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.

Memoirs of a Geisha (which I think, should have been renamed Memoirs of Bitchy Geishas)

Just caught the above movie tonight. Haven't read the book yet, so maybe that's why at the end of the movie, I didn't quite get the point of the movie. That geishas have hard lives? That love triumphs in the end but you still may not get the guy? That women can be real bitches? (I think the last point stood out the most, with all the catfights & backstabbing shenanigans that was going on throughout the movie).

Zhang Ziyi did a great job, as did the young actress, Suzuka Ohgo, who played the younger version of Chiyo. Felt that Michelle Yeoh's performance was lukewarm, and she sounded rather out of place with her semi-Japanese semi-Singaporean accent. Gong Li as THE bitchy geisha also played her role well. There was also a hodge-podge of other Asian actors (my husband & I call them the recycled Asians, as they take turns appearing in various movies & TV series as the token villian/Asian gangster/gung-fu master/wise old man, such is the sad state of affairs for Asian actors in Hollywood)). Ken Watanabe, as Chiyo's love interest gave a credible performance. What stood out for me, as far as the acting talent was concerned, was that it was understated, which was refreshing; many Chinese/Asian movies tend to have overly done, melodramatic performances by its stars, & this was a nice change.

Was it a good movie? Yeah, I think so - wonderful cinematography, costumes & make-up, which should garner it some Oscar nominations in their respective categories. Didn't think too much of the storyline though. In any case, it was interesting watching an ex-patient star in her first BIG Hollywood production...

Now I need to decide whether the book is worth reading or not...

Patient Safety

Thank you, Dr Kee & Dr Lee for voicing so eloquently, their views about changes that need to happen in order to improve clinical quality. I wish that these letters had been printed in the newspaper, with a greater audience, instead of just on the online forum. It would be one small step towards a greater understanding by the general public that medical errors do happen but a great deal can be done to reduce risk of these errors happening.

It will take a nudge from the people to get The Powers That Be to get things moving in the right direction where this issue is concerned.

Stee-rrrike!

I put on a softball glove, & picked up a softball bat today for the first time after a lapse of almost 20 years. I can already feel my muscles protesting & I dread tomorrow morning when I am SURE that I will have trouble crawling out of bed...groan.

In medical school, I played softball for my year (remember the FMS shield? Hmm, I wonder if the annual competition is still being held, with the grand finale of a play which made up a huge chunk of the total score!), & also for the faculty. It was always the same group of people taking part in the various sports. I, myself, not that I am a great athlete, did softball, tennis, squash (go figure) and basketball, in addition to lending a hand in making the props/costumes for the play.

I remember in our final year, everyone was very "boh chap" about taking part in the FMS games because we were all panicking & busy trying to revise for the finals. So not surprisingly, our year was at the bottom of the scoreboard once all the games had been tallied. All that was left was the final play.

24 hours before the day that the plays were supposed to be performed, the "usual" group of us decided, what the h***, this is our final swansong, might as well go for it. A very talented classmate put together a play, inspired by the successful British comedy "'Allo 'Allo", with music & lyrics even. We rehearsed into the wee hours of the night, put together a medley of costumes (some loaned from the Franciscan monks!), & used minimal props for the performance.

Well, guess what? We won the Play section of the competition! Quite unbelievable, eh? I think our juniors must have been pretty pissed off! Unfortunately, because of our "poor" performance in the sporting events, our overall score only managed to get us 2nd place. But we were happy anyway. Nothing beats the euphoria of putting together a successful performance.

Come to think of it, I think the most enjoyable times of med school were actually the extra-curricular activities!

S, M, L, XL

God.

I hate clothes shopping in the local stores. Talk about a blow to one's self-image. Most of the clothes seem to be made for stick-thin models. Looking for new clothes for Chinese New Year here is an annual nightmare. The "Women's Plus" sections have clothes seemingly designed for the fashion impaired. The "Normal" sections have clothes which would probably fit just one limb on my body.

Not that I am morbidly obese - I shop in the "Regular" sized departments in the US. I guess being born with a genetic disposition to being "big-boned" in Asia is a real detriment as far as trendy clothes are concerned.

