Saturday, January 31, 2004

Time is passing really quickly this morning. After being woken prematurely at 4:30am to help out with a resus case, a few more soon followed -- a hypotensive episode post-pacemaker insertion, a woman who drank Chlorox and slashed her wrists after an argument with her husband, and a couple who fell off a motorcycle that skidded. Just 30 more minutes to go! :)

Reading DocShazam's Jan 30 blog entry, I'm almost jealous of all the excitement she's experiencing. :P THREE helicopter flights in one day?! Landing on the interstate?! Aargh! I want to do that! :D

I guess we have our own thrills in the local context. Riding in ambulances back in med school was kinda fun ( once I got past the motion sickness, that is ). In truth, there were loads of non-emergency calls, mostly in the form of young women with hysteria after fighting with their husbands, or the hilarious case of a fellow who was jabbed over the sternum by a relative in the midst of a heated argument. The sternum, for your info, is a hardy piece of bone stretching down the middle of the chest wall, so the fork didn't penetrate beyond the skin layer. Some were prank calls that led us on a wild goose chase -- I hated those -- but the most interesting case was probably a call in the middle of the night which brought us to the scene of a pretty bad road traffic accident involving a drunken man whose car ploughed into a passing taxi travelling at high speed. Fortunately, everyone involved was all right, but from a lowly med student's perspective, it was something unforgettable. Nowadays, even major traumas don't get the adrenaline flowing. But being woken up to help resuscitate someone while I'm still bleary-eyed is pretty scary. :D

So go read Shazam's blog! She mentions "John", who turns out to be "Jane's" brother. If you're not familiar with Jane, scroll down to the bottom to read about her heartbreaking story. :(

Friday, January 30, 2004

Aaaah, nothing like a day off to make me happy. :) Didn't do very much with it though -- spent a few hours in town supposedly hunting for something to wear to a friend's upcoming wedding ( yes, another one! ) but left empty-handed. Everything's all about spaghetti straps now, which isn't up my alley. Looks like it's going to be the cheong-sam I bought a while back. Oops, shouldn't have spilled the beans. :P

The last night shift I did gave me a headache, not because it was busy, but because for some funny reason ( well, I know exactly why but I'm not at liberty to say ;) ) I got only 30 min of shut-eye. Not sleep, mind you. Just shut-eye, as in lying on the bed and shutting my eyes, but being kept awake by the stupid air-conditioner which desperately needs servicing, hello! Excitement-wise, I attended to a collapse case brought in in the wee hours of the morning -- a lady in her 80s who was found 50 feet from a burning factory ( yep, the one in the news ). She didn't have any burns on her, however. Just a few superficial cuts here and there. My chief, who was on call as well, said it had "all the elements of a mystery". I couldn't agree more. :D

Post-call, I managed to sleep of course, but hauled myself across the island after dinner to visit my 15-year-old cousin who'd been admitted to NUH for intestinal obstruction secondary to an internal hernia. I had no inkling of his illness until my uncle called us on Wednesday to say he'd been operated on. Aargh! What's the use of having a doctor in the family if you don't call him/her for advice?! Seems the poor boy had been vomiting non-stop since last weekend, but his parents happily dragged him to Kuala Lumpur for a holiday, only to cut it short when he deteriorated. He was so dehydrated his eyes were sunken, and he looked like a skeleton. He was also vomiting bilious contents ( ie. everything he puked was green in colour, an indication of obstruction ). Even more shocking is the fact that after he was admitted, the ward team sat on him for 2 days, even bringing medical students round to examine him. I'm not saying students shouldn't be allowed to learn, but not paying attention to repeated bilious vomiting resulting in severe dehydration is a little distressing. If I'd seen him, the first thing I would've done is an abdominal X-ray. And considering the fact that I've worked in CGH General Surgery and Internal Medicine before, they probably would've organized a CT scan stat.

Suffice to say, some imaging was done eventually, and my aunt and uncle informed that the degree of obstruction was so severe that my cousin required an emergency laparotomy that very day. He came this close to a perforation, which would've resulted in catastrophic peritonitis. From what I can gather based on history alone ( I didn't look into his case-notes ), he was admitted to the Paediatric Medicine department, then subsequently referred to the surgeon. I don't know how they do things over there, but I'm a little unnerved by this.

Anyway, I'm on night -- again! Should be okay, 'cos the Chingay preview is on at the moment, and this is also the Hari Raya weekend, which means people are out celebrating and preparing for the Malay New Year. Of course, I fully expect a deluge of drunkards and assault cases once we hit the midnight hour. There's just something so appealing about our ER in the middle of the night. It's as if the hospital switches on a giant neon sign at 12 am on the dot proclaiming "Come To Our A&E! Don't Go Home Like Other Normal People! Come and Torment Our Poor Doctors!" I'm not saying the hospital is sabotaging us in any way. It's just one of the possibilities swirling around in my head right now, which reflects the state of my psyche -- ie. irritated. Oh no, has the effect of my off-day worn off already? :))

On the lighter side of things, I enjoyed watching the latest episodes of "American Idol 3" this week. Though not as entertaining as the pilot, they still offered hilarious examples of the good, the bad and the ugly. One trend I noticed is how this year's auditions were full of people who love to argue. Telling them they're terrible only made them launch into song again ! And a lot of them are extremely full of themselves, saying how the judges can't recognize talent when they see it, that they "know" they're good, and on and on and on. One young guy even threw Simon's drink at him, which I thought was awful. I take back what I said about Singaporeans being super-nasty. I don't think we can match the Americans! :D

The bad ones didn't make that much of an impression on me this time, except for William Hung, a buck-toothed Hong Konger with way too much Brylcreem in his hair and a really thick accent. A smart guy ( he studies at Berkeley ), he somehow thought he could be the next Idol, and showed up to sing "She Bangs" by Ricky Martin. Now bear in mind that all those appearing before the judges had to go through a preliminary round first. Word has it the screening panel picked the best and the worst to proceed, leaving the mediocre ones out in the cold. This supposedly makes things more interesting -- and they're right! Hung cracked me up, and obviously cracked Randy Jackson up too -- the poor guy covered his face with a piece of paper the whole time, but you could tell he was convulsing with laughter. :D Of course, Hung didn't get to go to Hollywood, but I have to say he didn't sound all bad either. He wasn't off-key, but hearing "She Bangs" with a Hong Kong twang is really memorable, haha! Kudos to him for taking criticism well ( Simon was very forgiving though, so that's nice ), but most importantly, for his upbeat attitude and giving his best in the audition.

The good ones I picked out this time consist of 2 guys: the Indo-Chinese fellow ( I think he sang "Lately" ), and the big guy with a beard ( he's a football player but has a great voice -- he even did opera when he emerged from the audition room, wow! ). Next week, the hopefuls go to LA where the competition heats up. I can't wait. :)

And don't forget "Survivor All-Stars" screening on Channel 5 this coming Monday! I've got 4 words for you: Rob Cesternino must win.

Before I forget, if anyone reading this lives in Singapore and suspects he/she may have the bird flu, PLEASE go straight to Tan Tock Seng instead of other hospitals, because no matter where you're seen, you WILL be transferred there for further treatment. Criteria include:

(1) recent travel to affected countries, such as Vietnam, Thailand, Japan, Indonesia, Laos, Korea and the southern part of China
(2) contact with live poultry
(3) fever or flu symptoms

Okay, this has been rather long, so I'd better stop here. Thanks for reading! More another day -- or later, if I feel like it. :)

In the meantime, ponder this: How much wood would a woodchuck chuck if a woodchuck could chuck wood? :P

Tuesday, January 27, 2004

I had a really unproductive day. Woke up, ate breakfast, bought some groceries, ate lunch, got home, felt like crap ( still ), slept for 3 hours, ate dinner, watched a recording of "Spiderman" then came to work. I can't explain why I feel geriatric, but I'm hoping it'll pass soon, 'cos I can't study when I can't even think properly.

Anyway, at least I really enjoyed "Spiderman". :P It's such a good movie, and the script by David Koepp is just wonderful, especially the scenes with Tobey Maguire and Kirsten Dunst coming to terms with their feelings for each other. You know how cheesy love stories involving young adults and superheroes can get, but with competent acting and poignant dialogue, "Spiderman" rises above all of that. I've got my eye on James Franco though ( he plays Harry Osbourne, aka the Green Goblin's son ). I saw him play James Dean in a TV movie a couple of years back -- I think he won the Golden Globe for it -- and he may be the next Johnny Depp if he plays his cards right. Broody looks, riveting screen presence, a mysterious off-camera persona -- someone please give him a role he can really chew on.

This just in: the nominations for the 76th Annual Academy Awards have been announced, with LOTR: The Return of the King leading the race with 11 categories. No surprise there! It's up for Best Picture and Best Director, Best Adapted Screenplay and Best Score, among others. The outlook appears excellent. :)
One nomination that will have everyone talking is Johnny Depp in the Best Actor list, for his role in "Pirates of the Caribbean". Some might think this is a huge upset, but then, a few people I know think "Cold Mountain" sucked, so Jude Law's presence is equally irritating to them. :D For me at least, I'm ecstatic with Depp's inclusion, though it would've been nice if the Academy had picked a less, err, frivolous film. But I guess a whole lot of people feel he's worthy of a nomination no matter what, and the fact that "Pirates" is the movie responsible for his first shot at the Oscar is proof enough of just how much he's liked and respected in Hollywood. I wish I could root for him, but Depp's the obvious wild card, and Bill Murray or Sean Penn seem to be hot favourites, so I'm not going to place any bets! Congratulations to Depp, however, for this outstanding achievement! :)

Okay, I'm gonna start posting about my NZ trip. I'm just picking out random locations here, but will probably leave the best ( ie. Queenstown ) till last. :)

Waitomo Glowworm Caves

The link is provided above, so you can read more from the site. It's en route from Rotorua to Auckland, and extremely popular with the tourist crowd. The place is off the beaten path, yet swarming with people the morning I visited. While queueing to get into the cave, the guides repeatedly reminded us to be as quiet as possible, because the glowworms are highly sensitive to noise. This worried me quite a bit, 'cos I was standing directly behind a Korean toddler who couldn't stop wailing -- he wasn't crying, he was practically yowling his head off. Thankfully, the kid's mother had the sense to leave the line and take him somewhere else.

