Tuesday, January 31, 2006

Happy Lunar New Year!

Hope you had a great weekend. Mine was immensely enjoyable. :)


1. My back hurts. All that spring cleaning, swimming, playing with friends' and relatives' kids, and aging ( haha ).

2. Based on what I saw during my shift on CNY Day 1, I have a theory that all those calorie-loaded reunion dinners have a direct causal effect on coronary arterial plaques. Meaning: tuan2 yuan2 fan4 => AMI.

Although someone disagrees. :)

One guy with an evolving anterior STEMI decided to AOR discharge.
"Uncle, you MUST understand that you've had a heart attack, need urgent angioplasty, and may DIE if you discharge yourself against medical advice!"
"Yes, doc! I understand! Never mind lah!"


3. Almost got run off the road by this sociopath driving an SUV. CNY Eve, he swerves into my lane and I horn at him. He rolls down his window, screams at me for being "noisy", then when I remind him that it's my right of way, he shouts, "Right of way, right of way LAH! So WHAT?! Don't want to let me in, we BANG LAH!!!" before proceeding to ignore me. We're at a red light, and when it turns green, he jerks forward - attempting to scare me, no doubt. But he's got my hackles raised, and I don't take the bait. So I zoom past him, which drives him off the deep end. He races past me on the left, cuts into my lane, missing me by a mere couple of inches, then brakes so hard I almost got a heart attack. He speeds up again, but when I accelerate so as not to block traffic behind me, he jams on the brakes again. I get fed up, switch to the left lane, then he slows down and swerves towards me AGAIN! At this point, I've practically given up playing psycho games with him, so I stay behind at a safe distance and later filter off at a slip road while he glares daggers at my rear bumper.

And get this, there was a little boy in the back seat of that SUV.
Fact one: Road rage isn't quite so bad if it's just adults involved. But when a child's in the vehicle, well that's just plain irresponsible and reprehensible.
Fact two: the kid's most likely going to grow up to be another sociopath like his good ol' dad.

Is this incident reportable? Please advise.

In Hibernation

The day has come, but it couldn't be helped -- we're all just too busy.

However, further plans may materialize, so stay tuned.

American Idol 5 - Week 2

Spotted a few other stars-in-the-making.

Baldie #1: The cop who sang Marvin Gaye's Let's Get It On, then did a slow dance with Paula Abdul, before revealing that he's in fact MARRIED, which really pissed Paula off. But you gotta admit -- the fellow's got a fantastic set of pipes. Those high notes were pure gold!

Baldie #2: Hispanic dude whose name escapes me ( as does the title of the song he did ), but he's reaaaally good.

Blondie #1: Hunky chunk of beefcake called Jeffrey something-or-other. Voice is so-so. Obvious that he got through only because of his bod. Sad.

Blondie #2: Beautiful young lady named Kelly Pickler, who hails from a small town, was abandoned by her mother, has a dad in prison, stays with her grand-pappy, and hit a Kelly Clarkson number right out of the ballpark.

Paris Bennett: So far the BEST I've seen EVER. 16-year-old with vocals to die for ( did you hear her cover of that Billie Holiday song? ). Endearingly humble despite her relation to quite a few musical celebrities. Lovely girl.

Weekend Fix

Jay Leno's Tonight Show airs on local cable's CNBC Channel 15 every Saturday and Sunday at 10pm, and I've been having a ball watching all the fun. Recent guests include Jake Gyllenhaal and Heath Ledger from "Brokeback Mountain", Colin Firth ( "Bridget Jones' Diary" ), ex-supermodel Heidi Klum ( "Project Runway" ) and ice-skating Olympic gold medalist Sasha Cohen. Klum, in particular, was an absolute delight. She demonstrated quick wit, loads of bubbly personality, and had everyone in stitches when she repeatedly shot stern questions at fellow guest Ledger ( who played along by looking befuddled and terrified, heh ) and did a hilarious impression of her snowboarding instructor's surfer-dude slang.

A great way to spend one's weekend nights. There's also Jon Stewart's show on CNN Channel 14 at 11:30pm. Political satire with lots of Bush-bashing. I love it. :)

Feast Your Eyes

I don't really want to see movies in cinemas anymore ( high cost and microbiological loads ), but I'll make the exception for "Brokeback Mountain" and "Zoolander". If I find the time, that is. And the energy.

The latter's definitely worth catching. Don't recall much from the time I first saw it in the Fox Glacier region in New Zealand back in 2003, but I do remember laughing my socks off while my parents snored in the next bed ( we'd just completed a full day of major hiking ).

ER Discussion Part 2

In reply to milo's comments about the merits of direct admissions vs A&E referrals: since I've worked in different departments and experienced both systems, I think admitting rights should be allowed for the following:

- all medical disciplines
- most surgical specialties ( GS, ortho, neurosurg, uro )

Screening in the ER before admission is warranted for:

- cardiology ( don't play-play with chest pains, ok )
- eye
- O&G ( all those PV bleeds can be tremendously scary )

In addition, ENT and eye cases should preferably be reviewed by those on-call ( e.g. FBs, traumas, other complicated conditions ), rather than deferred to the A&E doc ( junior OR senior ) to handle. I once worked at an ER where the ENT MO refused to come down unless we'd CONFIRMED an FB ( either through x-rays or direct visualization ) and/or at least attempted to remove the darn thing on our own.
Although I tried to empathize ( maybe the MO is busy or very stressed for whatever reason ), it later dawned on me that it made no sense to subject the patient to prolonged / repeated examinations which is often VERY uncomfortable and, if done by inexperienced hands, extremely unpleasant, perhaps even dangerous.
Plus, this same ER had the horrible habit of allocating patients to consult rooms, so while you're digging around the guy's throat, you have this nagging worry in the back of your mind about your queue getting jammed. Of course, the patient is completely oblivious, but it does little for the poor doctor's psyche and every case that comes after the FB throat.

As for eye, sigh... the worst encounter I had was with an MO(S) who die-die refused at all cost to set foot in the A&E. He'd ask a million questions in a sarcastic tone. He even asked my senior whether she had "any understanding of basic eye anatomy"! Nasty bugger.
Anyway, I personally feel that ophthalmological diseases presenting at the ER deserve an urgent eye consult, even if it looks and smells like simple conjunctivitis. This is because -- and this stems from a short stint at the SNEC a year ago -- nothing is absolute where eyes are concerned, and even the simplest condition can deteriorate within just a few hours. A slit-lamp exam is almost always warranted, and this is a skill which requires adequate experience and sufficient time -- something not many A&E MOs possess and which the busy ER seldom accomodates.
My hospital provides excellent eye backup, for which I am extremely grateful. It also helps that the SNEC director knows my mother and me personally. Very nice man. :)


In response to Vagus' query, NO I HAVE NO PLANS FOR FEB 14. Haven't had any for the past 5 years, don't think that will change any time soon.

I'm not a chocolate-and-roses type of gal. What REALLY gets me going? That's for me to know, and for the guy to find out. :)

Okay, enough information for one day! Enjoy the rest of the New Year.

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