12.19.2011

hurry up and leave, 2011

The year's coming to a close and I'm glum. Not because it means I'm one year closer to death. Am momentarily stuck in a moment of feeling helpless. Driving for four hours straight, at times in rain so heavy I couldn't see more than 5 feet in front of me.. driving back to a rented apartment alone gives one a few moments to reflect.

It's not very gratifying to feel that I haven't made any difference to people. Do you realize how frustrating it is to come across patients regularly who travel several hours to wait another few more at a crowded clinic, to be seen by a registrar (they're lucky if they get one of the good ones..) for less than 10 minutes and then be either be told that they're not healing well, or they are but to come back in another couple of weeks once their broken bone has healed? Some of these people struggle to find the means to come, either because of lack of transport or lack of funds. Couple that with a painful injury, sometimes in a cast that doesn't allow them to bend at the knees to sit comfortably in the car... And yet, there are ads on TV telling people that help is never too far away (via helicopter), showing signs in the middle of nowhere with things like "pediatrician --> 500km" or "heart specialist <--- 630km" on them.

It's not near. It's bloody far away for these people. It's frustrating to be part of this system, where we're at the bottom of the food chain. People "up there" sit there making rules that affect the lives of many hundreds out there without full understanding of the implications for those affected.

Do you know how much of a lightbulb moment it was for me to admit to myself that I've enjoyed my short weeks of ICU more than I've enjoyed ortho all year (except for my secondment hospital posting)? Yes, the huge blocks of days off help a lot. Maybe it's that. Or maybe I feel like I'm doing something useful - like preventing home teams from inadvertently killing their patients from sheer neglect when I go on MET calls. Coming from someone who has been gunning to get into ortho since internship, this is huge.

I thought 2010 was a crap year. The workplace woes resulting in a non-negotiable boss-initiated week off, no questions asked. The stress associated with planning the wedding (would have been worse without the support of the Tubby-Hubby) - so much so that I forgot to actually enjoy the moment of getting married because it passed in such a huge blur. Sad, eh? The disappointment of not scoring an ortho interview (for that was the goal) and scrambling around to rack up the points. The bulk of it was mostly the mental torture stemming from work, and a particular colleague at the time.

This year was worse. It's like the universe is out to prove that it can outdo itself. The few moments we could steal of married life were good but we were mostly apart this year due to work. I'm renting an apartment nearly 300km away for goodness sakes. And then, I lost my rings. On the one-year anniversary of his proposal. Both rings. And then the bitching at work! This year took my workplace woes to a new level of hell. Then my car died on me. A minor crack in the radiator was undetected and ended up blowing the gasket. The engine needed to be replaced and the car was at the mechanic's for more than a month. I got stuck in floods, the worst in the region for decades. The regional hospital was basically in shutdown mode for the week until waters receded. And then my grandpa. The parents thought it would be a nice thing to tell me that my grandpa isn't likely to make it.. one month into his ICU admission overseas. You have no idea how much I seethed at being told so late. He died soon after. I found out on the train, via a text message. Gee, thanks for the kind gesture. The Tubby-Hubby was next to me on our way to pick up our wedding album. We were to bring it back home to show my grandparents the wedding they missed. It was the main reason we got the album made. He never got to see it. It kills me every time I think about it still. We flew back for the funeral. We flew back again less than a month later for the vacation we planned half a year ago, wedding album in tow. The poor Tubby-Hubby has occasionally had to suffer the under-the-surface bubblings of angst and frustration I can't contain but otherwise, I've been trying to lie low ever since..

So yeah, given all that, I'm glad this year's coming to a close. I'm glad I'm getting a new shot at things. I'm scared of not living up to expectations, but am glad nevertheless to start fresh. I'm glad that I get to go home every night to home, not some derelict run-down apartment where I look over my shoulder all the time to ensure my own safety. Two thousand and eleven, I'm glad you're going to be history soon.

12.15.2011

C is for Cookie

Sometimes, I wonder
Why suffer so?
Why jump through the hoops
When there's other places to go!

The operating room,
It has its thrills
Those bloody messes
And the drilling of drills!

But then I think,
Is this worth the time?
To while away the years
As I while away my prime.

I'd rather be happy
Than trudge through the day
To come back home exhausted
It's not worth the pay..

So once again
Here, I stand
At crossroads familiar
A decision in demand

But let me be,
And let me stay
In my dreamland
For another day!

So for all you friends
and family too
A happy Cookie Day
to all of you!



12.10.2011

medical marvels

Once again, I'm warning all of you. Do not land yourself in the hospital if you can prevent it. You will be surrounded by incompetent nincompoops, especially on weekends. Just take a peek at these pieces about UK hospitals. It's old news, really.

I'm most likely offering a skewed view so indulge me and share your thoughts with me after you hear out my tales. All names are fictional in this context.

***

Teddy, the ICU registrar receives a call on the Outreach phone, a dedicated line meant for consults by the rest of the hospital. His side of the conversation goes something like this:
"Yes, I remember Mr Connors. Uh huh. ..you're concerned about his heart rate?"
*long pause accompanied by a myriad of facial expressions ranging from bewilderment to utterly lost*
"So you're the team registrar?"
*another long pause with the facial accompaniments*
"So you're the intern?"
*a slightly shorter pause*
"So you're the nurse? Um.. why don't you call the resident looking after your floor to review the patient first, and if they have issues, they can call the medical registrar to review. If the med reg thinks the patient needs ICU to get involve, they can call us then."

For those of you who don't work in a hospital, the ridiculousness of this might be lost on you. I don't mean to sound elitist, but am just stating how the chain of command works. Ward nurses aren't supposed to MAKE referrals to any team - it's not the job they were trained to do, it's not their call to make. If they were concerned, they should refer to the doctor responsible for the patient they're worried about. If they're still concerned for the patient's safety, there's a MET call/Code Blue system in place to get senior help FAST. There was absolutely no role for them to call up the ICU registrar to request a review, yet this particular one was quite indignant that ICU hadn't reviewed this WARD patient (who was NOT in ICU) in two days and why not?!


****

The Outreach phone rings again.
Jack starts to talk to his counterpart, another registar, on the other end of the line.
The full story emerges after Jack hangs up the phone with a very bemused on his face.
"There's this paranoid schizophrenic patient down at the psychiatric unit who's refused to eat for the past two days now. They want us to bring him up here to ICU, sedate him and give him IV fluids"

... where do you even START?!

First of all, the patient is mentally ill and is a scheduled patient, basically classifying them as an involuntary in-patient. Therefore, as a doctor (they obviously forgot what that entailed), the psych team is legally allowed to implement any and all treatment/evaluation deemed appropriate to the benefit of the patient. That translates to "go and restrain him so you can put in an IV cannula to start the fluids through, you nincompoops"

So the ICU Outreach team troops down to the mental health unit to review this patient, made sure he was all ok and document that the medical ward is perfectly capable of having patients with cannulae in situ, and if they required any help to insert lines, to call the anesthetic team. The medical team hadn't even reviewed the patient yet, as Jack had advised over the phone.

As the ICU team troop back to the unit, Jack gets a call from some manager up in hospital administration, saying that it was unsafe to have the patient up in the ward. Honestly, medical admin, you're making that clinical call?! If you were so concerned about the patient, why don't you come and review the patient yourself to reach a decision, usurping both the medical registrar, the psychiatry registrar and the ICU registrar of their jobs?

Oh, the saga continues. After Jack finishes entering the review into the ICU database, the MET call/Code Blue pager goes off. Guess where at? No prizes for guessing.. the psychiatric unit. The reason? "The patient dropped his GCS a little." By the time the ICU team arrived again, the patient had his eyes closed. They flipped open immediately and the mouth uttered a very comprehensible "Yah, what mate?" as soon as the ICU registrar approached and tapped him on the shoulder. Decreased GCS - what utter crap!!


***

And then there were the phone calls - 3 so far in my two days at work this block of shifts. All kept asking about a certain patient in one of the ICU single rooms, inquiring about his health. Um, how do I put it without being blunt... "He died last week." It's like he hasn't let go.. his xrays are still around, random teams that have been involved with his care have been calling at random times (what consultant calls up on a weekend afternoon anyway!?), and even family have called. Awkward.

