In this dream I have bought a sky blue Nissan Micra. In the dream I shudder at my own poor taste - I think Nissan Micras aren't exactly the essence of style and am lamenting why I spent $20,000 on that car!
Anyway I pull up at the Woolworth's petrol station outside Casuarina. It's raining as I get out of the car to fill up. When I unscrew the lid, I see that the petrol tank actually looks like a big plastic bottle inside the car and the petrol just splashes in. I shake my head at the poor design and start filling it up. I look up and it only costs 70c/L! After a while I wonder how a Nissan Micra could have such a big petrol tank and decide to stop.
I walk inside to pay. The total is $54.25 and I hand the man at the till $55. When I get the receipt back and my change, I realise that the receipt is actually printed in Chinese and the items on it are completely random, as if I had bought things in a supermarket. Nowhere does it even mention the word petrol. I ask the man why I've been given this type of receipt and he says, just take it and go.
Suddenly it comes to me that this must be some sort of tax scam! I threaten to call the police and the man presses a big button on the wall. All these people immediately appear in the store and start calling things out over the PA system such that all the other cars in the petrol station scoot off quickly. I start to feel scared that I am stuck in this place with a bunch of thugs, but try to keep calm.
Then Will the ED consultant opens the door and he is standing there with his 5 year old daughter wearing a pretty pink dress.
"What are you doing here, Will? It's dangerous, you have to leave immediately!" I said.
"That's all right, I just came to save the day." He strolls in and picks up a candy bar for his daughter, who is very sweet.
"How? These men are really dangerous and they have guns!"
He hands me a copy of the NT news and says "The answer is there, as always, in the NT News".
I look down at the cover and there's a huge picture of a bunch of men being led away in handcuffs, and the title is Major drug bust in petrol station.
My spine chills and I wake up.
Saturday, 31 December 2011
Sunday, 25 December 2011
Haw Par villa
I had heard about Haw Par villa from my previous boss Tsin, who regaled me with tales of when he was taken there by his parents as a child in the 70s, when the place was all the rage for scaring kids into shape. Particularly gross sounding was the ten levels of hell, I knew I had to check it out for myself!
Built by the Tiger balm brothers (yes, the folks who invented tiger balm), it is a strange sort of Buddhist / Chinese theme park, where there were no rollercoasters but ethical and moral dioramas taken from old Chinese stories. As Singapore became more developed, it became less and less of a tourist attraction, slowly crumbling away in the south western corner of Singapore.
I was surprised to find that the new MRT line actually had a Haw Par villa station - I think it was meant to be. Some effort had obviously gone into restoring the place in recent years, and there were a fair number of families with little kids wandering around on the Saturday morning that I visited.
Most of the park consists of story dioramas and a really random assortment of statues which are just dotted around the place. Some of the staircases are fashioned into waves or caves and it was sort of eerie to walk around amongst these plaster statues that were built almost a century ago.
I had a great deal of fun making up captions for some of these dioramas:
There was also the most bizarre animal park, where three giant gorillas (about twice my size) sat down one side on a fake log, and the rest of the park was dotted with scared looking animals including some real menacing looking kangaroos (!), a few kiwis pecking at the lawn and this tree of koalas.
A few monuments to the Aw (Tiger balm) family were scattered around the park, and the centre of attention was this lake filled with turtles.
Other surprise finds included the weirdest diorama of a badger hospital (this badger doctor is obviously a vampire)
And also this Tiger car, I guess it'd be hard to lose in a carpark!
But of course the real attraction was the Ten Levels of Hell, which was inside a dark building of its own. It was barely lit inside by a dim red glow, which made everything look extra bloody. I think the sign outside warning that the place is PG should probably be extended to adults, especially after I'd read that being stuck on a mountain of knives is punishment for tax evasion!
It's so oddball that it's almost not gory, but there sure was a lot of blood in hell...
The solution? Well, one could dance around some Tiger balm
or alternatively just follow this helpful plaque at the exit (topped by a skull with daggers coming out of its eyes): The sea of suffering is endless, just turn around and the shore is there.
What a weird place. I loved it!
Built by the Tiger balm brothers (yes, the folks who invented tiger balm), it is a strange sort of Buddhist / Chinese theme park, where there were no rollercoasters but ethical and moral dioramas taken from old Chinese stories. As Singapore became more developed, it became less and less of a tourist attraction, slowly crumbling away in the south western corner of Singapore.
I was surprised to find that the new MRT line actually had a Haw Par villa station - I think it was meant to be. Some effort had obviously gone into restoring the place in recent years, and there were a fair number of families with little kids wandering around on the Saturday morning that I visited.
