An NS Boy's Earnest Attempt at an Excuse

Background:

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.

Driving Me Nuts

Me: Any other complaints , sir?

Patient: (silence)

Me: Hmm. Ok, Do you have A?

Patient: Sometimes.

Me: When you have A, do you get B?

Patient: A bit.

Me: What about C?

Patient: Ya, sometimes.

Me: D?

Patient: Oh yes. Occasionally.

Me: Er....

Patient: I have E too!

Me: (exasperated)

(Warped) Logic

An angry patient on why he was kicked out from an allied health providing unit, allegedly because he wasn't liked.

Patient: I guess i know why the nurses don't like me. 'Cause i don't like to talk to ladies.

Colleague: I think maybe your (explosive) tone plays a bigger role.

Patient: But you see, at home I also talk to my wife like that; how can these women expect any better?

Me and colleague: ...

What Kind Of Service Is This?!

'Oi!!!!!!!'

An irate family yelled at the top of his lungs and launched into a tirade of abuse against the nurses, exasperated that despite his mother's call bell rang twice, there was no one attending to her bursting bladder.

Nevermind a nursing senior tried to placate him and had apologised profusely, he became more abusive in language. A young nurse saved the day by bringing in a bedpan, averting a potential major disaster where the patient floods the entire emergency room with her huge volume of urine produced over the eternity of last 30 minutes (a nurse attended to her barely half an hour ago), drowning those who had the misfortune of devoting their life to medicine and nursing in the emergency room, along with the other patients...

'WHAT KIND OF SERVICE IS THIS?!'

Folding his arms and flushed with anger, he majestically glared at the healthcare minions that scrambled at his roar.

I had the misfortune of being his mother's attending doctor. But that did not stop me from being indifferent. I walked away to see another patient, to save a life potentially, rather than getting tangled up in PR mess.

Some people are just impossible.


How do you rate a hospital's service?

What is the benchmark that you judge the quality of your hospital experience against?
What, really, is your expectation of an emergency department?
What, do you make of nurses?

Dear friends, please bear in mind that a hospital is neither a restaurant or a hotel.

A hospital's primary purpose is to care for the sick (all of them, which in a busy emergency department like ours, amount to at least 500 patients a day), and when resources are adequate, secondarily we try to keep everybody happy and satisfied while at it.

Contrast this to other major service industries where customer satisfaction takes a whole lot more importance. Theirs are industries revolving around expendable needs and luxuries, where they are free to outprice low-income segments just to afford the level of services expected of them.

Hospitals just cannot afford to behave like hotels, restaurants, or airlines.

Consequently, nurses are not there to serve your every fancy and need at the flick of your finger like waiters or bellboys that subsist on your goodwill and tips. Theirs is a profession to serve sick people in need. Caring and tending to people with genuine health issues is their calling.

They are not your butlers/waitresses/cabin crew/cleaners/janitors. So do not expect the same service from my nurses.

Your average waitress doesn't wipe your bottom when you lose control of your asshole, does she? She probably will scream at you, get disgusted, and throw you out of the door.

Your average hotel concierge won't entertain you if your wallet is bone bare, save checking you into a room. Money comes first, your need will only be met as much as your credit limit allows for. Nurses don't give a fiddler's fart about how poor you are. As long as you are sick, you are their patients.

So if you want to boss around, go to Resorts World. If you are sick and you still want to boss around, try private hospitals.

However, if you end up in a government restructured hospital, please remind yourself that we are spreaded extremely thin with limited resources, and we have no choice but to do some serious prioritization all the time. In another word, we decide what is important and gets our attention first, not you. Some tasks will just have to wait, within reasonable confines of course.

We cannot attend to a bursting bladder and a blocked heart with the same urgency just to keep you happy. You cannot afford to have us do so too. Think about it.

So what kind of service is this?

HEALTHCARE SERVICE. Thank you.

I Will Never Look At Deodorant The Same Way Again

I have seen many similar XRs before but little did i suspect one day i will have the fortune of seeing one myself.

So far, i notice a unifying theme in their presentations.

