A Doc's Life is a underground Medical Blog about some poor Singapore doctors. They are sibei sian and very buay song. Best practices not observed!
(Warning: Grammar is non existent in this blog. Those obsessively compulsive about good English please go no further and book an appointment to see your psychiatrist in Singapore.)

Friday, December 11, 2015

Jiak Kin Jio

When you are a Dr, people expect you to know everything!

Whether traditional medicine is good for them. 

Er, wait ar, Dr Og go call my mother first and ask.

Whether going to work will aggravate their BP... 

ok la, ok la take MC la.

Whether the medicine can take with supplements. 

Wah lau, why you don't ask the G@C salesman who sold you your protein shake whether can take medicine or not?

Whether your son's girlfriend is good for him. 

Ok, aunty I saw your family for a long time now but don't drag me into your family politics leh. Plus, must maintain patient confidentiality and cannot tell your son all the naughty things his girlfriend (whom happen to also see moi the friendly neighbourhood dr) done before right? But thumbs up for the good intuition!

But lately... and strangely... people have been asking me about bananas.

Patient: Lokun, I heard bananas can treat my condition!
Dr Og: Is it? You read from internet is it?
Patient: Wah, you lokun, you don't know ar... I thought lokun should know everything! But its possible right? Banana can cure me.
Dr Og: Er, the only case of banana I have encountered was when this guy thought it was funny to shaft a banana down the wrong end of his digestive tract, hahahha...
Patient looking disturbed. 
Dr Og: Ok, I digress but look here, I really don't know if banana is good for your condition. If you like, eat lor. But please also eat your meds ok?
Patient leaves looking disappointed.

The reality is that a doctor doesn't know everything. We only know what science can tell us. Most of the time the science tells us "maybe" or "it depends (on so many factors that there is no way you can understand what I am about to explain so lets not waste each other's time)". Anyway, before I forget, better take a note to check bloods for this patient next visit, in case he takes banana qds and end up with hyperkalemia!


Friday, November 13, 2015

Grand Wayang Round

Nowadays be senior Dr is sibei pai miah (bad life). Last time Consultant in Hospital is like rock star. Can ya ya walk in front during ward rounds and got a whole entourage behind you. Got medical students, got medical officers, nurses (and maybe seventh month got others following, but that one another story). Wah sibei shiok ar. You know the surgeon is sibei humsup if you see the entourage is mostly pretty medical students, pretty MO and pretty nurses. You know the Consultant is gay if you see the entourage is... hee hee hee...

Source: http://lackcolor.com/pic-806-Lots-of-doctors

Of course these days things have changed. Nowadays, there are many many female Consultants as well. To be fair (and avoid kennah feministic attacks), female doctors are just as good as any male doctors. Their pet peeve is kennah called Missy by the ah pek whose memory remains in the 动荡的时代, pre independence Singapore. Hello uncle, now is SG50 Liao, char bor are no longer all nurses la. And matah don't wear Bermudas anymore lor.

I digress.....

In those days when "Consultant is King", you can imagine the kind of power the Head of Department wielded. He is literally the Godfather, with people worshipping the ground he walks on. Godfather will of course have a bigger ego than his Consultants and his entourage will of course be even more solid! When Godfather does ward round, it is not just a ward round, but the Godfather Ward Round, GWR. And because cannot be so obvious in public service, we usually call it Grand Ward Round. But what so grand? The Godfather of course.

GWR is a very important event. In the old days, it can be make of break. It is the time when Consultants become minions and melt into the background as part of the entourage. It is the time you impress the Godfather with your short skirt (why do you think now so many female consultants har?). It is also the time you try to siam being asked questions and being publicly humiliated by the Man himself. Most importantly, it is time when the patients gets the same orders and treatment but will somehow miraculously do better because those same orders came from the mouth of the Man (or they get discharged or transferred to some lesser teams if they don't get better).

I always feel that the big entourage probably did something for the patients.

"Wah! Tua Lo Kun Lai Liao!" They probably thought. Think of how powerful and therapeutic that scene must be! A whole army of doctors and nurses lead by the most senior and most capable doctor coming to see you in the bed and actually poking his finger into that orifice that is causing you problems. Everything also ho sei liao ar!

So wayang or otherwise, once a while Dr Og reminisces about the old times when GWR was done the traditional way. Nowadays, mostly you see lonely consultants rounding. At times, you catch them crying at one corner, lamenting how they kennah whack as junior Drs and now their turn to whack, there is no one around. I think we should bring back the good ol' times as I'm sure patients benefited from megalomanic Consultants and HODs and Dr Og always think of patients first :)

Monday, November 02, 2015

The Reason Why the Haze Has Ended.