I had a great deal of fun making up captions for some of these dioramas:
Yellow and red don't go together!
Life is more fun with three!
You never know what skimpily dressed woman you might find inside a giant clam shell
There was also the most bizarre animal park, where three giant gorillas (about twice my size) sat down one side on a fake log, and the rest of the park was dotted with scared looking animals including some real menacing looking kangaroos (!), a few kiwis pecking at the lawn and this tree of koalas.
Other surprise finds included the weirdest diorama of a badger hospital (this badger doctor is obviously a vampire)
And also this Tiger car, I guess it'd be hard to lose in a carpark!
But of course the real attraction was the Ten Levels of Hell, which was inside a dark building of its own. It was barely lit inside by a dim red glow, which made everything look extra bloody. I think the sign outside warning that the place is PG should probably be extended to adults, especially after I'd read that being stuck on a mountain of knives is punishment for tax evasion!
The solution? Well, one could dance around some Tiger balm
or alternatively just follow this helpful plaque at the exit (topped by a skull with daggers coming out of its eyes): The sea of suffering is endless, just turn around and the shore is there.
What a weird place. I loved it!
Monday, 5 December 2011
An unique outreach
So there we were on a remote island, a couple of hours flight from Darwin. We had arrived on our own little charter plane, crossing a crescent of deep blue ocean onto a lushly wooded island. The clinic was practically closed as there was a death on the island the day before, and everything was in lock-down mode. It appeared as if we had fatefully chosen a bad day to come to the island (and we only visited three times a year!)
We spent most of the morning seeing just a handful of patients. As we were having a cup of tea and getting ready to pack up and call it a day, a nurse ran into the tea room and shouted "We need a doctor! Emergency!"
It was almost a little surreal, as the tearoom really felt like someone's lounge room, and it didn't seem like we could be called to attend an emergency in such a cosy relaxed place. But as we ran outside, reality sank in - there was a landcruiser with a handful of locals, shouting and gesturing frantically at the motionless figure sprawled across the backseat.
For a split second my brain froze as I thought it was the lady I had just seen in clinic, but as I got closer I realised it was someone else. She didn't appear to be moving at all. My boss started doing chest compressions and all of us together managed to get her onto the trolley to move her inside the clinic.
Inside we realised that she was in a terrible way, and that she was probably "gone" as convention would say. Her heart had gone into a seriously abnormal rhythm and was unlikely to recover. We carried on the resuscitation, knowing the grim prognosis at the back of our heads. We looked at one another sternly and decided on ten minutes as a cutoff point, thinking that everything would probably end there and then.
Ten minutes later we were surprised to find that she had started to show signs of life. So we kept going, and going, and eventually got to a point where we had to make a decision to evacuate her to Darwin. It was a bad day to fly - Darwin was a no-fly zone because Obama was in town, and we ourselves had even seen the giant US airforce planes parked across the runway at Darwin like alien spacecraft as we took off in the morning. Careflight took several hours to come, and things had taken a serious turn for the worse during that time, though she was still alive.
I have never been called upon to bag ventilate a patient for four hours. The repetitiveness of the muscle strain aside, my mind was adrift in a sea of thoughts, about what had happened during the resuscitation, about what would happen to the patient once she made it out of this place (or would she?), about all the things that we didn't have on hand at the clinic.. about all the ways things could have been better.
But there was nothing I could do, other than rhythmically squeeze that bag. It was almost hypnotic, watching the oxygen go in and out. Eventually when Careflight came it felt like there were so many people in the room it was almost like a circus. As we got ready to leave the clinic, I looked outside and it was completely dark. There were dozens of faces in the front yard peering anxiously inside the security fence, and beyond those faces were even more, spilling out onto the main road. We drove to the airport and there was a crowd there too, all lined up along the fence near the Careflight plane. It felt like half the community was there, and though everyone kept quiet, it felt like a potentially unrestful situation.
Later I heard that she passed away in intensive care, which was more or less the expected outcome. Though she'd fought the odds to come back, the time before she got to the clinic that her heart had not been working and the long time it took for her to be retrieved, meant that she didn't really have a chance at long term survival.
I had never done an out-of-hospital resuscitation before, and getting to grips with the difficulties of being in such a remote location was certainly an eye-opener. A lot of things we take for granted in the hospital setting simply do not exist out there, and we were having to "make do" with what we had. There was a lot of thinking on one's feet, and given the circumstances I thought everyone involved did extremely well. On one hand there was certainly the feel-good factor that even in the community there were competent doctors and nurses serving the community, but there was also the sombre undertone that this is the harsh reality of life - getting sick 1000km away from the nearest major hospital is tough, and it's really touch-and-go. And not every community is going to have such a wonderful clinic, though it really makes one appreciate the work that remote health workers do.
