Whatever, there will still be an additional (but unnecessary) of RM124 plus GST to the patient's bill.
Tuesday, September 19, 2017
Whatever, there will still be an additional (but unnecessary) of RM124 plus GST to the patient's bill.
Monday, September 18, 2017
As if having an allergy is not enough, how about having an allergy to the medication used to treat the initial allergy??
40 year old woman admitted for nose surgery. In the OT, just before commencement, she developed an allergic reaction to the anti-vomiting injection. We treated the severe coughing and breathlessness with alternative medications, for fear of triggering another allergic reaction should the standard anti-allergic injection be used. The surgery was subsequently postponed for safety sake.
The allergic reaction subsided the next day & surgery proceeded with no further untoward incident, with administration of alternative anti-vomiting injection.
We really have no idea what we are allergic to until we develop it. Some are mild, e.g. to prawns, while other maybe severe or even life-threatening, e.g. to peanuts. As doctors, we were taught how to treat it, but it is safest to avoid the offending food or medication, if we are aware of it. Patients should communicate these previous incidents to their doctors, too.
Saturday, September 16, 2017
Wednesday, September 13, 2017
I met up with an ex-colleague over the weekend after a lapse of 26 ( yes, TWENTY SIX !!) years. And we both concurred that we didn't change much physically, as we immediately recognised each other.
Tuesday, September 12, 2017
T was my Best Bud in secondary school. We clicked because of our interest in chess and football. I then came to know his family very well.
Thursday, September 07, 2017
My Primary One class teacher, Pn RB, passed away last year. I've only fond memories of her. You see, I was the proverbial teacher's pet & it helped that my parents were friends with her.
This 60+ gentleman has been with the hospital since it started in 1990. He's an operating theatre assistant, preparing the room & helping the surgeons during surgeries. Very likeable chap & adept at his work.
Preparing the OT is like a pre-flight check. Would you board a plane scheduled to take-off at 2pm when the crew only starts checking at 2pm? Which means the flight can't possibly take off at 2pm. As if there aren't enough delays already!!
Wednesday, September 06, 2017
I was at the stadium to watch the Malaysia v Hong Kong AFC qualifying game, as I wanted to savour again the "live" experience of a competitive football match.
What a difference it was from watching in the comfort of home!! I never realised there was a section where local fans called ultras congregate and sing patriotic songs to the beat of drums...
...and no, I didn't hear them sing anything offensive to their opponents.
Speaking of patriotism, I am convinced sports is one unifying activity (food being the other) that transcends age, gender, race and religion. In unison, the crowd cheered when we scored the equalising goal & in one voice, boo-ed vociferously at the referee when he unfairly awarded an injury time penalty to the visitors. But just was served when HK missed the penalty. woo hoo!! unfortunately the stadium was less than a quarter filled, so the intense atmosphere was sadly missed.
Because it was windless, the air was a tad stale & reeking of cigarette smoke. I also missed the action replay like on television. I got distracted momentarily & completely missed the 1st goal.
Despite the unique experience at the stadium, I doubt if I would be back any time soon....
.....unless Barcelona or Real Madrid comes to town.
Tuesday, September 05, 2017
Monday, September 04, 2017
so also with the Malaysian F1 racing for the last time this month. this after the initial novelty of 1999 has worn off, plus the more attractive night race further south (alcohol on freeflow, city centre location, and entertainment by One Direction, Seal, Chainsmokers & Duran2), it's not surprising that something has to give.
with Proton, Bandar Malaysia, Forest City & Iskandar, amongst others, sold to foreign interests, the signs aren't good.
let's hope the F1nale is only restricted to motorsports racing.
Saturday, September 02, 2017
My orthopaedic colleague in another hospital is ranting.
Every time he sends patients to the Xray department, either
1) the queue is long,
2) the report takes ages to be issued
and worst of all....
3) the report is unreliable, inaccurate or inconclusive.
So, imagine you are the patient. You arrive at the clinic at 9am, see the doctor at 10am, go to the Xray department at 10.30am to see a long queue before you, get the Xray/scan done at 1pm, & wait for the report which is issued only at 4pm, and go back to the clinic only for the doctor to tell you that the diagnosis remains uncertain.
And you may need another scan.
You spent the whole day & loads of cash only to return to square 1.
You are upset, the doctor is upset and the cycle repeats itself.
No wonder my colleague is ranting.
Monday, August 28, 2017
Sunday, August 27, 2017
Satay without peanut sauce;
English breakfast without bacon;
Nasi lemak without sambal;
Cendol without gula melaka;
ABC without red beans...
Saturday, August 26, 2017
My father used to work with the British army in Singapore. We were quite financially well off. Staying in the clan's home, we had 2 rooms & we were the 1st family with a TV. We eventually moved out to our own home.
When the Brits withdrew, he was laid off. We tightened our belts during this difficult period. He then worked for a while with a timber company in Temerloh (Pahang) & then Paka (Trengganu), which means he was away from home a lot. When the company closed down, he came back & became a driving instructor. I still mention with much pride that I was taught by him.
