Monthly Archives: February 2006

Metamorphosis


Metamorphosis is a term used to describe ‘change’. For instance, a caterpillar becomes a coccoon and subsequently change or metamorphosize into a lovely butterfly.

Unfortunately, not all change are for the better. When I first joined this hospital about 3 years ago, a certain consultant just came back from his further training in UK. Before he left for UK, he was an easy-to-approach person. When he came back a couple of months later, I guess he also learnt the stiff-upper-lip attitude which typifies the Brits. He is now a consultant. He is no longer the jovial, easy person that he was. He metamorphosized. And, in our opinion, he changed for the worse.

No one is immune to change I suppose. Right after our specialist exams, we all changed one way or another. I have changed. I no longer do the work of a medical officer. I now carry different and more responsibilities. I now have medical officers who work under me. One nurse in the emergency department claimed that I have become “sombong” (arrogant), which I felt was untrue. Others will testify to it. 50 other nurses said I am still the same. So I guess it’s not statistically significant (p>0.05).

But some of us undergo accelerated metamorphosis! I have seen one medical officer who used to wear drab colored clothings and shoes that would have made Steven Chow proud (kungfu hustler shoes!) suddenly taking to wearing dresses (with slits mind you) and high heels almost immediately after she passed! And she had this new attitude to boot! The attitude says “I am now the boss, you kow tow to me, you vermins!!!”

Well one of us definitely went on an accelerated metamorphosis right after passing. She now orders people around, demands this or that, walks a few feet taller, and generally makes everyone’s life miserable. We call this the Consultoid Syndrome (meaning: one who behaves like a consultant when he/she is not anywhere near being one; an imposter of the most malignant kind). And today I was stabbed by one who was afflicted with this syndrome. That’s really sad, for her I mean.

I sincerely believe that if one does not forget his/her roots, the change will not be so drastic. I always try to remind myself that my ‘success’ did not come easy. My success was not my own. It was, first and foremost, by the grace of the Almighty God. It was also by the many sacrifices my fellow junior colleagues had to make for me in order for me to have time to study (they willingly took on some of my work…thank you guys!!). It was through the prayers of family and friends. It was through the support of many many people.

I also remind myself of the time I was a mere house officer slogging away miserably in the Kuala Lumpur General Hospital (my senior then dubbed it the “hell hole of Malaysia”; a dubious distinction which I feel still holds true). I remind myself of the sacrifices my parents have to make to put me through medical school. I remind myself of the years of hard work and the burning of midnight oil; the lost opportunities to see my children grow up (and they did grow so quickly!!!), the hardship my family had to go through….

And when I remember all these, I am deeply humbled. And I am thankful, to God, to my family, to everyone who have ever contributed even a little bit to my ‘success’. And when you remember these things, changing for the worse is unthinkable.

Metamorphosis and being stabbed!


I have put off writing about this matter for a long time; but today my mood is foul. I am upset. I just want to vent my anger by writing.

For the past one month, I have been assigned as a lecturer (specialist) in the Rheumatology ward. Honestly speaking, rheumato isn’t really my cup of tea, but work is work and I am more than happy to do my duties. Ward work was fine and I like to believe I got along well with the resident specialist in charge. Even the medical officer assigned there was easy to work with.

There is a reason why I was transferred rather abruptly from the general medical ward, where I was in charge, to rheumatology. The other specialist who was in the ward at the time “suddenly” felt that she could not cope with her thesis work while doing rheumatology. Her reason was that she had no time to draw blood from a certain clinic once a week because of her commitments in rheumatology. It’s all hogwash! Because, in rheumato, I had all the free time in the world. In fact, I managed to do the most literature research for my thesis whilst I was in rheumato than back when I was in the general medical ward! I shall not mention the real reason why she asked to be assigned elsewhere. Suffice to say there were some personality conflicts.

The only horrible thing about rheumatology was its clinic which starts at 2 pm on every Thursday and ends anytime between 6.30 pm to 9 pm, depending on how many patients were there! My thesis work (cardio related) makes it mandatory that I run the cardiac clinic which unfortunately, also falls on Thursdays. It runs from 8 am till anytime between 3pm to 5pm! Unfortunately since I am a lecturer in rheumato this month, I have to run that clinic as well.

