Thursday, May 31, 2007

American Idol #6

In the wake of Jordin's yawn-inducing victory, I found myself honestly disappointed.

Sure, she can sing, but did she win simply because Blake screwed up his one big chance at securing the title?

He chose the wrong song -- Maroon 5's She Will Be Loved, out of a repertoire of so many other great pieces ( e.g. Harder To Breathe, The Sun, Secret ); he went off-key too many times for comfort ( yikes ); he lost some of his infectious spunkiness ( ?stage nerves ). All of which contributed to a poor rendition of whatever-the-title-of-the-last-song-is, a mistake that hammered the nail into his coffin, so to speak.

Jordin's little voice-break at the end of that same number also helped garner votes, I'm sure. Nice touch there.

Well congratulations, Jordin. You've got talent, but it remains to be seen whether you're actually star material.

On The Lot

If you want to see what REAL STRESS is like -- at least in Reality TV Land -- this takes the cake.

In the pilot episode alone, 50 aspiring film-makers from around the world stay up for 3 straight days completing tough assignments running the gamut from making a pitch to cutting 2.5-minute shorts within a 24-hour period to writing mini-scripts and shooting a segment within an hour.

I think I missed a few of the follow-ups, thinking it's a weekly thing, so the latest episode had the group already whittled down to 18. Gah!

Being a huge TV and film buff, this is a show I enjoy immensely, for its breathless pacing, sharp editing and creative concepts.

There's this geeky guy named Zach who's a whiz at special effects and consistently wows the judges with his unbelievable set pieces. How does he do it?!

Stay tuned, and you won't regret it. :)

p.s. Looks like our sole Singaporean candidate has been eliminated. Darn.

[ Star Movies Channel 58 daily for alternating 1- or 2-hour snippets. ]

Work Related

My last post elicited quite a few comments -- thank you for that ( urgh included :)).

No time to write much at the moment, but I will be on leave for a few days next week, so hang in there, urgh!

In brief summary, things have settled down somewhat ( though the ambulance diversions haven't abated, I still get inundated by numerous patient reviews and can't fully depend on quite a few MOs just yet ). On the upside, we've identified a few A-grade contenders. On the downside... well, shall leave that to another day.

Time for lunch, then an afternoon shift awaits.

Thursday, May 17, 2007


Never a good way to start a blog entry. Especially after such a long hiatus.

Apologies in advance to those awaiting my comments on articles and such. Will get around to them in time.

For now, I just need to vent before I perforate a gastric ulcer. ( I'm sure it's already there, just that it's asymptomatic at the moment. )

I do, however, have bouts of chest pain nowadays. Like Cameron Diaz and her reflux symptoms in The Holiday ( which I just rented and really enjoyed -- short review to follow ). Or of a more pleuritic nature like the sharp pang I got during a resus early this morning.

Ode To Dante

The last fortnight has been pure torture. Here's a list of reasons ( not 100% comprehensive though ):

Circle #9: MOPEX changeover

Yes, we go through this painful process every 6 months, but the combination of a relatively weaker batch with multiple other factors has proven to be a major headache. I'm sure many colleagues agree that the last group made the transition to the A&E Department much more smoothly. The difference is most marked during night shifts, when manpower is skeletal and a single slow MO can hold up the entire queue.

Of course, we've had difficulties before, and understand the stress involved. Rest assured that we allow a reasonable period of adjustment and always try to believe the best of our junior doctors. Many who started out shaky later earned top appraisal grades and ran resus for us ( yes, even the 1st year rookies ), so we never write anyone off unless they're completely beyond redemption.

Circle #8: Blur MOs

Again, we try to be sympathetic, but certain lapses can still irritate. Running 5 different blood tests ( including the costly NT pro-BNP ) for a simple URTI or ordering 10 x-rays for every painful spot is just unacceptable. Not being able to read the x-rays you personally ordered kind of defeats the purpose. And scurrying out of resus to look for me to read an ECG for you ( while the patient sits there in pain and diaphoretic, with no IV line, SL GTN or oxygen ) -- well, this just makes me wonder what the heck you learned during housemanship ( which includes a rotation through internal medicine, which orders a lot of ECGs, no? )

Anyway, I'm hoping these MOs will learn fast, i.e. by the end of this month. Beyond that, my sharp tongue will take over.

Circle #7: Everybody lurves us

Including the other cluster's polyclinics and the private sector AND loads of GPs. We have patients who live on the other end of the island being shipped over, often at the doctor's discretion, sometimes at the patient's request. Nobody bothers to check which hospitals these people are on follow-up with ( or maybe they know and just don't care ), and the patients themselves don't say anything either. So we end up managing cases with long histories at other institutions, which is damn frustrating.