***

What about our Dancing Queen.. the one that's been in ICU for over 150 days and counting. The one that has stiffened up from being bedbound, intubated and ventilated for most of this time and has grown all sorts of bugs that can only be managed with nephrotoxic antibiotics that are reserved as a last resort? Now, do you think the family is being considerate, or being just plain cruel, to plaster the only wall she can see from her bed with enlarged pictures of the patient when she was well.. when she was leaning over balconies enjoying sunsets, or when she was playing with her grandkids. I call it cruel, especially if I was the patient sitting there with multiple holes in my abdomen from so many surgeries that I'm leaking everywhere. I wouldn't want to be reminded of what could have been, what was, what I could have done.. Yet, the family refuse to let her fade away in a comfortable, painfree manner but insist on us shoving tubes down the patient's throat and other awful maneuvers that wouldn't improve the patient's eventual quality of life.. if she made it out of ICU, let alone the hospital at all.

***

Oh, I could go on but my head hurts. So many other similar events happen on a daily basis. Add that to the incompetence of certain staff members on any given shift (or those with personality problems, or those that like the thrill of power struggles). Then add truly sick patients in ICU requiring medical attention. Then add the occasional procedure required like central or arterial lines. Factor in patients arriving and leaving the unit at any given time, plus the paperwork involved. All in a day's work. My head hurts =(

11.30.2011

ungrateful wench

The ICU. At night. Be scared. Be very scared... of Angry Amy. She reared her face and made a guest appearance last night when we had this lady yell the house down. Post-craniotomy for removal of a brain mets, she was brought into HDU and wouldn't shut her shrill little mouth all night. She obviously subscribed to the "The louder I yell, the more attention they'll pay me" school of thought. To make matters worse, she was Cantonese-speaking and her poor daughter had to interpret for her. The lady obviously could understand and speak some English, for by the end of the night, she was forming simple, blunt sentences such as "You no care" and "I want to leave." The daughter had enough before we hit this stage and left for home at around 4am in the morning.

Now, I don't have a lot of patience but I make up for it with tolerance. This lady had used up any and all -ence I had about two hours into the shift. She claimed she was in pain but refused analgesia. Ok.. that's not so uncommon amongst the patient population. Matyrs. Or plain stubborn idiots. That was just the tip of the iceberg. She then loudly claimed that ICU wasn't providing her adequate care along the lines of "24-hour care my foot. Someone comes to check on me every hour and looks at the computer. Otherwise, they only come when I yell out." So I spend the next 40 minutes going through explaining that ICU has gone electronic and all notes are in the computer now, to pointing out that she has a dedicated nurse looking after her and all sorts of things. She managed to say in English "I don't accept that" to all my explanations like a freeeeeeaking petulant child. She tried the "I want to speak to the boss of ICU" angle, at 3am in the morning. Uh, no. She finally agreed to have some fentanyl after demanding that she'll be fine with paracetamol. Uh lady, it's not your call. She still wasn't happy and resorted to "Oh, it's all my fault then, I'm wrong and you're right." and kept repeating that for the rest of the hour. *gnash teeth silently* Every. single. button. pushed. She kicked up such a fuss, claiming we didn't care for her, let her die, blahblahblah, that she set off the confused hypoxic guy opposite her and caused her neighbor to develop stridor.

So I cracked the shits. Apologized to her daughter and asked if she could please translate what I was about to say. And let the feral woman have it. I was this close to rhetorically asking her if she was the doctor here, and would like to dictate her own management after having her skull just cut open. Never have I said that to the patient, and seldom does the thought cross my mind. Seems really arrogant and I wouldn't have been able to get the words out completely before sheepishly apologizing halfway through.. but tonight. MAN. that close to saying it to her. crazy woman. Thanks a lot for reinforcing the maybe wayward views I have about Chinese culture and habits.. where the more you fuss, the more it means you care.. or how nothing else but an injection (for whatever ailment befalls you that day, even a sniffly nose) is the only way to "cure" you. Olanzapine gun, you were my best friend tonight =)

11.01.2011

Halloween 2011







So All Hallows' Eve 
Is here once more
But this year is different
From the ones before

Yes, there are things
That never seem to change
Like the Christmas decorations
In the supermarket range

Or the lack of pumpkins
That were suitable to carve
There were a few, a few weeks back
But the night itself was pumpkin-starved

But that's ok, 
Because I made do
Like every year, 
It's nothing new

The only change is
I'm now wed
'Twas a year ago today
I became a missus instead

So screw the candy
and the lack of tricks
Forget the kiddies
And the decorations for kicks

For Halloween is still not quite,
It's not quite right here, but that's alright
A feast we'll have, and a feast to enjoy
A feast for two without the fright!

10.28.2011

morons

I really really need to get this off my chest, especially before my night shift starts.
Am already cranky for not being able to sleep through this afternoon in preparation for the next few nights, and for having an awful dream where I met someone in-dream I really didn't want to see and then I wake up to find idiots in my inbox.

The medical admin where I currently work really need to get their act together. I've never come across a more incompetent team (despite having only worked long-term with three previous teams - one during university, the others up in Sydney).

I have been working at this hospital since mid-January this year. We're now nearing the end of October and I get an email saying "I have been advised that you have not been to see the staff at the Occupational Medicine Unit at The Canberra Hospital on Level 10 for your immunisation/vaccination screening." You're joking right? It took you until now? I went away for 8 weeks early on during the year and got my little vaccination card after getting verification of my immunization status. But, no, that doesn't count because we're in a frickin' different state that really doesn't have much going on  for it except that someone decided a while back to cordon off an area of New South Wales and declare it the capital territory. To be honest, I completely forgot about immunization. I vaguely remember attempting to do the right thing and seek them out, until I shortly gave up trying. Seriously, they open for two hours a day - from 1.30 - 3.30pm and then you need to go to another clinic for them to be happy you don't have TB. That clinic's not much better, opening between 12 and 3pm. What planet did these people come from!? Do they honestly believe that doctors who are hauling ass around the hospital trying to work have time to go up during their measly opening hours so they can shuffle some paper around? Especially surgeons?

And then there's that mandatory training of a new x-ray machine that the operating theaters are getting. You gotta know, this mass email telling us we all had to attend included everyone from registars to bosses from both orthopedics and plastics. The first email came out early August, telling us training sessions would be either Sept 8th or Sept 22 during bloody working hours: 2 - 4pm! Again, what planet did these people come from?! So a boss emailed, saying they'd rather come back Saturday and get the thing over and done with in one shot without having to worry that we were losing precious allocated theater time. After 2 more emails hounding for us to reply and sign up because training couldn't proceed unless there are 10 or more people (or what? you lose money? why does it matter if this is all mandatory for us anyway?), we get an email four days before the rescheduled session to say it's been cancelled. We have since had three more reschedulings and several emails in between to nag us of the new training dates. Why? Because they couldn't get their act together. The first two times, rescheduling happened because the bloody x-ray machine hadn't physically arrived. The last, was because they couldn't get it "commissioned" in time, whatever that means. Seriously?! Eleven emails since August and they still couldn't get it together.

And don't get me started on the horrible rostering, or their lack of responsibility.. or the fact that they somehow "forgot" to give the IT department a list of all new incoming doctors at the beginning of the year and therefore, none of us had passwords issued for immediate use on our first day of work. They're here to support us - bullshit! They told one consultant colleague of mine they would pay for his relocation costs, seeing that he was shifting all his stuff from overseas to here. He arrived, they stuck him in accommodation for only 6 weeks because his contract is for a year (and not 6 months, so apparently they're not obliged to provide him with accommodation) and then refused to pay for relocation costs because "it was never promised." Sorry, there's just so much wrong with this place.. I'm really really looking forward to leaving and have already started counting down the days. I don't know how anyone who has worked here before had anything good to say about it. Personally, all the consultants I've met have just smirked and skirted the issue about their previous stints here - and that's not even taking the awful medical admin into account.

And with that, off to night shift a little less angsty. =)

10.12.2011

another round of gnnnnaarrrrrgh!

Can i hazard a guess that it's universally annoying to all to know that one is right, but can't do a thing about it? Patients are lovely like that. they revive random sentiments every so often, just to keep me on my toes. Just yesterday, I had to talk to a 40 year old housewife in Mandarin to explain why her distal radius fracture really needs surgery.

