Keeping secrets

I don't try to hide the fact I have depression, which lead to two repeated years plus two deferred years when I was studying medicine. I don't feel ashamed I took longer than everybody else to get a medical degree. I knew I had problems and it wasn't entirely my fault.

Yet there are times I "bend" the truth. I don't exactly lie but the entire truth is not exactly revealed. The best example is when asked about my background. Due to my deep accent, I'm always asked my fellow staff about my upbringing. I always say I was born in Hong Kong but grew up in England. So there is nothing wrong there.

Yet there is always questions about duration and such. I'm always asked how long I have been back in Hong Kong. The real answer is ten years - five years of my medical degree plus the extra four years entailed plus my intern year. What most people expect the answer to be is six years - five years for the medical studies plus one year internship. So I never ever say an exact number. I always state I have been back for my university studies and have been so ever since. Not exactly the whole truth but not exactly a fib either.

So why do I "bend" the truth? Why don't I just admit to the fact I spent more time than anybody else to get a medical degree, just because of my depression? The fact is I got sick of explaining my life story every time this possibility crops up. Me explaining my life and my depression becomes like that game "Twenty Questions" when people try to narrow down the truth. At the end of the day I just want to simplify matters.

Occasionally I do have to get a sick leave when I go for my follow-up appointments. Then some parts of the truth do creep out. I'm always asked where have I been when I go to my psychiatrist. I usually say I just have to follow-up with my doctor and hope the questioning ends there but it never does. This leads to the inevitable question, "What are you being followed-up for?" which leads to me say, "Depression" and the barrage of questions afterwards.

I understand some people who keep secrets. It makes life a little more simple. Now I have some kind of understanding what schizophrenics and homosexuals go through. I would never say my predicament is exactly as does who are persecuted like gays and lesbian but some people expect you to conform the normal standards and if you have a deviance, you are most likely to keep it in check even if most people are willing to accept it.

Increasing levels of bureaucracy

Having requested my holiday leave* at the end of my rotation, I have finally finished surgery and will be going on to accident and emergency next month.

* I can never call my holiday leave "annual leave" as I get the leave four times a year. It can only be called annual leave if I can bunch up all my leave into one massive holiday, where I probably go back to England.

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I've only just left a surgery department where they recently opened another ward. This means another twenty six beds available and more opportunities for patients to receive treatment and surgery. This maybe good for the nearby population but does not bode well for junior doctors. We do not receive an increase in manpower, meaning an increase workload. I'm not complaining, having already left the department already.

This is just one of several examples of the increase level of bureaucracy in hospital work. It has been steadily creeping into the workplace. It comes with the organization you work with. The larger the organization, the more paperwork and guidelines you must follow and there is no bigger organization than a government installation. In recent months I have noticed how anal some people who set out these guidelines really are.

The first example I encountered was writing management orders for intravenous fluids. In the past I could just write what intravenous fluids I want for my patients in the management orders sheet. If the intravenous fluids contained potassium, I would have to write it on the drug sheet, which is fair enough since overdosing on potassium is very dangerous. For some reason, this policy was changed so I have to write ALL intravenous fluids into the drug sheet, whether or not it contained potassium or not. Also I have to write the frequency more explicitly. In the past I could write "2D1S Q8H" which means "two units of dextrose 5% and one unit of sodium chloride 0.9% every eight hours". Now I have to write "2D1S Q8H per unit/pint*" which means a few more seconds. If you are writing this for every week for every patient, the amount of time spent doing this starts to build up.

*Whoever writes "per pint" for intravenous fluids or even blood products is wrong. A pint is 565 ml, whilst an unit of intravenous fluids is always 500 ml, whilst for blood products it is usually 330 ml. Just being pedantic.

Another example of bureaucracy I have just encountered is blood taking. In the past we had to use a barcode system to print labels for blood specimens if we want to type and screen a patient. For those of you who don't know what that means, it basically means knowing a patient's blood group so we can give blood just in case. We had to use an electronic device to make sure the patient's identity was correct. It's quite similar to the mobile phone 2D barcode system you see. It would be fine if it was just for blood typing but now we have to use it for EVERY specimen, whether it is blood, sputum or urine. It is so annoying and so cumbersome and so time-wasting! At the end of the day, we want to avoid mixing up the patient's identity with somebody else but the specimen taking is still being done by a human and the placing of the label is still done by a human, which means it is prone to error. Putting another level of checking may reduce this type of human error but at what cost?

Bureaucracy is fine but there is a limit as far it can go.

Snapper happy

Yesterday I was at a friend's wedding. I only went to the ceremony because my friend was kind enough to invite me and I thought it would be impolite to turn the invitation down. I don't like weddings as I have stated in a previous entry. One of the aspects I don't like about how snapper happy everybody is with their cameras. I know the wedding day is a memorable event in anybody's lives and they want to record the moment so they can remember the occasion at a later date. That is why you employ a professional photographer to perform the task. For everybody else there really is no excuse.

If you are taking a few photos that is fine, I'll accept that. But if you are spending more time taking photographs instead of enjoying the occasion, you have really missed the point. Why take so many pictures and then when you come back to look at the them later, you cannot remember the occasion? Just try to enjoy the occasion and probably take a few pictures just to jog the memory later.

I really do blame digital technology for this. With the advent of the digital camera, people don't have to worry about wasting film or precious space. In fact they might as well keep their index finger on the snapper button. Another regard in which technology have seriously affected picture taking is having photo albums. In years gone by, we used to actually take out photo albums from cupboards or drawers and sat down with friends or families to flick through the pages and look at pictures of occasions such as birthday parties and weddings. Instead people just stored them on their computers, never looking at them again. That was the reason why I bought a digital photo frame for my parents, to get them to display the pictures they take of our dogs and the photos they take on holiday.

When people do put digital photos up on online albums, they never ever sort them out. They tend to download every single photo, meaning their album contains about a few hundred pictures. I remember lining up after the wedding ceremony yesterday to get some food, only to be held up by some guy who was taking several photos of the shao mei they were serving! I would understand if the food concerned was something rare, such as caviar or truffles but dim sum? And it wasn't one photo, it was three or four. I bet he would store them on his hard drive and download every single snapshot to his Facebook page.

I also despise having to pose for pictures. I just find it unnatural, having to stand their staring at the camera and smile like a Cheshire cat. It really doesn't capture the occasion. I always like taking candid photos rather than getting somebody to stop what they doing. Also you can get to do more witty comments on the photo as people tend to be more animated and doing several poses.

I took my camera yesterday but I left the camera in my car, which I rather glad I did because it spared me being sucked into being the rest of the congregation.

Depression and tragedy

I know many of you who read this do not have an interest in football. However the apparent suicide of German goalkeeper Robert Enke may have passed your radar screens. My heart goes out to his wife and his child.

It is a tragedy when anybody dies. For me it is even more of a tragedy when somebody dies due to a suicide from depression. This story reminds me of another German footballer, Sebastien Deisler, who quite the game at a young age due to depression.

I'm often angered by some people who think rich people and intellectual people such as sportspeople and doctors are immune to diseases such as depression and anxiety. They think money and success can buy you happiness or that you can 'think' your way out of a crisis such as feeling sad and panicky.

Just remember, depression can affect anybody. Nobody, no matter how successful they are, can escape from it

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I often wonder why some of my female friends are still single after all this time. Love is a consider source of bewilderment for me, probably due to the illogicality of it. I know at least three female doctor friends who are beautiful, intelligent and generous and as far as I know are sans boyfriend. Perhaps they do have a partner I know nothing about.

Before you ask, I have consider asking at least two of them out for a date. I am that desperate to even consider asking a friend out but I just have too much respect for my friends, I am such a coward and I genuinely fear the rejection that may come.

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I think Fabio Capello has missed a trick by only scheduling two friendlies between now and the next World Cup. With several first team players out injured, he needs to give deputies the chance to try out their skills on the world stage. The likes of Glen Johnson, Rio Ferdinand, Ashley Cole, Steven Gerrard and Emile Heskey are out injured. England need to give the likes of Wes Brown, Gary Cahill, Stephen Warnock and Tom Huddlestone more chances to play, even if it is for only 30 to 45 minutes.

Celebrity crushes

Like every heterosexual male, I probably have a crush on many a celebrity. However my type of fascination has diverted from having sex with them to possibly being their boyfriend. In that respects my criteria for liking a celebrity changes. They have to be close to my age, so people like Emma Watson are out. They also have to have similar intelligence to me and I would like deep conversations, so glamour models tend to be out unless I can proved wrong. With this said my criteria have lead to these ladies being my celebrity crushes

Julia Stiles She's not your typical Hollywood actress as she has tried her hand in all kinds of genres, from comedy to drama to action, and also dabbled in theatre. She's beautiful and has that great deep slightly husky voice I love. What really got it for is she temporarily took a break from acting to do a degree in English from Yale.