You can understand why I dread Thursdays. Not only do I have to run the cardiac clinic, I have to go over to the rheumato clinic right after that! At the end of the day, I would be physically and mentally tired, not to mention hungry and usually have a sore throat from too many consultations with too many patients. But I soldiered on, because it’s my responsibility. Because of my cardiac clinic, it was impossible for me to be on time for the rheumato clinic. I don’t have a clone to run the other clinic.

And what did I hear today? That woman complained to another cardiologist that I “never went for the rheumato clinic”!!!! This hospital is a small place. Whatever goes out comes around. To say that I am shocked, upset and angry would be an understatement. I am totally pi**sed!!!!

Actually the emotion I feel most at the moment is that of hurt. I cannot imagine that she, my colleague for so many years, can say this about me. What did she hope to gain from all this? She has been my classmate in medical school, we were together as fellow medical officers, we passed the specialist exam together and now this. I am speechless! Another stab from another “friend”.

I feel better now after writing all this. You want to see her picture? It’s in my blog, in November 2005, one of the pics there is hers. You will see her but you won’t see her face (it’s a broad hint).
Which brings me to the topic of metamorphosis….which I will write about later.

I want to nurse my wound. I will choose to forgive. I just want to forget the whole issue now.

Man and Boy


 

I popped over to the MPH warehouse sale last Friday. I bought a few things, namely puzzles and kiddy toys. I also managed to get my hands on this book by Tony Parsons. It was on 30% discount and I bought it for RM26 or so (will claim from income tax!).

Actually I have no idea what this book is all about. I heard it’s already being made into a movie. I first saw it in the hands of a cancer-stricken patient 2 years ago. She said the book touched her deeply and brought tears to her eyes.

Now, I am not saying I like to cry over a book, but if this book can bring tears to a patient in despair, there must be something worth reading inside. So, over the next few weeks or months (depending on hom wmany toilet breaks I get), I shall read this book. Am already at page 20 or so. Only one foul word so far, that’s a good sign; and no sweaty and heaving sex scenes (another good sign)! He he!

I can already imagine myself lying on a beach chair in the quiet beauty of the Redang Island beach’ sipping my pinacalada and reading this book while working on my tan. Ah, heaven!!!

Redang Trip


This year the MEMS (Malaysian Endcrine & Metabolic Society..or something like that) will be held on the beautiful island off the coast of Kuala Terengganu named Pulau Redang (Redang Island).

The last time I was in Redang was 3 years ago when I went for a “cardiology update” weekend. It was sponsored by a major pharmaceutical company.

Honestly, the ‘update’ was merely 3 hours long. The rest of the time was spent loitering around the resort (Berjaya Resort) and going snorkeling. I shall never forget the experience while snorkeling. One moment, as I waded into the deep blue sea from the beach, all I could see was clouded water and more clouded water, and then suddenly, the breath taking sight of thousands of fishes and corals appeared right before my eyes almost magically! It was AWESOME!!!

What I saw there left me amazed at the beauty that God created under the sea (including a giant Garupa fish almost as big as I am, which had a staring match with me; happy to say I won, and it swam away peacefully). And it made me long to go back there again.

What about the MEMS? You ask me. Well, what about it? Heh heh! I am definitely looking forward to going to Redang again next month. My trip will be sponsored by Astra Zeneca (thank you, thank you, thank you x a million times!).

The MEMS program is usually jam packed and there won’t be much time to actually go anywhere or do anything; but I guess a little sun and a little fun in the sea won’t take up too much time.

I wonder if that Garupa is still there…

Mr Apathy


The cardiac clinic is over! I am quite happy with my “harvest”. 23 patients raising my total now to 215! Yeah! The 200th mark was crossed some time midmorning. No one really poured out their sexual woes to me today (thank God!) but the last patient (exhibit no 215) nearly drove me to contemplate homicide.

