Spot The Problem

A recent MJA journal article published on 6minutes.com.au:
http://www.6minutes.com.au/articles/z1/view.asp?id=504114

As with a lot of cases of gripe, there isn’t a clear goal/obstacle to tackle. So what is really the problem here?

a) Low amounts of clinical contact with patients?
— This needs defining. What counts as ‘clinical contact’? Does re-inserting of a cannula into a petechial and well-worn arm count? I bloody hope so since no one else is going to do the job. Certainly not for our colleagues higher up the hierachy. I sometimes wonder (on a general basis) if our consultants can do cannulations any better than we do.

b) Too much clerical work?
— Its related to point (a), I know. But someone’s going to have to make the referrals, someone has to write the discharge summaries, someone has to rewrite the scripts and someone has to do the notes on the ward round. We want to get to know our patients, but we do have other responsibilities as well. Its not as if we went on our tea break <smirk> As much as we do deserve them <smirk>

c) Modern junior doctors are lazier?
— My cynical side says yes because the traditional role of the houseman has changed quite a bit over the decades. Bureaucratic work certainly does numb the mind and definitely numb the will.

d) Modern junior doctors don’t know enough?
— This begs the question, “how much are we supposed to know?”. There have been much written on these and I think the personalities in medical training have followed it and followed it well to a large extent. I know that my APO patient needs an ABG, and I know how to read them, and correct them (in general terms). But if you are going to blast me for being unable to say the 4th or 5th cause for a 1-2 drop in PaO2…then I don’t know what to make of that.
— I do certainly have no excuse for those who are absolutely shocking and especially those who make no attempt to correct themselves.

e) Are there actually more errors despite the generational change?
— I have yet to see evidence that the junior doctors of today are any less competent than their counterparts decades ago. All we have are hearsay which can be biased by personal pride and non-inclusive of the changes medicine (if not, life and culture) has gone through in the 20-21st century.

I certainly revitalized my dream of changing the system to one of having on-site consultants which are present in the unit throughout the day. I’ll write up an “Imagine…” post about this next time. Remind me.

Cheerio.

소녀시대 So Nyuh Shi Dae/Girls Generation

How did I end up fan-boying?

Simple answer is this: Yes they are beautiful. Yes they can sing. Yes they can dance. Yes they are absolutely hilarious (individually and collectively). But what really appeals to me are their group dynamics and the individuality of each personality within it. Its hitherto something I haven’t seen much in a group of talented entertainers.

By way of introduction, Girls Generation or “So Nyuh Shi Dae” (SNSD for short) is NINE member girl band from South Korea who debut in 2007. Mainly of pop influence, with some ballads tossed in, lately they are venturing into the dance genre. All of them are quite young, around the 18-20 are range. Larger than life in Korea, their popularity is expanding throught Asia and now for the rest of the world.

I found out about them whilst looking up more info about the Wonder Girls. I think the first song I heard was “Kissing You” and I thought to myself, “how weird is this lollipop dance thing?” That is the start of this love affair. Its my housemate’s fault. I’d have been oblivious to the fact otherwise.

To be honest, their songs are quite catchy with some cool dance routines and they act quite cute (sexy too!), but nothing special. I think the passion started after watching the documentary of their debut “Girls Go To School” and the individual MTV episodes on each member. It was then that I started to have a bigger affection for the girls.Each of them are special in their own way (I can talk about them some time else) and together the richness of their personalities are overwhelming.

This is the link for the “Guide to SNSD” courtesy of ssfsubs, the fan-subbing wing of the international SNSD fan forum soshified.com: http://www.youtube.com/user/ssfsubs#grid/user/284BF5EC3D9127C0

I am not one for fanboying mainstream bands, but these girls are special and I want to put them on that pantheon. I qualifiy to be in the “oppa (older brother)” fanbase hence my wish to cheer them on quietly with dignity, support them and protect them.

So…right now, its So Nyuh Shi Dae!

Cheerio and hwaiting!