The caves themselves are gorgeous. Filled with limestone stalagmites, stalactites and columns ( that's when the former two fuse ), the interior is tastefully lit such that visitors can see where they're going yet are able to enjoy the rather mystical atmosphere. The guides keep it interesting with their enthusiasm and field-trip style narratives, telling us how Dame Kiri Te Kanawa and the Vienna Boys' Choir have previously performed in the cavern, which affords exceptional acoustics and ambience. Cool. :)

It's a slow, leisurely walk down to the Glowworm Grotto. Don't be alarmed if drops of cold water hit you on the head or neck. These come from the stalactites above, and as one guide said ( quite seriously, mind you ), it's considered good luck when that happens! ( I experienced this 5 times, so yeah, I'm happy about it! ) As you near the grotto, anticipation mounts, and you're offered glimpses of scattered groups of glowworms while picking your way down to the water's edge. You then climb into designated boats, and push off to the main cavern.

Amazingly, the crowd obediently kept quiet, so we drifted in the darkness, engulfed by total silence. A few moments later, we looked up and there it was -- a huge mass of luminescent, metallic green/blue lights that covered the entire ceiling, like thousands of tiny emeralds in a magical night sky. Everyone, including myself, held our breath, marveling at this awesome sight above us. I even picked out a few individual glowworms crawling about -- 3 or 4 little lights in a row, squirming among the rest of the cluster.

The boat ride lasted about 10 - 15 minutes, then we were once again in the bright sunlight. We only realized none of us had spoken since leaving the cave when the fellow steering our vessel turned around, flashed a big smile, then cued us to say, "Aaaaaaaaahhhhhh!" :D

The photos don't do justice to the real thing, and tourists aren't allowed to take pictures, so hopefully you'll get to see it for yourself someday. Absolutely fantastic!

Monday, January 26, 2004

4-12 in resus on a Monday following the long Chinese New Year weekend. The big surprise: resus is busier than consultation! How can this be?! The odds of this happening are almost nil, and yet, even with 2 seniors and myself in here, we've been on our feet the whole time, sending patients for CT scans, calling ortho down for a referral, ringing the ICU...

I saw 2 patients with fits today -- one an undiagnosed diabetic who presented with his first seizure, another a known epileptic with breakthrough fits. Interestingly, both cases were almost identical in terms of seizure manifestation -- generalized jerking, mildly uprolled eyes, stiffening of the neck and facial muscles, YET remaining fully alert throughout. Tap them on the shoulder and they'll talk back. "Are you okay?" I asked. "I'm fine. Can you stop this shaking?" IV Valium did the job nicely. :)

Added a new link to my blog list today. I titled it "An American ER Experience", 'cos it's maintained by a 2nd year ER resident from the States. She writes well, and has a keen eye for details despite the fast pace and constant hassle of the job. A recent entry that caught my eye can be found in the Jan 22 post, which describes a Non-Accidental Injury case ( ie. a child who has been physically abused ). A harrowing, heartbreaking account.

I almost forgot to watch this year's Golden Globes. Woke up feeling as if my head weighed a tonne this morning, but at least I caught Peter Jackson's acceptance speeches for his Best Director and Best Motion Picture ( Drama ) wins for "LOTR: The Return Of The King". No-one deserved it more, and I hope ROTK will sweep the Oscars come March. Boy am I glad I joined the LOTR tours when I visited New Zealand! What an experience! :D

I met a rather annoying patient yesterday in consult, but for some reason, I failed to put this in the blog. :P It was a man in his 30s, well-educated, courteous, and part of the hospital staff ( administrative side, I think ). He came in with classical flu complaints, so I prescribed him the usual symptomatic treatment and wrote out a medical certificate. End of story, right? Far from it. The fellow then asked if he could have some antibiotics. Nothing unusual, so I had an answer prepared.
"This is a viral infection, so antibiotics won't make any difference. Just let your immune system fight it off. You'll be fine in a couple of days."
When I dispensed this advice to my other patients in the past, I rarely encountered any problems. But a few did require further explanations before being convinced, so I patiently reassured him a few more times.
"But Doctor, I NEED the antibiotic." he implored. "It helps me recover faster. If I don't take it, I'll get worse!" He seemed so sure he'd deteriorate without this "magic drug" that I noted a mildly crazed glaze in his eyes. An image of my patient bashing me over the head if I refused him once more transiently flashed through my mind, but thankfully I managed to suppress it.
"Okay, I'm not going to argue with you over this anymore." It was hard to keep my voice even, but somehow I succeeded. "I've already explained that this is a viral condition. There are no signs whatsoever of any bacterial infection, so I am NOT going to give you an antibiotic."
His comeback was immediate. "Then can I see another doctor?"
"If you register again, sure." I replied.
"But does that mean I have to queue and pay for another consultation?" he asked.
"I'm afraid so. And the other doctor probably won't prescribe an antibiotic either, because 95% of colds are caused by viruses."
That stopped him for a moment, and he hesitated, pondering his next move. So I swooped in for the kill.
"Look, trust me on this. Just take the medications as instructed, get some rest, and I promise you'll feel better in a few days' time. IF you get worse, just come straight back and we'll consider starting antibiotic therapy then."
That did the trick. "Okay doc. Whatever you say." Then he was gone.

Once he left the room, I realized my mouth was dry. The consult, which should've taken 3 minutes at the most, had swallowed up 10 minutes of my time, due to repeated, tedious explanations of the mechanism of action of antibiotics and the epidemiology of a simple flu. In all likelihood, this man represents only the tip of the iceberg. General practitioners and even some polyclinic doctors freely dispense antibiotics for colds on a daily basis. In fact, this same patient used it as a reason for me to do the same! I bluntly told him that such indiscriminate use was wrong, and that I wasn't going to follow suit. After all, I'm not the only doc in the entire country. If he really wants an antibiotic, I'm sure someone somewhere will give it to him.

It's 10pm, and I just attended to my 2nd diabetic ketoacidosis ( DKA ) patient for the day. 2 more hours / 120 more minutes to go. I miss my bed...

Shall leave you with the promised link to Kurt Nilsen's mug shot. He's 24, and already a father of two! Boy do I feel inadequate. :P

Sunday, January 25, 2004

I just began my afternoon shift, and am already fatigued. Interestingly, the crowd in the waiting area wasn't fully reflected in the queue system, which is kinda short. Spotted a few NS boys on the list, but thank goodness they're not seeing me. I'm NOT in the mood. :(

Crabby, you say? I suppose so. Not having a day off during weekends and public holidays sucks, and I've been doing this since November, when we first got word that our MO batch was only 60% of its usual cohort. Sure, we have night shifts sometimes, which gives us an entire free day before and after, but I'd like to have the whole 24 hours to myself, you know? I'm always so tired out after the call that I spend the whole day in bed. All my weekends get burnt this way, which is a shame. I really hope KKH Children's A&E will be an improvement.

I caught "World Idol" on cable last night, which was fun. :) 11 contestants from America, Europe, Australia and South Africa battled it out, but sadly, only 4 actually showed real talent ( in my opinion at least ). They were: Kurt Nilsen from Norway ( he won, by the way ), Kelly Clarkson from the US ( runner-up ), Ryan Malcolm from Canada, and Will Young from Great Britain.

Young has a rather high-pitched nasal voice, but his choice of song ( "Light My Fire" ) was spot-on. He already had 2 #1 albums by the time he competed on WI, and his experience showed. Relaxed and decked out in a cool outfit, his voice unwavering as he hit the high notes -- little wonder that even Simon Cowell said "Well done".
Malcolm, on the other hand, has that Buddy Holly thing going on. Like Clay pre-makeover, he favours thick, dark-rimmed spectacle frames and slicked back ( or slicked up, rather ) hair. Skinny to the point of appearing malnourished, his voice was anything but weak, and he gave a sterling performance of "He Ain't Heavy, He's My Brother".
I've never really liked Clarkson, probably because a local reporter described her as a diva with bad manners and an even worse temper. Then, whenever she sang on TV, she always looked like she was deliberately trying to drown everyone out. But the "American Idol" audience voted for her for a reason, and for the first time, I could understand why. She has a voice, no doubt about that, but despite being judged by a panel of rather nasty people ( yep, they chose lots of bad guys for this one ), that bright, sweet, almost sincere smile never left her face, and she was unfailingly polite and respectful throughout. Lucky for her, Simon was behind her all the way, and called her "a superstar". Interesting new perspective. I kinda like her now. :)
Now we come to Nilsen. First of all, have you seen his picture? The computer I'm using doesn't allow me to add links -- yes, another ancient machine down here -- so I'll see if I can do that another time. In a nutshell, as one frank fellow said, Nilsen "has the voice of an angel, but looks like a Hobbit". I actually think he looks more like a cute troll, but there's no denying his unbelievable vocals. His song choice? None other than U2's "Beautiful Day", one of the most difficult pieces to master, and dangerously vulnerable to comparisons and criticism if placed in the wrong hands. But the minute Kurt opened his mouth, I knew why he won this competition. He sounds exactly like Bono, and sings with such consuming passion I was mesmerized. It's almost mind-boggling to see this buck-toothed, round-bodied guy belting out the well-loved anthem with such aplomb. And considering the fact that Norway is the smallest nation participating, Nilsen's crown is nothing short of miraculous.
I turned to my mom and said, "Hmm, Singapore Idol doesn't seem that stupid after all. If Norway can produce a huge talent like Kurt, maybe our tiny nation can too." All we need is one. ONE person with a good voice, a dynamic personality, and just enough charisma to keep people riveted. Can you imagine a Singaporean competing with the likes of Ruben Studdard in the next World Idol? Whoa! :D

Now I'd like to ask for your opinions regarding a small dilemma I'm facing. Can't name names here, so let's call them X and Y.

