The Pensieve

related by HS, who has just returned from Korea, and gave us face masks from ‘the face shop’. to all the guys and gals mentioned in this blog, please don’t shoot the messenger (me), go shoot him. go be evil to him ok… yea…

reactions of the gals when HS gave them the face mask…

[thoughts: face mask? wait, did i hear wrongly? stan buys face masks?] proceeds to shake head a little…
to stan: oh face masks, from where?
interesting…

— dopey

blank blank blank [face mask? i’ve never used this in my entire life!]

— EW

very blank blank blank blank blank… [stares hard at the face mask and stares very hard at dopey, who was the unfortunate delivery of the face masks and ginseng ‘gold bar’] blank blank blank some more…

— ex female cg mate

oh stanley, thank you… so nice of you [why you give face mask wan?]

— female cg mate no. 1

hur hur hur… why you give face mask… [i hope the ginseng thingy is nice.]

— female cg mate no. 2

oh ok… thanks… [what?! face mask?!?! splutter sputter… stan… => face mask???]

— female cg mate no. 3

now for the guys’ reactions:
HS: hey wenky, you wan face mask?

oh ok ok ok!!! i wan i wan! [hands flapping up and down]

— wenky

HS: hey k… i got something for you, you’ll surely like it!

oh stanley, you’re so RITE! and it’s ROSE somemore! [hands flaying apart, in all directions, and proceeds to splatter HS and josh with a generous amount of saliva]

— hypoC

oh ok ok! i wan wan! can!! can!!

— ZH

stanley! i wan! yay!

— mr. greenspecs

later on… in a conversation between HS and mr greenspecs on the very varied responses from guys and gals about FACE MASKS…

cuz when even if we guys interested, also very difficult to buy mah…

— mr. greenspecs

though it’s still GP clinic posting… we’re fast running out of interest in the mundane coughs, colds, stomachaches and various patients with ‘hidden agendas’…

though hmmm we did see stuff like cleft lip, ?amniotic band syndrome, and other not-so-very-gp stuff.

we spent the day listening to our dear gp talk about
- politics and lky
- trading… commodities? derivatives? until now i still dun understand him. pengz
- altruistic docs
- how to aim for 2As2Bs or 3As1Bs during his time (long long time ago) so that he would get into med (cos all the 4As pple get slotted into law and engineering)
- how to negotiate with the greedy, unethical housing agents… (he sold his house today u know! and became homeless haha)
- something about ma2la4huo2guo1
- a case of molestation he’d once handled
- guidelines on breast examination (hehe)
- the definition of success…
- the meaning of shopping in orchard road for a lawyer… it means buying up 3 condos at one shot (without viewing the place). WOW!
- how he does not believe in proselytising… GOOD!

sh*t, i’m having corpus pruritus how la?

and i’m soooooooo bored!!! i can’t even think of anything sinful to do!

and now on to BRATS!
it’s standard practice amongst GPs (at least mine does) to give all kids that come into his clinic a sweet! 4 out of 10 of his patients are children… they range from about 2 to 7 yrs old? yet, NOT A SINGLE ONE OF THESE BRATS have said thanks to him without prompting…
and only… 2 out of all those kids i’ve seen so far (and that makes like 30sth kids) have been prompted by their parents to say thanks….
and….
only ONE kid has said thanks and bye and been really friendly and polite!
and guess what, this is a kid with problems of speech! (she’s had a recently-corrected cleft lip and still undergoing speech therapy).
haiz, i’m sooo disappointed in all these young parents!

想当初，my mum’s very strict with me and my bro… wa dun say thanks, go home kena scolded! lolz… after just a few times, it’s a-u-t-o-m-a-t-i-c… automatically greet pple and say thanks! parents these days ah… haiyo… what violin, what piano, tuition? send for special courses? JUST TEACH YR KIDS THE BASIC P’S AND Q’S FIRST LA!

finally, question of the day:

which speciality earns the most money? according to the IRA?

guess guess guess!

cuando éramos jóvenes, el amor fue una cosa exótica
que nos parecimos la fruta prohibida
las miradas supreticias pasaron entre los dos
y las mejillas se pusieron rojas

cuando nos hicimos más años, el amor se convirtió al pasión
un fuego de gran encendimiento
que se ahoga con tal rapidez
y se parece la llama de una cerilla

cuando somos maduros, el amor se hace un fuente
un fuente de vino que se puede embotella
para que disfrutar el sabor perdurable
la dulce con un gustillo del amargo

