The Emperor of All Maladies A Biography of Cancer (Siddharta Mukherjee)
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Sunday, August 27, 2006
Cliches are overused because they're true
I blog less these days, keeping to one of the principles I like to adhere to: "When there's nothing better to say, better to say nothing at all". Which is a good reminder for when you're like angsty and want to bitch like there's no tomorrow. But the fact is that there's always a tomorrow unless you're seriously suicidal, and you really don't want to wake up and face the catastrophe you've created with your words. It hasn't really happened to me yet (the catastrophe) but I've come close enough to it, to want to avoid it.
First week of Orthopaedics posting reminds me of everything I like and dislike about any surgical discipline in general. Ward rounds at 7.30 in the morning is still reasonable when it's in TTSH, but I am so not going to make it in time when we are posted to NUH for the next half of the posting. Also, waking up early takes a lot of getting used to after the late mornings of Fam Med posting (even during Emed I could wake up late because it was at CGH). It's a minor point. What I really dislike are the whirlwind rounds where everything is said so fast I wonder if the words ever get processed by a higher order thinking mechanism, and the patient lies on the bed bewildered by the abrupt nature of the visit. Ya, ya, time constraints, have to go to OT, clinic, no time to spare for the patients, so many of them. Rather ghastly. Having said that, my mentor is a great doctor most of the time. Clinics are awful too, all that standing for hours (too used to having chairs to sit on during Fam Med, again) and every patient coming in with some back pain or other. Back pain gets really boring after a while, you realise.
But I guess surgical disciplines are all about the surgery; in the OT the surgeon rules. We had a posting to the day surgery OT for half a day (having to go back to NUS for patho lectures in the afternoon, bleh) and the consultant was possibly the most student-friendly surgeon I've met in the OT besides Prof Low. He got both of us to scrub up to watch the operations close-up and do simple tasks like diathermy, holding retractors and cutting sutures (reminds me of the trainee MO in SGH surgery who said that M.R.C.S. stands for Member of Retractors and Cutting Sutures, heh) which is possibly the most I've done in OT so far, besides the T&S during Emed. I have to admit the feeling of being able to do something definitive to solve a patient's problems is rather euphoric, and of course there's an immense sense of satisfaction in looking at the nice neat surgery you've done. Haha. But I still think a lot of them have an inflated sense of self-importance. Definitely not the road for me.
Mostly the first week has been exhausting, as my body struggles to get used to the longer hours and increased amount of standing around (I always joke that standing in the terribly hard OT clogs is a therapeutic experience), and it seems to be a sign that I'm getting older when I spend more mornings out of every week wondering why I even bother to go to hospital. Or maybe it's just lack of interest for the posting.
There's been a lot of debate in the MSM (mainstream media), and out of it, about the stuff mentioned in the Prime Minister's National Day Rally, namely the foreign talent issue and the birth rate issue, which the PM has rather conveniently linked together - we are not reproducing ourselves, thus we need more foreign talent. Rather strange logic there, because bringing in foreign talent might help the economy and whatnot on a temporary basis, but when these young to middle-aged foreigners grow old we're going to have a bigger aged-population problem on our hands, unless you can counter that by saying that the foreigners prefer to have more children or something. So it's really a stopgap measure, and in 20 years we'll really start seeing the ill effects of this push, just like we're currently suffering from the effects of the Stop at 2 Campaign from long ago.
The problem with having children is just that, they're a problem. If you find that I'm looking at this in a rather cold and callous fashion, I apologise (the other day some lady wrote in to the Straits Times Forum all aghast and taken aback at another letter that described children as assets and liabilities, which I found rather amusing). This being Singapore, and us being Singaporeans, I don't think there's a need to hide the fact that we are all extremely practical people, or, dare I say it, we wouldn't be so successful today. Talk to any parent today and chances are very few of them will wax lyrical about the joys of having children; instead every stage of growth of a child has its own woes that the parents need to grapple. Babies need diapers, milk powder, etc, which are expensive. Children fall sick and need to see a doctor, you have to take leave to look after them. You need to teach the child the alphabet, numbers, even hanyu pinyin early so they won't be disadvantaged at school. Schoolwork is stressful, children may need tuition for multiple subjects. Teenagers have all those problematic issues that I won't bother to go into. If you have sons they need to do NS. On and on the problem list stretches, and it is a daunting prospect for any working couple aspiring to be parents, to say the least, unless you really really love kids or are really really optimistic. So don't blame the practical Singaporean for not moving past the Contemplation stage (haha stages of behaviour change glee!) when little has been done, or really, can be done to help them move into the Ready for Action stage.
Disturbingly, during the polyclinic posting, I learnt during a half day spent at the Well Women's Clinic that the government is considering stopping family planning services at the polyclinic as part of their campaign to increase the birth rate in Singapore. Excuse me, did you just see how far my jaw dropped? I'd like to think it's just a rumour that will eventually be proven as just a rumour, but still the implications are rather disturbing. And anyway, so what if the polyclinics no longer provide advice and medications or IUDs? Can't any clever young Singaporean woman just look for the same services elsewhere, albeit at a higher price? The workings of the brains of policy-makers in the government really baffles me sometimes.
I think I always get carried away when I start on issues like these, and I don't really have any good points to make anyway. Sheesh I'm breaking the Bhavani Commandment - thou shalt only criticise policy if you have constructive suggestions to make. I'm rather annoyed now because I spent so much time writing about the govt stuff that I can't write about the things I originally wanted to, but I guess that's kind of a sign that I'm not meant to write on them anyway, heh.
On to lighter topics. Courtesy of Raymond (he sent me the link on MSN) comes this really cute video that made me laugh a lot and brightened up my dreary Saturday afternoon. Elmo is so lovable it's impossible not to smile, unless you're a real Grouch, heh. Enjoy, and hope it brightens up your day too. Seriously, laughter is the best medicine.