Maybe they're just a vocal minority, a rare few who take arms and go online, and even go live.
Or maybe not.
Questions:
Are those voices of support? Perhaps rallying calls to others to listen?
And then... is that a silence of disinterest?
Hmm.
******
Personally, I have reservations about this one. Is the force strong in her? Really and truly?
Or is she just more self-aware and people-savvy than her MIW counterpart?
Listen to the words.
They're the words guaranteed to strike a chord in you.
They're the words to make you angry.
*****
"It's about You."
Yes. This is what Gen-Y wants to hear.
*****
I hear the words, and I hear nice thoughts. Idealistic thoughts. The big question for the opposition is - have you got what it takes? Really? Each and every one of you? To form a government, and run a country, the way you want to? Have you done all your homework? Have you done your contingency planning, your plan Bs if A doesn't work? Are you more proactive than reactive?
Are you different?
(Or are you just... angry?)
Winning the elections is only the first step...
Friday, April 29, 2011
Thursday, April 28, 2011
Tin Pei Ling is Not Young.
There's a lot to think about this elections. A lot that can be written, and too much that should not be said.
Other people are writing and saying these things. These are the Youth, the much hyped members of Generation Y who feel that they can write and speak with impunity; who were not born in the turbulent times of yesteryear, who do not remember because they were not there. I worry for them. I think that we may not quite have come as far as we think, and that their time is not... quite upon us yet.
Singapore is not quite ready for a myopic Me generation, that can think only of itself, and that equates running something as large and complex a country to the simple needs of the individuals.
I would have been distressed in my youth to think that an older self would have changed so very much that I would advocate moderation. I was young and hotheaded then, and I bore the men in white no love. I am older now; I bear them as little love as before, but some of the time I see sense behind the things they do and say, where before I could not. And some of the time they compromise themselves for a few Hard Truths, that cannot be told. Yet some of the shenanigans this elections... some of the antics have been hard to swallow. I can't write about those. Old habits die hard, and even if the culture of fear exists only between my ears, it's still there.
I can touch on some simple things though.
Tin Pei Ling is not young.
She is old enough to be a mother of two, even three. To be responsible for the well being of other lives, to have to think for them, and their futures. 27 is not old in this ridiculous country - it's nearly past prime, time for the shelf...
Nicole Seah is young.
Barely old enough to be a mother of a newborn babe. Fresh out of university. Someone not expected to have an ounce of responsibility about her, who could easy get away with going clubbing and being a good time party girl - someone not old enough to need to settle down and be responsible.
I watched the videos, same as everyone else.
I saw two very, very different individuals. One looked like a person who knew what it was to be responsible, who was self-aware, who could empathize with a target audience. Who had grasped the socio-political issues that were relevant to her and her "clients".
The other looked like someone trying to say all the right things - like someone who wanted to be the other.
Perhaps it's all window dressing. Perhaps it's all substance over form. Perhaps the proof of the pudding is in the eating as the men in white are so wont to say.Or perhaps not.
One thing is for sure - it's really, really not about how old they are.
It's about how mature they are - how old they are in their heads - how they see themselves in their heads - how responsible they want or do not want to be - why they are choosing the paths they are: their motives.
It's about who they were even before signing up for the cause - not about on the job learning or having the potential to become someone else.
Let's be very frank. Tin Pei Ling is not young. Nicole Seah is young.
One seems to be immature, and the other looks mature.
Tin Pei Ling is not that pretty. Neither is Nicole Seah, for that matter. I have friends and acquaintences far more blessed in the looks departments.
We're looking at them through very jaundiced eyes, comparing one to the other. We're not being objective.
Objectively speaking, BOTH these girls are not ready - both of them will have to learn on the job. Both of them have not learned the experiences born of hard-truths and mistakes that come only with age.
Both of them would lose nothing by waiting a little while longer to assume the mantle of tribal elder. Because that's really all an MP is, in this country.
Now is not the time to be raising fledgelings into government, when government looks so shaky and uncertain. Now is the time for leaders, for people who know how to fill in the cracks and shore up the faults - before the system breaks under its own weight.
******
The men in white need to know this: a state-created champion of Youth (and "new media" expert!) just will not work.
Generation Y is young.
Generation Y is immature and filled with teenage angst.
Generation Y is selfish and impetuous.
Generation Y does want not to hear sob stories about fathers, heart attacks and coffee shops - Generation Y does not want to hear that I am a common man/woman from the street and so I can be your leader. Generation Y doesn't give a flying f*** about Your Suffering or your Commonality.
Generation Y wants instant gratification - Generation Y wants musicians born and note made through sweat and hard work. Discovered overnight through insta-celebrity reality TV.
Generation Y wants their leaders to be strong - not to cry in public. To say that they have no regrets to date that will cripple them.
Generation Y wants their leaders to EITHER be common men but not wear it on their shoulder and trumpet it to the world - YET STILL be "uncommonly talented" enough to do things that they themselves cannot -- OR ESLSE be the uncommon man, born with a silver spoon in the ass - but with an unspoken humility that has the same effect - not trumpeting it to the world - with that same undefinable talent that transforms them into more than the layman can be.
Generation Y wants their leaders to look alive, sparkle, and shine. To be witty on their feet, to be unique, to have a fresh perspective - or at least a strongly personal perspective on things.
And most of all Generation Y wants their champion to emerge though popular vote - not be named by a "benevolant" father figure.
*****
Desmond Lee is too old to be a champion - he is Generation X.
But I applaud him for remaining the Gentleman that I vaguely remember him being, back in school.
It was good of him to help his opponents pass the line.
We need more people like him - in both camps. We need less of the ugliness, less talk about incorrectly documented employment statuses, or quibbling matters of mere seconds. We need more good conduct, and fair competition this elections.
We need leaders, not children.
Other people are writing and saying these things. These are the Youth, the much hyped members of Generation Y who feel that they can write and speak with impunity; who were not born in the turbulent times of yesteryear, who do not remember because they were not there. I worry for them. I think that we may not quite have come as far as we think, and that their time is not... quite upon us yet.
Singapore is not quite ready for a myopic Me generation, that can think only of itself, and that equates running something as large and complex a country to the simple needs of the individuals.
I would have been distressed in my youth to think that an older self would have changed so very much that I would advocate moderation. I was young and hotheaded then, and I bore the men in white no love. I am older now; I bear them as little love as before, but some of the time I see sense behind the things they do and say, where before I could not. And some of the time they compromise themselves for a few Hard Truths, that cannot be told. Yet some of the shenanigans this elections... some of the antics have been hard to swallow. I can't write about those. Old habits die hard, and even if the culture of fear exists only between my ears, it's still there.
I can touch on some simple things though.
Tin Pei Ling is not young.
She is old enough to be a mother of two, even three. To be responsible for the well being of other lives, to have to think for them, and their futures. 27 is not old in this ridiculous country - it's nearly past prime, time for the shelf...
Nicole Seah is young.
Barely old enough to be a mother of a newborn babe. Fresh out of university. Someone not expected to have an ounce of responsibility about her, who could easy get away with going clubbing and being a good time party girl - someone not old enough to need to settle down and be responsible.
I watched the videos, same as everyone else.
I saw two very, very different individuals. One looked like a person who knew what it was to be responsible, who was self-aware, who could empathize with a target audience. Who had grasped the socio-political issues that were relevant to her and her "clients".
