The young lady came from Bukit Batok.
"The vet did not accept my case," she replied as she was living quite far from Toa Payoh. Hamsters are not favoured by many vets.
Hard lump palpated around right hip. Disc-shaped 1.5 cm x 1 cm.
"Any other hamster biting her?" I asked.
"She lives alone."
A tumour? Unlikely. Too young.
I suspect it was a puncture wound (cage wire?)
Such cases are best hospitalised, given oral medication for 2-4 days rather than rush into surgery. This is a very young hamster and she may not survive the stress of surgery.
Day 2. Lost weight by 4 g. Sleeping during day time. Reviewed again at 3.58 pm. bright sunshine. took a picture. Pretty photogenic. Unusual case as there was no other hamsters.
I asked my assistant to check no. of faecal pellets passed per 24 hours and to give medication.
In retrospect, she could have been bitten prior to purchase and the bacteria infection developed under the skin over several weeks, resulting in a plate-like lump of pus. When did she buy her?
Thursday, May 20, 2010
Wednesday, May 19, 2010
72. Veterinary Internship and character references
Story 1: End of a 3-month internship
May 18, 2010 is the last day of internship for Teresa. Three months of 6 days of seeing practice had passed by so fast. This is the forgetful intern who had caused me great embarrassment in the case of saying that the weight of a 3.6 kg cat as 2.6 kg. On this last day, I told her that I expect her to do well in her first-year veterinary studies and not have to re-sit examinations.
Our last case study was the discussion on the X-rays of a Cocker Spaniel who had swallowed stones and was operated by another vet. I had asked the owner to bring in the CD of the excellent X-rays taken by another practice. "It would be a simple veterinary radiology case," I thought. "Just show where the two pebbles are located. Either in the stomach or intestines."
Teresa downloaded the images into the desktop. I was surprised that the positioning of the "R" and "L" were not in their usual position as shown in veterinary radiology books and in almost 100% of small animal practices. Vets are used to seeing the "R" on the left side of the X-ray and "L" on the right side. In the original X-ray, the "R" was on the right side. So, a vet who does not check these two letters, would naturally and incorrectly diagnose that one pebble is inside the stomach and the other is in the small intestine.
I said to Teresa: "Veterinary life is always full of surprises. Veterinary medicine and surgery can be extremely stressful and challenging. A human doctor needs to know one species. A human surgeon specialises in one system, e.g. the alimentary system. A vet needs to know various diseases of many animals and is expected to operate on all body systems from the nose to the tail. It can be overwhelming for a new graduate."
I explained to Teresa that a vet also needs to have an excellent knowledge of veterinary anatomy in studying X-rays. "If you look at the original X-ray, the one with the lateral view, you will think that one pebble is inside the stomach," I said. "It is actually outside. You will need a ventro-dorsal view to confirm it.
"From the dorso-ventral view, you can see that the pebble is outside the stomach in the small intestine if you mirror the image of the original X-ray. If you don't mirror image, you will think that one pebble is in the stomach and one is in the small intestine. This is because almost 100% of the vets view the X-ray with the "R" on the left side of the X-ray. The stomach is located on the left side where the "L" will be shown in the usual X-ray. In this X-ray, the "R" is on the left side and if the vet does not have an excellent knowledge of veterinary anatomy, he or she mis-diagnose the pebble as being inside the stomach. If he operates, he will find no pebble."
I gave her a tip. "Just use your fingers to palpate the whole stomach before you incise it and you will feel that there is no stone. Take out the small intestine and palpate the length. Don't just incise the stomach based on the X-rays. This is the second check."
Teresa had no idea what I was talking about as she had not studied veterinary anatomy but she is an intelligent girl and will know what I was talking about.
"What is that black circle inside the stomach?" Teresa asked. "It is stomach gas." I said. "It is not a foreign body."
The original X-ray before I made this mirror image to teach the intern would have confirmed that the pebble was in the "stomach". The he stomach is on the left side in the usual X-ray, but this original X-ray was not the usual one. The "R" was not to the left side in the original X-ray
"You have to know veterinary anatomy very well," I said to the intern who tested my patience with too many questions. "Otherwise, you will look at the X-ray and think that the pebble is inside the stomach. Assuming you have only one X-ray, the lateral view. You still don't have to worry. You use your hand to feel the stomach. Such a large pebble can be felt. Do not incise the stomach first."