X and Y will be getting married soon. X is nice, and we've known each other for 5 years now. We also previously worked together, and X left a good impression on me. Y, however, is a few years younger, and I only got to know this person a few months ago, again through work. But unlike X, Y is very unpopular. Reasons given include terrible work habits, sparse knowledge of even the most basic things, and worst of all, the inability to accept criticism and a stubborn refusal to change for the better. I've been hearing all sorts of unflattering comments from my fellow colleagues, whose accounts suggest that Y is also spoiled, bad-tempered ( some leaned more towards "nasty" actually ) and even a little condescending.

My problem: I am very concerned about X marrying Y, because I don't think X knows any of the things I just mentioned. In all likelihood, X believes Y is an angel who can do no wrong, but everyone else thinks otherwise.

So should I or shouldn't I tell X about Y? The repercussions are serious, of course -- X may get mad at me and our friendship may be jeopardized; X may tell Y, then Y will hate me too; friends of theirs may also get wind of it, then label me as "the busybody who tried to break this happy couple up", etc.
Or... X may listen to what I have to say, and think twice about Y.

Being disliked isn't the main issue for me. What concerns me the most is possibly being solely responsible for causing a breakup. Or in this case, making X call off the wedding altogether. Will I be able to live with the guilt, even if I feel Y isn't right for X?

I guess my inclination towards this course of action ( ie. telling X about Y ) stems from my own prior experience. I thought my ex was the greatest ( he arrogantly told me as much! ), and only found out about "the opposite side of the coin" much later. Seems everyone had been keeping mum because they didn't want to cause any friction, or yes, a breakup. But it made a very big difference to me, 'cos frankly speaking, if I'd known he was such a jerk to his colleagues ( even his friends ), I definitely would've been concerned. Sure, I put him on a pedestal when I was a med student, but once I hit housemanship and got to work with senior doctors who remain my role models to this day, I stopped ooh-ing and aah-ing whenever my ex told me he did something spectacular at work that day. I learned to value hard work and team effort, and always swore when anyone got the short end of the stick. So yeah, if I'd known my ex was famous for slouching off, I wouldn't be happy.

Some of you may ask: But is someone's work ethic a direct reflection of his/her character?
My answer: Yes. In fact, I think the best way to get to know a person is by working with him/her. And not just for a short period. Noooo, the longer the contact, the better. Add some stress and you'll see that person's true colours emerge. It's extremely easy to act nice and perky once you leave the office, but if someone can't handle problems at work without screwing others over, imagine how this person will cope with marriage, in-laws and kids.

But... that's me. Which is why I need to start a poll here. Hope you can leave your comments and tell me what you would do in my situation, and why. Any views will be greatly appreciated.
( P.S. Yes, I did ask my mother about it. She replied, "Tell X." then said, "Wait, what if X doesn't care? What if Y finds out and tells everyone you tried to break them up? What if etc, etc, etc." Which explains why I freaked out. :P )

Hmm, a rather depressing end to my post. Sorry about that. I shall now sign off and read the issue of Movieline sitting on my desk. Too tired to read textbooks today. :D

Saturday, January 24, 2004

One more hour to go. :))

So there's a lull in the queue - at last. A few of the other MOs came by to chat with me, and I directed one of them to this site, thanks again to Dave Barry. Prepare to be blown away -- pun fully intended, heh. :D Kushami !

And more:

Come On Baby, Light My Fire

Back To The Basics
-- key sentences:
(1) "But one woman in her 20s said she found the phone "scary". "Isn't this bad for your health?" she asked."

(2) Another woman, in her 30s, said she was interested in the mobile phone but was self-conscious.

"What troubles me is that I may look weird if I'm talking with the phone pressed between my eyebrows," she said."

Someone-with-too-much-free-time's website

I dare you to tell me these aren't CUTE
After getting home at close to 1am this morning, thanks to a busy afternoon shift *yawn*, I'm doing 9-5 today, and feeling a bit tired from lack of sleep. It's pretty crowded in the ER due to the post-New Year surge, but no frivolous attendances as yet. Lots of trauma cases, with people getting their hands and fingers slammed by doors and such. For some strange reason, I find that rather amusing. :P *wake up, wake up!*

Here're some links for your entertainment:

Clay on Jay Leno
-- scroll down to look for the heading. I don't have video on the computer I'm using at the moment, but I do have sound, and Clay's definitely improving on his live performances of The Way ( his 2nd single off the album ). He started out a little wobbly on some of his earlier deliveries, but is steadying nicely now. It's a tough song, with lots of high, running notes, but he's nailing it. :)

Just heard the interview segment -- no picture, aargh! Darn computer! :( But listening to Clay and Jay banter is good enough for me. Leno already sounds fully Clayverted, which is terrific, and Clay is his exuberant, snarky self, cracking jokes non-stop and showing off his ability to laugh at himself. He still talks about his "makeover", and how his driver's licence photo is a pre-transformation version -- Leno described it as "Jeff Goldblum (something something)". I couldn't read lips here, so if you catch it ( Marilez, help! :D ), tell me what he said!
My favourite bit is where Clay says he lost his wallet after he sang at the World Series, and how it's now "probably on eBay". That line just shot out of him from nowhere, and had me laughing hard! :) I just love his sharp wit!

Van Helsing
-- I completely forgot to put this in yesterday after getting sidetracked by sick patients. I just saw the trailer 2 nights ago, after AI3, and whoa, it looks REALLY good! Hugh Jackman's a big draw for me, but throw in Dracula, Wolf Man and Frankenstein's Monster, and I'm there! :D It's directed by Stephen Sommers, who helmed The Mummy and The Mummy Returns, both rolicking action-adventures that smoothly mixed Egyptian myth with stunning visual effects, humour and Indiana-Jones-type antics. If that mouthful wasn't enough to whet your appetite, then I don't think there's anything else I can say to convince you otherwise. :P Click on the link to view the trailer.

My parents told me over breakfast that the BBC reported something about Britney Spears' ex-husband hauling her to court for emotional distress. I didn't hear this myself, and haven't seen it on the Internet, so I'm just guessing here. What's-his-name sure cashed in big, getting invited to talk shows, giving magazine interviews, and now, embarrassing the poor girl. I used to think he was the victim, but it doesn't look like it anymore. Shame on you, err, whatever your name is.

It's only 2:30pm and I've seen almost 30 patients so far. At this rate, I may hit 40 before I get to go home. Sigh... 5pm can't get here fast enough.

Friday, January 23, 2004

And how was YOUR Chinese New Year? :D

I spent mine sleeping and eating a simple but delicious meal at home with my parents. Am in the midst of reading a gigantic book I borrowed from the Tanglin Club library, titled "A Century In Pictures", and featuring photos from the LIFE magazine collection. I'm only up to the 1920s right now, but the scenes depicted are both harrowing and awe-inspiring. As expected, the section on World War I had lots of battle snapshots, complete with one showing beheaded Serbian soldiers. A description of the Titanic tragedy also hit me hard, as it illustrated how human arrogance quickly gave way to recklessness and terrible tragedy.

My favourite photos, though, are those that capture famous people "in their element". From nobility to peasants, American presidents to poor immigrants seeking The American Dream, these characters are now forever immortalized on film. Good examples include Orville and Wilbur Wright's first airborne flight, Theodore Roosevelt with his wife and 6 children, Henry Ford perched at the wheel of his very first car, and Gene Kelly and Julie Andrews debuting on Broadway. One that really sticks in my mind is the picture of a young Irving Berlin sitting at the piano, fingers tickling the ivories. He was unknown when that photo was taken, then later catapulted to fame with musical numbers such as "Puttin' On The Ritz" ( which I sang with the choir back in college :P ) and the evergreen "White Christmas". For me at least, it's amazing to look at history spread out on a page. The camera is definitely one of the most ingenious inventions of our time! ( There's an old Kodak advertisement in the book. Its inventor, Mr. George Eastman, was an ex-bank clerk.)

Then of course, there was "American Idol 3", or what I'd like to call "The Randy and Simon Laugh-Fest". The two guys cracked up so many times I lost count, but I can't blame them either, 'cos some of the Idol hopefuls this year were TERRIBLE, or as Simon put it so well, "deluded" beyond imagination. "They don't know talent when they see it!" snarled one mean-looking African-American woman as she comforted her sobbing friend, a brunette Caucasian who seemed to think losing 80 pounds for the competition automatically qualified her for the next round. She later recovered her composure and spat, "Someday, I'M going to make someone TONNES of money!" before huffing off.

At the other end of the spectrum, we had two New-Agey fellows proclaiming how they have "good hearts" which ought to be "shared with the world". It didn't matter that they couldn't sing to save their own lives, prompting an irate Simon to snap, "This is American Idol, not Heart Idol." One of them even likened himself to Clay Aiken, as if that in itself endows him with talent. The bearded fellow creeped me out a little with his overly gentle voice and perpetually beatific facial expression. "I touched them with my singing, and that's enough for me." he sighed after being booted out of the audition. Bizarre. :D

However bad they were, the good ones more than made up for it. This year saw many stars in the making, all young, spunky and cute. On the gal side, I picked out Scooter Girl ( a self-confessed "over-achiever" who won the battle with anorexia and loves to speed around on a little foot-propelled scooter ) and the blonde Southerner who belted out "Black Velvet" and bears more than a passing resemblance to AI2's Kim Caldwell. Then there was a Macy-Gray lookalike, albeit a slimmer, prettier version, with a scratchy yet full-bodied voice that will no doubt invite even more comparisons with her famous counterpart in the months to come.

