my legs dipped into the water (up to the knees), to 'allow' my body to gradually accept the sudden change in temperature. Took me at least 10 minutes before I was able to totally submerge myself in the "icy" waters.

42

Today.

Me.

Winken Blinken and Nod

Insomnia hits me occasionally. Often, it is due to unresolved issues, running through my brain although the body is exhausted, preventing Sleep from taking over.

Tonight, there is no reason why I should not be fast asleep in bed right now. I can't think of anything that is bothering me, which may be keeping me up. My eyes are falling shut even as I type this. And yet, when my head touches the pillow, sleep eludes me. The harder I try, the further Mr Sandman seems to run from me...

Maybe I should try counting sheep...

Hugs & Kisses

As I read an article written by Linda Baker for the New York Times titled "When a mother must muzzle the nuzzle", about her attempts at weaning off the physical bonding she has with her children, it struck a chord with my own childrearing experiences.

I have always been a touchy-feely type of parent to my two boys. Hugs & kisses have always come freely from me to them & vice versa. Maybe it's a rebound phenomenon of my own childhood in which, as is typical of Asian upbringing, physical expression of love was not exactly a norm.

They still give me hugs & goodnight kisses. But I miss those "cling-to-your-neck-&-nuzzle-their-face-against-my-shoulder-&-neck" type of hugs which they used to give me. Something happens between the ages of 10 & 12. They develop a reserve that prevents them from giving you that all-out expression of affection. I guess it is a first step towards growing up. Perhaps this gradual weaning off process is a natural way to prepare for the day when they eventually leave the nest to make their own way in the world. I don't think it would make it any less painful, though.

Ahchoo!

Been sneezing up a storm. My allergic rhinitis has been acting up the last few weeks. Must be something in the air - mould, or the haze from Indonesia. Let me tell you, sneezing is very strenuous activity. It really drains your energy. I wonder how many extra calories I burnt up because of my allergy attack.

Those who suffer from VMR can empathise with me. Before the days of steroidal nasal sprays, one would wake up every morning with runny noses, sneezing fits, & oftentimes, clogged up sinuses. I think I spent most of the first half of my life breathing through just one nostril. Those of you who are not cursed with this affliction, don't take for granted this luxury of being able to use both nostrils at the same time.


Signed up for an ENT CME symposium this weekend. One of the topics being discussed: Allergic Rhinitis - A new Look at Immunotherapy.

Whoopee. Very timely indeed.

Blown Away

Wow.

What a concert it was last night. Mr A-Z (Jason Mraz), performing with percussion & vocal support from Toca Rivera gave a mesmerizing performance showcasing his vocal & guitar-playing talents.

I was amazed by the versatility of sounds & melodies displayed by a simple acoustic guitar with the accompanying percussion instruments (a small standing cymbal and a drum - not sure of the exact type, but it had a very Caribbean sound!). Even my boys, who are usually fans of heavy metal music a la AC/DC/Deep Purple/GunsNRoses, were suitably impressed (& hopefully inspired to add Mom's type of music to their repertoire of songs!)

I was blown away by how effortless he made it seem, with his improvisations, and his vocal acrobatics. The casual bantering with the audience was the icing on the cake.

This is what I call Talent.

Arty-Farty

Circles of Life- Angst

The Person

In the latest episode of Grey's Anatomy, Dr Christina Yang reveals to Dr Meredith Grey that the clinic she has gone to to "take care" of her unplanned pregnancy needed an emergency contact in case of unforeseen circumstances. And Christina has appointed Meredith as "The Person".

Scene

Meredith puts her arm around Christina's shoulders & leans her head against her in a show of support of what she is about to go through.

Christina (in her usual acrid tones): "You do know that this constitutes a hug?"

Meredith:" That's OK...I'm your Person."

This poignant & wonderfully written scene, which was brilliantly acted out by the two actress (Sandra Oh & Ellen Pompeo respectively)showed the friendship, trust & loyalty between the two friends.

I am lucky that I have a Person in my life. Someone who may not neccessarily be from within your family, or even your spouse, but whose relationship with you is such that he/she accepts, respects & supports you & your decisions at face value, no questions asked.

I hope everyone has their own Person too.

So Many Places, So Little Time...

