what's with the hoo-ha?

Slowly but surely, various friends and their friends and their friends start this stream of protest pictures and opinions about this Population White Paper over in Singapore. Without even having to do Google searches or any blog-hopping, I am pretty sure that the usual suspects floating around the Singapore blogosphere would have many opinions (witty or otherwise), analyses and of course, pictures adorning each blog or website.

All of this hoo-ha got me curious. I've got a million questions!

What is this magical 6.9 million number that keeps getting mentioned? What exactly is this Population White Paper and why is it suddenly such a huge piece of news now, and not.. say, last month or last year? Why are people so agitated over it? Why do people care enough to stage a protest in Singapore?

So I went and went straight to the horse's mouth and learnt a thing or two.

Some parts of it got me so agitated, I was rebutting every sentence I had read. 

From what I've gleaned, there are three components to the Paper. One's to do with the population and family planning. The second's to do with the economy and the last is to do with the quality of living. Within each section, there are more specific issues that are highlighted.

With regards to family planning and the population issue, the Paper wants to

• encourage marriage and parenthood 
• remain open to immigration
• help new immigrants adapt to the local way of life and "reinforce our values and sense of belonging"

So great! This Paper proposes to make it easier to couples to have kids and help young families settle into places of their own. How noble. How dare it assume that the norm is the traditional nuclear family, or that one needs to marry and then have children to be considered a family. What about those who do not want to get married, but are happily with the love of their life.. with or without kids? What about those who cannot have kids? Or the ones that live with extended family members and various generations under one roof, but have just started their own brood? Why are these families penalized for not conforming to the supposed "norm" the Paper sets, and therefore misses out on some of the potential benefits outlined?

The Paper also wants to allow immigrants to arrive and take root, with an annual quota declared to have some control of how fast the population will boom. The last point baffles me. Who exactly is deriving benefits from adapting local ways of life here? The local population, who can feel better about themselves compared to the newcomer and therefore, have a reinforced sense of belonging in an "us vs them" mentality? 

As to the economy, the Paper wants to

• create good jobs for the Singaporean Core 
• complement the Core with foreign workforce
• moderate the workforce so it doesn't "outpace infrastructures" and "to drive necessary" restructuring and productivity improvements

What does the Paper define as "good"? What does the population define as "good"? Do the two coincide? It's quite appalling that more and more people seem to view less and less jobs as appealing, or good. Apparently, word on the streets amongst the young'uns is that being the checkout chick is just as "bad" and "beneath them" as being a janitor, and the ideal job is one that garners the greatest fame/power/respect coupled with the fattest pay check requiring the least amount of effort to gain the aforementioned two criteria. This doesn't exactly leave a lot of jobs to pick from. Of course, one solution as the Paper proposes, is to import foreigners to fill in the gaps and work the jobs the locals don't want. There presumably will also be foreign imports to fill in so-called "top" jobs until there are local equivalents to match the level of expertise required, if possible. It's no wonder that the local workforce is scared of the foreign competition and losing out. It's no wonder that people feel compelled to work long hours to be ahead of any perceived competition amongst both local and foreign colleagues just to stand out amongst the crowd and earn their level-ups. And then you wonder why people aren't busy making babies to boost the population and why the Paper needs one section to address purely numbers... d'oh.

Local mentality has to change because currently, I don't think there's a long term solution that is viable. I'm in no way defending the Paper, but I can see where some of the plans stem from. The locals are so picky about the jobs available, they leave no other choice but for the powers that be to import foreigners. And then the locals complain about these foreigners competing with them for jobs and crowding their country. And THEN, the locals complain about the Paper when it tries to provide a stop-gap solution for this downward spiral as the locals become even more prissy and decline jobs that are no longer "respectable" or "fashionable." We haven't even begun addressing the issue of the ageing workforce yet! The local mentality has to change.

