More like the intricacies of life expressed through comedy – albeit in a simplistic manner.

I’ve been surfing the web a lot in recent times and chanced upon a nice variety of pictures that captures the different angles of how one views the world. I guess what makes them amazing is cause they hit a point home and give you plenty to smile about…:D

Courtesy of the [lol-sites!]

"I take the right ankle, OK buddy?"

Adolescent Psychology 101

The Cat and the Pelican

I think everyone agree with this!

That face spells C.O.N.F.I.D.E.N.C.E.

LOL

Murphy's Law

Co-parenting 101

Words of wisdom

10 points for accidental honesty

Behold the Venn Diagrams of Life!

The Theory of CHOICES

The Fundamentals of FINANCE

The Complexity of CORPORATE LIFE

The Rule of BASIC NEEDS

The Law of LOVE

Like them? I think these diagrams should be taught in schools.

Well that’s all for now folks! Stay tuned ūüėÄ

Matchmaking? Please, no.

January 5, 2010

Okie. Where do I begin.

An old friend of mine is about to get hitched soon and the couple are currently in a flurry of activities to prep for the wedding.

For some unexplained reason, they also felt this is a good time to play matchmaker to their still single friends. Although this is an unofficial list, but it seems to me that my name is on it. Geez.

In my honest opinion, I cringe at the thought of me being fixed up with some guy. I don’t see how is it gonna be all natural and casual, especially when both sides knew people are hoping to see some sparks and probably an eventual trip down the aisle. Some friends are even taking bets on how it’d turn out. Like World¬†Cup.

So…what are you doing this weekend?

Over the past several weeks, I noticed that there were some attempts (some blatantly obvious) to fix me up with some guy within the couple’s circle of friends. Oh Gawd.

This is a short compilation of those sheesh moments. 

Moment #1.

This conversation took place between me and the bride (to be).

We were walking in the park and our casual banter arrived at the topic of relationships.

Bride : Hey, what do you think of *Dumpling? (name has obviously been changed to ensure confidentiality)

Me : Huh? What do you mean?

Bride : I mean, you know, have you ever considered him?

Me : WHAT? Er, no. We are just friends.

Bride : Ohhh but think about it, would you consider him?

Me : Honestly? Not really.

Nothing against Mr. Dumpling here but I’m just not interested in being in a relationship at this point in time.

Bride : Why not? He’s a nice guy! Imagine if you get together with him and then we can double date! *trilling away*

Me : *blinks* Well I don’t think that’s gonna happen. I mean, I am not looking to be in a relationship now. And besides, I thought *Biscuit (a female friend of ours) is interested in him?

Bride : Hmm yeah, wonder how are they doing now? But I am so surprised she likes him! What did she see in him anyway?

Me : …*wtf?*

What was that all about? I don’t know if the Bride realised but Mr. Dumpling and I just both got insulted somewhat. So¬†was Ms. Biscuit.

 

Moment #2.

I was out having a catch-up with the couple’s bestman, whom is also an ex-classmate of mine.

Bestman : Eh I have this buddy of mine, I think I should introduce him to you. He’s very good looking.

Me : …Well thanks but never mind.

Bestman : Hey come on, I’m serious. He was the most good looking dude in our school last time – myself being 2nd of course.

Me : How big was your school? *grins*

Bestman : Mmm…bout 1000 plus students.

Me : I see. I’m not interested, seriously. I’m too lazy to be in a relationship. Lemme just eat and sleep happily for now.

Bestman : Nooo you have to meet him! One day I’ll bring him along ok? Ok?

Me : No, sheeesh! If he’s super good looking then why does he need you to introduce anyway??

Bestman : Well he’s really shy with girls. I think he needs my help. I’m really good with hooking people up. He’s a responsible guy and I can see he’s a family man. Good catch you know!

Me :¬†NO thank you no thank you *shakes head vigorously* If he’s good looking I’m sure he won’t have a problem finding other girls. He’ll be fine. Why don’t you worry about yourself first hah!

Bestman : Hoi, don’t talk about me here. It’s about you and him. Ok, actually…at first glance you might not find him very good looking. But after some observation, the more you look at him the better looking he gets. It slowly captures you.

Me : *in mock seriousness* Oh my goodness, so you’re saying I’ve to..like what, take a chair¬†to sit and wait for a POOF and out comes Takeshi Kaneshiro? I¬†can’t possibly just¬†sit around and wait the entire day you know!

Bestman : *laughs* Hoi, you ah…he really is that – ah forget it. Haih.

For a moment there I thought Mr. Bestman was channeling some used car salesman.

 

Moment #3

At another catch-up with the bestman. He was asking me about male pattern baldness.

Bestman : Hey…is there any cure for male baldness?

Me : Wow. Hmm there are a few treatments for it but it really depends on the cause. If it’s genetic then nothing much you can do about it. Are you…uh, asking for yourself?

Bestman : *catches me studying his hairline* No not me, it’s this close friend of mine. He’s been worried about his hair lately.

Me : Oh? How old is he?

Bestman : Around 28.

Me : That’s young. Is he having hair loss now?

Bestman : Yah it’s starting already. I think it runs in his family. He told me all his male relatives are somewhat bald by the time they turn 30 or 30 plus.

Me : Wow, that’s very early! No wonder your friend is so worried about it.

Bestman : Yah, what a shame man. He was the most good looking guy in our school last time (doesn’t this ring a bell?). He had so many admirers, geez.

Me : *raises eyebrow* Waaaaaaaiiiiiiiiit….Is this the same guy you were trying to fix me up with?

Bestman : *taps the table* YA that’s the one! Ooohh you remembered!

Me : Um, yah when you mentioned number 1 handsome dude in your school I thought I..

Bestman : *interjects* MAN! You really should meet him! I think he suits you! Give it a try, come on. You’re both single, who knows?

