Some things in life never change

My sore throat ain’t going away.

I examined my own throat with my penlight that i normally reserve for my patients.

I saw my tonsils.

They were swollen.

I thought only kids have tonsillitis?

Why are my tonsils so huge?

My throat aches.

I nearly gave my Flute lesson a miss.

I got the time wrong, was half an hour early.

Was ringing the wrong unit so the tutor never realized i was there.

On the verge of just taking off back home.

But i hung around anyway and i discovered my mistake.

Flute lesson was not too swell today.

I shall attribute it to my not-so-good mood.

Now i am back home.

And all i want to do is have a hot steaming dinner,

and settle on my couch with my Resident Evil novel.

But my mock exam is on Friday,

i have a shit-load of stuff to get through.

I marvel darkly to myself how i have gone through years of studying,

and yet some choices still remain the same.

The choice between studying and relaxing.

And always the former won.

I cannot help feeling bitter sometimes.

I have been thinking about finding a part-time job.

A few opportunities arose,

and i want to send in my application.

Yet i hesitate because this is my most important semester.

But i could really do with the money.

I could eat better and buy stuff without having to think twice.

Yet i fret about my exams knowing that my priorities are all wrong if i really do that.

But if i wait till the holidays,

will i have missed all these job vacancies?

Will there be a greater drought of jobs?

Should i not be proactive now and try to secure a job before it is too late?

Should i take a massive chunk out of my already hectice schedule?

Medicine does not pay monetarily.

The fees we have to pay and the part-time jobs we are kept away from.

The long hours we have to toil,

the social life we sacrifice.

The only good thing is the sense of achievement and fulfillment.

I wonder sometimes whether that is merely enough to keep us afloat in such a Capitalist society.

Crooked

I am down with ANOTHER sore throat.

My ears ache.

I dare not swallow for fear of the backlash of my nociceptors (pain receptors).

Please do not let me suffer another cold.

My next rotation on Monday is Haematology and Oncology.

Patients will be very very immunosuppressed,

and i will have to refrain from being near any of them.

This is the second cold i have in 2 months!!

What the hell is going on????

At least do not let me lose my voice.

I do not want to have to cancel my flute and language lessons this weekend.

I have been looking forward to them.

They are the highlight of my week.

Hai.

(The sun is out,

peeking amidst the sullen clouds.

At least that is a bright sign.

I can take the dogs for a longer walk.)

Misunderstood

Different talents needed

An excerpt:

SINGAPORE needs people with a sense of the aesthetics and not just people who get straight As in school, said Minister Mentor Lee Kuan Yew.

‘In Japan, to say you are a landscape architect, you have to have an aesthetic sense.’ The aesthetic sense is identified from a young age in Japan, he said. ‘From the first day in school, you set out to discover what is your talent.

‘They see how good you are with drawing, sculpture, playing with clay. If you’re very good, when you grow up, you become an artist, sculptor, painter…If you’re not so good you become an interior decorator, you dress up windows.’In comparison, ‘we hired people on the basis of their O- and A-level results’, Mr Lee said to loud laughter. ‘So you’ve got symmetrical minds, and the same thing happened with HDB flats, I looked at them, all the same shape and size.’

Read more here (ST).

Sometimes i wonder whether i have totally misunderstood this guy.

And that the rigid academically-focused mentality that was rampant throughout my schooling years in Singapore was really not what he intended,

and perhaps out of his control.

Or maybe this is yet another propaganda  tactic as he realizes that perhaps what he strove to cultivate in the past was now creating a backlash.

I really don’t know.

But i do know that the recent articles in the Straits Times which feature him,

have soften my attitude towards Singapore,

and for once,

i am actually contemplating (rather gingerly) the idea of returning to Singapore to work after i graduate.

The yellowest person i ever seen, and no, i am not refering to a Chinese!