 Then, there is this quality of living business that the Paper addresses. It wants to

• plan/create infrastructure ahead of demand with projected population in 2030 hitting 6.5 - 6.9 million
• implement infrastructure programs to expand transport etc
• explore new technology and solutions to optimize land use/create new land etc

Good for you. Good luck in making it work. I don't see why the Paper proposes to create unnecessary work for everyone. Why would you be so ambitious and increase the population by that  much, and then be pressured into developing new tech/solutions to cater for the population increase? Why are such pressures required to spur improvement? What about focusing on the current population and try figuring out what would make their lives easier to live, instead of ignoring them to focus on generations that may or may not come into existence? 

The long and short of it, in my view, is that the Paper outlines reasonable issues that have been identified as potential problems in the near future. It is certainly not wrong to highlight these concerns and formulate plans to circumvent future problems, although it seems to me that some of the plans appear to be temporary stop-gap measures without sufficient think-through of consequences or "nipping the problem in the bud" approaches. Have I also mentioned... the local mentality has to change or else, the Strawberry generation will be finding it harder and harder to attain any quality of life in the near future.

not another annual gripe

It's that time of year again,

Oh yes, you know what I mean.

Don't sit there pretending

This day, you haven't seen!

It's that awful feeling again,
Oh no, how will it go,
Will it be filled with laughs and smiles
Or will it be full of woe?

I'm sorry to say, I won't know
Because it's not my special day
I don't expect flowers or cake
But I bring lots to the fray!

Happy Birthday to all of you,
Those born on Valentines' Day
Hope everybeary had a blast,
And played the day away!

♥  ♥  ♥

starting anew

Where I am now, I would not believe my present Me if I had the ability to travel back in time and talk to my past Me - this little naive thing that just finished high school and felt the world was ending because there was no hope in getting into medical school, let alone university.

Every year since internship year, I've had my trials and tribulations. I had thought medical school was awful, and everything then meant the world. Then working life came along and completely turned that notion on its head. Now, I'm completely jaded after having survived the last quarter of 2012.

I was turning into this person that was scaring my friends, I later found out. Full of negativity, having a hard time keeping myself afloat, diverting all energy to maintaining the peace at work and leaving none for a happy home. Was always mad about something, or tired. Was always looking run down. Was not a happy camper. 

Three weeks away has helped. A lot. 

And so, with the new lunar year just starting, here's to starting anew.

May your year be beautifully wonderful... Happy Chinese New Year 2013!

Happy 2013!

Bye bye, Twenty Twelve and hello to Twenty Thirteen!

The Numnut Patient

So, in order to vent my frustrations and be completely unprofessional (for I'm too gutless say these things aloud at the time), here is where I'll be collating a list of numnuts I encounter at work. Live, learn, and don't repeat!

♥  ♥  ♥

Patient is about to undergo a total hip replacement. We find out just before wheeling him into the OR that his xray bag only contains a film of his chest. He makes a complaint about the admissions process, stating it was unclear and he was never explicitly told to bring his hip xrays too.

Dude. Hip replacement. Wouldn't hip xrays be logical here? Not the sharpest tack in the barrel..

Patient shows up to ED with a fifth metacarpal (finger) fracture. Why? He punched his friend.

Dude. Stop punching people. Especially friends. People with anger management problems, especially at 16 years old, should not have the luxury to access free medical services to fix up self-inflicted injuries. Like someone once pointed out.. the guy who punched someone else's window gets his hand fixed for free whilst the window's owner needs to call out a repairman and fork out money to fix the damaged window even though it wasn't their fault. now how is that fair?!

Patient's son requests rehab for his elderly mother who is 5 days post-hemiarthroplasty (half a joint replacement) of her hip. Sounds fair enough right? Not for a demented lady from a nursing home!

Ok, so this might be the numnut son but still vexed me to no end. A few more days in hospital getting physiotherapy once a day is NOT gonna help your mother walk better. Are you mental? Rehab means following directions and doing self-exercises. You, of all people, should know as you've got a physiotherapist of a daughter and been through rehab yourself. You seriously think your demented mother who can't speak a word of english and cutely woots like an owl will be able to benefit from rehab!? Get real.

