Friday, 26 October 2007

Being a Chinese is not by default a Mr LAU!!!!

I would have had a splendid on-call last night had it not for a distracting phone call from this #@"$! lady via my Msian mobile number.

The story goes like this. It was like what I have written in my previous post, the delivery unit was clear and there wasn't any patient to be seen. I had not slept well during the day prior to my call last night so I decided to hit the sack much earlier at about 12 midnight (In preapartion for a busy night). I went into deep sleep but was disturbed by not my bleep which was rather unusual but it was my mobile (Msian number and on roaming).

Now I generally do not answer any unrecognised phone number as my phone is on roaming (hence I will have to pay for any phone calls received from anywhere in the world) and kept that way only for emergency calls from family (and sometimes friends). This individual however was quite adamant to get in touch with the person on the other line. After ignoring the persistent vibrating phone for countless time I finally gave in and answered. At this point, I was really thinking that someone had wanted to get in touch with 'ME' urgently.

(grumpily waking up ..hehhehehe)

me: Hello?

#@$%! lady: Hello, may I speak to Mr Lau? (NO PLEASE I HAD NOTICED)

me: Erm, Mr Lau? I am terribly sorry but I gather you have got the wrong number. (thinking at this point it will end my conversation quite abruptly....I can literally hear the bill going up at F1 speed rate..)

#@$%! lady: Not Mr Lau? But you are Chinese right??

me: Yes, I am Chinese but I am not Mr Lau.

#@$%! lady: But Mr Lau gave me this number....errr ...err...I want to speak to Mr Lau. You are Chinese right?


I hanged up.

Really, I am seriously annoyed with this lady. Not only did she not comprehend that I am not the Mr Lau or Mr whatsoever having told her so, the #@$%! lady thinks that as long as you are Chinese you are then by default a Mr Lau!!!

My dad or some of my friends I have noticed tend to have a long conversation with people calling up the wrong numbers...

Most of the conversation includes:
'Who do you want to speak to?? Who is this?? What number do you wanna call???'

'Are you sure you have got the right number? My number is this this this'

Frankly, I do not see a point in asking what number the other person on the other line wanted as it is ALL IN THE MOBILE's DISPLAY and I DON'T really want to know who they want to speak to, full stop. SO I religiously hang up once they start off with 'harlo, ah ngu ah??' or 'Ah Lim ah, your bla bla bla bla'

Thursday, 25 October 2007

looking good..

Nothing to do with physical appearances i am afraid. What i am trying to say is the delivery unit's board is CLEAR!! Yup, no patient at all when i took over at 830pm tonight. Great... now i can just sit back and watch the 40+inch plasma TV in the doctor's mess. At least till i received my next bleep though.

Its final night of work here and to be honest i do prefer working a long 24-36 hours of on-call rather than doing long 12 hour shifts for 7 days in a row. It is just too tiring and exhausting.

Its confirmed, my last day in UK will be on the 5Th of November. By 11 am that very day I will be on one of MAS airlines heading back to Kuala Lumpur. Probably about time too as i dislike the coming cold weather. Its currently about 10 degrees C and perhaps due to some strong winds will drop to below freezing this weekend. BrrRRRrrrRRRR....

Time to get back to work....erm i mean act like i am working hard... shhhh

Tuesday, 23 October 2007

2nd of my last 4 nights

There is two patients on the delivery unit now. One in the pool with a history of IUGR( Intra Uterine Growth Restriction) and I just heard she is fully dilated and vertex is visible. Great. Why is she in the pool? Well..i think she initially had wanted a home delivery despite being advised not to as the baby was found to be ?IUGR and hence offered an induction. She declined but agreed to having the baby in the hospital. Further, she requested for a pool delivery (will post a picture of the pool, perhaps tomorrow after my call).

The other lady is only 7 cm dilated, only a cm change from her last review at 7pm. Well, sounds to me like a poor progress and she is just having about 1-2 contractions in every 5 minutes. Midwife is not sure of the position of the baby....hmmmmmm. I guess she might benefit from a few drops of syntocinon stimulation then. I do hope both patients are not going to be problems for me later.

Am drinking my cuppa now as i blog this entry.....

Sunday, 21 October 2007

Me and my mate's conversation...

It was not long ago I had a conversation with a mate of mine whilst we were walking around Portobello Market about the thought of having a tattoo. Yes, permanently having an inked design of desire on our skins. Why you may ask would I want such a thing on my body. There are many reasons why one would get a tattoo. Some to remind them of their loved ones, some as a symbol of spiritual beliefs, others just mainly to attract attentions.

