Holiday

Exam has finally ended. Time to rejuvenate and reward myself back at home-the pearl of orient. I would like to extend my sincerest thanks and appreciation to all the people who made this year a memorable one.

1) The patients. Without them, I wouldn't have acquired any of the skills and knowledge that I have thus far. And most importantly -the art of medicine.

2) My outstandingly dedicated tutors!

3) Specialists and consultants from both the surgical and medical department

4) MOs and all the HOs that I've had the pleasure working with! Gratitude is extended to Dr Fadzli for being so accommodating and for all the feedback, direction and assistance when I needed them. Not forgetting the house officers from D2, PP1, W4 who have indeed enriched my learning experiences.

5) Ward sisters and staff nurses!- Thanks for showing me that nursing has a very special place in the health care system. And you guys are indeed indispensable!

Take care and hopefully we will meet each other again next year in my subsequent postings.

Running out of water

It is incomprehensible that while our beloved country is planning on building a 5 billion ringgit 100-story sky scrapper.On the home front, HSA has run out of normal saline infusion solution. All the patients are now on either dextrose solution or half saline regardless whether they are diabetic or the fluid replacement therapy is apparently inadequate!

Spot Diagnosis?

Courtesy of C.S.Lee

Thoughts for the day

1) You're in deep shit if you have a pneumonia caused by staphylococcus aureus. A knowledge on how heroin is taken could possibly lead you to the diagnosis!

2) A drug addict taught me that heroin can be used in 4 ways

I) Injecting it

II)Smoking it

III)Snorting it through the nose

IV)Inhaling it-Chase the dragon

Smoking and chasing is safer as compared to the rest as it reduces the risk of OD.

3) Commonest cynotic congenital heart disease is still Eisenmenger's syndrome

4)You need 2 medical students, 2 house officers, one ward sister and another staff nurse to insert a branulla in an emotionally unstable patient.

5) The chicken and egg story in a 28 y.o hypertensive patient. Hypertension causes the CKD or the CKD causes the hypertension? A thorough search for secondary causes of hypertension warranted?

6) You need extreme patience to be an infectious disease physician. Day in day out, you deal with resistant bugs, patients who defaulted their treatment and among others.

7) Met a few patients with haematological disorders. APLS, thalassemia and AIHA. Heamatology is quite a fascinating field I think.

8) Observed a bone marrow aspiration and trephine biopsy. The doctor that obtained the consent must be very persuasive!

9) A pericardial rub sounds like a systolic murmur

10) Saw Dr Liu today in the ward. He asked: Why are you still here. You like this place so much? What's wrong with you? I winked at him. He tapped on my shoulder and said: Better come back and serve.