Ignorance is bliss..

Did you ever wonder how it is POSSIBLE that :

a. 98.2% (hypothetical number) of all 'medical' related deaths in the medical wards are ALWAYS due to Acute Coronary Syndrome(ACS).

b. 1.7% of all 'medical' related deaths in the medical wards are ALWAYS due to 'Septicaemia'.

c. 0.1% of all 'medical' related deaths in the medical wards are due to FAIRLY DIAGNOSED diseases.

d. 98.2% of all 'surgical' related deaths(deaths from the various surgical subspecialities) are due to Severe Head Injury.

e. 1.7% of all 'surgical' related deaths are due to 'Septicaemia'.

f.0.1% of all 'surgical' related deaths are due to FAIRLY DIAGNOSED diseases.

g. 98.2% of 'anesthetic' deaths are due to ACS.

h. 1.7% of 'anesthetic' deaths are due to POOR OPERATIVE TECHNIQUE.

i.0.1% of 'anesthetic' deaths are due to PROPERLY DIAGNOSED diseases.

j. There are NO deaths from 'ANESTHETIC CAUSES' ever.

h.50% of times in O.T, SOMEONE or the other WILL tell the surgeon/junior surgeon/M.O,'You have to hurry up and close faster'.

i.50% of times in O.T,SOMEONE or the other WILL tell the surgeon,'Your M.O the other day arrr...He arr....(something that would get the M.O in trouble).

j.50% of times in O.T,SOMEONE or the other WILL tell the 'Junior Surgeon','WHY cant the senior surgeon come and do this case!, we need it done fast'.

k.50% of times in O.T,SOMEONE or the other WILL tell the Surgeon/Junior Surgeon/M.O,'We NEED more blood NOW, and expect them to UNGOWN and run for it'.

l.50% of times in O.T,SOMEONE or the other WILL call the ward up 30min-1hour before the case is over, only for the ward staff to wait at the airlock with all the gear for long periods of time, just because they do not want a slight delay in hurrying a patient off.

m.98.2% of times in O.T,SOMEONE or the other WILL scold the ward for sending the patient late to O.T.

n.50% of times in O.T, SOMEONE or the other WILL call the patient from the ward during PASSOVER time, and the poor nurses and attendants who would love to go home to a hot meal and family would have to stay longer for fear of annhialation from the O.T staff.

o.98.2% of times in O.T,SOMEONE or the other WILL scold the ward staff for 'The monitors you brought have run out of battery etc etc', but fail to realise that they waited for LONG HOURS outside O.T, SO, D.U.H,surely the battery will surely wear off!

p.98.2% of times the O.T staff WILL BLAME the ward for constantly being late in their work WITHOUT understanding their problem of shortages and admissions. They DO NOT have an airconditioned lounge area, time to eat, time to sleep on stretchers in the recovery bay or time to shower, IN THE WARD.

q.98.2% of the time, HOUSEOFFICERS AND JUNIOR MO's are not given due RESPECT due to their junior position. They are ALL doctors nontheless, RESPECT IS DUE TO THEM!

r. There are NEVER delays in the ANESTHETIC department that they WILL EVER own up to.

s. All MODERATE risk patients are HIGH risk to the Anes team, and if the poor patient dies on table, it is SOLELY the fault of the Surgeon or ACS, ALLWAYS.

t. Blaming another team, for what they didnt do.yada yada yada,resulting in patients death is NORM, but no one offers CONSTRUCTIVE CRITICISM on how to AVOID SUCH PITFALLS again!

u. There is RARELY an EMERGENCY O.G.D.S by the SURGICAL team,due to the FLAWLESS QUOTE,'Optimise the patient first, then we see'.

v. An ILL upper G.I.T bleeding patient who is NOT optimised belongs to OTHER DEPARTMENTS if the patient happens to HAVE 'ANY' OTHER COMORBIDITIES.

w.An ILL upper G.I.T bleeding patient who IS optimised belongs to OTHER DEPARTMENTS if the patient happens to HAVE 'ANY' OTHER COMORBIDITIES.

