Awesome Talent

I saw this video clip on the Ellen show today & was blown away by this 14 year old girl's talent...

Aaaawwww....

This is an amazing video of a grateful lion - a modern day version of David in the lion's den. This lion remembers & hugs his rescuer...how sweet is that???

Tree Man

This is the worst case of warts I've ever seen!!!

A real-life Ent - poor guy...I hope he finds a cure. Or at least some way of keeping it under control.

Oldies but Goodies

"There is no age limit for applications."

I was pleasantly surprised to see this in a recent mass mailing I received from a certain medical association calling for applicants for specialist traineeship.

2 years ago, in a similar letter (I guess they send one out every year), I noticed an age limit in place for applicants. When asked by a director in the public health institution I was working in at the time whether or not I was going to apply for traineeship, I gave him a wry smile & said that I was too old. Admittedly, I was flattered by the look of surprise on his face when he realized that this lowly M.O. was already the mother of a teen & a pre-teen (at the time) & already over-aged for such lofty ambitions (sarcasm intended).

So why the change in policy now? If I had to make an educated guess, I would say it is to try to make up for the perceived lack of doctors in the public sector. Whether or not this will make more senior doctors step up to the plate...we can only wait & see.

I am glad the age limit has been abolished (for now, anyway). After all, in this day & age, 40 is hardly considered over-the-hill. Yes, the eyes may be starting to go a bit, & some of us need reading glasses to read the small print; and the reflexes may not be as good as, say, a decade ago. But the brain power is still there. Plus the added years of experience of practising general family medicine I think is a huge advantage.

But I wonder how this will affect the teacher-trainee relationship, especially if the trainee is one who was already practising medicine when his teacher was still struggling with the PSLE! It will be interesting, to say the least!

So does this mean that I am considering applying? Nah...not right now. But who knows? Five years from now, when I am an empty-nester, I may reconsider it. But by then, the policy may have changed again...

NOT Tit for Tat

This is what they do for us...

...& this is what we do to them...

So, who are the animals here?

Impressions from China - Trash talk

There seems to be a lot of China-bashing going on these days. The recent rumor that China is banning Bibles from the Olympic village next year is another instance of black-mouthing. Although the official religion is atheism here, Buddhist temples, Muslim mosques & Christian churches DO exist; and as far as I know, believers of these mainstream religions are allowed to practise their faith freely.

I personally have not seen any persecution of people who worship in churches here. There is a church service held every Sunday in the clubhouse here that is very well-attended by the expat population. I have yet to see any police raids on the place. Worshippers walk around freely carrying their bibles to & from service.

So I really don't know where the rumor started from.

Impressions from China - An Olympic Celebration

Last week, my sons' school celebrated International Day with a special focus on the upcoming Beijing Olympics. I was there, & it was pretty cool to be part of the festivities as well as a part of the Olympic flag which was made up of students, teachers & parents.

We also made it into the China Daily news...

Zagat for Docs?

Hmmm....what next? Michelin stars to rate doctors?

I have no issue with rating doctors...as long as it is done fairly. But when this is driven by an insurance company, it becomes quite suspect, really. After all, the bottomline (i.e. $$$) counts A LOT for these companies.

Impressions from China - Autumn in Beijing

You know, if you take away the gray haze, Beijing really is quite beautiful...

This was taken from the Mutianyu section of the Great Wall on a clear blue sunny day in mid-October.

Here is another view, this time, of mountain ranges adjacent to the Great Wall.

Awesome.

My attempt at an artistic shot - taken from one of the ramparts on the Great Wall.

In contrast, here are some pictures taken on a typical hazy day. These were taken in the Fragrance Hill & Summer Palace environs*.

View from Fragrance Hill.

This was taken on the grounds of the Summer Palace.

*for non-Mandarin speakers or those who are not terribly fluent (like yours truly), Fragrance Hills & Summer Palace are not user friendly at all. First of all, these places cover acres of ground with directions mainly in Chinese (& not very well placed either!) So if you go, make sure you hire an English-speaking guide.

The picture below was also taken at the Mutianyu section of the Great Wall, but at the end of October. As you see, the leaves have started turning red & yellow. What a difference two weeks make.

And to top it all off, a beautiful Autumn sunset by Roma Lake, near where we live. (This picture was taken by my fledgling photographer 13 year-old, showing off his recently acquired skills learnt during his Digital Photography module in school).