I don't know whether Teresa would remember this last case. But with 3 months of solid attendance at 6 days a week including Saturdays and Sundays, she must have had picked up a lot of knowledge. I wished her well. She was one of my best interns and one who caused me grief and great embarrassment in the case of
FORL in the Burmese cat. That is why some Singapore veterinary practices don't accept interns.
Story 2: Character referee sabotages the prospective intern's prospects
On this same day, the aunty of a prospective intern who had taken a lot of trouble to e-mail me phoned me. I was already fed up with this aunty who did not keep her appointment to meet me last Friday. During the conversation, I asked whether she could get a character reference who is not the mother for me to interview. The aunty said: "It does not matter. My niece can come to Jakarta when she comes back from the U.S."
I just could not believe my ears. This aunty was supposed to be the niece's character reference. She did not turn up after making an appointment last Friday. And now, she actually sabotaged her niece's prospects for internship. This was really weird. "Your niece has excellent grades and is the one who approaches me for an internship," I told the aunty in a loud voice. "She is an intelligent girl and has got her American professor to write her an excellent testimonial. Now you talk as if I am the one desperate for her services!"
I did not want to continue the tele-conversation with this aunty as I was really fed and I had plenty of things to do. The relative was actually sabotaging the niece's future. First, she did not turn up for her appointment to support her niece. Now she made casual remarks about internship. A take-my-niece as an intern or leave it, old boy!
The aunty must have thought that veterinary internships are a dime a dozen! Her niece has excellent grades and everybody will accept her as an intern. There is something not right with this thinking.
From this episode, all prospective veterinary interns should be careful as to whom they ask for help in getting character references. Never ask somebody who is not really keen to help. You really can get sabotaged. And it is an unpleasant experience for me to talk to such referees.
Updates and pic are at www.toapayohvets.com
May 18, 2010 is the last day of internship for Teresa. Three months of 6 days of seeing practice had passed by so fast. This is the forgetful intern who had caused me great embarrassment in the case of saying that the weight of a 3.6 kg cat as 2.6 kg. On this last day, I told her that I expect her to do well in her first-year veterinary studies and not have to re-sit examinations.
Our last case study was the discussion on the X-rays of a Cocker Spaniel who had swallowed stones and was operated by another vet. I had asked the owner to bring in the CD of the excellent X-rays taken by another practice. "It would be a simple veterinary radiology case," I thought. "Just show where the two pebbles are located. Either in the stomach or intestines."
Teresa downloaded the images into the desktop. I was surprised that the positioning of the "R" and "L" were not in their usual position as shown in veterinary radiology books and in almost 100% of small animal practices. Vets are used to seeing the "R" on the left side of the X-ray and "L" on the right side. In the original X-ray, the "R" was on the right side. So, a vet who does not check these two letters, would naturally and incorrectly diagnose that one pebble is inside the stomach and the other is in the small intestine.
I said to Teresa: "Veterinary life is always full of surprises. Veterinary medicine and surgery can be extremely stressful and challenging. A human doctor needs to know one species. A human surgeon specialises in one system, e.g. the alimentary system. A vet needs to know various diseases of many animals and is expected to operate on all body systems from the nose to the tail. It can be overwhelming for a new graduate."
I explained to Teresa that a vet also needs to have an excellent knowledge of veterinary anatomy in studying X-rays. "If you look at the original X-ray, the one with the lateral view, you will think that one pebble is inside the stomach," I said. "It is actually outside. You will need a ventro-dorsal view to confirm it.
"From the dorso-ventral view, you can see that the pebble is outside the stomach in the small intestine if you mirror the image of the original X-ray. If you don't mirror image, you will think that one pebble is in the stomach and one is in the small intestine. This is because almost 100% of the vets view the X-ray with the "R" on the left side of the X-ray. The stomach is located on the left side where the "L" will be shown in the usual X-ray. In this X-ray, the "R" is on the left side and if the vet does not have an excellent knowledge of veterinary anatomy, he or she mis-diagnose the pebble as being inside the stomach. If he operates, he will find no pebble."
I gave her a tip. "Just use your fingers to palpate the whole stomach before you incise it and you will feel that there is no stone. Take out the small intestine and palpate the length. Don't just incise the stomach based on the X-rays. This is the second check."
Teresa had no idea what I was talking about as she had not studied veterinary anatomy but she is an intelligent girl and will know what I was talking about.
"What is that black circle inside the stomach?" Teresa asked. "It is stomach gas." I said. "It is not a foreign body."