Patient cuts her finger a a tin can. Shows up in the ER with her employer (she's an au paire). Everytime someone approached her to do anything (like look at her cut, insert a cannula, etc), she screams like a moron with a litany of "no no noooooo!" in that flat, obnoxious way a two year old would as a tantrum erupted.

FFS, grow up. I don't have time to deal with an immature little brat like you close to midnight. your tendon is visible and we're doing this for your own good so shut up and deal with it. If you don't want anything done, feel free to leave the department and risk infection or functional damage to your finger. Plus, do you really want to be throwing a tantrum in front of the guy whose kids you're minding as their au paire? Idiot.

Patient complains incessantly of lower back pain. He's had it for over ten years, ever since he injured his back during a football tackle. Immediately after being introduced by the nurse, he straightens up from the pool table and clutches his hip, complaining of hip pain and proceeds to limp towards the examination room. Three steps later, he's walking with normal gait and hops onto the examination bed. Crosses his legs, takes off his shoes and proceeds to crack his toes. One by one. Inches from my face.

First of all, EWWW!! Second of all, if you're going to lie about random body parts being in pain, at least play the part more thoroughly. You must think I'm dumb, or you must not be the brightest bulb in the room, if you think I haven't done my background checks and realized you're dependent on opiods, have a history of aggression, on a detox program and is still craving your drugs. And as for the idiot registrar that asked me to see the guy in the first place, AT LEAST PUT HIM ON REGULAR PAIN RELIEF AND GET A BLOODY XRAY BEFORE YOU CALL FOR AN ORTHO CONSULT NEXT TIME!!

Patient cuts her thumb whilst gardening. That was four months ago. She shows up to the ER today because the base of the thumb looks a bit black with cellulitis and has a bit of ooze seeping out from two little puncture wounds. She now wants something done about it.
Did it not occur to you that something was not quite right when the base of your thumb started to develop this black patch that kept growing bigger? Was it not unusual to have redness and swelling and pain there too? Did you not think of seeking a second opinion when your general practitioner started to DIG at the black hole and make it worse? and last of all, WTF were you doing for the past four months?!?!

Patient stubs little toe on an outdoor sign in front of a liquor store. Aforementioned patient gets brought in BY AMBULANCE, but walks in. Superficial laceration seen at the little toe, not actively bleeding. Decided that it would be a good idea to argue with the triage nurse about how soon he should be seen, demanding to be seen by a doctor straight away. Leaves the emergency department without being seen by a doctor. First of all, it's a little fricking cut ON THE LITTLE TOE. Why the hell would you waste a few hundred dollars to call an ambulance, especially when you could have walked with the injury in the first place? And secondly, you selfish moron... your little cut on your little toe is just that. A Little Cut. What gall you have, to insist on a doctor seeing you immediately and ditch the pregnant lady who is bleeding from down there to attend to your little cut on your little toe?! Fuckwit.

Kid falls off his bike and is CARRIED into the emergency department by his parents. Said kid is screaming the house down with his swollen ankle in tow. Said kid isn't such a small kid. Twelve years old. A prepubescent teen. One that refused the ice pack to the ankle. One that is now waiting for xrays. Still snivelling. Still complaining of pain.
Look kid, unless you are Doogie Howser MD, shut up, stop screaming, take your painkillers and let the nurses put ice on your swollen ankle. Otherwise, get out of the emergency department and stop wasting everyone's time and resources. Walk out. I dare you. 

anger management

One big convoluted thought process led me to this particular thought that made me lose my train of thought.. that I cannot understand, but will always appreciate my mom not losing her cool this one particular time. It was so long ago, I can't even remember what sparked the whole incident. I vaguely remember being very upset, in my pajamas, with an equally upset mom. My dad was in Burma at the time. For some reason that I still can't fathom, my mom had me write a letter to my dad to air my grievances and she faxed it over to him in Burma. I can't even remember if my dad replied by fax or phone call, or replied at all, but the letter-writing was therapeutic in itself. I calmed down enough to go back to sleep. Back then, I thought my mom was an evil stepmother witch of a character and looked at her every so often with a look of distrust. Twenty-odd years later, I can exuberantly exclaim.. what an awesome mom for coming up with such an awesome way to diffuse a kiddie tantrum!