Oh well, come summer, Woodbury Commons, here I come!!!

simple pleasures

~ hugs & kisses from your child/children

~ finding life in a rock pool at low tide

~ the smell of a freshly bathed newborn

~ reading a good book while enjoying the ocean breeze & sounds of the waves crashing

~ discovering the first daffodil shoot peeking through the soil in between patches of snow in the waning days of Winter

~ coming home to your own comfortable bed after a vacation

~ laughing till tears roll down your cheeks

~ a girls night out with your best friends in the world, reminiscing about school, teachers & life in general

~ the first snow of Winter

~ the long days of Summer, when you can still enjoy daylight at 8 o' clock in the evening

So romantic, can die

Call me crazy, but I sat through a second viewing of "Pride & Prejudice" today, and liked it even better the second time around. Matthew Macfadyen as the dashing Mr Darcy certainly grows on you, as I had said before. There's just something about the Mr-Darcy-striding-through-the misty-meadow-towards-Elizabeth-Bennet scene that stirs my innards. *YUM*

After the last couple of weeks, I needed a "feel good" movie, and nothing lifts the spirits up like a good old historical romance with a happy ending.

Footnote: They showed the "Coming Soon" trailer of "Casanova" starring Heath Ledger & Sienna Miller- hmm...looks like my cup of tea :).

Hormonal Swings

Well. So much for the life changing event. It’s not going to happen after all. I must admit that I am a bit disappointed. This seemed like the last chance for us after all. Oh well. C’est la vie, as they say. At least I won’t be peri-menopausal, and post-natal at the same time. I am sure that many women out there will agree with me that hormones are powerful things & can produce all kinds of strange emotional reactions/responses/behaviour when they ebb & flow like the tides.

When I saw that second stripe appear on the test kit two weeks ago, my heart truly felt like it sank into the toilet bowl upon which I was sitting at the time while waiting for the result. It was a total shock. Why did I do the test? Well, any self-respecting doctor would tell you that one of the first things one has to test for in a female of child-bearing age who is overdue (no matter which end of the spectrum she happens to fall into!), is for pregnancy. So, as per my own medical know-how, I dutifully went out & bought one of those generic tests, not expecting to see a positive result at all. After all, I have been experiencing what I thought were peri-menopausal symptoms on & off for the last year (although I am rather “young” relatively, but still…) or so I thought. But this particular episode of amenorrhoea had gone on for a bit longer than usual, and hence the saga began.

In my mind, my family is complete. Hopes of having a third child had diminished after a prior blighted ovum & with advancing age. I had given away all the baby stuff, which I had stored & carted all the way from the USA with the intention of re-using them one more time. We have two great kids, had started planning for college for them, & had just gotten rid of the MPV.

So when the positive test came about, it really threw me for a loop, to say the least. It was a conflux (read: conflict + flux) of emotions; I was shocked, petrified, happy, anxious, cautious all at the same time. Thoughts of night feeds, diaper changes, strollers, weaning, toddler tantrums came flying through my mind simultaneously…with the associated flash of panic & depression. I was then cautiously happy but not hopeful, as the symptoms did not feel the same as when I was pregnant with my 2 boys. Much like with the previous failed pregnancy, I didn’t have the hyperemetic feelings, though there were fluctuations of appetite loss & occasional nausea. There was also the strange hypersensitivity to the smell of garlic (!!!).

I think when you, yourself, are the patient, being a doctor is a curse. You know too much. You know & can research into the risks & possibilities & complications of whatever medical condition you have (in this case, being an elderly multip – yeah, sounds awful, but that is the term used for pregnant moms above 35). And true enough, subsequent scans showed a non-viable pregnancy. My gynae said that most commonly at my age, this is caused by a chromosomal abnormality like trisomy 21. It was probably better to lose it now than to have to go through amoniocentesis & find out in the 2nd trimester.

I know it may sound cold to some, but I have tried to remain detached emotionally from what has been happening, in preparation for the ultimate diagnosis. Call it intuition, a “feeling”, a sixth sense, but deep down inside, I just knew that it wasn’t meant to be. So, no, I don’t feel depressed by what is happening. Admittedly, I’m a bit sad for the baby-that-never-was, & for unfulfilled hopes that have been re-awakened. But I know I will get through this. We, women, are resilient creatures!

Eating Wind

To those who have been wondering if I have dropped off the face of the earth, please be assured that I am still around & have not gone over to the Dark Side :). This especially so after my last rather cryptic post.

Reasons why I haven't been around are:

a) Have been chillin' out on a nearby Indonesian island for the last week;
b) Been dealing with a potentially life-changing event which caused
c) Writer's Block

Thankfully, I think I am over (c); (b) I am still dealing with & may write more about in a later post if I feel up to it.

