flux

balancing on this knife edge of uncertainty
i want to fall off the precipice
which side doesn't matter
as long as I fall
to end this state of confusion
and emotional torment

Memories

Watching the first episode of "Grey's Anatomy" brought back memories, both good & bad, of my own internship. The busy calls, "Nazi" residents, wonderful consultants who actually treat you like a person who is there to learn instead of just a grunt worker...these were so real to me. I wonder how laypersons reacted to watching how some of the interns were treated (made to look like fools). Doesn't seem too humane, does it? But it happens (unfortunately).

This looks like a promising series - I look forward to watching, and remembering, more.

Pride & Prejudice the Movie (*Spoiler Alert*)

Die-hard Jane Austen fans would hate this movie. Not only did they change & condense bits of the story (especially Darcy's explanation to Elizabeth about Wickham's past behaviour), but the screenwriters also modified some of the dialogue of the characters.

Me? I liked it. I especially liked the lead actors playing Elizabeth (Kiera Knightly) & Mr Darcy (Matthew Macfadyen); Donald Sutherland also did a superb portrayal of Mr Bennet & the scene in the study where he asks Lizzie about her true feelings for Mr Darcy brought me to tears. Judi Dench, as Lady Catherine De Burgh, did not fail to live up to her reputation.

The emotional angst & passion in the story were turned way up compared with the mini-series starring Colin Firth, & will satisfy the ladies who will swoon over Mr Macfadyen's Darcy. The scene in which he strides through a misty hazed meadow towards Elizabeth before they finally declare their love for each other, did for me, what the scene of Colin Firth in a sodden white shirt at Pemberly, did for Bridget Jones. Sigh...

I survived my first Teenage Party

No, not as a participant (I had my fair share of such do's eons ago), but as a Supervising Parent (God, I feel so old as I type that). My older son celebrated the end of the semester, as well as his 14th birthday this past weekend at our condo pool.

Having sixteen 13 & 14 year old boys & girls all in one place is no joke, man, I tell you... All those adolescent hormones raging, one boy was literally almost climbing the wall by the pool till my panicked husband stopped him! They were chasing each other around the pool, in the pool, out of the pool, singing songs, girls screaming/dancing....my poor neighbours...

They had to let out steam I guess, 8th grade is hard work, & it's been a strenuous Semester for the kids with almost no break since Aug (apart from a couple of days over Thanksgiving) till now. If I were them, I'd be screaming too.

But well, I survived to live another day. Don't ask me when I will organise another one of these things again - I need to recuperate first...I have another 2 years before my other son turns 14, so that should give me some time...

Christmas Spirit (or the lack thereof)

My son commented that I had lost the Christmas spirit this year. This was triggered by the fact that till today (count:10 more days till Christmas!) I have yet to put up a single Christmas decoration, let alone buy a tree!

"Why?" you may ask.

Well, first of all, I think that in the local context, getting a real tree is such a hassle, as there are no garbage trucks that pick up the used tree for recycling when the season is over.

Secondly, I have not felt that Christmas magic in a number of years. This is magnified by the fact that in the local context, the original meaning of Christmas has pretty much gone down the drain... I thought that Christmas was the celebration of the birth of Christ? For many (especially kids), it's just another excuse for giving (getting) presents. Oh, I know that there are Christians out there who know that there is more to Christmas than the presents & the tree, but I would hazard a guess to say that if you go out on the streets & interview one of the many shoppers thronging O. Road asking them what Christmas means, 8 out of 10 will tell you "Getting Presents".

I plead guilty to being one of those indulgent parents who tried to bring the magic of Christmas alive, with the tree & the stockings by the fireplace (we actually did have a fireplace while living in the US) & the cookies/milk for Santa etc. etc. Moving back to this tropical clime, this was hard to maintain (how does santa come down the chimney if we don't have one???). Believe you me, I tried to delay the inevitable Truth About Santa from my kids (they believed till they were 9 & 7 respectively!).

Sadly, with growing up also comes the loss of that faith in the magical (there goes the Tooth Fairy). And being caught up in the rat race of life has also resulted in a certain jadedness & a realisation of the hypocrisy over the whole Christmas rigmarole.