 

 

Now this is not the end. It is not even the beginning of the end. But it is, perhaps, the end of the beginning…

Next week is the last week of 6 years worth of university life. To be precise, 6 years of medical school life. Though it seems I will part with it without much fanfare, that is…if I don’t do something about it.

It’s been a long journey. Looking forward to a moment like this…its been something I have dreamt and thought a lot about. Finally, the time has come.
I guess I’ll revisit this theme again and again in the weeks to come. Cut me some slack, I deserve at least that much after all that trudging.

I like the quote above by Sir Winston Churchill. First heard it when watching some old World War 2 documentary (which I had always loved doing).

So…how am I spending the week? Probably slacking. I had run totally out of steam if not for the upcoming exams and the people I have been working with. I think throughout this semester, I have been well taken care of from both an educational and relationship perspective. Doubt I could repay their kindness as a student (excluding gratitude of course). Thus I must remind myself to work hard and work well with them next year since I will be seeing most of them again but in a different capacity.

Now…. for something SNSD in the next post. It’s about time.

Cheerio.

Something To Put On Here While…

I find the motivation to make a larger post here.

Recently I found myself commenting this to a close friend on MSN:

We have just completed the ‘Body Builder’ series in the ISM with the intention of helping our members discover their spiritual gifts and encouraging them to participate in ministry. To be honest, its one of the more successful “Lets Do Ministry” campaigns that I have been involved in. Kudos.

Questions is….will its effect last?
After interviewing some cell leaders as part of my ‘Intimate Talk’ net publications, personal initiative and self-motivation in seeking God has been the main reason why people participate in ministry and more importantly, stayed in it. Would generating a temporary herd mentality work? Or at least have some medium-term outcomes?

In Matthew 9:37-38, Jesus’ famous quote: “The harvest is plentiful but the workers are few. Ask the Lord of the harvest, therefore, to send out workers into His harvest field”. Sometimes I do feel that unlike the call to arms that Christians have used this verse for….its just Jesus lamenting the fact that most of us are happy to sit on our hands. A phrase full of sighs rather than a phrase for goading Christians to service (be it evangelistic or otherwise).

Heresy?

K-Pop Girl Group Craze

I blame my housemate for getting me into all these….

If only he didnt send me that parody video of the WonderGirls’ “Nobody”….

No excuses! But I love them nonetheless…they bring a fresh brand of song and dance to me. Not to mention there is a great spectrum of variety among the girl bands.

Goes without saying that SNSD (Girls Generation) are my favourite. Their posters adorn my door (the rear end, if you are curious).
But there are some great performances by other groups like Kara, 2NE1 (if I feel like hip-hop and rap) and a healthy mention to likes of the WonderGirls, After School and 4minutes.

Just as I have picked up rudimentary Japanese from anime….so I think I will from K-pop and a bit of K-drama.

Oh no!

Cheerio.

What Maketh The “Doctor”

Healer.
Smart.
Caring.
Rich.
Respected.
Avoid.
Sickie.

Plenty of descriptions come out when one thinks about the word or the title ‘Doctor’. What does great old Wikipedia has to say?

• Doctor (gen.: doctoris) means teacher in Latin and is an agent noun derived from the verb ‘docere’ (‘teach’)

• Originally, physician meant a practitioner of ‘physic’. This archaic noun had entered Middle English by 1300 (via Old French ‘fisique’). ‘Physic’ meant the art or science of treatment with drugs or medications (as opposed to surgery)

Many other people run around carrying the ‘Dr’ term too….but lets just focus on the medical ‘Dr’s.

Looking through my coursebooks….5 vital components maketh the “Doctor”

1. A sound grasp of the scientific basis of disease, its sufferer and the methods by which either the disease or the sufferer is ‘healed’
2. Adequate clinical skills to make valid hypotheses, order appropriate investigations and derive a diagnosis without excessive use of resources and jeopardizing the patient’s welfare.
3. A professional attitude in dealing with patients, fellow colleagues and the population as a whole. Behaving in a manner befitting the honour of this profession.
4. Continues to seek professional development continuously for the good of self as well as the medical community.
5. Able to perform his/her duties ethically, being an advocate for the best interest(s) of his/her patient.