Despite explaining that:
  • her bones would heal in about 6 weeks regardless of surgery
  • she would continue to have improving levels of pain until her bones healed
  • we would give her medications through the drip and tablets to control her pain
  • her arm would be out of action for the next 6 weeks until her bones healed
  • she would have poor function if her bones healed in a not-so-ideal position like they're in now
  • she may not have pain now, but may experience pain in the future with unsatisfactory positioning of the pieces
  • she will have no guarantee of finding an orthopod who will perform the required surgery up in sydney, let alone guarantee that the surgery will proceed at the latest, tomorrow
  • she doesn't even know where to find an orthopod
  • any number of friends she's got, unless they're in the medical system, will not even come close to getting her near an orthopod in Sydney (I was also thinking that it would prolly help if she had some English speaking friends in an English-based country but kept that thought to myself)
  • she is already fasted for more than 6 hours and is technically ready to go to theaters
  • she could be home in sydney by tomorrow afternoon if all goes well
  • she is lucky there wasn't much trauma on in theaters and we could fit her in within the next few hours
  • we don't advocate operations just because we like cutting people open and we have nothing better to do (shush, all you naysayers! *waits for the ortho-bashing*)


We traced lines and angles on her xrays to explain. We got her friend to explain (after we went through the above again in Mandarin because, much to my dismay, her friend couldn't speak English either. URGH!). We showed her what normal bone alignment was supposed to be like and what hers looked like. She obviously got it because there was a lot of tsk-tsking and shaking of her head along with her gasps.


And despite all that..



The lady refused surgery. 
And for what reason?


She was paiseh. Really, lady. You would rather live with a broken wrist that would very likely continue to collapse and shift in position (especially after you refuse a backslab because you were scared of pain) and cause you functional problems in the future, besides the possibility of pain and future corrective surgery or wrist fusion. You would rather live with that because you were too shy or polite or whatever you call it for not wanting to bother your friends by staying an extra night because you were only meant to stay one night. Really, lady? Really?


So, I got a bit shitty with her. I was right! She knew it just as well as I did. She knew I was being so persistent as her advocate, so she kept thanking me. That really made me more mad. I told her to stop thanking me because it wasn't going to help her wrist return to normal function. And then I launched into the consequences of declining surgery, making sure she understood them all. She said she did. Then she would start to thank me again. We went in circles and it drove me mad. My Aussie colleague could only roll her eyes as she figured out the gist of it without needing to understand a word of Chinese. Because nobody was happy, we got an ED intern that could speak Mandarin to reiterate everything again just to make sure the lady wasn't being daft because of my linguistic skills, or lack of.


By then, my colleague and I had had it. Why the hell were we wasting time with an obstinate idiot who obviously values "face" to avoid any "shame" (such as walking out with a backslab) more than her well-being, or that of her family's. So we left it at that and told her that ultimately, it was her body, her choice but she had to be put in a backslab as basic fracture management.


Imagine my surprise when I saw her name on the pre-op patient list this morning!!
She had some sense of self-preservation after all! Yay, there's hope.. but boo, she made me work for it dammit!

10.02.2011

oh chute!

uncouth neighbors with no manners irk me to bits. just had to get that off my chest..
out of curiosity, what's the worst "payback" anyone's given to their unruly neighbors? sadly, or not.. mine haven't been too creative. they mostly involved poking a broom or bouncing a ball up at the ceiling to coincide and drown out stomping from upstairs.. or sarcastic passive-aggressive letters. the latest of which had photographic evidence of the oodles of garbage left in front of our garbage chute. seriously, who does that?! they bothered to take the trash all the way to the chute but couldn't be bothered opening the door to dump it in! they're either really stupid, or really lazy.. or both. some people, honestly! *huffs*

9.17.2011

some people have all the luck

I thought these things only happened on TV. Obviously, I'm still too naive.
Came across a gentleman in his mid 40s in clinic yesterday who explained why he was a single parent..
His wife died of lung cancer earlier this year, and his teenage son now has metastatic testicular cancer because he hadn't mention the lump he found before, due to the goings-on with the mother. The guy  now has a broken elbow from getting hit accidentally at work by his boss and can't drive.. and is now relying on his dad to chauffeur him around to various medical appointments. D'ohs all over the place!


Besides the few we've got as inpatients who are there because of failed suicide attempts, this guy has probably one of the sadder stories I've come across in a while. =(

9.15.2011

celebrations schmelebrations

Today was a bad day at work. It was good in that I got to be in theaters all day and got to do my own unsupervised case, the first in a very long time.

But, I ache all over and my head feels like it's going to explode.
I feel like i'm an arthritic 90 year old granny.
My joints hurt when I move them. My palms hurt when I type.
I feel like one giant bruise.
I'm also dry retching again, and no, it's not to do with beta-hcg levels.

I had to quell a mob of very angry patients who had their surgeries cancelled today. they were threatening to revolt and one was a crazy drug-seeker with a verbally abusive partner.

I don't need to come home to flip through the news and find out that today is apparently R U OK day. My first reaction was "What new Facebook/chain mail fad is this now?" What kind of day is that?! Why only today? Can you not ask me if I am ok tomorrow? Or last year? Do you think that people are so dumb and so emotionally retarded that they don't have the humanity to comfort another human being feeling down or depressed, especially if it affected someone close? Seriously, who was the brilliant spark that decided to come up with another asinine holiday when really, every day should be a celebration of anything and everything that each of us want to celebrate. Why should we all observe earth day only once a year, and why should we all light candles to conserve energy for a mere few hours a year. what about the smoke emitted from the candles people burn during the blackout? Aren't there enough crazies out there, to not encourage more? Childrens' Good Manners Month, Festival of Sleep Day, Lost Sock Memorial Day, Have A Bad Day Day, Toothache Day... I could go on and on. and for goodness sakes, stop going down the path of idiocracy. I realize that a lot of these were made up tongue-in-cheek.. which makes R U OK Day even more irksome because it comes across as trying to be hip while reaching out with a serious message, a campaign of sorts. If you're going to come up with a bizzare holiday to celebrate and promote, at least learn to spell it properly instead of using  abbreviations.A good friend of mine committed suicide a few years back. He was very well OK, thank you very much.. except he wasn't. Obviously. Hence, the shock suicide. It would have taken a many R U OKs to have even seen it coming, if ever. One bloody R U OK day is certainly a tad too simplistic a dream that the day will change or save a life, just because you were part of the flock of sheep that thought it would be cool to initiate conversations, "meaningful" ones as the website states, with strangers and family alike.If people really cared that much, if they really had that awareness about them, they *should* and *would* be asking others about feelings and emotions as part of one's everyday routine.

So screw you, R U OK day. Thank you for your fake sympathy. As far as I'm concerned, the only celebrating I'm doing today is that of my hubby's birthday. Hmph.

8.29.2011

next year is starting to fall into place

do you have any questions to ask us?
.... noo. *awkward silence*

well, i've got one for you

(oh crap, time to start rifling through the memories again)

*i can't remember the exact wording. everything was a blur*

what would you say if i offered you the job right now

wow. i'd take it!

well, it's yours.

*stunned silence*

wow. thank you.

it's done. you'll be hearing from us officially soon.

...and with that, next year has already been planned. i never thought i'd be saying this, but man! am i glad to know i'll be back in sydney again! =D

8.20.2011

it's been an awful week
one i walked right through
didn't care much 'bout the goings-on
or of things that are yet to brew

it's no fun being in tears
especially on a bus
no longer mad, but just heart-achey
with no further need to cuss

my head still hurts though
and i nearly got killed
my car went off road
i left me a tad chilled

my ankle still hurts
from a fortnight past
a bruised elbow to add
clumsiness shall outlast

my interns have gone
with new ones to start
i hope they don't fight
i hope they'll be smart

karma strikes, yet again
for my colleague's in trouble
she lied again, that lazy bitch
she'll need a body double

a new week starts soon
a new week of hell
i hope it's less rocky
with lesser storms to quell



8.12.2011

workplace d'ohs

dear patient,
please find your common sense, or just a brain cell or two. please don't show up to clinics six months after your last appointment to whine about having to wait 1+ hours when i raise the possibility of an xray when you had all that time to get your mri done. after all, you were last told to get your mri so we could review further surgical options and unless you think we have xray vision, i don't see how else we could have helped you this time around without your scan.

*****

dear colleague,
please stop screwing us over. especially me. if you were truly sick yesterday evening, then at least have the courtesy to inform the rest of us so we could scramble around and come up with a contingency plan to cover your 7am - 9pm shift today. we are already short-staffed and i've already had to relinquish my precious theater days to help out at clinics. it's not very nice to send us an sms at 6.11 the morning of your sick day if you had known you were sick last night already. unless of course, you are just playing hooky.

*****

dear interns,
please tell your registrars sooner rather than later, if you're having problems with each other. we do not need to find out first from our head of department, asking us to sort you guys out because "your interns are fighting." it's hard not to laugh at the mental picture of a bunch of 20-something year old professionals with the responsibility over a many someone's life in a punch-out on the ward. i'm sure you guys were more civilized than that, but it's not nice to shout at each other either.

