33 posts tagged “reflections”
I used to be a perfectionist. Every base must be covered. Any possibility must be considered. Things must be done perfectly. There is no room for error. That has served be quite well...but then as I move along in life perspective change.
I think perfection is an over-rated virtue. Yes, aiming for perfection achieves many things. Aiming for perfection is a virtue sought after by some employers. Who wouldn't want their organization to function smoothly, efficiently without any problems ? ie perfectly. Who wouldn't want to score a perfect 100 marks in their exams ? Who wouldn't want to have perfect physical attributes?
However I think perfection is an imperfection in itself. Aiming for perfection shackles the imagination, it does not allow mistakes to be made, it does not allow room for much innovation and lateral thinking. Nothing goes wrong = nothing learnt. Perfection is like sterility.
And imperfection defines an entity as uniquely as their DNA. It makes a person who he is. Frequently imperfection strengthens the other virtues of the person. Being perfect is imperfect.
And I'm sure this "imperfect" one eyed cat is able to catch a mouse better than a "perfect" domesticated cat.
Just a ranting after a long day.
Have you wondered how much you knew about a person? Friends, colleagues, subordinates, superiors etc...
I've seen instances where "meek" House Officers turn into "monsters" once they complete their housemanship. I've seen House Officers who are "careless" became extremely conscientious Medical Officers. I've seen "famous consultants" who graced the cover of newspapers acting like a jerk towards his subordinates. I've seen quiet patients whom I rushed through consultation, who are the most appreciative later on. I've seen VIPs who acted as though the world owes them something and VVIPs who are extremely gracious and even willing to stay in 3rd class wards. I've seen people who are friends during times of need only.
In short, we can never tell a person by his looks, upbringing, religion, education, status or profession.
I wonder why some people chose to remain friends with jerks who are obviously in for his/her own benefit only? Why some people just cannot see through a person? I just wonder...Is it because the "friend" can crack a joke or two? Is it because he/she is good looking? Is it because it is entertaining to be around him/her? Is it because he/she is famous? Is it because he/she is rich? Is it because he/she is clever? Is this reason enough to remain as friends? I don't know but certainly I would think twice.
"We make them cry who care for us, we cry for those who never care for us, And we care for those who never cry for us" I find these words ring so true.
Maybe nobody is perfect. Maybe I'm too critical. But perhaps tonight I've seen another facet of human behaviour.
In a couple of minutes I'll be a year older. Yup...I'm spending a quiet evening at home coz my significant other is on-call. Decided to just lay back, look back and have a quiet dinner by the candle, with a chocolate cheese cake desert and perhaps a glass of Chivas ;)
I wish I was a party animal but I'm not. I wish I was as suave as Sean Connery or as stylo as Chow Yuen Fatt in "God of Gamblers" but I'm not. However I'm pretty happy with who I am. And I wish there was someone to share the moment with. It gets lonely at times.
Sometimes patients (and relatives ) do not like me very much as I'm frequently the harbinger of doom. Well, I have the unenviable task of breaking bad news to the patient (and frequently the relatives too). And of course as ridiculously as it sounds I do ask if they want to know the diagnosis.
I feel to give inappropriate hope or unreasonably high hopes to a patient is not right. Preparing a patient for death is just as important as giving hope to life. It's a tough balance. But when there is an 95% chance of a patient dying...would you prepare him for death or lift his hopes up for the 5% chance? Colleagues may disagree with me, but I'm being pragmatic and sometimes patient's relatives do not like to talk to me because of this.
I think preparing a person for death is extremely important. A person may have personal stuffs to settle, dark closets to open, people to forgive, ask for forgiveness etc etc. Giving inappropriate hope may deter the patient from doing things dear to him before he leaves this world. Patient or their relatives may start to look for futile treatments to improve the 5% chance. They may spend lots of money for dubious treatments (futile treatments are never a justification for desperation), numerous 2nd, 3rd and 4th opinions, makes excessive demands to their loved ones, ultimately leaving everything in a mess when they pass away. Not to mention the relatives later blaming the nurses and doctors and trying their best to find any minor fault which they think may have contributed to his (hastened) death.
