On the brink…

WARNING: THIS IS AN ANGST RIDDEN ARTICLE AND ANY SEMBLANCE TO ANY HUMAN OR ANIMAL, DEAD OR ALIVE, ORGANIC OR INORGANIC IS…, WELL, JUST TOO BAD.

Have you ever been pushed to the brink of giving up? When you feel so helpless?

The past 2 weeks have been especially trying for me. I seem to get one bad news after another. Let me tell you about them.

It all started, of course, with that painful bill for the repair of my car which was in ICU for 16 days.

And then, there was the complete apathy of people that I work with.

For a long time now I have been wondering why the hospital or people who deal with a particular condition related to HIV, drug addicts and dialysis patients aren’t interested in purchasing an injectable form of therapy to treat them even though there are funds for it. This therapy, though costly, have been proven to actually rid these patients of the debilitating illness. Now isn’t that good news?

But no, no one seems to be even mildly excited about it.

And then I got the answer last week.

Some one told me in a matter-of-fact manner:

“I HAVE NO INTEREST IN TREATING YOUR TYPE OF PATIENTS!”

So, finally it’s out. It was the ‘type’ of patients that prevented them from being treated.

And then there is this patient of mine (yes, that ‘type’ of patient) who has been admitted for 5 days before I was informed about him. He came complaining of right shoulder pain. For that 5 days, every one basically bypassed him, assuming that his complain was merely ’soft tissue pain’.

Until I saw him.

He has a fluctuant tender swelling extending from the root of his neck, covering his entire right neck, right suprascapular area, supraclavicular and infraclavicular areas and finally the right axilla. His right upper limb was double the size of his left. I took a needle and syringe and aspirated 20 cc of frank pus.

My request for an urgent MRI was turned down instantly without a call to find out if it is necessary but rather it was returned with a ’semi-veiled sarcastic’ request that my MRI request be reviewed by some one higher up. I felt like I was slapped twice in the face. After a review by some one higher up, a scan was felt to be justified and by the time it was done, a good 2-3 days were lost. This only added to my resentment for most (but not all) radiologists ~ some of whom I have had very bad encounters with. Doesn’t it occur to them that no one (especially a specialist) would order a scan just for the fun of it?

And then came the battle that I have fought many times over with my surgical colleagues ~ to try and get one of them to do a drainage procedure on the incredibly large abscess that is slowly taking the life of my patient. The surgeons took a look and promptly passed the patient to the ortho people.

And that’s how the status quo is. My patient is now in their ward, with no immediate plans. Surgery is delayed with reasons such as the coagulation profile is deranged, the patient is slightly delirious, etc etc.

God, the patient is in sepsis!!! What else do you expect? The longer the delay, the more septic he will be, the more deranged his coagulation profile will be and the more delirious he will become!

I have this sick feeling in my gut that my patient will pass away ~ all because no one wants to touch this ‘type’ of patient. I have fought so hard for this man, treating him from Feb 2008 and he was doing well for a spell. I would gladly take the scalpel and do the drainage myself, if I know where to incise!

And then the last piece of news hit me really hard 2 days ago.

I got a call from a friend. A friend of  his has just been diagnosed with HIV.

In the last 2 months, I have had this “friend of a friend being infected and diagnosed with HIV” scenario played repeatedly, like reruns of sick and lousy B grade movies. There is an epidemic out there! And there is absolutely nothing I can do about it.

A couple of weeks ago, after we heard the estimated cost for the repair of my car, one night, my wife turned to me while we were both trying to sleep and said:

“You know, sometimes I wish you are not doing what you do. I wish you would open a clinic or be in private practice, then we won’t have problems like this. But I know you can’t. You love what you do. You will be miserable in a clinic.”

You know, some times, I really felt like taking her advise and make her dream come true.

I feel so helpless, frustrated and on the brink of giving up, maybe throw in the towel and go open a clinic (I think the area where my mum and dad lives could do with a clinic!)

But I can’t.

