Attended Norah Jones concert yesterday. We had expected a crowd similar to our age, but to our surprise, we were among the youngest in the audience. The average age of the audience was roughly in their 50s. I guess her songs appeal to the more mature population.
And can I say that her voice is amazing. For a tiny lady, she has the most awesome voice. Truly captivating...
Thursday 18 March 2010
Sunday 7 March 2010
Tax returns
In the US, everyone is required to complete their tax return. As a newbie to the US, I wasn't exactly sure how to fill one out. When I was working in the UK, I did not have to fill one out as there wasn't any tax credit that I was eligible for (as far as I knew), thus this was all new to me.
To avoid being fined for any errors from my ignorance, I made an appointment with a Tax Return expert. As an alien resident, I wasn't eligible for certain tax credits (my newly purchased car) but I could claim back expenses for moving from the UK to the US. =)
The fee for the service of the Tax Return expert was $250, but my calculated tax return was definitely worth the fee paid! Yay!
Sunday 7 February 2010
CNY celebration
My first Chinese New Year celebration in the US. It was celebrated with friends, plenty of home-cooked food and completed with a traditional lion dance! Definitely makes the winter more tolerable....
Wednesday 20 January 2010
Being responsible
When I was on the Medicine service 2 months back, we looked after a young 20-year old female, who was 14 weeks pregnant, and had end stage kidney disease, requiring dialysis. She was admitted because she did not attend her regular dialysis sessions, thus was becoming toxic from all the toxins that was accumulating in her.
We dialysed her while she was with us. However, the problem was finding a dialysis center for her to continue regular dialysis. The social worker and the kidney doctors worked hard to actively find her a dialysis center but she turned them all down. The reason? She had no transport to get to the center. Although her parents lived nearby, she refused to seek their help. Her boyfriend could drive her to the dialysis center but could not be depended on to do so on a regular basis due to his job.
Yes, she could have called for a cab to take her to the dialysis center, but she refused. She did not want to pay for the cab fare. It was in her opinion that someone (maybe the government?) should pay for her transport.
As a result, we couldn't discharge her as she did not have a regular dialysis session set up. Finally, she discharged herself against medical advice and said that she would find her own dialysis center. All we could do was hope and pray that she would come to her senses. If not for her own health, but for her unborn child.
2 months later, I am working in the emergency room, and guess who I see being wheeled through the ER doors. The same patient, but with one difference. She was being accompanied by her newborn baby girl, struggling in her incubator after being born prematurely at 22 weeks just 2 hours ago.
22 weeks! That is barely viable!
As expected, she continued to not attend her regular dialysis sessions, and as a result, went into premature labour. It pains me to see this outcome as even with modern medicine, a 22-week old premature baby (if she survives) will likely end up with lots of medical problems in the future.
It really boggles the mind how irresponsible some people can be.
We dialysed her while she was with us. However, the problem was finding a dialysis center for her to continue regular dialysis. The social worker and the kidney doctors worked hard to actively find her a dialysis center but she turned them all down. The reason? She had no transport to get to the center. Although her parents lived nearby, she refused to seek their help. Her boyfriend could drive her to the dialysis center but could not be depended on to do so on a regular basis due to his job.
Yes, she could have called for a cab to take her to the dialysis center, but she refused. She did not want to pay for the cab fare. It was in her opinion that someone (maybe the government?) should pay for her transport.
As a result, we couldn't discharge her as she did not have a regular dialysis session set up. Finally, she discharged herself against medical advice and said that she would find her own dialysis center. All we could do was hope and pray that she would come to her senses. If not for her own health, but for her unborn child.
2 months later, I am working in the emergency room, and guess who I see being wheeled through the ER doors. The same patient, but with one difference. She was being accompanied by her newborn baby girl, struggling in her incubator after being born prematurely at 22 weeks just 2 hours ago.
22 weeks! That is barely viable!
As expected, she continued to not attend her regular dialysis sessions, and as a result, went into premature labour. It pains me to see this outcome as even with modern medicine, a 22-week old premature baby (if she survives) will likely end up with lots of medical problems in the future.
It really boggles the mind how irresponsible some people can be.
Monday 18 January 2010
No excuse
Am currently writing this at work. Am working the 11 pm to 7 am shift in the emergency room tonight and I am annoyed!
Have just seen a patient with chest pain and heart failure, who was just discharged from hospital 2 days ago. To cut a long story short, this patient definitely needs to be re-admitted due to his ongoing medical problems.
As the ED physician, we sign-out to the medical team receiving the patient to let them know about the background history of the patient, the preliminary diagnosis (I admit, sometimes our initial diagnosis can be wrong) and what we have done for the patient in the ED.
In my hospital, there are 2 teams admitting patients. One team is staffed by residents on-call, ie doctors in training (like me!) and the other team is staffed by locum doctors. Residents on-call work 30 hours overnight non-stop, while the locum doctors are on-call from 7 pm to 7 am only. Also, locum doctors are paid very lucratively for this work.