The original X-ray before I made this mirror image to teach the intern would have confirmed that the pebble was in the "stomach". The he stomach is on the left side in the usual X-ray, but this original X-ray was not the usual one. The "R" was not to the left side in the original X-ray
"You have to know veterinary anatomy very well," I said to the intern who tested my patience with too many questions. "Otherwise, you will look at the X-ray and think that the pebble is inside the stomach. Assuming you have only one X-ray, the lateral view. You still don't have to worry. You use your hand to feel the stomach. Such a large pebble can be felt. Do not incise the stomach first."
I don't know whether Teresa would remember this last case. But with 3 months of solid attendance at 6 days a week including Saturdays and Sundays, she must have had picked up a lot of knowledge. I wished her well. She was one of my best interns and one who caused me grief and great embarrassment in the case of
FORL in the Burmese cat. That is why some Singapore veterinary practices don't accept interns.
Story 2: Character referee sabotages the prospective intern's prospects
On this same day, the aunty of a prospective intern who had taken a lot of trouble to e-mail me phoned me. I was already fed up with this aunty who did not keep her appointment to meet me last Friday. During the conversation, I asked whether she could get a character reference who is not the mother for me to interview. The aunty said: "It does not matter. My niece can come to Jakarta when she comes back from the U.S."
I just could not believe my ears. This aunty was supposed to be the niece's character reference. She did not turn up after making an appointment last Friday. And now, she actually sabotaged her niece's prospects for internship. This was really weird. "Your niece has excellent grades and is the one who approaches me for an internship," I told the aunty in a loud voice. "She is an intelligent girl and has got her American professor to write her an excellent testimonial. Now you talk as if I am the one desperate for her services!"
I did not want to continue the tele-conversation with this aunty as I was really fed and I had plenty of things to do. The relative was actually sabotaging the niece's future. First, she did not turn up for her appointment to support her niece. Now she made casual remarks about internship. A take-my-niece as an intern or leave it, old boy!
The aunty must have thought that veterinary internships are a dime a dozen! Her niece has excellent grades and everybody will accept her as an intern. There is something not right with this thinking.
From this episode, all prospective veterinary interns should be careful as to whom they ask for help in getting character references. Never ask somebody who is not really keen to help. You really can get sabotaged. And it is an unpleasant experience for me to talk to such referees.
Updates and pic are at www.toapayohvets.com
Tuesday, May 18, 2010
A kind soul. Dysphagia in the cat: - a case of FORL?
TWO MONTHS AGO
A lady e-mailed to me regarding a cat whose owners sought help online as they had spent some money at a big veterinary practice. Now they had no money. So the kind soul enquired whether I accept payments (by the owner) by instalments.
I accepted the case.
Cat 5 kg. 5.1 years. 39.2 deg C. Very painful throat.
Difficulty in swallowing food for 1-2 months
History
"My cat eats a bit, drinks a bit but stops after a few seconds," the owner said.
Cause of dysphagia (difficulty in swallowing).
Sedation: Zoletil 100 at 0.05 ml IM sedated this old cat without problems. Isoflurane gas anaesthesia via mask was necessary to do a proper examination of the throat. I know that the owner would not be able to pay. However, I would not just give some antibiotics and send the cat home as there was something wrong with a cat not able to swallow for two months. Anaesthesia was costly but it needed to be done. In this case, there was a big ulcer at the side tooth PM4. Dental scaling and the right upper canine tooth was fractured and extracted. (see picture below).
Only the right nostril discharged pus. This was a case of right nasal sinusitis
Not surprisingly, only the right tonsil was inflamed and enlarged. I palpated he throat. It was very painful. Poor cat. He would die if he was not treated.
The owner said the kind soul would pay for him when I billed him. Obviously the kind just referred him to me. For the sake of the cat, I did not demand payment. I accepted $50 from him and I hope that the cat would be back to normal with the oral medication and after dental work.
The kind soul wanted to help the cat by seeking out a vet who might accept payments by instalments. The kind lady did a good job as the cat recovered fully after the dental work according to the owner who came 2 months later. Cats suffering from FORL (Feline Odontoclastic Respiratory Lesions) needs dental work to go back to normal as they have great pain inside the mouth.
2 MONTHS PASSED. The couple came back for medication without the cat. "The cat started eating the next day. He put on weight. He was OK for the last 2 months. Now he has some sneezing. My wife could have infected him."
"It is difficult to diagnose what's wrong without seeing your cat," I was happy for the cat who had been suffering for the last two months. Due to financial reasons and the recession, many owners simply ask for repeat medication. The vet has to advise accordingly. "It is not the tablets that work," I said. "There needs to be a proper examination."