x. ODD HOW ALL serious polytrauma patients in casualty BELONG TO NEUROSURGERY until proven otherwise, with or without a CT BRAIN.

y. ODD HOW ALL serious medical patients in casualty BELONG TO CARDIOLOGY until proven otherwise, with or without an ECG/Trop T/History of chest pain/Relevant comorbidities.

z. SOME departments CAN KEEP A PATIENT WAITING IN CASUALTY AGAINST THE CASUALTY DOCTORS ORDERS demanding all sorts of SPECIFIC SCANS (eg : Doppler flow to rule out vascular injury perhaps?) FOR HOURS AND HOURS.

To all of you who know me, you know that I mean well and harbour no ill feelings to any of you, because I know how your work is like and I respect you and what you stand for. You are my dear friends.

To those who FEEL this post is derogatory, speak up and let me hear you side, so I may better understand what it is that you do and why does it involve double standards. I am open to correction anytime. Make me understand why we cant work together and in the process, not hurt each others feelings and pride?

To those of you who FEEL hurt by this post, ask yourself, IS IT YOU who do the things mentioned and what is your JUSTIFICATION? If you are just, then you should not feel hurt at all.

To those of you who FEEL indignant, tell me why? Please. I would like to understand how bringing down and constantly victimising your other colleagues ARE acceptable.

To those of you who CONCUR that this is happening and you are only WATCHING as it does, MAKE A CHANGE and lets all WORK TOGETHER.

We are all HUMAN, and we have feelings. Whats WORSE than hiding behind cruel departmental NORMS is actually FOLLOWING departmental NORMS without realising the bad in what you do or say.

I say have COMPASSION FOR YOUR COLLEAGUES, YOUR FRIENDS. We are all on the HOME TEAM, all at par and striving for the same thing, namely excellent patient care and maintaining our own sanity while we work hard everyday.

To those of you who are team players, I SALUTE you and ADMIRE you. Above all, I RESPECT you for sticking to your convictions, principles and being FAIR to those around you. Patients COME 1st, PERSONAL ISSUES 2nd.

Only as ONE TEAM, we can pick ourselves up gracefully when we fall, to the comfort of knowing we did our best and those around us,our brothers and sisters from our profession, appreciate our efforts , without fearing the blame game and the real evildoers . No malice, no fear, no hate, no prejudice, only the spirit of FAIRPLAY , the sence of BELONGING and GOOD work ethics.

Is this too much to ask for?

Doctors never cease to amaze

Most medical people, supposedly the creme dela creme of society, live happy lives HOPING and WISHING their work insensivities and absolute disregard for their fellows go unsaid, or better still, unnoticed. How often has this happened to you? You feel like telling them, but will they respect you for being honest, or will they just shun you for it? I think there's also the element of CARE, whereby if you care very much for the person, you will extend your advice and any lengths of consideration, for they mean no harm, and people, like all things, are prone to misbehaving.

I received a rude shock yesterday at work, whereby I was told that a patient had died and a postmortem was required, as the doctors caring for him were unable to give a cause of death accordingly, even after 2 days of INTENSIVE treatment for MULTIPLE 'unapparent entities', in a unit in the hospital I work in.

To those of you who know me, and my flirtatious relationship with Lady Luck (*Oooh la la, she HOT), irrespective of which department I work in, you know and I know that this does not surprise me, I mean the fact that I get all sorts of cases EVEN in Forensics and at unGodly hours, AND i still hold the record for MOST neurosurgical referrals in one day (31); but hey, have I ever lashed out, unwilling to part with my cosy on call suite, to crawl and see a case?

I AM quite sure I havent, if I have, DARN IT,must have been my twin (*snicker). By the way, the phone call comes in after a whole day at Hospital Seberang Jaya (Murder #1) and after that, Hospital Sungai Bakap (Murder #2), and back home, late at night.

I was called up and asked whether a post mortem was required for a medicolegal case, and I offer my 2 cents, and what to say to the family concerned etc etc, and I had thought that the matter was solved, but then few minutes later, I get another call, saying I was 'FORMALLY REUQESTED' to be around during the postmortem by the respective department IN CASE NO CAUSE OF DEATH IS FOUND +/- POSSIBLY FOR DOCUMENTATION PURPOSES, FOR PRUDENCE.

