Tuesday, April 27, 2010

Just for Laughs #12 - A Crazy Patient

*SW = something wrong

Me:                         Morning! How can i help you, ma’am?

Auntie SW:         The rain was really heavy out there.

Me:                         Yup, it’s been raining season lately. How can i help you?

Auntie SW:         You see, i have this condition A that requires me to take warfarin, i have been taking it for ......

(rambling on and on about her disease for the last 10 years for 5 minutes while i was busy accessing my terminal for her old records in the hospital)

Me:                         Yes, i see that you have this condition for the last 10 years, and your last INR test done yesterday was great! But can you tell me what brings you here today?

Auntie SW:         Oh ok.

She flipped out a referral letter from her private cardiologist that she saw this morning. It was directed to the cardiology team taking care of her in my hospital, with a recommendation to lower her dose of warfarin.

Me:                         Hmm. You just saw your cardiologist this morning, and this letter is directed to the National Heart Centre. Where do i fit in this picture?

Auntie SW:         Oh i am going for a cataract operation in 2 weeks time in your hospital.

Me:                         So?

Auntie SW:         Can you please help me update my new warfarin dose in your computer system?

Me:                         Auntie, do you realise this visit costs you 90 dollar?

Auntie SW:         Yes i do.

Me:                         You could have just waited for the day you come for the operation and let them know of your new warfarin dose you know? The nurses then will serve you warfarin at your new dose.

Auntie SW:         But... what if they serve me the wrong dose? I can die from that!!

Me:                         Auntie...... No one dies from bleeding from a cataract op, even if you have warfarin on board. And you could have saved this 90 dollar by showing them the letter on day of admission.

Auntie SW:         Nevermind, i can pay the 90 dollar. Just update my new dosage on your computer for me.

Me:                         Auntie i can’t do that. My emergency room’s record do now show on their electronic prescription database.

Auntie SW:         Can you just try?

Me:                         It can’t be done. (My heart rate presently 140/minutes)

Auntie SW:         Really?

Me:                         Yes.... Auntie, why don’t i just cancel your visit and save you the 90 dollar? You just show your letter on admission as i have told you just now.

Auntie SW:         Hmm... Can you do an INR test for me today? I am willing to pay 90 dollar for that.


(i mildly raised my voice. just mildly, believe me. really. )

Auntie SW:         (sheepishly) Ok then. I go home then. You really cancelling my visit for real?

Me:                         YESSSSSSSSSSSSSSSS

Auntie SW:         Ok then. Bye. (walking out, then turning back) I really don’t need an INR test today?

Me:                         YESSSSSSSSSSSSSSSS. Bye.

Went through the trouble of erasing my entries and instructed the nurses to cancel the visit. So much trouble for saving 90 dollars. She might be dirty rich, despite the haggard clothing.

Was half way through my another consult when i heard a door knock, and the door was opened without me acknowledging first.

Auntie SW:         (popping her head in) Why don’t you uncancel my visit and do an INR test for me?

Me:                         (Heart rate 180/minute, face flushed with anger) I AM NOT GOING TO DO AN INR TEST FOR YOU AND YOU STOP WASTING MY TIME! GRRRRRRRRRRR

Auntie SW:         Ok ok... sorry.... (sheepishly went out again)

Being a doctor is a real health hazard. My cardiovascular risk must have gone through the roof that day.

Tuesday, April 13, 2010

Sharing: Be lucky - it's an easy skill to learn

Be lucky - it's an easy skill to learn
Those who think they're unlucky should change their outlook and discover how to generate good fortune, says Richard Wiseman
Richard Wiseman
Published: 12:01AM GMT 09 Jan 2003
Comments 1 | Comment on this article

A decade ago, I set out to investigate luck. I wanted to examine the impact on people's lives of chance opportunities, lucky breaks and being in the right place at the right time. After many experiments, I believe that I now understand why some people are luckier than others and that it is possible to become luckier.

To launch my study, I placed advertisements in national newspapers and magazines, asking for people who felt consistently lucky or unlucky to contact me. Over the years, 400 extraordinary men and women volunteered for my research from all walks of life: the youngest is an 18-year-old student, the oldest an 84-year-old retired accountant.
Jessica, a 42-year-old forensic scientist, is typical of the lucky group. As she explained: "I have my dream job, two wonderful children and a great guy whom I love very much. It's amazing; when I look back at my life, I realise I have been lucky in just about every area."

In contrast, Carolyn, a 34-year-old care assistant, is typical of the unlucky group. She is accident-prone. In one week, she twisted her ankle in a pothole, injured her back in another fall and reversed her car into a tree during a driving lesson. She was also unlucky in love and felt she was always in the wrong place at the wrong time.

Over the years, I interviewed these volunteers, asked them to complete diaries, questionnaires and intelligence tests, and invited them to participate in experiments. The findings have revealed that although unlucky people have almost no insight into the real causes of their good and bad luck, their thoughts and behaviour are responsible for much of their fortune.

Take the case of chance opportunities. Lucky people consistently encounter such opportunities, whereas unlucky people do not. I carried out a simple experiment to discover whether this was due to differences in their ability to spot such opportunities.

