‘Rude’ is an understatement.

Never thought I would actually have to put this up – one day! July the 13th, 2017 is the fateful day! With the mayhem that it was, it is a wonder that it was a Thursay, and not Friday the 13th :p

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Many a days, I’ve been irritated and irritated-politely ask patients to continue their conversation or pick up that call later. That wasn’t the issue today, though. Should have been NO GADGETS during consultations – I might create my own – Grrrr.

***

Ranting time, here goes:

She walked in with her semi-cracked-screen tablet into my room.

In the first quarter of my work shift today, within minutes of being seated, she was complaining about my colleague that I referred her to for a procedure – my RED FLAG mode was on! I defended my colleague (as per professional ethics) & in fact apologized on the other doctor’s & clinic’s behalf for her feeling that way (she claimed she was treated rudely and made to wait without having the procedure done, not once but twice).
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While I was having a look at her results, asking further history, and printing out some documents, madam was meddling with her tablet while talking (mostly complaining) to me. I was irritated, thinking ‘Behaving like a teenager, who doesn’t know what respect is’, but decided to keep quiet.

While auscultating her lungs from her side, she was still holding the tablet & that is when I noticed there was a moving image of hersef on the tablet – she was viewing a video of herself she recorded earlier! And I saw my wall-mounted otoscope & opthalmoscope on her screen background!!

She finally placed her tablet down when I queried, saying that is her own recording, nothing to do with me. The video recording was still running silently.
I completed auscultation (I guess I did my job still, despite my prejudice & irritation) & 
kindly asked her to delete the video.
Sshe said it is her own thing, nothing to do with me.

I asked her to show the video to me, she showed the first file, her mouth was moving as if she was talking – but it was a silent version. Horrors of all horrors, I saw part of the comment accompanying the moving image on her tab “Hey guys, …see an X’s nose…(few sentences long – a paragraph) following that, which I couldn’t read as she hid the comment & it started playing just the silent video.

?life recording
?uploaded to social media
I masked my pissed-offness & still politely requested her to delete it NOW.
Once again, she challenged me that it has nothing to do with meI said it is unethical of her to record something in my room (during a doctor’s consultation) without my permission, as there would be background noises of our conversation.

That is when I lost it.
She : Don’t worry, I didn’t record you. I just recorded myself.
I      : sarcastically Just because I don’t have a sign up saying you can’t record, doesn’t mean you can do it.
She : rudely Yes, you don’t have a notice in here. I know my rights

I      : It is common (almost said common sense) courtesy & knowledge

She : You don’t have to worry, I didn’t say I am at this doctors

I requested her to show me the video with volume & the words she has typed (I reached out for her to show me). She hurriedly pulled her tablet away & packed it into her bag, saying “You aren’t touching my tablet!”

I firmly told her to delete it now in front of me.

She : I know my rights. You just give me my MC

That was her agenda all long for the day, which I sensed from the beginning.
I       : I can’t help you as you are rude

She stomped out saying she will see another doctor to get her MC.

*
Still couldn’t find the exact sign I am looking for – no use of gadgets/photos/recording during consultation (unless if you are a kid accompanying parents, then keep the volume minimal). 
This is probably the closest to what I am looking for:
No Cameras No Cell Phone No Video Sign

Source: http://www.mysecuritysign.com/fos/no-cameras-no-cell-phone-no-video-sign/sku-s-8871.as

But then again, some smart-arse might say “There is no ‘No Tablet’ sign”
ROLL EYES!

#whencommonsenseaintcommon

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A Random Stranger

After handing over my car-key for service, was in line at the coffee machine when this elderly (old-old) gentleman, X caught my eyes. The manager was personally attending to him, making him a cuppa off the Nespresso machine. X was regaling a story about his 98year old friend, this lady who…blah blah blah.

With my hot cup of wake-me-up expresso in hand, I headed to the lounge & as what most of us are guilty of doing, started scrolling my phone. All along, couldn’t help noticing X out of the corner of my eyes & unintentionally eavesdropping on their general chats.

I smiled as X took the seat opposite myself.

X    : (returning my smile) Are you a customer here?
Me : Yes, I am (shutting my phone cover)
X    : Me too.
Pause. He took his seat.
X    : Are you buying a car?
Me : Nah…servicing.
X    : Must be a pretty new car.
Me : Almost 4 year old.
X    : If you had a car as old as mine, you’d just want it to not break down anywhere. Laughs
What I don’t like is coming back with a complaint. I was here yesterday. But, well…small issue.
Me : Oh dear. What happened?
X    : looking awkward. It would be very inappropriate of me to speak about it. Look, these guys are good. It is just a small matter. I shouldn’t speak of it.

