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This is the quotation from China social activities Mr Fang Zhouzi who is one of vocal voice in China against the traditional Chinese medicine in China.

He said : “TDM theories are not scientific.”
“They are just amalgam of superstition, metaphysics, philosophy and WITCHCRAFT.”
He has a website http://www.xys.org which contains many articles n the issue of TDM.

The misdiagnosed of a patient condution cause the delay of management and do harm to the patient.

As the first rule of being a doctor is ” DO NO HARM”, so misdiagnosis the illness of a patient is a CRIME.

We should strive to avoid misdiagnosis and my advice is if we are in doubt, we should order more test to confirm or to rule the diagnosis.

BUT first, it’s is vital to get a proper history from the patient. Then a thorough clinical examination and to arrive a diagnoses of a set of differential diagnosis and follow with the appropriate investigations to conform or to rule out investigation.

MIS-DIAGNOSIS a condition often arise from inadequate history taking, clinical examination and investigation.

Let take this case

55 year-old INDIAN man complain of epigastric pain a/w left arm pain.

The initial diagnosis by the GP is gastritis and gouty arthritis.

Careful history taking reveal that he is a smoker and do not have any previous history of gouty arthritis nor history of indigestion.

Symptoms of the pain is sudden, severe associated with sweating and nausea.

THIS GP obviously failed to get a proper history, given his age, his race  and risk factor, the GP could have entertained other important diagnosis such as Heart attack.

The patient had sought treatment at A&E department 1 day later after the pain remain unresolved.

At A&E, a ECG reveal ST elevation at V1 to V4 with the deep Q being formed.

THE MAN IS HAVING a HEART ATTACK – acute anterior-septal STEMI.

AND because the misdiagnosis by the GP, the patient can’t received a dose of thrombolytic therapy and thus he missed the opportunity of effective treatment

 

 

I don’t know what is happening to the doctors in Malaysia, and these day, everyone is taking about Houseman problems.

For outsiders (non doctors) may be confuse with the current trend.

It’s make them wonder, is houseman a doctor or not? Are the housemen part of the team ?

Apparently, housemen bashing is a favourite pastime of doctors which surprising some very junior MOs also joining the force of criticising.

Well, IMHO, it is just a trend showing the senior doctors are worrying about their jobs and they are being threaten by the influx of junior doctors (HOs)

Sure, they are definitely some bad apples (HOs)  and it’s the one that really give the Hos a bad name.

While every one pointing fingers toward the poor HOs,  we should asking ourself, are we a very good doctor?

Are we the super efficient and very knowledge HOs  in our housemanship day?

Are we have not making errors during my HOs ?

I DO, I still recollected that when I was a HO in medical, a young man who is a TB patient is in respiratory distress and I failed to put the patient in the acute bed and do the necessary things. My ass only saved by my specialist who managed to spot him when she doing her round. And she did remind me when I work with her.

Well, that is nothing really embarrassed about the blunders/mistakes that we make. The important thing is not to repeat it.

The juniors are really need to be taught and spoon feed. THEY DO NOT KNOW WHAT  THE STUFF THAT THEY ARE REALLY NEED TO KNOW!!!

It’s definitely easier  to poke fun at your juniors and to certain extend, insult and be little their ignorance, but does it help you and the Ho in the long run.

Would it be easier just to point and guide their to the right direction?

HAVE WE FORGOTTEN THAT WE ONCE MET SOME GOOD MOs/SPECIALISTS which provide guidance to us during the dark days of Housemanship?

Love you you  (  LOVE U U )
電影 夏日樂悠悠 主題曲
作詞:林天愛
作曲:林俊傑

C         C

C                                G
Love U U 我像孤獨的漁夫
C               G
說不出 愛的溫度
F             G         C               Am
很想給你幸福 你卻自我保護
F                            G
轉彎處 只剩下潮汐之外的荒蕪

C                           G
Love U U 卻在海裡迷了路
C               G
找不出 心的歸屬
F              G         C           Am
思念越嘗越苦 心跳亂了腳步
F                             G        G
怎麼我 讀不懂你唇語之間的無助

Chorus
C                                Am
就算用盡所有真心 卻到不了你的心底
F                         G
回憶難以靠近 你是我奢求的唯一
C                               Am
讓我用盡所有力氣 只要你相信
F                            G
我最堅持的聲音 只剩一句Love U U
C
Stay with me

F                                C
能不能別這樣放棄 能不能就放開自己
F                                G
海浪穿透我的傷心 請聽一聽愛的聲音

C                             Am
就算用盡所有真心 卻到不了你的心底
F                        G
回憶難以靠近 你是我奢求的唯一
C                              Am
讓我用盡所有力氣 只要你相信
F                               G
我最堅持的聲音 只剩一句Love U U
C
Stay with me

 

*after review other chord, all the 2nd line pls change from C  G  to Am  Em

 

我願意

作詞:姚謙
作曲:黃國倫
編曲:張亞東
C                     Am               F       G
思念是一種很玄的東西 如影隨行
C                    Am                F          G                Am
無聲又無息出沒在心底 轉眼 吞沒我在寂寞裡
Am                Em                F                     Em
我無力抗拒 特別是夜裡 想你到無法呼吸
Am                Em                F                 G     G7
恨不能立即 朝你狂奔去 大聲的告訴你
        C                    Am
願意為你 我願意為你
             F                        G7
我願意為你 忘記我姓名
        Am                   Em             F                       G7
就算多一秒 停留在你懷裡 失去世界也不可惜
C                    Am
願意為你 我願意為你
             F                        G7
我願意為你 被放逐天際
        Am                   Em            
只要你真心 拿愛與我回應
        F                     F           G7   C
什麼都願意 什麼都願意 為   你
F                         F           G7   C
我什麼都願意 什麼都願意 為   你