A Family Doctor's Tale

By Kenneth Kee

This book traces my journey from a medical student to become a full family and community doctor. It starts with my first entry into the medical faculty of the University of Singapore full of enthusiasm only to see a hall of cadavers all ready for dissection. Finally I became a medical doctor only to realize that it is conditional upon my finishing 1 year of housemanship or internship. I was sent from one department to another to finish my year of medical work in the public hospitals of Singapore. There was a lot to learn on the way and I improve on my medical skills as I went onwards on my journey to full registration. There were the good , the bad and the ugly among the medical doctors I encountered on the way as well as nursing staff and patients. I learn about the inevitability of death and sometimes however you hard you try, you can not save lives as you wish to. I learn about how to communicate with patients and later as a community doctor how to bond with them. Then there are the pitfalls of a medical doctor practice about the risks of accusations of molestations unless you take proper precautions. As a family doctor you become immersed with your community of patients and their problems. You become their family counselor and adviser. You find that the most important treatment of a patient is by prevention through health education and healthy living. After 37 years you become a part of the patient's life and his family. 4 generations of patients slowly become part of your medical life.
That is the life of a Family doctor and my tale of how I become one!
TABLE OF CONTENT
Chapter 1 IN THE BEGINNING
Chapter 2 THE NEW DOCTOR
Chapter 3 THE ENT DEPARTMENT
Chapter 4 A TALE OF 2 CANCERS
Chapter 5 THE ANESTHETIC DEPARTMENT
Chapter 6 A TALE OF 2 ANESTHETISTS
Chapter 7 ANESTHESIA, SURGEONS and SLEEP
Chapter 8 THOMSON ROAD GENERAL HOSPITAL
Chapter 9 EMERGENCIES AND NIGHT DUTIES
Chapter 10 MALARIA PATIENT
Chapter 11 THE MILK DRIP
Chapter 12 VALLEY OF THE DOLLS
Chapter 13 INSECTICIDE POISONING
Chapter 14 MEDICAL COLLEAGUES
Chapter 15 MEDICAL LOCUM
Chapter 16 THE RUNDOWN FAMILY CLINIC
Chapter 17 GROUP PRACTICE LOCUM
Chapter 18 FACTORIES, SHIP AND HOUSECALLS
Chapter 19 MY OWN FAMILY CLINIC
Chapter 20 MY FIRST PATIENT
Chapter 21 WORD OF MOUTH
Chapter 22 MY COMMUNITY OF PATIENTS
Chapter 23 THE FAMILY DOCTOR
Chapter 24 –ART OF COMMUNICATION IN FAMILY PRACTICE
Chapter 25 FAMILY COUNSELOR
Chapter 26 ASSISTANT DOCTOR
Chapter 27 THE PARTNERSHIP
Chapter 28 PITFALLS OF COMMUNITY DOCTOR
Chapter 29 PIN IN THE FOOT
Chapter 30 ARTHRITIS CASES
Chapter 31 ASTHMA AND BREATHLESSNESS
Chapter 32 GASTRITIS
Chapter 33 GASTROENTERITIS
Chapter 34 TRIGEMINAL NEURALGIA
Chapter 35 SKIN INFECTIONS
Chapter 36 THE COMMON COLD
Chapter 37 INFLUENZA
Chapter 38 STORY OF AMAZING COLD SORE VIRUS
Chapter 39 ORIGINAL POEM ON SPA
Chapter 40 A DAY AT THE SPA
Chapter 41 COMPASSION

• Language: English
• Publisher: Kenneth Kee
• Release date: Aug 3, 2012
• ISBN: 9781476220918

