The Dogs Always Get It Right......

...... even with cats.



During our Obstetrics and Gynaecology posting, we were required to assist in the operating theater. Before the specialist come to perform the caesarian section, we the small frys need to insert the urine catheter.

Scrub nurse passes urine catheter to Houseman.
Houseman uses left hand to part the labia, holds catheter in the right, then stares blankly.....

Scrub nurse: HO hurry up, the specialist here liao!
Houseman embarrassingly: Eh missy, can you tell me where the urethra (urine hole) is ah???

You see despite having passed our anatomy, urine catheters for female patients are usually inserted by nurses in the ward and we really have little experience in locating that little hole. Sometimes if you get lucky, the patient might pee on table and give it away. Other times you need the experienced scrub nurse to assist you because you really can't use your little finger to probe around.....

Now now, don't you look down on me. While i was discussing this difficulty with some friends over dinner one day, a female lawyer friend who was with us exclaimed "you mean there is a different passage for urine??!" She had thought all her life that it all came from the same hole.
So if a woman don't even know she has another outlet for urinating (lawyer: "you know, I've never bent down to look"), how can you expect a male to find it?

So it comes as no surprise that in our infertility clinic we have to go through every little detail. Below is an abridged conversation with a rather hao lian professional couple.

Husband: Doc, we have been trying for a baby for one year.

Doc: So how often do you do it?

Wife: We do it everyday. My horney got very good stamina.

Doc: I see I see..... so can you tell me how you do it?

Husband ponders: Lets see, I prefer to do it standing.... doggy also can....

Doc: No... No.... (Doc whips out a picture of the pelvis). Can you show me where you place your penis (trying to be sensitive)

Husband looking rather insulted: Oh come on.....
And he points to the anus.

There are also those who think that they are Martians and can reproduce through telepathy. ("I thought we just have to sleep together??!!") Before you laugh at these couples, I have to tell you I don't really think they are to be blamed. Rather it is this lack of sex education in school and our ban of pornography. (or they've been getting those lousy ones with mosiacs hahaha)

The Question

Having entered medical school, one of the most irritating question that can be asked of you is "Why do you want to be a doctor?"

You see, while the same question can be posed to other professionals, you would just laugh your head off if a law student told you he did so to uphold justice. Ha ha ha, who would believe him..... upholding justice, that's for Superman.

But seriously, for any medical student or doctors to be, this is a highly sensitive issue alright? We've gotta uphold our professional image!! Anyway, try telling any of your relatives that you're doing medicine because of the prestige, the money (which there isn't any, you're mistaken) and so that you can impress girls. You prolly will end up with a good spanking in the ass.

So most of the time, we have rehearsed answers of which we regurgitate everytime the question pops up during family gatherings and especially during Chinese New Year.

Irritating Relative (with the smallest Ang Bao): "Aiyoh Boy boy, I heard you got into med-cine, so clever.... (changes topic abruptly to catch you off guard) But Why you wan be Dr ar??"

Boy boy: " to built a democratic society, base on justice and equality, so as to achieve happiness prosperity and progress for our nation"
Oops thats the Singapore pledge but you get the point, prepare something, just don't get caught off guard.

Of course sometimes over a cup of coffee in the doctor's lounge, we lament over our poor choice of career. Reasons to join the profession are many and varied. Some really feel that it is their calling (more like culling) and destiny. Some come from generations of doctors and cannot imagine doing anything else. But most of us have reasons best put forth by a respectable senior of mine:

" You know.... I really shouldn't have watched so many of those Japanese adult movies"

WHAT CAN THE HOUSEMAN DO?

Saw this posted on one of the forums today... they were talking about a recent case of a patient who died from Stevens-Johnson. Then they diverted and started talking about other things...