As for the guys, I'm rooting for the African-American guy who dressed up as Elvis then did a cool-cat rendition of "Jailhouse Rock", plus a meek but likeable white boy who was asked to ditch his Dean Martin persona then ended up wowing the judges with his deep, rich vocals on "The Way You Look Tonight". A pair of black brothers got through to the next round, which will make for an interesting situation. And the two hot dudes -- one a brunette who sang a pitch-perfect "Unchained Melody", and a blonde hunk who serenaded Paula Abdul and sent her swooning -- will certainly raise the temperatures if they make it to the semi-finals and beyond.

Still, no-one -- and I mean no-one -- came close to Clay in terms of voice power, song delivery and personality. Sure, it's still early, and I didn't start appreciating Clay till the semi's anyhow. But I just feel that he's too hard an act to follow. I have no doubt some new stars will be discovered yet again. But whether they'll be able to duplicate Clay's success, or match his career longevity, is highly debatable.

Just read on Yahoo! News that Ben Affleck and Jennifer Lopez have officially broken up. Am I taking sides? You bet! I think Ben is better off without J. Lo the double-divorcee / diva. And am I imagining things, or did Jen bring him some horribly bad luck? "Gigli" flopped, then Ben's "Paycheck" bounced. Quick! Get out, Ben! Get out now!
So the next question is, who will be a worthy successor for him? Take it from me that Ben is a very intelligent guy with a super-sharp wit. Sadly, though, he also has a penchant for alcohol and hot babes. What he needs is a classy lady who can match him in terms of intelligence and humour, but also possesses an ability to calm him down and correct his boozing, womanizing ways. E.g. Annette Bening did it for Warren Beatty, while Catherine Zeta-Jones tamed Michael Douglas. I thought Kate Hudson would be perfect, but she ran off and married scruffmeister Chris Robinson. Jennifer Garner expressed how much she dug him during filming for "Daredevil", but hooked up with Michael Vartan after that ( perhaps because Ben was already taken, darn ). Gwyneth's already wed Chris Martin, so there goes another one. Oh wait! A-HA! How about Renee Zellweger? I think they'd make a fantastic couple. *crosses fingers* ( Yes, I have nothing better to do than to cook up scenarios like these. Awful, isn't it? ;) )

Okay, back to reality, aka the ER. The surge occurred at around 7-8 pm, and settled thereafter, which is why I managed to continue blogging. :P There were two highlights. The first was a 50-year-old man with chronic obstructive lung disease ( aka COLD, a by-product of chronic heavy smoking ). He had been intubated in the past, and progressed to the point of requiring home oxygen therapy, YET CONTINUED SMOKING. Never mind about it aggravating his medical condition, but smoking next to an oxygen source?!!

So he came in today with, that's right, a COLD exacerbation. Wheezing away on the bed, he was immediately given a nebulizer while admission was quickly arranged. 5 minutes later, he threw a seizure, his eyes rolling upwards and his pulse rate dropping by 50%. He turned cold and pale, but luckily was already in the resus area, so we promptly tubed and stabilized him, then sent him up to intensive care. I'm the only medical officer in resus this evening, so my two seniors gave me the chance to do the intubation. It was a little nerve-wracking, 'cos my ER chief was standing right next to me, but I got it on the 1st attempt, which was gratifying in an odd sort of way. :) Yeah, the things that get us docs going: "I stuck in a chest tube!", "I set a central line!", "I reduced a dislocation!", "I removed a fish bone!" Sad, isn't it? :D

Ah, yes, the other highlight. Two men were brought in for fighting. Guy A was punched by Guy B, because A was dating B's niece, and apparently beat the girl up yesterday, making B very mad, who then stormed over to A's house and whacked him in the face. Yay! :) But then, B sustained a fight bite with a boxer's fracture to boot, which made it an open fracture necessitating admission. B then said he didn't want to be admitted because he had to work. Fortunately, my finesse at frightening him ( I'm getting good at this, haha! ) finally caused him to relent. Word of advice: next time, wear gloves.

It's been a rather long entry today, so I'd better stop here. I'll try to start transcribing journal entries on my NZ trip soon, 'cos the magazine I've approached is being deluged with article submissions, so they'll probably only accept the LOTR piece. Watch this space. :)

A farewell gift for my readers:

The Plug.Net
-- discovered this when its author, Jay Carlson, left some comments after a visit here. I repaid the favour by dropping by his site, and I have to say, he has a gift for making the mundane really interesting, and seeing humour in everyday events in our lives. I thought the "Stats On Stats" category was hilarious! To get the archives, click on "Out With The Old" ( I'm going off shift now, but will try to look at those another day. )
Thanks for coming over, Jay! :)

Thursday, January 22, 2004

Notice anything different? ;)

Yep, the blog's undergone some insane makeover, thanks to idle time in the resus area -- shhhh. :P I did this mainly because I needed ( desperately ) to add links, which the old template didn't allow. Re-minisce has received the honour of being at the top of the list :D, and yes, to his chagrin and horror, I've added a few Clay Aiken website addresses as well. But I'm still toying around, so the list may change in the near future.

The new template's font size is a little large, but on the whole, the site looks brighter, and most importantly, minus the annoying flickering taskbar. Let me know what you think, good or bad. :)

Funny that these alterations should occur on the 1st day of the Lunar New Year. Pure coincidence! :D My night shift is finally over, with a tally of 40 cases seen, ugh. But I'm off now. Time to vegetate in front of the telly, yeah!

Wednesday, January 21, 2004

It's Chinese New Year Eve, and my question is: Doesn't ANYBODY have reunion dinners anymore?! I arrived at the ER at 9pm, and lo and behold, there was... a crowd! And from what I could see from the queue list, it's mostly flus, minor lacerations, and a few other assorted complaints. I don't know about you, but if I had a cold on NYE, I'd STAY HOME and perhaps see a doctor THE NEXT DAY, instead of RUNNING TO THE HOSPITAL LATE IN THE NIGHT. ( Sorry about the capital letters. The irritation has already set in, aargh! )

Just saw an old man with, yes, an upper respiratory tract infection, accompanied by a son who had the annoying habit of answering every single question I asked, before the patient could even open his mouth. After the third time this happened, I tapped the guy ( the old one, that is ) on his hand and said, "No no, YOU tell me what's wrong." after which his son got the picture. Then, I'm told that this same gentleman is flying to CHINA in 3 days' time. "China?" I echoed. "Not a good idea."
"That's what I told my dad!" the son replied. "But he just won't listen. Can you try to talk some sense into him?"
"Okay," I said. I turned to my patient and launched into a Mandarin lecture on the hazards of travelling to China right now, in view of the random outbreak of SARS cases recently, and the major risks he'd be taking because of the expected New Year crowds and migratory patterns.
"But I've already paid for the tickets," he answered, as if that was reason enough.
"But it's dangerous!" I responded. "What if you are exposed to the virus and bring it back to Singapore? What if your family gets infected?"
"That won't happen lah." He started laughing, then I gave up.

Well, I tried.

And now, at 2am in the morning, I've seen about 25 patients already, with maybe 5 to 6 toilet and sutures. Lots of allergic reactions as well -- seafood, unknown ingredients in exotic dishes. Yeesh. The one that takes the cake has got to be the young boy with a ( I quote ) "clogged nose". New definition for "emergency", guys.

If you've found my blog interesting thus far ( and thank you for reading :)), you'll definitely enjoy these links on Chris Rangel's blog. Dr. Rangel is an internal medicine specialist in the US, and a self-described "hospitalist". I emailed him once to ask for an opinion on the Iranian twins incident, and on the whole, he writes on both medical issues as well as recreational ones -- like me. :D

His list of links to medical blogs is comprehensive, and those under "Docs In Training" are quite a hoot. I'll leave you to browse on your own, as I will be reviewing these in more detail in an upcoming article for the SMA News.

By the way, Dr. Rangel has linked to this other blog, which talks about The Lord Of The Rings. The author obviously doesn't like Aragorn and Legolas, but he's a really funny guy, so it's all good. :)

Forgot to mention "A Perfect Murder", which was shown on TV last Sunday, and which I watched a couple of days ago. Had totally forgotten what a great movie this is. Michael Douglas, Gwyneth Paltrow, Viggo Mortensen -- a dream cast if I ever saw one. Gwyneth looks more beautiful than usual here, bearing more than just a passing resemblance to classic swan-necked ice-blonde Grace Kelly. Viggo is worlds away from his Aragorn persona, playing a playboy con-man with a dark side as well as a conscience. The former is well-shown in a short scene where, believing Gwyneth's character stood him up on purpose, he proceeds to flick black paint over a portrait of her in his apartment. His glee is obvious, yet pulsating with an underlying malice. Or maybe I'm the only one who sensed this, haha. :)
Douglas, as always, is the one to watch. My favourite film where he is concerned will always be "Romancing The Stone" ( go rent it! ), but "A Perfect Murder" is one of the few occasions where he plays the bad guy ( the other good one being "Wall Street", for which he won a Best Actor Oscar ). The chilling scene has got to be the attack on Gwyneth, while Douglas calmly listens in over his mobile phone, face expressionless, before hanging up when he believes she's dead. "I'm in!" he says to his fellow poker-mates, breaking into a satisfied smile. Classic movie moment! :)

Met a friend earlier this evening. He reads my rantings ( thanks! :)), and was a little concerned about my cynicism. Methinks I've been laying it on too thick lately, very sorry about that. :P But it's cathartic for me, in a way. Perhaps I'll copy what someone else has done -- maintain one blog for public consumption, then another for really personal musings. Hmm, sounds good to me. But I probably won't share it with anyone though, so you'll have to hunt for it somehow. Must make sure I don't type "SARS" anywhere, or I'll get quoted or linked to again. :D

I shall now leave you on a happy note. This is taken from the latest issue of USA Today, and talks about Clay Aiken's passion for a very special cause. Inspiring. :)

Clay Aiken idolizes kids with developmental disabilities

[ By John Morgan, Spotlight Health, with medical adviser Stephen A. Shoop, M.D. ]

Clay Aiken became a national sensation on the hit show American Idol. But while music may be his bread and butter for now, Aiken's real passion is giving a voice to children with developmental disabilities.