So the haze came back. They say the last time the haze was this bad was in 1997. Sure or not? Dr Og remember 1997, I was still a student. Remember was walking with a girl down the quiet road hazy hazy, machiam very romantic. Like in movie like that. Fast forward to today, no more quiet roads around liao and the haze like got a yellow tinge to it.

And as usual, Dr Og didn't get an air purifier in time when the haze struck. I spent many weekends searching online and offline but everywhere sold out liao! In some online electronic stores, even the category mysteriously disappear. Reminds me on how suddenly before midnight or at rush hours, all the taxi sure pang kee one!

So for the whole duration of the haze, my wife and poor kids have to survive on a single air purifier with a three year old filter. They are of course not very HEPA about it (pun intended hahaha). I was reluctant to clean the filter since that would mean me being hantam not only by the PM2.5 for this year's haze but also those that were collected two years ago when the haze was also bad!

I was trying to convince them that they can wear the N95 masks indoors. There are now huge stocks of N95s around so no scared don't have. Some even got air blowing one, so high tech! The kids of course complain that it is uncomfortable and don't want to wear. Hello! Lim peh assisted hours and hours of surgery in N95 plus PPE (personal protective equipment) also never complain. Remember that time, finish surgery, the scrubs so wet, can see the nipple shape liao!

Anyway, I still try my best to find air purifiers and finally found a few units in a store with real HEPA (and not the bluff HEPA type) filters. The air purifiers like more expansive than usual leh but never mind la... Wife and kids happy most important right?

And then hor, the very next day...

No haze liao.......

Singaporeans, you owe me one.


Friday, August 14, 2015

Elitism

Recently read a lot of news about elitism. Then people started kpkb on equality and equity like this boy call Russell. Wah Lau, sibei complicated la. Dr Og England buay sai one, cannot understand simi lai eh?

Actually Dr Og also sibei dulan some of these elite schools students sometimes. I have come across some really hao lian ya ya papaya students from RI / RGS. Talk very big like they know a lot about medicine also. Hello! Lim pek went to elite school when your mother haven't even ovulated you. You better show some respect ar like in those Taiwan shows call us 前辈!(Please don't call uncle hor. I not that old, thank you.)

Anyway, you go good school doesn't mean you elite liao. I check dictionary and dictionary say elite means:

"select group that is superior in terms of ability or qualities to the rest of a group or society."


So you can elite in values, elite in sports, elite in talking cock (like Dr Og, now put your hands down!), etc etc. If you are just elite in PSLE score, please go achieve something in real life before you come show pattern.


A good example of elite is the commandos. Every year they get best unit in army. But they also train the hardest and when war comes, they probably sacrifice first also. Plus many special force people will never reveal their identity and never get the glory they deserve.

This young boy, Russell, also sacrifice. He jit tao kamikaze. Shows his EQ sibei not elite. And Russell, if you go NS that time, complain here pain there pain go see lokun, you better show some respect and remember to call the lokuns 前辈!




Friday, May 15, 2015

Why You Don't Want to Be Happy with Your Doctor

Those of us who work in Hospital will know about the all important Patient Satisfaction Survey (PSS) season. This is when the admin staff suddenly appear from their dungeons and start distributing milo drinks and so-ta-piah (soda crackers) to patients. Dr Og always see some of the doctors steal the milo drinks and biscuits. Wah lau, don't so siah suay can or not... patients only get this type of good service once a year, so don't go and steal la.

But hor, this journal from JAMA which has been circulating around facebook for a while liao shows that higher patient satisfaction was associated with less emergency department use but with greater inpatient use, higher overall health care and prescription drug expenditures, and increased mortality.

What this means is: the more you like your doctor, the clinic or the hospital, the worse your outcome will be!!

Dr Og thinks this may not be true everywhere but sometimes, making the patients satisfied means giving them what they want. And one thing that patient always want is to go off medications. If I tell all my patients meng jiak yok liao (no need medications), I'm sure all of them will be sibei happy lor.

And they probably won't be well enough to make it for the next PSS to register their dissatisfaction.

Actually, what Dr Og thinks really will work is if we survey Doctor's Satisfaction! Surely if your doctor is happy, he will be in a better state to treat you and your outcome will likely improve. JAMA should really look into it! Unfortunately, I can't suggest this to hospital management as I have vested interest.

