kimochi d'aemii

o.0

2012-05-27T01:48:00.000+10:00

Came across this patient late one night this past week. She was mere hours after having an anesthetic for her 2-hour elbow operation. She was 94 years old. Standing at the foot of her bed. With the hospital light dimly shining from one side, highlighting all those nooks and crannies. Had to do a double take.
Couldn't help but share the awkwardness...

2012-04-24T21:34:00.001+10:00

Makes me so mad!!

The idiot is still parked there.

I can't physically get out of the car after parking it.

Even parking's tricky, depending on the dark green car to the left.

If they've parked too close to my space, that's it.

Can't get in at all.

The idiot owner of the silver car hasn't moved it.

Still there.

They are either away, or are choosing to ignore.

Either way, still makes me mad.

Inconsiderate pricks.

Any suggestions to resolve this are welcome!!

Have tried writing a note to them.

The Hubbs has toned it down for me.. by a LOT.

Said it was too angry.

I thought it was fine.

Maybe a tad passive-aggressive in suggesting that they risked damage to their car with it parked like that.

Hmm.

It's been 2 days and am still parking the chooqmobile streetside.

So unnecessary.

The strata's useless.

Called them just after 5pm, got diverted to some afterhours office of theirs.

The lady said I should've called back during business hours.

No shit, Sherlock.

I would've if I could've but I don't know that the car's still in my spot until I arrive home from work.

Which is after WORK hours, no?

D'oh.

Idiots.

Too many idiots.

*mutters and wanders off to chomp on some chocolate as a distraction* =(

random snippets on a rainy april afternoon

2012-04-23T18:16:00.000+10:00

the chooqmobile has been upgraded
for someone with a new car, i feel awfully guilty. especially so when i saw the old chooq at the dealership in the used car section waiting for a new owner =( especially more so when i saw them come at the old chooq with a screwdriver to erase its identity and replace the number plates with a generic one =(( *pouts*
the new chooqmobile is still settling in
got a new neighbor who unfortunately knows neither how to take care of their car (it's got matte, lackluster paint on the body with a huge dent to one side) nor how to park (their car juts so much into my space, the new chooqmobile had to park streetside for the past 2 days *GRRRR*)
the surgical colleague of mine is still a dickhead
i still can't make up my mind about my ortho colleague - he's too inconsistent at the moment. when he's good, he's awesome. when his heart's not into it, he's awesomely awful.
there is never a lack of idiots to fill the hospital waiting rooms
one idiot got told by two registrars at different times how smoking would affect bone/wound healing.. and as the second registrar turned to leave the room promptly asked if he could step out of the department to have a cigarette..
another got drunk and decided it would be a good idea to climb onto his friend's back to reach the roof. don't know what was on the roof but whatever it was better be worth the off-ended broken wrist he got that required plate and screws
is getting very sick of hearing the tune that accompanies "i've got the moves like jagger, i've got the moo-ooo-ooo-ooo-ooo-ooo-ooo-ooo-ooves like jagger" on the radio
is very pleased with the pot of herbs and the tiny tomatoes that are sprouting from a very under-loved balcony pot-plant colony i've had trouble attending to consistently

and that is all..

for now ;)

Stop it, Stop Killing Me

2012-03-12T19:53:00.000+11:00

A couple of stressful weeks have passed.
Survived.
At times, barely.

Thought I was getting over it all
And then my intern drives the stake in a bit more, then twists it.

My neck of femur fracture lady from friday..
non-english speaking, complained of pain yesterday evening.
my intern wasn't sure where tho the patient pointed to her chest
Didn't think it was a heart attack but it crossed his mind. Did relevant tests.. BUT DIDNT !@$@$## chase up the results. Called up medical registrar for advice.
Repeated blood tests today. Troponins came back even more elevated than yesterday's

I asked 'em to do an ECG
Listened to the patient's chest.
Overloaded. Crackles galore. It was like a symphony made up of pre-schoolers in there.
Chest xrays showed fluid, possibly infection
THE ECG HAD INVERTED T-WAVES.. like the one from yesterday evening did. It wasn't picked up at that stage. I WAS ON-SITE AND HE KNEW I WAS WORKING. WHY ON EARTH WAS I NOT CALLED ABOUT MY PATIENT WHO MIGHT HAVE BEEN HAVING A HEART ATTACK AT THAT STAGE?! (you have no idea how pissed off I am at this whole thing. We're talking compromised patient care here..)

NOTHING was done. I got the shits and called up the med reg for today. She didn't even get called to see my patient. She was asked by HER resident to review this patient, because MY intern had conveyed the message through him. She didn't know how sick this lady was at all.

