Friday, October 31, 2008

A Quick Entry

Caught Avenue Q last night ( preview performance, heavily discounted ticket prices ), and have this to say:


Was initially concerned about the Asian cast ( this being a Broadway import and all ), but the actors proved to be of an extremely high calibre, especially the 2 leads ( 1 male, 1 female ). I'm sorry I don't know their names, 'cos I didn't buy a programme, but the guy plays Princeton and Rod, while the lady plays Kate Monster and Lucy The Slut.

Get ready for an evening of irreverent humour, sans political correctness and subtlety. With songs titled If You Were Gay ( one of the best on the list ), Everyone's A Little Bit Racist, Schadenfreude ( listen for the punchline about Germans ), and The Internet Is For Porn ( the funniest of them all! ), this is one helluva rollercoaster ride from beginning to end, truly Sesame Street's evil, demented twin.

By the intermission, I guarantee you will find a personal favourite character ( mine's Rod - a Republican investment banker who's tormented by his homosexuality ), and laugh about the show's many hilarious antics ( Bad Idea Bears, a graphic puppet sex scene, and numerous corny puns ). I especially like the way they announced the intermission -- won't spoil the surprise here, but you'll be tickled pink. :D

My heartiest congratulations to the S'pore Repertory Theatre, who put up a jolly good show. Now if only they'd bring Jersey Boys and Spring Awakening to the Esplanade ( the latter has, sadly, closed its doors in NYC, apparently due to the economic recession ).

More Pictures

From the Temple of Luxor, by far the most beautiful of all the temples we visited in Egypt.

The columns are massive, as you can see, covered entirely with intricate hieroglyphic carvings. Every single one of them -- amazing.

Interesting how my photos are orange-hued, compared to the grey shade on the Net.

It was a balmy evening the day we dropped by. One of those moments that make you fully aware of life's many splendours, and mankind's astounding ingenuity.

A Treat For David Archuleta Fans

Singing a BEAUTIFUL hymn -- ahh, he should really consider releasing a Christian song album ( after doing a Christmas recording, that is :))

His debut LP will be released November 11th. And yes, of course I'll buy it.

Monday, October 27, 2008

In Retrospect

I hate these moments, when I get crabby about work.

Blame it on the endless parade of drunks brought in by ambulance, thanks to the "kind" souls who stumble upon these fellows and decide to dial 995.

Interestingly, many of tonight's patients belong to the older age group ( including the alcoholics ). But the sober ones actually have legitimate complaints, requiring admission and urgent intervention. Being often stoic, I can't blame them for swamping our ER in the middle of the night, after trying to endure their symptoms for as long as possible.

Of course, a significant proportion of the crowd hails from ambulance diversions, which are becoming a daily routine in recent months. I don't know what the heck is going on over there, and I'm obviously not at liberty to whack my colleagues, but there's clearly a problem, and I can't help wondering what's being done to solve it. Is this going to continue for all eternity? Have some mercy on us, for pete's sake.

Night shifts these days involve handling social ills rather than real medical / surgical emergencies. It's as if Singapore's become a festering cesspool of alcoholics, manjas and thugs. On any given early morning ( 12 midnight to 6am ), we see people so drunk out of their minds it's positively shameful. They strip, they spew vulgarities, they piss on the floor, spit at medical staff and police officers, come in bloody from fights, usually accompanied by friends who are equally wasted and kick up a major ruckus in the ER.

And they're supposed to be doing this all in the name of fun?!

I'm sorry, man. The only time I got anywhere near the definition of "drunk" was back in my GS MO days, when I had too much Long Island Iced Tea for my own good and had trouble driving home. Since then, I've made it a point to moderate my alcohol intake. That's the sensible thing to do, right? Why is it so difficult for these twerps to understand this? Where's the thrill in puking your guts out or feeling like crap? Yeesh.

There's also a rising trend in PSY cases among young adults. Depression, panic attacks, stress reactions, you name it. It's okay if they need someone to talk to or an early referral, but I can't stand it when they try to be funny. For example, I recently saw a young man who repeatedly presents with chest pain, for which numerous tests ( including TMX and echo ) have been performed, with normal results. When he returned one evening with the exact same symptoms and a completely pristine ECG, I reassured him that he was okay and could be discharged. He then became angry and accused me of trying to get rid of him. It took me 20 minutes just to pacify the guy, while the patient queue got progressively longer.