But I reckon my question scared him! He stopped speaking to me after that, and didn’t entertain my small chats much.

*

Well, Mr Grandpa impressed me big time! 😀

We are a generation of keyboard warriors! Very quick to comment or pass judgements, and make them viral in social medias & make a big hoo haa – a mountain out of a molehill, often. I admired X’s principle there.

I can’t remember when was the last time I made small talk to a stranger who isn’t a customer service person or because you had to. Oh no, I’m lying – there was this young-old gentleman I struck up a conversation with 2 weeks ago while queuing up at the bank. But, you get my drift? It is sooooo rare! I usually check out my social media, or catch up on reading up some interesting article when stuck in queue or am waiting for something or someone. Just like most of us – it is my phone that has my attention! Sad, uh…

Unlike the pre-technology-boom era! Where people, even strangers actually speak to each other to while away time. Nowadays it is common to see families & friends hanging out together in the physical sense, but each to his/her phone. We spend more time virtually than with one another. That is really sad when people do not value those who are in front of them, but glued to their phones instead.

Image result for family phone hang out

Seriously, we must be the most technologically evolved, yet poorest generation when it comes to real-life communications.

*

Back in the car showroom…

X got attention from all the staffs.

As he was leaving, manager told X, “Don’t worry, I’m sure you will bring in your car for service when you turn 100 years old.”

How sweet.

#heartwarming

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The Miracle of Gratitude

Thursday morning, I shared a post that appeared on my Facebook Memory from 1 year ago. Sharing the screenshots here. Kindly disregard the grammatical errors :0

Screenshot_2017-06-29-23-42-46_LI

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In the past year, I’ve treated their 4th family member too, which makes it all of them.


This evening at work, I saw the very patient’s name on my appointment list. That did put a smile on my face 🙂

Little did I suspect after running on time till 750pm, the rest of the night would be a craze! After a maddening hour of attending to emergencies & seeing patients who took longer than their allocated 10 minutes, it was her turn. I was apologizing profusely as she was waiting more than half an hour, actually, close to an hour!

Never in my wildest dreams – such a serendipity!! On the very night after sharing the memory too – WOW!

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She was in last week accompanying her husband who was unwell. That was one week into yet another nasty coughing episode (which finally almost stopped today!)
And today she brought me her homemade remedy of lemon-honey-seasalt as a get-well-soon little something (hope you have already recovered, but you can use this for the future)!
Now now, isn’t that sweetness overload? 🙂

This patient definitely made my day! Blessed I am…

She made me appreciate the law of Miracle too – GRATITUDE!

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The Big-C

The year I entered Medical School…
I had an aunty who was battling terminal cancer. Lost her at the beginning of that year – 2002. Hardly a month after she turned 49!

It was hard to see a dynamic woman bedridden, suffering in pain…to say the least. Berat mata memandang, berat lagi bahu memikul. Literally means ‘as hard as it is on the eyes that see it, the harder it is on the shoulders that carry it’. 

The Big-C! How I hate it…I am sure everyone does.


So, I entered Medical school with the thought of ‘helping people’. Losing a mother figure that I’ve had all my life made me take cancer seriously.  That was one reason I chose palliative care for my electives in Uni. I learnt an essential life lesson : It is from those who are dying that you learn how to live!

All along the journey (student & work-life), determined to do my best for each patient, as if they were a family member (for most of them, anyway).

Perhaps a tad selfish too.
You pray someone else will take bloody good care of your family, near & far – Their Doctor!
You believe what goes round comes round.
We doctors often miss being there for even our family members who are near, due to work commitments. I’ve known doctors who continued working while their own appendix was rupturing…

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Fast forward many many years later…
It struck again, and again.

An uncle of mine – I couldn’t even attend the funeral as I was on-call & couldn’t change the weekend call at such short notice. Although I wasn’t close to him, he has always been kind to us.

Cousin’s Grandfather – the hospital detected Big-C incidentally, only towards the end of his life when he was admitted for pain.

Grandmother – while undergoing palliative radiotherapy.

The latter 2 people lived to a ripe old age.

My best friend’s daddy whom I met at my family wedding, and a day later – lost his battle only few months after being diagnosed!