Now, my lady is getting worse. Trops are triple the amount from this afternoon. Requiring 8L oxygen to maintain reasonable sats. My colleague is on-site and on-duty until 9pm tonight and knows the events. WTF is my intern doing sending a text message to me at 6pm?! What exactly can I do for my patient off-site and why isn't he calling up the on-site registrar instead of texting?!

ARGHHHHHHHHHHHHHHhhh.
He will not only be the death of me, but possibly of the patient and future ones if he keeps this up!

Now please help me find a way to tell him all this without blowing my top off as I tell him...

Ignorance is NOT bliss

2012-02-16T21:45:00.000+11:00

Another one I have to get out of my system..
A complaint letter from a patient. We all knew it was coming. The patient had been deemed a pain in the butt. The nursing staff had warned me about how difficult it was to deal with said patient. There were two bits in the patient's complaint letter that irks the hell out of me. This patient is demanding and ignorant at the same time, leading to the formulation of some pretty stupid sounding complaints.

Like how the patient got moved out of ICU on a Sunday and wasn't seen for *gasp* two whole days!! Bullshit. An intern saw this patient on Monday. Yes, an intern. Fresh out of med school. A doctor nonetheless. I saw this patient Tuesday. Worked my butt off and didn't leave hospital until just past 2300h just to speak to this patient and address the concerns voiced. Then drove an hour's drive back to come back AND SEE THE SAME PATIENT AGAIN THE NEXT MORNING. So wtf is this complaint of this patient about? Doctors don't see all their patients daily over the weekend unless they are sick. Newsflash to ignorant-patient!

And the sarcastic bit about "are you confused, because I'm confused!" when I FINALLY clarified who her attending doctor was after two days of chasing down consultants and registrars and answered her bloody question. She gets her answer, then QUESTIONS IT?! WTF.

It's people like these that make me want to rant and rave and cuss at the world, and pad my already-unhealthy levels of cynicism. Ungrateful ignorant bitch.

℞: A Cup of Concrete

2012-02-14T20:16:00.000+11:00

Every so often, my ears perk up at a bit of news that floats through my bubble of a personal space and gets me all riled up for the wrong reasons. Like this little newsflash about how parents are deeming "fairy tales" a la Hans Christian Anderson and the Brothers Grimm fame ...too scary, opting for "modern" stories instead.. whatever that means. SERIOUSLY?! For those parents out there with that perception, what do you have to say about "scary" modern stories such as.. hmm.. let's say, Harry Potter and all the seven books about his "adventures"? There's death, kidnappings, battles, and *gasp* magic in those stories. If Jack and the Beanstalk was considered inappropriate for the modern kiddo because it was "too unrealistic," then you all should really boycott the fiction section and let your kids watch National Geographic documentaries for bed instead. Wiat a second, scratch that thought. They might be too scary for your kids because they depict animals hunting other animals! Oh no. Or what about all those cartoons out there showing cutesy characters bashing each other on the head.. like the Tom and Jerry, or Wile E. Cyote vs the Roadrunner.. OR WHAT ABOUT THOSE FREAKISH TELETUBBIES?! Scary much? 'Nuff said.

Parents apparently deem classics like Snow White and the Seven Dwarves and Little Red Riding Hood inappropriate for their precious coddled young because "dwarves" is simply inappropriate for the former, and they are uncomfortable explaining to their kids how the grandmother gets eaten by a wolf for the latter story. Man, these people should go read the original tales by the Brothers Grimm (go on, download it free off Amazon and read it off your Kindle!) and then come and complain that the sugarized, commercialized versions we know as "fairy tales" are pretty damn tame. There, I cussed. I suppose this entry, hell, this whole blog is now inappropriate for kids because it has scary bad words, oh my. Oops, I said two scary bad words.

Don't deny your childen the opportunity to figure out for themselves right from wrong, black from white, dark from light. Go ahead and deem fairy tales inappropriate and "too scary" (for reasons that will always baffle me), butt don't transfer those adult insecurities onto the children. Why can't these parents grow up a bit themselves and regale their children with fairy tales that spark the children's imagination. Yes the Snow Queen was freaking scary when I first read about her in my anthology of Hans Christian Anderson tales, but I figured out for myself at the age of seven that one, she wasn't REAL and even if she was, I had learnt what NOT to do from Kai and Gerda's mistakes. Yes, I was a little too overactive with my imagination at the time but if not then, then when? To those parents polled, if there are issues with the story, why not use the opportunity to use it as a teaching tool about life? Kidnappings too scary? Why not spin the tale around and ask the kids what THEY would do if they were Hansel or Gretel? Turn it into a "don't talk to strangers" and "be vigilant, stay close to mommy and daddy when we go out" talk.