I had short cases today. That means we perform a physical examination on a selected patient and get grilled by the doctor after. We were forewarned by a Fellow (someone who is one step away from becoming a Consultant, the highest and mightiest in the hospital hierachy).

“You guys are probably going to see that lady. She’s bright yellow.”

We just nodded, obviously not quite grasping what he meant. When the doctor pulled back the curtains and motioned for us into the patient’s cubicle, i saw the patient, inspected her surroundings, mentally did a double take, and this time looked at the patient carefully.

The patient made eye contact with me; i mentally froze, and could only manage a weak smile. I forced myself to maintain a Parkinsonian expression, refusing to betray my professionalism by revealing my underlying emotions.

That lady was YELLOW. Like a bright fluorescent yellow. Her scleras (eye whites) were YELLOW. She glowed with a sick yellow. When she trained those yellow eyes of hers on me, i felt my insides take a lurch. She looked like some zombie that just stepped out of my Resident Evil book. I stole a glance around the other medical students, and i could see a few of them trying to stifle their discreet expressions of horror.

How the hell did someone turn so yellow?!

The answer? Alcohol.

*Shakes head*

This lady is older than my mother. She knows she has liver disease and should not be drinking. Yet she did. I am not sure quite what to say.

But i ain’t gonna forget those large yellow eyes of hers in a jiffy. When we made eye contact, i knew instantly that i will be having some bad dreams for the next few days. I hastily looked away to wash away the image of those yellow eyes, but it had been seared into my memory. This is as bad as watching a horror show. Thank God my housemate came back from the country hospital early today. At least i know there is company in the house if anything goes wrong…

(Also i guess i should start getting use to it. I applied to do my elective end of this year in Africa. I will be seeing more exotic symptoms over there, if my application is successful.)

Jaw drops

Please tell me these kids are aspiring actresses and do not really mean what they said.

I’m ashamed to be a Singaporean if this is what girls are morphing into.

Chronic conditions

I have been seeing quite a number of patients with serious chronic conditions. Afflictions that started when they were kids and that have grown to shape their entire adult lives. Serious life-threatening illnesses that force people to re-evaluate their perspectives and priorities.

Today during outpatient clinics, a patient came in on a motorized wheelchair. I saw her in the waiting room whilst i was walking into the consultation suites. I did not pay her much attention because i did not think i will be seeing her. On hindsight, perhaps i was avoiding having to think about her condition and how it affects her. She has Multiple Sclerosis (a usually progressive neurological condition). She was diagnosed when she was 19. She is nearing 40 now. She has a catheter in because she cannot control her bladder. She relies on carers to take care of her needs – both physical and bodily functions. She can’t get to the toilet, and even if she can get there, she lacks the capacity to move herself onto the toilet bowl. Hence, when she needs to pass any motion, she either holds it in till the carer comes, or she soils herself, and sit in the pool of faeces till the carers arrive to clean her up. I kept mostly silent throughout the exchange between her and the consultant. I thought about her at 19 receiving her diagnosis, and wondered what her reaction was. I tried to put myself in her shoes, wondering how it feels like to be trapped in a wheelchair whilst other people her age were walking, running and skipping around her. I tried to envision how she felt when she saw her friends grow up and get married, whilst she contended with the harsh reality that no man may possibly choose to live his life with her wheelchair-reliant one. I tried to imagine her feelings when she had to grit her teeth and deal with the humiliation of having someone to clean her up because of her lack of control. And i felt very sad. And very helpless.

