SOUTH POLE

I’m completing my attachment at the current hospital & will be going to Hospital Kuala Lumpur (aka HKL aka Hell of KL) for the next 6 months. Based on previous experience, I would probably, most likely, not see sunlight throughout that period of time (ie go to work before sunrise & come home after sunset). A friend asked where am I going, where there is no sunlight? South pole??

Well, I don’t have to go that far. The place is just in KL. I don’t actually mind not seeing sunlight, not that I love the sun very much. But to work 36 hours a day is no joke (there are actually many other “Iron Ladies” in the country besides Tan Sri Rafidah Aziz). Mr. Liow says we are allowed to go home after 24 hours? We’ll see if that’s possible & I’ll be the happiest person…

In the meantime, I’ll have to “hibernate” from internet again. Sayonora for now. Will be back once I get to see the sunlight again.

CREATIVE PATIENT II

My colleague showed me this poem written by one of the patients whom we are treating:

Tiap-tiap penyakit ada ubat
Carilah seberapa cepat
Jangan lewat jangan lambat
Di Hospital UKM ada tempat

Malam tidur siang jaga
Makan atau minum ada selera
Staf-staf baik belaka
Ramai kawan sungguh gembira

Layanan staf-staf saya hargai
Banyak nasihat yang diberi
Tanpa bayar hanya pri
Betapa senang rasa di hati

ROLE REVERSAL III – BUYING MC

I felt sick two Wednesdays ago. It was kind of like a sudden onset thing. I mean, I was totally okay the day before, except for feeling a bit tired & sleepy. I was with the rest of the team (specialists, medical officers, nurses) at grand ward round when I started feeling feverish & having joint pain. I tried to ignore the symptoms till the end of the ward round, but it just got worse after that. I developed chills & rigors with some rashes on my upper limbs.

My diagnosis was viral fever. Had my FBC (full blood count) checked. Haemoglobin & platelet count were within normal range, but TWC (total white cell) was slightly raised. I thought that was peculiar, as bacterial infection would cause TWC to go up, not viral. But at least the platelet count was normal. I don’t mean to be paranoid, but living in a condo where people come to do fogging every fortnightly, I have to think of dengue fever as a differential diagnosis.

I still went to work the next day. I thought I’d be okay with regular paracetamol & increased fluid intake. Afterall, viral illnesses are self-limiting. But before I even started work, I felt sick again, with uncontrollable chills & rigors. I was already on 3 layers of baju & got the staff nurse to get me extra blanket. My symptoms subsided later in the day, with paracetamol & I actually managed to work full day.

I could prescribe medicine & order investigation for myself but I couldn’t sign my own MC. Neither could my colleagues & I couldn’t go to the Staff Clinic because I’m not a hospital staff (I’m just doing attachment). So I’m left with no other choice but to “buy” MC from the nearest GP clinic the following day.

At the clinic, the doc found out that my throat was injected & I was still having fever at 38.1°C. It came as a surprise to me as I did not have any symptoms of sore throat or cough. But it made sense, as bacterial throat infection causes white cell count to up & fever with chills & rigors is possible. I was given a course of anitibiotic & MC for the day.

Upset that my initial diagnosis was wrong, I checked my throat upon reaching home. It was really swollen & looked almost obliterated (gasp). I took my medicine diligently & recovered in no time.

FORMER MP, NOW PRESIDENT

Patient: Doctor, you’re very cute lah

Doctor: (smile)

Patient: You remind me of someone…

Doctor: Who?

Patient: You remind me of…Gloria Arroyo

Doctor: (Gasp. Not another Filipino)



*Refer to “8th Wonder of the world” (Sept 2008) & “Mistaken Identity” (April 2007)

PROTECTIVE GEAR

Last month, I saw an old Chinese aunty (who was previously treated for breast cancer) in clinic, who came for her follow-up visit. She was clad in a very nice looking ‘samfu’ (Chinese traditional wear). Clinical breast examination is mandatory, so I instructed the patient to undress. I noticed that she was having great difficulty in doing so & decided to help. Only then I realised that at every level of the buttons, there were actually 2 types (besides the typical “hook & eye”, there was also the “push button” type). I was so curious that I just had to ask:

Me: Aunty, why do you wear this kind of baju when you know that you’re coming to see doctor?