It's usually a fall landing on buttock.
Somehow there's a cylindrical object of considerable girth that happens to be sitting upright on the floor at the point just where the anus will eventually end up at.
Somehow the cylinder stays resolutely still in the face of a crashing asshole, rather than tumbling aside as i would expect.
Somehow the cylinder has such a smooth entry into the rectum that there's absolutely no evidence of external injuries/tear around the abovementioned orifice. I mean, we are all a bunch of tight ass-ed people aren't we?
And sometimes, somehow, after retrieval of the object, there's a condom sitting over the top of the cylinder that the patient conveniently forgets to tell you about.

Come on, just tell us upfront what you were up to. The cylinder may look like a rocket, but it definitely isn't a rocket science to figure out.

Honesty is the best policy. My sympathy takes a free fall down the vertical cliff the moment you try to convince me of the plausibility of the above Somehows.

Recalcitrant Patient

*Names and identities changed in this article. Coming next: The nuances of keeping clean, and cleaning...

'Morning Mr Liew', greets the consultant running the morning rounds. 

Mr Liew turned over to look at us quizzically, his head still nesting in the comfort of pillow. Peering at us intensely through fatigued eyelids that refused to hold up, he nodded at us once, and went back in search of deep slumber. 

Out of luck. The registrar goes on to pat at his shoulder repeatedly, much to his dismay. 

'Afebrile, vitals stable. Sats 99% at room air. Input and output...' I mumble as i read the clinical chart, while the MO(medical officer) scribbles at the case notes. 

I glance about the bed in the meantime, sizing up the patient in the clinical sense. Mr Liew is a new patient that was admitted while i was away so i have no knowledge of his diagnosis at all. 

A middle age chinese man, unkempt and unshaven, his appearance tells a tale of someone who did not have the favours of life shining upon him. His coarse features have a certain air of rebelliousness. Wearing a double chin and a sizeable beer belly, he probably was not too scrupulous about his health. Grinning at us with a display of yellow-stained teeth, he must have smoked like a chimney. I wonder what his problem is. 

The consultant goes to the end of bed and begins pulling the carefully tucked-in blanket out. 

Mr Liew shifts his weight around lazily as the blanket is being pulled away. I notice something moving in the pocket of his patient shirt. 

Through the thin yellow fabric, i can make out the rectangular shape of the object. Unable to tell what it is on first look, i turned my attention to his left foot, which is much more relevant than whatever that nestles in his pocket. 

He has had a transmetatarsal amputation (think chopping all toes and half of the foot transversely) of his left foot, exposing an array of cross-sectional bones and tendons buried within flesh. 

Being a patient of my team of doctors, this can only mean he has peripheral arterial disease, a condition where arteries in the peripheries (especially lower limbs) get clogged up with cholesterol or narrowed, causing the toes and feet to die off. 

The typical patient is an elderly man/woman with poorly controlled diabetes, hypertension, high cholesterol, and smokes too. However Mr Liew is only 40 years old. 

Listening to the conversation between the consultant and patient, i am shocked to discover that Mr Liew had an episode of cardiac arrest during his current hospital stay too. 

40 years old. That's really too young to have so many health issues. 

'When can i go home?' The patient asks impatiently, and rather animatedly as we inspect the condition of the amputated foot. The consultant has a hard time trying to convince him that he is not well enough to go home. 

Holding a sterile dressing towel in one hand, i lift whatever is left of his left foot up with another hand. As i lift his left foot high up to slide in the dressing towel, the mysterious rectangular object in his pocket slides out. I feel the same surprise that punters winning jackpot must have felt, minus the thrill. 

It's a box of cigarette, complete with a pictorial warning of a gangrenous foot. How fitting! 

I can literally see dark clouds hovering over the consultant's eyebrows. I can almost make out the sound of thunder as he chastises the patient for smoking. I steal a look at the sky outside, thank goodness it is a clear day with plenty of sunshine. 

Mr Liew looks at us defiantly, and shrugs his shoulders. I swear all of us look really defeated at that moment. Sometimes all the advances in modern medicine seem so futile. 

Why smoke again? When it has caused you to lose half of your foot? When it has made your heart stop once? 

I have no answer to that, and I hate to admit that i see traces of my friends in Mr Liew, friends that i care about.