Unsuspected source of sepsis

When I was an SHO many years ago, we had a case of PUO. Pyrexia of unknown origin. Young man, admitted with chills and rigors. History unrevealing. Denies IV drug use recent travel etc. Blood cultures grew all sorts of unusual organisms, not normally seen in septicaemia, and not normally seen in immunosuppressed either. Echo [...]

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Breath freshener overkill

Met a drug rep today who was trying to sell me an anticancer treatment for lung cancer. This first thing I noticed was an overwhelming smell of air freshener, as if he has emptied the entire content of the can into his oral cavity.
Poor soul, he was obviously trying very hard to mask that fact that [...]

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The flirt

Unusual complain today. I have a young man with a curable cancer receiving chemotherapy on the ward. He is tall, well built and rather handsome. he has a wife and 2 kids to whom he is close to.
I received word from the ward staff that he is flirting excessively and intensively with them. I will [...]

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The funny fallout from swine flu

It’s early days yet. Some reported cases in Scotland. People down south is getting worried. Staff here in A&E are demanding face masks, although there is no reported case in my city.
One day the infection control nurse found a junior doctor whose scrub pockets are bulging to the brim. When asked what they are: it [...]

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Aiyah more respect lah please

Compared to many Caucasians my age I look young. Many Orientals do look much younger than their Caucasians counterpart for the same age. Well, untill around 50, then there is that sudden plunge. Then the appearance of aging seems to accelerate to an diabolical speed…
Well, many of my patients find it hard to believe I [...]

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No Christmas cheers

I saw a patient who had very large inoperable supraglottic cancer with massive 8 cm neck nodes required emergency tracheostomy and percutaneous gastric tube.
Gave him some chemo and radiotherapy. In clinic today, nodes no longer palpable, and endoscopy done with the ENT cancer surgeon showed no obvious residual disease.
Unfortunately he was still at risk of [...]

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No money

Patient I saw today, a self confessed alcoholic and heavy smoker. Compulsively drinks 5 bottles of cider (an apple based alcoholic drink). Has a cancer that hopefully should be curable by chemoradiotherapy.
Complains at the end of the consultation that he doesn’t get any social benefits till Monday, so he doesn’t have any money to take [...]

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Patients in chains

Not sure why I keep getting referrals to see patients who are serving time in prison. Yes, even prisoners can get cancers, but why do they keep coming to me? There are more than 30 oncologists in my hospital!!
Treating these chaps present quite a few interesting treatment problems. When they come for treatment, they come with police [...]

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Jet lagged

Attending a conference in Boston at the moment. The jet lag is killing me. Yesterday a CHinese attendee sitting right  behind me fell fast asleep and was snoring VERY LOUDLY in an audience of ~ 2000 other people whilst the talk was still going on. I myself felt a bit embarassed.
Americans do like to superpack [...]

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I’ll take you home

Saw a very elderly lady yesterday with early cancer. She has controlled Parkinson’s, elderly, has very poor lung function and not suitable for surgery. She came along with her husband.
Had a long chat with them. After discussing about her cancer, prognosis and treatment options, I told her I felt she would probably tolerate radical radiotherapy [...]

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