*****

dear patient,
please stop being such an attention-seeker by constantly threatening us with legal action. it is not our fault that you alleged your injuries were from your boyfriend throwing you out the window, and that you no longer have a home to go to. please get it through your head that the hospital is not a hotel, that you are not allowed to be drinking bottles of wine and smoking, especially with broken bones that will be keeping you off your feet for a total of 6 weeks. you cannot decide to "visit" home and abscond from the hospital willy-nilly. we're not letting you back in the next time you pull a stunt like that. please do not even try to claim that nobody has taken the time to explain anything to you, including what injuries you have. utter bullshit. you had a fricking operation. you were shown your pre- and post-op xrays. hello? anyone home? how stupid do you think we all are, to not realize you're lying through your teeth?

*****

*sigh*
there were a few more moronic patients, especially at clinic. every other one would be either called "that loser" or "that moron"..
what a day.
glad to be back home with the hubbs for the weekend =)

8.09.2011

as nice as it is to have something interesting to share, sometimes.. like now.. i'm just glad things have settled down into a little rut. work's more tolerable now. they've revamped the roster and it makes a bit more sense. the new group of accrediteds are all lovely to work with, and very willing to teach - very awesome.

this past weekend could even be called... nice! we had the oddest of presentations to ED, including a dislocated fibula head with no associated fracture, a sternoclavicular joint abscess, and this kid that was so flexible she popped out her shoulders spontaneously. both of them. oh, and then there was the obturator dislocation of a 16 year old kid's hip from his MBA going at over 200km/hr (didn't know they could go that fast!), and the guy that slipped 3 meters down a tree to pop out his hip and smoosh his heel to smithereens with blood dripping from his open fracture at the foot of his bed. fun stuff. for me, not them.

and the best thing to look forward to right now? home in three sleeps! =D i was prepared that it would be hard to live three hours and 200-odd kilometers away from all that i called home, but honestly, i never realized it would be *this* hard. never again if i can help it!

7.08.2011

a wee little recap

we've gone and returned - three weeks of living someone else's life, done.
back to face the cold reality, literally.

i miss the (mis)adventures we've had already!

a quick run-through of what transpired, for there were way too many things to log.
tune into flickr for a brief pictorial overview. couldn't exactly include the 8gb+ worth of shots taken in total... all shots (ie the majority) with blackmail potential have been screened ;)

crammed airplane seats. singapore stopover for 3 hours at crummy hotel. red-eyed. taiwan. family. round-the-island tour. buffets. 7-11 meals. mos burgers. taiwan beer. hualian. taipei. taroko gorge. alishan. kaohsiung. shopping. night market. singapore. tourists. matching tees. hawker centers. wedding dinners. yam-seng ambush. more family. friends. memories. food lists. foot massage. exploration. more shopping. snuffles. dslr. crammed airplane seats. car registration fail. car registration done. late start. 4 hour drive. cold apartment. restocking. looking forward to next seeing hubby.

it was nice while it lasted... sorry we didn't have more time for all.
now, time to plan for our next (mis)adventure to help us recover from post-adventure blues...

6.09.2011

Does this sound fair?

Yah, what the title says.. does this email sound fair?
Sending it off soon if it doesn't come across as emotionally whingy!

--------------

Dear Medical Admin,

There have been some anxiety regarding the Bega rotation amongst my colleagues for various reasons, but we have all been told since early this year that we would all need to undertake secondments to both Bega and Calvary Hospitals. To my understanding, that was why everyone's Bega terms were reduced from 10 weeks to 7 weeks once we had a 6th unaccredited registrar onboard. The remainder of the year at that stage was redistrubuted amongst the remaining registrars who had not been to Bega, so it would be equitable and everyone would have the same amount of time there.

I have spent 10 weeks at Bega myself, instead of 7 weeks because of a misunderstanding between a colleague and I. I did not agree to the arrangement proposed, but the people in charge of rostering at the time were unaware and confirmed a roster according to the arrangement proposed by my colleage. This was later resolved after an unnecessary amount of meetings and phone calls that occurred during working hours and prevented me from seeing patients during fracture clinic for the duration of these meetings and phone calls, as initiated by my departmental superiors.

As I have completed my Bega term but have yet to undertake a Calvary Hospital rotation, I am expecting to work there at some stage before the end of the working year. I feel it is important for me to receive the same working and training opportunites as my colleagues, and the current roster does not address this for several of the unaccredited registrars, myself included. I would like to suggest:

- Redistribute rotations for the remainder of the year again re: Calvary Hospital rotations amongst those of us who have not had the chance to work there, as it would be the most equitable option. This is especially in light of the major restructuring of the year's terms halfway through the year. It was done earlier this year already as previously mentioned, as it was felt that everyone should receive the same opportunities. Therefore, why can it not be done again for the same reasons if everyone involved was first consulted?
- Get written confirmation from all parties involved in a shift swap or a term swap prior to the swap being approved and the roster amended.
- Include all affected parties in the discussion and feedback prior to a major restructuring of a contracted year, especially if occuring halfway through the year and two days prior to lengthy secondment changeover.

Please feel free to contact me if you have further questions or issues.

Kind regards,
Amy

6.07.2011

thirty days short

why couldn't you wait
for just thirty more days
i would then get to see you
through the taiwanese haze

everyone else, except for me
they all had their chance
to be there all the way,
to stay for one last glance

they broke the news
as we were on our way
to pick up the albums
of our special day

these albums were rushed
especially for you to see
to share with you
when here, you couldn't be

i wish you were still here
so we could give you a hug
there are so many things yet to tell you
at the heartstrings, you do tug.

so they broke the news
as we were on our way
the tears gushed out in public
much to the hubbs' dismay

to those who had passed us
on that horrid horrid day
they must've thought my hubbs was mean
to make me cry this way

it took a while to sink in
and then, i was still in shock
and the tears welled up from nowhere still
as i wished to turn back the clock

and then i thought i could,
could hold it together well
until i saw your photograph
and then the tears did swell

i bawled and bawled
and bawled some more
i had never known
such eyes so sore

now that everything is done and done
and you've become grey dust
i've finally found that closure i sought
keeping memories is now a must

the ones of you when we were young
and those of you as a hero,
a philanthropist, and a mentor,
with no cares for deniro

twelve more days until the day,
the day we were meant to meet
we're still going back as previously planned
except you won't be there to greet

i hope you didn't suffer
too much at the end
your fighting spirit was strong,
and that, i commend

i selfishly wish though,
that you could've fought more
so we could have seen you
to reminence the days of yore

5.19.2011


10 year olds should be banned from playing football!
*sigh*

long day, but not a bad day.
0645h - 0050h after midnight.
a day full of kiddies
*beams*

one kid after another with broken bones.
wait a sec, that didn't come out right. 

anyway, besides our ortho kiddie patients, there was literally a busload of elementary school kiddies from melbourne and the majority of them landed in our ED with gastro. don't want to sound mean but it was kinda funny seeing the whole waiting room flooded with little kiddies in their school uniforms. thought it was a school outing at first until i saw a few of them holding little puke bags. the kiddie ward nurses were uber stressed lol. nearly 30 kids in one shot!

long day, but not a bad day.
0645h - 0050h after midnight.
but you know what.. if i hadn't stayed back, i wouldn't have run into an old friend, G,  from med school
'twas nice to see a familiar face =)

5.15.2011

she does it again

i can't believe it. looks like i'm the official S-magnet.
she's gone off to a different hospital for the time being, yet still manages to get me in trouble and pisses me off from afar. now, that's what i call a pro. she does it again. and yes, prepare for my rambles again too.

......

i think it's completely inappropriate, and in my indignation, whinged to a few of the nurses that were unlucky enough to be nearby about it all just to get it out of my system. how fair do you think it is, and how professional would you rate it if you came in with some neurovascular compromise, losing sensation in your hands from a fracture.. or needed to go to the operating theaters to have your macerated, bleeding hand washed and explored and find that you can't have your injuries fixed because they've scheduled a 29 year old guy who was hungover, decided to jump over a concrete block but failed and cut his shin down to bone in front of you. the guy's otherwise fine, walking on his injured leg and denying pain. yet, he gets to go to the operating theaters ahead of you because, well.. he's going out with one of the doctors.

so yah. the boyfriend showed up to our ED. S called to ask my senior registrar to give him the vip treatment. couldn't get through and called me instead. !@#!#$@. i hate being cornered like that.