But if they really do the Doctors Satisfaction Survey hor, then at least we don't have to steal Milo and so-ta-piah (which incidentally is my fave snack)!

ha..ha..

Sunday, April 26, 2015

Love Bites!

Dr Og last time work in the ward will always try and avoid chatting too much with the patients. It's not like Dr Og don't like you all ok, it's just that lokun must have lokun decorum, which means that we must be distant and mysterious. After some of my fellow colleagues kennah stalked, it affirmed my stance further -- although the staff nurse tell me I not yandao enough to get stalked one....hhhhhmmmmpph!

I remember got one time when I was a MO, the baby MO haolian show me a thank you letter folded into a heart-shape from a patient. This patient was young and chio and he baby MO was very buaya type. The patient was actually quite well but was admitted for low platelets because tiok Dengue (those were good ol' times when there were actually enough beds to admit patients). We were all in the same team and the few younger male MOs including Dr Buaya were fussing all over her. For the first time, they would actually put up their hands to take blood.... for her of course. It was a strange sight. One MO tying the tourniquet, one MO preparing the blood tubes and the lucky one, who won the orh ar peh ar song, performing the venipuncture.

Me? I didn't want to join the the charade, preferring to attend to the ah pek and ah mah. The old folks usually talk talk talk but they don't really mind you not listening. Anyway they either forget who you are soon enough or if their senses are impaired, they may not know who you are in the first place. 

I like my distance.

So this baby MO and the few other MOs who fussed over the girl all received the heart-shaped-thank-you-letters on the day she was discharged. I think I would be lying to say that I was not slightly jealous and wondering if her telephone number was in it. (There was of course no way we would call her as that would be ethically wrong.) After all, all of us do like to be liked but it's really about the amount of effort you are willing to put in.

Few days later, there were some shouting going on at the counter and it was distracting me from writing my blog in the MO room. I walked to the counter and there was the girl and her mother shouting at the poor PSA. They were complaining that there was a big blue black on the area where the blood was taken and refused to accept the explanation that it was quite normal and that the blue black will go away. Soon the buaya MO & et al joined in to explain but it quickly escalated into a heated argument. 

It ended acrimoniously with the girl pointing at the buaya MO shouting, "I want to complain against you!" 

Mother and girl stormed off...... presumably to the Quality Management Office. (Sometimes you get a limited edition teddy bear if you complain hard enough!)

Moral of the story? 



Please press the cotton on the venipuncture site long long and not let go. Otherwise sure kennah haematoma!  

Tuesday, April 21, 2015

Faster and Furiouser!

So Fast and Furious 7 cheong pass $1 Billion liao. Dr Og played a part in that by having watched the show one week ago. Fast and Furious is one of Dr Og's favourite movie franchise (after Star Wars, Harry Potter, Avengers, LOTR, Transformers, Ironman, Superman, Batman, Spiderman, Toy Story, The Hunger Games, X-Men.......) There are bromance, fast cars and the Rock. Really, whats there not to like.



If anything at all to criticise, the screenplay writers got lazy and copied the plot of Avengers (who copied the plot of Transformers). It is basically about some people wanting to take over the world and these dudes with super fast cars stopping them and in between some buildings and cars get blown up. Like the Avengers these dudes have super power. They can jump in, out, down, up vehicles without falling by altering the law of Physics, they have invulnerability and can survive car crashes and falls from height without any substantial injuries, and their cars can even fly from one building to another. Unlike in Transformers (another movie about saving the world while destroying some cities along the way), the cars do not transform and start talking rubbish, which Dr Og feels is a good thing actually.

Dr Og also think Vin Diesel got lazy. This dude won some acting award last time tio boh? Why now he like only got one buay song face and one ya ya papaya expression?

The Rock (sorry dunno his name) was not bad in the show. He fell off a building and managed to hope  the char bor in his arms. After that he went hospital still alert and GC well! Only break a few ribs bones and had a cast over his arm. He later summon super power and break the cast by flexing his arm. So un un un believable, I tiok stunned like vegetable lor. But he redeemed himself immediately in the next scene by driving an ambulance to go help fixed facies Vin Diesel. An ambulance in fast and furious wor!

The Rock say he wants to do a spinoff for his character in Fast and Furious. I think Dr Og can contribute the plot:
The Rock after falling from so high and breaking this and that bone. And also anyhow AOR from hospital without proper treatment, was downgraded to PES C9L9. So he cannot work in the dunno simi government agency liao coz he fail medical board.

