transfer

this is ironic.

the patient was seen at the general hospital but his family requested to be sent to the private hospital. after major surgery & 2 days stay in the ICU, they have again asked to be transferred back to the general hospital because of diminishing funds.

herein lies the problem. vacant ICU beds in the general hospitals are hard to come by because of the large number of critically ill patients. so the waiting game begins. it's been 3 days since & still no sign of an impending transfer. with every passing day, the patient shows no sign of early recovery, the family are distressed at the depleting finances, and the doctors and staff hope for news of a vacant bed.

it's the same old story year in & year out.

**this post was drafted in 2015 but the state of healthcare has remain largely unchanged**

going soft

 i must be going soft.

i've been watching reruns of grey's anatomy & and ally mcbeal & there were 2 episodes that got me all mushy.

grey's anatomy : the one where denny suddenly died shortly after he got his heart transplant. lizzie, the intern who fell for him like a ton of bricks, cried buckets. a cautionary tale for health workers not to get too emotionally involved with the patients under their care but denny was such a charmer, even i can understand why lizzie was besotted.  :P

ally mcbeal : billy has been acting strange, what with his blonde hair & entourage of robert palmer type leather-suited girls. as it turned out, he has an inoperable brain tumour. Married to another fellow lawyer, he did confess to his old flame Ally that he still loved her all of his days & with all of his heart. He then collapsed suddenly in court & died. And Ally too cried buckets.

*this post was drafted in 2015 but time has not lessened the impact of death on me*

nothing ventured, nothing gained.

my colleague started private practice the same year as i did in 1997. 3 years later, we moved out & joined different private hospitals. another 3 years later, he moved out again & opened his practice in a shoplot & subsequently expanded to the adjacent lot as well.

his practiced flourished & he could employ 2 specialists to work for him. his 2-floor shoplot even had elevators installed.

everyone knew he was doing exceedingly well.

you'd thought he's reached the pinnacle of his career. behold, the coup de grace......

a Singapore group came over & offered to buy over his practice in a multi-million ringgit deal.

while most of us are contented practicing within the safe confines of a medical centre, my entrepreneurial & far-sighted colleague obviously took the path not taken & that has certainly made a difference.

congrats, my friend, you deserve the success for your courage & vision !!

lapse of concentration

i had a lapse of concentration yesterday.

i was doing an invasive procedure called central venous cannulation, essentially inserting a plastic tube (red arrows) into a vein lying within the chest, when i accidentally punctured the left lung.

this resulted in an abnormal collection of air (yellow arrows) called a pneumothorax in the space between the left lung and the diaphragm. it was potentially life-threatening and was managed by inserting another tube into the chest that provides an escape route for the air pocket into a bottle.

i just think it could have been avoided had i been more cautious. in a way, it was timely that it happened. i've been on a roll lately & this is just the wake-up call needed to remind me of the oath i took at the beginning of my career.....

first of all, do not harm.

locksmith on-call

my neighbour was caught out without keys to his front gate  at 11pm the other nite. he came over to ask if i have a saw which he planned to saw thru the padlock.

i don't have one & suggested he tried calling a locksmith who was willing to make house calls. the 3rd one that we contacted agreed to come & said upfront he was charging RM90.

he came over on his motorbike after 30mins & proceeded to tinker & pick the lock, eventually drilling & scraping at the key slot. i joke with my neighbour, an ENT specialist, that what the locksmith was doing is not too different from what he did at surgery - drilling & scraping.

the lock was picked after about 20mins, to my neighbour's relief. i don't think he relished the idea of spending the nite at my place.

& he whispered that he would have gladly paid even up to 2-3 times had the locksmith demanded that.

apology

what would it take to get an apology?

well, i myself don't offer one unless i feel i was at least partly to blame for the predicament. some people do so when the buck rests solely on their hands.

political leaders & industry captains have done likewise & stepped down from office for lesser shortcomings, eg. disagreement with policies, allegations of corruption & sex scandals, & the likes of Zaid & Soi Lek are to be commended. isn't it better to fail with honour than to win by cheating? or more poignantly, better to die standing than to live on the knees.

others may try to cling on & so subject themselves to the embarrassment of being shamefully dumped.

like you already are pelted with eggs on your face, don't get hit with the frying pan as well.

we are what we eat.

it's about a year ago when this news item was released.

i am writing this because a week before the fasting month started, i had to attend a meeting at the local health department. and sure enough, when the meeting concluded at 11am, we were invited to a jamuan teh, literally a tea treat, which you'd think would consist of some biscuits with a cup of tea - a quick bite just to tide over till lunch.

but then, not so in Malaysia & a jamuan would not be complete without the customary curry puffs, sweet kuih with even sweeter teh AND chicken curry with rice.

in fact, this is a worldwide curse & the EU will soon legislate obesity as a disability. which means, employers will have to provide fat people with health coverage & benefits (like someone who has fallen ill) & fat employees can seek legal redress if discriminated against.

