Tuesday, April 28, 2009

Who to blame?

Talking about the news, I'm sure the whole doctor community is abuzz with a politician who apparently had caught two doctors in HKL 'napping'.

and news from the grapevine is, the 20 patients were actually just 8 cases, the rest being relatives and the two doctors were not even on duty! But of course, these are the things that doesn't end up on front pages of newspapers.

I feel sorry for us lot, sometimes. We work way beyond our exhaustion sometimes; returning home way past dusk - just to make sure operations are done or that patients are escorted safely - but most times, things are just out of our control.

Take last Sunday, and I hope I don't get into trouble for this. We had three elective and one emergency case waiting to be done. I had gone for morning rounds with boss and proceeded to OT as usually he expects us to prepare the patient before (if he needs to) he comes in and does the operation.

Lo and behold, the anaesth MO informs me that the airconditioning in the OT had tripped during the night and the temperature of the OT had gone into the 30s. So, I waited and waited and after two hours, the aircond went on to trip two more times and the OT temp never came down below 22.

and this is the OT that had just been completed at the end of last year. Yes, I am talking about a 4-month-old OT and already it has been piling a bunch of incident reporting with regards to the airconditioning, the air pressure and what nots. Not to mention the door which is now coming off the wall, the broken hinges and the OT entrance which is like a mini waterfall come rain.

We ended up cancelling the cases and only managed to squeeze in one emergency case. But patients don't see the goings on behind closed doors, all they knew was that they had to fast for three days and STILL no sign of the op being done.

It is frustrating when your patient is upset and you know it isn't your fault. But who do you blame?

Not only do you have to deal with things that are occuring internally, you also have to deal with external stuff, like the expectations and attitudes of your patients. When I worked at the Outpatients Department (OPD), I had a girl who kicked my door just because I refused to give her an MC. She didn't have any complaints, all she came for was some allergy medication and she informed me that her boss had told her to get an MC. It is sad, but I know a lot of my colleagues give in just because we don't have time to deal with silly things like this.

Sometimes when I hang out at the OPD and perform routine medical examinations (RME) on students about to fly off for their degree in medicine, I jokingly ask them whether they know what they are getting themselves into. They smile with the youthful confidence that only the young (and ignorant? Hahaha) possess and I wish them luck.

In dire need of a holiday

April has been a hectic month. There was a period where I was at the hospital everyday for 13 continuous days with absolutely no weekend break.

Thus, it is of no surprise how much I am so looking forward to my holiday in Java. Of course, knowing me, planning the travel itself gives me a buzz. All Abg said was, you plan everything and just give me the itinerary so I know what is happening.

The hospital was in the news recently. A former patient of ours had gone to see a reporter and moaned about the bad treatment he got from an MO of the ward where he was recently admitted. Now, since the article did not mention the name of the MO, everyone who had seen the patient is now required to write a report, including yours truly.

Hmph. Macam la aku takde kerja lain.

I know think hope the person he meant wasn't me because he came to our table to say hello this morning. I couldn't bear to look at his face and be courteous. As much as I wasn't really chummy with the person whom the patient complained about, there is a sense of loyalty towards a work colleague and I am sure this is all just a misunderstanding.

Anyway, while I was chatting with my boss, I remarked on the fact that when I was studying in Belfast, the wards' notice boards were always full of thank you cards and every other day the nurses would get gifts of chocs and cakes and flowers. Perhaps it is part of their upbringing, being constantly reminded to watch their Ps and Qs and the practice of writing thank you notes after receiving gifts for birthdays and Christmases.

At bus stops, people would form a queue based on the order they arrived and they would get on the bus in the same manner. I wonder what people thought of our custom of jostling and elbowing our way in. Cars would stop to let you cross the street and men would hold the doors open for you. Till now, I still find myself holding doors open for the person behind me to come through.

So much for Adat Ketimuran, huh.

Anyway, I digress. I just had my last call of the month last night and it was pretty laidback considering the MO the night before could only sleep at 4 and the casualty had been kept busy till the end of the night shift. It's been a pretty good run the whole month so I am now anticipating a highly jonah oncall, which in the past, had always turned up just before a holiday.

Wednesday, April 08, 2009

This is how I feel when I am postcall....

p/s: My Che'Put sleeping under the coffee table.

Road Rager me

On the way to work, there are two stretches of 'lorong memotong's. One in the Tok Bok area and the other just a few kilometres ahead, where Yamud's house is.

I was driving to work this morning when I reached the first one with a dark coloured Iswara driving ahead of me. There were no cars in front nor the left of him. I had long gone past flashing my lights to idiots like these because I think their cars have probably been manufactured with steering wheels which could not maneouvre to the left, so I took the left lane and over took him.

At the next 'lorong memotong', I was following a black Naza Citra rather closely on the right lane. We were overtaking a kancil when the idiot took the left lane and wanted to squeeze in between the Citra and my car. I honked at him and instead of pulling back, he persisted on taking my lane. So I honked long and hard, glanced at him and showed him the finger.


Thinking about it now, I am not proud of what I did. It was very unladylike, (well, what's so lady like about me, doing Ortho and all that) and very rude.

I can still remember his face before I sped forwards, then proceeded to overtake the Citra and went on my way leaving Mr Idiot behind.

You think just because you lit your indicator lights that you can simply squeeze your car in meh? Just now you were dilly dallying taking your sweet time and now you suddenly decided that you're in a hurry?

If there is one thing I don't get about drivers here are their love for the right hand lane. Bawak la 40km sejam pun terhegeh2 kat lane kanan. Tak paham aku.

Thursday, April 02, 2009

The definition of 'jonah'....

...is after admitting two nonagenarians, one of whom is now on double inotropes, at 4 am is still admitting patients with low blood pressure, and with an Acute Pulmonary Oedema case waiting at the casualty because now there are no more beds in the acute cubicle in the ward.

but I suppose, that doesn't beat escorting cases to HRPZ II five (yes, 5) times on a 24 hour shift.

I've been back to KL during the extended weekend. Sometimes, returning to the west coast is like going on holiday in a another country. Cars are faster, the people are more wound up, houses and shopping areas bigger. I ended up coming back home a day earlier than planned, much to the chagrin of Ma, because I involved my cats in it.

By the way, Verver is now missing for a week. I was on call and Abg had let them out for the evening and she never returned. I'm convinced she has been hit by a car or motorbike and has gone to die somewhere else. The lack of closure is making me uneasy. Sad as it is, I'd rather see the body and know rather than left wondering.

Anyway, I'm up attending to the case of the nonagenarian with cardiogenic shock and also sepsis. Man, of all the things to end up with at 92. It has been sort of a "Hari Warga Emas Sedunia" today. I had gone to HRPZ earlier today escorting a case of peritonitis. She was 81 and had just returned from a family holiday in Penang. Her blood pressure wasn't great when I left her in the care of the Surgical MO.

I'm not sure whether it's a good idea staying up, hoping that the three hour-sleep I got from midnight is going to be enough, but it is Thursday today and I'm always hopeful on a Thursday.

Wednesday, April 01, 2009

The definition of unstable....

...is an 81 year old lady who is on triple inotropes (medication to bring up your blood pressure) of which all three are already on maximum dose, yet the blood pressure remains below 100 and whose Ryle's tube (tube from the stomach coming out through the nose or mouth) is pouring out dark brownish material.