Everyday, I'm surprised by how much I don't know. Quite, disquieting.
How can a drop of Pilocarpine, or even better, a bit extra history from patient, can save a getting a head scan? read on.
Heard of the notion of complete disease remission for newly diagnosed overweight diabetics? We all know losing weight helps, but there are probably more to it then just weight. Surgery, again, may be the panacea.
When asked by my patient "where you came from doc?", I often proudly proclaim "Hong Kong, been here 16 years!" I remember one patient asked me the same question a few months ago, but somewhat in a apologetic way, as if she really just wanted to find out where I'm from, without wanting to sound insensitive. The fact of the matter is, I have no issue of people wanting to know where I came from, for it's obvious from my looks, name, and accent that I'm not a NZ European. People will alway see race and ethnicity as defining characteristics, but I agree with the author of this article, that we should aim to "embrace the commonality of human experience that binds us together". Similar to vicar Glynn Cardy's view when he "camped with the Mormons"
Speaking on quality of care, until the day when a sample of every practicing clinician can pass both the written and clinical part of FRACP every year, I doubt anyone can think the Physician exam as it stands as a "relevant and meaningful measure of cognitive competence".
When is someone "disabled"? A brief review on how society sees and define disability.
We we giving out Losec like lollies?
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Recent events remind me of a road trip I had few years ago.
He was in his early 30s in the time, me in my early 20s. He was a person with enormous insight. A friend of the family, he was visiting NZ, from HK.
We got along fine in the first day or two. I used every opportunity to showcase what a beautiful country we have. Being a knowledgeable and opinionated guy, he was also an excellent sounding board on a variety of stuff we cared to talk about. We even peed together beside State Highway One under the starry sky when a toilet was no where in sight.
Then somehow things turned sour. I didn't know why at the time, but all of a sudden I didn't really want to know his opinions anymore. I was content if he would just listen to what I have to say, without giving me his opinions which by this time, had became his way of conversing with me. I would say "The weather is alway sunny in the part of the country." Rather then appreciate the fact that gee, must be nice to live here with weather so good, he would say something like "shame if you live here and doesn't like the outdoors then, there are many things one can do indoors anyway i suppose".
The last two days of the trip was hell. I really didn't want to be alone with him anymore. Benign as his opinions were, I just didn't want to know. I longed to go back to Auckland, to my own little room, without knowing yes, there are in fact many angles to an issue.
A "sweet escape" turned out to be one of the worst trip I ever had. A shame really, as it didn't have to be that way.
I asked myself why.
I later realized he was trying to put a different perspective on things, often the exact opposite view to what I had. This antagonism was refreshing for a while, for it was cognitively stimulating and challenging. After all, things are often not what they seem anyway. We should explore different opinions.
What he did was similar to the famous and insightful HSBC ads. I liked them alot.
The difference, however, was whilst our conversations were intellectual, emotionally I felt like I was being put down and disagreed on all the time. Why can't he just appreciate, for example, that the weather is good in Gisborne?! Man, what's wrong with him?! It was a shame really, as he did not intent to criticize at all. He was, after all, expressing a view, offering another angle to see a fact.
The minute I got home, I told myself that, to be a commentator, in many people's eyes, is the same as being a snob; at least emotionally.
One should be appreciative always, and comment only when specifically asked to. This, I have to work on.
From this week's journal watch:
Patient with disabilities, are you doing them a disservice? This piece examines this issue with humility - Assuming the worst
Is it knowledge, attitude or skill that your "problem junior" is lacking? A bit of a utopia piece for the rest of us but nevertheless an interesting read - The Problem Junior
These academics from my alma mater, a few I had the pleasure to worked with in the past, came up with this editorial piece. On the elusive grail of health service quality
Forget about the Golden Globe press conference, and who knows whether we'll have red carpets for Oscars this year. Rotten Tomato is my trusted movie review site. I'm glad some of the best movies in 2007 I've enjoyed made it on their list.
I've yet to doing some reading on this, but surely humans are emotional beings. The advertising industry largely relies on consumer's emotions to their ads for a living. Kevin Roberts wrote that famous "lovemarks" book, still sitting on my shelf untouched since it was first published over 3 years ago now. One of the reason why economist can't predict the markets with absolute certainty is because, we don't often act logically; that is, cognitively.
May "love" be the predominant emotion that rules us, rather then anger, paranoia and antagonism.
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It has been a busy and interesting start to 2008..a few interesting observations
My trusting mortgage broker friend told me we all have to work on our relationships. Working hard on our "day" job is not good enough - for before you know it, your "day" job will be all you have.
Rather then just listening to Mike Hosking on Newstalk ZB and the occasional switch to The Edge, the BBC world service on 810AM is rather refreshing. Although it's not till I saw the flags at half mask on the harbor bridge that I learn Sir Ed passed away
Whilst we live in a "free world", we have access to internet.. can express different opinions.. etc. We have to try hard to keep a wider perspective. We do this whilst holding on to our beliefs hence doesn't make us "principle-less".
The anger of one angry person should stay with that person. For anger is like fire, it spreads in no time.
We see what we seek for, and often nothing further
The writers for Boston Legal are brilliant
Two interesting links:
http://www.ekklesia.co.uk/
http://faithinsociety.blogspot.com/
One of the things that makes my life interesting is, the consult is never about "a case of heart failure", it is about one person touching on another person's life.
Doctor: I'm going to ignore the troponin, there's no evidence of heart trouble
Nurse: What do you mean you're going to ignore the trop, it's up
Doctor: It's been up before, he has no chest pain or ECG changes
Nurse: What is it normally? 0.28? this is high, have you talk to someone?
Doctor: Yes, but he has no chest pain, no ECG changes, I talked to a consultant, a chemical pathologist to get a Trop T done.
Nurse: So who are you?
Doctor: I'm the medical registrar, he won't arrest on you in the middle of the night
Nurse: Oh... ok, have you documented all this?
Doctor: Yes i have, here you go. Do you want my home number just in case?
Nurse: Yes doctor! haha..
You can't blame the nurse for being annoying, she's doing her job, afterall, despite in a very confrontational manner.
Everyone is better off with a laugh.
