I have my best friend, Ruth, to thank for this:

from thesundaytimes

JUNE 26, 2004
Our Columnist
When meals are hard to stomach...
By Andy Ho

MANY readers were quite taken aback by a recent letter in The Straits Times' Forum Page ('Patients need better support after surgery', June 19) that revealed how the writer's mother had had an operation in which her entire stomach was removed because of cancer. The first question callers asked was: 'How does the poor woman eat?'

With some difficulty. In fact, that was precisely why the letter writer, Ms Angeline Ang, aired the problem in public. Her mother now has a dramatic digestive problem called the dumping syndrome, for which her medical team had not adequately prepared the family, it seems.

Ms Ang said, rightly, that the surgeon or dietician should have explained any necessary dietary changes before the surgery, with intensive nutritional follow-up after the procedure.

But first what is dumping?

This refers to (whatever is left of) the stomach dumping or emptying its contents immediately into the intestines so the latter fills up too rapidly with liquid and undigested food. During a meal, the tummy very quickly feels full and starts making growling sounds (called borborygmi). The patient will feel nauseated and may belch, vomit or develop cramps and explosive diarrhoea.

If dumping happens later - say, one to three hours after eating - she may develop a rapid heartbeat, break out in sweat, and feel flushed, weak and breathless. She could also feel lightheaded or dizzy, have fainting spells and an intense desire to lie down.

Dumping is not dangerous, but is frightening. So where do these troubles stem from?

One clue lies in the fact that foods containing high amounts of sugar often make the symptoms worse. Sugars attract water. High concentrations of simple sugars in the undigested food exiting the stomach rapidly attract a lot of fluid into the intestines. That fluid races in from your blood, so the volume of blood circulating actually drops.

The undigested food and liquid dumped into the intestines distend it, causing problems like cramps and bloating. The rush-in of water and the resulting drop in circulating blood volume causes palpitations and lightheadedness.

That is the conventional explanation, anyway. Today, researchers are also looking into whether an overly rapid release of gut hormones also plays a role. If so, there may be treatment.

Another question the readers who called up about the letter had: Are there any drugs that help?

Dietary prohibitions and instructions are probably more important than drugs in managing the problem. Patients must eat several small meals throughout the day - say six - and avoid foods that contain sugar.

Protein and fat intake should be increased to fulfil energy needs but milk and milk products may cause gas and should be avoided.

Patients should also not drink at mealtimes, to reduce the fluid rushing into the intestines, but instead drink small amounts of liquids throughout the day. Adding dietary fibre like pectin or guar gum that form gels with carbohydrates can slow down sugar absorption and make the food take a longer time to pass through the bowels.

But, yes, there are now some drugs that do help. One that definitely helps is acarbose, made originally as an adjunct treatment for diabetes. Always taken with the first bite at every meal, acarbose acts by slowing down the digestion of carbohydrates. In this way it reduces the sugar load reaching the intestines. This prescription drug has been proven in rigorous experiments to slow down the digestion of starches.

Before you get all excited and think that this sounds a lot like those mass-marketed weight loss pills called 'carb blockers', note that acarbose slows down - but does not block - the digestion of carbohydrates. Rigorous studies have not found any weight loss with its use.

Its main side effect is delayed tummy problems, because when starches and sugars pass through the intestine undigested, they are greeted by lots of bacteria and yeast that digest them by fermenting them. This produces lots of carbon dioxide, so you get bloating, gas, and abdominal discomfort.

But these symptoms with acarbose do tend to decrease over time. Also, the patient must avoid some Chinese herbs such as ma huang and ginseng when taking acarbose.

Why some patients remain asymptomatic after gastric surgery, while others develop severe dumping remains unknown. Ms Ang should remain hopeful, as most patients afflicted with dumping do improve over time: Symptoms usually disappear in three to 12 months, but they also can be permanent.

_______________________________________________

Mr Ho is a great and kind man. He has offered me a wealth of info that I never knew up to now. Yes, even now. I have never knew that the drug existed As far as dietary advice goes, he's more helpful than that surgeon, doctor and dietician put together. I have to write a love letter to the guy to thank him.

I'm grateful, Mr Ho. Thank you for highlighting my problem to the public once again, especially after that horrendous and appalling reply by SGH (see below). Thank you for making me feel my letter has struck a cord and the community has been alerted to something important. My mum's condition is not trivial; my concerns were honourable and valid; and SGH is a piece of shit for crafting that deceitful and smug reply. I feel vindicated by your column. Most of all, I have dietary information to work on and I hope my mum's health can improve subsequently.

Addendum: Oops. He is Dr Ho. A Ph.D from M.I.T. (Courtesy of Shinhao)

*

And now time for a bastard's reply in The Straits Times forum. I think I will put this up after all:

JUNE 26, 2004
Patient given post-surgery health info

I REFER to Ms Angeline Ang Siau Wei's letter, 'Patients need better support after surgery' (ST, June 19).

Our staff provided pre- and post-operative information and dietary counselling to Ms Ang's mother personally during her hospital stay as well as contact details for any clarifications.

While the information provided in the diet sheet detailed nutritional care guidelines, an individualised meal plan tailored for Ms Ang's mother with examples of food items was explained to the patient before discharge.

However, we sincerely apologise if the information given to them was deemed inadequate. We have since contacted Ms Ang and arranged a meeting to further understand her concerns.

We wish to thank her for her feedback. We will continue to improve and strengthen our patient education programmes.

FOO HEE JUG
Chief Operating Officer
Singapore General Hospital

_________________________________

What a lousy piece of shit. Liar. My mum was not offered any pre-operative information and counselling. There was less than 24 hs before her hopitalisation and the operation. The whole thing happened too fast and sudden, such that we were totally caught unaware, and only can depend on the doctor's words. No time to react, probe and check because we were so worried and ignorant (then). We only had trust, not the vital and necessary information and counselling.

He said it would be okay. Just remove stomach. Still can eat and lead normal life. Period.

We were neither warned nor prepared for the horrific consequences of the operation.

And after the operation, you guys know what happened, as I wrote to the forum. Even that lousy "individualised meal plan", "tailored" so-called, was given to us after we requested for it. NOTE: We requested for it. It was not offered to us of their own initiative. And even then, that stupid dietician took close to two hrs to pen that.

Other than the dietician, there was no one to provide any other forms of post-operative information of any sorts. There were no contact details for clarification. Nada. Zilch. None, okay. My mum said nobody told her anything.

At any rate, you should have contacted me (and I wasn't contacted) about everything. I left you my bloody mobile no. and my phone is on 24 hs all the time. Why tell it to a patient who is already extremely weak and fatigued after the operation?

"...we sincerely apologise if the information given to them was deemed inadequate..."

Fuck you. It was scanty to the point of negligible. What deemed. It simply, is, was, inadequate. Period.

I am quite miserable. My computer has been possessed again. It keeps restarting and nothing I do can make it last long enough to reach the blue-y page that shows "Windows is starting up." It's depressing. Anyone knows how to drive away the spirit?

*

可能是月亮照错了地方 惹得我们都放大了感想
小事全部渲染成像生命的预言一样 于是爱传说成天堂

How come unhappy? Because. Because I have never been happy after we end for the day/night. I don't remember. I can be a lot of things before and during the meet, but I am just never happy thereafter. The usual unhelpful and indignant thought that surfaces immediately when I turn to walk proudly away is, Does he know what he's doing!?.

忘了吧 昨天感伤 谁也帮不上忙
关于爱 你问一百个人 会得到一百个不一样答案

He's been here before, the place where we were on Sunday. It left an impression, which is why I was brought here.

He said our table would allow us the perfect angle to see the sunset and the time we were seated by is crucial for the visual enjoyment.

Is it nice that he makes these little arrangements for my benefit; is it nice that he wants to order the buffalo wings for me; is it nice so on and so forth?