Perhaps I need to dig down deep inside & examine what Christmas has really meant to me all these years. Perhaps it has become more than just a religious celebration. Perhaps it is also a chance for us to celebrate the love & togetherness of a family, and a willingness to give joy & happiness to our loved ones. This does sound like it is getting all mushy, isn't it? Perhaps it means that I am starting to feel some of the Christmas spirit after all...

Elitism?

This letter to the editor in today's newspaper gives a different perspective on the difference between the "elite" and "neighbourhood" schools locally. I have heard of similar views from a friend of mine whose child goes to one of these "elite" schools.

I had been grousing to her about my dissatisfaction with the education that my kids were getting in the local system, and had thought that perhaps, it was because they weren't in one of the "elite" schools that the quality was lacking. She then replied that the only difference between these schools & a neighbourhood school was that most of the kids in the elite had the resources available to them to go for extra tutoring & "enrichment" courses; hence they managed to get better grades in their exams.

It was certainly an eye-opener for me that the education system has changed so much from the time that we were in school till the present time. Come to think of it, I remember getting a phone call from my son's Chinese teacher when he was in Pr 1, asking if he had anyone tutoring him in Chinese. At the time, being newly from the US, I had naively thought that putting a 6 year old child through extra classes outside of school was ridiculous, so had resisted doing so. The teacher had been shocked when I said no, & insisted that I should engage a tutor for him, as it was not possible for her to bring his grasp of the language to the acceptable standard without outside help.

Which brings me to the next question: if the teachers themselves think that they are unable to teach a child adequately & requests for the child to get extra tutoring, and if schools ROUTINELY schedule remedial/supplementary classes in addition to the normal school hours, does that not mean that something is not right with the system???

And another thing...I wonder why these "elite schools" tend to be grouped in districts where the affluent live? I know of at least 3 "neighbourhood" schools which have been displaced from their previous locations within these affluent districts (they still maintain their original names a couple of which were taken from the street names where they were located), & their sites taken over by the "elite" schools. Another form of social engineering, hmmm?

Lessons Learnt

Why do you want to become a doctor?

This question has been asked countless times to potential medical students during their pre-admission interview.

Standard answers probably include things like
a) "I want to help people"
b) "I think it is a noble profession".

More realistic reasons would probably include
a) pleasing the parents;
b) thinking that doctors lead glamourous lives (as portrayed on medical TV dramas),& are like the white knights of the days of old, charging in on their gallant steeds to protect patients and slay the disease-dragons
c) wanting to achieve a certain standing in society (doctors have historically been placed on a pedestal by society).

In rare cases, a student truly feels that it is his/her calling to become a physician.

The truth is, yes, you do get to help people -and this is invaluable. What they don't tell you is that you also get a lot of crap in return. And also, that white knight on a steed? Well, sometimes they have to deal with a blunt sword or being able to afford a steed at all; their king may also close off short cuts leading to the patients, & instead decree that they have to take the path that is laden with strewn logs & brambles.

So do I regret the decision I made of becoming a doctor? No. The decision was made according to the circumstances surrounding my situation at that point of time.

And do I think it a waste that I have stopped working as a doctor (for now)? Again, no. I believe I have put in my share of blood, sweat & tears; I do believe that I have saved countless lives, or at least improved the quality of life of many of my patients.

And in return, my experiences & knowledge gained during these years are priceless. I have learnt of the fragility of human life, and the resilience of the human soul to survive seemingly insurmountable setbacks. I have learnt that underneath all that skin, no matter what color it may be, we are all the same. I have learnt not to take life for granted. I have developed "thicker skin" so that ill-meant remarks don't cut as deep (thanks to certain 'senior' doctors during the houseman days). I have learnt to be a (hopefully!) better mother who doesn't panic at the slightest whimper of my child (thanks to postings thru neonatal ICU & pediatric surgery). I have also learnt that this is not a perfect world, and that sometimes, wanting to do right & actually doing it right are two entirely different things altogether. And lastly, I have learnt that politics is inherent in everything you do in this society; no matter how good your intentions are, you still have jump through the right hoops to achieve what you want to achieve - not an easy task if you are one who is not politically-inclined (read: good at brown-nosing).

