This post addresses one particular issue which may not interest anyone very much, so please feel free to skip ahead. My main reason for writing these next few paragraphs stems from a recent ( ?vicious ?malicious ?vengeful ) attack on an entry I made, dated Jan 30, about my poor cousin, as well as my character. The author only signs off as "Urgh", and since a request by myself for him/her to email me with his/her identity, for the purpose of further mutual clarification of details pertaining to this incident, went unanswered, I'd like to now bring this out into the open.

Here're Urgh's comments. [ You can view them directly at the end of the Jan 30 post. ]

"As you said,you didn't see your cousin until after his operation, having not read his case notes,all the pre-op symptoms you described-"sunken eyes" and looking "like a skeleton" were probably told to you by your non-medical relatives.Why are you so hasty to criticise what the medics did (or didn't do, as you asserted), and isn't it so lavishly proud of you to say,"?f I'd seen him, the first thing I would do is..."? Ah, the luxury of retrospection! Did he complain of abdominal pain? What in your mind would be the most likely cause of a 15-year-old with vomiting? Obviously even his parents didn't suspect it was so severe initially since they brought him to KL for a holiday..

How did you know he was "this close to a perforation" without talking to the surgeon, reading the case notes or being in OT yourself? E-laparotomies are done all the time, sometimes due to a lack of response with conservative management, not necessarily because of impending perforation.
You have clearly expressed expansive repugnance to journalists, but perhaps you should exercise more objectivity in your own reporting, as there are obvious repercussions. Will your readers go, oh no, avoid NUH? Quick find out who's the surgeon? Why don't you try a little more fact-finding before you lash out? I gather from your blog that you must be the quintessential good doctor.."


And here's my reply:

With regard to my cousin's illness:

He started vomiting on Jan 21, and was seen at the NUH A&E, where he was diagnosed with food poisoning -- something I do not find fault with. Discharged with the necessary medications, he went to KL with his parents and siblings the next day. He was still vomiting, but as mentioned earlier, had been seen the day before and was already on treatment. He remained in KL for another 2 days, before the trip was cut short due to his protracted illness. Upon their return to Singapore, my aunt and uncle took him straight back to the NUH A&E on Jan 24, where the paediatrician-on-call told them my cousin was "severely dehydrated", and required admission for intravenous fluids. In the ward, he continued vomiting bilious contents for another 24 hours, with no X-rays done, but a trial of feeds was instituted. My aunt and uncle then requested that an X-ray be ordered, but was told by ??the medical officer that it wasn't needed. After repeated requests, the investigation was eventually done, and a mere hour later, the surgical team arrived, and an immediate decision for an emergency laparotomy was made. The operation was carried out on Jan 25. The doctor who initially refused to order the X-ray, for your information, later expressed some degree of contrition to my uncle.

Urgh was extremely upset by my blog entry, as you can see from his/her reply. My initial post didn't include that many details, but since Urgh has made some incorrect assumptions regarding my opinions, I hope the above description gives him/her a clearer perspective.

Can I just ask those of you with medical backgrounds one question?
If you saw a 15-year-old boy with abdominal pain and recurrent bilious vomiting for 4 days, would you

(1) do an abdominal X-ray stat,
(2) keep him nil by mouth, or
(3) feed him?

And for the record, I trust my uncle's account of events completely. Unlike some patients / their relatives, he is far from suspicious or demanding, and only makes special requests if he feels strongly about them. He doesn't fabricate stories to make himself look good, or to make others look bad. He is also well-educated, and makes it a point to remember information correctly.

Anyway, so much for those aspects. Now I'd like to ask Urgh what precipitated this onslaught of insult-hurling. "Lavishly proud"? "Lash out"? "The quintessential good doctor" - a remark that is dripping with contempt? Have I ever come across as being so full of myself I think I'm God's gift to the medical profession? I suppose all my accounts of being verbally abused and second-guessed by patients, my frequent complaints about work, or my constant expressions of fear while being at the frontlines during the SARS and bird flu epidemics, have only enhanced this image of arrogance, eh?

