If you've been wondering why I didn't post till now, well, let's just say I've been suffering from a major case of "burnt-out syndrome". Although I haven't been on call for more than a week already, my weekend was spent sitting down, or lying supine, or falling asleep in the middle of drinking my mug of root beer. This morning's round didn't help either, with patients giving problems in a variety of frustrating ways, and another event that has recently been affecting me emotionally, but which will hopefully pass over the next few days -- I will provide an explanation soon.

A comment in The Sunday Times yesterday caught my eye. A doctor here related how in the past, most of us carried on with our work even when we had a fever, 'cos if we took medical leave, we'd be viewed as "wimps". How true. I don't know if this occurs overseas, but over here, most departments are short-staffed, and if certain people are on annual leave, it leaves very little leeway for others to take MC. I myself experienced this problem when I was a houseman doing paediatrics. I had sinusitis for 2 weeks, and after returning to work after 10 days of popping antibiotics, my temperature still hovered at around 39 - 40 degrees Celsius, and I did rounds wrapped in a sweater, taking Panadol every 4 hours, and yes, doing night calls. Finally, after being unable to eat or drink during one such night duty, I left the hospital in the middle of the night ( I'm still forever indebted to the friend who took over for me ) and got admitted at the Singapore General Hospital, registering a temperature of 41.5 degrees. On other occasions, I've done calls nursing sore throats -- sometimes not even being able to speak -- and how can I forget a X'mas Eve call in 1999, when I puked my guts out for 4 hours then went out to see some more patients, and carried on with rounds later that morning?

Those're just my stories. Let's not overlook the countless others who've done the same thing -- a friend who didn't know she had pneumonia till she had a chest x-ray done for a severely high fever, seniors who don't go post-call, who run clinics and perform operations even when they feel like they've been hit by a tonne of bricks. But with the SARS epidemic, this trend will of course come to a screeching halt. It has its good points, no doubt, but this also means that the baseline manpower shortage is now being stretched further. And with the absence of "professional locums" like those in the UK -- who can take your night call with the snap of a finger, mind you -- this has resulted in the cancellation of annual leave and off-days, which reduces morale significantly. Let me repeat -- I need leave. Is anyone reading this?!

And speaking of sad things, the upcoming SMA News will be online very soon, with eulogies for both Dr. Alex Chao and Dr. Ong Hok Su. I had the chance to read the former, which is written by the esteemed Prof. Low Cheng Hock from Tan Tock Seng Hospital's General Surgery Department. This is an important issue, and I look forward to having the rest of the world read it once it's ready.

Let me tell you another story so I can get it out of my system before I log off. ( This blog is very therapeutic for my frazzled psyche :))
This morning at around 7:30pm, I was driving to work and was in the process of turning right at the junction of Simon Road and Upper Serangoon Road. As I waited my turn, I caught a glimpse of an SUV stopped in the middle of the road ahead, and spotted a lady squatting over a figure lying on the ground. As my car was in moving traffic, I had to turn anyway, but subsequently made a U-turn and stopped a few metres away from the SUV.
The minute I got out of the car, a man standing nearby shouted for me to call the ambulance, which I did immediately. The person on the ground was a lady in her 20s, who had been hit by the driver of the SUV, a lady in her 40s. The younger woman was thankfully fully conscious, and didn't complain of any pain anywhere. However, she had a head wound, and a rivulet of blood had already flowed from her scalp down the road. Worried that the gash may still be bleeding, I quickly cleared her cervical spine and sat her up to check for any active spurting. There was none, but we took the precaution of placing a thick wad of tissues and applying pressure till the paramedics arrived. A middle-aged gentleman also stopped at this time, and offered us his handkerchief for reinforcement.

The ambulance arrived within 5 minutes -- very impressive! -- and a traffic policeman also showed up. The young lady was soon transferred to the nearest hospital.

It was only after the stretcher had been loaded that I looked down and saw that my left hand and forearm were stained with blood. In my efforts to move and examine the victim, I'd inadvertently smeared some of it onto myself. Under pre-SARS conditions, this wouldn't have fazed me, and although I doubt the woman has SARS, it suddenly dawned on me that I'd just put myself in grave danger. My mother, who learnt what happened after I gave her a call later, was understandably upset, but she knows that I would've stopped my car no matter what, even if she had been sitting right next to me yelling for me to drive on. :)

The one thing I wasn't happy about was how nobody else stopped to help them. It was a congested road, a busy morning, loads of people drove past and saw the accident, and STILL NO-ONE PULLED OVER. Perhaps if this had happened elsewhere, for example in the centre of town, things would have been different.