My 2 ringgits' worth on SIP

All in all, SIP has sparked off a series of discussive emails from the class - i frankly never have seen the class this strongly opinionated. Well as usual we get the usual emails with lofty ideals - the kind you read and wonder whether the composer has ever experienced life back down on earth. well thankfully for most of us humans, the emails were very real -- no altruistic or idealistic borderline bull, but just a very sincere , balanced opinion on SIP.

While I did enjoy the rush of excitement of carrying out my own duties during SIP, and being respected as a member of the team, that feeling has long died out and the bothersome worry of the MBBS has started to trickle in. After all, SIP was chiefly meant as a "orientation to HO" life, and certainly we can't learn everything a HO is required to know within these 6 weeks. The lack of a MCR number often makes us disadvantaged when performing certain duties with medico-legal implications -- like inking out prescriptions and accompanying DIL patients. It's like this is meant to be a "junior HO" thingy but we definitely can't experience the "full thing" as yet.

As such, it's meant to be a taste of HO life and to prep us physically and mentally for the life that beckons next year. But of all things, because of the demands of the curriculum, I question the need to have 6 weeks of Medicine SIP PLUS 4 weeks of Surgery SIP, while cramming the revision periods of Orthopedics and Paediatrics into 2 short weeks. Emergency medicine is mentioned again and again as a critical aspect of Medicine, and yet it's allocated just 2 weeks.

I think ppl should just wake up to the idea that lengthening postings doesn't necessarily increase your knowledge or exposure proportionately. Take Psycho Medicine - it's a dreary horrid 4 week 3rd year posting + a even more terrifyingly weary 2 week 5th year posting. I cannot deny PsychoMed is a very important discipline but what could have been done in 3 weeks has been unnecessarily stretched to 6 weeks. I think they should taken a leaf from O&G's book and realise that a revision M5 posting isn't always necessary depending on the context. .. Unless there's a lot of pride/ego in exerting the importance of one's own specialty.

Granted, life isn't just about academia but let us get 2 feet flat on the ground. YOU need a license to practise "practical medicine aka HOship and above", and the only way to do it is to pass your MBBS competently. Since the MBBS is still being entrenched in our old British colonial roots, there's still a lot of rote-learning and hypocritical examination drills that have to be drummed into us a la "I would like to examine for this and that to rule out".

These kinda examination drills aren't often experienced in practical medicine, because it's tedious, time-consuming and often unnecessary with hi-tech radiological equipment. It's ideal to continue being thorough during HOship, but this drive often falters under the pressure of time.

Oh well just my two ringgit's worth opinion on this.

An awful week ...

This was just a BAD week.

(i) i got told off by one nurse just because i accidentally mistook her for a very senior nurse and called her 'auntie'.

(ii) Isn't it ridiculous that some patients (and their relatives) expect the entire world to spin around their whims and fancies? Isn't it ridiculously inconsiderate that you demand your relative receive dialysis at a public hospital following the exact time-slot as in a private dialysis centre? And it's not as if they back down on repeated bouts of explanation that there are probably other patients who need dialysis more so than the patient does, and waiting a few hours more will not make any difference. it's so sad that in singapore, the most unreasonable or the one who makes the most noise gets the upper hand, while those quiet/silent/relenting ones just get the shorter end of the stick.

(iii) the minister's address was just full of fluff , worse than fann wong's interview with BBC. and the worst thing was that everyone was just patronising him. goodness.

SIP boredom

the new SIP rotation to endocrine simply sucks. there are 4 MOs , 1 HO , 2 registrar and 1 consultant + 4 SIP students = 12 people rounding at any one time. that's a ridiculous figure, and it's far far from the usual SIP student-HO-MO-registrar-consultant team i am so used to in Resp. It is that kind of time when you feel you are sometimes just wasting your time, but you have no choice but to stay. I seriously feel 6 weeks of SIP is way over the top when 4 weeks was suffice -- no doubt it provides students a very good learning experience, but i believe a 4 week intro was more than suffice to initiate us. moreover, it's not as if as SIP interns get to see everything a HO does -- because we are still unlicensed, we still don't get to see the full picture: we don't prescribe, we aren't allowed to run our own ABGs etc

anyway good food awaits.. had a bursting good meal at Orient Ocean restaurant at Miramar Hotel, where the buffet was a tad cheaper than Dragon Gate. unfortunately there's a point at which when you overeat till your overdistended stomach presses on your diaphragm and makes you feel breathless. and that's needless to say after plates of baked crab, soft shell crab, crispy duck, thai jelly-fish, seabasses, "soon hock" and 3 plates of mango pudding, gui ling gao and sago and etc etc.. i was nearly crawling my way into kossie's car like christy chung on aphrodisiacs.

sunday was horrid. boring and pointless ward-round in the morning, with the usual boring miserly changes to be done. at least we ate in peach garden at thomson plaza (very exp !!! but the wasabi prawns was reallly worth its status as the signature dish). topped it off with island cremery..(inferior to daily scoop.. mud pie, eskimo pie and baked alaska so-so.. i felt baked alaska was slightly better than the others)

drats.. monday blues sinking in .. the usual 12-person ward round beckons again tomorrow.. the word meaningless knows no boundaries.

A change of life..

Whenever I get lost, especially in this new endocrine ward, i reminsce about annie lennox's >Little Bird Me thinks the endocrine team is way too big for SIP students, but we'll see how the next 3 weeks pass.

