Worst Case Scenario....

The worst case scenario had occurred…. W (the locumer) had told Lem that he is going for a vacation in August, the whole month… That means 4 big lubang during the weekend. I told Lem that I could cover 2 of the Lubang … that means 2 more holes to be filled up…. It would not be a problem if Lem could cover for 2 day shift during the Sunday… but still, with the current pay scale, no commitment…We shall see…..

Worry....

I had written about a young chap with renal failure and received help from some charity body raising a quarter million RM enabling him to go up north so that some poor guy could sell his kidney for money…

After a struggle with the charity committee for a gene therapy rather than the transplant, his plea was rejected, he had gone to the north and received his new kidney. He had come back and returned to his study. He had written in one of his recent blog regarding his medication fee. He needs 2-3k RM per month for the immunosuppressive medication. He is wandering about his job in the future…he need a job with 2x of salary than a normal people, that is if he could secure a job with RM2-3k… he is dreaming of working part time and getting a double amount of salary with 2 jobs… but with his attitude, I think it would be very difficult…

Things would be smooth after your further study, that was what I was told during my high school days… yeap my parents were right, but nowadays, the society is different and graduation means nothing – this is one of the great article , a must read for youngling and parents

http://mag.chinatimes.com/mag-cnt.aspx?artid=10913

the urge of buying a land and setting up a farm had become stronger and stronger ….. a sanctuary of tranquility for the kids if they need it in the future….

Mona and his father.....

Yun was studying for her final last week. The social science subject had taught about the famous WeShe incident… A epic saga of an aborigine tribe fighting against the Japanese army. The tribe leader Mona Ludo was one of the warrior of the Seediq tribe. He had led his men fighting till their last breath for honor instead of living like slave. We bough the BD version and I saw the movie with the both of the kiddo … Hell of the film, I remembered at one of the preview interview, the director Wei TS had said that when they went to John Wo(one of my favorite director)to invite him as producer, John had told them that they could only shot 1 fighting scene with their Budget…..Indeed the movie making is an agony process..Yet the presentation was so fascinating

 The money well spent for the blu-ray version worth every penny. No regret of spending it....

Mona was a great warrior, However most of the tribe men could barely follow his step…. It reminds me about me and my kids….I had come so far but unfortunately I do know how to teach what I know to them. I hope they would be someone better than me, but I am not confident…they can’t trace my foot step as the way I raise them is different from what I gone through.

 I rather be the father of Mona seeing his son growing up as a proud person than being Mona himself. But the only thing I could do is to follow the way of THE BOOK hoping they would concur and learn……

oh i forgot....

There was this old man who come to ED c/o gastric pain. He claimed that he had eaten some contaminated food during dinner and pain had awakened him from sleep. He had however pointed to right upper quadrant of abdomen instead of the usual epigastric region.

I asked him what he had for dinner and he said as usual. I am not satisfied with this of answer most of the time. I don’t live with the patient and I don’t know what does the usual mean. I usually would dig the story and he told me he had some chicken soup. Should get the spot diagnosis by this time and I had asked him if he had any history of stone (that include urinary and gall bladder). He gave me a negative answer.

I proceeded with the physical examination and a positive Murphy’s sign was noted. I proceeded with the ultrasound and show the 3cm stone to him and told him about the diagnosis.

He then told me, “ yeah yeah I had gall bladder stone…” I asked him,” but you had told me that you had no stone in the past…”. The patient grinned and answered me, “ Oh I forgot…” Well, just another never trust your patient scenario….

It was  pain in the ass during those resident/medical officer days… clerked the patient like dog and during the specialist round, the patient gave another story – some of the time, one would get this unfriendly “you are lazy” stare from the specialist….time had passed but still, the same scenario happens again and again but this times, I am the one who give the “stare”-----to the patient of coz….

 

lou hang....

I had this lady who met an accident few days ago. She was involved in a bike vs bike accident. I had a chat with her while waiting for her wound to be cleaned up. She told me that the accident occurred at a traffic light junction. I told her that it would be a 50-50 case as the both the rider would claimed that the opposite party is the offender….Well, indeed the young chap turned up and told the police the story later…

Well the parents of the young chap came and after the police investigation. I told the lady the xray did not revealed any bony fracture and the young chap’s father asked me would it be better if an xray is being ordered. I told him serious that I would not be standing there telling the lady that her bone is ok if no x ray was taken.

Later on discharge, the father against asked me in front of the lady that would it be better to give a tetanus toxoid jab. The act frus me and I told him,” I won’t be discharging my patient if I had not done my job”. The father told me,” no lah, just do reminding of each other..” this really irritated me, “ do you thing that I am a first day on my job fresh graduate who need reminding on such basic job…?” I told him in a firm voice while looking into his eyes and walk off after a few seconds… Could have stay back and humiliate him further by telling him that this is not the way to act in real life, but still he is like 20+ years senior than me in life… well, just cut it..but while walking to my desk, the word, "lou hang" [cantonese] (老坑) came into my thought and I just grinned for a good 5 minutes.

The word "lou hang" is just another way of saying "lou hon"(老漢) in cantonese in a disrespectful way.... an old guy with no proper manner....nice term for the old chap even though he wore a proper attire...

I had met lots of people who came to ED ordering the medical team for this and that acting like they are so concerned about the victim…most of them had a little knowledge about medical but this make them look more like a fool…

ye how nga gan ji hang....