"....I certainly hope doctors feel a greater sense of responsibility towards their patients. Cite a bad ex. My granpa had a major op. Fixed to glucose drips thru left hand. She complained of pain. the houseman that came. Face very very black. Only say nothing she can do. drip is there on order of doctor-in-charge. Few mins later nurse came in to chk on my granopa ask everything ok? We told her bout the drip. She say will inform doc. We say dun need coz we know it will be that houseman again. A while later, houseman came in say must give my grandpa anti-vomit drugs. Why? The nurse told her my grandpa vomitted. We are like .... duhhh... However she told us the drip can be removed as long as he takes enough fluid as she has just checked with the doc in charge. I dun know how to make out of the whole medical outfit in Monkey Republic nowadays. Gone are the days when the doctors are all patient oriented...."
So let's have a MCQ quiz: "WHAT CAN THE HOUSEMAN DO?"

1. “…My granpa had a major op. Fixed to glucose drips thru left hand. She complained of pain. the houseman that came. Face very very black. Only say nothing she can do….”

WHAT CAN THE HOUSEMAN DO?

1. Put on some make up before approaching the patient
2. Remove drip on left hand and set new drip to right hand
3. Order for drip to be taken off and get screwed by MO/Registrar/Consultant the next round
4. Kiss the grandpa’s hand and say that she hopes it’s better after the kiss
5. Go for plastic surgery like Michael Jackson

2. “…Few mins later nurse came in to chk on my granopa ask everything ok? We told her bout the drip. She say will inform doc. We say dun need coz we know it will be that houseman again….”

WHAT CAN THE HOUSEMAN DO?

1. Feel hurt “…Yes… it’s me again…”
2. Feel happy “…Whew… never call me again…”
3. Feel sad “…I wanted to set plug on right hand…”

3. “…A while later, houseman came in say must give my grandpa anti-vomit drugs. Why? The nurse told her my grandpa vomitted. We are like .... duhhh...”

WHAT CAN THE HOUSEMAN DO?

1. Scold the nurse, asking why she lied about the patient vomiting
2. Give the injection anyway
3. Give the injection to the nurse
4. Give the injection to the relative who was “…duhhh….” Because he might be choking on his own vomit or he was nauseous

----------

Well, the above is tongue-in-cheek, and meant no offence to anyone. Not to the houseman, not to the nurse, not to the relatives and certainly not to grandpa. Because we are patient-oriented.

Of Diseases and Administrators

Ever since our gahmen's pro-creation policy was announced, many departments had started on five days work week. But as my boss correctly put it, "Diseases do not respect office hours". So most doctors are still rostered to come back on weekends to see patients. And yes, you guessed it (if you didn't, you haven't been reading enough of my blog, press Alt-F4), we don't get paid for the hours spent doing these morning rounds.

You can claim for transportation though it has come to my notice that despite the steep hike in petrol prices, our mileage claim had remained the same for the past donkey years.

And to compensate for the Saturdays off, our working hours have been increased by half hour per day during week days (you do the maths). As you see, while diseases don't respect office hours, administrators most definitely do......

Technorati Tag: singapore doctor medicine blog admin

Baker's Bread

Still on the topic of Obstetrics and Gynaecology, many of you guys out there might think that a Gynae doctor has the best job in the world. Which other job in the world allows you to ask the woman to strip, touch her and her husband still smiles at you and says thank you? Which other job in the world allows you to ask a woman to spread her legs and she willingly does it each and everytime? She doesn't even complain that she has a headache or no mood.
Wow, you might think that's the best job. You might think that the Gynae enjoys his job (I am not talking about job satisfaction). Think again guys

Firstly, as professionals (minus a few black sheeps), we only examine the woman if there is a need to. When we examine, it is with the intention to treat the patient and not for self-gratification.

Secondly, lets take a look at the profile of the patients who come to see a Gynae. These are the following categories

1. Middle aged (Above 50) women who come for Pap smear test

2. Pregnant ladies

3. Women who have discharge (greenish, whitish, or cheese-like)
4. Women with blood pouring out of them

5. Pretty young ladies (only in fairytales)

Don't think anyone would want to be faced with looking between the legs of any of the above categories except for category 5. Also, no one would like to have to smell the greenish, whitish or cheese-like discharge. If you think it smells bad, it probably looks worst.