Me : ….Never mind.

Very kind of Mr. Bestman in offering to introduce his friend to me, except that I am too lazy to bother – although I must say for his friend’s sake¬†I hope he would skip the part about the¬†follicular depreceation¬†the next time he tries to hook the guy up. I’m sure the friend would agree with me.

I don’t quite like the idea of matchmaking (especially when it’s done in an obvious manner) cause it gets awkward when both know they are expected to ‘get along’. And half the time you’d be wondering what have your friends told him about you and vice versa (I bet the other guy had no bloody clue now that random girls are aware of his, um, hair issue – thanks to his buddy informant).

The other thing about being fixed up is your friends are usually very keen to know how it went. They’d pester for details and feedback. Sometimes information gets passed¬†too freely and it ends up on the other side, which is normally not a bad thing unless something unpleasant has been said. For example:-

Friend : So tell me! How did the meeting go? How did you find him?

Girl : Well, he was alright I guess. Seems bit shy, we didnt talk that much. How’s he? Did he…say anything..?

Friend : Oh he said it was ok too, but he did mention you reminded him of Chuck Norris.

See?

At least she’s frank with how she feels

After much nagging on my parents’ part, I decided to drag my bum to the nearby park to take a walk or somewhat (as long as it can be passed off as ‘exercise’ to my parents). After keeping a while with this routine, I started noticing the people who frequent the place.

No monkeys were chased during the acquirement of this shot

As these people are random individuals from the neighbourhood (majority I assume), I don’t really know them personally so I started identifying them by their distinguishing points. Some of them are quite stereotypical, some are just unique. Some of them, I’m sure, just plain ended up in the wrong place.

Type 1 : The First-Timer

As the tag implies, these people are in this particular park for the first time. As this is quite a sizable area, they are somewhat overwhelmed and often wander around with their mouths open admiring the tall trees (and taking in the huge lake and the leafy hills) – which is not a safe thing to do as resident monkeys often have a timely bowel movement while above the ground. Otherwise, they are often seen taking a leisurely stroll, fanning themselves and appearing passably relaxed amidst the chaos that is around them.

Type 2 : The Average Jogger

Average as they come. Seen regularly, but not excessively frequent. Clad in simple exercise gear – T-shirt, shorts/tracks, and the usual sport shoes; minimalistic. Some may carry their tumblers of water, others (especially females) would equip themselves with a lot of ‘just-in-case’ paraphernalia such as foldable umbrella, pack of tissues, clean towels, extra shirts, etc. Usually spotted doing a few rounds the park and heading straight off right after. This group so far makes up the majority of the park visitors.

Type 3 : The Hardcore Athlete/Ironman

First thing that hit you is their serious face. Some look like they’re about to go to war. Some just look constipated. Then come the grunts that accompanies their self-applied tough exercise regime. They are always seen doing a zillion rounds (looks like that to me) and they would pass you several times per round. Drenched in sweat, they are often the silent envy of many as they overtake you swiftly and effortlessly – with their super-toned and ripped muscular frame that strongly hints their equally steely dedication at their local gym. Never seen stopping to indulge in small talk. If at most they just give you a slight wave and carry on with their punishing marathon.

Normally seen in track and field gear, although a common mistake may involve wearing spandex shorts which are probably 2 sizes too small.

Type 4 : The Wildlife Lovers

Not here to exercise. Equipped with many bags of leftover food (for some, fresh supply from the pet store) for the many creatures that reside at the park. Would spend a lot of time by the tree trunks coaxing monkeys to accept their bananas, which is usually followed by a rude shock as the monkeys took off with their tumblers, car keys, and their entire bag of food. The rest of the time is then spent chasing after your robbed belongings which would then classify as an indirect attempt at exercise. Any idealistic belief on monkeys being peaceful distant cousins of man are hastily dismissed soon after.

The same can be applied to those who came prepared with food for the fish and turtles. I’ve tried feeding the fishes/turtles many times and I realised that I spent more than half the time looking nervously over my shoulder if there’s any oncoming primate ambush. A lot of times the fish food are swiped by the hungry monkeys, often in a very startling and distressing manner to many as the entire ape army jump unto you and do tug-of-war with your bags. Some of the monkeys took off with the mobile phones and wallets in the skirmish which they conveniently dispose of into the pond once they realised it’s not edible.

Type 5 : The Nature Lovers

Not here to exercise either. Usually move in small groups and straddling along massive photography gear. State of the art cameras (like those you see used by National Geographic explorers) are swung around and they feverishly zoom in unto anything that resembles a leaf of flower. The more artistic ones would rummage their backpack for a pencil and a sketchpad to capture their surroundings on paper. The more passionate ones are often seen climbing the trees to get a good shot of the overlooking foliage. They conduct themselves silently and cautiously, slowly surveying their environment and studying the angles. They almost never interact with other visitors in the park unless, of course, they got stuck up the tree.

Type 6 : The Couples

There are a few types under this heading.

The Lovey-Dovey. Every trip to the park is a Valentine’s Day Celebration. Usually seen in work-out attire although the only sport they seem to be occupied with is kissing. Perched on the many benches that are found spread across the park, they are always found joined at the hands and going through the human courtship ritual. Would spend many laps walking slowly and meaningfully as they romantically gaze into each other’s eyes, only to break free very briefly to avoid walking right into the waterfall. Main age group in this category consists of adolescents and those under 30.

The Routine Couple. Walking in the park has been a regular itinerary for many years. Often walking confidently and nonchalantly, as the couple have been here for the umpteenth time. Indulges in less small talk than the lovey-dovey couple, these people are often seen quietly strolling and doing their rounds side by side. Facial expressions range from anything between serene and grumpy. Some may appear bored. Do not let their mild demeanour fool you as these people are amongst the most experienced when it comes to peacekeeping with the park’s wildlife. A rolled-up newspaper is an effective weapon against any offending primate.