The other looked like someone trying to say all the right things - like someone who wanted to be the other.
Perhaps it's all window dressing. Perhaps it's all substance over form. Perhaps the proof of the pudding is in the eating as the men in white are so wont to say.Or perhaps not.
One thing is for sure - it's really, really not about how old they are.
It's about how mature they are - how old they are in their heads - how they see themselves in their heads - how responsible they want or do not want to be - why they are choosing the paths they are: their motives.
It's about who they were even before signing up for the cause - not about on the job learning or having the potential to become someone else.
Let's be very frank. Tin Pei Ling is not young. Nicole Seah is young.
One seems to be immature, and the other looks mature.
Tin Pei Ling is not that pretty. Neither is Nicole Seah, for that matter. I have friends and acquaintences far more blessed in the looks departments.
We're looking at them through very jaundiced eyes, comparing one to the other. We're not being objective.
Objectively speaking, BOTH these girls are not ready - both of them will have to learn on the job. Both of them have not learned the experiences born of hard-truths and mistakes that come only with age.
Both of them would lose nothing by waiting a little while longer to assume the mantle of tribal elder. Because that's really all an MP is, in this country.
Now is not the time to be raising fledgelings into government, when government looks so shaky and uncertain. Now is the time for leaders, for people who know how to fill in the cracks and shore up the faults - before the system breaks under its own weight.
******
The men in white need to know this: a state-created champion of Youth (and "new media" expert!) just will not work.
Generation Y is young.
Generation Y is immature and filled with teenage angst.
Generation Y is selfish and impetuous.
Generation Y does want not to hear sob stories about fathers, heart attacks and coffee shops - Generation Y does not want to hear that I am a common man/woman from the street and so I can be your leader. Generation Y doesn't give a flying f*** about Your Suffering or your Commonality.
Generation Y wants instant gratification - Generation Y wants musicians born and note made through sweat and hard work. Discovered overnight through insta-celebrity reality TV.
Generation Y wants their leaders to be strong - not to cry in public. To say that they have no regrets to date that will cripple them.
Generation Y wants their leaders to EITHER be common men but not wear it on their shoulder and trumpet it to the world - YET STILL be "uncommonly talented" enough to do things that they themselves cannot -- OR ESLSE be the uncommon man, born with a silver spoon in the ass - but with an unspoken humility that has the same effect - not trumpeting it to the world - with that same undefinable talent that transforms them into more than the layman can be.
Generation Y wants their leaders to look alive, sparkle, and shine. To be witty on their feet, to be unique, to have a fresh perspective - or at least a strongly personal perspective on things.
And most of all Generation Y wants their champion to emerge though popular vote - not be named by a "benevolant" father figure.
*****
Desmond Lee is too old to be a champion - he is Generation X.
But I applaud him for remaining the Gentleman that I vaguely remember him being, back in school.
It was good of him to help his opponents pass the line.
We need more people like him - in both camps. We need less of the ugliness, less talk about incorrectly documented employment statuses, or quibbling matters of mere seconds. We need more good conduct, and fair competition this elections.
We need leaders, not children.
Wednesday, April 27, 2011
The Pledge
We, the citizens of Singapore,
pledge ourselves as one united people,
regardless of race, language or religion,
to build a democratic society
based on justice and equality
so as to achieve happiness, prosperity and
progress for our nation.
我们是新加坡公民，
誓愿不分种族、言语、宗教，
团结一致，
建设公正平等的民主社会，
并为实现国家之幸福、繁荣与进步，
共同努力。
This was the pledge as I knew it, when I was little.
pledge ourselves as one united people,
regardless of race, language or religion,
to build a democratic society
based on justice and equality
so as to achieve happiness, prosperity and
progress for our nation.
我们是新加坡公民，
誓愿不分种族、言语、宗教，
团结一致，
建设公正平等的民主社会，
并为实现国家之幸福、繁荣与进步，
共同努力。
This was the pledge as I knew it, when I was little.
Friday, April 22, 2011
The Mechanist
I've been thinking. It doesn't happen that often these days, but old habits die hard.
I'm doing a masters at a certain university in the west right now in something very esoteric. It wasn't my choice, and it was a mistake.
Many of the modules are poorly taught by foreigners who can barely speak English, let alone communicate complex concepts to the students.
One of the modules is taught by a Professor who speaks English fluently and clearly thinks in a very high-level way. So much so that he, too, cannot communicate the basic concepts to anyone who doesn't think at the same level.
One of our projects involved tens of thousands of computations to arrive at the desired outcomes. After all of two slides - about eight lines of text on the subject. It left me with a bitter taste in my mouth, and a desire to ask him :
Nabei. You &*(&*er (yes, asterix and all.) If I give you one lecture on performing a Whipple's operation and then told you to go do it over the weekend as homework how would you feel? What if I made my lecture really really technical and told you to go home and read what Kocherisation is by yourself before I examined you in your operative technique?
How would I like to be taught? I'd like to be taught by people who know what they are doing.
I'd like to be taught by people who can relate to me, who I can relate to as well, who can communicate clearly with me, who take my desires into consideration, and most of all, know what they are doing.
In that light, let's take a look at the elections.
In all honesty, this elections will not see a fundamental shift in power. I was reading Temasek Review until they went down, because, gosh darn it they were funny. The place is dominated by immature, rabid anti-establishment morons with a single agenda : bring death to the "PAPies" (or whatever)... and half of them write like speechwriters for... the Chinese Communist Party or something. But in their vitroil they're actually quite... entertaining, and some of the pictures they put up are pretty amusing. They're baying for blood, and Change RIGHT NOW.
Mr Chen Show Mao knows better - he didn't return as the messiah to redeem the nation from the clutches of a one-party system. He said as much - he was coming back to initiate the process of change, to start in motion the machine that would someday restore a credible opposition.
And therein lies the truth of it : the face of politics has evolved so... far so that our opposition is now in-credible.
Some of the individuals look promising, but there is no dream-team. There is no opposition. Single individuals do not a party make.
This election is not about an overnight shift in political leadership.
It is about the individuals and their candidacies, or claims to candidacy.
Who do I want in parliament?
I want people who know what they are doing. I want people who take my desires into consideration, who can communicate clearly with me, who I can relate to, and who relate to me as well.
There are promising candidates in all the parties - the PAP included. I want to know just how promising these people really are. I'd like to judge them as objectively as possible, because... these are people who will be Governing, for God's sakes.
Take Dr Puthucheary for instance - a man does not get to become a senior consultant in Pediatrics - in KK hospital not less - without an iota of EQ. I'd like to hear more from him - not read second hand what he purportedly said, in response to something he was purportedly asked. Has anyone ever seen that particular interview everyone's so upset about - anywhere online? I'd like to know how he thinks, and what he thinks about healthcare, for instance.
Take Nicole Seah, who looks (comparatively to someone else...) so very, very promising in her razortv speech, having had ample opportunity to do her past-year-paper rehearsels to some very familiar questions. I'd like to hear what she has to say when she's really challenged, and break it all down to understand how she thinks. She sounds very persuasive and mature - but that's what she does for a living - she sells images. She's an advertising executive. What policies would she personally like changed? How would she personally approach them? (not just party lines, but real, off-the-cuff thoughts and opinions)
I enjoy watching interviews when the candidates are clearly thinking; it's a little bit like debating. You see it in their eyes, their eyebrows furrow a little, or their eyes go a little vacant. The wheels spin. Intelligent things happen, or don't. And then the words come out and you Know.
