Halloween Special 1: Got eat medicine or not??

Dr Og actually retire from being a fake lokun for a while liao. But recently I met up with some real ones. They kpkb (ranted) so much I buay tahan have to write a blog about their experience to release some steam...

The story goes my friend Ah Seng at the polyclinic was checking on his patient's compliance. 

Dr Ah Seng: Uncle, wu jiak yok boh? (got eat medicine or not)

Uncle: of course la. i eat everyday. 

Dr Ah Seng: I see your medicine. Last time I give you for 28 days. (Dr look at Uncle's bag of medicine) Wah so much left ar. You where got take?

Uncle: You don't anyhow say hor. I take everyday I sumpah (I swear). 

Dr Ah Seng: Aiyah, you see yourself. So much left.

Uncle: Left over from last time one la.

Dr Ah Seng: Cannot be la uncle, I just started the medicine for you last visit. How can have left over... (let me count)... WAH LAU EH! HOW COME LAST TIME I GIVE YOU TWENTY EIGHT TABLETS NOW YOU GOT FORTY?

KUA TIO GUI AR! (GOT GHOST IS IT?)

My First Kiss

Recently Dr Og had to renew his BCLS certificate.The course is where an instructor runs you through Basic Cardiac Life Support, which comprises mainly protocols of Cardiac Pulmonary Resuscitation. Then you get tested by these instructors.

In the unlikely event that you are involve in a CPR situation in the hospital, you will be aware (hopefully you not the unaware one lor) that no one follows the BCLS protocol. The only reason why we have to get a FOUR letter word certification is because we have to get this three letter word accreditation. 

Dr Og very you yuan with BCLS / CPR. From very young age, I had attended CPR courses. I remember very small that time I went to Civil Defence and even had chance to play with fire extinguisher before being taught CPR. It was fun playing with fire before playing with mannequins! 

But hor, over the years, BCLS has become ridiculously kang kor (difficult)! 

Last time is just demo on the mannequin. The mannequin guai guai stay there don't make any noise one. Now the mannequin can excrete from the chest a strip to show your rhythm, timing and how deep you press his chest. Like I said, in the wards, where got follow all these timing rhythm and depth leh? It’s dare dare press and dare dare hyperventilate la. 

 Anyway, every human being body got the same meh. Train pushing how hard for what???!! Dr Og never touch many breast / chest before also know got soft got hard got big got small. Haha....

The BCLS also need very good stamina! If you fail one cycle because too fast too slow or too deep, you will have to repeat the whole cycle. Sibei chuaaaan ar! You have to keep blowing into an unappreciative mannequin with not the slightest response. Some of the mannequin lungs like sibei tough to expand. Some more seasoned ones like easier and looser. Most disgusting is the mouth taste of alcohol. Not whisky type of alcohol taste but the alcohol swab type of alcohol! A lot of the lao kok kok doctor all cannot tahan, halfway fall out liao. 

The most strange part about BCLS is that it is almost always conducted by nurses. Once, Dr Og even had a BCLS course instructed a non medical personnel who was a voluntary first aid provider. It is strange as most of these instructors have never performed CPR in their lives. Would you take driving lessons from someone who has never driven before? Most of the time, the nurses will try to help us pass. But some mean nurses will of course take the opportunity to take revenge on doctors. Also serve the doctors right if they never treat the nurses with respect in the wards. But sometimes if the doctor kennah his ex, then just too bad la. If you kiss someone you shouldn't have, now you just have to kiss the mannequin a few more times lor. It is all just karma!

source: http://www.quickmeme.com/Bad-Luck-Brian/page/3705/

Progress for Our Nation - Episode One

That day Dr Og go Geylang. Not the even number  Lorong ok, but the odd number one. Last time younger time, will go Geylang eat frog leg porridge, beef kway teow etc etc etc. Nowadays Geylang half is like Chinatown, half is kennah gentrified. Wah no longer got the same feel liao.