As for (a), I admit that I would have enjoyed it more if I were still working full-time :). I think it is true that we don't appreciate what we have until we don't have it, in this case, leisure time - to just laze by the pool/on the beach/in the spa. Eight months ago, I would have enjoyed this holiday a lot more, eager to leave the hectic deadlines & rat race of work & just doing absolutely nothing. I know that my kids enjoyed themselves just being in the pool as they had worked hard all semester in school. Hubby the workaholic was happy just hanging around the hotel, & having aromatherapy foot massages, and not having to answer phone calls & emails.

Maybe it's time for me to start looking at going back to work....well, at least on a part-time basis...I guess a "tai-tai"s life is not for me.

GREY'S ANATOMY

I taped the 2nd episode of this new series & just watched it tonight. I must say that this was definitely a more uplifting episode than the 1st one. Seeing Meredith Grey turn around from drawing lines between herself & the rest of the world, to drawing people into her circle was refreshing. This episode certainly reminded me that the practice of medicine can do some good after all, especially if we practice medicine for the sake of the patients.

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?

Michael Buble's concert was a Blast!

Talented, charismatic, good-looking and personable, this dulcet-voiced cutie-pie gave his all & more at his concert tonight! He charmed us all, male & female, with not only songs from his albums but treated us with a touch of opera and a little bit of rock 'n' roll.

Thanks, spacefan, for going above and beyond and getting me a program autographed by Mr B. himself! It was great to meet you finally. I am sure you will be giving us a brilliant review of the concert & a detailed blow-by-blow account of your pre-concert meeting with him (you lucky devil, you!).

Weighty Matters

Have you noticed how many ads there are in the newspaper/TV/magazines for weight loss centers lately? Most of the models used for these ads look underweight - BMIs of probably less than 17! The use of popular TV celebrities for such ads is also very common, despite the fact that these personalities were probably not in need of weight loss in the first place.

Growing up in the 70's & 80's, the obsession with weight (or the lack of it) was already rampant, and I've always had to deal with the "overweight" issue, no thanks to thoughtless comments made by well-meaning relatives & friends. I look at photographs of myself in my mid-teens & to my present self, I looked skinny!!! Fortunately I did not become bulemic or anorexic, but I do believe that I had suffered from a mild form of body dysmorphism, thinking that I was something that I actually wasn't. I only became comfortable with my self after moving out of this country & living in the USA for several years. It was somehow "more acceptable" to be heavier than the so-called beauties that one saw in ads & on TV.

Moving back here again, not only was I inundated with all these images of skinniness that one is supposed to strive for, but shopping in the stores for clothes which actually fit was a nightmare & absolutely depressing. The only clothes which could fit a size 14 (considered "normal" sized in the USA) could only be found in the Womens Plus section. And these clothes were not exactly the epitome of fashion either.

A few years ago, a local celebrity almost lost her life when her liver failed due to her taking a weight loss supplement that was hepatotoxic. She did not appear to be overweight in the first place, but probably under pressure from her peers or from her job requirements, she started taking these supplements. Fortunately, she survived after a liver transplant.

At that time, I thought that it would be a wonderful platform for someone like her to promote being healthy (having learnt her lesson which almost cost her her life) instead of chasing that never ending goal of looking like the models in a fashion magazine & being obsessed with reaching a BMI of less than 17.

Unfortunately, that did not happen & the next thing you know, she appears in ads as a spokesperson for a weight-loss center.

Adolescents these days are faced with so many societal pressures, especially the girls - I wonder what it will take for that all-important wake-up call that health and a good self-image is more important than being skinny. I wish that the media & celebrities would take a lesson from Dove's Campaign for Real Beauty, and start sending the message that self-worth does not depend on what you look like, how large or small you are, what colour your skin is, and how old you are; I know it's cliched, but it's what's inside that counts.

RENT!

Yeehah! Just booked excellent seats to this award-winning Broadway musical that will be performed here. During our many visits to the Big Apple, hubby & I would often say "Hmm, maybe we should catch 'Rent' this time." but we never did. With 2 kids in tow, and given the exorbitant cost of Broadway tickets so that we had to think of the most "cost-effective" way of the whole family enjoying the theatre experience, we always ended up watching more age appropriate performances like "Grease" or "Stomp" (which are both excellent performances as well, by the way). And when we do try to get tickets, it's perpetually fully booked.