So to all you potential doctors out there, don't let my rantings & the rantings of other doc blogs discourage you from becoming a physician. Just make sure that you don't go into it with rose-tinted glasses, like some of us did, & you will be fine.

Learning English

This letter in today's newspaper reiterates the point I was trying to make in a previous post.

Learning a language (be it English, Chinese, Malay or Tamil) is more than just filling in the blanks or multiple choice questions. Let's hope the folks in the Education Ministry realise it soon...

Gimme a Break!

Ever since I started my self-imposed sabbatical away from the world of medicine (both clinical & non-clinical) 6 months ago, people I meet, be they family members, friends or even newly acquainted persons, ask me why I stopped working & when I will be going back to work.

My much repeated answer to the first question is, to summarise it: disillusionment, dissatisfaction, re-prioritization of my life.

Why disillusionment? I must admit that this started way back in the first years of my residency, when I was posted through the then-compulsory outpatient rotation (in my case, a polyclinic posting). The workload back then was just as bad (if not worse) than it is now. I remember my personal record of seeing 100 elderly patients with chronic illnesses on a Saturday morning from 8.30 am to 12.30 p.m.!!! It was literally come in, sit down, measure blood pressure/pulse, listen to heart/lungs, repeat prescription & out they went. Not quite the ideal situation for consults, as you can imagine.

Another eye-opener for me was the lack of scruples in our fellow man. My inherent (& perhaps naive) idealism in the goodness of human nature took a battering when I came across numerous malingerers (especially those NS guys -sorry, but this was based on my personal observations) hoping for MCs.

And in more recent times, I have grown increasingly disillusioned with this so-called "noble profession" as I see the dog-eat-dog world of corporate medicine, fighting to get contracts with companies, with undercutting and fancy packages (with sometimes dubious value) geared to attract HR managers. Doctors have become assembly-line workers, churning out patients from their consultation rooms. The higher the number of patients they see, the better it is for the practice since more consults = more $$$. I know that this is not reflective of all doctors, & that my skepticism & jadedness is a result of my personal experiences, but I am sure there are many fellow physicians out there who feel the same way.

And then there are the patients. Period. I am sure angrydoc's blog will give you many examples of doctor's dealings with patients which can be rather, ahem, challenging :). I have also recounted some of these experiences in some of my previous entries.

As for the 2nd question, the answer is simply: I don't know. I have yet to feel the urge or the calling to resume clinical practice. Whether or not I will ever feel it again, I don't know...I may still go back to practising part-time or as a locum, just to keep the neurons firing, but not just yet...let me take a break first.

What a Classic Line!

"I was born naturally, but brought up Caesarean." - Adrian Monk from the series Monk

I heard this line last night on the latest episode of Monk & cracked up! I think it will be a classic. I had to think deeper after my initial response (i.e.ROFL) to its superficial comedic delivery by the talented Tony Shalhoub to figure out what Monk meant when he said that. My personal take on its meaning is that Monk was born, like most everyone else, a normal baby. But subsequent "interventions" (i.e. situations which occur , and people he interacted with during his life) - hence the term "Caesarean" upbringing- resulted in the neurotic person that he is now, with all his oddities & quirks.

I love the analogy & I think it applies to all of us, as each & every one of us have our own distinctive neuroses & dysfunctionalities (to different degrees!).

I love Monk! More, more!!!

English Lit.

The movie adaptation of Jane Austen's "Pride & Prejudice" will hit the local cinemas in December. I have already asked a couple of my ex-schoolmates if they would be interested in coming along with me to watch this chick flick (hubby had resignedly said,"If you really want to watch it, I will accompany you." Sweet intentioned that he is - hee hee - I won't submit him to the torture of sitting through 2 hours of Jane Austen's dialogue).

Reason why I am so keen to watch this is because I remember reading this book for English Literature, one of my favorite subjects in Secondary school. What made it even more fun was that some of us were assigned "roles" (characters) from the book, & we read out the dialogue as if we were acting out the book in a play. Reading this book brings back many enjoyable memories of reading & learning to appreciate the beauty of words & what emotions some words can evoke in me. I remember reading Poetry which could stir up emotions in me that I never knew existed!

