Here is an interesting entry about CPR & DNR in response to a New York Times article, The Last Word on the Last Breath.
I was surprised that an actual analysis was done & published in the NEJM on survival rates in CPR on TV!
I remember how dismal the success rate was during my stint in A & E oh-so-many years ago. Most of the patients who were admitted collapsed had already been down for more than 15 minutes. At that time (I don't know about now), the paramedical staff in the ambulances did not do intubations on the field. So most of the time, our efforts in the department were basically "going-through-the-motions" for a reasonable amount of time, before pronouncing death. Most of these collapsed patients had pre-existing co-morbidities & elderly or were victims of severe trauma, so our efforts were not unexpectedly futile. I remember the sickening crunch of breaking ribs while I did chest compressions, especially in the elderly & frail.
The only time I managed to bring back a patient was a gentleman in his 50's suffering from an acute exacerbation of COPD, who, right in front of my eyes, desaturated & went into ventricular fibrillation. Immediate CPR was instituted, & he was successfully resuscitated & immediately sent up to the medical ICU (whose MO was not terribly happy with accepting this very ill patient, but hey, what to do, A & E in those days were not equipped or staffed to monitor patients requiring close monitoring).
Even in the wards, many family members still insisted on going all out for the patient in spite of how gravely ill that patient was. Perhaps they didn't realise how traumatic CPR can be on an already weakened body. I can certainly understand why letting go is hard.
When my time comes, I will make sure that my family understands my wishes & let me go in peace. I admit I have yet to sign an AMD nor have I made a living will. It's one of those things which one keeps putting off, thinking that one still has time to do it. I really should get off my a** & get it done...
Wednesday, October 11, 2006
Monday, October 09, 2006
Heartbreak
I am an emotional wreck. We have made the heartbreaking decision to put down our very old, very large dog whom we’ve had since she was a pup. She has not been doing well since we moved into an apartment over a year ago. Arthritis, cataracts, incontinence – diseases of age – afflict her & makes it hard for her to get up & walk on ceramic tiles, & she leaks pee if you don’t bring her downstairs fast enough. Hard for everyone.
I’ve been putting off this decision while desperately trying to find a good home with a garden for her to enjoy her last years with some degree of comfort but alas, in a country where most people live in government housing that disallows dogs beyond a certain size, it has been a futile effort. The fact that she is almost 11 years old, weighs 80 lbs & has these health problems don’t help either. It would be hard to find anyone willing to accept a pet like this, & not fair to burden someone else with these problems. We looked at a no-kill shelter to see if it was an option but seeing how overwhelmed they are with the number of dogs they have to foster, we didn’t see how our dog could be happy in that kind of situation.
Euthanasia is emotion-ridden. I think my reluctance to face this ultimate decision is partly for selfish reasons too. I don’t want to go through the trauma of loss & grief. Tears have come at the most unlikely moments. But I need to also think about the quality of life issue. Should I, due to my selfishness, allow her to go on like that? It breaks my heart each time I see her trying to struggle to get up so that we can bring her down for her toilet break. I suspect she has some degree of heart failure as well, as she pants really hard from just walking less than 100 m.
This is hard, and it involves an animal. How much harder would it be if it involved a human life. I can’t imagine how Dr Kevorkian did what he did, although if you look at it in a cold, clinical & detached way, it sounds like a logical solution to an existence wrought with pain & suffering. Problem is, as human beings, we aren’t cold or detached when it comes to a loved one. At least, we shouldn’t be. As for being clinical, well, the arguments for and against euthanasia among the medical community have been & will always be an ongoing & controversial one.
Stop crying, aliendoc.
Note: In my opinion, euthanasia & the Advance Medical Directive are two different issues.
I’ve been putting off this decision while desperately trying to find a good home with a garden for her to enjoy her last years with some degree of comfort but alas, in a country where most people live in government housing that disallows dogs beyond a certain size, it has been a futile effort. The fact that she is almost 11 years old, weighs 80 lbs & has these health problems don’t help either. It would be hard to find anyone willing to accept a pet like this, & not fair to burden someone else with these problems. We looked at a no-kill shelter to see if it was an option but seeing how overwhelmed they are with the number of dogs they have to foster, we didn’t see how our dog could be happy in that kind of situation.
Euthanasia is emotion-ridden. I think my reluctance to face this ultimate decision is partly for selfish reasons too. I don’t want to go through the trauma of loss & grief. Tears have come at the most unlikely moments. But I need to also think about the quality of life issue. Should I, due to my selfishness, allow her to go on like that? It breaks my heart each time I see her trying to struggle to get up so that we can bring her down for her toilet break. I suspect she has some degree of heart failure as well, as she pants really hard from just walking less than 100 m.
This is hard, and it involves an animal. How much harder would it be if it involved a human life. I can’t imagine how Dr Kevorkian did what he did, although if you look at it in a cold, clinical & detached way, it sounds like a logical solution to an existence wrought with pain & suffering. Problem is, as human beings, we aren’t cold or detached when it comes to a loved one. At least, we shouldn’t be. As for being clinical, well, the arguments for and against euthanasia among the medical community have been & will always be an ongoing & controversial one.
Stop crying, aliendoc.
Note: In my opinion, euthanasia & the Advance Medical Directive are two different issues.
Friday, October 06, 2006
Compassion
"At the behest of Amish leaders, a fund has also been set up for the gunman's wife and his three children." YAHOO! News: Donations to Help Amish families (AP)
If one could find a silver lining behind the darkest of clouds, this would be it. The compassion shown by this gentle community for the family of the man who killed their young is something that should be emulated.
The Amish live in Lancaster County, Pennsylvania. I remember making road trips to this picturesque area, our car often having to follow behind horse-drawn buggies on the streets. Parking lots included areas of buggy parking. Towns with unlikely names like Bird-In-Hand & Intercourse (!!!), restaurants with names like "Good & Plenty" and "Plain & fancy", featuring traditional Amish (& very fattening) food like fried chicken, Chow Chow (a vege dish), Shoo-fly pie (so named, because its sugar content attracts flies!)...all these bring back fond memories of our lives in Pennsylvania. The Amish eschew modern conveniences like automobiles & electricity, and dress in plain clothes, the men wearing the characteristic broad-brimmed hats. They still speak in an old German dialect (despite the misnomer Pennsylvania Dutch, they originated from Germany, fleeing persecution because of their religious teachings.
If one could find a silver lining behind the darkest of clouds, this would be it. The compassion shown by this gentle community for the family of the man who killed their young is something that should be emulated.
The Amish live in Lancaster County, Pennsylvania. I remember making road trips to this picturesque area, our car often having to follow behind horse-drawn buggies on the streets. Parking lots included areas of buggy parking. Towns with unlikely names like Bird-In-Hand & Intercourse (!!!), restaurants with names like "Good & Plenty" and "Plain & fancy", featuring traditional Amish (& very fattening) food like fried chicken, Chow Chow (a vege dish), Shoo-fly pie (so named, because its sugar content attracts flies!)...all these bring back fond memories of our lives in Pennsylvania. The Amish eschew modern conveniences like automobiles & electricity, and dress in plain clothes, the men wearing the characteristic broad-brimmed hats. They still speak in an old German dialect (despite the misnomer Pennsylvania Dutch, they originated from Germany, fleeing persecution because of their religious teachings.
Tuesday, October 03, 2006
Live Long & Prosper
Not for these people. First this. Then this. And now this.
Despite being married to an American & having lived in the US for several years in a typical suburban neighborhood, & pretty much assimilated into the lifestyle there, I still don’t get the obsession of some Americans with the “right to bear arms” portion of the Constitution.
My husband has tried explaining it to me from the perspective of American history & how, when the constitution was first written, it was meant to protect the citizens from tyranny. I can understand that scenario back in the 18th & 19th century, when lawlessness was rampant & there were no proper law enforcement agencies in existence or available to those living in remote areas of the country.
But now, in the 21st century, I don’t get it. I know that there ARE responsible gun owners. But there are also nutsos out there who, due to warped reasons of their own, decide out of the blue, that he needs to kill some people.
Then there are kids out there as well, hormone-ridden, angst-filled youths, trying to get by in the stressful times of modern day living, who have easy accessibility to their parents’ guns or rifles, who one day decide that it would be cool to use their fellow schoolmates as target practice.
I guess having been brought up with Asian values which places society above self (for the most part, anyway), it’s hard for me to support this “right to bear arms” argument. If I had to choose between that & an innocent’s right to live, it’s a no-brainer.
Despite being married to an American & having lived in the US for several years in a typical suburban neighborhood, & pretty much assimilated into the lifestyle there, I still don’t get the obsession of some Americans with the “right to bear arms” portion of the Constitution.
My husband has tried explaining it to me from the perspective of American history & how, when the constitution was first written, it was meant to protect the citizens from tyranny. I can understand that scenario back in the 18th & 19th century, when lawlessness was rampant & there were no proper law enforcement agencies in existence or available to those living in remote areas of the country.
But now, in the 21st century, I don’t get it. I know that there ARE responsible gun owners. But there are also nutsos out there who, due to warped reasons of their own, decide out of the blue, that he needs to kill some people.
Then there are kids out there as well, hormone-ridden, angst-filled youths, trying to get by in the stressful times of modern day living, who have easy accessibility to their parents’ guns or rifles, who one day decide that it would be cool to use their fellow schoolmates as target practice.
I guess having been brought up with Asian values which places society above self (for the most part, anyway), it’s hard for me to support this “right to bear arms” argument. If I had to choose between that & an innocent’s right to live, it’s a no-brainer.
Tuesday, September 26, 2006
Words of Wisdom
I want to give this writer a standing ovation.
Patients and doctors must be loyal to each other
I REFER to the letter, 'Fees aside, pick the right hospital and doctor' by Ms Virginia Goh Min Wen and Dr Victor Teoh (ST, Sept 22).
It is obviously prudent in matters of health, to choose a hospital not based on the cost of treatment but the clinical outcome or effectiveness of therapy.
At the same time, it is not only the skills of the specialist or the quality of the equipment in a hospital that determines good clinical outcome.
Most of all, a patient needs a doctor who will act continually in his best interest.
Patients need doctors who are loyal and place their welfare as their first consideration, even at times at the expense of subjugation of the doctor's personal interest.
Patients, like all humans, have multiple and often varying interests.
Doctors, like all professionals, have multiple interests and commitments.
Some personal interests of doctors which may come into conflict with their professional obligation and thus the patient's welfare and interests include accumulation of wealth, fame, academic position or rank, or even the promotion of scientific innovation.
In today's medical-commercial complex, doctors can inadvertently be drawn to promote the interests of the pharmaceutical industry, companies that produce medical devices and equipment, insurance companies and even hospital bottom lines.
When conflicts of interest arise, there may be, in extreme cases, neglect of professional duties but more often a compromise of the independence of clinical judgment.
In a medical encounter, it is not only the knowledge and skills of the doctor that are important in the clinical outcome but also the independence and quality of the clinical judgment.
The judgment may be tainted so as not to serve the patient's best interest.
The clinical judgment can be compared to the plan and strategy of the diagnosis and therapy.
Thus, even with careful and expert execution, an inappropriate plan and strategy will not lead to a good outcome.
In addition, it is important for patients and the public to know that in the rapidly changing knowledge and technology of modern medicine, medical uncertainties are a common feature of medical practice.
New therapies and technology may not be fully validated.
Protocols of therapy continue to change and many areas of disease and treatment are still unknown.
Every patient brings his own special features to the illness and therapy.
There are large grey areas in medicine where the doctor must exercise clinical judgment.
Independent and good clinical judgment, based on scientific facts, clinical skills and experience and based on the particular patient's context, needs to exercised to serve the best interest of the patient.
To act in the best interest of his patient, the doctor must not only be up to date in his knowledge and skills on the diagnosis and various treatment options, but must also have a good knowledge of his patient and his interests.
Equally important, the doctor must have knowledge of himself and his motivation.
Unfortunately, in the hospital setting when a patient seeks a specialist consultation, the clinical encounter is transient and between strangers.
Many times, patients hardly remember the name of the specialist they consult, let alone the medical information exchanged.
The specialist who sees several patients a day remembers them as diagnostic labels in medical notes.
Specialisation in medicine no doubt increases expertise and more proficient practice.
At the same time, it runs the risk of compartmentalising the patient to organs and waters down the quality of the doctor-patient relationship.
For patients to benefit from a good clinical outcome, optimally utilising medical facilities at affordable cost, a collaborative effort is required between the generalist family physician who knows the patient well and the specialist who has the special skills to carry out the treatment.
It is not always easy for anyone, let alone the patient, to judge whether his doctor is acting in his best interest and welfare.
However, some professional behaviours are surrogate markers to show the doctor is acting in the patient's best interest.
A doctor who spends time and effort giving medical information and options to empower the patient to participate effectively in medical decision making, tells of his concern for the patient's interest.
A doctor who acts in the best interest of his patients not only keeps up to date with his skills and knowledge, but also fills in any gaps by not hesitating to consult his colleagues and getting a second opinion.
One's medical colleagues often have a better insight of their another's clinical competence and patient-centeredness of practice.
Thus the value of a medical referral to a specialist by the family physician.
Unfortunately, in today's society, the climate for and culture of having a regular primary or family physician is not strong.
For patients and their families to run around by themselves seeking the right hospital, right doctor and right specialist for the patient's illness is a common phenomenon locally termed 'hospital (or doctor) hopping'.
Information from books and the Internet leaves many gaps.
Hospital and doctor hopping is nearly always detrimental to the patient's welfare, whether in acute illness or chronic disease care.
It also erodes loyalty and continuity of care.
Nor is it cost-efficient.
The simple formula in choosing the right doctor for the patient, for a good clinical outcome at affordable cost, is for patients and doctors to be loyal to each other and communicate effectively.
The challenge for policymakers and the medical leadership is to build a climate, culture and system which will ensure and promote this loyalty and communication.
