Friday, April 25, 2008

Work Rules

After the "My boss & I" article, i saw this at another corner in SCN. Very funny as well! It's called the "Work Rules":

1. Sickness
This is not allowed under any circumstances. We will no longer accept your MC as proof of illness. If you can walk to your doctor, you can certainly come to work.

2. Death, other than your own
You must arrange to attend all funerals very late in the day after your work is done. This is provided we approved your leave.

3. Death, your own
This is acceptable as an excuse, but we would like at least 2 weeks notice as we feel it is your duty to teach someone else your job.

4. Personal hygiene
Entirely too much time is spent in the loo. In the future you will follow appointed time to go, according to alphabetical order of names. If you miss it, you must wait till the next day when your time comes around again.

5. Quantity of work
No matter how much you do, you'll never do enough. Please do not have doubt on this matter.

6. Quality of work
The minimum acceptable level is perfection at all times.

7. Advice from owner
Eat a live frog the first thing in the morning and you will be hopping around all day without feeling tired.

8. The boss is ALWAYS right.

9. When the boss is wrong, please refer to rule 8.

Darn funny work rules..but in fact, my department is currently super short of JMO/HOs..3 are leaving by next week and there'll be only 5 left..sigh calls every other day are gonna be inevitable. By then, these work rules are probably becoming reality? Hope NOT..!!

Thursday, April 24, 2008

Thinking of being an Obstetrician?

I just realized that one of my posts: A Perfect Surgery HO was used in efenem's blog, without me knowing it. Then I saw one interesting post of him, so I suppose i can just do the same. HA. (efenem, i'm just kiddin. But i really quite like your this post=D)

So You want to be an Obstetrician? Here's his thoughts on O&G:

1. The most tensed medical specialty everywhere in the world; it involves antenatal care, medical and surgical natal care, and postnatal care of the mother and the baby. And then there’s clinic! That seems to be a lot of work more than a sane person can handle! (Ya it's whole lots of care, from preconception to antepartum/intrapartum and postpartum care..)

2. It is the most sued medical specialty. In the US, 76% OBs have been sued at least once, 57% twice, 42% three times or more. The family expects you to make no mistake; even a little defect beyond your control can come with lawsuit. Many obstetricians have high malpractice insurance premium, differing in different countries. (Yup i couldn't agree more on this)

3. Most bloody, nauseating and complicated specialty, making those in surgical specialties look very mild and tame. That’s what I heard when an obstetrician came to MRSM Taiping to give medical career talk. And I confirmed that myself when I first time watched the delivery of a reluctant-to-push mother. Birth is beautiful? Think again! [Hmm it can be complicated, but can't be the most bloody & nauseating la..after all, Obstetric department is the only dept where you see new can be very, very gratifying=)]

4. Most obstetricians are men since most of them are very strong (physically and mentally) to handle bloody surgeries, abortions, miscarriages and other stuffs. But so far that I asked from my peers, only women want to be OBs, no man so far. Maybe I wasn’t asking enough. (There's saying that man who joins O&G will get somewhat "womanized" in fact they are the men who know women the most..)

5. Myths and Superstitions; there are things like when an OB is trying to do God’s job such as taking away life of a baby (abortion), he/she is cursed and doomed forever. Some OBs have reported to have failed conceiving child of their own. Maybe there’s a psychosomatic correlation I couldn’t fathom. Maybe that’s never true at all. (Hmm no comment..)

6. According to a survey, OB is one of the specialties with the least likelihood of physician’s satisfaction. As in previous points, the work is always stressful and demands perfection; for the mother and the baby. (Hence it comes with the sky-high pay! But with equivalent pay-back price..)

(Credits to efenem)

Sunday, April 20, 2008

Doctor & Patient 2

Continue from the previous post..

An obese patient came to clinic.
Patient: "Doc, i think i'm seriously overweight. What should i do?"
Doc: "Oh you just simply need to exercise more."
Patient: "Then what kinda exercise should i do?"
Doc: " Very easy, it's mainly neck exercise. You turn your head to left, then to right. That's all."
Patient: "Huh? Then how many times should i do it in a day?"
Doc: " depends. Whenever someone invites you for meals or pass you something to eat, you have to do this exercise until he walks away.."
Patient: "......"

Saturday, April 19, 2008

My Love with Cards

Even since i was bitten by the magic bug, cards have become something indispensable in my life. Though I know that magic is not entirely about cards, well I can perform other things too, but cards have been most of my interest, kinda like my "specialty" in magic.

Card collection is definitely one of the best things in life.

