Monday, April 14, 2014

Powerpoint

Just finished doing a last minute powerpoint presentation for coming morning.

I like doing powerpoints, I like talking, I like presentations.

I like sharing what I know, although it is very limited in magnitude, to be honest.

Anyhow,

In so many powerpoints I have done before,

there was once, that whenever I thought of the presentation, I will smile.

It was a time when I got the day of presentation wrong.


Funny people do funny things.

Weird people do weird things as well.

:(                      TTM again.

ok sleep. Good nite people.


Saturday, April 12, 2014

-

Unfortunately, I am a damn damn weird person.


An old song that came to mind.



(emomode)


Saturday, April 05, 2014

Oh Patients

I have read a lot of comments, regarding the state of our country's healthcare.

Many stinging criticisms has been put forward by many, on a lot of issues related to healthcare; the overcrowding hospital wards, long waiting time in accident and emergency, incompetence, unprofessional and insensitive medical staffs and so on.

I must admit that there are a lot of weaknesses in our system.

Much have been said about the doctors. Doctors' quality, medical errors, attitude problems and so on.  


As a doctor myself, I have to say that we are a big part of the system and of course we should be rightfully blamed when the system fails.


Honestly, it is getting increasingly difficult to do a good job as a doctor.


Not about the time of work. 


Not about the seemingly low pay in comparison with what other professionals are getting 
comparing to the time and effort spent.

Not about the stress at work actually.


To me, it is more about the patient factor.


I once met Mrs A, 55 year old lady, who takes up 2 jobs as helper in hawker stall. 


I spent so long talking to her way past the lunch hour, and that of my clinic nurse, to get her to change her diabetic insulin jabs, only to get her telling me, with full conviction in her eyes, that she has some friends taking herbal medications from China and they are all cured of diabetes.


"Western medications are good, but herbal medications has no side effects,"reasoned Mrs A.


There was then a Mr B, a 60 year old retired civil servant, who refuses a medication called Perindopril after I said that we need to check the bloods after two weeks in case the medication causes the kidney function to worsen.


"Why are you starting me on such medication that can hurt my kidneys? Where you graduated from? I want to see your specialist."


Those words are hurtful, Mr B.


Then there was also a Mr C, who is so unhappy after waiting for hours in the clinic. "I paid taxes you know," said Mr C.


I am not from the Inland Revenue Mr C, and I don't care a slightest bit, whether you have paid your taxes or you are getting a BR1M.


I always find patient's attitude, beliefs and character towards our "Government Service", very mystifying.


To the extent that I think solving this might save more lives that finding a new vaccines, getting more specialists or building more hospitals.


People can wait for same duration to pay an expensive fee, to see a private doctor but cant seem to do the same for in a free, government clinic.


They thanked their private practitioner who referred them to public hospital with a fee, but gets very agitated in public hospital's clinic when the nurses over the counter give an appointment to see specialists later.


"It is cancer you know! How can you see in TWO weeks!" 


"I want to talk to your specialist now!"


No wonder it is always very difficult to keep specialists in government settings.


It is not about the pay. It is not about the burden of the workload.


It is the patients' general attitudes towards a free (oh well there is a fee); cheaper service.


There are so many who smoke a few pack of cigarettes a day, eat nasi kandar at midnight, but expect to have a life without disease and refuses medications.


"My friends all okay and no problem. Doctor, you got check properly or not?"


"My uncle smokes 2 packs a day, he is still up and well at age of 79, Doctor, I know what I am doing".


Sometimes it is very difficult; 


And i always think to myself, so then what kind of patients would make my job a bit happier and easier?


Is it the highly educated ones, who thoroughly googling their diseases' pathophysiology and the gold standard management; and demanded the best medications that even I myself not authorised to give my own mother. 


We have never given away substandard medications, just not the most expensive ones.

Or is it the not so well educated ones, who are not bother to know their diseases and only keen to seek opinion from the bomoh and listen to their friends in the kampung, changing doses of medications on their own according to their "feelings".


The answer is I dont know. 


Patients are always patients, with their unique expectations and beliefs. Some of these beliefs and expectations are really making doctors' life difficult.

Having said all that; there are always some patients who makes us smile. 


Those who appreciate, thankful, and listen to what you have said and compliant the medications and advices. It is an absolute beauty and satisfaction to see they get better, at least the numbers, as they might not felt the differences between blood pressure of 170/90mmHg or 120/70mmHg.


But sometimes we cant do a good enough job for certain patients, because of the number of patients in our settings. There are times when we want to monitor them more closely, but if doing that would mean operating the clinic way past 2 pm. I do sometimes felt a bit worried for some of these patients. 


There are simply too many patients who we cant get it out of the hospital systems to the local polyclinic because apparently the waiting time there is too long for them.

There is one thing for sure, and there is one thing that I think we all should spend some money on.


Patient's Education.


Patients have to be responsible for their own health. 


It is actually to me, the most difficult part in being a good doctor; to educate your patients about their diseases. 


We must strive to educate the public. We have rethink our strategies to educate, to strengthen our public health efforts. It might seem impossible to have the makciks and pakciks in kampung to be able to adhere to the diabetic diet, but we must try harder

Preventative, health talks might seem less glamour and less effective than the minimally invasive coronary artery bypass surgery, but it will save more lives than the latter.

Friday, April 04, 2014

Tree of life.

Went to buy porridge in a stall that will greet you:

wait for at least 30 mins.

saw this old house next to it.

i think with some marketing, this can be marketed as a tourist attraction.

#penang

Thursday, March 27, 2014

Tourist

Went to Taiping zoo last month.

Quite a nice place to bring old ppl actually.

my mum likes to see animal one.

not museum or palace.

we both have no cultural appreciation i guess

Doctors

I would like to have a post to remember a nice uncle that passed away because of a heart surgery during my time in Kuching.

Dont sure why, thought of him today while driving back from work.

I remember seeing him in the ward's corridor, asking him if he is okay to postponed the surgery for another three months because the ward is very full.

He said okay; without much hassle.

No pain one, he said.

I felt bad, just like to every other patients I sent back.

I offer MC for a week, medications check, upgrade of medications if they are on some cheapo cheapo drugs, thats how I tried to mend the situation.

I am cheating them actually, of their rightful surgery, because really, the line is long.

This uncle is funny. He shops for doctors, he went to Doc A, took some meds, then go to Doc B, took some other meds, then Doc C.

He is taking all of those!

On three similar medications, but different names and colors.

We should all spend more time with our patients.

Unfortunately, the scenario is not as easy as we hope for.

We all have parents/wife/children/relatives/friends to settle at home after work.

So we tried to finish our work on time.

Not right isn;t it?

I was told that I am a good person the other day.

but i felt bad almost every other day for every patients I seen.

#psycho.

Sunday, March 23, 2014

Precallblues

I have always think that there are so many things in the world that we cant change.

That we can only accept and move on with the change that the particular thing has made onto us instead.

Sometimes we cant help but to think of what is the purpose of our life.

The roller coaster of life is mystifying.

All good things will come to an end, and vice versa

Hopefully.

And thankfully.

Then why we need to mend something that are to be broken again?

Cant we just leave it broken and dont use that again?

Or we pretend we do not have anything to be used in the first place.

The darkness point is the point that made us to take a different route which seemingly more glowy.

Everyday is a new day.

And yet, we are still the same self.

And because the finish line is unknown

The result is never certain.

And one moment you think you are doing allright, winning the race, and that life is complete.

It will come crashing down at another mo.

Because life can puncit any mo.

#iamsorrytobeobssessedwiththejourneyilikeitsosomuch.