Aunty: I purposely one…

Me: Huh? Why?

Aunty (sheepishly): Hehe…I thought if doctor see I got difficulty, doctor will say, aiyah nevermind lah, no need to examine lah...

Me: (pengsan)

ONCALL SYNDROME : SIGNS & SYMPTOMS

• Periorbital oedema (from lack of sleep)
• Acne vulgaris (due to lack of sleep & emotional stress)
• Low back pain (from doing CPR)
• Abrasion wound (sustained while climbing onto patient’s bed to do CPR)
• Athralgia, myalgia (from physical stress & hospital acquired organisms)
• Altered sensorium & hallucinations (from lack of sleep/ rest)
• Epigastric pain & heartburn (lack of food)
• Xerostomia, angular stomatitis & dysphagia (lack of fluid)
• PTSD (post-traumatic stress disorder) – from running over a cat & killing it instantly on the way to work, in front of the Emergency Department

EASY WHAT

My colleague, Dr. L, saw a young man (let’s call him Mr. X) with a particular tumour who had to undergo chemotherapy. The patient was advised to go for sperm banking as treatment & the disease itself could result in infertility. After making the appropriate arrangments, my colleague updated our specialist about it:

Dr. L : I’ve already referred Mr. X to the Fertility Clinic for sperm banking, but I’m not sure how they’re gonna do it… (referring to the process of registration, counselling session & so on)

Specialist : Easy only what…they just need to give patient some magazines & a bottle

NOT ENOUGH

Seems like micropore's not enough, need elastoplast...stronger...

MULTI PURPOSE

I still remember how we used to carry micropore plaster & torniquet around as housemen (especially in O&G posting) for IV (intravenous) line setting. Recently I found out another use of the micropore...

STILL DOWN

Everything seems to be down lately, not just the computer system...

THANK YOU FOR CALLING

Hello and thank you for calling The State Mental Hospital.
Please select from the following options menu:
If you are obsessive-compulsive, press 1 repeatedly.
If you are co-dependent, please ask someone to press 2 for you.
If you have multiple personalities, press 3, 4, 5 and 6.
If you are paranoid, we know who you are and what you want, stay on the line so we can trace your call.
If you are delusional, press 7 and your call will be forwarded to the Mother Ship.
If you are schizophrenic, listen carefully and a little voice will tell You which number to press.
If you are manic-depressive, hang up. It doesn't matter which number you press, nothing will make you happy anyway.
If you are dyslexic, press 9-6-9-6.
If you are bipolar, please leave a message after the beep or before the beep or after the beep. But Please wait for the beep.
If you have short-term memory loss, press 9.
If you have short-term memory loss, press 9.
If you have short-term memory loss, press 9.
If you have low self-esteem, please hang up. Our operators are too busy to talk with you.
If you are menopausal, put the gun down, hang up, turn on the fan, lie down and cry. You won't be crazy forever.
If you are blonde, don't press any buttons. You'll just mess it up.

(Courtesy of Dr. LJ)

INTERESTING SIGNS

Sign over a Gynecologist's Office:
'Dr. Jones, at your cervix.'
--------------------------------------------

In a Podiatrist's office:
'Time wounds all heels.'
--------------------------------------------

On a Maternity Room door:
'Push.. Push. Push.'
--------------------------------------------

At an Optometrist's Office:
'If you don't see what you're looking for,
you've come to the right place.'
--------------------------------------------


*Got this on the email (from Dr. LJ of SGH Kuching)

ALWAYS DOWN

I saw patients in the dark (well, not totally in the dark lah, but 2 out of 4 fluorescent lights in my consultation room were out) for the last 2 days. Computer system is still down. Probably needs viagra. As for myself, I think I need patience & anger management course...

WHY LAH?

We change duty every month as part of our training. So this month I’m no longer in the clinic, but covering the chemotherapy daycare. If you thought the lack of soap in the clinic was bad enough, the consultation room at the daycare doesn’t even have a sink & obviously no soap. Every time after I examine a patient, I have to pop over to the nearest toilet to wash my hands. There is minimal soap there & no tissue. Patience is indeed a virtue.

To add salt to wound, the computer system has been down for more than a week now. As a result, I have been unable to trace patients’ blood results or view images (x-rays, CT scans, MRI etc) & this really hinders my job. Patients are obviously unhappy.