Backtracking a little.. this whole thing stemmed from a particularly frustrating day at work. I KNOW that everyone sympathizes with me and a lot of them get very very mad on my behalf at some of the things I deal with at work that is simply out of my control, but becomes my responsibility to correct anyway. Today was one of those tips of the iceberg that bobbed above the surface. Made me reflect on how I deal with the shitty situations at work, and wonder if there's a better way. At the moment, I take deep breaths and the mini-shit storms pass. Very few disappear like that though. The majority of time, I end up whinging to a sympathetic ear, or to the ear of someone I respect as a colleague or a friend. Sometimes, I get a dose of reality and I suck it up. Most times, I get validation and then, the anger passes. Personally, I worry that at some stage, these people I rely on to vent must surely become sick of my incessant whinges. Incessant not because I like to whinge all the time, but incessant because without fail, there is at least ONE incident on a daily basis that involves me cleaning up someone else's mess.. for the sake of the patient(s). Look, I wouldn't be able to sleep at night knowing that someone was missing their dose of antibiotics, or something important to their treatment, just because I refused to write it up "because my colleague is supposed to do it but didn't, so it's not my problem." So I continue to clean up. And I continue to whinge. 

Obviously, this isn't working out too well. I'm going to one day exhaust any good will and listening ears, or drive my blood pressure so high I bust an artery or something. But is there a better way?

Writing things down used to work for me as a kid. It still does, hence the existence of this blog. Most things are too minor to survive the one-hour drive back and still have enough kick to keep my blood boiling. Not sure what to do for now but it's something to ponder about, I guess. The saving grace is that my numnut colleague will be away for a week or two soon. I'm happier with him gone. I do more work, I'm more tired, but at least if there's shit to clean up, it's my own doing with nobody else to blame. 

Bloody Hell

I don't like alcohol. There are very VERY few wines I'll drink. These are all either dessert wines or red wines. Maybe I'm picky. Maybe I'm snooty. Call it what you want. I don't like alcohol.

Especially not tonight.

I don't appreciate being called at 11.35PM to be asked to drive an hour into hospital to review some drunk guy in his late 30s who decided it would be a great idea to stick his arm through a window and give himself a cut that hasn't stopped bleeding somewhere near his elbow.

WHAT DO THEY EXPECT ME TO DO? There's nothing major near the cut so I know it's eventually gonna stop bleeding if they put enough pressure on it and elevate it for long enough. I'm not calling a whole theater crew plus an anesthesiologist back after midnight to dig around someone's arm to burn off some idiot blood vessel that wouldn't stop oozing when I know it's gonna stop.

If I could translate all my angst about the whole situation, and my severe annoyance at having to drive all that way for some idiot fuelled by alcohol, into death stare beams ala Cyclops from the X-Men, I would GLADLY drive all that way to stare first at the stupid laceration and congeal the bleeding blood vessel, shrinking it to oblivion so it will never ever ever dare bleed again. And then, I would set my gaze on the owner of the aforementioned blood vessel and stare HIM into oblivion.

Bloody hell. Literally.

Times like this.. makes it so crystal clear to me what an idiot I am to persist and willingly subject myself to all this. A few more of these to confirm my biased beliefs, and soon, I may be outta here for good. C'mon universe, you know I've already got one foot out the door. Stop trying to hurry me along.

Shoo, Vile Bile!

Why does it happen

Year after year

Crappy workmates

My reputation they smear

I'm sick of the stabbing

The hits to the back

They act all helpful and friendly

But they're really just a quack

So year after year

I struggle and I cope

And things seem to work out

It gives me some hope

And then I forget

For just a short while

Before the next year

Again brings up the bile

So every week I wonder

And every day now too

What say I about walking away

Without anything more to do?

What a huge relief

I think that'll be

Sometimes I can't wait,

Can't wait to be free

blown away

What a day today has been
It is my destiny as I have been
I had to get at the Crowne g'day
You can meeting the press my you are
David
There's no point in continuing
Send a direct let you know get it right
Oh no
You have to get any of it and I get out

----

So much for trying to dictate through the Tab..
Let's try again, with fingers on a solid keyboard this time. The gibberish above translates to:

What a day today has been
It's one of the shittiest I have seen
I had to get up at the crack of dawn
To attend my meeting and suppress my yawn.