Admittedly, Jane Austen's austere & rather long-winded writing style frustrates me immensely at times; and yet, I am still drawn to reading her books (as a matter of fact, I have all her novels); perhaps I am a masochist! I even have some of the previous movie adaptations (Sense & Sensibility, Emma) as well as the TV series version of Pride & Prejudice in which Mr Darcy was played by a rather wooden Colin Firth (highlighted in Bridget Jones' Diary).

Literature is no longer a compulsory subject in local schools, which is a pity. It is a shame that many of our children will not know writings of Shakespeare or Bronte or Austen, nor the poetry of Yeats or Keating. It is obvious that the standard of written & spoken English locally has deteriorated tremendously in the last decade or so. Someone in the Ministry of Education should realise that the study of a language does not comprise solely of filling in the blanks of Cloze passages (what the h*** does Cloze mean anyway??? Can't find it in any respectable dictionary!) & answering multiple choice questions. Children need to be exposed to the different forms of writing & not only will they grow to appreciate the power of language, but at the same time learn so much more about the world around us.

When my older son first transferred to the international school system after spending 5 years in the local system, he struggled with Reading & Language. Yes - this despite the purported high standard of English in the local schools. He realised that what he had been doing previously was just skimming the surface. In his new school, he had to actually read books, analyse paragraphs, and learn to use different tools in writing. It took him a couple of months to change his mindset as far as learning the language was concerned. And it is only recently that I see a change & vast improvement in his language skills when he had to review a poem (below) by Langston Hughes called "A Dream Deferred".

Not bad for a 13 year old, eh?

A Dream Deferred:
Why it’s Memorable

“A Dream Deferred” by Langston Hughes is very memorable because of its vivid, detailed imagery. His use of pauses and hyphens causes the desired, unsteady beat to create stress in the poem. For example, he put “Harlem” at the beginning, asks a question, and he has an off-beat question at the end and they all don’t follow any steady rhythm like the middle of the poem does. He probably did these things in this poem to show that a dream deferred is random and out of place. Hughes also used harsh “st” sounds and “s” alliterations to create undesirable images and slithering, flowing sounds to show slyness. For instance, he wrote, “Or fester like a sore – And then run?” this creates an ugly or even painful image of a sore in the reader’s head. Another example: he wrote, “Or crust and sugar over – like a syrupy sweet?” which creates an encroaching, slithering manifestation of a rotting candy. Using all kinds of devices, Hughes creates a lasting impression in the reader’s mind.

Harry Potter & GOF

Watched Harry Potter & the GOF tonight. Have mixed feelings about it. Loved the special effects, and the stars of the show did a wonderful job, but somehow felt like the movie had a rather chopped-up-then-put-together-again feel to it. I guess the director was trying very hard to squeeze all the important elements of the story into it, without ending up with a 4 hour movie! I wish that some of the supporting characters like Cedric, Fleur & Cho had been given more screen time & allowed to develop their characters a bit more. Even Snape didn't get to show his colors as much this time around. And Sirius was reduced to literally ashes in the fireplace in just one scene.

A-n-y-hoo, I think it's worth a second look (we are such movie buffs that we tend to go a bit overboard sometimes!) to catch some of the minor bits & nuances which we may have missed the first time around. Hmm...maybe will try Gold Class.

Of Witches, Wizards, Magic & Hogwarts

What is it about Harry Potter that draws grown-ups into his world & his adventures? We bought advance tickets for Harry Potter & the Goblet of Fire last week when the tickets first became available for sale. I am probably more excited about the movie than my sons! I have even marked the date on which we are watching the movie in RED on my calendar, that's how excited I am!

I bought the first Harry Potter book (Sorcerer's Stone) out of curiosity about the hoo-ha that surrounded its popularity. My older son was not even old enough to appreciate it at the time. My husband soon got drawn into it by the time the 3rd book came out.

I guess part of the appeal is the fantasy world of magic, where bones can be mended with a potion, or time can be relived using a magical necklace. It's a form of escapism from the real & often mundane world. Something about living in a boarding school also appeals to the teenager in me, who used to read the Mallory Towers series by Enid Blyton, wishing that I, too, could do the same.

