A Patient's Perpective- My GP attachment essay

Found this while cleaning up my room.This is my trainee intern GP assignment.
I did my rural GP training in Reefton, also known as the "Town of Light". It is the first place in New Zealand to have electricity.
The story itself is not that exciting. Oh well..

Local boy who's been overseas for too long get gastroenteritis from eating at local stall

 Jan 17 2012   last updated 1021GMT


SIBU: Local boy who's been overseas for a long time but still thinks he is local contracts diarrhoea from local food stall.
Mr Noob, who refused to give his name and age, has been overseas in some "ah mo" country for a while and is back for CNY.
He has been seen frequenting all the local coffeshops and stalls around town.
He still views himself as "local" despite the different sentiment of true locals.
It is reported at 1600 pm yesterday, he started getting chills and shakes and subsequently developed diarrhoea.
He is now bedridden with misery.
He refused to give a comment so we have interviewed the people around him

Friend: I told him lah, foreigner come and eat here always get "lau sai" lah. But he don't believe.
He say his stomach like iron. Can tahan. Now see?

Stall owner : Haiya that budak, cannot even speak local properly. I already know lah. Speak with accent but try to be local.  I knowlah, he olledi like banana, where got can tahan local spicy food? I make sambal belly belly nice one, u wan or not?

Stall owner 2 : I see him already know, this boy sure trouble one. Cannot even order food properly. See already sien. He even say "thank you" somemore. Ptuiii! Who says "thank you" around here!
He dunno, I already chop him! ( makes chopping movement with his hand )
Somemore, he try to pay with with 50 ringgit note. Jialat! I hate people who give me big note. Sia ba jin eng ( foochow: eat full nothing to do) Wah he think this is hotel hah?

Passer-by : I saw that nerdy pale boy, eating so happily there. I think.. where is this boy from ah. Speak "ing ung" (Foochow: english) somemore. Want to show off issit. Very "gen"" issit? Take picture of his food somemore. Good good.... now he get kena.

Mother: I told him, dun eat outside so much, not good for you. Eat at home already can. But he never listen.

Brother: Hahaha, he kena "owned"

Our latest report is that he is recuperating in an airconditioned room, cos he is too weak to take the heat.



Reuters 17 Jan 2012


This is the author's impression of the possible scenario

* the above story is not true news but inspired by real life events

Its a trap!

Just letting you know that it's a trap!

Text received today
extra duties available:  Duty med 3 HO TPMH night duties from Friday 30 Dec for 7 nights or part thereof
call RMO Unit 3641585
thx RMO Unit.  CHCH Hospital

Night HO workload - A walk in the park

Email received yesterday
Friday 30 December   ·        
Acute Medical Registrar GM10   0800-2300 ·    
 Medical Night Reg 2        2230-0830
Saturday 31 December ·    
  Medical Reg Wards 18&19   0800-2300 ·     
Medical Night Reg 2        2230-0830
Sunday 1 January ·  
  Medical Night Reg 2        2230-0830
Monday 2 January  ·   
Medical Night Reg 2        2230-0830 (unconfirmed extra duty) ·     
  Post Acute Med  Reg GM6 
Tuesday 3 January  ·     
Medical Night Reg 2        2230-0830 (unconfirmed extra duty)
Wednesday 4 January  ·        
Medical Night Reg 2        2230-0830 (unconfirmed extra duty)
Thursday 5 January ·    
  Medical Night Reg 2        2230-0830 (unconfirmed extra duty)

Med Night reg 2 workload - Getting whipped with barbed wire


Caveat - Night HO must help out "if busy"

Another "It's a trap "  video

About buttock pain

Pain in the butt is a criteria for spondyloarthropathy

Case Study: Alien Infestation as Atypical cause of Chest and Rib Pain

Date 23/11/2080

Admitted under GM 19, Dr Chang. Rejected by cardiology- unlikely to be cardiac.