In my reply in the "comments" box, I said that I had 3 theories regarding Urgh's identity: an NUH doctor ( perhaps with a friend / relative who's a reporter ), someone I'm acquainted with ( who obviously greatly dislikes me ), or a reporter ( who may or may not have a friend / relative who's a doctor in NUH ). I tend to favour the last possibility, as I can't think of any medical professional who would be this nasty to his/her own colleagues, even if a difference in opinions exists. As for the second option, only one person comes to mind, and only because he also favours multisyllabic words, flowery adjectives, and NUH. But then, I believe his sense of overwhelming guilt prevents him from hurting me further, so that goes out the window too. :)

The reason I think Urgh is a reporter is because of his/her telling comment about my "expansive repugnance" of the press. Okay, I admit I am responsible for giving the wrong impression here. My feelings are actually directed at certain reporters, rather than the general journalistic population. However, my opinions are also shared by many in the medical profession. One senior professor even voiced them out loud to me once, after a scathing article in the newspaper criticized a certain hospital's handling of SARS cases, plus a few other boo-boos ( remember Ms. Mok? ). This is further compounded by the newspaper's propensity for putting doctors in a bad light, either in the form of a column by a reporter stricken by breast cancer, or multiple complaint letters published in the Forum Page. Is my distaste directed against everyone at The Straits Times? Of course not. I can name 3 journalists who have my deepest respect -- Sumiko Tan, Helmi Yusof ( he might be on hiatus right now ), and Tan Shzr Ee ( my classmate from RGS ). The first two have emailed me before, even after some sarcastic feedback I gave, to share their own views and thank me for reading their articles. Imagine that! Such graciousness and maturity earned my admiration instantly, as opposed to, for example, Tommy Wee's nasty reply when I pointed out his obsession with leggy blondes ( am I wrong? ). Shzr Ee, on the other hand, has always been an extremely nice person, and an exceptional writer. I have high hopes for her as a future Chief Editor. :D

Last but not least, I hope Urgh doesn't think I'm sabotaging NUH. I am only relating my cousin's case, nothing more. I never extrapolated that NUH is crawling with incompetent doctors, nor did I ever tell people to avoid going there at all costs. I worked in NUH Cardiology in 2002, and greatly enjoyed my time there. I also got to meet and work with a number of excellent colleagues from the various medical and surgical departments. But I still feel that a simple X-ray would've helped my cousin, and if anyone violently objects to this remark, feel free to explain why so we can discuss. If I wanted to have a monologue that's immune to any form of criticism, I wouldn't have installed a comments box now, would I?

Before I end, I'd like Urgh to try asking anyone who's worked with me before about my skills as a doctor. This isn't a challenge, by the way. I just think Urgh would benefit from some objectivity with regards to his/her opinion that I'm not good at my job. I take what I do very seriously, and having someone question my ability ( someone who conveniently hides beneath the cloak of anonymity ) sickens me.


Okay, now on to something a little less annoying. :)

I take my hat off to Simon Cowell, Paula Abdul and Randy Jackson, for kicking Michael "Unchained Melody" Keown out of the competition in the latest episode of "American Idol". I can only describe this guy as being profoundly "full of it", which is a great pity, 'cos he has a good voice, and would've gone far with his talent and looks, IF ONLY he hadn't come across as cocky and complacent. Eat your words, Mikey! The hunky beefcakey blonde (I can't be bothered to remember his name ) also didn't make it, har har. :D

Spotted many of my favs among the final 32 -- Matt "Rose Bowl footballer" Rogers, Jon "pen salesman" Peter, John "Dean Martin" the redhead, and Fantasia "Macy Gray's little sister". Can't wait for next week!

Second, I'd like to recommend "High Crimes", starring Ashley Judd, Morgan Freeman and Jim Caviezel. Based on a novel, it may seem dry and boring based on content alone ( wife defends husband accused of a military crime he claims he didn't commit ), but I found it to be a terrific film, almost on par with "A Few Good Men". Caviezel outshines his two bigger co-stars easily, but I can't describe it for you for fear of giving the whole plot away. It screens on cable TV, so go check the catalogue.

"Survivor: All Stars" airs again tonight. Wonder who's going next?

Anyway, I just realized that readers' comments on my blog up till Jan 22 have all disappeared after my recent "renovation" of the website, something I didn't expect, but which I obviously can't rectify. My sincerest apologies to everyone affected, especially those who posted about the SARS entries.