I wish that I could be that bird
And fly away from here
I wish I had the wings to fly away from here, yeah.
But Mamma I feel so low
Mamma where do I go?
Mamma what do I know?
Mamma we reap what we sow
They always said that you knew best
But this little bird's fallen out of that nest now



Last week's dim sum at Min Jiang at ACJC rochester park was semi-exquisite dining, above average quality of dim sum and reasonable prices. Kossie dented his car there doh~!!

Hell had no fury like a woman scorned

Wah i tell you. today was an affirmation why i would never wanna enter a relationship with a woman anytime soon.

My registrar is this petite , sweet looking pretty dainty lady. But today was just a wayyyyy bad day for her.. there's this patient who's medically resolved but just awaiting placement in AMKCH. obviously the latter has taken a few years to correspond with us, and in SGH, every single bed is worth its weight in gold.. even platinum. Zero tolerance for patients who overstay their 3-5 day maximum stay.

It first started with her throwing barbs at the nurse over the phone in AMKCH. Next, she brusquely demanded to look at the case-file of the patient. Next, 2 rounds of interrogations: first directed at our hapless MO who was new to the team, and subsequently HO who was fibrillating like an atrium in a thyroid storm. To my horror, marilyn overheard my name being mentioned as one of the ppl who called up AMKCH to negotiate. (YEAK)

i find it ridiculous contextually even in this age of equality that a woman can make 3 overgrown men ( especially our sumo king HO ) fibrillate like tofu in a Kushinbo buffet-plate. i dunno larh but i find it very difficult to handle the mood swings of some women.. the worst thing about some women is that when they're gloomed, they will make the wHOLE world gloomed with her.

Yummy queen..

Gosh neglected this blog for a week now.. can't blame larh all the long working hours and the calls.. things have definitely eased up a bit with the new consultant(s) .. not so many Cks,aldolases and gazillion changes to be done for just a single complaint of muscle ache. Call on pre-National Day with Tunn was quite well-spread out... quite a even flow of cases throughout the night.. even got some time to spread my legs out on the MO room to get some 20 minutes of shut-eye in the ward 45 MO room. Cases-wise, i am just getting the impression that the A&E physicians are just admitting every single case of abdominal pain just to cover their own asses.

Well significant non-medical events... for once Kossie drove!! thank god, i need a break from the stinky traffic. went out first for indian rojak at Middle Road .. really small eatery snuck between buildings, but the prawns were realli grilled to perfection that you can crunch on them whole like those crazy japanese geishas on Japan Hour. next stop was to this Dragon City restaurant at Harbourfront on xhua's excellent recommendation, where they had this fAntastic spread of seafood and 1000 other items at a-la-carte buffet style. I was quite impressed by the black pepper crab and the way they do the fish like back in KL. lots of garlic ... but like most buffets, they add some kind of starchy powder to the soft shell crabs dishes to make us feel fluid-overloaded and thus lose appetite. looks like we have to use kossie's new vacuum cleaner to do a manual evac on ourselves before we use it on suin's unwanted lovechild.

somehow i didn't feel too good larh even b4 the buffet.. i was bleeding quite bad down there when i went to the toilet one too many times.. sometimes i wonder if these toilets recycle glass shards as toilet paper..

SGH SIP continues on and on..

OK week 1 passed.. sort of settled into the pretty stressful team environment. I guess the only way you can survive in this kinda stressful environment is to be steady and assert your competency, which i am struggling to do.. Saturday was like a normal day except we get to go off earlier at 1pm after finishing the changes.

Sunday was call day for me , where I was posted to Renal ward. Fwah.. some of the veins are finer than a thread but i find that giving them a hot milo drink or taking bloods after lunch has better yield. Of course i usually try my luck before lunch, and if cannot after 1 poke, i will flash them a "i'll be back..." smile much to their chagrin.. i generally find the renal patients more tolerant to the pain larh though.. probably because the dialysis needles aren't any smaller.

whatsmore, some of the team physicians demand for massive quantities of blood (like 3 culture bottles and tubes of every colour of the rainbow).. pls lor the renal patients usually have one arm gone to an AVF , the other arm veins are usually iffy.. leg veins look like they can only support enough for a hypocount reading. my HO was only too glad to suggest a femoral ABG for the 25ml needed.

the new consultant for my team is much more relaxed and less gungho about putting 10001 changes during rounds, which means much less to do. the registrar is given a lot more freehand to manage the patients in a sense coz' his rounds are quite perfunctory. Well today was a bad day. my only change was doing a ABG for a patient in my cubicle. Bad mistake manz. She screamed so loud and dug her fingernails into my arm as i was barely inserting the needle into her wrist. What's this? Newton's 1st law.. when someone's in pain, he or she will inflict an equal and opposite pain on others..

Obviously i was too unnerved to get much blood from the elusive radial artery .. i never was very good with radial ABGs in the first place. what's more the patient put on this stinky Axe Brand medicated oil which triggered a massive rhinitis of mine. it was especially bad since all the oil vapours were re-circulating in the enclosed space within the drawn curtains around her bed. my eyes were tearing and my nose running as i was doing my last few changes like updating patient's familes over the phone. there's this friendly elective student from australia who noticed i had a runny nose , and offered me this super potent Australian flu tablets (which contained a cocktail of decongestants). Took one tablet .. tasted like rotten semen , and i felt a bit better.

Bad mistake #2: i started feeling really really woozy driving back along the shitty traffic-congested AYE (chlorpheniramine in those tablets plus the fact i hadn't much sleep for the past 7 days). As I neared my exit from AYE, i nearly wanted to peng san liaoz .. when i finally reached home, I CRASHED.

Woke up and screamed. I was supposed to have watched this movie with Kossie and Xhua at 1930. Drats. This hospital life is really causing me to die a slow death...