Patient Name: Corporal J .Hicks
Age: 32
Male

Presenting complaint: Chest pain - 1/52

History of Presention Compaint:
Patient has had 1 week of central chest pain. Feels like "pounding" At time feels like chest about to burst.
Pain radiates to back. Pleuritic. Associated with SOB.
Chills and sweats for 2 weeks.
Haemoptysis 4 days.
Recent long haul flight from mining colony #210 on Betelguese system.
Cryostasis for 1 month.
Arrived 2 weeks ago
No calf swelling or calf pain.
Previously fit and well

Past Medical History:
Asthma

Medications:
USCMC issued Stim-packs

NKDA

Family History:
Negative for cardiac or thromboembolic disease

Social History:
Recent assignment to Colony #210 Betelguese system
Corporal in United States Colonial Marine Corps
Non smoker
Some alcohol


O/E Patient is pale and diaphoretic.
   BP 100/55mmHg   Temp 37.5
  Sats 88% RA
Pulse 110/min
JVP raise at 6 cm
Pectus carinatum?  Chest dullness to percussion bilaterally.
Very prominent ventricular heave
Chest reduced breathsounds and crackles throughout
Abdo distended, mildly tender. Epigastric tenderness.


Differentials: ? PE
                   ? LRTI
                    ? Alien infestation

Plan :
Isolation chamber
Needs armed security 24/7
Enoxaparin
IV Cefepime + Metronidazole


Date 24/11/2080

Post take:

Patient died overnight.
Chest wall exploded while in isolation chamber.
Alien facehugger unleashed from thoracic cage.
Successfully neutralised by arm guards after killing one guard.

Postmortem not planned as risk of contamination
Body for incineration
Notified Galactic Ministry of Health and US Colonial Marine Corps

THE FOLLOWING MINISTRY OF HEALTH WARNING HAS BEEN ISSUED!

If you have pounding chest pain and have been in alien contact within one month, please DO NOT board any ships.

Always wear mask and gloves when dealing with contaminated patients!

The M41a Pulse Rifle is your doctor recommended management for alien induced chest pain. 

Preferably with a grenade launcher attached.

Hero Profile- Avinesh

A tribute to a true GM Hero

Descending from a long line of medicine men, the art of healing is in his blood. While people scamper from disease and suffering, Avinesh seeks it. While some of his comrades feels he borders insanity, there's nothing more he revels in than combating sickness and disease. No matter how filthy and vile the working condition, a true medicine man never backs down from fighting affliction.




Avinesh the Sage



Strength       Agility       Intelligence

          

26+3.2      23+ 2.0        28+ 2.3

Skills

  Healing touch

Level 1 - Heals 1 target for 50  hp
Level 2 - Heals 1 target for 100 hp
Level 3 - Heals 2 targets for 100 hp
Level 4 - Heals 3 targets for 150 hp


  Summon Minions

Avinesh can summon minions to assist him in time of need

Level 1 - Summons a trainee intern to help
Level 2 - Summons a house officer to help
Level 3 - Summons a registrar to help
Level 4- Summons a consultant to help

Physician's blood

Avinesh can take pain, but pain only makes him stronger. For each 10% damage taken, he gains more efficiency.

Level 1 - 5% increased movement and heal speed
Level 2 - 10% increased movement and heal speed
Level 3 - 15% increased movement and heal speed + 2hp/sec healing aura
Level 4 - 20% increased movement and heal speed + 5hp/sec healing aura


ULTIMATE


 Extra Duty Strength

Avinesh tanks the workload of the whole hospital

Level 1 - Extra duties                   +10 Strength
Level 2 - Extra heavy duty           + 20 Strength
Level 3 - Super extra heavy duty  +30 Strength

DOTA VS GENERAL MEDICINE

What did you do today?
Oh I played Dota.
What the heck is Dota u might ask? (ask Wiki)
Actually I think practicing general medicine is a bit like DOTA.
Do you know why?
Because DOTA stands for Defence Of The Ancients!
In GM I feel like I'm defending the ancients everyday.
What if GM was like DOTA, what hero would you choose?