Last but not least, I leave you with this thought.

A baker works all day in the bakery, kneading dough, baking the dough. For the whole day, he is faced with the sight of bread, the smell of bread and the sight and smell of more bread. Do you think when he goes home at night, he would still want to eat bread?

(Certainly there are bakers around who work at a donut factory, so all day long he just see bread with holes. All he wants to do after work is to eat a Baguette...)

Misfire

Misfiring - always the case of having the wrong head, in the wrong hole.

While we are still at the topic of Obstetrics and Gynaecology, the flipside of the joys of birth is the agony of abortions. Everyone of us have heard from our young and naïve friends on how their girlfriends got ‘accident’. We would automatically start thinking that their girlfriends were most probably hit by a truck (that would explain their looks) with or without the truck reversing to hit her one more time (for the more ugly ones).

Nope, they are not talking about vehicle-vs-pedestrian accidents. They are talking about how they accidentally forgot to use a condom, or her accidentally forgetting to take the pill or him accidentally misfiring inside her.

During our O&G rotation many of us have come across absurd stories on how the girlfriend got ‘accident’. One of the most brainless story I heard was that in the heat of passion, they couldn’t find a protective device. Having searched the kitchen high and low, they finally settled on cling wrap! Cling wrap of all things. They should know how easy those things break and tear. Well, as they say, the rest is history. Cling wraps are for preserving food. Not preventing pregnancy. Maybe the producers of cling wraps should put a warning label on the box.
“Cling wraps have not been proven to prevent pregnancy. Anyone thinking of using this product to prevent pregnancy should have their heads checked by the shrink before attempting to use it”

For goodness sake, unless the guy thinks that he wants to make his little brother slimmer, go buy a box of durex. (Heard they used cling wraps and chilli oil in a certain slimming centre. To me it is more like marinating.) Can’t afford durex, then go for the cheaper alternatives. Be warned, the cheaper brands may mimic the cling wrap and accidents still happen.

Boyfriend: Doc, how arh? She really pregnant arh?
Doc: Yups. She is in her 6th week of pregnancy.

Boyfriend: Die lar like that. (Perspiration starts coming out of his forehead). Her father sure bring parang and force me to marry his daughter. [Shotguns are not allowed in Singapore, thus the parang is the next best alternative]
Doc: ….

Boyfriend: Cannot lar like that, I am only 18 leh, and I going to enlist for NS next week leh.
Doc: Wait, you are going to enlist in NS? I think I better excuse you from firearms. You are too prone to misfire.(The last part of the dialogue is only a figment of my imagination and is in no way a doctor will ever reply in such a manner)

At this stage, the couple must make a decision. To go ahead with the pregnancy or to end it. It is a painful choice to make.

So when it is raining, always wear a bright coloured raincoat when crossing the road. We don't want accidents to happen.

The Miracle of Birth

Many readers had expressed concern over my past posts with references to the anus! While I do not discriminate against homosexuals, I definitely have a virgin ass. However I do heed their advice to blog on holes of some other kind.

After graduation, from being the most senior medical students, we were again scams of the earth, the lowest life form in the food chain, Housemen (the americans calls them intern). In State General, we were allowed to choose from either paediatrics or obsterics and gynaecology (O&G) for one of our rotations. Since paeds was such child play, I chose to get acquainted with female problems (and parts) and pregnancy.

If you are expecting gory details on me performing vaginal examinations, please switch channels. Yes! Today, my post is on the miracle of birth!! The beauty of the dawn of life!!

But really, if it was really that great, I would have at least tried becoming an O&G trainee (or a father earlier). The worst part about it all was the smell.... or rather the stench. "Dr! Dr! The waterbag break liao!!!" Wah lau, i really don't know how to describe the smell. Try mixing baby powder in urine and you're near.