Anyway Dr Og along the way visit an old friend who is a GP. Last time, his business very good one. People who stay around the area liked to go see him. So in morning he busy give the ah girl and ah boy MCs. At night, he busy giving the call girls penicillin. 

Those were a long time ago. Over the years, his business seemed to have dwindled. Dr Og also never really ask him la. Sensitive mah. 

That day, there were no patients when I was at his clinic and he brought up the issue himself. 

“Og ar, I think I got to move to a new location.” He said. 

“Wah, you here very long liao leh. I thought you last time like it here coz lunch can go karaoke for some quick fun???! Too many hostesses ask you for free consult isit??” I teased him. 

(In case, his wife happens to be reading , this is of course entirely fictional. Lunch time he usually eating some nice hawker food around the area which explains his current size)

“No la, now people so lazy, no more open at noon la. Actually I called a few ex patients and you won’t believe why they don’t come back!”

“Why??!!” I was curious to know.

“They tell me that they can’t stand having to climb the stairs up to my clinic!” He lamented.

So it seems that in the past, people were quite used to and were happy to climb stairs. But after HDB upgraded and added lifts to every floor, Singaporean lost the will to climb! No one was willing to climb stairs these days and his clinic was in a walk up building on level three with no elevator...

Sighing away, he told me that ironically, a 80 old lady who had OA knees still visited him regularly. She herself stayed in a walk up apartment and despite the pain, she had to climb stairs to get home and did not mind doing so to see her GP. We both agreed that had she not been made to climb stairs, she may not even be walking anymore!

Dr Og don’t know how to console this old friend. Singapore has progress but in the process there can be some people who kennah some collateral damage. 

Just like him, I too miss the good old times. 

On the Other Side Part 1

John could feel his face tensing up and the creases between his eyebrows deepening.

The irritation was building up. 

Sure, he was late five minutes for his appointment but he had been waiting for an hour already. He wondered if the receptionist disliked him and pushed him to the back of the queue, but then again, the last patient (who went in 30 minutes ago) was still inside. Every time he approached the counter to ask how long more he had to wait, the receptionist gave him a dirty and judgemental look. That was if she even bothered, she was busy most of the time preparing medications and answering phone calls.

Finally his number was buzzed and he went into the consultation room. At least the doctor was apologetic. As John continued to complain about the long wait he noticed that the doctor had a look of resignation. Feeling bad, he stopped complaining and started telling the doctor about his discomfort.

__________________________________________________________________________

Every day is a rush.

Morning is a rush to bring the children to school. Screaming at the kids to hurry up. Negotiating the traffic. Dropping them off. 

David is never late for work. He would arrive at work early after dropping the children off  to avoid the morning jam. He also hated the judging eyes of the patients if he came into the clinic late. Today was the same. He arrived early, parked at his favorite spot and  went to the office to answer emails. 

5 minutes before the clinic started, he was already seated in the clinic room. As usual, the first patient did not turn up on time and came half an hour late. As usual, his clinic was double booked and unfortunately today, everyone seemed to be turning out. 

As he looked at his queue system on the computer, his anxiety was building up as there was now five people in the queue waiting. Also he had to pee... but he reckoned he would see the next patient before going to the loo. And then the next... and the next.

When he called John in, he knew all was not well. John looked angry and before he could even apologize, John started complaining on the long wait and how his time was wasted waiting so long. He went on and on about how David was a tardy doctor. 

In his mind, David was wondering if the PSA (Patient Service Associate) at the reception hated him. Or maybe the clinic manager was against him. Why is it that his clinic was not only full but always double booked???!!!!

David wanted to stop John from ranting on so that he could get back to the consultation. But he knew from experience that would just escalate things and he would probably just end up with a complaint to the hospital. He even swallowed his sigh. 

Thankfully, John stopped after a while and The rest of the consult was easy enough. 

————————————————————

The PSA, Jane, took a peek at Dr David as he walked into the clinic room. She noticed that he was always suspiciously early. She wondered in her mind if this Dr  David took a liking to her. After all, given her beauty, who wouldn’t. It must be, since doctors are always late for clinics. 

