LULU!

We love this word. We don't know its origin, or how it crept into our vocabulary.

lulu (n.)
one who has been duped / easily duped

Several examples to illustrate its meaning :

Scenario 1
I was at McD trying to get some take away dinner. There were 3 counters, only one of which was operational. I went to an empty one, but no one was manning it, and no one intended to (there were idle staff members milling around, looking busy). As soon as I joined the queue, a staff opened another counter and immediately served a lady who had just walked in. I swear she saw me come first. I felt like a lulu.

Scenario 2
I caught POTC : At World's End last week. Felt rather pleased I could get tickets. Enjoyed the movie, though the ending was less than ideal. Cleverly surmised that a 4th movie was definitely on the cards, as there were loose ends and no closure. Capt Jack Sparrow lost his Black Pearl? Will was separated from Elizabeth? Learned today however that there was a "second" ending, which came up after the credits. Yes, you guessed it. I felt lulu-fied.

Scenario 3
This is a frequent occurrence at Baskin Robbins - being short-changed. For instance, the bill says RM 22.06. If you pay RM 22.10 you won't get any change back. They won't accept RM 22.00 either, because you're 6 cents short. They think we are lulus.

Get it?

You Are In My Way

Two words : Selfish + Inconsiderate


This car belongs to my neighbour, and it's parked outside everyday. Of course, my portion of the driveway is trespassed and sometimes I have difficulty reversing my car out of the porch. That's all right, Mr Neighbour. Your action is perfectly understandable, given that you don't want to block your own driveway so that your family members will find it a breeze to drive in and out everyday.

Motivation note to self : Make tonnes of money so that someday I can afford to be a hermit holed-up in some posh one-elevator-to-one-unit condo.

Round And Round We Go

Life is an endless series of rounds.

This downward spiral (pardon the pun) is detrimental to members of my team. Here's how :

• my FEET hurt - even Clarks and Hush Puppies can't save me


• my THROAT hurts - from repetitive case presentations
  


• my HOUSE OFFICER hurts - from scribbling what is essentially the same information over and over in the patient's notes

• my PATIENT hurts - how many times does an abdomen need to be palpated?

• my NURSE hurts - HO says to turn off the oxygen, MO says to put it back, specialist says to change to oral antibiotic and remove IV cannula, consultant says to continue with IV. Huh?

• the ENVIRONMENT hurts - God knows how many trees we can save by cutting down on paper use, which can be achieved through minimising entries in patient's notes. If it's going to be a seen by aka S/B entry ending with a continue same treatment aka CST entry, why bother duplicating it?

I don't know a better way to do it, but multiple ward rounds are counterproductive.

Everybody Hurts. Maybe REM was really singing about us.

Home Alone

I am home alone.

Hubby's been doing back-to-back calls. He is the one man in a one-man unit - no surgeon, no fellow trainee. And all this in a teaching hospital! The higher authorities want the show to go on. Comply, or risk being kicked out from the programme. Hardly a choice.

And so one man has to pack his clothes and move into the hospital. Watch TV with the nurses, eat out alone, send dirty laundry to his parents' house (nearer) and get bitten by bugs that occupy his call room bed.

And somewhere, about 90 km away, his wife comes home to an empty house everyday, finding no one to listen to her b***h about the horrible things that happened at work. She too has to dine alone, and is running out of meal ideas. Having now to drive herself in search for food, she sticks to familiar places (mainly along the route from home to hospital and back!) - she's been lost in this town on more than 1 occasion. She's fine otherwise. Laptop + Internet connection + DSLR + car that takes me places - man = FINE. Of course, Laptop + Internet connection + DSLR + car that takes me places + man = PERFECT!

A typical homemade dinner

Can't believe 1 month is nearly up. I will soon be home alone...no more.