Holly Walsh What I really want in a woman is a good sense of humour. Nobody understand my sense of humour - the dry sarcasm and seething irony. I've seen and heard Holly Walsh in "8 Out of 10 Cats", "Edinburgh and Beyond", "Mock the Week", "The Now Show" and "Never Mind the Buzzcocks" and think she gorgeous. I would like her with longer hair but I can't have everything (or anything for this matter).

Tomoko Kojima You are probably wonder "Who?". Tomoko Kojima is a cheerleader for the Tampa Bay Buccaneers and has been for the past six years. What I like about her, apart from being gorgeous and fit, is that she went to a foreign country to fulfill her dream of being a cheerleader. I could have picked any other cheerleader like Amber Lancaster or Renee Herrlocker but Tomoko is Japanese (I love Japanese girls) and can speak English, which has ruled out all other Japanese models/idols.

Priscilla Ng Probably a bit too close to home, Priscilla Ng is a reporter for my local TV channel TVB Pearl. Not only is she beautiful but I think she gets a bad end of a deal at TVB. I think she is there for a little eye candy, which has been epidemic in Hong Kong news channels. She also has to present the weather and the late news as well. I know I have no chance with her, even if she was single but I think she does an excellent job.

Superstition

I'm suppose to be getting my new car next week but there is a delay. Namely my parents are not happy with the license plate I've got. The people at Volkswagen have randomly assigned a license plate number - NZ 6421. For most readers they will see nothing wrong with that. However if you reverse the numbers, you'll get the sequence "124" which in Cantonese sounds like "easy to die". Because my parents are superstitious, they are getting me a personalized license plate. I don't know if that is even worse or better - believing Chinese numerology or spending HK$3000 for a personalized license plate.

I'm not one for superstitions. I don't mind walking underneath ladders. I don't touch wood when saying something bad might happen. I do say "bless you" more out of politeness other than being scared of somebody's soul escaping their body. In this day and age where logic has now reigned, I'm surprised superstitions still have a place in modern times.

Look I don't mind have rituals you perform when doing something but if you believe these acts change your fate, perhaps you should stop reading astrology in the newspapers.

Assignment of blame

Recently the Hospital Authority (the Hong Kong equivalent of the NHS) decided to make major medical incidents public, such as the mixing up of patients' identities and the incorrect distribution of medication. I would expect the general public are horrified such mistakes still continue and will demand to know who is responsible. Not a week goes by without me hearing on the evening news of another "medical incident". People might think the number of incidents has gone up whilst hearing the news but to be honest the number of incidents reported in the news has increase only and the actual number of medical events has remained static. Nevertheless there is always the promise of a full enquiry to find who is responsible.

Yet some times even if somebody is to blame, then what? I hate to state this and this is only my personal opinion and not the opinion of doctors or the Hospital Authority - mistakes will happen. The public health system is run by humans and we humans are fallible to the odd error. We can put in more stringent measures and add more layers of bureaucracy to ensure such mistakes never happen in the future. However the efficiency of the system will dramatically decrease as doctors and nurses will spend more time filling in paperwork rather than doing their job.

In this age of increasing information at our fingertips and with high efficiency of bureaucracy, everybody thinks it will be easy to find out who is to blame. When we are angry or have lost something dear to us, we all want somebody accountable for their actions. Yet sometimes there is nobody to blame. Sometimes it is down to fate and Heisenberg's Uncertainty Principle. We do live in a world where chaos reigns and we are governed not just by the laws of physics and human behaviour but also to random chance.

In other words, things happen because they happen.

That is why I want to stick up for politicians like Gordon Brown. People blame Gordon Brown for the state Great Britain is in but it is not his fault the economy collapse - blame the bankers, especially the ones in USA. Also there was a lot of anger when Barack Obama was awarded the Nobel Peace Prize. This is the first time people have been angry when somebody good has won a prize. If you want to blame somebody, shout at the Norwegian Nobel Committee for making such an unusual decision.

Years ago, I used to get angry at everything and everyone about the state I was in. Now I just learn to accept the fate I have been given with and try to alter it myself.

Fads and trends part 2

To continue my previous post about fads and trends, there are certain number of fashions which I find ridiculous to exist and even more ludicrous that anybody follows them.

1. The iPhone phenomenon

It first began with the iPod and now the latest must-have gadget is the iPhone. People are constantly taking it out in front of friends and fiddling with the poxy thing. Probably half of the people I know own iPhones and I always see them updating their Facebook status with them.


I don't see why people have to use them all the time. I don't feel the need to be constantly in contact with the internet. Anything that comes up on the internet that I urgently need; such as emails, can usually wait until I get home. It cost a ridiculous amount to buy and with restricted service plan that seems to be provided in every country in the world, it adds more charges to your wallet. People tend to forget that there are similar phones out there, including the HTC and the Google phone that has just come out. Some of these have better functions over the iPhone. People really need to shop around.

With that said, I do feel guilty when I get out my iPod Touch. It looks similar to an iPhone, only thinner. It has the same capabilities, apart from the phone and camera functions. I do constantly fiddle with my iPod Touch but I find it a good device to replace my previous mp3 player and it has good games on it to occupy me when I am on-call or travelling on public transport. Plus the fact it came free with my MacBook Pro is an added advantage, which leads me on to the next fad I hate.


2. Being a slave to Microsoft Windows


Around 90% of people use Microsoft Windows. People always encounter problems with Windows, but never think of doing something about it. Firstly they can change the operating system. Linux and Mac OS are far superior operating systems which can be adapted to easily. They also have the added advantage of never suffering from attacks from viruses, trojan horses or worms.

I have had my MacBook Pro for about three months. Apart from a few minor slow downs and some adapatation, I don't have any problems with working on Mac OS X. I'm rather glad I switched to Apple since it is much faster and much more user friendly. Heck is so much faster on startup, I stopped switching my laptop on and going to the toilet as I used to with my old laptop since it took so bloody long to load up.

I think people only use Windows because everybody else uses it. They fear the incompatibility, especially when they need to present a Microsoft Powerpoint presentation or require reading a Microsoft Word document. People tend to forget that there is a Microsoft Office for Mac. Even though it is adequate, there are still some compatibility issues (due to Microsoft, not due to Apple). I'm rather glad I freed myself of the Microsoft dependency and want to avoid giving Bill Gates anymore money in the future.

3. The Mini Cooper

The Mini Cooper, when it came out at the beginning of the millenium, used to be cool. It was a great modern reinvention of a classic. However it has gradually become uncool over the years because just too many people have bought it. There are so many good cars out there.

The same idea applies to anybody who buys a Mercedes/BMW/Lexus, just because it is an expensive car. I hate those people who use the car as an image status rather than a fine piece of automotive engineering. These are the people who constantly buy the newest car, changing their vehicle every two years. Thankfully there is an upside to this - it allows us less mortals to buy good reasonably new cars at affordable prices.

4. Glory supporters

These are bandwagon jumpers who tend to support any footbal team that is successful. They tend to switch allegiances faster than Katie Price can publish an autobiography. In recent years these so called football fans switch from Chelsea to Manchester United to Barcelona to Real Madrid. They say they are fans of football but true football fans stick with their team thick or thin.

At first I'm guilty of being a glory supporter. I first started supporting Arsenal in 1990-1991 because they won the title that season. I have no local affinity to the club, having never lived in the Highbury area. Since then I have supported Arsenal even through the bleak black years in the mid-nineties, when George Graham was involved in the bung scandal, when Nayim was lucky to lob David Seaman in the 1996 Cup Winners' Cup final and in the past few years when we haven't won a trophy in four years. But I'm still supporting Arsenal, because they are my club.

Other fads and trends I hate
- Switching your mobile phone every two years to the 'latest' model when you clearly don't use 90% of the functions on the phone.
- Wearing designer clothes because they're designer clothes.
- Playing also those Facebook applications when real life beckons.

Please don't turn to sheep - be a lion instead.

Fads and trends part 1

I just saw the most appalling news today. For those who know me, I used to be very enthusiastic about films and the movie industry, being quite up-to-date with the upcoming releases. However I was very surprised and shocked to hear "Fame", one of the most iconic films of all time, had been remade and will be out for release soon.

Some part inside of me wept loudly because it died. Over the summer I saw the remake of "The Taking of Pelham 123", another classic movie, released with big names headlining the thriller. The remake of classics has just proven two things to me.

Firstly Hollywood has finally run out of ideas and are just remaking old films. There was once a rumour, which was featured in "The Island", that there are only thirteen real stories with different variations being made by the studios in Hollywood. I don't think that is true. In the 1970s, Hollywood was making original stuff like Taxi Driver and Close Encounters of the Third Kind. Nowadays nearly every movie is linked to a true story, a book or some other form of media. It is obvious each film must have some angle so people are enticed to come and see it. I initially thought "Wanted" was an original film, only to find out it was adapted from a graphic novel/comic leaving me very disappointed. There are enough good ideas and writers out there to make original films. Hollywood, just give these ideas and writers a chance.