At times like these, I wonder if I'll still be doing this %^&$ work 10 or 20 years down the road. Emergency medicine is one of those rare specialties where even the most senior consultants still do night shfits. I'm starting to feel ancient, not sure if I can take any more of this.

But then I think about ward rounds and clinics, and the ER begins to look good again. :)

Anyway, I recently attended to a young lady with severe epigastric pain who failed to respond to multiple medications, despite a soft abdomen, normal vitals, bloods and x-ray findings. When I wanted to admit her, I called her husband to update him ( he was at work ), but was told to wait for him to come to the ER 2 hours later so he could talk to his wife and see if she could be discharged. She was in so much pain she shed tears, and I relayed this information to him, to no avail. I gave him the 2 hours he requested, but when he failed to turn up on time, I marched back to the lady, told her I would admit her as long as SHE granted permission, and she begged me to send her to the ward.
Turns out she was incubating an acute surgical condition and subsequently went for emergency laparotomy. I could've admitted her sooner if I hadn't decided to wait for her spouse. Won't make that stupid mistake again.

Got an earful of attitude from a ward MO the other day, when I called to ask a simple question about whether to admit to one department or the other. Granted, I only identified myself by first name, not by rank ( I do that only when calling doctors who are known to cause trouble ), but this guy spoke to me in a sarcastic tone, even though I didn't even ask him to come down to the ER or accept an admission. I later consulted my friend, who's this MO's registrar, and was told that the MO gets compliments from patients. Hah! Why am I not surprised? There're lots of doctors like that, who treat patients like royalty and know which senior arses to kiss, but trample all over those who don't directly impact their career prospects. I've met enough of such hypocrites to develop a thick skin ( and ample amounts of bitterness ), But I have a very good memory where such encounters are concerned, so you've been marked, pal.

This warpath mode has been building up for a while, though unleashed only now. I suppose last week's Sun Festival helped lighten my mood significantly. Too bad the effects have worn off so quickly, heh.

It's times like these that make me miss the carefree days of my youth. As I write this, I'm playing the soundtrack to Beyond The Sea on my PC, with Kevin Spacey singing a verse from Once Upon A Time:

"Once upon a time
The world was sweeter than we knew
Everything was ours
How happy we were then
But somehow once upon a time
Never comes again...."

It's extremely sad, yet also comforting in a weird way. But I've long realized that happiness entails an active search which, in my case, extends far beyond work. How can I possibly define my existence through patients, when there's travel, music, film and exquisite prose to occupy my thoughts?

Maybe someday, I'll hit the jackpot with a personal project, and bid medicine farewell. Till then, I shall rant periodically, for your reading pleasure. :)

Thursday, October 23, 2008

Review Of Peter Cincotti's Concert, Esplanade Concert Hall, 21st October 2008

I don't know what the review in today's paper will say, but here're my personal thoughts.

Long-time readers of my blog will remember that I saw Peter in Rome in 2005.

3 years is a significant period of time, and naturally, Peter's musical style has evolved dramatically. While his first 2 albums featured mostly jazz covers with a smattering of pop ballads, his latest record, East Of Angel Town, is produced by David Foster ( who's mentored the likes of Josh Groban and Michael Buble ), comprises 13 self-penned tracks, and has a much edgier sound.

Tuesday night's audience was an eclectic bunch, comprising young and old, local and expatriate. What we all had in common, though, was a deep appreciation for this young man's sensational talent.

Opening with track #1, Angel Town, this set the mood for the rest of the evening, as Peter and his 5-piece band jammed heartily and the concert hall reverberated with their energetic rhythms. Sitting in the centre of the 8th row, I initially found it a little jarring, but got accustomed to it quickly. Guess the hall's superb acoustics aren't exactly suited to music of this amplitude.

Peter followed with Be Careful, Man On A Mission and Cinderella Beautiful, then covered the remaining tracks on the album, only omitting The Country Life.

Especially noteworthy are Another Falling Star - a slower-tempo-ed ballad and my favourite on the record, which Peter sang beautifully - and Always Watching You, which he explains is inspired by what he sees from his New York apartment. The latter made an especially huge impact, thanks to a spirited and sexy rendition, very different from the studio version.