Bragging Ladies

During a ward round with my consultant, she pointed out an old lady whom she knows personally. This lady speaks proudly of her children to anyone who would listen; both have successful careers in UK and Australia respectively. Yet, she is alone in her twilight years. No one visits her in the ward. I was instantly reminded of a Petronas Chinese New Year TV ad, which I loved.



I look forward to these gems by Yasmin Ahmad every year.

Not A Playground

There's a presence in our hospital corridors or wards I strongly feel we can do without.

It is that of children's laughter, merry-making, play.

I remember the times when my mother was admitted to a government hospital. My dad would leave my brother and I at the hospital playground while he went up to the ward to see my mum. I used to think that cruel and not very child-friendly, but this rule was not made without good reason.

I'm not Scrooge, but I don't like the sight of children in my ward. We see toddlers lying on hospital beds, kids crawling under the beds or chasing after one another while their parents look on with adoration. There's a potential hazard at every corner waiting to befall these little ones - trolleys and drip stands they could knock into or over or dirty slippery floors they could slip on. There's also an unseen danger - nosocomial bugs they could pick up. If we have to allow children into the wards, more supervision is required.

Kids will be kids, but the hospital is not a playground.

Not My Fault

How do you apologise for something that's no fault of yours?

Over the years I have had to put on a brave smile to endure hostility, anger and disappointment hissed at me from disgruntled patients. Drip finished, still not replaced. Drugs administered late. BP not checked but charted. Urine bag on the verge of bursting and not emptied. Bed too high. Bed too low. Ward too hot. My MRCP training dictates that I have to be impartial, objective, calm and empathic. And so I have always been impartial, objective, calm and empathic. I always apologise on my nurses' behalf, on the hospital's behalf, and heck, on the Health Ministry's behalf! All this while the patients, sensing a diplomacy they mistake to be guilt or fear, intensify their tirades against all the wrongs that have been committed against them.

We have nursing sisters who should be overseeing such things. Today a patient of mine complained incessantly about poor nursing practices that had befallen her (she being a former nurse herself). I asked my ward sister to join our "discussion" (mostly one-way sonar traffic with the patient doing all the talking and us listening) hoping that she could come up with some solutions.

She spent the whole morning grumbling about how she always had to apologise for things she didn't do! Hmm.

These days, I take diplomacy a bit further. I take the patient's side. Ever so subtly I nudge them towards making a formal complaint. Let the hospital director hear about our shortcomings. Maybe then things will improve.

We always have to learn the hard way, don't we?

Hair Woes

I'm a low-maintenance woman.

I couldn't sustain a high-maintenance existence even if I wanted to. I hold an unglamorous job, and while I maintain that style AND substance will get you far, I'd look out of place all dolled-up. Not in the hospital anyway. My only indulgence? Trips to the hair salon.

Of late, these trips have become somewhat stressful, and not unlike a visit to the hospital. Here's how :

THE WAIT
Sure, some salons entertain walk-ins; the hot shot ones by appointment only. There's no numbering system, no irritating ding-dongs indicating your number is up. But you wait, nonetheless.

NO CONTINUITY OF CARE
Then, the person you trust with your hair is not always available. He may be on leave, or held up with another patient...I mean customer. Darn, but he knows my hair history. Are you sure the junior MO...I mean stylist, is competent? Which hair design institute did he graduate from anyway?

MORE THAN YOU BARGAIN FOR
I come for a wash-and-cut, but I always end up with a new diagnosis that requires further treatment. Hair too frizzy. Scalp too greasy. Colour fading. Excessive hair loss. Each time there's a new - expensive - product to be purchased to avoid further complications. If my hairstylist conducts a spot-check of my bathroom he'd conclude that I'm a customer who practises polyhairproduct-y but who has compliance problems (bottles and bottles of unfinished hair products).

THE DEFAULTER
My stylist expects to see me more frequently than I can afford (both temporally and financially). He says, see you in 6 weeks for a trim and I don't turn up unless my bad-hair days become more intense, more frequent and occur even when I'm not post-call. I'm a bad customer, but I have no time.

