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.

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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. 

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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.