Secondly the current youth are just far too lazy to watch something "old", no matter how good it is. I seriously challenge anybody to go out and watch the original "Fame" or "The Taking of Pelham 123". Those are very good films which don't need to be remade. The youth of today just want to see anything that is new and trendy, rather than go back to the classics. I hate it when people don't watch movies or listen to music just because it is old. I still listen to the vast majority of my music, even if it is more than ten years old like Blur or The Beatles. The quality of the music hasn't deteriorated, so what is the problem?

Please Hollywood, whatever your do please don't remake anymore classics. If they start to remake movie such as "The Godfather" or "Apocalypse Now", I think I'm going to the mountains to live as a hermit.

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Speaking about being new and trendy, quite a number of people I know own iPhones. I always wondered whether they bought an iPhone because it is a good device, has great functions and applications, or just because everybody else has bought one. I know a friend's sister only bought the new iPhone 3GS just because "it has a white back cover". Don't people know there are other phone/PDA hybrids out there, like the HTC or the new Google phone?

There are other trends and fads out there which I don't understand. People have to understand there are other options out there and they don't need to be like sheep, following the crowd. Please don't buy something or follow something just because everybody else does. I always use this analogy whenever somebody says, "everybody else is doing it" - if everybody was throwing themselves off the tallest building, would you too?

Next time I will write about what fads and trends I hate, except for the iPhone trend which I just mentioned. This ranges from cars to football teams.

England's World Cup squad

The website Football 365 has a very good article about which players should be in England's World Cup squad for South Africa 2010. Although I generally agree with the article overall, I don't think the selection criteria should be in the form of a ladder. I think most coaches when picking a squad will select by position rather than the quality of their players. So here is my view of who might be going.

Goalkeeper (number of places: 3)
On the plane: David James, Robert Green
In contention: Ben Foster, Paul Robinson, Joe Hart
Only if swine flu breaks out: Chris Kirkland, Scott Carson

David James, despite playing for the English Premier League's bottom club Portsmouth, is still the best English goalkeeper by a mile. His absence has proven this point. The only problem is will Capello continue to pick him if Portsmouth still play as they are. With James's absence, Green has been deputizing admirably and seem to be the second choice.

The third goalkeeper spot is up for grabs. At the moment Ben Foster is taking his chances. Much will depend when Edwin van der Saar comes back to takes his place in the Manchester United goal with Ben Foster reverting back to benchwarmer. Paul Robinson brings experience but I think his England days are past him. It might be better to bring a young pair of hands to get the experience.

Right-back (2)
On the plane: Glen Johnson,
In contention: Wes Brown, Micah Richards
Only if swine flu breaks out: Luke Young, Gary Neville

Although his defending capabilities will be exposed against better opposition, Glen Johnson is currently England's top right-back. He has the ability to go forward and deliver crosses. With that in mind, the back-up will probably be a bit more defensive minded. This is probably why I put Brown ahead of Richards. Both are capable of playing in the centre of defence as well, which will bode well for Capello as he might not take four specialist centre-backs, but Brown has better defending qualities and big match experience compared to Richards. The only problem for Brown is that he is not playing regularly for Manchester United. Yet Gary Neville was called up to the England squad over the summer despite playing very few matches for his club, so Brown still has some hope.

Left-back (2)
On the plane: Ashley Cole, Wayne Bridge
In contention: Leighton Baines, Stephen Warnock
Only if swine flu breaks out: Nicky Shorey, Paul Konchesky

Probably the most secure and undramatic position in the England squad. Cole and Bridge have been the mainstay left sided defenders since the beginning of this millenium. Although the likes of Shorey have gained a couple of caps in their absence, it will be definitely those two on the plane to South Africa this summer.

Centre-back (3-4)
On the plane: Rio Ferdinand, John Terry
In contention: Matthew Upson, Joleon Lescott
Only if swine flu breaks out: Phil Jaglieka, Gary Cahill, Curtis Davies

Rio Ferdinand and John Terry will definitely be starting for England during the World Cup but the most definite issue is who will be deputizing for them. In recent games when one or the other has been out injured, Matthew Upson has been filling their boots. Yet he is not world class. Joleon Lescott is the only other real contender but he has floundered when put in an England shirt. With England having already qualified for the World Cup, Capello might want to use the two remaining qualifying games as a chance to see Lescott and Upson under real pressure. Cahill & Davies have been called up but I don't think Capello will be bringing uncapped centre-backs to play against the likes of Brazil and Spain. Jaglieka is currently injured but has shown he is capable of playing in the big leagues and his versatility will also prove to be an useful asset.

Right-midfield (2)
On the plane:
In contention: Aaron Lennon, Theo Walcott, David Beckham, James Milner, Shaun Wright-Phillips
Only if swine flu breaks out: Leon Osman, David Bentley

Probably the most open position to be filled by Fabio Capello. No player is a definite in this position. Currently with his league form and recent displays for England, Aaron Lennon will be filling the right of midfield. Theo Walcott has been played the most as right winger by Capello plus he can pushed further upfield if required. Milner has the ability to play across the whole midfield and up front. Beckham has been a great impact substitute for England in the past year and can play in the centre is the dubbed "quarterback" role if required. This is why SWP is so low down in the thinking. Although he is a good player, can Capello afford to bring a specialist right winger who isn't that world class?

Left midfield (2)
On the plane:
In contention: Ashley Young
Only if swine flu breaks out: Stewart Downing, Joe Cole, Matthew Taylor

With Steven Gerrard starting on the left and Milner deputizing, I doubt anybody can push their way through to be on the plane bound for South Africa. Ashley Young has to have an outstanding season to even be considered for the squad. The likes of Downing and Cole have to get of the treatment table and on to the field before even thinking about World Cup places

Centre midfield (4-5)
On the plane: Steven Gerrard, Frank Lampard, Gareth Barry
In contention: Owen Hargreaves, Michael Carrick
Only if swine flu breaks out: Scott Parker, Jermaine Jenas

With Gerrard, Lampard & Barry dead cert on going to South Africa, only one or two places are really up for contention. Even though Gerrard will most likely be playing on the left and free up a spot, I think Beckham will be picked as a third right midfielder to cover both right and centre midfield. Currently Michael Carrick is filling the spot but I don't think he will be testing the likes of Argentina and Holland. Capello will be hoping Hargreaves can get fit soon and have a decent season for Manchester United, as his defensive prowess, passing ability and versatility makes the most ideal holding midfielder, even better than Barry. I don't think Capello will bring three holding midfielders in the likes of Barry, Hargreaves or Carrick as he will want to leave the fifth centre-midfielder (if takes that many) to be more attacking.

Forwards (4-5)
On the plane: Wayne Rooney, Emile Heskey, Jermaine Defoe
In contention: Carlton Cole, Peter Crouch
Only if swine flu breaks out: Gabriel Agbonlahor, Darren Bent, Dean Ashton

It is most like Rooney and Heskey will start with Defoe coming off the bench. This leaves one more big striker to fill the post. Currently it is a straight fight between Cole and Crouch with the West Ham United player having the edge. Although Crouch is reasonable in the air, he likes the ball at his feet unlike Carlton Cole who can be a target man just like Heskey.

Current prediction
Goalkeeper: James, Green, Foster
Right back: Johnson, Brown
Left back: A. Cole, Bridge
Centre back: Terry, Ferdinand, Upson
Right midfield: Lennon, Walcott
Centre midfield: Lampard, Barry, Beckham, Hargreaves*
Left midfield: Gerrard, Milner, Young
Forward: Rooney, Heskey, Defoe, C. Cole

* If fit, otherwise Carrick
On standby: Robinson, Richards, Carrick, Crouch

Hypocrisy maybe the word

I know my Cantonese is very poor. Not being able to read or write is, at times, a matter of shame being Chinese. Yet I manage to get by in normal day life. The only problem or piece of humiliation is when I have to order dishes in a restaurant, leading me to dine at establishments with pictures of their dishes in their menus or where the menus are in English. I do get a lot of grief from people around me, especially nurses, who tell me to learn Cantonese properly so I can advance my career. Doctors are a little bit more sympathetic and patients find it amusing. A lot of people, especially nurses, tend to correct me about my pronunciation or grammar.

With that said, I don't even attempt to correct people's use of English, even though I might have a standpoint since English is my first language. I hate it when Chinese people always say "Thank you 你", which literally translates as "Thank you you". I cringe when people say words wrong such as "mechanism". I tend to believe the quality of English used nowadays have deteriorated, thanks to the Internet, text messaging, online chatting and emails.

I don't think anybody has a deserved right to criticise anybody else on any matter. The only position where somebody can comment on somebody else's action or words is if they themselves are experts in that area or have experience in the field. I don't like it when sports commentators or journalists criticise athletes or players on their performance. It is OK when you are a former player criticising a player about the sins of diving, since you know what it is like to play against cheats.

