landed - LCCT.

We landed back in LCCT on time - thanks for the bad weather(strong wind took the credit). It was a not a tiring flight. I took a nap and was in good shape when we landed. Well, it was quite a walk from the plane to the LCCT. I had read about "the march" - well, you get what you pay..

I was surprised when we reached the LCCT. There was this fever screening unit at the entrance. There was this long queue. The line was arranged in U shape and the line was not moving (STATIC !!!!). Violation of first rule in the fever screening station - static = increase risk of infection. There were a few staff nurse and MA assistant medical officer( they were renamed recently) standing in front. One medical officer was sitting at the end looking at the monitor. Taiwan had declared that the H1N1 is being treated like general influenza and no special measure to be taken just 1 week before I leave.
We finally passed the imigration and taken our luggage. I saw my brother in law - Wan waiting and we headed to Port Dickson - my uncle's house. It was 55 km away and I had not seen my granny for the past 5 years. I heard that she was in bad condition for the past 1 years. I wanted to see her. She cared for me and my brohter during our high school days - she often gave RM50 to us during our visit to her house. My parents was not doing well than...

I couldn't get any map for my GPS so Wan had did a sketch from the google map. I got a gonav S900 which run on papago R15 which I later upgraded to VRone. However the only Malaysia map I could lay my hand on was a R12 version. And I couldn't get any R12 Papago. So I gave up.
The navigation was easy when we passed by Sepang Town - it was a place I never forgot. I still remembered the incident - My dad was driving a Nissan C20 and we were on our way home from Chuah(yeap- the origin of Nipah Virus). The C20 was having problem igniting and needed a push-start. We were passing by Sepang town and there was this fire going on. Police was controlling the traffic. My dad was impatient as he was afraid that the car would switch off during the jam. He horned and one of the fat/hugh build , mustached police officer walked by - he asked my dad to pull over and ordered my dad down - he was taken to the balai(station). We had waited in the van for hours before he was released. I saw the disappointment and depress in my dad's eye but just didn't know how to support him verbally. I learned that he was the OCPD (officer in charge of the police department, 1 crown at least) of the town. I could imaging how my father begged for his pardon ... a sad one and my conclusion was  - PDRM sucks, he had no right to do that ... just a horn - and someone was detained for hours ...
The road was familiar and I saw development along the road. Shop houses were build and Apartment were placed.  When I reached my uncle's house it was almost 10... I saw my granny sleeping in the living room... She get old and so do I....

to say or not to say...

Well, I did my Mon, Wed, Thrs call last week... heck, it was worst than I thought.... it was no the stress of not getting any sleep, but time being wasted on resting. I rather go back to those 15 shifts per months scheme.
It sounded like a good news when boss broke the news during my weekly meeting. Someone is coming. I got the following info :
1.A board certified Emergency Physician
2.Working in hospital nearby
3.He is senior (means older than me...)
4.His current employer is willing to let him go eventhough his contract ends next year

I had a closed friend(senior) working in that hospital and he is currently holding very senior post there. I could have call him up but I didn't - I was afraid that he give me any negative comment and in that case I would be in deep shit. Boss might taken my advice and stopped him from coming and the lubang(hole,night shift ...etc..) still there. Then I had to cont my 10 shifts/month life. If I withhold such info, than if later boss know that I knew before hand and I am also in deep shit. So rather don't ask...
Well, unfortunately our nursing superintendent got a call from our ex-colleague ( she is assistant head nurse in our ED and late resigned due to family reason, she is currently ED AHN in that hospital) - our colleague to be is incompetent and having attitude problem. His current employer and ED staff just cant wait to sent him away...

Well, we had one hot potato at the moment and un-shakable as we couldn't get any replacement, now there is another one coming in.... our nursing superintedent would go and talk to our matron to see what can we do...
Well, 2 wks to month end...lets see.....

Lubang ( hole )......

