Sunday, November 21, 2004
Mind numbing
I'm beginning to wonder about my sanity. It turns out I really am an A&E junkie at heart, and I kind of miss it. Sitting here on call (second in three days) pretending to read my surgical textbook thanks to a shocking lack of foresight (oh my laptop. and my story book. still at home. noooo) I am actually becoming rapidly bored. I shouldn't be complaining because this means nobody is being admitted, but somehow not being on the shop floor inflicting pain on patients saving lives is... just not the same. It doesn't actually feel like "work" to me. Even standing in OT assisting feels more like being a med student, probably because I am not operating yet. Minor ops are also very much a houseman thing, since we used to do some minor ops back in my prereg house officer days... and while mindlessly fun, are also kinda boring in a way.
mm. I wonder if I'll get in trouble if I go hang around A&E. quite possibly.
why didn't I bring my laptop (with DVD player) and my donny darko DVD... bleah.
With my luck, I am probably going to pay dearly for daring to post this online...
*****
Defensive Medicine
After several days on the job I'm getting this feeling that medicine here in Singaland is very much defensive medicine. Gone are the gung-ho discharges of yesteryear from my littlehovel A&E... here everybody gets admitted for any form of nonspecific abdominal pain, or even for head injuries from the dizzying height of 1.3 m (which, to be honest, was just a little bit less than the height of the patient)
Better still, almost everyone with a head injury appears to be getting CT heads; the reason for this is because the "criteria" here for CT are a lot less stringent, and any form of loss of consciousness (even for a second or two - naturally meaning that all patients who have fallen down have lost consciousness, because the stock answer is always "maybe, maybe 1 second lah" or any claims of memory loss get shunted straight into the Doughnut of Death within a nanosecond, regardless of time of the day. Interestingly, even potentially unstable patients get encased in their metal caskets - the caveat is that they have to be accompanied by a house officer. Apparently house officers over here have that magic life-saving touch which we simply didn't have back in the UK.
Having said all that, people here seem to have much thinner skulls, and suffer extradural haemorrhages from the simple act of falling out of bed. And not a double bed either. (temporal # through MMA)
I have this horrible suspician that I've discharged a lot of major brain injuries in my time now... sans CT, or even SXR.
meep.
On the other hand, a lot of people are glowing in the dark over in Sunny Singapore when they needn't be. I guess that's probably a good thing, saves on lighting bills.
mm. I wonder if I'll get in trouble if I go hang around A&E. quite possibly.
why didn't I bring my laptop (with DVD player) and my donny darko DVD... bleah.
With my luck, I am probably going to pay dearly for daring to post this online...
*****
Defensive Medicine
After several days on the job I'm getting this feeling that medicine here in Singaland is very much defensive medicine. Gone are the gung-ho discharges of yesteryear from my little
Better still, almost everyone with a head injury appears to be getting CT heads; the reason for this is because the "criteria" here for CT are a lot less stringent, and any form of loss of consciousness (even for a second or two - naturally meaning that all patients who have fallen down have lost consciousness, because the stock answer is always "maybe, maybe 1 second lah" or any claims of memory loss get shunted straight into the Doughnut of Death within a nanosecond, regardless of time of the day. Interestingly, even potentially unstable patients get encased in their metal caskets - the caveat is that they have to be accompanied by a house officer. Apparently house officers over here have that magic life-saving touch which we simply didn't have back in the UK.
Having said all that, people here seem to have much thinner skulls, and suffer extradural haemorrhages from the simple act of falling out of bed. And not a double bed either. (temporal # through MMA)
I have this horrible suspician that I've discharged a lot of major brain injuries in my time now... sans CT, or even SXR.
meep.
On the other hand, a lot of people are glowing in the dark over in Sunny Singapore when they needn't be. I guess that's probably a good thing, saves on lighting bills.