As the session progressed, Jane noticed that the patient John kept looking her way. After a while, he came to the counter to ask her how long it would take. And the he came and ask again! 

“Aiyah! Why these guys cannot just ask me for my number instead of so much pattern??!!”

She thought...

Non-Medically Medical Dilemmas

In medicine, there is always sibei alot of dilemmas one. Use this drug can save patient but hor she will get fat, come back scold you jailat jialat. So how ar? You tell her about side effect or not? You know girls they rather die than fat!

But today, Dr Og not talk about this type medical cheem cheem or ethical type of dilemmas. In a doctor's life there can sometimes be very peculiar and special types of dilemmas.

When Dr Og was a (fake) junior small lokun, I always amazed by some of the senior doctors the hair like helmet one. Some like Darth Vader pattern. Some like birds nest. But all got pattern. When we xiao yi sheng, usually not so hiao la because no time for anything. When your medical school girlfriend don't even have time or bother to pluck their armpit hair and their hair more chor (coarse) than yours, you also paiseh to gel your hair until so nice just to go to school, tio boh?

But later when you more senior then hor start to change, will comb hair nice nice and wear nice shirts and Burberrryyyy ties. Senior liao, must play the part and look the part lor. Or not, not pro(fessional) leh.

In Medicine decorum is very important and held to the highest standards!

But then because of this comes the dilemmas!

1) If you are on call at home and they tell you patient will soon be admitted liao from A and E...
- Do you stay awake and wait for the phone call (never ever go down hospital coz patients sometimes don't make it from the A and E. ((I mean they decide to go home and not get admitted la))), OR
- You catch a nap only to have to be awakened again!

2) If, in the same case, you get awakened up to attend to the non urgent case in the ward liao,
-Do you brush your teeth, take a bath, comb and gel your hair nice nice OR
- You go looking like you just woke up, with hair very luan and with bad breath?

3) If you are in the middle of talking to the patient in the ward or in a clinic session and you need to lao sai...
- Do you lun and finish the consult (but let out some farts coz those really cannot lun one) OR
- You tell patient "Sorry ar, tak boleh tahan, and run off to the toilet?"

4) When your junior on call with you proved herself to be incompetent (which is why you had to be awakened in the middle of the night)  and you gave her a piece of your mind (bad breath included)  cries in the toilet and refuse to come out post call...
- Do you say sorry and buy her chocolates OR
- Do you tell her she is not fit to be doctor and please go find another job.

5) If your Prof has a a lot to say and say and say and you are going to be late for your one year old's birthday celebration...
- Do you excuse yourself and risk offending him OR
- Do stealthily text your wife that you are going to be late and know that you are going to get it from her.

6) If the female medical student leaned too close to you (maybe coz you started combing you hair and now more yandao) and you feel something soft,
-Do you educate her about observing good personal space at work and risk social awkwardness OR
- Do you just keep quiet? (and also keep very very still and avoid any #metoo misunderstanding)

And last but most annoying,

7) If you have seen the patient in the ward and returned home at 2am.
Do you bath and wash your hair coz OCD? OR
Bath but don't wash hair coz the hair will be wet? OR
Don't bath and just jump into bed with germs and gel-on-hair and all???????

Hmmmmmm....

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...

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.....

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.

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.

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.

Fresh Off The Boat

Wah! Today the news NUS student got punished for making freshmen orientation look like lup sup bar! Actually what did they do huh? The picture on the ST website shows the freshmen dancing line dance niah. The article also mention the Arts Faculty got student kennah kar chng bua gu you (butter backside) for simulating rape during orientation? Wah really karma lor. Some say these the ginnahs kennah punished very buay kum wan since these were traditions pass down by seniors. Wah lau, you NUS elitistest (I invent this word one elitist plus -est), senior tell you to jump then you jump meh?