The common reaction given by the patient (and more frequently their relatives ), especially Christians I must admit, is that perhaps a miracle will happen. Yes, a miracle can happen I agree. But we cannot make decisions based on the hope that a miracle will happen. Yes, you might survive a 10 storey fall by miracle, but would you bet on surviving the fall?
Preparing someone for death is difficult. It's unpopular, nobody likes to hear it, nobody likes to do it. And nobody will thank you for telling them chances are they are dying. Not in our Asian culture anyway. We avoid it, we give inappropriate hope, we pass the buck, we refuse to address it. But I think it's absolutely necessary at the risk of looking as if we are "taking the easy way out", for not trying hard enough.
I had a 90 year old rather frail patient with end stage kidney disease who needs dialysis. Everybody knows dialysis slots are extremely limited (we are not in USA or Europe) and nobody wants to "give a death sentence" to this patient. She may get a couple of "urgent" dialysis but long term slots are not available. So the decision was left hanging. And unfairly I feel, doctors pushed the decision to the patient's children! Hey dialysis is not risk free, the patient may well collapse during dialysis. What the patient's children said? They said " Doc, you do what you think is best. DO NOT ask us again for our decision (to dialyse or not). Several doctors have asked us the same thing many many times ". My colleague and I made the final decision - rightly or wrongly. I would have done the same for myself.
On the other extreme there are relatives of dying patients who wants "Everything to be done to ensure the patient lives for as long as possible", whatever living means to them, perhaps to avoid their own conscience of "killing" the patient. Prolonging death is unethical. Not to mention the extremely limited resources which perhaps could be used to save someone else.
Does common courtesy and manners still matter today? Or have they given way in this "dog eat dog" world. Yeah, using vulgar language and signs are entertaining. It captures the attention and perhaps achieve the objective more clearly and faster. Some people seemed to idolize vulgarity, rudeness and brash language as though it is something great, something most people won't dare to do. So the person who does it must be brave, great and deserve to be idolized. Very "keng" as they say.
From our Member of Parliment, to even doctors, perhaps specialist and consultants too, we have seen such behaviour and language. An example of this is here. More often than not, it is spoken within an inner circle of pals. On and off we do blurt out some expletives, but is it great to make it as a habit? We have heard swearing, expletives, vulgarity uttered on a daily basis, most of the time behind close doors. The irony is that some people seemed to idolize people who uttered them, whether explicitly or secretly. What is so great about it? It is certainly easier to blurt out an expletive than to construct a courteous sentence.
I've had House Officers who came to the department, not bothering to introduce themselves to the Head of Department or their specialist and started working in the wards as though they place belong to them. Some do not even bother introducing themselves to the Sister of the wards either. For crying out loud, if you visit a friend's house, common courtesy dictates you inform the owner of the house that you are coming to visit, isn't it not?
How often do people remember to use the term "Thank you. I appreciate it"? Whatever happened to common courtesy and manners? Isn't there any other way to converse other than using expletives? Politeness may not be as entertaining as swearing but to me it indicates humbleness, softness in character and perhaps finesse. Although there are great pretenders out there, it isn't a reason not to be polite. I remember how I would receive a big slap on my face from my parents whenever I utter any languange which is remotely vulgar during my childhood. Alas we can't do that to the adults who uttered vulgarity at their whim and fancy.
However I can avoid people with only vulgarity in their vocabulary. If not I may forget how to converse in a civilized manner.
Rice, is something we may have taken for granted. In the era of MacDonalds, steakhouses, Japanese cuisine and fine dining, rice is something regarded as cheap food. It is not surprising to see people in buffets ignoring the rice and target the "expensive" food like meats and seafood instead. In the restaurant, we have often seen extra rice being asked and then not finished and left on the table.
In a country where natural resources are aplenty, yesterday I was given an insight on how a local family, as the guardian ( also known as "jaga") of a probably multi-million dollars sports complex had for dinner. The local lady was given a room (more like a store room) beneath the spectator's seat to live. 3 elderly ladies were sitting around a discarded table and heaps of discarded chairs which was used once for some VIP parade in the stadium but were now left to rot. A couple of malnourished cats roamed nearby.