Oh this is hopeless
There's no point in continuing
Oh, so now you get it right
Or not.
I'm gonna have to continue this at home.

-----

So..
I get home after the meeting
I manage to fit in some shopping even - yay Ikea!
I plod off to work, sleepy
The radio warns of gale force winds up to 100km/hr today
*shrug*
So I drive along and wonder why traffic is especially bad
Things start to click when I encounter about 4 -5 different fire trucks, sirens blazing, during my commute
The radio was reporting havoc throughout Sydney, with a school having to be evacuated because its roof had been blown away.
Then I hit the hill leading up to the hospital and there's traffic.
Something clicked again. Oh no..
Could it be..
!@#$%$@$%
Of all the schools, it had to be the one right next to the hospital.
Of all the intersections they could block, it had to be the choke point where beyond that, there was only one way in and out of the hospital.
The policewoman didn't care that I worked at the hospital.
I should've said I was a DOCTOR and ask if she would take responsibility for poor patient care by not letting me pass. DAMN. My one and only chance to flaunt it and I missed it.
She couldn't care less and made me park down a side road somewhere and said I would just have to walk up the hill to the hospital. Because it wasn't safe to drive, she said.
So I was lucky enough to find a parking spot because the rest of the world was looking for one too. And then I got out of the car and walked. In gale force winds. In rain pouring down sideways because of the wind. With debris. Making my eyes bloodshot and watery. Hard to walk straight. Nearly blew me away. Hard enough as it is without the painful eyes. But with my luck, I had the painful eyes to deal with too. Was basically walking blindly up the road to the hospital, head ducked down, one hand on my hood to keep it from blowing off.
I looked like I had come from a heavy duty session of serious crying by the time I reached the hospital.
I think I would've been a lot safer INSIDE my car than unprotected and walking along the pavement if the winds were blowing and they were worried about injuries from flying debris. Especially when they were still trying to tack remaining roof back on at the school at that stage.
So I get into ED.
Funny how the boys avoided eye contact even though they were in my line of sight. Funny how they suddenly veered off to my right or left. WTF?! Can't deal with a girl who's been crying?
The clincher was that one of them decided to ignore the "crying" completely and proceeded to tell me about his patient he wanted me to review.
I was cranky by then. That didn't help. So I snapped that I already knew about his patient, hence my presence in ED in the first place and that yes, I know about the other patient too but could he please let me at least put my bag down and get the crap outta my eyes first before he continues? Geez.
I still had fluid pouring outta my eyes and was non-stop sniffling throughout his monologue. Guess it wasn't obvious.
Saline did the trick. Eyes better. Bloodshot though. Stupid hard contact lenses. At least I could see again without searing pain shooting through the eyeballs everytime I blinked. Was still sniffling. Went to see a patient. Was happy I had a plan. Was typing it on the computer. THE POWER WENT OUT. !@#$#!#$%#
Lost my progress notes. Computers were rebooting. Mine remained dead. Couldn't be bothered to reboot. Scribbled on paper. Should've stayed with paper I tell you. All this computerized notes stuff is clunky, time-consuming and useless during natural disasters.. when hospitals tend to be busiest. Go figure.
Anyway, the misadventures continue.
The ultrasound machine got killed during the power outage - wasn't hooked to the backup generator and we think the power surge killed it. Fingers crossed for the CT machine. All theater cases except absolute life-threatening emergencies were cancelled for the rest of the day.
I went to catch up with my intern. Put it out there straight up that I was cranky and summarized what had happened, be snappy with the handover. Halfway through, she stopped and asked if I ok because she realized I was sniffling every few seconds. WTF?! What on earth did she think I was telling her right at the beginning?!
Eventually got through the day and got home in one piece.
Now, time for bed so I can face the backlog of cancelled cases in theaters tomorrow.. *Groan*