Culture shock #2
Singaporeans are surprisingly ignorant about their own medical problems. One would think that, amongst such an affluent and highly educated population, there would be more awareness of health-related matters. But there isn't. My Singaporean patients seem to be quite disinterested in personal health. I feel like grabbing some of my patients and screaming, "Don't you care?! It's your life we're talking about here!!!"
Perhaps my expectations of patients are a little too high. I expect all my patients to be able to tell me or provide me with information regarding the following:
1. What sort of medical conditions they suffer from.
I am used to hearing my patients reel off all their various diagnoses, counting them off one by one on their fingers. In Singapore, patients need alot of prompting and encouragement to get them to reveal their medical history. Just asking them an open question such as, "Do you have any medical problems?" or "Do you have any heart problems?" is not enough. I have to be very specific and condense everything to simple closed questions like "Have you ever had a heart attack?". Even then, I have encountered Singaporeans who deny having serious heart problems but who have already had major heart surgery!
2. What surgical interventions they have undergone and why they took place.
Normally, this is a cue for my patients to tell me gruesome stories about 'going under the knife' and complain about post-operative pain and rehabilitation. Singaporean patients are very reticent about this subject and know very little about what exactly took place during their surgery or why surgery was indicated. Some of them will even outrightly deny that they have had any major surgery, despite having long train-track scars down the centre of the abdomen ("Dunno for what!").
3. What medications they use regularly for their ailments.
Even my most elderly and decrepit patients in the UK would carry a list of prescriptions with them, and if they didn't, they could at least tell me what the medications were for ("A small white pill for my bowels, doctor"). Over here, I'd be lucky if I get a response like "In the morning I take one tablet and in the evening I take five tablets". More often than not, I get no response at all, just a mournful shaking of the head.