Wednesday, April 18, 2012

corporate's life....


The ED had become very busy lately….our pt amount had increased 30% since 1+ months ago… still able to coup with the situation but still, the calls from the ward is another stress.Not sure what would happen and calls would be worse than ever.


The doctor’soffice is situated in between the 1st and 2nd floor… adimension which not supposed to exist in the building plan. It looks just likean office in a company. There is a reception hall with sofa at the entrance. Adining area with ? coffee maker and some drinks. 2 call rooms with 2 beds each.
A large area which separated into 20+ cubicles, each cubicle has a desk 2 cupboards … Boss had told Lem to pick a spot and both of us had picked a seat beside the window…. Nice view with larger space.


Not sure if Iwould stay forever but it is the first time, I had an office seat….anothermilestone for me…


The hospital even issued a discount card…. bigger and bigger it grows and become more complicated on the job....


Thursday, April 12, 2012

Mourn....Fatty....


The alarm of my hand phone rang at 5:00am, I woke up and did the routine before I woke up the kids…. Fatty past away last night….Fatty was Yun’s pet hamster… Fatty(a she) was passed over to us from a church member. The man of the house was severely ill (lung cancer with brain metastasis) and the family had to split up as the lady of the house had to look after the master in the hospital. The pet owner, a girl of Yun’s age had to stay in her granny house. Fatty had to be place at the  “kaki lima” besides a dog during that periods. The family had decided to “let” Fatty go later on and we thought it was a bad move and took over Fatty.


Fatty was about 2 yrs of age when we took her in. She was quite aggressive trying to attack every object that approached her initially. After months spending times with her, she became more friendly and tamer…


We had done some reading and knew that Fatty is at her last period of her life as most of the hamster live about 1 1/2 years…. At the age of 2, she is considered very old… I knew that day would come initially. It was another year since Yun started to look after her...


Fatty had become very thin when we came back from Malaysia, We had placed her again to her old master for a period of 2 weeks during the trips. Fatty was very weak and refuse to eat during that period. I had had a check on her and found that she might be emotional disturbed by the change of environment. In the mercy of LORD, she had regained her vitality 1+ weeks later and started to eat well, but she become less active and slept more than she does….a sign of aging....


Last night, when I was feeding the Titi and Dragon Cat (the 2 hares); I found that Fatty did not came out from her strawberry cave(we bought it for her during a trip up north)…. She usually come out and sniff for food and I would feed her some vegetable… I had bad feeling about it; I took a glance at the strawberry cave and she was not moving… I took her out and found that she is not breathing. I summoned Ving and the kids…. The kids were very sad and bursting in tears….Fatty was in her sleeping posture and food was noted in her paws….


It is time, I had expected it but still....


Today, I took everyone of the house to a ground in front of our church. Conducted my first funeral service and let Fatty rest in piece… I was tearing when I said the prayers….It is a loss for everyone in the family…it was a lesson for all of us regarding life, with pain and mercy from our LORD….


Fatty, may you rest in piece , we would remember you for ever…


Wednesday, April 11, 2012

Attitude ... it does matter...

We had an ex colleague rejoining us few weeks back…W is Burmish who graduated from top medical school here in Taiwan. He had failed to pass the board and later ended up working in some construction site down south. He was introduced to our boss many years ago, I had just returned from Malaysia then. He was posted to ICU and ward to freshen up his skill and knowledge. He had shown poor skill and knowledge and lack of working passion then. Posted to ICU and he had placed himself in the discussion/resting/office of ICU after the morning rounds instead of busying with order and charting. The skill parts were worst as he had no idea of sterile technique… Well, Boss had asked him to leave after few months of effort. Lem had given him some ref. material for the board examination on his leaving.


Few years later, boss had told us that he had passed the board and currently undergoing training in orthopedic. Good for him, a shame seeing a medical grad earning a living on hard labour.


Well, aprox. 1 + month ago, boss had introduced him to both of us while Lem and I was doing the morning Passover.


The introduction was a little bit weird,


Boss had told us that


1.W would be standing by for trauma case in the night
2.our senior orthopedic surgeon would be covering for him /going in with him for ops in OT.


3.We can call W for large/contaminated wd which need to be done in ED


W had told us that,


1.He is good at ankle – his mentor is an ankle expert


2.He can do trauma and nerve repair is not a problem


3.He is keen to learn everything – even medical management


Boss impression – he is under probation,


W impression – he is good….


Few days later, Lem told me that he had overheard a conversation between W and the management – it seems that W is still staying in a motel rather than a unit rented by the hospital. The management had never treated a doctor in such way - > rooms/house would be ready / almost ready on arrival…Lem told me that W might be still having attitude problem…


1.W is always playing with his Ipad – whenever he sits down, no matter where he is, no matter how busy is the environment


2.A case was send up to the OR and he had sit in the ED (With his Ipad of coz)  for 30-40 mins after the patient was sent up.


Another few days later, Lem had told me that Boss is going to let him go…. And Lem told me the incident that happen for the past few weeks..



  1. 1.    OR (boss doesn’t know about this…)


He had done a few ops. He had done a Total hip replacement, which had taken him a long time to decide how to make the 1st incision, and later the procedure was completed by the surgical aide and the prosthesis sales rep.


He had done a plating which later re-ops by the senior surgeon, the plating took him 4 hrs to complete…



  1. 2.    Pharmacy


He had called up the pharmacy on his OPD session asking for drug info(mainly the use, QID or TID , AC or PC) for most of the drug (Except acetaminophene and some antacid). The pharmacists were irritated by his act…



  1. 3.    Ward and OPD


The nurse had complaint about his attitude and prescription…


He was in a fuss when the management asked him to leave…. He had threatened to let the hospital suffered in the future after the meeting….


This was the 2nd orthopedic surgeon I encountered who cannot operate properly… There was this urban legend about surgical training – the senior surgeon would bar those incompetence and attitude problem training resident from entering the OT. These residents would still pass their board but eventually ended up as one who cannot operate….I think I had seen one again….


Boss might had heard some rumor in prior to hire him and that was why he had no hostel to stay in…..


Well, it is not the knowledge nor skill, it is the attitude that matters… 


ACLSI - see u next year...

I did not make it to the list…..I did bad in one station, below average on another and the rest of the 2 was ok….well, I did not get the approval of 7 examiner and thus, again I was struck off the list…


 


Well, depress I was but still, those who passed include


- one who teaches no pulse than Chest compression for child pass(shoule be no pulse and <60/min c poor perfusion) : best candidate in our group....


- shock: volume ->rate>pump (wrong sequence)


- spent lot of time on intro than on hand skill


And much much more which violate the examiner introduction of what not to be done...


Well, the chief examiner had told us that it is an evaluation which based on "luck"...don't be depress if you fail....WTF.....


 


 I felt it was my destiny, time is not up yet and next year I would give it another try….


Well, nothing much to cried about and life goes on….