Planning our summer vacation now. We have to make the obligatory trip to visit my M-I-L in New York City; this will make it our gazillionth time in NYC (no offense to NYC but I really would like to see other places in the USA as well :)). We'll probably have to limit ourselves to road trips on the Eastern coast of the USA within reasonable driving distance from Manhattan. Anyhoo, am looking at Martha's Vineyard (seems pretty enough on the websites that I've seen but don't want to end up going to a tourist trap), Providence (am attracted by the town from what I saw in the short-lived but excellent series a few years ago), Newport (hubby trained there while in the US Navy, & says it's a pretty town). Maybe I should also look south & see what's there.

Kids & husband don't really care as long as they get to make their pilgrimage to Matt Umanov (a guitar store that has been in the Village area forever). Of course, Woodbury Commons (factory outlet stores!!) is a must. Maybe a Broadway musical (been trying to get Lion King tickets for the longest time....seems to be perpetually sold-out...I guess I should start trying to get tickets NOW).

There are soooo many places in the world that I'd love to visit - horseback riding in the Canadian Rockies; cruising down the Nile; riding a camel to the pyramids; a safari in Kenya...these are some of my dream vacations. Oh well, one of these days...

It's Not About the Money

There has been some discussion lately about the economics and business of Medicine and some of the ethical & moral issues surrounding this. Oftentimes, these issues get lost in all the rhetoric.

In my POV, I don't think the debate is over whether doctors should make a lot of money from their profession. I don't begrudge highly skilled surgeons and well-respected, knowledgeable physicians earning large amounts of money for services rendered in practising good solid Medicine. Many have & still do make a lot of money for much needed services mostly in the private sector, to cater to people who can afford it (hopefully!).

I think most of us in the medical community have no qualms about denouncing the doctors who prescribe addictive drugs like benzodiazapines or Subutex or codeine-containing cough mixtures inappropriately. This is clear-cut inethical behaviour.

However, when doctors start to perform aesthetic procedures on teenagers, prescribe weight loss medicine to non-obese patients, or order a gamut of largely unneccessary tests under the auspices of Health Screening, I start to wonder at the motives of these "healers". I don't feel comfortable with doctors pandering to the vanity of the masses, the way they do now, with the numerous ads one sees in various publications expounding the availability of aesthetic services. They have become glorified beauticians. The LASIK procedure is also being aggressively promoted (not as bad as in the US but still...), and now that the competition is heating up, I wonder about the decision making process both for the doctors (in patient selection) and for the patients (same day service - eye assessment + procedure done on the same day...does that leave time for the patient to actually go home and think through this???).

It is all these gray areas which we should question ourselves about.

The Business of Medicine

Ooo...angrydoc is really angry today...

Like it or not, Medicine is a business now.

Young At Heart

I turn 42 in a few weeks. I certainly don’t feel 42 in my head, although my body & its various parts beg to differ & remind me of that fact constantly. And I sometimes need my sons to help me read the date on my watch :).

I can still appreciate contemporary music & don’t limit my selection of listening pleasure to songs from the 70’s & 80’s. Matter of fact, the radio stations that are “memorized” in my car’s stereo system play contemporary & rock music. Michael Buble, Linkin Park, Green Day, Maroon 5, James Blunt, count among some of my favourite musicians to listen (& even sing along!) to. Admittedly, I don’t do research into these artistes bio-data & memorise their dates of birth, favourite food, names of pets etc. like I used to do as a teenybopper screaming over Donny Osmond’s purple socks.

I occasional drool over hunks like Brad Pitt, & enjoy looking at nicely toned 6-packs (& hubby is OK with it. Really.)

I can still empathize with my teenage & pre-teen sons, nephews & niece. I know all the angst (ha! One of my favorite words!) that they feel during this hormone-filled phase of their lives.

Just the other day, my husband commented amusedly, “You’re still such a kid!” when I almost jumped up & down with excitement upon seeing a documentary on ‘How Star Trek Has Affected Technology ‘ on the Discovery Channel. During one of hubby’s usual channel surfing sessions, I had caught a glimpse of William Shatner narrating while clips from the various series of Star Trek played. I forced him to stay on that channel while I watched the two back-to-back episodes that night. I am a closet Trekkie (actually just ST:TNG or Star Trek: The Next Generation for the uninitiated; & to a lesser degree, ST Voyager); in fact, only my immediate family (i.e. hubby & sons) knows that I have watched every single episode of ST:TNG thanks to syndication in the US ☺, have actually attended two Star Trek conventions while living in the US (and no, I did not dress up as a Klingon nor a Ferringhi☺) & went to the Star Trek exhibition in Suntec City when it came to Singapore a few years ago.