只是谁能救赎谁的过往 只是谁能填补谁的遗憾
千回百 转 难 爱却不是最后一站

I'm not sure if it's nice because I would like OB markers.

你的吻还留在日记上 我的泪埋在被里流光
说要忘 难 爱情里最后的笨蛋

For my literature mates, that means, I would like proper signifiers. Now, signifiers move, obviously. They are not attached to the signified permanently. But the rule of thumb is, they are pretty stable and established. Signifiers signify what they mean to signify, especially when they come in a relevant and constant stream in which all the signifiers fit to form a pretty obvious/clear picture. Or else, there would be absolute chaos and we can't communicate properly.

Candlelight dinners
watching sunset
going for walks alone
all things planned and supervised by male companion

Is he aware of the above standard signifiers, what they mean in the usual context, that is, in the world that is populated by various other men and women, who engage in similar practices and their relation to each other in the face of things, as they stand?

He should stop messing with my signifiers. Just because his unorthodox ones work on a different plane, doesn't mean I have to displace mine to speak to him.

I hope that the signifers still mean what they are supposed to mean in the realm of dating for the rest of you. Signifiers are significant in aiding understanding of what a situation and a person's intentions. Unless you are as unlucky as me.

只是谁能救赎谁的过往 只是谁能填补谁的遗憾
千回百 转 难 爱却不是最后一站

爱只是借过的小巷

明天的路还那么长

I don't like being brought to Seletar camp where the airport is.

I don't like to dine alfresco in the best private corner.

I don't like to watch the sun sets.

I don't like the candle on the table.

I don't like the ballads play.

I don't like your ordering half a dozen of buffalo wings to share when you never asked me prior.

I don't like your easy intimacy and your showy display of knowing me by teasing about my obsession with chicken wings.

I don't like your attempting to peel your chicken skin and pass them to me (I only like the skin on my chicken).

I don't like you to liken peeling chicken skin to peeling prawns.

I don't like you.
__________________

I'm always incredibly bummed after being with him. Slightly depressed. Slightly flippant. Quite tired. Rather resigned. Mostly disgusted. Must it end this way for every moment spent together?

Why, for the umpteenth time, am I doing this?

It's a bad habit I have. Not dangerous, just bad.

I walked up to the uniformed lady and told her the patient has been admitted to Ward 58 for 10 minutes already and yet, no one was attending to her.

The lady hurried to the ward with me and that's when we saw the patient being surrounded by three student nurses.

Oh. They are here at last, I see. And I thanked the lady for coming along with me, but it seems that her assistance is no longer necessary.

The lady approached the patient and the nurses for a closer inspection, before turning to me and said.

Hi. I'm Sister Joycelyn. And how do I address you? Dr?

For one insane second, I was petrified that I looked old enough to be a Professor...ie Dr Ang. Then it ocurred that she thinks I'm a doctor.

You can call me Angeline. And I smiled.

Now, I have always known I'll be a great lawyer and people have expressed surprise that I don't actually possess a law degree, but it had never crossed my mind that I can project image of a competent doctor to people very well (mind you, and she's a Sister, in charge of the ward!)too, at my most casual. Which is something rather cool. Now I can start thinking I'll make a great doctor, at least much better than those I've come across, they, who lack initiative and they, cursed with the inability to explain medical issues succinctly and clearly and attempt to things gloss over.

*

The above can only mean one thing: My mum is back is hospital, again! And yes, she's the patient whom I was narrating about. Obviously. I only care that my mum is well attended to; who cares about the other patients? Get their own children to demand for better treatment on their behalf.

My mum, resisting to go to hospital, finally relented when we brought her for the checkup, and agreed to be warded. Not that she's in life-threatening (choi choi) danger at the moment. Just severely weak and dehydrated (but it's still quite horrid enough). She's currently on the drip but also taking food orally, with the doctor (same person who operated on her) monitoring her condition.

My sis noted too, that this time round, the doctor definitely took improved efforts to explain and clarify, and was rather forthcoming. I felt so too. I'm not sure if it was the result was the forum letter news that had travelled all the way to the SGH corridors to all parties involved, or simply because yours truly was a lot more firm and aggressive this time round. At any rate, this is not a bad thing, but the earlier damage can not be undone in spite of it.

I was just as firm to the nurses who had missed a feeding time (every two hr feed with Ensure) yesterday. Another senior nurses explained they had to sponge/bathe my mum and take her blood pressure and all first, and hence was delayed by an hr. And hence, her Ensure was served concurrently with breakfast.

I retorted that my mum has no stomach and it's ridiculous for her to down Ensure (which can be substituted for meals) with another meal. She will definitely suffer from indigestion. And that they need to get their priorities right. My mum is warded due to her poor appetite, so her dietary needs ought and must supersede all other things like bathing, changing bed linen. Just feed her at the instructed time, okay. We have to be punctual for her condition to improve.

Well, she's my mum. And it's common sense. They need to know that this patient has to be especially tended to (as in, they must always check her needs are met), else her daughter will march straight up and demand why, why, why. It's sad, but sometimes, that's the only way to get things done. When you keep approaching people to make sure they are doing their work, they will be kept on their toes. I was a bit naive to believe in professionalism, for it's tiring to be professional all the time!!! I grant that. So some patients will reap the professionalism, if they are lucky. But I'm fronting the persona of a no-nonsense someone now who knows her stuff, so that all the professionalism have to be directed to my mum. They can be shoddy to others. But, not to this particular patient.

As I do my rounds in the hospital, checking that things are in order, I realise that some nurses whom I've not interacted with knows my name and how I'm related to that patient, ie my mum. So I suppose it is working. People are paying attention. I don't care, so long as you fuss properly over my mum, else you die.

*

Another Malay patient commenting I looked like my mum. Your daughter very beautiful, she cooed. And your mum looked very young, you two very alike. That was another very cheap thrill. My mum always felt I resemble her in looks and temperament (and temper). It's a slight consolation that she'll live in me (choi choi choi).

*

Last night, Ruth remarked that if she din know me and just read my blog, she'll think i'm quite mad at the way I wrote (her terms were rave and rant), and that He is a figment of my just as mad imagination because she can't believe a person like that truly exist.

*

Speaking of madness, I must concede somewhat affectionately, but exasperatingly that indeed, he is rather mad. At 01:20:36, 26-06-2004, my mobile rattled again.

Details will be forthcoming later in the morning today. Prepare to wear shoes for walking...

I can't believe this! Well Ruthie, looks like that pretty thing I bought last night with you can't be worn today.

It's quite sad that he has to see me all the time in my most unglam, since the stuff we do don't warrant dressing up (berms and tank tops, urgh). But I reckon if he don't mind me at my worst, and I can stand him, this can't be too bad.

He is mad. It is 11:02:06am and I have no idea where and what.

I hope he remembers we actually have an agenda, at least I do. And not just walk walk walk till I collapse from fatigue. I also want dinner.

*Ring*

Okay, he just called. We are just walking normally, like what other people consider normal. So I can wear anything I like. We are going to Northeast. I'm supposed to take 168 from my place and once the bus get on to the highway, to get off the first bus-stop after it (and where the hell is that, where will I be).

And he informed I have a reply from SGH in the forum. I din even notice it, and I already read today's papers!!!! Well, the reply is so grossly stupid and deceitful and wrong that I wouldn't even bother to put a link up. But I'll save it and add it on to my heap of evidence of lousy services.

He's really great.

*

I'll be totally happy if my mum gets much better and the relevant SGH higher management gets fired. We'll take one step at a step, babe.

I woke up quietly laughing today.

I dreamt we were in his car and for some odd reason, my mum and sis were in the back seat. And they left the car shortly after, silently.