Then i met my former research colleague. And she was the last person i really wanted to meet today but there was no turning back. We were at a traffic intersection. She too has Multiple Sclerosis. She too, is in a wheelchair. Friends have told me that her condition was deterioriating. I have not taken any notice; did not want to take any notice. I prefered to maintain a distance. But we made social conversation as we walked to the train station. The green man changed into a red one and started flashing. Ordinarily i would have made a dash for it, but i did not know whether she was capable of doing that. I asked her and we did. I half-brisk walked, half-slowed down to make sure she could keep up in her motorized wheelchair. Then we came to a flight of stairs leading to the train station. I walked towards the steps without thinking and suddenly i realized that there were no slopes or elevators. It had never occurred to me how disabled people could access this train station. I paused for a minute unsure of what to do. My colleague did not even hesitate. She bade me farewell with a smile and sped off to a corner where presumably there was a ramp in existence. A ramp that i have taken for granted. I hurried down the stairs and the escalator. My train came in two minutes. I boarded it. I wondered whether my colleague managed to board the train. As the doors closed, i saw her sped in her wheelchair down the platform towards the driver’s end. I looked and i willed the driver to stop. To wait. To allow her to catch up and board the train. The train pulled away from the platform. I scanned the passengers on the platform. And i saw her, waiting patiently for the next train, in her wheelchair. And i thought how unfair Life is. That two people can have the same aim, yet the effort needed by one to achieve it can be so unbalanced. And i felt sad, and helpless all over again.

There was another patient. She whizzed into the consultation room, cheerful and humourous. Then she told the doctor what she had. Breast cancer, bowel cancer, two autoimmune diseases and Celiac disease (wheat gluten allergy). I was so astounded and appalled i could only look down at my notes. How can someone be struck with so many disease at one time? And how can others be spared and live life so smoothly? I cannot comprehend this.

And yet another patient. Struck with Polio since he was five. He has been in pain since. He is almost 60 now. When i asked him whether he has any joint pain, he looked at me, smiled and said, “I have been in pain since i was 5. Pain is nothing new to me. I can deal with it.” I did not know how to respond to his statement. At that very precise moment, i knew whatever i have studied from my innumerable medical textbooks, did not prepare me for these situations. I kept silent again. Words can be so inadequate sometimes. But i mumbled a reply to acknowledge that i heard what he was saying and i am sorry because i cannot say i understand what he is going through.

These are just some of the many patients i have been meeting recently. There were the countless young women who have to grapple with fertility issues because of their health diseases. People who have to shelf their plans of having any children, people who have to work through their marriages because of their health conditions.

The past few days have made me question exactly what i intend to do in Medicine. It is obvious that in all these patients, Medicine has not exactly attain a level that can help relieve these patients of their afflictions. No one has a clue as to what to do, and mostly these patients really just have to go through life, forging on their own.

It just makes me realize how fortunate i am, and those people around me, are. It makes me see even more clearly how selfish healthy people can be, and how they take for granted, so many of the small things in Life. And i am just speechless. Like i say, words are insufficient. Sometimes i feel like a hermit crab, seeking refuge in my shell, as i watch the world pass me by.

This woman is so inspiring

The cynical looks on the judges’ faces,

the unkind jeers of the audience.

Yet she persisted on.

And triumph the Underdog did.

Her performance was very moving.

I was captivated by the video and watched it half a dozen times.

Beautiful.

Susan Boyle.

Service industry

Last week i did a small road trip to a town that i had wanted to visit for some time now.

I heard they have good steak, another good reason to travel over 300km for dinner.

Personally ET and i had fun weaving through the hilly areas, navigating round sharp bends and basically bullying all the slow drivers on the road.

Anyway it was after midnight when i finally returned to the city.

There was massive roadwork going at the end of the highway.

ALL the lanes were closed and we were travelling along the emergency lane.

This highway must be the busiest in the whole state.

Monstrous trucks and freightliners run the place.

I was stuck behind a freightliner and i could not see anything in front of me.

Hence when he diverted into another lane, i followed him only to realize my mistake.

We had driven into a toll area.

There was no way for me to backtrack, but to pay the damn AUD$13 fee.

I was really disgruntled about the whole thing.

I did not need to use the toll road, and in fact exited 10 metres from the entrance.

Secondly, the people doing the roadwork should have anticipated that drivers may get confused and get diverted into another lane, considering how they closed every single other damn lane.

But no, i have to pay the fee.

