A Doc's Life - More Memorable Moments (P.S. 4)

Scenario: GP Clinic; patient previously diagnosed with hypertension.

Again, this doesn't refer to one isolated case, but is a description of a commonly encountered situation involving hypertensive patients. Oftentimes, the patient comes in, not with the intention for follow-up of high blood pressure, but for another complaint, eg URTI, GE etc.

Me (after handling the presenting complaint): "By the way, I notice that you are on Drug XYZ for high blood pressure. Let's check your blood pressure & see how well controlled it is."

Patient:"I stopped taking the medicine already."

Me:" Why?"

At this point, there are two possible answers which illustrate misconceptions that patients have regarding the condition of hypertension:

a) Patient:"I finished the whole course already, so I thought I am cured."
b) Patient:"My friends told me that I shouldn't keep taking the medicine otherwise I will never be able to stop." (For some reason, some patients think that anti-hypertensives have some kind of addictive effect on their bodies).

I have lost count of the number of times where I have had to explain the chronicity of hypertension & the need for close follow-up & medication to keep BP under control. Yes, I have even resorted to expounding scary complications of uncontrolled hypertension like stroke, heart problems, kidney failure etc. to get the point across.

I don't know if this ignorance is a local phenomenon, or whether my overseas colleagues also encounter the same misconceptions.

A Doc's Life - More Memorable Moments (P.S. 3)

Subject: Sex Ed for Dummies – I know it is impolite to call someone a dummy, but after you have read this encounter, you’ll know where I’m coming from…

Patient is a female of child-bearing age. This is not an isolated case but a fairly commonly encountered experience.

Patient: “ Dr, there’s something wrong with me; my menses is late. It was supposed to come 2 weeks ago. It’s usually very accurate.”

Me: “Are you married?”

Patient: “Yes,”

Me: ”Do you or your husband use any form of contraception?”

Patient: “Er, no.”

Me: “Do you have symptoms like breast tenderness, nausea, loss of appetite…?”

Patient: “Er, ya, actually my breasts have been feeling a bit tender & my appetite is not so good.”

Me: “Well, you may be pregnant. Let’s do a urine test to check, shall we?”

Patient: “But it cannot be! We just got married last month & we were not planning to have a baby till one or two years later!”

Me: “Err…you don’t use any contraception…?”

Patient: “No.”

Me (patiently): “OK, then you may be pregnant. We can confirm it with a urine test.”

Patient exits room with a doubtful expression on her face…

Pregnancy test comes back Positive.

Me: “Congratulations! You are pregnant!”

Patient: “How did this happen? We were not planning for a baby……..” etc. etc…


Sigh…I sometimes wished that I could have told these patients that mind-control & will power are usually not terribly effective methods of contraception....

A Doc's Life - More Memorable Moments (P.S. 2)

Scenario: ER in a small hospital on a Saturday evening. Patient is a Chinese gentleman in his 40’s, who came in with his hand wrapped in a bloodied handkerchief.

He had been trying to catch an iguana (to eat. The Chinese are notorious for having an appetite for any creature that crawls, walks, swims….basically anything under the sun that is not toxic to the system). I guess the iguana was not too keen on being a dish on the dinner table.

On examination, his hand had multiple (& I mean multiple!!!) smooth edged lacerations on both palmar & dorsal surfaces which looked like razor cuts.

Looking at the pattern of injury, it looks like what had happened was that as he reached out to try to grab the lizard, the creature clamped down on his hand (I honestly didn’t even know that lizards had such sharp teeth). And as he reflexively tried to withdraw, it refused to let go, hence resulting in said lacerations ranging in length from half an inch to 3 inches.

Fortunately, there weren’t any tendinous nor nerve injuries although most of the lacerations were deep enough to warrant stitches. Took me a good hour to suture him up (must have been about 15 to 20 lacerations in total).

Oh, and the lizard got away ☺ ….go lizard!