Yeah, I still feel like a kid sometimes. I am not going to conform to society’s perception of what a woman approaching middle age is supposed to look like or be like. My motto in life now is "Live & Let Live". That’s the great thing that comes with maturity, life experiences & growing older – self-confidence and a greater appreciation for life.

Oh, and one more thing…I don’t need reading glasses yet. Really.

Just Being Random

angst

noun a profound feeling of generalized anxiety or dread.

ORIGIN German, ‘fear’.

(Definition from askOxford.com)


Don't you think the word "angst" is so apt in describing the emotions that one goes through no matter how old you are? It is so much more versatile than "anxiety" or "fear", don't you think?

Childhood separation anxiety, teenage hormonal-induced mood swings, puppy love, first love, broken hearts, pre-marriage jitters, maternal worries, empty nest syndrome...it's all so angsty.

At the Crossroads

In today's papers, Dr Huang gives us his take on the practice of Medicine today.

He writes: "The tragedy with the mantra, 'Medicine is now just another business', is that some among us are beginning to believe that it is true."

Let's be honest here...if one were to take a poll among medical students now on why they want to become doctors, what proportion would indicate "Want to earn a good living" as a major reason? I suspect a large percentage would.

Realistically speaking, being a doctor is like "having an iron rice bowl" (鐵飯碗 - a Chinese idiom referring to an occupation which guarantees job security & a steady income) - you would probably not end up among the statistics of the unemployment rate. Quantum of income would vary, but I sincerely doubt that any established, fully trained doctor would be classed in the lower or middle income groups. Unfortunately, the "business" end of Medicine has become, in many instances, the bottomline for many doctors & the "companies" they own or have a share in.

He also writes: " Many now strut around like some centrefold media superstar in the most unlikely magazines. 'Glam' sells and these coffee-table tabloids naturally fly off the racks."

I think he probably refers to the (mostly) aesthetic physicians/surgeons who are featured quite regularly in magazines targeted at the female population, as well as the well-heeled. Let's hope that we won't end up with the local version of "Dr 90210" (an American TV series on the gossipy E channel which features real-life cases of plastic suregeons in Beverly Hills).

Dr Huang also states that "The challenge facing us is how the medical profession is going to harness the tools that modernity affords us and, by self-regulating moderately, ensure that the 'outliers' in our profession do not tarnish the good reputation that our forebears had so painstakingly built over the centuries."

A challenge indeed. I anxiously wait to see where & whether the Powers draw the line with some of the more dubious practices we see.

If Only They Knew

The recent spate of letters related to high cost of medicine, alleged wrong prescription of medicine, & expectations of how doctors should practise medicine, have me reflecting again, on the varied reasons why I decided to take a break from clinical practice more than a year ago.

I see how patients' expectations have become so unrealistic (their ignorance is not entirely their fault, I have to add; it's just that their idealistic views have not changed with the times) that many expect their doctors to be at their beck & call, at the expense of the doctors' personal lives.

I see how money plays a huge factor in how doctors practise medicine. Unfortunately, the advent of managed health care, and medical groups becoming publicly listed, or bought over by listed companies which have to answer to their shareholders, have resulted in the dollar sign becoming a top priority when running a clinic. I know that there are ways of practising medicine (NOT negligently) which can improve profits for the company, and oftentimes, these methods are encouraged so that profit margins look good for the shareholders. However, some of these methods go against the grain of one's soul as a doctor (and no, you don't have to be negligent to practise "profit-geared" medicine).

It's a vicious cycle really, since the average patient expects that a doctor is there to look after his/her health, not thinking that the person whom they have placed on a pedestal would try to squeeze extra dollars out of him/her in doing so. Extrapolate this to corporate clients with some of these expectations who sign contracts with medical groups or managed health care companies (eg. some end up with packages which include unneccessary health screening tests with huge profit margins)- you are looking at potentially hundreds of thousands of dollars ( and I am only referring to primary care, not even specialist care here). And there ARE other ways of "making more money" which I will not mention here...