Besides having to tahan the stench of amniotic fluid (your nose gets desensitized after a while), you also have to learn to dodge it!!! I kid you not!!!! Often when we do a vaginal examination on the woman in labour, the amniotic sac tears and the amniotic fluid gushes out. The same thing happens when we artificially rupture the amniotic membrane to induce labour. Wearing an apron helps but you do get splashes on your shirt and expensive Ferrakahmoh ties, not sparing your favourite Bally shoes as well.

I can personally attest to having experience an exploding amniotic sac. Instinctively, I shouted "Arti! Arti!" And those of us with previous millitary training managed to take cover and avoided getting drenched in fetal urine(yes, thats what makes up amniotic fluid). The wall about 2 metres away was not so lucky and the cleaners had a hell of a time clearing the mess.

We also had to help shout to encourage mothers-to-be push.

Newbie HO: "Aunty, maybe you should push harder? Yes, you are doing well...... Harder abit hor....."

More Experienced HO: "Push! Harder! Harder! I see the head!!! Come on you're almost there!!! Harder! Yes! Yes!"

Lao Jiao HO: "Push...... (Yawns) Push...... Push......"

After hours of pushing, I would have lost my voice. Everyone is relieved when the loud cries of the newborn fills the room. Daddy is filled with joy, tears flowing down his cheek, while carrying junior. Mummy is too tired to bloody hell care (and I swear I heard her curse the defective condom). Ahhhh.... the miracle of birth!

Of black sheeps and wolves

Doctor(DR): Good morning, what brings you here today?
Patient (Pt): Hi. I am having a headache. Went drinking last night.

DR : Oh… so how’s your headache now? Did you sustain any fall and maybe hit your head or sustained some other injuries?
Pt : (looking like he was trying not to smile) No lah. Maybe just hangover.

DR : So how are you feeling now?
Pt : I am better lah, but I don’t think I am well enough to work. Can you give me an MC for today?

DR : But didn’t you say you are feeling better? And today is only half-day for you….
Pt : But so “sian”, I am the only one rostered to work. The rest don’t need to come today.

DR : I don’t think that is a very good reason to ask for an MC.
Pt : (Can be seen thinking, brows furrowed) Actually, doctor, I also have diarrhoea this morning.

DR : Ok…. So how many times did you have diarrhoea, and when did it start?
Pt : It started this morning. Must be the seafood I had last night…

DR : So apart from drinking, you had seafood too?
Pt :Yes… beer and seafood mah… I also cannot remember how many times I vomited…

DR :Thought you said you had diarrhoea?
Pt : …I meant to say diarrhoea…

DR :Ok. So was there any blood in your faeces…was it black in colour?
Pt : I did not notice.

DR : Any other problems, like abdominal pain, vomiting?
Pt : No, only diarrhoea.

DR : In that case I will need to examine you, both externally and internally. Which means I need to examine your abdomen and also inside your rectum. I will put a finger into your rectum to check your stools.
Pt : Is that necessary? The internal examination?

DR : Well, you cannot remember whether there was blood in your faeces. Sometimes, in some infections, you can have bloody diarrhoea.
Pt : (mumbled something) ok..

DR : Can you please get onto this examination table?

( ….abdomen soft and non-tender. Bowel sounds present, not hyperactive. PR done. Hard brown stools. No melena noted….)

DR : Thought you said you had diarrhoea?

(This entry shall end here)

There have been quite a few letters to the newspaper forums lately and discussions made on some internet forums that army doctors are not “caring” or “professional” enough. It has been implied that they treat everyone as though they are faking their symptoms etc. Well, all the doctors do worry about missing something serious as it could mean their livelihood at stake if they were found negligent. No one likes to be disciplined, reprimanded or having to be hauled up to stand in front of a committee of enquiries.

And even if there were such uncaring doctors around, it is only a very, very small percentage of them. Like I said before, there are blacks sheeps in every strata of society. It is important to know that obviously, some patients have the intent to take the doctors for a ride. We do not consciously doubt them. We do take each and every patient seriously, but we must also be aware that such possibilities do exist. Boys do cry wolves at times, and in the army, there are many boys.