S had said he was being triaged in ED, and if i could make sure he gets treated correctly and if i would go see him later when i had time. in my head, i was thinking "later, definitely". after all, i figured that if the nurses were triaging him, they would know how bad his injury was.. and if it was bad enough, they would give me a call to review sooner or later. plus, i had just been assigned to procure all the scans this one patient had so i could email them to another specialist up in sydney. for those of you who have no idea how hard it was to extract all images from the guy's CT, MRI, ultrasound and plain films from the computerized xray system to something sendable by email.. it was fricking time-consuming!! thank goodness for irfanview =) and that was half the battle. the other half was to contact this specialist i've never met to ask him to look at these films for us. honestly, wouldn't blame him for asking "and just who in the world are you again?" .... oh, and then to be bombarded by calls every 5 - 10 minutes from the rest of the hospital, ED and GPs from all over the state at the same time. frankly, i didn't have time to go see S's boyfriend.

so, i was there trying to sort this guy with his gazillions of images out and i get a call from my senior reg. she happens to be good friends with S and finally got S's message about the bf. i nearly lost it when my senior reg told me to go and see the boyfriend in ED now "as a matter of priority". that phrase is so gonna irk me to pieces like how bush's "war on terror" catch-phrase irked a few people. i could hear my volume dial up a few notches and the pitch rise a bit as i slowed my words down and enunciated quite slowly to my senior reg as she was deaf and stupid that "i know he is in ED but i am sorting out the abscess guy for our boss, and i will see the boyfriend as soon as i can afterwards." it was enough to get the attention of the guy sitting next to me at the computers who turned and introduced himself as the consultant of the team we were dealing with. man, he must've thought i was some hot-headed arrogant orthopod in training after hearing my tone of voice =( i was so appalled and embarrassed..

so anyway. yah. i survived. i feel mean and i like it, just at this moment. i feel mean deriving happiness from the knowledge that there's some justice in the world because two such horrible people had managed to find each other. i had to take a history from the boyfriend and book him into theaters for his wound washout. his wound was the size of a 20 cent piece. yah. that's more important and urgent than that macerated hand with cuts all over it with blood dripping down. right. sorry, i digress. i haven't quite swallowed the whole bitter pill yet, you see - getting bossed around by a senior registrar i don't respect, having to choose between professional duty and not offending the senior, having to even have to see the loser boyfriend at all... i know what the right thing to do is, and i know i'll get into trouble if i do the right thing. that's the bit that irked me the most. knowing that S got with a loser made the bitter pill a bit easier to swallow... not only does he smoke, but is also a pisshead. the idiot was drunk after 10 pints of beer last night and felt it would be appropriate to tell me he's still hungover at 5pm the next day. *points to an imaginary level above my head* respect. *points to the spot under my shoes* where S and her bf stand.

gnaaarrgh. it just really really gets to me though i know i shouldn't let it. i'm all about following the principles. any principles. life principles would be nice. it infuriates me to no end that people with more urgent injuries get delayed treatment just because this one loser had a girlfriend who happened to work in the field his injury fell into, and so happened to know the senior reg working that day who was just as pushy, arrogant and inconsiderate as his girlfriend who would find that bossing the junior registrar and delaying other people's treatment sat well on her conscience. it sucks to come back to reality.

5.08.2011

and here we go again

what doesn't kill me
will only make me stronger
the chin just needs to stay up
just a tiny bit longer

i don't know yet
if what's done was right
to have gone home
or stay to fight

it was one of the most
difficult things i've had to do
but a decision was made
and i'll stick to it like glue

for if i don't,
i really do fear
i'll lose my sanity
and things i hold dear

so with a glint
in my eye
i return to my hell
and pray i won't die

5.03.2011

hoping to leave the cranky pants behind

so my computer clock tells me it's 10.52 at night.
and i have a few things to get off my chest before i head back to the hospital

indulge me, yet again.. for i suspect i'll be ringing in my 30s talking to a middle aged alchoholic who choked on a roast dinner yesterday and has been sent to ED from whoopwhoopland.

politics
already whinged about bin laden. done, dusted. now onto the political scene in singapore.
political awareness is one thing, falling back into sheep mentality is another. nicole seah is good, tin pei ling is bad. if one is in, the other is out. black and white. one or two. that seems to be the general consensus via everyone and their uncle's facebook musings over the past few weeks. well, tell me then. what's so good about nicole seah? when asked about her experience in politics and policy making during one interview (or lack of, as she joked), she answered like she was sitting for a camp counsellor interview. sorry little lady. what you do in secondary school and what you call "community service" isn't unique to just you. hell, everyone had to do it. our class went to help out old folks and took them to east coast park for a bbq! does that mean all of us have what it takes.. hang on, why were you talking about community service anyway when the question was about your political experience? seriously, what about the idea that neither is good? what about option three? or five?

work
shut up, do your job and don't take me for granted. i will have a word to my resident tomorrow for refusing to chart up post-op antibiotics for all our patients today because it wasn't her job. bullshit. stop telling me the same thing five different times by five different people. stop telling me i have to see such and such patient. i don't have to, not if they haven't been properly seen by ED. stop pointing out the obvious to me. i KNOW the kid walking from ED to the elevators with his arm in a backslab and sling is MY patient going up to the kiddie ward. i have eyes that work, you know. there's only one ortho reg on one ortho team in the hospital. it's not that hard to work it out. start telling me stuff that matters, like patients you've accepted for transfers to our hospital. especially ones that are non-orthopedic because, well, they don't show up on my patient lists and it's very annoying to be called about patients supposedly under my care i don't know about! i'll just call you and ask you what the plan is, at one am in the morning. how about that?

life
you know what? nothing immediate =D the hubbs tells me lublub at just the right times when i think i need the emotional support. the hubbs is making the effort and that's all that counts. the family is generally ok. able to talk more to the dad. working on it. the only worry would be my maternal gramps - icu for a month now. not sure what's going on as info i'm getting is through my parents. gist of it was some sort of intracranial bleed post fall and now still has a gcs of 3, tubed. worried. didn't help over easter weekend. the hubbs made some of it go away. coping better.

5.02.2011

so they say he's dead. and now what?

whoopdedoo, he died.
so what?

yes, it might sound like a very good excuse reason to party and it definitely is a huge boost for morale and patriotism (how convenient is the timing of the news in relation to everything else that's going on in the world.. the fighting in the middle east/political unrest, the elections in the states, etc?), but if you take the time to think it through, it boils down to "so what?"

do you think that because bin laden is "dead" (how many times have we heard that before in the past decade?), that all of this horrible mess they call terrorism will go away? that his supporters, or any enemies of his enemies, will suddenly snap out of it and rescind all they believe in and/or fought for all these years? that the world will now automagically be full of sunshine and rainbows?

so what?
was it worth the manpower, the further deaths after 9/11, the effort and the time of countless people across the world that was spent over the past decade looking for this one man when it was well known that he had legions of followers and supporters at his beck and call? wouldn't all of that have been better used for other causes? some community out there must have surely been deprieved of basic food and shelter at some point during the past decade. some sick kid out there needed a gazillion-dollar surgery to save their life must have surely been in existence during the past decade. you get my drift..

so i may come across as callous to those who have been affected by 9/11. i can honestly say i will never be able to truly comprehend the amount of grief, anger, hurt and other emotions experienced by this group of people but hearing the stories, and merely the mention of the date sends chills down my spine still. yet, placing myself in the shoes of someone who had lost family or friends during 9/11 as best as i can, i cannot come up with a reason to go out there and party like there's no tomorrow just because they say bin ladin is dead. at best, i can heave a great big sigh that something has been done, that closure has been achieved. and then i would start worrying about the repercussions of the news. i would think that the harder the party-goers party, the more the gloaters gloat, the more angry the supporters and family of bin ladin will get.. which could possibly translate to something more vicious for everyone else that doesn't belong to "them" ... so, all the more reason not to party, whoop and celebrate but instead, spend the time reflecting in my own private domain and  enjoying the closure.

4.30.2011

a weekend of angry amy

So we have this guy who's expected to arrive tonight with a closed tib/fib fracture. impressive to see on xrays. i do my bit, i tell the bed manager and the ED guy and i tell my boss. everyone knows he's supposed to come. ED calls up just now with the simple message "your patient has just arrived." my initial reaction was "so? (long pause)"

ffs, even if it was an expected transfer from another ED, shouldn't our ED at least LOOK at the patient? i already told 'em to please have a look at the patient when he arrived to make sure pain's ok and he hadn't developed compartment syndrome. so really.. they can work him up for calling me outright without looking at the patient.. and if they argue that he was a direct admission, then why is the patient in ED and not on the wards in the first place?!