After his American Idol success, Aiken, a special-ed major, says he is "in a position now to be a voice for people with developmental disabilities."

"I fell in love with working with the kids," says Aiken, whose national tour in support of his No.1 album begins Feb. 24 in Charlotte, N.C. "Kids with autism and developmental disabilities think differently ? their view of the world is much more pure and innocent."

Aiken began working with kids at the YMCA and then a local elementary school where he was asked to teach a class as a substitute. Only after he accepted the position did Aiken learn his students were autistic.

"I also worked with an agency called Autism Services, which placed me with the Bubel family in the Charlotte area," Aiken says. "They are such an inspiration to me. I bonded very closely with their son, Mike, who has autism and the whole family. I liked that they didn't make excuses for Mike. They didn't expect him to get special treatment but simply to be included like a normal citizen.

"As I became more involved teaching, I saw children with developmental disabilities being turned away from inclusion in programs and so my dream became to fix this in some small way," Aiken adds. "There are so many kids and families that need our support."

According to Best Buddies International, a non-profit organization dedicated to enhancing the lives of people with intellectual disabilities, nearly 8 million Americans have intellectual disabilities, formerly termed mental retardation. The number of individuals with developmental disabilities, however, has been estimated as high as 10 million.

"Developmental disability is an umbrella term that usually implies that a person has some adaptive challenges ? cognitive and/or physical disabilities ? and has difficulty managing his or her tasks of daily living," explains Wendy Wood, associate professor of special education at the University of North Carolina at Charlotte.

Wood points out that people with developmental disabilities are not simply or automatically mentally retarded.

"Individuals with intellectual disabilities are typically identified by IQ measures," says Wood, who acted as Aiken's independent study supervisor. "But a person with cerebral palsy might have a normal or even above-average IQ yet still may have issues related to performing tasks of daily living. This person would still be considered developmentally disabled."

Developmental disabilities include:

? Autism

? Down syndrome

? Intellectual disabilities

? Cerebral palsy

? Birth defects

? Other neurological or cognitive impairments

Real American idol

Diane Bubel, Mike's mother, recognizes that Aiken's work with children with autism isn't easy and says it demands "patience and true respect for these children as people first."

"Mike's autism is severe so one of his biggest challenges is communication," Bubel says. "He cannot speak, and he can't always process what is said to him. You can't just tell things like 'put your shoes on,' so it can be very difficult. But once you have a child with a disability you have a choice: You can suffer with it or you can choose the happy road. We chose the latter."

They also chose Aiken to work with Mike. Bubel knew very quickly Aiken had the right stuff ? both as a teacher and a singer.

"Clayton walked in the door with unconditional love and no expectations," Bubel says. "It's rare to find people that open and understanding. And pretty soon we realized what an incredible voice he had and just kept telling him to audition for American Idol."

Aiken recalls the support they provided. "Eventually I had to audition or she wasn't going to leave me alone," Aiken jokes. "And the rest, well it worked out pretty well."

Far better than Aiken ever dreamed.

Not only did he become a star almost overnight, but he believes his American Idol success allows him to fulfill his true vocation.

"I was already studying special education at UNC, but then American Idol took me away from my student teaching, and I wasn't going to be able to graduate," Aiken explains. "I had to find another way to get enough credits to graduate. So we figured out an independent study about non-profits and special education. My assignment was to create a mock foundation that would work with kids with special needs."

Aiken completed the needed course credits and graduated. After the show his career really took off and he saw an opportunity to make his dream a reality

"Teach the children well'

"After the show it began to look more and more like I really could create a foundation that helps kids with developmental disabilities," says Aiken, who will appear on NBC's Ed this Friday, "not just in the Raleigh area but to help kids nationally and internationally."

When Aiken told Bubel he was naming the organization the Bubel Aiken Foundation, she couldn't believe it and was moved to tears.

"We want the message of the foundation to be inclusion ? we want to 'open doors and open minds,'" Bubel states. "We want people to get to know our children and understand that by knowing them they will be better people. It's true in our family. My daughter Emma is more patient, wise, understanding and less self indulgent than most kids her age because of Mike."

Inclusion is multilayered in its impact, positively affecting the child's education, socialization and emotional well-being.

"If a child with a disability is included with children who are not, it's not just a social benefit," Aiken states. "It has a self esteem and emotional benefit to be treated like other students. 'Handicapped' is a label society puts on people. It's not something kids are born with. A child may have a disability but the handicap comes from society when they tell that child they can't do something."

Aiken says the goal is to instead figure out how they can do that activity ? to include them in programs.

"Inclusion also helps kids academically and they start to pick up on socially correct behaviors," Aiken explains. "And the benefit is two-way. Kids without disabilities learn so much ? possibly more. Instead of just seeing a kid with disabilities down the hall in a classroom, they get to learn about them. Ignorance leads to prejudice. Inclusion provides them an opportunity to learn compassion, acceptance and tolerance ? all skills which make our society better."

Aiken hopes he will be at his best when his tour begins but says he has a "higher purpose."

"I am in a position now to be a voice for people with developmental disabilities," Aiken says. "I think all of us have a higher purpose for what we are doing. The visible higher purpose for celebrity is to create awareness for issues that need a voice. I'm just doing what I always planned on doing ? teaching and helping children with developmental disabilities."

Have a good Chinese New Year then! Will probably make my next entry on Friday. And don't forget, "American Idol 3" starts on Channel 5 tomorrow night! :P

Tuesday, January 20, 2004

Finally, it's 10pm. One more hour to tahan. And after going through a few chapters of my A&E text, I think I'll just call it a day and read as many Dave Barry columns as I can possibly lay my hands on before I go home. Here's a sample for ya:

2003: A Dave Odyssey

Click on "January" at the bottom of the article to start sifting month by month. Laughs guaranteed. :D

** Quote from the March summary: "An outbreak of the SARS virus in Asia is blamed for dozens of deaths, many of them travel agents committing suicide."

** From May: "Elsewhere abroad, Chinese health authorities, stung by accusations that they have been slow in reacting to the SARS virus, announce that they will execute anybody who gets sick."

**From September: "In his victory statement, (Arnold ) Schwarzenegger announces that he will appoint a stunt governor, who will handle the tasks that he is physically unable to perform, such as pronouncing words." and "China, culminating a two-decade effort to develop a manned spaceflight program, puts its first astronaut in orbit. Work begins immediately on a program to develop a way to get him back down."

**November: "In other entertainment news, pop superstar Michael Jackson again finds himself in legal trouble when authorities in Santa Barbara order him fingerprinted and booked on charges of ''extreme creepiness, even for California.'' Jackson's attorney expresses outrage, telling a press conference that his client ''doesn't even HAVE fingerprints.''

**AND December: "The month's biggest surprise occurs when U.S. troops finally capture a filthy and bedraggled Saddam Hussein hiding in a hole along with 11 other members of the cast of the CBS reality show Survivor: Iraq. "

And not forgetting this article on the presidential race in the US, which had me laughing so hard -- but desperately stifling it 'cos I'm still technically working a shift -- I had to maintain a Valsalva manoeuvre so long I almost passed out. Well, only doctors will understand the joke I just made, so... :)

A big carrot calls for peas on earth by Dave Barry

Time to go home now. Adios!
Haha! Adding a few links for your reading pleasure. [ All thanks to re-minisce, still the greatest author of them all. How I enjoy making him blush. :) ]

Dr. Goat's Blog
-- I love the January 12 entry, in which he deftly insults a certain Ah Lian who shall remain unnamed.

Cool Street Art-- under the Jan 19 post; sounds like a fellow Singaporean blogger.

-- borrowing her "Bohliao Quiz" for a sec. My own answers follow below.

A: I haven't travelled that extensively, and taking available land space into account, right now I'd say Queenstown, South Island, NZ. Yeah, I love it that much. :)

A: Locally, that would be my living room. Give me a warm, sunny late afternoon and a good book, or an excellent show on TV or DVD, and I'm happy.

A: Pubs with Sarong Party Girls and horny expats. Swore never to return to those seedy joints ever again.

A: Okay, this question's a little cheesy, but I'll answer it anyway. In my line of work, I'd definitely like to have the ability to successfully resuscitate every single collapsed case in the ER. And I don't believe in discriminating -- not so much in Singapore, but overseas, you may have to treat someone who, for example, went on a shooting spree then ended up being shot himself, or something to that effect. Me, I just want all my patients to have a second chance.

A: Probably my ex-boyfriend. I'd like to rewind to that crucial period when I knew in the back of my mind that something was wrong, but decided to ignore it. I'd like to have told him, "This isn't working out." and leave before it was too late. Before all the betrayal started. Before I stupidly tried to salvage the relationship not because I loved him, but because I was nursing a bruised ego.

A: The sunflower.

A: ER physician is definitely one of them. But equally high on the list is photojournalist. I used to prefer "war correspondent", or perhaps "entertainment reporter", but photography speaks volumes and offers an even wider range of experiences.

Darn it, re-minisce! I just spent an hour going through your links, instead of studying like I'm supposed to. [ Excuses, excuses :) ]

Sometimes I wonder if it might have been better to remain anonymous when I first started blogging. Provides more freedom for the discussion of "sensitive topics" without having to worry about people ( ie. Straits Times journalists ) knowing your name and paging you multiple times in the middle of your overflowing clinic. Hmm, I suppose I could build a new blog from scratch and vent at will, but sadly, my brain isn't equipped for such complex multi-tasking. :P

Is it really only 7:30 pm?!
Looks like the upcoming Chinese New Year is keeping the crowds away. *standing up to wave my arms in the air and do a little chicken dance* Okay, I'm back in my chair. Got my Oxford series text on Paediatric Emergencies with me, all ready for reading over the next few hours.