Kenneth Kee

Medical doctor since 1972.Started Kee Clinic in 1974 at 15 Holland Dr #03-102, relocated to 36 Holland Dr #01-10 in 2009.Did my M.Sc (Health Management ) in 1991 and Ph.D (Healthcare Administration) in 1993.Dr Kenneth Kee is still working as a family doctor at the age of 74However he has reduced his consultation hours to 3 hours in the morning and 2 hours inthe afternoon.He first started writing free blogs on medical disorders seen in the clinic in 2007 on http://kennethkee.blogspot.com.His purpose in writing these simple guides was for the health education of his patients which is also his dissertation for his Ph.D (Healthcare Administration). He then wrote an autobiography account of his journey as a medical student to family doctor on his other blog http://afamilydoctorstale.blogspot.comThis autobiography account “A Family Doctor’s Tale” was combined with his early “A Simple Guide to Medical Disorders” into a new Wordpress Blog “A Family Doctor’s Tale” on http://ken-med.com.From which many free articles from the blog was taken and put together into 1000 eBooks.He apologized for typos and spelling mistakes in his earlier books.He will endeavor to improve the writing in futures.Some people have complained that the simple guides are too simple.For their information they are made simple in order to educate the patients.The later books go into more details of medical disorders.He has published 1000 eBooks on various subjects on health, 1 autobiography of his medical journey, another on the autobiography of a Cancer survivor, 2 children stories and one how to study for his nephew and grand-daughter.The purpose of these simple guides is to educate patient on health disorders and not meant as textbooks.He does not do any night duty since 2000 ever since Dr Tan had his second stroke.His clinic is now relocated to the Buona Vista Community Centre.The 2 units of his original clinic are being demolished to make way for a new Shopping Mall.He is now doing some blogging and internet surfing (bulletin boards since the 1980's) startingwith the Apple computer and going to PC.The entire PC is upgraded by himself from XT to the present Pentium duo core.The present Intel i7 CPU is out of reach at the moment because the CPU is still expensive.He is also into DIY changing his own toilet cistern and other electric appliance.His hunger for knowledge has not abated and he is a lifelong learner.The children have all grown up and there are 2 grandchildren who are even more technically advanced than the grandfather where mobile phones are concerned.This book is taken from some of the many articles in his blog (now with 740 posts) A Family Doctor’s Tale.Dr Kee is the author of:"A Family Doctor's Tale""Life Lessons Learned From The Study And Practice Of Medicine""Case Notes From A Family Doctor"

Book preview

Chapter 1

A Family Doctor's Tale IN THE BEGINNING

I have never planned on becoming a doctor.

I was looking forward to a career in mathematics or chemistry.

Those were my favorite subjects.

I like solving mathematical problems and I look forward to experiment with the chemicals bought from the drugstore.

Then one day I came upon a Reader Digest condensed novel Not as a stranger

.It was all about a poor medical student who became an assistant to a Family Doctor and eventually took over the family doctor’s practice.

It was inspirational.

Then came medical TV serials such as

1. Marcus Welby M.D,

2. Ben Casey,

3. Dr Kildare ,

4. Doctor in the House.

I resolve that I would try to be a good family Doctor.

My mother whose older brother was a doctor in China encouraged me to take up medicine.

My mother has always been my source of inspiration.

She is not only loving, kind hearted and always helps the unfortunate.

She would be a good nurse except she does not like blood.

Instead she became a very good teacher.

So it was at the tender age of 18 years, I entered the medical faculty of the University of Singapore.

The first day was a nightmare.

Entering the dept of Anatomy, I was presented with a large hall of corpses and the strong smell of formaldehyde.

Suddenly the dream of being a doctor became a nightmare of looking at & cutting up of a dry preserved corpse for the next 18 months.

In the meantime there were the endless lectures of anatomy, physiology and biochemistry.

Life became rather rushed.

Unlike other undergraduates, we were studying through out the whole year with 4 semesters instead of the 3 semesters in the Arts and Science faculty and 2 weeks break in between.

There were daily taking notes of complaints of patients and examinations of patients.

There were also procedures like:

1. drawing blood from patients,

2. watching surgical procedure done by eminent surgeons,

3. doing minor surgical procedures like removing small lumps and bumps,

4. stitching of cuts and cleaning of wounds.

5. learning from results of live autopsies of dead people

The most important assignment was the catching of 20 babies at the Kandang Kerbau Maternity Hospital (the biggest baby factory in the world in the 1970’s) or the delivery of 20 babies in the hospital by natural birth.

So it was after 5 years of tutorial and practical medicine that I finally graduated as a medical doctor.

Even then I had only 1 month rest before being called up for my housemanship –

a compulsory year of working in the hospital before becoming a fully registered doctor.

Chapter 2

A Family Doctor’s Tale THE NEW DOCTOR

It was the first day of my life as a doctor.