Because if I do, some people will die. I can’t live with that.

Fri, 150808 @ 0700

Protected: Exam Bloopers 22 (PW: Abbreviaton of the type of Ca lung which cavitates)

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333,333 hits today

I think my blog will reach the psychological threshold (to borrow a stock market phrase) of 333,333 hits today.

Sigh, it takes me so long to reach this when some people reached it in a few weeks!

Thurs, 140808 @ 0700

Exam Bloopers 21

Yesterday my daughter told me that one of the question in her science paper was this:

What is the function of a spring in a dynamo?

She could not answer that question and according to her, most of her classmates could not answer either.

Back when I was young-er, I used to cycle to school, right up till I was in Form 4 when I decided to walk because it gives me more time to think and enjoy the quietness (my neighbourhood then was quiet and walking to and fro to school was enjoyable).

My bicycle was one of those old fashion ones and at night, when i need some light, I press the lever of the dynamo and it will place the head of the dynamo onto the bicycle wheel, thus generating electricity. Of course pedaling with the dynamo engaged takes a bit more leg power.

But my daughter’s idea of a dyanamo (she has never seen one and frankly I feel the teacher should not ask that question if she did not first explore whether her pupils know what is a dynamo) is this:

A bottle of DYNAMO liquid detergent!

I bet she was wondering what is a spring doing in a bottle of liquid detergent.

Sigh.

How things have changed.

Thurs, 140808 @ 0700; Jimbo don’t feel so gay* today.

*fun; lighthearted; cheerful (Oxford Advanced Learner’s Dictionary).

The NGV Report 2

As a follow up to my first report, 2 forums have been started on other websites. For those who are interested to read up on what others say, please visit these links:

1. The NGV Community

2. To NGV or not to NGV

I will continue to update on my experience using NGV here, in the hope of creating awareness regarding the use (and associated calamities) of this ‘clean’ fuel (It sure cleaned me of my life savings!)

Wed, 130808 @ 1415

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Exam Bloopers

Will there be one today

Or won’t there be one?

Watch this space…

Wed, 1308080 @ 0727

Night Classes

* I got this in my email from Terence. Have a good laugh. Good for releasing exam tension.

Ah Beng: Ah Seng ah… I’ve been taking night courses for 3 months already, next week is the exam.
Ah Seng: Oh… Good luck ah.

Then Ah Beng started show off…

Ah Beng: Ok, I test you, who is Graham Bell?
Ah Seng: Don’t know
Ah Beng: He is the inventor of phone la… in 1876, see… if you take night courses, you would know this.
Ah Seng: …………………… *speechless*

The next day, Ah Beng shows off again…

Ah Beng: Ah Seng ah… let me ask you, who is Jean Jacques Rousseau?
Ah Seng: Wash your toilet one ah?
Ah Beng: No! He’s the author of ‘Confessions’, nah nah nah… told you already, if you take night courses, you would know this.
Ah Seng: ……………………. *speechless + frustrated*

The next day, once again…

Ah Beng: Do you know who is Alexander Dumas?
Ah Seng: Your gay partner?
Ah Beng: Choiii!!! If you don’t know don’t simply answer la. He’s the author of ‘The 3 Musketeers’, if you take night courses, you would know this.
Ah Seng: ………………….. *speechless + frustrated + irritated

This time Ah Seng cannot tahan (stand) anymore and ask Ah Beng…

Ah Seng: Eh… Do you know who is Ah Kaw?
Ah Beng: Errrr… No!
Ah Seng: He’s the guy sleeping with your wife!! If you stop night courses, you would know this!!
Ah Beng: …………………… *fainted*

Tues, 120808 @ 0700

The NGV Report

It’s been a little more than a month since I converted my car to run on CNG. Lots of people have since asked me, “How is the NGV?” or, “Is it worth installing?”

And my response?

Well, if you drive a Hyundai Matrix (like the one above), DON’T!!!! (Unless you wish to have lots of heartaches or have tons of money stashed in some off shore account to spare).