Oh yeah, and there's a strange trend where patients opt to be admitted at our hospital instead of being transferred back to their original parent institutions. May be a self-referral, AOR discharge to come over to us, or more commonly, they end up at our A&E during one of many ambulance diversions.

Circle #6: Questionable referrals

One short shift in the consultation area was more than enough for me earlier this month. Maybe the new OPS MOs are just being paranoid, but hey, we do get weird memos from doctors with very small MCR numbers, for "undisplaced fracture of the distal phalanx of the little toe, sustained 1 week ago", or "cough for 1 year", or "headache for 10 years".

I kid you not.

The day I spent in P3 was marred by an unpleasant experience with a DM foot patient's angry children ( both in their 20s ). Chronic leg ulcer on regular dressing at OPS, referred for "abscess and gangrene".

Turns out the teeny-tiny area of black pigmentation has been there for weeks, with no progression, and she only had mild cellulitis ( for which the OPS didn't even treat before referring ). Relatives were pissed, and so was I. Only problem was that I was PO-ed with the polyclinic doctor, and they were PO-ed with me. Spent 20 minutes explaining why she could be managed as an outpatient, that the referral was unwarranted, that they could always return to us if the infection got worse, and they thought I was brushing them off. Sensing a potential complaint, I gave them the last-resort option of admission -- which they declined.

Could've seen 3 other cases during that episode. Thanks a lot, Dr. ***** from **** OPS. >:-(

On the flip side, I've encountered cases who first consulted the OPS or GP clinic and were given appointments dated 3 months later, for complaints which actually require immediate admission. E.g. Classical anginal symptoms with recent escalation, and obvious ischemia on ECG; definite melena on PR ( given a gastro appointment in June, haha ), just to name a few.

Blame the doctor, or the educational system? You tell me.

Circle #5: Ambulance diversions

I KNOW it's sanctioned. I KNOW there's a set of criteria to follow. I KNOW it can get busy over there.

But we're seeing more than 400 cases daily ( 100 more than our usual off-peak day average ), and now hit almost 500 on Mondays and weekends. Our resus room is ALWAYS full ( as was the case for my extremely busy night shift yesterday -- my 1st solo call, woohoo! ), and considering the current bed crunch in the wards ( ICU and HD / ICA included ), we can't even clear resus fast enough to receive new patients.

We also have fewer MOs ( total, per shift and especially during nights ).

I'm just saying: maybe we should be allowed some respite as well. It's only fair, right?

Circle #4: Manja mama's and papa's

Have been getting a lot of those lately.

Usually teenagers or young adults. Female. Typical Ah Lian. Or fitting the low-pain-threshold profile ( ask any doctor if you're not clear ).

Often drunk. Hyperventilating and bawling their eyes out. Surrounded by 10 different guys vying for their attention -- also drunk, tattooed and verbally abusive to A&E staff ( but oh-so-sweet to the annoying attention seeker at the centre of it all ).

They always get seen first ( i.e. get to jump queue ) because they kick up the biggest fuss. I practically ordered a nurse to stick one of them in P3 the other day ( young woman sobbing because of an infected sebaceous cyst -- huh?? ) but alas, even the AC kena trumped because the nurse didn't want the big crowd in the waiting area to see the patient looking so "distressed".

So much for "emergency".

Circle #3: Lack of sympathy

Nobody cares how busy the department is. They just complain about the waiting time for consultation, investigations and beds. We keep explaining that we've got an overflowing resus room, that there're multiple ambulance diversions occurring, that there's a bed shortage, but they just... don't... care.

And just to side-track a bit: since when did patients start assuming we know everything about their medical / surgical conditions, absolving them of all personal responsibility? "Just check your records lah, it's in there what", even though their last admission was >10 years ago, hence the records are on microfilm in a warehouse and won't be retrieved for another week. Almost no-one knows the names of their medications, and everyone has a "heart problem" ( even if a recent treadmill / echo / Holter / stress MIBI +/- coronary angiogram were ALL NORMAL ).


Circle #2: The BMU mystery

Okay, I'm not allocating blame here, but can someone tell me why beds mysteriously become available at 3am in the night?

Circle #1: There are no beds!

Someone please build 3 more hospitals, 'cos Northern General isn't going to save us.

Read this quickly, because I expect a phone call from admin very soon, after which I will probably be "advised" to delete my rant -- warranted as it may be.