Dr Og is genuinely quite disturbed since I have a daughter. Also nowadays boys all very weak. If son kennah groped (by other boys) during orientation also will get traumatised. But lets leave the future aside, Dr Og's daughter still small, and reminisce about the past......

Long long time ago, Dr Og was also an undergrad freshman. Sadly, my orientation was also traumatising but no where near so happening as the Arts Fac people leh.

When you join the medicine orientation, first and foremost is disappointment. Somehow, most of the chio girls fail medicine interview and all go dentistry. Left maybe one or two not bad ones. To begin with already not so many girls coz that era got quota for female medicine undergrad. By orientation time, the few pretty girls (actually only two) already chope liao. There was a medicamp where I suppose is orientation for orientation and those girls got hitched liao. Dr Og of course din attend, wah lau, army not enough camping ar????). And so begins a merry go round of inbreeding.

What did we do in the medicine orientation as freshman? There was no hanky panky. There was no simulated games of any kind. There was no lewd cheers. Boy, was it traumatisingly boring! Actually, we were making some float (the Chingay float kind of float) for Rag and Flag. Build some imaginary boat which is mounted on a motor vehicle is already very boh liao, but to have to build some Disney themed float is as regressive as it gets. I thought we go Uni to become adults? At least do some Sci Fi or Horror, Vampire vs  Alien design la (last time no Zombies yet, now I sure suggest Zombie apocalypse float).

So Dr Og decided just stay under radar and quiet quiet follow instructions. I quietly stick colour papers (and pray silently for all the unnecessarily dead trees) on the float but then suddenly, this self appointed as leader skinny girl come and scold me.

"Why you tear the paper never use scissors to cut??!!!" She screamed at me.

Hello aunty, the judges sit how far away look at your float? You think they can see the paper is cut or torn meh?

The girl buay song went to complain to a senior year two medic who was some mad socks president. He came over and attempted to ask me to use the scissors. I picked up the scissors, put it in his hands and told him, own time own target, carry on. Senior tell me to cut then I cut meh? I flip my motorola clam shell phone open, call my buddy Ah Bui, "Bro meet you Arts canteen eat beef kway teow!" There sure more happening!

NB: The point of the story? If you blind blind choose to follow tradition and do what your seniors did, then don't kpkb when you kar chng tiok bua gu you!

The Sweet Sweet Smell of Frangipani... Remembering SMM Ulu Pandan

The Seventh Month has been over for a month liao and today is Mid Autumn Festival, so Dr Og wishes everyone happy happy eat mooncakes and carry lanterns hor. Touch wood but if you thinking of stuffing yourself silly with mooncake, please learn the Heimlich maneuver first ok? 

But today, my topic is closer to if you suay suay choke and die, then the festive colourful lanterns. May not be auspicious but now what century liao, tiok boh.

Those of us who are old enough would have had the privilege of having trained in Ulu Pandan Camp which was were the School of Military Medicine was for a long time. Recently army released this video about SMM which prompted me to write this post (and help them promote their video la):

What they never tell you is that SMM is a super haunted place. (But I guess they did allude to it at the opening scene. The two chaps are probably ghosts being able to just appear and disappear...) I have briefly touched on this in my previous posts but since this video rekindled those memories, I feel it is timely to share in greater details.

During my time in SMM, many strange things happened. It was not long into the posting that we were told that one of the the prowling check point had to be brought down from the top level at level four to the ground floor as things like chairs and tablets were flying around ala Poltergeist in the classroom on that floor. The phenomenon was witnessed by so many that the senior officers did not protest when the request was made to move the checkpoint down. 

We were also told that the SMM grounds were where there was a massacre and many were executed and buried during WWII, making it super dirty. It was said that many bodies were excavated when they build the swimming pool which was never really ever used. 

Before long, strange things started happening in our platoon. We heard sounds of soldier marching ...Left Right Left Right Left... in the middle of the night. A platoonmate swore that a locked door of a basement bunker was shaking violently as if something was banging on it and trying to get out from the inside. Some other mates saw an old man squatting by the road side in the middle of the night, praying and sticking incense in the ground but no such man existed when we asked around. The atmosphere was getting pretty spooky even though we continued with our training like nothing happened.

