Archive for July, 2009

I need Prozac.

Posted in cloudy days, doctoring tales, penny for my thoughts on July 30, 2009 by twotwoeight

I am deeply frustrated.  On a scale of 1 to 10, I’d say I was somewhere between 99-100.  This H1N1 situation is getting out of hand.  After reading the papers this morning on what DG had to say about the H1N1 death in Malacca, I feel so discouraged and don’t even feel like going to work anymore.  So we were instructed to have a higher index of suspicion for patients presenting with ILI (Influenza like illness) so as to detect H1N1 cases earlier and start treatment.  Number 1.  More than two-thirds of our paediatrics ward are patients who present with respiratory symptoms.  So are we supposed to assume all these people are potential H1N1 patients seeing as the number of local transmission cases are rising?  Number 2.  If we suspect more and more people to have H1N1, then where are we supposed to “isolate” these said patients? The isolation ward has only that many beds, and who draws the line at which patients should be isolated? Number 3.  Even if we suspect these patients to have H1N1, the current protocol is that we don’t take throat swabs from everyone and even if we do, and the throat swab is positive, treatment is not warranted for every patient who is H1N1 positive. Number 4. If you want us to isolate more and more patients, that would mean a whole new work burden because then extra staff has to be allocated to tend to these isolated patients, which would ultimately of course be shouldered by the medical officers and staff nurses.  Which leads to extra calls per month.  Which is what is happening now.  This leads to decreased manpower in the already overcrowded and busy wards, and hence overworking the healthcare workers. Number 5. We are asked to detect cases early so that treatment can be started early as the antiviral drug is most effective if given within 24-48 hours of presentation of symptoms.  But the protocol states that only patients with moderate to severe symptoms should be given the antiviral drug to prevent emergence of drug resistance.  By the time the patient develops signs of moderate to severe disease, wouldn’t it be more than 24-48 hours?  What about healthcare workers who have come into close contact with H1N1 positive patients who have been ecposed to the respiratory secretions?  Are we supposed to wait until we deteriorate?  Doctors have also been reprimanded because of cases which were only given symptomatic treatment when they first presented with mild flu-like symptoms and sent home.  What do you suggest be done instead?  If we were to admit every patient coming with mild flu-like symptoms, we might as well admit the entire population.  Retrospectively, it is very easy to find faults and said “You should have done this” or “You should have known better”, but put yourself in the situation on the frontline and you would know the dilemmas faced at that moment.

I foresee that this madness is only going to escalate, as we live in this world populated with irresponsible and ignorant people.  Take “home quarantine” for example.  The entire concept of “home quarantine” is misunderstood, either secondary to ignorance or blatant stupidity.  There are advertisements and messages in the media every single day emphasizing the importance of home quarantine.  And yet, we have people who bring their month old babies to visit relatives who have been home quarantined, and these relatives welcome them with open arms and hold and kiss the baby.  The next day, when they develop fever, then they start to panic and worry whether or not it could be H1N1.  So tell me, who’s more irresponsible?  The mother, who brought her baby to visit the relative, or the relative who knowingly hug and kiss the baby? Ultimately, the one that suffered is the innocent helpless baby.  What about mothers who send their children who are on home quarantine because the school has closed due to cases of H1N1 to take care of their younger siblings in the hospital?  Because of people who willingly expose themselves to the risk of H1N1 and then panic when they develop flu symptoms, hospitals are overcrowded as the number of unnecessary admissions are on the rise.  As it is, working through lunch has already become a common phenomenon.

Maybe man has evolved to become so arrogant and think they are indestructable that they are not afraid of illness and death.  Hence, this current pandemic is not even worth a worry.  How else can you explain the increasing number of patients and visitors in the hospital?  The sight of children happily playing catch and throwing balls and laughing without a care in the world, rolling on the floor is surely a sight for sore eyes. I mean who wouldn’t be happy watching kids play? Oh wait, did I mention, this “sight” was in the subacute cubicle of an overpopulated children’s ward with a daily bed occupancy rate of more than 130%?  I could only hold my tongue that long as I watch the parents just chit chatting amongst themselves and ignoring their children creating havoc and shouting their lungs out in the middle of the ward.  I put the blame solely on the parents for this.  Actually, I don’t quite understand why is it that people are not worried or cautious when they come to the hospital especially with the current H1N1 pandemic.  Wouldn’t you be worried if all the healthcare workers in your ward suddenly started wearing facemasks?  If I were a patient or visitor, I’d be paranoid that there was something going on.  But apparently not, as the ward is still as full as ever.