Plantar Fasciitis

Boy, what a pain this is.

I just read this article from Medscape about Plantar Fasciitis.

I am sure GPs will agree with me that this is one of the most common foot problems seen in their clinics. And treatment can be difficult as well as it tends to drag on or become a recurrent condition in some patients.

The article mentions most of the modalities of treatment we would generally use (although now, I tend to discourage patients from getting steroid injections into the affected area....damn painful, & also not advisable) but seems to have left out NSAID’s for symptomatic relief.

Oh, and I think they could have mentioned CROCS as well…. :)

Tough Calls

How does one make such a decision?

Oct 22, 2007

Weigh options when saving premature baby

I REFER to the article, 'Saving tiny tickers' (ST, Oct 11).

It is indeed heartening that medical advances allow the babies mentioned to enjoy a new lease of life.

Infant mortality has been reduced drastically because of the excellent medical care and services provided by Singapore's health-care workers.

However, we should not use the plain vanilla number of initial infant survivals as the basis of a job well done by health-care professionals.

This holds true, especially for extremely premature babies.

With advances in medical treatment, younger and younger 'premmies' are able to survive.

However, some will have disabilities, from minor to major, because of their early arrival and subsequent damage to their brain and under-developed organs.

If a baby is severely brain-damaged, where his quality of life in future is likely to be almost non-existent, should the doctor go all out to save the baby, just so he is alive for another painful day?

Or should the doctor let the baby die with dignity, through compassionate inaction?

Who should be the one to make such an important judgment call on the treatment (intensive, moderate and just enough to prolong the life, letting go) for the tiny patient?

For parents, this dilemma can be very much be like that of the relatives of a brain-dead patient.

It is therefore important that a clear standard set of rules and guiding principles be provided and adopted for extreme premmies' treatment, as this is a sensitive and grey area where emotions, and personal and religious morals and convictions play a big part.

It is important that the parents have a say in the premmie's treatment and can make informed decisions.

This is because, as parents, their decisions will be based on what is best for the baby.

Doctors should not be biased against their young patients' parents, even when the parents' views and opinions differ greatly from theirs.

Doctors should also respect parents' decision on treatments offered to the baby, even if they disagree with the parents' decision.

At the end of the day, it is the parents, not the doctors, who will have to care for the disabled child.

Thus, treatment options should be scaled towards what the informed parents want.



As a resident working in the NICU, I grappled with such dilemnae almost daily. Why save the premature, especially the severely premature, when the child eventually develops disabling conditions like cerebral palsy, bronchopulmonary dysplasia, ROP, all requiring long term medical care, with questionable quality of life. And the caregivers, having had to deal with the heartbreaking situation, are now saddled with a huge hospital bill, & look forward to a life time of probably repeated hospital stays & visits & seeing their child suffer.

But as a resident, one sworn to save lives, we pretty much did our damnedest to save even the most premature of babies until we knew that there was nothing much else we could do for him. I don't remember any one of the parents trying to stop us from doing so. I sometimes wondered why.

But then I became a parent. I then realized that the love one has for one's child, even unborn, is undescribably all-encompassing. I understand now, why these parents would want the doctors to try their damnedest, no matter how disabled or how much suffering their child might end up with. In a way, it's a selfish kind of love.

In any case, it's a tough call to make. To save or not to save. You tell me.

Impressions from China - Blocked

And the blockages continue. First it was Blogspot then Flickr and now You Tube.

It's annoying.

Appreciate your freedom, people out there.

Mountains & Molehills

A case of who knew too much about Clooney

By Gina Piccalo, Los Angeles Times Staff Writer October 11, 2007

A New Jersey hospital is at the center of a storm over its suspension of 27 staffers. The action, over viewing of the actor's file, seems 'a little harsh,' his publicist says.

George Clooney's medical records and the hospital staff who may or may not have leaked them to reporters have caused quite a dust-up at a North Bergen, N.J., hospital this week, leading to a month's suspension of 27 staffers without pay and thrusting Palisades Medical Center into the rigorous churn of the worldwide celebrity news cycle.

The story was bested this morning only by Lindsay Lohan's whereabouts since rehab, and naturally hundreds of bloggers debated the hospital's actions. Camera crews flocked to the Palisades Medical Center, and reporters flooded the phone lines of the hospital and the union representing some of the suspended staffers.

