Life's short

http://www.straitstimes.com/Breaking%2BNews/Singapore/Story/STIStory_308041.html


Masses of teens going on a killing spree, in bright day light..Such audacity. Just imagine the amount of grieving that it has caused to the victims' loved ones

I'm fuming.
Gek Kiangs should be given options of performing treatment for themselves.. since no one's holier than thou. As such, they should be writing textbooks for aspiring medical and dental students, and that would bode well for the nation's aspirations as a medical hub.
I was given a lesson on wound healing 101 (Geh Kiang version), who asked very highly challenging viva questions
a) when the gums are fully covered up, and without pus, who can you be so sure that there's no infection inside(screams :inside) the socket?
A: this is so mentally stupefying, that i find it hard to answer

b)(after being informed at xrays have been taken post op to exclude post op infection) But, you can't see the infection on the xray right!?!?!
A:which part of 'xrays to exclude post op infection do you not comprehend?

c) why must there be stitches in the first place? Shouldn't there be more oxygen so that the cells can survive better?My beautician said more oxygen can increase cell turnover in skin
A:...............................maybe the next time you go to the beautician, you get her to do dentures for you as well, cheap good fast, quality guaranteed

d)(aft taking antidepressants and having improvement in pain)the pain improved not because of the medication, but because when I see the the doctor, I start to feel that I'll get better, so it's more of psychological than the medicine given to me....
A: I'm flattered that I've got such great healing powers! =)! Maybe the next time round, I can sell my photos on the Net for USD$200, get this pt to be in my facebook fan club, and write endorsements for me! Any takers?

Above has been mentioned by Prof Geh.. so all of you ppl out there! Go attend more CDE/CME sessions by these Gehs.. you'll be loving every moment of it!

One fine day, I decided to walk from Outram Park, to Raffles City where I was meeting my uni classmate. I had ample time to spare, and it was one of the rare occasions where I brought out my camera, so I started taking random photos of monuments around.

Some pics





A couple taking wedding shots

Working with that special someone

It must be a case of bad karma.. must be the god of tuna, since I'm packing tuna sandwiches everyday... He's punishing me for finishing those cans of tuna off.. hence what happened today happened. It all started with the fatal call that I picked up at 0750 hrs

Caller: Is this the mobile clinic of Dr Dodo?
Me: (thinking: who's the goon.. ppl just say MDC blah blah) Yes.... (a few seconds later..... realisation of the caller's identity, and frantic silent prayers ensued)
Special someone: Hi, my nurse is on MC today, I called Dr c and she asked me to go over to your mobile and help out
Me: (relieved) Oh, we have cross country today, so we're not screening cases. Morning we're doing stock taking and afternoon, we're havign few appt cases, but we can handle them! No worries!
SS: Oh, but it's ok. I can come and help out. (goes on a rambling on why he doesn't want to go back to the centre, cos he's leaving for KL at 7pm, lives in CCK, doesn't want to go back to take luggage, cos it's very leh cheh...........)
Me:(half asleep from the grandpapa's story) ok, but we REALLY don't need your help.
SS: can i help you in the stock taking then?
Me:(HUH?) Ok, why not you do your stock taking. Or maybe give dr c a call? She may suggest something more productive

0800(in the toilet), phone rang
SS: ok, i've spoken to her, I'm going to come down, and drive your nurse personally to my mobile and I'll return her during the aft noon.
Me:(return the nurse? your nurse is a book ah?) Ok, I'll speak to her later, cos I'm in the toilet. I heard her mention sth about sorting out consent forms also for the audit.

0810: After discussion, realised that there's no point in me doing stock taking since I won't know where some things are kept.. So both of us decided in taking on this mission together. With heavy hearts, we packed our gloves, laptop and drove to the school. Reached at 830. But SS only reached at 855

