"Some" is NOT a number, "Soon" is NOT a time

This is quite a well known quote from Don Berwick.

Indeed, when people are indecisive or are afraid to make decisions, they resort to vague answers like these.

Other famous variants include, "use your best judgement", "do your best".

No wonder, we are paralysed by inaction when directions are vague.

Come on people, make a stand, and take a stand!

How Singaporeans can help with Swine Flu preparedness

The media is filled with news about the swine flu outbreak with Mexico as the epicentre.

By now, more than 16 countries have reported cases - some confirmed, some still suspects and today we received news about the first death of a 23-month old toddler in the US.

Singapore, to-date is still clear, but as a nation we are gearing up and are now at DORSCON level YELLOW of preparedness.

10 ways fellow Singaporeans can help?

1. Maintain high level of personal hygiene.

2. Be considerate - if you are not feeling well, cover your mouth with a mask, and see a doctor. Cover your mouth when you cough.

3. Protect yourself - if you can help it, why put yourself at risk by visiting the affected countries?

4. Try NOT to visit hospitals, unless absolutely necessary

5. If you need to visit a hospital, do NOT bring a crowd - limit to ONLY 2 visitors per patient. Do not be angry with hospital staff when they are just doing their job controlling visitors

6. Love your loved ones - don't bring your kids to hospitals

7. Mask up when requested at Hospitals - please PUT ON your surgical mask when asked to do so in a hospital. It is to protect you. And because you are protected, your family is also protected

8. Dispose of your mask properly in bins - otherwise somebody else will have to pick up your used masks and may be infected

9. If you are a patient, the hospital may call you to ask for postponement of non-emergency surgery as part of outbreak preparedness. We understand you are anxious about your medical condition and your surgery but know too that such measures are taken in the interest of patients and the public. Speak to your doctor if you have concerns

10. If you know of others who bears the symptoms of swine flu and have travel history to affected countries, gently nudge them to see a doctor as soon as possible. Over them a mask if you have one.

If we all play our part, Singapore will be better prepared to weather this storm. Thank you.

A Tribute to my mentor in healthcare...

My wife was doing some springcleaning this week, and she found a montage and tribute that I wrote for Song Khim (my mentor in healthcare) in 2000 when he left Changi General Hospital for NUH.

Looking back, the quote that I wrote for him is almost like a prophesy when I read it today - some 9 years later:

"The seed that you have sown in each one of us will bear much fruits all through the years! Thanks for developing, nurturing, and leading me, Ops and CGH."

The pictures tell the many faces possible from a simple me... enjoy

Be on Stage...

When I got up this morning, I flipped to my facebook and saw an interesting video post by a friend with a comment that said "touching...". As it was still early, I decided to click on the video to see what could get a grown man to say "touching".

The video was about a lady Susan Boyle taking the stage on the Britain Got Talent show. She was fat, had unflattered features and did not look the look of a winner. One could tell that the judges were cynical about her and as the camera panned the audience, it is easy to tell too that they too were against her. How could a star emerge from someone as ordinary as her was the unspoken language. When asked what was her dream, she said she wanted to be a professional singer. Answering the question, "Why has it not worked out so far", she said "because she has not been given a chance before, and tonight it is going to change..."

When the music started and when Susan Boyle started to Sing the song "I Dreamed the Dream" from Le Miserable, the crowd and the judges were immediately awed by her voice. Before long, she had a standing ovation and the rest is history....

There is a Susan Boyle in all of us. We all have talents, but like Susan Boyle, our talents need to be "on stage" before they may be recognised and enjoyed.

Have we taken the courage to allow our talents to be on stage? If not, watch this video on youtube and be encouraged.

