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...