The Wedding Couple. They’re here to pose for their wedding album. Accompanied by a mini entourage comprising of at least a photographer and a wardrobe assistant which often doubles as an obliging maid for hire. The golden couple would be fully dressed in their wedding gown/tuxedo etc with hair and make-up done.

If you walk past close enough you can hear the photographer very patiently/stressfully giving instructions on how to pose to the couple – “Hubby please stand closer a bit, Wife smile a bit more please, come on you have to look happier, yes very good…Wife turn your head a bit towards me, yes more, Hubby put your arms around her…Oi your eyeliner’s running, Assistant!! Fix the eyeliner please!” – and so forth. All this under the sweltering equatorial sun.

It must be hard to look delirously happy and in love (in 30+ degree C heat) while wearing thick gowns + high heels/suit and tie and trudging about the park’s landscape (I have personally seen a couple climbed up a tree to get their shot. The bride wore Adidas under all the white lace).

Type 7 : The Family

Inevitably in a group. Peak incidence is during the school holidays. The assault is lead by a bunch of¬† screaming kiddies, followed shortly by a harrassed and puffing mum. Occasionally a grandma/grandpa is seen trailing behind, trying to control the kiddies by voicing disciplinary orders as they try to keep up so they are within the kid army’s earshot. Each unit has their own flurry of activities; one son jumping into the mud pool in his new jeans, a daughter¬† mistaking monkey turd for Play-Doh, and another little guy squealing with glee after managing to foster his first screaming relationship with a nearby monkey – all in exchange for his mother’s Sony Ericsson handphone.

Failure to instill order into the unit would result in the mum roping in the help of the dad. Usually dressed in working clothes (taking kids to the park after work), he would then peel off his socks and remove his patent leather shoes, hike up his smart slacks, as he tread barefoot into the pool of mud to extract his adorable offspring (whom would be shovelling mud with his mini plastic shovel and swinging it around wildly in an early study of projectile motion).

Break time would include a mini picnic. This can be a challenging task for the parents to carry out as instructions such as “after you play in the mud, wash your hands, and then you can eat your chips” are often carried out in the wrong order by the kiddies. The more versatile kids chose to multi-task.

Type 8 : The Auntie Squad

Membership is open to aunties only, albeit informally. They have the highest decible output per meter square in the entire park (only sometimes put to shame by a screaming 3 year old). They can be seen somewhat patrolling the park and furiously engaged in deep meaningful conversation, such as how to cook ginseng chicken, or what their daughter-in-law bought for their last visit, or which gynae clinic has better parking facilities. The more excited ones would be seen waving and gesturing madly when stressing a particular point, sometimes poking a passerby with their steel-pointed umbrellas in the process.

They are generally avoided by the rest of the other groups in the park, as they are so engrossed in their debates that they wouldn’t know what’s in front of them. Many side-stepped when faced with them.

Type 9 : The Fashion Conscious

Never seen in ill fitting clothes or hair out of place. Matching and trendy branded sportswear is compulsory. All colour coordinated from their headband to their sneakers, from their make-up to their iPod. Has great consistency in terms of the words plastered all over them (think ‘Nike’, ‘Adidas’, ‘Fila’, etc). Female make-up would consist of the full works which include foundation, blush, lipstick, eyeshadow, faux eyelashes, sunblock, and topped off with a dainty sparkly hair pin at the fringe.

Carries themselves with great flair and greets their passing jogger friends in an elegant wave ala Miss Universe. It is taboo to be seen wiping their sweat off their brows using their sleeves; any removal of obvious perspiration is to be done via the gentle and lady-like pat-pat-pat motion using a 100% cotton pad. Failure to recognise the consequences of the excessive sweating-heavy make-up combo would result in the face looking like a melting pancake.

The male version of this also includes heavily branded gear, accessorised with wraparound RayBans and matching knee/elbow guards. No make-up here, but hair is immaculately Brylcream-ed to resemble the latest metrosexual idol in fad. Posture while running/jogging is absolutely important – many conquered the laps while adopting the ‘puffed-out chest’ stance like Hercules/Conan running after the ice cream truck. Often seen casually changing their shirts/singlets in the crowd after their run, smugly putting their hard-earned 6-packs on display.

Type 10 : The Fisherman

Here to catch fish. Seen clanking around hauling a variety of fishing nets, accompanied by an equally impressive variety in portable makeshift containers/aquariums. Best bet to find this type would be the isolated portions of the river/lake where they can happily be knee-deep in the water and baiting the fishes with overnight bread. Their main grimace would be being spotted by kiddies (“That uncle’s catching fish! I wanna seeeeeeeeeee!”) which would mean the little ones jumping right into the water in their excitement and causing a mini-tsunami.

As the activity is done at the far end of the park, any need for the loo would be massively inconvenient (as the nearest one is perhaps 500m away – far for a kid). For those kiddies who hang around to watch, the need to empty their bladders would be met by them getting into the water next to you (so they can hold unto you for support and balance) while they pee into the river. This is promptly followed by a transient warmness felt by the fisherman’s legs as the freshly excreted urea whirled momentarily around his calves.

Type 11 : Your Guess is As Good As Mine

Not too sure of their purpose nor their actions. Seen wandering the area clad in park-inappropriate attire (from business suits to clubbing wear) and walking around aimlessly, sometimes in circles. Would pause and look around (sometimes purposefully) before heading off to walk in circles again. Not physically active enough to be exercising, nor relaxed looking enough to be having a leisurely walk. Difficulty blending into the environment as they stood out looking lost or uncertain. Appears distracted most of the time.

Secret society meeting? Missed a bus stop? Need leaf Pokemon? Hmmm.

*     *     *

Merry Xmas people!

Cards. Life.