The government needs money especially when they are handing out an AUD$900 bonus to every taxpayer for last year in the hopes that EVERYONE WOULD SPEND IT.

(I really feel otherwise. AUD$900 is too little an amount to invest in anything substantial and too much to spend on anything frivolous.)

Anyway i had three days to call up the toll office to pay for the fee or i will get a late notice and an AUD$100 penalty.

I put it off till the very last minute.

Like i say, i was very unhappy about the whole thing.

Problem was i lost track of time and no longer knew whether i have exceeded the grace period.

Behold my conversation with the person on the other line.

“I was re-directed onto the toll road on Wednesday night because of massive roadworks and i need to pay the fee.”

“You have exceeded your grace period by a day. You need to wait for the late notice.”

I kept silent and then i remembered it was midnight on Wednesday so that makes it Thursday, except i don’t really remember.

“If i was on the toll road after midnight, that would make it Thursday and i will still be within the grace period right?”

“Yes.”

“Can you check the time my car was on the road please?”

Without skipping a beat, “Sorry i can’t do that. It takes too long on the computer.”

I was flabbergasted.

What do you mean take too long??

These guys must be operating on a loss since their computers are not even updated with the latest technology.

Also when people call up to clarify especially when there were roadworks, surely, damn it, you will take the time to bring it up on the computer.

“Ok never mind. If i pay for the fee now, and i find out i am behind my grace period, does that fee credit to the late penalty.”

“No.”

Unsure and in disbelief about what i just heard, i paraphrased my statement.

“So if i pay the fee now, and i find out that i am late, i still have to fork out the whole penalty amount. I am paying double then?”

“Yes.”

I felt a surge of intolerable fury at how these guys were operating.

But as soon as i felt the anger, it slowly dissipated.

I was and am not surprised.

This is Australia.

Their service industries are really shitty.

It just blows my mind how these people seem to get away with it.

Are all Australians so laid back that they choose to close one eye, or have most of them kow-towed to these ruthless companies?

It really bothers and puzzles me.

Gosh.

This country’s economy really needs to get a whacking for them to wake up and realize that they won’t survive long given their current attitudes.

I should have known better

An insight into a medical student’s life.

As fifth years, we are encouraged to see and clerk as many patients as possible. Studying from textbooks should not be done when we are in the hospitals, but preferably under candlelight and moonlight in the night (although i am not quite sure exactly how much time we really have left when we do get home. I mean, if you do not want a social life then i guess it is possible. But for saner people like me, i like to have a life outside of Medicine, and therefore i do need time to practice my flute, revise my languages, take my dogs out for a walk, go for a run, or just head out for a meal with friends. Not quite sure what they mean by studying outside of the hospital).

Our 8++ hour day in the hospital should be put to more constructive use by hounding patients and politely insisting that they tell us why they are in hospital and all their relevant histories. Never mind that we are the hundredth student to bug them. Never mind that they have given their stories so many times, that on many occasions, they even produce the correct medical jargon to us. The rationale is that when we see real life patients with symptoms, we remember the medical conditions better. This is true, and i highly attest to it. Unfortunately, we still need some idea of what the hell we are looking at. Therefore, it is not very practical to just survive on clerking alone. Anyway, that is not the point of this entry. (Also, in case you are wondering how come i am not putting what miserable time i have left outside of the hospital to cram more knowledge into my feeble brain, i came home early, high on a small panic attack, because today i happened to be very lost in my tutorials and that was very scary. Also, i skipped a Philosophy lecture (about Voltaire) just to come home and learn about liver diseases, so i am not too happy about this. At all.)

Anyway yesterday was a good day. That means i saw a substantial number of patients. However it very nearly turned out otherwise. My conversation with my first patient went like this:

To the elderly gentleman sitting serenly in his chair…

“Hi, i’m RGK and i am a medical student. I would like to have a chat with you about your medical condition and to perform a physical examination. Is that ok with you?”

“Ok,” patient nodded.