Dr T. Thirumoorthy
Patients and doctors must be loyal to each other
I REFER to the letter, 'Fees aside, pick the right hospital and doctor' by Ms Virginia Goh Min Wen and Dr Victor Teoh (ST, Sept 22).
It is obviously prudent in matters of health, to choose a hospital not based on the cost of treatment but the clinical outcome or effectiveness of therapy.
At the same time, it is not only the skills of the specialist or the quality of the equipment in a hospital that determines good clinical outcome.
Most of all, a patient needs a doctor who will act continually in his best interest.
Patients need doctors who are loyal and place their welfare as their first consideration, even at times at the expense of subjugation of the doctor's personal interest.
Patients, like all humans, have multiple and often varying interests.
Doctors, like all professionals, have multiple interests and commitments.
Some personal interests of doctors which may come into conflict with their professional obligation and thus the patient's welfare and interests include accumulation of wealth, fame, academic position or rank, or even the promotion of scientific innovation.
In today's medical-commercial complex, doctors can inadvertently be drawn to promote the interests of the pharmaceutical industry, companies that produce medical devices and equipment, insurance companies and even hospital bottom lines.
When conflicts of interest arise, there may be, in extreme cases, neglect of professional duties but more often a compromise of the independence of clinical judgment.
In a medical encounter, it is not only the knowledge and skills of the doctor that are important in the clinical outcome but also the independence and quality of the clinical judgment.
The judgment may be tainted so as not to serve the patient's best interest.
The clinical judgment can be compared to the plan and strategy of the diagnosis and therapy.
Thus, even with careful and expert execution, an inappropriate plan and strategy will not lead to a good outcome.
In addition, it is important for patients and the public to know that in the rapidly changing knowledge and technology of modern medicine, medical uncertainties are a common feature of medical practice.
New therapies and technology may not be fully validated.
Protocols of therapy continue to change and many areas of disease and treatment are still unknown.
Every patient brings his own special features to the illness and therapy.
There are large grey areas in medicine where the doctor must exercise clinical judgment.
Independent and good clinical judgment, based on scientific facts, clinical skills and experience and based on the particular patient's context, needs to exercised to serve the best interest of the patient.
To act in the best interest of his patient, the doctor must not only be up to date in his knowledge and skills on the diagnosis and various treatment options, but must also have a good knowledge of his patient and his interests.
Equally important, the doctor must have knowledge of himself and his motivation.
Unfortunately, in the hospital setting when a patient seeks a specialist consultation, the clinical encounter is transient and between strangers.
Many times, patients hardly remember the name of the specialist they consult, let alone the medical information exchanged.
The specialist who sees several patients a day remembers them as diagnostic labels in medical notes.
Specialisation in medicine no doubt increases expertise and more proficient practice.
At the same time, it runs the risk of compartmentalising the patient to organs and waters down the quality of the doctor-patient relationship.
For patients to benefit from a good clinical outcome, optimally utilising medical facilities at affordable cost, a collaborative effort is required between the generalist family physician who knows the patient well and the specialist who has the special skills to carry out the treatment.
It is not always easy for anyone, let alone the patient, to judge whether his doctor is acting in his best interest and welfare.
However, some professional behaviours are surrogate markers to show the doctor is acting in the patient's best interest.
A doctor who spends time and effort giving medical information and options to empower the patient to participate effectively in medical decision making, tells of his concern for the patient's interest.
A doctor who acts in the best interest of his patients not only keeps up to date with his skills and knowledge, but also fills in any gaps by not hesitating to consult his colleagues and getting a second opinion.
One's medical colleagues often have a better insight of their another's clinical competence and patient-centeredness of practice.
Thus the value of a medical referral to a specialist by the family physician.
Unfortunately, in today's society, the climate for and culture of having a regular primary or family physician is not strong.
For patients and their families to run around by themselves seeking the right hospital, right doctor and right specialist for the patient's illness is a common phenomenon locally termed 'hospital (or doctor) hopping'.
Information from books and the Internet leaves many gaps.
Hospital and doctor hopping is nearly always detrimental to the patient's welfare, whether in acute illness or chronic disease care.
It also erodes loyalty and continuity of care.
Nor is it cost-efficient.
The simple formula in choosing the right doctor for the patient, for a good clinical outcome at affordable cost, is for patients and doctors to be loyal to each other and communicate effectively.
The challenge for policymakers and the medical leadership is to build a climate, culture and system which will ensure and promote this loyalty and communication.
Dr T. Thirumoorthy
Duh Moments
Duh Moment #1
Patient needs PAP Smear done. I tell her to undress & lie on couch while I prepare the equipment. I return to the examination couch & notices that she still has her underwear on.
Me: "Er...you need to remove your underwear in order for me to do the PAP Smear."
Patient: "Oh, is it? I need to remove my underwear?"
Me: "Er...yeah" (Inner Me: "Duh")
Duh Moment #2
Patient complains of headache. After taking history, I tell her I am going to check her blood pressure.
Patient: "Do you want me to take off my watch?"
Me: "Er...no." (Inner Me:"Duh")
Patient needs PAP Smear done. I tell her to undress & lie on couch while I prepare the equipment. I return to the examination couch & notices that she still has her underwear on.
Me: "Er...you need to remove your underwear in order for me to do the PAP Smear."
Patient: "Oh, is it? I need to remove my underwear?"
Me: "Er...yeah" (Inner Me: "Duh")
Duh Moment #2
Patient complains of headache. After taking history, I tell her I am going to check her blood pressure.
Patient: "Do you want me to take off my watch?"
Me: "Er...no." (Inner Me:"Duh")
Saturday, September 23, 2006
Heroes
I stumbled upon this new series called Heroes starting in the US on NBC Sept 25 while I was perusing my son's latest installment of Civil War (a new Marvel comic series) - OK, OK, I admit it, I still read comics...
Anyway, take a look at the trailer. I think it's going to be a hit & will especially appeal to superhero/comic/scifi/fantasy fans & geeks (like me!). We need a bit of fantasy & optimism especially when we are bombarded daily by news of bombs & terrorists & coups & wars.
Let's hope Mediacorp brings it in.
Anyway, take a look at the trailer. I think it's going to be a hit & will especially appeal to superhero/comic/scifi/fantasy fans & geeks (like me!). We need a bit of fantasy & optimism especially when we are bombarded daily by news of bombs & terrorists & coups & wars.
Let's hope Mediacorp brings it in.
A Xanax Moment
I think I need some Xanax.
Why? Well, we’ve just found out that we will be moving to China.
Oh, don’t get me wrong, I am actually feeling very excited about this new adventure. But I’ve some trepidation about the transition. Been getting tension headaches the last couple of weeks while awaiting final news (which we received this past week) on this.
Things like the kids’ schooling: how they will adapt, whether there will be continuity in what they are studying here & what they will be studying there, the timing of the transfer - should we let them finish off the school year (which ends middle of next year) before moving them over (but then this would involve some logistical acrobatics as A’s new position starts next month) or transfer them in the middle of the school year (i.e. Dec!!!) so that the whole family stays together.
Things like what to do with our home: Sell? Or rent?
Our (very old & large) dog with a few health problems – a heartbreaking decision will have to be made here.
I think I had a mild anxiety attack last night while thinking about all this - slight chest tightness with a sensation that I couldn’t quite inhale completely. It lasted only a few seconds.
A. doesn’t understand why I get all angst-y (that word again!). I guess that’s the “Men are from Mars, Women are from Venus” thing going on. We women tend to think things through to the bone, gnawing over every small detail ESPECIALLY anything involving our children & their well-being. Guys? They just breeze through, with the attitude that they can conquer any obstacles in their way as long as our immediate needs (Food & Shelter) are taken care of.
Breathe, aliendoc, breathe…
Why? Well, we’ve just found out that we will be moving to China.
Oh, don’t get me wrong, I am actually feeling very excited about this new adventure. But I’ve some trepidation about the transition. Been getting tension headaches the last couple of weeks while awaiting final news (which we received this past week) on this.
Things like the kids’ schooling: how they will adapt, whether there will be continuity in what they are studying here & what they will be studying there, the timing of the transfer - should we let them finish off the school year (which ends middle of next year) before moving them over (but then this would involve some logistical acrobatics as A’s new position starts next month) or transfer them in the middle of the school year (i.e. Dec!!!) so that the whole family stays together.
Things like what to do with our home: Sell? Or rent?
Our (very old & large) dog with a few health problems – a heartbreaking decision will have to be made here.
I think I had a mild anxiety attack last night while thinking about all this - slight chest tightness with a sensation that I couldn’t quite inhale completely. It lasted only a few seconds.
A. doesn’t understand why I get all angst-y (that word again!). I guess that’s the “Men are from Mars, Women are from Venus” thing going on. We women tend to think things through to the bone, gnawing over every small detail ESPECIALLY anything involving our children & their well-being. Guys? They just breeze through, with the attitude that they can conquer any obstacles in their way as long as our immediate needs (Food & Shelter) are taken care of.
Breathe, aliendoc, breathe…
Saturday, September 16, 2006
Friday, September 15, 2006
No Survivor?
Hmmm.
This is an interesting development.
Survivor 13 : Cook Islands started today in the US. And I notice Mediacorp hasn't got it on its TV schedule. Somewhat strange seeing that every single season of Survivor has been broadcast on the same day as the US so far.
Could it be the fact that a racial theme has been used to divide up the teams? Is Mediacorp afraid that Singaporeans won't be able to take it? Will our sensibilities be SOOOO affected by this racial divide? Are our values & morals so weak that they are afraid that this multiracial harmony in which we exist will be destroyed by this TV program?
I wait with bated breath to find out...
This is an interesting development.
Survivor 13 : Cook Islands started today in the US. And I notice Mediacorp hasn't got it on its TV schedule. Somewhat strange seeing that every single season of Survivor has been broadcast on the same day as the US so far.
Could it be the fact that a racial theme has been used to divide up the teams? Is Mediacorp afraid that Singaporeans won't be able to take it? Will our sensibilities be SOOOO affected by this racial divide? Are our values & morals so weak that they are afraid that this multiracial harmony in which we exist will be destroyed by this TV program?
I wait with bated breath to find out...
Letters to the Forum
Why do people write letters like this to the newspaper?
"No lunch served on SIA's flight from S'pore to Shanghai
I recently took SQ826 flight to Shanghai, departing Singapore at 8am and arriving at Shanghai at 1.30pm. I was very disappointed that no lunch was served on board. Food was served at about 9am to 10am, which was called brunch. It was breakfast to me.
When I asked about lunch, I was told that only one meal was served on that flight. I pointed out that the flight only landed at 1.30pm, so the one meal in the morning was not sufficient to fill our stomach. I was feeling hungry then, but the stewardess could only offer me cup noodles, peanuts or biscuits.
I was disappointed that not even light snacks were served during lunch time. Other airlines normally provide main meals and light snacks on board. SIA's management should ensure that passengers are served sufficient meals on board.
Tan Saw Bin (Ms)"
This lady could very well have written to SIA directly to voice her complaint and give her suggestions. I find it hard to understand the mentality of such people. It's the same with medical-related complaint letters. Instead of going straight to the hospital or clinic with their issues, patients or their kin write to the newspaper.
And it looks like this letter is going to open another can of worms...
"Don't salvage lives that will weigh on family
THE article, 'Parents of the disabled have a long list of woes'' (ST, Sept 13), serves as a launching pad for me to write to ST Forum on a topic I have felt very strongly about for a long time.
Of the long list of woes, one dominates that of all elderly parents: 'Who will look after my child after I pass on?' Many parents have expressed this concern to me.
In other cases, I have reminded younger parents to cease their globe-trotting in search of a miracle cure and set aside funds to provide for their disabled child while not neglecting their other children.
For those who can afford it, I advise them about setting up a trust fund. But many do not have enough money to provide for their disabled offspring for as long as the patient will live.
I understand the parents' pain and burden because I see it so often. It is one of the reasons I have written to ST Forum more than once about not salvaging lives that will be a burden to their family and society.
My conviction was further strengthened last Tuesday when a patient in his 50s, who I have seen for more than 15 years, came for his annual check-up with his sister.
Surprised, I asked what happened to the father who was the one who brought the patient every time.
'He passed away' was the sister's answer.
'But he looked in good health when I saw him last year.'
'Actually, he jumped and killed himself. He meant to take my brother with him but could not do so.'
I was greatly saddened. The father had asked me for help to find a nursing home for his son two years ago. I gave him a list and he phoned each of them, promising to will everything to the home which would promise to look after his son.
He had a landed property which he lived in, but that too would be willed to the home when he died.
Last year, he told me sadly that all the homes wanted money upfront and turned him down.
As medicine advances, more and more brain-damaged patients will be salvaged. We doctors are playing God all the time though we pretend we should not.
We are trapped between the old days when many of these disabled patients would die because medicine could do no better, and a rational era (which may never come) where doctors and families can come to a rational decision that 'enough is enough'.
As a First World country where millions of dollars are being poured into making us a cultured and vibrant society, could a few million dollars be spared to build nursing homes for disabled patients whose parents are getting too old to look after them any longer?
Dr Lee Wei Ling "
Our esteemed colleague had previously written into the papers with her views on the surgery performed on the Nepalese twins, one of whom apparently is not doing well, requiring full-time care from her family. I suspect this letter will also trigger off a spew of responses.
I can't say that I disagree with her views entirely, especially where it comes to building nursing homes for disabled patients or at least, some kind of daycare or support facilities to help care-givers with what must be an extremely difficult situation. I myself have asked the question "Why?" many times when I did my rotation through Neonatology, resuscitating premies, & taking care of severely ill neonates. Many end up vegetative or with terribly compromising health conditions likely leading to lifelong complications which tax not only the wallets of their parents, but are also emotionally draining. But it was not my call to deny or withhold available treatment. When called to resus, you resus.
Perhaps I am cold-hearted, but personally, if I had a child whom I KNEW was going to go through life with a multitude of health problems if we kept him/her alive with all our modern medical means, I would rather let him/her go peacefully instead of having to suffer through a life of questionable quality.