[ p.s. Would make things a lot easier if there wasn't a firewall for Blogger at work. How else can I comply if I'm stuck on shift and can't access the Internet till I get home? ]

Ahh, that felt good. :)

Good Luck, Blake!

I must admit I'm very surprised by the turn of events on American Idol 6. Melinda has always been tipped to win, but Blake has clawed his way through the all-female line-up to battle for the Idol crown with an equally talented Jordin Sparks.

Think Blake is quite the dark horse of the competition. Was pretty much under the radar most of the competition before emerging from his shell more recently -- most notably this week, with an absolutely perfect rendition of Maroon 5's This Love.

I enjoy Jordin's spirit and gorgeous voice ( much nicer than Melinda's rough tone ), but she's still too young, and faces the risk of sinking into oblivion ( remember Diana DeGarmo? ) if she doesn't play her post-Idol cards right.

Elliott Yamin sang his guts out during a guest performance today. Hate his hair, but gotta love that voice.

People magazine predicted early on that Blake would win -- just based on the number of Internet posts he's generating on Idol b-boards. Looks like they're going to be proven right. Go Blake! :)


The Closer -- an Erin Brockovich-styled cop TV series starring a very spunky Kyra Sedgwick. Pilot was hilarious and well-written. Airs Fridays on Starworld Channel 18.

The Greatest Game Ever Played -- will repeat on HBO later this month. Shia LeBeouf shines as a poor boy with a truly God-given talent for golf. Good script, tight direction and excellent acting make the film both compelling and inspiring.

The Holiday -- just rented the VCD and really enjoyed it. Admit the last third is pretty cheesy, but it teaches a lot of good lessons, one of my favourites of which is "In the world of love, cheating is unacceptable." I tell you this from personal experience, so perhaps that's why I love the show so much ( same way I can't get enough of Someone Like You ).

Jude Law is yummy. :)

Memoirs of a Geisha -- kinda liked this one too, but the ending was deeply unsatisfying and ( if I remember correctly ) different from the novel. Try to ignore the laughable accents ( most of which are non-Japanese ) and concentrate on the amazing cinematography and beautiful depiction of the nation's rich culture.

Japanese men are a very good-looking bunch, FYI. Asking for directions around Tokyo was fun. :)


The Queen -- my mother, who's practically a walking encyclopedia on British royalty, was unimpressed, as was I. Seemed very run-of-the-mill, almost like a made-for-TV movie. Should've given the Best Actress Oscar to Meryl Streep for The Devil Wears Prada, which was sooooo much better.


Now that I've missed my chance to catch Spider-man 3, I've got my sights on Zodiac. David Fincher is a genius, and his latest effort received rave reviews in the US. Can only imagine how good it is. Will be on leave the week after it's released -- yes!

Thanks for reading. Wish me luck with the admin people. :)

Tuesday, May 01, 2007

He's Back!

If you're already a Michael Buble fan, I don't have to ask you to do this. But if you're an MB newbie, then please... buy this album.

His latest offering is interestingly named Call Me Irresponsible, and he performed the title track during a recent guest appearance on American Idol 6 ( jazz week ).

Funnily enough, despite its official May 1st worldwide release date, I managed to get my hands on it last Friday ( April 27th ) at a nearby Sembawang Music Shop outlet. They hid the disc behind the counter but displayed the promotional poster in the window. Made me feel like I was doing something illegal, haha. :)

On to the album review proper.

Overall opinion: always favourable, of course. Michael can sing anything and breathe new life into it, and his vocals remain strong and smooth as ever.

Still, I have to say that of all his 3 studio recordings so far, this is probably my least favourite. His personal best was It's Time ( 2005 ), on which he really stretched himself and produced beautifully rendered classics like Song For You, Quando Quando Quando, Try A Little Tenderness, Save The Last Dance For Me and ( the one I love most ) You And I.

His debut in 2003 was equally stunning, with smouldering covers of Fever, Moondance and The Way You Look Tonight.

Call Me Irresponsible, on the other hand, heads in a slightly different direction, which has its pros and cons. The good part is, he shows off his playful personality more, especially on tracks like I've Got The World On A String, That's Life and Everything. Still, much of the trademark MB style is retained, as he croons gorgeously on Eric Clapton's Wonderful Tonight ( redone as a Portuguese jazz ballad -- sounds very similar to The Way You Look Tonight ), Me And Mrs Jones, Always On My Mind and Dream.