The lady had plain white rice for dinner with a bowl of Maggi Mi for company. Yup, plain white rice and maggi mi as the "vegetable". Something tugged at my heart. In our country where natural resources are aplenty, and multi billion mega projects are cropped up on a daily basis, this is something that should not happen. (to me at least)
Poverty is a disease which needs to be eradicated. When our country can boast the tallest and longest and can offer ONE MILLION RINGGIT to an Olympic gold medal, I can't help but wonder about the priorities our country is taking.
What is the point of having the most sophisticated scan machines and medications when patients do not even have proper nutritious food to eat due to poverty? Who benefits more from the the purchase of medications? The patients or the middleman or the pharmaceutical company? If you ask me, proper nutrition and food has more benefit than the few hundred ringgit anti-platelet agent. Proper nutrition and food is going to help the bed bound stroke patient with horrendous bed sores more than the few thousand ringgit of antibiotics.
Poverty is endemic around here. We have read about the apparent fair distribution of the country's wealth in various forms and agendas but to me what's more pertinent is the fair distribution of opportunity. Every citizen should be given equal opportunity to better themselves rather than dishing out money to them. If lazy people do not want to work despite given the opportunity then they themselves are to be blamed. But I can't help but feel that most people here (especially locals) do not have the opportunity to better themselves as these opportunities are being siphoned by the "powerful connected" people leaving crumbs behind.
I'm sure many of our leaders' children are busy studying overseas while back at home there are so many children who are not schooling due to poverty. They have to find means to put food into their stomach instead. Some schools are in dilapidated conditions too.
With the rising price of rice, I'm not surprised if some poor village people may need to resort to eating tapioca to survive. Which reminds me of the time of the Japanese Occupation as told to me.
Poverty, is the world's most prevalent and deadliest disease. Not heart attacks. It is the greatest tragedy of all times if a person dies of malnutrition due to poverty in our country. Which I'm sure is under-reported.
Yeah, I get these bouts of reflections quite often. Thinking whether the career path that I've chosen is the correct path. Whether I'm still passionate in this field any longer. Honestly I don't know.
I cannot fathom how can some doctors in public hospitals go to work everyday doing rounds at 7am each day, seeing patients, then rush off to clinics to see patients again till past lunch, then doing a second round in the evening before going back AND THEN going for locum at night! In addition to the weekend locums!! They will be seeing patients every minute of their breathing lives. I think it's unhealthy and I just cannot bring myself to do that. Perhaps monetary reward is a very strong motivator to some people. But monetary reward is not about passion (maybe some people are passionate about money and what it can bring hahaha), it's about the necessity to survive and thrive in the rat race. Which is absolutely necessary, btw.
Passion is something you'd do without any rewards. You'd do it because you loved doing it. Not because someone asks you to. Not because you have to. But you want to.
I don't think I want to sacrifice every minute of my breathing life listening to complaints and ridiculous demands, plus practising defensive medicine to prevent lawsuits even if the monetary reward is good. My soul will wither away little by little. And I cannot live without a soul.
Nope, I need to breathe in the smell of flowers and fresh grass, to listen the endless waves at the seaside, to glance at the bright eyes of a dog, to pat its head, to feel the wind blowing against my cheeks, to have a great conversation. They are the food of my soul. Yeah right! - the only odour you'll smell in KL is the haze.
What would you do with passion? I keep thinking to myself again and again...to find the answer. I'm determined to move towards it even if I have to pay the price.
In the mist of the frantic rat race, where the survival of the fittest prevails, I would often stop to ponder what is the meaning of life. Not because I cannot compete and win. I've been there, I've done that, since school days. Does winning the rat race give any meaning to life? Coincidentally a friend forwarded me this poster.
Competition is part of life. It's not about personal satisfaction. It's about survival. I keep reminding myself. More so in an Asian country.
But is survival is all there is in life? Are we no more than ants struggling to survive for example? Hmm...tough question.
Decades ago, perhaps a lady would be esctatic in receiving a rose and card during courtship. (I might be wrong here hehehe). If one were to do that today, chances are you're not gonna get any second chances. (Cheapskate would be the term used ). Cold hard cash or its equivalents will definitely work better nowadays hehehe. That's life in the rat race man.