"sorry, boss, i'm calling in sick today as i feel breathless just getting out of bed!"

sounds surreal, doesn't it?

from dust to dust.....

my senior in med school passed away earlier this year (read here)

and just last week, a fellow alumnus a year my junior passed on, too. it's strange how things work. he was scheduled for tumour surgery when he suddenly collapsed in hospital the day before, probably from a major heart attack.

but he is in a better place now. i know this for sure because his last posting on his FB page was :

For to me, to live is Christ and to die is gain. (phil 1:21)

rest in peace, Dr L.

the worst

that's the superlative my colleague proclaimed a few days ago.

he was berating the way the nurses ill-prepared for his surgical case. i had to agree with him. it was messy & it slowed down the whole OT list.

i do miss those days when the nurses were more dedicated, competent, conscientious & thorough in their work.

when things run like clockwork with minimal self-inflicted disruptions.

when there was just one or two private nursing schools.

just in case you didn't notice, private healthcare isn't what it used to be. ringgit & sen, now more than ever, precedes service.

i am sure you have your own horror stories or even personal experiences to tell.

camping out

finally, the boy is roughing it out......

tent - checked

sleeping bag - checked

bottles of drinking water - checked

note book - checked.

it's his scouts' camping trip. was it held out in the forest or forest reserve? outdoor camping site? on a field?

actually, none of the above.

it was held in the school compound. still, that hasn't dampened his enthusiasm for the outdoors, for roughing it out away from the comforts of home & for bonding with the fellow scouts.

however, he did call for help...to replenish drinking water for the 3-day camp out.

GST.....the final word.

seriously, none of us thinks the govt has thoroughly thought & worked out the breathe and depth of the GST.

how is it they were flip-flopping over the GST for pre-paid top-up cards?

is healthcare exempted or not? if not, why announce otherwise?

why the need now to consider to increase the number of medicines to be exempt or zero-rated?

be assured the saga will not end with this recent confusion.

how is it that they didn't learn from countries that implemented GST ages ago & avoided their mistakes?

i know for sure GST, as a consumption tax, is a fairer form of tax collection, but perhaps the timing is premature, or that it should have started at a lower level, say 2-3% first.

& there should be no exemption nor exception. tax everything but at an affordable & less painful bracket first.

while the government is whipping up confusion at every turn of the implementation process, the rakyat is suffering.

aren't you?

sigh!

GST 2.0

i stared at this for some time.....

while many are fortunate to be able to seek attention at medical centres & specialists' hospitals, this booklet is stark reminder that, while we often take things for granted, like clean running water & electricity, there are those on the other side of the social divide who are not so privileged, having to make do with river water & kerosene lamps.

& then there are those whose healthcare needs can only be met in government-run facilities.

i had a middle-aged lady recently who was admitted to the ICU for a critical illness. after a week of intensive treatment, we managed to get her thru the most difficult period but by then, her family's fund was running low & they requested for her to be transferred to the ICU of the local public hospital.

believe you me, it's extremely difficult to get such a vacant ICU bed but by a twist of events, we managed to get a vacant bed the next day. she was promptly transferred but unfortunately, she passed on after 2 days.

it's impossible to say if she'd have a better chance at survival had she remained at our hospital but it did leave a hollow feeling in me.

with the expected RM22b to be collected this year from the recently imposed GST, hopefully we'll get .......

.......a better public transport system instead of a luxuriously-furbished jet plane for the private use of the elite few

.......basic necessities for the rural folk instead of a monthly million ringgit electricity bill for just one dwelling....

......and well-trained medical staff in well-equipped public hospitals instead of mushrooming private medical schools recruiting mediocre students.

GST

goods & services tax.

or, government say thanks.

or, a mean april fool's joke.

but i say...