UPDATE
The cat came in for an examination because the medication did not work. He suffered from an upper respiratory tract infection and high fever. This was likely to be due to a viral infection as he had the freedom to wander outdoors.
Two months after the first consultation, the cat had to come back.
He had cat flu. Vaccinate your wandering cat to prevent cat flu
if you can't keep her or him at home
He had never been vaccinated. "A 20% loss of weight," I told the owners. "This is serious." I taught the owner how to open the mouth to examine for ulcers and how to give the oral medication and electrolytes as he wanted the cat to be home.
P.S
Many Singaporean cat lovers permit their cats to stray outdoors. Vaccinate your cat yearly to prevent the common respiratory and other viral infections. Yearly dental checks help your cat to live longer.
Update at www.toapayohvets.com
A lady e-mailed to me regarding a cat whose owners sought help online as they had spent some money at a big veterinary practice. Now they had no money. So the kind soul enquired whether I accept payments (by the owner) by instalments.
I accepted the case.
Cat 5 kg. 5.1 years. 39.2 deg C. Very painful throat.
Difficulty in swallowing food for 1-2 months
History
"My cat eats a bit, drinks a bit but stops after a few seconds," the owner said.
Cause of dysphagia (difficulty in swallowing).
Sedation: Zoletil 100 at 0.05 ml IM sedated this old cat without problems. Isoflurane gas anaesthesia via mask was necessary to do a proper examination of the throat. I know that the owner would not be able to pay. However, I would not just give some antibiotics and send the cat home as there was something wrong with a cat not able to swallow for two months. Anaesthesia was costly but it needed to be done. In this case, there was a big ulcer at the side tooth PM4. Dental scaling and the right upper canine tooth was fractured and extracted. (see picture below).
Only the right nostril discharged pus. This was a case of right nasal sinusitis
Not surprisingly, only the right tonsil was inflamed and enlarged. I palpated he throat. It was very painful. Poor cat. He would die if he was not treated.
The owner said the kind soul would pay for him when I billed him. Obviously the kind just referred him to me. For the sake of the cat, I did not demand payment. I accepted $50 from him and I hope that the cat would be back to normal with the oral medication and after dental work.
The kind soul wanted to help the cat by seeking out a vet who might accept payments by instalments. The kind lady did a good job as the cat recovered fully after the dental work according to the owner who came 2 months later. Cats suffering from FORL (Feline Odontoclastic Respiratory Lesions) needs dental work to go back to normal as they have great pain inside the mouth.
2 MONTHS PASSED. The couple came back for medication without the cat. "The cat started eating the next day. He put on weight. He was OK for the last 2 months. Now he has some sneezing. My wife could have infected him."
"It is difficult to diagnose what's wrong without seeing your cat," I was happy for the cat who had been suffering for the last two months. Due to financial reasons and the recession, many owners simply ask for repeat medication. The vet has to advise accordingly. "It is not the tablets that work," I said. "There needs to be a proper examination."
UPDATE
The cat came in for an examination because the medication did not work. He suffered from an upper respiratory tract infection and high fever. This was likely to be due to a viral infection as he had the freedom to wander outdoors.
Two months after the first consultation, the cat had to come back.
He had cat flu. Vaccinate your wandering cat to prevent cat flu
if you can't keep her or him at home
He had never been vaccinated. "A 20% loss of weight," I told the owners. "This is serious." I taught the owner how to open the mouth to examine for ulcers and how to give the oral medication and electrolytes as he wanted the cat to be home.
P.S
Many Singaporean cat lovers permit their cats to stray outdoors. Vaccinate your cat yearly to prevent the common respiratory and other viral infections. Yearly dental checks help your cat to live longer.
Update at www.toapayohvets.com
Treat your veterinary internship seriously
INFORMATION FOR PROSPECTIVE INTERNS INCLUDING VETERINARY UNDERGRADUATES/VET TECHNICIAN STUDENTS FROM POLYTECHNICS
I receive many e-mails regarding internship. Some writers obviously have not visited the Toa Payoh Vets webpage to research on the requirements of internship (this webpage). These applicants will be rejected.
Market yourself well if you want to do well in life and get what you want. This is the reality of life. There are strong competitors and other factors affecting your chances of being successful. Therefore, be prepared if you want to be an intern. In Toa Payoh Vets, internship is Dr Sing's giving-back to the community rather than a tool to recruit employees. Therefore, applicants need to satisfy the following:
1. Application via e-mail/post. E-mail to judy@toapayohvets.com giving 5 reasons in 500 words as to why Toa Payoh Vets should accept you as an intern. Enclose your resume, 2 character references and academic results of your "O", "A" levels and undergraduate grades or equivalent.