Am very very appalled at how much society has changed. In my eyes, I think that with the mentality these parents have of "protecting" their kids, they're just coddling a generation of pushovers who will grow up so insulated from all things "bad" that they won't have the mental or emotional capacity to deal with life's lows that will surely come with life's highs. Seriously people.. in the words of a senior I once worked with, drink a cup of concrete and harden up!!

2012-02-03T23:36:00.000+11:00

another month has quickly gone

and what a month it has been

we're recovering slowly still from

all the things we have seen!

we scooted over an ocean or two

and saw some awesome views

we ignored all the fuss from new year's day

and blocked out the earthquake news

we readied our tummies

and pigged out in style

their goodies were yummier

by more than a mile!

sushi and tamago,

sashimi and rice

sour calpis and yakult

served up with ice!

ramen and curries,

udon in broth,

tempura and sake

we felt like a sloth

temples and fire,

coin tossing with glee

museums and ghibli

there was so much to see!

'twas a pity when we had to leave

we pouted and whined

for we weren't quite done

there were so many one-of-a-kinds

but we eventually made it back

with both bags filled to the brim

and then i realized work was to start

things started looking a tad grim

things turned out a wee bit worse

for the other guy couldn't work

it meant i was working 24/7

that first week drove me beserk!

things have settled, now that he's back

my workload's thankfully less

yet, things aren't quite settled

for i'm still feeling stressed

but everything's good, for this weekend, i'm off!

chillaxing is what i'll do

a brand new start excites me so

gotta feeling smiles will brew!

and the tone has been set

2012-01-01T01:06:00.003+11:00

Two thousand and twelve.

You've only been here for 23 minutes and you already suck!!
Am stuck in Canberra. Was hoping to catch the Sydney fireworks on TV. Please enlighten me... which of the local channels actually showed live coverage of new years' fireworks, let alone the Sydney ones? All I could find were reruns of some Barbra Streisand movie, an episode of That 70s Show, some sci-fi thing called Paranormal talking about alternate universes and gravitons (interesting stuff tho!), some Star Trek episode where some Trekkie looking like Data was making out with some Elvira-like female and Van Helsing, amongst the numerous SBS channels that included Bollywood movies. I had to search through Youtube to watch the fireworks that I could've seen from our apartment, had I been in Sydney. So, I watched the fireworks belatedly on my laptop, alone. Without the hubby. WHEN I COULD HAVE SEEN IT LIVE, even if it was via TV. Pathetically sad, even for my standards.

Spent the rest of it since I started this post talking to my parents. Lovely as they are, I had wanted to call up my grandma's place to catch up with all my aunts and uncles and cousins. I thought they'd all be there, but nobody tells me anything as usual. Turns out, everyone had left for their respective homes in different countries around the world by today. Ended up yakking to my parents for nearly an hour instead. Was kinda nice to be able to tell them I had thoughts of leaving medicine completely. Again, I blame two thousand and eleven for that change of heart.

Two thousand and twelve. You better shape up and get your act together. Don't you dare emulate two thousand and eleven or I'll kick your butt so far, you'll end up in some parallel universe. *roar*

hurry up and leave, 2011

2011-12-19T22:13:00.002+11:00

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.

C is for Cookie

2011-12-15T15:28:00.000+11:00

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!

medical marvels

2011-12-10T21:44:00.000+11:00

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 =(

ungrateful wench

2011-11-30T09:49:00.001+11:00

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 =)

Halloween 2011

2011-11-01T23:15:00.003+11:00

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!

morons

2011-10-28T18:40:00.000+11:00

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. =)

another round of gnnnnaarrrrrgh!

2011-10-12T21:58:00.001+11:00

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!

oh chute!

2011-10-02T20:36:00.000+11:00

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*

some people have all the luck

2011-09-17T07:26:00.000+10:00

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. =(

celebrations schmelebrations

2011-09-15T20:13:00.002+10:00

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.

next year is starting to fall into place

2011-08-29T13:51:00.000+10:00

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

2011-08-20T15:29:00.000+10:00

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

workplace d'ohs

2011-08-12T22:43:00.000+10:00

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 =)

2011-08-09T17:54:00.001+10:00

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!

a wee little recap

2011-07-08T22:26:00.000+10:00

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...

Does this sound fair?

2011-06-09T23:03:00.001+10:00

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

thirty days short

2011-06-07T21:02:00.004+10:00

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