Death: The High Cost of Living

I am an avid fan of Neil Gaiman and in his best work to date, Sandman, Death is the sister of Dream. She is protrayed as a perky goth girl.... how nice.

In reality, death is lurking around us all the time. Especially for those of us in the medical profession. Perharps so much so that sometimes we forget the tragic side of death and become numb to it.

There was a time when I was still young and nothing in life seemed impossible. I believed that we should spare no cost in saving every life. It was only after becoming a doctor that I realised my believe was just magical thinking of an immature child.

My first professional encounter with Death was with a lady in her fifties. She suffered diabetes and consequently her heart was failing. Her husband had admitted her for a severe infection of her right leg. The only way to save her life was to cut off the leg but there was no chance of her surviving such an operation given her heart condition.

I had seen her briefly during the morning round and she was pretty alert despite the high fever. As I made my way around the wards in the afternoon, I noticed her chatting with other patients, smiling to the nurses. I was paged in the night and the nurse in charge told me she had stopped breathing.

When I arrived at the scene, the MO was already there. I was panting from the 100 metre dash looking all flustered and unsure. The MO gave me a reassuring smile and told me that nothing needed to be done. Just to certify that the patient is dead.....

Pupils fixed and dilated
No heart beat
No breathing
No response to pain
No reflexes

This is Death. She is not a perky goth girl. She was cold and distant.

Night Calls II...

The last post was for the minor things that happen.

Major things happen just like in the movies. A patient might be found not breathing or without heart beat. Code Blue is announced over the PA system and the team doctors rush to resuscitate the patient.

All sorts of wires will be connected to the patient monitoring his heart rate, oxygen levels, ECG rhythms etc. CPR will be started with the most junior doctor jumping on top of the patient and pumping the chest. To give the uninitiated a better idea, CPR is actually more tiring than sex. The danger of the resuscitator collapsing himself is a real possiblity.

The second most junior doctor will see if there is a need to stick a tube down the patient's throat to help the patient breathe. By this time, the senior doctor would have arrived and will be looking through the patient's record to determine the cause. Although from the outside this whole senario looks like what army terms as operation cluster f**k, it is actually very well orchestrated and organised. There is hierarchy to be maintained. No one oversteps his boundaries. Sometimes we manage to get a heartbeat back. Often we don't. And when we don't, there isn't that dramatic "Let's call it. Time of death 0400hrs". (Duh! that's in the movies).

It is a quiet affair, certifying death......

Night Calls...

The bane of every junior doctors.

Each of us are scheduled to do a few every month. As the day of the call approaches, the morale of that doctor will sink to rock bottom. In movies, the doctors on-call can go about their lives, going pak tor until their pager beeps. In reality, the doctors have to stay in the hospital and wait for things to happen (by Murphy's law, shit always happens). This means that the night before a call, he/she has to sleep early (means cannot go cheong until 3am.) Will be stuck in the hospital the day itself and still cannot go cheong the next day! (usually no sleep on call day so the next day shack like hell). That's 3 days in a row cannot cheong!!!

What do we do when we are on call? We take care of all the patients under our department. Every little shit thing that happens, we handle.

Nurse: Doc, patient in bed 8 has a fever, patient in bed 19 has not passed urine since he slept, and patient in bed 20 complain of pain.
Doc: What's the temperature of patient in bed 8?
Nurse: 37.6 deg celsius
Doc goes see the temperature charts... Bed 8 has been having fever for the past 3 days. It is coming down. (Doh!)
Bed 19 has not passed urine since he slept. Obviously what.. who pees in his sleep??? So should I wake him up to pee??
Bed 20 has pain. But where? Head pain, stomach pain or backside pain? Can't the nurse get more information before alerting the doc? Like that, must as well, give all patients our pager number and get them to call us directly. At least like that we can get more information.