He retires to become an ambulance driver and learns to drift ambulance at the hill behind MOH which used to be KEVII. Because of his extraordinary driving skill and speed, unhuman strength to pick up any casualty without a stretcher and ability to bump off all the slow coach cars jamming up the road to SGH A and E, he manage to improve our national ambulance response time single handedly! Complaints such as this totally disappears as the Rock can get you to TTSH and KKH at the same time with his doppelganger super power (how can this be a Fast and Furious movie without some ridiculous right?)!

Also SNEC can sponsor all their doctors' lovely sports cars (which would otherwise be just parked there anyway and never see the real speed they were built for). The name of the movie I also think swee swee liao, call Faster and Furiouser: Ambulance Cheong No Enuff. In line with our Singapore motto of Faster Better Cheaper... for SG50 Swee la!

_________________________________________________________________

RIP


Wednesday, April 15, 2015

Tips on How to Make Your Doctor Like You (Part 2)

Last week, Dr Og teach you how to make your doctor like you. If you haven't try better quick quick. There are of course lots of research to show that if your lokun like you, he will treat you better. Even the char kway teow uncle will give you more hum if he likes you right?

Here comes some more tips!


4. Listen (After You Talk)

You are after all C-O-N-S-U-L-T-I-N-G your doctor (and paying to do so), so its only right that you L-I-S-T-E-N to the consult (to make your money worth it). Many patients switch off when they are told things they do not want to hear and when sh#t hits the wall, they will claim "Wah, Loctor why you neh tell me don't take meh-cine will be so jialat."

Wah lau... Dr Og told you so and also judiciously documented it down in the case notes ok. But you weren't listening, were you. Not likable at all... humph.

5. Self Diagnosis and Treatment

Being ke kiang and demanding your doctor to give you treatment for the diagnosis you think you have is not likable at all lah. Yes, you can Google about your symptoms but you did not spend 5 years in medical school, one (tortuous) year as a Houseman and another 4-5 years in specialty training. You did not spend thousands of hours seeing and treating thousands of patients with the same problem.

Even if you more clever than the doctor, pretend pretend a bit. Trust me, when the doctor sayang you, the injection also not so painful one.

Anyway if you really so so clever, you don't need to see and doctor or to have him like you. Press Alt-F4.

6. Assuming Responsibility

And if you so clever and you think you can self diagnose and self treat like taking a selfie on your smart phone, please also take responsibility for the risk you put yourself in hor.

Aunty (from last post): "Lokun I ok liao, the medicine I stop liao, can har?""
Dr: No la, best continue la. You choose to stop anything happen not my pasar ok."
Aunty: "Means I can stop la, can har, you say one har!"

One month later...

Aunty Angry: "Wah lokun you say can stop, see now so jialat, you bluff me ar!!!"
Aunty's Son: "Wah lokun, why you tell my mother to stop medicine??? You sabo ar, I port you to hospital!"

Now even the son is unlikable, hai...

7. Maiming or Killing Your Doctors

If your doctor is dead, he really cannot like you. Attacking him will really do no good to your patient doctor relationship because there will be none left. If you really don't like your doctor just change la and maybe the next doctor same pattern as you. 

In China, doctors are frequently attacked and sometimes killed by buay song patients and relatives. Some of you may say orbid good since the doctors there take bribes and angbaos and some of you may laugh it off since Singapore is like the safest place in the world. But low crime doesn't mean no crime;  being threatened and even actual physical violence are not so uncommon. Nowadays, doctors kennah thrown hot milk and infected needles and even tiok kicked ar!

Why so liddat? The doctor will be so scared that he will be standing at least ten feet from you during consult liao, the stethoscope where got long enough?

Aiyah, its really easy for your doctors to like you. Just be patient, polite and nice (how hard is that right?). Being liked by your doctor will bring unprecedented privileges and extra KY jelly before the fingers do the walking.....


Sunday, April 12, 2015

Tips on How to Make Your Doctor Like You

So you really want your doctor to like you ar? If not you wouldn't have ended up in this page from Google search right? Don't be shy, you are just one of the many Lokun Worshippers out there. (For stalkers out there, to read the special how to make your doctor LOVE you post, press Alt F4 now!)

And what if you don't like to lick like a doctor? Yes, you will be treated equally whether your doctor like you or not... but you will be treated more equally if your doctor does. After all, as much as you doctor lovers refuse to believe it, we are humans after all.

