The Final Call

Okay....just felt like writing another nearly day-to-day thing you'll encounter as a houseman and a medical officer, and all the way to specialist and consultants. Something that we'd have to consider doing upon encountering a dangerously ill patient, or to put on better words, those who are dying. We call it issuing a DIL (dangerously ill list) to the family members of the dying patient. Here we'd explain the prognosis of the patient to the family members, and then to ask the family members of their expectations of the patient, and how far would they want us to go on managing the patient when the patient's heart stops beating.

Most of the time, the answer will always be, "Doktor buatlah apa yang terbaik."

Impromptu Getaway

This took place in early March 2011, while I was waiting for my MO posting. Azman had the idea to go to Singapore during his end of posting holidays, and as I had nothing to do at the time, immediately agreed to tag along, and we asked Neehad and Ihab whether they would be interested to come along - hence completing our mini 'Glamberts' team for this impromptu getaway. Neehad was game, but Ihab had just returned from Indonesia and to go on a vacation again was not exactly a good idea for him. So it was just us three. My inclination of going was simply because of two reasons 1) I haven't been to Singapore then, and 2) More subjects to practice my photo-taking style.

I have long since realized that my favorite subjects to capture upon are always people, and scenery. So that will be the theme for this entry.

Chinatown

Hindu temple in Chinatown. Colorful. 

Random traveller, captured. **Neehad likes this picture a lot. **

Pectus Carinatum

Pectus carinatum is an overgrowth of cartilage causing the sternum to protrude forward. It occurs in 3 different ways. The least common way is post surgically after open heart surgery. Sometimes the sternum does not heal flat and there is a protrusion of the sternum. The second most common is from birth. It is evident in newborns as a rounded chest and as they reach 2 or 3 years old the sternum begins to grow outwardly even more. The most common occurrence for pectus carinatum seems to be in the 11-14 year old pubertal male undergoing a growth spurt. Some parents report that their child's pectus seemingly popped up 'overnight'.

While doing Locum at a private clinic near where I lived in Shah Alam a couple of weeks back, one of the patients I have encountered then was this child. When his parents brought him in, in my mind I was like OMG OMG what is this condition called? I couldn't remember what it is called back then, my mind being diluted with the usual cold cases I had seen that night. This child apparently had undergone an open heart surgery prior to attaining this condition. So apparently, post-surgical pectus carinatum is very rare. Luckily the child came in only because of runny nose, which can be easily treated, InsyaAllah. I asked the parents if I could take a picture of him. They didn't mind at all. Apparently I was not the first doctor who had asked.

More about it here: http://en.wikipedia.org/wiki/Pectus_carinatum