*angry face+++*

the world tonight is full of horrible bitches

what's the male equivalent ... a jerk? doesn't quite have the same oomph as calling someone a bitch, especially if that someone is a he. anyway, just had to let off steam. just got back from work. one forty in the morning. need to wind down before i can fall asleep. good time as any to whinge and let it all out so i can hopefully get some sleep before work starts again at about 8am tomorrow. indulge me.. i'm tired and hungry. i munched on all the snacks the nurses brought in for their night shift already, and ate the hospital sandwiches and gobbled up my two milo bars meant as an emergency food stash. but i'm still hungry and tired =(

so, the last straw came in the form of a forwarded email from my home hospital (which isn't very home-like at all!) asking me to redo my timesheets because they didn't correspond to the pre-existing pay periods.  How hard can it be to understand that I'm off by a week but so what? The next timesheet follows on and everything matches up except for the fact that I've got the pay periods they want technically on two different pieces of paper. Isn't that payroll's job to sift through it all? Isn't that what they pay 'em to do? Sorry man, they aren't paying me to re-write my fortnightly timesheets to make your job easier, you lousy payroll department. All you can do is write out asinine emails shifting responsibility because "medical admin didn't forward us your payslips, please take it up with them for a breakdown of your payslip." So, you're telling me you can't dig through whatever files you have and explain my payslips to me.. the same ones you've emailed me in pdf form?

so before that, everything was building up. it's been a lousy day for everyone here... except for possibly william and kate, and all the people stalking watching their wedding. My home hospital was being obstructive as usual. I'm staying on out of sheer stubborness. Would've cut and run long long ago if not for my pride in keeping promises i've made, and to be contrary and show 'em i can survive whatever shit they throw at me.
I had a guy fall from 2.7m off a second storey platform he was working on. The guy's broke both his wrists and his left eye's so badly bruised and swollen that he can't open it at all. Even though he hadn't passed out from the fall, he should have a CT scan to rule out any fractures or bleeding inside his skull from the fall. The surgical registrar at my home hospital agreed. The question was now about when to send the guy up for the CT scan, given that we don't have access to a CT scanner until Monday. The ED person was such a bitch about it all. I told her the above and she started getting all uppity, saying it was a soft sell. I'm sitting here twitching, thinking to myself "you moron, what part of it do you not understand? you and i both agree he needs a CT scan and we can't get one until Monday, so it would only be logical to send him up there for his scan, no?" Of course, i phrased it in a more civil manner but they she got up even higher on her high-horse and cut me off with "well it looks like you guys aren't coping too well with him there"... so that really got me twitching and it was my turn to cut her off with "excuse me, we're coping very well here thank you. i just wanted to know from you when we should send him up for his scan (you bitch, i thought)"

And then there was the ED moron from my current hospital. Doesn't bother to look at the patient because the doctor before her had seen him. Doesn't bother to re-examine the patient. Calls me at midnight all chirpy and fake nice to tell me that this dude has a small bowel obstruction and will need admission. In my head, i was thinking - well if you've decided already, then what the hell are you calling me for? I've had several other previous run-ins with her and her mismanagement so i immediately get my angry face on when i hear her name. Run-ins like the time she refused to take bloods and run basic tests on a lady with lower abdominal pain who was five weeks pregnant based on a home pregnancy kit. She didn't think it was important to know what this lady's B-HCG levels were and refused to do 'em. That same night, she also didn't send any bloods off for a man transferred by ambulance with VT.. or so i heard from the medical ward nurses later on. So anyway, I digress. She doesn't do jack shit for this patient except read his xray report, assume he's got a small bowel obstruction and therefore automatically needs a surgical review and admission. I told her i'd go and see the guy in Ed, and not 5 mins pass when the bed manager comes up to the ward and is trying to arrange a bed for the guy. good thing i was there and had whinged to the ward nurse, because both of us said "hang on, he's not coming in to stay overnight" The ED bitch had already told the bed manager otherwise, how presumptuous! IF she was going to be admitting patients without them having been reviewed by the people she called, then she should either call the consultant to take over care, or admit them under her own name. How rude of her! anyway, when i went down to ED, the guy was walking around comfortably and was able to puff his tummy out all big and rigid to show me how distended it was when it first happened. He's since passed wind and opened his bowels. He's even said he feels sheepish about coming to ED at all because he feels fine. We came up with a plan - that he could go home knowing it was a bit risky, provided he was pain-free with no analgesia for at least 4 hours after his last pain medication, and that he could tolerated a normal diet (ie sandwiches) without any symptoms. The guy was shovelling down yogurt after managing to have some OJ when I left...'nuff said.

Urgh, so i ramble. Have run out of steam. Shall end it here for now. Hope to get some dinner, and then some shuteye =(

4.19.2011

corporate callousness

so the spate of unfortunate events continue.
goody goody gum drops.

we had finally decided to book our flights for our getaway mid-year. thought everything was hunky-dory. had connecting flights booked, was going on a five day tour of the country i was born in but never got to know. it was gonna be fun.. being a tourist in one's own country, exploring it with the hubbs.

and then i get a call from singapore airlines.
they would have to rebook our 1.30am flight from singapore to taipei to a 12.20 flight the same date.
*shrug* no biggie. thank goodness we picked the earlier flight and was landing in singapore at 9.40pm the night before.

or so we thought.. until i got the confirmation email with our new flight times. 12.20 PM.uh-oh.
our tour was meant to start at 11am and with the new flight time, we wouldn't have even left singapore at 11am, let alone be in kaohsiung to start the tour. the rep on the phone only said twelve-twenty. never said am or pm. i had assumed. still, it would have been nice for her to be more thorough and confirmed. the time properly.

so, the calls to the customer service center began. and man, has it been a journey. the fiasco hasn't even ended yet. for nearly every day for a week, i would call 'em and get a different person each time. some were more dense than others when i had to explain my situation for the umpteenth time from the very beginning with each new customer service rep. my calls have been "escalated" to a different department (or a supervisor, depending on what rep i talk to) three different times now. each time, i've been told to call back in the next 24 hours to get an answer. i give them some time. i call back in another 2 - 3 days.. and get more irate each time that i'm back to square one. at one stage, one very rude rep placed me on hold while i was still talking. he had assumed i would answer yes when he asked to place me on hold. he put me on hold for fifteen minutes, only to get back to me and offer alternate flights. i bluntly told him that if he had bothered to listen, he would have known that i already knew of these flights he was "offering" and the purpose of my call was to CONFIRM my flight schedule change to these "offered" flights. the guy then put me on hold for close to ten more minutes to tell me that i can't confirm my accommodation request but can confirm my flights. again, i told him bluntly that if he had bothered to listen to me at all for the thirty seconds i managed to talk to him for in our twenty five minute phone call, he would have learnt that i called only to confirm flights and not accommodation. idiot.

they don't seem to understand that regardless of any of the flights they've offered to rebook us on.. including the current ones that reach singapore at ten past midnight and leave singapore for taipei at 8.35am, each combination of flights would require us spending a night. now, correct me if i'm wrong but i'm under the impression that if an airline cancels a flight, they are obliged to provide their customers with alternate arrangements that include rebookings, refunds, providing accommodation if an overnight delay occurs and some even provide airport meal vouchers. oh ho ho.. not singapore airlines. each rep has maintained that the airline policy was to rebook the customer to another flight with the shortest connecting times and their obligation ends there. when told that the umpteenth time, i asked the rep if he thought what he proposed was reasonable to any sane person - that we would spend the 8-odd hours between our flights in the airport terminal and sleep on the terminal chairs when it was through no fault or plan of ours to have to spend the night in singapore. he may not have seemed to think it a big deal but out of principle, i don't see why i have to either fork out money to get accommodation or have to sleep on airport terminal chairs when the airline cancelled our flights and can't book us on any other.. PLUS to be further inconvinienced by having to miss our 5-day tour at our destination. they're lucky i'm only asking for them to provide us accommodation for the night instead of making them pay for the tour they're making us miss - all because they cancelled flights due to "operational reasons" as i was told by the rep.

at this rate, i'm irate enough to stamp my feet and ask for a refund. ranked one of the top airlines in the world my ass. maybe so, but they sure are lacking in basic courtesy and goodwill.