People who know where I work have been asking if I saw the man who died in a house fire in the East Coast area a couple of days back. The answer is no. I was on night shift, and I believe he was brought in during the day. Reports state no fewer than 10 doctors were called in to help resuscitate him. I can't confirm that at the moment, but off the top of my head, it sounds a little inaccurate. We've got medical students around, so maybe someone mistook them for doctors. Still, it's possible I guess, with 2 or 3 ER physicians, 2 or 3 general or orthopaedic surgeons, maybe even a few medical or anaesthetic people chipping in. Must've been quite a scene. Pity I missed it.

Drama in the ER is unpredictable yet expected on every shift, and I've had my share of experiences, extending all the way from medical school to my years as an MO. In 4th year, I watched an ER doc deliver a breech baby right there in resus -- successfully, mind you. [ Unbelievable! ] CPRs and intubations get a little routine after a while, so the things that stick in my mind are: the young fellow who shot himself in the head when his girlfriend left him; the woman who coughed / vomitted a fountain of blood after a tonsillectomy; the various multi-trauma victims ( especially those who committed suicide -- the most tragic ) and yes, even the super-nasty ones. For one of my fellow year-mates, seeing 3 SARS cases without knowing it till after the diagnosis was made at TTSH was nerve-wracking. I hope I don't have to go through that again. One similar episode during my internal med rotation is more than enough.

The January 2004 issue of the SMA News is out online. Here's the link:

SMA News 1/2004

Check out "Kill Hospital Bill: Vol. 1" by Dr. Toh Han Chong, a consultant oncologist at the National Cancer Centre, and our deputy editor. He's a movie buff, like myself, so his article has lots of film analogies, which make it both hilarious and great reading. :D A good illustration of writing talent within the local medical community.

I don't have much to report today, but remember to watch "Monk" tonight, 9pm Channel 18 Starworld, on cable. :)

Monday, January 19, 2004

*Deep breath*
Okay, re-minisce, don't hate me! :P

Blame it on an empty ER. Blame it on having too many computers in the A&E Department, all hooked up to the Internet. Okay, blame it on my perverse sense of curiosity. :D

I dropped by Xiaxue's blog, and the best assessment I can give you is... a mixed one.

First up, that huge photo of her is tacky, for whatever reason she chose THAT to be her mug shot to the world. Scroll down a little and you'll see the message box, bearing Ah Lian-speak from the author to her "readers" ( I put in the inverted commas because, if you notice, the messages are from her alone, with no entries from "visitors" that I could see ).

I only looked through the current page of posts, so I'm not going to comment on whatever she wrote before this. One of her more recent ones had multiple photo shots of a John Little warehouse sale at the Singapore Expo, and her ecstatic squeals over various articles of clothing, cosmetic products and perfumes. I can almost imagine her eyes rolling into the back of her head from the immense pleasure she was obviously feeling. Surreal.

Then, there was an, err, interesting entry about her annoyance regarding a couple's incessant kissing in front of her on a bus. She claims she set fire to the guy's hair, but this is obviously untrue, 'cos if she HAD, The New Paper / Lianhe Zaobao / The Straits Times would've splashed it all over the front page.

Further down, she talked about "Jeremy", whom I have no inkling of, save the fact that he chose some woman over her. Ex-boyfriend perhaps? Anyway, after eliciting some strong, unpleasant reactions when I read her more recent posts, her rants about Jeremy actually stuck a chord with me. All that talk about certain women being fake and getting the man in the end is something I've always been pretty fed up about. After all, my ex was duped by a sweet-looking physiotherapist with a less-than-pristine reputation and what some of my medical friends described as "a very obvious ulterior motive". This same cute-faced girl called me on the phone a few months after my breakup, claiming that she wanted to find out how I was doing, when in truth, she'd freaked out when my ex suddenly stopped dating her, so she wanted to ask me if we'd gotten back together. For a moment, I felt sorry for her, 'cos even if she WAS the third party in all of this, we'd both been treated badly by the same guy. So I told her how I too was deceived, how he hurt me so terribly I almost gave up my career at one point, how adept he was at lying over and over again, and how she should stay away from him and save herself any further pain. But she wouldn't listen. In the end, when I put in a last-ditch effort and told her, "He isn't a good man.", she replied, "Maybe not to YOU."

Wow, I still remember that statement so vividly, even after more than 3 years. Her tone was chirpy, yet laced with venom. Imagine the smiling boa constrictor from the Disney cartoon "Jungle Book", if you can. She got back with my ex soon after, and for a time, pictures of the two of them during a holiday in China existed on his personal website. But all that has disappeared without explanation as of a year or two ago, and last I heard, he'd gone to the US to do some research on I-have-no-idea-what. They could very well still be a couple, and honestly speaking, the best thing I can say about their relationship is that they truly deserve each other. If they find happiness together, then good for them. If not, then I can't say I didn't see it coming from a mile away.

All right then. That's the end of my monologue. :) Xiaxue: I don't agree with most of the things you write about, but I share some of your emotions, and believe it or not, applaud your ability to just let it all hang out. I do most of my ranting at home, partly because putting my name to this very public blog, and being a member of the SMA News' editorial board and a medical professional requires some decorum on my part. Maybe I can start a totally new blog under a pseudonym in the future, then you'll see the real fireworks. :D

The only bone I have to pick is regarding Xiaxue's language, which is extremely offensive. Sure, swearing isn't illegal, but she strikes me as a pretty smart person, and is probably capable of being sarcastic without having to resort to the convenience of expletives, which are, in my opinion, tools used by those with challenged vocabularies. [ It's a lot easier to slot in the f-word instead of an actual adverb or noun. ] Also, she may want to watch her back in case someone decides to launch a lawsuit against her for the heck of it.

I'm not going to get involved with any battles here, but re-minisce, a big pat on the back for you, and I'll say it again for the record, you're a terrific writer. :)
1:30am Monday morning. Yeah, I'm on night shift yet again. Not too bad at the moment. There was a surge just after midnight -- Singaporeans being their usual selves ( "Let's see, stay home or go to the ER at an unearthly hour and bug the exhausted doctors there with complaints that are NOT of the emergency variety??? Of course bug the doctors lah!" ). Sigh.

Well, we managed to clear the crowd, so one of the MOs is hopefully taking his nap now, while mine isn't due for another 4 hours, ack. Not feeling that great today, for, er, feminine reasons. Sometimes it sucks to be a woman, but anything's better than national service for sure. :P

So much to talk about today. The Straits Times was full of scandalous content again, as expected for its Sunday edition. One ST reporter commented to me previously that the editors WANT such stories, so there goes all remaining respect I had for our local paper. Examples for this morning include a piece on high-end karaoke lounges that cater to wealthy businessmen, an article about women in China going for plastic surgery in order to secure jobs, and another on sexual problems faced by local adults.

Regarding the first, the closest I got to a lounge in the Novotel Apollo Hotel is the corridor from the car park to the lobby. That short walk yielded 2 groups of drunken men accompanied by women wearing heavy makeup and skimpy clothes. What was I doing at the Apollo, you ask? Attending a school dinner with my mom, of course. What did you think? :)

As for the second, the key words I've picked out are from a plastic surgeon in China: "People should understand that plastic surgery can't fix all problems." The rest of the feature is dangerous propaganda -- women giving their testimonies about how going under the knife helped them look beautiful, get them acting jobs or higher salaries, etc. I have very strong opinions on cosmetic operations related to plain vanity and nothing else. There are far better ways of spending tens of thousands of dollars, and alternative methods of boosting self-esteem.

As for the third, I can't comment, 'cos I know nothing about it. :D It's interesting, however, to read that Singapore was found in a survey to have one of the world's lowest frequencies in terms of sexual intercourse ( the other two belonging to Sweden and Malaysia ). The highest rates exist in Eastern European countries -- which I suspect has something to do with the insanely cold weather there. The US came in with a surprisingly low number, but what I'd like to know is, where's China, India and Africa in all this? For countries with exploding populations and STD scourges, you'd think they'd be high on the list.

Back to the ER. A friend of mine, who's also a year-mate and current fellow department MO, had the F-word hurled at him earlier this evening, from none other than an NS boy. Nasty bugger, that one. Sounded like he had some "supratentorial problems" too ( check with a doctor friend if you want to know what this means ). My poor friend is usually effectively stern with such people, but might have been caught offguard this time, because I didn't hear him scold back. If it had been me, I would've given him a piece of my mind, 'cos my hormones are making me extremely irritable these days, and I'd been more than happy to unload some of that tension if given sufficient reason. Bring it on, baby! :)

The bird flu epidemic is spreading, with authorities cautioning about a scale possibly similar to that of SARS. No fun. Okay, enough said. :(

Am tempted to check out Xiaxue's blog, after hearing about how horrible she is. Darn it, re-minisce! Why did you have to start a war and pique my interest?! :P Hmmm... I'll think about it. :)

Saturday, January 17, 2004

Whoa, re-minisce made me the subject of one of his posts! :P

"In other news, hordes of sex-crazed recalcitrant miscreants have descended upon spacefan's blog, taking her to hithero unimagined heights of ecstacy.

Okay, reality check. Actually she's just been getting a lot of hits from my site (eh? A lot of people read my site?) via the url link on the left (Disturbingly rabid Clay groupie).

After a gentle chiding (pow! biff! bang! etc) re-minisce has decided for the well being of various individuals (himself notwithstanding, kindly left standing) to state explicitly that the Clay in "Clay groupie" refers specifically to Clay Aiken, and not the common garden variety that resembles a small, unintelligent lump of putty. (Recommended read : Feet of Clay, Terry Pratchett)

So to you perverts flocking to Spacefan's site : get yer minds outta the gutter and purge from yer nasty little minds those deviant, gooey erotic images of Demi wossname and Patrick whositwhatsit, passionately (but productively) transforming a messy, shapeless lump of clay, into a messy, shapeless lump of clay.


But... he forgot to add "Aiken". Aargh! :)

Slow Saturday afternoon. Reeeeaaaaalllllllyyyyyyyyy sssssllllllooooooowwwwww. The Chinese New Year festivities must be keeping everyone away. Cool. Nothing better than sitting on your butt and reading magazines, surfing the Net, and earning money for it. :D Too bad the Shift Allowance thingy hasn't begun yet. By March, we'll be back to the crazy hell that this ER is famous for and used to. Darn.

