Friday, November 10, 2017

We help each other... .

It was an easy going weekend shift. I was doing 10-10 shift. I had to wake up early, did my cycling round and sent the kids to school by 7am as it was schooling weekend for the kids.
I arrived at the ED on time and started my shift. A senior couple came in with a mid-aged male. The patient was an elderly male assigned to my colleague L. He presented with SOB and later was diagnosed as congestive heart failure with possible acute coronary syndrome. The accent of the couple had raised my attention. It was Malaysian mandarin they were using. I glanced through the patient address and found the keyword Johor.
The consultation was a smooth one and after diagnosed as Acute coronary syndrome. The loca tour guide had asked for a referral to K city. The local tour guide left the scenario and an elderly female[who later identified herself as the Malaysia tour guide] joined the couple for further management. Later the lady tour guide came to me for help. She asked me if I could help her to contact the local tour guide as her phone was not working properly.
I assisted her on the calling with our phone.
The referral was done promptly but during the payment session. The lady tour guide came to me again asking me what to do as she had not enough NTD. The fee was NT19993 and she had only NTD 12000. The wife of the patient had joined the conversation and told me that  she had only SGD and asked me if the hospital accept SGD. Well…of coz we accept but at a very bad rate…I remember once there was this foreigner who paid the bill with USD; the rate offer by the management was as low as the hotel rate…
I told the ladies that I would help them with the exchange. The wife asked me what was the rate I want. I googled and shown it to her for fairness. She agreed with the rate and I went to the ATM at the 7-11 next door and drawn 7000NT. I gave her 6700 for SGD 300(It was supposed to be 6650 according to google).
They had then proceeded to the counter for payment. After a good 30min, while I walked pass the counter, the ladies were still at the counter. I approached them and found that they were still short of NTD 1000+ as the lady tour guide was reluctant to help out on the sum. Finally the lady tour guide gave in but was still short of NTD 293. I took the NTD300 from the leftover of NTD7000 and given it to our counter staff and settled the scene.
The wife asked me why did I help them? I told her,” Malaysian helps each other…especially when we are not in Malaysia…” We had a short chat, the wife had asked me where did I reside in Malaysia. I told her that my parents live in Johor. I told her that her husband should undergo the angiography here as it would be cheaper here than in Malaysia.
Well, the elderly was about the age of my parents and I could imagine their feeling of being stranded in a foreign place. Their offspring were supposed to manage this kinda of troublesome matter for them but yet they were helplessly facing the situation here. A hand was what they need….

Later the nurse who escorted the referral came back and told me that everything was fine….

Monday, November 6, 2017

the code, the oath.....

I still recalled the day I took my oath, even though I could not remember what I had recited but could still remember the rule of do no harm….
Well, few months ago, an O+G specialist had posted in a line group regarding a case. A 34 weeker in labor had presented to ED and he was consulted. The Os was fully opened and the O+G specialist had decided to transfer the case under the ground of preterm.
The case was initially referred to a hospital nearby with 24hrs labor capability that is 30 mins away from the ED. The referral was denied on enroute as the on call pediatrician refuse to accept the case. The ambulance had however detoured to another tertiary facility further up north.
The specialist had later shared in the line group:
The driver had competently driving the ambulance fast and steadily.
The accompanied nurse had done her job of pacifying the patients…
Most important, the patient had done her best withholding the delivery…..the baby just popped out minutes after their arrival in the receiving ED….
I grinned and mumbled, “WTXXXk”…..well, should have delivered the baby rather than took the chance doing a transfer. What if the child decided to come out on the ambulance and really had need a resus and intubation…
Another orthopedic surgeon I knew had involved in a fight with his local neighbor after a “you should let my car pass through first” incident. He was walloped by a few residents and later he told the ED that He would not see any referral patient from the neighborhood. Totally unacceptable situation…
I presumed they had forgotten the oath and the rule of DO NOT HARM…. Violation of the code of conduct and knowledge we had taught, it is still a Noble profession ? well, I had recently read the blog of Dr Pagavalan….he had quoted what the founding dean of UM, Tan Sri T J Danarj, said “ The day the medical education is commercialized and medical practice is commercialized, that’s the day prostitution of medicine starts”.
Can’t agree with him no more, I had quotas , KPI and other indexes to meet apart from providing care to my patients….

As for the prostitute part, I had always told my nursing colleagues,” I am nothing better than those ladies standing beside the wall( a Taiwan synonyms of prostitute), at least they got to finish their meal before seeing their client….. I can’t, I need to put down my spoon and fork whenever you girls called me, or else you would keep ringing the phone every 20 seconds….”