So if you will like a gentle per rectal examination (with a prostate massage extra service), here are some tips on how to make your doctor really like you:

1. Punctuality

Yes, sometimes you need to wait a bit when you are on time. But you have to know, doctors are egomaniacs and you will damage their egos if you make them wait for you instead. So if you guai guai come early, your doctor will really appreciate la. Even if you need to wait long long, so what? It is all worth it because your doctor will like you! If he ever even offer a hint of apology for making you wait, quickly counter apologize for causing him to apologize. In this way, both of you can quickly get over the "why you always late" and "why need to wait so long" issues and focus on the medical problem at hand.

2. Gifts

Dr Og has received all sorts of weird stuff from patients, including stuff toys, belts (yes belts!) and some suspiciously used objects. Most patients would present normal gifts like fruit hampers or bring us some drinks and food.

Honestly, no need la. 

No Ang Baos please! Singapore doctors cannot be bribed. Do not even try giving us anything more than $10 in value as your doctor then has to waste time to declare this to Human Resource. Most of the time gifts that are of substantial value will be sold off and proceeds donated to hospital endowment funds.

The best stuff Dr Og has received are thank you notes or cards to say tell us that they are better. A simple thank you never fails to melt your doctor's heart, boost his morale and improve your likability!

3. Talk

The patients that Dr Og definitely cannot tahan are those who refuse to talk.

Dr Og: "Aunty, simi tai chee" (Madam, what ails you?)
Aunty sulks: "......"

Dr Og: "Aunty, li si tolo boh ho sei" (Madam, where do you feel unwell?)
Aunty continues to sulk: "......"

Dr Og: "Wah lau, li mai kong wei, mai liao si kang, er bai ka lai la, lua kau lang jin zuay la" (Perhaps you will like to think about what your problem is and come in later?)
Aunty finally squeezes a line: "Wa simi tai chee, li si lokun kuah buay chut meh? Li si simi lokun?" (I got what problem you cannot see with your eyes is it!)

 It is absolutely ok to write down in point form, what you will like to communicate with your doctor. In fact this is an efficient way to let your doctor know your problems. Avoid coming into the consult with pages and pages of prose as your doctor immediately knows you are a kan cheong spider and your likability drops to rock bottom.

To be continued...

Wednesday, April 01, 2015

Thank you, LKY

If you have followed my blog (and if you allow me to be narcissistic enough to think that I have fans who do), you would know that I am not the die-die-must-be-doctor type of doctor. Nor do I think that being a doctor is prestigious. There is also nothing elitist about being a doctor and you know that when those property agents don't really give two hoots about you when you go kay poh at launches.

Nevertheless, I have to acknowledge that doctoring does bring to the table a stable and good paying job. Many people still think that being a doctor is a big deal and many doctors still want their children to become doctors. I have many classmates who studied medicine because their doctor parents wanted them to. There are plenty of Dr families out there where the whole clan is in the medical field one way or the other.

Unfortunately, Dr Og is the low EQ and blur like sotong (that's why I hide in my clinic write blog) type and I am totally unaware of who is who and whose lao pek is who in medicine. For some strange reasons, I have no inclination towards 关系 building. I had zero connection when applying to get into medical school. I went through medical school without ever trying to network or rub shoulders with the who and who because I was totally blur about these things. As a junior doctor, I shied away from even going for department gatherings and if I had to, I cringed every time I see junior drs try and angkat the senior doctors and HODs. When I became more senior, I often find out too late that that junior dr I just gave an earful is the son or daughter of so and so (not that it would have made a difference).

Despite my limited EQ, I think I managed ok in my career. I was judged or at least I felt I was judged by my work, and not by my background (I had none) or by who I associated with. There are of course the typical stories of how so and so got into medical school because of a certain connection and how some cannot-make-it HOs / MOs got their traineeship in those prestigious specialties because their fathers and mothers were so and so. I would be a fool to think that favourtism or cronyism do not exist in some form or another in Singapore, but at least where I have worked, it is as minimal as it can get anywhere in the world. Despite all these, there was more than enough meritocracy for us, the unconnected sons and daughters of unconnected people, to get by.

We have our founding Prime Minister, Mr Lee Kuan Yew, to thank for a system based on meritocracy. I don't think I need to belabour the points given that there have been ample broadcasts about Mr Lee's ethos in nation building. Much have been said about him. Nothing more for me to say except... Thank you!