Totally wrecked, utterly disgusted!!

Disgusting! Disgusting! Disgusting!

That's the exact word that echoed throughout the hospital last night.

I admitted a 76 year old lady from a nursing home. Not the ordinary nursing home, but a supposedly HIGH DEPENDENCY nursing home. One which was meant to be providing high level of nursing care 24/7. Very much like spending one's life in an Intensive Care Unit in the community. Mrs S is known to have Progressive Suprenuclear Palsy (PSP), a condition which mimics Parkinson's disease.

A quick glance at her, I knew she had been neglected by her NH. In a very bad way. She was unkempt. She was wearing a dirty food-stained nighties. A few abrasions were evident in her face, some of which were infected and oozing pus. On further examination she had a huge pressure sore in her sacral area. She was also struggling for her breaths. She was severely dehydrated.

Worse still, when one of my nursing staffs catheterised her, pus...I repeat..PUS was drained directly out from her bladder!! Another nurse described it as bad mustard-coloured. More yucky discharge was found dripping out from her genitalia.

As she was non-communicative as a result of the PSP, I decided to phone the NH to obtain more background stories.

1. Mrs S had several falls in the last few days. On one occasion she became drowsy after a fall. (For those who are not familiar with medicine, drowsiness/confusion/coma after a fall often suggests severe head trauma, which includes an intracranial haemorrhage. A medical opinion is mandatory under these circumstances) The staff at the NH however thought the doctor should not be called out to examine the patient.

2. Due to the nature of her PSP, Mrs S had difficulty swallowing. This makes her highly at risk of developing an aspiration pneumonia (ie chest infection due to vomitus getting into the lungs). Those idiots in the NH failed to acknowledge this, and kept on feeding her in the usual manner. And now she came in because of just that.

3. One of the most basic nursing skills is to turn bed-bound patients regularly in order to prevent pressure sore. No half-decent nurse would ignore this simple but important task. But guess what? Those idiots again failed to carry out their duties. Mrs S's sacral sore was like a volcano crater. If that's not bad enough, the staff whom I spoke to over the phone claimed she wasn't aware of her sore!! I decided I won't even bother asking her about Mrs S's bladder and vaginal discharges.

My wife and I come from a third world country. Whenever we discuss about United Kingdom we never fail to admire British civilisation. "How advanced these people are!" "How did they manage to build such a sophiscated castle in the 12th century?" Bla bla bla....In short, we have very high regards for the Brits and their civilisation.

This unfortunate encounter with Mrs S made me rethink my opinion about this supposedly developed, industrialised superpower of the world. A country which at one time colonised 1/3 of the world. How could these people from the NH do such things to a vulnerable old lady?? I'm starting to lose faith.

Our Echo Technician...

Regretably, I ran into argument with someone in the hospital again yesterday.

One of my patients became very unwell suddenly yesterday morning. Despite discussions with two senior consultants, we failed to establish the diagnosis. Dr G suggested an urgent echocardiogram, which I dutifully ordered.

Two hours later, one of the CCU nurse phoned me, saying that the Echo Department refused to perform the test. Realising the gravity of the situation, I placed a quick call to the department. The Echo technician explained to me that she asked the patient to be sent down to the department 1/2 hour ago, but patient didn't come. She won't do it now as the patient had missed her allocated slot.

I asked her, 'Do you take into consideration that the patient might have been too unwell at that time to attend her echo appointment?' To which she replied, 'Don't you dare speak to me like that!!'

I further added, 'Surely it's more important to do perform a test based on clinical priorities'

She very unhelpfully said, 'Well! If it's so urgent, then you should find someone else to do it'

I would if only I could. The problem was the only people who can perform an Echo in the entire hospital were herself and her other colleagues. They ARE the Echo Technicians, for God's sake!

My boss called me at 0830hrs today. Was told by her that the Echo Department have registered their displeasure with the way I handled the situation. Why am I not surprised??

Boring life

Life in the hospital is getting more boring by the day. I'm seeing the same sort of patients day in and day out. I'm starting to lose interest. I need more challenges!!