Worse still. At 3am in the morning, after a 20hr shift of running up and down the wards. We get called to see a patient.
Patient: Lohkun arh.. Pak tor tia. Sah jik bo pang sai liao arh (Doctor, stomachache. 3 days never pass motion already)
3 days never pass motion, dunno how to tell the day doctor. Must wait until 3am at night then tell doc. But then again, thinking back, these were usually old ladies who had difficulties sleeping and they justed wanted someone to talk to.

These are just the minor things that happen in the night. For the major things that happen at night, wait for the next issue... (To be continued)

Fat Hope of Slimming

Now what is this obession with slimming??? Sure, flats are getting smaller but I really don't think anyone need to diet til they are like bamboo sticks in order to fit in. All those sofa sets sold in Courts with interest free instalments can surely hold at least 2 fat ass-es.
Well, dieting is still primarily a female preoccupation and it takes one crazy woman to know another. But it is pretty disturbing when a medically trained personel like my senior staff nurse proudly revealed during the morning round that she was taking the same slimming product as our TV Ah Jie. By the way, I think she is already too skinny, not that she meddling with her weight can help her look good in any way......
Why spend thousands of dollars attending a slimming centre when all they do is wrap you up in plastic and make you lose water? I can do it for you FOC..... provided you are a hot babe (and my wife is not at home). Try standing under the sun for a few hours, pretty much the same effect. But make sure you applied your SK-II with Pitera. (Another unsubstantiated, evidence-less product. This one even female Drs use!!!)
Just so that you know, there are many medical alternatives. Pharmacologically, there are stimulants (which can cause you to go psychotic), lipase inhibitor (you will leak oil down your ass) and appetite regulators. If not, laproscopic banding can always be done to decrease the space in your stomach. More accurately, these treatments are for anti-obesity purposes ie BMI; 30 (figure prolly lower in Asians). And not for those with fat hopes of having the figure of a model!

MOdelling

Dr. K Lum always wondered why she was scheduled to be on call almost every day.





"...Modelling is the learning of behaviours and skills that can occur by observation without direct reinforcement...."

When we are junior doctors, fresh from medical school, many a times we learn from what we see. Usually, unless you are a damn chio babe (few are far in between. Refer to previous post for explanation), you will spend most of your time in the hospital with your medical officers. The damn chio babes will probably have more time with the more senior doctors. I believe that the MOs' behaviour and attitude do rub off on the junior doctors. You either learn to be like them, either for better or for worst. Or you try not to be like them. Usually for the better.

Here at State General, there are a few categories of MOs:

1. "Simply bo-chap" type
- These MOs just want to finish their bond and get out of hospital. They do their job sufficiently not to get into trouble. They grumble about hospital policies and how sian things are in hospitals.

2. "Sian cha bo" type
- These MOs will only spend time with you, teaching, guiding etc if you are a female. Sometimes, beggars cannot be choosers.

3. "Ninja" MOs
- After the morning round (where the senior doctors like the registrars and consultants are around), they will disappear. Sometimes, I think they were summoned by some feudal lords on some secret mission, because there's no way to contact them at all. They're not in clinic, not in the ward. And they only return pages hours later. Ninjas cannot carry handphones is it??
- They reappear during the evening round. Yes, when the senior doctors are around.

4. "Foreign Talent" MOs (NTS)
- I must qualify and say that some FTMOs are wonderful people, brilliant doctors. Not all of them are black sheeps, though most of them are black.
- Words that I have heard used to describe them include "lazy", "sly", "cunning", "useless", and the rest are not suitable for kids surfing this site.
- I have heard about this FTMO who made the House Officer(HO) deliver her breast milk (which she expressed during the day) to her husband waiting somewhere else in the hospital.

(during busy day in the ward)
FTMO: Can I be excused from the ward round?
Registrar: Erm... why is that necessary?
FTMO: I need to pump my breasts.

5. "Horse fart demon" type
- Rather similar to the Ninja, only appearing when certain people are around, but these MOs can be recognised by their pouty lips, developed after years of kissing ass.