Make It Out Alive featured a drawn out jam session that drew deafening cheers, and Witch's Brew enchanted with its piano solo, a bit I greatly enjoy because of its similarity to a Bach fugue.

Peter hasn't lost his love for performing, displaying many traits which I noticed back in 2005, such as tapping and stamping his feet, bopping his head to the beat, and flashing huge smiles at his band.

This time round, however, he was much more enthusiastic, at some points getting so worked up that he leaned forward a tad too much, causing his seat to tilt precariously on 2 legs instead of 4. I really worried he'd topple over, but luckily, he didn't. :)

The physical demands of the performance took its toll as well, with Peter taking frequent gulps of mineral water, wiping his forehead with a towel, and pausing to catch his breath in between songs, taking a minute to compose himself and recover before launching into the next piece.

My seat provided a wonderful vantage point - I faced his back in Rome, but this time, I saw his side profile, had a clear view of his hands, and was treated to a full frontal whenever he switched to the keyboard situated behind him.

He's still as boyishly handsome as ever but has also definitely matured, with an easy on-stage confidence and more banter with the audience.

Best of all, he's put some weight back on ( instead of looking gaunt like he did in Rome ), and his floppy fringe has reappeared. Yay! :)

He closed the show with 2 encores, the first a new composition titled Nothing's Enough -- a heady mix of pop, jazz, rock and even a little disco -- and the second, a cover of David Guetta's Love Is Gone. Both are available on YouTube. I'll take a listen one of these days to familiarize myself with the melodies, 'cos it takes me a few spins before a tune sticks in my head.

The audience that night was truly fantastic. It wasn't a full house, but the cheers more than made up for this, and many stood to applaud the guys at the end. A well-deserved ovation indeed!

Peter stayed back for an autograph-signing session, but I opted to take my chances at the post-show reception instead, and was duly rewarded.

Held at the VIP Tent across the road, this was supposed to begin at the official time of 10pm, but Peter arrived early, and I managed to speak to him for quite a while. Here's a gist of what happened ( won't bore you with a minute-by-minute description, don't worry ):

Bits of our conversation:

Me - Will your next album be produced by David Foster as well?
Peter - Oh, I hope so! I really enjoyed working with him on this one.

Me - Will you be in Singapore for long?
Peter - Oh, no, we actually have to catch a flight later tonight 'cos I'm performing in Vegas the next day.

Me - I'm going to be in New York next year. Will there be a summer tour?
Peter - Definitely. We're going to launch the album in the U.S., and there should be a tour after that. Check the website for details!

Somewhere in the middle of this, my mom ( who adores Peter, by the way ) blurted out that we'd met him in Rome before, to which Peter replied with an uncertain "O-kay". I could tell he couldn't remember the encounter and felt bad about it, so I interjected with "I don't think he remembers, mom", wanting to add "... but it's all right". But before I could say that, he turned to me and asked, "Was it last year?" I said no, it was 2005, prompting a laugh as he pointed out that our meeting was "way, WAY back!", using his hands to make sweeping actions in the process.

He then posed for pictures, separately, with each of us. As I wielded the camera and looked around for someone to hold my mom's plate of food ( there was a small buffet at the reception ), Peter gallantly stepped forward, said, "Let me take this for you." then deposited the plate in ( I think ) his tour manager's hands. I didn't know he worked with Peter at this point, so I was slightly horrified, thinking this poor man was a fellow guest. It was only later when I saw Peter leave with him in a car that I realized who he was. Whew!

Peter was extremely sweet to my mom. He actually asked me whether she's my mother early in our conversation, then shook hands with her and gave her a big, gorgeous smile. When he posed for the photo, he hugged her tight and leaned in close, flashing a happy grin as I cued them both to "Smile!". He looked at her intermittently even though he was talking to me most of the time, so she wouldn't feel left out. And he waved at her again just before leaving for the car.

To me, he's remained the same warm and friendly chap from 2005. He still tilts his head towards me to hear what I'm saying, maintains steady eye contact, and shook hands with me more than once ( twice that night, compared to 3 times in Rome, haha ).

This is probably superfluous, but he is unbelievably good-looking, and has grown even more dashing through the years. He wore a white shirt with a metallic grey suit, and seems to have shot up by a few inches as well. You can't imagine how much I enjoyed talking to - and staring at - him. :)

He tried to leave the reception by inching towards the exit in stages, moving from the buffet table area to the wine bar then the grass verge. My mom and I had retreated to the wine bar after the photo-taking, as other fans came over to say hello to him. But he kept coming our way, then as he passed us again, he looked at me, smiled, and said, "It was great meeting you" before getting waylaid by an Indian man and his wife. I could only manage an appreciative smile, being caught completely off-guard.