December 2, 2009

Life is very much like a game of cards, don’t you think?

Every one starts out with a unique hand that they’ve been dealt with. There is very little or no control over what one would get.

You look at what you have. There are probably a few combinations that you could do with yours. Have to make do with what you’ve got.

As the game goes on, cards come and go. Some change hands. New cards are dealt.

You may decide that there’s some cards you want to keep. Others you could do without. But as the game progresses (or as fate dictates), sometimes one may have to sacrifice their plans to stay in the game.

Sometimes the card that you gave away may turn out to be the one you eventually need.

Sometimes the card that you value highly may not bring you equal return in worth.

The cards you desire are determined by your needs and wants; your setup moves in the gameplay

The cards that appear worthless and redundant to one may be treasured by someone else. A card would be worth better to a player who sees its possible/potential use.

There are other players in the game. Some you play alongside with, some against. This can change with turn of events.

At the table, no one is truly independent of another. One player’s move may affect the next. Some you can read, some you can’t.

Changes are inevitable. One has to decide how to play through these changes.

Your next move is essentially your next best guess. Some contemplate the risks, some risk it all.

Small wins may matter the most at the end of the day.

It takes skill, patience, and wisdom to maximise one’s winnings; but even greater may be required to know when to fold and let things go.

And of course – you win some, you lose some. It’s a gamble after all.

Aw shucks!

Quiet, isn’t it?

November 11, 2009

A year has gone by – rather quickly in hindsight. There has been many changes that I got involved in so hence the long drought.

It wasn’t exactly a straightforward phase for me. There has been some heavy contemplation, lots of idle pondering, few uncertainties, some hesitation, a couple of decisions, and a lot of mixed feelings thrown in.

This is probably the prologue of an impending rant.

Yup that's my handwriting

Work in progress...check back soon!

MURPHY’S LAW of being an intern:-

After 5pm is when the patient finally decides to let you know that they’ve been having chest pains all along.

When you think you’ve got everything on your trolley, you’re wrong. There is always something left behind.

Some nurses are really efficient. They page you for every single minute change in the obs. Example: “Patient’s blood pressure dropped from 145 systolic to 140. You happy with that?” – Ya very.

Just when you need to pee very badly, a MET call happens.

10 minutes before you finish for the day, a patient churns out a highly worrisome ECG.

The day you are late for work is the day all your consultants decide to have a morning round.

There is no better timing to have an itch on your back when you’re in sterile gloves inserting a urinary catheter.

A precious blood sample which was HIGHLY difficult to obtain gets¬†discarded because you’ve forgot to stick a bradma on the tube – you were too busy rejoicing on your success after 8-10 tries.

You can tell a highly abnormal X-ray from what’s normal. It’s the ones in between that gives you the shits.

You’re about to prescribe a common drug for the patient with multiple allergies. You couldn’t remember what they were and neither could he.

Just when you couldn’t be more harassed, the family shows up ‘demanding to know what is going on’

You have no problem at all getting up-close examining the MRSA patient’s throat. Then he coughs on you.

There are about 10-15 things you still have to do. Suddenly your consultant pages you to head straight to theatre with urgency. You drop everything and rushed to get scrubbed up – to discover that the only instructions are “Here, hold this”, which you spent the next hour doing exactly just that.

Once out of the OT, you rush back to the wards to resume your work…only to realise you left your handover sheet somewhere in the changing room.

You walked all the way from one end to the other end of the hospital to see your single outlying patient. Upon arriving there, you were just informed that he got transferred to the ward that you’ve just walked from.

The file that you’re looking for is never there.

Patients whom are otherwise well would tell you every single little thing that is wrong with them. The truly sick ones would let you discover them for yourself.

It only takes a sunset for a sweet, frail, elderly patient to transform into The Terminator.

*     *     *

“Aiyoyo…why like that?”

September 7, 2008

Past few working days were pretty screwed-up.

I’ve¬†decided on¬†a different manner of expressing/ranting/venting about this particular issue. I believe this would reflect how I felt more accurately at that point in time.

Thursday. 0700 hours.

Dragged my bum to work. Boh kau kun. I was wearily checking up all of my patient’s blood results on the hospital’s system when I realised one of the units was without an intern for the day.

Aiyo, cham liao lah. Tia tiok kio wa lang ki cover eh.

My unit has two interns; me and another colleague of mine who’s currently expecting her first child. The unit which one of us would have to cover consisted of over 20+ patients. Kia see lang.

Thursday. 0730 hours.

I’ve discussed this with my fellow colleague. We thought okie, we’ll go ahead with our own unit’s ward rounds and later BOTH of us would accompany the other unit’s registrar for his ward rounds. That way at least there’s 2 newbies whom would jointly cover as opposed to just one poor newbie. Sounds pretty okie.

0815 hours. Finished our ward rounds. Just realised that our unit has racked up an impressive list of to-do stuffs before the day ends. I told my pregnant colleague beh yau kin, wa zhe ge lang ki cover the other unit la.” The other unit has a heck a lot more patients, and it’d probably be a better idea if I’m the one covering (considering it’s only either one of us going over).

0820 hours. Met with the other registrar, informed him I’m the covering intern. Okie off we go for the rounds.

1000 hours. Wah kanasai. Chin chin si kanasai. So many patients with so many problems. This unit’s patient’s are all entirely new to me, and today the unit decided to discharge a third of their patients. This would mean approxmately 6-7 discharge summaries requiring submission.

Each of the discharge summaries require the poor newbie to fill in stuffs from A-Z about the patient. It isn’t usually that complex but in this case it is complicated by the circumstances that I’m only the stand-in for the day and I’ve no bloody clue what’s up with them (except for the fact that they’re going home).