A Doc's Life - More Memorable Moments (P.S. 1)

After completing my mini-series on “A Doc’s Life – Memorable Moments” last year, I have recently recalled further anecdotal tales of more similarly memorable moments. And since people, for some reason, seem to enjoy such stories, I’ve decided to add a post script to this series, named, quite unimaginatively: “A Doc’s Life – More Memorable Moments”.

Here is my first P.S.

Scenario: My first day of work in a GP clinic in the heart of town. Patient is a tall good-looking gentleman (his appearance is totally irrevelant to the topic at hand, I know, but what the heck, I am of the female persuasion, such things do leave a lasting impression - GRIN -), a backpacking tourist from somewhere in Europe.

The patient entered my room, carrying a backpack with him.

Me: “What can I do for you today, Mr. ____”

Patient: ”I think I have worms.”

Me: “Er, how do you know?”

Patient: ”I found it in the toilet after I did No. 2.”
(OK, OK, he may not have quite put it in exactly that way, but I figured it would be easier on the sensibilities of some of my readers if I paraphrased it).

Me (apprehensively): “Sure…”

He then proceeded to take out from his backpack a small plastic jar covered by a piece of (clean) toilet tissue secured by a rubber band, & placed it on my desk.

(Sidenote: I have a phobia of all things that creep & crawl; spiders, cockroaches, worms, lizards etc etc. I have debrided necrotic ulcers, helped remove ischemic bowels, amputated limbs, seen & handled partially amputated /crushed limbs, but I still CANNOT touch creepy-crawlies....such is the nature of phobias)

I stared at the bottle, half expecting the worm to spring out of the jar, through the tissue paper, and on to my person (hey, phobias are illogical fears. Note: ILLOGICAL).

The patient must have seen the look in my eyes & very kindly said: “It’s dead. Would you like me to remove the cover?”

I nodded & apologized & explained my phobia.

He then removed the cover, & true enough, there was a very dead worm of the Ascaris spp. (better known as the roundworm to laymen) about 6 inches long. The patient must have picked up the infestation during his backpacking journey through Thailand or Vietnam.

The last time I had seen the Ascaris was during our Parasitology module in Medical School (I think it was in 3rd year) & the ones we were shown had been preserved in formaldehyde for God knows how long. Doctors here (at least GP’s in town practices) hardly ever see such infestations, since Singapore, being the developed country that she is, has high standards of hygiene & sanitation. So this was the first time that I had actually seen a “fresh” specimen, & I called my colleagues into my room to view it as well. I think the patient must have thought we were a bunch of “swaku”* doctors for being so fascinated by a worm.

Anyway, I gave him a prescription to get anti-helminthics.

And, oh yeah, he very kindly threw away the jar & worm for me.

*Swaku = local slang to describe someone who is unaware of, or oblivious to, what would be considered common knowledge - quite hard to define, actually, if you are not Singaporean.

Laughter is the Best Medicine

I was trying to clear out some trash from my archives when I came across this little vignette I had received in one of those chain emails one receives from friends occasionally. It made me laugh so hard (I almost pee'd in my pants - pun intended) that I just had to share it with some of my girlfriends who were also ROFL when they read it.

Ladies...enjoy!


The Real Restroom Story - author anonymous

My mother was a fanatic about public bathrooms. When I was a little girl, she'd take me into the stall, teach me to wad up toilet paper and wipe the seat. Then, she'd carefully lay strips of toilet paper to cover the seat. Finally, she'd instruct, "Never, NEVER sit on a public toilet seat."

Then she'd demonstrate "The Stance," which consisted of balancing over the toilet in a sitting position without actually letting any of your flesh make contact with the toilet seat.

By this time, I'd have wet down my leg and we'd have to go home to change my clothes.

That was a long time ago. Even now, in my more "mature years, "The Stance" is excruciatingly difficult to maintain, especially when one's bladder is full. When you have to "go" in a public bathroom, you usually find a line of women that makes you think there's a half-price sale on Nelly's underwear in there. So, you wait and smile politely at all the other ladies, who are also crossing their legs and smiling politely. You get closer and check for feet under the stall doors. Every one is occupied.