Patient 1 : How is my blood test?
Doctor: I’m sorry, I can’t seem to get it on the computer

Patient 2: What does my CT scan show?
Doctor: Hmm…sorry, I can’t get the images on the computer

Patient 1: Why like this?
Patient 2: How come like that?
Doctor: I also don’t know lah, have to ask Mr. Liow

WHAT'S THAT?

I was a refered a case from the Orthopaedic Ward during my recent oncall. The patient (we shall call her Mdm X) was an elderly lady with breast cancer & metastasis to the spine with cord compression. The symptom of lower limb weakness (as a result of spinal cord compression) had been present for about 2 months, but there is no total paralysis yet. So the neurological deficit may still be reversible (either with high dose steroid, radiotherapy or even surgery). After reviewing Mdm X, I wrote down my plan in the her folder:

1) Continue analgesia
2) Worthwhile to start Dexa
3) To discuss with Oncologist about radiotherapy
etc

Shortly after I left the ward, the Orthopaedic staff nurse (SN) called me on my handphone:

SN: Doctor tadi review Mdm X kan?

Me: Uh-huh…

SN: Dalam plan, nombor satu, continue analgesia, yang tu saya faham…tapi nombor dua, worthwhile to start Dexa…apa itu worthwhile?



* Analgesia means pain relief
* Dexa is short for Dexamethasone, which is a steroid

MEMOIRS OF AN ONCALL DOCTOR - TGIS

People told me it was going to be very quiet in the ward during Hari Raya, as everybody “balik kampung” during the festive season. But it was not to be. I broke the tradition by filling up the ward with multiple admissions from the A&E (accident & emergency). I used to just get some “sprinkle” of my housemate’s “Jonah-ness”, but I think this time around, it’s the Jonah Hurricane.

Day: 6 out of 7

8.00am
Drive to work
Ward round at Male & Female Wards

10.30am
Finish ward round
Paper work
Phone rings

A&E MO: Eh, you’re oncall again?

Me: Yup

A&E MO: I thought you were oncall yesterday…& the day before yesterday…&…

Me: We’re oncall the whole week, Monday to Sunday

A&E MO: Wah…tak pengsan ke?

Me: (Memang nak pengsan lah ni)

A&E MO: By the way, I have another case to refer...


11.00am
Clerk in the new case
Can’t view blood results & x-ray images on computer – system down
Problems arise in the ward
Attend to problems

12.30pm
Feeling extremely hungry
Food court & canteen both close (for Hari Raya)
Drive out to nearest restaurant (which happens to be KFC)

12.45pm
Queue up at KFC
Many customers
Only 1 counter open

1.00pm
My turn to order
Phone rings
Staff nurse needs me in the ward
Take away festive combo (damn hungry)

1.20pm
Settle problem in the ward
Go to car (to drive home & eat)
Phone rings
Staff nurse needs me again in the ward

1.40pm
Drive home
Have lunch
Lie down for a while, exhausted

3.00pm
Phone rings

Help is needed in the ward

6.30pm
Settle problem in the ward
Go home for dinner

8.00pm
Phone rings
Staff nurse needs advice

10.00pm
Go to bed

10.30pm
Phone rings
Staff nurse needs advice

1.20am
Phone rings
A&E MO needs advice

3.00am
Phone rings
Staff nurse needs advice

5.00am
Phone rings
Staff nurse needs advice

6.30am
Alarm clock rings
Thank God it’s Sunday (ie. last day oncall)
Hand over pager 8am Monday

CREATIVE PATIENT

My colleague got this as a hari raya gift from her 70 plus year old patient, who hand made the 2 peacocks herself (from used cans). So sweet...

HOSPITAL TERMINOLOGY II

Jonah (refer to “Oncall Teruk- The Sequel”)
A doctor who is so very busy during his or her oncall duty. Things tend to happen (one after another) that one can’t even imagine. My housemate, L, is by far the most jonah person I know. Colleagues & other staff think that the “mandi bunga” cannot work anymore. What L needs to do now is to take the next available flight to Thailand to pray at all the Buddha statues there.