I'm actually quite looking forward to my week of nights, starting from this Friday. As much as I hate night shifts (I love my sleeps, obviously) I think it's about time for me to go on night duty again. At least I'll be practising real medicine, and not seeing the same bunch of old ladies and gentleman who have nowhere to go because of lack of residential beds.

I want to be overworked! I want to clerk lots of new patients! I want to be a true hospital slave!!!

CNY's eve dinner

As predicted the wifey had done an excellent job yet again. I helped myself to a 5- course feast last night.


CNY treat from the wifey 


Wifey and her masterpiece 

The highlight was obviously the Yee Sang. Mom said she sent it all the way from Malaysia two Mondays ago, but unfortunately it failed to reach us in time. Flapped we didn't: we made our own Yee Sang. 30min prior to the dinner!!

Having not tasted Yee Sang for the last 9 years, I thought I had already forgotten how it taste. But as soon as the first spoonful gone in and hit my tastebuds, it instantaneously brought back sweet past memories!


Yee Sang - before being 'attacked' 


Yee Sang - after being attacked 

Later I learned that this sumptuous dinner could easily feed 5 hungry stomachs. Do I care? NO!! I think no one would, if they have the priviledge of tasting such delicious home-made meal.

If I were to be very honest, I couldn't care less about the food or the Yee Sang. I was just glad to have a companion, sitting down with me at the dining table, on a CNY's eve. That's what I would call HAPPINESS.

May the Year of Rooster bring luck and prosperity to everyone!!

9 long years

Tonight is the night.

After leaving my family to pursue studies and career in UK 9 years ago, I have been celebrating Chinese New year all by myself year in year out. But not any more! Now that I have a companion-for-life I'm very much looking forward to the CNY's eve dinner tonight. The wifey has been planning the dinner for quite a while now. The menu has changed countless of times. She has been researching through the WWW and cookery books, with the aim of making me the most memorable CNY dinner.

Tonight is indeed The Night.

Don't come here in Feb or Aug..or ever!

It's a common belief that early Feb and Aug each year are the worst time to be admitted to hospital. Why? Because new batches of hospital slaves come on duty. They include newly qualified docs who probably still can't tell a fibula from a tibia, and some more experienced docs who are good at treating patients but don't have the slightest clue about their new hospitals.

Mortality rate for in-patients soar during these months. More medical mishaps happen too. Needless to say more risk management forms are being put against the slaves.

I'm not condoning anyone. But personally I think these problems can be resolved if there are more doctors serving in the hospital. Simple mathematical equation:
More doctors = Lower Patient:Doctor ratio = Better care = Less morbidity/Mortality

Instead unnecessary monies are being poured into hiring fatcat managers, who look after statistics rather than the patients. We are here because of patients, we build hospital also because of patients. Yet the Management are more interested in 'keep the stats right to look good'. Unfortunately reductions in mortality/morbidity rates are not targets that have been set by the Government, hence no action from the Management. Until then patients will be seen in A&E within 4 hours (as dictated by the Gov), but then die off quickly after that!!!

Home Hospital

The wifey has not been very well in the last few days. Troubled by severe neck and shoulder pain after coming out from 'Meet The Fockers'. Her being a romantic and loving wife, loves to lean on my shoulder during a movie. I think she must have strained her neck muscles by doing just that.

Paracetamol after paracetamol. Massage after massage. We even tried some traditonal massage oil. But the pain just won't go away. Soon walking up and down the stairs became a big struggle for her. I teased her by calling her a robot, as she scrambled down the stairs in a hilarious robotic manner.

The wife was in bed all day on Monday, hardly able to move. Very reluctantly I volunteered to cook dinner. The last time I cooked for her, she was very enthusiastic before I served the food, but lost her appetite the mo she saw the food that I'd prepared. I kept things simple this time. Surely I could manage making some pasta without causing her becoming nauseated. Luckily it turned out reasonably ok. Well..at least the wifey cleared her plate!

She is now more or less back to her normal self. I'd love to think it's all because of my TLC, and to claim credit for that. I just hope she won't be asking me to cook for her again!!!