Once they have vanished from sight, my friend demanded to know why I didn't bother to introduce him to them, or them to him, and I was like ?! Sorry lor, the thought just never crossed my mind and does it matter? So he wasn't happy at all, not at all.

After we parked the car in the basement and walked out to see sunny skies once more, I realised I had left my small, pink (and very dirty-looking)cat pouch and mobile in his car. Silly me. Told him about it very meekly (for he was still fuming over the earlier incident)and he tossed me his car keys, telling me to go and retrieve my things while he will walk on slowly, and I'm to catch up with him later.

At the carpark, I got flustered because I couldn't find his car. I swear, I just can't find it!!! And since my mobile was inside the car, I couldn't contact him. *worries* and just as I thought this has to be the most horrible date we have ever had between the two of us (beats all the ones with heavy silence hanging over us hands down), it occurred to me this was probably a dream.

And so I woke up, quietly laughing that I should have such a dream of us.

*

At any rate, I'm seeing him tomorrow night. We are supposed to rehearse for my meeting with Brenton next Friday.

As usual, I have no inkling of where we are heading.


I'll keep you informed on the details for Sat. Give me some time.

Isn't it just *wonderful* to have someone constantly planning on where to take you? While a lot of times (44%), any date (with him) starts off promisingly and ends up in a spectacular mutual silence, I'm always reminding (perhaps the right word is *consoling*) myself that he does redeem himself quite well in the way he tries to make things different for us. Effort is always appreciated by me and he really takes me by surprise, usually.

I will like to suspect he does this with other girl friends, but it's rather unconvincing, so I've given up on trying to psyche myself into believing I'm not special to him. It's unrewarding and in a way, quite unfair to someone who has never been less than unwaveringly faithful in the last four years that we have known each other. Which is not quite the case for me, since I almost fell into a wrong pit when I had thought he din care. Maybe he had had such moments too, but the thing is, we always bob back within distance of The Other. To the extent, if we never end up together, I guess it will be extremely hard for another friend to match up. You can't imagine just how terrible it can be. Given how we have been and are still covering isolated/relatively unknown areas in Singapore, and have been going a lot of places which I din know exist myself, and exploring on foot, there will always be somewhere reminscient of times together. Like I take the train past Kallang and am reminded of how we trudged once through the plains and river there. How the way to SGH will take me very near Cantonment Road and I'm unwillingly brought back to a scene of potential fuse and great awkwardness. You know, the likes.

Whenever I looked back and reviewed(or admitted regretfully) that I made some very wrong choices in life, I thought of how I would never know this person if the choices hadn't been this wrong, and certain emotions would be pacified.

I hope he finds me just as great. Well, I'm pretty sure I'm greater.

*
当男人能提供足够的「因为」去满足女人的「为什么」时，女人便会爱上他。

In my case, it's happening with a twist. I can ask all my why-s and where-s and how come-s in the world till the cows come home, but he never tells. Just says that I will know eventually and that it's good enough he knows to tell me but not how he knows, and I can just take his word for it.

If one can trust another so, to the extent immediate answers are no longer important, it is probably a rather clear manifestation of a liking of a particular kind. Also, quite obviously, if we can hang out at the oddest places alone, it's a rather ahem, proper indication how far affections stretch.

You may believe that, Ms Angeline Ang.

Disclaimer: Unless this disclaimer is removed, the contents that follow are subject to great change and editing and addition because quite obviously I'm just taking notes as things float into my brain and drafting this at random.

I would like accountability, explanations, follow-up actions and solutions, please.

Emphasise that my mum is in real bad shape. Not herself at all, very weak and dazed.(The doctor should have warned, at least speak of the repercussions of the operation, to get us prepared. Now feel cheated. He made everything sound effortless and so easy.)

Part 1:

It is just ridiculous and unreasonable to expect patients who are suddenly diagnosed as very sick (and their families) to take initiative to question extensively and exhaustively the doctors about available treatments, side effects, and push for a detailed prognosis about the patient's exact condition.

(1) Obviously, the diagnosis came as a shock, and there's an extremely limited timeframe to react and read up on the sickness (like in my mum's case), hence the utter reliance on doctors to provide crucial information.

(2) There's implicit trust in the professionalism and expertise of the care-giver, given they are specialists and trained.

(3) The patient (and family), being the layman, would not know what crucial information is being omitted (like Vitamin B12), unless the doctor points it out

The doctor ought to already have the initiative drilled into him to impart all necessary information to the patient to minimise distress and helplessness. This is the minimal reasonable expectation of the doctor, to explain to the patient the options and the repercussions to make an INFORMED CHOICE before embarking on the treatment, instead of taking advantage of the patient's (and family's) fears and ignorance. It is something so very obvious and very simple and very basic that I cannot understand why the surgeon/doctor (and he's apparently a Senior Consultant) in my mum's case failed to do. Below are just a few chosen examples of his negligence that I'm citing to drive home my point regarding his negligent behaviour when comes to my mum.

I'm deeply regretting the operation because (a) it was not an informed choice and (b)the post-op care was negligible and we were not given support at all. In fact, the hospital made a lot of mistakes (more tales of negligence)that aggravated the trauma. It was, and is, for it continues up to now, most appalling to be the victims of such pathetic treatment.

But back to the doctor's negligence,
(expand on examples) I hope you can look into this and offer me an explanation.

* ramblings to be arranged coherently

Then talk about dietician, mere parroting of what's on paper that I can say myself. Dun see how the dietician is any helpful. Aghast by the so-called catalogue. *extract and expand on forum letter*

Hospital's after care. gave me mum wrong medication. never prepare letter in advance. no instructions upon discharge. sent the letter by post without follow-up, not taking into account my mum has several drug allergies. Waste of time, disappointed and disillusioned again and again. I had to call the department myself to come into possession of the knowledge that my mum has to take special pills prior check-up, which she was given none and not notified about. And this knowledge was incidental, accidental, I had called for another reason. So this is just horrible. Goes back to negligence - doctors and wards, whose negligence, all conveniently forget??? No excuse. I hope to have accountability.

Ah Law :)

Re-emphasise that my mum is in real bad shape. Not herself at all, very weak and dazed. And I want to see her getting the proper treatment and attention she needs. The doctor, whoever seeing her, to keep us fully informed. No repeats of the tragedy.

To Be Continued...

A Brenton Ong called this afternoon.

"Huh? You say you are from SingTel?!" Quite prepared to cut him off.

Well, turns out he's from SingHealth, and is in charge of looking into the issues that my letter in the forum brought up and so, supposed to give me satisfactory answers.

Fine. Except I'm not quite sure who this Brenton guy is, and his portfolio. The Internet only turned up a guy with the same name dabbling in HR, who I'm pretty sure can't be it.

And so in turn, I turned to my usual friend whom I looked to and up (but only in the very literal sense of up, I'm afraid)in moments of the sort (moments meaning the abominably unspeakable and frustratingly indescribable. Otherwise vaguely encapsulated by the term "intuitively").

In less than 10 secs after I put down the phone, I received the information. Very useful, very effective, to the extent sometimes you wish you have more friends with immediate relevance that you can tap on at will ("How come you can find and I cannot???" "Aiyar. I just can."), so that you won't have to turn to a particular person. Or rather, you have a choice of not returning, even if the sense of choice is a lullingly false one, since you have never thought of seriously leaving for good, and that it will always be that you choose, never something or someone else over it. It's quite unfortunate that the inability to go is further augmented by the occasional star performances that save many dates and days and nights and ensure a weird continuity of being quietly together. But that's going into a personal realm, so we'll leave this as that. And go back to Brenton, the new man in my life.