As if the day couldn’t get any worse, upon returning from lunch, my car park has been taken.  Again.  When the guard was questioned, this time it wasn’t Samy Vellu’s relative.  This time it was a Datuk.  What the fuck? I don’t give a shit whether or not you’re a Datuk or Datin or a minister, you have no right to park in other people’s allocated parking space.  The guard on duty is even better, when asked how come he let the Datuk park at my place even though he knew it was not his parking, his reasoning was because he was a Datuk.  And he said if I’m unhappy, I should go and see the Datuk myself as he had already done his job.  Which part of his “guard” job did he do??? His job is so simple I feel like taking his salary and just sitting there not doing anything.  Sure seems like a much better deal compared to the doctor’s job.  Easier, less stress and safer.  And when people put you down for not doing your job, you can just come up with feeble excuses.

This world is so screwed up.  Am I frustrated? That would be putting it mildly.  I am already having cough and cold.  Call me crazy but I’m fervently praying that I will run a fever of 39 degrees so that I can have a legitimate reason to not work as I will have to be on “home quarantine” due to exposure to H1N1 patients.  What if I die from H1N1?  Perhaps this is a process of natural selection to wipe out those with poor immunity and those with not enough gray matter to expose themselves unnecessarily to H1N1.  Like silly idealistic people who became doctors.

The loss of Yasmin Ahmad

Posted in cloudy days, love on July 26, 2009 by twotwoeight

Bernama

KUALA LUMPUR: Renowned film and advertising director Yasmin Ahmad died here at about 11.25pm on Saturday night.

~Taken from News Straits Times

sepet

I still remember the first time I watched Sepet.  Ironically, it was in Singapore.  The movie touched my deeply and it was in my mind for a long time afterwards.  And I still remember the second, third and fourth time I watched it.

Yasmin Ahmad’s works of art speak volumes, and always leave you pondering.  Through her movies and clips, she reaches deep into your soul and tugs at your hearstrings in ways that you never imagine possible.

Her passing will be a great loss to mankind.

Overflowing with Love.

Posted in love, radio in my head on July 23, 2009 by twotwoeight

Two Words – Lea Salonga

In a while, in a word,
Every moment now returns.
For a while, seen or heard,
How each memory softly burns.
Facing you who brings me new tomorrows,
I thank God for yesterdays,
How they led me to this very hour,
How they led me to this place…

Every touch, every smile,
You have given me in care.
Keep in heart, always I’ll,
Now be treasuring everywhere.
And if life should come to just one question,
Do I hold this moment true?
No trace of sadness,
Always with gladness…
I Do…

(instrumental)

Now a song that speaks of now and ever,
Beckons me to someone new,
Unexpected, unexplored, unseen,
Filled with promise coming through.
In a while, in a word,
You and I forever change,
Love so clear, never blurred,
Has me feeling wondrous, strange,
And if life should come to just one question,
Do I face each moment true?
No trace of sadness, always with gladness,
I Do…

Never with sadness…
Always with gladness…
I Do.’

Simple yet meaningful.  Favourite track on my playlist currently.

Cat or dog person?

Posted in random bits on July 19, 2009 by twotwoeight

While I was having my pedicure done, I burst out laughing when I read this…a dog’s New Year’s resolutions.

Cats

The book is hilarious!

A Bad Dog's Diary

Answer? Definitely a dog person. 😉

When in Saigon…eat!!!

Posted in gastronomical delights, professional tourist in the making, through the lens on July 19, 2009 by twotwoeight

Saigon is in its own unique way, a gastronomical heaven.  And especially so for me, who is not a big fan of rice, there are oodles of noodles, tons and tons of wraps and rolls of different varieties, lots of fresh greens and not forgetting the smorgasbord of internatoinal cuisine available!

Noodles galore

Noodles galore! All kinds of colours and texture.  You always get a serving of fresh vegetables and herbs to go with your noodles which you can add to your heart’s content.

Condiments

And eating like a local means adding tons of lime to all your food!  Not to mention a concoction of salt and pepper…especially good for finger foods.

Colourful pickles

Not only that, they have lots of different kinds of sauces and dips of which most are fish sauce-based to enhance the flavour of the many snacks and finger foods available.  And they take the trouble to be creative with your pickles too!