I'll post the YouTube links the next time I blog from home. But they're easily found via Google. Just type "Peter Cincotti, Nothing's Enough" or "Peter Cincotti, Love Is Gone".

Of course, one of the best things I like about Peter is the fact that he acted with Kevin Spacey in the Bobby Darin biopic, Beyond The Sea. One degree of separation from Mr. Spacey himself!

Peter's expressed a desire to return to Singapore soon ( "hopefully next year" ) for another concert, so let's hope that becomes a reality. Your fans here would love to see you again.

Monday, October 20, 2008

Waxing Lyrical About Simple Pleasures

A recent email from a friend who's currently posted overseas was most encouraging, since I get heckled from time to time for who knows what reason.

An update about photos - I'm not allowed to share those from the F1 race, because they're not "official". As for the ones from Egypt, I will put more up the next time I log on from home ( which is becoming pretty rare these days ).

This entry will focus on a few miscellaneous events, all of which share a common theme.

Sun Festival Gala Concert 18th October 2008

I purchased tickets the very morning they were released online, more as an early birthday present for my mom, who LOVES Robert Redford.

She's disappointed about his last-minute absence, but the evening was nonetheless enjoyable, because of the programme's variety, and Geoffrey Rush's humour and humility.

The full-capacity audience comprised a large number of Caucasians, with many of the men decked out in formal suits and tuxedos.

The Academies Festival Orchestra, which was specially convened for this event, consisted of young musicians from local and foreign conservatories. They were indeed impressive, displaying great competence and even some showmanship as they covered an eclectic repertoire featuring Prokofiev, Strauss, Puccini, Bernstein and Gershwin.

I'm no expert on classical music ( at least in comparison with the true connoisseurs ), but I'd like to think that I have a pretty good ear where tone and technique are concerned. In these particular areas, the orchestra definitely deserves accolades.

Before starting his segment, Mr. Rush deadpanned, "I've always dreamt of being Robert Redford", to raucous laughter and applause. His narrative lasted approximately 30 minutes, and was quite entertaining. However, my mother couldn't help commenting at the end about how she would've preferred to see Mr. Redford instead.

After the intermission, I was pleasantly surprised to see Mr. Rush take a seat with his teenage son somewhere in the 4th / 5th row, along the left aisle. Yes, they were sitting with us mortals! Those around him looked shocked at first, but settled in nicely thereafter, and I could see Mr. Rush's profile clearly even though I was maybe 12-13 rows diagonally behind him. His mane of puffy grey hair is a dead giveaway. :)

Dame Kiri Te Kanawa's segment came next, interspersed with instrumental performances by the orchestra ( during which she would leave for short interludes ) and items by the Vienna Boys Choir.

The latter proved to be sorely disappointing. Perhaps the hype proved too overwhelming for them, or, more likely, the song choices were less than inspiring. Having served on the RJC Chorale for 2 years, I can understand a choir master / mistress wanting to diversify, but listening to little boys belt discordant - not to mention depressing - pieces only serves to dampen one's spirits.

Thank goodness for Dame Kiri, who proved why she's one of the world's premier sopranos. Dressed in a glamourous azure(?) sequined gown and cloak, and positively dripping with diamonds, she was statuesque and regal as she stood on-stage, occasionally letting loose and swaying to the beat ( on a Bernstein number ).

But her voice was the true star of the night, buoyed by the Esplanade Concert Hall's incomparable acoustics. She expertly controlled every detail, adjusting volume and tone, adding little nuances, and hitting impossibly high registers with effortless ease.

I am no fan of opera, but Dame Kiri is the only soprano I will pay money to see, at least just once. It was worth every single cent.

The audience was a little reserved, bestowing a standing ovation only after she performed an encore item from Madame Butterfly ( breath-taking! ). We were treated to a total of 3 encores, no less!