It was exhilarating.

It was exciting.

It was quickly brought down to earth or hospital ward.

The head of Ear Nose Throat Department of Singapore General Hospital spent little time to introduce his consultants and medical officers to me (the only houseman and the most junior doctor around to do all the ward work).

We then make a ward round of all the inpatients to update the latest information on their medical conditions and also which patient will be fit for discharge on that day.

The houseman (me) was of course supposed to do these (so called red tape) as well as to take blood tests and fill out all the information on new patients admitted to the ward.

After the ward round I got around to do all the paper work and blood tests.

It was a small department which was why only 1 houseman was attached to it.

The patients were generally post-surgical recovery cases who of course may need pain killers and constant monitoring for post operation complications.

Of course there was also the odd nasopharyngeal cancer patient who was on chemotherapy because his or her cancer was fairly advanced.

So it was work and work and work again as new cases come and old cases had the usual pain and bleeding after operations.

I had never liked the word cases because it was so impersonal.

I would try to know my patient’s name, what sort of work they were in.

I also believe in helping the nurses and nursing aides in their work as I do not consider myself superior to them.

After all I had just started on my medical journey while they had so much more experience in their many years in nursing

One of the many disadvantages of being a doctor was the long hours we are expected to work.

When there is a night duty, a doctor has to work from 8am in the morning up to 1pm the next day.

Of course the main work was from 8am to 5pm.

From 5.01pm onwards we have to attend to the new cases admitted to the ward as well as the inpatients in the wards that has complications like bleeding postoperatively or had severe pain or unable to sleep.

Because the Ear Nose Throat Department has fewer emergencies, life at night was not too bad and usually there was some time to sleep.

However because there were fewer medical officers and being the only houseman in the ENT dept, night duty happened about every 3 days including Sundays and public holidays.

Meals such as dinner and breakfast were served by the ward assistants.

For me, I was allowed to see some outpatients when I had finished my ward work.

Ward work includes taking blood for testing, registration and clerking (taking a history and examination report) of new patients who were just admitted through the Emergency Department and the outpatient specialist clinics.

Clerking of patients was just a term for writing in the complaints of the patient, your examination of the patients, writing the findings and suggesting the investigations and symptomatic medication for the patient.

Outpatient work includes:

1. Removing a fish bone from the throat,

2. Removing a small marble from the nose of a child,

3. Removing foreign bodies from the ears,

4. Stop bleeding from the nose

In addition I was allowed to assist in some operations.

I was lucky enough to be able to do a tonsillectomy operation with a trainee medical officer guiding me with instructions.

Chapter 3

A Family Doctor’s Tale THE ENT DEPARTMENT

The Ear Nose Throat (ENT) Department of Singapore General Hospital is one of the smallest departments with 4 consultant ENT Surgeons, 2 medical officers and 1 houseman.

It is however one of the most essential department of the hospital as 80% of cases are generally the ear nose and throat conditions.

However 90% of the cases can be seen as outpatients or by experienced Accident and Emergency Doctors and General Practitioners.

Our job is to handle those ENT conditions which the Accident and Emergency Doctors could not handle.

Typical conditions are:

1. Foreign bodies in the ear and nose such as small marbles, small parts of toys, cotton buds in the nose of children, which can be removed with a nasal forceps or sucked out with suction tubes.

2. Fish bones or chicken bones stuck in the throat which can be removed by crocodile forceps.

If further down the throat an endoscope may be required to remove the bones sometimes under general anesthesia.

3. Severe infections of the ear with pussy discharge which require drainage of the pus.

4. Severe blockage of the ear by wax which my required syringing of the ear with warm water to remove the wax.

5. Peritonsillar abscess or quinsy which is an abscess or bag of pus surrounding the tonsil causing blockage to food, swallowing and even breathing.

A cut just above the tonsil will usually drain the pus and relieve the blockage.

However the patient will normally have to stay in hospital for one or two days to make sure the bleeding stop and he or she is able to swallow and breathe properly.

He or she is then scheduled for a future operation to remove his tonsils.

6. Bleeding from the nose is an emergency which has to be attended quickly because of the danger of loss of blood.

Most mild bleeding of the nose comes from bursting of blood vessel of the septum