The not-so-good part? He gives the impression that he's playing it safe, which is a huge pity considering his immense success with It's Time, where he pushed the limits in vocal delivery and contemporary arrangement.

The result: Album #3 pales in comparison to #1 and #2; though if this had been his debut, it probably would've launched his career anyway, 'cos there's no doubt it's good. Just that it isn't as good as its predecessors.

Right then, beating about the bush aside, here's a brief summary of the tracks:

What Works:

Wonderful Tonight -- Eric Clapton's slow rock ballad works amazingly well as a rumba. Credit goes to the exquisite arrangement ( lots of strings coupled with a sexy Latin beat ) and Michael's soothing performance. Ivan Lins, who duets with MB, does a competent job, but it's really his exotic accent that adds the icing on the cake. :)

Everything -- one of 2 original compositions MB co-wrote with his pianist / music director Alan Chang, this is an upbeat and infectiously happy pop piece, complete with cute lyrics like "You're the swimming pool / on an August day". My favourite line though, is "And I get to kiss you baby / just because I can", which he infuses with a combination of cheeky mischief and winsome longing. Very very nice indeed.

Dream -- this was written by Johnny Mercer, who also penned the legendary Moon River, Autumn Leaves, Summer Wind and One For My Baby ( And One More For The Road ), among others. Dream is a lovely little song not unlike Charlie Chaplin's inspiring and heartwarming Smile. As Michael whispers "Dream, when you're feeling blue / Dream, that's the thing to do / Just watch the smoke rings rise in the air / You'll find your share of memories there", I can feel my pulse rate drop and the world outside fade into oblivion. Highly recommended for drives home from work after a tough day. :)

Call Me Irresponsible -- This is vintage MB is all his glory. Naughty and irreverent to the core, with a superb swing orchestra backing, you'll be tapping your feet and snapping your fingers in no time.

L-O-V-E -- Another cutesy classic ( bonus track on the Singapore album ), given the MB workover. I adore it. :)

What Doesn't Really Work:

It Had Better Be Tonight -- comes across like a lounge act in a Latin nightclub, a la Barry Manilow's much maligned Copacabana. Didn't like it much.

Always On My Mind -- believe it or not, Willie Nelson's version ( nasal and simple as it may be ) conveys more angst. Somehow, Michael's crooning doesn't fit this particular love song. Go figure.

Comin' Home Baby -- Maybe I'm just disturbed by the fact that a Grammy Award-winning R&B group is now reduced to singing backup. It isn't that bad a performance, but let's face it, Michael doesn't NEED backup, and even if he did, it doesn't HAVE to be Boyz II Men providing it. I found it pretty lacklustre and routine.

I still recommend this to potential buyers. But if you have any doubts, just sample it at HMV or That CD Shop. The good outweighs the bad, I promise. :)

A music video for Everything can be accessed here. Keep checking his tour schedule, 'cos he always drops by Singapore months after a new album's released. I just hope he doesn't come down while I'm overseas. Will be away for 4 weeks later this year.

Another Album Review

I like tenors. Especially young, good-looking ones from Italy. :) But only if they have real talent of course. :)

Just picked up Vittorio Grigolo's debut CD, and man, can this guy sing. He can belt anthems and Broadway classics with aplomb, yet easily switches to serenade mode on the softer, more tender tracks.

Songs worthy of mention:

You Are My Miracle ( a duet with lead Pussycat Doll Nicole Scherzinger )
-- make sure you plug in your earphones or play it in the car, because letting the sound dissipate will destroy the effect completely. Nicole is utterly mesmerizing ( eat your heart out, Sarah Brightman ), while Vittorio shines with his beautifully controlled delivery. Ahhhh. :)
There's a solo Italian version right at the end ( track 13 ) which is also breath-taking.

-- a Keane anthem sung like an Italian aria! Once your head stops spinning, you'll love it. :)

-- woo, quite simply the best and my personal favourite. ( I happen to be a huge West Side Story fan since childhood. ) Vittorio soars effortlessly through this immensely challenging Broadway classic. And the closing note is pure heaven. Major goosebumps!

Which reminds me, I should place an order for a 7 Brides for 7 Brothers DVD on Amazon one of these days. My all-time favourite musical, surpassing even The Sound of Music.

Spider-Man 3

No, I haven't seen it.

No, I don't think I'll be able to catch it in theatres, considering how all the shows at the cinemas I frequent are almost sold out by now.

Got my May roster on 30th April, hence the delay.

Am working lots of morning shifts. Considering how I avoid the crowds, evening and weekend shows are out of the question.