1000-1100 hours. After the rounds, I had to retrace my steps with all the patients as I head to each of their wards to write the progress notes retrospectively. There isn’t usually much time for the intern to document the review etc as the registrar rattles off stuffs at bullet speed; most of the time I’d just scribble down on the handover sheet and we move on. I tried writing as fast as the registrar could speak and my writing siang ka sai ane kuan. I gave up, and told myself I’d make a mini rounds by myself thereafter to document stuffs in the file.

1100-1430 hours. Spent the entire time doing the discharge summaries. Quite jia lat because I had to sieve through their thick files in order to fill in the relevant information. By the time I’ve done half of them, my head was swimming with random information from the previous entires – ranging from where is their pain to whether they’re able to pangsai or not. Sometimes I get a bit mixed up between the patients whom came in with lau sai and those who really tat sai.

1500 hours. I remember this. Out of the blue I got a call from some angry nurse.

Nurse: Why haven’t you been answering your pager?!?

Me: Huh? But I haven’t been paged…*Aiya, CB, jiang wa chor simi*

Nurse: I have been paging you for the last 2 HOURS!

Me: Well I haven’t received any. What number did you page?

Nurse: 258.

Me: See, that ISN’T my pager. *HAH ki chiak sai la lu*

Nurse: WELL, whether it is your pager or not that’s another story. We have a clinic full of patients waiting for you.

Me: Whaaaaat?? You mean pre-admission clinic for this unit?? No one informed me about it! Oh crap!

Nurse: YEaaaahh well your patients are all waiting for you.

Me: WHat time does it meant to start? *KaNASAI! boh lang ka wa kong this unit’s clinic is today!*

Nurse: It started at 1pm *Niama , OH NOES!!*

Me: OMG I’m sorry. No one informed me they have a clinic today. I’ll be there RIGHT NOW.

I hung up, and hauled my sorry ass to the clinic which was situated across the road.

1530-1700 hours. I had managed to see all the patients within 1+ hours. Some were obviously boh song that their doc took such a long time to attend to them. I remembered literally bowing and apologising of the great delay due to some miscommunication. Thank goodness they’re alright after I’ve explained myself.

1700-1730 hours. Ran back into the hospital. My colleague (from my own unit) was waiting for me for a quick handover and it’s her day off tomorrow. She has been managing the unit by herself earlier today due to me being away elsewhere; we thought it would be beneficial for me to get a quick update as I’m the one alone in my unit tomorrow.

We were both rostered on till just 4pm but due to the circumstances everything was significantly delayed. Thankfully, the day is over.

Friday 0700 hours.

LIN LAO HIAH I was informed that the previous intern I was covering the day before is calling in sick today, and we’d have to cover again. It’s even worse today as there’s only 2 interns on today (usually we have 5) to cover across 3 units. This would mean we’d have about 30+ patients each. It certainly didn’t help that for some reason my home unit has increased its patient load by four-fold. Alamak.

0900 hours. Received a call from the admin. Apparently they’re trying to find some doc to replace the missing intern(s) and we were asked to cover till then.

Truth is, we are aware that they’re not gonna find anyone sometime soon. Due to budget saving attempts, it is highly unlikely for the admin to utilise a 3rd party pool of medical officers as they’re more expensive. If they can’t get someone internally to replace the interns, the the rest of us would be stretched to cover. Like yesterday. Tulan.

1200 hours. Por tor eiao. Boh chiak langsung. Mad rush sorting stuffs out across 3 units. For some reason the families decided to visit and requested to see the doctor. Trouble is I’m not their usual attending doctor and I am, yet again, clueless.

Patient’s family: Hi doc. How is my mum doing? *Aiyak, who’s your mum again ah?*

Me: Oh, she’s doing alright. Slowly getting there. *flicks through the handover sheet* Her blood results are normalising, so that is a good sign.

Patient’s family: What is the plan from here onwards?

Me: Good question. I’ll have to look through her file. I wish I’d be able to tell you off my head except that I’m not her usual attending doctor. *sigh*

Patient’s family: Oh I see. How’s the endoscopy results? She had a gastroscope done yesterday.

Me: Ah if I am not mistaken that turned out to be normal. *Flips the pages furiously searching for the scope report* Ah here it is….yes, it’s all normal (phew!).

Patient’s family: Oh…then what is the cause of the bleeding then?

Me: At the moment we’re not too sure. We were suspecting a gastro tract bleed except this was proven otherwise by the scope. She’s currently stable and we’re still investigating. Her bloods, like I mentioned, were normalising so this is certainly good news.

Patient’s family: Oh thank you doc. Thanks for your time.

Not every family meeting happened like the above. Some required me to haul 2-3 thick files belonging to the patient to read it out to the family. This, of course, is very time-consuming.

1530 hours. Admin called me up, requesting if I could do overtime till 7pm. I thought since I’m gonna be stuck here anyway sorting out stuffs so why not. Might as well get paid for it, hah.

1830 hours. What started as a usual medical review turned out to be a full-blown chaos as the patient was discovered to be having a heart attack. Suddenly we’ve the ICU and the cardio docs involved. Aiseh man, almost pangsai-kor.

2100 hours. Me and the other intern wearily stepped out of the hospital. Stuck at work for 14 hours with an empty stomach. I was too tired to drive myself home and thankfully, my fellow intern was kind enough to give me a lift home.

We thought of grabbing a quick bite to eat, so we drove up to the nearest McDonald’s drive-thru. Believe it or not, in our half-awake minds we paid for our food and proceeded to drive straight PAST the¬†collection point¬†without taking our food. It wasn’t till a few minutes later that we realised we just drove off without the food. PFFT.

Of course, we turned around. Spent a good while laughing our butts off over it.

Thankfully I’m not rostered on for this weekend. Otherwise I’m gonna be super sien.

Ever thought of the similarities?

Following post contains gratitious warcraft speak.

