new year again...

1/1 and I am sitting in front of the ED desk, sharing patient with Lem…

Our 5^th staff is joining and some of the shifts will have 2 physicians treating patients… The actual number should be 6 according to the rule but 5 is enough to pacify the committee. Night shift is reduced from 10 to 8. I am reducing my govt clinic round to 2…

Last year was an exciting year for me; my health was at a verge of failing and with grace, I was able to recover. If I had not been to Sri Lanka, I would not have found the way which not only cure myself but also revived my dad from his stroke. As a western medicine practitioner, I become aware that there is something beyond the evidence-based medicine which I had believed for almost 20 years. The participation in the 3 “missio-dei” was a milestone in my life, I would be going back to Sri Lanka and Thailand next year to conclude what I had started….

It was a year of disastrous for my homeland, from plane crash to flood, I hope next year would be better…

I am looking forward toward this year as my course with the seminary would be wrapping up in April and still praying what would be my path in the future…

frus...

I got a text message when I woke up in the morning... it was sent from the auto sms system to alert me regarding some major abnormality of the imaging I have order.

The message was a “suspect neoplasm/malignancy” alert regarding a 19 y/o female who had presented to ED for acute gastroenteritis. She had a intra-uterine device implanted (which made me remembered her…) and I had discharged her with oral medication yesterday.

As a physician serving as first liner in a small hospital; I do not enjoy the luxury of having a 24hrs radiologist support. We would get our report hours or maybe days later.

The message confused me as what kind of information could one gathered from a KUB film to reach a diagnosis of neoplasm.

I was a little bothered by the message and when I gone to work the next day and saw the report:

“… Moderate enlargement of the uterus is seen, myoma should be R/O….

I was a relief….well, fine at least I did not miss anything…

It was hours later when I got a similar text message which alert me of a patient whom I had just admitted to ward for pneumonia minutes ago.

The reports :

“  Abnormal opacity is seen in Rt middle lung field…”

No impression was noted but he classified the report as possible neoplasm…

This time, I am a little frus as I had noted in the application form that the patient was febrile and cough was noted.

There was a film which was taken 1 months ago and it was completely normal…

Well, nothing was mentioned about the pneumonia though…

It had been only 1 month and all the emergency medical staff was irritated by this new radiologist…

Radiologist is usually our last resort and if the radiologist is unable to give us a definite diagnosis(I am not asking 100% of the time but at least most of the time), it would be difficult for us... 

but the worst part was not giving a definite diagnosis for the situation but to raise some out of cosmo possible neoplasm diagnosis to further complicate the condition....

blessed...

Back to the desk after my tour to Sri Lanka..

I did not intend to join the medical tour initially, however after I could not resist the invitation and I agreed to come back for the medical mission later in December.

For me, vacation is not a problem as I could arrange my 15 days off according to my needs, but for the children, it would be a pain as they would need to take leave from school. However not much struggle for me after praying; I knew that I would have to bring them along.

Unlike the Satun tour which consist of less than a handful of member. The team consisted of 7 doctors and 7 nurses and other supporting staffs (including 2 professors of basic medical science, chef and kiddo[Yun and Xian]).

The tour was complicated in the beginning. When the registration started, my family was turned down as the organizer related that it would be a medical mission and kids were barred from joining. I did not complain but was approached later by another elder that they would remove the restriction as my services would aid the team.

I missed the 1st pre-tour meeting as Ving did not check on her email regularly. Not much was discussed on the second meeting and I was in a mist of what to prepare.

My pre-tour night shift of 10 shifts in 13 days had increased to 13 shifts over 15 days (due to my trip back to Malaysia).

On the 1^st day of the journey, I had left out a few detail..

1. Left out some Lankan Rupee and 1/5 of the USD I supposed to bring in the vault

2. Did not properly place one of my surveillance cam..

3. Place one of the wireless phone charging on the deck...

The above detail does trouble me but I had to live with it…

Later during the transit in Hong Kong, Ving had a very bad gastric pain….

Xian started to cough when we landed in Bandaranaike Airport…

D2 -> Yun broke the lens of my NEX-3 (luckily it was the lens of the protecting filter)

D3 -> Ving had diarrhea and fever with bodyache and joint pain

D4 -> Yun had fever with fatigue (no diarrhea)

Years ago, when Ving first mentioned about going to a medical mission; I told her that medical mission is not mean for any family -> Don’t be a burden to the team as we might be the one that other people need to look after during the mission… Definitely due to my crow mouth and I did not “touch wood” after saying that..

Ving and Yun recovered after 3 days without complication but it started to rain and the northern and central part of Sri Lanka were flooded; we had to detour a few times before we reached Colombo again for our flight

The medical mission was smooth though....

Everyone gained something during the trip; a trip blessed by the great one indeed….