When the Fat Lady Sings

Recently (ex) MM and (ex) SM stepped down. This triggered me into thinking about retirement. Many patients I have seen do not seem to understand that retirement needs to be planned and we need to learn how to slow down and relac lah.

Doc: Uncle you got any hobbies?
Ah Pek: Simi Orhbeee???
Doc: no, no uncle, not guiness stout. What you do when you are free?
Ah Pek: Feee? I work work work then go home jiat bah, koon la.
Doc: Er, what do you like to do when you are not working huh? Things you like.
Ah Pek: Don't haff.
Doc: You listen to music?
Ah Pek: No
Doc: Watch TV
Ah Pek: No, I work so hard everyday to support children, family. Where got time?

I used to think that these Ah Peks were just having me on. I imagined that they were having lots of fun in Desker Road on weekends distributing their CPF payouts. But having spoken to many over the course of years (plus they never asked me for viagra), I realised that the generations born prior to 1960s had it ingrained in them that the only route to success was hard work. They sloughed their life away for their family and did nothing for themselves.

The problem being when they retire, they suddenly find themselves with no work to do, no hobbies and having absolutely no idea how to pass the day. The children are busy with work and their spouses may find them to be a nuisance at home since they are not used to having them around. They find themselves irrelevant and becoming a relic more than anything else. The loss of role can lead to much stress and many psychological woes.

So what should Dr Og do when he retires from blogging (medicine being only a delusion of mine)? I was thinking of politics but gave up the thought as I don't fancy sweating in a blue shirt shouting to a crowd of 30,000 in a stadium. And honestly, you will never see me in a red shirt coz the only time I'll wear one, if I ever do, is during Chinese New Year.

Indeed sibei cham if you cannot find something sane to do!

Next up, Dr Og's (patented) Preparation for Retirement Programme ... Akan Datang

Tags: Retirement, Medicine, Singapore

Singapore M.D.: A Lifetime to Master

Singapore M.D.: A Lifetime to Master

Residency, Ageism and Me (Yes it's always about me)

So the first batch of Duke medical students will be graduating this weekend. Congrats wor.

Totally unrelated, I was ignored when I asked for free tickets (offered on Twitter) to Zouk this Saturday. Dr Og just asked for fun la (my principle, anything free just ki chew first) and really given my age, lack of vitality and that I will be cheonging at Shanghai Dolly ( sorry I cheena one) on Friday, it is unlikely I will be able to survive Zouk on a Sat night.

While I did suffer some narcissistic injury when the fellow twitter did not offer me the free tix ( and worse ar never follow me on twitter), I also knew that my time in Zouk is (long) over. This has nothing to do with ageism. Do you see ah peks running hundred metre sprint?

Its not just the young ones who get to enjoy everything! There are also other stuff whereby being older works in your favour. The older folks have seats choped for them in MRTs and buses, can scold you if you take their seats and Stomp you until you apologize! They can also get senior citizen prices for movie tix. No wonder all the ah peks gather at Yangtze.

What Dr Og is saying is that whatever your age is there is a right place for you... I used to cheong Zouk but now I reminisce and spent Saturday resting. One day it will be my turn to be hanging around Yangtze getting cheap tix to 肉脯团19 but until then I stick to bit torrent.

So what do you do when you have people who are older than Consultants (hopefully not Senior Cons) graduate and needing to do housemanship meant for young Drs? They invented the Residency.

Ok, not exactly invent coz this one is basically copy cat the US of A. As these graduates are older, they cannot be put through the same vigorous training that Drs since the time of modern medical training started in Singapore have been put through. They will die! Like if I go Zouk on Saturday. They need to rest. So, less patients for them in clinics and even if they do night calls they cannot see more patients than the no. of fingers they can count on one hand. (Hopefully dun get one so old cannot even count fingers la).

This is all very good coz they can now continue to study very hard for their postgrad, publish sibei cheem and solid papers in renowned journals (as depicted in the newspaper article) and do all the things that Dr Og and the doctors of his time were not able to do coz we sloughing away seeing patients. I was told I may soon need to vacate my clinic slot to make way for the residents. I will also need to supervise them even though I am not appointed as a faculty member and will not be getting any head count for the work. Plus I will need to see the cases which traditionally can be managed by junior Drs since now we must protect their workload. The patients will have to pay to see a consultant even if they do not need that level of care.