2. Please note that we do NOT accept interns with poor academic grades and no two character references. In other words, your "A-level" and polytechnic grades must be in the top 5% to be accepted as prospective undergraduates in veterinary schools in the U.K, Australia, New Zealand or U.S.A. This usually means at least 3 straight As and some Bs at "A" levels or Junior College Year 2 results. Applicants with acceptance by the Veterinary School overseas will be given priority.
3. Applicants should provide their grades in their school and get 2 character references if they want to see practice in Toa Payoh Vets by e-mail or post. E-mail for internship without any required supporting documents will mean that you do not know how to be successful in the real world.
4. Knowledge of digital photography will be an advantage. Show me your portfolio if you have such knowledge.
5. E-mails without our above requirements and those with attached files will not be entertained. We don't download attached files due to concerns about viral infections. Therefore, learn how to include your character references inside the e-mail directly or post the application to Toa Payoh Vets, Blk 1002, Toa Payoh Lor 8, 01-1477, Singapore 319074.
6. Interviews by Dr Sing. Bring your original certificates and testimonials together with photocopies. Testimonials unsigned by the teacher or referee or without letterheads are suspect and are unacceptable. I will phone your referees, therefore ensure that they are prepared to talk to me about your character and integrity.
7. Payment for internship. Please note that you will not be paid. If your parents or you expect payment, please apply elsewhere.
8. Honesty is most important for interns as dark forces in your mind seem to work harder at the growing up age to deviate you from the "straight" path. Thefts of money and property of Toa Payoh Vets will be reported to the police.
9. Diligence at keeping records and writing up cases within 48 hours are required. I will discuss with interns some cases. If they don't have time to record the findings and challenges encountered in the handling of such cases, how can they learn and profit from the internship? I note that there are many interns from Junior College not adhering to this requirement. This is a bad attitude.
9.1 Pen and Paper/Electronic pens. It is best you bring your non-electronic book to write down details and instructions of the cases.
I know some young ones are used to keying messages into the mobile phone. You are the internet generation. However, I cannot wait while you thumb furiously my verbal instructions and discussions of the cases into your mobile phone because I have lots of things to do myself and I can't wait for you.
Therefore, pen and paper are still necessary. However, if you have an electronic pen, it is OK with me. Reports are to be submitted within 48 hours by e-mail to me.
10. Personal safety. Toa Payoh Vets is in an industrial park but it is a very safe place to work in the evenings. I had an internist who told me her grandmother was worried about her working in the evening and therefore she should work during office hours. In such cases, my reply will be to just stay at home. Veterinary work in the real world involves evenings and weekend work.
11. Gossip. Try not to waste time spent at Toa Payoh Vets by idle talk with my staff. They have lots of work to do but some of my staff simply love idle chat and gossip with newcomers. Most likely you will find that you need time management and that you practically have no time to complete your tasks. So why spend time gossiping?
12. Self-discipline & targets. You should write up the daily cases within 24 hours (that is why I will ask whether you have a note-book) and e-mail them to me (not as attached files - you figure how you do it electronically).
13. Independence. Ask your mother not to phone me enquiring about internship on your behalf. I don't accept students who can't be self-reliant. Please ask your parent or best friend NOT to accompany you for the interview. But if mum comes, introduce the parent/s to me as a matter of courtesy. Best friends are best left at home! This is one time you need to cut the apron's strings and be confident as you embark on a new and wonderful adventure into the big animal world.
In conclusion, many young people come for interviews and work unprepared without resume and requirements. Some girls come with their mothers and best friends for the interviews. Please note that you are asking for an internship and therefore should be well prepared for the interview so as not to waste time.
Internship is serious business for you. You will learn the ropes and the challenges of the real world in a commercial veterinary practice. It is so much different from your school or home. It is not a travel or boat cruise at Toa Payoh Vets. It is not your "grandfather's house" where you come and go as you please and relax at Toa Payoh Vets just like the young man in the picture of "The Magnificent Twelve".
There is much to learn and much to teach the interns going to study to become good veterinarians in the very short time you are with me.
A lot of time and resources are given to the intern to get them on the feet into the exotic and beautiful veterinary world. I don't want youths who are not up to my expectations to be at Toa Payoh Vets. Therefore, ensure that you are able to comply with the above requirements before you apply to be an intern at Toa Payoh Vets.
Common behaviour of Singaporean interns observed. Tardiness and not being punctual at work are commonly observed for the previous interns. This is unacceptable and your internship may be terminated immediately.