I pulled the curtains around us for greater privacy.

“Why are you in hospital?”

“For my Rheumatoid arthritis.”

I looked at his hands. Not deformed at all. At this stage, alarm bells should have gone off in my head, but i reserved my judgement. In case you don’t know, in this era and in a modern society like Australia, conditions such as Rheumatoid arthritis do not usually progress to the extent where they require hospitalization. The progress of this disease is usually arrested very early on with medical interventions.

“When were you diagnosed with Rheumatoid arthritis?”

“A year ago.”

“Are your medications not working?”

“They are.”

At this stage, even louder alarm bells should have gone off in my head, yet i chose to ignore all these warning signs. Why would a guy whose medications are working for him, be in hospital, for a condition that does not usually require hospitalization??

“Ok, so what is wrong?”

“I want a second opinion. I think a specialist should be involved in my care.”

Uh-huh.

I changed tactics.

“What other medications are you on?”

“I don’t know, why don’t you check my medical file. The Air Force keeps intensive tabs on me, i am from the Air Force.”

“I will not be able to access that file and also it is better to ask you first.”

“Aren’t you from the Air Force?”

“No, i am a medical student.”

Creeping thoughts of government spies and surveillance entered my mind, and suddenly i wondered whether i should just cut my conversation short.

“You are a medical student with the Air Force.”

“No, i do not work for the Air Force.”

“Where do you work then?”

“In this hospital.”

“You are from the Air Force,” he insisted.

At this point, i really do not know how to continue our conversation. It was also at this juncture, this man’s wife visited.

“Hi,” she said.

“He’s still very confused isn’t he? He has got meningitis. When can his shunt be put in?”

I stared at her feeling rather stupid.

For the past twenty minutes, i have been trying to hold a coherent conversation with a man who does not even know what was going on around him?

Nice.

Oh my God, seriously…

Top 3 specialties i am steering clear of:

1) Reproductive Medicine

2) Endocrinology

3) Dermatology

Argh.

So painful studying these 3 rotations.

I hope he/she waits for you.

Source: PostSecret

(The regret is terrible.)

SS

Secret Service.

Gestapo.

Fearful.

Lurking everywhere.

Suspicion.

Responsible for the social mayhem.

Sowing the seeds of distrust and misery.

Despised by everyone,

yet everyone tried to remain on their good side.

SS.

Also stands for Shit Stirrer.

Historically different,

but present through the ages.

Not much difference in concept really.

Generating the same sort of resentment.

I can’t wait to be rid of such people.

But then i realize,

i cannot be a better person without these people.

So as much as i like to put a bullet in their heads behind their backs,

i have to grit my teeth and learn to live with them.

They exist…so we can learn.

Train rides

A few weeks ago, i was on the early morning train to the country hospital. I have to take two trains to the hospital – a city one that runs from the station near my place to the city interchange, and then the country one from the city interchange to the country. I had to be at the country hospital by 7.30am because of the ward rounds, hence i am always on the first city and country-bound trains. The trains’ schedules are arranged such that i have about four minutes to dash from the city platform to the country platform before my country train departs. Therefore, I cannot afford any delays.

Prior to that day, i have naively assumed that my trains could never be delayed. I mean, there is no traffic at 5am in the morning, no reason for any delays because commuters are not propping the doors open for their mates who are running late. Alas, again, i was proven wrong. One station past mine on that day, the train came to a halt. I did not think too much about it because i know the train driver can compensate by driving a little quicker along the route. But then we stopped for a long time, long enough for me to worry and glance at my watch, as i tried to plot the fastest path from the city platform, up the escalators, down a flight of stairs, and to the country platform.

A couple of minutes later the train driver’s voice emanated from the intercom.

“I apologize for the delay but there is a man lying on the tracks, and we can’t move till the police arrive to remove him.”

Almost instantly, a collective groan arose from the few other commuters on the train, who were mostly blue-collared workers.