Celebrity
A famous doctor who has been to space, done modelling, ventured into restaurant business & so on & so forth. His name was suggested as the guest of honour for a breast cancer awareness campaign, since he had done wonders for cervical cancer. The ambassador for breast & cervical cancers is preferably an individual who poccess both organs, but it doesn’t really matter since the main objective is to attract women of all ages to participate.

8TH WONDER OF THE WORLD

Being a doctor in the government sector has never been a bed of roses or a stroll in the park, but rather a bed of “duris” & a fall (with abrasions & laceration wounds) in the drain. The “sabun” episode may seem trivial, but it sure does add salt to wound. Sometimes I wonder how I managed to survive this 8 years. That’s why there is a need for laughter otherwise kepala will pecah. Funny questions/ comments from patients (usually old aunties & uncles) sometimes just brightens up the day.



Patient 1
Patient: Doctor, are you from here (refering to Malaysia)?

Doctor: Nope, I’m not from here (refering to KL)

Patient: Ohh…I thought so…are you Filipino?

Doctor: (Gasp) Do I look or sound like a Filipino?

Patient: Filipinos speak good English

Doctor: (……and Malaysians don’t?)



Patient 2
Doctor: Good morning, Aunty (in Mandarin)

Patient: Oh, good…you’re the first Chinese doctor I meet at this hospital. I can’t really understand Malay & I have many doubts about my illness

Doctor: (Explaining in great detail about breast cancer in Mandarin)

Patient: Wah…doctor, how did you learn all those medical terms in Mandarin?

Doctor: Oh, I learn from patients…and nurses

Patient: I thought you're from China

Doctor: (This is the first time someone has said that. My Mandarin must have improved tremendously over the years…an OCBC no more)



Patient 3
Patient: (who came with husband) Doctor, you look very young. How old are you if you don’t mind me asking?

Doctor: Why don’t you take a guess?

Husband: Must be 20 plus

Patient: Where got 20 plus, aiyah you ah. Doctor in specialty can’t be 20 plus only lah. Must be 30 plus already lah…

Doctor: (Wife smarter than husband)



Patient 4
Patient: Doctor, are you mixed?

Doctor: No, I’m pure Chinese

Patient: Really? But you look like mixed…like those actress in the TV

Doctor: (head reached the ceiling already)



* OCBC stands for “Orang Cina Bukan Cina”

SINCE WHEN HOSPITAL GOT CHICKEN?

(Pic courtesy of Dr. LJ)

LUX & PALMOLIVE

Date: 2 days before Malaysia's 51st Merdeka Day
Venue: Doctor's consultation room

I was frantically looking for soap (to wash my hands) after examining a patient's backside (with gloves on, of course) but to no avail. This is roughly the conversation between one of the clinic staff & me:

Me: Kenapa tak ada sabun?

Staff: Memang tak ada sabun. Bilik 2nd bos pun tak ada. Hanya bilik big bos (refering to our head of department) saja ada...

Me: Habis tu, macam mana nak cuci tangan?

Staff: Kena bawak sabun sendiri. Dr. N (who is a colleague of mine) pun bawak sabun dia sendiri

Me: (pengsan)

BANK ROBBERY

This is just too funny not to share. Got it on my email.

Excerpted from an article which appeared in the Dublin Times about a bankrobbery. Once inside the bank shortly after midnight, their efforts at disabling the security system got underway immediately. The robbers, who expected to find one or two large safes filled with cash & valuables, were surprised to see hundreds of smaller safes throughout the bank. The robbers cracked the first safe's combination, and inside they found only a small bowl of vanilla pudding. As recorded on the bank's audio tape system, one robber said, "At least we'll have a bit to eat. "The robbers opened up a second safe, and it also contained nothing but vanilla pudding. The process continued until all safes were opened. They did not find one pound sterling, a diamond, or an ounce of gold. Instead, all the safes contained covered bowls of pudding. Disappointed, the robbers made a quiet exit, each leaving with nothing more than a queasy, uncomfortably full stomach.

Next day, the newspaper headline read:

IRELAND'S LARGEST SPERM BANK ROBBED

WARD ROUND/ CLINIC JOKES

• Our PM used to wear batik a lot, but now he prefers jeans.

• We are expecting a change of government soon... from 3M (started from Tun M's time) to 1 'S'

• One can go to space & come back as an orthopaedic surgeon, no need to take exam.