"It is just sickening," said one hospital receptionist of the newshounds. "There's more important things going on in the world."

Indeed. But -- spoiler alert! -- those things won't be covered here.

Clooney and his girlfriend, Sarah Larson, took a spill while riding the actor's motorcycle in northern New Jersey on the afternoon of Sept. 21. Clooney suffered road rash and a cracked rib, and Larson injured her foot. They were treated and released from the hospital the same day.But news of the incident ricocheted around the Internet and made headlines around the world (as did subsequent footage of Clooney escorting his paramour as she teetered along on crutches).

Palisades Medical Center found itself at the heart of the news story and launched an investigation into staff access to Clooney's records. So far the hospital hasn't accused its staff of leaking the information to the press, but the investigation revealed that as many as 40 hospital staff members accessed the actor's personal medical records in apparent violation of federal law that bars staff members who are not directly connected to a patient's treatment from consulting a patient's medical records.

Since then the story has gained momentum, leaving the hospital struggling to go about its daily work while at the eye of a celebrity news story. The 27 staffers were suspended on Friday. The hospital released a statement today, emphasizing that its staff "adheres to a strong code of ethics that respects the privacy and confidentiality of all of our patients.

"Eurice Rojas, the hospital's vice president of external affairs, could not be reached for further comment.

A spokeswoman for the Health Professionals and Allied Employees union, which represents seven of the suspended workers, has publicly criticized the suspensions as premature until the hospital's investigation is complete. Some suspended employees may have been legally permitted to view the records, said union spokeswoman Jeanne Otersen.

"I'm looking at the Web and seeing how widespread [this story] is," she said. "Whether you are John Doe or George Clooney, you have the same rights to privacy. The same goes for the staff. They have rights too. Now you have a tenfold violation of his privacy. . . . I think there's a different way to handle it so that you both protect patients and educate workers and make sure that, while people are held accountable, there's due process."

For his part, Clooney -- known for his lively debates with the media on its treatment of celebrities -- has taken this latest security breach in stride.

On Tuesday afternoon, he issued a statement in defense of the staffers and emphasized that he had nothing to do with the investigation of the alleged leak.

"This is the first I've heard of it," Clooney said, referring to the suspensions. "And while I very much believe in a patient's right to privacy, I would hope that this could be settled without suspending medical workers."

"This is not our issue," Clooney's publicist Stan Rosenfield added today. "This is between the hospital and their employees . . . . This was not anything we instigated. We felt that perhaps suspending medical workers was a little harsh."

gina.piccalo@latimes.com


Yes, patient confidentiality is important & is well understood by health care workers.

But suspending 27 hospital staff for one month with no pay??? That's a bit much, isn't it?

I wonder if the same punitive action would have been imposed if the patient happened to be John Smith, plumber instead of George Clooney, movie star?

Impressions from China - Blue

Yesterday we saw blue skies. An unusual occurrence here in Beijing where a grey haze has become what we are accustomed to & a PSI of 90 is called "Good" day. The clear air was a result of a full day of slow drizzling rain, washing away the fumes & pollution coming from the kazillion vehicles, factories & what-have-yous.

It was wonderful seeing the Blue again, with white flurries of clouds interspersed amidst the cumuli nimbus, & breathing in clean air without the smell of exhaust or chemicals. We could even see the mountain ranges north of us - a rare & beautiful sight, indeed.

I wonder how long it will last. Today looks promisingly Blue still. The day is still crisp, with sunlight brightening up this fall day.

Mmmm….nice…I'd better go outside today & & enjoy it whilst I can, before the muck builds up again, which should take, oh, another 12 hours or so, I would think.

Disconnected

We’ve been offline for almost 3 whole days now. THREE WHOLE DAYS.

It’s sad how reliant we’ve (at least our family) become on our Internet connection. It feels like losing the use of my left thumb. (I don’t mean to belittle the importance of the opposable digit, but on the contrary, emphasize on the importance of keeping connected with the cyberworld.)

Email, Facebook, Blogging, Google…all a means of keeping connected with family, friends, & the community at large. For work, or for school, or just plain daily living, we’ve felt lost without it. Hubby needs it to access his email from home; kids need it to research school work, do homework & just for keeping in touch with friends in far away places.

By the time you read this, we obviously would be back online.

Hallelujah.

Impressions from China - Corn, anyone?