Snails

Fancy stuffed snails for breakfast? 🙂

Supper by the roadside

What better way to “do as the locals” than to have supper at the roadside? One of the best tasting grilled chicken I’ve had, fragrant and slightly crispy skin on the outside, tender and still succulent meat on the inside…yum yum.  And they have all sorts of chicken parts available too 😉

Local kuih

While we were having supper, there was a lady who came selling an assortment of local sweetcakes. Aesthetically pleasant, no doubt…but nothing fantastic.

Typical Vietnamese dinner

Went to have a proper meal at a Vietnamese restaurant in town.  A typical Vietnamese dinner? From the top left – grilled fish, mango salad, stewed pork in coconut sauce, stir-fried pumpkin flowers (something new to me, but definitely nice!) and stir-fried morning glory.

Pancakes, Vietnamese style

One of the many snacks famous in Saigon, Vietnamese crepes, or banh xeo, which literally means sizzling cakes are stufffed omelettes made of rice flour, cumin and coconut milk.

Finger food

More yummylicious snacks…to whet your appetite!

Steamed rice crepe rolls with grilled pork

Wraps and rolls! My favourite 🙂

Summer rolls

Vietnamese fresh rolls, also known as summer rolls are rice paper rolls that often include shrimp, herbs, pork, rice vermicelli and other ingredients wrapped up and dipped in peanut sauce.

Banh Cuon - rice flour steamed rolls

They love their spring rolls so much that there is actually a restaurant called Wrap and Roll which specializes in local Vietnamese fare which serves up a wide variety of wraps and rolls!

What a gastronomic journey! Trust me, after you have had the good fortune of tasting local authentic Vietnamese cuisine, you will realize that the Vietnamese fare we get in Malaysia pales in comparison, and nothing beats the real thing. 🙂

Remedy for your sweet tooth

Posted in gastronomical delights, professional tourist in the making on July 18, 2009 by twotwoeight

Coconut ice cream

Authentic coconut ice cream served in a coconut and topped with as assortment of unique condiments like sweetened pineapple, berries and nuts making it a heavenly concoction on a hot day!

Che

Che – a general term for a sweet dish or dessert.  A famous dessert stall inside Ben Thanh Market offering a variety of local favourites, whether you like it hot or cold.  The row of colourful glasses at the bottom is very similar to our leng chee kang, where you can have the ingredients of your choice topped with handfuls of crushed ice and syrup.  Crème caramel is another favourite here!

Quintessentially Saigon

Posted in gastronomical delights, penny for my thoughts, professional tourist in the making on July 14, 2009 by twotwoeight

Saigon

Watching the cars and motorcycles waltz and tango to an orchestra of car horns and feisty verbal exchange, and wondering in amazement how everyone comes out unscathed every single day.

Admiring pretty Vietnamese ladies dressed in their traditional costumes (which leave little room for breathing) balance themselves with much poise and grace on the backs of the motorcycles with their legs crossed neatly on one side, oblivious to the noise and madness surrounding them.

Waking up in the morning, leaning on the balcony with a cup of hot coffee, listening to the distant sounds of the traffic and the occasional crow of the rooster whose internal clock needs fixing as the city slowly wakes up to another day of hustle-bustle.

Doing as the locals do, sitting on a park bench enjoying the sun and breeze, while watching people of all ages sit at the side of tree-lined streets without a care in the world, enjoying a cup of coffee or a cold beer and occasionally munching on sugar canes or a corn-on-cob (or so I’ve been told ;)).

Waiting in anticipation for a gastronomical surprise, seated at a little table and stools reminiscent of doll tea-parties, shaded by towering magnificent decades-old trees in a quiet part of town as aunty prepares her renowned homemade noodle of the day.

Noodles of the day

Feeling as if having stepped into a time machine and being transported back to the good old days upon walking into local restaurants and eateries where walls are covered with posters of yesteryears and the furnishing reminiscent of the 50’s.

Living the “expat-life”, reading the papers and magazines while sipping a cold drink and enjoying crème caramel and rich creamy ice-cream melting over warm brownies, knowing there’s no need to look at the time or worry about life and all it’s menial details.

Reminiscing about those long-forgotten and much missed carefree childhood days, while laughing at the antics of two little boys playing by the roadside in an engaging game of to-do-or-die sword-fight armed with just simple wooden swords, pure bliss written on their faces.

Quintessentially Saigon…to me anyway 🙂