Finally, a door opens and you dash in, nearly knocking down the woman leaving the stall. You get in to find the door won't latch. It doesn't matter. The dispenser for the new fangled "seat covers" (invented by someone's Mom, no doubt) is handy, but empty. You would hang your purse on the door hook if there was one - but there isn't - so you carefully but quickly hang it around your neck.

Mom would turn over in her grave if you put it on the FLOOR; you yank down your pants, and assume "The Stance - Ahhhh, relief. But then your thighs begin to shake. You'd love to sit down but you certainly hadn't taken time to wipe the seat or lay toilet paper on it, so you hold "The Stance" as your thighs experience a quake that would register an eight on the Richter scale.

To take your mind off of your trembling thighs, you reach for what you discover to be the empty toilet paper dispenser. In your mind, you can hear your mother's voice saying, "Honey, if you would have tried to clean the seat, you would have KNOWN there was no toilet paper!"

Your thighs shake more. You remember the tiny tissue that you blew your nose on yesterday - the one that's still in your purse. That would have to do. You crumple it in the puffiest way possible. It is still smaller than your thumbnail.

Someone pushes open your stall door because the latch doesn't work. The door hits your purse, which is hanging around your neck in front of your chest, and you and your purse topple backward against the tank of the toilet.

"Occupied!" you scream, as you reach for the door, dropping your precious, tiny, crumpled tissue in a puddle, and sliding down, directly onto the insidious toilet seat. You bolt up quickly, knowing all too well that it's too late. Your bare bottom has made contact with every imaginable germ and life form on the uncovered seat because YOU never laid down toilet paper - not that there was any, even if you had taken time to try.

You know that your mother would be utterly ashamed of you if she knew, because you're certain that her bare bottom never touched a public toilet seat because, frankly, dear, "You just don't KNOW what kind of diseases you could get."

By this time, the automatic sensor on the back of the toilet is so confused that it flushes, sending up a stream of water akin to a fountain that suddenly sucks everything down with such force that you grab onto the toilet paper dispenser for fear of being dragged off to China. At that point, you give up. You're soaked by the splashing water. You're exhausted. You try to wipe with a gum wrapper you found in your pocket, and then slink out inconspicuously to the sinks.

You can't figure out how too operate the faucets with the automatic sensors, so you wipe your hands with spit and a dry paper towel and walk past a line of women, still waiting, cross-legged at this point, no longer able to smile politely.

One kind soul at the very end of the line points out that you are trailing a piece of toilet paper on your shoe as long as the Mississippi River! (Where was it when you NEEDED it??) You yank the paper from your shoe, plunk it the woman's hand and tell her warmly, "Here, you just might need this."

As you exit, you spot your hubby, who has since entered, used and exited the men's restroom and read a copy of War and Peace while waiting for you.

Annoyed, he asks, "What took you so long, and why is your purse hanging around your neck?"

This is dedicated to women everywhere who have ever had to deal with a public restroom (rest??? you've got to be kidding!!).

It finally explains to the men what really does take us so long. It also answers their other commonly asked question about why women go to the restroom in pairs. It's so the other woman can hold the door and also pass you a tissue.

Pirates 2

Didn't quite fancy the sequel to the Pirates of the Caribbean: Curse of the Black Pearl. Found the story rather confusing, probably due to the oftentimes incomprehensible accents of the various characters (I wonder if all pirates speak with that strange brogue).

Why was Davey Jones after Jack Sparrow?

Why did Elizabeth Swann handcuff Capt Sparrow to the Black Pearl, guaranteeing him an almost certain death (note: ALMOST)? Especially after giving him a super-passionate kiss?

Why did they go back to that strange witch doctor lady with the incomprehensible accent?

Oh well, at least we managed to catch the teaser trailer from Spiderman 3! Venom aka Eddie Brock, played by Topher Grace of That 70's Show fame, is going to be one of the new villians!!! And we actually saw his trailer in NYC!!!





Mark your calendars: May 4, 2007

We've a Long Way to go

This article was in The New Paper:

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

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

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

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

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

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

UPSET

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

But he was turned down again.