You may feel that you are not paid, therefore you can come and go as you please. Toa Payoh Vets actually must spend time and money to mentor you.
You are not an asset to the practice at this time of your life and if you feel otherwise, please do not apply for internship. The world does not owe you a living. You have to prove that you can be an asset to Toa Payoh Vets by your actions and your diligence once you are accepted as an intern. Note that punctuality at work is important in Toa Payoh Vets. If you feel that you can't be punctual or wake up early in the morning to go to work, please do not apply for internship.
Note that your internship will be terminated immediately if your working attitude and punctuality is not up to my expectations. Ensure you have sufficient rest at home. I have seen interns yawning or sleepy during my case discussions. This is not an acceptable behaviour and may mean instant dismissal. Therefore, treat your vet internship seriously. Your good or bad behaviour serves to undermine Toa Payoh Vets' scheme of internship for future applicants and therefore you need to do your best.
Even if you are selfish don't care about other young ones by displaying poor work attitudes during internship. In any case, your internship will be terminated immediately if you show little passion or interest in veterinary medicine and surgery. Note that testimonials are given only for interns who have worked full-time and for more than 4 weeks. Others will receive a record of attendance.
I receive many e-mails regarding internship. Some writers obviously have not visited the Toa Payoh Vets webpage to research on the requirements of internship (this webpage). These applicants will be rejected.
Market yourself well if you want to do well in life and get what you want. This is the reality of life. There are strong competitors and other factors affecting your chances of being successful. Therefore, be prepared if you want to be an intern. In Toa Payoh Vets, internship is Dr Sing's giving-back to the community rather than a tool to recruit employees. Therefore, applicants need to satisfy the following:
1. Application via e-mail/post. E-mail to judy@toapayohvets.com giving 5 reasons in 500 words as to why Toa Payoh Vets should accept you as an intern. Enclose your resume, 2 character references and academic results of your "O", "A" levels and undergraduate grades or equivalent.
2. Please note that we do NOT accept interns with poor academic grades and no two character references. In other words, your "A-level" and polytechnic grades must be in the top 5% to be accepted as prospective undergraduates in veterinary schools in the U.K, Australia, New Zealand or U.S.A. This usually means at least 3 straight As and some Bs at "A" levels or Junior College Year 2 results. Applicants with acceptance by the Veterinary School overseas will be given priority.
3. Applicants should provide their grades in their school and get 2 character references if they want to see practice in Toa Payoh Vets by e-mail or post. E-mail for internship without any required supporting documents will mean that you do not know how to be successful in the real world.
4. Knowledge of digital photography will be an advantage. Show me your portfolio if you have such knowledge.
5. E-mails without our above requirements and those with attached files will not be entertained. We don't download attached files due to concerns about viral infections. Therefore, learn how to include your character references inside the e-mail directly or post the application to Toa Payoh Vets, Blk 1002, Toa Payoh Lor 8, 01-1477, Singapore 319074.
6. Interviews by Dr Sing. Bring your original certificates and testimonials together with photocopies. Testimonials unsigned by the teacher or referee or without letterheads are suspect and are unacceptable. I will phone your referees, therefore ensure that they are prepared to talk to me about your character and integrity.
7. Payment for internship. Please note that you will not be paid. If your parents or you expect payment, please apply elsewhere.
8. Honesty is most important for interns as dark forces in your mind seem to work harder at the growing up age to deviate you from the "straight" path. Thefts of money and property of Toa Payoh Vets will be reported to the police.
9. Diligence at keeping records and writing up cases within 48 hours are required. I will discuss with interns some cases. If they don't have time to record the findings and challenges encountered in the handling of such cases, how can they learn and profit from the internship? I note that there are many interns from Junior College not adhering to this requirement. This is a bad attitude.
9.1 Pen and Paper/Electronic pens. It is best you bring your non-electronic book to write down details and instructions of the cases.
I know some young ones are used to keying messages into the mobile phone. You are the internet generation. However, I cannot wait while you thumb furiously my verbal instructions and discussions of the cases into your mobile phone because I have lots of things to do myself and I can't wait for you.
Therefore, pen and paper are still necessary. However, if you have an electronic pen, it is OK with me. Reports are to be submitted within 48 hours by e-mail to me.
10. Personal safety. Toa Payoh Vets is in an industrial park but it is a very safe place to work in the evenings. I had an internist who told me her grandmother was worried about her working in the evening and therefore she should work during office hours. In such cases, my reply will be to just stay at home. Veterinary work in the real world involves evenings and weekend work.