Would you be able to agree with this?

Interestingly (if you are able to read), this is what the Hippocrates Oath has to say about all these:

“I swear by Apollo Physician and Asclepius and Hygieia and Panaceia and all the gods, and goddesses, making them my witnesses, that I will fulfil according to my ability and judgment this oath and this covenant:

To hold him who has taught me this art as equal to my parents and to live my life in partnership with him, and if he is in need of money to give him a share of mine, and to regard his offspring as equal to my brothers in male lineage and to teach them this art–if they desire to learn it–without fee and covenant; to give a share of precepts and oral instruction and all the other learning to my sons and to the sons of him who has instructed me and to pupils who have signed the covenant and have taken the oath according to medical law, but to no one else.

I will apply dietic measures for the benefit of the sick according to my ability and judgment; I will keep them from harm and injustice.

I will neither give a deadly drug to anybody if asked for it, nor will I make a suggestion to this effect. Similarly I will not give to a woman an abortive remedy. In purity and holiness I will guard my life and my art.

I will not use the knife, not even on sufferers from stone, but will withdraw in favor of such men as are engaged in this work.

Whatever houses I may visit, I will come for the benefit of the sick, remaining free of all intentional injustice, of all mischief and in particular of sexual relations with both female and male persons, be they free or slaves.

What I may see or hear in the course of treatment or even outside of the treatment in regard to the life of men, which on no account one must spread abroad, I will keep myself holding such things shameful to be spoken about.

If I fulfil this oath and do not violate it, may it be granted to me to enjoy life and art, being honored with fame among all men for all time to come; if I transgress it and swear falsely, may the opposite of all this be my lot.”

Makes interesting read  =)

Cheerio.

Quotes from Haruki Murakami’s “Kafka on the shore”

I love Murakami’s works and here are some quotes which I thought were worth remembering…

“According to Aristophanes in Plato’s “The Banquet”, there were three types of people,” Oshima says, “Have you heard of this?”
“No.”
“In ancient times people werent just simply male or female, but one of three: male/male, male/female or female/female. Each person was made out of the components of two people. Everyone was happy with this arrangement and never really gave it much thought. But then God took a knife and cut everyone in half, right down the middle. So after that the world was divided just into male and female, the upshot being that people spend their time running around trying to locate their missing other half.”

“Of course they wrote to each other every day. ‘It might be good for us to try being apart like this,’ he wrote to her, ‘then we can really tell how much we mean to each other.’ But she didn’t really believe that. She knew their relationship was real enough that they didn’t need to go out of their way to test it. It was a one-in-a-million union, fated to be, something that could never be broken apart. She was absolutely sure of that. But he wasn’t. Or maybe he was, but simply didn’t accept it. So he went ahead and left for Tokyo, thinking that overcoming a few obstacles would strengthen their love for each other. Men are like that sometimes.

• This quote reminds me of why we doctors don’t go around scanning everyone with all we have. Eg. Random abdominal pains that get CT-ed every time, only to find nothing, and then later getting leukaemia from radiation over-exposure. Perhaps not everything in life needs to be stretched. Doing for the sake of doing might lead to disaster.

Of course its important to know what’s right and what’s wrong. Individual errors in judgement can usually be corrected. As long as you have the courage to admit mistakes, things can be turned around. But intolerant, narrow minds with no imagination are like parasites that transform the host, change form and continue to thrive. They’re a lost cause and I don’t want anyone like that coming in here.

Hagita let out a loud laugh. “It isn’t a question of intelligence. I’m not all that bright, I just have my own way of thinking. That’s why people get disgusted with me. They accuse me of always bringing up things that are better left alone. If you try to use your head to think about things, people don’t want to have anything to do with you.”

My grandpa always said that asking questions is embarrassing for a moment, but not asking’s embarassing for a lifetime.

• Amen

“Don’t ask me. God’s God. He’s everywhere, watching what we do, judging whether its good or bad.”
“Sounds like a football referee.”
“Sort of, I guess.”