We did find out later that the "soldier marching" was just one of our platoonmates sleep talking. The bugger too stress and still practicing his marching in sleep and the problem was fixed after one blanket party. The rest of it, we see no evil hear no evil, pretend nothing wrong.

What Dr Og personally experienced happened one late night when me and another platoonmate were on prowling duty. We were walking towards the back of the camp to the  pre-war pump room (those who worked or been to SMM will know the pump room) where the check point was. 

On reaching the pump room, there was a sudden strong whiff of sweet flower smell which I had never experienced before. I looked at my platoonmate and he looked at me. Without another word, both of us just started running as fast as we could until we reached the guard house. When I asked him why he ran, he said, "Dunno man, just felt suddenly super scared!" Exactly how I felt, gripped with fear. We didn't really talked about it after that as we were not too proud of ourselves. 

Only much later did I find out from my mother, after telling her the story on some random occasions, the significance of the sweet sweet smell of Frangipani. 

Attack of the Aedes Mosquitoes

Just like that, Singapore becomes a Zika hub. The si lang Aedes mozzies one up us; even before we can hoot dengue, they hoot us with Zika.

Actually Dr Og (and possibly all other doctors) have been wondering why it took so long for Zika to reach our shores. After all, Aedes the mosquito IS endemic in Singapore and it IS more local than most homo sapiens in Singapore. And mebbe hor, the Zika virus is also more local and Singaporean than we think. Dr Og not anyhow say one; I have evidences Zika virus may be local.

1. Zika tries to be elitist.
Like all kiasu Singaporean, Zika cluster also must cluster around high class place like Elite Terrace wor!

2. JB custom will kar cheow (disturb)
You know we go JB, always kennah custom issues. Long wait.. oops thats our side problem...  Anyway, now JB custom officers will make life difficult for Zika virus like they do for Singaporeans.

3. Zika in Southeast Asia since long time liao
You can read this paper yourself.  It is more likely than not that there has been Zika outbreaks in Singapore for long long time liao. But since its self limiting and of little harm, like the other one thousand and one viruses, people and doctors just bochap.

But now with the scare in Brazil, Zika become famous and since Singapore epidemiological surveillance is so tekong, we are picking up loads of cases. Dr Og do agree that vector control is very important, even more so now than ever. Last time, we fight the Aedes only prevent Dengue. Now if we whack Aedes, we one stone two birds ar! So more worth it...

The mozzie wipeout however is not very the sucessful leh (obviously doesn't work since dengue and Zika is on the rise), It is always hard to get people to do the right things. Like in Hospital, ask lokuns to wash hands is harder than anything. Touch cadavers, various body secretions, do PR, don't wash hands also can eat lunch.

So Dr Og think we need new campaigns to kill the Aedes. I suggest recruiting the Hougang Horde to help. They are those people who swarmed the road in Hougang Ave 10, like zombies, just to catch a Snorlax for Pokemon Go. These people sibei wu eng, don't mind risking limb and life to catch things and damn thick skin don't even leave when scolded by residents and horned by cars (thick skin prevents mosquitoes bites mah).

But if everyone can contribute, will be even better right. Now the mozzie wipe out got five steps...

Just add step 6 lor. Step 6- if see mosquito, KILL with bare hands

Don't be lazy and soft la Singaporeans, see one mosquito, kill one and if we all just kill one per week, with our rapidly growing population, soon Aedes extinct liao!

Whoa Gold Medal!

08:45hrs - Came early to the clinic, patient is early too! Woohoo

09:00hrs - Seeing second patient.

09:10hrs - Done with second patient. Tried loading OKTO on PC. Cannot! Simi update to latest web browser???????

09:12hrs - Heng can watch on handphone! Just starting...

