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After working for 4 months, i agree that to be success in medicine, one need to perform and get your boss to like you.

Especially in presenting cases.

It’s alway a struggle like me, who had not acquired or not in presenting. On top of it, one needs to be a sweet talker. I can’t pretend to know the case A to Z which i see and review an hour ago and confabulate the facts which i not aware of it. So, my boss alway got mad for it.

My boss had not spend lunch for me at the end of posting. He once said he had lunch with good performing HOs.  Well, i know that and I the one who performance not up to his expectation. (especially after the disastrous call last Monday) Too bad. Luckily my consultant still think i’m fine and sign my logbook.
New posting starts tomorrow, gotta faces new consultants, new specialists and new MOs, wish me luck.


I’d been a IT worker for 5 years, a HO for 4 months, and a street hawker for past 24 years.

I basically growing up with the food stall. 2/3 of my life and countless days I spend at the stall.  My parent start a food stall in early 80s after moving to PJ. Dad salary was not enough to supports his 7 children. My mum starts to sell Chang, at one time, nasi lemak and finally settle on selling “economic frying mee”.

The business had one time prosper, and slowly deteriorate as time change. Mum still operate the stall and i’m still helping her in the stall whenever i free.

Every time, whenever i got stress from my HO job,  me wonder how nice  is to work  in my mum stall. No stress and no “multiple bosses” to face and get “screwed”. Obviously because the stall’s boss is my mom and it’s a half day job.

Work starts at dawn around 5 am till 10 to 11 am. Usually, afternoon is a free time.

Well, this job not involving saving people life, but it’s provide affordable breakfast for the customers.

After starting my HO, i still find time to help out in the stall during weekend. Since the coming new posting got no weekend off, so i guess i had less opportunity to work in the stall. Got to plan for weekend leave then.

Maybe i should take over the business someday, morning for the food stall, afternoon for clinic work, then i getting the best of the 2 worlds.

Well, today is the last day for me in the surgery posting.

It’s had been memorable 4 months.

But…it’s also a testing time.

I’d had been working in other job before and I can see, being a junior member in a computer firm is definitely better that being a house officer.

Not all the personnels in a hospital suffered.

The nurses, for example, they usually work hand in hand.

The lab fellows, and to a certain, the pathologists, their job pressure is similar with what my old job.

The abusive behaviour occurs almost in every level of the medical team

The consultant mistreat the specialist

The specialist mistrest the MO

The MO mistreat the HO

the HO mistreat the nurses

Are we’re being strict or we have a very high expectation of the everyone because we dealing with life???

Are we’re being bossy will be a helpful in anyway of improve the care of patients?

Some MOs and specialists are fond of offered non-constructive and damaging comments.It’s not for the HOs with glass heart. During the training, i wonder how many time one’s pride had been damaged and hurt.

It’s a place for wooden heart doctor, no matter how many times one try to smash it, it would not break into piece.

NO WONDER, not many people will survive in a hospital environment. And if they survive, they often had a bitter experience.

I serious think that we can change for better..

I’m not sure what are the other doctors felt when the patient show deep appreciation for your help. But for me, it’s certainly a joyful occasion.

This patient whom had a colostomy due to cancer, had the half yearly follow-up. She rather not concern about the disease but more concern for the financial burden of the disease. It’s cost her at least RM50 per month. For some, it’s is a large sum.

I review her condition and order blood tests and then I’m write a letter for her to seek welfare support.

Patient really shows deep appreciation for the simple gesture and i just thought,”oh that why i like seeing patient”…

Kind of addictio, don’t you think?

perhaps doctors do need appreciation to get them going..

Lots of time, when you see your patient going home with a healed body (not necessary all the time),  somehow it paid for being work hard for the calls.

Not every patient is discharged by doctors.

Some, they signed an AOR ( at own risk) and discharged, which is fine with us, and those whom had absconded.

The latest, A patient who a look of IVDU, thin and pale ( he denied it, but admitted to smoke marijuana, well, i believed him, he has good veins), had an operation done and a drain tube inserted. He had slightly prolonged ileus, which kept us from feeding him. Otherwise, he is doing well.

For some unknown reasons, he sneaked out of the ward with the drain tube still in his abdomen during the visitation hour.
They are many reasons to why patient sneak out from the wards, i can only think of few:for one, avoid paying bill, foreign workers whom really can’t afford it. They do it when they getting better.

second, unsounded mind aka mental illness patient.

thirdly, cannot stand of having their hands, legs and neck been poked by needle. (rare cause, usually mean then patient is too ill to abscond)

fourth, refused treatment but can’t get an AOR but they did not know it.

fifth, feared of being caught. I wonder my patient know the doctor-patient confidential which protects him.

and more….. so

i found a paper on the issue which show:

The majority of patients who absconded were middle-aged males admitted through the Accident and Emergency Department to the specialty of general medicine.

Most incidences occurred within 24 hours of admission while in the emergency admission wards.

Twelve percent of incidents were repeated episodes of absconding.

The most common clinical diagnoses given to this patient group were drug overdose, intoxication, and soft tissue injury. Known drug addicts (29.3%) formed a substantial proportion of the patient group.

Forty- seven patients returned to the ward within a few hours, while a further nine (7.8%) re-attended the Accident and Emergency Department of the hospital within 4 days.

Several adverse outcomes were recorded: one patient died following a fall from height and two patients committed criminal offences.

I’m really hope he can find someone to have the drain removed, before it’s cause him harm.

September 2007
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