4.09.2011

travel troubles

so..
we've decided to postpone our honeymoon and do a proper family holiday instead of trying to cram too much into the little precious leave time we've got.

we're now trying to confirm accommodation and man...tripadvisor.com has the most hilarious reviews. helpful and entertaining for us, unfortunate and sad for the people submitting the reviews to have gone through such vacations from hell. wasn't too surprised at the lack of quality, but more at the extent.

hoping to spend some time as "tourists" and see singapore in a new light, we decided to revisit sentosa. that's fine and all. the problem is with the hotels. all the pros mentioned were standard things expected of four and five star hotels, so it's nothing to pat them on the back about. the cons mentioned are the bits that scare us. couldn't help but share. here are a few recent gems (as current as april 8th)  from the tripadvisor site that is making us shudder and cringe, and laugh... holy moly.

"The hotel is a little run down, with koi fish dying in the ponds and unkempt lawns."
"I was put in a room with a view on the wall of a neighboring building"
"The main bed was rock hard....although we were provided with a mattress cover which helped."
 "We also didn't like that there was pump soap, shampoo and condition. The previous guests could have used it, someone could have put something in it as well as there was no seal on them - very unsanitary."
"Balcony door handle came off within 10 minutes of entry into room"
"Found in the bedside drawer a shopping mall receipt the previous guest left behind."
"No "Do Not Disturb or Make My Room" signs/indicators."
"Holder of the above bottles badly installed and comes off the wall"
"There were no drinks in the minifridge. There were no snacks available either."
"To be fair it had a nice big balcony. Which is probably the best thing I can say about the room."
"Now, in the room, there is a sofa bed which is supposed to open up in to a bed for my kids. And when we went out for dinner, we had expected a turn down service when we returned at nearly 9pm. There wasn't any. So I had to work out how the sofa opened up myself. Then put the sheets on. The worst part was the design of the room was terrible. When the sofa bed opened out, it blocked the cupboard. So once it was opened, there is no way of opening the cupboards. And guess where the extra pillow and blankets were? In the cupboard! What a waste of my time!"
"The fridge had a half drunk can of beer and the carpets were very dirty."

For hotels that bill themselves as 4 - 5 stars... honestly. such a load of crap being offered! they'd have to throw in way more than the breakfast that they didn't include to entice us to book rooms with any of the hotels there. Even if they included the $10,000 drink at the Blu Bar on 36 at the Sydney Shangri-La that comes with it's own room and diamond into the room price, I'd still have second thoughts about staying at any of the hotels on the island.

So.. we're back to square one for now. =(

3.31.2011

i'm glad i'm not on call

today would've been a good day. i still think it turned out alright just because i got to leave before 6pm today and didn't need to stay back to deal with the uber-pear-shaped mess that wasn't my fault. no really. not my fault!

fracture clinics are always great. get to follow up patients post-op and don't have to dictate letters! sometimes, like today, we finish early after our little teaching session and i get to stop by town to the local organic vegetarian cafe for lunch - yay =) then the day started to suck. nothing we decided on during ward rounds this morning got communicated to the nursing staff. then, the garbled messages that did get through got even more garbled as it got passed along to the bed manager. i would've irritated the hell outta switch calling back several times within the hour just asking to be put through to the bed manager but hey, they couldn't give me a direct line either so really, i maintain it wasn't my fault.

and then came the ED reviews. the poor guy that the ED locum had misdiagnosed as having osteomyelitis had been on IV antibiotics for the past 24 hours, but his red and swollen elbow had just grown bigger in that time. the ED locum was a tad worried by this stage and thought he'd give me a call. alarm bells rang when he mentioned a normal xray with a red swollen elbow of sudden onset associated with direct trauma and full range of motion at the affected joint. that's not fricking osteomyelitis!! a septic joint, i can understand as a misdiagnosis, but i can't fathom how the hell he came to conclude the guy had osteomyelitis with a normal xray to boot. olecranon bursitis, you toot. burrrrrsitis.

anyway, that was just frustrating but easy enough to sort out. then came the guy who cut his arm with a sheet of steel and had decreased sensation. fair enough.. manageable. what wasn't manageable was dealing with trying to slot all these cases into theater. then came the other guy of similar age that went and confused everyone else because there were too many cooks spoiling the broth and all the messages got garbled again between ED, the bed manager, the theater nurse unit manager, the team leader in theater and me. and then the surgical ward nurse manager wanted to join the fray too.

but this guy.. man, i should've taken a picture when i had the chance. he was a guy in psychiatric high dependency unit who had escaped from his locked unit during an interview. it took six grown men to pin the guy down as he tried to bolt. the guy nearly made it but got himself tangled in some barbed wire fencing and cut himself all up. he also lost his pants in the process as someone tried to grab his legs. he's now in his wee undies, sporting a splendid muddy gaping hole on the flexor aspect of his wrist that spans a good 3 - 4 inches in diameter with random strands of mangled skin stretched across and little blobs of fat. took me about 2 hours to sort him out logistically because theater staff flipped about having some psychotic guy on suicide watch being anywhere near theaters. i don't really blame them but he was a staffing nightmare to enable him to get the wound washout in theater that he really needed.

looking back, it wasn't too bad. the bit that irritated me all day was the fact that all the messages weren't getting through to everyone that needed to hear them, causing a ton of miscommunication with people "updating" others with old information and confusing everyone. that, plus bed block and coordinating theater times. my only consolation is that i get to go home and sleep in peace with no fear of getting woken up in the middle of the night if and when the psychotic patient decides to make a bolt for it again!

3.24.2011

when it rains, it pours

Apparently, whatever's out there in the universe following me with a giant raincloud decided that there was more left in store for me. you know the huge deluge that's been through a lot of the NSW east coast earlier this week? Well, Bega was one of those affected areas that's now been declared a national disaster zone. We flooded. It was so bad, my boss was flooded in and his home on the hill became a little island. He had no power and couldn't show up to work until 2 days after the floods.. and then he had to kayak for 20 minutes from his home to get to dry land to get picked up by his colleague to show up for work today. I kid you not.





Someone was watching over me though. I was supposed to have driven up to Canberra on Monday. Wasn't looking forward to that one but I got my stash of mandarins, big bag of Doritos and my 1.5L bottle of freshly squeezed limeade ready in my little Chooq-mobile and planned to drive very very carefully through the mountains in the downpour. It wasn't raining as badly when we had first driven down, and even then, we had to drive through some pretty awesome but scary uber thick fog through windy two-lane mountain roads that included hairpin turns for a good hour or so. I was bracing myself for this trip back, but I never made it. The Chooq-mobile decided to strain and grunt up one of the slopes on the way out of town, flash me an exclamation sign on the dashboard and spiked a temperature that sent the thermostat needle way past the red mark. I had to turn back and it was for the best! If I had lost my common sense, I would've plugged on and either have been stuck in Canberra for the next few days because they closed the road due to mudslides and car-sized boulders, or had broken down in the middle of nowhere halfway up the mountain to then be freaked out by the mudslides and falling boulders the size of cars. Either way, not very good.

My payment for being kept safe? The price was a new engine on the Chooq-mobile. Ouch.

As an aside, I should probably stop planning to visit places. Seems like every place I want to go visit has been struck by a calamity this year. Japan for our honeymoon's now off. New Zealand was our backup, also slammed by an earthquake. Vanuatu was also on the cards, also stuck by an earthquake. Had been planning to visit the Bega Cheese Factory this weekend on my off days.. it's now flood-stricken. Where shall I plan to visit next...hmm?

2.27.2011

there is nothing else left to do but laugh

Have you ever had so many things go wrong for you in such a short span of time that you think there's someone out to get you, that there's a grey little cloud spurting rain and lightening following you over your head or that you're in a horrible twisted dream you can't wake up from, no matter how hard you pinch yourself?

It's been like that lately. Not quite sure what's in the air, but certainly nothing positive from the universe.
After the whole Bega fiasco, it turns out that I scored a pyrrhic victory. S had the last laugh (for now!) - I was greeted by no keys to pick up (because she had dropped them off at a different spot from normal on Friday night when she left) and had to use the spare key which was a bit raw in the lock. After sufficient turning and grunting to get the door open, I walk into a living room with a theater scrub cap on the ground, a couple of cloth placemats strewn across a crumb-ridden dining table and random plastic bags/paper on the carpeted floor. My tour of the hospital-provided unit continues to the kitchen, where I'm greeted by a countertop full of old dried up blobs of various sauces and a sink literally overflowing with dirty dishes/pans that spill onto the countertop. The stove has bits of dried food around the burners and the microwave is dirty when I open it. The bedrooms only harbored tiny daddy long leg spiders, the least of my worries and disgust. The bathroom sink had a used toothbrush on one side of it, and a plastic bag with strands of hair dangling from it into the sink and some sort of plastic packaging on the other side of it. The toilet bowl's in a room all by itself and has an empty toilet paper roll and kleenex box on the floor flanking the bowl. I move onto the laundry room, to be greeted with crumpled up theater scrubs thrown in the laundry sink and I open the lid of the washing machine to be greeted by what appears to be bed linen thrown in there but not yet washed.(I poked around a bit more with one timid finger afterwards and there is UNDERWEAR in there! eeew!)

