Short Post: Reality Check

You know, everyone bitches about their work.

But ultimately at the end of the day, I sincerely believe that we do the best we can under the circumstances, to provide the best possible patient care. And although we have different work practices in different conditions, the aim is still the same. I do believe it, that’s why I do what I do.

There, reality check over, back to the angry ranting!

Great Read: The Plot Against America by Philip Roth

The work of fiction writes about World War II and what might have happened had Franklin D. Roosevelt not won the election, had the famed aviator Lindbergh become President and if anti-Semitism had swept across America (well, that’s a bit of an exaggeration)… written from the perspective of a young Jewish boy watching his safe haven disintegrate around him.

It’s got a vivid description of American Jewish life, so detailed it seems the author were recalling from memory, enmeshed within an exciting “What-if?” scenario.

And J. feels that one of its strengths is that it never really strays into the realm of improbability. One can, especially seeing the reactions of people in the recent US elections, believe that such a scenario could have happened. And a similar one could still occur. It’s no 1984, but therein lies its strength.

Biostatistics for Research

J. attended the Biostatistics for Research (Advanced) Course held by the SGH PGMI (Post-Graduate Medical Institute) and it was good. He’s had a little bit of experience playing with SPSS on the basic-intermediate scale and thought it would be useful to understand the statistics of medical research a little better.

Maybe it goes a little too far, but possibly, just possibly, all clinicians should attend a course in medical research + biostatistics so as to better understand how the evidence that we rely on on a regular basis comes about. For instance, how tedious it is to come up with a scoring system (e.g. for cirrhosis) that has good clinical correlation.

It was a useful course, though the course prices ($700) was somewhat exorbitant and wiped out a good percentage of J.’s HO training fund. Ah well.

Less Than Ideal Timing

Hanging around at 5.50pm one day, J. saw the HO on call (let’s call him HO5) for his ward come in. (people renamed, bed numbers renumbered, etc. for the purpose of anonymization)

“Hey man, I’ve just got one case to hand over. He’s in bed 72. Patient with myelodysplastic syndrome, sepsis with DIC (disseminated intravascular coagulation). But he’s alert, we’ve been checking bloods everyday and it’s all improving. TW downward trend, coagulation profile looks good. Can’t quite wean down the oxygen yet though. Just to keep an eye on him. I think he’s stable for now, shouldn’t give you any problems on call.“

5 seconds later:
-ring ring- “Hello doctor HO5 are you the HO on call for ward 93? Patient in 72 stopped breathing please come now,” says the nurse on the phone standing behind J. to the HO on the phone in front of J. Via the phone.

Hmmm… 72? That sounds familiar…

Anyway, J. went to run the resus since it was his patient anyway. Despite aggressive CPR, atropine, epinephrine, ventilation… resuscitation unsuccessful and stopped after 30min on grounds of likely futility. Damn.

Food That’s Just Not Worth It – Part 1

“In these uncertain economic times” (my new catchphrase for sounding smart on the economy when I’m just a layperson trying to sound smart. smartass.) , one has to be guarded with one’s spending. Although that’s actually the reverse of what will revive the economy but I don’t care as long as I’m not living in the streets.

And today we are going to explore the topic of food that scores damn bloody low on the value-for-money scale. Let’s start it off.

1. Fast Food Joints

J. went to drop some relatives off at the airport and thought “Hmm, they’ve gone, I’m on my way back.. I’ll just grab a quick bite. Passing by Burger King, his eye was drawn to the new BK Stacker Double – two beef patties with cheese, topped with turkey bacon and the new stacker sauce. “It just tastes better!”

NOT.

Without the meal, the burger itself came to $4.95. A small burger comprising thin, dry beef patties with dry, non-crispy turkey bacon on a limp bun cut into two, it left a sick feeling in J.’s stomach 10min after he had stomached the thing (hey, why did he do it if it didn’t taste good? idiot.)

This is classic of the fast food burger joints. Burger King, McDonald’s, Long John’s, etc.

2. Mid-Range Western Food Restaurants

Meeting up with some friends the other day, J. couldn’t be bothered to think of a decent place to eat at… so the friends came up with one of the worst possible ideas… Breeks, run by Zingrill. It’s a dang profitable business.

Slap some fish on a plate with some butter rice, a bit of coleslaw and charge $15++ for it when the same could be obtained from any school canteen Western food stall. Smother some drumlets in a disgustingly sweet generic barbeque sauce, the whole stack looking from far like a pile of faecal matter, and call it buffalo wings in “special” sauce.