The list goes on and on, but I suppose every organisation has these people.
Fortunately, the majority of seniors are really great people, wonderful, caring doctors.
They may be very strict towards the HOs but all things are done with good intentions, to help them learn.

There are:
- MOs who are willing to help do changes for the poor HOs, clerk new cases etc.
- MOs who stay back after office hours to help the junior doctor with the evening changes.
- MOs who never fail to impart their knowledge and skills to the new doctor.
- MOs who take up appropriate responsibilities when things go wrong, as they do sometimes (and not make the HO the scapegoat!).
- MOs who ensure that the HO is not bullied by the nurses.
- MOs who reply to their pages promptly and don't sound as though they wanna bite your head off for paging them.
- MOs who genuinely treat you as a colleague, a friend rather than a subordinate.

To all these MOs, we can say that we learn a lot, and we strived to be like them, if not better. And we sincerely give our thanks.

Digital Evacuation

This finger has boldly gone where no normal finger had gone before!



While we are still on the pelvic region, let me relate my early experience on digital evacuation. An elderly bedbound gentleman was admitted to the ward and the family was complaining that he had not moved his bowels (means never shit lah) for the past few days. A previous Dr who had examined him noted that his faeces were impacted (means stuck liao loh).

Nurse: Dr Og, you need to do a digital evacuation for that patient.
Newbie (feign ignorance): huh? simi digital evacuation.
Nurse: digital like your finger and evacuation like dig !!?
Newbie: yah yah, but can't nurses do that??
Nurse (pek chek liao): NO, this type of thing only Dr can do. Your Consultant order one.

Threatened by the nurse, I had no choice but to go up to the poor old man. I put on my latex glove and inserted my digit ( index finger lah). The poor man who was unable to communicate verbally let out a loud groan. The initial disgust in me soon dissipated when I realised that hard brown stool were not unlike gardening soil. Being an avid garderner, this was not too difficult after all!
Finally I was done. I pulled out my digit in pride that I have helped this old patient. It was only then that I discovered my glove was torn and what was I to find on my digit! SHIT!

Moral of the story: always double glove!!! (applies for condoms as well I guess hahaha)

Of Penises and Vaginas

Obviously, I cannot put up pictures of penises and vaginas.
So here's a picture of Spongebob Squarepants instead.

For many of us, medical school was the first time you see another person naked. Regardless of how crude it may sound, it's the time when we see *REAL* penises and vaginas for the first time. Certainly there are those among us whose sexual exploits are already legendary before they enter medical school, but for the common people, what we know mainly come from what we see in textbooks (and perhaps on the internet, for those with time to *ahem* study extra materials).

Certainly there are stories of how those moments are. My favourite one has to be this and for obvious reasons to protect privacy, names cannot be revealed.

A female medical student was examining a groin mass, likely to be a hydrocele or a hernia. She was alone with the patient at his bedside in a subsidised ward with the curtains drawn. Her fellow students (we call them clinical group mates) were all waiting outside for her to complete the examination and describe what she examined, in other words, a short-case presentation.

She did quite a good job, talking about the location, size etc about the mass. But she went on to casually remark that this patient’s genital was hard when she thought penises should be “soft”. She then proudly declared that she picked up a clinical sign that none of us could. She described seeing “pus” come out from the tip of the penis and declared that the patient probably had some infection…

I can safely say that if she took a swab of that “pus” and sent it for microscopy, culture etc the report would probably be spermatozoan ++++. I don’t think anything will grow in the petri dish though.

My Panadol

Houseman Survivor Guide (Monkey Edition)
I. Introduction
II. Hospital Hierarchy
III. A Typical Day
IV. Painkillers
V. Meet The F*ckers


Surviving in the medical faculty, be it as a medical student or a doctor, is not an easy task. This is especially so when you are just a junior member of the team (ie a House Officer or a Medical Officer) because shit tends to gravitate downwards. Nevertheless, being the altruistic and impressionable young lokuns that we all were, we took the shit in the face (literally).
Tips to surviving medical housemanship/ internship will be dealt with in due course but two things shine in their contribution in making good doctors.