Mr Apathy* (*name have been disguised to protect the identity of the real pest) walked into my room and I could immediately smell the foul stale breath of about 20 cigarettes emitting from his nicotine darkened teeth. He recently had a myocardial infarction (a heart attack) last month and had to undergo an emergency angiogram which revealed that all 4 of his coronaries were like Indah Water pipes (ie..blocked). They managed to balloon up one of them and left the others for later.

Mr Apathy sat next to my table and as he slowly poisoned my pink virginal lungs with second hand smoke emitting from his oral cavity, he revealed that he did not come for his last appointment, he did not go for the blood tests, and he did not go for the myoview test (which would reveal how many more of his nicotine-laden coronaries can be salvaged). It dawned on me (one of those Isaac Newton moments, you know, when he discovered the laws of gravity) that this man simply doesn’t care even if he just expires in front of me!

Initially I was a little upset, not because my airspace was being polluted even as he breathed, but at the apathy that was so evident in him. However, later, I realised that there was a reason for his attitude; He simply did not understand what the previous cardiologist who saw him said to him! He was illiterate. And this fact was not reflected in the cardiologist’s notes. Reading that specialist’s jottings gave me the impression that everything was properly explained to the patient. Sigh!

Now, waves of compassion flowed over me as I expended precious saliva in explaining the whole load to him again. After spewing half a gallon of saliva, I could make out a flicker of light in his eyes as he slowly comprehended the whole affair. And then came the climax…or rather, the anti-climax. Despite all my effort, he really really didn’t care about his condition! Arrgh!!

Oh well, I decided then to just let things be. I can’t force him to do what he obviously does not think is important. Still we parted in good terms. I wished him well. I hope he will be well. I really really hope so.

Harvest Today!!


Yup! Another cardio clinic today and that means I can get more patients for my thesis. I should be able to cross the 200 mark today. Oh God, let me have at least 20-25 patients! I think I will probably slow down once I touch 300 patients.

The cardio clinic is long, running from 8.30 am till anytime between 4-5 pm! It’s a surprise that so far none of the cardiac patients have keeled over and expire while waiting 4-5 hours in the subzero temperature of the clinic. I am all fortified to tackle the clinic…with a big plate of fried mee hoon+mee (tasted the same anyhow) and a good cup of coffee (actually half a cup as I spilled half of it).

What I am not fortified to do is the Rheumato clinic which starts at 2 pm. I usually join this clinic as soon as I finish with the cardio clinic. The Rheumato clinic runs till about 8-9 pm! Ugh! It’s a terrible clinic to run as most of the patients suffer pain, pain, pain…in just about every joint! It’s terribly depressing when one patient after another walk/limp/crawl/wheeled into your clinic and all they complain of is pain!! One of my friend coined the term LJT Syndrome which means Lung Jung Tia Syndrome (those who know Hokkien will know…basically it means pain everywhere syndrome!)

Oh God, give me strength for the day and compassion for the patients, and a bit of in between time to run off and get a snack or a drink or visit the loo. Amen

Avian Flu


Clinic was over by 12.30 pm just now. Had to rush and grab a quick lunch and then rush to the department for a briefing on Avian Flu. Apparently my hospital has been designated (again) as a centre of referral for any possible Avian Flu outbreak. Now that there has been a genocide of some chickens in Gombak, everyone is getting a bit jittery. H5N1 is here!!!!!!

Which reminded me of the SARS outbreak a couple of years ago. I was a medical officer in Seremban Hospital at the time and we were so darn short of staff (actually, we are always short of staff!). So, we had to do 1 week on call each during the outbreak. Basically, if there were any patients admitted into the quarantine ward during the call, we will have to attend to the patient. Truth be told, there weren’t all that many patients and each of us prayed fervently that there would be no patients during our calls.

My prayers failed me at one point (I think God wanted to teach me something, I guess) and lo and behold, a Punjabi man decided to take a train trip to Singapore, just like that! Apparently he had an eye appointment at the Tan Tock Sing Hospital there (we later found out that his appointment was postponed to another date, which he knew and forgot!). As if our eye doctors here are not good enough for him. He went despite knowing that there was an advisory against travel to the republic.