After the concert ended, I kept my eyes on Mr. Rush, and spotted him walking to a nook near the stage before disappearing behind a wall. I saw people exiting through the same route, but upon venturing in the same direction after most of the hall had emptied, I stumbled upon Mr. Rush himself, still standing behind the wall, chatting with 4-5 Caucasians. He was facing me directly, but engaged in conversation. I was only about 3 metres away, and got a REALLY good look at him, which was great! :)
He's a lot taller than I expected, and I'm very sure he would've chatted with me if I'd had the guts to approach him. His son's rather tiny for his age, but very cute. :)

Ah well, I'm glad to have gotten close to yet another Oscar winner ( in addition to Kevin Kline and Nicolas Cage from my U.S. trip last year ).

Special mention goes to Julian Reynolds, who conducted the orchestra for Dame Kiri's and the Vienna Boys' performances. His energetic body language was such a pleasure to watch! Like an Energizer bunny fused with one of those cymbal-banging monkey toys. I kid you not. :)

Next up, Peter Cincotti's concert on Tuesday. Haven't seen him since Rome in 2005. Hope I'll have the opportunity to say hello.

Something Else I'm Greatly Looking Forward To

The Bridge Project's staging of A Winter's Tale, a collaboration between our local SRT, the Brooklyn Academy Of Music and London's Old Vic Theatre ( the latter currently run by my favourite actor, the very accomplished Kevin Spacey ).

I don't want to be presumptive, but in mid-2007, I emailed the Old Vic about the SRT's collaboration with the Royal Shakespeare Company, which resulted in Sir Ian McKellan coming to Singapore to perform in King Lear. I asked if Mr. Spacey would consider working with the SRT to bring some plays to our shores, but didn't receive a reply.

So when I read about the Bridge Project in the newspaper, I couldn't help wondering if my email made an impact after all. If it did, then I couldn't be happier. If not, it doesn't really matter either.

My greatest wish, however, is to see Mr. Spacey on the Esplanade stage someday soon. I've followed his career closely for almost 10 years now, and he consistently receives rave reviews for his stage performances. The Iceman Cometh is probably his most famous work to date. And a friend of mine who managed to catch him on Broadway not too long ago, in Moon For The Misbegotten, told me he's absolutely mesmerizing.

And speaking of mesmerizing, I'm currently hooked on ( or, more accurately, desperately addicted to ) Philippa Gregory's The Other Boleyn Girl, a 500-plus-page paperback that traces King Henry VIII's affairs with the Boleyn sisters. I haven't seen the film adaptation yet ( starring Eric Bana, Scarlett Johansson and Natalie Portman ), but the novel is keeping me up late into the night because it's just so bloody good. Reads a little like some fluffy romance at certain points, but the historical detail helps lift it above the usual Judith McNaught / Julie Garwood fare ( I know, because I've read them before :)).

That's my new obsession -- English royal history, circa Tudors era, to be exact. I have the HBO series The Tudors to thank. Jonathan Rhys-Meyers is excellent as the hot-tempered, conflicted monarch, and the production boasts splendid costume designs, tight scripts, and superb direction. Who would've thought that 4-5 episodes dwelling on Henry's efforts to divorce his wife Katherine would be so compelling?

Am now eyeing Gregory's latest novel, The Other Queen, which will feature Mary Queen Of Scots. I'm all ready for more sleepless nights. :)

And, last but not least, a short comment about the upcoming U.S. Presidential elections.
After watching 2 Presidential debates and 1 V.P. showdown, I will be horrified if the Republicans win - again. George W. Bush's successful re-election was a shock, and Americans need to learn from their mistakes, dammit!

My main concern should Obama win, is his safety. In the most recent debate, he voiced unhappiness about McCain's supporters yelling "Kill him!" when Obama appeared at rallies. Considering Colin Powell's own refusal to stand for office for similar worries in the past, it's obvious that there're those who will not tolerate an African-American leader, and who are fanatical enough to provoke a civil war should an assassination attempt prove successful.

I only hope such a day will never come to pass.

Before I sign off, a short rundown of films I recently caught:

No Country For Old Men - Disappointing, because I'm familiar with the Coen brothers' work, and this comes nowhere close to their best, i.e. Fargo and Raising Arizona. The storytelling here isn't as strong as I expected, considering the Best Picture and Best Director Oscar wins. However, Javier Bardem is bone-chillingly terrifying - his Oscar is well-deserved.