So there it is. The disillusionment sets in. Maybe eventually, the mindset of the patients will change & they will start to really question whether their healthcare needs are being taken care of cost-effectively or not ( I stress - "COST EFFECTIVELY" - not CHEAPLY). Maybe eventually the patients will also realise that doctors are far from angels (we'll gladly relinquish that image to the nurses *GRIN* who really do deserve that accolade) & are not gods & actually do have personal lives too :).

One day. Maybe. But not soon I think...

Hear, hear!

Some quotes from letters in today's newspaper in reply to a recent complaints from patients regarding doctors not seeing patients if they go to the clinic close to closing time, & high prices charged etc...

"I believe that doctors have a duty to attend to medical emergencies at all times but I'm afraid I will have to disagree with the assertion that I'm obliged to deal with any patient with any kind of complaint at anytime." Dr Sim Sze Keen

Well said, Dr Sim!

"There is currently no strain of pathogen causing the influenza or common cold that's acutely present just a few minutes before midnight. Most of the patients would have been experiencing symptoms in the preceding hours and there is no reason for them to be attended to when they decide to turn up at the clinic at closing time." ">Tan Shian Ming

I wish more patients had the consideration & common sense shown by Mr Tan.

" Let us not publicly complain or accuse without a clear understanding of doctors and the constraints they face. We should also refrain from giving comments to the media on certain medications and their prices without clarification." Miss Adeline Ng Su Mei

Thank you, Miss Ng, for voicing your support & understanding. Your sentiments echo what many doctors feel, and goes to the heart of the cause of many complaints - lack of communication or misguided reluctance of patients to speak directly to their doctors/nurses regarding their concerns. For some reason, they think that writing to the newspaper, or even their MPs & Ministers will solve their problems.

An Open Letter

Dear I.M. Sik:

First, let me say that I understand you are not feeling too well, & can empathise with your feelings of anxiety over your medical condition. I hope that you will be able to take the sentiments expressed in this letter with an open mind, and hopefully be able to appreciate that practising Medicine in the modern world is not as easy as you may think.

Doctors go to work everyday with the hope of making their patients feel better. I don't think anyone of us have intentions of killing/maiming/injuring their patients. In a perfect world, everything would come up rosy & everyone would live happily ever after. However, as you know, this is not a perfect world, & unfortunate things do happen, often beyond the control of us mere humans (yes, even doctors are human & not gods!). Whenever possible, safeguards & contigency plans are in place to try to minimise or rectify these unfortunate incidences, but not everyone can be saved due to factors like age, concurrent medical conditions & just sheer bad luck.

In this material world, the question of cost often comes up. Everyone expects excellent medical care with minimal cost. But surely you must understand that logically speaking, that is not possible. There will always be trainee doctors, who will eventually take over the role of their senior & more experienced consultants & professors. If they are not given the chance to learn (under the supervision of their teachers) how will they ever achieve the expertise needed in the future?

It is also not possible for everyone to be under the direct care of a consultant otherwise these poor doctors would not even have time to take a meal let alone do ward rounds, or surgery or spend time with their own families!

Ultimately, there needs to be a relatively fair way of distributing the healthcare needs without compromising on healthcare standards nor on the morale of the healthcare workers. And one way which the institutions have done so is to allow the subsidised patients to be seen by Medical Officers with supervision from their superiors. You have to admit that the amount of subsidy given by the government is not small, and the amount that each subsidised patient has to pay for consultation, drugs, investigations, surgery etc. is a small fraction of the actual cost! It is hard to fathom that many people don't blink an eye about spending hundreds & sometimes, thousands of dollars on slimming treatments, massages, facials etc at the spa & yet gripe about the cost of seeing a doctor when they have a health problem. I sometimes wonder if they have their priorities right.

I hope that you will also understand that doctors have personal lives outside the hospitals and clinics. They have spouses, children, and even hobbies to even out the balance of an otherwise stressful life. So please do not begrudge a doctor for closing his/her clinic on time if it's not a dire emergency or urgent condition. Do take note that locally, we are, indeed, extremely fortunate that there are clinics open 24 hours even on Saturdays & Sundays & public holidays. (Doctors often spend their evenings & weekends with their patients instead of with their own children.) Not so in some of the developed countries. They open from 9 to 5, Mondays to Fridays. If you catch a cold or a flu outside office hours, you can jolly well get your own medicine from the local supermarket. Urgent cases & emergencies would go to the ER. Locally, we are actually spoilt for choice; unfortunately, this is largely unappreciated.