If you ask me what is the greatest drug ever made, I will without a doubt tell you its Panadol (paracetamol). A doctor can survive a drilling 24 hrs call without sleep but he might not be able to endure the next 8 hrs of work with his head throbbing and about to explode! Headaches are not only caused by energy sapping night calls but also by nurses running around like headless chickens when someone in the ward (usually an angry relative) collapses. The consequences are not only related to work as the good Dr also has to fulfil his/her partner's sexual needs!

The other is of course my daily dose of caffeine.

First Day

Tan Ah Kow waited a long time
before getting into Medical School

The first people that welcomed us into medical school @ State General, Monkey Republic, were the cadavers. And no, I am not referring to the lecturers in medical school. At least during our time, the first class in medical school was always on the anatomy of the upper limb. We were told to buy some instruments and scalpel blades, and for most of us, we were sure that they were not for some hearty meal organised for the new students.

I suppose we were rather apprehensive about seeing dead bodies (emphasis on bodies) for the first time. (You must remember that at that time, C.S.I., whether it was in Las Vegas, New York or Miami was just a concept in the subconscious mind of a dreamy and probably poor writer in America.) Well, it was a longish hall filled with about forty blue body bags. In them were mainly old men and a few old women. This does not represent the ratio of male and females in medical school at that time, of course.

What I remembered was that these dead bodies had name tags tied to their feet, with their names, i/c numbers and last addresses written on it. The addresses were probably those belonging to old folks homes. This was done so that if one day, some family members suddenly remembered they have this relative lying in the old folks' home (and probably need their help to remember some bank account number or safe's combination lock code), they can come and claim the body. Or should I say body parts.

Relatives: Can I see Mr Tan Ah Ba? I/C 1234567A?
Anatomy Dept: Which part do you want to see?
Relatives: Can I claim the body?
Anatomy Dept: Sure. Here's the left upper limb. We're sorry it's not connected to the body. Oh, you may notice that some of the bones in the hand are missing, but the students are having this test next week and they need the specimen so that they can recognise this groove on this particular bone. (of course, MCQ tests are stories for another day)

How it all begins....

At the tender age of 18, some boys in green decided that they had enough of millitary training. You see, most of us would have led relatively sheltered lives with daddy & mummy getting everything for us. All of a sudden, you have this staff sergent swearing vulgarities in our faces. So, the easiest way out was to get into the medical faculty and disrupt from national service!!!

The first hurdle was of course the interview for admission to the medical faculty of Children Women Old People and Anything Else Teaching Hospital.

You have five interviewers taking turns to ask you anything and everything under the sky. Well, we did get to book out camp, so what the heck! No one really knows what criteria they use to select medical students. Maybe see your face "song" or not?? There has always been this conspiracy theory that the interviewers don't like girls a lot 'cause female medical students are always sibei pai kua and the pretty ones get booted out to other faculties. Just check out the hot babes in Dentistry and you know what i mean! Or you can look at the sexy ladies in Arts and Social Sciences? Maybe even those chio girls in the Science faculty? Perhaps the girls in the Engineering Fac? (but then again... perhaps not. =P)

So if you heng heng kenna selected means you get to siam army for the next 5 years and go havoc in the hostels. But due to army policies, some unlucky souls still don't get disrupted. But since all their relatives already know they are going to be doctor, cannot siam liao.

The picture shown is that of Hippocrates. Nope, he is not trying to cut the dude, he is treating him!!!!! Believe me you!

A Dog's Life

SGDR is about the fictional lives of doctors from General Children Women Old People and Anything Else Teaching Hospital. It is the ONLY hospital in the remote and ancient nation of Lan Fang Republic somewhere in Nowhere. It is not real or representative of the medical community at large. However it does parallel a dog's life.....