Just Desserts (I)

So the Out-Laws have been to visit this weekend to help us with the packing. With the 3 of them around, it made everything so much easier.

We split up into different rooms, armed with boxes, masking tape and magic marker pens and made swift work of it. I'm glad for all the reams of newspapers and plastic shopping bags I'm constantly squirrelling away (despite MDH's protests), it all came in so handy as wrapping or cushioning material.

Later in the afternoon, S-OL and D-OL decided to go out and stretch their legs, leaving me behind with M-OL who wanted to make dinner.

I was in charge of dessert.

We still had alot of fruit in the fridge from the last grocery trip we made, so I really wanted to use it up, but I didn't want to just serve up cut fruit topped with sugar and cream. So M-OL suggested that I make a strawberry tart.

So we made a biscuit base out of crushed Hobnobs and melted butter, then spooned over double cream whipped stiff (I spent 15 minutes hand whipping it with a fork since we'd already packed my electric whisk) mixed with plain yogurt, topped it with cut strawberries and raspberries, then drizzled over a toffee sauce made from melted Wurther's Originals and cream.

Voila!
Doesn't it look beautiful?

We put it in the fridge for an hour or so, so that it would set a little bit more, and because I reckoned it would taste better when it's really really cold.

M-OL dusted it with icing sugar just before serving it, and it really did taste incredible. I was really pleased and proud of myself. I'm not good at dessert making, so I was surprised that it had turned out so well, and it was such a simple dessert to make. Especially the toffee sauce - I just put two tablespoons of double cream into a bowl with five wurther's original sweets, and blitzed it in the microwave for 40seconds before stirring it up into a sauce. I bet you could just do the same thing will all sorts of different fruits.

Actually, I still have some more of this strawberry tart left over in the fridge. I think I shall go and polish it off now - I mean, we're moving house after all so it wouldn't do it leave it, would it?

Good morning, it's great to stay up late

Big breakfast
Originally uploaded by Sunshine follows me.

MDH staggered through the door at 8:30am this morning, after a very very long night on call.
He's been doing a whole week of night duty at the Emergency department and it always knocks him out. Worst of all, canteens are shut at night, so he doesn't get to eat during his 12 hour shift (not that he'll have any time to stop for a meal anyway).

I'm not usually at home when he gets back from work, but it's a weekend, and I'm not working this Saturday.

So I made him a nice big breakfast - buttery scrambled eggs on toast and juicy grilled sausages. For my poor worn-out MDH. I don't often get a chance to pamper him like this.

He gave me a weak smile, a kiss and a cuddle before heading off to bed. He's now fast sleep, wrapped up under the covers emitting rumbling noises.

We do work hard for our money.

Training my patience

I will not strangle any of my patients or smack any of their relatives upside the head. Not even...

- The sadist in bed 5 who turns his hearing aid to the 'OFF' position whenever I walk near his bed. He nods and smiles at me, cupping his hands behind his ears whilst watching me grow purple in the face from bellowing.

- The masochist in room 2 who keeps spitting out her painkillers and then complaining that she has got 'a great big bellyache, ooh help me, doctor, help me'.

- The 12 relatives of bed 24 who keep asking me when she is going to 'grow back a new leg' (I'm sorry, but nobody can grow back a leg after it has been cut off. Yes, starfish do grow back new legs, but she's not a starfish. No, even though she used to like swimming, she's not a starfish.). Everyday. 3 times. Each.

- The young narcissist in bed 65 who keeps getting me to feel his chest to make sure it is completely flat. He's convinced that the bruises he sustained during his all-too-literal 21st birthday bash are going to make him grow breasts. Then I catch him practically giving himself a hernia trying to peer down the front of my blouse.

- The rotund man in room 15 who assures me that he is keeping to his low fat diet whilst spreading a double portion of butter on each half mouthful of toast. "I lost 5 ounces last week but this week I put on 2 pounds", he says.

I will not throttle any of them. I will have patience with my patients.
I will smile sweetly, and then go outside and bang my head repeatedly against the wall.

Meme?

I have no idea what "meme" is supposed to mean, but I gather that it's similar to chain letters, except not as irritating.

So Thirty Pounces sends me this 'shoe meme'. No problem, I'm game for anything! What I really want to know is, will I win any prizes for answering?

Total number of shoes owned: 12
2 pairs of strappy day-wear sandals
1 pair of strappy party sandals
1 pair of wedding shoes
1 pair of black ballet pumps
1 pair of clogs
3 pairs of boots
1 pair of thong flipflops
1 pair of house slippers
1 pair of Nike trainers

Most expensive pair of shoes:
My beloved black leather Salvatore Ferragamo boots - they were on sale!

Cheapest pair of shoes:
House slippers - bought from the market for SGD$1.50. Bargain!

Last shoes bought:
Knee high boots from ASOS

Shoe under work desk:
I'm a doctor - I don't get a work desk, although I carry my black ballet pumps in my haversack so I can change into them at work.

People I pass this meme onto:
err...okay...
budak
stellou
ketsugi

Wow.
Suddenly I feel really like I'm part of an online community.
Also, I realise that I am obviously suffering from a severe lack of footwear. Look how many shoes these girls have got! I have to jump on the bandwagon, follow the crowd, keep up with the Jones's! I should show those blogs to MDH and tell him how deprived I am.

Unforgiveable sins?!

I've just done something really terrible, and MDH is now forcing me to blog about it (oh, the shame).

MDH was happily reading the latest Harry Potter book and happened to make a comment on certain deaths that occur during the course of the story. I answered him without thinking, and turned round to see a look of horror on his face.

I had inadvertantly told him the ending of the book.

Whoops.

I felt really really bad about spoiling the novel for him. But, as MDH already knows, I'm not very good at hiding things from him and I cave very easily. And I should also remember that however good MDH is at guessing endings, I'm not meant to agree or disagree with any of his theories until after he's finished reading the novel. He actually predicted most of the significant plot points of 'Harry Potter and the Half Blood Prince' quite accurately, and I have had a very hard time over the past week trying not to give anything away.