PAST MEDICAL HISTORY

My recent “role reversal” reminded me of the times that I had been a patient, since my Day 1 of life:

I was born a tiny baby, with periorbital oedema (swollen eyes). Doctors thought I had congenital liver disease. So, as a neonate, I was already subjected to blood tests & investigations. So kesian hor. Results were all negative of course, as the periorbital oedema turns out to be a ‘trademark’ that stayed till this very day. It becomes obvious when I don’t have a good night sleep (best example: post-call)

I come from an atopic family. I had my first asthma attack at the age of 3. My respiratory tract is tremendously super-sensitive. I have had infections from the top to the bottom (ie. from upper respiratory tract infections to bronchitis to pneumonia). My greatest enemies are dust & pollens. I was a regular patient at the local hospital, that the nurses there actually gave me an “accolade” (ie. the girl who takes Piriton like taking rice). Piriton (or Chlorpheniramine) is an anti-histamine which can be used for runny nose, allergic rhinitis or any allergic reaction. When I was studying in New Zealand, I dreaded spring the most, as pollens would be flying everywhere. My record was sneezing non-stop 30 times. (Of course I didn’t count lah, a very empathetic friend of mine did.)

My second greatest enemies are dogs. I was bitten by my neighbour’s dog when I was in Primary 4. Received 4 stitches. The scars are now still visible on my right shin. I remember wailing on top of my lungs when the MA (medical assistant) at the Queen E Hospital did the T&S (toilet & suturing). While my classmates treated me like a ‘princess’ (they carried my bag, bought food for me & I didn’t have to do any duty during recess), my PE (physical education) teacher wasn’t so kind. I had a “D” on my report card, with the comment “cannot run, cannot do long jump”.

It is never fun doing PR (per rectal) examination on patients, but at least I can tell them exactly how they are going to feel during the procedure. I fell (from height) & landed on my bum at the Outward Bound School, when I was 14. Suffered an anal tear (ouch!) & presented to the paediatrician with fresh PR bleed (eek!). The rest is history.

FOLLOW UP APPOINTMENT

I went for my follow up dental appointment on Saturday. I wished I didn’t have to go, but I didn’t want to be a non-compliant patient/ defaulter. Spent almost an hour & a half on what I call the “electric chair”. The dentist gave me LA before he started drilling & digging deep into the root canal of my affected tooth. Although there wasn’t any pain, I could feel the amount of pressure the dentist applied. It felt as if my oral cavity was the bonnet of a car & the dentist a mechanic trying to fix a defective component of the car engine.

I felt pain after the LA weaned off & had to take analgesics again.

It is no fun being a patient.

WHAT’S IN A NAME

Pic didn't turn out so well. It's the microbiology report of a patient whose tracheal aspirate was sent to the lab for culture & sensitivity. Note that the name of the doctor who ordered the test is underlined in red (which reads Dr. Trachea). It could be a typing error, but it sure reminds me of a Dr. Vena whom I have referred a case to before. If I can remember correctly, it was a Nephrology referral. It would have been interesting if it were a vascular case.

(Pic courtesy of Dr. LJ of SGH, Kuching)

ONCALL HANGUS

This is worse than oncall teruk...

(Pic courtesy of Dr. LJ of SGH, Kuching)

ROLE REVERSAL II – A PRETTY HORRIFIC EXPERIENCE

It was almost like a deja vu, but not quite. I started having toothache last Tuesday. It was a dull nagging pain initially, which I tried to ignore (again). Not surprisingly, it got worse the next day & affected my sleep. My cheek on the affected side was a little swollen & I felt feverish. I decided to consult a dentist at my hospital.

I first called up the Dental Clinic. The staff who picked up my call advised me to go to the Staff Clinic, which has an ‘in-house’ dentist. Unfortunately, I was not allowed to register at the Staff Clinic because I’m not their staff (I’m only doing a 6 month attachment at the hospital). Okay fine. The next thing I did was to go back to the Dental Clinic. I was willing to pay as a private patient, but again I was not allowed to do so as I’m actually a staff. What the ****

I was losing my patience already & decided to contact one of the dentists personally. I told her my problem over the phone. She sounded quite alright. Since the toothache was troubling me quite a bit, she advised me to start taking antibiotic (Augmentin) & pain killers first before she attempts to do anything. It would be too sensitive for her to examine or do any procedure at that point in time. That seemed like quite a reasonable approach. I was also advised to do an x-ray of the troubled tooth & its adjacent counterparts.