Someone please tell me what you think of the film. I'll probably end up borrowing the DVD, arrgh.

Speaking of DVDs

Rented a few this past fortnight.

Casino Royale -- bloody fantastic. Fully agree that Daniel Craig's the best Bond ever. Not conventionally handsome, but possesses loads of charisma, and has one of the best swaggers I've ever seen ( other notable contenders include Matthew McConaughey, Jeff Goldblum, Michael Douglas and Robert Redford ).
Yes, I pay attention to how a guy walks. :)

Curse Of The Golden Flower -- wow, didn't think anything could be more tragic than Thomas Hardy's The Mayor of Casterbridge, but this almost takes the cake. Lots of melodrama, but doesn't have much of a kick. I can see why it wasn't nominated for a Foreign Film Oscar.

The Prestige -- didn't like it. Had high hopes, but it bored me despite my trying so hard to enjoy it.

The Departed -- the foul language ruined the experience. And there're loopholes. Especially near the finale. Best Picture? Nah...

Blood Diamond -- Couldn't tahan and only finished half of it. A perfect example of how good actors can't save a film which suffers from a dull script and poor pacing.

Better Shows Worth Watching

1. Anything with Peter Sarsgaard in it.

I first noticed him in Shattered Glass, where he plays a tortured editor to perfection. ( He won tonnes of well-deserved awards for this breakout role. )
However, he also played John Malkovich's son Raoul in The Man In The Iron Mask ( costarring Leonardo DiCaprio ).
Then, I caught him in Flightplan, a very stupid movie in which Jodie Foster acts like a raving lunatic. Fortunately, Sarsgaard holds his own and is the only reason I bothered to sit through this drivel.
Most recently, I saw him in Jarhead with Jake Gyllenhaal. It's a very underrated film but deeply affecting. Sarsgaard plays a sergeant who is so traumatized by his experience in the Gulf War he later sinks into depression and has a mental meltdown. Performances are excellent all around, and make sure to sit tight during the burning-oil-wells scene, as it literally rains black gold and drenches the entire Kuwaiti desert. Awesome. :)

By the way, Sarsgaard's girlfriend is Jake Gyllenhaal's older sister, Maggie, who's another quirky actress famous for playing very kooky characters ( e.g. an S&M-addicted assistant to James Spader's domineering boss in The Secretary ).

He's definitely among the top 3 on my Favourite Actors list, along with Kevin Spacey and John Cusack. Spacey and Cusack have already appeared together in Midnight In The Garden Of Good And Evil. Now if only ALL 3 would act in the same movie someday.

2. The latest episodes of CSI ( Season 7 )

Liev Schreiber joins the team as Gil Grissom ( William Petersen ) goes on extended hiatus.
Schreiber is another terrific actor ( on my Top 5 list ) who's done everything from comedy ( watch him cross-dress and tango with Steve Martin in Mixed Nuts ) to horror ( the Scream trilogy, The Omen, The Manchurian Candidate ) and romance ( The Painted Veil ).
Boyfriend to Naomi Watts ( King Kong remake gal ), with one of the best voices around ( voices are big with me :)). Rent his movies if you have time.


Prison Break. The plotholes finally got to me, and I bade it farewell 2 weeks ago.

Watch Out For...

Supernatural Season 2 - premieres May 29th on AXN.

On The Lot - mid-May on HBO.

Last But Not Least

For your reading pleasure:

An article on medical blogging, from the May 2007 issue of the Annals of Emergency Medicine.
Drs. Allen Roberts and Nicholas Genes were part of the writing team for The Lingual Nerve a couple of years back ( the team included myself and other medical personnel from the US, England and Australia ), and I'm thrilled to see them featured in the interviews. Very nice guys, both of them.

Addition to the SMA News editorial board:

With the recent reshuffle, we've managed to persuade one extremely talented writer to join us in stirring things up. Just need a formal meeting to finalize things then you'll be able to enjoy humourous pieces along the lines of the legendary Hobbit's column.

Be safe:

Couple of nights ago, 2 young fellows were hauled in by ambulance after being attacked by a parang-wielding man at a hawker centre. Yes, a bustling hawker centre. At dinner-time. One can only imagine the chaos at the scene, but the victims' conditions were absolutely horrific, with one chap's hand almost completely severed at the wrist, and the other... well, let's just say he was practically minced.

Both survived, but will no doubt require prolonged rehabilitation, with guarded prognoses where recovery is concerned.

Lesson to be learnt here: Singapore isn't safe anymore. Where the hell are the police?!

Posts on Vietnam to be postponed till next time.