Tuesday, April 27, 2004

*looks around furtively*

[ hushed tone ]
8-4 today. Yesterday was a SCORCHER, and I'm not talking about the weather. Saw 42 cases, with only 30 minutes of free time -- ie. my lunch break! Typical Monday morning, I suppose ( I was 9-5, while my 8-4 friend saw almost 50 patients ), but this is getting a bit ridiculous. Honestly. What ER has a total of 400 - 500 patients per day? And a "community hospital" by definition some more? Most tertiary institutions usually hit about 300 or so. People in the East are either abusing the system, or they're all really unhealthy, or just plain hypersensitive about even the most minor of illnesses. But then we also get patients who live in Hougang and Jurong. Prudent to have a common queue perhaps. You know, to lengthen the waiting time and discourage frivolous attendances?

A few MOs and I have discussed the individual queue system on many occasions. Obviously, it has its pros and cons.

Plusses: Prompts speed and ( hopefully ) efficiency, discourages skiving ( e.g. choosing to see easy cases, seeing slowly so others have to work harder), definitely shortens waiting times.
Minuses: Many many! Increased stress ( try having 8 people waiting on your queue with no letup in the constant flow, or a whole string of complicated cases, with each taking twice the usual amount of time to clear ), little leeway for even a simple doctor-patient conversation, exhaustion, flaring tempers, complaint letters...

I've always supported the common queue system, and the last year has only served to reinforce this opinion. I was never this fed up at SGH, and can totally understand patients' frustration when I talk really fast and shoo them out in an effort ( unknown to them, of course ) to get to my other 8 patients waiting outside ( Easterners also like to make a hell of a lot of noise once they hit the 30-minute mark, then the nurse comes in to tell you exactly that, which is an indirect manner of saying, "Hurry up!" -- super-irritating, I tell you ).

When I was at SGH, the common queue afforded us the luxury of giving the appropriate care to the right people. URTI -- 3 minutes tops. Minor injuries -- 5 minutes, then refer as necessary. Not so straightforward ones -- 10 minutes, maybe more, depending on what needs to be done. We could answer queries without watching the computer or the clock, we felt no need to rush through our reviews of test results or observation cases, and interestingly, patients there rarely kicked up a fuss about the waiting periods, even when they hit 3-4 hours during the worst peaks. ( I also noticed people there are a lot nicer to doctors, which I can't explain. But a lot of them are in the geriatric age group, so maybe that's one reason. )

Speaking from the viewpoint of a junior doc, I can tell you that allocation of cases is hazardous, not just to the patients, but to the MOs as well. If we have sufficient manpower, it doesn't pose any major problems, but if we're short-staffed ( which is what happened to my current batch ), seeing 40 - 50 cases per shift takes a heavy toll, and both sides end up really unhappy.

The awful truth, however, is that waiting times are sacred. At least to the people upstairs ( and I don't mean the ward teams ). Financing, manpower allocation, performance appraisals, etc. Waiting times probably form a large part of an ER's overall assessment, and my personal feeling is that this approach is fraught with ( dangerous ) errors. Does anyone even bother to look at the bigger picture anymore? Do they ask why? Do they take other factors into consideration -- e.g. the number of complaints, the number of cross-department referrals / admissions, the number of non-emergencies which clog up the line but contribute significantly to the statistics? Does anybody give a damn about good patient care and communication?!

[ okay, venting completed :) ]

Almost 4 hours in. Tally so far: 30. %^$&%$#*%%! 3rd May can't get here quickly enough...

Eye For A Guy Episode #4

Hah! Another side-splitting episode, this time with resident clown Eugene as the star. After a group dinner at Rachel's apartment, the guys are grilled by 3 of her good friends ( who pop by very unexpectedly ), with hilarious consequences.
"Have you ever checked out Rachel's boobs?" one asks.
"Err, yeah, I admit that I have." Gotta admire Sivert's candour. And he said it in a very nice way too. :P
"If I gave you a thousand dollars right now to bow out of the the competition, would you do it?" asks another.
Mark: "NO WAY. I wouldn't leave even if you gave me FIFTY thousand dollars. It's all about Rachel, not about the competition at all."
Eye-rolling from Rachel's pals.