But now it's coming to our neck of the woods, & I HAVE TICKETS {jumping for joy!}!!!

One other great thing about this performance is that it is supposed to be direct from New York (although it is also featuring an Asian actress/singer) so I don't have to struggle with understanding Australian accents - historically, "Broadway" plays which come here seem to be mainly produced and performed by Australian casts (nothing against Australia - beautiful country, warm & hospitable people; just darned difficult to understand their speech:)).

A Doc's Life - Memorable Moments 10

This is my final installment in my mini-series of Memorable Moments. Note that these moments occurred over a span of over one & a half decades, and I hope that I haven't given the impression that a doctor's life is full of these "unusual" happenings :). In most cases, a doctor's life is usually routine, oftentimes mundane, and not as glamourous & "happening" as portrayed in most TV series & movies...

Scenario: GP clinic

I am sure that a lot of doctors out there have had the experience of meeting with rather ignorant patients not being terribly clear about their medical conditions & treatment. Eg, when asked about what kind of medication they are taking for diabetes/hypertension/arthritis/gout/heart problem, they reply "One round white tablet, half a blue oval one, & a small red one" like we are supposed to know what kind of medicine they are referring to just because we are doctors).

Patient was an elderly gentleman who was there for a medical examination for insurance purposes. He was accompanied by his wife & son. I took the usual medical history (nothing significant, according to the patient & his family).

When I exposed his abdomen, lo & behold, there was a mid-line abdominal laparotomy scar, at least 8 inches long! The following exchange ensued (note: patient's dialogue has been translated from a local dialect into English, so pardon the glaring grammatical mistakes):

Me: "I thought you said that you had no surgery done before? What was this scar for?"

Patient (grinning):" Oh, small thing only lah. 16 years already - not important!"

Me: "This is a very big scar. Didn't the doctor tell you what was wrong with you before you had the operation?"

Patient (gleefully): "No lah, doctor say cut so I go and cut lor!!!"

I was speechless.

A Doc's Life - Memorable Moments 9

Scenario: GP clinic in the heart of town.

Patient was a lady in her mid-40's complaining of a vague vaginal discomfort of 2 weeks duration. No significant medical history of note; menstrual history was also normal, with LMP 2 weeks prior to consultation.

After taking her history, I proceeded with an abdominal examination and then a PV during which I was surprised to feel a firm irregular mass in the posterior fornix of the vaginal vault. Thoughts of "tumor", fungating mass" etc ran through my mind, but I didn't want to say anything until I could visualise it. I proceeded with a speculum exam & saw a brownish colored FOUL SMELLING mass with a tail - it was a retained tampon (her LMP was 2 weeks prior, which allowed for Lord knows what kind of micro-organisms to proliferate in that very fertile medium...).

The patient was shocked when I told her what it was, & I could tell that until I actually showed her the offending object, she could not believe that she had forgotten to remove it.

My consultation room smelt like something had died and was decomposing, even after the patient had left; and we had to allow it to air out for several minutes, spray plenty of air freshener before it was fit for occupation again. The last time I had experienced something so malodourous was as a medical student doing the forensic path posting and had to undergo the "traditional" exposure to a decomposing body - that smell just sticks to your clothes for the rest of the day...

A Doc's Life - Memorable Moments 8

Scenario - Labour ward of a teaching hospital

I had just helped bring into the world a healthy baby, and had delivered the placenta. I was repairing the episiotomy when suddenly, I hear a "PLONK" of something dropping on the floor behind me.

"Did you drop the baby???!!!" I yelled at the nurse in panic, in the middle of a stitch.

"No," the nurse replied calmly. "Daddy just fainted" she continued matter of factly (I guess it was a fairly common occurence for the men NOT be able to take the bloodshed, gore & trauma of childbirth).

I had to check Dad for head injuries (fortunately, he was fine) after finishing the repair.

I have always known that men are not as macho as they'd like you to think. Somehow, the sight of the episiotomy & the placenta being delivered are the things that tip them over...

A Doc's Life - Memorable Moments 7

Scenario: Local teaching hospital - Internal Medicine ward

My first encounter with death. I was an intern, and medical school definitely did not prepare me for dealing with death, the dying & their loved ones.

The patient was a 40+ year old lady with advanced CA Breast that had metastasised to her lungs. Despite the oxygen mask, she was gasping desparately for air. Her pre-teen daughter was at the foot of the bed, crying; her husband was at her bedside, crying & pleading with his wife to "hang on, fight it, fight it..." Before our very eyes, she was being asphyxiated by the cancer cells that had taken over her lungs.