“Just run him over,” a tradesman said out loud.

My heart sank. I was certainly going to miss my country train. And like i say when shit happens, it will always hit the fan. On the day, it was not a ward round that i had to attend in the morning. It was a tutorial that was specifically arranged by the ENT (Ear, Neck and Throat) surgeon. Hence my absence would be extremely conspicuous.

But the train started moving a few minutes later, albeit agonizingly slowly. I wonder what was happening.

As on cue, the train driver’s voice blared over the announcing system.

“What’s happening now is that the guy has gotten up and has started walking up the tracks. We are cautiously following him.”

I was appalled. This guy is obviously not drunk. He knows that by moving, the Police would have a harder time reaching him as they have to track him down the tracks. I tried to dispel my anger by pointing out that this guy probably has a mental illness and requires help. It is his mental illness at play. That thought did nothing to assauge my anger. Instead my fury was re-directed to the failures of society and its inability to help its own citizens, therefore allowing such people to become a burden on those who are proactive and who work hard for themselves.

I text my friends whom i suspect would be awake as such unearthly hours, just so i can groan and laugh about my predicament. It did strike me later on that it must have been quite fun to have a massive train follow one meekly behind, just like a pet dog on a leash. You know, if that culprit got off the hook with a mere slap on the wrist, then i have no qualms about doing the same atrocious act myself. I mean, a slap on the wrist versus a once-in-a-lifetime opportunity to lead a train on the tracks. What a tale to live and talk about, ain’t it?

We stopped at the next station again. A passenger boarded my carriage. Someone asked him whether he knew anything about the culprit. The passenger laughed, “I saw him walk past on the tracks.”

Why did you not stop him dude? I thought silently to myself.

One part of me lament the numerous rights this country has for its citizens. If i had it my way, i would be waiting for no police. Instead i would physically haul him up by the collar and give him a good boot in the head for wasting all our time. One does not need a band of police to do the right thing i reckon. One martial artiste is good enough.

DS once told me about what a Chinese national said to her when the same incident happened on a different line, during peak hour rush.

“This country is too good to its citizens. The Police coax and persuade the criminal off the tracks. In China, our police would have just knocked him out cold and dragged his ass off the tracks.”

I am not sure how accurate this person’s opinions is, but it is sure as hell funny. At that time.

Anyhow one of the friends i text was in the train behind mine. She managed to get off the train, and hail a cab, so she ended up at work early and not late. She offered to share the cab with me, but i declined because i will not be in time to catch my country train. She mentioned that her train driver had a sense of humor. He told the passengers that if they wanted a smoke, they could step out and do so, and he would signal to them if it is time to get going.

Amazing huh?

The Police ambushed the guy two and a half stations from where we encountered him. Six patrol cars, a long line of traffic at 5.30am in the morning and lots of flashing lights. Unbelievable. I hope that guy finally gets the help he needs. His is a very desperate plea for attention.

So i had to wait an hour for the next train and was fifteen minutes late for my tutorial. To his credit, the surgeon was very nice about it, though i was grilled about laryngeal cancer for quite a bit.

This blog is almost forgotten

I took the day off from the hospital today.

I am down with the flu.

It started with a niggling uncomfortable throat, the signs i am all too aware of.

Then it became a raging sore throat and even my ears ache.

The nose dribbling started last night.

Maybe it is because i worked two shifts at the cafe over the weekend,

even though i have quit.

(The owner needed help, the other baristas were away, what can i say?

Let’s just hope that kindness pays.)

Maybe it is because on one of the shifts,

my work colleague pointed out a strange grassy smell in the cafe.

I would not have known any better until she told me that that was the smell of marijuana.

She was astounded i have never smoked weed in my life.

I was astonished that some ignorant little tweet was smoking weed right outside the cafe.

Do you know how selfish is that?

Why do you insist on taking everyone out with you when you made the sole decision of ruining your lungs?

So anyway.

I am sick.

And not happy.