Finally, a humble word of advice - take charge of your own health. Know your medical history & the drugs that you are taking or allergic to, so that when you next see a doctor, he doesn't have to guess or trace records which would take time away from the consultation. Don't be shy to ask questions about your management, your condition, and your treatment. If in doubt, get a second opinion. Most of us wouldn't mind (this is not a matter of losing face; it is your health we are talking about). Remember that risks are inherent in everything we do, including crossing the street! Same thing with medical procedures - do not take for granted that risks are non-existent. Risks vary depending on the treatment/procedure/surgery. Ask your doctor what they are & what are the chances of developing complications; know what the possible complications are. Success rates are also variable depending on the medical condition; and although we would like to be, we are in no way, miracle workers! Discuss all this with your doctor. In this way, you would be able to make an informed decision on how you want to be treated & managed.

Wishing you all the best,

Sincerely,

Doc MD

Boys are ALSO from Mars & Girls from Venus

My 14 year old son recently suffered a bout of viral GE, with fever, nausea, abdominal cramps, vomiting, diarrhea, the works. Threw up all over the bathroom except the toilet bowl (must be a guy thing, trying to will himself not to vomit or suppress the feeling till he couldn't tolerate it anymore, hence, did not make it in time to the aforementioned receptacle).

He went back to school & described his illness to his friends. I believe the words "Projectile Vomiting" were mentioned, probably with a rather graphic description of the state of his bathroom in the aftermath.

The reaction from his female friends : "Eeewww!!!"

And from his best friend (a guy): "Awesome, dude!"

Go figure.

Happy Valentine's Day!

Here's a cute poem my son wrote for his Math Valentine's Day assignment:

You are the coordinates of my coordinate plane,
Showing me the way so I don’t go astray.
You are the equal sign of my equation
The exponent of scientific notation
You’re also the parentheses that keep things together
A binomial we shall be forever.
If you were mine,
I’d be just fine,
Will you be my valentine?



Happy V Day, everyone!

True Colors

Self esteem.

Something that all of us struggle with. From childhood, especially through adolescence & even as mature women, self-doubt & poor self-image affect the decisions we make & how we live our lives.

Watch this.

Drugs!

Hah! The wonders of medicine...say what you may about the COXIBs but within hours of ingesting the first dose of Celebrex, the pain had reduced by 90%! Hallelujah, I don't have to hobble around the house like an old lady anymore!

One of my pet peeves is the misconception by patients that analgesic drugs (more commonly known as "pain-killers") are bad for you & makes you rely on them (I'm not talking about the opiates even). Some are averse to taking even Panadol, let alone 'stronger' NSAIDS like mefenamic acid, ibuprofen or a COXIB.

More often than not, I have to explain to them that pain is caused by inflammation, & if you make the inflammation go away with the above mentioned drugs, voila! the pain disappears too. So the drug is not PURELY a pain killer, but it acts on the inflammation causing the pain. Of course, at the same time, you would need to elucidate the cause of the inflammation, & address that problem at the same time.

I am not advocating prescribing analgesics or anti-inflammatory left, right & center, but if indicated, the results can be wonderful (as personally experienced recently *GRIN*), & leaves one with a much better quality of life.

Now, back to my softball game......

My Left Foot

Man...I did something to my left foot. Since starting softball 3 weeks ago, my left heel & base of 5th metatarsal has been tender. I know, probably a bad case of plantar fasciitis. But the pain on the lateral part of my foot is a bit worrying...I hope it's not a stress fracture.

I know, I know, I should go see a podiatrist or an orthopod or at least get an X-ray done. But I hate going to see doctors. Yeah, sounds strange, me being one & all.

Maybe it's just me but it feels awkward when I consult a doctor. It's like, I feel like I should be able to diagnose myself already (sic). Even the other way around, if I happen to see a doctor who has come in as my patient for something as simple as an insurance check-up, I feel uncomfortable.

They say doctors make the worst patients & I think I am a classic example. Sigh...if the pain goes on much longer, I'll have to call up one of my orthopaedic colleagues for a consult.