Archive for September, 2009

Great Sites: Gizmo’s Freeware Reviews

There are many gems of freeware programs on the interweb hidden amongst the trojans and adwares. How do you decide which ones to use?

Gizmo’s Freeware Reviews

It used to be a hugely popular site called “Top 46 Freeware Programs”. The owner seems to know his stuff and the site is frequently updated. Over time, I’ve noticed that popular adware programs like spybot s&d and AdAware have decreased in efficacy… and Gizmo’s right on top of every new development.

Tired of Norton/McAfee and wondering what free antivirus program is available? No money for Quicken but want a personal finance manager? This is the site to go to.

Like a lamb to the slaughter…

I am going to take the MRCS (Member of the Royal College of Surgeons) Part 1 and Part 2 examinations in a couple of days time, and feel ridiculously unprepared. In the past weeks, I’ve been cramming at any time possible, and feel very glad that the department I’m working at now has been able to grant me study leave to revise.

That, and a temporary membership at one of two sites: One Examination or PasTest Online Revision has aided as well.

It is almost time… and it’s not even MRCS Part 3 (the most difficult to pass). Why, then, do I have this sense of impending doom?

Time to hit the books again.

(bad books! bad bad books!)

Another Stage of Life

You know you’re no longer fresh out of medical school when many of your classmates are getting married.

Methinks it’s time for the quarter-life crisis to kick in.

The Blame Game

Before we go ahead, though, here’s something that needs to be pointed out.

Consent is not a get-out-of-jail-free card for negligence.

No one said it was.

Whenever a complication happens, despite the pre-operative counselling, the patient and his/her family look for someone to blame. It must be the surgeon’s fault! It was the inexperienced one, wasn’t it? The operation wasn’t kept as clean as it should be! The surgeons only want to chop and a smaller operation could have been done!

Of course it couldn’t have been that the patient had had uncontrolled diabetes mellitus and hypertension for years on end and was now presenting to the vascular surgeons with basically an end stage disease of infection in a leg with peripheral vascular disease. It wasn’t that the daughter harassed the doctors who had offered a ray amputation at the time the operation was feasible and convinced the mother to reject the operation. It wasn’t that after weeks of non-surgical treatment despite counselling that even an AKA did not achieve adequate clearance of unhealthy tissue.

Hello, people, can we take some personal responsibility for our health here.

The Danger of CB Thoughts

Yes, CB thoughts are a concept that was introduced to J much earlier, but it was only in a rotation through General Surgery that the term “CB thought” was taught to him. CB – being an acronym for a vulgar Hokkien term for parts of the human anatomy.

The rule is –

If you think that things will go smoothly, everything bad will occur.
If you say out loud that things will go smoothly, everything bad will occur x many many.

Example 1:
Sitting at breakfast, a colleague in J.’s team looked at the day’s operating schedule and said, “Oh looks like today will be a good day, we’ll probably be done at 3pm.”

DUM DUM DUM!

To put it in a nutshell, a patient proceeded to have severe BGIT requiring urgent scopes etc. etc. and the entire team’s day ended at 8pm.

Example 2:

On call, a senior said, “Tonight’s call seems okay. After this we go and eat prata. Call me when OtherColleague is back from his shower.” and walks out.

DUM DUM DUM!

5min later, the house officer calls J. 2min later, they are resuscitating the patient. 3min later, the senior is leading the resus. 2 hours later, the patient is alive and in the ICU. There was no prata, but there were patients in the A&E begging to be seen.

Yes. As you might imagine, this is not a good thing to be happening. With that in mind, go forth and work! With no CB thoughts.

Video: Bio-Rad GTCA Song (with lyrics)

I love Bio-Rad advertisements. Here, with the follow-up to the PCR Song, is the GTCA SsoFast song, to the tune of YMCA.

Lyrics below.

Continue reading

the poor stay poor – smoking in singapore

Mr L is a new case that presents to the surgical clinic. He has been referred for a right elbow superficial lump that warrants excision.

Straight off the bat, he says (in Hokkien), “Doctor, how much does it cost to remove this lump? Can I use Medisave? I can’t afford to pay, you know, this clinic visit, can I use Medisave?”

“Chill out, Mr L,” says the youthful, brash hip-hop-wannabe junior doctor (now called young-punk-doctor (in equivalent Hokkien), “let me take a proper history and do a proper physical examination just like how I’ve been taught to do in medical school, yo. Peace.”

55 year-old Chinese male, no past medical history of note. Smokes two packs of cigarettes a day for the past 40 years. Drinks two bottles of beer one time a week.

Singapore has bloody expensive cigarettes and alcohol. A pack of Malboro’s/Dunhill costs about S$11 (US$7.70/RM27) (guess-timated price). With cheaper alternatives, he’s spending a bit less than 20 dollars a day excluding food/drink/transport! Young-punk-doctor doesn’t spend 20 dollars a day! He doesn’t go drinking once a week (he doesn’t have time to)!

And here Mr L is, trying to figure out how to pay for a comparably cheap minor day surgery without even contemplating cutting down on a major cause of (a) his lack of cash (b) his future medical expenditure.

Doh.