I never say to patients, "I know how you feel" even though I have been a patient. It is their body I have no idea what they are going through. I do hate it when my doctor friends say, "I know what you are going through. I have been through psychiatry..." I really want to say at that point, "If you know how to drive, do you know how to drive a racing car or know what Michael Schumacher is going through when he drives that Ferrari F1 car?" No of course you don't. It is just better to say, "I'm sure what your going through is difficulty..."

Recently I have been suffering from hypocrisy from my parents recently. I tend to be on the internet a lot, mainly gawking at babes. I have been told by my parents to cut down on this. With this said, most of the time my mum and dad spends on the internet using Facebook applications, such as a farming game and mahjong. I find it hard to take their advice of cutting my use of the internet when they spend most of their time on the internet as well.

It is so much easier to criticise when you have somewhere to stand from.

Single and desperate

I was going to write an article about fads and stereotypes but lately something else has been on my mind. I'm going to whine about the lack of my love life again. If you are not interested in reading yet again about the absence of romance in my existence, please go somewhere else...

Still here? Then let's begin...

I use Facebook far too often. Unlike other people who seem to use this social networking site for means other than social networking, such as playing those blasted applications involving mahjong or planting crops, I actually follow how my friends are getting along in their lives. I always feel left behind when I compared my life to my friends and colleagues. Not a day goes by when I see another person I know putting his or her pre-wedding photos up and I have to fake some congraulatulations for them, when most of all I feel envy and depression. Other people are announcing they are pregnant and others are stating they have broken up.

And what am I doing? My state is similar when I rub my shoes against the carpet - I'm static. I'm in the same state I was ten years ago, just fatter and actually have a job. I'm twenty eight years old, never had a girlfriend and I'm still a virgin, which irks my fragile male ego. I hate to use a feminine phrase but my biological clock is ticking. I thought by this age I would be married but now I don't feel my chances of meeting somebody are getting better.

I work most of the time and spend most of my free time at home. I don't like going out that much, since I hate the social life in Hong Kong. I have reduced the amount of alcohol I drink. All this significantly reduces the chances of meeting somebody. My hobbies are not great ways of socializing either. I spend most of my time cooking at home and I like to watch movies by myself, either at home or in the cinema. I don't go to exercise much and most of my keeping fit, if I'm actually bothered, is cycling (again which I do on my own) or going to the driving range - something which I do on my own and not really a sport which women engage in.

I could look to my circle of friends but most of my friends are doctors and I don't really want to hook with somebody in the same field. No offense to all my doctor friends but most of us are quite boring. I would like somebody who can talk about something other than their patients or the latest advancements in the medical field. That also rules out nurses, no matter how cute or sexy they are.

What also limits my options are my criteria. I do have very selective needs as such. I would like to meet somebody who has a similar background to me (Western upbringing, broad views) but in Hong Kong, meeting somebody like that is very difficulty. With most people having a Cantonese background, finding a lady I like is similar to sieving for gold in a river.

I'm starting to get desperate now. I'm rating all the women I meet into categories. I've started signing up to online dating sites. I'm contemplating starting to do some exercise, not for my health but in the hopes of meeting women by either going to the gym or making me slightly more attractive. Yet I'm still to cowardly to look through those online dating sites and ask somebody out.

At the end of the day, despite all the criteria I have put out and all the restrictions I have put on myself, everything boils down to one factor - I like her and she likes me. Simple? I wish it was.

A few tidbits

To follow on from my previous post, I have never been tutored and have never tutored anyone, so I have no experience of tutoring. Obviously I have helped people with their homework in boarding school but that is as far as my expertise goes. Tutoring only helps marginally - either you don't have the enthusiasm or intelligence to lift you any further than what you can possible achieve. Also people put too much emphasis on exams and school. There are people who don't conform to the rigid system that entails during our secondary school education but when they get to the real world, they can achieve anything. Exams and interviews do not properly correlate with work or school performance.

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I don't know why Apple allow downloading of music from iTunes for Hong Kong customers. I want to download music now, since I don't really want to buy albums but it doesn't let me. This is why people illegally download music - because there is no way you can legally download music.

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Why can't the normal population understand that when you have a disease or medical condition, these things take time to heal, they don't necessarily will heal 100% and there is a limit what medicine can do. Medicine is not voodoo magic - take one pill and you can heal all the sicknesses you have. Patients have become more and more demanding, thinking what they hear from other people or what they read in magazines and the internet is correct without considering the opinion of an expert. I do understand it is their body and their decision to make but if they don't listen to the doctor's advice, why do doctors even bother explaining to the patients.

It's the same thing with people buying shares. They need to understand that shares will not automatically rise in price, it may take time to increase in value and they can go down in price. That is why I don't have any sympathy for those Hong Kong people who buy funds with shares from the Lehman Brothers. They were told about these shares and they still want their money back. If you cannot bother to listen, why listen at all.

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I'm very satisfied with how Arsenal's start to the this campaign has gone. Four wins in a row and an easy Champions' League group. Didn't like how Eduardo dived to win that penalty against Celtic on Wednesday. Arsene Wenger should drop him for the next game, even if it is against Manchester United. I don't want players of Arsenal doing that.

Dent in the wallet

When I graduated, I promised myself I would stop illegally downloading TV shows, since I was no longer a poor university student but instead a poor intern with a meagre salary. I don't download music from the internet, since I'm not an avid listener. I used to get computer programs online but stopped recently (I explain why later).

Nowadays I stopped downloading the TV shows. The last TV series I illegally downloaded was the second season of "Pushing Daisies", a brilliant dark comedy series which was tragically stopped after only two seasons. I'm still downloading the entire series of "Star Trek: Deep Space Nine" since I started that quite a long time ago and it is still downloading. I still have too many DVDs I still haven't seen

Most of the time I'm downloading TV shows which I cannot get on DVD or other paid means, such as the current series of "Top Gear" or "Mock the Week". If there was a subscription service, I would pay for those programs, as long as it was a reasonable price. The other major media I download are podcasts. It is great to have podcasts, since they are free and if you don't like music, there is another whole world of media you can listen to. I recently become more infatuated with comedy, so I download more comedy such as The Guardian's coverage of the Edinburgh Fringe Festival.

(One thing I don't understand is why they need to call podcasts 'podcasts'. They're just downloadable radio programs or audio programs. They're only called podcasts as an amalgamation of iPod and broadcast.)

Since I've become a medical officer, there have been numerous dents in the wallet recently. Firstly there are aspects of my job which require money, such as membership to the professional associations. I also had to pay back my mother for paying for the last two holidays I went on. The first item I bought when I became a medical officer was a car - the new Volkswagen Golf TSI (Mark VI). Unfortunately, due to the high demand, the car will only be delivered by October. That's actually a good thing, since it will cost me about four months wages. So by the time it will arrive, I would have earned enough money to repay my dad who paid for the car.

Recently I have been replacing many of my electronic items. The first electronic item I replaced was my notebook. My old notebook has started to break physically with cracks appearing at the bottom of the screen, the power button is slightly screwed up and every time I use too many programs, all the programs automatically close. After a long time slating off Microsoft and Windows, I decided to convert to the Force and get a Mac. I got a MacBook Pro just a few weeks ago. Since my Dad works for an university, I got a discount on the MacBook Pro and also got an iPod Touch for free. It took me some time to get use to Mac OS X operating system but I'm finding it great. I'm using my old notebook just for downloading porn.

Today I went to an electronics fair in Wan Chai. Since there were many items going cheap at the fair, I decided to go and blow my hard earn cash. I bought a new digital camera, an iPod station for my iPod touch, a new USB hard drive and a digital photo frame. Before people start saying I'm deviating from my leftist roots and become a material hoarder, I like to say that I need all this stuff. The digital camera we have at home is not very slim and has a very long delay when you press the button to take a photo. Additionally it doesn't belong to me - it belongs to my parents. The USB hard drive is required for work and for backing up my files from my two notebooks. Lastly I always whine about people taking photos with their digital camera, storing them in their computers and never looking at them again, which is why I got a digital photo frame.

I think that will be enough spending for now - it will be just bread and water for lunch for the next few weeks.

Tutoring

This is my first blog entry using my new MacBook Pro. No, I'm not going to take pictures of my new notebook or christen the laptop with a funny name like Sebastien or Johann. I'm just going to treat my MacBook Pro like a MacBook Pro and not like the new baby in my life.

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I still feel despondent about work. I'm starting to become my worst fear - a doctor who is gradually become more dismissive of patients complaints.

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One of my cousins recently got his results for his HKCEEs, which is equivalent to GCSEs or SATs. Unfortunately the results were not very good. To continue his secondary school education, one is required to have attained fourteen points in his or her HKCEEs. My cousin only got six points. He is now at a crossroads, whether to continue with the books or seek vocational training. As my family are well versed on education, my dad has been given my aunt (my dad's sister) plenty of advice.

