Wednesday, January 02, 2008

Sad, But True

First entry of the new year, and it's a grouchy one.

These aren't new problems, though. Been festering for some time, but reserved them for later in view of the festive season.

Still, I know readers enjoy it when I gripe, so here's a little NY present for you. :)

So Whose Fault Is It Anyway?

Let's discuss this "hypothetical" scenario.

Young man from a top secondary school enters a top junior college, and eventually gets into medical school.

However, he fails to excel in the course, flunking exams along the way.

Fortunately ( or unfortunately ), he clears the finals, and is unleashed into the medical workforce.

Housemanship is disastrous. Everyone agrees he's totally inept, and he's forced to repeat one of the postings.

Word spreads like wildfire through the hospital, with the senior administration made equally aware of his performance.

The eventual recommendation made upon completion of housemanship: more suited for NON-CLINICAL work.

The chap is now out-of-phase with his peers ( repeated a posting, remember? ), so he has the dubious privilege of being able to choose his next posting as a fresh medical officer, with almost 100% certainty of getting it since he doesn't have to jostle with the rest of the cohort.

And he picks ( drum roll... ) Emergency Medicine.

Bearing in mind the earlier recommendation ( i.e. non-clinical, people! ), he is nevertheless granted this request by a certain Hospital Top Gun, who emails the Emergency Department's Boss, BUT FAILS TO MENTION this fellow's history horribilis to the unsuspecting HOD, who is only aware of the manpower shortage in the ED, and happily welcomes the young man with open arms.

Within the 1st week, the new recruit is flagged out as hugely problematic.

His history-taking is atrociously bare, and physical examination totally unreliable. He has absolutely no idea what he's doing, and compounds the problem by frustrating the seniors who are asked to vet his cases. Busy shifts add to the stress, with patient queues coming to a complete standstill as seniors are tied up sorting out his mess.

His supervisor is informed and looks into the matter. The MO is counselled and given a reading list to complete, with close supervision by all seniors on shift to minimize damage.

2 months later, he shows mild improvement, but still looks spaced out most of the time, and can't shake a profusely annoying habit of starting his sentences with "Umm, I have this complicated / weird / funny case and don't know what to do / what the hell is going on."

So far, no-one's perished at his hand. But there've been a few close shaves, and he's been banned from night shifts completely.

Aside from the poor work output, he was also caught lying a number of times ( claiming he did something when he didn't, asking nurses to alter results ), but has since desisted after a stern warning from his supervisor.


The act being: stuffing an incompetent 1st year MO in the ED, with the knowledge that he is totally unsuitable for clinical work.

How the hell did he slip through the cracks and end up in the Emergency Department, where a significant number of patients are on the brink of death, where astute assessments and quick decisions save lives, and lying cannot and will not be tolerated?

Of course, some of you will suggest that the ED seniors do some intensive one-on-one tutoring with the fellow, with regular progress assessments and such. Rest assured that these are already in place and will continue until the end of the posting.

But, one has to wonder what happened during medical school and housemanship. Many cannot fathom how he could've cleared the finals. And surely the year he spent in Medicine and Surgery must've drummed some sense into that head of his?

Only another 4 loooong months to go...

The "Power" Of The Press

Recently, we received a request for a piece on how to manage common minor illnesses and injuries at home without rushing to the ED during the busy festive period.

This was meant to be published in the newspaper to help educate the public, and I quote: "so they don't all end up at your A&E!"

I helped to write the article, spending 2 hours in the middle of the night drafting the damn thing in order to meet an insane deadline with some time to spare for the others to vet and edit accordingly.

It was comprehensive and deserved a prominent spot in the paper.

Sadly, the final product was a "side bar" type of column, so small I didn't even see it during my quick-flips of the main section over the next week or so.

The result? Massive patient loads at the ED during the X'mas and New Year periods, averaging 450-500 a day, many for minor complaints like fever, flu and sprains / mild contusions.

All I can say is: the newspaper owes me 2 hours of wasted time.

Now For The Upside

Following the dearth of worthy concerts in 2007, 2008 is looking mighty appealing!

Shows I will be catching within the 1st 3 months alone ( burned a huge hole in my pocket, but it's worth it! ):

January -- The Rise and Fall of Little Voice

February -- The Police

March -- Harry Connick Jr and Maroon 5

Another incident involves my 10-year-old cat, whose become increasingly frail and suffered a number of illnesses recently. His usual vet wasn't meeting our expectations so we sought a 2nd opinion elsewhere, with excellent results.

Still, there was a time around the X'mas season, when we had to seriously consider the option of putting him down to end his suffering, since ( at the time ) we thought we'd exhausted all possible treatments and lost all hope.

One thing most people don't expect of me is my soft core. Sure, I have a hot temper and won't tolerate nonsense of any nature, but I easily tear up under the right conditions ( real- and reel-life situations -- Grey's Anatomy and Brothers & Sisters always punch all the sensitive buttons, haha :)).

But there's a difference between crying over a TV show / movie and really breaking down. 5 years ago, my cat battled an almost fatal bout of leukemia and miraculously survived. This time, it's another virus which has been lying dormant but now rears its ugly head and wreaks havoc with my pet's immune system.

That week, as I helplessly watched him weaken despite the surgeries and powerful antibiotics, I had to shoulder the burden of deciding whether to let him go ( one of the disadvantages of being the sole doctor in the family ). His life literally flashed before my eyes -- from holding him in the palm of my hand when he was a newborn babe, to his snoozing in my lap as I mugged for exams, to his concerned gazes and comforting presence during my painful breakup, and his now increasingly frequent cuddling under my quilt whenever I take a nap.

He has brought so much joy to our family, possesses an ever-evolving personality, and is just...absolutely...adorable.

I know he will leave us someday, but not just yet. He's responded very well to the new treatment and remains as frisky as ever. But at least we're ready for the ball to drop at any time. For now, we will treasure our remaining time with him -- the longer, the better -- and pray for a few more years together, God willing.

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