That afternoon, I went through the second year clinical skill examination.
It is rather immaterial to describe everything in detail. Nonetheless, when I met my friend BK the next morning, I could not refrain from sighing, “You know, I’m a bit depressed after doing the examination. It seems that I am very outdated and, in a modern world, we should not express ourselves subtly!”
“Alas! What happened?”
“It goes like this. For the part of examination that I was in charge of, students need to use a cotton wool ball and a sharp toothpick, both are supposed to be disposable. Unfortunately, more than half of the students forgot to throw away what they had used. Although it is not counted in the original marking scheme, I consider the step that these future doctors omitted being critical because toothpicks are a kind of sharps and should not be left next to the patient after use.”
“Yes…?”
“I tried to remind the students what they had not done – but none of them seemed to understand.”
“What actually did you say?”
(To be continued.)
Wednesday, May 7, 2014
Tuesday, May 6, 2014
Performance
A few days after the dinner, I was asked to take part in the clinical skill examination of our second year students.
I lunched with my friends BK and LS before the examination; they both did the same just a few days ago, and, knowing what I was going to do, they naturally gave me some briefing.
"You know, the whole thing is very artificial and it is quite impossible to fail," LS said, "They score one point by greeting the patient, another point by explaining what they are going to do, and another by washing their hands, and so forth. For my station, they hold their stethoscope and are supposed to listen to the heart - but I can never tell whether they could really hear anything, and, it really doesn't matter, because that is not counted in the marking scheme."
"Exactly. The entire business is very theatrical. It's just a big drama." BK added.
"Alas! I now understand why we don't invite students of The Hong Kong Academy for Performing Arts (香港演藝學院) to act as surrogates for our clinical examination," I said to myself, "Because they are actually our students!"
I lunched with my friends BK and LS before the examination; they both did the same just a few days ago, and, knowing what I was going to do, they naturally gave me some briefing.
"You know, the whole thing is very artificial and it is quite impossible to fail," LS said, "They score one point by greeting the patient, another point by explaining what they are going to do, and another by washing their hands, and so forth. For my station, they hold their stethoscope and are supposed to listen to the heart - but I can never tell whether they could really hear anything, and, it really doesn't matter, because that is not counted in the marking scheme."
"Exactly. The entire business is very theatrical. It's just a big drama." BK added.
"Alas! I now understand why we don't invite students of The Hong Kong Academy for Performing Arts (香港演藝學院) to act as surrogates for our clinical examination," I said to myself, "Because they are actually our students!"
Monday, May 5, 2014
Observe
In the evening after receiving some divine messages from extra-terrestrials, I went to another dinner meeting on the teaching of medical students.
Again, there’s nothing groundbreaking discussed. In the middle of the dinner, however, W put forward her view, “I always find it difficult to understand why our colleagues take so much effort to do clinical teaching or mentoring or supervision or whatever. Isn’t it possible to ask the students to sit there and see what we are doing? I suppose they could learn quite a lot by just observe.”
I was horrified. Thank goodness CL, a senior consultant from another hospital, took the trouble and explained to the senior geriatrician why simple observation doesn’t work. To me, the argument is self-evident: If most of us could learn by observation, all of our hospital amahs would, with time, be promoted to become consultant physicians, and the desk of our ward clerk would be the professor of medicine.
Oh, maybe that does happen.
Again, there’s nothing groundbreaking discussed. In the middle of the dinner, however, W put forward her view, “I always find it difficult to understand why our colleagues take so much effort to do clinical teaching or mentoring or supervision or whatever. Isn’t it possible to ask the students to sit there and see what we are doing? I suppose they could learn quite a lot by just observe.”
I was horrified. Thank goodness CL, a senior consultant from another hospital, took the trouble and explained to the senior geriatrician why simple observation doesn’t work. To me, the argument is self-evident: If most of us could learn by observation, all of our hospital amahs would, with time, be promoted to become consultant physicians, and the desk of our ward clerk would be the professor of medicine.
Oh, maybe that does happen.
Sunday, May 4, 2014
New
Message #2 of the meeting: We should be cost-cautious when prescribing expensive medications to our patients.
That’s no news. Nonetheless, CP reminded the few of us who are not familiar with the public relation tactics of the Hospital Authority, “Some of you may say the government has given us extra money to cover the cost of many new and expensive medicines, and wonder why we should hold our purse tight. The problem is, the extra funding that we get is for new patients. In other words, by receiving the money, we have to meet a target and start certain number of new patients each year on these expensive medicines. After one year, these patients are no longer new, and, if they need to continue with their expensive treatment, we have to use our own budget; although we continue to receive the money, we have to use it for starting treatment on new patients – and the vicious cycle continues.”
“Gosh! Most of the drugs that we use are for the treatment of chronic diseases. It is silly for the extra-terrestrials to expect the treatment would last for only a year!” Some of us murmured.
I smiled, “I suppose our friends outside the solar system are trying to suggest we should hold off treatment until a patient could live only for a year!”
That’s no news. Nonetheless, CP reminded the few of us who are not familiar with the public relation tactics of the Hospital Authority, “Some of you may say the government has given us extra money to cover the cost of many new and expensive medicines, and wonder why we should hold our purse tight. The problem is, the extra funding that we get is for new patients. In other words, by receiving the money, we have to meet a target and start certain number of new patients each year on these expensive medicines. After one year, these patients are no longer new, and, if they need to continue with their expensive treatment, we have to use our own budget; although we continue to receive the money, we have to use it for starting treatment on new patients – and the vicious cycle continues.”