Phew, lucky for me I'm not into facials, manicures or pedicures.

The Wedding

I'm attending the wedding of a long-time friend today.

I'm looking forward to it despite being day 2 post-call - stressed-out skin, less than sensational hair, a pair of tired-looking eyes and some insect bites on distal extremities which I could in no way cover up (Insect bites? Probably from bugs that co-inhabit the bed in my on-call room).

I'm looking forward to it because I'd be meeting up with people I grew up with, way way back in the pre-Blogger, pre-YouTube, pre-Friendster era. It's nice to see what varied lifestyles we have each pursued. It's even nicer to celebrate our similarities, that we can still pick up where we left off and laugh at the same silly things.

Mostly though, I'm looking forward to it because hubby and I could pretend that we are celebrating our other wedding anniversary (which falls on the same day) in a swanky hotel on another person's expense. Mwa ha ha ha!

Now, how do I assimilate a DSLR into my look without looking like an overdressed photographer on the job or a pretencious wanna-be photographer?

*Other wedding anniversary : when we threw a dinner reception to celebrate our marriage which had taken place earlier

What's In A Name?

Took the lead from Jimbo and decided to check out a name-bestowing site. Wow, I can have a monster or sexy or cyborg name!

Get Your Cyborg Name

Get Your Sexy Name

Get Your Monster Name

It's silly but fun. Harmless and surprisingly delightful on a post-call day!

Food For Thought

TODAY'S SPECIAL

hors d'oeu-vre

Bread and butter

soup du jour

Cauliflower soup

entree

Pizza Pie with Swiss Cheese

or

Grilled Salmon with Anchovy Sauce

dessert

Strawberry Ice Cream

Coffee or Tea

What a doctor/pathologist may envision instead :

Anchovy sauce pus of a liver abscess


Pizza pie (?new fusion food) appearance in CMV retinitis

Strawberry cervix of trichomoniasis

Cauliflower-like growth of a laryngeal papillary squamous cell carcinoma

Bread and butter appearance of fibrinous pericarditis (you'd have to drop the bread on the floor to leave that kind of texture!)

Swiss cheese appearance of emphysematous lung

We see food in everything.

Thin...and Loving It!

I have a positive body image. Well, some parts may be entirely delusional, but if I like myself with conviction - false belief or otherwise - that's a good thing. I learnt from a tender age not to take things at face value. Looks-aren't-everything was my mantra because, well, I was more brainy than I was pretty. Smacks of sore loser-ism, I know. I'd just rather call it positive body image. After all, my husband (then boyfriend) saw beyond my pimples and orthodontic contraptions, and he always thinks himself lucky to have me! (All husbands think that of their wives, I reckon.)

So why did it bother me so when more than 3 people I met over the weekend commented, similarly, that I had become thinner? Well, thin is supposedly good. I've been thin all my life. But now I'm thinner! Those remarks did not have a complimentary ring to them; they were more you-poor-thin-thing-what-happened-to-you kind of remarks. Do you know what's disturbing? The fact that I was sufficiently bothered!

I weighed myself that very night. I hadn't done that in a very long time. I just wasn't weight-conscious (remember, I have a positive body image). I discovered that I hadn't gained a single ounce since the fifth form! Boon or bane? I feel healthy. I eat heartily. I am clinically euthyroid. My body mass index is well within the normal range for Asians. Why was I bothered at all?

(Chant) Positive body image...positive body image...

I guess I allowed myself a moment of frivolity there. There are a lot of people out there whose obesity is no choice of their own, or underweight persons who are that way because of medical reasons. Me? I should just be glad that there are labels that carry my size, or a seat that fits my rear, or food that I can eat without ever having to count every calorie. The next time someone calls me thin, I'll thank him for the compliment!

Fashion Tips for MRCPians-to-be

You are what you wear.

