Remembering SARS - Part II

We know that ward sisters like to hoard stuff. Can be pens, rulers, toilet papers, swabs and a variety of other daily supplies. I had always conveniently attributed this to our frugal ways since Singapore was a third world country not too long ago. Though of course when you need something in the ward it can be really frustrating. One example was disposable ECG leads. We were always made to reuse ECG leads sometimes to the extent that it is full of (many) patients' (many) hair and was no longer sticky. If you have the experience of holding on to loose ECG leads with your fingers and trying to use your leg to press the start button on the ECG machine, you will know how frustrating and humanly impossible that can be.

Inconvenience is one thing that I can accept. Potentially dying is not. 

When SARS first struck, some ward sisters decided it would be a good idea to hoard the N95 masks. With the virus full blown in Singapore by April and fatality climbing, the possibility of getting infected and dying became real! It was like a movie playing around us, somewhat surreal. Perhaps for some in the hospital, they continued to be in denial.

Being the lowest lifeform in the hospital then as a houseman, we were bounced around each day when we try to get our daily stock of N95 masks. We were told by the ward to get it from the OT but the OT told us that the supply there is only for surgeons operating. When we asked the ward, we were told by the ward sister that there was no stock.

"Zero, no more stock." She told us affirmatively.

We retreated to the MO Room to how our usual kpkb support group sessions.

"Er, I saw the sister carry so many boxes into the nurse manager room leh! How can be no stock ar!!???" One friend cried foul as everyone started complaining loudly.

"Wait ar....." Another fellow houseman stood up and shouted before exiting the room and crouching slowly towards the nursing manager's room.

He disappeared out of sight for a few minutes and returned to the MO room with one box of N95 masks. Enough to last us for a couple of days.

"Wah you went to sister's room and kapok ar?" I exclaimed.

"Well, you can't steal that which does not exist in the first place." He told me with a wink.

RESPECT...

In the next few days, N95 masks became readily available with the hospital's official decree. 

SARS despite being all bad did improve infectious control in the wards. I'm sure ward sisters won't hoard disposable ECG leads anymore these days. Even if its not unhygienic, reusing leads with hair-stuck-on, seriously gross la.

Remembering SARS - Part I

Early March 2003. 
A new strain of virus have been reported and was apparently causing deaths in countries like China, Hong Kong and Vietnam. A recommendation was made for doctors who were seeing feverish patients to don N95 masks in addition to other universal precautions. 

I was a junior (very junior) doctor in a surgical unit. Honestly, I was never surgically inclined and this was just one of those postings I had to pass through. In fact I was near the end of the posting and celebrations were round the corner. 

The news of the new deadly viral strains were causing some concerns but no one seemed to really care, definitely not the nurses. When I questioned them why they were not wearing masks when treating febrile patients, they laughed in my face.


"Why, you scared is it... hahahha......"


Is China, HK and Vietnam really that far away? I asked myself.  


One night, I was asked to see a febrile patient with abdominal pain. He had a travel history. I asked the ward  staff for a N95 mask. The nurses refused. I asked to speak to the nursing officer. 


"Aiyah, its just appendicitis. Why you need the mask?" She said, attempting to dismiss me. 


I insisted on the mask and threatened not to see the patient if not given. She could have called my bluff but she relented begrudgingly and not before making threats about how my Consultants would hear about this.


After slapped the mask into my hands and she couldn't help adding, "You better keep this with you for one week. This very expensive mask!"


None of us would have known that this very nursing officer would be the one who will soon be going after doctors who did not follow infectious protocols as the pandemic exploded  in our face soon after.


In the next week or two, the new viral strain was named Severe acute respiratory syndrome SARS)  and the very first cases appeared in Singapore.

Thank You

After a long while in a place, Dr Og decided that it was time to move on. And when you are no longer useful to an organization, you suddenly realise how much they really do care about you..... they don't. Well, it can be rather disconcerting and sad, especially when this Dr is narcissistic and suffers ego bruising easily, but as the Chinese saying goes, short pain better than long pain.

So here I was sitting at my new office opening up envelopes and in one of them I found a thank you card. It was from a patient (from my previous hospital) and his family wishing me all the best. I'm sure the little kiddo was made to sign the card rather unwillingly. Hahaha. It was a nice simple card with a nice simple message.

But seeing the card, I knew that the time I spent in my previous organization was not all in vain (wished I've done less silly admin work though).

Thank you for the card, it was important for me :)

Dr Og's Off-White Paper on Preparing Singapore Healthcare for 6.9 Million People

Dr Og is apolitical and will not comment on the quality of toilet paper in public hospitals let alone the recent White Paper on Population. Honestly Dr Og is a small lokun with little helicopter perspective and the last time I comment on TCM also tio scolded... haiz

Anyway, whether in 2030 we got lak bak gao chup ban lang (6.9 mil) or not, Dr Og thinks we better start preparing our healthcare system and hospitals. Don't goondu goondu buy super tight skinny jeans and discover after Chinese New Year all the goodies cannot wear liao, right!!??!!