"No lunch served on SIA's flight from S'pore to Shanghai
I recently took SQ826 flight to Shanghai, departing Singapore at 8am and arriving at Shanghai at 1.30pm. I was very disappointed that no lunch was served on board. Food was served at about 9am to 10am, which was called brunch. It was breakfast to me.
When I asked about lunch, I was told that only one meal was served on that flight. I pointed out that the flight only landed at 1.30pm, so the one meal in the morning was not sufficient to fill our stomach. I was feeling hungry then, but the stewardess could only offer me cup noodles, peanuts or biscuits.
I was disappointed that not even light snacks were served during lunch time. Other airlines normally provide main meals and light snacks on board. SIA's management should ensure that passengers are served sufficient meals on board.
Tan Saw Bin (Ms)"
This lady could very well have written to SIA directly to voice her complaint and give her suggestions. I find it hard to understand the mentality of such people. It's the same with medical-related complaint letters. Instead of going straight to the hospital or clinic with their issues, patients or their kin write to the newspaper.
And it looks like this letter is going to open another can of worms...
"Don't salvage lives that will weigh on family
THE article, 'Parents of the disabled have a long list of woes'' (ST, Sept 13), serves as a launching pad for me to write to ST Forum on a topic I have felt very strongly about for a long time.
Of the long list of woes, one dominates that of all elderly parents: 'Who will look after my child after I pass on?' Many parents have expressed this concern to me.
In other cases, I have reminded younger parents to cease their globe-trotting in search of a miracle cure and set aside funds to provide for their disabled child while not neglecting their other children.
For those who can afford it, I advise them about setting up a trust fund. But many do not have enough money to provide for their disabled offspring for as long as the patient will live.
I understand the parents' pain and burden because I see it so often. It is one of the reasons I have written to ST Forum more than once about not salvaging lives that will be a burden to their family and society.
My conviction was further strengthened last Tuesday when a patient in his 50s, who I have seen for more than 15 years, came for his annual check-up with his sister.
Surprised, I asked what happened to the father who was the one who brought the patient every time.
'He passed away' was the sister's answer.
'But he looked in good health when I saw him last year.'
'Actually, he jumped and killed himself. He meant to take my brother with him but could not do so.'
I was greatly saddened. The father had asked me for help to find a nursing home for his son two years ago. I gave him a list and he phoned each of them, promising to will everything to the home which would promise to look after his son.
He had a landed property which he lived in, but that too would be willed to the home when he died.
Last year, he told me sadly that all the homes wanted money upfront and turned him down.
As medicine advances, more and more brain-damaged patients will be salvaged. We doctors are playing God all the time though we pretend we should not.
We are trapped between the old days when many of these disabled patients would die because medicine could do no better, and a rational era (which may never come) where doctors and families can come to a rational decision that 'enough is enough'.
As a First World country where millions of dollars are being poured into making us a cultured and vibrant society, could a few million dollars be spared to build nursing homes for disabled patients whose parents are getting too old to look after them any longer?
Dr Lee Wei Ling "
Our esteemed colleague had previously written into the papers with her views on the surgery performed on the Nepalese twins, one of whom apparently is not doing well, requiring full-time care from her family. I suspect this letter will also trigger off a spew of responses.
I can't say that I disagree with her views entirely, especially where it comes to building nursing homes for disabled patients or at least, some kind of daycare or support facilities to help care-givers with what must be an extremely difficult situation. I myself have asked the question "Why?" many times when I did my rotation through Neonatology, resuscitating premies, & taking care of severely ill neonates. Many end up vegetative or with terribly compromising health conditions likely leading to lifelong complications which tax not only the wallets of their parents, but are also emotionally draining. But it was not my call to deny or withhold available treatment. When called to resus, you resus.
Perhaps I am cold-hearted, but personally, if I had a child whom I KNEW was going to go through life with a multitude of health problems if we kept him/her alive with all our modern medical means, I would rather let him/her go peacefully instead of having to suffer through a life of questionable quality.
Tuesday, September 12, 2006
Singapore Dreaming & the IMF/World Bank meetings
The latest local movie production, Singapore Dreaming, opened last week. One of its producers is fellow doctor, acclaimed plastic surgeon, Woffles Wu. Together with husband & wife team, Colin Goh & Dr Woo Yen Yen, they do a credible job in creating something that shows the heart & soul of Singapore.
It revolves around the lives of an average Chinese-Singaporean family. Dad, Loh Poh Huat, is the typical wannabe, disdainful of HDB dwellers, & counting the days when he strikes Toto & can afford to move into his dream condo & buy his dream car & join an elite country club. Mum is a housewife, content with her duties of keeping house, cooking & brewing ‘liang teh’ (herbal tea) everyday for the family. Oldest child is Mei, a secretary married to an ex-Army regular, C.K., who now struggles to earn a living by selling life insurance. Mei has always struggled for her parents' love & attention, and being born a girl is a great disadvantage in this struggle. Younger offspring is Seng, the precious son, the ne’er-do-good, sent off to the golden land of America to get a degree from an American university so that he can return after graduating to earn a good living & repay the money spent by his father & his long-suffering fiancée, Irene, to support his studies. Or so it is hoped.
A multitude of local social issues are laid bare: our obsession with the 5C’s, our oftentimes hypocritical attitudes towards domestic maids, urinating in lifts, the preferential treatment shown to sons vs daughters. Swipes are taken at the kiasu-ism of Singaporeans, with a mother shown admonishing her kindergarten-aged son rather violently for scoring 95% in a spelling test instead of 100% like his classmate. Dr Woffles Wu even makes a cameo appearance as a family friend paying his condolences at the wake of the ill-fated Loh (“No need to give so much, OK,” he tells his wife softly, as they approach Mei to give her their condolence money, “They won 2 million dollars, you know.”)
It was a raw experience, watching it. So raw that it was almost painful. Although it sometimes seemed that the storytellers were trying to squeeze too many issues into one movie, it was all very real & familiar to me, as a Singaporean. Seeing it all exposed on the big screen made it almost embarrassing to be a Singaporean, although at the end of the story, everyone gets his/her comeuppance.
And what does Singapore Dreaming have to do with the IMF/World Bank meetings? Nothing direct, really (apart from the fact that the movie opened in local theatres just 4 days prior to the start of the meetings – hmmmmm…coincidence? ☺ ). It just made me think of all the aesthetic remodeling & “cosmetic surgery” (all of which would have done Dr Wu proud ☺) that has been taking place in the preceding few months to pretty up this little island of ours. After watching the movie, it became more obvious that we really needed all the surface touch-ups.
It revolves around the lives of an average Chinese-Singaporean family. Dad, Loh Poh Huat, is the typical wannabe, disdainful of HDB dwellers, & counting the days when he strikes Toto & can afford to move into his dream condo & buy his dream car & join an elite country club. Mum is a housewife, content with her duties of keeping house, cooking & brewing ‘liang teh’ (herbal tea) everyday for the family. Oldest child is Mei, a secretary married to an ex-Army regular, C.K., who now struggles to earn a living by selling life insurance. Mei has always struggled for her parents' love & attention, and being born a girl is a great disadvantage in this struggle. Younger offspring is Seng, the precious son, the ne’er-do-good, sent off to the golden land of America to get a degree from an American university so that he can return after graduating to earn a good living & repay the money spent by his father & his long-suffering fiancée, Irene, to support his studies. Or so it is hoped.
A multitude of local social issues are laid bare: our obsession with the 5C’s, our oftentimes hypocritical attitudes towards domestic maids, urinating in lifts, the preferential treatment shown to sons vs daughters. Swipes are taken at the kiasu-ism of Singaporeans, with a mother shown admonishing her kindergarten-aged son rather violently for scoring 95% in a spelling test instead of 100% like his classmate. Dr Woffles Wu even makes a cameo appearance as a family friend paying his condolences at the wake of the ill-fated Loh (“No need to give so much, OK,” he tells his wife softly, as they approach Mei to give her their condolence money, “They won 2 million dollars, you know.”)
It was a raw experience, watching it. So raw that it was almost painful. Although it sometimes seemed that the storytellers were trying to squeeze too many issues into one movie, it was all very real & familiar to me, as a Singaporean. Seeing it all exposed on the big screen made it almost embarrassing to be a Singaporean, although at the end of the story, everyone gets his/her comeuppance.
And what does Singapore Dreaming have to do with the IMF/World Bank meetings? Nothing direct, really (apart from the fact that the movie opened in local theatres just 4 days prior to the start of the meetings – hmmmmm…coincidence? ☺ ). It just made me think of all the aesthetic remodeling & “cosmetic surgery” (all of which would have done Dr Wu proud ☺) that has been taking place in the preceding few months to pretty up this little island of ours. After watching the movie, it became more obvious that we really needed all the surface touch-ups.
Monday, September 11, 2006
9/11
Five years past,
In disbelief I watched,
Mouth agape,
As planes smashed
One after the other
Into the two towers,
Televised “live” on CNN.
Oh my God, oh my God, oh my God.
This can’t be real,
It can’t be happening,
It must be a trick,
A camera trick,
A scene taken from a movie.
Then they fell
Like a stack of cards,
One after the other
Within seconds,
In a rising cloud of dust
That spread throughout Manhattan.
Another plane
Smashed into the Pentagon,
Another one into a field in Pennsylvania
One after the other.
Was that it? Was that it? Are there more?
Please, no more, no more, please.
Oh my God, oh my God, oh my God.
It felt surreal,
My mind numbed
By the thought of all those lives
Snuffed by unimaginable evil.
Terror transmitted halfway across the globe
Through the wonders of technology.
It was real
And yet unreal.
We lost our innocence
That fateful day,
No more trust
In our fellow man.
We have to find our way again,
Someone help us find our way again
Five years ago, on the night (in Singapore) of Sept 11, I watched CNN broadcast "live" as planes smashed into the two towers of the World Trade Center. It was an almost out-of-body experience, as my brain numbed, & my heart screamed "No!!!" in terror & disbelief, while I watched the buildings crumble down into nothingness.
I called A immediately - he was away on a business trip - he would call his mother as soon as we hung up. He had heard the news but had not seen the terror screened on the tube. She lives less than 15 blocks from where it happened. Fortunately, she slept through it (amazingly) as she is a late riser. He told her to keep her windows shut, & not to venture out into the streets due to the uncertainty of the situation. She had a freezer stocked to the brim with food, thankfully.
After that conversation, it became impossible to contact her as the phone exchanges in that area had been affected by the destruction. For three weeks we remained incommunicado, but was fortunate that A's best friend who lived in Brooklyn was able to contact her & let us know that she was OK despite the area being cordoned off.
Although America has recovered outwardly from this assault, scars remain from that fateful day. Although unspoken, suspicion remains of those who are of a particular faith, or who look & dress a certain way. But can one blame them?
My younger son still worries about his dad's plane crashing when A goes on his frequent business trips despite my reassurances that taking the plane is safer than driving a car. Until recently, he always made sure that whenever possible, A & I were accompanied by either him, or his older brother, whenever we went out, so that they could protect us in case we were "attacked" by terrorists. A sweet but illogical sentiment. But can one blame him? We lost our innocence five years ago.
In disbelief I watched,
Mouth agape,
As planes smashed
One after the other
Into the two towers,
Televised “live” on CNN.
Oh my God, oh my God, oh my God.
This can’t be real,
It can’t be happening,
It must be a trick,
A camera trick,
A scene taken from a movie.
Then they fell
Like a stack of cards,
One after the other
Within seconds,
In a rising cloud of dust
That spread throughout Manhattan.
Another plane
Smashed into the Pentagon,
Another one into a field in Pennsylvania
One after the other.
Was that it? Was that it? Are there more?
Please, no more, no more, please.
Oh my God, oh my God, oh my God.
It felt surreal,
My mind numbed
By the thought of all those lives
Snuffed by unimaginable evil.
Terror transmitted halfway across the globe
Through the wonders of technology.
It was real
And yet unreal.
We lost our innocence
That fateful day,
No more trust
In our fellow man.
We have to find our way again,
Someone help us find our way again
Five years ago, on the night (in Singapore) of Sept 11, I watched CNN broadcast "live" as planes smashed into the two towers of the World Trade Center. It was an almost out-of-body experience, as my brain numbed, & my heart screamed "No!!!" in terror & disbelief, while I watched the buildings crumble down into nothingness.
I called A immediately - he was away on a business trip - he would call his mother as soon as we hung up. He had heard the news but had not seen the terror screened on the tube. She lives less than 15 blocks from where it happened. Fortunately, she slept through it (amazingly) as she is a late riser. He told her to keep her windows shut, & not to venture out into the streets due to the uncertainty of the situation. She had a freezer stocked to the brim with food, thankfully.
After that conversation, it became impossible to contact her as the phone exchanges in that area had been affected by the destruction. For three weeks we remained incommunicado, but was fortunate that A's best friend who lived in Brooklyn was able to contact her & let us know that she was OK despite the area being cordoned off.
Although America has recovered outwardly from this assault, scars remain from that fateful day. Although unspoken, suspicion remains of those who are of a particular faith, or who look & dress a certain way. But can one blame them?
My younger son still worries about his dad's plane crashing when A goes on his frequent business trips despite my reassurances that taking the plane is safer than driving a car. Until recently, he always made sure that whenever possible, A & I were accompanied by either him, or his older brother, whenever we went out, so that they could protect us in case we were "attacked" by terrorists. A sweet but illogical sentiment. But can one blame him? We lost our innocence five years ago.
Friday, September 08, 2006
TV Land
RS: Supernova
Final four are Dilana, Toby, Magni & Lukas.
Storm was ousted last week after repeated being in the bottom 3. I guess Supernova has to listen to the fans. She gave a heart-wrenching performance of Pink Floyd's "Wish You Were Here" which brought even Jason Newsted (Bass Guitarist) to tears; but that was not enough to save her.