I wanted to yell at her husband to stop, to comfort his wife instead of asking her to struggle on, I wanted to cry with the daughter, but it was not my place to do so...I had to leave the room to compose myself before I broke down. I did not re-renter it until the patient had passed on. Fortunately, I had an understanding MO.

A Doc's Life - Memorable Moments 6

Scenario: Largest maternity hospital in the local scene; I did a 6 month rotation through the Neonatal ICU.

I saw and did things which I would never have imagined if I hadn't gone through this posting. Among the unforgettable are congenital abnormalities some of which I would be unlikely to see again in this lifetime.

SIRENOMELIA: Or the Mermaid Syndrome. This baby was a BBA (our acronym for Born Before Arrival), still birth, born to a Malay family. It (unclear of it's gender) had just one fused limb with a single toe. The upper half of the baby looked absolutely normal.

CUTIS APLASIA: The baby was literally born without any skin. According to literature, this rare condition usually affects part of the body, most commonly the scalp. However, in the case that was admitted, the ENTIRE baby had no skin. He was covered by a thin transparent glistening membrane. You could see his muscles, superficial blood vessels etc. We kept him as comfortable as possible; setting an I/V on him was a nightmare. He survived for 3 days before passing away.

ANENCEPHALY: This was an undiagnosed case, because of lack of antenatal follow-up. The baby was a stillbirth.

ACHONDROPLASIA: This was also undiagnosed antenatally, despite adequate follow-up. Understandably, the mother was depressed. We kept the otherwise healthy baby boy in the ward longer than normal to prevent the parents from doing anything "drastic" in the immediate post-partum period, and arranged for them to see a counsellor.

One of the most heart-wrenching, gratifying, stressful, tedious tasks we had to perform was the resuscitation and intensive monitoring of premature babies, some as small as 700 grams. Blood gases, electrolytes, parenteral nutrition all had to be closely watched to keep them alive. It became a bit of a moral dilemna for me after watching the effects of surviving prematurity: CP, BPD, developmental delays, mental retardation (some more severe than others). Was it worth saving their lives? I had to accept that the moral decision was not mine to make; as doctors, we were there solely to save lives when called to do so. There was even one instance of a mid-trimester TOP who called for the NICU MO-on-duty (moi) to go to the gynae ward to resuscitate the 23 week old fetus who had been expelled & was actually crying! This little life clung on for 3 days before letting go...It was hard not to weep with the mother, who, for whatever reason, had to go through this ordeal and live with her decision.

This posting was the most stressful and at the same time the most enriching one I had gone through. Not only did I learn so much about the resilience of babies (they are not as fragile as one might think), but it would later serve me well for my adventures as a new mom (I did not become one of those panicky moms who would call the pediatricians when Baby refused to stop crying/refused to suck/poo-ed too much/poo-ed too little). And in the rare free moments, the nurses taught me how to feed/burp/bathe the babies - this definitely was good practice!

A Doc's Life - Memorable Moments 5

Scenario - Orthopedic Dept of a teaching hospital. Patient is a young gentleman involved in a RTA.

This happened midway through my Orthopedic rotation as an intern. It was early in the morning when this patient was admitted through the A & E department. He was a motorcyclist who had skidded and ran into a roadside barrier.

His right knee had been almost totally amputated, and was literally hanging by a skin tag posteriorly. The tibia/fibula had been avulsed from the femur - we could see the glistening white femoral cartilage of the knee joints. It had been so "cleanly" (for lack of a better word) torn off that not even the meniscii nor the cruciates had been left behind.

The team tried to reattach the limb but unfortunately, by the 3rd POD, it was obvious that the distal limb was not going to survive, and had to be amputated. Understandably, this young man at the prime of his life developed clinical depression and had to be transferred to the psych ward later.

During my Ortho postings as an intern as well as an MO, I saw countless injuries, some mild, some fatal, due to motorcycle accidents. I decided then that no child of mine, nor family members, nor friends would get on a motorbike, if I could help it.

Terror Strikes Again

Bali, once a haven & paradise destination for thousands of tourists, has again become a victim of religious fanatics. What makes someone become a willing participant of such an awful act? And I am not talking about just Muslims. Other religious extremists like Christian white supremacists are just as guilty.

