Sheer Arrogance

I just have to get this off my chest before I go off for the weekend. We referred a patient (who is the mother of a consultant here) to the orthopaedic department for what we thought might be a hip fracture. We sent a referral letter to the orthopaedic consultant on call. By tradition, usually a Medical Officer will write the referral and sign his name on behalf of the referring consultant (hence, the ‘BO’ in the picture which in malay meant ‘bagi pihak’ or on behalf of ).

In fact, only the medical department do this. Other departments usually just ask the house officer to call us when they refer a patient and much of the time, the referring house officer hasn’t the faintest idea what the patient has and what the referral was for! And what do we do? We keep our cool and see the patient anyhow. The patient matters, protocol is secondary.

The referral letter was returned to us today. On it was scribbled rudely “CONSULTANT TO CONSULTANT ONLY. BP not acceptable”. The patient was not seen.

To me this smacks of sheer arrogance. To Prof C, I have this to say, “please do not be such an arrogant person. Please do not let your pride or ego cloud your judgement and compromise patient care. What if it had been your own mother who needed the referral? Think about this”.

You know, this was a referral for another Prof’s mother who is 93 years old! I wonder how many other elderly mothers out there who have no prominent or influential sons are being deprived of care simply because a person has too inflated an ego to care.

In the same vein, Mawi’s (our local singing sensation) dad was admitted to IJN (National Heart Institute) for some cardiac problem recently. This was much publicised by the media. Just how many fathers of unknown sons out there are admitted daily for cardiac problems and not a word would have been mentioned.

We must stop being egocentric hypocrites….

Have a restful weekend everyone.

Bed time story

 

I remembered a time not too long ago when my wife and I would take turns putting our then 2-3 year old girl to sleep. It usually starts with getting her to lie down on her bed and snuggling next to her. Next, she would break into a string of choruses, ranging from ‘Twinkle2 little star’ to some sunday school songs or some silly Barney songs she picked up from the purple dinosaur. Often I would take turns singing with her. The songs would be accompanied by actions. It was fun.

Of course I would read her the bed time story. She would choose the book and I will read it, usually in an as animated fashion as possible; complete with sound effects of various cars, animals, etc etc. Her books then were not so thick (she has now finished all the books on ‘Narnia’ on her own) and usually we are done in a few minutes.

Next, we would get on our knees and pray. Her prayers were simple: “Father God, please grant daddy, mummy and me a good night rest. Please take care of Ah Kung and Ah Ma (maternal side of the grandparents) and help Kung2 and Po2 to know Christ (my parents), Amen”. Short and sweet. Mine would be more elaborate stretching from asking for blessings to settling the home/car loan etc etc (just kidding about the last part).

And then she would lie down again. I would get up to switch off the lights and we will say out “ooohs and ahhhhs” as we gazed up to the ceiling where I have stuck maybe a hundred ‘glow in the dark’ stars of all shapes and sizes. We would stare till the stars began to fade and she would say “stars going to sleep now”. I would hug her, and give her a little peck on the forehead and say “Good night sweetie, I love you”. She would give me a hug and a kiss in return. The little ritual would end with the phrase “Good night, sleep tight, don’t let the bed bugs bite, I love you!”.

It’s been a while since I last did that. Some how in the course of the years, this little ritual got lost. Now I see her only on weekends (when I am not on call); most times I am too tired to put her to bed. And when I could, it was hurried. Prayers were said (if said at all) in a few short sentences. The hugs are still there, the kiss too though now she is now less inclined to give me a kiss. The singing has long stopped. The stars are fewer now (we moved her to another room and we didn’t stick so many start on the ceiling).

I miss those days. I think I have paid a very heavy price with this Masters program. We all have. Now she is all grown up. She no longer thinks her daddy is superman or Einstein. Some of her behaviour is starting to worry us. MMed has taken their daddy away.

Lord, I just hope it’s not too late when I am done with this course. My son is now 2+ and I still have not done with him what I did with his sister. Sigh!

I don’t want to be the big bad wolf….

Hemo-hyperthermia

Rounds actually finished a little earlier today….15 minutes earlier than the usual 12.30pm or so. But it has been a stressful round all in all. It’s not because the patients were particularly ill, it’s because of the relatives that really got onto our nerves. Sigh! A whole bunch of ‘glutalgia majora maximuses‘. Arrgh!!!