I don't really know what my mate's reason was for his Celtic Cross and i didn't really asked him but will do so when we meet up again in the next few weeks. But a Celtic Cross is the characteristic symbol of Celtic Christianity, though the symbol has older, pre-Christian origins. Such crosses formed a major part of Celtic art. This design is also referred to as the Irish Cross, or as the Cross of Iona. Well, at least that's what i came across via Wikipedia. They are not easy to do. Interlacing knots, a chief feature of Celtic tattoo art and a symbol of the constancy life, is one of the reasons why these tattoos are so difficult to create. Their cyclical design and symbolic emphasis on knots that have no beginning and no end.

Well, we did walked into a tattoo parlour that day but walked out quite soon after as it seems quite a dodgy place. I think many people have in the past linked tattoos with sailors, criminals, heavily bearded bikers, the Yakuzas, triad members or even the punks. But these days, they are quite a common sight. When I was working in Sarawak I have encountered a number of patients with the famous 'tribal' tattoos.

Later that month or I received a message from him saying he had already made an appointment to have one done. The day after I was supposed to meet up for BBQ in London to view his design but because I was on-call that weekend I only managed to view this above picture.

So did I then got myself one? Yes I did, but not after a while. I had always wanted something special, something that reminds me of myself, something which is unique in its ways...and hence I decided on a pair of wings. I drew myself a pair of wings. own design...well partly as I had to show it to my tattoo artist and have her change or make them a tattoo possible one.

Why wings? Well, to me my angel wings represents partially the rebellious side of my personality. My freedom. It symbolises enlightenment, guidance and protection "to be taken under the wing" and perhaps inspirational. It also represents my loved family.

Did it hurt? To be honest, one of the many reasons I wanted one was to be able to feel the pain. That feeling is difficult to describe. I would say it felt like a nagging cat's claw digging into your skin and pulling across. The outline is rather uncomfortable compared to the process of shading and filling in.

Will i have another? Yes...of course. The day I had it done, I was already thinking of having another. It can be very addictive.

Was i worried about possibility of infectious diseases? Well, if i were to have it done in Malaysia, yes i would. My artist's place is as clean as a dental clinic (if not cleaner) and all equipments are disposable. They are also registered with the local health authority. There is no nicotine smell, no dodgy drug pusher sitting in the corner or alcohol in sight. So, no i am not worried.

And here it is, my wings.......


Only about 2 more weeks or so and I will be on my way home. Excited..yes you bet. However I do have mixed feelings about how I will be adapting to work in Msia. Various things came to my mind.

Firstly, I will have to start writing in patients notes and not have them typed out by the secretaries (from my dictation). It would be a disaster trying to figure out the long list of medical problems from patients because;

a)almost always they are not aware of their own personal health problems

b)they are only aware of a single miracle drug called 'the white pill of KK' (Kementerian Kesihatan's famous pill)
There are other reasons of course...

In terms of Obstetrics, some of them includes;

a)Back to the good old days of limited antenatal scans for dating in all patients. I will be expecting patients coming in fully pregnant and ready to labour away without any antenatal care at all. This including no routine 20 weeks anomaly scans, so a number of patients would turn up with fetuses with spinal tube defects, heart defects, etc.

b)Screening? In terms of detecting trisomy or chromosomal defects? Well, again...none, as i believe its illegal to perform termination of pregnancy so there is no point in doing it. is so expensive to perform amniocentesis that only the private sectors are able to offer such services.

c)What about patients choices?? As in caesarean sections? I can just imagine myself giving an hour of counselling on the benefits and risk of a vaginal birth after c-section as well as a planned elective c-section to be followed by a response of 'Tak tahu lah. Doctor rasa apa paling bagus saya ikut sajalah' or 'Suami saya cakap potong sajalah' and perhaps just a blank face?

d)No community midwife to lend a helping hand for the continuity of care for the obstetric patients. i.e we doctors see all patients in the clinics.. so hm mph...100 odd per clinic..busy busy busy. Hence..the 10 minute consultation for a patient who had travelled 3 hours from her home (1 hour walk, 1 hour boat ride and the remainder 1 hour of bus journey to the clinic) requesting to be seen first bypassing the 30-40 odd patients ahead of her because she need to make her way back.


a)Although we have the cervical screening programme, but we do not have (i feel) a good recall system where patients are automatically reminded to attend the health clinics for repeat smear test. And hence...I am sure I will be seeing many cervical cancer patients within a year (I have not encountered a single one here after two years).

b)Conservative management for ectopic pregnancies would be very difficult as patients need to pay for the test done (beta hcg) and hence would be way too costly for them as compared to surgical or medical treatment. Follow up would not be feasible and the risk of them collapsing in a kampung somewhere is a possibility.

c)Although NICE has issued a guidance on the management of menorrhagia using the MIRENA as the first line of treatment, I doubt many would be having this as again it comes down to cost. So it would still be the reliable tranexamic acid or norethisterones...

d)There isn't any proper primary care trust where patient health information are constantly shared with the hospital or made available partly because patient do a lot of 'GP shopping'. Perhaps the GPs may want to group together and form a trust?

