Sometimes They Don't Survive

Statistics is very much part of our training in medicine. The graph above is known as a survival curve and every step signifies a death. Whilst a million death is a statistic, each death is to a doctor a powerful if not sometimes painful reflection.

For we may try our utmost and do whatever we can but sometimes, some will slip through our hands. With each death and with the bias of hindsight, there is always that nudging, albeit transient, feeling of guilt. The feeling that I could have perhaps done things better or that I could have done more, if I can do it all over again.

Or perhaps it is with the knowledge that with each death, we are ourselves one step closer, that is the origin for this wishful thinking of saving our patient's life, such that ours may one day be saved.

But alas, sometimes, and oftentimes, they don't survive.

The Avengers

Those who have not watched the Avengers must go and watch la! Especially lokuns. Not only was it very shiok to see Ironman fly here fly there, Hulk jumping around, Cap American cheonging aimlessly, the Avengers actually delivers a  very important message. Like in our Lokun Choo, Avengers is all about team work!

In a medical / surgical team, you always need the goodie two shoe like Captain America who does not care about pay or fame. A also stands for Altruism and he is always ready to throw the A card in your face. If you tio smack by him, its almost like kennah Cap's shield. Sure faint big time!

You will also always have the maverick like Ironman, narcissistic because his lao pek wu liu and he drives a Porsche to work. But no worries, Cap will keep him in check! Only problem is he will get all the girls la... (just accept it ok.... you drive Chery QQ, he drive Porsche...)

In every team, there will be a Hulk. Forever angry with everything and bashing around. You dunno why he is jumping in anger but he complains incessantly about everything including canteen food no good, weekend rounds too many, pay too low (which is true) and changes too many. Most of the time, Cap has to come in to damage control for him. Others may hate him but Cap will tell you he has a nice side to him known as Bruce Banner and is harmless la.

Thor is my fave character in the Avengers. Who don't like a pretty boy who thinks he is God? Unfortunately narcissism may cause conflicts in the team and Ironman will fight it out with Thor for that one chiobu nurse! Thor will lose as he is actually in love with himself (something only Gods can do) and is too busy playing with his own loin lock. Thor's greatest weakness is his hammer. It behaves like a boomerang; dunno how many times he tio whack by his own hammer liao!

Most teams will have a Hawkeye but some teams may have a lesser version, the Cockeye. Hawkeye is the most hated member of the team. Problem is that he likes to shoot arrows at people. If you tio his rapid fire, good luck. Cockeye abit better, coz he shoot arrows but everytime buay tio!

But hor, the most important member of the team is Black Widow! There must always be a sweet young thing in the team to make all the difficult blue letters to the hum sup senior doctors. Any unwarranted urgent radiology scans that your Consultant ask for, ask her to settle, sure can! However, she must be zhai enough like in the movie so that Ironman, Thor, Cap America and Hulk not matter how horny won't dare to touch her coz she is thorny.

It is important to remember that like the Avengers, we need to work together as a team to repel any possible Alien invasion. Good luck!

打点滴

Ok, if you guys are expecting daily updates, please don't. Just happen that I read this news I buay tahan must share my experience:

Patient: 医生，为什么不帮我打点滴！
Loctor: You have tension headache, iv drip will not help. Your blood counts are normal. No infection, no need for iv antibiotics.
Patient: 不行！我在国内每次头痛都打点滴！打了马上好！
Loctor: I'm telling you there is no indication. You are not dehydrated. No need iv.
Patient: 你是怎么當医生的呀! 我头痛就是要打点滴! 痛死了!
Loctor (in broken Mandarin ((I know, this loctor damn jialat, English Chinese all broken))): Tamade dian di ni de tou!! Chi wang yao ma shang hwei jia! (Google Translate: Madam, you can go home after having your pain killers.)

In some countries, strange as it may be, it is a cultural norm for patient to get an i/v drip for any condition or complaint. In Singapore, we like to do things for a rational reason. 不爽你又能怎样?

48 Men

The ongoing saga of the 48 men (and counting) reminds me of the times when we take a sexual history for our patients...

Loctor: Uncle, you got visit commercial sex worker or not?
Ah pek: Huh simi lai er?
Loctor: I mean prostitute la.
Ah pek: Huh? simi prostitute??
Loctor: Aiyah, chicken la...chicken...
Ah pek: Orrrhhh, Gwer! Got la. But tell you ar, I call chicken and then only talk la. I never do it...
Loctor (puzzled): Huh, talk only?? Never have sex??
Ah pek: Yah lah, no piak piak. But talk I also pay...

It is not uncommon (really) that (male) patients tell us that they have gone to CSWs but ended up only having conversations. The possibilities are:

a. Uncle cannot stand
b. Uncle forgot to take his Sildenafil (if you dunno what that is, click on the link, brand names not provided here as Dr Og is impartial!)
c. Uncle bought Sildenafil from JB and kennah counterfeit.
d. Uncle depressed, just need someone to talk to (unlikely because visiting a gahmen psychiatrist is cheaper and most Vietnamese don't speak local dialects)
e. Uncle tok cock (literally)

It is strange that not one of the 48 men brought up the defence of "I only talked to her niah!" in Court. Best still if the victims (48 men) can prove that they have some sort of erectile dysfunction or premature ejaculation and could not have penetrated the victim (under age CWS). Whatever the case, it will be impossible to prove that sexual intercourse actually took place though I am not sure if that has any legal impact. Maybe just having the intent and having made payment is bad enough to land you in jail.

So the next time you try to get a sexual history from uncles, don't forget to remind them to check the i/c or passport of the CSW. And if they really just need to talk, refer them to the appropriate people like counsellors, psychologists... (don't bother referring to psychiatrists, they don't generally talk to patients). Beats spending nine weeks at the wrong side of Changi!