He's always been thrifty in his spending. In fact, when we go to the supermarket, he'll just wait outside because he said he has nothing to buy while we filled our trolley with groceries.
I still retained that DNA. Which is why I was ecstatic when I found this ......
After all, I AM my father's son. I think I'll wear this to church tomorrow.
Friday, August 25, 2017
my daughter says she wants to do internal medicine. either that, or cancer research.
i feel it's good to have an ambition. at least, there's something to look forward, and work towards, to. an objective to focus & channel one's energy & time.
but the wise man has this to say....
Many are the plans in a person’s heart, but it is the Lord’s purpose that prevails. (prov 19:21)
i should know. after all i wanted to be a bus conductor, and then an aviation engineer.
see how i turned out.
Thursday, August 24, 2017
Wednesday, August 23, 2017
I love this class USSB. Upper Six Science B.
Marvelous Chemistry, Biology, and General Paper teachers, and special mention to the late Mr GV Pillai, Physics teacher. I did apply to be an engineer, you know, but I digress.
And my beloved classmates who were comrade-in-arms in work & play.
I'd like to think you've all impacted my life as much as I have yours.
Tuesday, August 22, 2017
Monday, August 21, 2017
It's often proclaimed that wherever we are, whatever we do, it's for a reason. Like if we had not gone there, then ...... or, If we hadn't done that, then...........
If you are religious, you'd feel it's even like a divine decree.
Last Wednesday, I was at such a place and time. My scheduled case didn't not take place & at 4pm, I was just walking pass the surgical ward, getting ready to change & go off.
I got an urgent call from that ward that one of the patients I had anaesthesied earlier that morning was having a convulsion & was not conscious.
I was by the bedside before you could say Code Blue. With the help of the nurses, we proceeded to do CPR. Although the heart momentarily stopped beating, we managed to restart it because prompt action was instituted early, which is the essence of CPR anyway.
The stay in ICU was quite stormy, and we weren't sure if the patient has suffered brain damage because he remained unconscious for 2 days after that. But on the 3rd day, as we scheduled him for CT scan of the brain, he suddenly opened his eyes & started to respond to instructions.
All I could say was Hallelujah. It felt like a religious decree that I was at that place at that time.
The patient was discharged very much alive from hospital today.
Wednesday, August 16, 2017
In a way, looking back, I felt I was indifferent at best & negligent at worst.
The nurse called me last night about a late admission. This patient was supposed to have surgery this afternoon & I would usually see & assess on the morning of the surgery. Not knowing any detail of this patient, I refrained from giving any medical advice over the phone, lest it was inappropriate. Besides, once I start getting involved, I know the nurses will call me for every discomfort the patient may complain of throughout the night.
Therein lies my predicament. I am a doctor and yet I want a good nite of uninterrupted sleep, because I am not on call.
At my age, I dislike, & try to avoid, on-call duties, because I am on my worst behaviour without sleep.
Tuesday, August 08, 2017
Sunday, August 06, 2017
It's time for the daughter to pick the hospital elective posting for next year.
Her 1st choice is a popular district hospital 160km away because there are more hands-on & practical experiences there. She will have to find new accommodation in the district & may be on the road often.
The 2nd is the city hospital only 12km away & 25 mins by train. On top of that, she already lives near the train station. For logistic reasons, being a foreign student, I much preferred she remained in the city.
As it turned out, she was allotted the city hospital. I was glad. And I forgot to mention that had she been posted to the district, she planned on getting a car & driving the 320 km round trip every week.
Thursday, August 03, 2017
i was on-call & the 1st case for the day was a 70+ year old lady for a DHS insertion, a procedure to fix a broken hip. the standard anaesthetic technique in that hospital was to give a general anaesthetic supplemented with a local anaesthetic (epidural).
the general anaesthetic went smoothly but i had some difficulty with the lumbar epidural, resulting in the accidental puncture of the dura. instead of abandoning the epidural & just have the general anaesthetic, i proceeded against better judgement to attempt again at a different (higher) level. after administrating the full 20mls of the local anaesthetic, true to form, the blood pressure crashed & the patient heart stopped. resuscitation was unsuccessful.
i can't tell you how angry i was with myself for such a novice mistake. maybe i was indifferent, maybe i was over-confident but i will never, ever forget how a lapse in concentration resulted in this unnecessary death. one good thing that came out of this was the unwavering support the consultants gave me, even at the inquiry for peri-operative morbidity and mortality.
i want to believe this made me a better doctor today & that death was not in vain.
Tuesday, August 01, 2017
Having worked at the hospital for 25 years, from a shoplot practice to a new independent medical centre, and then to be part of a major healthcare chain, you'd think she'd be missed when she finally retires.
Truth be told, I can't remember the last time I have worked with a nurse so obnoxious, I just dread if we had to assist surgery in the same theatre.
I won't miss her. Seriously. Honestly.
Monday, July 31, 2017
In my 1st job in the UK, I was waiting for the hospital transport to get me to another hospital. As the van stopped in front of the lobby, a middle-aged gentleman in a full suit, coat, tie & all, disembarked from the vehicle. Trying to be friendly, I approached him.....