There Will Be Blood - I LOVE this movie. An original screenplay by Paul Thomas Anderson, vividly interpreted by Daniel Day-Lewis, and brilliantly supported by co-star Paul Dano. The latter's portrayal of a charismatic priest who falls prey to his own inner demons is marvelous to watch. Day-Lewis is, as always, masterful. He makes Daniel Plainview utterly irredeemable yet pitiful at the same time. Highly recommended.

1408 - Based on a Stephen King novel, this horror flick stars John Cusack, looking worn out as he struggles to stay alive and sane in an infamous haunted hotel room. The movie isn't half as good as Cusack's better films ( Say Anything and Grosse Point Blank, to name two ), but his performance here is definitely the most emotional I've ever seen. Recommended only for Stephen King fans and John Cusack diehards.

21 - Caught this en route to Egypt. Stars Jim Sturgess, Kate Bosworth and Kevin Spacey ( the latter's the only reason I bothered to even watch this ). Turns out to be a pretty good flick, tracing the true exploits of a group of M.I.T. geniuses who perfect the art of card-counting and use their skills to win big in Vegas. Spacey's role as a mentoring professor is multi-faceted and at times frightening. Watch for the confrontation scene between Spacey and Sturgess. That cold stare is guaranteed to stop one's heart.

Deception - Ewan McGregor and Hugh Jackman star in a decent thriller about an exclusive sex club that leads to blackmail and murder. Starts off interestingly enough, but deflates in the last half hour. Doesn't help that damsel in distress Michelle Williams is bland and has zero chemistry with McGregor. The least she can do is take her clothes off like the rest of the women, no?

Sex And The City: The Movie - This one, on the other hand, has so many sex scenes I'm surprised KrisWorld screened an uncensored version. Lots of humping and pumping going on, but thankfully, it actually helps propel the plot. Turns out to be a frivolous tale when you really think about it, but the ride is pretty fun, so I'm not complaining.

The Counterfeiters - Best Foreign Film Oscar winner this year, but lacks the oomph factor. Holocaust atrocities are kept discreetly hidden behind wooden fences and walls. If you want a bigger dose of reality, watch Schindler's List.

The Savages - Thorougly enjoyed this one. Philip Seymour Hoffman is a hoot as a lovesick professor of philosophy, and Laura Linney is fabulous as his neurotic sister. The chemistry is so strong you actually believe they're siblings, and the script is both hilarious and insightful. Still, no-one does family dysfunction as well as Wes Anderson, so give The Royal Tenenbaums, The Darjeeling Limited and The Life Aquatic With Steve Zissou a try.

Elizabeth: The Golden Age - Renting this DVD proved to be a strange coincidence, since I got it days before it was announced that Geoffrey Rush would replace Robert Redford at the Sun Festival gala concert ( Rush plays shrewd advisor Walsingham in the movie ). This sequel covers Elizabeth's war with Spain, as England's Protestants fight the Catholics. There's an assassination attempt, lots of political intrigue, and of course, a sweeping romance involving a love triangle. Clive Owen is dashing as the pirate Walter Raleigh, and Cate Blanchett has got to be the most gorgeous woman on the face of the earth, since she can pile on the two-way cake, wear costumes that make her look like a pontianak, and STILL look impossibly beautiful. Try THAT, Angelina!

On the telly, there's The Celebrity Apprentice, which just started its run a few days ago. Don't expect big movie stars on this one, but there're some famous sportsmen, musicians and models, my favourite of whom is Gene Simmons from Kiss. This hard rocker who wears Gothic makeup on stage is a softspoken mogul when out of the spotlight. Plus, he's got a wicked sense of humour, and had me in stitches.

Also, the latest season of Whose Line Is It Anyway? is back on cable, complete with wacky skits and show-stopping improv singing. Comic genius at its best.

Coming attractions: Recount, an HBO original movie starring ( yet again ) Kevin Spacey, to be shown on November 1st. And... the new Beverly Hills 90210 hits our screens Nov 4th.
Don't bother watching Grey's Anatomy Season 4, which has degenerated into pure drivel ( Isabel saves a dying deer in episode 1, and Meredith discovers she has a half-sister - I caught this in Cairo, and consider it a huge waste of time ).

Have a good week ahead.

Saturday, October 11, 2008

Catching My Breath the tail end of a tiring night shift.

It wasn't bad in the textbook sense, but the patients trickled in continuously, and the nursing changes piled up until by 3am, there was a mountain of folders stacked on the counter, waiting to be sorted out.