I enjoyed a 10 days holiday and prepared for my 1st call…a relaxing morning, but still I was very tired after 3500 km of flying time and 400 km of driving – a 6 hrs sleep was not enough. But nothing like a heavy blow on the head during a hang over. I got a missed call from hospital and I called Lem ; bad bad news… our colleague Ong had asked for an emergency leave – or a so called “step out”. He had a bad week and his insomnia had worsen and he did not slept for 1 weeks. He decided to quit temporary on last Friday. Well, a 8 night shift “lubang”(hole) on this month call list. Boss had called for an emergency meeting to discuss such matter. I did a quick analysis and decided to share 2 of the shfits. That would my shift from 6 to 8 this month(minus the 10 days in Malaysia). The worse thing – following months to come, a 12 -13 night shifts to be filled. I couldn’t imaging how we are gonna survived. The meeting was not only about Ong’s leave but also something about the National health bureau’s budget for us. Well, a miscalculating leading to a major cut for this quarter. Negotiation was still going on and we might had to face some challenge in the future as we might have to opt for case by case reporting scheme instead of budget limiting scheme. Well, that was not my focus. I had a discussion with boss and our financial controller(boss’ wife) and I had told them that the ED physician is heavy paid in ex hospital and it had become one of the index. Well, I saw the financial controller punched her calculator ... When Lem rejoined us, boss had given us an option - 3 of us take over what had left over... Neither Lem and I wanted to commit anything... well, the pay is far too less and no worth of it to risk our life... yeah risk our life -from time to time, Lem had asked me in a joking manner - why not we take over the 720hrs shift(whole months), my answer was - when we would become human Ba Kuang ( dried meat in Hok Kian) in 3 months time. Life was hard but I rather stay alive - suffer or enjoy that was another story. I offered to take over 2 shifst and Lem would cover the Tuesday's call - for this months....

When would they let go ?

It’s look like still a panic situation here… the govt still considered H1N1 as a major threat as I read it from the newspaper, but most of the relative had no feeling about it – after all no one around them had hooked up with the disease. Well, 10 days before I returned, the Taiwan department of heath had declared that the H1N1 is no longer a major threat like SARS – our reporting system had shifted from daily to weekly and only the severe case with be posted. When I reached the low cost carrier terminal(LCCT), we saw this long line up at the entrance hall. The line up is just like a cribbage score board. There were a team of medical staffs collecting the declaration and handing out brochure. The line was static for 5-10 minutes. I said to Ving – “total wrong setting ,that is another way of spreading the disease”. The line was static and if there is one H1N1 patient – than we could be infected. So isolation would be more difficult as the front 3 and back 3 rows rule could not be applied in this situation. The Ministry of health is still spreading news of panic around the newspaper – well, don’t know when they would let go …..

i wanna fly ...

I had been an aviation fan for half of my life… I remembered there was this card game during my school days. There was a title for each card – cars, sport cars, plane, tanks… Different vehicle was printed on each card. The cards were distributed and one of player would be the caller. The caller would decide which item to be compared. I learnt a lot of info regarding vehicle/plane/tanks from it.

Later when I got my first computer(8088, 64k ram, 2 floppy drives, CGA monitor). I dipped myself into the world of flight simulator. I had failed a lot times (more than 100) before I did a successful landing. I had played many flight simulator games since then. I purchased paddle, throttle and a good joystick later on (With my own money of coz..). One of my favorite model was 737…I day dream that during one of my flight between KHH and KUL, I might have the chance to help the plane land if the pilots failed…(day dream only of coz…)

Since we had 40 min left before our check in, we decided to have a tour in the aviation museum just next to the Tao Yuan International Airport. I remembered during my school days, it was named CKS International Airport. But the green govt had wanted de-CKS-rization to be done, so it was renamed.

Apart from the poster based history regarding flight. There were these cockpits for the visitors to get a real feeling of being a pilot…

 

hell load of plane model...

fighter jet cockpit...

not F14 definitely..but who cares...

top gun ?

Any way we had a great experience….

 

 

ED is a mess

We had a discussion 2 days after the incident. My colleague had brought the problem up to the hospital superintendent. He is a surgeon and he is a man of principle. He had refused to provide the report when the patient asked for a referral. The act of our ortho man had irritated him – as the patient did not admit to my service than I am not his attending surgeon, so I have no responsibility to signed those papers.

If his statement is true, then my colleague CQ is not attending doctor(he did not see the patient at all), and the ortho man is also not his attending doctor – eventually I would be the one…I was the ED doctor that saw him.