Because Mondays are my busiest days filled with clinics.

I am missing out on a lot of learning.

Annoyed.

Trust

I committed a serious breach of trust last night.

In order to defend the name of someone,

i had no choice.

On hindsight perhaps with the way the conversation was leading,

it was inevitable.

But on foresight,

maybe i should have and shall discreetly steer the entire discussion from such topics in the future.

Right now,

i am stun with myself and my own credibility.

Not quite sure who i can trust at the moment (including myself).

To be accepted in peoples’ lives,

you need to first open up and give a part of yourself before they will do the same.

I am not very sure i can do that first.

It is too fast, too soon and out of control.

I think there are going to be changes in our friendships.

Kindness

Today i discovered what the worst kind of feeling could possibly be:

When someone treats me with kindness, and i know that there will be no way i can repay them.

I will forever be indebted.

And i guess in a philosophical sense,

this can also be the best way to exact your vengeance on your enemies.

The gratefulness that can never be translated into useful action is regretful.

I will remember the kindness of my Clinical Dean today.

And i hope one day i can repay it.

Too keen, i am telling you

I was supposed to watch a thyroidectomy (removal of the thyroid gland from the neck region) with JK today.

Except i woke up at 3.45am and was utterly exhausted.

So i decided to cut ENT (Ear Nose and Throat) ward rounds.

Come 5.45am when i had to absolutely catch the next train,

i dragged my weary self out of bed,

fed the dogs,

took a shower and was ready to go.

Except i stared longingly at my bed.

Made a decision and crept back into bed,

wet hair and all.

8.30am my guilt for cutting clinics woke me up.

I called TT.

By her logic i should go to the hospital today because i had two tutorials on in the afternoon.

And so i decided to.

An hour before i was scheduled to leave my house,

i wanted to practice my flute.

I haven’t had time all week to play the flute,

nor any time in the next few days before my lesson on Saturday.

5 minutes into playing,

TT called me to discuss a patient she was due to present in an hour.

A patient with puzzling symptoms.

Left sided weakness sparing the face.

And she had a power of 4- when she turned her head towards the left.

Pins and needles in her left finger tips and big toe.

No infarcts or scars on her CT scans.

We tossed out several differentials.

I had to run out of my house to catch my train by the time we ended the phone call,

with yet no conclusion,

and worse,

no flute practice.

1pm and i arrived at the country hospital.

I microwaved my lunch and ate it,

whilst having a strange conversation with a fellow med friend.

I turned up for my tutorial and learnt that the later one has been postponed to Friday.

We waited in the wards for our one remaining tutorial.

Half an hour later we were informed that the consultant was tending to an Emergency,

so our tute was canceled.

Basically i rocked up all the way to the country just to eat my microwaved lunch.

Unbelievable.

I packed my bags and was ready to catch the next train out,

when i made another split-second decision.

I refused to head back to the city without even seeing a patient after a four hour commute.

Together with TT we saw a patient.

Massive infarct in her brain (stroke).

Occipital, parietal and temporal lobes.

She was blind but her eyes were fine.

We tried to talk to her and within a few seconds we found out it was useless.

She was confabulating.

We did our higher centre examination and it was pretty much conclusive.

Then i took the train home.

What did i say?

Too keen i am telling you.

Oh and TT’s patient?

After a lengthy list of differentials that included stroke, TIAs (Transient Ischaemic Attacks) and seizures,

the doctor said one word.

“Hysteria.”

Boy, what a day.

Feedback

The system of asking for feedback is an idealistic one.

People and organizations love to request feedback because it could improve their characters/services,

but more importantly i have gradually come to discover,

it makes them look good simply because the act of asking for feedback makes them look sincere in their dealings.

Unfortunately i do not like giving feedback.

I would if it really helps things.

But when you ask for feedback,

and i give you one,

and you end up being defensive and almost chide me for providing the feedback,

it makes me wonder what is the point.

Also it makes me lose respect for your organization.