He's apparently, if you check on the link, the Director for Quality Sevice. We have tentatively arranged to meet next week. My next blog entry/entries will be systematic reports of what transpired (note-taking of what to highlight to him, to be presented in the best possible light to in my favour to achieve my aims, you know, like essay plans...), my dissatisfaction and disappointment in the service and professionalism of care workers, their negligence yada, that they can't expect patient and family members to keep probing them for crucial information (since we won't know what is crucial and what we are to know), they would have to bear in mind constantly they have to voluntarily and responsibly tell the patient and families what they have to know.

We were not privvy to a lot of important information that the doctor and nurses failed to bring up. It was only by surfing the Net and calling helplines (whose numbers I got from the Net again, and friends). Due to the acute lack of knowledge and the absolute failure on the care givers's part to impart to us these knowledge (since we won't know what we don't know, it's the care givers' imperative to let the laymen know. They cannot forget or assume. As a result, we were unprepared and ill-equipped to provide the best care for my mum. And even calling the hospitals, the doctor was curt and unhelpful, and just tell us to send mum to hospital. So most of these, expand, elaborate, and give excellent examples (no shortage of that).

Most importantly, my intentions ie the kind of results I want to see, esp the short term ieie my mum gets superb care. Macro/micro. What immediate, tangible of solutions can he offer. And before I make the trip down, I'll jolly well make sure it's worth my time. He's to listen and respond to all the shit I took and I shall not depart until he has assured and convinced me what are the things he can do to mitigate the nasty state of things as it is and the efforts he will ensure his staff undertake to pre-empt further and future unhappiness.

And of course. Disciplinary action against Ah Law. Nothing less than a formal written apology and a face to face one.

I was awakened by the rattling of my mobile this morning and it was only 7.14am.

Shinhao's sms read: Your voice is heard. I hope it gets better for you and your mum.

It vaguely registered that he might have meant the forum had published my letter but I was still groggy and the letter was sent on Sunday (so long already, I was almost convinced it's a gone case), so I asked what he meant.

Your letter is published in the rival State owned mouth piece lah. You mean you dun know?!

I tried to explain to the man it was really too early for me to buy the papers, so yes, I din know, until now, thanks to someone, I do.

After years of writing works of little utility, I'm glad you have made your little contribution of intelligible text. Your maiden foray into print media?

I pointedly ignored the barb. Yes, my brilliant works of fiction may be of little utility to you, but they got quality and, I just haven't had the chance to send them to relevant sources. They are of minimal utility only because they haven't been published yet, okay, you nincompoop- All these uttered in silence because we have gone through this before, many, many times.

But back to my forum letter. Although the letter was prompted by horrible circumstances, I'm nonetheless 虚荣 enough to take pride in the simple fact it was published. Yay, me!!! So I told friends to save the article for me so that I can have proper copies to look fondly back upon. And I shall laminate my copy!!!

Shinhao said my letter appeared to be blaming the dietician more than the doctor. But ahh, this is called strategy, got technique one. Obviously for the letter to be published (which is my secondary aim, so that I can achieve my primary one), I can't be all accusing and hysterical and venomous. I need to be cool and professional and focused. And I chose post-op welfare care as the point to raise, such that the chances of being published are high.

And why do I want it published? Under usual circumstances, the PR unit of SGH will have to formulate a reply and at least say they have contacted me and are looking into my case.

Once they make contact with me, I'll be able to pour out all my grievances in full strength and demand proper treatment and accountability for my mum.

This is of course my primary goal, to secure better services for my mum and to warn SGH and their shitty doctors I'm not someone to be trifled with.

So nevermind the watered-down version in the Forum. I need to be published first to get the attention. Of course it's a super bonus if it opens a floodgate and everyone else writes in to share their sad hospital stories. A revamp of the entire lousy system would be a dream come true. And I'm responsible for the social landscape change (in the ideal Singapore world lah). Shinhao would be so proud of my utility :)

Like I said, it's a great pity I din end up a lawyer (and I'll be such an excellent one) or doctor to be of useful relevance now but I can write. And this is enough to take care of some things and people proper when it comes to the crux.

Don't you ever dare push me into a corner. I'm well-educated and I know my rights and the scary thing is, I'm not afraid. I'm not like one of those helpless families who can only appeal to helplines and friends. I take real action. When push comes to shove, you will be the one whimpering.

*

I dun need a special day, I realised. I just need a special hour. Yesterday, work ended early at Bugis Junction itself, so I made a brief round and bought a girly pink pretty bag and a pretty long mini which I can wear for work and play in less than an hour. Very pleased by my buys and that it took me no time at all! I'm back on equilibrium, and none the worse for wear.

*

My mum is neither improving, nor deproving. Excuse my tardiness if you have yet to receive any replies from me if you have been trying to contact me. I will get back asap, so don't don't give up on me! It's just that lotsa of things have been happening lately, and tonight, I've to work on an event too, and it's Saturday! And I'm not ashamed to admit I pick sleeping over replying your calls, sms-es and all.

I'm looking forward to a day in which I can shop and just do what I want and generally be all impetuous and petulant, ie an Angelinesque day in the Angelinesque life of normalcy.

This day is something I allow myself everytime I've been a good and repressed girl for too long, ie staying put somewhere like home instead of going out, heading straight home everyday after work, no movies, no plays, no walks, no lazy sessions over slow meals etc, etc, and etc.

I can last an optimal of 2.5 weeks without the mentioned perk, after which I begin to feel increasingly shortchanged, ill-compensated and unappreciated by all around me, like I'm giving up too much. Which is not necessarilyt a fair thing to feel, but this is how the temperament is, and i'm not ready to temper with it. Just like how I can't function well in heat, I don't function at all without my special day.

The special day ought to be due soon.

I will go for cynical and practical any day but I suspect many will accuse me of being ungrateful instead. Oh well.

Eventually when all that comes back are just as general and vague and possibly worse, you just end up wondering whether it is indeed true that people like us, who chose what we chose, have failed to live decently in the real world. For when shit happens, we are hardly equipped to deal sensibly with it, given the lack of knowledge-that-really-matters and an acute deficit of relevant connections. Running in circles, because everyone of us is just as ignorant, since we move in the same circles, more or less, is rather sad, and most unhelpful. But I concede this ain't anyone's fault; it's only most unfortunate.

I have not augmented beyond what I already found out. Progress is dismal and frankly, I'm tired. Tired of reading similar things over and over again (It shows something, when the same information keeps popping up but remains as uninformative as ever) and rolling my already tired eyes energetically when I come across yet another intent of well-meaning but oh-so-not-tailored-to-my-needs. Either that, or it's something so obvious that I cringe and do infinite takes.

I'm particularly irritated at those who have asked me to go church or chant scriptures during this period. This is just so insane. Knowing that you know what I believe in, I seriously don't think it's going to change just because I might be living through a crisis or so. I have gone through many, many of them and I have maintained a very firm stance on this. Plus I hardly think it's proper to delve into any religion just because I need something badly. I'm sure you will agree

Church? I rather stay home and be useful. Chant? The person was saying it's no loss, just give it a shot and I glared at him and shooed him away, totally irritated. I got other things to do, real-world, practical things. If I hadn't written the HT myself then, would going to church or chanting have taken care of it?

I'm perfectly okay with what I believe in and I do pray in my own way. I appreciate every prayer that you say on my behalf and for me, just dun, dun, dun pull me into your particular religion now. It's the last thing I need and the sure-fire way of making me DL.

A GP whom a friend introduced was bad enough at being helpful but towards the end, when it was pretty obvious we ain't getting anywhere, he asked if I were a Catholic. If I were one, he will ask me to pray. Turns out he is a very devoted Catholic. What is this...like DUH. Is someone going to die or is not worth saving because he/she does not belong to your religion? Must it always come back to religion in the end?

Let's just all pray in our different ways okay. Your prayers matter to me and I believe in prayers. I just resent it when you expect me to adopt a particular mode of praying when I've already got one.

I hope to draw attention to the lack of crucial information, necessary support and care services offered by Singapore General Hospital by sharing my very recent and distressing experience.