There are 3 hero classes to choose from in Dota.

Choose your hero!

Agility
                                                       


Agile and  nimble, agility class heroes and can move fast between patients and wards. Able to clerk patients at high speeds. Unfortunately, a high metabolism means this agile hero needs frequent breaks and can burn out if worked too hard physically and mentally. These heros are particularly adept at attending to cardiac arrest calls at the "blink" of an eye.

Intel
                                                          

High intelligence heroes can heal the sickest and most complicated patients . However work speed is slow because of attention to detail. This maybe be a disadvantage on busy acute days. High mana regen means the intel hero doesn't suffer mental fatigue as much as other heroes but he's not immune to physical lethargy. Intel heroes that are low in agility stats are usually not favoured in ward rounds cause they tend to draw the ward round out to very late game.

Strength
                                                     

Physical strength is important on long stressful acute days . The ability to work long hours and take physical punishment is almost a requirement in medicine. Strength heroes are blessed with unnaturally large bladders and stomach so, they can work long periods without taking a break . The fast regeneration ensures that only short breaks are necessary for full recovery. These heroes are ideal if your hospital is short staffed because they can withstand an enormous amount of work before succumbing. In Dota they are called tanks.

In reality, all doctors and dota heroes have varying amount of all 3 attributes. It's important to have the right mix in a team for things to run smoothly. Teamwork is of utmost importance in both Dota and Medicine.

GLHF!

Is an iPad 2 worth more than a Kidney? A comparison.

Well..... is it?
This might be old news, but it's true, a 17 year old boy from AnHui province in China decided to sell one of his kidneys so he could buy an iPad2.
"I wanted to buy an iPad2, but I didn;t have the money"
"When I surfed the internet, I found an advert posted online by an
agent saying they were able to pay RMB 20,000 to buy a kidney"
So he went to a shoddy hospital, had his kidney removed and was 
paid RMB22,000.
1st of all, I would like to commend the honesty of the black market kidney harvesters. They could have easily left him for dead without a single cent. Instead they paid him the full agreed amount. 


Ok, lets talk about this topic now, is an iPad 2 worth more than a kidney?


1. Monetary Value


A kidney on the black market may be worth up to $50,000 USD. This boy was paid a measly $3400 USD.
1 tip for you! Check your market prices before executing a trade!
So monetary-wise, a kidney is worth more than an iPad 2, which retails for about $499 USD at the moment!


Winner - Kidney!


2. Happiness value


How much happiness can an iPad 2 give you?
I don't really know, but apparently his life was so sad it wasn't worth having 2 kidneys.
He believed that the iPad2 would complete him more than 1 kidney
The apple website says  "When you pick up iPad, it becomes an extension of you"
" it's got an all new design, just beautiful"
" when you get your hands on one, it feels totally diffferent"


Winner? It depends
Just asked these guys in the video below

3. Specs ( I took a few quotes from iPad launching speech)


" It is an all new design"
Your kidney - same design for years


"It's dramatically fast, with the A5 processor"
At 17, your glomerular filtration rate is about 90-120ml/min


"It's great, it's duo core processors"
Your kidneys comes as duo, but we are only talking about one for comparison.


Winner - iPad2 ?


4. Battery life


iPad2- 10 hours
Kidney- 70 years


Winner - Kidney


5. Funtionality


iPad2- "And it makes surfing the web, checking email, watching 
movies and reading books so natural, you'll wonder why you ever
did it any other way"


Kidney- it removes toxins from your body so you don't die. Losing one kidney won't kill you, but might make u a bit tired


Winner- Kidney


6. Bragging rights


Not everyone in your village can afford an iPad 2 , but almost everyone has 2 kidneys


Winner - iPad2 

Conclusion: I think I will have to favour the kidney slightly, at the risk of sounding uncool.


Perhaps iPad vs kidney should never have been the question but rather, what has happened to society that a person would sell a vital organ in exchange for a consumer product?


Oh well, perhaps there will be an iKidney app.