Wednesday, July 31, 2002

Have been reading a other people's blogs lately -- for a random sampling, click here -- and realized that I've been writing a lot in my entries. Hmm, maybe I'm making up for lost time, or perhaps I just don't know when to stop. :)

Anyway, I don't know how often I'll be able to post from this point on, as I start my cardiology posting at the National University Hospital tomorrow. Haven't done a medical posting for a year or so -- have been immersed in General Surgery and Orthopaedics, you see -- so ward rounds lasting more than half an hour will be the norm for the next 3 months. Aaargh! But at least I'll get to finally defibrillate a human being. All my previous experience has been on mannequins, which just isn't the same, as you can imagine.

Here's the latest scoop to end off the month of July:

1) Memento : Sat down to watch this last night, and let me tell you, believe all the good things you've heard, 'cos they are true. Based on a short story by Jonathan
Nolan, this film is directed by Christopher Nolan ( not sure exactly how they're related though ), and stars Aussie thespian Guy Pearce as an
insurance agent with "a condition" -- ie. hippocampal injury from a prior head injury sustained in a struggle with the men who raped and murdered his
wife. He proceeds to seek out the killers, but his journey is revealed to us backwards instead.
I'm always intrigued by movies that defy convention -- "The English Patient", which weaved 3 different plots into a seamlessly beautiful love story;
"The Sixth Sense" and "Unbreakable", which made me regain faith in Hollywood again -- and "Memento" certainly takes the cake. Besides being an
ingenious concept, it is impeccably filmed and will keep you riveted even after a tiring day at work. Pearce is absorbing in his role as Lenny, the
hapless and desperate husband to a brutally murdered wife, and is the glue that holds everything together. Carrie-Anne Moss and Joe Pantoliano are
merely supporting actors here, and pretty unremarkable.
What ultimately lifts this film, though, is the screenplay. Try picturing the actual layout of the script, and I guarantee your head will start spinning.
Fantastic! Rent it!!

2) Anyone read the article in the Forum page 2 days ago in The Straits Times? It was written by my classmate in med school, Dr. Ang Seng Bin, where he voices his views
on how doctors see so many patients at polyclinics that they hardly have the time to educate them properly about their own diseases.
I totally agree that doctors have an important role to play in counselling patients so they know how to manage their own illnesses. But the fact that Singaporeans are now
"better educated" and "more well-informed" should relieve the burden on our part, rather than add to it.
I once wrote to The Straits Times -- I've been criticizing them a lot on their website, so don't hope to see anything of mine being printed ever again :) -- saying how frustrated
I get when intelligent patients who are capable of taking care of themselves walk into my clinic and expect me to spend the next 15 minutes explaining the details of their
conditions to them. This includes minor things like ankle sprains, gastroenteritis, or even a small bump on the head.
Some of these "educated" persons are also guilty of being non-compliant with medications or dietary restrictions, telling you they have no time, or that they have to enter-
tain clients and are unable to refrain from drinking, smoking or eating rich foods for fear of losing contracts. Are these the actions of smart people? University degrees don't
guarantee common sense, I gather.
I remember one patient from a previous posting -- an Indian lady in her 30s with idiopathic thrombocytopenia. I met her in the wards when she was admitted for bleeding,
and was impressed with her enthusiasm in participating in the management of her condition. She searched the Internet for information and statistics for each type of treat-
ment, and showed them to the consultant/registrar, asking for their opinions. Best of all, she was very open-minded, and never once argued with the senior doctors. After
some discussion about the pros and cons, she would accede to whatever therapy was deemed best for her. Her main aim, she told me, was to better understand the
disease she had, and know what to expect.
How many Singaporeans can compare to this lady? Very few. Most patients here would rather spend their time enjoying life than sit down for an hour or two reading up and
learning more about something as important as a medical condition they have. They'd much rather haved someone explain everything to them during clinic visits, or in the
wards. After all, they're paying the doctors and nurses to do just that, right?
My friends overseas sometimes can't believe it when I tell them the situation here. In the UK and USA, patients are pro-active. And contrary to what you hear about law-
suits galore, most people are actually very pleasant, and respect their doctors.
Seng Bin, your points are valid. And as you put so correctly, "No matter how well-trained doctors are, they will not be able to have good communication with patients in
the short time available." And since medical manpower shortage will not be solved overnight, the next best thing is for patients to educate themselves.



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