11. Gossip. Try not to waste time spent at Toa Payoh Vets by idle talk with my staff. They have lots of work to do but some of my staff simply love idle chat and gossip with newcomers. Most likely you will find that you need time management and that you practically have no time to complete your tasks. So why spend time gossiping?
12. Self-discipline & targets. You should write up the daily cases within 24 hours (that is why I will ask whether you have a note-book) and e-mail them to me (not as attached files - you figure how you do it electronically).
13. Independence. Ask your mother not to phone me enquiring about internship on your behalf. I don't accept students who can't be self-reliant. Please ask your parent or best friend NOT to accompany you for the interview. But if mum comes, introduce the parent/s to me as a matter of courtesy. Best friends are best left at home! This is one time you need to cut the apron's strings and be confident as you embark on a new and wonderful adventure into the big animal world.
In conclusion, many young people come for interviews and work unprepared without resume and requirements. Some girls come with their mothers and best friends for the interviews. Please note that you are asking for an internship and therefore should be well prepared for the interview so as not to waste time.
Internship is serious business for you. You will learn the ropes and the challenges of the real world in a commercial veterinary practice. It is so much different from your school or home. It is not a travel or boat cruise at Toa Payoh Vets. It is not your "grandfather's house" where you come and go as you please and relax at Toa Payoh Vets just like the young man in the picture of "The Magnificent Twelve".
There is much to learn and much to teach the interns going to study to become good veterinarians in the very short time you are with me.
A lot of time and resources are given to the intern to get them on the feet into the exotic and beautiful veterinary world. I don't want youths who are not up to my expectations to be at Toa Payoh Vets. Therefore, ensure that you are able to comply with the above requirements before you apply to be an intern at Toa Payoh Vets.
Common behaviour of Singaporean interns observed. Tardiness and not being punctual at work are commonly observed for the previous interns. This is unacceptable and your internship may be terminated immediately.
You may feel that you are not paid, therefore you can come and go as you please. Toa Payoh Vets actually must spend time and money to mentor you.
You are not an asset to the practice at this time of your life and if you feel otherwise, please do not apply for internship. The world does not owe you a living. You have to prove that you can be an asset to Toa Payoh Vets by your actions and your diligence once you are accepted as an intern. Note that punctuality at work is important in Toa Payoh Vets. If you feel that you can't be punctual or wake up early in the morning to go to work, please do not apply for internship.
Note that your internship will be terminated immediately if your working attitude and punctuality is not up to my expectations. Ensure you have sufficient rest at home. I have seen interns yawning or sleepy during my case discussions. This is not an acceptable behaviour and may mean instant dismissal. Therefore, treat your vet internship seriously. Your good or bad behaviour serves to undermine Toa Payoh Vets' scheme of internship for future applicants and therefore you need to do your best.
Even if you are selfish don't care about other young ones by displaying poor work attitudes during internship. In any case, your internship will be terminated immediately if you show little passion or interest in veterinary medicine and surgery. Note that testimonials are given only for interns who have worked full-time and for more than 4 weeks. Others will receive a record of attendance.
Monday, May 17, 2010
68. Incredible But True Story: When the chips are down - Part 1
INCREDIBLE BUT TRUE STORY
Year: 1998 - 2003 SARS (Severe Acute Respiratory Syndrome)
Location: Singapore, Desker Road Coffee Shop
Yuan: Hokkien Peranakan. Male, Singaporean. Late 30s. Retrenched. Jobless. Estrangement from his wife. No children.
Big brother: Triad chief of Desker neighbourhood
Pig face: A look-out
Susan: Coffeeshop drinks operator
Between 1995 to 1998, there was a period of recession. Singapore was affected too even up to the early 2000s before SARS appeared in 2003. One of my friends lost his marketing job and could not find any executive job for several months. His marriage was on the rocks and his mum sided with the daughter-in-law for some reason I am not sure of.
The HDB re-possessed his apartment as he was unable to pay the mortgage for many months. He had to move out to room with some friends. He always had a coat-and-tie job in exotic places. I would marvel at his stories of interesting people he had met and the closing millions of dollars of sales for his employers in securing accommodation regional hotels and resorts.
The recession just stopped people from travelling and so he was retrenched. After several months of rejections in his job application, Yuan lost all his savings. He was not the type to go around looking for loans from friends.