My mum was unexpectedly and suddenly diagnosed as having stomach cancer on 31st May. She was told to go for an operation as soon as possible.

My family had implicit trust in the professionalism and expertise of the medical consultant and surgeon. We quickly made arrangements and my mum had her entire stomach removed on 1st June.

It was only after the operation that I realised to my cold horror, how paltry and inadequate post-operation support and information were, if they are made available at all.

Firstly, my mum no longer has a stomach. She has to watch her diet and currently suffers acutely from The Dumping Syndrome. I had expected detailed and comprehensive information on my mum’s diet from the dietician.

However, the dietician at SGH gave my family only a single sheet of paper explaining the “Postgastrectomy Diet”. The generic guidelines were supposed to cater to both patients who have had parts of or their entire stomachs removed.

The guidelines had no concrete examples of what to consume ideally. At best, they were vague. At their worst, they were meaningless to a layman and state confusingly to “choose foods which are high in calories, protein and nutrients”.

There was no FAQ section attached. There was also no mention of the possible undesirable symptoms or complications which may arise for the patient and family to take note and to adopt pre-emptive measures.

I was most aghast and dissatisfied by the limited information offered, to say the least. It was fair and reasonable to expect a more extensive and specific diet catalogue. But I understand from the dietician that this is the standard and only sheet of dietary advice they issue to postgastrectomy patients. This is not helpful at all.

Upon my mum’s discharge, my family was also not advised on whom to turn to for post-operation support in the event we need additional information on the disease, advice and reassurance on the condition of the patient as we monitor her progress at home, and the options rendered available to us should there be exceptional circumstances.

I had to surf the Internet for relevant information, enlist my friends to help, make numerous phone calls and repeat details over and over again to various organizations, on top of everything else.

I believe in the necessity of establishing a strong network of support and information for patients and their care-givers. In my case, there was a severe lack.

I hope SGH can look into this and improve their post-operation care services to minimise the trauma and helplessness experienced by both patient and family.

DR LAW NGAI MOH
mbbs(sin), mmed (int.mel), mrcp (uk), facg
fams (gastroenterology), frcp (edinb)

Senior Consultant Gastroenterologist & Physician
Department of Internal Medicine
Director, GI Mobility Unit
Visiting Consultant, TTSH
Visiting Consultant, Gastroentroenterology, Changi General Hospital
Clinical Senior Lecturer of Medicine, NUS


Remember this guy. Remember his name. This is the person who recommended the surgeon who operated on my mum, to my mum.

He is also the person whom I approached in my attempt to back track and understand what happened prior to the operation. Like why did he recommend the surgeon, how many reports does he possess on my mum etc, can I have a copy.

Cos my sis accompanied my mum during the few visits at Changi Hospital. We believed it was an ordinary check-up then, and additional check-ups were just to make doubly sure. I don't see the need to accompany my mum then. You know, most of us have to make a living and we try to save leave for the biggies.

My sis and mum can be quite blurred blurred at times so I thought it best to check with this ah law guy how many records/reports exactly did he pass to them first.

Point taken when he talked of confidentiality issue and the need to protect privacy. I can even concede he may make slight sense when he said I must bring my mum over personally before he care to reveal anything, even though she's in a very weak condition.

Politely, I said I wun want to make a wasted trip but may I clarify if I can gain full access to files on my mum supposing I have her with me.

Absolutely, said ah law, attitude straining already.

Then he said:

Not that I want to criticise you, you know, but things reach this stage then you come and concern after your mum, isn't it abit too late. And he repeat it another two times with slight variations but meaning the same thing ie why am I bothering now. And he told me not to call again, cos he wun entertain me anymore.

Why should I explain myself to such a fucked-up asshole. Isn't it obvious as mentioned? And as a doctor, he failed to be professional and instead attempt to do a guilt-trip on me and be most unnecessarily sarcastic. It was a redundant remark aimed to strike a blow to a person where it might hurt most. Instead of abiding by the philosophy code of Doctor's Honour (the whatever Hippo. Code), he attempted to deliberately inflict greater distress on a situation that did not warrant it at all. And worse, repeatedly intentionally repeating the statement to be aggravting and hurtful.

Remember this name. LAW NGAI MOH

I don't care who the fucking hell you are. I don't fucking care if this is the norm doctors treat patients and their families (ie, like shit) which is what everyone has been telling me. I don't care fucking shit. No one treats me and my family like this.
You can be a doctor, with long titles behind you that clogged up ur card like a tail of shit but. BUT.

NO ONE GETS AWAY WITH TREATING ME LIKE THIS.

I'm just me. Scholar. BA (HONS). Lit and Philo major who dabbles sideline in Jap and Law. But it's good enough to deal with the nasty slimeball that you are.

I can write excellent letters. Good luck to you. Ah Law.

My mum can't seem to retain food and liquids for long. She keeps vomitting, so I'm worried for obvious reasons, and she doesn't eat much to begin with.

It's been only two days since her discharge and since she's been weaned off the intravenous feed, so I reason: that she needs time to get used to consuming food in the usual way, that it's a common enough syndrome, plus my very experienced nurse aunt assured me my mum is not showing any signs of dehydration as yet, so I dun have to act like a gan-cheong spider.

Anyhow, for news apart from my mum:

(1) My current boss was at cross-roads just yesterday, on how to feel towards me. She told me on wed to do a report by end of this wk, but there were too many meetings and I din have time to work on it at home, so I told her meekly could I pls hand it in on Mon.

It turns out I was supposed to get another department's team to do the job for me (well, that was not what's been written in emails, but nvrm)...oops, but I wrote 50% of the promo plan already. My boss was like ?! noooooooooo!!!! You tell the other department to do it!!! We got other things!! Okay. Oops? She called me on my mobile later that she just met the other department's director and they both agreed I was very hardworking. Okay. Thanks? Paiseh lor.

(2) The earth-shattering news would probably be that my ex-boss, you know, that person who attempted to cut me down to size and break me with horrible words and menial, petty tasks, has apparently reliquished half of her portforlio to join my current boss. Not that she was invited, mind you. It was a no-choice absorption. Hi, so we met again.

(3) My current boss just told me to extend my stay with her. Just tell HR I said so, she said. So obviously (2) and (3) together are !?

(4) The other is that my eventual and final department I'm to go to just undergo major changes too. It's been destabilised and Jude (who's from there) advised me to consider going over when things are more settled. I don't know. (2), (3) & (4) together just give a headache man. I shall lead a day at a day, just like my mum.

(5)My boss told someone I will make a good researcher. It sounds rather bad. Running through my mind what I could have done to lead her make the unflattering conclusion, I think it could have been my ability to find for her the mp3s she wants in no time at all. I just happen to know a good site what. Sigh.

(6) Jude asked me out to share he's leaving the company to join a cable network. I'm happy and proud 'coz he beat helluva lot of competitors to land the coveted post. We can still meet over dinner since his workplace is just in Tampines. And we expressed dismay and disillusionment when we compared his new workplace with the old. Oh well. I will be here for better and worse.

(7) Someone said my hair looks very good, is it permed or natural (yet again!). Incidentally, my hair was also the focal point when I met never seen before friends and long time no see relatives saw my mum and saw me. Beat that, ex-boss. You and your stupid, dry, dyed, rebonded tresses and my very black (thus to you, old and severe looking *rolls eyes*) curly natural locks! Boo.

And back to my mum after the commercial break:

Thank you to those who kept us in your prayers. Thank you for offers of help and the influx of info. Thank you for the phone calls and contacts. Thank you Ruth for your bird nest with wild ginseng. I'm better today. Yesterday was bad, I suspect coz I din sleep. During work, just hearing a familiar voice calling my office line inquiring about my mum and I made me burst into tears. Quite cheesy and gross. But yeah, I have my unflappable and perky composure back since.

