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')
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.