I am not a man of trouble. When my night shift head nurse told me about the incident, I told her that she should have called me and I could have logged on to the hospital server and signed the report and referral letter from my house. (with full of grumble of coz…).

Well, what is the problem with our ortho guy ? Well, I had heard many rumors and most of them were negative one. Don’t mind and care about his act, but there is one tradition in our hospital – covering each other ass as you can. Well, I had not only once help my colleague signed the report.. So what was the big deal….

Well, he had skipped the discussion and we have talked freely, it seems that everyone was pre-brief(means gossip had become public secret). Our surgeons had decided to talk to him about the ecological situation in our hospital - hopefully he is smart enough to coup with us… I had told Lem if I heard anymore comment about “ ED is a mess” again(that was what he said during the surgery because the patient had changed his mind). He had blamed the ED for not persuade the patient to admission - my point of retailiation - the ortho man had no mouth ? he could have talked to the patient prior to surgery as the patient was given spinal aneasthesia instead of general. 

I would start my “messing up” – I would not help the ortho man to signed his surgical consent and would insist he come down to see the patient and signed the consent before he went in and scrub….

one should think big but not there

I had this unpleasant encounter days ago…I went off by 6pm and passed over a few patients. There was this patient who went to OT – huge popliteal fossa wound with tibia-fibula closed fracture. He had decided to admit after the surgery and I signed the admission form.

Just before I left, the patient’s colleague came to me and said they wanted a transfer (back to their hometown) after the ops. I told me we would assist the transfer after surgery before I left. 

The next day, I met our night shift head nurse and asked about the case and she spitted to me about what had happened…I was shocked when I heard it…

Our ortho man had grumbled in the OT about the patient not being admitted to his service and then when the patient came down from the OT , he refused to write a referral letter(form to be exact) and medical report for the patient under the reason- Since the patient was not admitted top my service then I am not the Attending Surgeon and why should I write those for him…He was stopped on the way by the head nurse and refused her request when she asked him to help.

The head nurse later had tried to keep the patient back to avoid such conflict(no one wanted to write those document…)

Crap shit kinda excuse – how the hack the ED physician know what he had done on the patient… Lem knew the incidence hours before I was told about the matter. (he is the ED head …). He was displeased but refused to comment and act any further. I told the head nurse, this man definitely to be educated properly… Our hospital is a very small hospital and no one is another person enemy…

Flight back home...

It had been a chaotic week for me… finally I am going to set foot again to the land where I spilled my blood(a malay way to say motherland)…Well, I had 2 shift to go from Mon to Thrs, then Friday would be THE DAY… I planned to put up a night in Tao Yuan where the airport situated…but later I found that it was not a good idea. The flight commenced at 4pm and there is still 4 hrs for me to “wander” around.

So I had a change of plan. I decided to move up in the morning. A risky plan but I thought worth every effort. Well, my plan was good – Ving did a last minutes packing. When I reached home by 6pm Thursday, no bag was packed yet..Well, the packing was completed late that night.

The morning drive was a sleepy one as I was so tired. 8hrs sleep for the past 48 hrs..I was exhausted. But the drive had to be done and Ving looked more tired than me…I had to take the last stand. Drive was smooth though, I took the 2nd North-South Highway where the traffic was less crowded. I completed the 380km drive after 4.5hrs(2 stops).

It was too early for check in yet(I tried a web-check in but failed instead). We took a tour at the aviation museum nearby..Very nice one , real cockpit and models. We left the museum by 1pm and when we arrived at the check in counter there was quite a crowd there. 4 counters were opened and I got my boarding pass 20 min later.

 We took our car to the car park and a van ferried us back to the airport. We passed the immigration without problem. I had been having problem with the security check since years ago. Always due to my St John Buckle. I had an bad experience on my last exit. The officer wanted me to take off my belt. I was very displeased about the action.

We had a snack at the restaurant nearby the boarding gate and headed to the C5 gate by 3:40pm. A totally different experience. A330 is a big airplane and with the 400 seats fitted in, it looks bigger. Now I am writing this blogs, squeezing my self with my 15’ ASUS (regret that my boss given me a big one instead of a 12’ one..) Anyway – 2 hrs before the flight land….