what title?
Sunday, June 03, 2007
Bouncing off the walls today. Ended night shift rather late and by that time it was closer to noon than night. Just feeling very restless though not in a bad way. On the way home was just thinking how good it was if I could start training in wushu again - just had the weirdest compulsion to start performing a complicated series of leaps and kicks and slashing with a sword. Not in a rampaging sort lets-see-how-many-people-i-can-kill way; rather, it's a sublimation of the agression that I believe each of us carries within. To transform something as deadly as a sword (ok, I know they use blunted swords in performances) into an artisitic form. And the freedom - leaping and flying through the air, the feel of the weighted weapon in your arm, the sound of it parting the air. Gosh, I'm really waxing lyrical about this. I miss all of it.

That was another level, though. Even at the time I traind most regularly I couldn't do most of the showy stuff. I could imagine doing it, yes, so close but out of reach. Maybe another couple of years, if I'd kept at it. I didn't though; years out of practice now and feeling terribly unfit. Sigh. I miss the spring I felt even doing something as simple as walking. The agility and flexibility that came naturally with it. I have to crouch to pick something from the floor now, and keep bumping against corners. It didn't use to be like that. I'm getting old - old, and unfit.

When I arrived at home, still feeling restless, I picked up the guitar sitting gathering dust at the corner. Yet another victim of my career - I somehow had this idea that the calluses formed from pressing the strings will interfere with my work. Heh. So I started playing, well at least it's something I could do in my living room that won't break either the furniture or my bones. Now I got the Entree from Partita 1 stuck in my head and can't get it out. Argh. I don't know which is preferable - this, or the obssession to fly through the air.
Friday, May 11, 2007
The taxi driver told me that the way I pronounced "emergency" in Chinese sounded like "economy". After several tries I still did not manage to get te correct tone. Getting farther afield, it started sounding like "golden chicken", and we spent most of the journey laughing about it.

Terribly slow going today. I hate getting druggies and psychiatric patients, and of course the universe decided to introduce a few today. Yet it was interesting to observe how one fakes Parkinsonism. And even more interesting to speculate why one wants to do that. The dark, or sometimes just plain ludicrous, side of the human psyche. The adventurous part of my brain often wonders just how exciting it will be to do psych... the last frontier and all that. At other times, though, I think it'll be demoralising or plain sad. Human frailty - there is no better way to witness that than running the emergency room at the mental institute, methinks. I get the occasional encounters with te neurotic or psychotic patients and usually can't stop obsessing how and why someone turns out that way. Nature? Nurture? I had a day at the paeds psych unit as a student and it was both a baffling yet harrowing experience; at least vicariously.

There was this girl of eleven who started cutting herself. Her mom was getting a divorce and se was doing it to "exert a semblance of control in her own life", thus our tutor expounded te theoretical aspects after the session.

Looking back, I sometimes wonder what became of that girl. Paracetamol overdose at fourteen? Get panic attacks at sixteen? Turns to drugs and alcohol at seventeen? Incarcerated in a mental hospital before she reaches the age of majority?

Or maybe she managed to put that all behind her and grew up more or less normal - but what is normal anyway? One who was found by the Bureau of Statistics to have no official complaint? Who served the Greater Community, never got fired and satisfied one's employer? Had anything been wrong... *we* should certainly have heard. Indeed.

(with thanks to W. H. Auden, 'The Unknown Citizen')

Thursday, May 10, 2007
How strange. I just ate blue eggs.

Who'd have guessed that if one scramble an egg with red cabbage one will end up with blue eggs?

There goes the useless fact of the day.

I've been thinking of writing about people who abuse the ED as a quick-fix to get a medical cert but of course I keep postponing it. This was all thanks to the super-crowded state of the ED of a certain hospital in this nation-state - for whatever reason there were just not enough medical officers working there for the past six months, so on bad days people have to wait for four hours or more to see a doctor. Now when you are rushing to prevent the account from being in the red (and the names on the list do turn red literally when they've been waiting longer than 110 minutes) there is nothing more irritating than to see a person who obviously fakes his symptoms so that he can get a day off.