Prudence my ass, but hey, since the formal order was apparently made at 7.30am that very day, and the patient (GRHS) only passed away at 10.30pm, I was bewildered.

a. How did an order like that come about, 15 hours before the patient, {God rest his soul} (GRHS) passed on? Still eludes me.

b. How did a 'NOT SURE WHETHER A POST MORTEM WAS NEEDED' circumstance follow an order like that, whereby, it may seem a POSTMORTEM was surely unavoidable to begin with?Eludes me further.

c. Was there no WORKING DIAGNOSIS to begin with? Why so much obscurity? Was told there was no working diagnosis as to the patients current reason for deterioration leading to his passing.

d. Why rush and do the postmortem at 11pm at night? Was told that the family INSISTED.

All these questions begged answers, so I spoke to the specialist on call, who was a gem of a person, and I thought, hey, he's a friend and they did need help, so why not, just go over and and see what I could do, for the patient (GRHS) and for the team. After getting all necessary work done, and after that I still had another case to do, which I could only start at 12mn while I was waiting for the relevant post mortem order and police photographer.

After each case, I try and make it a point to explain the findings of the case, what investigations have been sent and the circumstances of the death, to the relatives, for purposes of closure, which I find helps them mourn their loss. To my surprise, they were very pleasant ( NOT demanding or PUSHY as was described when they apparently INSISTED on the PM be done late at night to begin with), and I was getting a little suspicious, so I probed on.

Guess what?! They mentioned that a certain member of the caring team responsible for the deceased, from the ward, (name witheld due to extreme embarassment), told them that HE WOULD NOT BE AROUND THE NEXT DAY, AND HENCE WOULD NOT BE FREE TO DO THE POSTMORTEM AFTER 8AM THE NEXT DAY.They certainly had the impression that the Forensic Department would be closed on Saturday and Sunday, and they would not be able to collect the body till Monday, explaining why they requested for the late night PM. I wonder who gave them that impression?

THIS ISNT RIGHT.

Since the bloke wanted to go back STAT post call, so an elaborate story of DECEIT was coined to HIS ADVANTAGE! = Its like asking for a preoperative assessment on a Saturday for an ELECTIVE OP planned for the following Monday, for a HIGH RISK PATIENT!?! WTF! And the best part is, the family ONLY wanted to take the body of the deceased back the NEXT MORNING.

What would you feel if you were me? I guess I was not suprised what people would say or do to get ahead in this world, with their own interest solely in mind. SELFISH BRUTE, LYING BRUTE.

The way I see it, work is work, one should not complain of the burden of work, as its our responsibility, fair enough, but work ethics are subject to comment. Ethics = professional way of doing things + professional courtesy, is as absent as 'taste is to our on call food' (*was feeling rather cheeky saying this!). To rush in the rain, to perform a postmortem after being given a scenario of immence urgency, fuelled by lies by person/persons manipulating the mourning state of the next of kin of the deceased, for reasons founded on personal gain and benefit is indeed SAD.

What would be the JUSTIFICATION, in all FAIRNESS. If any one person from this chain reaction (those involved) : Me, or any of my staff, the police officer/officers who have to come and be there, or even the family members of the deceased, had something tragic happen to us in transit or during the course of our 'latenight' rondaywoo (am not sure how the spelling goes, sorry) = Eg : A horrid motor vehicle accident, being mugged or held at knife point, being shot at (not uncommon nowadays), gang attacked by Mat Rempits, needle prick injuries during the case (the patient would surely not have his VD screen done, it being a Friday night), exposing oneself to an array of infectious diseases at an hour prone for mistakes to happen etc etc)...

We all need GOOD REASONS to put our life on the LINE, TO BE RUSHING AT UNGODLY HOURS, and if its not to SAVE LIFES or to MAKE A WORLD OF DIFFERENCE , then I guess they aren't significant reasons after all. Is that too much to ask for a honest cry for help?