I'm finally catching up with my pile of Time magazines. In the Jan 12 issue, there is an article titled "The Return of SARS?" ( note the question mark ), by Karl Taro Greenfield. Nothing sensational within, just straightforward reporting from a more political viewpoint, but the last paragraph had this:

( With regard to the recent case confirmed only through lab tests, and concerning a patient with no known exposure to the virus ) The pressing question is where did this infection come from?

"If this is SARS," says Huang Wenjie, director of respiratory diseases at Guangzhou General Military Hospital, "that means it is out in the community, and this may be a seasonal disease." One that, in all likelihood, won't be eradicated any time soon.

"Seasonal disease" is a very nice way of putting it. How about "sporadic, unpredictable outbreaks that have the potential to spread like wildfire and wipe out thousands of helpless human beings, with no hope of a cure"? Sorry if this sounds alarming, but it's the truth. Some already postulate that SARS can remain dormant, subsequently reactivating itself when conditions are optimal. Future cases won't be confined to laboratory staff or scientists or medical personnel -- they will very likely be people ensconced in the thick of society, coming into contact with hundreds of others on a daily basis. No-one outside of the hospital wears masks, thus the easy mode of transmission. (And by the way, all that brainwashing about covering your mouth when you cough or sneeze has gone down the drain. Just go to any public place in Singapore and you'll know exactly what I mean. ) The Chinese population is now becoming more mobile, both within and outside their country. And with the incubation period of up to 21 days, you could be sitting next to a SARS patient without even knowing he's already infectious.

Frightening? I hope so. I can understand the need to play this down, and I'm certainly not running around screaming, "We're all gonna die!", but bear in mind the danger of playing this down too much, and letting complacency take root and fester into outright arrogance. One of my registrars did right when she stopped me during a resuscitation, telling me to wear the space suit prior to intubating the guy. I found myself saying, "But he has no risk factors for SARS." Her answer was simple: "Better to be safe than sorry. Just put it on."

Wise words to remember. Stay alert, people. The battle is far from over.

Before I go, here's something to alleviate whatever gloom I may have caused. :)

The Happy P**** Song

[ obviously, the composer hasn't heard of PARAPHIMOSIS -- go check your medical dictionary ]

Friday, January 16, 2004

Taken from the December 29 2003 issue of Time magazine. Now this is the type of writing I'm talking about! [ Note: some of the events mentioned are a little erroneous, but I just want to illustrate the author's skill, not so much his knowledge of LOTR. ]

Review of The Return of the King, by Richard Corliss

Well, it's back. The film event of the millennium -- three superb films recreating JRR Tolkien's epic series of novels -- reaches its climax with The Lord of the Rings: The Return of the King. For the thrd year in a row, Jackson gives us a robust cinematic retelling of the war of Middle-earth, as the hobbit Frodo ( Elijah Wood ) and his fellowship of humans, elves, dwarfs and the wizard Gandalf ( Ian McKellen ) surge into battle against the dark power of Mordor's Lord Sauron.

The king in the story is the hunky human warrior Aragorn ( Viggo Mortensen ). But Jackson is the true lord of these Rings. The New Zealand auteur spent seven years on the trilogy, collaborating on the scripts with Fran Walsh and Philippa Boyens. He chose and directed this perfect cast, orchestrated the smashing visual effects -- Tolkien's bestiary on the march in fantastical realms. In Return, the giant trolls, four-tusked elephants and flying screeching serpents of Mordor will amaze adults and may startle small children. The spider monster Shelob, creeping up on Frodo and mummifying him in a silken straightjacket, offers a delicious horror-movie frisson.

Viewers don't play this movie like a video game. They are seduced to live inside it. In one brilliant visualization, the hobbit Pippin ( Billy Boyd ) manages to light a bonfire at the top of Gondor to alert his distant comrades to a military victory. On a far hill, a second fire is lit, its flame echoed on farther mountaintops, on and on into the dawn. At last, it's wartime.

The Ring films, like Master and Commander, celebrate old-fashioned martial virtues: honour, duty, comradeship, sacrifice -- soldiering on, under an immense, sapping burden. Though the trilogy percolates with bracing adventure, it is a testament to the long slog of any war. Pain streaks the faces of the film's stalwart warriors. They know the enormity of their foe and know that the child hobbit who bears the Ring is far from them -- surely in peril, perhaps lost forever. At one point Aragorn asks Gandalf, "What does your heart tell you?" and in a little movie epiphany, the wizard's face briefly warms, brightens, and he says, "That Frodo is alive."

The boldly choreographed battles are really a diversion from the story's great drama: three little people -- Frodo, his companion Sam ( Sean Astin ) and the ex-hobbit Gollum ( Andy Serkis and a lot of CGH geniuses ) on their way to Mount Doom with a mission to destroy the Ring. Cringing and crafty, Gollum is the rebellious servant, subverting Sam's selfless impulses, trying to twist allegiance of the pallid, ailing Frodo away from his friend. ( So poignant are Gollum's turbid emotions, and so persuasively is this computer critter integrated with the live performers, that he deserves a special acting Oscar for Best... Thing. ) The devotion of Sam is inspiring. His plea to Frodo -- "Don't go where I can't follow!" -- makes him the film's real hero.

At 3 hr. 20 min., The Return of the King occasionally slows to a trot. There's a long middle passage where half a dozen characters in turn muse and fret at length. After the climax there's a plethora of meetings and farewells, most of them extended versions of the goodbyes in The Wizard of Oz. But Jackson is entitled. He surely felt that he and his companions of the Ring had waged their own hard, heroic battle and that sentimental adieus were earned.

The are, too. The second half of the film elevates all the story elements to Beethovenian crescendo. Here is an epic with literature's depth and opera's splendour -- and one that could be achieved only in movies. What could be more terrific?

This: in some theatres, the Ring trilogy will be shown back to back to back. What a 9-hr. 17-min. trip -- three huge installments, one supreme enthrallment. Ecstasy trumps exhaustion in the reliving of a great human quest, a cinematic triumph.
Good Friday afternoon. A check with my blog's site meter generated a hit number of more than 100 yesterday -- what gives? :) This makes me either (1) pretty happy, 'cos it means more interest in my inane ramblings, or on the flipside (2) really worried, 'cos for all I know, someone's written strange or bad things about me, and people are dropping by for the wrong reasons. These 2 scenarios hold true for the link "re-minisce" put on his blog. It's made quite a few readers click on it to come here, but yikes, he listed me as "a disturbingly rabid Clay groupie"! HEY!!! :P

Nah, I don't really mind. But I'd respectfully request that he put the word "Aiken" behind "Clay", so people will at least know who this Clay fellow is.

Re-minisce, whom I know personally ( though not literally "in person" ), is currently doing an ER rotation in the UK, a terrific writer, and appears to have his own groupies too. :D Here's the link for those of you who are interested:

Re-minisce's Blog

Point of interest here. Have been seeing quite a lot of a certain Dr. Sanjay Gupta in magazines lately -- he's a Time medical correspondent and was listed among the top 25 sexiest guys for People mag in December 2003 -- so I thought I'd put up this link for you to take a look. There's actually a "Gupta Girls" website somewhere ( I saw it but will save him the embarrassment of circulating the link, should he somehow find my blog, haha! ), so this one's the more "formal and legit" webpage. He also hosts a medical segment on CNN, and has been to Iraq, where he huddled together with US troops in the thick of Gulf War II. He's 35, a neurosurgeon by training, and has said that he enjoys talking with patients, unlike most doctors, who, in a survey done, "interrupt you within the first 11 seconds".

Dr. Sanjay Gupta

Or how about this one:

Dr. Sanjay Gupta's Portfolio on CNN

[ Yes, it's a quiet shift! :D ]

There's yet another reality programme on cable, airing every Thursday night on Starworld Channel 18. Called "For Love Or Money", it has 1 bachelor picking a lady from among 15 hopefuls, but with a catch -- the women are informed that the "winner" will receive a US $1 million cheque, but the guy has no clue of this arrangement. So you have 2 camps: those who claim they don't care about the money, and just want "true love", and those who want the dough and could care less about the man's feelings.
It's an interesting concept, but totally ruined by the very very dull bachelor, a guy named Rob who, granted, is tall and striking in looks, not to mention a defense criminal lawyer, BUT comes with a dopey persona and says some really stupid things. You'll get the full dose of the bad stuff during the elimination round, as he speaks to each lady in turn. He complimented one on her red dress, but added that it matches the rug they were standing on!? And he's one for fetishes too: women who wear bondage-type gear like leather strappy shoes or metallic breast-boosters routinely get the "Pretty exciting!" thumbs-up from him. Puh-lease...

One episode is more than I can take, so I won't be tuning in anymore after the excruciating pilot. At least "Joe Millionaire" was palatable, partly because I actually liked Evan Marriott. He may not be highly educated, but at least he was sincere. This Rob guy just looks as if his wet dream has come true, and he can't wait to get started. Ugh.