MDH is surprisingly good at guessing endings of novels and movies. Just to give you a vague idea about how good he is at picking up clues, he managed to guess the ending of 'The Sixth Sense' movie just by watching the trailers (He told me later that it was obvious from the way everyone was saying 'you'll never guess what happens!'). So, whenever he tells me that he couldn't predict the outcome of a story or film, I know that the twist at the end is really going to be something extraordinary.

I think he gets a kick out of being right.

P.S. MDH, I'm sorry I told you the ending of the book. It was an accident!!! Please don't exchange me for a new and improved model! *grins hopefully*

Moving house

I have loads and loads of things to do this week. Moving house is such a hassle. The In-Laws have kindly decided to help us out with all the packing, and I've booked a moving company to help us with the transport.

I don't mind the actual move so much. I'm excited about being able to explore a new part of the UK. It's fun seeking out the good watering holes and relaxation spots, finding a new favourite tea house/bric-a-brac store/park bench/supermarket/museum. I like roaming through streets in the suburbs, admiring gardens and window boxes, learning the quirks of the area and its inhabitants.

Moving house is okay. It's the packing that really gets me. Packing really stresses me out. I like to think that it's because I hate compartmentalising my life into little boxes, but really, I hate packing because I'm too lazy to do it properly. It involves too much planning and coordination and...effort.

Which is why I feel so blessed by my In-Laws who volunteered to help out without being asked.

It's nice to have family.

7 days to go

I have 7 days to go until the end of this surgical posting. My next 6 month gig is an Accident & Emergency post down by the south coast. It'll be more stressful and more exciting and much more weird, like being thrown into rough waters with a rubber duckie lifebuoy.

I start a new role as a senior house officer (euphenism for first rate pondscum - at present I'm a pre-registration house officer ie. second rate pondscum). I'll actually get to make decisions all by myself, and people can actually sue me for negligence.

I can hardly wait.

Comfort eating

Today it is cold and rainy outside, and I'm feeling too lazy to cook. So I'm going to defrost one of the many packets of frozen hawker food that I have squirrelled away in the freezer.

Yes. I smuggle Singapore hawker food into the UK. I freeze them on the day I buy them, then wrap it in plastic bags and put the packets in between my clothes just before heading to the airport. It stays frozen all the way, and when I defrost it and heat it up in the microwave, using it's original brown paper wrapping, it really does taste almost as good as the real thing.

Well, it's better than all my half baked attempts to make my own char kway teow. It just doesn't have the same taste that comes from being seared in the hawker's wok - which probably hasn't been scoured for several generations.

I have learned that quite a few of the really good hawkers are used to having their food exported. In fact, some of them even make an effort to pack their wares into neat little squares to make it easier to store, and they give me tips on exactly how to defrost and reheat it to preserve it's original form and taste. They really take pride in upholding the standards of their work.

Now, if you'll excuse me, there's some chai tow kway awaiting me in the microwave oven.

Mundane?

I love grocery shopping.

I love walking through the supermarket and looking at all the things on display. It's like looking at all manner of endless possibilities - things I need around the house, things I would love to have, ingredients for new and exotic dishes, tiny luxuries and necessities, activities I could be doing...

Grocery shopping with MDH is really fun as well. We pass by items on the shelf and discuss what we might be eating this week, what bargains we have found. We take turns choosing certain items that we buy weekly - cheese, milk, bread, ham.

This week, it is my turn to choose the cheeses - so I picked Red Leicester and Double Glouscester. I've been wanting to try these ever since I heard the Monty Python cheese sketch. They look as if they'd melt nicely when I make grilled sandwiches.

MDH has chose granary bread and white soft baps, and (to my utmost dismay) liver sausage slices.

In retaliation, I have been allowed to get semi-skimmed milk instead of the usual full fat.

We both spent alot of time in the fruit section picking out this season's summery produce - punnets of deep red strawberries, ripening nectarines, juicy-looking blackberries and raspberries. I can hardly wait to blend them into smoothies or eat them with vanilla icecream!

The best part about grocery shopping today is that it has put things in perspective, for me at least. In the grocery shop, no one is talking about the events of the past week. Children are begging their parents to buy sugar-laden snacks, staff members are stacking shelves, old ladies totter along with their shopping trolleys. There's a wonderful smell of roasting chicken coming from the rotisserie, there's some loud voice saying 'Harry Potter Books Are Now For Sale', and I'm pushing a squeaking trolley and trying avoid running over toddlers.

And I know that Tony Blair is right, and all of England continues moving swiftly on as usual.

It's beginning

I know that the police don't shoot for no reason. I know that if that suspect was a suicide bomber, many more lives would have been lost.

But I'm still shocked that the man is dead.

Edit (14 July 2005):

So it emerges that the man was a Brazilian electrician - explains why he might be carrying a heavy belt full of wires. It also explains why he might not have clearly understood (in his panic) what the policemen were shouting.

And the policemen were all in plain-clothes. So now I understand why he was trying to escape. He probably thought he was being attacked by a street gang. I would have done the same - 20 men running at me screaming and waving a gun, I'd try to run away.

It was a terrible mistake, and people make mistakes. People are bound to make mistakes in this state of heightened awareness.

This all makes me feel so unsafe.

I'm glad I'm going to be moving further away from London soon.

Serves us right!

Two days after I made an observation about the recent epidemic of influenza, both MDH and I have been struck down with the said virus. Poetic justice, eh.

We've called in sick and are both dosing ourselves with copious amounts of Lemsip (a combined solution of paracetamol and decongestant - tastes bad by the way) and Ribena. MDH is alot more ill than I am. Presently, he is sweating and shivering underneath our duvet, muttering to himself about bats and potatoes and something called 'poo-mouth'.

That's the problem with working in a hospital. We spend so much time in close contact with all sort of disease...so when we get sick ourselves, we get really really sick.

Not Again

More blasts in London.