When the residents become specialist themselves they will discover that they never received an essential training which we oldies have mastered to survive public healthcare, the art of seeing many many patients at one setting...But it's really all ok, since they who have invented the residency have a ready backup in the form of FTs where the supply of Drs is seemingly endless.

Tags: Residency, Medicine, Singapore

Lan Fang Republic, Malacca and Their Relevance to Singapore

Alert: Contains seriously heavy reading and historical stuff! Do not read on if you only use one side of your brain!!!

I was surprised when Lan Fang Republic was mentioned by MG Ki Chew. Dr Og is politically apathetic but I was one of the top history student for my year and I would have become a historian (really!) if I din become a dog doc.


Lan Fang Republic - Huh?
And honestly, what the *#@# is Lan Fang? I have not in my most comprehensive (means chow mug la) study of Southeast Asian history ever come across this name. There can only be two reasons:
1) The historians are so f%$% up they forgot to mention Lan Fang (except in some minor articles)... OR
2) LF Republic was so insignificant no one cared.

I leave you to your own conclusion and unless you have an IQ of 10, the conclusion would be 2) anyway. The only reason why LF Republic is recieving any attention at all is because our MG decided to Ki Chew (literally).

The Malacca Sultanate
Now, let us look at Malacca. (Of course not Malacca of today lah, bodoh!) The Malacca Sultanate was founded no later than 1400 by a Malay prince, Parameswara and was invaded by the Portuguese in 1511 (lasted at least a good five years more than LF Republic!) In its time, the Malacca Sultanate achieved the following:
1) Conversion to Islam in 1409. To date, Islam remains the main religon of the Malay Peninsula.
2) Prevented Thai influence in the Malay Peninsula by successfully repelling their attacks.
3) Encouraged bilateral trade and inter-racial marriages with Chinese when the Sultan married a Ming princess. This was the beginning of the Peranakan culture (or not you where got Little Nonya!!).

The Fall of the Malacca Sultanate
Some may say that the fall of the Malacca Sultanate was inevitable as the Portuguese were too much of a force to deal with. But seriously, our red hair (and hence ang moh) dudes have travelled half the world in ships (not even economy class can??!!!). Some internal factors hastened Malacca's demise!

1) Weak ruling government
The golden age of Malacca, with its wealth and prestige, very much depended on one leader Tun Perak who is the Prime Minister equivalent. After his death however, there was no successor capable of running the state. The Sultan, Mahmud, paid no heed to the administration of the government. He allowed his officers to act as they pleased and this encouraged much bribery and corruption among them.

2) Dependence on Foreigners
Many of the foreign merchants were not loyal to the government of Malacca and some jumped ship (again literally!) and backed the Portuguese during the attack on Malacca. A Chinese merchant, for instance, provided on loan, 5 huge barges to the Portuguese while a Tamil merchant supplied information on Malacca’s defense system. Lagi worse, the Sultanate hired Javanese mercenary soldiers who were not willing to die for a country which wasn’t their own and they chow liao liao when Malacca came under siege.

In short: Weak government and foreign talents were in part to blame for the fall of Malacca.
 
I think as Singaporeans, there is a need to understand the lessons learned from Malacca Sultanate. Who will Stand Up For Singapore (fave national day song!). External and alien funds can flow out as easily as they flow in. When crisis strikes, only the loyal locals will stay and fight. Time and again this has been shown in history.
 
And what is the relevance of LF Republic? Beats me....

Tags: Lan Fang Republic, History, Singapore

You really want to be a doctor???

I hate to say this, but I am getting more senior aka lao liao :( And throughout the years of my practice I have been called upon by some relatives, friends, aunties or uncles to advise their relatives, friends, sons, daughters, nieces and nephews who aspire to be a doctor.

So I am writing this such that next time anyone ask me for an opinion, I will Ctrl C and Ctrl V this. Before I become demented...