It's 5.22am 10th June now. I had logged off and tried to sleep at 2.30am. Pretended to sleep for 45 mins before giving up altogether. I can feel familiar waves of cold fear washing over me. Slightly more than a year later, they are back.

I've never been insomniac, nor too stressed to eat and drink, until that night, when I realised I could fail my hons year because my HT was deemed incomprehensible by all but me. And it wasn't just a simple matter of rephrasing; no amount of rewrites will save me. If I don't write the whole thing from a brand new angle in three weeks, shit will happen. So I went without a lot of things for 2.5 days just to think, and think, and think and type, and type and type. And for the first time in my life then, I felt real fear.

I feel it again now, as I hear my mum wheezing, gasping and moaning even as I type another piece. Only this time round, it's not a matter of my will power or within my control anymore. Another individual is involved and I can't do anything to help because the pain is hers to bear. I cannot complete it for her. My steely resolve has failed me this time when it has sailed me through everything else. I can only sit by the bed and offer useless company and look distressed.

It's my fault for trusting the doctor implicitly. That I was only too encouraging and supportive of the decision to go for the operation. I should have checked up more, requested politely for an extension, asked more questions, before embarking this ridiculously irrational leap of faith. Jude was asking me if I checked with another doctor and so on and I just, looked stunned. No, Jude, I'm afraid I didn't. It just din occur to me the doctor might have his own interest in mind. I just believed he meant to help my mum. Stupidly so. How silly of me. Ethics. Hogwash.

I almost managed to convince myself by evening, that to give the benefit of the doubt, that maybe the doctor was correct in removing the growth and the whole stomach to give my mum a better chance at survival. But when I reached home, I was horrified to see how thin my mum has become within a week. She's in constant pain (Fuck chemo, and fuck the op)and can't eat or drink much.

I think my mum might just shrivel, waste away and die first before the cancer gets to her. Her legs are scaly. Is this a sign of dehydration? I applied a lot of moisturiser on her and she was very irritated.

The hospital did not advise on the after-care post discharge from hospital on 9th June, Wed, not at all. And I'm sorry. I thought my sis would be smart enough to ask. Work kept me away and I was saving leave. The dietician only gave a single small sheet of handwritten note showing sample menu items apparently. This is ridiculous and most unprofessional. There was no support nor information on how to care for the patient. This is just so fucking shit. And a million things are happening at work, lots of shifts but that later. Like shit lor.

I think I'm scared and stressed. And for the record, Qiuyan is currently in my super bad books. 'Coz she feels my anger at the doctor is misdirected. It's ONLY A MISCOMMUNICATION, in her words. And you know how government hospital contacts are openly displayed on sites or you can call simply the receptionist for a general enquiry about how to get a person's email right. So I was testing (after I got DULAN at the miscommunication part) if she is *insert unknown adjective* by asking if she could ask ard who is in charge of what, just find out discreetly for me...and she just said it's no good, it'll put her in a difficult spot and she wouldn't know anyway, her peers also wouldn't know. Like hello. You scared what. I should be scared. I'm turning cold.

A Checklist of things to do:

(1)ask friends to ask friends to network for quick help, info and data through emails

(2) pose a list of questions that should have been asked before proceeding with the op. Now I just demand explanation and accountability since nothing can be undone. The doctor will just have to entertain me, I'm afraid.

(a)What is the stage of the disease?
(b)What are my treatment options? Which do you suggest for me? Why?
(c)Would a clinical trial be appropriate for me?
(d)What are the expected benefits of the treatment?
(e)What are the risks and possible side effects of the treatment?
(f)What can be done about side effects?
(g)What can I do to take care of myself during therapy?

(3) call up the dietician and demand a better presented and more detailed menu plan.
and pose her these questions:

(1.1) Is the pain due to the still raw wound; would it lessen with time? she can't sleep at all. what is considered a normal condition in her case?

(1.2) what is the ideal nutritious and hydrated menu a patient with no stomach at all should follow? cld you please recommend any nutritionist's contact or a trusted, reliable family doctor to me if you have?

(1.3) is it correct to say my mum needs significantly less water coz she has no stomach? she can only eat and drink in very limited amounts now within a selected food group...BUT i'm very concerned she might shrivel up and die of dehydration very soon instead of losing her to cancer. already her skin is getting scaly. i applied a lot of moisturiser on her just now. what is the minimal optimum water intake, and the maximum? is she supposed to drink very little - is this the norm and just how little can little get?

(1.4) is there anything i must provide and that i must not miss out? any essential nutrients? like i know that vitamin b12 is something a stomach-less person can't absorb and it has to be injected into the body etc etc (this is true right?). is there anything else i should know?

(1.5) is there a recommended stomach cancer support network to join?

(4) pose the same questions to whichever doctor is seeing us for the check-up two weeks later

(5) Update Shen in the twist pf events and enlist her brother's aid.

(6) call up the guy who recommended my mum to SGH.

*useful note*
Endoscopy -- an exam of the esophagus and stomach using a thin, lighted tube called a gastroscope, which is passed through the mouth and esophagus to the stomach. The patient's throat is sprayed with a local anesthetic to reduce discomfort and gagging. Patients also may receive medicine to relax them. Through the gastroscope, the doctor can look directly at the inside of the stomach. If an abnormal area is found, the doctor can remove some tissue through the gastroscope. Another doctor, a pathologist, examines the tissue under a microscope to check for cancer cells. This procedure -- removing tissue and examining it under a microscope -- is called a biopsy. A biopsy is the only sure way to know whether cancer cells are present.

StagingIf the pathologist finds cancer cells in the tissue sample, the patient's doctor needs to know the stage, or extent, of the disease. Staging exams and tests help the doctor find out whether the cancer has spread and, if so, what parts of the body are affected. Because stomach cancer can spread to the liver, the pancreas, and other organs near the stomach as well as to the lungs, the doctor may order a CT (or CAT) scan, an ultrasound exam, or other tests to check these areas.

Staging may not be complete until after surgery. The surgeon removes nearby lymph nodes and may take samples of tissue from other areas in the abdomen. All of these samples are examined by a pathologist to check for cancer cells. Decisions about treatment after surgery depend on these findings.

(7) check with my Fourth Aunt nurse on whether there could be negligence in the after-care procedures.

(8) Useful links:

American Cancer Society, Inc.
1599 Clifton Road, NE
Atlanta, Georgia 30329
800-ACS-2345 (800-227-2345)
http://www.cancer.org
AMC Cancer Research Center and Foundation
800-321-1557
http://www.amc.org
Cancer Information Service
800-4-CANCER (800-422-6237)
http://cis.nci.nih.gov

Follow-up with Friends who are to get back
(1) Jude will ask his doctor cousin
(2)Chinyi will check with nurse mum
(3)Chih Yuan will check with brother doctor.

well yes, i'm just trying everyone and everything, you have a problem with that?

MY MUM IS SUFFERING.

Oh well. Time to prepare for work. Don't visit, Ruth. Don't come, Kaile. Wrong Time. If you want to be really useful, do your research and feed me with what I need now.

Plan a proper menu for my mum. Find out. Stop her from losing anymore weight. Stop her from turning into a dried prune. So there.

I have been immensely DULAN eversince this afternoon, when my mum called to inform me that her cancer has been confirmed as the fourth stage, ie last stage by the doctors.