I can't believe it.

update (one hour later):

Apparently, we're on standby, not full alert. This probably means that not so many people were affected. I'm so glad that the number of casualities are alot less this time round. But I can't help thinking that it still happened, despite the tightening in security. At least this time we are prepared. The atmosphere is alot more calm than it was two weeks ago. It's still horrific that it's happened again, though.

update (three hours later):

No casualities and it's already 4 hours since the incidents. Thank God. Apparently only detonators were used, so the explosions were smaller and less harmful.

This is not good for the Asian community. Already the discovery that the initial bombs were carried by British-born Asians really shocked us and made any Asian on the streets a potential suspect. Police officers have been especially skittish around non-Caucasians these last two weeks. I even had my backpack and mobile phone confiscated and examined thoroughly by police officers. Somebody should keep an eye on the Caucasian population too. There are Caucasian muslims around too, you know, and there's always the IRA.

This is exactly what terrorists want, isn't it? An atmosphere of fear, mistrust and suspicion. And widespread panic - although thankfully I don't see anyone hysterical around here.

It could get really ridiculous.

Simple measures

I've noticed quite alot of people complaining of fevers, dribbling noses and sore throats. They come to my A&E department, and sometimes I want to say to them "Is this an Accident? Or an Emergency?". I would also like to tell them that most of these problems will go away in a few days with simple measures - lots of fluids, lots of rest, lots of fresh air.

Some of these people have not even tried anything at all before coming to hospital...and it is such of waste of their time to wait for hours to see a doctor, only to be sent home again with a prescription for over-the-counter drugs (and the prescription cost more than the medicines do!). We don't give them antibiotics in the UK - I know in Singapore, doctors like to hand out antibiotics like sweeties...but people really pester them for antibiotics and won't be satisfied otherwise.

Most of these flus, coughs, colds and whatnot tend to be viral infections rather than bacterial infections - and for those of you who studied biology in secondary school, you'd know that antibiotics only really work on bacteria and have no effect on virii. And there's a danger in using antibiotics willy-nilly.

So here are some ideas that everyone should try out first before seeing a doctor for 'antibiotics'.

Soluble paracetamol is not only good for sore throats (gargle it and swallow!), but it brings down fever and takes away headache. Give it an extra kick - dissolve it in coffee. Soluble aspirin is also good for sore throats and headaches, but it doesn't do much for fever.

For those of you with dribbling noses and watery eyes, try using some antihistamines - you can buy them over the counter. Lots of different brands, all of them work in the same way, but if I were you I'd ask for the non-drowsy type so that you can still function.

And...try simple linctus (ie. cough syrup) for coughs.

Yeah.

So try these measures before heading for the GPs and the A&E, okay?

Hazards in the workplace.

Today I was examining one of my patients when he decided to empty his bowels on my shoes.

I feel so violated.

I also feel sorry for the poor fellow - he was so embarassed.

When I first started this job, I used to wear my smartest and nicest clothes.

Then I got a bit of blood spattered on my favourite blouse. So I couldn't wear it in polite society anymore.

Then I got wise.

I still dress up smartly to go to work...but I don't wear my nicest outfits to the hospital anymore.

Nothing is free (I)

The problem with the British National Health Service (NHS) is that it is free of charge.

If people knew how much money everything cost, maybe they wouldn't complain so much.

I just had one of my patients pull out her drip and empty the entire contents of the drip bag onto the floor. The antibiotics in that drip cost £700 per bag. So she's just poured £700 onto the floor and the cleaners are now mopping it up as I type. The cleaners are busy mopping up the equivalant of their own monthly salary. What a waste.

My patient doesn't care, because she's not paying anything for her treatment. It's a real shame.

It just makes me so angry.

Sometimes, I really want to write out an invoice, just so that people know how much their stay in hospital is actually worth. Just so they know.

Gloatingly

Mine! All Mine!!
Originally uploaded by Sunshine follows me.

Today I went grocery shopping at Sainsbury's and I finally bought the latest Harry Potter novel.

You'd be surprised at how many of my patients are reading it in hospital - so many families brought the book for their ailing relatives the day it was released. All the porters, radiographers, cleaners and some of the nursing staff and doctors too. They huddle together in little groups whispering to each other.

Well, now I have a copy too!

First, I have to figure out how I'm going to read through this book without MDH stealing it from me...

Here's some money, buy yourself a bell.

When people get ready to go to hospital, why don't they ever EVER have a shower first? I mean, seriously, would it hurt to have a shower and put on some clean clothes? I have to touch these people with my bare hands, and it is sometimes all I can do to stop myself from shuddering.

Before anyone goes to hospital, please have a shower, paying special attention to the creases in the groin area, the underarms and the belly button. There is nothing worse than having to put your hand in those areas, and find all sorts of tasty tidbits stuck there for goodness knows how long. Unearth the territory behind your ears, all ye who are well-endowed (and this includes the men) should scrub underneath your breasts, and I don't care how long your nails are, as long as they don't have 5 years of soil stuck in them.

Honestly.

I once had a patient who was not only clean, but was also fastidious about her appearance. Every morning, when I came to see her, she smelled pleasantly of rose-scented soap and was wearing a neat dressing gown, and even had lipstick on.

Maybe you think she was being vain about her appearance, and why not? She was in hospital, a public place and just because she was ill didn't mean that she would let herself look any less presentable. She was actually quite unwell, but it was such a pleasure to look after her, because she seemed to be making an effort to look after herself and in doing so, she felt less miserable.

Of course, I'm not talking about those patients who are rushed into A&E after a dreadful accident, or people who can't move their limbs. But the rest of you who are otherwise fit should be able to spray on some eau de toilette and suck on a minty sweet, eh?

Anniversary surprise #3

Canapes
Originally uploaded by Sunshine follows me.

I'm peacocking in front of the mirror with my new necklace, when MDH eyes me critically and says, "I think you need to change your clothes."

I look at him quizzically. What's wrong with my jeans and blouse?

Gazpacho cup-a-soup
Originally uploaded by Sunshine follows me.

"Not where we're going. You'll need to dress up posh."

I am genuinely shocked. Posh? The poshest dinner we've ever had together was at our own wedding. We're a fish-and-chips, burger-and-fries, pasta-and-water type couple. We've never been to a restaurant where we get more than one set of cutlery and drinking glasses.