Perhaps I should stop being so sentimental and get slapped hard again. Happens when my birthday is not far away and I'm moving another year closer to meet my maker.
Btw I shall be joining a squash competition soon against some great guys. It's not for money, fame, recognition or status. It's for personal satisfaction. That's the kind of competition I like hehe ;)
Is it still rewarding to be a doctor? Does it still bring personal satisfaction? Is being a doctor still regarded as a noble profession? How does the community regard the medical profession nowadays? (We all know about the monetary satisfaction part :( When a mechanic increases his charges by 30% - here it's no big deal but if doctors increases their fee by 30%, prepare for a national backlash ).
Some of these questions will haunt many doctors time and again. The times when we question our decision to stay in the ever litigatious, hostile and ever unthankful environment. How many times can one recall a deceased family thanking the doctor nowadays for trying his best ? ( may not be the best in the world, but probably his best under the severe limitations - whether in knowledge or facilities ). More often than not the deceased family nowadays would be finding fault if any negligence had occurred and whether some $$ can be made from it. Thanks to the adverse publicity of the medical profession by the press and the increasing borderless internet world. ( When can the public realize that some fantastic experimental therapy in USA is not offerred in the remote jungles of Borneo for instance?)
When the medical student excitement of a diagnostic problem is hampered by bureaucracy and limitations of the real world. Why do clinicians need to convince the radiologist about the need for a scan for instance? Or to convince a pathologist that the particular blood test is required? These are supposed to be supportive services for the clinicians...not a hampering services for the clinician. Why does this happen? Probably because funds/facilities are limited...clinicians have to compete with each other to get that elusive supportive service.(To be fair, some doctors ask for tests unreasonably too). It is understandable under the circumstances but is it understandable for the sick patients or their relatives? Problem arises for clinicians when the request is denied and sometimes as a result, a diagnosis cannot be reached conclusively. When the patient dies without a conclusive diagnosis, questions will arise from relatives why this and that wasn't/cannot be done !!! Aah...and then that familiar complain will come.
And if the clinician suggests the patient pays to get the supportive services/treatment in the private sector, the patient will ask why must he pay for such a service when is available in the public hospital !!! If it's that urgent, he should be entitled to that service in the public hospital for free!! Worse still the patient may think that the clinician is in cahoots with the private services/sector. It's a losing battle from the start for the clinician. It's a "can never win" situation in my opinion.
The brunt of all sides, from the "unsupportive services" to the administration to the discontented patient will fall to the clinician. Hospital administrators will always need to cut costs, limitating the clinician's choice of investigation/treatment while at the same time expecting the clinicians to fulfill "customer" satisfaction! What bullshit! It's like telling the clinician "You can't have this or that and that also because we don't have the funds but make sure you still treat the patient well (with what?) and still make him happy". Welcome to the real world! Costs of healthcare and patient's expectations have escalated. Public hospitals and doctors will bear the brunt of it.
Is it still rewarding to be a doctor? Do you expect doctors to be still enthusiastic? To add salt into injury, probably a mechanic charges more for his "consultation" than a GP doctor is allowed to.
Times have truly changed.
On one usual day at the squash courts, I was greeted by a small "Miao!". A small malnourished kitten appeared below the seats looking at me with its big eyes. I was never a fan of cats but this kitten seemed well, cute. It jumped up near my bag and curled itself. At first I was apprehensive in petting it on its head (read; toxoplasmosis), but finally my heart gave in. It was so cute and just wanted someone to show it some affection. I pinched its neck and lifted it up. From then on, every time I come to the squash courts, the kitten would just follow me.
It was malnourished but it has these wonderful big eyes. It was happy. It ran everywhere with curiosity, without fear. Under the chair, above the chair, into the courts, along the corridors etc. There was a plastic plate nearby with some dried rice, obviously someone has been feeding it.
I just wonder if it would be happier living well fed but living within 4 walls, or be free but eating crumbs.
Too bad I didn't bring my camera - will try to take some pics next time.