Before you pass judgements on me, for being CALCULATIVE OR PICKY, let me tell you this.


a. I am NOT calculative, period.


b. I do postmortems at all times of the day, everyday, + on weekends, on public holidays, when the O.Ts are closed (*haha), and when there are natural disasters, even when I am laughed at for RUSHING TO THE HOSPITAL, 'THEY'RE DEAD ANYWAY, WATS THE RUSH' (some say). My luck is unparalled for its 'JONAH'NESS, and I have yet to meet a match. If you have a candidate in mind, i'd like to find out how they deal with their GIFTS.

c. If there is a reason for doing a case at 3am even, I WILL come and do the case (you must be wondering what reasons right?)

d. Promptly performing once duties is NOT directly related to how ALIVE a person is, meaning, even in DEATH there are some URGENCIES, that only time, the people and process of mourning, and experience will reveal.

e. I have the UTMOST respect for all my colleagues and the doctors at HPP, for they are the backbone of this hospital and their role is VITAL. Above all, they are my friends. I have worked in 8 departments over the last 4 years in HPP and my loyalty is to HPP, always. All of us, in this profession WORK OUR BUTTS OFF AGAINST ALL ODDS,BE IT CRAPPY NAGGY PATIENTS VS THE OCCASIONAL NICE ONES, WHINY SELFISH MANAGEMENT WHO WORK US TO THE BONE WITH CONSTANT SHORTAGES OF STAFF & FAKE SMILES THE MORNING AFTER { WHEN THEY HAVE HAD THEIR BEAUTY SLEEP AND WE SURELY HAVENT}, 4TH WORLD WAGES, APPALLING WORKING CONDITIONS AND HOURS THAT DEFY LABOUR LAWS, AND UNFAIR PARKING WOES (had to add this one, touche!)..For what..For our patients. Period.

I do NOT relish writing findings that would suggest poor care has been offered to patients, and by this, does not IMPLY that I know it all. Most people would say, 'Aiya, its easy to say who did what wrong when the patient is already dead..etc etc','He dont know what its like, he can talk easy cos he see patient after they die..etc etc', but HONESTLY, IT ISNT EASY AT ALL.

Everytime I do a PM (post mortem) / clinical PM, involving any department in HPP or in other states that we in Penang cover (Kedah and Perlis too), I pray and hope there are NO SIGNS to suggest substandard care, I REALLY DO. I do not want any doctor, who works so hard, to be penalised for any INNOCENT OR NON INNOCENT MISTAKE! I do not RELISH that at all, no matter how much I might hate the person or persons involved in the case, I have to be professional and give them their due, and TRY MY VERY BEST to offer a proper & fair assessment on the case concerned. This is VERY HARD, and just because this is NOT APPRECIATED, does that mean I should not be professional and do as I please? Of course NOT.

If that means I have to spend 3-5 hours doing a case, reading through folders the size of the Encyclopedia Britanica, and taking specimens I myself would have to process and read, adding to my exponential pile of work, I still would, cos ALL you out there are BROTHEREN IN THE PROFESSION, and although my job, as UNGLAMOROUS AND UNNAPEALING as yours might be, is something I HONESTLY like doing and I feel it reaches out and in a small way, speaks FOR & ON BEHALF of all of us when OTHERS are HAPPILY bashing us and our credibility in.

I am not a MATYR, nor have I cured CANCER, but if I can make one small difference, that may provide closure to those who mourn the loss of their loved ones, or to clarify a death which was wrongfully blamed on a doctor/doctors or a department, I would be still feel like I have done some good in this world AND would continue to do what I do, and better myself. LAUGH at me now, the day WILL come when your own peers/profession will TURN THEIR BACKS ON YOU, and then what? When you least expect it, the DEAD will exonerate you with the help of the living, who fend for your rights even when you never gave two hoots!

TEAMWORK is important you guys, between all of us, between departments and in all aspects of our lives. If we ourselves are divided in times of peace inside our own profession, for selfish personal gain, what will become of us, in turmoil with those especially outside our fraternity?