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About 1 month ago, lost another aunty (my parent’s cousin) to a recurrence. Always enjoyed a good chat whenever we met at family events. She personally shared her journey after losing my best friend’s dad who had a somewhat similar disease, a day after his funeral, 2 years ago. Heard that she was ill again. Was intending to visit her when I go home soon, but it was never to be.
Rest In Peace _/_

*

2 weeks ago…
Another aunty lost her battle to terminal cancer. Another mother figure. All her 3 kids are doctors! Sigh…and we couldn’t do anything, medically! She had to have the type that has very poor prognosis. Isn’t it painful to even read this?
She was only 56!

Thanks to my gem of a boss, I managed to visit her few weeks after her diagnosis – hardly 2 months before her time was up. I still can’t believe she is no more. I have good final memories of her…the last conversation was a short and sweet one during Mother’s Day. She was too ill & I never spoke to her again.
I was hoping against hope & keeping faith that I will get to spend some more time with her again during my upcoming planned holiday, that she will live on to see a few milestones in her family later this year. But…sigh! God had other plans.
Rest In Peace _/_

*
Again and again, it struck & won! Took away people close to me & makes me feel helpless.
A common denominator – some of the loveliest people on planet Earth. Nobody is perfect – they have their flaws. But, they aren’t the type to harm another.

And when it involves relatively young people who have yet to live for themselves – SIGHhhh! 60 or 65 is the official age to be considered old, isn’t it? Why this kind of suffering towards the end? I know…Buddha said Life is Suffering.
But, Karma??? my foot! I am losing Faith in Karma…

Especially when I see toxic people who make life hell for others, being blessed. Okay, so they might be suffering in other ways, that we bystanders can’t see…you say? That’s another story altogether.

Image result for karma is fake

That is, IF you Exist!

But for the nicest people, why of all the things, why Cancer? Why that much of suffering?! I continue questioning…


15 years since my first experience in losing a yet-to-be-old dear aunty to the big-C, and comparing with my latest loss merely few days after celebrating my 10th working anniversary, my thoughts are different now. Losing another yet-to-be-old darling aunty of mine, now my only thoughts are : What is the point of being a doctor?
Both of them came into the families before I was born. They have always been there as far as any memory or photo (of mine ) goes. And just like all the other dearly departed – they join the ‘Memories’ part of life. No more reality.

I hate you, big-C. I hate you from the bottom of my heart!

P.S: One thing that I hate more – Fake news about cures that belittle medical approach! Just like those anti-vaccine movements, I’m seeing alot of anti-cancer treatment posts on social media angerAlternative treatment as an adjunct is fine – Faith wins half the battle. Provided, it IS NOT harmful!!!

tomb

As the age old lesson goes : Treasure people. Tell & do things that you intend to without any delay. Show them the love NOW. Not when it is too late.
Live Life to the Fullest.

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Happy Anniversary to the Doctor in Me  ——<<@

Happy Anniversary to me!!! 10 years…wow, how time flies! So many bittersweet memories…ups and downs…and A DECADE has whizzed past! 😮

Reminiscence

When I graduated 10 years ago, I didn’t have the slightest notion that I’d be where I am today. Am nowhere near my original aim (to be a specialist at this juncture of my career). But then..Hey! Why insult myself by comparing myself with others :p 

I’m my own Hero…in the form of the Future Me! So destinations and timelines change, but the GOAL remains.

11.06.2007 – I still remember my hospital director asked me with some concern if I’ll be okay starting on my own when my other 4 Unimates were given postings in pairs. Little did she know what a survivor I had been in the preceding 5 years! I won’t forget the funny advice from my first ever head of department (HOD) either, on day 1 of officially reporting in for work. After enquiring my marital status, “Don’t get married during Housemanship”! Indeed, “Yes, boss! ” :p

I fit in well in every posting & gained and maintained friendships in my colleagues (and even medical students) better than during my undergrad years. To my surprise, the rotating nature of housemanship every 3-4 months suited me best & I actually enjoyed housemanship (contrary to the general complaints about HOship being toughest years of work life). Always thought I was one made for routine and familiarity – Surprise Surprise…

I was equipped with a high dose of nasty people antibody by then though – that definitely helped heaps in getting through internship (and rotten apples of employers many years later)! Little did I know what bends lay in the road ahead for me…career wise.

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I’ve read somewhere, ‘Imitation is the sincerest form of flattery’. Knowing I inspired some juniors to take up Paediatrics, though I didn’t end up pursuing what I decided on in the 3rd year of my career had felt weird. 

But I’ll never trade my formative working years for anything else – Internship, District posting & Paediatric MOship! They molded me into who I am today. General Practice has been my domain these past 5 years, when I decided to change the direction of my sail…to flyaway. 