I hate to be harsh in this situation but I have to say that in society, there will always be people who are destined to be doctors, lawyers and engineers and other people who destined to be mechanics, cooks or salespeople. What I am trying to say nicely is that there are clever people and there are stupid people. That doesn't mean that mechanics, cooks or salespeople contribute to society or won't earn a lot during their lifetime. I know a lot of my friends who cannot change a car tyre, boil an egg or properly fold clothes.

What I hate about today's society is that we put so much emphasis on education or more precisely proof of education. I don't doubt that knowledge is power and useful towards your life. Yet people wants so many A's during their exams to get into a good university to get a degree to earn lots of money. What we learn in school isn't really that useful in life. When did anybody need to know the dates of the World War II battles or the use of differentiation in everyday life. What they should teach us in school is practical stuff, from wiring a plug, cooking (both boys and girls) and economics.

We have gotten to the stage that we think an university degree is so important, parents and students are willing to fork out thousands of dollars to pay tutors to teach them stuff they should be taught by teachers in school, and those souped-up faux tutors who grace advertising boards like they were superstars or models don't really teach them anything. Students get taught how to perform well in exams, not the knowledge or skills which will last them a last time.

Education is important but know what education is important is much more vital.

Legalized lying

One of the good things about the British Broadcasting Corporation is the lack of advertising. I know many people find the idea of paying over one hundred pounds per year proposterous when they can get TV for free. Yet for the quality of programming the BBC offer plus the added bonus of not having to sit through minutes of non-sensical advertising is a price worth paying.

I remember two great quotes of advertising. One is by the great science fiction writer H.G. Wells: "Advertising is legalized lying." Any advert just tells you want you want to hear. Most of the stuff said in advertising is the twisted truth. There are two types of products whose advertisements illustrated this points - baby milk formula powder and beauty products. For those milk formula adverts, they always sprout multiple acronyms such as DHA which the formula milk contains. They insist it will make your baby more cleverer. It may be that these added nutrients will help your kid more intelligenct but as a doctor of the Hospital Authority, we are not allowed to recommend any milk formula powder and quite rightly. I, as a normal citizen and a doctor, will still insist that breast milk is still the best. And what is wrong with cow's milk anyway?

Just by looking at the woman in Hong Kong just shows none of the beauty products offered on TV and in magazines don't actually work - I don't see any beautiful women walking the streets in Hong Kong. I especially hate the adverts by FANCL starring that annoying Gigi Leung. Woman look up to her because they think she's beautiful but I don't find her that attractive. She really cannot sing or act in my opinion. All that is going for her is she's tall, but men don't necessarily want any lady taller than them.

The second quote I like by advertising is this: "Advertising gets you to buy items you don't need or want." It is quite shocking to hear the largest department in a company is usually the marketing department and most of the cost of a product is usually due to advertising and marketing. If we had half a brain, we would consider the advertisement but not necessarily obey it.

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Why do I feel listless at work? I'm cruising through my job at the moment, currently in first gear. I don't do any studying in the evening, which I should do. At times I do wish my job was a little bit harder and more demanding.

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I found out in a news report that women my age outnumber the males in Hong Kong. It should make me more in demand but I don't feel that. I am looking for someone but with my job, my personality, my psychiatric history and my demands I fell I'm more a liability than a piece of treasure.

The nanny state

Whilst watching an episode of the new series of "Top Gear", this game of 'car sauna' popped up.



The last part of the clip is what I want to emphasize about. Nearly every part of our lives requires pampering from the government. Every summer in Hong Kong there are alerts issued by the Hong Kong Observatory warning us that the weather is really hot. I can tell it is really hot by the sweat running down my face and my need for a cold drink. I don't need the weather girl to tell me go into the shade and get out of the sun.

I think 99% of the population comes under the category of "competent enough to know what 'hot' is". I understand the alerts and warnings are mainly for the elderly and other people who are generally incapable of thermoregulation. Yet if really cannot tell that the temperature is rising, should you really be living at all? What gets me are the people who know it is hot and do nothing about it. These are the really stupid hikers who trouble the ambulance services by not bringing enough water or shade with them.

The other area which really miffs me is hygiene. Since Hong Kong has been greatly affected by SARS, avian influenza and human swine flu, there has been great emphasis on washing our hands after doing anything dirty. I know this is supposed to prevent the spread of infection amongst the community but there is a downside to all this handwashing. We won't challenge our immune system enough if you don't give it enough virus and bacteria to fight. This leads to an inability to handle minor infections plus increase rates of allergic diseases such as food allergies, asthma and eczema. It is true the more hygienic a community becomes, there is a decrease in infectious diseases but there is an increase in allergic diseases. I also believe it might lead an increase to cancers, as the immune system handles those as well but I have no evidence to support this - it is my own personal opinion.

What I want to state is that we don't need a Big Brother to make decisions for us - we just need to get the information ourselves and make the choices ourselves.

Boy racer crazy

I was on-call for the second time in orthopaedics at on Wednesday. I admitted four patients throughout the day, was able to go out for dinner and sleep throughout the night. The work hasn't been that taxing. Since it is a small hospital, I don't have that many patients to handle. Currently I have eleven patients under my care, most of them run of the mill problems like back pain and foot ulcers. The cases are varied, so I have a great exposure to everything. The situation has left me with a considerable amount of time. I should be studying orthopaedics and ENT but my mind is not in it. I need to start picking myself up soon.

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Currently I'm in the process of buying a car. At the moment my father is driving me to work. It is not the most ideal situation, as the current hospital I'm working at has this strange policy that only the doctor or his/her spouse can be the owner of the car if applying for a parking permit. So I'm spending most of the trips in the morning eating breakfast whilst my dad chauffeurs me to work.

So what car am I buying? Since it is a first car for me (I'm excluding the Renault Megane Espace I had since I didn't own it), I'm obviously going for a small car. Unforunately the options are quite limited. My dad is always going on about resale values, so I had to rule out cars that I liked such as the Suzuki Swift. Also many of the European cars are expensive here in Hong Kong and if I was back in England, I would have considered the Ford Focus or the Fiat 500. I don't want something too run of the mill and boring, so the Honda Jazz and the Toyota Yaris are out.

I was seriously considering the BMW 1 series. It is a great car and well built. It is also rear-wheel drive, which I like. The only problem is that it is really costly on the wallet, going at HK$300K+ and that is a BMW. Unfortunately bankers who buy BMWs give them a bad name. I consider most BMW and Mercedes owners/drivers as cocks, who think they own the road just because they have an expensive car.

Most of us having some form of stereotyping people depending on what car they own.... which I'll elaborate on in a latter blog entry.

So what is my choice? I've decided to plump for the new VW Golf Mark VI. Not the GTI since that is out next year in Hong Kong. There is a waiting list for the car and I won't be able to get the car until about October - that is how popular it is.

So what does the VW Golf make me? A boy racer.

Cultural identity

I've just finished internship and started my life as an resident in family medicine. I will be rotating through various hospital specialties for the next two years. The hospital where I'm at is quite small, the patient workload is currently very small. Actually life is very easy at the moment. The maximum number of patients underneath my care is sixteen. I'm on-call today and I haven't had much to do. I've had two patients to admit and they weren't very difficult cases. There is a lot of benefit to having a nice 2nd on-call medical officer to call upon.

There are problems with being at a small hospital. The variety of cases at this hospital is not that great compared to a large hospital, so my scope will be very limited. There are no interns. Many of the duties which would have been performed by interns, such as printing specimen labels and renew drug sheets, have to be performed by medical officers. ]I will be performing various 'intern' duties for the next year. I already accepted I would have to intern duties but thankfully less than usual. That's the price to pay for the next two years and for having a reduced workload, compared to being at a larger hospital.

Also I have to attach to other specialties during each rotation. For this rotation, I have to attach to Ear, Nose & Throat Surgery. I don't mind it but the only problem is I have to go to another hospital ten times for the next three months, which has serious consequences on my time, duties and wallet.

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After ending internship and before entering residency, I went for five days in Chiang Mai, Thailand. It was a very good holiday, with the hotel resort I was staying at a very good choice. If anybody stays in Chaing Mai, try "The Chedi" hotel resort for its service - truly world class.

That's not the main point of my blog entry. Whilst on vacation, I just couldn't help about the well being of the locals. Tourism is a big industry in Thailand with the economics and the culture a selling point. There are good sides to tourism, bring in much needed revenue plus exposing people to other people's cultures. Yet I was always thinking about the adverse effects of tourism. It brings out the unsavoury personality of people, trying to make as much cash as possible with as little ethic as possible. There were massage places and people selling their wares in every street. I don't oppose to people trying to make a living but at times there is a need for regulation, to prevent people getting ripped off.

Also I went to a local village to see the culture of the hill tribes. Most of the village was filled with shops trying to sell products varying from bags to dried fruit. I don't know if tourism is that great when you are trying to sell your cultural identity to raise a few bucks. I know Thailand is not alone in this problem, with every country having this dilemma.