I don’t even want to talk about it. But I have to say that I have great respect for all Geriatricians. You know, you will seldom find such annoying relatives in any other medical wards except the geriatric ward. My boss says it’s because of guilt. The all empowering force within each of them (because they haven’t been doing much for thier parents when they were much younger) which is now let loose in full force onto the medical staff taking care of their beloved. I think Geriatricians are great people, being able to take this abuse day in and day out. I would have gone insane or done something homicidal.

The patients are mostly very gentle folks. Some of them have such gentle demeanour. There is one chinese lady with a perpetual smile on her face.

Not so the relatives.

5 more hours to the end of the day, 26 days more to the end of the month….and I am counting.

Btw, the title of this article was coined 5 minutes ago as I munched on some over cooked kangkung with rice and a very rigor-mortised fried mackarel. It means ‘blood boiling’.

TGIF!!!!

I woke up this morning, feeling like I am 80++ ( I wonder if working in the geriatric ward has this kind of effect?). I ache all over, have this pounding headache on the right side of my head, the muscles in my neck and back are taut and painful, I feel nauseous…generally my body is screaming for an MC!!!! If I am a woman, I’d probably diagnose myself with either PMS or early pregnancy. Alas, I am not. I think I am going to be sick.

Yesterday was another e-prescribing horror at the cardiac clinic. The computer hanged for 2 hours! I had one patient sitting next to me, waiting patiently (at first) for me to fiddle with the stupid computer for eternity. We made small talk…lots of it. By the end of the fiasco, I know him like my own blood brother! The fiasco was ended by the sudden appearance of the ‘Charlie’s Angels’ (4 beautiful young malay girls from the IT department) who burst into my room, and declared that I have to go back to old school prescribing until they can sort of the problem. Sigh!

Yesterday was a good day….my thesis now has 425 recruits. Another 75 to go. Hallelujah!

It rained as I rushed to locum (ah, probably that’s why I feel sick now la, I got caught in the rain) after the cardiac clinic. Locum was the usual ho hum, except for 2 patient…

The first was a young Indian chap, very good looking (spots ear rings on both ears) and apparently, he just got married last month. As with any newly weds, they were ‘doing it’ regularly, probably overdoing it. He’s got all kind of blisters and bruises on his, you know, wee-wee and he got worried. I took a look and the lesions didn’t look alarming. My conjecture was that he has been rather ‘rough’ (poor wife). My advice? “Go slow brother, take your time….blah blah blah, you know, the whole birds and the bees stuff). He wanted a blood test and I asked him to go do a HSV serology just in case. Still, I told him not to doubt his spouses’ fidelity.

The second memorable patient was a lady who is a lecturer in a certain institution of higher education (that got bumped off the top 100 list). She was so scantily dressed (ala Eva Longoria, mind you). Her complaint? She was alarmed that spots have appeared all over her arms. Actually I counted 7 spots. Apparently one of her colleague has got similar spots and has become ‘worst’. Apparently, another doctor told her colleague (a guy) that it was due to some exotic ‘worm’ that is not found in Malaysia and the ‘worm’ has laid eggs all over his body causing the offending lesion!

I am like, “What hocus pocus?”!!! Anyway, our Eva Longoria was convinced that she was totally infested with the eggs of this exotic worm. The eggs are hatching out of her skin….arrgh!!!!

I told her that it’s unlikely to be due to a worm. She looked at me as I spoke sanskrit! You can tell she was unconvinced. So, I told her that it’s probably best to visit the same doctor who treated her worm infested colleague since he has diagnosed him with such an exotic diagnosis. She said to me “You are the doctor, you should tell me what these spots are!”.

I looked at her and said “We doctors don’t profess to know everything. If I don’t know something, I tell my patient so, rather than cook up a cock and bull story like exotic worms”. You could almost see Eva here smoking at the ears.

Finally I told her that the lesions are probably some kind of ‘septic spots’ (well, they do look like them!). She wanted antibiotics and I gave her some. She seemed happy after that, convinced that the medications will eradicate all the ‘worms’ in her body. Sigh! I can’t believe a lecturer can be so ignorant.

Long day ahead, more rounds in the merry old ward. But TGIF!!!!