If a psychiatrist interviewed a group of such people, would he find that they have some kind of neurosis/psychosis? I just cannot believe that a sane person would do something so vile. I NEED to believe that mankind is not that cruel.

A Doc's Life - Memorable Moments 4

Scenario: Emergency Dept in a small suburban hospital (refer to earlier blog on MM1) at the end of a particularly busy shift.

The hospital operator calls the A & E department to inform us of an incoming patient in labour being driven to the hospital by her husband. Note: this hospital has no O & G Department as it had been recently transferred to a larger maternity hospital. There were also no neonatology facilities.

I was the only doctor on duty that had experience in O & G as an intern, and had also done a rotation in the Neonatal ICU as an MO, so tired as I was, I gowned up in preparation for the patient's arrival. Fortunately, we were equipped with an obstetrics kit.

When the car arrived, I found the mother in the backseat, with the baby already delivered, and apparently healthy (to my relief), still attached to mum. Dad was understandably in an anxious state. I had to go into the backseat area to cut the cord so that mum could be transferred into the hospital where I delivered the placenta, and repaired the small perineal tear. Fortunately, I had delivered enough babies during my internship posting to remember how to check the placenta, secure hemostasis and do the repair.

Mother & child were both well, when we later checked with the maternity hospital which they had been transferred to later, and the labour ward staff were apparently very happy that I had done them a "favour" by repairing the tear for them!

As for the car, I have always wondered what Dad did with the amniotic-fluid-soaked backseat...

A Doc's Life - Memorable Moments 3

Scenario: Health screening facility (same as in MM 2)

This is not quite medical related but it left a mark because it was my closest brush with the showbiz world so far :)

Celebrity 1 - a world renowned movie star from a country in Asia. Very pleasant lady, down-to-earth, with none of the airs one would associate with mega-celebrity-dom. She looked exactly like she does on the big screen. Pity that my fluency in Mandarin is so lacking, and my interaction with her was purely business (i.e. health screening related); it would have been nice to have chatted with her about life as a big-time movie star. But then I am not the sort who would fawn over a star (well, I might make an exception for Tom Cruise or Brad Pitt - hehe). The other staff WERE fawning, and posing for pictures with her etc etc.

Celebrity 2 - not so well renowned the world over; more on the local scene. Rather introverted but pleasant enough, I suppose. Can't blame her for wanting to keep to herself, given some of the crazy fans who can "stalk" their idols. Didn't really know her marital history too well (I am not a huge fan of the local Chinese dramas) so I think she was surprised when I asked her during history taking, what her marital status was. :)

Other "celebrities" I have come across during my time with the corporate practice included MTV VJ's & some local "stars" whom I had to do pre-employment checkups on. Some were more full of themselves than others - I think I probably put them down a peg or two with my ignorance of who they were until after they had left the clinic, my more star-strucked assistants enlightened me on whom they were and what shows they starred in.

I wonder if my reaction would have been the same if someone like Tom Cruise walked through my clinic doors for a consult...

A Doc's Life - Memorable Moments 2

Scenario: Health Screening facility in the heart of the business. Patient A is a SYT (Sweet Young Thing) who is there for a medical check-up - part of her benefits from her company who has signed up for standard package deals for their staff.

As part of the check-up, PAP smears are also included for ladies who need them. I routinely ask them, during history taking, whether they are married or sexually active, before informing them of the neccessity of doing the PAP smear. Ladies who are VI(virgo intacta), I tell them that they don't need to have it done until they start being sexually active.

Me: " I see that you are single; are you sexually active?"

Patient A (bashfully):"No."

Me:" OK, so you don't need to have the PAP smear done today."

Patient A (anxiously): "But isn't it included in the package?"

Me:" Yes, but only married ladies or ladies who are sexually active need this test done. Since you are neither, you are not at risk. Moreover, you are a virgin and doing the test would be extremely uncomfortable or even painful."

Patient A:" But since it's included, I might as well do it."

Me:" You really don't need to, you know." I follow on with a short explanation about the discomfort & possible bleeding that can result from the smear.

Patient A:" Never mind - I want to do it since it is paid for already."

After noting in the case notes that the patient insisted on the test being done despite explanations, I proceed with the procedure at the end of the check-up. Needless to say, it was not a terribly pleasant experience for Patient A...I will leave the nasty details to your imagination...

Sigh...a fine example of the Singaporean trademark of kiasu-ism.