And there's something I came to understand only after learning magic. Do you that there are some mysterious and captivating knowledge in cards? Thousands of years ago the symbols in our common deck of 52 playing cards, plus the jokers, were created as a calendar and lifetime guide for the earth. The 52 cards represent the 52 weeks of the year. The 13 cards in each suit represent the 13 annual cycles of the moon, and the 12 face cards represent the 12 signs of the zodiac. The numbers on all of the cards added together from each of the four suits, equals 364? The days of the year less one. The joker represents the 365th day of the year, and the 2nd joker represents the extra day in leap year. The four suits represent the four seasons of the year, and the seasons of our lives. The two colours, red and black, represents day and night. Interesting isn't it?=)

And cards have brought me to know so many interesting people and friends. Brendan is one of them. Oh ya, and there's a term to describe ppl like us, the "cardician", meaning the card magician. I used to thought there's another quite good one - cardiologist, the specialist of cards! Hehe..i think one day when i become a cardiologist, the double meaning can be applied to me dy. Ha.

My 2nd flourish video posted on youtube. I've long prepared to film the 3rd one, but time is really a limiting factor! Hopefully can do it pretty soon. Enjoy the vid, and feel free to give comments!=)

Thursday, April 17, 2008

Interesting Chest Xray

This is a 10 year-old boy presented with chest pain, associated with worsening severe breathlessness for 2 days, with history of URTI symptoms about 2 weeks ago. He was in respiratory distress and was nearly intubated. ECHO showed dilated 4 chambers, severe MR/TR with pericardial effusion. (Btw, hence the CXR features- globular heart shape)

I guess you're having something in your mind? Ya he's treated as Rheumatic carditis.
End of story? No it's not. I had a feeling that there's somethin more.

If you do notice, there's associating pulmonary congestion, and dilated all chambers shouldn't occur so fast, if it's just a first onset acute rheumatic fever.

So I did some further questioning. I asked the child and his parents that whether he had any similar febrile illness before. They took some times to recall, and finally gave a history that, at his age of 4, he had an episode of high grade fever, associated with joint pain which was "migratory", but he did not seek any treatment. He was well for a period of time, then started to have intermittent chest pain, fatigue and exertional dyspnea, but he thought he's just being "weak" and did not pay much attention to it.

And that matches the whole picture. A massively dilated heart with pulmonary congestion points more to a chronic condition, and this child was actually having rheumatic carditis, but it was an acute on chronic condition.
He responded well to treatment and currently awaiting to see the paeds cardiologist in IJN soon=)

Friday, April 04, 2008

A Perfect Surgery HO

I finished my surgical posting 2 weeks ago..and i must say that it's the best posting ever. I've heard much of how nice it is and till I got there, it's still better than i expected. There, all MOs, specialists or even the head of dept will treat you like a friend! They respect your thoughts, concern about you/your life/family & everything..basically a very warm, supportive and motivating posting. I'm just gonna miss it a lot. (and esp wanna say big thanks to mohan, thinesh, calvin, mark & all other MOs, for guiding and helping me so much!)

And when i did some revisions about surgery, I came across this in the "Surgical Recall" book..gosh how could i not notice it's so funny! It's about what makes a "perfect" HO:

A Perfect Surgery intern/(house officer)

1. Never whines/ complains
2. Is never hungry, thirsty or tired
3. Is always enthusiastic
4. Is never late
5. Makes the intern/resident/chief look good at all times
6. Knows more about his patients than anyone else
7. Loves operation theatres, never wants to leave the hospital
8. Is the first one to arrive at clinic and the last one to leave
9. Reads from a surgery text everyday
10. Is confident but not cocky
11. RUNS for materials, lab values, test results etc before rounds
12. Smiles a lot and has a good sense of humour
13. Always writes the op note without question
14. Loves to do op and can never get enough

And this is the best..
15. Has a steel bladder, a cast-iron stomach, and a heart of gold!

Does such super HO ever exist?=)

Wednesday, April 02, 2008

My Boss & I

I'm in charge of SCN now and Elaine has reminded me a few time that in the Sister's room, there's an interesting article. I finally saw it and found it REALLy funny, so just to share it here. It's called "My Boss & I":

When I take a long time,
I am slow;

When my boss takes a long time,
he's thorough.

When I don't do it,
I am lazy;

When my boss doesn't do it,
he's too busy.

When I do something without being told,
I am trying to be smart;

When my boss does the same,
that is initiative.

When I please my boss,
that is apple polishing;

When my boss pleases his bosses,
he's co-operating.

When I do good,
My boss never remembers;

When I do wrong,
He never forgets.

It's just soo bitterly true!!=)

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