A number of factors contributed to my DUNLAN-NESS (there's absolutely no other words to describe, anger doesn't even come close enough):

(1)WHY NO ONE TOLD US THE CANCER WAS AT THE LAST STAGE PRIOR THE OPERATION, THE OFFICIAL REASON BEING

(2) THE DOCTOR'S INSISTENCE (AS EXPLANATION) THERE WAS NO WAY OF TELLING THE CANCER WAS AT THE LAST STAGE PRIOR THE OPERATION; AND THAT IF

(3)MY MUM HAD HAD AN UNNECESSARY OPERATION THAT WOULD ONLY HANDICAP HER FURTHER, AUGMENT HER DISCOMFIT, EXTEND HER UNHAPPINESS AND SIGNIFICANTLY AFFECT HER QUALITY OF LIVING IF SHE WOULDN'T BE LIVING VERY LONG WITH, OR WITHOUT THE OPERATION ANYWAY.

I'm contesting PT (2) because:

(a) My mum went for a grand total of 3 scopes prior the operation, at an average of once every week, including the one she had just a day before the operation. Are you telling me you can't even give a rough estimation at all through the scopes? What about the x-rays and all? What if you combine all the reports and examinations? Whether it is irrefutably true that
there is absolutely no way of saying if the cancer has reached the last stage before the operation is something I will find out (and everyone who knows, who is reading this blog can help find out) and if you are wrong, you are going to be so dead once I'm through with you.

(2) I feel there could be deliberate withholding of information and somewhat intentional misleading somewhere along the line. The doctor recommended the operation and yes, i was grateful to him for performing the op on my mum immediately. But. BUT. The doctor never answered my questions on which stage the cancer is at but he did say that before removing my mum's stomach, he would have to see if removing the stomach would help. There was a chance that if the cancer was too widespread (ie, pretty hopeless, I guess), they would cancel the op. So I keep vigilance outside the waiting area and was very glad 4hs later 'coz I was sure this meant the op was taking place. And so it was. Except that now, wham, last stage. How to convince me, you tell me. Doesn't last stage just mean, oops, too late?

If you had informed duly that it was at the last stage, my family can at least carry out certain plans before we agreed to the op, if we agree at all. But no, you din. And the official reason is, you wouldn't have known. Can't you hazard an intelligent guess at all? Well. I stay unconvinced that you can't know, maybe not conclusively, but reasonably, you should have grounds for diagnosing which stage at the very least. I'm charging them with negligence and the intent to mislead and withhold certain info.

Since it was already at the fourth stage, we might refuse the operation altogether. Now, my mum has to suffer the indignity of eating lousy liquid food at frequent intervals in very limited portions, and she might die anyway, probably according to you. You tell me. DUNLAN.

And so you said to go for chemo, you advised, all the same.

What are the chances of outsmarting the cancer, given it's the fourth stage, like you say?

Actually, you said, very rare.

DULAN.

I think I'll just let my mum die at home, in peace, no pain and still pretty, in my care, thank you very much.

The best part had to be when I asked in all seriousness and just a hint of mock incredulity and sarcarsm, that Doctor, you mentioned right after my mum's op that all visible signs of cancerous growth have been removed but that there is a high risk of recurrence. Given that at this moment, all signs of abnormality have been eradicated, would you concede it is a fair statement to say that the chemo you recommended is more a preventive measure than anything?

He went, um, and said it is fair.

Preventive mar. Means may not grow, nevermind what stupid stage. What if my mum gets lucky from now and there's no recurrence. Wouldn't she be going through the treatment for nothing? The flip side is going through the thing and die slowly and agonisingly. Well, as long as I'm your daughter, you can forget about the treatment then. We will all die someday. Let's enjoy life while we can.

Sorry, I just remember an even better part. The super part has to be where this other doctor called me, after I requested politely to have a copy of the tissue evaluation, only to have him being rather rude and evasive. Anyway, he called and started ranting how he discovered I had lost my dad and he totally understands how terrified I must be at the thought of losing my mum. He understands I feel helpless and vulnerable (my take is he meant IRRATIONAL. Everything else is a euphemism), and he would do everything to give me support and explain to me from scratch what cancer is. And I mean it when I said he ranted. He went on and on without pausing. I was naturally more DULAN than ever. Leave my dad out of this. You are being unprofessional. I just want the report. And I'm only DULAN, if you insist that I have to feel anything.

I think my mum was probably reeling in shock and disappointment, so I popped over for a visit. Yes, Ruth, I went to the hospital again today after all. The calls that decided and changed everything henceforth came only after I told you not to come and visit and all.

My mum was happy and relieved to see me. But I think I was still more DULAN than ever. And because it was so overwhelming, this urge to bring someone to ruin and the hospital down, I told Shinhao to meet me after his work.

So, the gentleman inquired, somewhere deserted or teeming, lit or dark?

I rolled my eyes dramatically (although he can't see coz we were on the phone, and he isn't in the loop about recent happenings so far). Okay I want deserted, and not too bright pls.

We ended up in Clifford Pier (Me: We are going to stand and talk?! Him: Got view mah) and well, it wasn't very helpful to the real circumstances but you know, it went okay, in that weird sense.

And once again, Jude proves he is psychic. He smsed me at 7pm tonight to ask to have lunch together tomorrow. I said no, 'coz I'm having it with CK. But he can choose between dinner tomorrow
and lunch on Thursday.

I hate being bonded, you know, in case you din know. I'm gradually convinced companies bond the brightest only to ruin them. I dun see a bigger picture here if there's one. Why bother to spend all that money on me just to waste my time? Another scholar from my batch has broken her bond after less than 8 months of service. She probably has to cough up half a million, which she did. Which suggests how hateful the entire situation must be for her to pay and leave.

*

Went over to the other office for a meeting today and pop by to a department in which I used to intern in 2002. There's another scholar there who started his service during my stint, though his was under that particular department, whereas mine is considered a generic one in which I can move around departments.

He remembered me and called out my name. It was a pleasant surprise. We shook hands and I was genuinely glad to see him, still like this, meaning (I'm sorry but.)that he is STILL, a marketing executive after like 3 years (His bond is for 4 years, NTU Comms grad).

It makes me feel better that I'm not the only one stuck in a dead-end situation. Sometimes, all one needs as a booster is knowledge that someone else is in a particular position TOGETHER with you. While I certainly don't relish being stuck, it is comforting that I'm not the only one held back by bureaucracy and ineffective allocation of resources. And it's coming only to my first year. What's it compared to his 3?

*

We inquired after each other. He thinks I got a good deal (ie my work after grad) and I made a face. But we din have time to go into real details for both sides of the story coz he has urgent emails to type and I have to attend a meeting. And like I said we dun really know each other that well. I think it's just the affinity that comes from knowing we are both, for better or worse, bonded haplessly. But here's a person I would meet for lunch the next time I come to this place (yes, we have said we would, anyway).

*

Work today wasn't brilliant. I don't know what they require of me. It was stated explicitly in an email for me to do this, and then after I had done the deed, it was thrown back that it was "too cheem", plus the reproach why am I doing this and wasting my time. You tell me. Din you ask me to do it? And I thought the trailers I wrote were of standard but no, one senior said too cheem. My ex-colleague liked them though. Anyhow, the whole thing is considered scrapped and crapped for me.

*

Went to visit my mum after the disheartening day. I also experienced a very vulnerable period lasting a grand 15 minutes during which I could feel water welling up (thanks to contribution from every aspect of my life) and had someone offered a kind world or physical comfort ie a strong shoulder, I would probably burst into tears. I'm rather tired of being sensible. Can someone please take care of me?

Thank goodness, such a cheesy moment flitted by quickly. But not before I did a thing I would shake my head at during saner moments. That is, sending an sms, in Chinese somemore.

我：心情不好，要不要出去？你可以选日子。

Yes, I will like to feel him near me. His quiet but anchoring presence is always assuring (no matter how he may anger me now and then) and I will be safe from all the chaos in my life. 我想他。I don't think he is aware of what's been going on but he might have guessed, given the *stubborn* conversation we had last Saturday.