Toby's original composition, "Throw It Away" won him the encore (and a brand new Honda!) which he dedicated to fellow Aussie, Crocodile Hunter, the late Steve Irwin. His rousing & energetic performance had everyone singing along. A potential chart-topper, it had excellent guitar riffs, brilliantly performed by the House Band's Rafael Moreira.
My faves to win? Either Dilana or Toby. Dilana has had a rough couple of weeks, & her popularity has dropped after her foot-in-mouth debacle with the media. She still gives impressive performances, although her weakness in songwriting may proof to be detrimental. Toby has the looks, talent & charisma to capture fans for Supernova, especially those of the female persuasion! And in an industry driven by popularity & moolah (more fans=more albums sold=more$$$!), this could give him the edge over Dilana.
Entourage
I loved the most recent episode screened this week! Vince Chase (Adrian Grenier), low on funds after committing himself to buying a multimillion dollar house, decides to do an ad for a Red Bull-like product targeted at the Chinese market. Bai Ling guested as the stunt co-ordinator, to teach him martial arts moves for the ad. She ended up teaching him not only kungfu moves, but also techniques totally unrelated to martial arts (ahem!). The episode ended with the final product - the ad itself, dubbed in Mandarin. Absolutely Brilliant!
Final four are Dilana, Toby, Magni & Lukas.
Storm was ousted last week after repeated being in the bottom 3. I guess Supernova has to listen to the fans. She gave a heart-wrenching performance of Pink Floyd's "Wish You Were Here" which brought even Jason Newsted (Bass Guitarist) to tears; but that was not enough to save her.
Toby's original composition, "Throw It Away" won him the encore (and a brand new Honda!) which he dedicated to fellow Aussie, Crocodile Hunter, the late Steve Irwin. His rousing & energetic performance had everyone singing along. A potential chart-topper, it had excellent guitar riffs, brilliantly performed by the House Band's Rafael Moreira.
My faves to win? Either Dilana or Toby. Dilana has had a rough couple of weeks, & her popularity has dropped after her foot-in-mouth debacle with the media. She still gives impressive performances, although her weakness in songwriting may proof to be detrimental. Toby has the looks, talent & charisma to capture fans for Supernova, especially those of the female persuasion! And in an industry driven by popularity & moolah (more fans=more albums sold=more$$$!), this could give him the edge over Dilana.
Entourage
I loved the most recent episode screened this week! Vince Chase (Adrian Grenier), low on funds after committing himself to buying a multimillion dollar house, decides to do an ad for a Red Bull-like product targeted at the Chinese market. Bai Ling guested as the stunt co-ordinator, to teach him martial arts moves for the ad. She ended up teaching him not only kungfu moves, but also techniques totally unrelated to martial arts (ahem!). The episode ended with the final product - the ad itself, dubbed in Mandarin. Absolutely Brilliant!
aliendoc's top 10 peeves about driving in Singapore
I have been driving for almost 25 years, out of which 18 years were on Singapore roads. I have realised that the only time (OK, almost the only time) I cuss & use four letter words is when I am driving in Singapore. Here goes:
#10
Pedestrians who take there own sweet time crossing the road when there is a long line of cars waiting to pass through at a busy intersection (Think: Junction of Orchard & Paterson Roads just outside Wheelock Place).
#9
Waiting at the red light, then seeing the driver in the vehicle next to you picking his nose/ear, inspecting his finds then flicking it out his window.
(EEEWWW!)
#8
Waiting at the red light, then seeing the driver in the vehicle next to you wind down his window & projecting a loogie which misses your car by 3 inches.
(Double EEEWWW!)
#7
Motorcyclists who treat the lane dividers (or any space between two vehicles) as a designated motorbike lane.
#6
Motorcyclists in #7 who travel at a speed of 60 km/h (or less) on the expressway, making it difficult & dangerous for other vehicles to overtake him.
#5
Tailgaters who follow you like their car was magnetized to yours even though you are traveling at the maximum speed allowable.
#4
While waiting at a side road trying to get on to a busy road, you notice cars which don’t indicate that they intend to turn off into the side road, resulting in you missing a precious chance to turn out onto above said busy road.
(!@#%!!)
#3
When you indicate that you are trying to switch lanes, the oncoming car on the lane you are trying to switch to speeds up to block you off instead of slowing down.
(Double !@#%!!)
#2
Taxis which trawl for fares – they either travel at a snail’s pace; or make sudden swerves & stops to catch the passenger.
And aliendoc’s #1 peeve about driving on Singapore roads:
Drivers who allow their babies/toddlers/children to clamber all over the car- in between the front seats, on to the back ledge behind the back seat- or sit on the front passenger’s lap instead of being restrained in a child’s seat or by a seat belt. Don’t they know that their children would make excellent projectiles if they were involved in a collision???
#10
Pedestrians who take there own sweet time crossing the road when there is a long line of cars waiting to pass through at a busy intersection (Think: Junction of Orchard & Paterson Roads just outside Wheelock Place).
#9
Waiting at the red light, then seeing the driver in the vehicle next to you picking his nose/ear, inspecting his finds then flicking it out his window.
(EEEWWW!)
#8
Waiting at the red light, then seeing the driver in the vehicle next to you wind down his window & projecting a loogie which misses your car by 3 inches.
(Double EEEWWW!)
#7
Motorcyclists who treat the lane dividers (or any space between two vehicles) as a designated motorbike lane.
#6
Motorcyclists in #7 who travel at a speed of 60 km/h (or less) on the expressway, making it difficult & dangerous for other vehicles to overtake him.
#5
Tailgaters who follow you like their car was magnetized to yours even though you are traveling at the maximum speed allowable.
#4
While waiting at a side road trying to get on to a busy road, you notice cars which don’t indicate that they intend to turn off into the side road, resulting in you missing a precious chance to turn out onto above said busy road.
(!@#%!!)
#3
When you indicate that you are trying to switch lanes, the oncoming car on the lane you are trying to switch to speeds up to block you off instead of slowing down.
(Double !@#%!!)
#2
Taxis which trawl for fares – they either travel at a snail’s pace; or make sudden swerves & stops to catch the passenger.
And aliendoc’s #1 peeve about driving on Singapore roads:
Drivers who allow their babies/toddlers/children to clamber all over the car- in between the front seats, on to the back ledge behind the back seat- or sit on the front passenger’s lap instead of being restrained in a child’s seat or by a seat belt. Don’t they know that their children would make excellent projectiles if they were involved in a collision???
Thursday, September 07, 2006
Patient Empowerment
I read a very illuminating, and thought-provoking article, "The informed patient" by Dr David Tovey (Editorial Director of the British Medical Journal) in the September issue of the Singapore Medical Journal. He talks about “information therapy”, a term coined by Don Kemper of Healthwise to describe the prescription of knowledge by doctors to their patients to help them make better decisions about health care.
We doctors are so used to being purveyors of medical knowledge, that I am sure that I am not alone in admitting that when I used to encounter a patient armed with reams of information printed out from the Internet, my heart would clench a little with anxiety, and I subconsciously started to build a wall of resistance to this perceived challenge to my so-called authority!
But I have learnt that most of the time, these patients are only trying to empower themselves with knowledge so that they can understand their medical conditions or treatment. Those who are savvy enough to Google for information about their medical problem are usually able to understand that not everything can be believed and are open to a frank discussion on what information is reliable & what is not.
As human beings, we doctors can’t be expected to be all-knowing (we are not superior God-like beings after all, although some may think so - heehee!) of everything that is available on the Internet. There are thousands of bonafide medical studies & papers out there – as well as a kazillion websites full of quack info. I don’t think anyone in their right minds would expect us to read & memorize it all. What we can hope to do is to guide the patients & help them to separate the wheat from the chaff.
Websites* have been set-up from the UK & USA with information targeted at patients, explaining the condition, its treatment etc in language that non-medical persons can understand. Some even have a doctor/hospital finder.
We cannot ignore the fact that the Internet is a vastly used resource by many. I think we have to be ready to expect our patients to seek information therapy in addition to prescriptions from us!
* These are some examples. Some can only be accessed within its own country.
www.cochrane.org
www.webmd.com
www.healthwise.org
www.nhsdirect.nhs.uk/
www.besttreatments.co.uk/btuk/home.jsp
We doctors are so used to being purveyors of medical knowledge, that I am sure that I am not alone in admitting that when I used to encounter a patient armed with reams of information printed out from the Internet, my heart would clench a little with anxiety, and I subconsciously started to build a wall of resistance to this perceived challenge to my so-called authority!
But I have learnt that most of the time, these patients are only trying to empower themselves with knowledge so that they can understand their medical conditions or treatment. Those who are savvy enough to Google for information about their medical problem are usually able to understand that not everything can be believed and are open to a frank discussion on what information is reliable & what is not.
As human beings, we doctors can’t be expected to be all-knowing (we are not superior God-like beings after all, although some may think so - heehee!) of everything that is available on the Internet. There are thousands of bonafide medical studies & papers out there – as well as a kazillion websites full of quack info. I don’t think anyone in their right minds would expect us to read & memorize it all. What we can hope to do is to guide the patients & help them to separate the wheat from the chaff.
Websites* have been set-up from the UK & USA with information targeted at patients, explaining the condition, its treatment etc in language that non-medical persons can understand. Some even have a doctor/hospital finder.
We cannot ignore the fact that the Internet is a vastly used resource by many. I think we have to be ready to expect our patients to seek information therapy in addition to prescriptions from us!
* These are some examples. Some can only be accessed within its own country.
www.cochrane.org
www.webmd.com
www.healthwise.org
www.nhsdirect.nhs.uk/
www.besttreatments.co.uk/btuk/home.jsp
Wednesday, September 06, 2006
Educating the Whole Person
I share Dr Huang's sentiments & hopes on the recent initiatives announced by the MOE.
Educating our young is something I feel very strongly about. My gripe about the local system is the narrowness of its curriculum & its emphasis on getting good grades in tests & exams.
When we moved back here, my older son went directly into Primary 1. He was in the 1st grade in the US system. What a culture shock it was! So unsurprisingly, my son took about a month of tears & stomach aches before he adapted to the local classroom, crowded with 40 boys & one very harrassed teacher!
Coming from a Pennsylvanian suburb, where tuition classes for preschoolers/kindergarteners are unheard of & where the only enrichment "classes" I'd heard of were Kindermuzik & Gymboree, I was flummoxed to see such classes being advertised in newspapers, community centers, etc etc catering to children as young as 3 or 4 years old! As a matter fact, I refused to have my son take Chinese tuition lessons at the tender age of 7, as I expected his school to be able to teach him what he should know. Alas, 6 months into the school year, I received a call from his Chinese teacher asking if he had any supplementary help from a tutor at home. Upon finding out that he had none, she "gently encouraged" me to find one for him. In my heart, I thought that something was very wrong with a system which requires its students to spend additional time OUTSIDE the classroom with external tutors in order to achieve what they are expected to achieve IN school. Time spent outside of school should be reserved for recreation, leisure or relaxation. Or so I thought.
After 5 years of enduring this (during which my second boy started in Pr 1), my husband & I made the decision to transfer them into an international system, where we hoped that our childrens' potential could be explored more fully. Yes, Math & Science are important but are other areas which are similarly important like the Arts & Music. And the standard of English being taught...don't get me started on that!
We didn't want our kids to become automatons churned out at the end of their primary/secondary education, excelling only in passing exams from rote learning, but not daring to/not knowing how to form their own opinions about the world around them.
What a turnaround it has been over the last 3 years! My kids' minds have been challenged to think deeply & to analyse what they are reading instead of wholesale remembering/regurgitating the contents of a text book. In English, they actually read literature books & learn how the authors have used the language to tell a story & express themselves. My older son actually had some problem "re-aligning" his neurons to think this way in the initial few months, as he was so used to just filling in the blanks & choosing answers for multiple choice questions!
In addition to the quality education they receive, they also get to 'hang out' with children of other races & nationalities, an opportunity they would never have been able to get if they had stayed local. This is especially important in a world that is ever growing smaller with globalisation. Despite what they say about greater integration of races in schools with organised events, together with the media hype focussing on the few who actually DO mix with other races, I still notice that in real situations, like still clique with like.
So yes, there has been some sacrifice on our parts, in order for our children to get the education which my hubby & I feel they should get. The formative years are sooo important to how they will turn out as adults.
My hope is that our current Education Minister's visions will be realised (hopefully sooner than later). The incentives & gratuity payouts to the teachers are commendable indeed; what needs to be fixed next is the way that students are taught, & the system that places emphasis on test/exam results. We have to remember that we are shaping a whole being, & not just that area of the brain reserved for memorising texts & formulae.
As the slogan for the United Negro College Fund goes: "The Mind is a Terrible Thing to Waste"
Educating our young is something I feel very strongly about. My gripe about the local system is the narrowness of its curriculum & its emphasis on getting good grades in tests & exams.
When we moved back here, my older son went directly into Primary 1. He was in the 1st grade in the US system. What a culture shock it was! So unsurprisingly, my son took about a month of tears & stomach aches before he adapted to the local classroom, crowded with 40 boys & one very harrassed teacher!
Coming from a Pennsylvanian suburb, where tuition classes for preschoolers/kindergarteners are unheard of & where the only enrichment "classes" I'd heard of were Kindermuzik & Gymboree, I was flummoxed to see such classes being advertised in newspapers, community centers, etc etc catering to children as young as 3 or 4 years old! As a matter fact, I refused to have my son take Chinese tuition lessons at the tender age of 7, as I expected his school to be able to teach him what he should know. Alas, 6 months into the school year, I received a call from his Chinese teacher asking if he had any supplementary help from a tutor at home. Upon finding out that he had none, she "gently encouraged" me to find one for him. In my heart, I thought that something was very wrong with a system which requires its students to spend additional time OUTSIDE the classroom with external tutors in order to achieve what they are expected to achieve IN school. Time spent outside of school should be reserved for recreation, leisure or relaxation. Or so I thought.