“Gosh! Most of the drugs that we use are for the treatment of chronic diseases. It is silly for the extra-terrestrials to expect the treatment would last for only a year!” Some of us murmured.
I smiled, “I suppose our friends outside the solar system are trying to suggest we should hold off treatment until a patient could live only for a year!”
Saturday, May 3, 2014
Withdraw
Attended a regular meeting.
No, it is not really a meeting, but, rather, a kind of gathering which we are supposed to receive messages and instructions from extraterrestrials.
Message #1 this time: Drug D will be removed from our pharmacy. It is to be replaced by D - the same medication basically, except for the dosage schedule.
Sitting at the back of the meeting room, AN asked, “Why should that happen? D has been around for so long and D has nothing different!”
She was right, and I share her frustration. The old and the new preparations are even similar in their costs. Nonetheless, because D is commonly used, we have to explain what’s going on to all these patients.
“There are adverse incidents related to D reported.” CP murmured.
I smiled, “Of course! It may cause choking and suffocation if not swallowed properly!”
No, it is not really a meeting, but, rather, a kind of gathering which we are supposed to receive messages and instructions from extraterrestrials.
Message #1 this time: Drug D will be removed from our pharmacy. It is to be replaced by D - the same medication basically, except for the dosage schedule.
Sitting at the back of the meeting room, AN asked, “Why should that happen? D has been around for so long and D has nothing different!”
She was right, and I share her frustration. The old and the new preparations are even similar in their costs. Nonetheless, because D is commonly used, we have to explain what’s going on to all these patients.
“There are adverse incidents related to D reported.” CP murmured.
I smiled, “Of course! It may cause choking and suffocation if not swallowed properly!”
Friday, May 2, 2014
Opinion
While I was reading Karen Armstrong’s book on my way home, a story that I heard many years ago (and I am being reminded of very recently) came through my mind.
************************
One day, the god decides to give some thought on the value of human life, with the aim of improving this transient journey of ours on earth.
He asks a few representatives of human beings.
“Our life is too short, We should be able to live longer so that we can better prepare ourselves for heaven.” Abraham says.
“Why should we take so much time to raise our children? If babies are like ponies and could stand up and feed themselves once after birth, we would have more time to worship god.” Jacob says.
"We need more didactic guide to how we should lead a living." Moses says.
And the discussion goes on. Each and every prophet gives his opinion and suggestion.
At the end of the day, the god sighed, "What a waste of time. It's my fault. You are all living men. How do you know what to expect in heaven and how to prepare for it?"
************************
One day, the god decides to give some thought on the value of human life, with the aim of improving this transient journey of ours on earth.
He asks a few representatives of human beings.
“Our life is too short, We should be able to live longer so that we can better prepare ourselves for heaven.” Abraham says.
“Why should we take so much time to raise our children? If babies are like ponies and could stand up and feed themselves once after birth, we would have more time to worship god.” Jacob says.
"We need more didactic guide to how we should lead a living." Moses says.
And the discussion goes on. Each and every prophet gives his opinion and suggestion.
At the end of the day, the god sighed, "What a waste of time. It's my fault. You are all living men. How do you know what to expect in heaven and how to prepare for it?"
Thursday, May 1, 2014
God
My recent leisure reading is A History of God by Karen Armstrong.
I bought it from Books Kinokuniya (紀伊國屋書店) of Kuala Lumpur two years ago. This is a monograph about the evolution of the concept of god (specifically, the god of Judaism, Christianity, and Islam) in the past 3000 years. The topic is one of my favorite subjects (relation between philosophy and theology), but, to begin with, I do not have a high hope. This paperback is over 400 pages, with densely packed words, full of names and professional terms, and no figure.
But, I am happily proved wrong. It is true that the text is boring here and there. Nonetheless, there are a lot more insightful chapters. The first one-third of the book is largely around the two anonymous authors of Genesis (denoted as E and J in the book), how their views differ from the other, how they affected, individually and together, the concept of god in the following centuries, and how it ends up as the idea of Trinity. The last third is about the concept of god amongst famous philosophers – Descartes, Spinoza, Hegel, Kant, Nietzsche, and so forth, and why modern man consider the god is dead.
It is a bit heavy, I know.
I bought it from Books Kinokuniya (紀伊國屋書店) of Kuala Lumpur two years ago. This is a monograph about the evolution of the concept of god (specifically, the god of Judaism, Christianity, and Islam) in the past 3000 years. The topic is one of my favorite subjects (relation between philosophy and theology), but, to begin with, I do not have a high hope. This paperback is over 400 pages, with densely packed words, full of names and professional terms, and no figure.
But, I am happily proved wrong. It is true that the text is boring here and there. Nonetheless, there are a lot more insightful chapters. The first one-third of the book is largely around the two anonymous authors of Genesis (denoted as E and J in the book), how their views differ from the other, how they affected, individually and together, the concept of god in the following centuries, and how it ends up as the idea of Trinity. The last third is about the concept of god amongst famous philosophers – Descartes, Spinoza, Hegel, Kant, Nietzsche, and so forth, and why modern man consider the god is dead.
It is a bit heavy, I know.
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