A Doc's Life is a underground Medical Blog about some poor Singapore doctors. They are sibei sian and very buay song. Best practices not observed!
(Warning: Grammar is non existent in this blog. Those obsessively compulsive about good English please go no further and book an appointment to see your psychiatrist in Singapore.)

Tuesday, February 20, 2018

Nothing Compares... to Paper

As you get older, its sibei jialat. Things that you like and are familiar with become obsolete.

Pager long obsolete liao...

Blog obsolete liao (though got people scold me why I so long neber write blog...)

Facebook obsolete liao (now chow ginnahs only use Instagram... Dr Og also try to use but old people more long winded and my tremulous hands take picture is all blur blur one)

J-Pop, long long time obsolete liao,  even for K Pop, G Dragon and Big Bang people all forget. Only remember BTS!

Actually sometimes, LAW also can become obsolete!

In Medicine, it is obvious that there are people trying to make paper obsolete. Now, it seems like we are all going to enjoy paperless wonders in the form of National Digital Electronics Unhealth Recordings. Actually, Dr Og very support this move. Now I can know the entire history of my patients! They like or they don't like, I can see when they last kennah STDs, had piles, cannot pass urine or kennah TB. More info is always solid. Like these days before driving, you can see which road got jammed so you can decide should take KPE ECP AYE CTE or mebbe PIE CTE AYE BKE. It really doesn’t matter that information overload sometimes get me stunned like vegetables especially when all the roads are jammed up on Friday evenings. Sigh, if only the last patient came on time...

Of course Dr Og only exaggerating la. I’m sure any International system will be sibei secure one! There will be layers and layers of passwords required before you can see all these sensitive info. It will be like a peekaboo striptease type of thing lor. 给你一点,不给一点 hahaha. Only sometimes like playing strip poker, you get bored liao when the computer keeps winning, you still cannot see the 两点 and give up altogether.

Now obsolete - In the days of 286 CPU and CGA, it WAS literally 2 dots!


But hor to utilize all these IT stuff means we have to make paper obsolete and use some sort of  IT system. Those already using probably know the frustration of going through this warning and that confirmation before you can get to any real stuff.

Paper is still the best! It smells good! It feels good! Can practice my wonderful calligraphy and sign off signature big big like a big boss. While computer can crash, what can happen to paper? The worst is kennah coffee stain. (coffee very important for lokun to survive so don't you judge!)

Alas, paper will become obsolete like it or not. End up we spend more time trying to enter data than actually seeing (or talking to, or examining)  patients. But hor, given that all the data in the cloud now, maybe what doctors in the future need to palpate are not patients but data.

PS: Song tribute to paper. Nothing compares to you... we will miss you when the day comes...

Sunday, March 19, 2017

How Long?

Duration of illness is often an important part of history taking when we see patients. I am not sure if it is a local phenomenon but patients tend seem to have difficulties with this all the time...

Lokun: "So uncle, how long have you had this symptom?"
Ah Pek: "Wah, very long...". He goes into deep pondering...
Lokun: "How long is very long ar?"
Ah Pek: "So long, I can't remember.. you know, it's not like some other long part of my body that can be measured, hehe."
Lokun: "Ok, long as in 5 cm 10cm or... See, now you confuse me! I mean days, weeks, months, years?"
Ah Pek: "Ya, very long liao......" And he continues his deep pondering.

To be fair, its not just the elderly gentlemen who frustrate doctors, many young people can't seem to provide proper duration of their illness. We don't need to know the exact number of days, but roughly, can or not?

Buay tahan.....

Tuesday, January 03, 2017

The Day After

Urgent blue letter in the late evening?

Sometimes it was easier just to accept and comply, then to argue and reject. 

I sat by her bed knowing that there was nothing else to do. She was not a particularly likable patient. Perhaps it was the way she (or her condition) made me feel helpless. Still, I resisted the urge to just do something, scoot off and get on with the rest of the night call.

She was ranting about how her life had been horrible and that even at a time like this, there was no one by her side. She felt that she deserved better and Lady Luck had been cruel. I reassured her a little but mostly sat by the bed quietly listening. I did not want to lie that everything was ok and I did not know what else to say. Initially I contemplated how I could end the conversation and to move on with my work. After a while, I decided to just sit there and listen for as long as I could since it was not a heavy night. 

Eventually her difficulty in breathing ended the conversation. The nurses came to assist her, relieving me of the huge uncomfortable sense of helplessness.

The next morning, before the end of the call, I checked on her. Her bed was empty. She did not make it past midnight. I felt guilty that I did nothing for her. On my way home, I played the Sound of Silence in the car. Always soothing and calming. 