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Over these 10 years, there has been many a day and night I’ve wondered & pondered about numerous things about all in a day’s work…even reached the extent of feeling fed up/ burnt out:

  • Being the punchbag in inter/ intradepartmental ‘wars’. 

  • The critically ill patient you’ve stayed up almost the whole night long who didn’t make it the next day. 

  • The deaths that breaks your heart, holding back tears when breaking the sorrowful news to the family & then crying in the on call room or toilet. 

  • Even when you are unwell and working, but have to hand out MC to people who are visibly healthier than yourself. 

  • The non compliant patient who comes down with a preventable complication & you feel so frustrated but realize you limitations in ‘taking the horse to water but can’t force to drink’. 

  • The ones who make you feel that you care for their health more than themselves. Being verbally & even physically abused by patients because you refuse to bow to their demands. 

Those are just tip of the iceberg.

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And then, there are the moments of helplessness when you can’t be there/can’t do anything for family members who are ill themselves, when you wonder “What’s the point? ” 

While you are doing your utmost best in caring for someone else’s loved one, you hope & Pray that your loved ones will be in the care of someone who will leave no stones unturned too ^

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The high stress of dealing with human life doesn’t make any of it easy. To those who think it is a glamorous job, I pity their ignorance. How many people would dream of a job where you deal with all the bodily secretions of another human being? 

All these while being unattached to the patient. Detached attachment was a lesson I’ve learnt well in all these years. 

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And then there are the social occasions and the day to day life where I prefer not to be asked about my profession. Hate lying you see…in case they happen to be your patient some day :/ The numerous times I try not to roll my eyes at the lame ‘MC joke’! Sigh….

And to not appear ‘lansi’ (proud) nor dumb when you are faced with the “Since you are a Doctor, I have this..list of complaints” and similar lines from relatives, friends & acquaintances. 

Seriously, we think and speak enough about work and diseases and hear enough complaints about ailments and absorb negativity in our day to day work life that we would very much appreciate social conversations which doesn’t revolve around the same. I’m sure I can speak for most doctors who believe in work life balance! There are some who will link everything to medical related things – I like to stay far faraway from them out of work setting :p

Appreciate the majority of my beloved family & friends who do not grab the opportunity for a free consultation during the ‘let my hair down’ or holiday moments! :* However, I don’t mind being contacted/asked for an opinion from close ones, especially in times of need. 

The greatest irony in this is that the nearest and dearest are the ones to ignore our advise & concerns…probably seeing us as their ‘little one’ still. Sighh

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BUT…despite all these, it is an Honour! To be given the TRUST. Not because you have gained it. But just because from the dawn of times, Doctors have been privy to not only patients’ physical issues, but emotional and mental issues as well. 
Someone who is a complete stranger gives you access to their personal, and often even intimate details (although in some cases it takes abit of an effort to build the initial rapport). 

And not forgetting,  the occasional ‘darling’ patients, whose mere words or actions reminds you that “It is all worth it”. A simple heartfelt Thank You goes a long way in making our day, trust me. 😀 Knowing we have made a difference, somewhere along the way…touched some lives.

That’s why this is not just another job, but a Passion…a Vocation! That, is the beauty of my Profession. 
When all is said and done, never, ever could I imagine quitting doctoring patients. Doctor = ‘Do cere’ = To Care. 

A special shout out of THANK YOU to all the teachers, mentors, colleagues, nurses & healthcare staffs I’ve had the pleasure to work with in this past decade!  And my regular patients who trust me 😀
Cheers (to myself) to many many more years as a Doctor! May I do no harm & do some good, while maintaining a work life balance _/_ 

And…

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P.S : How am I celebrating this milestone today? Working, of course! :p Yup…a Sunday! It is a long weekend here (Queen’s Birthday) & I’m definitely making this a milestone to remember…pre, mid & post (work) 😉

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AMC MCQ -Preparation

PART 4 of my IMG’s Road to Australia series.

<< PART 3 : Latest update – of EICS, AMC Portfolio & Fee Structure

 

So far, we have gone through the pre-AMC exam sign-up paperworks & setting up your AMC portfolio.
We have discussed about the English test too (which in my opinion is best taken when things are more certain due to the 2year’s validity period).

Next : Sign up for a date for MCQ (Part 1).

Exam format – Single Best Choice (of 5), with NO negative marking!

What next?

STUDY!! 😀 


The best time to take these exams would be fresh out of medical school – will ace parts 1 & 2 without much trouble, no doubt! However, as doe-eyed hopeful new doctors on board in our respective countries, how many of us would have decided to embark on the road less travelled (upon graduation)?