Lyrics:(...quite a sad song though)

There was a time when men were kind

When their voices were soft

And their words inviting

There was a time when love was blind

And the world was a song

And the song was exciting

There was a time

Then it all went wrong

I dreamed a dream in time gone by

When hope was high

And life worth living

I dreamed that love would never die

I dreamed that God would be forgiving

Then I was young and unafraid

And dreams were made and used and wasted

There was no ransom to be paid

No song unsung, no wine untasted

But the tigers come at night

With their voices soft as thunder

As they tear your hope apart

And they turn your dream to shame

He slept a summer by my side

He filled my days with endless wonder

He took my childhood in his stride

But he was gone when autumn came

And still I dream he'll come to me

That we will live the years together

But there are dreams that cannot be

And there are storms we cannot weather

I had a dream my life would be

So different from this hell I'm living

So different now from what it seemed

Now life has killed the dream I dreamed.

Bitter and Sweet

Life's perfection sometimes lie in its imperfection.

I just watch a video on facebook called "Beautifully Imperfect". The setting is one at the funeral where the wife steps up to say her eulogy for her deceased husband. She described noises that would ordinarily disgust most people - her husband's snore which she described it as a car engine that refused to start in the morning, and his "rear wind" that would be so loud in bed that it would sometimes jolt himself awake. However, these are noises that remind her of his presence and she has come to miss with his passing. These imperfections are perfect for her and she would give anything to hear these sounds again when she goes to bed.

The bitter and sweatness of life needs to be treasured. In a different kind of way, I am beginning to experience these same types of feelings over the last few days - not in my personal relationships - but with the people around me in a special place. A place where I have easily grown to love and in my imperfect ways helped made it more beautiful. The sound and scent I have grown familiar and the people super special. But I know that I know that know, I will treasure the time I've had.

Why Vision is important...From Alice in the Wonderland

Organisations as much as individuals need vision. Vision offer dreams and hope and make existence more meaningful. This is a quote from Alice in the Wonderland story that will serve to remind us of this...

"Would you tell me, please, which way I ought to go from here?"

"That depends a good deal on where you want to get to," said the Cat.

"I don’t much care where--" said Alice.

"Then it doesn’t matter which way you go," said the Cat."

--so long as I get SOMEWHERE," Alice added as an explanation.

"Oh, you’re sure to do that," said the Cat, "if you only walk long enough."

Grace in Medicine

No one in healthcare wants mistakes to occur, especially when they harm patients.

However, when mistakes do occur, as humans do - honesty, transparency and the willingness to learn from mistakes have proven to be key successful ingredients when communicating with patients.

This Grand Rounds blog entry "Getting a finger from the patient" is an interesting read about grace from patients when healthcare providers do the right thing when things go wrong.

Will the finger save mankind?

I was driving back home after breakfast this morning, when I turned in to the sleepy quiet road leading to my house. "Sleepy and quiet" because there usually isn't alot of fast traffic, until...

As I made that turn, I had to straddle between 2 lanes because there were cars parked along the left hand side as this was a residential estate. Little did I realised that there was an on coming taxi. I quickly pulled my car left and stepped on the brakes to avoid a collision. Before I could wave that I was sorry, I noticed that the taxi driver did not even try to slow down (even though I was at fault) and instead directed all his energy and attention to show me the "perfect finger". I am convinced that he was not interested in avoiding an accident, showing his middle finger to me was more important. It is as if the finger was a magic wand, "waving it" will magically prevent any collision.

If this were true, I wonder it will heal the world and save mankind? Maybe, just maybe, it may even help the world turn the corner during this global financial crisis!

The longing to be home...

It has been 2 weeks since I left home for a series of learning visits to US hospitals, attended a summit and a congress. At the end of the first week in the US, I learnt that my wife had been admitted to the hospital for dengue fever.

Even though I had an eventful time in the US, this time the longing to be home has never been stronger. The thought that I am really needed at home but am miles apart from my family was a difficult feeling to describe. My heart was really hurt when I called back one day, only to realised that my wife's platelet count had continued on the decline to 23k, my daughter Mel missed her mother so much that she cried for 3 hours and my eldest daughter told my wife that she felt like an orphan. That was when an early flight back to Singapore was confirmed and now I am on my way home.