In contrast when everything's been carefully rehearsed, the answers come a little too quickly, without pause. Faces bear relief, or are stony masks while words come flooding out in breathless torrents, and perhaps the words don't quite make sense when lines or words are missed here and there and the recital goes a little wonky but the narrative just carries on, and on... because all thoughts are focused - not on the question - but on the answers.
you Know too, then.
*********
What is UP with Singtel and Facebook?!
*********
“The person in the photo is just my friend. He works for a community club. We took that photo during one of the grassroots leaders’ wedding.”
“He was never my boyfriend. I find the episode extremely funny,”
Just a thought.
This is actually the wrong response.
It just struck me why.
If I were in her shoes - or if any of you were in her shoes, would we be finding it amusing that our friend was getting bashed online for associating with us? The guy's been called fat, ugly, unworthy - and a host of other things.
How is his personal life suffering? Is there any backlash to his own relationships? If he's truly just an innocent bystander, he deserves our sympathy. Perhaps even an apology.
And he deserves the sympathy of his friends most of all.
Extremely funny?
Got funny meh?
I'm doing a masters at a certain university in the west right now in something very esoteric. It wasn't my choice, and it was a mistake.
Many of the modules are poorly taught by foreigners who can barely speak English, let alone communicate complex concepts to the students.
One of the modules is taught by a Professor who speaks English fluently and clearly thinks in a very high-level way. So much so that he, too, cannot communicate the basic concepts to anyone who doesn't think at the same level.
One of our projects involved tens of thousands of computations to arrive at the desired outcomes. After all of two slides - about eight lines of text on the subject. It left me with a bitter taste in my mouth, and a desire to ask him :
Nabei. You &*(&*er (yes, asterix and all.) If I give you one lecture on performing a Whipple's operation and then told you to go do it over the weekend as homework how would you feel? What if I made my lecture really really technical and told you to go home and read what Kocherisation is by yourself before I examined you in your operative technique?
How would I like to be taught? I'd like to be taught by people who know what they are doing.
I'd like to be taught by people who can relate to me, who I can relate to as well, who can communicate clearly with me, who take my desires into consideration, and most of all, know what they are doing.
In that light, let's take a look at the elections.
In all honesty, this elections will not see a fundamental shift in power. I was reading Temasek Review until they went down, because, gosh darn it they were funny. The place is dominated by immature, rabid anti-establishment morons with a single agenda : bring death to the "PAPies" (or whatever)... and half of them write like speechwriters for... the Chinese Communist Party or something. But in their vitroil they're actually quite... entertaining, and some of the pictures they put up are pretty amusing. They're baying for blood, and Change RIGHT NOW.
Mr Chen Show Mao knows better - he didn't return as the messiah to redeem the nation from the clutches of a one-party system. He said as much - he was coming back to initiate the process of change, to start in motion the machine that would someday restore a credible opposition.
And therein lies the truth of it : the face of politics has evolved so... far so that our opposition is now in-credible.
Some of the individuals look promising, but there is no dream-team. There is no opposition. Single individuals do not a party make.
This election is not about an overnight shift in political leadership.
It is about the individuals and their candidacies, or claims to candidacy.
Who do I want in parliament?
I want people who know what they are doing. I want people who take my desires into consideration, who can communicate clearly with me, who I can relate to, and who relate to me as well.
There are promising candidates in all the parties - the PAP included. I want to know just how promising these people really are. I'd like to judge them as objectively as possible, because... these are people who will be Governing, for God's sakes.
Take Dr Puthucheary for instance - a man does not get to become a senior consultant in Pediatrics - in KK hospital not less - without an iota of EQ. I'd like to hear more from him - not read second hand what he purportedly said, in response to something he was purportedly asked. Has anyone ever seen that particular interview everyone's so upset about - anywhere online? I'd like to know how he thinks, and what he thinks about healthcare, for instance.
Take Nicole Seah, who looks (comparatively to someone else...) so very, very promising in her razortv speech, having had ample opportunity to do her past-year-paper rehearsels to some very familiar questions. I'd like to hear what she has to say when she's really challenged, and break it all down to understand how she thinks. She sounds very persuasive and mature - but that's what she does for a living - she sells images. She's an advertising executive. What policies would she personally like changed? How would she personally approach them? (not just party lines, but real, off-the-cuff thoughts and opinions)
I enjoy watching interviews when the candidates are clearly thinking; it's a little bit like debating. You see it in their eyes, their eyebrows furrow a little, or their eyes go a little vacant. The wheels spin. Intelligent things happen, or don't. And then the words come out and you Know.
In contrast when everything's been carefully rehearsed, the answers come a little too quickly, without pause. Faces bear relief, or are stony masks while words come flooding out in breathless torrents, and perhaps the words don't quite make sense when lines or words are missed here and there and the recital goes a little wonky but the narrative just carries on, and on... because all thoughts are focused - not on the question - but on the answers.
you Know too, then.
*********
What is UP with Singtel and Facebook?!
*********
“The person in the photo is just my friend. He works for a community club. We took that photo during one of the grassroots leaders’ wedding.”
“He was never my boyfriend. I find the episode extremely funny,”
Just a thought.
This is actually the wrong response.
It just struck me why.
If I were in her shoes - or if any of you were in her shoes, would we be finding it amusing that our friend was getting bashed online for associating with us? The guy's been called fat, ugly, unworthy - and a host of other things.
How is his personal life suffering? Is there any backlash to his own relationships? If he's truly just an innocent bystander, he deserves our sympathy. Perhaps even an apology.
And he deserves the sympathy of his friends most of all.
Extremely funny?
Got funny meh?
Saturday, April 9, 2011
Miyagi Dowan Tin Pei Ling
Mr Miyagi writes why he doesn't want Tin Pei Ling to be a member of parliament.
This isn't the heart of the tin man, the eye of the tiger, the center of the storm in a teacup. This is a fringe thought that doesn't need redress, because his isolated deviant thoughts are insignificant when there are bigger issues at hand.
Only a very few people are willing to dissociate maturity from age, and only they are struck by how mature TPL is, or is not; how much depth her replies to Razor TVs interviewer displayed - or did not. How much her present self - and past self - thinks for the future, than for today - or does not. And since only a few people constitute a minority, they are not of substantial consequence.
The sad but real reason our public is angry isn't because they Don't Want Tin Pei Ling, but because they Want to BE Tin Pei Ling.
And hence the vitriol, the rabid dredging through facebook and twitter, and the raking of the coals. Hence the allegations of sleeping with the enemy / boss, the rants that she is too young.
This, being the "majority vote" (google Tin Pei Ling. You'll be amazed at how many pages of angst appear) is worthy of redress, and the Powers that Be have done so. This is bad behaviour, and it shows you are all Blathering Idiots, and therefore Wrong. (and frankly, they are right.) It is a Simple Extension therefore that Since you are Wrong, Tin Pei Ling is the Right Candidate.
Whether she is the right or wrong person for the job, and whether she should button her top button up or not are beyond me.
What I get out of all this, is an immense sadness that we have had so many years as a nation to grow, but this is what we have become.