These are just the tip of the iceberg of my concerns. Lastly, I have always wondered how one become a consultant in Msia. I do not recall we have a system to promote someone from the specialist status to consultant status and correct me if i am wrong but it appears that if you are in the service long enough and grow some white hair, then perhaps you can then be promoted in such a manner. Do enlightened me...

Just my thoughts. You may disagree or perhaps miraculously agree with me but I welcome all comments..


Monday, 8 October 2007

Time to pack

I have only about a month to go before heading back home. Lots of things to pack. Somehow i find it really amazing. I came with a single large baggage and i am going home with at least 6 boxes and two large baggage. Hmm looks like i have done quite a bit of shopping here in the UK.

Had my last three nights of on call and it has been surprisingly quiet. Last night itself i only needed to review a patient at about 3 am, and the rest of the night i stayed in bed. Now that's really good as i am practically the only doctor doing all the ObGYN stuffs at night from 830 pm till the next morning. Although i had a chance to warm up my on call bed, i must admit that i have not slept in recent times when i am on call. I believe that i am being paid not to be in my bed but to stay awake to work like the rest of my team. The midwives.

Arrggghhh so much to pack.... hmmm alright then...back to work...

Friday, 5 October 2007

Monster working long nights today

I will be working long nights today. It would be my 1st of the last 7 nights i will be working prior to my departure from this hospital as well as this country. I hate working nights. No SHO to talk to. Nothing to do. The doctor's mess is too far from the delivery unit to hang out in. However i do like the fact that they have a huge 40+ inch flat screen TV there with SKY satellite network. Hmmm... oh well.... might as well get over it...

Thursday, 4 October 2007

The Monster in Me...

Am very tired today. Had a long session of antenatal clinic and felt could have been more productive in seeing more patients. It just so happened that there are two difficult or rather complicated patients to deal with and required plenty of counseling and discussion. Then later on the day, had to see a couple with a newly diagnosed cystic hygroma on the antenatal ultrasound scan. Both the patient and husband were indeed anxious and I cannot imagine how i would feel if I were to be in their shoes. Anyways, will be referring them for further scan in Cambridge under the feto maternal unit and hopefully its just an isolated soft marker.

In the afternoon, I showed some of my new colleagues around the hospital and dealt with some rota issues. To be honest, am not too keen in arranging the rota for the next few weeks. So, that completed, I went down to town to hand over to 'Karen' my 'wings' to be amended so that I can have it done (will blog about this another day). The receptionist said that the earliest booking would be in December! ahhh... now how am I going to have it done before that????? well..I would just have to wait and see really.

So, came home and had no mood to wash my clothes. Went back out again and rent 300 to watch tonight. Ordered Chinese take away because mood to cook my dinner. Yes.I do cook my own dinner. And yes...I am not that bad a cook. Have Jamie Oliver to be my mentor (via BBC on the TV).

Will have to do my laundry tomorrow morning since I will be doing nights tomorrow.

Somehow..I fear that I am turning into a monster after all that had happened today (as you can see above, taken today evening). Argghhh!!!

Wednesday, 3 October 2007

WSH Registrar Leaving Do 02102007

The Obs and Gynae department had arranged for a leaving do for all of us specialist registrar as it was time to move on to our next job (well..for me another month though). We had dinner at this place called Chez Gerard. Brilliant food. Excellent wines. Wonderful people. Almost all the consultants were there to dine with us. We had also the company of the ever wonderful midwives, the gynae clinic nurses, MCTA, and our SHOs as well. Tears were shed and plenty of hugs and kisses but the main important thing was we had fun. The clinical director gave a speech and gave us each a miss/mr book based upon our working attitude and what the rest felt about us. Inside each and every one are the signatures of all our consultants. ahhh...... i am missing this place already. Will make the most of it the next and last month of work here.

Monday, 1 October 2007

My drawing...

I have finally completed the second of my drawings, or an attempt at canvas painting using acrylic paints. I took several pictures to show the progress I made each time as well as the final product. I named this piece..the awakening of docperineum.... hehhehe