The Raid (Ward Rounds) – All preparation goes to ensuring this is pulled off satisfactorily. All team members would meet at a pre-designated spot. The senior doctor¬†(raid leader)¬†would ensure a game plan is set up prior to commencing. The interns (noobs) would be the ones organising the patients’ files holding information regarding the patient’s health and mana points (HP and MP). Some interns would need a cuppa (elixir of patient resistance) before starting the deal.

The Mob – The patients. Every one of them is different, yet similar (as in they all give you problems). More often than not, the success of a patient review depends on the approach (the first pull). If the entire team is efficient and balanced, usually the raid goes well. Always approach one patient at a time and do not leave till you’ve concluded the review in the event of aggro-ing more mobs than you can handle.

The Guild/PartyThe treating team. It’s all about balance. Without the senior doctor (main healer/raid leader) in sight, things could awry very easily. If this is the case, then the noobs would have to step in to continue the raid. Full concentration is essential, no one appreciates a member being AFK. Usually with one or two men down, the party would be more prone to the liberal use of potions (handbooks/cheat notes).

The Non-Playable Character (NPC) Other co-habitants of the realm. Typical of NPCs, they could make your job either much easier by giving you useful items (e.g. pharmacists) or by handing more work to you (quest-giving NPCs, e.g. demanding nurses). Due to the nature of the NPCs, they could frustrate you further due to the unable to attack target warning.

The Warrior The surgeons. Full of rage, they are often a melee class where close combat is essential (surgery). Everything is hands on. Physical distance from the mob is a no-no. Proximity is essential to engage in combat. Warrior raids end as swiftly as they start due to the constant charge option.

The RogueThe drug reps. Full of energy, they sneak up to you without you realising. Once they have engaged you, their incessant talking would make it difficult for one to escape (stun lock). It would be easier if you are aware of their presence (either mark or faerie fire) to make a quick getaway before they ambush you.

Health points (HP) – Physical endurance. Deteriorates over time when in a raid. Able to be replenished by some access to food or rest.

Mana points (MP) Corresponds directly to intelligence points. Usually the higher the level (e.g. senior doctor), the greater the mana pool as they tend to have more intelligence points. However, there are some really complicated patients (elite mobs) whom possess the ability to drain your mental capacity over a really short amount of time Рsometimes instantaneously. This phenomenon is also known as mana burn.

HP+Mana Fountain – The Cafeteria. Self-explanatory.

KitingReferral. This is usually done when one is clueless/stumped/lazy when dealing with the patient (mob). The patient is being directed away from you and to elsewhere. Failure to kite properly would result in the aggro being returned to you.

Combat Log – Patient’s case/progress notes. Detailed interaction between you and the patient. Documentation of every medication and spell used.

Damage over Time (DoT) – Your pager. Every beep deals subsequent damage to one’s HP.

Lagger – Usually a noob, when he/she is a bit behind the rest of the group. Often seen going round in circles.

Windwalk РWhat you do when you see the clingy, demanding, unreasonable patient.

Out of Mana (OOM) – Mental shutdown. Often would need the person to sit, drink, and do nothing for a while to regenerate.

Illidan Stormrage – A delirious patient who’s a former champion kickboxer in his heyday. Unstoppable.

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Don’t you think so? ūüėÄ

Of cows and Kage Bunshin

August 11, 2008

Am back for the weekend. I’ve finally caught up with Naruto Shippuden.

I’ve been away on my rural rotation over the past few weeks. It’s not too far of a place, but far enough for me to decide it’s too much of a hassle to keep driving back and forth.

To be honest, so far it has been really good.

The hospital provides accomodation for visiting staff, and I’m fortunate to be allocated a fairly decent cottage (something like a well-furnished cabin). There’s bedding and towels; kitchen’s all stocked with crockery and cutlery. There’s a few rooms in one cottage and am currently sharing with 1-2 other doctors (one’s a fellow intern as well).

I got rostered on day shift for the very first week so I was the first to arrive. Initially I planned to move my stuffs in the day before, except that I ended up packing the entire night prior due to some fantastic form of procrastination. Kept telling myself “Another 10 minutes of YouTube wouldn’t hurt” except that in reality the 10 minutes eventually became something close to a few hours. Lazy bum, I know.

It’s a pretty pleasant drive once you get out of the metropolitan area. Soon I’m seeing huge fields of green and yellow pastures dotted with dairy cows (yup the black and white ones). There’s just so many of them and they all look alike (How can we be sure they are not capable of performing Kage Bunshin? Maybe they have us fooled for ages).

There’s much lush greenery to be appreciated, given that the weather is relatively warm and dry. You still get the odd driver pulling over by the roadside to take a leak.

I think the hospital has about 15 doctors at any one time.

It’s a pretty small place, where everyone knows everyone. There’s about 4 doctors in the ED while the rest are mainly scattered upstairs. People have been really warm and welcoming, which is really fantastic ūüėÄ

Things are pretty laid-back here, although not the same can be said for what comes through the ED doors.

Things are bit different in the rural setting, you tend to see a lot more trauma cases (mainly arising from work/farmyard injuries). I remember spending roughly half of my time just suturing partially severed fingers and whatnot. The most recent case that I did suturing on was a guy who had his fingers caught in an automated chainlink. The motion hauled him across for a few feet before the bit of flesh gave way and freed him off it.

The hospital’s near a skiing resort, so we do get a fair bit of skiing injuries. Majority of them came in after taking a tumble through the snow. One fellow, however, stood out amongst the usual.

This is a fairly young kiddo. When I first had a look at him, I thought, “What an¬†unusual position to be sitting in”. He was sitting upright on the bed, with both of his arms splayed out and palms upwards. I would’ve likened his posturing to one of those common meditative stances except that he looks too miserable to be in a zen-like state.