Me: Hi, is this the van to the WH hospital?
Him : Yes, indeed it is.
Me : By the way, I am Dr T & I am the new SHO. And you are Dr........?
Him : I am Ray & I am the hospital porter.
Lesson #1 : in the UK, most men in the service industry, from top down, wear full suits.
Lesson #2 : Introduction is commonly by 1st names.
Therein, began my memorable 4-year sojourn in a foreign country.
Saturday, July 29, 2017
My friend's daughter is having her wedding reception dinner tonite. I am going to be late. I am thinking about the peer pressures of the modern day matching of life long mates.
I sensed that my friend was a bit disappointed. You see, the bride is a dentist and it would be expected by some quarters that she would pick someone with a similar honorific, e.g. Dr. Whether she wouldn't or couldn't doesn't matter, at least to me. I played table tennis with the guy last week and from that brief encounter, I was impressed with his soft spoken manners & politeness.
Doesn't matter if he's just plain looking or just an architect. He's in for the long haul. A successful marriage goes beyond looks & vocations. They both love God & that counts for everything.
And love is all they need.
Congrats, Ivan & Yen.
Friday, July 28, 2017
I've always thought that I have fostered a blood-is-thicker-than-water bond with both my kids.
It's our (the boy's & mine) ritual to have breakfast on Saturdays when we have no commitments - he, to the school and extra-curricular activities, & I, to the hospital. Usually we'd have either the chicken briyani or tosai/canai. Yes, we're that set in our ways. So when I asked him today if we are OK for breakfast at 9.30am tomorrow, he said it depends if he could wake up on time.
His response rankled me a bit; if he really enjoy having breakfast with me, he'd make every attempt to get up by that time, as I would. Besides, 9.30am is not that early by any measure.
I know when kids grow up, they often have their own circle of friends which they would want to hang out & chill out with, at the expense of the family
But I'd rather hope he'd choose dad over sleep. We'll see.....
Sunday, July 23, 2017
Friday, July 21, 2017
Made this decision in 1979 & never looked back since.
Through thick & thin, sleepless nites in the four seasons, forgoing social activities & staying beyond appointed working hours (what's that?), in life & in death, the Lord sustained me.
I have found my calling.
Wednesday, July 19, 2017
Tuesday, July 18, 2017
This is a malignant growth of the ducts that connect the liver and gallbladder to the small bowel. These ducts deliver bile to aid digestion of fatty food. Diagnosis is often late & the downward course is often rapid.
My colleague's brother had it & he just passed away today. This condition struck a resonant chord with me because the very 1st patient I had as a medical student in the surgical ward (circa 1982) was this cheerful and obese middle-aged gentleman who was admitted for jaundice.
Mah Hung was his name & how I can still remember that, I don't know ...... maybe it was because he was my 1st surgical patient & I saw him every weekday till he finally passed away.
But I will never forget his kind words to me during one of our meetings. He advised me to work hard to be a good doctor and hoped that I will be a specialist one day.
Dear Uncle Mah, you are long gone but your kind wish did come true. I was touched then, just as I am today. Thanks for being my patient & my teacher, for who you were, what you had & what you went through. May your soul rest in peace.
Thursday, July 13, 2017
Yesterday, the drug rep invited the 6 of us out for dinner. 3 of us couldn't make it, so the senior colleague, on his own accord, invited a few nurses to take the place of the absent doctors.
In the end, 5 nurses turned up & 1 even brought her grown-up daughter. Even though the dinner came under company expenses, I felt it was highly inappropriate for my colleague to invite the nurses for what was clearly an invitation for doctors only. And to bring your daughter for a department function spoke volumes of the lack of etiquette & common sense.
I felt sorry for the rep. I wonder how she is going to explain to her boss about the extra (non-medical) heads for dinner, at RM85 net per pax?
Tuesday, July 11, 2017
This is the Big Event of my year so far. Last August, my walking buddy told me of a vacancy in his group going up to Mt K in April this year. Having been mulling about doing the climb for some years, I jumped at the opportunity to realise this dream.
We started training by climbing the local hill (vertical ascent 140m) & despite carrying backpacks of 7kgs, it was far short of the 8km trail & 3200m vertical ascent of the real thing. But it was better than not hike training.
There were 6 of us in this group. They had originally planned for 2015 but the earthquake put paid to that. So, after a 2-hour bus ride from Kota Kinabalu, we finally arrived at the park HQ in Ranau, which is already 1800m above sea level. We will spend a nite here & the adventure starts the next day.....
It's been 2 years since my last entry. This morning I had a brief chat (read: 2 sentences each) with an ex-classmate from 6th Form & she persuaded me to reconsider blogging. So here I am.
I think I was more diligent previously because there were stuff I wanted to share.
But I stopped because I felt it was time consuming, to fire up the laptop, to draft & rewrite the narrative, so that it sounded credible, with punctuation in the right places & tenses correctly emphasised.
But mostly because the smartphone was a gadget from Mars & I hadn't subscribed to a data plan yet. That all changed now, & I can literally blog anywhere, anytime.
So here I am. Feel free to welcome me back.