Studying while working is no joke. Especially if you are taking up self study, and there are no official study breaks. But it isn’t impossible! I have come across a good number of candidates who did it on their own salute.

Introducing the bible for AMC MCQ exam – THE BLUE BOOK!

Beautiful explanation for each question. Some of these questions do get tested, though not much. But it covers the common topics & gives one an idea of how to approach the exam.

To be honest, I hardly touched my copy of this book while I was in Malaysia. Working full time didn’t allow me much time to study. And our so-called study dates ended up being movie dates or chill out sessions – LOL.


My mates and I enrolled for the VMPF preparatory course for Part 1 back in winter 2012, in Melbourne, which is now home to me.
VMPF has since changed name to HEAL.

These 2 are among the providers of AMC Part 1 (MCQ) bridging course:
1/ HEAL – 6 week course. Location : Melbourne & Sydney
2/  https://www.arimgsas.com.au/product/online-mcq/ – 5 week course. Location : Melbourne & Online.
It is interesting to note the latter offers Online tutorials too. I don’t know of anyone who have done it, do share your experience if you have.

Both offer trial exams. Even if you aren’t enrolled for the bridging course, but want to assess where you stand, you may give the trial exams a go.

In short, I found the course helpful though tiring. It was a pseudo-holiday in Melbourne. Mainly I was indoor in a heated room, with 20+ other candidates, stuffing our brains with exam-oriented information. We were learning to tackle the questions, the exam technique. The intensive course and the 2 trial exams (at the beginning & end of the course) prepared me well for my exam which was a couple of weeks after my course ended.

I stayed on for 2 weeks in Melbourne & appeared for my MCQ exam here. Main reason being, if I went home, I knew I would have back to the daily grind. Having study partners in the same library helped!

To date, I don’t know my CBD as well as some holiday-goers do! Still exploring it…

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I digress. Back to the Blue Book – managed to finish it during the course, and another round during my study break. The notes and approach learnt from my course & discussions helped me Pass Part 1 at the first attempt. In fact, almost everyone I know from my course Passed at the first attempt.


AMC MCQ exam venues – in Australia & overseas. 

My fellow Malaysians, there isn’t a centre in KL. Bangkok or Singapore would be the closest.

All the best to all AMC Candidates!

Link to Frequently Used Terms/ Acronyms

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Zero Tolerance to Abuse/Violence

So, it is now wrong to ask people to not smoke in hospital premises?
Wrong enough to be punched in the hospital itself?
So does it mean healthcare staffs are just supposed to walk around with eyes yet blind, and tune-off to their surroundings, with a “I don’t care attitude!” and don’t voice out anything that is improper? If we dare do anything, we should be prepared to not only be verbally, but physically abused?

Gosh…we weren’t given that manual in med-school!
Should we incorporate SELF DEFENCE as a subject in all healthcare related modules?

Praying for the speedy recovery of surgeon, Mr Pritzwald-Stegmann ^ 

Sharing some snippets from this article from The-Age-Victoria’s :

http://www.theage.com.au/victoria/box-hill-hospital-employee-in-critical-condition-after-serious-assault-20170531-gwgz8g.html

“Mr Pritzwald-Stegmann is aged in his 40s and is the father of two young children.

It is believed he was on his way home at the end of his shift and became concerned about people smoking near the hospital doors when the assault occurred.”

“Detective Senior Sergeant Ian Shepherd said the surgeon was hit in the face and fell to the ground unconscious.

Mr Pritzwald-Stegmann was stabilised at Box Hill Hospital before being transferred to The Alfred where he underwent surgery on Tuesday night. He remained in a critical condition in intensive care on Wednesday.”

Violence in Victorian hospitals

  • An October 2016 Fairfax Media analysis of health services’ annual reports showed there were 8627 reports of occupational violence in Victoria’s public hospitals in the year to July, and of those 1166 resulted in staff injury or illness.
  • April 2017: A nurse at the Royal Melbourne Hospital was allegedly held hostage at knife point and by a 60-year-old male patient.
  • October 2016: A patient angry about waiting for care drove their four-wheel-drive through the glass doors of the emergency department at Sunshine Hospital. In a separate incident at the same hospital, a patient slit their wrists, sprayed blood on staff and punched a nurse in the face repeatedly.
  • April 2016: A patient cornered two staff in a trauma ward at Royal Melbourne Hospital and punched a nurse in the face.
  • February 2014: Neurosurgeon Michael Wong was stabbed up to 30 times in the foyer of Footscray Hospital as he arrived for work.
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