You obviously are not interested.

Worse,

you completely miss the point and go round in circles about something else.

Recently i got told off by the conductor on the train for not buying a train ticket.

I attempted to buy one off him.

Firstly, the station i was at did not sell the tickets till 9am, even though they were open at 5.30am.

Secondly, i have seen people getting their tickets from the train conductors on the train and no one gets yelled at.

Lastly, i have bought a ticket from another conductor the day before and i had asked him about the tickets, and he said i could get my tickets from the conductors on the train.

So when i got yelled at by this conductor at 5.45am in the morning,

i was obviously very confused and annoyed.

He implied i was trying to evade my fare, which is very insulting.

Also i should add that the conductor comes through the carriages every time,

and the only way i could possibly evade my fare is to jump out of the carriage.

And why would i possibly do that?

My life is not worth just AUD$12.60.

And naturally i got upset.

I let him do his yelling,

and when i reached the hospital,

i was still aggravated enough to send an email to the train organization.

I was really coherent and i was not mean in the email at all.

In fact i did state that perhaps that bald conductor may be right and i had to pay my fare before boarding the train,

but they need to be aware that the other train conductors (which is plenty) are encouraging people to buy their tickets on board,

and for a new country train travellar like me,

being accused of evading my fare and getting yelled at in public is not very funny at all.

I even offered solutions just to indicate that i am not upset because this conductor yelled at me but i am frustrated because their regulations were not clearly stated – that they should adopt more sign-posting and ensure that all their conductors are sticking to the same regulations.

I got an email a week later.

It did not say anything about the other conductors or their lack of sign-posting.

Instead it just sung praises of that rude conductor and berate me for breaking the regulation,

which dude,

is really not the issue i am talking about, am i??

This is the email i got:

Thank you for your feedback expressing concern that the conductor of a XXX train from XXX took issue with you for not having first purchased a ticket prior to boarding the service at XXX Station.

I am writing to advise that is an offence under the Transport Act for a passenger to board a train at a staffed station without first purchasing a ticket. Passengers who fail to purchase tickets at staffed stations prior to travel may be issued with an Infringement Notice for fare evasion. Running late for a train is not considered a valid excuse.

Passengers who board at a staffed location without first obtaining a ticket will only be sold a single journey ticket. This is to encourage passengers to obtain their tickets before boarding and to minimise the incidence of fare evasion.

On train ticket sales are only for those passengers boarding at unstaffed stations or, for those passengers who wish to upgrade from economy to First Class travel. The conductor on the train was correct in advising you of your responsibilities regarding the purchase of tickets prior to travel.

Thank you for taking the time to contact us advising of your concerns. I trust the above clarifies matters for you.

This person was assuming i was running late or i was trying to evade my fare or whatever.

The conductor never asked which station i boarded the train from or whether the ticket office was open or not.

And certainly the issue here is not about the conductor,

but the lack of sign-posting and the behaviour of other conductors who confuse new passengers like me.

So people are still going to get yelled at even though it can be through no fault of theirs.

See why i hate giving feedback?

People just do not acknowledge their mistakes.

This is a disgrace.

Anyway this is not the first time i have seen such a response.

It is just very disappointing.

From now on i will just keep my mouth shut.

As long as it ain’t my character or my organization we are talking about,

the others can do what they like.

It is their future.

Ants

I was washing my face when i noticed a line of ants under the mirror.

I followed the line of ants.

They trailed all the way into the bin.

The toilet’s bin.

Where it contained no consumables.

Only stuff associated with the lavatory (i.e. girls’ stuff).

I opened the lid and saw some ants scurrying amongst the contents.

I recoiled in horror,

and hurriedly whipped out the Mortein spray.

Gave the toilet a good spray,

and changed the rubbish bag.

I am a bit concerned now.

Either my housemate or i am having glycosuria or having pre-diabetic symptoms.

Why else would small black ants be in the toilet’s bin???