This is the story. He was drunk in expired grape juice (alcohol!) and had this brilliant idea of seeing if he could dive over a toboggan. So he took a few steps back (after putting down his beer bottle I presume) and started to run for the jump.

Jumped, he did. Dived over, he did not. Dive INTO, more like.

He somehow landed right on top of the hard toboggan with both of his arms out in front of him in an almost 90 degrees angle. Both arms absorbed almost all the impact and it started hurting like hell (in his words). He couldn’t move, as he couldn’t feel his arms.

Thankfully for him, he was found by the ski patrol. I took a look at the patrol report and someone wrote “Found in a push-up position”. It took a huge amount of morphine and a smack of sedatives to reduce both arms to a neutral position.

We did an Xray of both shoulders and well, both of them had popped outta their sockets. They were quite badly dislocated and may require reduction under a general anaesthetic.

Honestly, I haven’t done a shoulder reduction before so I needed some advice. The senior doctor on duty thought it’d be worth trying to manipulate both manually under sedation before leaving it for general anaesthetic. Okies.

Before you know it, the poor dude was surrounded by 4 doctors all ready to pop his¬†shoulders back in. Thankfully we sedated him (cause it’d be bloody painful) and managed to somehow reduced both successfully (although at one stage the patient did screamed out while being semi-conscious). I had the grand job of holding his jaw up (as he was going into deep sedation with all those stuffs we’re giving him to knock him out) as the senior doctor¬†wrangled his arm back in place.

The poor fellow must have felt really embarrassed. When we were discharging him, he received a round of advice from concerned/amused staff.

Patient : Bye guys….thanks.

Me : Don’t dive anymore okie?

Nurse : And don’t get drunk!

Another nurse : And not at night, please!

Ward clerk : Yeah no jumping!

Patient : *red faced* Um, I know. Bye and thanks.

Not everything would usually end that light-heartedly.

One cold winter morning, a nurse walked into ED and announced “I need a doctor to step out with me”.

I just started my shift not long ago, and have yet to be attached to any patient. I thought okie no problem. Apparently they wanted a doctor to see this patient outside.

She led the way, and we ended up in the car park. Along the way there, I was informed that I’ll be certifying a DOA (Dead on arrival).

I must say I’ve never examined a patient at the back of a van before, let alone a deceased one.

The undertaker pulled open the boot of the van and there he was, all wrapped up and on a stretcher. I looked at the undertaker questioningly, and went “Do I examine him right here?”.

“Yeah do your thing”, he hollered. His voice almost inaudible against the howling wind.

Okie. We unwrapped the plastic sheets. The man looked, well, dead. His face was dusky blue and motionless. This man had a collapse in the outdoors and they were unable to revive him. Sounded like he had a massive heart attack.

It was over in 10 minutes. Silent chest and unresponsive pupils. I made sure I listened to his chest for at least a good minute or so to minimise my chances of missing some signs of life. I could hear the undertaker in the background talking to the nurse about how one guy woke up and found himself in the morgue. Apparently he was just unconscious but was declared dead by…um, mistake. Yikes.

Certified him dead. Undertaker re-wrapped the body and we headed back in.

I did wonder, what if that guy’s¬†family decided he is to be cremated (wrongly believing that he’s permanantly gone)…and if he hadn’t woken up in time? That’s gotta be one effing big screw-up, man.

Anyway, gotta get back to my packing.

Weekend’s the only time I’m able to do my laundry. Gotta do the washing, drying, and the ironing before tossing them all back into my bag for the coming week (at rural). I was spending way too much time this weekend watching anime (I think i sat through 15-20 episodes of Naruto Shippuden) and am gonna have to resort to some last-minute packing.

Hmmm…seems like the entire Konoha village is entrapped and they’re about to fight. I’ll uh…do my packing tomorrow I guess *smiles sheepishly*.

If only I knew Kage Bunshin.

“You are getting all the overnight handovers”

I peered at the list. There must be about 20 odd patients still lingering in the ED.

“Half of our doctors have taken leave today. We’re really short and you’re taking everything”

Oh wow. This would mean that I’d be the one sorting out all the overnight patients. The docs on duty the night before looked really weary and worn out. It looked like they had a pretty rough night. There were a few patients in the resuscitation cubicles; one was unconscious, one with very bad shortness of breath, and one whom had lost probably a few litres of blood overnight due to an assault.

I consoled myself. At least it’s the registrar who usually takes over the resus patients. The serious stuff.

“Hmm, registrar is busy. Okie Newbie, you take the resus patients”

You must be kidding me.

I mentally pictured my jaw dropping. There I was, in the middle of the morning handover, imagining myself demonstrating all sorts of¬†horrific newbie incompetencies. It’s not easy juggling several patients in an acute setting, let alone now that I’ve suddenly got 20 plus in my hands.

Resus patient #1 РUnconscious patient. His heart arrested and staff were all jumping on him performing CPR. Unfortunately the effort was futile Рpatient died. According to the paramedics the patient had the arrest in the back of the ambulance and by the time he was brought to the ED it was approximately 20-30 minutes after.

Resus patient #2 – Came in with huge difficulty breathing. Patient was propped up in bed with a huge face mask strapped unto her face. Oxygen was trained via 2 huge lateral blue plastic tubings. She was leaning forward with her arms gripping the bedrails and breathing heavily. For a split second she reminded me of a scuba diver.

Resus patient #3 – Is missing. Or at least I thought he was till I was informed the surgeons have admitted him. This guy appeared in the ED overnight post-assault with a huge knife sticking out of his bum and blood gushing out of his wounds. Previous doctor was exclaiming there was ‘blood everywhere’ and waved animatedly for emphasis during handover. We can only imagine. As inappropriate as it was, the image of a chef sticking a knife into a hot bun came into my mind.