In the past month or so, this has become a familiar site. The end of summer marks corn harvest time, & I have to say the Chinese are resourceful in using what is available to them.

Our neighborhood is built amidst villages. A lot of the land has been taken over by sprawling expat compounds. Previously mostly farmland, there are still large areas where various crops are grown, depending on the season.

When the corn was ready for harvest, all those ears were stacked on the neighborhood streets, for lack of available space, in hundreds of piles, exposed to the elements, road gravel, passing vehicle exhaust & the occasional wandering stray dog or animal (I shudder to think what else these dogs may have done besides sniff at these piles of corn!). After a week or two of drying, the villagers put these ears of corn through machines which de-kernelize(is there such a word?) the corn, after which the kernels of corn are again left on the roadside to air before subsequently being ground into cornmeal.

I really, really wonder if there is further cleansing or sterilizing of the end product before it is sold as a consumable product. Maybe it's meant for the pigs?

Who knows? This is China.

Aliens in America

This looks like a promising new series that addresses our differences (as well as our similarities) head on, without the double-talk & hypocrisy that is so rampant nowadays in the guise of political correctness.

Crossing my fingers that it will reach our shores (or at least, our satellite waves!) eventually!

Finish the Fight...

The marketing blitz surrounding the Halo series of video games has been phenomenally & amazingly successful. I pre-ordered the 3rd installment of the game for my boys & had to stand in line (which snaked all the way outside the shopping mall!) to collect it, surrounded by fans, some wearing the Halo 3 cap & gear...grown-ups, mind you, not kids!

It has spun off into novels & even a movie, due to be released in 2009. I can't imagine what it will be like then...

Money Can't buy Everything

Hah. A lesson learnt about citizenship & what it should be about.

I've said it before & I will say it again: Being a Singaporean should be more than how much one is paid for one's services, no matter what those services may be - whether it be sporting ability, intelligence, scientific knowledge or artistic talent.


This fiasco has cheapened this country's citizenship. Obviously, these athletes were in it for the money & not for love of this country. Why the Singapore Athletics Association went along with it is beyond me.

Imports 'failed', but locals will take up baton: Athletics chief
Cubby Leongcubby@mediacorp.com.sg

HE ONCE memorably said that if medals were what Singapore was after, then he could simply "hire" athletes from China to deliver.


Under the country's Foreign Sports Talent Scheme, Mr Loh Lin Kok eventually recruited China-born shot put specialists Du Xianhui, Zhang Guirong and Dong Enxin.

The two women received their Singapore citizenship in October 2003, while Dong got his in May 2001.

Another shot putter, Luan Wei, and hammer thrower E Xiaoxu, touted as possible graduates of the scheme, were brought to Singapore in 1999.

But today, Mr Loh, who is president of the Singapore Athletic Association (SAA), brands his association's efforts a "failure".

Du and Zhang are back in China after disagreements over training and salary issues; Luan is currently embroiled in a court case with the SAA over unfair dismissal; E Xiaoxu dropped a similar action due to financial constraints; while Dong has failed to live up to his billing thus far.


"The foreign talent scheme has failed miserably," Mr Loh admitted in an interview with this newspaper.


"The characters were, quite simply, unreliable. Two have abandoned us and another two have charged us in court. As a medal prospect, Dong is unreliable, too.

"When I brought the China-born athletes over in 1998, I wanted the sport to be more professional, to have full-time athletes training professionally. But they've abused my generosity."

Does that mean the SAA has lost faith entirely in the foreign talent scheme, launched in the 1990s?


"No, we are not going to abandon it," said the SAA chief. "It's just that the previous failures have taught us a bitter lesson. From now on, we will have to tread even more cautiously and look at each case with a microscope before making any decision."


The closer scrutiny of foreign-born athletes augurs well for the local athletics fraternity, for the SAA can concentrate on grooming the home-grown talent coming through the Singapore Sports School and other institutions under the Ministry of Education.


Eight of the Republic's best youngsters qualified for July's World Youth Championships in Ostrava, the Czech Republic (see box), and Mr Loh is counting on this pool of juniors to kick-start a new era in track and field.


"There's a new generation taking us out of the rut. Right now, we might have to suffer a bit," he said. "But believe me, when it bears fruits, they are going to be bountiful and they are going to be beautiful fruits."


