Sunday, May 18, 2008

Good Read

Found a good read about housemen. According to the author, the house-officers are classified to few types: the "Don't know", "Don't know, don't care", "Don’t Know, Don’t Care, Bullshit Non-stop" and the "Know Something, Can’t Do Anything" type.

Very interesting read indeed. And I really agree that HOs make up an extremely important portion in our healthcare system, and hence their qualities inevitably reflect how good/bad our healthcare system is.

Having been inspired by the article, I think i have encountered a few more types of HOs:

The "Chipsmore" Houseman
The typical "Now you see, now you don't" HO. One of the most hatest type of all. If you happen to work with them, you'll find yourself developing refractory hematemesis soon. They'll disappear anytime during working hours, and be totally uncontactable. You'll practically get mad especially if you're left alone in ward handling every single thing helplessly.
After variable duration they'll reappear, giving all sorts of ridiculous excuses:
"Oh you called? Phone no battery la..no i wanted to call you back one..but credit JUST finished.."
"Oh i went back to take shower la..sorry forgot to tell you.." (take shower..for freakin 3 hours?! during the time that you're on call somemore? Can't you see how busy the ward is?)

The "Forever-EL" Houseman
EL stands for emergency leave. Supposed to be for unanticipated emergency, but is frequently misused for various purposes. I have met one HO who's taking EL "regularly", using similar reasons every time - to attend relative's funeral. It's either his aunt, uncle, cousin, or grandparents, a total of 4 ELs in about a month time. If not his close friend revealed that all those were lies, we almost wanted to investigate why the mortality rate is so high in his family in that month.

The "Don't know, don't care, Dangerous" Houseman
I'm really concern about this. I think ultimately nobody can know everything, but one thing has to be sure: You are a SAFE doctor. Code of ethics no.1: Do good, do NO harm to patients. If you're not sure of something, pls spend some efforts to ask/ find out before you "empirically" do it. I've seen one HO attending a patient just transferred back from ICU, who developed SOB again in ward. No one can believe what she wrote in the plan:
"Noted patient breathless...SPO2 76%...some examination findings..
Plan: Nasal prong oxygen. KIV discharge today."

I can understand that new HOs can be quite helpless sometimes especially in handling the cases which he/she is not confident about. But once you're not sure, pls ask. Do not put patient's health at risk just to save your pride. No one will scold a HO for asking.

At the end of the day, what we're looking for is not how smart you are, but how safe you are as a doctor. And your attitude, instead of just knowledge, will certainly determine how far can you go in your career.

Saturday, May 03, 2008

銀行家與漁夫的故事

Read this somewhere..a very meaningful story=)

........ 話說這位投資銀行家在墨西哥某海灣度假,看見一個年輕的漁夫在碼頭釣魚,手到拿來,不到半句鐘時間便釣了十多條肥大的活魚,塞滿整個水桶。
漁夫收桿離開,投資銀行家語帶不解問道:「為什麼不多呆一會兒,可以釣更多的魚?」漁夫回道賣掉這些魚已經夠換來好幾天的家用,等需要時再釣吧。投資銀行家好奇,問漁夫除了釣魚,是怎麼過日子。漁夫答道:「我釣魚的時間不多,沒錢用時才到碼頭或出海捕魚。白天我和我的孩子們玩、睡午覺,下午和太太漫步、溫馨溫馨,晚上和朋友們喝酒吃飯、唱歌跳舞玩結他,一直玩到深夜。我們平時睡覺很晚的。」

投資銀行家於是教訓他:「你太不思進取了。你應該花多點時間去釣魚,多釣多賣多賺,然後買一隻大漁船,釣更多的魚。」漁夫不明所以:「之後呢?」投資銀行家續道:「之後賺了錢便換更大、更多的船,把船租出去,再把你村內的漁民組織起來,變成為你賺錢的船隊。到那個時候,你就不需要自己出海,你可以自己開一個魚食加工廠,做自己牌子的魚肉罐頭,自己生產、推銷。」

漁夫更加不解瞪大雙眼問:「那我豈不是很忙碌?我豈不是沒有時間陪伴家人,不能晚晚和朋友吃喝玩樂?」投資銀行家安慰他:「我是投資銀行家,我可以幫你,把這個業務做大做強,然後安排公司在紐約交易所上市,到時你便是千萬富翁了。」漁夫聽罷有點興奮:「這要用多長時間?」投資銀行家回應:「如無意外的話,只需10至20年時間。」漁夫心裏冷了半截,續問:「公司上市後又如何?」

今次是投資銀行家有點興奮了,他回道:「公司上市後你可以退休,搬到一個美麗的小漁村去生活,白天和你的孩子們玩,中午睡個午覺,下午和你的太太一起溫馨溫馨,晚上你的朋友們喝酒唱歌跳舞玩結他,一直玩到深夜!逍遙快活,多麼寫意。」

漁夫冷然回應:「哦,我現在不就是這樣生活嗎?我為什麼要等10至20年?」 .............

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