After 5 years of enduring this (during which my second boy started in Pr 1), my husband & I made the decision to transfer them into an international system, where we hoped that our childrens' potential could be explored more fully. Yes, Math & Science are important but are other areas which are similarly important like the Arts & Music. And the standard of English being taught...don't get me started on that!
We didn't want our kids to become automatons churned out at the end of their primary/secondary education, excelling only in passing exams from rote learning, but not daring to/not knowing how to form their own opinions about the world around them.
What a turnaround it has been over the last 3 years! My kids' minds have been challenged to think deeply & to analyse what they are reading instead of wholesale remembering/regurgitating the contents of a text book. In English, they actually read literature books & learn how the authors have used the language to tell a story & express themselves. My older son actually had some problem "re-aligning" his neurons to think this way in the initial few months, as he was so used to just filling in the blanks & choosing answers for multiple choice questions!
In addition to the quality education they receive, they also get to 'hang out' with children of other races & nationalities, an opportunity they would never have been able to get if they had stayed local. This is especially important in a world that is ever growing smaller with globalisation. Despite what they say about greater integration of races in schools with organised events, together with the media hype focussing on the few who actually DO mix with other races, I still notice that in real situations, like still clique with like.
So yes, there has been some sacrifice on our parts, in order for our children to get the education which my hubby & I feel they should get. The formative years are sooo important to how they will turn out as adults.
My hope is that our current Education Minister's visions will be realised (hopefully sooner than later). The incentives & gratuity payouts to the teachers are commendable indeed; what needs to be fixed next is the way that students are taught, & the system that places emphasis on test/exam results. We have to remember that we are shaping a whole being, & not just that area of the brain reserved for memorising texts & formulae.
As the slogan for the United Negro College Fund goes: "The Mind is a Terrible Thing to Waste"
Monday, September 04, 2006
Scoring Docs
I came across this webcast from Medscape, from which I receive regular updates on medical news. It reminded me of angrydoc's bonus bogus story.
Here's the transcript, if you are unable to view it (you have to subscribe):
"What Are Patients Looking for?
Posted 08/18/2006
Steven R. Feldman, MD, PhD
Patients generally can't tell whether doctors are making the right diagnosis or prescribing the right treatment, but patients do make judgments on the quality of care they receive. Their perceptions are affected by their interactions with the practice on the telephone, the ease of finding parking, and their interactions with staff and healthcare providers.
Based on my experiences as a physician, I started an online patient satisfaction survey service, www.DrScore.com,[1] where patients can rate their doctors and look up doctor ratings. We've analyzed the survey results to determine what patients think is important to an excellent medical experience.[2] Quality of diagnosis and treatment plays a role, but more importantly, patients value access and communication with their doctor; a doctor who is supportive, caring, and compassionate; follow-up on test results; quality facilities; and a friendly office staff.
Sometimes we doctors are so caring, so well trained, and so efficient that we can quickly identify a problem and know exactly what to prescribe. When we do that, though, the patient may feel that we were uncaring and that we didn't take the time to do a proper examination or consider the best course of treatment.[3] It's not enough to just be caring and technically expert; the doctor also has to make the effort to communicate that care and empathy to their patient and to provide a uniformly excellent medical experience. When doctors do that, patients are more satisfied. They are also more trusting and adherent to medication -- they actually do better clinically -- not to mention being less likely to sue![4,5] By measuring their patients' satisfaction, doctors gain the information they need to assure patients the best possible medical care experience.
That's my opinion. I'm Dr. Steven Feldman.
References
1. DrScore. Available at: www.DrScore.com Accessed August 10, 2006.
2. Anderson R, Barbara A, Feldman S. Seven traits of outstanding physicians as reported by their patients. 2006. Available at: http://www.drscore.com/press/releases/7traits.pdf Accessed August 10, 2006.
3. Bendapudi NM, Berry LL, Frey KA, Parish JT, Rayburn WL. Patients' perspectives on ideal physician behaviors. Mayo Clin Proc. 2006;81:338-344. Abstract
4. Renzi C, Tabolli S, Picardi A, Abeni D, Puddu P, Braga M. Effects of patient satisfaction with care on health-related quality of life: a prospective study. J Eur Acad Dermatol Venereol. 2005;19:712-718. Abstract
5. Stelfox HT, Gandhi TK, Orav EJ, Gustafson ML. The relation of patient satisfaction with complaints against physicians and malpractice lawsuits. Am J Med. 2005;118:1126-1133. Abstract"
Who knows, one of these days, we may have a Singapore version of Dr Score...not that bogus after all!
Here's the transcript, if you are unable to view it (you have to subscribe):
"What Are Patients Looking for?
Posted 08/18/2006
Steven R. Feldman, MD, PhD
Patients generally can't tell whether doctors are making the right diagnosis or prescribing the right treatment, but patients do make judgments on the quality of care they receive. Their perceptions are affected by their interactions with the practice on the telephone, the ease of finding parking, and their interactions with staff and healthcare providers.
Based on my experiences as a physician, I started an online patient satisfaction survey service, www.DrScore.com,[1] where patients can rate their doctors and look up doctor ratings. We've analyzed the survey results to determine what patients think is important to an excellent medical experience.[2] Quality of diagnosis and treatment plays a role, but more importantly, patients value access and communication with their doctor; a doctor who is supportive, caring, and compassionate; follow-up on test results; quality facilities; and a friendly office staff.
Sometimes we doctors are so caring, so well trained, and so efficient that we can quickly identify a problem and know exactly what to prescribe. When we do that, though, the patient may feel that we were uncaring and that we didn't take the time to do a proper examination or consider the best course of treatment.[3] It's not enough to just be caring and technically expert; the doctor also has to make the effort to communicate that care and empathy to their patient and to provide a uniformly excellent medical experience. When doctors do that, patients are more satisfied. They are also more trusting and adherent to medication -- they actually do better clinically -- not to mention being less likely to sue![4,5] By measuring their patients' satisfaction, doctors gain the information they need to assure patients the best possible medical care experience.
That's my opinion. I'm Dr. Steven Feldman.
References
1. DrScore. Available at: www.DrScore.com Accessed August 10, 2006.
2. Anderson R, Barbara A, Feldman S. Seven traits of outstanding physicians as reported by their patients. 2006. Available at: http://www.drscore.com/press/releases/7traits.pdf Accessed August 10, 2006.
3. Bendapudi NM, Berry LL, Frey KA, Parish JT, Rayburn WL. Patients' perspectives on ideal physician behaviors. Mayo Clin Proc. 2006;81:338-344. Abstract
4. Renzi C, Tabolli S, Picardi A, Abeni D, Puddu P, Braga M. Effects of patient satisfaction with care on health-related quality of life: a prospective study. J Eur Acad Dermatol Venereol. 2005;19:712-718. Abstract
5. Stelfox HT, Gandhi TK, Orav EJ, Gustafson ML. The relation of patient satisfaction with complaints against physicians and malpractice lawsuits. Am J Med. 2005;118:1126-1133. Abstract"
Who knows, one of these days, we may have a Singapore version of Dr Score...not that bogus after all!
Thursday, August 31, 2006
Alien Nation
In the USA, when you become a PR, they give you a card that identifies you as a Resident Alien. This is widely known as the Green Card (although it’s not actually green, but pink; maybe once upon a time it used to be green). I got this card almost a decade & a half ago, when I got married.
Theoretically speaking, I have been an alien* for more than half my life. My parents moved here when I was barely out of toddlerhood. My dad was, what you would today call, a foreign talent, who left his home country to seek a better life for his kids. He & my mom landed here, liked it & decided to call it home. With his qualifications, he found a job here, & made a comfortable living. He became PR of this country & by default, so did my sister & I (mom was already Singaporean by virtue of birth). I only naturalized when I turned 21 due to some sexist ruling that said that only a Singaporean dad can sponsor a PR minor to become a Singaporean. So I had to wait till I became an adult before naturalizing on my own merits (i.e. doctor-to-be – therefore desirable citizen, I assume ☺).
Growing up, I was never made to feel different by my Singaporean friends. For all
intents & purposes, Singapore was home to me, despite my different colored IC & foreign passport. There was no talk of whether foreign talent was good or no good; my family & I were accepted for what we were (& still are!).
Hence all this recent discussion about foreign talent bemuses me. When did it become such a controversial issue? And why?
I remember in the 70’s, construction workers & cleaners/sweepers were made up mainly of locals. Somewhere between then & now, foreigners took over these “undesirable” jobs, presumably because Singaporeans were unwilling to take up menial jobs & dirty work. Hence foreign workers filled this niche. I didn’t hear anyone make any noise about that.
If the government hadn’t made it an issue in the recent years, would it be so hotly discussed now? Would people be more accepting of the fact that sometimes, you have to look at the person & what he/she can do instead of looking at his/her passport before deciding if he/she is deserving of working in this country?
After all, if these people are willing to uproot their families to make their living here, & there are employers who are willing to hire them, why the fuss? Could it be that the jobs being talked about now are higher paying ones, & not cheap labor.
I truly believe that if you have the ability, the desire & the qualifications to do a job, you WILL be able to get the job that you deserve. So I don’t see why Singaporeans are making such a big deal over it, unless they are not confident of their own abilities to get the aforesaid jobs in the first place. But then, that is a different kettle of fish altogether, innit? ☺.
*part of the reason why I adopted the moniker “aliendoc”
Theoretically speaking, I have been an alien* for more than half my life. My parents moved here when I was barely out of toddlerhood. My dad was, what you would today call, a foreign talent, who left his home country to seek a better life for his kids. He & my mom landed here, liked it & decided to call it home. With his qualifications, he found a job here, & made a comfortable living. He became PR of this country & by default, so did my sister & I (mom was already Singaporean by virtue of birth). I only naturalized when I turned 21 due to some sexist ruling that said that only a Singaporean dad can sponsor a PR minor to become a Singaporean. So I had to wait till I became an adult before naturalizing on my own merits (i.e. doctor-to-be – therefore desirable citizen, I assume ☺).
Growing up, I was never made to feel different by my Singaporean friends. For all
intents & purposes, Singapore was home to me, despite my different colored IC & foreign passport. There was no talk of whether foreign talent was good or no good; my family & I were accepted for what we were (& still are!).
Hence all this recent discussion about foreign talent bemuses me. When did it become such a controversial issue? And why?
I remember in the 70’s, construction workers & cleaners/sweepers were made up mainly of locals. Somewhere between then & now, foreigners took over these “undesirable” jobs, presumably because Singaporeans were unwilling to take up menial jobs & dirty work. Hence foreign workers filled this niche. I didn’t hear anyone make any noise about that.
If the government hadn’t made it an issue in the recent years, would it be so hotly discussed now? Would people be more accepting of the fact that sometimes, you have to look at the person & what he/she can do instead of looking at his/her passport before deciding if he/she is deserving of working in this country?
After all, if these people are willing to uproot their families to make their living here, & there are employers who are willing to hire them, why the fuss? Could it be that the jobs being talked about now are higher paying ones, & not cheap labor.
I truly believe that if you have the ability, the desire & the qualifications to do a job, you WILL be able to get the job that you deserve. So I don’t see why Singaporeans are making such a big deal over it, unless they are not confident of their own abilities to get the aforesaid jobs in the first place. But then, that is a different kettle of fish altogether, innit? ☺.
*part of the reason why I adopted the moniker “aliendoc”
And he's out...
In a shocker elimination, Ryan Star was the next contestant booted out of the competition in Rockstar: Supernova. It seemed like everyone had their mouths gaping open when this was announced by Tommy "Hatchet Man" Lee, including myself. I had expected Storm to be the next one out.
Never fear, I think Ryan has enough to talent to make it without Supernova. I suspect that he may even out-shadow them eventually, judging from the 3 tracks I've heard so far from Supernova.
Never fear, I think Ryan has enough to talent to make it without Supernova. I suspect that he may even out-shadow them eventually, judging from the 3 tracks I've heard so far from Supernova.
Wednesday, August 30, 2006
Rockstar: Supernova
Things are really heating up at the rockstar mansion! After Dilana's booboo with the media hounds, emotions ran high when they got home, culminating in Dilana breaking down & Magni ending up with a "flesh wound" on his head! Drama, drama..ooh, I love it!!!!
Performances this week were based on fans' votes - we got to vote on who should sing what. I think Ryan, Toby & Dilana nailed their performances. Magni was good but could not outshine these three.
Storm was struggling with her song "Bring Me to Life" by Evanescence, while Lukas did a very energetic version of Lithium despite his "dislike" of the song. I don't like him though...too arrogant, IMHO. Yes, you can be arrogant during a performance, but if you carry that attitude off stage, you end up p***-ing off many people. I don't see Storm fronting Supernova; she just doesn't fit. I think she will be the next to go.
Darn website...can't seem to vote online!
Performances this week were based on fans' votes - we got to vote on who should sing what. I think Ryan, Toby & Dilana nailed their performances. Magni was good but could not outshine these three.
Storm was struggling with her song "Bring Me to Life" by Evanescence, while Lukas did a very energetic version of Lithium despite his "dislike" of the song. I don't like him though...too arrogant, IMHO. Yes, you can be arrogant during a performance, but if you carry that attitude off stage, you end up p***-ing off many people. I don't see Storm fronting Supernova; she just doesn't fit. I think she will be the next to go.
Darn website...can't seem to vote online!
Tuesday, August 29, 2006
Dear Diary
The summer vacation is finally over, & the kids went back to school a couple of weeks ago. Has it been only 2 weeks??? It seems longer than that. They are in full swing, with a hefty amount of homework almost daily.
Z, a freshman in high school, is starting to realise that high school work involves a lot more depth than what he did in middle school. He is joining a gun club (!!!) & a performing arts club (the appeal being that he & his "band mates" can jam together in school). I hope he can cope with the extra activities. I was hoping that he could also involve himself in a community service club, but don't want him to get overwhelmed. Maybe he can do an adhoc type of thing during the school year, if something pops up.
W, 7th grader, is "joining a band". Not sure how this will work out, because at this age, a lot of it is talk, & high hopes which may eventually not end up the way they want it to. His band is supposed to audition for a talent show, but have yet to have a full fledged rehearsal. It will be interesting to see how this will turn out.