Below is the chat that explains what happened

(r: Me, S: friend, dr c: boss, D: my nurse, H: SS's nurse)
r says:cos my sch no sch today.. cos x cty
r says:and H on mc
r says:so dr c ask us to go over to help
r says:and gosh
r says:took my life man...
r says:he just started calling pts the moment we went into his moble
S says:what happened?
r says:D hasnt even set up her things.. dunno where H kept her stuff..
r says:for me.. i've not even set up my laptop yet
r says:and this guy just said. ok i'm doing appt, you're doing screening cases.. and he went off to call like 6 pts
r says:wth!
r says:then after that
r says:realised that he updates the consent forms one by one, he doesnt use the class list function
r says:and i thought he doesnt know of that function
r says:and i told him.. u can update as a whole class
r says:he told me
r says:er.. ya..Sue also does it that way.. that's one way to do it, but i do it this way..
r says:i was like.. wth.. waste so much time befor each pt to update consent.. when u can easily update as a class...
r says:its like saying.. from yishun to amk.. u can either take the train 2 stops down, or you can go to jurogn east, change to the green line, change at raffles place, go to the red line.. and stop at amk..
r says:which one would u choose?
r says:and he passed me this orange file with this gigantic stack of consent forms, and he files up all the forms according to class.. and i haveto fish out those that are not updated and screen those
r says:really do a lot of extra stuff
S says:haiyo
S says:but he's still at his first sch or second now?
r says:and havent finish yet
r says:at his first sch
r says:he's shifting on 7th
r says:then i was in charge of screening right
r says:then i realised that d did not have the class list to call pts
r says:cos there were no lists on the table
r says:so i told d, take the consent forms and call from there, and pass to me when pt is here.. if not how she know who to call right
S says:yup
r says:then that guy said u know what? i'm so pissed
S says:what he say
r says:"hey, dont do that, it'll be v messy!'
r says:i was thinking
S says:hahaha
r says:walau.. as if things are not messy enough
r says:then i said
r says:then nvm lah
r says:u tell me where's the class list.. if not she wont know which pts to call right
r says:like who rejected consent and so on
S says:is there one?
S says:as in do they keep it
r says:and guess what.. he said there is..
r says:and he told me.. he doesnt know where is it
r says:so how? u tell me lah!
S says:then in the end what happened
r says:so i copied the names on a list for d
r says:and passed to her lor
r says:i said.. ok nvm.. consent forms i keep
r says:so irritated
r says:then somemore
r says:ok.. there was this korean guy whom he called , but i can't find his consent form
r says:so i asked him.. boy, did u hand it up?
r says:boy said yes
r says:i asked special someone to coem and find or give me the consent form if it's with him
r says:that guy can't find the consent form.. and it's darn messy the file
r says:so i said.. i dont want to see the pt lah
r says:cos i just came.. no consent, how i know if the parent say ok or not ok
r says:and u know what he said?
r says:he said.. in this case it's different, it's not like the pt did not hand in the form, but the pt did hand in, but we can't find the form
r says:i was thinking.. so... can i imagine a piece of paper in front of me, that resembles the consent form.. and i imagine that the parent consented?
r says:so i shld be seeing the pt
r says:what logic?
S says:huh ya
S says:so in the end, usee?
r says:no lah!
S says:ya dun see la
S says:no point.
y says:if special someone turn around and say i told her don't have consent form, but she still saw
r says:and come on lah.. only one screening case
r says:are you that hard up for me to see that one screening case?
r says:he knows that we don't have the consent form
r says:and he wants me to see!
S says:ya that's really absurd
S says:dun care abt him
S says:but at least it's just a day
r says:half a day in fact
S says:oh hahah thats good
r says:and he was pushing for the powervac guys to come and clear the tank
S says:huh?
r says:cos he said.. monday he's on leave
r says:i mean.. the tank is full lah
r says: supposedly.. clearing the water tank would stop his workflow
r says:powervac clear water tank.. guan1 ni3 pi4 shi4
r says:they clear outside, your pts are inside
r says:not like u can't use the water when they're clearing the tank
S says:yah precisely
r says:at first he wanted to follow us to the mobile
r says:u know his reason?
S says:why
S says:he lonely?
S says:haha
r says:he told d 'cos i'm a guy'
r says:d was like.. ya.. i know
S says:huh
S says:so?
r says:but u're not seeing pts what!
r says:why do u need to care if you're alone or not, if no female pts are inside?

I shall be turning vegetarian soon, to atone for my bad karma.. hopefully it'll help

At the end of the day, stupidity reigns

A magazine recently ran a "Dilbert quotes" contest. They were looking for people to submit quotes from their real-life dilbert-type managers.Here are the top ten finalists:
1. "As of tomorrow, employees will only be able to access the building using individual security cards. Pictures will be taken next Wednesday and employees will receive their cards in two weeks."(This was the winning quote from Fred Dales, Microsoft Corp. in Redmond, WA)
2. "What I need is an exact list of specific unknown problems we might encounter."(Lykes Lines Shipping)
3. "E-mail is not to be used to pass on information or data. It should be used only for company business."(Accounting manager, Electric Boat Company)
4. "This project is so important, we can't let things that are more important interfere with it."(Advertising/Marketing manager, United Parcel Service)
5. "Doing it right is no excuse for not meeting the schedule."(Plant manager, Delco Corporation)6. "No one will believe you solved this problem in one day! We've been working on it for months. Now, go act busy for a few weeks and I'll let you know when it's time to tell them."(R&D supervisor, Minnesota Mining and Manufacturing/3M Corp.)
7. Quote from the Boss: "Teamwork is a lot of people doing what I say."(Marketing executive, Citrix Corporation)
8. My sister passed away and her funeral was scheduled for Monday. When I told my Boss, he said she died on purpose so that I would have to miss work on the busiest day of the year. He then asked if we could change her burial to Friday. He said, "That would be better for me."(Shipping executive, FTD Florists)
9. "We know that communication is a problem, but the company is not going to discuss it with the employees."(Switching supervisor, AT&T Long Lines Division)
10. One day my Boss asked me to submit a status report to him concerning a project I was working on. I asked him if tomorrow would be soon enough. He said, "If I wanted it tomorrow, I would have waited until tomorrow to ask for it!"(Hallmark Cards Executive)