I gave both lucky and unlucky people a newspaper, and asked them to look through it and tell me how many photographs were inside. On average, the unlucky people took about two minutes to count the photographs, whereas the lucky people took just seconds. Why? Because the second page of the newspaper contained the message: "Stop counting. There are 43 photographs in this newspaper." This message took up half of the page and was written in type that was more than 2in high. It was staring everyone straight in the face, but the unlucky people tended to miss it and the lucky people tended to spot it.

For fun, I placed a second large message halfway through the newspaper: "Stop counting. Tell the experimenter you have seen this and win £250." Again, the unlucky people missed the opportunity because they were still too busy looking for photographs.

Personality tests revealed that unlucky people are generally much more tense than lucky people, and research has shown that anxiety disrupts people's ability to notice the unexpected. In one experiment, people were asked to watch a moving dot in the centre of a computer screen. Without warning, large dots would occasionally be flashed at the edges of the screen. Nearly all participants noticed these large dots.

The experiment was then repeated with a second group of people, who were offered a large financial reward for accurately watching the centre dot, creating more anxiety. They became focused on the centre dot and more than a third of them missed the large dots when they appeared on the screen. The harder they looked, the less they saw.

And so it is with luck - unlucky people miss chance opportunities because they are too focused on looking for something else. They go to parties intent on finding their perfect partner and so miss opportunities to make good friends. They look through newspapers determined to find certain types of job advertisements and as a result miss other types of jobs. Lucky people are more relaxed and open, and therefore see what is there rather than just what they are looking for.

My research revealed that lucky people generate good fortune via four basic principles. They are skilled at creating and noticing chance opportunities, make lucky decisions by listening to their intuition, create self-fulfilling prophesies via positive expectations, and adopt a resilient attitude that transforms bad luck into good.

I wondered whether these four principles could be used to increase the amount of good luck that people encounter in their lives. To find out, I created a "luck school" - a simple experiment that examined whether people's luck can be enhanced by getting them to think and behave like a lucky person.

I asked a group of lucky and unlucky volunteers to spend a month carrying out exercises designed to help them think and behave like a lucky person. These exercises helped them spot chance opportunities, listen to their intuition, expect to be lucky, and be more resilient to bad luck.

One month later, the volunteers returned and described what had happened. The results were dramatic: 80 per cent of people were now happier, more satisfied with their lives and, perhaps most important of all, luckier. While lucky people became luckier, the unlucky had become lucky. Take Carolyn, whom I introduced at the start of this article. After graduating from "luck school", she has passed her driving test after three years of trying, was no longer accident-prone and became more confident.
In the wake of these studies, I think there are three easy techniques that can help to maximise good fortune:

  • Unlucky people often fail to follow their intuition when making a choice, whereas lucky people tend to respect hunches. Lucky people are interested in how they both think and feel about the various options, rather than simply looking at the rational side of the situation. I think this helps them because gut feelings act as an alarm bell - a reason to consider a decision carefully.
  • Unlucky people tend to be creatures of routine. They tend to take the same route to and from work and talk to the same types of people at parties. In contrast, many lucky people try to introduce variety into their lives. For example, one person described how he thought of a colour before arriving at a party and then introduced himself to people wearing that colour. This kind of behaviour boosts the likelihood of chance opportunities by introducing variety.
  • Lucky people tend to see the positive side of their ill fortune. They imagine how things could have been worse. In one interview, a lucky volunteer arrived with his leg in a plaster cast and described how he had fallen down a flight of stairs. I asked him whether he still felt lucky and he cheerfully explained that he felt luckier than before. As he pointed out, he could have broken his neck.
Richard Wiseman is a psychologist at the University of Hertfordshire. His book, The Luck Factor (Century), is available for £9.99 + £1.99 p&p. To order, please call Telegraph Books Direct on 0870 155 7222.

An NS Boy's Earnest Attempt at an Excuse


Time and Place: Sunday morning, in P3 (Priority 3) clinic

Quirk: Instead of the usual mix of elderly and young people looking genuinely sick, all the patients lined up to be seen were:
  1. 18-19 years old who were supposed to be ghettoed inside National Service Camps (NS boys)
  2. dressed up so well that they should have been in a mall instead. And also wore perfumes.
  1. pink rosy cheeks
Me: struggling hard to spend more time on genuinely sick patients while sifting through a pile of NS boys flocking to the ED to get medical certificates to delay going back to their camp after a long weekend.

Me: cough? colour of phlegm?

NS boy 1: yes. green.

NS boy 2: yes. slightly greenish yellow.

NS boy 3: yup. tinge of green.

NS boy 4: cough so much that my throat hurts, and the phlegm i spit are all greenish!!
. (patience wearing thin)

NS boy N: yes. the sputum green in colour loh!

Frustrated at the same predictable answers to all my questions, as if they were all using the same ’NS Boy’s Handbook to Getting Medical Certificates’, I slammed the table and blasted.

Me: Why all the NS boys are coughing out greenish sputum?!

(NS boy N was shocked by the sudden hostility, hence a pause of few seconds, looking contemplative)

NS boy N (sheepishly offered) : err... maybe water in Tuas ... not clean?

I fell off my chair.