A Doc's Life - Memorable Moments I

Scenario: 7 year old boy, admitted to the Emergency Department of a small suburban now-defunct Hospital on a sweltering Saturday afternoon.

This little chap had the misfortune of catching his unprotected foreskin in the zipper of his shorts. Now, I don't know why, but in the local situation, many parents do not seem to see the wisdom of having their young sons put on underwear thereby exposing their nether regions to the hungry teeth of zippers.

Anyway, usually, with such patients (& I had seen a few, young & not so young), I'd apply some topical LA (for what it's worth :), probably more for its psychological benefits than anything else) wait 1 minuntes, then yank the zipper loose and "Voila", the member is free with nothing more than a mild abrasion. The patients would then be sent home with some topical antibiotics without further ado.

In this case, however, and exceptional large piece of foreskin had been caught by the zipper (sorry guys, I can imagine the winces and thighs clenching together) and the aforesaid method did not work. I must admit that this patient was extremely brave and did not cry a tear.

Undaunted, I asked the nurse for a pair of forceps, hoping that I would be able to pull off some of the zipper's teeth, hence freeing the patient's organ. Now, this was a particular busy Saturday afternoon, with many patients and staff outside the treatment area (separated by a curtain). There I was, sweating buckets, trying my damnedest to loosen the darn zipper, and the boy yelling at me,"Don't touch my penis!!!" repeatedly, and me responding," I am NOT touching your penis!". I wonder what the other patients must have been thinking...

Unfortunately, my attempts proved unfruitful, and the boy had to be admitted to the Surgical Department, where, apparently, even under GA, the surgeons were unable to remove the foreskin from the zipper. The patient ended up with a circumcision.

The Force is With You

Patients, my young Padawan, will prove to be both the reason AND the bane of your existence. They will be the ultimate test of your abilities to resist the Dark side.

You will face the challenge of remaining calm when faced with a storm of demands from multiple patients and their families.

You will face the temptation of profiteering by selling generic drugs at brand name prices.

There will be times when you will feel the urge to succumb to the Darkness called MHCs.

There may even be times when you will feel overwhelmed by Anger & Frustration as you try to deal with these entities called Patients who will test your endurance to the limits with their unending questions about their ailments, and demands for cheap and immediate treatments for their illnesses.

Remember to take a step back, breathe deeply and focus on the reasons why you took the steps towards becoming Medi Masters at the Beginning of your Journey. Find strength from within and from the Force of the Hippocratic Oath and remember the Medi Masters of the past who have had to deal with greater Patient loads than you.

May the Force be with You.

"Must-see TV"

LOST
This series is like quicksand: it sucks you in bit by bit, week by week, till you are stuck and enmeshed in its sometimes complicated plots & flashbacks. My favourite character is Locke - the ex-paraplegic with an astounding knowledge of weapons & the art of survival, who mysteriously regained the function of his legs after the plane crash. I can't get away from watching this!

CSI (the original series)
Somehow, the characters from the original CSI (based out of Vegas) are more appealing with their quirkiness & idiosyncracies, especially Grissom. I must admit that it took me some time to get hooked to the series.

Las Vegas
A light drama, not terribly imaginative with its stories, but its fast pace & unique camera work & editing is addictive. Plus its characters are appealing, with eye candy for the guys as well as the girls (Josh Duhamel - yum).

House MD
The latest medical drama, which I believe has garnered a few Emmy nominations. Appealing to me as a doctor because its main character voices out loud what many doctors keep inside...their true feelings about some of their patients and the practice of medicine today. Hugh Laurie does a great job in the lead; it is hard to believe that he is actually British.

Gilmore Girls
This much ignored series has wonderful dialogue with lively exchanges between Lorelei & Rory Gilmore (mother & daughter). It makes me wish for a similar relationship with my own mother...

AGING SUCKS

I am beginning to feel more aches and pains these days. No matter that I didn't too anything extremely strenuous; it could be just from sitting or lying in one position for too long. The MCP & IP joints of the fingers are also feeling it. I tried playing the piano after long years of not touching a keyboard - my fingers didn't feel like my own. I used to be able to do scales & arpeggios like nobody's business. Sigh.

I played tennis with my boys a few weeks ago. OMG, when I tried to hit a ball overhand, I felt something pull on the right side of my back, snapping like a broken string of a guitar. Thank God the pain was only temporary. But it made me realise that my body is aging faster than my mind. Sometimes, I still feel like the teenager who used to play tennis for ECA.