My patient was being admitted to the service staffed by the locum doctor, thus I dutifully called the locum doctor to sign-out my patient. Halfway through my presentation, she interrupts me and says, "FYI, I have capped for tonight, so if you have any more admissions, you will need to call the consultant himself from home to come in to admit the next patient."
(Each physician is limited in the number of admissions they can admit per shift, and the locum doctor is limited to 6 admissions. This was her 6th admission.)
I continued my sign-out and I could tell that she felt that this was an unnecessary admission. From my own previous experience as the medical physician receiving patients from the ED, I have personally been annoyed before as I felt that some patients did not need to be admitted. However, this patient definitely required admission as it would have been medical negligence to send him home.
I can understand the receiving doctor's frustration at having to admit another patient, but hey, you're being paid for your hours. Being paid very well too!
And there was absolutely no need for the FYI. Telling me that will not change my management for the next patient that comes through the ER door. If the next patient needs to be admitted, he/she will be admitted. Even if I have to call the consultant from home to do it. Threatening me with the FYI does not scare me in any way whatsoever.
It disappoints me that there are physicians working with this kjnd of attitude.
Have just seen a patient with chest pain and heart failure, who was just discharged from hospital 2 days ago. To cut a long story short, this patient definitely needs to be re-admitted due to his ongoing medical problems.
As the ED physician, we sign-out to the medical team receiving the patient to let them know about the background history of the patient, the preliminary diagnosis (I admit, sometimes our initial diagnosis can be wrong) and what we have done for the patient in the ED.
In my hospital, there are 2 teams admitting patients. One team is staffed by residents on-call, ie doctors in training (like me!) and the other team is staffed by locum doctors. Residents on-call work 30 hours overnight non-stop, while the locum doctors are on-call from 7 pm to 7 am only. Also, locum doctors are paid very lucratively for this work.
My patient was being admitted to the service staffed by the locum doctor, thus I dutifully called the locum doctor to sign-out my patient. Halfway through my presentation, she interrupts me and says, "FYI, I have capped for tonight, so if you have any more admissions, you will need to call the consultant himself from home to come in to admit the next patient."
(Each physician is limited in the number of admissions they can admit per shift, and the locum doctor is limited to 6 admissions. This was her 6th admission.)
I continued my sign-out and I could tell that she felt that this was an unnecessary admission. From my own previous experience as the medical physician receiving patients from the ED, I have personally been annoyed before as I felt that some patients did not need to be admitted. However, this patient definitely required admission as it would have been medical negligence to send him home.
I can understand the receiving doctor's frustration at having to admit another patient, but hey, you're being paid for your hours. Being paid very well too!
And there was absolutely no need for the FYI. Telling me that will not change my management for the next patient that comes through the ER door. If the next patient needs to be admitted, he/she will be admitted. Even if I have to call the consultant from home to do it. Threatening me with the FYI does not scare me in any way whatsoever.
It disappoints me that there are physicians working with this kjnd of attitude.
Tuesday 12 January 2010
The price of healthcare
I received the medical bill for my trip to the emergency room.
And I was in shock!
IV lines and first bag of IV fluids $ 250
Second bag of IV fluids $ 80
IV anti-nausea medication $ 60
Grand total $ 945
And this is just for IV fluids. No blood tests or imaging of any kind. I cannot believe how expensive healthcare is here.
Yes, I do have medical insurance, but even with insurance, you are required to co-pay a certain percentage of your medical fees. I am required to co-pay 20%, which means this will cost me roughly $180.
How I miss the NHS......
And I was in shock!
Physician history and examination $ 205
Level 3 emergency room $ 350IV lines and first bag of IV fluids $ 250
Second bag of IV fluids $ 80
IV anti-nausea medication $ 60
Grand total $ 945
And this is just for IV fluids. No blood tests or imaging of any kind. I cannot believe how expensive healthcare is here.
Yes, I do have medical insurance, but even with insurance, you are required to co-pay a certain percentage of your medical fees. I am required to co-pay 20%, which means this will cost me roughly $180.
How I miss the NHS......
Friday 8 January 2010
New York - Cambridge
Photo copyright NYCfoto.com (taken from www.cam.ac.uk)Found this photo while surfing through my alma mater's website. To mark the University of Cambridge's 800th anniversary, the Empire State Building was lit in Cambridge's emblematic light blue. It sure does stand out beautifully.
Photo taken from www.cam.ac.ukAlso found this song titled, 'Empire State of Mind' by Jay Z featuring Alicia Keys. Quite a cool hip-hop song with elements of electropop and orchestra pop. It has been featured in an episode of Gossip Girl and is in the trailer for Sex and the City 2 which is due out in Summer 2010.
The song-writer wrote it when she was feeling nostalgic about New York while in London. Now if only someone would write a song about Cambridge...
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