I told myself, it was the new year and it would be a better year.

It was only after a few years (more of experience) later that I accepted that I did the best I could have done, spending that little bit more time with her.

*******

The end of 2016 claimed many, even on the last day for some of us. For those who did not get to see the day after, may you RIP.

Thursday, October 20, 2016

Pokemon-No-Go

Seems like the Pokemon Go craze is gone as quickly as it came. Dr Og was for a while playing quite a bit and life seemed to have some meaning again. But after a while become a bit sian also hor... everyday catch Rattatas and Pidgeys. What so fun about catching rats and pigeons. In real life catch rats can earn more money than being a doctor. Pigeons last time young catch using the box and a stick method liao.

When Pokemon Go was at the peak of its popularity, people were cheonging around like crazy to catch Snorlax, Lapras, etc. Few times Snorlax appeared near Dr Og's clinic and caused jam in the roads. Heng, Dr Og did not get trapped.

But a patient I was seeing stopped the consult halfway to cheong for the Snorlax. He then proudly told me he managed to catch it when he came back.

"Doc, my friend halfway at work all stop their work and go catch. I bet you don't dare ar. Hahaha...", he said.

This somehow lead me to a distant memory.

@@@@@@@

The Registrar hung up his handphone and returned to the ward round. I was a medical officer and those were the days when consultants only came by two to three times a week. Most times they would hear that "everything is ok" and they disappeared as quickly as they appeared (in all fairness, when they are needed they will miraculously appear like fairy god mothers). The Registrar lead the ward rounds on most days and made all the calls.

The round that day went on uneventfully with the usual careful history taking and physical examinations. When it was time for the traditional after round kopi break, the Registrar told me, "Bro, I need to take urgent leave. Daughter just had a fit."

With the round done and patients taken care of, he ran off.

@@@@@@@

The patient is right. I don't dare to leave my clinic halfway to go catch pokemons. It is not because Dr Og is too proud to do so. Trust me, I ran and squeezed and cursed and screamed when I caught my Lapras and when my Lickintung ran away. 

But... if my Registrar did not just run off on hearing that his daughter just had a fit for the first time and left us junior doctors in the lurch and if he continued to complete the round calmly and carefully despite the anxiety that must be going through him, I don't think I would dare leave my clinic or my patients unless life and death.

Pokemons? No, I wouldn't dare.

Monday, October 03, 2016

Gender Bias Part I

The Radiologist held up the request form and his hand was shaking. He was reading the form as he would a X-ray, against the light of the ceiling. I made a mental note that radiology was a discipline I would never consider, given that the radiologists I've met so far, half a year into my Housemanship, were nothing short of coo coo.

"You can go and tell your consultant there is no way I will do this!!! This is ridiculous!!! There is no urgency!!!!" He bellowed.

I wasn't particularly flustered given that this sort of treatment was a day in day out affair to me by now. It was just that I could not stand his stale cigarette smelling breath in my face. I uttered some apology and had wanted to leave. After all, I've done my part. The consultant wanted me to kamikaze and I had kamikazed (君要臣死 臣不得不死). The Radiologist had a rejection rate of almost a 100% for urgent requests and there was a 100% risk of getting at least an angry stare of disapproval if not the more common hairdryer treatment of being yelled at.

Unfortunately, he was not done with me yet.

"And it is not COOP LOOP, you....... It's COPE LOOP!!!!! You think chicken coop?!!! You......"

Ummm, the dark dingy radiology department did somewhat remind me of a chicken coop.... Freudian slip, my bad.

He took out a marker, drew several lines across "coop" and then wrote the word "cope" across the whole of the A4 sized request form. As he handed the form back to me, he hesitated for a while. Realizing that the nurses might misconstrue that he had agreed to the procedure since his distinct handwriting (and his distinct stale cigarette smell) was spluttered across the request, he tore the form into two before giving it back to me.

As I was to exit the radio department, my pager unsurprisingly rang and I had to make a call back to the ward. A female house officer strolled in and waved a big hello to the Radiologist. His deep frown turned into a crooked smile and they started chatting. I wouldn't say that his hands was all over her, but they were close enough. She then took out a request form in a by-the-way manner and he happily signed it without even so much as to glance on it (his eyes were on [the wrong parts of] her).

I waited for the female HO outside. She was a good friend.

"Wanna go quickly grab some dinner before going on-call?" I asked her and she nodded.

"Wah you damn power. You know, I'm still a 100% reject rate!"

"Next time wear a skirt la!" She said.

Moral of the story: unless you are wearing a skirt, don't expect your busy fellow male HO to wait for you for dinner.