I know that come Nov 18 when we are watching the movie, I will be on the edge of my seat with anticipation as the scenes unfold and JK Rowling's words are transformed into the images on the big screen. I also know that I will wish that the movie will never end - that's how it's always been in all the Harry Potter movies- and that the magic will somehow continue...but it never does, and eventually, it has to come to the bittersweet end.

Must-See TV...NOT!

I was appalled at the standard of a local TV drama series which premiered last night called "Lifeline", which is about a group of paramedics & police officers. I am all for supporting local talent if it exists! I wonder if the TV stations have quality control people who screen through the programs first before they are allowed to make the cut into prime-time!

I was cringing through the 1-hour episode with the wooden acting, poorly scripted dialogue, unimaginative storyline; even when the credits were rolling, the background showed a scattering of what was supposed to be ECG tracings (I think!) which looked more like the scribblings of someone testing out a pen at Popular (a local chain of stationary/book stores).

Sigh...local TV needs to be revamped, especially the programming. For the last decade or so, prime time slots of between 7.30 pm to 9.30 pm have been reserved for mainly locally produced comedies, reality programs & now dramas, while award-winning TV programs like Desparate Housewives, CSI, & previously X-files, E.R., Chicago Hope etc were relegated to late night slots of after 10 or 11 pm.


SOAPs are like DOPE

Do you realise that soapy dramas like One Tree Hill have an almost addictive effect on its viewers??? I watched one episode of this series (targeted mainly at the teenage female audience)during one of my "nothing-better-to-do" moments & was reluctantly, slowly, but surely, drawn into the convoluted happenings of this small town called Tree Hill. The story revolves around characters from the local high school - two of them, Lucas & Nathan are half brothers on the basketball team. They share the same father (Dan) whose brother (Keith) is in love with Lucas's Mom (Karen). There is a plethora of other characters like Jake (a single parent to an infant girl), Brooke (Lucas's ex-girlfriend), Peyton (Brooke's best friend whom I think had a fling with Lucas but I am not sure cos I wasn't watching the series when it happened), Haley (Nathan's girlfriend & now wife!) & Jessie (???I think that's her name??? - anyway she is the mother to Jake's baby girl). Latest cliffhangers in the season finale has Nathan's mom (Deb) having a one night stand with Keith; Lucas leaving Tree Hill with Keith; Dan having a heart attack; Coach Whitey (basketball coach) on the verge of discovering the diagnosis of his eye condition; Jessie trying to find Jake who has run off with their daughter after she threatened to fight for custody; & Haley & Nathan finally consumating their relationship after a quickie wedding. Confused enough??? My husband begged me not to tell him about the story ("No, no more...enough!!!") when I was trying to explain it to him while I was watching the taped final episode of the season. I think I will try to cold turkey myself off this series even when the new season starts....

Something's Gotta Give

A renowned advertising executive, Neil French recently resigned after creating an uproar over a remark made about why women don't make it to creative directorship. He said something to the effect that because of motherhood, women just do not have what it takes to get to the top of the heap in the advertising world.

In my personal opinion, his remarks probably holds true for many other professions, including Medicine. The demands & time needed to, first of all, complete medical school, then internship, and then possibly traineeship, are arduous & draining, both physically & mentally. I know that there are thousands of ladies out there who have become excellent clinicians and heads of departments, or set up their own GP clinics working morning noon & night for most of the week and at the same time, have managed to start families, balancing work & family life with amazing dexterity. But one wonders if the quality of life achieved is satisfactory, and whether their families (especially the children) suffer as a result of this tenuous balance.

We may want to be Supermom & Superdoc concurrently, & there are probably some women out there who can be both, but I think that is the exception rather than the rule. Like it or not, women ARE from Venus & men ARE from Mars, and apart from our physical differences, the psychological and emotional make-up of the two genders are very different. Somehow, when men are at work, they are able to focus totally on their job - forget about planning for dinner or whether the kids have homework, or whether the kids are revising for their tests/exams etc. Women, on the other hand, often times have to multitask - seeing patients, planning what's for dinner, making up a grocery list, worrying whether the kids are doing their homework...

I told my ex-boss once after lamenting about the shortage of doctors in our practice: it's tough hiring female doctors, isn't it? What with maternity leave and going part-time once the babies arrive, and children's MC etc... He just smiled & said "You said it, I didn't!" I guess many people don't voice out what is quite obvious in their minds for fear of repurcussions (a la Neil French). But we have to admit that something's gotta give...