09:14hrs - Lun lun lun.... Ai yar liao

Some milliseconds before 09:15hrs - GOLD!!!!!!!!!!!!!!! Whatsapp whatsapp whatsapp

09:16hrs - Wipe off tears. Compose self. "Next patient!"

Congratulations Joseph Schooling! You have done us proud! 

The High Cost of Living (Actually Staying Healthy)?

Recently, a patient got dulan (henceforth DL) when his doctor billed her for two illnesses at the same setting instead of one consult. The case of the angry patient caught the attention of a reporter who seems perpetually DL with doctors. She then managed to get MOH and many doctors DL when she wrote that:

"The Ministry of Health (MOH) said there is nothing wrong with the way Dr Wee charges." 

MOH wrote back that they never say "nothing wrong" so don't anyhow say hor. Wait, MOH didn't really say that. They said this. SO PLEASE DON"T DL ME CAN?

Moral of the story? Singapore everyone also DL?

This issue of rising medical cost is of course a real issue. Dr Og and family also get sick and sometimes going to see real doctors can be sibei heart pain, so I can liao kai when you see a doctor you want to get the most out of it. Come for flu, also better get stomach checked coz like abit pain pain liddat. Wait, better also check the heart, coz later see bill confirm heart pain.

But from the other perspective, life also not easy for doctors la. In public hospital when your department lose money, your CEO start looking at the HOD eyes big big. In public still can hide here, siam there. After all is ah gong footing the bill.

In private, its your own problemo liao. Who call you hiao, want to go to the dark side tio boh? Got one day, a private specialist complain to me. He say someone complain he overcharge and never follow the price guidelines provided by SMA. Wah, the guidelines are so ancient Dr Og also almost forget liao (actually Dr Og never received the guidelines coz I always default membership payment for SMA until they DL me hahahaha).

But hor, if you do a simple google search, some jokers still putting up the price guideline online! Even as recent as June 2016. See this and this! For your info, the price guideline was found to be contravening competition law. Its all too cheem for Dr Og to explain so please read yourself la.

So what does this all mean? It means that since 2007 after they withdrew this price guideline, it has not been updated. Should doctors follow a 2007 price guide? I don't know about you but the bak chor mee I always eat was at most $3.50 in 2007. Last month, the owner just raised the price to $6.00. I don't blame him given how inflation has been in Singapore.

As for my private specialist friend, it turns out that the price he charged was within the range of the price guideline. The complainant obviously didn't bother to do his homework properly. When the specialist found out he told me, "wah, I'm charging 2007 rates ar?"

He so DL he decided to raise his charges.

National Day Parade 2016

Wah, time flies. SG50 came and go and we have celebrated yet another NDP., SG51 liao A new citizen recently asked me excitedly if I would be going to the national stadium to support the NDP. I can understand that having just obtained his red i/c, he was excited about NDP, but having watched the same routine every year for as far as I can remember, Dr Og was just not going to get all gaga about it.

The last time Dr Og actually went to a NDP was many many (many x many)  years ago. We were providing medical coverage and even simulated the worse case scenario of carrying an injured VVIP on a stretcher from the VVIP box down the stadium steps to the evacuation point. At the end of the day, the exercise proved to be futile as the NDP that year (like every year) was uneventful.

The only injuries incurred where likely the ones sustained by the poor medics who had to carry the 0.1 ton kilo medical officer (simulating the heaviest VVIP there possibly could be) on the stretcher. Trust me it was hard and dangerous work! I'm sure some of the medics can still feel the stretcher slipping out of their hands and the aches and pains sustained that day every year when they watch the NDP.

Yesterday's NDP took place at the new stadium and Dr Og heard that now stadium got to pay alot of money then can use. This is also same like hospitals, programs upgrade liao, patient gotta pay extra. Patients always complain, why need to pay more? Come on leh, you get new stadium, sibei solid new grass for the soccer pitch and stadium roof can open and shut like Transformer, of course pay more right? Same thing mah, new program, new admin staff (sorry always no chiobu one, if you need to know), protocols so complicated that reads like the inner circuitry of  a Transformer, so pay more lor... Even though the end results to end users still the same end of the day, the stadium seat still looks hard and uncomfortable like before...