Anyway, he was already running a temperature when he stepped onto the train to Singapore (at the time, there were SARS cases in Singapore); in fact he was refused entry at the custom check and he returned on the next train. Unfortunately, for me, he came back even more feverish and promptly came to the hospital, and since he fulfilled the criteria…well, technically he was in Singapore, even though it was just at the customs office, he was admitted.

That’s when my woes started. In order to see him, I had to shower (in the royal ward, no less; since the royal ward was converted into the SARS ward) before seeing him. I had to wear this space suit thing complete with long gloves and head visor. It felt like a personal sauna and I was sweating like a creature of porcine descend (politically correct statement). I had to take his history, examine him, take all the bloods, discard the space suit, shower again before going out of the ward.

Taking history from the patient was an extended course in patience and fortitude. He couldn’t remember much and he got all his dates wrong. I don’t blame him, he was as old as my grandma.

And I had to see him 3 times a day! Imagine how many times I had to shower (and use the royal potty) just to see him. He stayed in the ward for 8 days! S0 I had 24 showers in 8 days on top of my normal showers at home. Sigh! At the end of the ordeal, I felt like I had a extreme makeover. All the cells on my body were new…the old has been dutifully showered away. I was fully and truly desquamated.

I just hope this nightmare isn’t going to recur with the avian flu.

And no, he didn’t have SARS.

Huge, Hard and Throbbing….


MIGRAINE! Ha! You thought I was going to write a sleazy romance novel huh? No la, I woke up with this huge headache. I just knew it will happen. The heavens did not pour out the usual evening shower back where I stay last night and I had to endure a very warm humid night (hot hot hot! Even inspite of showering endless times and sleepy buck naked).

There are many triggers for migraine and definitely a hot sleepless night was one of them. Will tell u more about this “thorn in my flesh” next time.

And now, it’s like 5 minutes before the clinics start and I have this huge pain in my head. Took a Cerebrex and also an ergotamine pill (we doctors are super good at self-medication). The headache has ebbed somewhat. I wonder if I could put on an Oscar winning performance to secure a MC for the day…I doubt it. It’s hard for a doctor to get an MC from another doctor. Sigh!

So, I will just have to bear it out and hope this headache don’t transform into blurring of vision, vomiting, diarrhoea, fits and paralysis (it can happen, you know). Lord, may all my patients today in the SLE clinic be stable, short-winded and few. Amen.

Postprandial somnolence


Or in layman’s term: “So darn sleepy after a heavy lunch!!!”. Went to a lunch talk sponsored by a drug company (no, we are not drug dealers). It was on something about Alzheimer’s disease. My mind was too hypo (low in sugar) to comprehend what the person in front was talking about! By the time she finished, I was all ready to stand up and give her a standing ovation nonetheless and tell her that she is through to the next round (See you in Hollywood!!!), ala American Idol style.

No-la, actually her presentation was pretty bad. Lunch consisted of very very colored and toxic looking nasi briyani (how would i describe it….oiled fragant rice??), stewed chicken (which I suspect were actually crows shot by the Klang municipal council), briyani gravy containing dubious looking pieces of ?what, some vegetables cooked way beyond normal time, killing both bacteria AND normal cells and the complimentary crackers all washed down with sour orange juice. Very very unhealthy; very very untasty, but what the heck, it’s free. :-)

Why do I bother? Well, because I am broke and a free lunch is better than no lunch! My part time work is tomorrow, now, if only I can hold on till then….. I will now go into anaerobic metabolism until my part time work gets over tomorrow and I get paid!

And, traditionally, on Tuesdays we have to listen to a medical talk presented by any one of our junior colleagues on any “subject of interest’. Today’s subject being “Nephrotic Syndrome secondary to Amyloidosis“. Don’t get me wrong, it was all good stuff and interesting (read, mildly) but it was hard to concentrate when you have loads of briyani juice coursing thru your very lifeblood! And he went on and on and on and on and on….even after the consultant hinted broadly that he ought to stop! Ugh! Some people are just so dense.

Well, it just ended. Not sure any of it entered my briyani fat laden brain but I feel so good, I can feel a slumber coming over me; I can feel my systems shutting down… one by one. zzzZZZZZZZZ….hmm, what’s for tea, I wonder?