Random patient #1 – Was hard at work coughing till she heard a ‘crack’ followed by a ‘pop’ over her ribs. Chest X-ray didn’t quite show any obvious rib fractures (but then again it’s not easily picked up to begin with) although there was a small area of lung collapse. For further review and could be discharged home if pain is manageable. It’s not uncommon to pop a rib while coughing or sneezing a lil bit too hard. I’ve heard a case where a guy cracked his rib from laughing too hard (and another whom dislocated his jaw). Must be some really¬†funny stuff.

Random patient #2Huge tooth abscess. Had a tooth abscess drainage¬†done recently but wasn’t taking the prescribed antibiotics. The infection blown over and the patient ended up with a really swollen jaw (looked as though he hid a ping-pong ball in his cheek). Oral (facio-max) surgeon on-call remained uncontactable for the rest of the day and this guy needed an urgent transfer under another surgeon outside the hospital. The infection trailed up his nasal sinuses and is now discharging from his nostril. Not good.

Random patient #3 – Another jaw abscess except this is on the side opposite of the previous guy. Very huge and angry-looking swelling right under this guy’s jaw. He was in agony whenever he speaks and was obviously frustrated as he had multiple recurrent abcesses before this one. Both of these guys needed IV antibiotics and subsequently tranfers over to another hospital. I have a strong feeling there was a mix-up with the on-call roster of the oral surgeon; he didn’t appear on our on-call list although under the main system he apparently is.

Random patient #4I didn’t find him, he found me. I was at the work area writing case notes for another patient when he stood right in front of me.

“You a doctor?”, he said. I nodded. “I need to talk to you”.

He leaned towards me and whispered, “See that nurse over there? The one in pink?”.

I had a look. Yup I could see the part-time nurse donning the pink scrubs.

“Don’t let her anywhere near me. She turned up at my house trying to kill me“.

¬†I took a good look at him. His face was flushed and he looked absolutely determined with his point; speaking with such great conviction. Chances are he’s most likely one of the psychiatric patients who had wandered out from his cubicle and forming delusions throughout his trip. One part of my overactive imagination thought, ah what if it’s real? What if it’s a conspiracy?

My workload smacked me back to reality. I could have given him a mini lecture on the basis of delusions and one’s mental state but was plainly too lazy to even start. Too much to do, too little time.

“Okie, don’t worry. If there’s any concerns you could discuss this with the head nurse”, I mentioned.

The patient was agreeable to this and ventured back to his bed. Seemed pretty satisfied with the reply for someone whom was worried about a perceived murder attempt at him 2 minutes earlier.

Random patient #5 – Young guy whom was stabbed with a pair of scissors overnight. Story was some guy out the blue walked up to him and jabbed his abdo with the scissors. I took a look at the wound; appeared pretty superficial. Patient stated that he didn’t knew he was stabbed until he saw the pair of scissors held by his assailant afterwards. Yikes.

Couldn’t quite decide which one was more astonishing;¬†the thought of¬†scary dudes randomly stabbing people with scissors or my patient whom was still looking all bright and chirpy after being stabbed. Hmm.

Random patient #6 – The cute lady with asthma who just can’t help but to relieve everyone of her life story despite her shortness of breath. Having the hissing nebuliser mask on would usually deter anyone from talking but nah not this one.

She belongs to the category of patients whom would answer your questions with 5-10 minutes of irrelevant details of her day followed by the important bits that you’re looking for. This lady started with “I woke up one morning…” and followed¬†up a re-enactment of the conversation that took place between her and the local bakery shop owner. Still not too sure when the shortness of breath started but I do know that she had french loaf for tea.

Random patient #7 – The patient with a very very demanding mum. All questions are to be directed to the domineering mother whom would be throwing in a demand at the end of almost every sentence. It was an interesting sight; the patient looked distressed, the mum looked pissed, while the granny just looked at the TV screen. The mum was adamant that the patient needs urgent medical attention ASAP by the senior doctor and was starting to get kinda preachy. I think we spent more time pacifying the mum above all else.

The patient is pregnant and was vomiting more frequent than usual. Mum took up the arms and started heckling the staff, ‘commanding’ the attendance of the senior specialist. Honestly, there were many more serious patients to be seen and there came a time where we told the mum straight up that they’d have to wait – they’re not really a priority at the moment. We left the room while the mum scoffed and sulked. Granny’s still watching the TV.

Random patient #8 – Hero. I first saw him with a cervical collar and a heavily bandaged head. News was he scooped up his lil’ son to escape from a wave and ended up running head first into a slab of jagged rocks. He was preoccupied with getting out of the way and didn’t realise he was running towards a huge rocky wall. Ended up lacerating his forehead and getting a concussion.

Thankfully the head and neck scans turned out to be normal overnight and he’s discharged home. I saw his lil’ bub visiting his papa in the morning and they looked really cute together. Awww.

Random patient #9 – This young guy has a cervical collar on as well but his story was nothing similar to the previous patient. After much interrogation and quizzing from the night doctors, he sheepishly revealed the history of his injury:-

1. He was chasing his girlfriend around the room.

2. Girlfriend hopped unto the bed and promptly off to the side.

3. Guy hopped unto the bed after his sweetie but was propelled head-first into the wall.

4. All fun ended there.

I had a look at the notes written by the previous doctor and saw “Head vs. wall“. Nice summary.

Random patient #10 – Now, this isn’t one of my patients BUT I was nearby when his attending doctor was discussing the case with the consultant. My ears picked up the words:-

“…testicles got stomped on by a horse…”

It was incredibly unfortunate to have that certain anatomy at the receiving end of a horse’s hooves, but also immensely lucky that further scans showed the testicles to be intact. Huge PHEW there.

These are the few that I could recall from that particular shift. The rest of the cases are not particularly outstanding (or maybe I’m just bit too lazy to think). I do have a story concerning swollen balls but I’ll save that for another day *grins*.

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