I think exposing your cultural identity without looking like a sell-out can be done, it is just fine balance.

N.I.M.B.Y.

Recently in Hong Kong, the government wanted to convert an old secondary school in Mui Wo, a rural town in Lantau, into a rehabilitation school for drug addict children. The school has been abandoned for quite a few years since it was closed down due to a lack of number of students. It has caused quite a reaction amongst the local resident of the town. The local residents are against the conversion, saying that they are not opposed to having drug addicts in the neighbourhood but they have stated they want the local secondary school to be revived.

That is all good... if you really mean it. However the residents have reacted quite violently to the moving of the drug addict rehabilitation school to their area. They haven't been vocal for a local secondary school until the news that the moving of a drug recovery school was announced, now they say they want their old school to be revived. And why haven't we heard them being more vocal when the school was closed down in the first place?

What really swayed me that the local Mui Wo residents didn't really want drug addicts in their area was when they shouted during the consultation meetings, "We don't was drug addicts in our area" not "We want a secondary school for local children".

It is a classic case of NIMBY syndrome or Not In My Back Yard. Typically it is for building of new facilities in rural areas but it can be applied in this case. Everybody was in favour of expanding the drug rehabilitation school into other areas, due to overcrowding. Yet when they hear it is in their area, they immediately make excuses of why it shouldn't be in their area or they don't want it in their back yard. It is often apply to other members of society. We all in favour of reforming child molesters or the mentally ill, but when we get wind they live next to us or work in areas we visit frequently, we become uneasy with that idea.

Somebody has to have a drug rehabilitation school in their area. They just have to stick with the idea.

Duty and honour

I'm finishing up watch the fifth season of "House" before I started resident training. I've just watched the episode where Kal Penn departs. When I heard the actor was leaving his acting profession to join the White House, I thought it was remarkable and applaud him for this noble move.

When I first heard Kal Penn was leaving Hollywood for his post as Associate Director of the White House Office of Public Liaison, I instantly thought of Pat Tillman. I'm not a big follower of American football but when the story broke that an professional NFL player was going to enlist into the United States Army Rangers, it made me feel some pride for the human race that not all of us are in it for the money. He enrolled into the US Army after 9/11 as he thought he had a duty to perform.

We all should take good examples from Tillman and Penn. They left their profession in the height of their career, with fame and fortune at their doorstep, to take up some civic duty because they felt it was the right thing to do. I know many celebrities from film and sports donate their money and time to charitable causes but they still hold on to their day job of multimillionare stars. They would probably argue the skills are best spent in their chosen field, which is probably right. But it would be nice if these celebrities would do a lot more, rather than keep charging so many dollars to turn up at a charity event and naming charities after themselves.

There are actors and sports players who decide to enroll in another field, such as journalism or politics or charity post, after their career has finished. This is noble as well but this happens after they have milked the previous career dry with nothing left but dust. Couldn't they have done this early? I'm sure they had enough money in the bank which would set themselves for life, so they can go and dedicate themselves to their new role instead of being handed 'ambassador titles' from the UN.

Kal Penn and Pat Tillman should be applauded - it is just a shame there are not more people like that in the world.

Superficiality

I know I am a superficial guy. I look constantly at Hong Kong women and wish for the day where most of them will wear high heels, actually have thighs that are larger than their calves and wear revealing clothing such as short skirts and low cut tops.

I know I'm not going to see that in the wards. I have yet to see a babe, either as a patient or as a patient's relative. And if any of the female doctors wore any clothes showing skin I think most of the male patients will suffer a heart attack and that would mean too much paperwork.

Yet I know most nice looking girls don't have much up top and I'm not talking about breasts. I looked at two Playboy Playmate video profiles and once these models opened their mouths it was quite obvious there weren't even two brain cells to knock against each other. Yet all people, ladies and gentleman, continue to look for the ideal-LOOKING person rather than go for personality, brains or humour. That is why people were astonished Susan Boyle could sing. The population is bought up with Mariah Careys and Avril Lavignes of this world and we don't have an ordinary looking girl who can sing properly.

Increased admissions

Life is going reasonably well at the moment. I'm in the process of being registered as a resident / medical officer. I'm still sorting out the paper work, which is still like any other kind of bureaucracy in that it is totally unfathomable. I honestly don't understand why people in administration can make this simpler. Anyway I'll be signing the contract later this week and will be attending the orientation at the hospital next week.

Closer to home, the current work is hectic. The Accident & Emergency department at our hospital has closed down its observation ward for repairs until September. This means patients who normally go to the observation ward for a few hours are being directed to the admission wards in the hospital. I was at the history meeting for our department today and it was noted there were eighty-two admission yesterday, when normally the medical department only receives fifty admissions per day. More admission means more work to do - more investigations to order, more discharge summaries to type up.

Thankfully I only have to suffer this for fifteen more days. That's four more calls and I'm on holiday and can wave goodbye to my life as an intern.

Jumped-up dancers & frumpy singers

I'm really glad "Britain's Got Talent" is over. For those who live in Britain, you should be surprised by the amount of press coverage the show has received overseas. There has been daily bulletins on our local news leading up to the final. The word "overhype" could be used to describe the situation. I'm just relieved this overblown talent show programme has now ended, at least for another year. I really don't like any of the celebrities involved. Simon Cowell & Piers Morgan are just nasty men who you wouldn't want a conversation with. Ant & Dec should have gone to jail for that fraud telephone scheme they were involved with. Amanda Holden is OK but really should get out of that show if she wants to be deemed 'credible'.

The show has been helped by the character of Susan Boyle, even though she didn't win. Every credible act who appeared in the program shows they have talent. But why are we surprised by this? There are a lot of talented people all around us and we don't even notice. We probably have colleagues, family members or friends who can sing, dance and play musical instruments. We just don't go out and try to find them. At least "Britain's Got Talent" gives these people a chance to show their skills, probably the only redeeming factor of the show.

And why we on the subject, why should we be surprised when somebody is oridinary looking has a beautiful singing voice? I just hate the media-lead society we live in when we assume anybody who is beautiful/handsome is presumed to be clever, talented and nice when it is usually the opposite.

I just like to wish Diversity, Flawless, Susan Boyle, Hollie Steel and all the other performers who took part good luck and remind them to keep their feet on the ground.

It's been a long time

It has been a long time since I written in my blog. For the first time at work, I've been busy. I'm currently in my internal medicine rotation as an intern and it's been a constant stream of labour. I've been admitting patients, left, right and centre. I've been setting intravenous drips and taking arterial blood. Even after two months in the job, I'm still incapable of setting up BiPAP/CPAP/ventilators for people who have difficulty breathing or setting up drug drips for atrial fibrillation. I know that last sentence may have flown over some people but just let me say that I should be able to do that.

Also for the past two months I have been miserable. I saw my psychiatrist last week and I related to him that I have been feeling depressed since I started my final rotation. I don't mind the workload in internal medicine but the difficulty of the situation coupled with some really nasty superiors doesn't make it better. Perhaps it is the anxiety of having to go to interviews and get a job which has led me feeling more sad. Or it could be the impending future, having to take on more responsibility, rising to become a resident and still don't know anything or give a crap if a patient lives or dies.

It is not like I don't have matters to write about - my misery in internal medicine and having to deal with psychosomatic symptoms when I'm on-call, like chest discomfort, palpitations and muscle cramping, my forthcoming future and having to sort out things such as buying a car and pay taxes, how Playboy Playmates look great but when you hear them speak you know they don't have two brain cells which you could bump together and Susan Boyle.

But right now I'm not that enthusiastic about writing about anything. I rather keep surfing the internet and watching "Red Dwarf" episodes, which I have managed to watch the entire back catalogue. I've gone into the mode where being stationary is comforting.

Frustration

I had the most frustrating few days in my life...

Firstly I was reported for looking at Japanese models (fully-clothed) on the internet at the computers in the K2 Doctors' Common Room by a male doctor. I don't know his name and all I know was that he was in the surgical field since he was dressed in green OT attire and was middle aged.

The next day (Friday) I was called by my supervisor to meet him and in my opinion was inappropriately treated. My supervisor didn't ask for my side of the story. He made me feel like a sexual deviant, saying "Are you so stressed that you have to look at these photos?" He asked me how my job interviews were going, which I don't think is relevant to the matter. Now he's linking my work performance to this incident and asking members of staff to monitor my performance in the ward. I'm really thinking about taking this matter further and asking somebody higher.

Then on Sunday I had one of the worst on-calls in my short career. I only got to have dinner for 15 minutes (no lunch or breakfast), I didn't sleep at all and I got two patients started to deteriorate on me - one with septic shock and one with a drug overdose in the ward.

Sometimes I think this job is not worth the effort...

Against your own kind (part two)

I got a reminder the other day as to why I don't like Mainlanders...