— por elena c.

literal translation:
when we were young, love was an exotic thing
that seemed to us like the forbidden fruit
surreptitious glances pass between two people
and they blushed

when we became older, love became passion
a fire of great brillance
which extinguishes itself with similar rapidity
and is akin to the flame of a matchstick

when we are older, love becomes a fountain
a fount of wine that one can bottle up
so as to enjoy the long-lasting taste
of sweetness laced with an aftertaste of bitterness

lalala… good mood today! woohoo!

but scenery drawing is really tough manz… and next wk, laoshi wants me to bring tougher pics… he’s chosen two from my collection liao.

this is the original:

and this is my product, after a painstaking 4 hours (haha actually 4 hrs quite fast…)

sorry that the tones look like two halves, tt’s cuz my scanner only scans A4 size… and somehow, the two halves ended up with different tones… and yea.. i’m too lazy to photo-edit so that the colours are more similar on both halves…

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to everyone medical please please please read evolution of dispassion.

to everyone non-medical but wondering how doctors and nurses look seemingly apathetic or dispassionate in the hospital environment… please read it as well.

haiz, the second last paragraph perfectly expresses my feelings when i face death in the wards…

wa laooo… dunno why so shag!

GP posting is sapping away my energy as if it were O&G… and we all know that was one helluva posting (which i enjoyed immensely by the way. heh heh)

GP posting is NOT a posting to learn about diseases, drugs, sophisticated drug-drug interactions or how to calculate yr DMARD dosage for the patient…

it’s about
^ how to build up trust and good relationships with all your patients (and boy oh boy! my GP is really good at it!)
^ how to be a shrewd but humane businessman
^ how to find out yr patient’s ‘hidden agenda’, which is almost one of the fundamental characteristics of a successful GP
^ knowing about all kinds of conditions… and being fast in detecting them. in a way, you’re the first person an ill person seeks help from and you have quite a big responsibility, especially with regards to referring urgent cases to the hospital in the right way

i think being a GP is tough, and the public and medical fields ought to give them more respect and credit for the tough job.
being a GP is not as simple as many pple might think… and not everyone will be a successful GP!!!

first you’ve got to deal with junkies… yes there ARE drug addicts coming to you to get all kinds of drugs!
ooooh and i heard from my friends… some even look like yr typical shopping-at-NTUC-aunties!!! omg!

then you’ve got over anxious parents who bring their kids to you for the slightest hint of a cough and start demanding a whole truckload full of drugs! heh.

you’ve also got those who come complaining of diarrhoea, vomitting, nausea, headache, bodyache, bloating… blah blah blah when actually they are totally fine and merely want an MC.

and of course apart from that there are drug reps to deal with…. all the 讨价还价…

and then….
today…. A PATIENT PUNCHED ME!!! aiyo… that kid was soooo naughty! he had chicken pox and was still running around the clinic banging doors and kicking chairs… boo-ed at me as well. so rude! i dun blame him, i blame his mother. i hope he’s getting treatment for hyperactivity, or getting a good whipping from his dad… he even tried to attack the gp… clawing for his stethy… tsk tsk…

now for praising my gp… lolz… (i’m sure he’s not reading this blog, so it’s not sa-ka-ing la)
He let me interview one of his patients for my second case report today… he has Parkinson’s disease and a complicated psychosocial and financial background. it was a lovely touch when the GP told the patient that he would not be charging him for the consult and meds!

hmmm my gp let me do CME questions today… hehe… and went through how to cope during emergencies… taught me how to refer patients and demonstrated how he communicated with various specialists and other GPs… hmmm apart from that, he’d show us all kinds of non-medical stuff… and tell us all about life as a GP… his family, his children… made me feel very welcome in his clinic. he also enjoys a very good relationship with all his staff, even though he nags and scolds them once in a while… he even gives them exams!

but unfortunately, he has this liking for making us try or do things we’ve never done before…
like, he wanted reema to try liang teh… if she weren’t fasting these few days, i bet he’d make her try kiam chai, kiam neng and kiam hur! today, i was made to try liver (which i know how it tastes and absolutely do not like it! especially in huge chunks like today… eeeeek!) and lung (urgh…) and kidney (omg… luckily it didn’t taste uraemic)… and he treated a whole meal at this famous bak kut teh place….