It had been raining for the past few weeks, not surprise during this plum raining season. The weather is affected by the southwest monsoon… with the 2 typhoon Talim and Guchol surrounding the Taiwan, it was speculated to be the worst raining session ever. The local govt. had declared a holiday on 6/20 and the kids were happy. I did not enjoy the leave as I had to go to work anyway.

Driving to work is a challenging task even though the road is not expected to be flooded but the water pooling along the roadside cause a splash from time to time proved to be some fun driving across it. Z was a good car but still it shortcoming was the height, it is just a wagon but with Fefe, I lost the fun of maneuvering but gain the confident of driving through minor flood, I always remembered my dad’s advice – [ye how nga gan ji hang[Cantonese] ]drive through with 2^nd gear, never stops or else – if water enter your exhaust pipe, you are done…

….I had a smooth drive as the was only a handful of car during the drive. It was raining intermittently with no heavy down pour.

The rain had become smaller in the midnight and I had a hard call….

I had encountered a tough drive during a heavy rainy day back in Malaysia. The rain was so heavy that I could barely see the road with my wiper at its maximum speed. However I had multiple similar encounter here in Taiwan and getting used to it...

It is one of the worst year, rain and earth quake here and there, I really missed Malaysia which is relatively disaster free….

filial ....(1st time I use this word...)

Lem passed over this patient to me….a 70 y/o male which was found sitting at the crematorium nearby our hospital. The worker had found him unresponsive and he was sent over to us by local rescue ambulance. Lem saw him at noon and he was alert (hand to face test was done and his hand did not land on his face…). He had however refuse to response /answer all our question. I took over the case at six and he refused to answer my question. Later in the night, he started to talk but was able to give us only a phone number.

We had managed to contact one of his son and he said he would communicate with his brother and decide who would come to get him; it was 10+pm then.

He is also a case of uremia on hemodialysis. He was supposed to get his dialysis on that day. I had planned to get him hemodialyses in the morning if he is still around.

I called up the hemodialysis center he was receiving his regular hemodialysis to get some basis data. The nurse told me that he had two sons and 1 daughter. The daughter stay up north and he took turns staying in his sons house. The 2 sons did not call up and the patient decided he wanted to take a train back to his house….I let him do so as he was alert and was able to move around with good appetite...

One of our nurses called up his son at 7am that morning and the son told the nurse that we are harassing him….

Well….where is the fundamental family value…I felt pity for the old man….at leaving, he had told our staff he had gone to crematorium because he wanted to be cremated and get some peace…indeed with this kinda of sons....

I had seen many off spring who is not filial to their parents. It always serves as a reminder to me. If you treat your old folks badly, than that is what you will get from you children, but still, if you treat them good, it doesn’t guarantee you child would do it to you. Seems like a losing investment but still just can't be calculative about everything....at least I could sleep comfortly in the night...

 

GE13..

The thought of going back for the voting still haunt my soul…. The GE12 was a stunning one for me… For sometimes, I had given up hope that the opposition would perform, especially those days of working with the MOH; I just can’t figure up people would like to settle with the situation. I had heard voice but still didn’t see any changes. I been to the Health officer introduction course conducted by the state health office – specially for Medical officer working in the health side(klinik kesihatan). The course was held in a very secluded resort – Kuala Gula, I drove a few hundred km to reach there. There was 2 non-Malay MO among the 10+ who joined the courses. During the course a senior medical officer had shared her opinion with us- > she actually talked about the privileges of the Malays and “advice” the Malays MO to stand up strong and not to satisfy with the right but to build a life of themselves with pride. She quoted that Chinese had to save up since young for their children education fund but most of the Malays don’t…..

But still BN swept during the GE11….

At the night of GE12, I went to a company dinner with my family. I came back at about 11:00pm and logon to the net. There was only a handful of result..and at 3am, I woke up and saw that Selangor and Penang were taken by the Pakatan. It was a stunning one.

I am still looking for a change, and I wanted to be there if that should occur. The election would mostly held during the school holidays at the end of the year… The reason is simple, it will be a close fight and a chaotic rally leading to curfew might just happen. It would be relative safe for the children if school is closed, no Monday shutting down of school is needed in the worst case scenario…

Most of the citizen (with whatever right or not) did not benefit from the current government, only some that share a piece of the pie…most are struggling with a moderate salary – trying to buy a house and car with a forever lasting installment….

I don’t mind our minister is being paid a million/year provided the country is progressing and every citizen is paid some dividend (just like our neighbor country) every year. But what I saw was a Minister who don’t have the guts to take out his own RM24200 for a car license plate – what he is afraid of ? a check from the MACC or he is too stingy?

Still 6 more months to go…. Lets see what kinda of joke they would perform…..

money not in my pocket.....

It had been 2 months since we joined the new insurance payment scheme….the 1^st batch of revision was supposed to be declared 2 weeks ago, the management had estimated a 30% reduction on the 1^st pass…. but we had not heard a word from the claim department….

I went to the nursing department for some errand and stopped by the claim department. I met the person in charge and asked her about the result….she told me the deduction rate was 12.8%...WTH, a very good result indeed, a 10% increase of amount of bed, 20% increase of bed occupancy rate and 15% increase of investigation rate….the is a boost of 30+%....well, maybe a good bonus increment next year for us…..