Flame on people (:::putting on my asbestos suit:::)

Music & Magic

I brought my younger son, an aspiring percussionist in his school band, to watch & listen to the Cincinatti Pops Orchestra at the Esplanade Concert Hall, in the hope that seeing them perform will inspire him to greater heights with his music. I did not expect to be moved myself, but indeed, moved I was by the magic of movie music brought to life by an amazing orchestra.

The resounding percussion introduction of the theme from "Lawrence of Arabia" actually gave me goosebumps, while the theme from Star Trek: The Next Generation stirred up memories of this TV series - I think I watched every single episode of this sci-fi saga (sigh...I miss Capt Jean-Luc Picard & his crew...).

The versatility of this talented group of performers showed in their interpretation of music from Broadway (Cats, West Side Story), to Disney (Mary Poppins, Beauty & the Beast, the Mickey Mouse Club, to name a few) to epic movies (Star Wars, Harry Potter, 2010: Space Odyssey, Jaws, E.T., Lord of the Rings etc). Their encore finale of a Benny Goodman tune from the Big Band era almost had me Lindy-hopping in the aisles!

What a night it was.

Things that go Bump in the Night

I watched a pseudo-documentary yesterday about movie director M. Night Shyamalan, who has given us great thrillers like "The Sixth Sense" (my favourite of all his movies), "Signs", "Unbreakable" & "The Village". All these movies have the common theme of 'things are not what they seem to be'. The documentary, done in a very tongue-in-cheek manner, implied that Night himself 'sees dead people', much like the character, Cole, did in The Sixth Sense. Although I loved the movie, especially the twist at the end, it scared me to bits! Boy, was I glad then, that my night call days were over & I did not have to wander the hospital from ward to ward in the still of the night...

I have heard stories of certain hospitals here being haunted by spirits; unsurprising, as many of them were pre-war buildings, & were used during the Japanese Occupation for God knows what. One of these hospitals, apparently had hidden tunnels under its grounds, in which the Japanese invaders imprisoned patients & left them there to die.

Fortunately, I do not possess a sixth sense (thank God!) & would be totally oblivious even if an unsettled spirit waved its appendages in front of my face & did the mamba - a blessing, as once upon a time, I did have to wander through the dark corridors of an old maternity hospital to patients located in different blocks...it certainly had the right atmosphere for a horror movie.

Colleagues have told me that certain areas in certain hospitals are notorious for being "inhabited" by restless spirits, but I have yet to hear a first-hand account of such an encounter. So far, it has all been just hearsay. Maybe someone should compile a "True Hospital Ghost Stories" book.

We ARE Human After All

Recently, I attended a lecture by an eminent professor who spoke about medical errors and its impact on not only the patients but also the doctors & healthcare professionals who treat them.

The topic of Medical Errors is an important & interesting one, which was brought to the forefront after the report ”To Err Is Human” from the Institute of Medicine in the USA in 1999, which highlighted the alarmingly high mortality rate & cost of adverse events.

Doctors, nurses & other healthcare professional do not go to work everyday with the intent to kill/maim/injure their patients. We are not God (although some may believe & behave like they are), and human error is inevitable. It is a fact of life. Misdiagnoses, missed diagnoses, mis-treatment, omissions of treatment all happen. Is it avoidable? Absolutely.

A huge first step needs to be taken in changing the climate of fear that surrounds every medical error that happens now. The first reaction (after correcting or attempting to correct it) is usually one of how to cover up the fact that the error had ever occurred in the first place. There is usually a blame fest that surrounds such an error, with fingers pointing every which way. This culture of blame needs to change within the medical community, first, before systems & processes can be put in place to address the problem. Without the fear of punitive action, people would be more willing to identify errors or near misses. After all, if you don’t know where the problem lies, how will you correct it? Currently, who would dare to report the problem for fear of being blamed for the problem in the first place. A vicious cycle, eh? And how would the person who made the error feel? Pretty damned awful.