Me
I am going to be doing a locum job next month, once a week. Already did one session a couple of weeks ago, & I can honestly say that I do NOT miss work. I had that "been-there-done-that" feeling. At this point, it's hard for me to picture myself going back to full time clinical work. The passion is just not there. I have been considering the possibility of setting up my own business offering a consultancy service to interested parties to help them optimise their health-care needs. That way, I could use my knowledge & prior experience to do some good. Darn, I wish that med school had included a module on business studies.
Just found out that my Art teacher is moving to Jakarta. Aaahhhh! So sad! I really loved the art lessons. Now I will have to go look another class that is just as flexible & just as fun - I think it will be hard to find.
Am rather starved for good, non-depressing movies. We watched "Love Wrecked" starring Amanda Bynes last weekend, to our regret. I had hoped for a light-hearted romantic comedy, but ended up with a silly & rather juvenile storyline, with pretty bad acting. "The Devil Wears Prada" starts this week; with Meryl Streep, Stanley Tucci & Anne Hathaway, I hope that this will be more enjoyable.
Am also hoping that some world-class acts will head this way. Had wanted to watch Westlife, but my 'kaki' had some prior engagements & couldn't make it - I didn't fancy going to a concert on my own as I expect that most of the audience will be comprised of teenyboppers. Robbie Williams - tickets are so expensive + he is performing at the National Stadium which has sucky acoustics & not a great place to hold rock concerts (I had attended 2 concerts there before, by Michael Jackson & David Bowie - not worth the money). I refuse to pay $300 for it. Am considering watching "tick, tick Boom!", a musical based on the life of Jonathan Larson (who produced Rent) - will need to check out reviews on this before deciding.
Whom do I wish was coming here to perform? James Blunt, Jason Mraz (again), Nickelback (surprise - I really like their music), Green Day (another surprise - they're good!), just to name a few. I wouldn't mind watching Supernova, no matter who wins the contest. I have grown to appreciate Tommy Lee's antics & rather manic expression on his face when he is playing his drums. At this point, my faves to win are Dilana & Ryan Star.
I found my old English Lit books from Sec 3 & 4 - an anthology of poems, & Animal Farm by George Orwell, among them. All my scribblings & notes on the edges & in between the lines are still there & legible (although my aging eyes are finding it a bit hard to read some of it!). What great memories I have of our English Literature lessons. It was one of my favorite subjects as it allowed me to pour my heart & soul out on paper when asked to analyse certain poems or certain areas of the books. I didn't realise it at the time, but I think this helped to balance out the rote-learning & regurgitation we had to do with the Science subjects.
Z, a freshman in high school, is starting to realise that high school work involves a lot more depth than what he did in middle school. He is joining a gun club (!!!) & a performing arts club (the appeal being that he & his "band mates" can jam together in school). I hope he can cope with the extra activities. I was hoping that he could also involve himself in a community service club, but don't want him to get overwhelmed. Maybe he can do an adhoc type of thing during the school year, if something pops up.
W, 7th grader, is "joining a band". Not sure how this will work out, because at this age, a lot of it is talk, & high hopes which may eventually not end up the way they want it to. His band is supposed to audition for a talent show, but have yet to have a full fledged rehearsal. It will be interesting to see how this will turn out.
Me
I am going to be doing a locum job next month, once a week. Already did one session a couple of weeks ago, & I can honestly say that I do NOT miss work. I had that "been-there-done-that" feeling. At this point, it's hard for me to picture myself going back to full time clinical work. The passion is just not there. I have been considering the possibility of setting up my own business offering a consultancy service to interested parties to help them optimise their health-care needs. That way, I could use my knowledge & prior experience to do some good. Darn, I wish that med school had included a module on business studies.
Just found out that my Art teacher is moving to Jakarta. Aaahhhh! So sad! I really loved the art lessons. Now I will have to go look another class that is just as flexible & just as fun - I think it will be hard to find.
Am rather starved for good, non-depressing movies. We watched "Love Wrecked" starring Amanda Bynes last weekend, to our regret. I had hoped for a light-hearted romantic comedy, but ended up with a silly & rather juvenile storyline, with pretty bad acting. "The Devil Wears Prada" starts this week; with Meryl Streep, Stanley Tucci & Anne Hathaway, I hope that this will be more enjoyable.
Am also hoping that some world-class acts will head this way. Had wanted to watch Westlife, but my 'kaki' had some prior engagements & couldn't make it - I didn't fancy going to a concert on my own as I expect that most of the audience will be comprised of teenyboppers. Robbie Williams - tickets are so expensive + he is performing at the National Stadium which has sucky acoustics & not a great place to hold rock concerts (I had attended 2 concerts there before, by Michael Jackson & David Bowie - not worth the money). I refuse to pay $300 for it. Am considering watching "tick, tick Boom!", a musical based on the life of Jonathan Larson (who produced Rent) - will need to check out reviews on this before deciding.
Whom do I wish was coming here to perform? James Blunt, Jason Mraz (again), Nickelback (surprise - I really like their music), Green Day (another surprise - they're good!), just to name a few. I wouldn't mind watching Supernova, no matter who wins the contest. I have grown to appreciate Tommy Lee's antics & rather manic expression on his face when he is playing his drums. At this point, my faves to win are Dilana & Ryan Star.
I found my old English Lit books from Sec 3 & 4 - an anthology of poems, & Animal Farm by George Orwell, among them. All my scribblings & notes on the edges & in between the lines are still there & legible (although my aging eyes are finding it a bit hard to read some of it!). What great memories I have of our English Literature lessons. It was one of my favorite subjects as it allowed me to pour my heart & soul out on paper when asked to analyse certain poems or certain areas of the books. I didn't realise it at the time, but I think this helped to balance out the rote-learning & regurgitation we had to do with the Science subjects.
Thursday, August 24, 2006
Survivor 13
The upcoming season of Survivor: Cook Islands will see an added twist, when the teams are split up according to race.
This should be very interesting to watch; race is a sensitive issue in the USA (& here as well) & many people like to tiptoe around it & pretend that it doesn't matter. It shouldn't matter, but in reality, the color of our skin is the first thing that is seen & often dictates how we are perceived (& sometimes, how we are treated).
It will be very telling to see how this will play out in Survivor. It will either highlight glaring differences, or show that underneath all that pigment, we all belong to the human race. I hope it's the latter.
"...and it washed over me for the first time in my life just how much importance the world had ascribed to skin pigment, how lately it seemed that skin pigment was the sun and everything else in the universe was the orbiting planets...
...It seemed to me it would have been better if God had deleted skin pigment altogether."
Excerpt from "The Secret Life of Bees" by Sue Monk Kidd
This should be very interesting to watch; race is a sensitive issue in the USA (& here as well) & many people like to tiptoe around it & pretend that it doesn't matter. It shouldn't matter, but in reality, the color of our skin is the first thing that is seen & often dictates how we are perceived (& sometimes, how we are treated).
It will be very telling to see how this will play out in Survivor. It will either highlight glaring differences, or show that underneath all that pigment, we all belong to the human race. I hope it's the latter.
"...and it washed over me for the first time in my life just how much importance the world had ascribed to skin pigment, how lately it seemed that skin pigment was the sun and everything else in the universe was the orbiting planets...
...It seemed to me it would have been better if God had deleted skin pigment altogether."
Excerpt from "The Secret Life of Bees" by Sue Monk Kidd
Wednesday, August 23, 2006
crocs
Damn ugly.
But damn comfortable.
Especially for people with plantar fasciitis (like me!).
I luuurve my turquoise blue flip flop crocs. ☺
Monday, August 21, 2006
Mind-boggling
My jaw dropped & I could hardly believe what I was reading today in the Straits Times. One of the Singaporeans interviewed about what their hopes & wishes are, & their reaction to PM Lee Hsien Loong's National Day speech was a working mum, Mdm Kimberlie Chong. She is a mother of 4, & director of a business she runs with her husband. I reproduce part of the answer which she gave that had me gasping in disbelief.
Madam Chong was also pleased with the stress placed on schools to teach young Singaporeans to acknowledge their roots.
"Parents these days simply don't have the time to teach their children such subjects as moral values and Singapore's post-independent history."
Is it a wonder that the kids are growing up the way they are? The "Me" mentality, materialism, etc. With parents like Mdm Chong who do not make the time to teach moral values to their kids, I'm not surprised. I had previously blogged on this very issue, & Mdm Chong's statement seems to support what I am seeing in parents & kids today, with child-caring being left predominantly to their domestic helpers.
Being a parent is not to be taken lightly. That's why I feel that the Baby Bonus is not something that is beneficial in the long run in producing a society that we want to be proud of. If one can't make time to raise your kids right, then don't have kids at all. Period.
Madam Chong was also pleased with the stress placed on schools to teach young Singaporeans to acknowledge their roots.
"Parents these days simply don't have the time to teach their children such subjects as moral values and Singapore's post-independent history."
Is it a wonder that the kids are growing up the way they are? The "Me" mentality, materialism, etc. With parents like Mdm Chong who do not make the time to teach moral values to their kids, I'm not surprised. I had previously blogged on this very issue, & Mdm Chong's statement seems to support what I am seeing in parents & kids today, with child-caring being left predominantly to their domestic helpers.
Being a parent is not to be taken lightly. That's why I feel that the Baby Bonus is not something that is beneficial in the long run in producing a society that we want to be proud of. If one can't make time to raise your kids right, then don't have kids at all. Period.
Sunday, August 20, 2006
MHC
Attended the SMA convention on MHC yesterday.
Take home message: MHCs are here to stay. And GPs will need to put their brains together & come up with a way of managing their practices in order to manage the managed care companies in a way that won't compromise on quality of care or cause them to lose their livelihood.
How did the local situation in the private GP sector arrive at this stage? $5 consults? Losing money because reimbursement for medicine is less than cost?
I have never set up my own clinic. Never wanted to because I knew the sacrifices it would entail as far as my personal life & quality time with family is concerned. But I never foresaw that competition would heat up to the point where docs would be willing to sign up with money-losing MHC contracts just so that they would gain (or hope to gain) market share.
One of the speakers mentioned that we need to include an accounting module in the GDFM course. I wholeheartedy agree. Perhaps it's even time to include a Business module in NUS's Medicine curriculum called "The Business of Medicine". Let's face facts. Medicine is not all about altruism; in order to survive in this dog-eat-dog world, we need to be wise to the ways of the world.
After all, doctors set up clinics to treat patients, and yes, there will be patients who may not be able afford to pay for medications, and I know that doctors DO give allowance for this; but they also need to earn enough to pay their rent, their staff, feed their family, pay their monthly mortgage installments etc.
Take home message: MHCs are here to stay. And GPs will need to put their brains together & come up with a way of managing their practices in order to manage the managed care companies in a way that won't compromise on quality of care or cause them to lose their livelihood.
How did the local situation in the private GP sector arrive at this stage? $5 consults? Losing money because reimbursement for medicine is less than cost?
I have never set up my own clinic. Never wanted to because I knew the sacrifices it would entail as far as my personal life & quality time with family is concerned. But I never foresaw that competition would heat up to the point where docs would be willing to sign up with money-losing MHC contracts just so that they would gain (or hope to gain) market share.
One of the speakers mentioned that we need to include an accounting module in the GDFM course. I wholeheartedy agree. Perhaps it's even time to include a Business module in NUS's Medicine curriculum called "The Business of Medicine". Let's face facts. Medicine is not all about altruism; in order to survive in this dog-eat-dog world, we need to be wise to the ways of the world.
After all, doctors set up clinics to treat patients, and yes, there will be patients who may not be able afford to pay for medications, and I know that doctors DO give allowance for this; but they also need to earn enough to pay their rent, their staff, feed their family, pay their monthly mortgage installments etc.
Thursday, August 17, 2006
A Doc's Life - More Memorable Moments (P.S. 8)
Scenario: 4th year Med School; infectious disease rotation
At that time, the infamous Middle Road Hospital was still around (this is about 20 years ago). Patients with skin problems or STD’s were managed there. (I've always wondered about this strange combination ☺).
As part of our posting, we were supposed to go on a field trip to a red light district to see how prostitutes are “managed”. There were 3 main districts: Johore Road, Desker Road & Geylang. I think most of us were hoping to see Geylang, where it is supposed to be the most “high class” of the 3, with specially designed beds & other contraptions in the brothels (whether this is true or not, I have no idea ☺).
Anyway, my group was sent to Desker Road with a social worker. Basically, what the medical social worker needed to do was to make sure that the “workers” had been keeping up with their regular visits to Middle Road for tests to ensure that they were “disease-free”. Those who were cleared were given green ID cards, which they had to show to the MSW who did spot checks.
There is a widely held misconception that prostitution is illegal in Singapore. Well, that’s not true. As long as the sex worker worked in his/her registered brothel & was holding a valid green card, it was OK. However, if they solicited their services on premises other than the brothel, they could be arrested. I am assuming that this, or a system similar to this, still holds true.
Desker Road is in a not too great area of the city. The brothels were located in old pre-war shophouses. Inside, the space was subdivided into spartan looking cubicles each containing a bed & a sink. Each brothel had its own “type” of sex workers:
a) Women
b) Old women – and I mean old. The lady whom we saw there looked like someone’s grandmother. In fact, she was wearing a traditional sam-foo type of outfit. We later found out that she REALLY WAS someone’s grandmother. When we asked her why she was still doing this kind of work, she said that she needed the money to support her (useless, IMHO) son who was already in his 30’s, and toddler grandson. Sad, really.
c) “Women” – transvestites, who looked more female than the real women; they were beautiful with gorgeous slim & toned bodies. They also tended to have exaggerated feminine gestures, & dressed in extremely revealing clothing (think: blouse made of some kind of net-like material, with no undergarments). One of them told us that "he" was saving up for gender reassignment surgery.