As a very compliant patient, I did exactly as I was told. The dentist said she would look at the x-ray & let me know later via her dental assistant (DA). She said perhaps she could see me in 2 days time. Meanwhile, I should continue on my antibiotic & analgesics.

The dull nagging pain then became a more severe throbbing pain which not just affected my sleep, but my meals & my work too. Naturally, I tried to get back to the dentist. She was busy, so I spoke to the dental assistant. She said her boss’s appointment list is full for the next 2 weeks & I can only see her after 2 weeks. 2 weeks? The gods must be crazy.


(This is roughly the conversation between me & the dental assistant)

Me: Can you please tell the dentist that the pain is getting worse & it is affecting my work? (I was then put on hold for a while)

DA: Dentist say if you want MC, just come over to Dental Clinic & she will give you MC

Me: Then what about the x-ray? What did the dentist say about my x-ray?

DA: Dentist saw the x-ray. Didin’t say anything

Me: 2 weeks is too long, can’t you give me an earlier appointment? (put on hold again)

DA: Dentist will see you next week, Tuesday, earliest appointment


That night (Thursday), the throbbing pain got worse & I actually went in to the hospital for ‘a shot in the arm’ (intramuscular Tramadol). That was the only parenteral (injection) analgesic available in the ward. The jab was superb, my pain subsided very quickly & there was no more throbbing. But at the same time, I also became drowsy quite fast. This is a side effect of Tramadol, which is an opioid (as mentioned in my original “Role Reversal” post)

I slept on & off till the next morning. Took a cab (was still a bit woozy so decided not to drive) to a private dental clinic. The Dentist was fully booked from morning till evening (which was good & bad). Good because the number of patients usually indicates the doctor’s skill & bad because I might have to come back the next day or find another dentist. But something which I wrote (or declared rather) on the registration form made them offer to slot me in between their pre-booked patients (ie. Occupation: Doctor)

An x-ray was repeated & showed a small abscess at the apical region- not at the same tooth, but the one adjacent to it. I wasn’t surprised or in denial, unlike before. I had sort of expected this when I started having the pain. But of course, I can’t help asking why me?

Like I said in my old post, I’m an obsessive-compulsive teeth brusher, who does it so many times a day. Some people I know brush only once a day & nothing of this sort happen to them. Isn’t that so unfair? My mum said maybe it is because I brush so many times that I get this problem.

I spent the next 1 hour on the dentist’s chair (which sounds nearly as dreadful as the electric chair). LA (local anasthesia) was given to numb my jaw before the dentist did his job in drilling, digging & draining my diseased tooth. I was put on a pair of dark glasses throughout the session so that I didn’t have to see what the dentist & his assistant were doing to my oral cavity. I thought that was a brilliant idea, on the dentist’s part. I burnt a hole in my pocket for the procedure, x-ray & consultation fee, but I left the clinic a satisfied patient.

Back at home, I continued taking my antibiotic & pain killers (namely Paracetamol, Voltaren & Tramadol – but not all at the same time, milder one first & slowly go up the analgesic ladder).

While the dental problem is almost solved (follow-up appointment is in one week’s time), another problem arose. The day after my visit to the dentist, I developed generalised body rash with pruritus (itchiness) which was most likely a delayed allergic reaction. I think I fit snugly into the description of a ‘high risk patient’ (see “Hospital Terminology” post). Fortunately, the symptoms subsided slowly with anti-histamine from my housemate, who was already prepared to send me to the ED (emergency department) if I had started wheezing.

I do not know what caused the the allergic reaction. It couldn’t be Augmentin as I had been taking it for many days. In fact, I had the same antibiotic, on top of Metronidazole (Flagyl) during the first episode. It could be Tramadol but Voltaren is more likely the culprit.

The last time I had an allergic reaction was to a type of alcohol, about 2 years ago when I was still in Kuching. I had pruritic rashes & asthma attack, where I sought treatment at the ED of my old hospital. In New Zealand, where I drank alcohol only on social occasions, I only experienced rashes but no wheezing. After the episode in Kuching, I had stayed away from all types of alcohol. Maybe that’s a good thing.