This isn't the heart of the tin man, the eye of the tiger, the center of the storm in a teacup. This is a fringe thought that doesn't need redress, because his isolated deviant thoughts are insignificant when there are bigger issues at hand.
Only a very few people are willing to dissociate maturity from age, and only they are struck by how mature TPL is, or is not; how much depth her replies to Razor TVs interviewer displayed - or did not. How much her present self - and past self - thinks for the future, than for today - or does not. And since only a few people constitute a minority, they are not of substantial consequence.
The sad but real reason our public is angry isn't because they Don't Want Tin Pei Ling, but because they Want to BE Tin Pei Ling.
And hence the vitriol, the rabid dredging through facebook and twitter, and the raking of the coals. Hence the allegations of sleeping with the enemy / boss, the rants that she is too young.
This, being the "majority vote" (google Tin Pei Ling. You'll be amazed at how many pages of angst appear) is worthy of redress, and the Powers that Be have done so. This is bad behaviour, and it shows you are all Blathering Idiots, and therefore Wrong. (and frankly, they are right.) It is a Simple Extension therefore that Since you are Wrong, Tin Pei Ling is the Right Candidate.
Whether she is the right or wrong person for the job, and whether she should button her top button up or not are beyond me.
What I get out of all this, is an immense sadness that we have had so many years as a nation to grow, but this is what we have become.
Monday, April 4, 2011
The SALAH Handbook
In a sudden moment of catharsis...
... rumours abound on the net how Dr Chee Soon Juan is actually a PAP plant to cause the opposition to own-self explode from the inside-out...
... well the TPL fiasco... maybe, just maybe... the opposition is... could it be? naah...
... but it all fits so well...
devious!
*****
randomthoughtsofamedstudent.blogspot.com is facing his imminent return to the welcoming arms of our local healthcare system with some trepidation, what with all the bad press the local inmates have given him.
Reading him brings me back to when I first came back, and reminds me how I'd wished there was some kind of handbook or manual for me to read, perhaps not to help me cope with what are ultimately very personal issues, but rather to let me know that I wasn't alone, and that someone else out there gave a damn, and really understood. It reminds me of the handfull of people who have asked me what working here is like, after already making the decision to come back and rendering any useful advice I could give (like "DON'T!!! NIET! NEIN! BU YAO!") invalid.
So here it is, the very first draft of the
Singaporean-medics Abroad Looking At returning Home (SALAH)
Handbook.
**************
Welcome to your new life as a houseperson in the world-renowned medical hub that is Singapore.
To successfully make your transition from normal human being to cockroach as seamless as possible, please peruse this entire document before disposing of it.
These are the Fundamental Tenets upon which your new and wonderful life as a physician or surgeon commences :
1. You are Beneath Contempt.
You are Houseman. Your sole purpose is to perform "Changes" (ie menial jobs like taking blood, ordering X rays, etc.)
From time to time you will hear nice words like "learning opportunities", and "protected teaching time", and "mandatory post-call rest hours".
These do not apply to you, since you are not Resident. Residency is reserved for those who have already been Assimilated. One day after your Assimilation you may be afforded Residency. For now, you are Probationary, coupled with Houseman and therefore beneath contempt. (Contempt is Houseman. Resident Houseman is ConteNt.)
As a subcitizen you must realize that you are expected to perform an unreasonable number of changes in a very short time, every day, and to not leave hospital until your changes have been done. In addition, you must complete your changes in time for the results to be ready by the exit round in the evening.
I was fortunate to return as a medical officer and didn't have to suffer the pain of Housemanship in Singapore.
I've watched my housemen coming to work... early... and leaving... late with some sadness, before letting the Medicine of it all wash over me as my housemen drone the results to me, and we go through the checklist of who is well and who isn't. It's just the way it is.
2. You must conform to working hour restrictions.
The ministry now mandates that you keep a log of the number of hours you work in hospital. This means that you must finish your changes in time, and ostensibly knock off work and be out of hospital before a certain time. Regardless of the realities of sheer volume of changes. A houseman who goes beyond their mandated working hours is judged to be inefficient and may be unofficially penalized. A department which has housemen going beyond their mandated hours is judged to be noncompliant, and penalized, officially.
Here are some short phrases to expand your vocabulary :
Everybody likes a team-player.
Truth is subjective.
"Performance Appraisals" are Very Important.
3. The nurses are not your friends
I remember the nurses from the UK who were peers, and interested in what they did.
Our nurses, for all practical purposes, are sentient machines. Much like you are, except you are a Change-making Machine, and they are Bed-Making, Patient-Turning, Report-Passing Machines.
They are a superior model to you, and you are beneath them. This is important to remember, because if ever you overstep your authority on an individual nurse, you will get away with it. She will act subservient to you to your face.
And then all hell will break loose, in a very subtle / not so subtle way, after her colleagues begin to discriminate against you, and after her Sisters get in on the gangbang.
You must remember that they are a separate community, and when push comes to shove it reverts to "Us versus Them" in this country.
I remember an OT nurse from the days when I was in Orthopedics. She was young, pretty, capable, and bright as a button. One of the Profs recognized this and used her to close all his wounds. I first discovered this when I was closing a knee, and she decided to lend me a hand. We smiled at each other and she started closing the opposite end. We shared a silent cameraderie. I marvelled in the privacy of my mind that a nurse could stitch, and so well at that. (OT nurses specialize in counting.) Our two strands met in the center and the result was Immaculate. It was almost a Movie Moment.
Unfortunately, her Sister walked in the door at that point. The result was a mess.
And Loud.
We are not here to work with each other. We are not working in tandem to improve patient welfare. We are working for our own Kind, exclusively. Patient welfare is an incidental byproduct of this union - sometimes.
Bear that in mind, when you are laughing and joking with them, or perhaps flirting lightly - they are not the same as the nurses from where you came.
Be advised to avoid flirting. One of the nursing subroutines is Gossip Making Machine, and Gossip can have unexpected consequences one day in the very, very distant future.
4. Your Role is Different.
The Patient-Doctor relationship is always unique to each consultation, but here in Singapore there is a strong bias towards a Client-Service Provider relationship. This is more frequently than not a more stressful relationship, with less satisfaction afforded to the physician, and more to the patient (or their families).
Young people (read : Me generation) here want to be in control, even if they don't have any fundamental grasp of the salient medical or administrative issues at hand.
They have an understandable perception that they are entitled to a lot, since they are paying a lot.
However many fail to realize that they aren't paying a lot at all, with the government subsidizing most of their healthcare. And that by the same argument that entitles them to be rude to their surgeon / physician, and/or barge in on someone else's consultation and demand to be seen because they have been waiting for too long outside the clinic, and/or complain when they see a doctor leaving clinic / eating food in the cafeteria prior to clinic / complain when they do not get the same doctor for all their visits / complain when they are seen by junior doctors or students -- by that very same argument - that money rules all - private patients who are paying more than them are entitled to more. The straits times forum over the last few days tells a different story though; double standards are sadly the norm and the system backpeddles to save face.
