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 =)

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.

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

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.

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.

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 =(

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.

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. =(