So Dr Og presents his:

Off-White Paper on Preparing Singapore Healthcare for 6.9 Million People (And A Core of 3 Million Singaporeans).

1. Health Promotion

HPB monkey! Source: HPB loh

Health Promotion Board has always been very solid in providing educational materials to promote good health and well being. From animals to vegetables, their adverts (almost) always strike a cord with fellow Singaporeans. In fact I think they are well prepared because the mascots they use are very international, like generic elephant, giraffe and monkey instead of recognizable local species like orang utan or dugong. So our ever increasing international crowd will have no problems identifying with these beasts.

However, in my Off-White Paper, I will like to propose having overseas health promotion! After all by 2030, most of our residents will be foreigners. It will be too late for any brainwashing form of health promotion by the time they are parachuted in at their middle age. And don't you want to see those HPB monkeys speaking in Tagalog?

2. Training of Doctors
If you are not in the medical line, you may not know that postgraduate / specialist training for doctors has undergone a major change in the past few years. We have cleverly adopted the American system of residency training (think Dr Doug Ross (George Clooney) in ER or Dr Meredith Grey (Ellen Pompeo) in Grey's Anatomy). That's cool right? Particularly when we are becoming a really international nation.

What is even more cool is that while the old training trains doctor to be fast and accurate when seeing patients, the new residency programme allows the trainee doctors to slowly take their time. But with 6.9 million where got time, tio boh?

Therefore in the new residency, not only need to learn how to see patients fast fast, also need to learn to hold urine and skip lunch. The exams will not be about clinical work but how long your bladder can tahan before you need to use rubber band (for guys, for girls, can someone from the female sex advise?). Indeed, with 6.9 million people, there will just be people(not urine or faeces) overflowing toilets lor!

3. Improvements in Hospitals
3a. Increasing Hospital Beds

Hospital Beds in 2030!

Given that there is simply a lack of hospital beds now with just 5.3 million people, there needs to be innovative ways of increasing hospital beds! We are already parking beds on corridors. So Dr Og suggest triple decker beds! Never mind if its so crowded until like those 雾锁南洋 (The Awakening) refugee boats! By then we all will be so use to being pack like sardine and be totally desensitized!

Since there are so many water features and ponds in hospitals, we can also have floating beds on them. So patients can now truly enjoy the soothing sound of water running. These luxurious water beds will of course only be opened up to rich private patients.

3b. Translators

Being truly international, we need to hire translators. No, we do not need translators for the various South Asian or exotic European languages. First we need English to English translators. Strangely in the hospital, everyone speaks English but nobody seem to understand each others' English because of the accent. For eg. we will need a translator for someone to translate Indian English to Singlish or from American English to Filipino English. The combinations are scarily more than Street Fighter 4 combos and we need to hire translators now!!!

Secondly, we will also of course need translators for our local spoken languages and dialects as we will soon be the minority. Even now, our ah pek ah emmm are having a hard time communicating with the medical staff in the wards and clinics!

4. Engage TCM and  other traditional healers
My last suggestions. Get TCM and traditional healers to help out! Sure, they don't practice evidence based medicine but so what? There are 6.9 million people can?!! And all deserve some form of medical help right?

Mostly, I'm adding this in to appease the dude who posted an angry comment on my TCM expose. :)

TCM Exposé!

Stop looking at the legs and focus on the Leng Yong drinks!
(Source: http://christallehuang.blogspot.sg)

Patients always ask Dr Og about TCM, aiyah very pek chek lah. All I know about TCM is last time small I fever, my mother give me leng yong drink. End up I my fever never subsided for one week. Now I smart, just take panadol and pour whatever tonic my mother gives me. hahaha

But the most irritating thing about traditional medicine is this scenario:

Ah pek: "Lokun, why cannot recover one. You no good la"

Lokun: "Ah pek you got take your meds boh?"

Ah pek: "No leh, I am taking herbal medicine to adjust the Qi. The sinseh say my body too cool liao."

Lokun: "Alamak, just take both lah."

Ah pek: "Cannot! Take Chinese meds cannot take Western meds. Will cheong!"

(Disclaimer: no ah peks were ever hurt or injured in the making of this blog. Though sometimes there is an urge to knock their heads.)

In any case, Dr Og did some investigative journalism and here are some photos of Traditionl Chinese Medicine made the most traditional way. You decide if these are things you like to ingest, ok?

Wah, another innovative use of children's playground! Air dry TCM!

TCM medications processed and made the most traditional way. No western factories or industrial manufacturing! Just leave on the ground for extra ingredients!

A closer look. Just hanging around, hanging around...

Wow, pigeons all around the area. Mebbe they need to put up a scarecrow!