They also don't want to hear it - they don't want to hear that everyone else has been waiting just as long, that the patient you're barging in on now deserves as much time to be seen as you and you're eating into his time wasting time barging in on my room with the only possible outcome - of you being shown back out the door to await your turn - happening whether you vent your frustrations or not. That the doctor leaving clinic isn't even running the same subspecialty as the one you're consulting for / is going to attend to a ward emergency. That the doctors have just finished a long round seeing sick someones who aren't your Grandpa today, but might well be tomorrow... and are snatching a bite before going to run clinic for the next X hours at the very real risk of forgoing lunch, and food is one of those things that keeps people buoyant enough to face a long clinic with a sort-of smile. That junior doctors rotate in and out and even middle grades change teams or hospitals from time to time and that is why you can't see the same doctor through the years, unless you are consistently seen by a consultant - ie a private, paying patient. That big teaching hospitals are teeming with students who will one day be sitting across the table from you as your consultant, and they need to start somewhere too, or else wind up being shitty, incompetent half-trained doctors.
They don't want to hear it. They just want to be told that they are right, and they are king. They want to feel that they are in control, and the fact that they are called later after barging in to the room is proof positive that they made a difference in the grand scheme of things.
What can we do about it? Well, we can eat a hearty breakfast, then grin and bear it... We can be the face of the faceless organization and stonewall the patients politely. We have to - it's Us, or Them.
Speaking of which, I remember once upon a time firmly telling families requesting a "denial of service (information)" to the patients (mum won't be able to take the news that she has cancer. you musn't tell her!) that my patients were my priority, not their families, and that it sounded like they had communication issues and that lying wasn't going to achieve much, since frankly the patients would know eventually - it's their bodies. And that they would be even unhappier being kept in the dark. I would tell them that I'd be back in half an hour to break the news, and perhaps they could use that time positively.
Things are different here. Your role is different here. Your role is to write down in capital letters on the top of the case sheet PATIENT DOES NOT KNOW DIAGNOSIS, or else see to it that someone else does. Because the structures of the family units are different here. The heads of the families are the middle-aged childern, not the elderly. It's all rather confusing, and counter-intuitive. But eventually it strikes you - the old fogies really, really don't want to know. Most of them anyway. They just want to lie in bed and be doted on by their kids, and let the tides wash them whichever way they will. And for the select few who, years later find out after countless colonoscopies that the little operation they had to take out a small harmless lump was in fact a hemicolectomy for carcinoma of the colon, and are outraged... well... nobody really cares about how they feel. They only care that you betrayed the covenant of silence. Prepare for a complaint letter from the family. (Interestingly, the "betrayed" never think to write in and complain about being kept in the dark by their loved ones. Fascinating.)
4. The Patients are Different.
Language for one. It may be a relief to be able to speak in Singlish - for a while. Until that monolingual patient who only speaks Hokkien comes in. (Hua Yi Buay Heow) Or Cantonese. Or Tamil. Or Malay. Or...
Communication is often suboptimal because of this. We rely on family members to help us translate things. Things get lost in translation. Things like "you have cancer" turn into "don't worry there's nothing wrong, you just need a small operation." Things like "I'm sorry we did all we could" turn into "nothing lah."
Old fogies are more passive, as mentioned above.
Young punks are more aggressive.
Overall, people are less educated - not in terms of highest standard of education attained, but in terms of information. They are less informed, and more opinionated - they've read one or two dodgy articles online, or heard something from somebody's aunt, or their dad lived for five years with cancer of the lung before some doctor killed him off after he was admitted to hospital, or their TCM consultant has told them something different -- and suddenly they're the experts, and you're someone to be suspicious of.
These are of course the exceptions to the norm. Most of the time things will pass by smoothly enough. But when you hit a stumbling block like this, what will you do?
It was hard when I first came back, having to explain to a belligerent, inappropriately aggressive family member that novo-7 is not the standard of care for an intracranial haemorrhage, and that grandma might still be dying even with it. It was difficult to think with his face so close to mine that the spittle from his mouth as he shouted was landing on my glasses. I chose to be civil and attempt to explain it to him, with aid of the internet, over and over again until it became apparent that he was not here to hear, but to shout. At which point I told him as much, and left the ward, and hit a wall some distance out from the ward in frustration. (Hitting the wall, it's a turn of phrase, isn't it?)
Now that I've been Assimilated, I do what everyone else does. Talk until their time is up (approximately 5 min) then excuse myself and leave. If they didn't take anything on board in those 5 minutes, in clinic, on the ward... if they were too busy making themselves heard to hear in return - then nothing you say will make a difference. If there's a complaint letter hovering somewhere in the background, chances are it's already been written, and posted to the New Paper - even before Ms X showed up on the ward full of righteous fury.
Interestingly, sometimes Ms X shows up for the first time, after Ms Y and Mr Z, her sister and brother have spent the last month with dear old dad, and are completely informed and understanding. And Ms X will be the one to rain fire and brimstone upon the incompetent healthcare providers so obviously intent on killing dad, nevermind that she doesn't know why he's even been admitted. There's a simple reason for that, I think, and I think it's guilt. Ms X actually deserves more time; I usually give her about 15 to 20 minutes before packing it in.
People are different here.
5. The Other Doctors are Different.
Perhaps these are biased memories, but it seemed easier to be happy with Medicine while back in the UK.
You'd be hard-pressed to find someone here happy and fulfilled in their medical lives. The common grouses are excessive hours, incommensurately low pay and lack of public gratitude.
I think you'd be missing a fundamental truth if you chose to focus on any one single point of the above - or even on all of them combined. The truth of the matter is many doctors are depressed. Cast your net wider and you'll see it's not just doctors.
I remember how everyone used to go get pissed thursday (or was it wednesday?) nights at the pub, from the consultants to housemen. And how we'd all dance and generally make fools of ourselves.
I can't help but compare those memories to the present-day infrequent department parties, when professors and peons auto-segregate, and professors remain... professorial.
Yes, there is decorum and aplomb, and dignity befitting of royalty here. But maybe we've just... forgotten how to have fun.
How to cope? Just remember that fun here starts when you step out of hospital. Remember your family, your wife and your children are what make living worthwhile. I don't know if it works, but that's what everyone does.
7. Ethics are Different.
Be prepared to back down on those ethics your medical school ingrained into you. And prepare yourselves for the changes in your own ethical code which will invariably follow. It's a natural progression.
Perhaps the only real rule is to stay out of trouble, and don't offend anyone, be it your colleagues or your peers.
A few random names to google :
S***n Lim
Eu K*ng W*ng
Also, there is a "right" way and a "wrong" way to effect diplomacy. Again, see the above.
More random terms you need to know before you start:
"Do Not Resuscitate" - what is the difference between this and...
"Max Ward Care / Not for SICU / Not for intubation?"
Dangerously Ill (DIL) - what is the difference between this and...
Dangerously Dangerously Ill (DDIL) ?
Hypothetical question :
Is it ethically permissable to inform a family who lives far away that their father / mother is dangerously ill and they should hurry down as soon as they can to see him, if the patient is fading fast and their chances of making it in time are about as high as an opposition team winning a GRC? If not, perhaps it is kinder?
How about if the patient is already dead from say, a massive MI?
8. The Administration is Different.
This goes from the ministerial level, to the SMC, to the SMA, down to your local hospital administration.
There are notable differences between administrations of different countries.
Ours is a strong administration, that is efficient in achieving its aims.
Do not bemoan your "low starting pay" as a cockroach though. There have been recent revisions. Prior to them housemen were truly earning a pittance, at levels inappropriate for university graduates.