This wasn't helped by the usual flood of drunks, and a stream of "chest pain" complaints, assaults, and of course, NS boys.

I chanced upon this article in the latest issue of the SMA News, written by a friend who currently sits on my institution's medical board. He mentions a Straits Times piece which dwells on the same topic, but I missed it as I was overseas at the time. Would appreciate a link, or an emailed soft copy.

My two cents? The problem is a lot more complex than most people imagine. Raising the consultation fee is no deterrent, as evidenced by the many "bad debtors" we see flagged in our computer systems. Some of these patients come almost daily, but never pay their bills. This constitutes what hospitals describe as "write-offs", because you know you'll never get the money no matter what tactics you employ.

Coming up with a "sliding scale", with higher fees for certain hours compared to others? Makes sense, but doesn't seem fair. After all, there are those who come at odd hours because they had to finish a shift or had other important business to attend to first. Some choose to tolerate their symptoms, only to have them magnified in the wee hours when they realize they can't sleep because of the pain, or become anxious and decide they'd better get themselves checked out once and for all.
Many visit the A&E after midnight for gastrointestinal symptoms, no doubt related to suppers / pub crawls and other nocturnal activities. With our central location and easy access, it's only natural that they'd flock to our ER.

It's hard to penalize such cases based on attendance time alone. In fact, it's impossible to do it to anyone. All they have to say is "Well, I didn't know I wasn't that sick and could've seen a GP / waited till the next morning. I'm not a doctor what." How do you answer a question like that?

As for the NS boys, one can never be sure what's brewing beneath the surface these days, with our seemingly healthy young men dropping like flies for unknown reasons. It's genetic, I tell you. Perhaps some autosomal dominant gene on the Y chromosome that doesn't manifest till adulthood. The genius who discovers that should win the Nobel prize.

Patient education? Good luck. As locals become more well-educated, they choose to use their knowledge for worthy pursuits, such as (1) demanding to be seen stat because how can you call yourself an emergency department if I have to wait 30 minutes dammit, (2) telling you they want blood tests, xrays and scans, just because they know they're available at the ER, never mind whether they're indicated or not, and (3) lodging complaints.

How about channeling your energy and so-called intelligence into learning more about your own medical conditions, instead of telling me you have "a heart problem" each time you come to the hospital? Stop telling me "everything's on your computer, right?" when our technicians decide to shut everything down during one of their upgrading exercises. And by the way, we can't trace any cardiology records if your last appointment was more than 3 years ago.

I'm just appalled by the fact that these well-educated adults often have no idea what medications they're on, expecting us to retrieve their prescriptions from the system. Those who are managed by private doctors almost never bring their meds to the hospital, necessitating a phone call to the physician-in-charge, or at worst, compelling a relative / friend to trudge home and bring the meds to us.

I mean, I consider Singaporeans to be pretty smart, but their lack of interest in something as important as their health is just deplorable. Compare them to the Westerners who occasionally pass through -- they're able to recite complex medical terms and rattle off medication lists without blinking an eye. Either that, or they come carrying relevant medical records from their home countries, which make our lives so much easier.

Locals, on the other hand, treat their ward discharge summaries like toilet paper.

For now, the best solution is to boost manpower in the ER -- nurses, doctors, healthcare assistants, security guards. We're overworked, constantly at risk of making mistakes, and frequently harrassed by angry patients and relatives. Stop spending money printing posters and doing up corridor walls and put those funds where they'll do some real good.

Saturday, October 04, 2008

Quick Photo Entry

Here're a few I took of the Temple of Queen Hatshepsut, located near Luxor. You can read about its controversial history at this website.

It provides an awe-inspiring sight, as the temple is cut into the cliff face, and offers panoramic views from the upper terraces. Hatshepsut is the only Queen with a temple dedicated to her, but is depicted by statues as a Pharoah.

It's one of the more well-preserved ancient structures accessible by the public, but doesn't offer that much in terms of sightseeing opportunities. However, its unique architecture and background of political intrigue make it an essential stop on any Egyptian tour.

The caves contain tombs, currently closed to tourists.

Click on the pictures to enlarge for closer scrutiny.

And... a link to the trailer for the next movie I intend to watch at the cineplex. Pity James McAvoy isn't in this. :)