Sadly, Dr Og missed most of the NDP yesterday and cannot give you a good review of it. I was celebrating NDP by wearing red and white, walking along the streets and throwing red and white pokeballs at virtual monsters. I'm sure Niantic like very pro Singapore gahmen and launch Pokemon Go over national day weekend for all to celebrate!

Also, actually Dr Og hasn't gotten over the Post Traumatic Stress Disorder of falling over the stretcher from on top the stadium steps that faithful day!!!!!! Darn, those medics!!!!

Jiak Kin Jio

When you are a Dr, people expect you to know everything!

Whether traditional medicine is good for them. 

Er, wait ar, Dr Og go call my mother first and ask.

Whether going to work will aggravate their BP... 

ok la, ok la take MC la.

Whether the medicine can take with supplements. 

Wah lau, why you don't ask the G@C salesman who sold you your protein shake whether can take medicine or not?

Whether your son's girlfriend is good for him. 

Ok, aunty I saw your family for a long time now but don't drag me into your family politics leh. Plus, must maintain patient confidentiality and cannot tell your son all the naughty things his girlfriend (whom happen to also see moi the friendly neighbourhood dr) done before right? But thumbs up for the good intuition!

But lately... and strangely... people have been asking me about bananas.

Patient: Lokun, I heard bananas can treat my condition!
Dr Og: Is it? You read from internet is it?
Patient: Wah, you lokun, you don't know ar... I thought lokun should know everything! But its possible right? Banana can cure me.
Dr Og: Er, the only case of banana I have encountered was when this guy thought it was funny to shaft a banana down the wrong end of his digestive tract, hahahha...
Patient looking disturbed. 
Dr Og: Ok, I digress but look here, I really don't know if banana is good for your condition. If you like, eat lor. But please also eat your meds ok?
Patient leaves looking disappointed.

The reality is that a doctor doesn't know everything. We only know what science can tell us. Most of the time the science tells us "maybe" or "it depends (on so many factors that there is no way you can understand what I am about to explain so lets not waste each other's time)". Anyway, before I forget, better take a note to check bloods for this patient next visit, in case he takes banana qds and end up with hyperkalemia!

Grand Wayang Round

Nowadays be senior Dr is sibei pai miah (bad life). Last time Consultant in Hospital is like rock star. Can ya ya walk in front during ward rounds and got a whole entourage behind you. Got medical students, got medical officers, nurses (and maybe seventh month got others following, but that one another story). Wah sibei shiok ar. You know the surgeon is sibei humsup if you see the entourage is mostly pretty medical students, pretty MO and pretty nurses. You know the Consultant is gay if you see the entourage is... hee hee hee...

Source: http://lackcolor.com/pic-806-Lots-of-doctors

Of course these days things have changed. Nowadays, there are many many female Consultants as well. To be fair (and avoid kennah feministic attacks), female doctors are just as good as any male doctors. Their pet peeve is kennah called Missy by the ah pek whose memory remains in the 动荡的时代, pre independence Singapore. Hello uncle, now is SG50 Liao, char bor are no longer all nurses la. And matah don't wear Bermudas anymore lor.

I digress.....

In those days when "Consultant is King", you can imagine the kind of power the Head of Department wielded. He is literally the Godfather, with people worshipping the ground he walks on. Godfather will of course have a bigger ego than his Consultants and his entourage will of course be even more solid! When Godfather does ward round, it is not just a ward round, but the Godfather Ward Round, GWR. And because cannot be so obvious in public service, we usually call it Grand Ward Round. But what so grand? The Godfather of course.