Marinated pork in 3 ways
Originally uploaded by Sunshine follows me.

So I dig out a dress from the back of my wardrobe and off we go.

John has decided to take me to the poshest restaurant in town.

Wow.

"Just this once, because it's our very first anniversary."

I totally agree. I reckon we should be allowed to be extravagant, just this once.

"And I want to totally spoil you."

Oh yes, I totally agree.

Watermelon sorbet
Originally uploaded by Sunshine follows me.

It's a cool evening and there's a pleasant smell of wisteria in the air. We decide to dine on the terrace out back. There's nothing like dining al fresco when the air isn't thick with humidity.

We order a main course and a dessert each, but the chef keeps sending extra items to our table with his compliments.

Raspberry souffle and sorbet
Originally uploaded by Sunshine follows me.

A generous, thoughtful man.

Our eyes widen everytime we take a bite. Our senses are overwhelmed. The taste of the food is beyond description. Our conversation dwindles as we savour our meal.

The portions look small but for some reason we were full to bursting at the end of dinner. We stagger back to the car, sated.

When we got home, we sat on the couch, sipping water and watching our wedding video.

And for a moment, the whole world seemed to revolve around us.

Anniversary surprise #2

"Shut your eyes," says he.

I squeeze my eyes tightly shut. "Where did you hide it?" There wasn't a nook and cranny in the house that I didn't search, trying to find out where he'd hidden my anniversary gift.

I thought about what I'd bought for him - a slim new leather wallet, dark brown with a slightly roughened surface for that rugged look. Lots of room inside for plenty of cards and receipts and the other junk that he likes to squirrel away.

"I put it inside one of the videoboxes on the top shelf. Too high for you to reach, and I knew you'd never touch 'Starship Troopers' with a barge pole."

Darn! Didn't even think of looking there!

He slips something cool around my neck, and I hear him whistling through his teeth as he tries to get the clasp together.

"Open your eyes"

Spoilt rotten
Originally uploaded by Sunshine follows me.

It's beautiful.

"Do you like it? I thought it would suit you"

I answered him with a big hug and a kiss. "I always knew you had good taste."

Anniversary surprise #1

The doorbell rings. It's a large box for me.

A dozen longstemmed red roses.
Accompanied by this message.
Thank you, darling.

Colours

When the sun shines brightly in the sky, when the waters of the lake are deep and clear and still, his eyes are glowing and transparently blue like the moonstones of Sri Lanka.

When the sand is soaked with foam, when the kestrels hover overhead, when the fieldmouse scuttles amongst the barley stalks, his eyes are golden like two sweet pools of soft caramel.

When the dew is on the grass, when light filters down through the woodland canopies, his eyes glitter pale silver and green like the scales of a dragon.

When thunder rolls through the sky, when snow whistles through the air, when the moon rises pale in the night, his eyes are grey like the sea after a storm.

And I look into those eyes and I see myself, myself, only myself, and I know that I fill your vision as I fill your heart.

And my heart is also filled.

Happy Wedding Anniversary, MDH.

P.S. There! Now don't complain I never write enough about you on my blog!

And it's not so bad

Just when things were getting really rough at work and I was starting to lose my grip on sanity, the drug reps (ie. people who give us freebies whilst marketing their products) show up and one of them gives me this little piece of work.

So cool! I could hardly believe my fortune. Doctors fight each other for little trinkets like this. They make great presents. I've been dying for months to get hold of Viagra goodies.

"It'll get you up in the mornings," said the rep, eyeing me with displeasure as I choked back a snort of laughter.

I gave it to MDH when I got home and he moaned about what people would think of him if we displayed this prominently in the house. He's insisted on placing it on the mantlepiece anyway.

Then, MDH whipped out this chocolate brownie cake that the Aged P had secreted away in the house as a present and had forgotten to tell us about it. He'd found it in a drawer in the kitchen, wrapped in paper. We had it for dessert. Yum.

And to round it all off, MDH decided that he would give me a relaxing back massage using my favourite 'Mande Lulur' body lotion.

"I want to thank you for giving me the best day of my life, Oh just to be with you is having the best day of my life" - Dido

I wish I had a river that I could sail away on

It's not a good day. My patients are yelling because I'm refusing to send them home ("No, you can't go home until you can feed yourself!"), the nurses are bleeping me every five minutes to harass me, I've got relatives chasing me round the hospital trying to get updates...

Sometimes I think people overestimate my abilities as a doctor. I may be a good doctor, but it doesn't mean that I have powers of :

Omnipresence ("Why weren't you here?" "Because I was not on duty at 3am!")

Omniscience ("So what will be the results of the scan?" "I don't know, because it hasn't been done yet" "Yes, but what will be the result?" I mean, do I look like I have Xray vision to you, chump? Do I look like I can predict the future?)

or Omnipotence ("Make me better now!")

When will people understand that DOCTORS ARE HUMANS NOT DEITIES?

I must admit that some doctors so strut about the place as if they were gods. But it's all a myth! Doctors need to eat and sleep just like everyone else!

I need to close my eyes and take my mind far away from here, and leave it someplace quiet and peaceful, just to stop myself from screaming.

Physician, heal thyself.

Today has been a particularly exhausting day.

One of my colleagues is on leave at the moment, so I'm covering for him and taking on all his patients and jobs. My Senior Registrar and Senior House Officer are on a surgical training courses this week, so there's just the Consultant and myself on the firm, so when the boss is away, I'm the most senior member of the team.

Grr-rreat.

Additionally, some bright spark down in the admissions department decided to book 11 patients onto my surgical pre-assessment clinic today (normal clinic size is about 4-5 patients). This means that I'm not only post-take (ie. all the new patients from overnight are in my charge), and post-list (all the elective surgical patients from yesterday are in my charge), but I also have to clerk in and workup an additional 11 patients and make sure all of them are in fit condition for surgery.

It has been a long day. I normally manage to take time out to have breakfast, but I didn't get a chance. Then, I forgot to have lunch because I was so busy sorting out a 'sickie' who had to be transferred to the high-dependancy unit, so by the time I got to the canteen it was closed.

