Stepping down

 

I had a talk with my dep supt (Admin) lately…. He told me he will be stepping down. I was not shock as he had been saying for sometimes… he is a man of honor and he tried to do things the right way. He reminds me a person – my ex SJAM Area Sergeant Major – a strict person who give you an impression he is a military man. He followed the rules and regulation strictly and set a good example for me. He inspired me during my cadet day and I wanted to trace his steps.....  I was lucky enough to wear the crown over my right wrist later on, although for a short duration but I was proud to hold such rank...

 

I don’t know what are the causes leading to his stepping down (not resign, as he is a valuable person to let go,  he is proficience not only in admin but he has the skill of negotiating with the Bureau of Health insurance). I did not ask what was the reason, there is no politic here in this hospital so it is definitely  related to his character. I did a intelligent guess about his successor and I got an indirect confirmation(not a nod or shake of coz..)from him. A short sided person who focus on “balance” will be taken over… Well, nothing much to say nor shout, Life go on – need to coup with it ….

Moving the Database

Finally move my database of prescription order and POMR from the “open”, “non-secure”, “anyone could assess and delete” server’s hard disk to the NAS…

More secure to most of the user of coz, still prone to attack by hacker grade user but I doubt anyone in the hospital have the ability to do so…

Well, it took me a few hours of replacing the path and upgrading the core program. Hopefully it would be the last time I moved. The database had growth from 200k to 2.5G in the past 2 years. The MIS dept had given me a space of 250G which can hold for 10 years…so far so good, it had been 3 hrs since the upgrade and no complaint from any user “yet”!!

 

Next step would be the integration of triage score to the HISMAX system. Later, if we had to join the e-medical record program I would have to password protect the path….long way to go and I don’t know if I would be staying for that long….

Surviving Hell Week....

 

It was one of the strenuous weeks in my life… survive though, but with some minor neurological impairment – memory impairment… I tend to forget thing/matter – e.g. I forgot where I placed my hand phone after getting out from the toilet…

I really forgot what was the principle or concept when I agreed to the roster Lem prepared… 24-12-24-24-14-24-24 (black colour = hrs/shift, red = rest hours)

… 4 nights shift in a week… I had done 5 night shift in

a row but that was 12 hrs shift and only covered the ED. However this time, it was different; not the shift, but my age… almost 40 and still struggling with night shift. I told myself should have gone to the recruit seminar organized by the lion city ministry of health….

 

In the future, no more than 3 shift in a week, I claimed…3 months of MMOH pay done in one week, really not that kinda money I should earn around this age…

 

Anyway I celebrated my 39 years birthday this week… job is still unstable as CM is leaving and someone is coming in and taking over the job of head of ED. Well, maybe time for a change for me, as I had discussed with Lem about my future… maybe I would go for sub-specialty training earlier than I expected.

I am still recovering from my memory impairment, I figure this is the worst insult my brain could tolerate… one more jab and that is it – moron I would be….

one thousand years old falcon....

 

 my birthday coming up next week….Those 2 kiddo were darn happy as it was toy shopping day. One of the non-traditional rule in our family – buy toys only on special occasion such as birthday. So my birthday is coming and it is time for them to buy toys…Xian had been through the “pick up anything you want” phase and he is very cautious and considering while buying toys. He wanted to pick up a magic performance set and Yun had no idea. Since next week will be "HELL WEEK" for me (3x night shift) and I would be working on my birthday - We decided to do an early shopping....

 

We went to Toyrus and Xian changed his mind and wanted a lego model airplane. He wanted a blue one but it was not available and he picked up a trash truck instead. Yun forfeited her option and wanted a round in the book store. I bought a picture finding game for them and something caught my attention while we were touring along the Lego section. I saw the midi size “millennium falcon”.

 

About 6 months ago, I saw the “Ultimate collector edition” – Millennium Falcon in store and it cost RM800….I almost bought it but had successfully suppress the urge. However it was the price which had attracted me – it was RM200 initially and now it is selling for RM120….Well, that was it…..

However I did not get the luxury of building it as Yun and Xian had offered to help me…Well, at least I could “zoom” around with it…

Cyanotic hand....

I made the spot diagnosis of prolonged compression when I saw the patient showing his hand to me….However the nurse had hinted me as soon as I walked into ED that he belonged to the “sleeping group”. The sleeping group refers to a bunch of local IV drug addict who inject themselves with Stilnox apart from the regular heroin. Yes, Stilnox is a kind of “ORAL” sleeping pill. However this group of people would grind the pills into fine powder and mixed it with distilled water and injected in their body. I had had such act before. They would come to our psy OPD and sometimes ED requesting for Stilnox.

compare the nail bed...