We spent most of the morning seeing just a handful of patients. As we were having a cup of tea and getting ready to pack up and call it a day, a nurse ran into the tea room and shouted "We need a doctor! Emergency!"
It was almost a little surreal, as the tearoom really felt like someone's lounge room, and it didn't seem like we could be called to attend an emergency in such a cosy relaxed place. But as we ran outside, reality sank in - there was a landcruiser with a handful of locals, shouting and gesturing frantically at the motionless figure sprawled across the backseat.
For a split second my brain froze as I thought it was the lady I had just seen in clinic, but as I got closer I realised it was someone else. She didn't appear to be moving at all. My boss started doing chest compressions and all of us together managed to get her onto the trolley to move her inside the clinic.
Inside we realised that she was in a terrible way, and that she was probably "gone" as convention would say. Her heart had gone into a seriously abnormal rhythm and was unlikely to recover. We carried on the resuscitation, knowing the grim prognosis at the back of our heads. We looked at one another sternly and decided on ten minutes as a cutoff point, thinking that everything would probably end there and then.
Ten minutes later we were surprised to find that she had started to show signs of life. So we kept going, and going, and eventually got to a point where we had to make a decision to evacuate her to Darwin. It was a bad day to fly - Darwin was a no-fly zone because Obama was in town, and we ourselves had even seen the giant US airforce planes parked across the runway at Darwin like alien spacecraft as we took off in the morning. Careflight took several hours to come, and things had taken a serious turn for the worse during that time, though she was still alive.
I have never been called upon to bag ventilate a patient for four hours. The repetitiveness of the muscle strain aside, my mind was adrift in a sea of thoughts, about what had happened during the resuscitation, about what would happen to the patient once she made it out of this place (or would she?), about all the things that we didn't have on hand at the clinic.. about all the ways things could have been better.
But there was nothing I could do, other than rhythmically squeeze that bag. It was almost hypnotic, watching the oxygen go in and out. Eventually when Careflight came it felt like there were so many people in the room it was almost like a circus. As we got ready to leave the clinic, I looked outside and it was completely dark. There were dozens of faces in the front yard peering anxiously inside the security fence, and beyond those faces were even more, spilling out onto the main road. We drove to the airport and there was a crowd there too, all lined up along the fence near the Careflight plane. It felt like half the community was there, and though everyone kept quiet, it felt like a potentially unrestful situation.
Later I heard that she passed away in intensive care, which was more or less the expected outcome. Though she'd fought the odds to come back, the time before she got to the clinic that her heart had not been working and the long time it took for her to be retrieved, meant that she didn't really have a chance at long term survival.
I had never done an out-of-hospital resuscitation before, and getting to grips with the difficulties of being in such a remote location was certainly an eye-opener. A lot of things we take for granted in the hospital setting simply do not exist out there, and we were having to "make do" with what we had. There was a lot of thinking on one's feet, and given the circumstances I thought everyone involved did extremely well. On one hand there was certainly the feel-good factor that even in the community there were competent doctors and nurses serving the community, but there was also the sombre undertone that this is the harsh reality of life - getting sick 1000km away from the nearest major hospital is tough, and it's really touch-and-go. And not every community is going to have such a wonderful clinic, though it really makes one appreciate the work that remote health workers do.
Friday, 2 December 2011
A few favourite quotes
Patient with STEMI: Doctor, I have this terrible pain in my chest, it's just like a buffalo is sitting on my chest!
Kirsty: Why would the surgeons even ask for an ECG? So they can fold it up and fan themselves?!
Dr Chacko (trying to explain to a patient going for a mitral valvuloplasty using a model of the heart): Guys, where is the mitral valve?
Patient with a stroke: my body was just swaying, like a tree in a cyclone
At handover, after 30 admissions: we need to marinate our brains in coconut liquor to continue
Dr McDonald: some patients are clearly obligate anaerobes
Kirsty: Why would the surgeons even ask for an ECG? So they can fold it up and fan themselves?!
Dr Chacko (trying to explain to a patient going for a mitral valvuloplasty using a model of the heart): Guys, where is the mitral valve?
Patient with a stroke: my body was just swaying, like a tree in a cyclone
At handover, after 30 admissions: we need to marinate our brains in coconut liquor to continue
Dr McDonald: some patients are clearly obligate anaerobes