Sometimes I wonder about what it says in terms of the nationalism in this country. So all healthy males 18 years old and above have to complete 2 and half years of military service. So? You'd think it's the end of the world if you see the whiners filing through the ED door on a daily basis. We have this thing called the Sunday night fever - somehow just hours before they have to book in to camp after the weekend off they start coming in for amazingly minor symptoms just for the hope of delaying the inevitable start of the week.

I usually give them what they want. A day off? Sure, doesn't cost me to be nice. Just get out of here and stop listing all your medical factoids. What's that? you've got foot rot? How long? Since you join the army 2 years ago? Well, my dear boy, the cure is simple. It's called ORD (for those who don't live here, it stands for Operationally Ready Date. Basically the time when one completes one's national service).

Unfortunately, I think this sort of practicality kind of backfires. I don't know if the hospital develops a reputation as a soft mark, because it seems I just see more and more of them every week. It got so bad that I was suggesting half tongue-in-cheek that we should create a fast lane for these guys so that you can save time and space. Maybe a table outside the department, with a huge sign saying NS BOYS THIS WAY. Then they're given a questionnaire of the common symptoms e.g. fever ___ days, runny nose ___ days, cough ___ days, vomitting, headache, muscle ache, etc. After that they get seen by an MO at the open space - one needs only look into their throats, listen to their lungs and make sure their necks are supple. After that they get a prescription based on the symptoms they tick. Oh, and don't forget the MC. Four or more symptoms get them 2 days off, but anything more than 10 symptoms gets a penalty of no MC, because that can only mean they're faking it. Furthermore, they earn the ire of the poor MO who's got to type all their symptoms.

It's quite useful to let people know the ground rules. On a particularly bad day not so long ago, I stood near the entry of the fever facility, which is basically this wooden structure housing the febrile patients (a measure which supposedly protect the rest of the population from such things like bird 'flu), and commented rather loudly to the nurse that I'm a very pro-MC doctor because I believe one should get enough rest before the symptoms get more severe. A stitch in time saves nine and all that jazz. It's just that I hate it when people start making up symptoms in hope of garnering more sympathy, and, presumably, longer MC.

I wonder if the guys inside overheard what I was saying. That day it seemed most of everyone came up with very reasonable complaints and gave their imagination a much needed rest. Everybody got to go home fast and I was happy, too.
Thursday, April 12, 2007
And I saw the light at the end of the tunnel... my eyes, my eyes!

For a second there I thought I'd say goodbye to the vision in my left eye.

All of this started because it was a good shift last night. Because it was a good shift last night, I was consequently fresh and perky in the morning. Practically bouncing off the wall. And as a result of that I collared one on my colleagues who happened to be a trainee Opthalmologist and asked him for an informal consult for an eye problem I've had for years. I was expecting maybe a few lines of discussion of possible diagnoses and what sort of things I've gotta watch out for, but this colleague, bless him, told me he'd gladly examine my eyes proper.

Now when you say proper eye examination it means dilating the pupils so that whoever it it examining can get a good peek into your soul - erm, I mean, your retina.

A couple of drops of Tropicamide later and I was sitting in a darkened room while waiting for the stuff to work their full effect on my poor unsuspecting iris sphincter muscles. After a while everything became so bright and I couldn't focus sharply on anything. I grabbed a lighted torchlight in my fist and it lit up my entire hand so much I could see the veins mapped on the luminous orange background like those pictures of fetuses.

But the eye examination itself. Gosh. I've in the past sat unflinching while a chinese physician tried to manipulate a broken collarbone into a better shape but this is just... well, not painful but it's just something I could not tolerate it seemed. It was like looking directly into the sun after an eclipse - not that I have tried that since they say it would ruin your eyesight. My dear colleague, and my common sense, assured me that the people who designed those slit lamp machines would certainly not let that happen, though. After a few miserable minutes during which I could see afterimages of the vessels in my own eyes my colleague finally declared he was done - or perhaps gave up is a better word. My eye just kept drifting closed beyond my control, despite my best efforts to cooperate with instructions to keep them open.

So he wrote a referral letter filled with unfamiliar terms such as metamorphopsia and photopsia and arranged for me to go to the Eye Clinic for examination with better equipment than what we have in the ED.