GWR is a very important event. In the old days, it can be make of break. It is the time when Consultants become minions and melt into the background as part of the entourage. It is the time you impress the Godfather with your short skirt (why do you think now so many female consultants har?). It is also the time you try to siam being asked questions and being publicly humiliated by the Man himself. Most importantly, it is time when the patients gets the same orders and treatment but will somehow miraculously do better because those same orders came from the mouth of the Man (or they get discharged or transferred to some lesser teams if they don't get better).

I always feel that the big entourage probably did something for the patients.

"Wah! Tua Lo Kun Lai Liao!" They probably thought. Think of how powerful and therapeutic that scene must be! A whole army of doctors and nurses lead by the most senior and most capable doctor coming to see you in the bed and actually poking his finger into that orifice that is causing you problems. Everything also ho sei liao ar!

So wayang or otherwise, once a while Dr Og reminisces about the old times when GWR was done the traditional way. Nowadays, mostly you see lonely consultants rounding. At times, you catch them crying at one corner, lamenting how they kennah whack as junior Drs and now their turn to whack, there is no one around. I think we should bring back the good ol' times as I'm sure patients benefited from megalomanic Consultants and HODs and Dr Og always think of patients first :)

The Reason Why the Haze Has Ended.

So the haze came back. They say the last time the haze was this bad was in 1997. Sure or not? Dr Og remember 1997, I was still a student. Remember was walking with a girl down the quiet road hazy hazy, machiam very romantic. Like in movie like that. Fast forward to today, no more quiet roads around liao and the haze like got a yellow tinge to it.

And as usual, Dr Og didn't get an air purifier in time when the haze struck. I spent many weekends searching online and offline but everywhere sold out liao! In some online electronic stores, even the category mysteriously disappear. Reminds me on how suddenly before midnight or at rush hours, all the taxi sure pang kee one!

So for the whole duration of the haze, my wife and poor kids have to survive on a single air purifier with a three year old filter. They are of course not very HEPA about it (pun intended hahaha). I was reluctant to clean the filter since that would mean me being hantam not only by the PM2.5 for this year's haze but also those that were collected two years ago when the haze was also bad!

I was trying to convince them that they can wear the N95 masks indoors. There are now huge stocks of N95s around so no scared don't have. Some even got air blowing one, so high tech! The kids of course complain that it is uncomfortable and don't want to wear. Hello! Lim peh assisted hours and hours of surgery in N95 plus PPE (personal protective equipment) also never complain. Remember that time, finish surgery, the scrubs so wet, can see the nipple shape liao!

Anyway, I still try my best to find air purifiers and finally found a few units in a store with real HEPA (and not the bluff HEPA type) filters. The air purifiers like more expansive than usual leh but never mind la... Wife and kids happy most important right?

And then hor, the very next day...

No haze liao.......

Singaporeans, you owe me one.

Elitism

Recently read a lot of news about elitism. Then people started kpkb on equality and equity like this boy call Russell. Wah Lau, sibei complicated la. Dr Og England buay sai one, cannot understand simi lai eh?

Actually Dr Og also sibei dulan some of these elite schools students sometimes. I have come across some really hao lian ya ya papaya students from RI / RGS. Talk very big like they know a lot about medicine also. Hello! Lim pek went to elite school when your mother haven't even ovulated you. You better show some respect ar like in those Taiwan shows call us 前辈！(Please don't call uncle hor. I not that old, thank you.)

Anyway, you go good school doesn't mean you elite liao. I check dictionary and dictionary say elite means:

"select group that is superior in terms of ability or qualities to the rest of a group or society."


So you can elite in values, elite in sports, elite in talking cock (like Dr Og, now put your hands down!), etc etc. If you are just elite in PSLE score, please go achieve something in real life before you come show pattern.


A good example of elite is the commandos. Every year they get best unit in army. But they also train the hardest and when war comes, they probably sacrifice first also. Plus many special force people will never reveal their identity and never get the glory they deserve.

This young boy, Russell, also sacrifice. He jit tao kamikaze. Shows his EQ sibei not elite. And Russell, if you go NS that time, complain here pain there pain go see lokun, you better show some respect and remember to call the lokuns 前辈！