• Is AFL then a reference to polytheism?

“Perhaps,” Oshima says, as if fed up. “Perhaps most people in the world aren’t trying to be free, Kafka. They just think they are. It’s all an illusion. If they really were set free, most people would be in a real pickle. You’d better remember that. People actually prefer not being free.”
Jean-Jacques Rousseau defined civilization as when people build fences. A very perceptive observation. And its true – all civilization is the product of a fenced-in lack of freedom.

• A brilliant quote this one. Though quite a cynical picture of human lifestyle.

Not that anybody’s life had more clear-cut meaning to it. What’s really important for people, what really has dignity, is how they die. Compared to that, he thought, how you lived didn’t amount to much. Still, how you live determines how you die. These thoughts ran through his head as he stared at the face of the dead old man.

“Are memories such an important thing?”
“It depends,” she replies, and closes her eyes. “In some cases they’re the most important thing there is.”

Cheerio.

A Sense of Belonging

Today is the day I start my 5-week stint flying solo in general practice.

Stepping into my allocated room…there was this short emotion of euphoria and excitement. There was nothing special about the room really. 1 table with a computer (which is awfully buggy) and filled various types of forms. An examination bed and a sink next to it. 3 chairs and 1 comfy office chair.

I placed my stethoscope on the table and proceeded to arrange a few other essential stuff on it.
Tongue depressors: check
Othalmo/oto-scope: check
Penlight: check
Textbook: check
MIMS: check
and etc etc….

Opened a paper pad, placed my pen on it.

I logged onto our medical admin software. Looked up the first unassigned patient and placed my name next to it.

Took a deep breath, went out the door to the waiting room and wailed in my strange accent “Mr ____?”.

Hence, into the oblivion I go.

And I strangely felt, this is where I truly belong.

Funny how it took 6 years to get there…

Cheerio.

The_Observer Looks At The BE-attitudes (Matt 5)

 3″Blessed are the poor in spirit,
      for theirs is the kingdom of heaven.

The key to the kingdom of heaven lies in the acknowlegement of our spiritual bankruptcy. Aye?

Being churchy and Christian-like doesnt help us. Aye?  <— c/ref Revelations 3:17-22

Over the weekend…I was just thinking that its about time we end this ignorance and false hope in humanity.

We know that we can’t save ourselves but yet we still try to ‘earn’ our way back in guilt.

Worse, we associate our level of spirituality with the people/community around us. We compare with others and when they let us down spiritually, we feel despondent too.

Lets face it, when the dust settles and when all things are said and done….whats left is just God and you. There is your treasure that you should’ve sold all you had for.

If you don’t acknowledge your own spiritual poverty, if you don’t do anything about it and hence, the crap hits the fan….then that’s your own problem.

It is not dependent on the ’spiritual level/maturity’ of the person next to you. Sure, he/she can share what works for him/her, and you can learn from that. But that is about it.

The true work of salvation happens inside and only inside. The Word of God is more than enough for it to happen.

If only people bothered to read, study and apply it.

“Let Us Not Give Up Meeting Together”

This was quoted last night during our Austin CMDFA meeting and I love it. I asked the question to our guest speaker with the hope that she can share with us some tips that kept her walk with God close throughout her years as a physician, a missionary and as a person. Our host in the discussion following this mentioned Hebrews 10: 22-26

let us draw near to God with a sincere heart in full assurance of faith, having our hearts sprinkled to cleanse us from a guilty conscience and having our bodies washed with pure water. ²³Let us hold unswervingly to the hope we profess, for he who promised is faithful. ²⁴And let us consider how we may spur one another on toward love and good deeds. ²⁵Let us not give up meeting together, as some are in the habit of doing, but let us encourage one another—and all the more as you see the Day approaching

The words underlined are the crux of how we can keep our focus right and our path straight…making sure we take the gate/path which leads to life.

As I continue to ponder and make the difficult decision of leaving my current ministry, I pray that I don’t forget this.

Cheerio.