Why do you think we're made to wear white coats anyway? A robe doesn't a good doctor maketh, but until one opens his mouth or touches the patient, he can fool anybody into thinking that he is competent. Because he wears the white coat and looks the part. Also, added bonus if he wears the tie too!

So how do you look the part going for exam (specifically MRCP UK)? Admit it, it's relevant and pertinent. And don't judge me because I spent time fretting over what to wear on my exam day. I had worked hard, and I wasn't about to let a less favourable first impression cloud the judgement of my examiners.

Concern #1 : Hair
Bun? Too severe. Ponytail? Too girly. Long and loose? Too unkempt. I ended up pony-tailed. A friend of mine took it a step further - she got her hair done in a salon just hours before the exam. Well, she passed!

Concern #2 : Top
All right, we all agree that the powersuit is the safest bet. Very professional. I was undecided on the shirt. Pink? Again, too girly. Blue? Probably. I finally opted for a white Victorian-style blouse with some lace trimmings. Feminine, but subtle.



Concern #3 : Bottom
This was the tough one. Skirt or the pants? In the end, the skirt for me.

Concern #4 : Shoes
Flatties? Pumps? Heeled-pumps. Needed to look taller lest they think I look too juvenile to become a physician.

Concern #5 : Brain
The most important fashion accessory. I operate on many modes - sharp, confident and pleasant, or slow, sluggish and stammering, or high-strung and fidgety. I think I wore my brain well that day, when it mattered the most.

So there, I was what I wore on my exam day. I was definitely assessed based on my skills as well as my appearance. Don't call me shallow. I am of substance, but I do not think style and substance have to be mutually exclusive.

*Even the Singaporeans put emphasis on appearance. There's a section in Look and Proceed - a useful clinical skills book written by Singaporean doctors - that teaches you how to stand when you face the examiner, where to "hang" your steths when idle etc. Like, seriously.

Old Is Gold

People say I'm good with old people.




I'm more surprised than flattered. Who, me? I'm hopeless with old people. I can't remember the components of a mini mental state examination, and so I can't perform one without reference. I don't deal with age-related complaints very well - the aches and pains, constipation, poor vision, the forgetfulness. To make up for my lack of experience in geriatrics, I inject an extra dose of kindness in my approach.

How do you not feel compelled to be 10x nicer to the pakcik in shabby clothes with a backpack and an umbrella who had travelled in a bus from another district just to see you in the clinic? Or to a polite octogenarian with a walking stick who drove himself to the hospital but had to take a RM2 cab ride from the car park (about 2 hills and a mortuary away) because it was too far for him to walk? I think we owe it to these elderly folks to spend more than the customary 5 minutes to take a BP and ask close-ended questions. Find out how they came, who they live with, what they used to do, what they do now.

Have a heart, people. We'll all be droopy and saggy and wrinkled one day too.

This Is What I Think...

"Good course...compulsory for anyone even thinking of attempting PACES!"
Dr VMA, Tunku X Hospital

"Intensive...it whipped me into shape; so crucial just weeks before the real exam"
Dr FBC, University Hospital

"The best course available locally...book early to avoid disappointment!"
Dr ABG, Oh Pee Dee Clinic

Very cheesy comments, reminiscent of those gosh-it's-so-good kind of remarks you'd find in the inside covers of paperbacks.

You see, I have been asked to submit a comment on last year's PACES preparatory course organised by the country's premier private medical university for use in their promotional flyers for this year's event (since I was a participant...and passed!) I presume they want only good comments, but the first thought that sprang to mind was, it's not cheap! Well, the PASTEST courses in UK cost much more, but I hear they are really good. The price has escalated this year for the prep course in Singapore, but then NUS brings in good tutors from UK. A few years back, they had Dr Praveen Kumar (the Kumar of Kumar and Clark)!

So what of the local course? I can't really compare, this being the one and only prep course I've ever attended, but we have our share of prominent local clinicians who are actual MRCP PACES examiners. Can't say much for the cases though, but then again the patients were mostly from my hospital so it didn't feel like we were seeing fresh cases. What was important to me though was the opportunity to size up the competition - people you would be up against on exam day.