Technically speaking, since my car was installed with NGV, I have not driven it for more than 2 weeks, tops!

The first week I got the car, it ‘died’ at every other traffic light, increasing in frequency until exactly one week later when it completely stalled on the fast lane of a busy road!

I got the car fixed in a day (and missing work as a result), and the mechanic told me that it was due to ‘timing’ problem.

One thing that constantly bugged me was this:

This little light on my dashboard has persistently lighted up ever since the NGV thingy was installed. The light is an indicator for me to “CHECK THE ENGINE”. The mechanic told me that “it’s okay, because the engine ‘cannot’ recognise the CNG as fuel, and so the light will come on”. He told me to just “ignore it”.

After the car was fixed, I drove it for another week without much problems, the ‘timing’ being fixed and the car did not ‘die’ anymore at traffic lights. I even drove to KL on Monday and back without any problems. The little orange light on my dashboard was still there and as instructed, I ignored it.

Tragedy struck on Tuesday. Right after passing the Bangi exit on the North South Highway, on my way to KL, the car stalled completely with smoke coming out from under the bonnet!!!

What happened next was a nightmare that lasted more than 2 weeks (16 days actually). The car was towed back to the mechanic who installed the NGV and though I suspected it had everything to do with the NGV he installed for me, he (not surprisingly) denied it vehemently. He said the NGV thingy was not to be blamed.

Isn’t it a coincidence that my car, which has been driven for 3 years without problem and serviced every 5000 km, should start to act up right after the NGV was installed?

My car engine overheated and suffered a severe meltdown. Initially the estimated cost of repair was RM6 K but it quickly escalated to much more beyond that as the mechanic found one fault on top of another with the engine. He also bought a whole load of spare parts which in the end, he did not use and still charged into the bill!!!! He said these expenses were not anticipated!

I was really depressed at the time. I was looking at years of debt. I couldn’t sleep and lost my appetite and zest for practically everything else. I thought of calling old friends or class mates for help, you know, trying to borrow a bit of cash here and there (after all, a lot of them are doing a lot better than me AND they constantly call me on the phone for a quickie telemedical consult every time they have problems with difficult patients, FOC!).

In the end I did not.

I decided to hold on to what I read in the Bible at one of my darkest moment then: “Stand still, and see the salvation of the Lord” (Exodus 14.13).

Help came from a totally unexpected source! (Sorry, I’m forbidden to say more).

Still, it does not lessen the pain when I finally got the bill.

The bill of pain.

The total came up to a little less than RM 9 K! I almost had a heart attack.

So much for trying to save money with NGV. Sigh…

I’ve learned a lot through this unpleasant episode, much of it too personal to write here.

It’s been 7 days since I got the car back. It’s running with a ‘recond’ engine inside. It sounds quite okay. So far it has been running smoothly. It hasn’t died out at traffic lights (except twice when we forgot to step on the accelerator on starting). There have been no funny sounds nor strange smells.

And today, I’m driving it to KL again. I still drive with all the muscles in my body tensed up and my eyes constantly darting between the road and the temperature gauge. The little ‘check your engine’ light is still constantly lighted and I must admit, is a visual irritant. My wife would be tensed up worrying that I might again be stranded on the highway with a smoking car. I am keeping both fingers and toes crossed and praying fervently for divine favour.

I’m still driving around using CNG.  Whatever little that I save would go a little in paying off that big big debt. It would go on for years and years and years. Sigh.

So, in the final analysis, I repeat again my admonishment: If you drive a Hyundai Matrix and wish to switch to NGV,

DON’T!!! IT”S NOT WORTH IT.

Mon, 110808 @ 0700

New date for climb

The Gunung Datuk climb which was supposed to take place yesterday did not happen (due to lack of quorum!). Instead, it has been postponed to next Saturday (16th August 2008). The rest of the details are the same. If any of you plan to join us, please let me know in advance.

Sun, 090808 @ 2139