Hire temporary staff to layer generic brand ice cream and call it a mudpie going for $14++. Put some generic garden vegetables together and charge $6. Now that’s profitable.

why go for it? J. would suggest avoiding places such as Fish & Co., Manhattan Fish Market, Breeks, Cafe Cartel, etc.

That’s all for now… but more to come shortly.

Interesting Movie: Tokyo!

Having a day end early, J. passed by Cathay Cineleisure and decided on a whim to catch a not-so-mainstream movie. Tokyo! is a collection of 3 short films, thrown together to showcase the sights and feel of Moscow.

Yes yes, Tokyo.

The three segments are:
Interior Design contributed by Michel Gondry
Merde contributed by Leos Carax
Shaking Tokyo contributed by Bong Joon-ho

How a Hypothetical Selfish Prick Would Mess Up People’s Calls

To illustrate my point, I’m going to use a hypothetical situation. Let’s imagine that there’s somebody from my senior (by one year) batch in medical school. To make him look really villainous yet incompetent, let’s say… he failed his final exams and had to wait another 6 months to pass his final MBBS examination. This imaginary friend is a big fan of the digital Ixus brand of cameras… so let’s call him Canon (“Delighting you always.”)

On his last week of General Medicine posting he was placed on Saturday HO2 call (hypothetically, just because the TTSH Gen Med HO2 call is miserable). The day before the call (Friday), he is frantically trying to avoid doing his call.

He asks HO-on-Call-on-Friday and says he was on call two days prior, he claims. HO-on-call looks at him like he’s crazy. “I’m on call today! I can’t be on call two days in a row!”

He asks HO-on-Call-on-Thursday and says he was on call one day prior. HO-on-Call-on-Thursday looks at him incredulously. “Hello… me too. I didn’t even have a chance to see my call room yesterday.” She neglects to check whether he was, in fact, on call.

Cruddy Book: Mario Puzo’s The GodFather The Lost Years

This is an unashamed attempt at milking the cult phenomenon of The Godfather for all its worth. Mark Wingardner’s attempt at continuing the series after the death of Mario Puzo falls flat on his face.

J. read all Mario Puzo’s subsequent books, none of which were even remotely close to the standard of the original. The Godfather was a pretty special book which told a gripping story that made you sit down and read it all the way through.

J. struggled through two chapters before deciding he’d read the rest later. Which he did. In dribs and drabs because it was dead boring. Please, save your time and don’t even think about The Godfather’s Revenge, written by the same pretender.

TTSH vs SGH: Handing Over of Cases

In TTSH, at around 5pm or so the HO/MO on call gets a number of calls. Generally, these go something like this:

Hello, J. ah? This is K. from Ward 8B ah, got 2 cases to hand over to you. First one is 8B/65, Mr Genericname Tan, severe pneumonia, DIL Max ward fluids no inotropes, family informed already so just keep an eye out. Second is just to check blood and do check FBC 4 hours after, 8B/59 GS saw planning for scope tomorrow last Hb 6.9 GXM sent off waiting for blood to arrive. Can? Thanks.

Apparently, in SGH Medicine given the breadth of the wards the HO/MOs have to cover, this isn’t the case. Instead, you get a call from the nurse in the middle of the night.

SingTel: “You move into new address, now we harass you for Ah-Long’s $20k”

SingTel is asking me to pay my handphone bill. Only thing is, they transfered over 110 dollars worth of debt from some other account to my account and demand that I pay it. What the hell?

Here’s the background. I started work in May, and received a corporate handphone with a corporate line with a corporate rate of about $14 a month. We would receive the bill at home, pay it and get reimbursed the money by the company with our monthly payslips.

Despite having informed them of a change in address, they sent the first 2 month’s bills to my own place… that had already been demolished. Okay.

The first bill I received was in August: $179.20.

W.T.F. In our line of work, receiving loads and loads of incoming calls is the norm… hence free incoming. There are 80 min free outgoing calls, and I used a total of… 19min. 500 free SMSes, of which I used 28. And that’s what I’d been doing every month.

Refusing to believe that I could spend so much, I took a look at the bill. Aha!

MISCELLANEOUS CHARGES AND CREDITS

Tfr of Acct Bal from A/c [RANDOM NUMBER] to [MY ACCOUNT NUMBER] 117.84
Tft of Acct Bal from A/C [WEIRD NUMBER] to [MY ACCOUNT NUMBER] 0.94

More background history. Apparently the number I took over for 4 months from when I started working for the company until I gave up the phone (with its number) on 1st September had been used by prior employees account a different account number. I’m guessing that the previous deadbeat user hadn’t paid his bills (the account is registered to Company Name) and now they want me to pay.