Cookie baking

NVS

It's been close to a month since I've started seeing pts at NV. The school is housed in the middle of housing flats in Yishun, and the building is 19 years old and counting. The architecture and layout reminds me of the old RJ compound, small, but cosy, a rather homely feel.
The students that I've seen by far are the worst behaved amongst the 3 schools that I've been to. However, the encounters I've had were much more interesting as compared to the other two schools. Population wise, this school has the smallest enrolment. There are only 3 express classes, and 5 other Normal classes.
On some days, I can really be driven crazy by the din that is created by the rowdy students. They usually come in their cliques, and usually it's a all-or-none strategy employed by such students. You either see none of them, or take in the whole jing bang, rowdiness and all. They would refuse to go back to class after you're done with one of them, and they would only leave together when the clique has completed treatment. On some occasions, the clique would refuse to leave, choosing instead to stay in the mobile to enjoy the aircon, expressing their fascination at our 'microwave'(autoclave) oven, playing with the extra chair or simply, being a nuisance. My nurse was worried that the staff may be unhappy with the students staying unnecesarily, but I'm thinking, the teachers should be grateful to us for taking all these students in, who would otherwise disrupt their lessons in class, judging from their behaviour in our mobile.
Some of the students are clearcut disciplinary cases. Most of them come with tongue studs, lip piercings and what have you. Interestingly, they are often the ones who complain that scaling is painful. To me, that tongue piercing of 3mm in diameter looked much more daunting than my scaler tip. Some come in with nicotine stainings and equally potent breaths to match, and are currently under counselling for smoking cessation. They represent the modern Hokkien Shakespeare, and exhibit proficiency in dishing out vulgarities in 3 out of the 4 national languages.
There were even three students organising a group confrontation in my mobile when one of them was recieving dental treatment. One of the them(from sec1) had been 'diaoed' by a sec 2 boy, and the sec 3 students were planning to call in reinforcements to support their confrontation. Apparently, they operate by neighbourhoods. Members at Admiralty are too far to render any support. Yishun members had to be rounded up for the 'big' event.
Of course, there are the perennial jokers. One guy who required root canal treatment for a decayed tooth insisted that I 'knock his head, make him sleep' and give the injection. I duly rejected. There was no need to sacrifice his continued cognitive development for an infiltration.
In general, it has been a culture shock, as well as an eyeopener. Previously, the most rebellious act I've done in school was to turn up late for school. My school life really paled in comparison. However, it is disheartening when you think of them as kids who had just left primary school 3 years ago, but changing from innocent young kids to such rebellious teens. But well, in my short encounters with them, I do advise some of them to work hard for their future. Hopefully, some of my advice had had some effect. Meanwhile, I shall pray that my sanity will be preserved in the midst of the ruckus that the cliques create during my screening sessions.

Yesterday, the mobile DOs made our way back to HPB to attend the briefing on the workplan for HPB for this year. Figures and numbers had been bandied about, and we were told to improve on the targets set last year. Sometimes I wonder,statistics is used by the administrators to rate performances and determine the employees' efficiency and work quality. However, in clinical situations, numbers simply do no justice to the complexity of clinical practice. Grey areas do exist. Sometimes, compromises are made in the pursuit of fulfilling the numerical targets. Well.. but I guess there's not better way to go about evaluating the performance of an institution.
Anyway the briefing ended early, and we managed to sneak out to Clarke Quay, bidding a silent farewell to koffAahemBkoffT. Had lunch at Azabu Sabo(is it spelt like this?), tried the Hokkaido hotball. It tasted like fried potato or sweet potato, topped with vanilla ice cream, red bean and Japanese sweet potato. DS tried a dessert similar to an expensive chocolate ice kachang, minus the jelly beans. The food there looked rather promising, will go back one day to try their main courses.
Attended the NUS symposium today, saw many familiar faces, seniors, Profs and other clinical instructors. The lecturers were rather engaging, especially Prof Stanley Malamed. Americans seem to have a way in lecturing, they're always more engaging, more interesting than the rest, and the way they weave anecdotes into their script is amazing. The other Italian speaker spoke on usage of MTA, and some of his philosophies are rather radical, from my personal point of view, well... take the stuff with a pinch of salt I guess.
Tomorrow will be a packed day of lectures again. Time to zzz..

Today marked the end of the posting at HPB centre, so no more crying kids for a long long time. Back to my mobile tomorrow, together with my DSA, but handling a much more notorious school. Hopefully they'll cooperate, not default on appointments so that I can clear my quota.
North View, here I come!