Someone's gotta work!

When we were house-officers, due to the overwhelming number of Chinese colleagues in our department, my husband and I were not able to take leave. Both of us were on-call on new year's eve and by 4 pm I was the only doctor left in the ward. I had never felt so alone in my life! I was an ocean away from home, and for the first time in my life missing the reunion dinner with my family. But my MOs had other ideas. One bought us chocolate cakes from Hilton, one delivered a 5-course meal (befitting a reunion dinner) from Sarawak Club and another got us a whole roast chicken! And so the 3 of us (me, hubby and our MO on-call) had the closest thing to a reunion dinner while on duty, in the nurses' pantry! During that moment, we were indeed "family" - bonded by the common pain of missing our real families, yet deeply obligated to care for our patients, festivities or not. That night, as expected, admissions were few - I think there were only 2 after dinner; for fast AF and hypoglycemia. At 12 midnight, I stood by the windows on the 6th floor, and joined by my patients, stared in awe as the night sky exploded in a myriad of colours. Well, I guess I never could have witnessed it from this vantage point if I were some place else. I knew that in the other ward, my husband was sharing the same spectacular sight. Since then we have experienced several Christmases in the hospital and enjoyed the carolling and fireworks.

To our Chinese co-workers holding the fort during this holiday season, thank you. May you have fond memories of your experience, like I did.

Happy Valentine's Day!

Dear hubby,

You're a lucky man. Your wife has a romantic spot, but oh, how she hates love commercialised. That's why she has never given you the cold treatment or throw a fit when you fail to give her flowers on every single Valentine's Day we've been through. I mean, 15 ringgit for a stalk of rose? (Or does it cost more now? Gee, I guess I'm out of touch). I'd think you foolish to fall for this kind of exploitation. And baby, diamonds are so politically incorrect. Who'd want to be adorned with these blood-tainted rocks? Who'd want to indirectly fill the coffers of terrorists so that more lives could be lost? (Yes, thank Blood Diamond - perhaps it's not all fiction after all). But you caught me totally unaware when you dragged me into a luxury (for us, anyway!) watch store - the intimidating sort with a glass door and snooty sales assistants - and got me one fine specimen! It cost you more than a month's salary, but remember this :

Watch : RM xxxx
Dinner for 2 : RM xxx
The look of joy on your loved one's face (that's me, of course) : PRICELESS


I guess I'm a lucky woman too. No, not because of that watch, but because I have you. Happy Valentine's Day.


Love,
Wife

Shit Happens!

On my list of top 5 most dreaded bedside procedure : peritoneal catheter insertion. I think a lot is left to chance when, despite all the precautions we take, some mesenteric vessel or bowel might be sitting right where you intend to stab with a trocar with "gentle force", but force nonetheless, waiting to be perforated. Yes, it's a blind procedure, and I hate being in the "dark"! Is there no better way? Induction of a false ascites isn't necessarily trauma-proof either. I recall an incident sometime last year when my house officer informed me that, on withdrawing the 16G cannula after infusing adequate amounts of fluid into the peritoneal cavity, she had noticed the tip to be faecal-soiled. True enough, after staring at it for a good minute, I finally decided it was faecal material after all. I complimented my HO for her keen eye (it was a tiny speck!) and good sense not to have proceeded with the procedure, but informing me instead. In a place where someone is always to blame for something bad that happens, I told myself that night that I would stand up for this girl if anyone were to start finger-pointing. She had performed the procedure correctly; the patient was unfortunately a victim of a recognized complication of peritoneal dialysis. A former consultant of mine in Kuching once asked me, "So (my name), how many of the stab PDs you did that were complicated by bowel perforation/vascular injury?". Then, having been in service for 3 years, and having performed quite a number of such a procedure, I said none, feeling rather pleased with myself for the clean sheet. He said, "Then you haven't done enough!" and went on with his collection of horror stories associated with PD gone awry during his younger days. No, he's not condoning this practice of unwittingly rupturing guts and tearing vessels, but simply to state a point - even when you have taken all precautions, shit (pardon the pun) sometimes happens. If it hasn't happened to you yet, you're either very fortunate or not doing enough PDs. Since then I have caused 1 case of jejunal perforation; my patient however survived the laparotomy and went home well, if only with an unsightly abdominal scar. Needless to say, I was upset. With that I guess I had done enough. These days, I'm lucky to be able to delegate this task to my HOs trained to do PD. I look forward to the day when stab PD will no longer be mentioned in standard medical text, except perhaps under the section "A History of Renal Support"!

07.07.07

Have you cast your vote? The competition for the New 7 Wonders of The World is on and you can vote online for your 7 favourite heritage sites (out of a shortlisted 21). At time of writing The Great Wall of China is leading the race...wonder if it has anything to do with China being the most populous nation. Malaysia, a young nation relatively, is not represented but please exercise your right. An event of such monumental scale transcends race, nationality and borders. Be a part of this historic, global event. Every citizen on this planet has a right to vote. I've done my bit - and I can proudly declare to my kids years on that I had a part in selecting our new world wonders. My choice? Why, Angkor Wat, Taj Mahal, Machu Picchu, the Pyramids of Giza, the Great Wall of China, Acropolis and Coliseum, of course! The final 7 will be announced in Lisbon on 7 July 2007.

Beatocello!

Let me present to you Dr Beat Richner and his cello...otherwise known as Beatocello! He sings, plays the cello, cracks a joke or two, and talks passionately about his work in Cambodia. On a recent trip to Siem Reap, I had the opportunity to attend his concert and meet him in person. Dr Richner is a Swiss paediatrician who helped set up several non-profit hospitals in Siem Reap and Phnom Penh offering free medical treatment to sick children
(www.beatocello.com/Assets/richner_history.html). The operating costs of these institutions are funded by donations alone. In between his cello solos, we were shown videos depicting the sad state of healthcare in Cambodia. Picture this : mothers ambubagging their own children for there was no ventilator, children getting infected with HIV-tainted blood as there was no facility for donor blood screening, the still widespread use of chloramphenicol as a first-line drug for the lack of a better but more expensive option. His point is, why is it that standards deemed unacceptable in the developed world still apply to poorer countries? Aren't these children worthy too, simply because they come from a less-privileged background? Well, he is a remarkable man, and the locals speak highly of him. Wished there were more individuals like him around.

Beatocello plays every Saturday at 7.15pm at the Jayavarman VII Hospital auditorium. If you happen to be in Siem Reap, take a break from the temples and go experience Beatocello. It might be life-changing.