Now, can you blame me for seething after the hubby and I drive three fricking hours through 220km, most of it through rain and fog to be greeted by the appalling state of the unit S left it in!?

(On the bright side, this unit's better than my rented one and it's already all hooked up to the internet!! yay!! also on the bright side, I gots the hubby! double yay!! And triple yay for finally appearing married to everyone else because the replacement wedding band arrived and was brought up by the hubby!!)

Oh, and then there's worse.

I'm supposed to be training in orthopedics. That means bone related. I don't know which bright spark thought it would be a good idea, or an idea at all, to have the orthopedic registrar cover general surgery AND obgyn. Now, go mull on that one.

And as if things were on a roll, the hubby went and hurt himself badly and had been limping around for the past few days with a nasty wound to the elbow. Though I'm supposed to only know about bone-related injury, any wound that exudes a pool of liquid isn't too good a wound to have, no?

And the kicker for the day was the phone call I received from a colleague of mine informing me that he'd rather I hear the bad news first hand from him, rather than filtered through later on. A patient had an operation on the wrong side of the body. It was a very unfortunate chain of mini-disasters that culminated into one big horrible one and my heart sank when I heard the news. From the xrays not having markings indicating which side of the body the part was on, to the consent form having the wrong side, to the wrong body part being marked, to the demented patient pointing to the wrong side, to the patient not being clinically checked just before going into the operating theater... it all snowballed.  We're just going to have to wait and see if the family will press charges and pursue it any further.

What a weekend.

Am going to be on-call for the next two days, and then this coming weekend. Good luck to all the surgical patients who don't have orthopedic problems because all you've got is me!

Now Monday, bring it on!!

2.23.2011

double-crossed

how many ways can you screw a person over, over the same issue?

i whinged and whined about how i got screwed over regarding Bega not even two weeks ago.
well, it appears that i am in the process of getting screwed over again. over Bega. by the same person. such awesomeness!

i had initially wanted to send this out as an email to the consultant organizing the Bega roster, and cc: the Screwer-upper but in the end, i think it was more of a therapeutic exercise. i could organize my thoughts better after typing it all out and i feel less angry.

here we go:

Dear Consultant and Screwer-upper (we shall call you S from now on - Screwer-upper is too long to type every time),

This is a follow-up to our conversations today to ensure there is no miscommunication.

As discussed with Consultant, the roster for secondment to Bega will remain as it currently is and I will be going to Bega this coming Sunday in preparation for commencing work Monday, February 28th.

As discussed with S, I do not agree to commence my secondment to Bega in April for various reasons. These include:

- Other registrars being affected with a new Bega roster, as they have made plans according to the current roster. This includes a three-way swap between S and two other registrars over several weekends in the coming months that has been agreed upon, and the changes reflected in the current main hospital roster sent out to the group. It is above and beyond my role to be responsible for shifts accepted by my colleagues based on their personal reasons when it was not allocated on the original roster.


- I have made new plans, on short notice as well, to accommodate the current Bega roster, as I was under the impression 1+ week ago that I was originally allocated to go to Bega in April. Some of these plans are irreversible, especially on short notice again. One of these plans, as mentioned, involves my unit being sub-leased for the time I have been rostered to work in Bega. I feel that it would be highly unprofessional to break my agreement and ask my tenants to vacate on such short notice, potentially leaving them homeless or in temporary accommodation so I can remain in my current unit if I was to stay at the main hospital as S suggested for me to do.


- S feels that S has just settled in at Bega and would like to remain, rather than move back to Canberra after two weeks. I acknowledged that everyone requires time to settle in, and it would have been easier for everyone involved, both hospitals and registrars, if we had followed the original plan of going to Bega in 10-week blocks. However, the current Bega roster was drawn up to coincide with the wishes of S as S had discussed with Consultant less than two weeks ago. This was after two long conversations prior to this decision stating that I did not agree to the arrangements as stated on the Bega roster, and that if arrangements could be made to stay for two weeks on short notice, why not remain for the next 8 weeks? The rest of the group have now planned rostering and personal activities around the current Bega roster. Everyone in the group has been inconvinienced in some way due to the changes, including a restructured main hospital roster with more overtime shifts per week and no theater days for unaccredited registrars.


- The main hospital roster has undergone a major restructuring, with some shifts being removed altogether. This is mostly because of the lack of registrars and recent emergency events that have resulted in registrars unable to work their rostered shifts. Given that the restructured roster is only one week old, it would be detrimental to the functioning of the subspecialty team to need to review the main hospital roster again to accommodate for any changes caused by a new Bega roster.

I have suggested once again to S, that if she is unhappy regarding the current working roster, that she should speak to Consultant about possible alternatives like she had previously done.

I have stated that I do not, and cannot speak on behalf of my other colleagues at the main hospital but I do not agree to further changes to the Bega roster given the above reasons.

S has stated that S will speak to the other unaccredited registrars to find alternative arrangements if possible to allow S to stay at Bega.

I didn't feel the need to justify or further elaborate on my personal reasons for not going to Bega in April. One of which was just based on the principle of the matter!! Such nerve! Let's not mention that we've already booked and paid for plane tickets from Bega to Sydney for the hubby this Sunday. Or the fact that I was lucky enough to have expressions of interests in this unit for this odd time period (I have an wonderful agent!). Or the fact that my orthodontic treatment has been changed due to the unexpected secondment happening more than a month earlier than planned. Will S reimburse the extra costs entailed? Will S find me accommodation for the 10 week period where I will be homeless if she insists on remaining at Bega while other tenants stay at my apartment unit? I could go on, but I'm tired of harping on the issue. I just needed to get it out of my system once and for all, and pray to any and every sentient being out there that S doesn't succeed in screwing me over again.

2.21.2011

an ode to the rooster cow

my blog, my rules, my domain!
SO... i've decided to plug my fingers into my ears and shut my eyes really tight
i'm gonna ignore everyone for just one night
as i chant "lalalalalalalalalalala" without restrain!

for those of you who shiver and shudder at mushiness, as i once have, steer clear and stop reading.
you have been warned.


.........


i've never met anyone
who loved me for me
except for my parents
as anyone could see

as dense as i am
though i see it now
it took three-odd years
to find my dear cow

the rooster he is,
and a rooster he'll be
yet he insists on being
a cow full of glee

it never ever occurred
to my wee little brain
that someone else
could love just the same

the new year has barely
started to roll
yet tears have splish-splashed
as events took their toll

yet through the ups
and more through the downs
you make me smile again
especially through my frowns

i'm thankful and grateful
and so full of awe
that you're here with me
tho ain't sure what you saw

so thank you dear hubby
i love you so, you know
to the rooster-cow i married
you know, i love you so

=)

2.11.2011

the backstabber strikes again

dear selfish bitch,

you do not get to screw me over yet again.
i thought you were young, green and naive. a bit like me. oh, ho... how wrong was i!
i tried to help you out by working the second weekend at our new workplace because you had "personal problems" as you told the group. you told me you just wanted the weekend off because it was your birthday.
i still went soft and agreed. it was the worst thing i've ever done. i lost my wedding AND engagement rings that weekend because i took your shifts. i was never supposed to have been there at all. i would have never lost my rings that weekend if not for you.

and then you screw me over by lying to the powers-above that i agreed to go to bega. then you rub it in by messaging everyone else but me an sms of thanks, that you were helping me out by going down for two weeks. what a bunch of bullshit. especially when people already knew you were picked to go to bega first and hence, if anything, i would be helping you out by going down the third week.

so now, you send an "updated" roster where you've penciled your own leave in, and conviniently forget that you had agreed to work my upcoming weekend shifts in exchange for me working yours that weekend i lost my rings. you then wrangled your way out and have roped in another colleague to work this weekend shift you took off me and now, that colleague has bailed and you've run into rostering problems yourself because of all the shift swaps you've done.

so i've sent out a mass email to everyone letting them know that i am not working the upcoming weekend shift. you do not get to screw me over again with your selfishness, bitch.

unkind regards,
amy