Pay revisions are not pegged to civil service. Medical professionals are servants, but apparently uncivil.
There is doubtlessly a reason for this. Perhaps there are just too many of us.
Do not stir the pot, or bite the hand that feeds you. Spectacular things have happened in the past.
The system is oddly dichotomous when analyzed from a financial perspective.
Either way you need to decide early on what your career path will be. Early on is now, when you have just graduated from medical school - because you are a graduate student and significantly older than the rest. There is an unhealthy obsession with age in this country. Life stops after 20, yet 27 year olds are too young for politics...
If your priority is to make money fast and have a comfortable lifestyle, become a GP. The net earnings over time will outstrip those of a government specialist.
The alternative is to give up medicine altogether and use your degree to seek another job. As ridiculous as this sounds now, it isn't. Senior Pilots for instance bring home $50k or more a month. Politicians need money to remain honest and uphold their integrity, so they earn... more than I can count in my head.
If your priority is to make ridiculous amounts of money to swim in, then specialize NOW. Choose your specialty NOW, even before you graduate. Join a residency programme NOW. It's what everyone else is doing, right now... and exit early, and go private. And become a very, very rich one trick horse. Just avoid $24 million bills.
If your heart is in it for your art (ie surgery) or the intellectual challenge (ie medicine) then tough luck. You're doomed to stick it out in government service and earn less than your peers in many of their lucrative business careers, and your lot is to whinge about it for the rest of your life, or else to just put it out of your head altogether and do what you enjoy most. If you fall in the latter category you are admirabe, but probably deluded or else dysfunctional in some way. Sadly, I am in that category.
9. Everything is Different.
Yet everything is the same.
Some things are better, some things are worse. It was the best of times, it was the worst of times and all that.
Standards of living here are good, possibly even high.
Costs of living are also high, if you seek the lifestyle of a young, executive professional, which although you kind-of are, you're not... (remember the cockroach) Decent sized condominiums cost in excess of a million dollars. Landed property cost about four to more times this. COEs are expensive. Annual road tax is about a month's salary.
If you are comfortable with a lower standard of living, you can achieve this comfortably, eg living in a HDB flat - which is fairly good and comfortable, functional living.
Things are clean here. Really clean. Sidewalks are clean, roads are clean, HDB landings are clean. Ministers are clean.
It's just the public toilets that are filthy... MRT toilets made the news today.
For some strange reason people here like to drape toilet paper into the bowl and trail it out, in the mens loos. Perhaps its to line the seats while they squat on the sitting toilets? Nobody ever lifts the seats. This makes for pee-water tracking out onto the floor thanks to inconsiderate laws of physics (capillary action).
This highlights something unspoken about our population.
It is a tiered population. Clean and dirty.
These should be sufficient for now.
... rumours abound on the net how Dr Chee Soon Juan is actually a PAP plant to cause the opposition to own-self explode from the inside-out...
... well the TPL fiasco... maybe, just maybe... the opposition is... could it be? naah...
... but it all fits so well...
devious!
*****
randomthoughtsofamedstudent.blogspot.com is facing his imminent return to the welcoming arms of our local healthcare system with some trepidation, what with all the bad press the local inmates have given him.
Reading him brings me back to when I first came back, and reminds me how I'd wished there was some kind of handbook or manual for me to read, perhaps not to help me cope with what are ultimately very personal issues, but rather to let me know that I wasn't alone, and that someone else out there gave a damn, and really understood. It reminds me of the handfull of people who have asked me what working here is like, after already making the decision to come back and rendering any useful advice I could give (like "DON'T!!! NIET! NEIN! BU YAO!") invalid.
So here it is, the very first draft of the
Singaporean-medics Abroad Looking At returning Home (SALAH)
Handbook.
**************
Welcome to your new life as a houseperson in the world-renowned medical hub that is Singapore.
To successfully make your transition from normal human being to cockroach as seamless as possible, please peruse this entire document before disposing of it.
These are the Fundamental Tenets upon which your new and wonderful life as a physician or surgeon commences :
1. You are Beneath Contempt.
You are Houseman. Your sole purpose is to perform "Changes" (ie menial jobs like taking blood, ordering X rays, etc.)
From time to time you will hear nice words like "learning opportunities", and "protected teaching time", and "mandatory post-call rest hours".
These do not apply to you, since you are not Resident. Residency is reserved for those who have already been Assimilated. One day after your Assimilation you may be afforded Residency. For now, you are Probationary, coupled with Houseman and therefore beneath contempt. (Contempt is Houseman. Resident Houseman is ConteNt.)
As a subcitizen you must realize that you are expected to perform an unreasonable number of changes in a very short time, every day, and to not leave hospital until your changes have been done. In addition, you must complete your changes in time for the results to be ready by the exit round in the evening.
I was fortunate to return as a medical officer and didn't have to suffer the pain of Housemanship in Singapore.
I've watched my housemen coming to work... early... and leaving... late with some sadness, before letting the Medicine of it all wash over me as my housemen drone the results to me, and we go through the checklist of who is well and who isn't. It's just the way it is.
2. You must conform to working hour restrictions.
The ministry now mandates that you keep a log of the number of hours you work in hospital. This means that you must finish your changes in time, and ostensibly knock off work and be out of hospital before a certain time. Regardless of the realities of sheer volume of changes. A houseman who goes beyond their mandated working hours is judged to be inefficient and may be unofficially penalized. A department which has housemen going beyond their mandated hours is judged to be noncompliant, and penalized, officially.
Here are some short phrases to expand your vocabulary :
Everybody likes a team-player.
Truth is subjective.
"Performance Appraisals" are Very Important.
3. The nurses are not your friends
I remember the nurses from the UK who were peers, and interested in what they did.
Our nurses, for all practical purposes, are sentient machines. Much like you are, except you are a Change-making Machine, and they are Bed-Making, Patient-Turning, Report-Passing Machines.
They are a superior model to you, and you are beneath them. This is important to remember, because if ever you overstep your authority on an individual nurse, you will get away with it. She will act subservient to you to your face.
And then all hell will break loose, in a very subtle / not so subtle way, after her colleagues begin to discriminate against you, and after her Sisters get in on the gangbang.
You must remember that they are a separate community, and when push comes to shove it reverts to "Us versus Them" in this country.
I remember an OT nurse from the days when I was in Orthopedics. She was young, pretty, capable, and bright as a button. One of the Profs recognized this and used her to close all his wounds. I first discovered this when I was closing a knee, and she decided to lend me a hand. We smiled at each other and she started closing the opposite end. We shared a silent cameraderie. I marvelled in the privacy of my mind that a nurse could stitch, and so well at that. (OT nurses specialize in counting.) Our two strands met in the center and the result was Immaculate. It was almost a Movie Moment.
Unfortunately, her Sister walked in the door at that point. The result was a mess.
And Loud.
We are not here to work with each other. We are not working in tandem to improve patient welfare. We are working for our own Kind, exclusively. Patient welfare is an incidental byproduct of this union - sometimes.
Bear that in mind, when you are laughing and joking with them, or perhaps flirting lightly - they are not the same as the nurses from where you came.
Be advised to avoid flirting. One of the nursing subroutines is Gossip Making Machine, and Gossip can have unexpected consequences one day in the very, very distant future.
