Memory lane No 1

Back in winter 1999, somewhere in a remote area, an old huge hospital stood grandly on top of a green-hill next to a 6 acre park.

A pimple-ridden medical student was all eager in doing his first ever ward round with a group of housemen, registrars and consultant. The team stopped by a patient who was looking rather breathless on oxygen support ventimask 24%.

"So Malaysian lad! What do you know about Chronic obstructive airway disease" Professor James Conaglen a 68 year old medical consultant took off his reading glasses and gave his infamous cold icy stare toward the rather innocently-looking medstudent.

With his clean crisp white coat the 6' 5' giant easily towered everybody else in the team physically & emotionally so to speak.

"Well sir, the disease is characterised by (bla bla) in which (yada yada) and last but not least, the treatment would include ( badabim bada bush)." in one confident single breath.

"Boy, humor me for a while here will ya, did you find yourself constipated this morning?" Conaglen grew a nasty-looking smirk at the corner of his lips.

"Err not really, why would you asked that?" the young man smelled something was bloody rotten in the state of Denmark.

(drum roll...)

"Because son, I think you are full of shit." He laughed away, savouring his golden moments.

Funny, after all these years. That's the only thing that I could remember from his teaching round (except of course the case of a 50 year old bloated lady who farted every 5 minutes).

+++

Btw folks, Earth Hour was here at 8.30pm last night. All the wards including the ICU have pledged its full support and were all excited in joining the mass effort in saving our world energy.

Or is that really what's going on? - any brave conspiracy theorist out there?

"Yippie kayeeeee mother-earth!!"

Farewell to stranger

"Life is shorter than you could imagine. Better make full use of it. Don't just sit on your chair whining about how bad life is treating you" He uttered those words slowly yet in a steady strong manner.

I could tell that it was one of his good days, the time when the pain was not that bad and he could breathed normally, sipped his tea while throwing some random advice at me while I looked at his pain-relief chart. Nothing could take 'chatty personality' away from a man. Not even cancer.

The old man was diagnosed with pancreatic cancer few weeks before I met him. One of the most painful entity ever known to mankind. Though the dull intermittent pain could be ease down with regular doses of morphine. Still at time he would jolted and whimpered in agony due to what we call 'breakthrough pain'.

His wife died many years ago and his only child was living abroad but often came home to visit him. A stubborn man he was, he insisted to stay on in Malaysia, believing that one should die on the same land as one were born. Well fortunately he had a maid to help him manage those final months of his life.

He passed away almost 4 years ago, in his sleep. Just few weeks before his 70th birthday.

"I have regrets y'know. Few of them, but I've lived my life to the fullest. The only thing I wish for is to have my wife here with me - even for a few second..."

"... I just wanna look at her one last time before I pass on".

He smiled gracefully.

A tale of two heroes

I've always thought that the man who stood in front of that tank on that fateful day was one brave soul who stood his ground in the name of democracy.

However I had forgotten that there was another man in the equation, the one who was inside the belly of the iron beast.

The tank driver could easily be court marshalled by the army for not driving his tank forward. I suppose a direct violation of his superior's order would spell death by firing squad (... okay maybe not but what the heck - i'm such a helpless romantic fool when it comes to tales of bravery & courage).

Instead the man inside the tank made his stand on that day too. A universal truth proclaimes that it is not easy to take another man's life.

(especially if that man was only armed with 2 TESCO grocery bags)

Passive on call

6pm - Call from respiratory team, they just saw a patient with suspected TB meningitis. They've started the anti-TB meds. Somehow still wanna do CT brain with contrast, and if no hydrocephalus. They want me to proceed with lumbar puncture (LP) . Yeah right in middle of night. Like that gonna change any management for the night. Come on guys, I despise your sense of humour.

7pm: A 43y male with acute myeloid leaukaemia M4 on HIDAC regime developed rash and facial flush. No laryngospasm. Lungs clear. No anaphylactic shock. Discussed with hematologist. IV hydrocort 200mg IV with IV piriton 10mg. Stay cool.

8pm: 54 y male with Wallenberg syndrome a week ago now had his BP skyrocketed to 200/100 while on 3 anti-hypertensive meds. I started him on IV GTN 5 mcg/min. Let bring the baby down slowly.

1opm: The guy who need LP had multifocal infarct shown on the CT brain, looks like an innocent by-stander. Vital signs stable. Anyway, as much as I 'wanted' to do the LP. His relatives were not around to sign the 'informed consent' form. Damn it - looks like tomorrow's job then.

11pm: Got call from standard 6's classmates. They wanna have quick reunion. So had few drinks and dinner in front of the hospital.

12.30am: Zzzzzz

630am: Fresh saturday. Were I'm oncall last night?