Anyway, who needs "For Love Or Money" when the 3rd season of "American Idol" debuts next Thursday on Channel 5? I can hardly wait, 'cos the first episode always focuses on the ones who didn't make the cut -- often painfully tone-deaf people with denial issues. Last year, we had Edgar Nova, an Enrique Iglesias lookalike who, sadly, sounded like a dog that had just been hit by a car. I, on the other hand, will be watching for anyone who might be the next Idol. I admit Clay didn't catch my eye when he first appeared during the auditions and "heats", but once he belted out "Open Arms" during the semi-finals, that was it! It's anyone's guess who this year's winner will be, but I strongly doubt he/she can surpass the Clay Aiken. :)

Have been catching up with my backdated issues of Time magazine lately. The December 15 issue had a poignant story about China's struggle with the AIDS epidemic, and I was very surprised to learn that Dr. David Ho, that very famous American-Chinese who pioneered the triple cocktail regimen back in the mid-1990s, is heading this ambitious effort. The journalist, who also travelled to the affected areas with Dr. Ho's team, penned an extremely poignant and heart-breaking article. I've been a loyal subscriber of Time magazine for the past 10 years, and the standard of writing never fails to impress. Its team of reporters can make even the most technical or political topics exciting, through the sheer power of well-chosen words and beautiful prose. Compare and contrast this to some Straits Times journalists, e.g. whoever it was that wrote the article on the Toa Payoh Industrial Park fire recently, and you'll see the stark difference. People died! It was a high-stress situation! Your writing made it sound like a slumber party! ( Oh wait, slumber parties are more interesting. )

Can't think of anything more to add right now. Gonna grab dinner, then might post more if I have something. If not, have a good evening. :)

Thursday, January 15, 2004

Darn, now I'm confused.

Should women stay single?

Thanks to Dave Barry, or should I say, "judi". Yay, Dave's blog is up and running again!

Dave Barry's Blog

So was it a good call? I'd say yes. It's 7am, and I've seen less than 20 patients! Somebody pinch me! :D

And looky here: humour on a local news site!

ChannelNewsAsia Cable Car Story

I emailed the link to Dave Barry, so don't be surprised if it shows up in one of his later entries. He gets thousands of hits a day. Wouldn't this be a nice way to introduce his readers to Singapore -- the land of crazies who can't wait to dehydrate in a flimsy metal box hanging from an even flimsier wire. :P

Now hoping the morning shift people won't be late.

Wednesday, January 14, 2004

Looks like the recent identification of a handful of SARS cases in China has resulted in a surge of interest in the disease. Quite a few visitors have dropped by via links to other SARS-related websites, so once again, if you're looking for entries pertaining to SARS on this blog, please click on the archives to the right of the screen, under the months of March, April and May 2003. Thanks for reading. :)

Night shift on a Wednesday. Crossing my fingers it'll be a quiet one. Our head of department is on with us -- he always helps see patients whether we're swamped or not -- so we have backup! :D

So I got an interesting email today. Seems the eastern cluster will be allocating night duty allowances to ER doctors ( MOs included, yes! ) for shifts done on weekends and public holidays. Called a Shift Duty Allowance, it will be $150 for MOs and $155 for registrars. The $5 difference is across the board, ie. it happens in all other medical and surgical departments, but this makes a huge difference to those of us suffering manpower shortage and burnt weekends right now ( e.g. myself! ). The scheme starts in March, and will result in a significant pay rise, which definitely eases some of the pain. :P Hey, I currently have no off or standby days on weekends and public holidays, which is awful, so being "reimbursed" in any way is an improvement.

It's official: I'm gonna join the focus group for a discussion with Singhealth administrators at a later date. Where're your emails?!? Send them to me quick! You want to be heard, don't you? ;)

Saw something really exciting in the papers today -- the next Survivor season will feature players from the previous series, starting from the original on Pulau Tiga, to the latest on Pearl Islands. Winners like Richard Hatch and Tina Wesson will make a comeback, together with memorable participants such as Jerri Mahey ( aka "the bitchy one" ), Rupert ( aka Peter Jackson's twin, haha! ), and Rob Cesternino ( my all-time fav Survivor ). No prizes for guessing who I'm rooting for. But this season will no doubt be the toughest by far, 'cos everyone knows everyone else's tricks, and they're all veterans. Is the trophy still going to be a measly $1 million? I think they should at least double it! In any case, this is one season I am NOT going to miss no matter what!

Just saw a really creepy patient. Well, actually, the patient's relative was creepy. He kept insisting on an X-ray for, get this, an ear infection. I told him multiple times that an X-ray isn't going to make any difference, 'cos (1) it can't show ear anatomy, and (2) it won't change management. No, no, he went, we WANT the X-ray even if it isn't useful. What for? I asked him. We just want it done, he replied. I just told him I wasn't going to do it, typed up the prescription and referral letter, and asked them to go to the counter to get the appointment and medication. The guy -- who looks stoned, by the way -- then refused to leave. ( His "relative" was perfectly okay, and went off to the counter as instructed, but this guy JUST STOOD THERE REPEATING "WE WANT AN XRAY" OVER AND OVER AND OVER AGAIN. ) I started to feel a bit threatened, so I promptly got up and walked out ( well, I had to visit the restroom anyway :P ). He later made some noise about it, and I can hear my department chief talking to him right now. At least he isn't screaming obscenities, like some people I've met in the past.

[ Going into resus now. Will post again soon. ]

I'm back. Haha, just spoke to my chief. He said the same thing about not having to do an X-ray. Said the guy hounding him was a little strange too. Seems he preferred my chief's explanation, despite it being IDENTICAL TO MINE. Some people say I look like a college student. Think that had anything to do with this? It doesn't pay to look young. :P

The news has been reporting about the Vietnam bird flu situation. I heard something on the BBC about the Hong Kong bird flu actually. Anyhow, cases in Singapore, should they arise *touch wood*, are to be sent to TTSH as per SARS protocol. Let's pray we stay out of this epidemic, or my parents will get insomnia again.

So did you watch "Monk" last night? It was absolutely hilarious, as usual. :D Following that was "Se7en", which reminded me what a genius Andrew Kevin Walker is ( he's the guy who penned the script ). Then there was Kevin Spacey, who gave a chilling performance as the killer. I'd forgotten what an excellent film this is, till I watched it again yesterday. Fantastic. :)

There're trailers on Channel 5 these days, advertising the screening of "A Perfect Murder" this Sunday at 10pm. Besides having Oscar winners Michael Douglas and Gwyneth Paltrow, it also features Viggo Mortensen as the con-man having an affair with Gwyneth's character. If you're a Viggo fan, make sure you tune in. He's gorgeous in this movie. :D

All's quiet in the resus area. Looks like I've got free time on my hands, although one of the other MOs on call told me he has "very bad luck" during night shifts. Hopefully, that won't be the case today.

Tuesday, January 13, 2004

Day off! Just finished mopping the whole house, feeling tired...

But I'll perk up later when "Monk" comes on -- 9pm Channel 18 ( Starworld ). If you've been sitting on your butt instead of tuning in, then for goodness' sake, switch it on! I promise you won't regret it. :)

Helping to spread the word: Changi General Hospital's A&E Department is having an open-house this Saturday from 2 - 3:30 pm, and on Sunday from 4:15 - 5:45pm. All doctors are welcome. If you want to meet me, I'll be on afternoon shift on Saturday ( 4 -12 ). Won't be around for the Sunday session 'cos I start at 9pm. Be sure to bring a gift. ( Just kidding :P )

Also, I hear Singhealth is meeting up with junior doctors soon to form a "focus group" addressing important issues, i.e. finding ways to stop the exodus of MOs to the western cluster. I actually volunteered to be a part of this group, but I'm not the pushy sort. Just want to sit in and listen a bit, offer some views, and pass on messages from fellow MOs. So if you've got a point to raise, email me at

So the next MOPEX exercise is already beginning. I'm gonna ask for KKH A&E next. I'm really out of touch with babies and little kids, and REFUSE to do another ward posting, with all the ward rounds, endless clinics and night calls. I'm happy in the ER, so I'd just like to stay there for the rest of my life, if that's ok. :)

We've got medical students with us again. Don't see that much enthusiasm in their eyes -- unlike my own when I did a rotation in NUH's ER way back in 4th year. Maybe it's because they join us in their 3rd year nowadays, and don't have sufficient background in things like orthopaedics and anaesthesia / intubation. I'm trying to whet their appetites by making everything sound super-fascinating: "Look! A Colles' fracture! ( flip open my Apley ortho handbook with all the cool pictures ) See? The criteria include blah blah blah. ( point them out on the X-ray ) Then you reduce it like this, etc." OR "Check out this ECG! ( proceed to give short tutorial on ECG reading techniques )" OR "Do you know how to differentiate between fresh and stale melaena?" ( hey, I only found out about this crucial detail when I became an MO, mind you! ).

Right now, we're letting them learn how to set plugs, insert urinary catheters, assist in resuscitations and practise suturing. All vital tasks that will prepare them for housemanship. Speaking from personal experience, I learnt all these procedures during the ER rotation, and would definitely have suffered terribly as a house officer if I hadn't already done them before as a med student. I don't think any other posting allows you to be so hands-on, so make good use of it!
And if I somehow manage to persuade one of them to consider specializing in emergency medicine down the road, I'd be really pleased. :)

SGH Gastroenterology has a new head of department. Prof. Ng Han Seong has become Chairman of Medicine, and succeeding him is none other than the sole female of the group, Prof. Chow Wan Cheng. I worked in gastro for 6 months in 2000 during my first-ever MO rotation, and despite all the warnings from other colleagues, telling me it's really tough and stressful, I thoroughly enjoyed my time there. I learnt so much from my seniors, from proper management of patients to cultivating of good work habits. I would entrust them with the lives of my closest relatives and friends, and have no qualms about consulting them myself if the need ever arose. Prof. Chow is among the best physicians I know, but also leads a very rich life outside medicine! Never one to take shortcuts, I still remember a 6-hour ward round we once did on a particularly busy morning, stopping for 5 minutes in the middle of it all while I did the fastest abdominal tap in my career so far! My warmest congratulations on her recent promotion!

Last but not least, Clay Aiken's new release, The Way, has blasted up the charts on Singapore radio, woohoo! It debuted at #1 on Power 98's Top 10 countdown last night, shocking everyone but also sending us into the stratosphere. :D :D :D The Way is one of my favs on Clay's album, and will be released with Solitaire as a separate CD single very soon. Solitaire! The Neil Sedaka classic that Clay sang on American Idol but which was excluded from the Measure of a Man record will now be heard in its full glory very soon!

Time for dinner. "Se7en" is on Channel 5 tonight. Think I'll catch it again, for Kevin Spacey. ( Brad Pitt? He can't even compare! :) )