But guess what? I walked out of the exam ward grinning and shaking my head in disbelief. I had for my skin station a gentleman with pachydermaperiostitis, which I took the trouble to read up after coming across this big word in PACES MRCP. And it's free.

Seriously.

Little Kathmandu

There's an outbreak in my ward.

An outbreak of err...Nepalis!

I had a field day on my call last Saturday receiving one Nepali after another. Poor guys. To leave your home country for the promise of wealth and a better life in bolehland is one thing, but to get bitten by the evil Aedes aegypti and end up in a third world health institution where nobody understands a word you say, is surely something else.

Some spoke a smattering of English, and some, remarkably, Malay. Then there were some who spoke neither, but somehow history taking was accomplished with the help of wild gesturing. I say wild because - trust me - there is no genteel way of communicating the meaning of vomiting, bleeding or diarrhoea. The only word I know to utter in Nepali (or Hindi, I think) is namaste, but I usually spare them the agony. I mean, there's only so much nee hao mas or apa khabars you can stomach from gwai lohs who visit our country, so I won't do the same to these poor Nepali souls.

None of them pulled a bleeding, plasma leakage or shock stunt on me that night (despite the fact that my very considerate boss Jimbo turned up in a RED shirt!). I hope they get well and get out of the hospital soon. And that they will return to their beautiful country Nepal when they have made enough money, where there's little chance of falling ill with dengue fever.

*bolehland = Malaysia, where nothing is impossible
Aedes aegypti = the mosquito vector that carries the dengue virus
namaste = ?hello and good day in Hindi
nee hao ma = how are you in Mandarin
apa khabar = how are you in Malay
gwai loh = cantonese slang for "white man"

Shattered Glass

Did you catch this in your Sunday paper?

"KLANG : A couple had the shock of their lives when the windshield of the car they were travelling in shattered into thousands of pieces.

Mr and Mrs K were on their way back to Seremban. The incident took place at 2 pm, just as the car was approaching a flyover several kilometers away from the Kota Kemuning toll plaza. The otherwise pleasant journey was ruined by a loud crashing sound, followed almost instantaneously by cracks that formed radially from the point of impact. They did not know what hit them.

Mrs K was furious. Although there was no eyewitness to attest to her claim, she was certain a stone had been thrown in their direction. "We were not trailing any big trucks carrying debris or rocks so it could not have been a stray pebble that hit us. There must be someone on that fly over intentionally hurling an object at us. What scums! Don't they know that lives could be lost? We could have lost control of the car; the glass shards could have injured us. What kind of sick people are we raising?" Mr K was also visibly upset. He had lost his prized collection of car stickers accumulated from the different places he had worked in.

Car stickers beyond salvage

Traffic was not disrupted. The said flying missile had not been discovered, but police have yet to rule out any foul play. No KESAS official could be reached for comment."


That sort of summed up my weekend. A damaged car, no Spidey ticket, and pathetic broadband service.

An Everyday Hero

*This fine piece of art work is the property of Gustav Klimt

I could submit a heart-warming story of her to the newspapers, for a shot at the attractive prizes at stake. But you know what? It won't win.

She has no superpowers. She is not perfect. She has bad days. She has quite a temper. She doesn't drive. She raised us with a lot of help from her husband. She never walked through fire or parted oceans. See? I have no mother-overcoming-adversaries kind of tales to share.

So mum, you'll have to settle for a blog spot instead.

You are to us in ways that other people will never understand. Simply put, there's only one of you in this whole wide world. And for that, you're our HERO.

Happy Mother's Day!

*This is a tribute from the daughter who never inherited your infectious-laugh gene, and never found out what day in May Mother's Day falls on. Nonetheless, I hope I've made you proud with... ahem...the good job you did with me!