The hand was cyanosed and I could only felt the radial pulse. The ulna pulse was absent. I asked him what he had injected himself with and he denied initially and told me to give him something to ease the pain. I told me I am not going to give him anything unless he tells the truth. I finally got the word out from his mouth and he admitted that he had injected himself with Stilnox powder. I gave a ketoprofen IM shoot and a referred letter to a nearby hospital with radiology facilities. Don’t expect to see him in a near future….but just wandered what would happen to his hand?

Bleed to death.....

I was dragging my tired leg from the car park toward the hospital and met one of the ICU nurse leader. I waved at her and she returned me with a bitter look,” I am the first from the day shift to go off..” . What the FXXX, day shift ends at 3pm and it was 5:40pm. She added, “we where busy with big brother SE…”… In our hospital, nurses would tend to add the title of big brother to any of the paramedics (lab technician, radiographer, surgical aide) as a respect. SE is one of the ambulance drivers cum EMT. He had joined our service 10 yrs ago, just after I left for my service for MOH. He was a known case of alcoholic liver cirrhosis, with multiple episode of Esophageal varices bleeding. He had been intubated in the past for hepatic encephalopathy and yet he still drink from time to time.

We were chatting 34 hrs ago before I pass over my shift. Although expected but still I was still shock to hear the news. I quicken my step and rush to ICU. CH, our gastroenterologist , and CM was there. I took a glance at what he had, 2 peripheral lines, 2 central lines was in placed. Blood was dripping in but not fast in enough. CH saw me and pass over to me. 16 units of packed had gone in and 6 were left. I ordered another 12 while squeezing the blood. He was hypotensive and tachycardic. Semicomatose and intubated. Still he managed to struggle a bit. A good sign but not enough. Blood was rushing out from his nostril like spring water and from time to time, he would expulsed a big gulp full of blood from his mouth despite the nasogastric tube decompression. Darn bad sign…

He was admitted the day before with multiple episode of coffee ground vomitus. CH had done a ligation through endoscope and bleeding had seemed to stop. However he was noted with vague abdominal pain after drinking a large amount of water (supposed to be sip only ….). CH had then ordered a computer tomography of abdomen and he was sent to the examination room. During the transfer, he had noted with heavy bloody vomitus and passed out. He was rushed back to ICU and intubated. That happened 5 hrs before I came to work.

Well, I then proceeded to ED and did a pass over with Lem…Lem told me that ZE is not going to make it through the night. I tend to deny it and wish I could do the best….

It was a bad night…. I had an acute myocardial infarction(inferior wall) – transfer for tPA, a perforated peptic ulcer – sent for ops, an ulna artery occlusion (yes… show the picture later…), incomplete abortion – transfer for DnC, chronic respiratory failure case who extubated himself…. Well, ZE had gone into arrest during the process and I managed to get him back after a trial round of antihyperkalemic regimen. I was right, the potassium was 7 something. Well, we had poured in too much blood and he was acidotic(pH 6.9).

I managed to pass him over to Lem by 12 noon when I go off after 1 more round of arrest-resuscitation (due to hyperkalemia off coz). Well, he was comatose after the first round of resuscitation.

I told the nurses to call me up if he is certified later as I am the sports club chairman (the actual name supposed to be employee welfare committee). I had to pay tribute to the family and arrange the needed (flower etc.)

It was 22:15 when I received the call….

Betrayal

What can a person with a extramarrital affair fight for us ?

I had recently learnt that after a triangular election - the representatives of MCA had decided that someone who had a extra-marrital affair is suitable to lead the party....

Yes, he had appolozied 2 years ago, resigned from a ministerial post.... but still look at what he claimed in the past - he claimed that that was his "private affair".... In my point of view - that is very wrong, a politician have no private life , as a leader pleading for votes and supports, one have to show a high moral standard to gain trust from the public. I remembered reading this chinese noval regarding "Yong Zhen" Emperor - the emperor has no household matter - his household matter is the country matter.... no private life at all.

Chinese had always proud of the tradition - Confucious thought and others good virtues.... but how many of them had really read those books? 

The MCA had been lead by a few chinese who can't even speak proper chinese in the past, I am a victim.... - what good to speak chinese? why  sent your child to chinese school ?  That were those comments my parent had to tolerate during my school days. Why those people dare to "suggest" to my parents - because, only a few of the MCA leader could speak chinese properly(read? that is definitely out of question...)...

I think a leader of leading chinese party should be of good personality - I expect a higher standard ...the act of electing someone with an extramarital affair and posting as actor in a porno-grade movie clip(still in my M2 card...) [set up - but not framed...]  by a bunch of representatives really shock my nerve....

The problem is not with him - but those who had elected him...

My belief :   A man who can betrayed his partner of life because of his dick can stabbed anyone in the back for his own interest....should we trust him ?