Anyway, what puzzles me now is that I never had any allergies to medication in the past. I had taken Ponstan before for dysmenorrhoea (period pain) & Voltaren is from the same family. Oh well…I guess life isn’t interesting if there are no events once in a while…

HOSPITAL TERMINOLOGY

VIP & VVIP
(Not those driving big cars like Mercedez or BMW or Perdana, these are very & very very irritating patients)

I don’t mind if patients like to ask a lot of questions (even if the questions are 2 pages long & written on A4 size paper), because as patients, they ought to know what exactly is happening to them & what treatment they are having, but it gets on my nerves when things like this happen:


Case 1
Patient: (with a rombongan of relatives coming to visit) I’ve been here for 3 days, no doctor come & see me, didn’t give me any medicine, I’m just waiting & waiting

Relative: (angry & looked like ready to challenge the small petite doctor) So what’s the status now??

Doctor: (very calm but a bit sarcastic) The status now is…..the same…. as what I’ve informed the patient & his wife….today, yesterday & the day before yesterday

Patient: No medicine for 3 days

Relative: Why no medicine?

Patient: You see this little canulla here (on patient’s arm)? Our nurses have been giving medicine in the form of injection 3 times a day for the last 3 days & patient is actually improving with the medication


Case 2
Patient: (loudly as if an emergency had occurred) Nurse! Nurse! Nurse!

Nurse: (rushing to patient) What happened?

Relative of patient at next bed: (also rushing to help) What happened?

Patient: (now in a soft voice) Nothing, I just want my walkman (which is placed at the cupboard next to the bed)


Case 3
Patient: I can’t go to toilet, I feel weak (which is actually fair enough)

Nurse: Okay, then I get you a bed pan. We will pull the curtain & you can ease yourself here

Patient: I don’t want bedpan

Nurse: How about pampers? Then you don’t have to worry till the next morning.

Patient: I don’t want pampers

Nurse: Then what do you want?

Patient: I want the doctor to put in a catheter

Nurse: Doctor is not here at night. Doctor will only come (from home) when there is an emergency

Patient: Then call the doctor to come now



UK
Stands for ‘ubat kampung’, very popular among Malay patients

Bomohs tend to promise something that doctors can’t (ie. CURE, for cancer & many other chronic diseases)


US
Stands for ‘ubat sinseh’

Ranges from powder to liquid or even tablet form (sinsehs are now getting more & more sophisticated, some even have name cards & distribute pamphlets to hospitals), usually made from plants, including grass & mushroom


TM
Not telekom malaysia but ‘troublemaker’, usually a relative or family member of a VIP or VVIP (Examples – as above)


High risk patient
Either a relative/ family member of a medical staff or is a medical staff, tends to ask a lot of questions & the more the questions, the more problems/ complications seem to arise

WRONG END

I recently called the Neurology Ward accidentally when I actually wanted the Nephrology Ward. The staff who picked up the phone said, “Oh, sorry. Sini kepala, bukan kencing.”

IS THAT A NERVE?

After a combined meeting with the Orthopaedic & Pathology Departments, our Consultant, Prof F, mentioned that one of the Orthopaedic Consultants should have been a Neurologist. One would have thought that the bone surgeon has the mind of a physician, but it turned out that his name is Prof Saraf.

SAY WHAT?

A 70 plus year old Chinese uncle with throat cancer & depression was seen at the Psychiatric clinic not long after he was discharged from the Oncology Ward. He was noted to have frequent vomiting, poor oral intake & generalised body weakness. The Psychiatric doctor who saw the patient decided to admit him to the Oncology Ward.

At Grand Ward Round the next day, the staff nurse-in-charge presented the case to the Consultant & his team, comprising of specialists, medical officers & other medical personnel.

Everyone was awaken (especially those who were sleeping/ falling asleep) when the staff nurse said, “This patient has oropharyngeal carcinoma & he is admitted for sterilization.”

The Psychiatric doctor had written the plan as “to admit patient for stabilization” & the nurse had read it wrongly.

JUST IN CASE

An ex-colleague of mine, who is now a physician in Miri Hospital, was referred a case from the Orthopaedic Ward. The patient, a very frail 80 year old lady, was admitted for a hip fracture. My friend was amused & irate at the same time as the reason for referral was “in case the patient dies of unknown medical cause”.