Even though the decision may mean that for the first time since 1989 Singapore would almost certainly not win a track and field gold medal at the South-east Asia Games in Korat, Thailand, from Dec 6 to 15, the SAA supremo remains upbeat for the future.


"We are in transition," he said. "Instead of relying on foreign talent, we are putting our faith in a bunch of really promising youngsters, all born in Singapore."


The athletics chief is also looking for a radical change in the local club scene to pump-prime the sport. From Wings Athletics Club to Swift, there are some 20 such organisations affiliated to the SAA – but with some pulling in different directions, with what Mr Loh describes as an "I don't trust you, you don't trust me" attitude.


He believes such rivalry is "unhealthy" and is looking to adopt the school-based American system, with schools here taking over the grooming of young athletes.


Said the 59-year-old lawyer: "Right now, the Singapore Sports School is leading the way towards an American tertiary format. Its manufacturing process is good.


"Of course, it's not easy to manage schoolwork with athletics, but times are different now -- it pays to be in sport these days … We have insisted that the athletes are not put under too much pressure at a young age. American athletes complete their degrees in eight years, and we can adopt that."


Mr Loh was SAA president from 1982 to 2004 before making way for his handpicked successor Tang Weng Fei, a businessman and former hurdler. But Mr Loh was never far from the scene and two years later, he was back in the hot seat when Mr Tang stepped down.


Said Mr Loh: "People may call me autocratic, but running an association of this nature needs tough measures.


"Some clubs seem to exist for the sake of bickering, others just want to chase that elusive title of 'best club'. But there's a bigger picture here. The duty of the athletes is to perform, not get involved with club politics."

Copyright ©2005 MediaCorp Press Ltd

White Coats No More

This is a great move by the UK Department of Health.

White coats off, UK docs told

LONDON — British hospitals are banning neckties, long sleeves and jewellery for doctors — and their traditional white coats — in an effort to stop the spread of deadly hospital-borne infections, according to new rules published yesterday.

Hospital dress codes typically urge doctors to look professional, which for male doctors, has usually meant wearing a tie. But as concern over hospital-borne infections has intensified, doctors are taking a closer look at their clothing.

"Ties are rarely laundered but worn daily," the Department of Health said in a statement. "They perform no beneficial function in patient care and have been shown to be colonised by pathogens."

A 2004 study of doctors' neckties at a New York hospital found nearly half of them carried at least one species of infectious microbe.

Last year, the British Medical Association urged doctors to go without the accessories, calling them "functionless clothing items".

The new regulations, which will take effect next year, mean an end to doctors' traditional long-sleeved white coats, Health Secretary Alan Johnson said.

Fake nails, jewellery and watches, which the department warned could harbour germs, are also out.

Johnson said the "bare below the elbows" dress code would help prevent the spread of Methicillin-Resistant Staphylococcus Aureus, or MRSA, the deadly bacteria resistant to nearly every available antibiotic.

Popularly known as a "superbug", MRSA accounts for more than 40 per cent of in-hospital blood infections in Britain.

Because the bacteria is so hard to kill, healthcare workers have instead focused on containing its spread through improvements to hospital hygiene.

Doctors and nurses who do not adequately wash their hands pose a far bigger risk to patients warns Dr James Steinberg, an Emory University infectious disease specialist. — AP

When I was an intern, then an MO doing hospital postings, we had to follow a dress code, which meant ladies had to wear skirts (no pants allowed unless on night call), & covered shoes (meaning court shoes, not thongs or Croc-like sandals!) while the guys had to wear ties or bow ties. It was a pain especially when, as an intern, you had to do all the scut work, running around the wards, doing multiple rounds a day, setting drips, taking blood (no such thing as phlebotomists in my day :( ).

I don't know about other doctors, but I find it less of a strain on my back to squat next to the patient's chair or bed when setting drips or taking blood (& also less risk of exposing my chest to the male patients!!!). Try squatting in a skirt. If it's a slim cut one, damned difficult. If it's a flare skirt , you end up sweeping the floor with it. And the shoes...OMG, talk about plantar fasciitis & bunions!

I used to envy the docs I saw on TV wearing those oh-so-comfortable scrubs. I wonder why doctors in Singapore can't change into scrubs when they get to the hospitals (even if they are not working in the OR), & at the end of the day, leave them for the hospital laundry to wash so that they don't bring home all those nasty hospital germs.

Besides, I think scrubs are sexier looking than street clothes.

:)