I drank half a cup of tea before getting bleeped away to review a patient who had pulled out her urinary catheter (OUCH). I must have looked like the living dead because some nurse took pity on me and gave me a biscuit. It had chocolate on it.

I had to work a couple hours overtime, so by the time I finished I was so weak that it took me an hour to walk back home from the train station (usually takes me ten minutes). My legs were like reeds shivering in the wind. I haven't yet made dinner or washed the dishes or sorted out the laundry I was going to do today.

Right now, the computer screen swims in and out of focus and I'm getting that tight feeling in the muscles of my forehead which signal the beginnings of a headache.

I'm going to go and lie down, sod the housework.

I should take better care of myself.

Yay!

In other news, I've just won a book from this generous, generous person. I love books about food. Thanks Domestic Goddess!

The New York Job?!

I just watched the remake of 'The Italian Job' yesterday (one of my mates taped it off the TV and we watched it together).

Now I know why it received such poor reviews. It was just wrong. Wrong wrong wrong. Most of it takes place in New York and it seemed to be American vs American, really. The whole point of the original film was in the Brits thumbing their noses at the Italians. "Hey look at us outrun your Ferraris with our Mini's! England is the greatest! Woohoo!"

I don't understand this need to 'remake' old film classics.

The day I see 'Dr Zhivago' remade (with new digital effects!)....*mumble mumble*...

Countdown!

I have added this neat little Daisypath ticker to the blog which counts down the days until our next vacation - a visit to Singapore. Yay! Watch time fly by.

Aren't the ladybird bugs sweet?

Fair trade

The India Shop, originally uploaded by Sunshine follows me.

This little family-run business imports beautiful handmade goods from India, aiming to preserve traditional craft skills. They abide by the fair trade policy, supporting family firms and co-operatives that treat their workers with respect and pay them good wages.

I'm especially attracted to the ecofriendly bags - made from discarded polythene bags that are collected, cleaned and processed using a method developed by a non-profit organisation that employs women from the Delhi slums. The bags look really funky - bright colours and sturdy looking designs.

Pretty cool, huh?

Feisty

It's Sunday night and I've been fast bleeped to see a 104 year old lady. I'm on the other side of the hospital, so I sprint down the corridors wishing once again that the hospitals would see fit to issue us with electric scooters.

"She's eating and drinking," the nurse informs me when I stagger onto the ward, puffing and clutching my chest, "But still a little dehydrated, so she needed a drip and she's pulled out her cannula."

Doesn't sound like it's a priority call to me but seeing as I'm already there I decide to give it a go. Poor lady. It sounds like a straightforward case of 'Crumbleitis' (as my Senior House Officer calls it - we are all terribly ageist out here. Heh.)

Mrs 104 is sleeping in her chair with her false teeth hanging halfway out of her mouth. Somehow, the bottom row of dentures have turned round in her mouth, and now she has two rows of top teeth, like a shark. The nurses have left the cotsides (bedrails) up on the hospital bed, presumably to stop her from climbing back in. They sometimes do this to stop elderly patients from sleeping during the day, and then waking up in the middle of the night feeling cantankerous. Well, it hasn't worked. I stifle a giggle. I try to wake her up but she opens one eye and gives me a withering glare before going back to sleep.

Thinking she is too knocked out to resist, I begin cannulating her.

WHAM!!!!

Ouch....

Mrs 104 has boxed me soundly in the head. This is not a feeble smack. This is a proper right hook. My ears are ringing.

"You bad, BAD girl!" Mrs Rocky scolds. (Actually, she said "Roor farf, FARF Garf!" whilst readjusting her dentures, but I'm used to Crumblese.)

Suddenly I decide that Mrs Rocky doesn't really look terribly dehydrated to me. She's feisty for 104. Heck, she'd be feisty for 24.

Later on that day, I walk past her room again. Some odd movement catches the corner of my eye and I llook round to see Mrs Rocky standing on top of her chair, hanging onto the ceiling lamp with both hands, attempting to swing herself over the cotsides to get back into her bed. "Arrrr!!" she says defiantly, as her dentures clatter to the ground.

Tarzan, as far as I'm aware, isn't a 104 year old lady.

I quickly run to get the staff to help me get her down before she falls off and breaks her 104 year old bones. The nurses are like offended hens, clucking round Mrs Rocky as they tuck her into bed. I suppress the urge to cackle hysterically.

Feisty.

Mr Topsyturvy and Beryl

7:30am. I've just walked onto the ward and I'm sipping a cup of tea whilst checking through blood test results from the previous night. All around me is the gentle sound of snoring and the occasional rustle as someone turns over in bed. I love this ward because the nursing sister always makes me a cup of tea in the morning (and if she's feeling especially generous, there'll be two little chocolate digestive biscuits acoompanying it).

A scream pierces the silence.

"BERYL!!!!"

I look around in surprise. Who is Beryl? There aren't any nurses on this ward called Beryl.

"BERYL!!!!"

Some nurses emerge from around the corner.

"BERYL?? BERYL!!!"

"Who's Beryl? And what's with all the shouting?", I ask the nearest nurse.

"Beryl? Where are you Beryl? BERYL!!!"

"Oh, it's the new guy in sideroom 3," she sighs, "He's just been transferred over from Central Hospital. 85 years old, deaf, slightly confused. He goes on like this whenever he's awake."

"BERYL!!!"

"Any reason why he's in a sideroom? He's not infectious, is he? And he doesn't sound all that sick."

"BERYYYYYLLLL!!!", says Sideroom 3 in agreement.

The nurse smiles wanly. ("BERYL!") It must've been a long night for her. "We moved him to the sideroom because one of the other patients tried to strangle him after listening to him shout for an hour"

"So, what's with all this 'Beryl', then? He's not trying to pull some 'rosebud' thing on us, is he?"

"BERYL!!! Come on, Beryl!"

Right, I say to myself, it's time to stop the shouting.