today, he was rather thoughtful… the first thing he asked me when i got into the clinic was whether i felt better. (i’ve been having a rather persistent cough, for which chlorpheniramine, terbutaline and other drugs did not work) so he took a look at my throat and gave me other drugs to try. i hope it’ll all work out… i wanna be ok by next week cuz he said he wants to give us vaccine.. (FOC somemore… hehe so nice ah rite?)

anyway, tomorrow is an off-day for him. which means free for me too!

hmmm must start thinking of something nice to get him… i think it has to be FOOD… FOOD FOOD FOOD FOOD FOOD!!!
maybe dabao bak kut teh from adam road. lolz…

asthenia (as·the·nia) (as-the¢ne-[schwa]) [asthen- + -ia] lack or loss of strength and energy; weakness.

cutaneous asthenia, 1. a disease of cattle and sheep, similar to human Ehlers-Danlos syndrome; the skin is fragile and easily torn. It is due to an abnormally low activity of procollagen N-endopeptidase. Called also dermatosparaxis and Ehlers-Danlos syndrome. 2. Ehlers-Danlos syndrome (def. 1).

myalgic asthenia, any condition characterized by a sensation of general fatigue and muscular pains.

neurocirculatory asthenia, a syndrome characterized by palpitations, dyspnea, a sense of fatigue, fear of effort, and discomfort brought on by exercise or even slight effort; considered by most authorities to be a particular presentation of an anxiety disorder, the physical symptoms being attributed to autonomic responses to anxiety or to hyperventilation. Called also Da Costa’s syndrome, effort syndrome, and irritable or soldier’s heart.

periodic asthenia, a condition marked by periodically recurring attacks of marked asthenia.

tropical anhidrotic asthenia, a rare condition seen under conditions of heat stress, in which miliaria profunda causes extensive occlusion of the sweat ducts, producing anhidrosis and heat retention that may lead to heat exhaustion with weakness, dyspnea, tachycardia, elevation of body temperature, and collapse. Called also sweat retention syndrome and thermogenic anhidrosis.

oh dear, i think i’m dreading tomorrow’s FULL day posting at the clinic… 9 to 5 leh! pengz liao. i really really think i’m going to hate it in there! i just feel i don’t belong inside that cluttered up place with posters ranging from hormone replacement therapy to weight loss programmes to the 6-in-1 vaccine. AHHHH!

i read some part of the ‘primer’ notes, it’s fine and i agree with what they say inside. haha yeah, so COFM-ish. but i totally CANNOT accept the way a GP has to think and react.

things i don’t like to make myself do:
- treat symptomatically…
eg.
pt: doc, i have a cough, runny nose, some sore throat and a fever…
doc: ok, i’ll give you some panadol, something to clear your nose, something for the cough and lozenges. i won’t give you antibiotics because this is a virus. (and out goes the patient)
- having to bargain and hassle with the drug rep like you’re talking about fish in the market… haiz… have to calculate the profits and negotiate for discounts or freebies or ’splitting’ the stock with others…
- be stuck in a clinic ALL day long, with NO one else to see except patients, patients and more patients… and occasionally, getting 2 medical students to come brighten up your day (i hope)
- nag nag and nag more at recalcitrant, non-compliant patients
- be writing out unnecessary medication (eg. panadol, which i’m sure the patient has at home) or perhaps giving everyone who has the flu some flu medicaiton, regardless of whether the patient really needs it or not…

i hope that tomorrow i get some hands-on, get to clerk patients and interact more with them, or i’m just going to slide off the examination couch (yes, i’m perched high up on that couch ALL day long… butt going to get contact bed sores…) … and that tomorrow we’ll manage to find both case reports!

yay! one thing for sure though, this clinic has quite a heavy patient load… it was non stop flow all the way… saw a big bunch of URTIs inclusive of pharyngitis, AR…. a couple of eczemas (it’s surprisingly common!), kids with flu/fever… a couple of those with viral GE… 2 accidents, trigger fingers… vaccinations… even one high CA125! quite a gd variety… but… it’s SOOOO boring!

save me from the deathly claws of COFM… begone begone begone!

btw, what the hell is ASTHEMIA??? and er… klatskin’s tumour some kind of GB CA.

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