You think being a doc is cool like in House MD, can any old how scold patients or like in Grey's Anatomy all pretty girl and handsome docs sleep here sleep there? Better wake up your ideas!

Ok, lets be objective and list down the pros and cons.

Pros

1. Job stability. And I am saying rock stable! How many drs have gotten sacked from a public hospital? This is like what durian sellers say "Bao Jiat!" Only that in our case, it is real.
2. Not Bad Pay. Mah hiam buay pai. You can well afford a 2 litre car, place your little one in a Montessori and bring your family for a holiday once a year.
3. Job stability. I still see those koyak Drs walking around after donkey years! You can't lose your job!
   No such thing as retrenchment :)
4. Good leave entitlement. Lots of leave, 24 days or more of annual leave, additional conference leave, blah blah.
5. You get to be called Dr. And can hao lian.

Cons

1. School Fees. Would have set you back by ??100,000k before you even start practising and that does not include your bond!
2. Pay Not Bad? Ai hiam kennah sai! Trust me, you will be frustrated as your Sec, JC classmates out earns you. As a successful Dr, you will be earning what your friend the successful banker pays for income tax, unless of course you are into the business of overcharging royalties of some banana republic. But heh! that banker dude was an asshole from your class who could not string two english sentences together. Can't take that? Well, he is getting all the girls too! Be consoled, the bankers will always tell you that you have Job stability (see Pros 1.... and Pros 3 also lah).
3. Long hours. Longest I have clocked was 36hrs, without food and just some sip of water. I have been told that things have since gotten better for junior Drs. But the work still has to be done right? Who does it? Yes, me! And you the junior Dr when you become senior. Doh!
4. No time to take leave. Not uncommon to see Senior Drs burn their leave coz there is just no time to take. Even if you do claim or your leave, you will die clearing your work before and after.
5. Transport claim still at 60cents/km.
6. Most likely, you will be unhappy. Ever seen a happy Dr? If you do, you better double check you bill
7. You think you can hao lian??? You will hate being addressed as a Dr. Insurance agents, sales people, real estate agents will assume you are very rich and you will not ever get any special discounts! When someone shouts for "Dr Dr", its to get you to do work or to attend to some emergencies...  

In short, don't be a doctor unless you are into the business of healing or helping people and you are overwhelmed with altruism and self sacrifice, or you are so narcissitic that you are deluded into thinking the above.

Just my take, don't flame but you can add to the pros and cons if you like!

Tags: Education, Medicine, Singapore

Jiak Por! (吃补)

Traditional health supplements are becoming a boom market given that it is becoming quite a fad in the west.

Locally, you can see all the Chinese medicinal hall mushrooming in general hospitals and you can even find one in our local mental institution!

Jiak por is on everyone's mind and despite the lack of evidence in these quasi medicinal products, they remain extremenly popular. So much so that I've heard of medical professionals spending tens of thousands of dollars buying TCMs on trips to China!! Whether they kennah cheated only they know lah!

What is really disconcerting is that as a doctor, we often get asked about traditional medicines as part of our consults with patients, though honestly I know as much about TCM or Tongkat Ali as my mother who has a Pri 6 education. But you see, patients expect their Drs to know everything...

If a Patient ask: Lokun, can tell me this ginseng good or not ar??? Jiak liao can por naw, make me smarter??

The Junior Dr will reply: I don't know. Do I look like a Chinese Sinseh???

The Senior Dr will reply: There is no good evidence when it comes to traditional medicines but if you have tried it and find it useful, its ok to continue taking.

The Private Dr will reply: Aiyah this brand no good la! You buy from me this special ginseng essence from Chang Bai Shang! See got my face on the box somemore!

All the Drs are thinking: You want smarter, get a brain transplant...

Lately, I had a patient's family member asked me whether eating placenta is good for the patient's condition. He further instructed me to read up about it when I told him that I have no clue about placentas since I last did an Obgyn posting many years ago. So being ever the conscientious doctor that I am, I googled the subject "eat placenta" and found a wiki on Placentophagy. The pictures made me lose my appetite immediately... much less Jiak Por.....

Tags: Fun, Alternative Medicine, Homeopathy