I walk into sideroom 3, and there sits this elderly gentleman. He's had a major operation on his skull to remove a large collection of blood that had seeped over his brain following a very bad fall. He has lost the use of one eye, which rolls around in all directions, giving him a topsy-turvy sort of appearance.

"BERYL!!!", he shouts at me, by way of greeting.

"Hello, Mr Topsyturvy, is anything the matter?"

"Where's my bottle of pop?" he demands, waving his hands imperiously, "I want my bottle of pop."

I see that his family have kindly left a crate of Pepsi for him, tucked away from sight in one corner of the room. "Hang on there, I'll fetch you some."

As I pour out the Pepsi into a two-handled plastic mug, Mr Topsyturvy inspects me with his good eye.

"You're not Beryl," he observes, "Where's Beryl?"

"You're in hospital now."

He takes in this new piece of information. "Ah. So Beryl's not here now."

I hand him his mug of Pepsi. He mumbles his thanks and starts chugging it down whilst I leave the room.

Later on during the week, Mr Topsyturvy has caught on that half the nurses on the ward are named 'Marie'.

"MARIE!!!" he bellows belligerently down the corridor, "MARIE!!!"

And then, hopefully, "BERYL???"

We visit him everyday, and the consultant comes to see him twice a week. Our consultant is a stiffbacked fellow who always looks like there's too much starch in his shirt collars. Mr Topsyturvy is unafraid of Dr Starch's unfriendly appearance.

"Hello darling!!" he says, cheerfully grabbing Dr Starch by the hand. He pats Dr Starch on the head and gives him a kiss on the cheek, oblivious to the looks of horror on our faces.

"Beryl came to see me yesterday," he whispers, "She's my lady friend you know."

Dr Starch's face is frozen in a shocked smile. He beginning to sweat and looks like his skin will crack from the strain at any moment. The nursing sister shakes her head surreptitiously. Only Mr Topsyturvy's family have been to visit, and they have no idea who 'Beryl' might be.

"How nice for you," Dr Starch says hurriedly before escaping down the corridor.

A month goes by and we have finally found a nursing home with the appropriate rehabilitation facilities Mr Topsyturvy needs.

The afternoon of his departure, Marie helps him into the shower room (he wants to look nice when 'Beryl' comes to accompany him to the nursing home). As Marie turns the shower on for him, I hear him yell indignantly "MARIE!! I'M ALL WET!!!".

I'm smiling to myself when I turn round and see a tiny pink lady with snowwhite hair.

"May I help you?"

"Oh, I'm Beryl." says the pink lady, "I'm here to accompany Mr Topsyturvy to his new home."

!!

Attempting to retain my compusure, I exclaim, "Oh! He talks about you all the time."

She blushes even more pinkly and says shyly, "His family don't know about me yet. It's a secret"

!!!!!!!!

Oh, Mr Topsyturvy, you sly dog.

Why doctors need to carry megaphones

TSCD: (approaching 96 year old man) Hello sir, are you in any pain?
Mr 96: Eh?
TSCD: (louder) Do you have any pain?
Mr 96: (looks shocked) Who, me?
TSCD: (bellowing) Yes, you. Do you have any pain?
Mr 96: (very upset now) NO! I don't want any cocaine!

A little bit of silliness

Here's something I thought would make everyone smile - the wonderfully wacky Robot Parade! In this cool e-shop, a bunch of artists sell what they refer to as 'crafty goodness' - reconstructed clothing, dead bunny heads, monster wallets, .

My personal favourite is the bucktoothed coin purse. Thick black spectables, furry faced, not much on the top - reminds me of all the Singapore NSmen I used to know.

Heh.

Seriously, though, check it out. Some of the slogans on their homemade button badges ("Banjos not Bombs!!") are especially relevant.

It's awfully quiet today

"Whatever they do, it is our determination that they will never succeed in destroying what we hold dear in this country and in other civilised nations throughout the world" - Tony Blair, 7 July 2005

It's very quiet out here today. Even though the devastation is not half as bad (thus far) as the Bali or Madrid or New York attacks, I think we're all shocked that it could happen in London, despite all the measures taken against terrorism. We all knew it might happen, and it did. It's a nightmare.

And at such a time. It is good that the G8 summit still carries on, and life in Britain continues regardless. I am amazed at the stoic faces around me.

Some of us still feel the need to talk about what happened. There's not a single person working here who hadn't, for a few hours, feared for the life of a friend or relative working near the blast areas. Nervously, we all giggle about our reactions to the 'major incident' call that went out on our bleeps - first logging onto the BBC website, then reaching for our mobiles, then gathering in shock in front of the nearest television and finally, running down to the A&E department.

It was so amazing how, in crisis, the whole medical system seemed to come together, work as a team. Porters magically produced trolleys and wheelchairs from thin air. Rehabilitation hospitals managed to create almost 100 beds for anyone who was stable enough but not well enough to go home. Nurses from various wards whipping through the cupboards and pooling together the stock, organising themselves into teams. Doctors lining the emergency department or holding fort in the wards. It was chaos at first...but soon enough, we were all ready.

It was pretty horrible, though.

Sometimes, when it comes down to it, I just have to admit that the world is so full of evil and there is so much darkness in the hearts of men, so much capability for destruction.

I fear that Britain will lash out blindly in revenge, full of hatred and anger.

My thoughts and prayers are with all those whose lives still hang in the balance, all those who mourn, all those who survived and are fearful.

It's a sad time for Britain.

This is NOT GOOD!!!

Just been fast bleeped by 'major incident centre'. This has never happened before.

Bombs in central London.

Oh. Crap.

Update: (4 hours later)
So my hospital was on 'Major Incident Alert' and everyone was rushing about madly in greens trying to get things organised. The TVs in all the wards were tuned into the BBC. Some of the patients in A&E decided to self-discharge to make room for casualties coming in from London.

I was part of the team of discharge coordinators - basically we went on a rampage through the wards, sending home any patient who was eating and drinking, frantically scribbling out discharge letters which were then sent to the pharmacists who were frantically checking and dispensing.

20 dead, 150 confirmed seriously injured and casualities being moved out in red London doubledeckers. And they haven't even begun evacuating people from the underground system.