The eyes are also starting to go. Reading the road directory is a chore now, especially the street names. And trying to read the lipstick color off the base? Fuh-get it. I can still read the newspaper...but I know I am fighting a losing battle & will need reading glasses in the coming year or two.

Sigh.

Circumstances

My niece has been groaning & moaning about school & the system. She wants to join a school that offers the more well-rounded IB program but cost is a huge factor as my nephew is already attending it. Her mum can't afford to put both kids in there, & out of her 3 kids, My niece is "the one most likely to survive the local system". Unfortunately, this will probably mean that she will end up in the local uni with its straight laced programs & parroting form of learning. Hopefully she will choose to major in something that will allow her to widen her horizons after she graduates.

I feel melancholy when I heard the phrase in bold above, not that I fault my sister at all. But I was in the same position as my niece during my schooldays. As the "brainiac" of the family, I made it into JC & then in NUS. Not so for my sis & bro. Because of their "lesser" academic abilities, they were given the chance to pursue their studies overseas & in "alternative" albeit more expensive methods. My parents could not afford to do so for all of us.

Ironically, I found myself trapped in a system that did not encourage me to explore & stretch myself, & subsequently, followed the safe & tried route of becoming a well-respected professional. I can't say that I made the wrong decision in my choice of career, as I made the best decision I could given my circumstances & what was available to me at the time. But I want & hope that my own children will be given wider choices as they develop & find themselves. Hopefully, they will end up doing what they love & have a passion for, and be able to earn a living doing so.

Hence all the sacrifices that A & I are willing to put up with, in placing them in an excellent international school with a curriculum & teachers which even the local university would envy.

I can't help but find myself wondering "what if"...if I had been given the chance that my kids have now, would I be doing something that I passionately believe in & love? I guess I will never know...

Human Nature

Watching the afternmath of Hurricane Katrina, human nature has reared its ugly head. Looters, rapists, murderers taking advantage of the catastrophe. And all the political finger-pointing which to me is pointless now. Get a grip, people! Use all that energy for more constructive purposes, puh-leese!!! Leave the blame fest till later!!!

Loss

Yesterday, I attended the wake of a classmate's 16-year-old daughter. She had passed away from a congenital heart disorder which she had been diagnosed with in the antenatal period & had not been expected to live beyond the first weeks of life. She miraculously beat the odds & survived till her 16th year without any corrective surgery.

I cannot fathom the heartache & sorrow which my friend & his wife must be going through on losing their child. Although they had 16 good & fulfilling years with this miracle child, & have 3 other children to help them bear their loss, she was still their daughter.

I cannot imagine losing either of my children, and hope that I will never have to go through the experience...

Neither Here Nor There

I guess that's kinda like what I am feeling right now. We have finally moved & settled in (more or less). Part-time maid started today so I don't feel so stressed about housework now... Kids started school last week & we have to get into the new routine of the long commute.

Next step for me is figuring out what to do with my spare time - volunteer work? Art courses? Riding lessons? Start my own consultancy business???

House M.D. - new series about a cynical, jaded senior consultant with horrible bedside manners! The dialogue really cuts to the chase about how doctors (moi, for one) think & feel about their profession & some of their patients! House: "Treating illness is why we became doctors; treating patients is what makes so many doctors miserable."!!! His response to a mother who refused to give steroidal inhalants to her son for fear of "powerful" medicines was also a gem. Wish I could have used some of these House-isms when I was working at Shenton!

Insomnia

Haven't been able to sleep well/enough the last few days. Probably due to the fact that we are in the midst of preparing to move into a new apartment which we have just completed renovations on. Now the hard part of packing & & cleaning & moving things over.

Had a garage sale last week to try to find "better homes" for some of our belongings. The preparation that went into this was very much like going through the memories of the last 15 years. Bittersweet sometimes, nostalgic, a bit sad, as I realise that my kids will never be babies again, and that I will not have anymore babies to hold (until one of the my boys give me grandchildren!) Going through the photo albums was especially emotional, looking at pictures of people who looked so youthful, some gone forever, some ageing gracefully, some not so gracefully.

I can't wait for this move to be over and done with...maybe I can get some sleep then...

quickie

just a very short entry now: been too busy to post. New home, moving, packing, sorting, organising, worrying, stressing...you get the picture. Add sleep deprivation to that & it's not a pretty picture.

more later...