Now, what systems am I referring to, you may wonder. An excellent example that was given by an expert on patient safety is that of the ATM machine. Previously, people would often leave their ATM cards in the machine after withdrawing their money. So a system was put place whereby the machine would alert the user (with an incessant beeping) to retrieve his card from the slot before issuing the cash withdrawal & receipt. It is almost impossible for the user to leave his card there now, as the machine WOULD NOT proceed with the transaction until the card had been retrieved.

The aviation industry has improved by leaps and bounds as far as safety is concerned, and is often used as the gold standard. So why can’t similar systems be put in place in the healthcare world to minimize risk of errors? In fact, many healthcare facilities in the USA, the UK and Australia have done so with encouraging results.

Here’s a little factoid for you to mull over: the chance of you dying from a medical error in a hospital is higher than you dying in a plane crash or from a nuclear accident. That is to say, being a patient in a hospital is more dangerous than flying in an airplane or working in a nuclear plant – think about it…

It’s time to start making changes, and accept/admit the fact that mistakes do happen in the practice of medicine. We are, human, after all.

Racism & Medicine

Racism reared its ugly head recently in the news, when two bloggers were charged with putting up racist remarks on the Internet. I wonder how many doctors have encountered racism in the line of duty. Don’t get me wrong, I don’t believe that racism is a huge problem here, but I think that racial intolerance does exist even in this so-called multicultural, multiracial country. Usually this is subtle but I have come across overt racism against physicians.

I know of instances in which patients request NOT to consult with a certain doctor because of his/her race (and it was NOT even a language problem because the patients spoke English). This happened in a GP setting in a multi-doctor clinic, and I am pretty sure that this has happened in the hospitals & specialist clinics as well. I am not sure how other clinics or hospitals would handle something like this, but at this place, the clinic acceded to the patient’s request. And this was not an isolated incident. Unfortunately, many local organizations are not progressive enough to face up to such behavior, for fear of losing the business of the clients. Basically, they have sold their soul.

From another angle, I was once accused of racism by a patient and that the medical staff was treating him differently because he belonged to a minority race. Now, being accused of racism by a rather inebriated patient in the wee hours of the morning at the Emergency Department wasn’t something I was going to take lying down. I replied civilly but indignantly to this gentleman that it didn’t matter whether he was black, purple, green, yellow, brown or white, he would be treated just the same. He clammed up after that.

What would you do if you encountered either of the situations above? What would your employer or the institution that you work for do? Would you treat your patient any differently because of his racist attitude? As for me, in the first situation of knowing that the patient is racist, I treated the patient’s medical problem, as I would any other. However, I admit that my behaviour towards this person was colder than normal although I did not go as far as giving a lecture to the patient about racial prejudice. I felt that if I had done so, it might have compromised the doctor-patient relationship.

What would you do?

Ethical Aesthetics & Lifestyle Medicine

I'm sure many have heard of the term "Lifestyle Diseases" - conditions like Diabetes, Hypertension & even Obesity which can be contributed by factors like sedentary lifestyles, bad dietary habits etc.

The term "Lifestyle Medicine" came to mind when I noticed the increasing number of physicians catering to people looking for medical means to "correct" imperfections, be it wrinkles, freckles, love handles, cellulite, flabby thighs (you get the picture). Don't get me wrong, I am not trashing Aesthetic physicians or plastic surgeons; I believe that it is their prerogative to assess and treat these patients if they feel that there are benefits, and I believe that most are ethical & make the right decisions.

However, when I read about things like 'Mesotherapy', 'Carboxytherapy, 'Laser Lipolysis' (not cheap procedures, by the way!), I start to wonder at the true efficacy of using these methods to "treat" patients. The thought of fat being dissolved by lasers/chemicals delivered to the subdermal layers to be subsequently removed by one's own body sounds too good to be true (unless one was living in the Star Trek Universe. I have always wished that we had one of those tricorder devices used by Dr Beverly Crusher in the Star Trek:The Next Generation TV series whereby she could diagnose an illness just by waving one of these thingeys over the affected body part -cool!- but then I digress...).

I hope that these physicians also advise their patients that if they continue with their previous lifestyle habits (not applying sunscreen, not eating right, not exercising regularly), these "conditions" would, more than likely, recur & require more treatments, which means more moolah spent (and correspondingly received)...food for thought, eh?