I was riding the hospital lift down when it stopped at one floor. Somebody graciously kept the door open whilst everybody in the lift waited for whoever it was to enter the lift. It seemed that nobody was going to enter the lift until we saw a kid dragging an adult into the lift. The adult was oblivious to the fact the lift had arrived, as she was 'talking' on the phone. I put 'talking' in quotation marks as the woman was actually shouting down the phone.

I often comment on the volume of Chinese people when they talk but this woman took the biscuit in terms of voice intensity. She really didn't need the mobile phone to talk to the person since that person would have heard it anyway, even hundred of miles away.

So how did I know this woman was from the Mainland. Apart from the usual clothing & facial features, she was shouting in Putonghua, or whatever dialect she was speaking. I have no qualms about people speaking Putonghua. I think the Chinese language is beautiful. I know Putonghua (or Mandarin for my Western friends) is actually easier to learn, with fewer tones to learn and the spoken and written language being exactly the same, unlike the Cantonese dialect. So why is that when I hear anybody speak Putonghua to me, I still roll up my eyes and curse in English? Like a lot of Americans and British people who go on holiday abroad who think everybody in the world understands English, many Mainlanders expect all Hong Kong Chinese people to understand Putonghua just because they are Chinese. I'm sorry to say that I don't understand Putonghua and talking to me in Chiuchow, Fukien or whatever dialect you should choose will not make me understand what you are saying.

I don't expect people who come to Hong Kong to all speak Cantonese. There are many expatriates from Western countries who come here to live and work. I expect not one of them to speak conversational Cantonese. Yet they can manage to get somebody who can speak the local language to communicate with essential people, such as in restaurants, services and in the health sector, to acquire whatever they need. It seems people from Mainland China are incapable of doing this. Somehow they just keep shouting and shouting and expect you to understand.

Which leads me on to another point why I'm extremely prejudice towards Mainlanders - manners. For some reason Mainlanders have never ever been taught to be polite towards other people. I've been trying to explain it since I've noticed this. My parents keep telling me it is a cultural aspect but I seriously don't believe that. One thing common to many cultures is the lack of greed and the basic awareness of "Love thy neighbour like thy self". I know that phrase is Christian in origin but other religions, from Islam to Buddhism, share the same belief.

Neither it is a socio-economical problem. I know many people in England who are not well off and they manage to be courteous and kind. Plus I know many Mainland businessmen who are well off and are just as rude as a British football hooligan. Somehow the basic manners are just not instilled into Mainlanders. They just don't seem to say 'goodbye' at the end of a phone conversation. They don't let people off lifts or trains first. I don't think it is a regional aspect either. The Koreans and Japanese are very polite. I love one aspect of Japanese life - people are generally looked down upon if you are seen talking on your mobile in a train carriage. I hate it when people shout down the phone so the whole of the train can hear. Why is it that the Chinese people are incapable of talking quietly? I cannot have a conversation with my dad without having my hearing tested afterwards. This has lead me to stay away from holiday resorts where Chinese people usually reside to ensure I have a quiet holiday. You can tell Chinese tourists from a mile away - they have no manners and cannot speak quietly.

Maybe I'm just a snob and extremely condescending. I expect everybody to have good manners and know how to say 'excuse me', 'thank you' and 'sorry' in the language to wherever they go on holiday. I look down on people who cannot give up their seat in the bus or train to the elderly and disabled. I expect patients to listen to me and understand what I'm saying, even in my broken Cantonese. I wish everybody who at least not consult doctors for the trivial of things, that common colds and flu do not require a doctor to prescribe medication which can be bought at a pharmacist.

Prejudices have no place in the world but we all have them. I think if everybody was born perfect, we would never make the effort to improve. So why is that I'm willing to acknowledge my faults but other people are not capable of doing so?

Against your own kind (part one)

I like to think I'm an open-minded person, willing to accept people for their beliefs and behaviour. It should come natural for me, having lived in three different countries (although very Westernized in nature) during my childhood and having been surrounded by people from various nations during my school years, first in an international school and then a boarding school. Additionally several years with depression has allowed me to experience what it is like to be a psychiatric patient. I find it especially difficult to comprehend why doctors and medical students still hold some stigmatization of psychiatric patients.

Yet I do have one prejudice in life. I am ashamed to admit it but I whenever I meet people of this nature I instinctively roll my eyes and look down upon them. It's not Mormons or evangelists I despise. I can understand their intentions in spreading the word of the Bible, even though they might piss off some people along the way with some ill-advised methods. I can tolerate Tottenham Hotspur and Manchester Unitd fans, knowing football fanaticism is a delusional state which very few can escape from. All football fans think their team is the best in the world and will religious defend their club to the extremes of insanity.

The kind of prejudice I usually infect is somewhat strange - I'm prejudice against people from China.

Yes, I'm racist towards my own race. I would have to clarify my prejudice. I'm somewhat look down on people from Mainland China. I don't have any problem of people generally from Hong Kong, although people who know me well know I don't like Hong Kong compared to other countries. I get along fine with any Chinese people who were brought up abroad, like USA or UK, seeing they have a similar background and upbringing compared to me. Neither am I belittling the achievements of the Chinese and their culture. I have a great respect for Chinese arts, thinking the youth of today have no appreciation for such things with the bastardification of the Chinese language. I know the Chinese people invented paper money, the printing press and fireworks in the past, showing they were light years ahead of their Western counterparts.

Yet whenever a Chinese person starts talking Putonghua to me, wherever it is a patient or a doctor, I just automatically think, "Go back over the border." I know I shouldn't be thinking like this way. I'm a great believer of open borders. People should be allowed to immigrate/emigrate to other countries for political, social or economic reasons. In fact I'm a benefactor of such immigration policies, having become a British citizen and my brother can claim Australian nationality if he wanted to.

There are some people who take liberty with these immigration policies. One example is right here in Hong Kong. Pregnant woman from Mainland China come to Hong Kong to give birth, so their child can benefit from free health care and education. I'm sure USA suffer from the same problem with Mexican mothers and some other countries probably have the same dilemma. Yet the problem continues up the ladder, with people from China coming to Hong Kong, intending to find work but just winding up on the dole, claiming benefits and living in free housing. They never intend to find work in the first place. I know a vast majority of Mainlanders do actually get work, finding the kind of employment Hong Kong people don't want. It is the minority who give the majority a bad name.

What really gets on my nerve about Mainlanders is the behaviour and manners... which I will write about next time because I need to calm down before I past out due to excessive anger.

In the doldrums

I don't know why or how to explain the situation but I'm miserable. I'm not enjoying life at the moment but I cannot find a reason why I should be hating my life. To paraphrase a fine author, Nicky Hornby, from his famous book "Fever Pitch", I have a good job, in reasonable good health and family plus friends who like me. So why should I be in the doldrums?

Could the job application situation be the problem? All the interns are talking about the inteviews they are having right now and I know I have to wait for the Family Medicine interviews, which are later than other specialties. I'm not worried about getting an interview, or even a job. Probably I'm just fed up of my fellow house officers talking nothing except their job prospects.

Yet even that cannot really explain why I'm so lacklustre in my job. The workload is not that excessive and I'm able to manage quite contently. Yet I don't get that satisfaction anymore of helping people or doing something to impress other people. Basically I stopped caring about anything. I may have even pissed off another professor in a different department, bringing the number of specialties I have officially pissed off to three (four if there is an official complaint and they have to talk to my head).

I'm even losing interest in the hobbies I used to love. I don't watch movies so often anymore, at home or even in the cinema. I just want to stay at home and forget about society & civilization. I don't follow the NBA anymore, having no interest or time. Probably the difference is I'm pointing my interests into other areas, such as cooking and British comedy.

I wish I could get out of this rut but something about me likes being in here...

Goals and dreams

Two events recently passed me by without incident. The first was my twenty-eighth birthday, where curiously enough I was on-call. The second was Valentine's Day.

So why do these two days have any relevance to me? When I was in my teens, I had many goals and aspirations I wanted to achieve. Yet very early on in life I knew I wouldn't accomplish any of these dreams. I didn't take sixteen GCSEs or six A-Levels, although I got pretty close. I didn't get into Cambridge (but I'm in some ways I rather glad I didn't). At this stage I'm pretty sure I won't win the Nobel Prize in Medicine & Physiology or receive an Oscar for Best Original Screenplay, even though there is still plenty of time for me to start on that screenplay I always keep in the back of my mind.

There is still one aspect of my life I haven't mentioned. I said to myself I would get married by the time I was twenty eight years old. Even though I technically I have a year left, I don't think I will be achieving this in the next twelve months or any months after that.

I know I whinge and blog about this subject constantly but I have to face the facts. I have a very small social circle, mainly consisting of doctors. I don't really want to marry a doctor, mainly due to the fact that doctors only talk about medicine. I do want a life outside of the medical field and can't face the fact if I go home I could be faced with my medical small talk. Neither do I have much time to date either. I rarely go out to pubs, nightclubs, social occasions or parties, so the opportunity for even a one-night-stand is not remotely even in my hemisphere.