ONCALL TERUK – THE SEQUEL

Recently I learnt of a term which has got nothing to do with the famous New Zealand’s All Blacks, Jonah Lomu. Apparently, “Jonah” means someone who is “hot” during oncall time, ie. has the affinity to attract patients like bees to honey & ants to sugar.

My housemate, L, who is also my colleague, is one of the most “Jonah” person I know. Our passive call at HUKM Oncology Department stretches over a week, ie. from Monday to Sunday. L had to return to hospital after hours on the first day itself. This went on a few times throughout the week with the grand finale on Saturday & Sunday, where L had to sleep in (at the ward).

My most dreaded fear came true. Being L’s housemate & the next person to oncall after her, I was afraid of getting some of her “Jonah”-ness. True enough, she did pass on some to me. My call was rather “hot” too, with multiple admissions from the Emergency & multiple mortalities….& I had to sleep in at the ward as well, sigh…

Anyway, my week is up, thank goodness for that. Now I just hope (& pray) that my next call will not be so “Jonah”.

Maybe I should go play some rugby…

OCCUPATIONAL HAZARD II

Two anaesthetic medical officers met at a dinner function, together with their spouses. After the usual hello’s & how are you’s, one of doctors commented, “Your wife has a short neck, difficult intubation.”

ANTICIPATORY EMESIS

A talkative Chinese uncle was having his second cycle chemotherapy at our Oncology Ward at HUKM when the whole team (specialists, medical officers & nurses) was doing rounds & came to his bed. He was telling the medical personnel his experience during the first chemotherapy. One of the medical officers, a Malay lady, asked the uncle (who can’t speak English), “Uncle, sekarang ada muntah kah?” And the patient’s reply?

“Sekarang, belum lagi muntah. Tapi, sekejap lagi akan muntah.”

THE PSYCHIATRIST AND THE PROCTOLOGIST

Got this from my buddy Dr. LJ on the email:

Two doctors opened an office in a small town and put up a sign reading:

"Dr. Smith and Dr. Jones: Hysterias and Posteriors."

The town council was not happy with the sign.

So the doctors changed it to read,"Schizoids and Hemorrhoids. "

This was not acceptable either.

So in an effort to satisfy the council, they changed the sign to "Catatonics and High Colonics."

No go. Next, they tried "Manic Depressives and Anal Retentives."

Thumbs down again. Then came "Minds and Behinds."

Still no good. Another attempt resulted in "Lost Souls and Butt Holes."

Unacceptable again so they tried "Analysis and Anal Cysts." !

Not a chance. "Nuts and Butts?"

No way. "Freaks and Cheeks?"

Still no go. "Loons and Moons?"

Forget it. Almost at their wit's end, the doctors finally came up with:

"Dr. Smith and Dr. Jones, Odds and Ends."

Everyone loved it.

A DOC'S LIFE

You know you’re an overworked government doctor when…

1) You don’t see the sunlight (you go to work before sunrise & come home after sunset)

2) You sleep at the hospital more than you do at home

3) Your neighbours probably think you work as GRO because you always come home late & sometimes don’t come home at all

4) After a night of oncall, you notice 3 big pimples on your forehead

5) On closer look, your eyes resemble those of a panda

6) At year end, you realise your annual leave is untouched

7) You go back to your hometown only once a year

8) You go to the hairdresser & she/ he asks you, “Wah…your hair so long already. You never cut ah?”

9) You go to your beauty therapist & she exclaims, “Wah…so many pimples, how long already you never do facial?”

10) You weigh under 40kg without having to go on a diet or do exercise

SAFE SEX

I read this joke in the newspaper after former Health Minister Dr. Chua Soi Lek admitted that he was the man in the infamous 'sex video'--

"Latest advice from the Ministry of Health - for safe sex, wear a face mask, not a condom."

CHRISTMAS BLUNDER

In the hospital, we often use the phrase "top up", for example, top up medication or top up haemoglobin (by means of blood transfusion). While having lunch with an old friend on X'mas Day (at a popular restaurant at Mid Valley Megamall), I asked the waitress if I could "top up" my drink. The bewildered waitress looked at me for a moment, then asked, "You mean refill?"