Sunday, August 24, 2008

Million Dollar Question

Ya I have a million dollar MCQ here. Choose the best answer:

It's 4am. Sleeping time for every normal human. Somehow (I really dunno how), you realized your lips are quite dry. Maybe cracked a little bit. You will:

A. Continue to sleep.
B. Drink more water.
C. Get up from sleep, drive to hospital emergency department and see doctor.
D. Call ambulance to come get you to go hospital to see doctor.

If you choose either A or B, it's very likely that you're doing something normal ppl will do. If you chose either C or D, and so happen that you're seen by a tired mad doc, beware that you stand a high chance to get admitted. Yes admitted for dry lips. To a special ward. It's called psychiatric ward.

I have no idea what's in certain patients' mind nowadays. This "tragedy" happened to me, that while I was doing night shift, having seen all the crazy cases that drained me physically and mentally dried, I still had to see all the "non-emergency cases" that came in continuously. (Night shift is something scary, that one people is covering all 3 zones).

So I was very, truly deeply shocked by this young man, 24 year-old, healthy-looking, came to casualty at 4am, telling me that he found his lips dry, and slightly cracked. And pls believe in me that, HE HAS NO OTHER COMPLAINTS. I examined him with my widest imagination of all possibility of diseases but in the end the final diagnosis would just be: cracked lips. Treatment - the simplest being "pls drink more water", or if not, maybe a lip balm can help.

4am. Cracked lips. Drink more water will do.
Can someone tell me what's the urgency to see doc?! This is not something normal people will usually do right..

Sooner or later, maybe it's the poor doc who'd be forced to go mad and be admitted to psychiatric ward!=)

Friday, August 15, 2008

What a GREAT Day!

As I said, good or bad things, they just happen. Anytime, no signs, and most of the time when you least expected it.

I had another "special visit" again today. My hospital director suddenly came down to emergency department, wanted to see me and my department head. Apparently it's regarding the incident which the "VIP" was managed here few days back.

She looked serious. She asked to trace back the ticket, looked through it slowly. I was just having kinda rapid heart rate, wondering what's going on.

She looked at me, "Dr Lee, were you the medical officer who attended him?"

"Yes." (swallowed saliva)

"In fact, Dato has personally contacted our director-general (Health ministry DG) regarding this, and DG just called me this morning."

"(OMG, is it something good or bad?) I see..may I know is there any issue with this?"

My director raised her eyebrows, "OF COURSE there's an issue. If not I won't purposely come down and see you right?"

"(Heart rate increased to 180 again) Issue?"

"He wants to say congratulations to you. Dato's very satisfied with the management here, he said thank you, and he's impressed with the efficiency here," Finally she smiles and shakes my hand, "Good job."

I think no one can really imagine how relieved I was. And also my department head. He should be quite palpitative too.

The whole team found this very encouraging and was happy with it. I think my boss is the happiest, he has been smiling the whole day. Then he asked me, "Hey Lee, well done. I think you just stay in the department la, forget about medical.." I was like, "Errr..hmm haha. I'll see..maybe..." But seriously it's becoming difficult to decide, since emergency medicine just seems quite as interesting as medicine. See how la.

But anyway, this is really my "kembang" day la. Happy. Yay=)

Wednesday, August 13, 2008

Doctor & Patient (3) - Frustrating Chapter

Case 1

9 year-old boy complained of mild giddiness.
On examination, he's perfectly fine.

Doc: "He doesn't really need medication.."
Mother: "Huh? No medication? Nothing at all?"
Doc: "Hmm..alright..." (planned to give some vitamins)
Mother: "But is it ok for him to take medication? He's still small right..."
Doc: "That's what i said, no need medication."
Mother: "But what if he feel giddy again? At least give something.."
Doc: "So actually you prefer me giving medication or not?"
Mother: "How I know? I'm not the doctor. It's up to you..."
Doc: "Then no need medication."
Mother: "Huh? No medication? Nothing at all?"
Doc: "......"
Neverending story...

Case 2

18 year-old young man.

Pt: "I noticed something wrong with my..testes."
Doc: "Oh..which is?"
Pt: "The left one is lower than the right."
Doc: " only noticed it recently?"
Pt: "Ya..during yesterday's shower. Something's wrong isn't it?"
Doc: "It's perfectly normal."
Pt: "(Doubtful) Is it? Coz I asked my dad, he also said it's not normal."
Then the dad came in, "Doc, do you think you can refer him to a specialist?"
Doc almost fainted.

(What you think will happen if this is referred to a specialist? It'll become a national news man!) Lesson - Bring your anatomy book around during clinic. You never know when you'd need to show "proof" to the patient.

Case 3

17 year-old girl comes for a urine pregnancy test.

Pt: "I'm afraid i'm pregnant. I missed my period this month."
Doc: " got a bf?"
Pt: "Ya..."
Doc: "Were you..together with him last month?"
Pt: "Ya..."
Doc: "Ok understood. Ya let's check your urine."

Urine pregnancy test negative.
Doc: "Hmm it's negative. Actually, the 'together' you meant was..."
Pt: (started crying)
Doc: "It's ok..don't worry you can tell me..."
Pt: "He kissed me.."
Doc: "Kissed...hmm...(pls don't tell me that) you mean kiss ONLY?"
Pt: "Ya I already told him not to but he still kissed me..I'm so worried I might get pregnant...(sobbing)"
Doc: "......"

Doc feels like crying, too.

* This incident just happened this evening in the casualty. I'm really wondering what's wrong with the current sex education system. Apparently, she asked her mom and her mom also asked her to come for the pregnancy test. Sigh.

Related posts:
Doctor & Patient (1)
Doctor & Patient (2)

Friday, August 01, 2008


This is Barton Kamen, MD, PhD, professor of pediatrics and pharmacology, as well as chief of the division of pediatric hematology/oncology in Robert Wood Johnson Medical School.

From a classic doctor’s black bag stashed beneath his desk at The Cancer Institute of New Jersey (CINJ), Barton Kamen, MD, PhD, pulls out a couple of magic tricks. Now you see the scarf. Now you don’t. Kamen incorporates these magician’s props into his life as a pediatric cancer specialist just as if they were real medical tools. Not in league with a chemotherapeutic agent, stethoscope or thermometer, of course, they are the “ice breakers,” he explains, which help to engage children’s senses and break down their defenses and fears.

...When asked what he might do when confronting the tears of a mother, he answers, “I’d cry with her. I can’t take care of kids and not be human. I don’t believe in keeping professional distance. I just don’t.” And therein lies the magic of Kamen’s best medicine. In fact, look up the definition of magic: “the use of means … that are believed to have supernatural powers to produce or prevent a particular result (as in … death or healing).” A magician is someone who is “able to produce startling and amazing effects.”

- Extracted from UMDNJ magazine "Magic + Medicine = Cancer cures"

Magic undoubtedly brings happiness. Looking at him holding the bicycle cards, I'm just wondering whether i'll be doing the same thing in future, pulling out cards and magic tricks from my bag (like now) and keep on entertaining the patients.

I guess I will. Magic and medicine are just inseparable in my life!=)

Related posts:
My Love with Cards
The Wonder of Magic

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