All in all, it was an interesting morning.
Wednesday, January 17, 2007
ah, 2007. another year in the making.

resolutions abound.. somehow i'm rather optimistic about this year. maybe it's the relatively increased amount of free time i have - sort of able to sort my thoughts and keep myself happy; which was hardly the case in my last posting.

this has also convinced me that eventually my career decision will be directed by such lifestyle choices. i want time to spend outside work. time to pursue my hobbies. time to spend with friends and loved ones. time to read. time to be alone. time to experiment in the kitchen. perhaps even time to join a proper choir and/or train in martial arts again (not at the same time).
Wednesday, May 10, 2006
Playing God
- for Mr K: whichever way you choose to go, good luck be with you.

No, he's not doing very well at the moment, but we're keeping an eye on him and hopefully he will-

79 - 64 - 52 -

Ma'am, Sir, would you please wait outside.

(sh*t. Code Blue!)



(rumble of crash cart, schick of a curtain and we have our own little sweltering kingdom surrounded by damp curtains. you old man is our queen bee - languishing in your unconcerned stillness at the centre of frenzied activity while we, your worker bees, slave for the hatching of the next breath and the sustained pulse of artificially oxygenated blood flowing through your brain)


71 years old, full-house risk factors, previous stroke, no sir, he's ambulant - yes - independent
perfectly lucid he was talking to me earlier -

(crack of ribs, bouncing of the bed, face smothered by the consuming kiss of the silicone face mask of the respirator - at this age having such a wild time with a girl in bed is probably not too healthy for you)

one miligram adrenaline - resume cpr - come on, heart, you have to beat faster and harder than that - second dose adrenaline -

stop, he's coming back! BP? 130/70.

- where's the blade; someone lube the ET tube - check the balloon - suck the secretion - we'll paralyse him first he's too stiff - how's the potassium? prepare the sux, half vial, dilute with normal saline. nice and slow, that's it.

saturation 100%.


ok, let's wheel him out.
Wednesday, May 03, 2006
Ends and beginnings. Last day in my final posting as a trainee. That was yesterday. I'd been going to this hospital for the past four months, walking from home every morning and getting my breakfast from the coffeeshop across the road. Always the same thing - no matter how I try to deny it I suppose I'm a creature of habit after all. The man at the drinks stall knew me so well he would prepare the drink I always ordered the moment he saw me cross the road. Teh, ban sao. Tea (with milk and sugar), luke warm. Otherwise he would fill the whole cup with boiling water and I'd spend precious time trying to drink it without scalding my tongue.

So that day I walked out of the apartment wondering if I should tell the man behind the counter that I'm changing jobs - one sometimes wonders how familiar one should be with people one sees in the context of everyday life, yet who are neither an acquaintance nor a colleague. Sure enough I could stand and talk with the next person on a queue about the weather, but telling them that say, I could feel a storm approaching even when I'm indoors without access to a window, now that just feels a tad too personal. Anyway. I walked out and saw that the shop was closed. And it was still closed today. I wonder if they are undergoing renovation or maybe they have moved elsewhere.

Last day at work. The last day I could hide behind a 'P' in my registration number. P for Provisional. P for Protected. P for 'Prentice. And I always say that no matter how people try to make this line of work sounds scientific and all, it is mostly art, or rather craft, and I was an apprentice turned journeyman now.
blog of someone who's going crazy, or else getting enlightened. sometimes it's hard to tell the difference, you know? i'm a jack-of-all-trades who dabbles in photography and martial arts (not at the same time), reads books of every description, keeps stray animals and tries to pass exams in my free time. That was then. Now I work, and work and work, and I don't know what possessed me but I find myself bloging again. And no, I didn't forget to take my pills this morning.

03/01/2004 - 04/01/2004 / 04/01/2004 - 05/01/2004 / 05/01/2004 - 06/01/2004 / 06/01/2004 - 07/01/2004 / 10/01/2004 - 11/01/2004 / 01/01/2005 - 02/01/2005 / 02/01/2006 - 03/01/2006 / 05/01/2006 - 06/01/2006 / 01/01/2007 - 02/01/2007 / 04/01/2007 - 05/01/2007 / 05/01/2007 - 06/01/2007 / 06/01/2007 - 07/01/2007 /

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