It's going to be a long night.

Update (6 hours later):

It's horrible out here.

It's really really horrible.

Update (8 hours later):

Managed to get home alright.

Major delays on all the transport systems and mobile networks were down for more than 5 hours. Hospital was in chaos - cancelling the elective surgical lists and outpatient clinics, kicking patients out left, right and centre, ambulances being diverted to London leaving other emergency cases waiting, patients and staff weeping in the corridors.

Fortunately, we didn't get as many patients as expected - seeing as we are located on the outskirts of London. But I expect there will be heavy repercussions on our surgical waiting lists and outpatient clinics. And who knows how many other emergencies around the county are being neglected whilst everyone prepares for the onslaught of Central London casualties.

I hope the trains will still be running tomorrow so I can get to work. Things are going to be quite shaky for a while more.

Not to harm - Medical Ethics (IV)

When I walk down the corridors of the hospital, I often get cornered by relatives of patients who want to discuss their loved one's condition and options for treatment. Many of them struggle with making difficult decisions, and one of the topics I am often asked about is the concept of Euthanasia.

Now, anyone who is asking more information about euthanasia, is usually in a rather delicate frame of mind. Perhaps they have a relative suffering from end-stage cancer or a debilitating condition like multiple sclerosis or parkinson's disease. Perhaps they have been asked to make decisions about treatment plans. I still find it very difficult to discuss treatment options with patients and with relatives, because I need to be very clear in what I am trying to communicate, whilst remaining sensitive towards them.

Euthanasia, as I understand, means 'good-death'...but nowadays it points towards the intentional killing of a person because of the suffering or illness endured by that person ('Mercy-killing' or 'Physician assisted suicide' are other common terms). This is totally different from withdrawing 'life-prolonging' treatment.

Now there are many stages of hospital treatment, which I categorise as follows:
1. For cardio-pulmonary resuscitation (CPR)
2. For Active invasive treatment
3. For Active conservative treatment
4. For Passive/supportive treatment

Stage 1 treatment is all about bringing someone who is 'dead' back to life. A person who requires cardiopulmonary resuscitation is someone who has no pulse and has stopped breathing - so we start chest compressions to try to keep blood flowing to the brain, and breathing into his lungs to keep oxygen in the blood (until someone comes along with the defibrillator and yells 'STAND CLEAR!' and tries to jumpstart the heart with 200J of electricity).

In a normal, young and healthy person, CPR has a 4 out of 10 chance of restarting the heart and breathing, and on average 2 out of 10 patients will survive long enough to leave hospital. The odds really are not bad at all...in a young, fit and healthy person. But what about an elderly, sick person with lots of problems? CPR is not a kind, gentle procedure. It is rough and ugly and very painful.

More than once, I have felt ribs snap under my hands, and I have seen patients come back to the living after CPR, but die a few days later, spending their last moments drifting in and out of pain and consciousness, hooked up to machines.

The decision whether or not to perform CPR on a person is a joint decision made by the patient, the patient's family, the doctors and the nurses. The patient, of course, gets the last say - which means, anyone between stages 2-4 can also be for CPR if they so request it.

Stage 2 is active, invasive treatment. By 'invasive', I mean treatment that is painful, which usually involves either cutting open a person (on the operating table) or the use of anaesthetics to keep a person asleep and paralysed.

For this stage of treatment, you need to know there is a small chance that the person involved might be able to be weaned off the tubes or survive the surgery or wake up once the anaesthetic has been withdrawn. There is no point in performing invasive procedures on a person who is more likely to die faster from the procedure than the disease that they have. Active, invasive treatment is usually for life-saving procedures.

For example, I will cut out the lung cancer, and I will put tubes down your throat to help you breathe but if your heart stops beating, I won't try and restart it with 200J of electricity.

Stage 3 is active, conservative treatment. This is treatment that involves either very simple instrumentation (like the insertion of a small needle into a vein or small tube into the bladder) or medication that can be swallowed, inhaled or injected or extracorporeal intevention like radiotherapy. This is usually for life-prolonging treatment.

In this sort of treatment, I may give antibiotics through the vein to treat your chest infection, I may do blood tests on you to make sure you are adequately nourished, I will give you chemotherapy but I won't cut you open to remove your underlying lung cancer.

Stage 4 is passive or supportive treatment. This is the treatment of symptoms only - like pain, dehydration or discomfort (eg. muscle spasms, nausea, dry mouth, difficulty breathing). At this stage, life-prolonging treatment is seen to be futile, because under natural conditions the person would already be dead. At this stage, the patient understands that death is coming soon and is unavoidable. This is usually more difficult for a patient's family to accept than a patient. Everybody knows that death comes to all living creatures but that concept just never seems to be realised.

In stage 4, I will keep you as comfortable as I can with fluids/oxygen/medication, I won't keep jabbing you repeatedly with needles, and if you pull out your nasogastric tube (tube we put down the nose into the stomach to give liquid foods), I won't force it down again.

You can see how stepwise the withdrawal of treatment is. Physicians do not actively assist suicide, we do not overdose you with a lethal injection but we also do not keep your body alive just for the sake of keeping it alive.

If you are dying and we know there is nothing we can humanly do to stop that then we let you slide away slowly or allow you to go home to be in a friendlier environment. We try to keep you conscious as long as we can so that you can sort out your affairs or say goodbye to the people who matter most to you. And when you are delirious, we try to keep you relaxed and out of pain. We will withdraw treatment at your request, but we will not reinstate treatment that is futile and would only speed up your demise. We try as hard as we can to respect your decisions, wherever possible.

It's hard for doctors, too, because we also need to come to terms with the fact that there is nothing more we can do to make things better for you, because we have reached the limits of our capacity to help.

It is in this time where doctors step back, realising that for all that we try to do, only God is the true Healer.

2012

London won the bid for the 2012 Olympics! Now we can all look forward to more traffic congestion and higher taxes! Maybe I should buy a flat in London now and rent it out to Olympic fans for exorbitant rates. Heh.

So far away

The Aged P leaves for Singapore today, and I won't even get to give her a goodbye hug.