他：本人为了争取执业执照，在律师楼日夜埋头苦干。但本人会设法抽空，进一步研
究适合地点，请等待消息。

Has he started lawyer-ing at a law firm already? I don't know, and I don't care. I just want to see him. It really doesn't matter where we go. But he is always so fond of the whole Let-Me-Take-You-Somewhere-You-Have-Never-Gone-Before-And-I-Will-Not-Tell-You-Where-We-Are-To-Go. It's nice, and exasperating, at times. But I suppose if this reads well as an indication of his affections and intentions (XX would probably knock my head and bellowed what is my patented line in hons years at me: ISN'T IT OBVIOUS? Well, not really? :), then I'm glad it's all happening. I do appreciate all your efforts and I will try to remember them at moments I get upset at you and have doubts about us.

*

I also smsed Kaile. Who is supposed to be back in Singapore today. Hey, if you are reading this, I repeat, pls don't go on such trips again. Don't you see a pattern here? Apparently each time you go away, something will happen to me (the last time you were away,X upset me, you weren't here, so I got to know Y and 8 months later, you know the story. Like Major Duh)and I can't get you and it's just like Ack. How come you always away when things are very happening!!!

So. Did you get me any bags? Want to read the new stuff I wrote? Technically, you owe me a treat for proof-reading the thesis but it can be offset by your reading of my works.

*

In other news of normalcy and utter frivolity dated to one week ago (stuff that got lost due to lack of time),

(1) I wrote complete my first parter. Standing at a whopping 14399 words, it's longer and better than my Hons Thesis. Beat that. Go me. Let me know if you'd like to read. It's in Chinese. Obviously.

(2) I love bumping into Jude when he is wearing his white oversized shirts. He just looks so good and his face lights up when he sees me. It's a visual turn-on and a cheap thrill at work. Like last Fri (I din wear glasses again and he was like, angeline!?), I walked past someone, and remember thinking, wow, so tall and cut such a hot figure and oh well, it turned out to be someone I do know. So we chatted for a while (even though I was running late for my movie :P) yeah, lunch, dude. I'm saving our lunch dates for really bad days. Just dun leave the company before I do, k.

(3) Someone taking the same MRT as me was the spitting image of the Korean star I lust after ie 韩在石. Nor,he's that super good-looker in Models and the currently showing 我心荡漾 on Channel U. But unfortunately,I believe this is a one-off chance encounter. The cheap thrill is, he did turn a few times to look at me and later on when he got off (at Kallang!), he brushed past (somemore it's not skin to skin kind but the tingly hair on hair type. His aiming is good) me even though there were sufficient space between us to avoid any point of contact.

It feels nice and normal to be blogging frivolous stuff. Hurray for Frivolity!

My mum has been diagnosed with cancer. After 3 months of throbbing pain in her stomach that ranged from mild to mildly severe, she did a conclusive scope on Monday that showed up a huge growth in there. The situation was pretty tense because the doctor in charge was kind enough to cancel his leave just to operate on her immediately the next day.

The operation lasted for 8 hours and for the entire time, my sis and I camped outside the operating theatre. For the first time in many years, the fear of losing someone became real again. And akin to the last time, this was a surreal feeling, to be in a particular position in which television and movies have exploited and corrupted most absolutely, to the extent you are very conscious that you are behaving in line with familiar cliches. The first drop, the coldness, the patient's why-me repertoire, just about everything.

*

I saw an aunt from my Dad's side for the first time in 6 years. Eversince Dad passed away, we have cut off all ties with them.

To them, "looking after us" means sending a representative to drop by every 4 months or so for 5 mins at our place, culminating in the generous gesture of stuffing a $50 note in our hands. Like hello, I can do better as a beggar in just one day, you know. It was painful and burningly humiliating. And I will always remember his side as money-grabbers who were unkind to my family since young because we were so awfully poor.

Now that I'm bigger and very much respectable socially (why do you think I'm a hons grad and a scholar? Nothing just happens), my family is better off, (thanks to me!!!). But still.

Yes, I hold nothing but bitter and vengeful thoughts when it comes to those relatives. I long to see their obituaries in the papers and laughingly attend their funerals like how some of them were disrespectful 6 years ago. I trust my cousins are good-for-nothings and I'm the best amongst all of them.

It's unfair when you consider how nothing terrible happens to them, and my mum, who's still very pretty, kind, smart and in her prime, has been a widow for so long, and now, cancer.

But back to my aunt, so I was polite but distant and I rolled my eyes when I heard her talking loudly to my mum's sisters of my Dad's mum had a stroke that left one side of her face sagging, and how terrible it is yada yada. Obviously, I can't feel any sympathy, esp if you throw in how that woman is already in her 80s and has no major ailments at all so far.

Anyway, so my mum's sisters were telling me how that aunt and the rest of Dad's side would really love to help us. What is stopping them is only their fear of our rejection. I coolly replied it was an entirely valid one and anyway if they had insisted and were sincere, what could have stopped them. In fact, I din want to inform them at all. Whatever for huh. It was my mum's side that informed them, despite my mum's reminders that her elder daughter would be most displeased. Still, it's been done so.

So. So the thing that angers me most now is how the aunt (and only the aunt was there only for yesterday) must have carried the news home and today, the first day after the major major operation, I see no one else from my Dad's end visiting, not even the aunt. What kind of fucking shit is this, you tell me.

*

I haven't slept in days. If you throw in the 10-day event in which I slept only at 1am on the average before turning up to work at usual time a week back, you'd understand why I'm sleep-deprived. I have never quite recovered. I think I look like shit. And I'm meeting the GCEO on Fri for a scholar tea.

I came home on Mon night (was shoo-ed home by an irritated Mom), wanting to continue my chinese novels (since I can't sleep anyway)and the bloody computer BROKE DOWN in the most peculiar way. It has been attacked by a malignant strain of virus that KNOWS exactly what matters to me most, right now. So I can't open my word/chinese files and so I can't write at all. And I'm horrified that all these files could be gone FOREVER!!!
I can only surf the internet and type my blog. This is weird. And life is shit. And to add on to the list of indignities I have suffered recently, I returned home on Tue night to find my flat plunged in complete darkness. Somehow in the entire block, my flat has managed to fuse itself and so, blackout. It's just shit.

It would be a lie if I don't admit that I do the why-me repertoire (as opposed to my mum's) myself now and then, but I do a pretty good job of overcoming that. I'm special, I tell myself. All genuises walk a hard path. Hence, the father's early demise; the various family's misfortunes, my struggle to write in midst of a career, for a career etc etc.

Regarding my mum's case, the operation is considered a success. But she has had her entire stomach removed (!?) so. It's quite depressing, really. The doc said there's a high (!!??) risk of recurrence and said she'll have to undergo the painful chemo FOR SURE. Which is so shit. Like we have no family history of cancer at all!!!! Why my mum??? Why not the evil people? My mum's body has been severely wrecked, so the thought of therapy just makes me cringe.

Many thanks to Qiuyan who helped me to translate a medical report prior the check-up on Mon, and for the simple, practical reason that she is going to be a doctor, who happens to be a very good friend of mine. I feel safe checking stuff with her and generally inquiring over and over again.

and mention of practicalities, if you want to contribute in various ways (got money, buy me things. no money, give me other things), here's a check list:

1)you can ply me with useful stuff like tonics...bird nests and ginseng etc etc for my Mum. I will shamelessly accept. No chicken essence, pls. It's of no use in my Mum's case. The doc has advised tonics.

2)help me print my stuff and lend me your computer to type out (just a couple or so hs) my works so that I can submit a couple of them before end June (which is why it's doubly the shit...I have a deadline to meet!!!)

3) be nice and let us have some fun together. I still need a social life, no matter what.

4)you can curse my Dad's side.

That's what I can think of now. Shall grab some sleep. Already took leave on Mon and Tue. Have to work tomorrow. Can't take anymore, 'coz I believe I need all the half-days in the world for the rest of the year.