Surprisingly, the highest rate for service was for category c. At that time, it was between S$30 to S$40 per session. The poor old lady only earned $5 to $10 per session, while the “regular” women earned about $25 per session.
On leaving the brothels, we walked through the alleyway behind the shophouses, and there were vendors with tables set-up there, selling different kinds of devices supposed to enhance one’s erotic experiences! We were really quite surprised to see these things being sold openly although we (innocents that we were * GRIN*) couldn’t figure out how some of those things worked or where they were supposed to be fitted/worn!
An eye-opening experience.
At that time, the infamous Middle Road Hospital was still around (this is about 20 years ago). Patients with skin problems or STD’s were managed there. (I've always wondered about this strange combination ☺).
As part of our posting, we were supposed to go on a field trip to a red light district to see how prostitutes are “managed”. There were 3 main districts: Johore Road, Desker Road & Geylang. I think most of us were hoping to see Geylang, where it is supposed to be the most “high class” of the 3, with specially designed beds & other contraptions in the brothels (whether this is true or not, I have no idea ☺).
Anyway, my group was sent to Desker Road with a social worker. Basically, what the medical social worker needed to do was to make sure that the “workers” had been keeping up with their regular visits to Middle Road for tests to ensure that they were “disease-free”. Those who were cleared were given green ID cards, which they had to show to the MSW who did spot checks.
There is a widely held misconception that prostitution is illegal in Singapore. Well, that’s not true. As long as the sex worker worked in his/her registered brothel & was holding a valid green card, it was OK. However, if they solicited their services on premises other than the brothel, they could be arrested. I am assuming that this, or a system similar to this, still holds true.
Desker Road is in a not too great area of the city. The brothels were located in old pre-war shophouses. Inside, the space was subdivided into spartan looking cubicles each containing a bed & a sink. Each brothel had its own “type” of sex workers:
a) Women
b) Old women – and I mean old. The lady whom we saw there looked like someone’s grandmother. In fact, she was wearing a traditional sam-foo type of outfit. We later found out that she REALLY WAS someone’s grandmother. When we asked her why she was still doing this kind of work, she said that she needed the money to support her (useless, IMHO) son who was already in his 30’s, and toddler grandson. Sad, really.
c) “Women” – transvestites, who looked more female than the real women; they were beautiful with gorgeous slim & toned bodies. They also tended to have exaggerated feminine gestures, & dressed in extremely revealing clothing (think: blouse made of some kind of net-like material, with no undergarments). One of them told us that "he" was saving up for gender reassignment surgery.
Surprisingly, the highest rate for service was for category c. At that time, it was between S$30 to S$40 per session. The poor old lady only earned $5 to $10 per session, while the “regular” women earned about $25 per session.
On leaving the brothels, we walked through the alleyway behind the shophouses, and there were vendors with tables set-up there, selling different kinds of devices supposed to enhance one’s erotic experiences! We were really quite surprised to see these things being sold openly although we (innocents that we were * GRIN*) couldn’t figure out how some of those things worked or where they were supposed to be fitted/worn!
An eye-opening experience.
Wednesday, August 16, 2006
A Doc's Life - More Memorable Moments (P.S. 7)
Scenario: Pediatric Surgery Department of a large local hospital
This was where I did a 6-month rotation. This is where I:
• found out I was pregnant with my first son; had hyperemesis gravidarum due to aforementioned pregnancy, resulting in my having to run out during ward rounds to throw up, asking the nurse to jab me with IM Dramamine during one of my calls, and almost throwing up on a patient when I was assisting the on-call consultant in a laparotomy. The sight & smell of gas-filled loops of ischemic, necrotic intestines which popped eagerly out of the neonate’s abdominal cavity was not a pleasant one, pregnant or not;
• saw my first (& only) omphalocele;
• learnt how to do laser circumcision. And I am proud to say that my handiwork was pretty good too. Thing about using lasers is that you have to have good hand-eye-foot co-ordination. Hand because you have to target the laser, eye because you have to see what you are doing (duh) & foot because that’s how you turn the laser beam on & off (or shoot the laser, as a layman would say). There was a fellow from another Asian country who wasn’t terribly good with his hands, & one time, when I was assisting him, I saw him inadvertently “shoot” the laser at the glans penis – he didn’t lift his foot off fast enough. My eyes widened in horror & I cringed in empathy (although I am female, I could still imagine how sensitive that area is). Fortunately, it was a very small, very superficial burn.
• was taught how to differentiate between abdominal guarding & voluntary rigidity (in babies & children, who tend to be more sensitive to being palpated, this can be quite hard to do).
• developed a phobia of calling up radiologists on call to help confirm & manage intussusception. For some reason, certain radiologists were terribly unfriendly, and seemed to do the barium enemas very grudgingly. I often wished I could have told them: hey, I don’t like waking you up in the middle of the night either, but this kid is in pain, & signs point to a likely diagnosis of intussusception, you know!
• learnt that projectile vomiting in babies with pyloric stenosis is REALLY projectile, if you know what I mean;
• realized that many “head injury” patients tended to be admitted at night. I think the parents had no time to worry until after dinner, when fearsome thoughts & scenarios start flashing through their heads about the bump on their DDC’s* heads although the bump may have been sustained a week ago.
*DDC = Dear Darling Children
This was where I did a 6-month rotation. This is where I:
• found out I was pregnant with my first son; had hyperemesis gravidarum due to aforementioned pregnancy, resulting in my having to run out during ward rounds to throw up, asking the nurse to jab me with IM Dramamine during one of my calls, and almost throwing up on a patient when I was assisting the on-call consultant in a laparotomy. The sight & smell of gas-filled loops of ischemic, necrotic intestines which popped eagerly out of the neonate’s abdominal cavity was not a pleasant one, pregnant or not;
• saw my first (& only) omphalocele;
• learnt how to do laser circumcision. And I am proud to say that my handiwork was pretty good too. Thing about using lasers is that you have to have good hand-eye-foot co-ordination. Hand because you have to target the laser, eye because you have to see what you are doing (duh) & foot because that’s how you turn the laser beam on & off (or shoot the laser, as a layman would say). There was a fellow from another Asian country who wasn’t terribly good with his hands, & one time, when I was assisting him, I saw him inadvertently “shoot” the laser at the glans penis – he didn’t lift his foot off fast enough. My eyes widened in horror & I cringed in empathy (although I am female, I could still imagine how sensitive that area is). Fortunately, it was a very small, very superficial burn.
• was taught how to differentiate between abdominal guarding & voluntary rigidity (in babies & children, who tend to be more sensitive to being palpated, this can be quite hard to do).
• developed a phobia of calling up radiologists on call to help confirm & manage intussusception. For some reason, certain radiologists were terribly unfriendly, and seemed to do the barium enemas very grudgingly. I often wished I could have told them: hey, I don’t like waking you up in the middle of the night either, but this kid is in pain, & signs point to a likely diagnosis of intussusception, you know!
• learnt that projectile vomiting in babies with pyloric stenosis is REALLY projectile, if you know what I mean;
• realized that many “head injury” patients tended to be admitted at night. I think the parents had no time to worry until after dinner, when fearsome thoughts & scenarios start flashing through their heads about the bump on their DDC’s* heads although the bump may have been sustained a week ago.
*DDC = Dear Darling Children
Goosebump moments
OMG. Wow. More goosebump moments this week on Rockstar Supernova - Ryan Star singing Phil Collin's "In The Air Tonight" & my fave, Dilana singing the classic "Cat's in the Cradle" by Harry Chapin. Awesome.
It's strange isn't it, how your body responds to certain moments of a musical performance or a movie - chills start to run down your spine, & goosebumps form on your skin, & sometimes you even feel the sting of tears in your eyes.
"The Sound of Music" - when the von Trapps performed Edelweiss before fleeing Austria.
Watching Jason Mraz perform live at the Esplanade.
Watching & listening to my sons perform an acoustic guitar version of "Sweet Child of Mine" in perfect synchrony.
Hearing the Vienna Boys Choir.
Singing along to ABBA songs during Mama Mia.
Goosebump moments, all of them.
It's strange isn't it, how your body responds to certain moments of a musical performance or a movie - chills start to run down your spine, & goosebumps form on your skin, & sometimes you even feel the sting of tears in your eyes.
"The Sound of Music" - when the von Trapps performed Edelweiss before fleeing Austria.
Watching Jason Mraz perform live at the Esplanade.
Watching & listening to my sons perform an acoustic guitar version of "Sweet Child of Mine" in perfect synchrony.
Hearing the Vienna Boys Choir.
Singing along to ABBA songs during Mama Mia.
Goosebump moments, all of them.
Tuesday, August 15, 2006
A Doc's Life - More Memorable Moments (P.S. 6)
This letter to the papers today reminds me of the naivete of some of the patients when it comes to matters related to their health or bodily functions.
Scenario: 3rd year Med School - Community health project for SMPH (Social Medicine & Public Health, now known as COFM - Community Occupational & Family Medicine). My clinical group did a project on hypertension & obesity; to gather data, we had to go to various units in HDB estates to measure BP, take height & weight etc.
Head of this particular family was a gentleman in his 40's with 4 daughters. As we were about to leave after gathering the neccessary info, he pulled me aside & asked: "I only have daughters. Is it because I only eat fish & don't eat meat?"
Me: "Er, no."
Him: "So what kind of diet should I take so that I can have a son."
Me: "Er, doesn't matter, what you eat won't affect the sex of your child. But for your health, please eat a balanced diet."
Not sure if he believed me or not.
Scenario: 3rd year Med School - Community health project for SMPH (Social Medicine & Public Health, now known as COFM - Community Occupational & Family Medicine). My clinical group did a project on hypertension & obesity; to gather data, we had to go to various units in HDB estates to measure BP, take height & weight etc.
Head of this particular family was a gentleman in his 40's with 4 daughters. As we were about to leave after gathering the neccessary info, he pulled me aside & asked: "I only have daughters. Is it because I only eat fish & don't eat meat?"
Me: "Er, no."
Him: "So what kind of diet should I take so that I can have a son."
Me: "Er, doesn't matter, what you eat won't affect the sex of your child. But for your health, please eat a balanced diet."
Not sure if he believed me or not.
Hearing Things
Hmm.
I wonder if I am hearing things. I thought I heard on the news on radio yesterday about scholarships being offered by A*Star to foreign students with a condition that they become Singapore citizens. I looked for it in the Straits Times yesterday & today. Nada. I tried searching for it on the Channel NewsAsia website. Nada. I tried looking for it on the Today Online website. Still nada.
Hmm. Perhaps I am having auditory hallucinations.
Either that, or the Powers That Be are trying to spin it such that it will sound more "acceptable" to the average Singaporean before publicising it in the print media.
After all, citizenship is something that should be something held dear to one's heart; you can't buy patriotism or loyalty with material rewards (with the cost of higher education these days, a hefty sum in this case). And in order to become a Singapore citizen, these scholars would have to renounce their original citizenship as part of the process. Not something that should be done lightly.
That's why I was looking for details in the news on how this would be implemented.
Will we be attracting people who would change loyalties at the drop of a hat? What will happen if a few years down the road, after they have completed their studies, they decide that they are not willing to be Singaporeans after all? What will the authorities do? Confiscate their passports? Fine them? Make them pay $xxx,000? Can you really put a price on this?
I guess I really shouldn't be surprised if this is true. Sporting talents have already gone this route.
I anxiously await to hear more.
I wonder if I am hearing things. I thought I heard on the news on radio yesterday about scholarships being offered by A*Star to foreign students with a condition that they become Singapore citizens. I looked for it in the Straits Times yesterday & today. Nada. I tried searching for it on the Channel NewsAsia website. Nada. I tried looking for it on the Today Online website. Still nada.
Hmm. Perhaps I am having auditory hallucinations.
Either that, or the Powers That Be are trying to spin it such that it will sound more "acceptable" to the average Singaporean before publicising it in the print media.
After all, citizenship is something that should be something held dear to one's heart; you can't buy patriotism or loyalty with material rewards (with the cost of higher education these days, a hefty sum in this case). And in order to become a Singapore citizen, these scholars would have to renounce their original citizenship as part of the process. Not something that should be done lightly.
That's why I was looking for details in the news on how this would be implemented.
Will we be attracting people who would change loyalties at the drop of a hat? What will happen if a few years down the road, after they have completed their studies, they decide that they are not willing to be Singaporeans after all? What will the authorities do? Confiscate their passports? Fine them? Make them pay $xxx,000? Can you really put a price on this?
I guess I really shouldn't be surprised if this is true. Sporting talents have already gone this route.
I anxiously await to hear more.
Friday, August 11, 2006
World of Terror
I wonder if this will ever end. At the moment, I have great doubts. Terror begets terror.
Technology, the Internet, science - all this is literally at the fingertips of those who are warped in their minds. They think they are fighting for the greater good, whatever that may be. But all they do is create fear, and wreak havoc on society.
Perhaps that is what they want to achieve. To make us all afraid; to change our way of life; to do away with the peace of mind that most of us have. If that is their objective, I am afraid that they have already succeeded.
No more liquids on airplanes. Parents have to do taste tests on their children’s food before they are allowed on planes. Yeah, I think they have succeeded.
Will it ever end? Maybe. But it will take a wake-up call of unprecedented nature like a huge catastrophe of massive proportions. Or divine intervention.
That’s how optimistic I am.
Technology, the Internet, science - all this is literally at the fingertips of those who are warped in their minds. They think they are fighting for the greater good, whatever that may be. But all they do is create fear, and wreak havoc on society.
Perhaps that is what they want to achieve. To make us all afraid; to change our way of life; to do away with the peace of mind that most of us have. If that is their objective, I am afraid that they have already succeeded.
No more liquids on airplanes. Parents have to do taste tests on their children’s food before they are allowed on planes. Yeah, I think they have succeeded.
Will it ever end? Maybe. But it will take a wake-up call of unprecedented nature like a huge catastrophe of massive proportions. Or divine intervention.
That’s how optimistic I am.