I know most of my mates in Singapore envy my independence and the fact that I am located half a world away from the Aged Ps. They complain to me about having to deal with domineering parents who interfere with their lives, having to call home constantly to let them know their whereabouts, having to bear with angry naggings and freezing silences.

But I miss being able to talk to my parents and not have to worry about long distance phone charges or calling them up at inappropriate times. I miss standing next to Mum, folding laundry whilst she irons, chatting about random events and gossiping about my cousins. I miss watching Dad fall asleep watching TV and grumble "I'm listening!!" when I attempt to change the channel. I miss Mum clucking round me trying to force feed me more vitamin C. I miss Dad complaining that I never drink enough water.

And most of all, I miss being around to comfort and support my parents when they are worried or stressed or sad...and I would dearly love to be able to pop by with chicken soup when they are unwell or drag them out for a meal after Church on Sundays or insist on visiting just to help with the housework. I want to do all the things a loving daughter should be able to do - but I can't.

I mean, even with all the little niggling idiosyncrasies, they are family. And I will always miss them.

It's only Tuesday!

I am so exhausted. And it's only Tuesday. And I'm on call this weekend, so the horror doesn't stop on Friday like it usually does.

I hate working 12 days in a row. It always makes me feel so ill at the end of it - a combination of being totally overworked, and not getting enough fresh air. Cabin fever, I tell you.

Funnily enough, I don't feel 'thin and stretched' when I'm really tired. I feel brittle and slightly cracked - like clay that hasn't been fired properly. Half-baked, as it were.

People are just not made to work continuously without taking a proper break. I don't even get a break in the evenings on workdays, because I have to sleep early in order to wake up at 5am to get back to work. I really look forward to my weekends because I can catch up on my sleep as well as spend some time outdoors.

At least it's summertime now. In wintertime, I go to work in the dark and come home in the dark - I can go for a whole fortnight without seeing the sun. It's horrible.

I thought I'd put up this picture of brightly coloured beach huts to cheer myself up - I met lots of elderly people on this beach, pottering around the huts tidying things up or sitting together on sofas in the hut enjoying a cup of tea.

Someday in the future, maybe I won't have to wake up at 5am to get to work on the weekend. I can get up at noon and sit in my beach hut.

I really like the blue and yellow one.

What makes an SPG?

When I was a hysterical, hyperventilating fourteen, I remember being asked by my equally hysterical and hyperventilating friends about what I would look for in a boyfriend. Being the time-wasting, homework-avoiding individuals that we were, we all sat down and wrote out lists of criteria (using different coloured pens, of course).

I think my list went something like this...
'My Dream Guy'
1. Must be a dedicated Christian
2. Is not married/engaged/attached
3. Treats his own family with respect
4. Is tall!!!!
5. Must have dimples
6. Must love music
7. Must love my parents
8. Must think I'm incredibly hilarious
9. Is pretty hilarious himself
10.Doesn't have allergies
...and so on.

Now, way back then, the idea that he would also be 'Chinese' and 'Singaporean', I assumed would be pretty obvious. My girlfriends were far more pedantic than I and included both the former and the latter as part of their top ten criteria. Maybe this shows how, even then, I was already more open to the idea of interracial marriages.

On the other hand, when I was preparing to go abroad for university studies, my mum casually mentioned that I might marry an Ang Moh and settle abroad. The very horror of that idea made me so upset that I cried more or less continuously for the rest of that week. Perhaps I'm not as liberal-minded as I think.

I didn't limit my dating circle to caucasians only...in fact, all my previous crushes and boyfriends were all Chinese. It just so happened that my last boyfriend was the first and last Caucasian I would ever date - and I married him.

When we were still dating, I brought him home to Singapore for a visit. To my surprise, I started to notice side-wise glances and tutting and surreptitious pointing from strangers in MRTs and buses and shopping centres, as well as the occasional "SPG!" hissed through gritted teeth. I guess I had not realised that I would be judged by the company I keep. Naive, eh?

I hadn't thought of myself as an SPG (Sarong Party Girl) before then, but I did wonder what an SPG would be like. What would make a girl into an SPG? Would the SPG date only caucasians or expatriates? Does the SPG have a fetish for the white man or is she attracted to his independence and generosity? Does the SPG revel in the transcience of the relationship or does she see it as her ticket out of Singapore?

Am I an SPG?

I don't think I am.

I think a real SPG fancies the Caucasian Expatriate because he is a caucasian expatriate. If an SPG were to make a list of criteria of suitable boyfriends, 'Caucasian' might be top of the list. She would choose the caucasian over the oriental any day, even if both suitors were equally matched.

I don't actually think of MDH as caucasian; that is, I don't seem to look at him and see the colour of his skin. Being a caucasian is part of who he is but it is not all that he is. To me, he is simply MDH.

And, by the way, he fit all the criteria that my hysterical and hyperventilating fourteen year old self had set, so many years ago.

Dilly dilly

Norfolk Lavender
Originally uploaded by Sunshine follows me.

This picture was taken at a lavender farm in Norfolk. The farm, from a distance, is a stone building drowning in a hazy purple-blue sea.

It was a warm day, and the scent of lavender was so heavy around me, I felt I could roll myself up in it like a blanket and go to sleep.

Made In Singapore

forestprints, originally uploaded by Sunshine follows me.

Stumbled across this wonderful homegrown boutique with quirky forest-inspired designs by the talented Lynda Lye (her blog is pretty funky too).

I love the little fantasy world she's created on her website...and the odd creatures that live in it are so, so, so cute. All lovingly handmade, one-of-a-kind pieces - teeshirts, toys, accessories, cushions - in a veritable smorgasbord of colours and textures.

Forever

Norfolk, originally uploaded by Sunshine follows me.

Sometimes, on a very clear day, you can see forever.

The day I took this picture of the arable fields of Norfolk, I was feeling peaceful and very glad to be part of this huge, huge, wonderful landscape.

In all its moods

Somehow, the sea always seems to reflect my mood.
The day I took this picture of the North Sea, I was feeling sad, cold and incredibly homesick.