4. Your Role is Different.
The Patient-Doctor relationship is always unique to each consultation, but here in Singapore there is a strong bias towards a Client-Service Provider relationship. This is more frequently than not a more stressful relationship, with less satisfaction afforded to the physician, and more to the patient (or their families).
Young people (read : Me generation) here want to be in control, even if they don't have any fundamental grasp of the salient medical or administrative issues at hand.
They have an understandable perception that they are entitled to a lot, since they are paying a lot.
However many fail to realize that they aren't paying a lot at all, with the government subsidizing most of their healthcare. And that by the same argument that entitles them to be rude to their surgeon / physician, and/or barge in on someone else's consultation and demand to be seen because they have been waiting for too long outside the clinic, and/or complain when they see a doctor leaving clinic / eating food in the cafeteria prior to clinic / complain when they do not get the same doctor for all their visits / complain when they are seen by junior doctors or students -- by that very same argument - that money rules all - private patients who are paying more than them are entitled to more. The straits times forum over the last few days tells a different story though; double standards are sadly the norm and the system backpeddles to save face.
They also don't want to hear it - they don't want to hear that everyone else has been waiting just as long, that the patient you're barging in on now deserves as much time to be seen as you and you're eating into his time wasting time barging in on my room with the only possible outcome - of you being shown back out the door to await your turn - happening whether you vent your frustrations or not. That the doctor leaving clinic isn't even running the same subspecialty as the one you're consulting for / is going to attend to a ward emergency. That the doctors have just finished a long round seeing sick someones who aren't your Grandpa today, but might well be tomorrow... and are snatching a bite before going to run clinic for the next X hours at the very real risk of forgoing lunch, and food is one of those things that keeps people buoyant enough to face a long clinic with a sort-of smile. That junior doctors rotate in and out and even middle grades change teams or hospitals from time to time and that is why you can't see the same doctor through the years, unless you are consistently seen by a consultant - ie a private, paying patient. That big teaching hospitals are teeming with students who will one day be sitting across the table from you as your consultant, and they need to start somewhere too, or else wind up being shitty, incompetent half-trained doctors.
They don't want to hear it. They just want to be told that they are right, and they are king. They want to feel that they are in control, and the fact that they are called later after barging in to the room is proof positive that they made a difference in the grand scheme of things.
What can we do about it? Well, we can eat a hearty breakfast, then grin and bear it... We can be the face of the faceless organization and stonewall the patients politely. We have to - it's Us, or Them.
Speaking of which, I remember once upon a time firmly telling families requesting a "denial of service (information)" to the patients (mum won't be able to take the news that she has cancer. you musn't tell her!) that my patients were my priority, not their families, and that it sounded like they had communication issues and that lying wasn't going to achieve much, since frankly the patients would know eventually - it's their bodies. And that they would be even unhappier being kept in the dark. I would tell them that I'd be back in half an hour to break the news, and perhaps they could use that time positively.
Things are different here. Your role is different here. Your role is to write down in capital letters on the top of the case sheet PATIENT DOES NOT KNOW DIAGNOSIS, or else see to it that someone else does. Because the structures of the family units are different here. The heads of the families are the middle-aged childern, not the elderly. It's all rather confusing, and counter-intuitive. But eventually it strikes you - the old fogies really, really don't want to know. Most of them anyway. They just want to lie in bed and be doted on by their kids, and let the tides wash them whichever way they will. And for the select few who, years later find out after countless colonoscopies that the little operation they had to take out a small harmless lump was in fact a hemicolectomy for carcinoma of the colon, and are outraged... well... nobody really cares about how they feel. They only care that you betrayed the covenant of silence. Prepare for a complaint letter from the family. (Interestingly, the "betrayed" never think to write in and complain about being kept in the dark by their loved ones. Fascinating.)
4. The Patients are Different.
Language for one. It may be a relief to be able to speak in Singlish - for a while. Until that monolingual patient who only speaks Hokkien comes in. (Hua Yi Buay Heow) Or Cantonese. Or Tamil. Or Malay. Or...
Communication is often suboptimal because of this. We rely on family members to help us translate things. Things get lost in translation. Things like "you have cancer" turn into "don't worry there's nothing wrong, you just need a small operation." Things like "I'm sorry we did all we could" turn into "nothing lah."
Old fogies are more passive, as mentioned above.
Young punks are more aggressive.
Overall, people are less educated - not in terms of highest standard of education attained, but in terms of information. They are less informed, and more opinionated - they've read one or two dodgy articles online, or heard something from somebody's aunt, or their dad lived for five years with cancer of the lung before some doctor killed him off after he was admitted to hospital, or their TCM consultant has told them something different -- and suddenly they're the experts, and you're someone to be suspicious of.
These are of course the exceptions to the norm. Most of the time things will pass by smoothly enough. But when you hit a stumbling block like this, what will you do?
It was hard when I first came back, having to explain to a belligerent, inappropriately aggressive family member that novo-7 is not the standard of care for an intracranial haemorrhage, and that grandma might still be dying even with it. It was difficult to think with his face so close to mine that the spittle from his mouth as he shouted was landing on my glasses. I chose to be civil and attempt to explain it to him, with aid of the internet, over and over again until it became apparent that he was not here to hear, but to shout. At which point I told him as much, and left the ward, and hit a wall some distance out from the ward in frustration. (Hitting the wall, it's a turn of phrase, isn't it?)
Now that I've been Assimilated, I do what everyone else does. Talk until their time is up (approximately 5 min) then excuse myself and leave. If they didn't take anything on board in those 5 minutes, in clinic, on the ward... if they were too busy making themselves heard to hear in return - then nothing you say will make a difference. If there's a complaint letter hovering somewhere in the background, chances are it's already been written, and posted to the New Paper - even before Ms X showed up on the ward full of righteous fury.
Interestingly, sometimes Ms X shows up for the first time, after Ms Y and Mr Z, her sister and brother have spent the last month with dear old dad, and are completely informed and understanding. And Ms X will be the one to rain fire and brimstone upon the incompetent healthcare providers so obviously intent on killing dad, nevermind that she doesn't know why he's even been admitted. There's a simple reason for that, I think, and I think it's guilt. Ms X actually deserves more time; I usually give her about 15 to 20 minutes before packing it in.
People are different here.
5. The Other Doctors are Different.
Perhaps these are biased memories, but it seemed easier to be happy with Medicine while back in the UK.
You'd be hard-pressed to find someone here happy and fulfilled in their medical lives. The common grouses are excessive hours, incommensurately low pay and lack of public gratitude.
I think you'd be missing a fundamental truth if you chose to focus on any one single point of the above - or even on all of them combined. The truth of the matter is many doctors are depressed. Cast your net wider and you'll see it's not just doctors.
I remember how everyone used to go get pissed thursday (or was it wednesday?) nights at the pub, from the consultants to housemen. And how we'd all dance and generally make fools of ourselves.
I can't help but compare those memories to the present-day infrequent department parties, when professors and peons auto-segregate, and professors remain... professorial.
Yes, there is decorum and aplomb, and dignity befitting of royalty here. But maybe we've just... forgotten how to have fun.
How to cope? Just remember that fun here starts when you step out of hospital. Remember your family, your wife and your children are what make living worthwhile. I don't know if it works, but that's what everyone does.