Eugene goes last. Having had more than a few drinks earlier, he's completely plastered by the time it's his turn in the hot seat. Slurred speech, boisterousness, maybe even some conjunctival injection ( I was staring quite hard :)). Bet his alcohol breath was obvious too.
"I'm a lot more honest when I'm drunk," he announced. Rachel's friends were evidently tickled.
"Okay, so what flaws does Rachel have?"
"She isn't the most intelligent person I know." Wow, he wasn't kidding when he said he's truthful! And brutally so too! :D

Rod Monteiro, who was in the 3-friend interview panel, and hosts the morning show on Class 95 with Glenn Ong and the Flying Dutchman, took a shine to Eugene instantly. "I like him, man. He's a straight guy."
Sivert also got good reviews, but Wai Chung was labelled as "boring", and "not Rachel's type".
Mark, whom I read somewhere was named Cleo magazine's Bachelor of the Year 2003, wasn't popular. "I just didn't get a good vibe, man," Rod kept repeating. I couldn't agree more. :)

In the end, poor Eugene got eliminated. I get the impression this is more about looks than anything else. All the ugly ones got kicked out really quickly, now leaving the more presentable ones in the last leg. My favourite? Definitely Sivert. How come he doesn't have a girlfriend though? Hmmm...

Next week: individual dates. At last! And it appears Wai Chung brought Rachel back to meet his mother. Cue theme from "Psycho". :P

In other news, I've got my eye on 3 upcoming films. I've only seen 2 movies in the cinema these past 4 months -- LOTR: ROTK in December, then The Passion of the Christ 2 weeks ago. In May, we've got Shrek 2, Van Helsing, and Troy ( the one with Brad Pitt and Orlando Bloom, yowzah! ). Redeeming my UOB Credit points like crazy, heh heh. Free movie tickets, can't beat that. :)

Mustn't forget...
My thanks to Mark Richmond from Class 95!

I sms-ed the station almost a month ago to tell him about Peter Cincotti, and he actually ordered the guy's CD all the way from the UK ( it was sold out locally ), and devoted the whole of last week to playing tracks from the album, even with a nice biography segment thrown in. ( I was working nights a lot at the time, and missed it, aaargh! )
Anyhow, I finally heard Cincotti's lovely cover of "Rainbow Connection" ( aka the Kermit D. Frog anthem ) during the dinner jazz programme yesterday, en route to the new place to unpack some more stuff. Mark tells me it's a big favourite with listeners, but Michael Buble's Sway is still more popular than Cincotti's version. Awww... Never mind, I will keep requesting Sway and drum it into everyone's head. :)

Mark prefers "Ain't Misbehavin'", which I agree is one of the best songs on the CD. But they're all terrific, actually. Go to the website I highlighted to learn more about this great talent, if you haven't already read my previous review ( have to go hunt for the exact date I posted that ). He's going to play Carnegie Hall, and is booked solid till 2005. Talk about rising stars!

Hopefully, with added attention from Singaporean fans, he'll drop by someday soon for a concert. Getting my money ready... :D

Movie quote:

I'm just going to plough through as many Kevin Spacey films as possible for now. He's got some of the best lines ever. From "American Beauty":

[at the dinner table]

Carolyn Burnham ( Lester's overbearing, frustrated wife, played by Annette Bening ): Your father and I were just discussing his day at work. Why don't you tell our daughter about it, honey?

Lester Burnham ( Spacey ): Janie, today I quit my job. And then I told my boss to go f*** himself, and then I blackmailed him for almost sixty thousand dollars. Pass the asparagus.

Carolyn Burnham: Your father seems to think this type of behavior is something to be proud of.

Lester Burnham: And your mother seems to prefer I go through life like a f****** prisoner while she keeps my dick in a mason jar under the sink.

Carolyn Burnham ( outraged ): How dare you speak to me that way in front of her. And I marvel that you can be so contemptuous of me, on the same day that you LOSE your job.

Lester Burnham: Lose it? I didn't lose it. It's not like, "Whoops! Where'd my job go?" I QUIT . Someone pass me the asparagus.

*laughing -- boy, I'd forgotten how great this movie is!*

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