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

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

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

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

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

Singaporeans can also be inconsiderate in indirect ways.

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

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

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



Smile Singapore 2006 indeed.

Singapore Idol...NOT!

Don't get me wrong.

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

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

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

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

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

High hopes.

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

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

I think I will watch Rockstar: Supernova instead.

A Little Book with a Big Heart

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

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

Here are some excerpts:

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

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

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


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

Soul searching

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

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

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

Huh???

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

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

A promising attitude, I thought.

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

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

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

Ladies Night Out

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

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

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

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

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

A glimmer of hope?

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

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

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

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

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

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

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

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

There is hope yet.

Not that Super

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

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

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

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

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

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

Smile Singapore?

Good grief.

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

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

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

Holiday Highlights

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



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

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



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

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

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

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

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


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



THE HAPPIEST PLACE ON EARTH

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

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



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



UNIVERSAL STUDIOS & ISLANDS OF ADVENTURE

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

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

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

Now, I just need to recuperate from the vacation!

I Hate Flying

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

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

Will post more when I am less groggy...

Checking in...

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

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


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

More later...

On Hiatus

Heading for here...

...and here...

...and maybe here if time permits.

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

Proud Mom

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





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

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


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

Excerpt from “Because You Loved Me”



My little boy is growing up…

Back to School

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

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

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

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

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

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

Simplify:



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

Solve the equation if possible:



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

Factor by grouping

rs – 6r – 5s + 30


Here are some I couldn’t do:

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

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


Solve:



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

Graph the system of inequalities and state the solution:




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



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

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

Freaky

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

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

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

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

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

But it WAS weird though.

X-Men: The Last Stand

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







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

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

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

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

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

Way To Go, Taylor!

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

AI Fever

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

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

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

I really hope Taylor wins it.

On Mediation

In another letter to the papers today:


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

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

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

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

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

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

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

One kind doctor shared with me the following:

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

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

Lee Soh Hong (Miss)

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


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

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

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

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

On raising a child

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

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

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

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

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

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

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

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

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

Eric Ho Wee Kim



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

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

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

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

Da Vinci

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

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

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

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

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

Go, Right Brain!

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

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

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

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

Abstract-ion: complete

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





HOPE: (LIVING A LIFE FULL OF COLOR)


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

Motherhood

Yesterday was Mother's Day.

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

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

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

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

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

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

Bart: "Because we're poor?"

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

Bart: "Why?"

Homer: "Because we have children."

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

The Rewards - immeasurable.

ISTJ

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

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

Eerily accurate...

MOVIE MANIA

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

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

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

COMING SOON

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

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

Politically (in?)correct

Well.

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

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

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

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

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

MI:3

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

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

One Big Happy Family

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


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

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

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

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

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

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

Religious Fervour

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

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

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

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

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

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

My Baby

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





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

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

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

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

Great Expectations

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

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

Art imitating Life

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

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

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

Abstract-ion

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

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

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

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

Coloring Outside the Lines

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

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

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

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

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

Random Thoughts on...

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

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

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

Good Grief

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

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

Oy vey.

Weirdos

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

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

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

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

Talent

JAMES BLUNT

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

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

AMERICAN IDOL

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

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

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

Hats Off

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

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

Room with a View

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

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

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

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

Pride & Prejudice (again)

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

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

Sometimes You Just Have To Listen To Your Gut

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

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

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

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

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

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

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

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

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

Brrrrrrr

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

Cases in point:

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

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

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

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

42

Today.

Me.

Winken Blinken and Nod

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

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

Maybe I should try counting sheep...

Hugs & Kisses

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

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

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

Ahchoo!

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

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


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

Whoopee. Very timely indeed.

Blown Away

Wow.

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

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

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

This is what I call Talent.

Arty-Farty

Circles of Life- Angst

The Person

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

Scene

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

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

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

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

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

I hope everyone has their own Person too.

So Many Places, So Little Time...

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

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

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

It's Not About the Money

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

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

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

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

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

The Business of Medicine

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

Like it or not, Medicine is a business now.