What makes the situation worse is my criteria. I wouldn't say I'm picky or particular. I'm not like most men who want a lady with beautiful looks and a great body (although that would be nice) or is extremely wealthy. Unfortunately the lady I want is not your typical Hong Kong woman. I would like a Western upbringing and the ability to speak English fluently. I want an open mind in all areas. Yet the ability to find a lady like this seems to be difficult if not non-existent.

I really have given up. I have resorted to living the rest of my life as a bachelor.

A week of hell...

I'm glad I'm on leave for this, after the ongoings of the previous seven days. I don't know where I should begin describing a week's worth of bad luck.

One of my medical officers is on leave and added to the fact one of my fellow interns was also on leave, the workload rose like the world's recent hatred for bankers. Having to be on-call three times in six days doesn't help focus your mind either, especially when one of those nights happened to be an awful piece of bad luck. Usually there are only three to four male admissions per day whilst I admitted eight men who clearly were unlucky or not careful enough what they were doing.

On the same night or should I say in the early hours of the next morning there were two emergency operations which needed to be performed. The first operation, a closed reduction of an elbow fracture, was simple enough. The other operation was much more complicated - an above knee amputation for a demented elderly man who has severe leg contractures at his hips and knees. It required me pulling the patient's legs apart so the main surgeon could get access to his whole leg for nearly an hour before disaster struck. Whilst trying to put his scalpel back into the kidney dish, the surgeon accidently cut my finger.

Simply cutting your finger in normal life is not really much of a fuss but don't forget I work for a government organization. That means one thing - paperwork. I had to report the incident as an injury on duty and get myself seen to by a doctor even though I could have cleaned and dressed the wound myself. I had to get my blood taken and get it taken again in a few months time, just in case I get infected with a blood borne infection such as hepatitis B, hepatitis C or HIV. Even though it is unlikely, since the patient has no history of these infection, it still has to be done. Working in a bureaucracy means everything has to be noted, reported and catalogued. People working in hospitals don't dread the complications of surgery, they just dread the administration afterwards such as the extra forms which have to be filled in or having to report the findings in the next meeting.

I'm just glad I'm on leave this week. I hope my fellow interns are coping without me. I tried to help by typing up progress notes for a majority of patients on my last day before I left for my break but I happened to be on-call on that day as well and could only do some of the male patients as well as all the female patients. Hopefully for their sake nobody has to be discharged so when I get back I get to do it.

Nowadays I'm just relaxing at home whilst sorting out my own life's administration - filling out my intern logbook, sorting out photos I have taken, filling out my residency post application and so forth. It's a bit pathetic when you are so busy you have to perform these tasks whilst you are on leave. Yet when I'm working I'm just too tired to sort out these details.

Right now I'm just enjoying myself at home, playing Lexulous online and trying out new recipes...

Stuck in the middle of you

One of the most amusing things has passed me by this week. One of our medical officers is admitted to our ward as a patient for an injury. I cannot say anymore due to confidentiality issues and my fear of being beaten up by the aforementioned doctor but at least he's getting the best attention.

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There is a lot of tasks during internship which I don't mind performing. The clerical work is fine, such as typing up discharge summaries and writing prescription orders. I even like blood taking & intravenous catheterization, probably due to some sadomachoistic tendencies I have.

Yet there are some tasks we interns do not like. Performing ECGs are the prime example. ECGs take a considerable amount of time to perform, entailing numerous leads which seem to tie themselves into knots and requires the patient to lie completely still for one single ECG reading. That is difficult if the patient is a child or mentally unsound. I had this problem with a granny who came in with a fracture of the hip. Unfortunately she also had dementia and every time I put the chest leads on the patient, she kept pulling them off. It is the same with kids when I was in my last rotation - the buggers could stop squirming and crying.

Another task I hate performing is liaising with other doctors. This happens when I have to book any urgent investigations or consult other departments for their expert opinion. Unfortunately the house officers are the middlemen in the situation, having to convey what his/her medical officer wants from the other doctor. Sometime this entails a good amount of guess work since the medical officer doesn't write/state why he/she orders the investigation/consultation or the house officer doesn't think the investigation/consultation is necessary.

Then when the investigation/consultation is conveyed to the other side, the house officers get chastized for ordering a ridiculous investigation or consulting the doctor for such a minor problem, even though it was not their decision to make.

Please don't shoot the messenger for bring the message. Shoot the person who wrote the message.

A year for heifers

Big elaborate decorations adorning every store you see with staff giving out the traditional greeting. Visiting relatives you haven't seen for a year and realizing, when you meet them, why you don't see them for one year. Eating traditional food that you wouldn't eat at any other time of year. Receiving boxes of chocolates as presents when you hate chocolate.

Sounds familiar doesn't it?

I'm not writing about Christmas, although I could be doing so. I'm actually writing about the Lunar New Year, which has just passed. I'm rather glad it is over. I'm not a great fan of holidays. There are just too many people at one time and I don't have relatives whom I don't want to meet. It's not that I hate them. I just don't have anything in common with them and rarely have anything to talk about with them. I spend the least amount of time at the dinner table and more time in front of my cousin's TV playing "Gears of War 2" on his Xbox 360.

I know it sounds sadistic but I'm glad I could work on one of the three public holidays. At least I got some unexpected 'lai see' from people I don't know and from some people I do know. I know I don't need the money but who doesn't like money when given to you free with no strings attached?

Well I'm glad the Lunar New Year is over for one year. I'm just dreading the next celebration in my life...

Getting into the groove...

I am more or less settling into my post as intern in the orthopaedics department. The hours are not harsh but I just have to wake up to perform ward rounds at 7:20 am with my medical officer, who happens to be visiting for six months from Argentina. This situation means I have to do some extra duties than is normally expected, such as translation between the medical officer and the patient and being a middle-man in helping the medical officer understand the hospital's way of working. At least this doctor is very nice and teaches me how to perform a proper neurological examination.

In fact all of the doctors are nice in orthopaedics. I'm currently attached to the spine team and the sports team. I asked to be attached to these teams for various reasons. One of the fields I'm considering entering is sports medicine, so being with the sports team lets me know what I need to know. Also I'm interested in join the department as a resident, which means making myself notice to the head of the department, who is head of the spine team. I hate playing politics but I know I have to play the game to get ahead in life.

In that respect, I already sent out my cover letters and CVs for job applications. I have decided to go for family medicine and, as mentioned, orthopaedics at my current hospital. I have already received my first rejection, from the orthopaedics department. The letter said they are only receiving applications from April onwards, so I'll try again later. I'm still waiting for the replies from the family medicine. If the orthopaedics letter got through, hopefully the other cover letters were received by the respective doctors.

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Speaking of politics, it was great to see the inauguration of Barack Obama as the 44th President of the United States of America. It was also great to show Barack Obama fluffing his lines. That shows he's human after all. It also shows how influential conspiracy theorists are, since Barack Obama had to be sworn in again in private later to quell the suspicions that he wasn't President.

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The other big political story I want to mention, since I haven't blogged for quite some time, is Israel. I don't know enough about the Israel/Arab situation to claim to be an expert but I have learnt enough from history that peace cannot be achieved by the total annihilation of a race or a group of people. Israel cannot achieve peace for themselves or for the region if they try to kill every Palestinian on the face of the earth because there will always be retaliation and revenge. Both sides need to sit down and compromise (a very important word) if they want to achieve peace for both their people.

The outside world, especially the West, have got to stop feeling guilty about Israel and start clamping down on Israeli aggression. Israel are no longer the bullied, they are the bullies. People have to realize if you are criticizing Israel, you are not being anti-Semitic.

I don't care which side kicked it off this time around. The brave person is the one who admits he or she has to sit down and talk. That will take courage.

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Seeing a patient die in front of your eyes is not the most pleasant experience one goes through. In the past when I was a surgical intern, I didn't know enough about the patients to have an emotional attachment so I wasn't so upset when I had to certify their death.

This time around, there is one particular patient under my care where it is heart-wrenching watching the person die. It is quite obvious this patient has cancer and since the way I'm talking about him/her, it is terminal. What makes it more upsetting is the circumstances. The person has quickly deteriorated in front of my eyes. The patient was admitted at the beginning of this month and in the past three weeks the patient has quickly deteriorated in front of me and there is nothing we can do for him.

Also the patient has such a loving family and friends. Every day the family visit the patient and there is quite a large extended family and friends who visit the patient. Literally at least 10-20 people visit the patient each day. It is bad that the patient cannot see the daughter get married or the son graduate from university. Unfortunately we cannot pick who can live or die - that is God's duty.

I don't know how I feel when the patient dies. Hopefully is later rather than sooner, for the family's sake that they can have more time with the patient.