While catching an internal flight earlier, I was really worried when my flight which was scheduled at 2.40pm was delayed to 5.30pm, then changed to 4.00pm due to changing weather conditions. The thought that I will arrive home later than scheduled on Saturday was not an outcome that I desire. Thank God, I made it through that flight and am now awaiting SQ flight to Singapore.

Yes, it will be Saturday morning when I arrived in Singapore. Perfect time for me to catch my usual breakfast with wife at the mee kiah stall at Serangoon. At the same time, I can almost imagine my 3 kids swooning over me at the door.

Glad to be home soon...what a wonderful life!!

That's why people don't stay healthy...

I received this random email and found it very funny. Funny because people do engage in such kinds of reasoning (hopefully rarely) and irrational exuberance...enjoy!

Q: Doctor, I've heard that cardiovascular exercise can prolong life; isthis true? !

A: Your heart is only good for so many beats, and that's it... don't wastethem on exercise. Everything wears out eventually. Speeding up your heartwill not make you live longer; that's like saying you can extend the lifeof your car by driving it faster. Want to live longer? Take a nap.

Q: Should I cut down on meat and eat more fruits and vegetables?

A: You must grasp logistical efficiencies. What does a cow eat? Hay andcorn. And what are these? Vegetables. So a steak is nothing more than anefficientmechanism of delivering vegetables to your system. Need grain? Eatchicken.. Beef is also a good source of field grass (green leafyvegetable). And a pork chop can give you 100% of your recommended dailyallowance of vegetable products.

Q: Should I reduce my alcohol intake?

A: No, not at all. Wine is made from fruit. Brandy is distilled wine, thatmeans they take the water out of the fruity bit so you get even more of thegoodness that way. Beer is also made out of grain. Bottoms up!

Q: How can I calculate my body/fat ratio?

A: Well, if you have a body and you have fat, your ratio is one to one. Ifyou have two bodies, your ratio is two to one, etc.

Q: What are some of the advantages of participating in a regular exercise program?

A: Can't think of a single one, sorry. My philosophy is: No Pain...Good!

Q: Aren't fried foods bad for you?

A: YOU'RE NOT LISTENING!!! .... Foods are fried these days in vegetableoil. In fact, they're permeated in it. How could getting more vegetables bebadfor you? !

Q: Will sit-ups help prevent me from getting a little soft around themiddle?

A: Definitely not! When you exercise a muscle, it gets bigger. You shouldonly be doing sit-ups if you want a bigger stomach.

Q: Is chocolate bad for me?

A: Are you crazy? HELLO Cocoa beans! Another vegetable!!! It's the best!feel-good food around!

Q: Is swimming good for your figure?

A: If swimming is good for your figure, explain whales to me.

Q: Is getting in-shape important for my lifestyle?

A: Hey! ! 'Round' is a shape!Well, I hope this has cleared up any misconceptions you may have had aboutfood and diets. And remember: 'Life should NOT be a journey to the gravewith the intention of arriving safely in an attractive and well preserved body, but rather to skid in sideways - Chardonnay in one hand - chocolate in the other - bodythoroughly used up, totally worn out and screaming 'WOO HOO, What a Ride'AND..... For those of you who watch what you eat, here's the final word on nutrition and health.It's a relief to know the truth after all those conflicting nutritionalstudies.

1. The Japanese eat very little fat and suffer fewer heart attacks thanAmericans.

2. The Mexicans eat a lot of fat and suffer fewer heart attacks thanAmericans.

3. The Chinese drink very little red wine and suffer fewer heart attacksthan Americans.

4. The Italians drink a lot of red wine and suffer fewer heart attacks thanAmericans.

5. The Germans drink a lot of beers and eat lots of sausages and fats andsuffer fewer heart attacks than Americans.

CONCLUSION

Eat and drink what you like. Speaking English Being American is apparently what kills you.