Wednesday, August 09, 2006
Rock Star: Supernova
This show airs every Wednesday night at 8 pm...the same time as Singapore Idol. I hate to say this but, everytime I tune in to this program, I switch to SI during the breaks, & almost immediately, I switch back. How do you compare?
THIS...is talent.
One word: Dilana.
She. Rocks. Big. Time.
Check out her version of the Johnny Cash classic "Ring of Fire". "Ring of Fire"??? you may ask yourself. But if she released this as a single tomorrow, I betcha it would be a hit.
Not convinced? Check out this...her rendition of Cyndi Lauper's "Time After Time"...
Or this...
No matter what kind of music she chooses, she makes the song her own. She has been the most consistent of all the performers (although Ryan Star did give a very sexy, soulful version of REM's "Losing My Religion" last week) & every week, her performances with her powerful throaty vocals have not failed to deliver.
Goosebumps, every week.
THIS...is talent.
One word: Dilana.
She. Rocks. Big. Time.
Check out her version of the Johnny Cash classic "Ring of Fire". "Ring of Fire"??? you may ask yourself. But if she released this as a single tomorrow, I betcha it would be a hit.
Not convinced? Check out this...her rendition of Cyndi Lauper's "Time After Time"...
Or this...
No matter what kind of music she chooses, she makes the song her own. She has been the most consistent of all the performers (although Ryan Star did give a very sexy, soulful version of REM's "Losing My Religion" last week) & every week, her performances with her powerful throaty vocals have not failed to deliver.
Goosebumps, every week.
Monday, August 07, 2006
For Trekkies...
All you Trekkies out there, check out this video which was created when a rumor went round that Matt Damon is going to be starring as Capt Kirk in the next Star Trek movie! It's a hoot! Goes to show how strongly Trekkies feel about this beloved franchise.
I admit that I consider myself a Trekkie as far as Star Trek: The Next Generation is concerned, & have even attended a couple of conventions in the US, but I'm not as fanatical as some of the weirdos out there!!!
I admit that I consider myself a Trekkie as far as Star Trek: The Next Generation is concerned, & have even attended a couple of conventions in the US, but I'm not as fanatical as some of the weirdos out there!!!
Sunday, August 06, 2006
A Fairy Tale
For those who went to watch "The Lady in the Water" expecting a tale of paranormal twists a la The Sixth Sense, you will be disappointed. M. Night Shyamalan's latest production is a modern day tale, a fairy tale, if you must.
I went in with an open mind, after having read the rather dismal reviews it received, & was rewarded with a story of faith, the restoration of hope & belief in the goodness of humanity. I have always enjoyed Paul Giamatti's performances, & he doesn't fail to deliver as the unlikely leading man with a tortured past of loss & suffering.
Mr Shyamalan slyly includes in his story, a character - a movie critic, no less- who, in a suspensely moment, narrates the developing storyline as if he were outside the story, before coming to a nasty end. I could appreciate his dig at the movie critics of the world!
I liked it.
I went in with an open mind, after having read the rather dismal reviews it received, & was rewarded with a story of faith, the restoration of hope & belief in the goodness of humanity. I have always enjoyed Paul Giamatti's performances, & he doesn't fail to deliver as the unlikely leading man with a tortured past of loss & suffering.
Mr Shyamalan slyly includes in his story, a character - a movie critic, no less- who, in a suspensely moment, narrates the developing storyline as if he were outside the story, before coming to a nasty end. I could appreciate his dig at the movie critics of the world!
I liked it.
why
"conflict in the middle east"
a recurrent headline
from as far back as i can remember
why?
i didn't understand
i don't understand
jews
muslims
christians
killing
and being killed
the hatred ripples
far & wide
now our neighbours
are sending "support"
more lives
to kill
& to be killed
so much hate
too overwhelming to understand
why?
a recurrent headline
from as far back as i can remember
why?
i didn't understand
i don't understand
jews
muslims
christians
killing
and being killed
the hatred ripples
far & wide
now our neighbours
are sending "support"
more lives
to kill
& to be killed
so much hate
too overwhelming to understand
why?
Friday, August 04, 2006
Entourage
I find myself strangely hooked to a new HBO series, Entourage.
Season 1, comprising of only 8 episodes, is currently playing on Tuesday nights at 9 pm on HBO (Starhub Cable channel 60). Season 3 is now being screened in the US.
This Emmy nominated series is about the celebrity lifestyle of a movie star, Vince Chase (played by pretty boy Adrian Grenier) & his entourage of childhood pals comprising of his brother, Drama (Kevin Dillon), best friend/Manager, Eric (Kevin Conolly), and Turtle the “COO” of his household (Jerry Ferrara). On the sidelines are his agent (ably played by Jeremy Piven), and publicist (Debi Mazar).
At first glance, one is surprised at the success of this series of half hour episodes. After all, how many of us can relate to the extravagant lifestyle of the rich & the famous. But I guess celebrite is such a draw these days as evidenced by the appeal of gossip newspapers, & the way papparazi is drawn to taking otherwise mundane pictures of Brad Pitt crossing the street, or Britney Spears drinking a cup of coffee – The People want to see such things.
Anyway, it is interesting to watch this supposed insider look at how the celebs really live (after all, Mark Wahlberg is one of the executive producers). Loose women & one night stands, smoking pot, spending ridiculous amounts of money (eg splurging >$300,000 on a car, then returning it to the dealer the next day) – all the clichés by which we think of how these Others live, you name it, it’s there, & couldn’t be further from how we plebians live.
It’s probably morbid curiosity that draws us viewers in…
Season 1, comprising of only 8 episodes, is currently playing on Tuesday nights at 9 pm on HBO (Starhub Cable channel 60). Season 3 is now being screened in the US.
This Emmy nominated series is about the celebrity lifestyle of a movie star, Vince Chase (played by pretty boy Adrian Grenier) & his entourage of childhood pals comprising of his brother, Drama (Kevin Dillon), best friend/Manager, Eric (Kevin Conolly), and Turtle the “COO” of his household (Jerry Ferrara). On the sidelines are his agent (ably played by Jeremy Piven), and publicist (Debi Mazar).
At first glance, one is surprised at the success of this series of half hour episodes. After all, how many of us can relate to the extravagant lifestyle of the rich & the famous. But I guess celebrite is such a draw these days as evidenced by the appeal of gossip newspapers, & the way papparazi is drawn to taking otherwise mundane pictures of Brad Pitt crossing the street, or Britney Spears drinking a cup of coffee – The People want to see such things.
Anyway, it is interesting to watch this supposed insider look at how the celebs really live (after all, Mark Wahlberg is one of the executive producers). Loose women & one night stands, smoking pot, spending ridiculous amounts of money (eg splurging >$300,000 on a car, then returning it to the dealer the next day) – all the clichés by which we think of how these Others live, you name it, it’s there, & couldn’t be further from how we plebians live.
It’s probably morbid curiosity that draws us viewers in…
Saturday, July 29, 2006
Cosmetic Surgery
Has anyone noticed lately that roads are being repaved left, right & center?
Wonder if it has anything to do with the upcoming Big Meetings?
;)
Wonder if it has anything to do with the upcoming Big Meetings?
;)
Sex (or the lack thereof)
Are Singaporeans ready for this?
Not many patients consult GP’s for sexual problems. I don’t mean sub-fertility or menstrual-related problems. I’m talking about actual problems with the physical act of intercourse. ED is probably the most common sexual problem for which males consult their GP’s since the advent of the little blue pill (Viagra, for those who have been living under a rock). Even then, most patients with ED feel more comfortable consulting male doctors.
I have had a few female patients come to me with the distressing problem of vaginismus. They were generally very embarrassed by their problem - so much so that one of them waited a whole year of non-consummation of her marriage before striking up the courage to talk to me about it! It can be extremely distressing for a couple faced with this situation, as they are often too embarrassed to talk to anyone about it. I believe this is just the tip of the iceberg; God knows how many people live with problems (emotional as well as physical) with their sex lives. And judging from responses from the patients who have approached me, they are unaware that there are specialists out there who can help with these problems.
In a conservative society like ours, sex, let alone sexual problems is a difficult topic to bring up for discussion over coffee or the dinner table. And, conservative or not, parents are probably the last people on earth one would want to discuss one’s sexual life with!
And it doesn’t help matters that sex education is so lacking in the local schools. I think the majority of teachers are ill-equipped to handle this sensitive subject. For crying out loud, many people (teachers included) can’t even utter the words “vagina” & penis” out loud without humming & hah-ing or sniggering! I remember going through my son’s Primary 5 health education book when he was still attending a local all boys school, & seeing a chapter on the human reproductive system. When I asked him if his teacher (a lady) had gone through that chapter yet, he said yes, but she skipped the bits on the female organs! I was quite astounded.
Judging from the very successful turnout of the first sex exhibition held in South-east Asia last year, I think Singaporeans are more than ready! Heck, I was surprised to find this on a government website! Yeah...I think we're ready...
Not many patients consult GP’s for sexual problems. I don’t mean sub-fertility or menstrual-related problems. I’m talking about actual problems with the physical act of intercourse. ED is probably the most common sexual problem for which males consult their GP’s since the advent of the little blue pill (Viagra, for those who have been living under a rock). Even then, most patients with ED feel more comfortable consulting male doctors.
I have had a few female patients come to me with the distressing problem of vaginismus. They were generally very embarrassed by their problem - so much so that one of them waited a whole year of non-consummation of her marriage before striking up the courage to talk to me about it! It can be extremely distressing for a couple faced with this situation, as they are often too embarrassed to talk to anyone about it. I believe this is just the tip of the iceberg; God knows how many people live with problems (emotional as well as physical) with their sex lives. And judging from responses from the patients who have approached me, they are unaware that there are specialists out there who can help with these problems.
In a conservative society like ours, sex, let alone sexual problems is a difficult topic to bring up for discussion over coffee or the dinner table. And, conservative or not, parents are probably the last people on earth one would want to discuss one’s sexual life with!
And it doesn’t help matters that sex education is so lacking in the local schools. I think the majority of teachers are ill-equipped to handle this sensitive subject. For crying out loud, many people (teachers included) can’t even utter the words “vagina” & penis” out loud without humming & hah-ing or sniggering! I remember going through my son’s Primary 5 health education book when he was still attending a local all boys school, & seeing a chapter on the human reproductive system. When I asked him if his teacher (a lady) had gone through that chapter yet, he said yes, but she skipped the bits on the female organs! I was quite astounded.
Judging from the very successful turnout of the first sex exhibition held in South-east Asia last year, I think Singaporeans are more than ready! Heck, I was surprised to find this on a government website! Yeah...I think we're ready...
Wednesday, July 26, 2006
A Doc's Life - More Memorable Moments (P.S. 5)
Subject: East is East and West is West?
In a society where a large proportion of the population still ascribes to traditional (or, in a more currently used term, alternative) medicine, I would get asked questions that, as a Western-trained doctor, I found difficult to answer.
A typical exchange:
Me: ”I’ll give you some medicine to help with your sore throat & phlegm. This is probably due to a viral infection, & you should get over it in a few days.”
Patient: ” Is it heatiness*? I ate a lot of chocolates yesterday.”
Me: “Er, I’m sorry, I really can’t say if it’s heaty or not, as I was not trained in Chinese medicine. This is probably a viral infection.”
I usually don’t brush it off as nonsense, as I like to keep an open mind. I occasionally even agree with the patient if I am too tired to explain, & the patient goes away happy that he/she has self-diagnosed the cause of his/her symptoms.
Another example involves a patient who is either recuperating from surgery or from an injury. He/she would ask me to confirm the “fact” that they should abstain from food like chicken & prawns as they are ”toxic”, & also from dark soya sauce as it would result in a hyperpigmented scar. I try to give them my opinion, but I usually don’t protest too violently, as I know that no matter what I say, these beliefs, which have been handed down through God knows how many generations, will persist; and they would abstain from those food items anyway.
*The concept of ”heatiness” & “coolness” is one held in Traditional Chinese Medicine to cause a variety of illnesses. Eg. Sore throat, phlegm, cough are attributed to one’s body being too “heaty”, often due to “heaty” foods like chocolates, anything fried, durians etc (the list goes on). Hence, “cooling” remedies like herbal teas are used to treat the symptoms.
In a society where a large proportion of the population still ascribes to traditional (or, in a more currently used term, alternative) medicine, I would get asked questions that, as a Western-trained doctor, I found difficult to answer.
A typical exchange:
Me: ”I’ll give you some medicine to help with your sore throat & phlegm. This is probably due to a viral infection, & you should get over it in a few days.”
Patient: ” Is it heatiness*? I ate a lot of chocolates yesterday.”
Me: “Er, I’m sorry, I really can’t say if it’s heaty or not, as I was not trained in Chinese medicine. This is probably a viral infection.”
I usually don’t brush it off as nonsense, as I like to keep an open mind. I occasionally even agree with the patient if I am too tired to explain, & the patient goes away happy that he/she has self-diagnosed the cause of his/her symptoms.
Another example involves a patient who is either recuperating from surgery or from an injury. He/she would ask me to confirm the “fact” that they should abstain from food like chicken & prawns as they are ”toxic”, & also from dark soya sauce as it would result in a hyperpigmented scar. I try to give them my opinion, but I usually don’t protest too violently, as I know that no matter what I say, these beliefs, which have been handed down through God knows how many generations, will persist; and they would abstain from those food items anyway.
*The concept of ”heatiness” & “coolness” is one held in Traditional Chinese Medicine to cause a variety of illnesses. Eg. Sore throat, phlegm, cough are attributed to one’s body being too “heaty”, often due to “heaty” foods like chocolates, anything fried, durians etc (the list goes on). Hence, “cooling” remedies like herbal teas are used to treat the symptoms.
Tuesday, July 25, 2006
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.
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.
Saturday, July 22, 2006
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....
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....
Friday, July 21, 2006
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!
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!
Thursday, July 20, 2006
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.
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.
Tuesday, July 18, 2006
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.
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.
Saturday, July 15, 2006
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
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
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