"Render unto Caesar the things that are Caesar's, and unto God the things that are God's" matt 22:21

the govt is determined to get its pound of flesh. you can't change that now, even collectively, but you can determine who rules at the ballot box.

the pilot light & the hypocrite

we are having a demo machine in OT to be appraised for possible purchase.

the briefing on the operation of this machine was given by the vendor some days back & we're taking turns to use & get familiar with it.

i noticed this white light (arrow) on the right side of the machine...

i thought it was the pilot light, which is normally switched on when the main OT lights are switched off during certain procedures. we weren't doing any of those procedures, so i proceeded to switch it off.

the machine suddenly stopped & the screen went blank. as it turned out, what i thought was the pilot light was actually the power on-off button. good thing the vendor was present & she immediately pressed the button again & the machine came to life. phew!

i've often chastised my assistants that they shouldn't do things if they are not sure how or when they should be done & to ask 1st if unfamiliar with the procedures.

looks like i should heed that advice myself. after all, when you point one finger at someone, three other fingers are pointed back at you.

i bowed my head in shame.

makanan sampingan

those were the exact words the patient replied with when i asked her if she was having a late dinner. it's the local phrase for a supplementary meal.

admitted for a nose procedure the next day, she was eating fried mee with fried chicken when i dropped in on her at 9pm. having had dinner just 3 hrs before & now, another full portioned fried meal? i'd suppose that's common practice in this age of 24-hour fast-food restaurants & mamak shops.

still, she ought to exercise (pun intended) caution considering that she's only 22 years of age & already weighing 99kgs.

there must be some truth in a recent print report that Malaysia is the most obese nation in the region. furthermore, a case is being brought up at the European Court of Justice to consider obesity as a disablility. the implication for employers is that they may have to treat overweight employees better & even provide support, be it psychological or medical.

we may not be far behind this.

passing the torch

my senior in med school passed away recently while on a family vacation. he was in coma for a few days prior to that & it was an uncanny coincidence that on the day of his passing, his son was supposed to start year 1 in med school!!

i remember him well as a jovial fun-loving guy because we stayed in the same hostel for a year. we never met again after graduation 30 years ago & i only knew about his passing because his son & my daughter are classmates now.

it's almost like his demise was timed perfectly to coincide with his son's start in his medical career. i am certain, in this twist of fate, he will carry the torch his late dad proudly displayed all these years.

my friend TJ, may your soul rest in peace.

tuition

the bane of most students & a major expenditure of most households.

because scoring straight As is the lifelong target from kindergarten to varsity.

OK la, i am just exaggerating.

but not by very much.

case in point : me.

i had taken BM tuition up to form 3 but not at form 5. which explains why i got a strong credit in form 3 but only a pass at SPM level. (yes, you've guessed correctly that i wasn't a straight As student.)

so, tuition is actually quite useful, if taken in the right attitude.

now that the boy is in form 1, we are thinking of trying to take the right attitude for his tuition. we came to the conclusion that he will only take BM tuition for now & he will be home tutored for the other subjects. i took it upon myself to teach him maths & science. however, today, he asked me a geography question.

so, what better way to study ...no, master geography than to take out the secret weapon.....

a map of the world....with latitudes, longitudes, international date line & the Marianna trench. that should keep him from mischief for a while!!

:-)

flown the nest.....again!

 

my daughter has gone back to varsity a week ago.....and yes, even after all these years of living away from us, i still miss her much.

very.

in the 3 months she was home, we managed a family vacation to hanoi & penang, played hosts to her friends on 3 different occasions & shared many happy memories eating out at her favourite food haunts.

                      **a most delectable pandan pancake with gula melaka & matcha green tea**

however, there are 2 stand-out events that particularly endeared her to me :

1) she taught me to appreciate the now concluded sitcom How I Met Your Mother. well, she didn't really taught me, but it's just that she has been watching it & when i watched with her, i sort of caught on. yes, it's legen.......(wait for it).......dary!

2) we enjoyed our walks/jogs around nearby the taman rekreasi. away from the prying eyes & ears of the rest of the family, we managed to share some of our dark secrets.....

"the long and winding road, that leads to your door, will never disappear" (beatles)

PS. i forgot to mention she left another mark behind, one we will not forget for a long, long time.....

                                                       **ouch!!**