7. Ethics are Different.
Be prepared to back down on those ethics your medical school ingrained into you. And prepare yourselves for the changes in your own ethical code which will invariably follow. It's a natural progression.
Perhaps the only real rule is to stay out of trouble, and don't offend anyone, be it your colleagues or your peers.
A few random names to google :
S***n Lim
Eu K*ng W*ng
Also, there is a "right" way and a "wrong" way to effect diplomacy. Again, see the above.
More random terms you need to know before you start:
"Do Not Resuscitate" - what is the difference between this and...
"Max Ward Care / Not for SICU / Not for intubation?"
Dangerously Ill (DIL) - what is the difference between this and...
Dangerously Dangerously Ill (DDIL) ?
Hypothetical question :
Is it ethically permissable to inform a family who lives far away that their father / mother is dangerously ill and they should hurry down as soon as they can to see him, if the patient is fading fast and their chances of making it in time are about as high as an opposition team winning a GRC? If not, perhaps it is kinder?
How about if the patient is already dead from say, a massive MI?
8. The Administration is Different.
This goes from the ministerial level, to the SMC, to the SMA, down to your local hospital administration.
There are notable differences between administrations of different countries.
Ours is a strong administration, that is efficient in achieving its aims.
Do not bemoan your "low starting pay" as a cockroach though. There have been recent revisions. Prior to them housemen were truly earning a pittance, at levels inappropriate for university graduates.
Pay revisions are not pegged to civil service. Medical professionals are servants, but apparently uncivil.
There is doubtlessly a reason for this. Perhaps there are just too many of us.
Do not stir the pot, or bite the hand that feeds you. Spectacular things have happened in the past.
The system is oddly dichotomous when analyzed from a financial perspective.
Either way you need to decide early on what your career path will be. Early on is now, when you have just graduated from medical school - because you are a graduate student and significantly older than the rest. There is an unhealthy obsession with age in this country. Life stops after 20, yet 27 year olds are too young for politics...
If your priority is to make money fast and have a comfortable lifestyle, become a GP. The net earnings over time will outstrip those of a government specialist.
The alternative is to give up medicine altogether and use your degree to seek another job. As ridiculous as this sounds now, it isn't. Senior Pilots for instance bring home $50k or more a month. Politicians need money to remain honest and uphold their integrity, so they earn... more than I can count in my head.
If your priority is to make ridiculous amounts of money to swim in, then specialize NOW. Choose your specialty NOW, even before you graduate. Join a residency programme NOW. It's what everyone else is doing, right now... and exit early, and go private. And become a very, very rich one trick horse. Just avoid $24 million bills.
If your heart is in it for your art (ie surgery) or the intellectual challenge (ie medicine) then tough luck. You're doomed to stick it out in government service and earn less than your peers in many of their lucrative business careers, and your lot is to whinge about it for the rest of your life, or else to just put it out of your head altogether and do what you enjoy most. If you fall in the latter category you are admirabe, but probably deluded or else dysfunctional in some way. Sadly, I am in that category.
9. Everything is Different.
Yet everything is the same.
Some things are better, some things are worse. It was the best of times, it was the worst of times and all that.
Standards of living here are good, possibly even high.
Costs of living are also high, if you seek the lifestyle of a young, executive professional, which although you kind-of are, you're not... (remember the cockroach) Decent sized condominiums cost in excess of a million dollars. Landed property cost about four to more times this. COEs are expensive. Annual road tax is about a month's salary.
If you are comfortable with a lower standard of living, you can achieve this comfortably, eg living in a HDB flat - which is fairly good and comfortable, functional living.
Things are clean here. Really clean. Sidewalks are clean, roads are clean, HDB landings are clean. Ministers are clean.
It's just the public toilets that are filthy... MRT toilets made the news today.
For some strange reason people here like to drape toilet paper into the bowl and trail it out, in the mens loos. Perhaps its to line the seats while they squat on the sitting toilets? Nobody ever lifts the seats. This makes for pee-water tracking out onto the floor thanks to inconsiderate laws of physics (capillary action).
This highlights something unspoken about our population.
It is a tiered population. Clean and dirty.
These should be sufficient for now.
Sunday, April 3, 2011
Beginning of the End
Back in the day when I was still a bushy-eyed, bright-tailed spring chicken, I remember how some of my less anatomically confused peers would wax lyrical about how they wanted to enter politics to fix the PAP from within.
I used to snigger cynically and think privately that the machine will never change from within, but just assimilate all who strive to be different.
I've never been interested in politics in Singapore despite once having been a debator, because, well, there are no politics in Singapore. There's no debate, no engagement of intellects. Motions are passed at the time of conceptualization, not in parliament. (Interestingly I remember a very dignified old Englishman who, post craniotomy for a devastating brain bleed, when asked if he had passed motion replied grandly, "young man, motions are only passed in parliament!") AS I've aged I've realized that that's what makes Singapore special though. Brutal efficiency translates into instant action. The players don't matter as much as the process.
The fielding of Tin Pei Ling has struck a chord within me though. It's a bit like the tolling of a bell that just won't stop.
Let's see how people have reacted to her thoughts :
temasek online
Temasek Review
Online Citizen
Onesingaporean
Rockson Tan (by proxy) - this one is priceless. hahhahahahahaha
Let's see what Tin Pei Ling has to say...
Hmm.
Well, what I will say is this - I remember Desmond Lee. We used to call him "The Minister" - not because of his father, but because of the his demeanour - staid, sombre and sincere to the extent of being priestlike.
I'm glad for the people like him entering politics - on both sides of the fence. I'm glad for the people who are willing to do what it takes, to make the changes that need to be made, or to pull an Atticus Finch with the hopes of achieving an aim, even at the cost of a personal loss.
I just can't help wondering this time around though, just who is the underdog here? The public is crying foul - while the rest of us spectate with bated breath.
I used to snigger cynically and think privately that the machine will never change from within, but just assimilate all who strive to be different.
I've never been interested in politics in Singapore despite once having been a debator, because, well, there are no politics in Singapore. There's no debate, no engagement of intellects. Motions are passed at the time of conceptualization, not in parliament. (Interestingly I remember a very dignified old Englishman who, post craniotomy for a devastating brain bleed, when asked if he had passed motion replied grandly, "young man, motions are only passed in parliament!") AS I've aged I've realized that that's what makes Singapore special though. Brutal efficiency translates into instant action. The players don't matter as much as the process.
The fielding of Tin Pei Ling has struck a chord within me though. It's a bit like the tolling of a bell that just won't stop.
Let's see how people have reacted to her thoughts :
temasek online
Temasek Review
Online Citizen
Onesingaporean
Rockson Tan (by proxy) - this one is priceless. hahhahahahahaha
Let's see what Tin Pei Ling has to say...
Hmm.
Well, what I will say is this - I remember Desmond Lee. We used to call him "The Minister" - not because of his father, but because of the his demeanour - staid, sombre and sincere to the extent of being priestlike.
I'm glad for the people like him entering politics - on both sides of the fence. I'm glad for the people who are willing to do what it takes, to make the changes that need to be made, or to pull an Atticus Finch with the hopes of achieving an aim, even at the cost of a personal loss.
I just can't help wondering this time around though, just who is the underdog here? The public is crying foul - while the rest of us spectate with bated breath.
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