He decided to open a food stall in a corner two-storey coffeeshop at Desker Road selling laksa. As to why he set up a stall in this notorious red-light district, I did not ask him but I made him show me the real place as his tale of setback was incredible for a Singaporean brought up in a Hokkien Peranakan family with no connections to the underworld or to the politicians and top businessman.
I had met him for lunch two days ago on April 21, 2010. I wanted to learn some secrets of his success as a marketer for a corporation and how he bounced back from a severe setback in his life. Learn from the best and successful person. Books can only teach you theories.
Lately, I had been meeting men and women in dire straits and looking for loans. So a meeting with Yuan was so much positive for my spirits as his stories were entertaining and uplifting. During lunch at the Hans Cafe eating his favourite sweet and sour fish, I asked Yuan to re-tell me my favourite story of working in a combat zone called Desker Road.
Desker Road was and probably is a "red-light" district and I imagine the place to be frothing with gangsters. It is a place that looks normal during the daytime, but I could imagine that the Singapore Mafia had a strong presence there.
Yuan recalled vividly the behaviour of gangsters in Singapore while he was operating a small food stall. "One day, a young man on a bicycle beckoned me with a finger to get out of my stall to meet him outside the coffee shop. He wanted to extort protection money from me."
Yuan said: "Brother, I can give you free laksa. "I have no money to give you." The extortionist was not pleased and threatened him bodily harm. "Why are you so depressed nowadays?" Susan, the coffeeshop lady asked Yuan who was usually a cheerful person. No customers want to buy from unhappy people and he always showed a happy front. He was selling laksa at $3.00 per bowl and could sell 100 bowls per day during good periods.
His friend who owned the coffeeshop had asked him to start a stall and said: "Pay me $25.00/day or whatever amount you can." So, Yuan had no pressure unlike the Marina Square food courts whose rental is $10,000 - $15,000 per month in 2010.
"Susan is the wife of the Landlord and operates the drinks stall," Yuan elaborated. "She will barter free drinks for my laksa. But I cannot barter my laksa for her Tiger Beer or Guinness Stout."
"I don't want to cause trouble," Yuan had told Susan what happened. Soon Susan told him, "You will see some fireworks today."
"So, what happened?" I imagined the beast in man to be brought forth. The extortionist would be chased into a dead end by gangsters with poles, parangs and machetes and hit and clubbed and hacked to death.
"Big Brother (the gangster chief) came for dinner and I served him. I usually gave him two eggs for his laksa." I have always thought that the triads and secret societies were wiped out by the number "999" in Singapore as the Singapore newspapers seldom report on gang warfare. Maybe the tabloids report such incidents but I don't read tabloids. Many Chinese secret societies had numbers but somebody told me that the only gang in Singapore is "999" nowadays. Even in the red-light district of Desker Road, I had presumed.
For the benefit of readers, "999" refers to the Singapore police force who is the top dog except that the control of loan sharks appear to have slackened.
Yuan recounted: "Big Brother ate his laksa. Then he asked his side kick to get Pig Face who was cycling up and down the alley between Desker Road and Rowell Road. Pig Face came and Big Brother said: "When my mother does not cook my lunch and dinner, I come here to eat. Why are you harassing Yuan?"
Yuan means "Handsome" in the Hokkien dialect according to my friend as this was his nickname in the coffeeshop. That was what Big Brother called him and this is what I call him for this story as I can't identify him as he is a real living person.
More Hokkien expletives followed. Big Brother nodded his head and slammed his right fist on the table, spilling out the gravy of his laksa. He squinted his one good eye and curled the fingers of his right hand downwards at Pig Face. His men rained punches onto Pig Face's abdomen. Pig Face fell and he was kicked more times.
Extortion and violence are part and parcel of secret societies but as I did not associate with such elements, this was the first time I had heard of the culture of the gangsters at Desker Road.
"I presume the gangster chief and his men get free meals from you for protection," I said to Yuan. "He always pay for his meals," Yuan said to my surprise. "Gangsters do have their code of ethics. Do you know what Pig Face does for a living?" "No," I said. "”Pig Face's job was to cycle up and down the alley between Desker and Rowell Road.
Whenever he sees the police, he will sound the alarm or ram his bicycle into them. This will alert the sellers of pirated CDs and pornographic material." Since Playboy magazine is prohibited in Singapore, there must be a demand for such items amongst the young national servicemen." Yuan continued as he completed eating all his food:
"Pig Face is a runner." But runners can be ambitious too to rise up the corporate ladder. Only that he picked the wrong person to extort. All the characters I had written had disappeared although the coffee shop, now taken by a new management, still exists.
After one year selling laksa, there was a marketing job in the a hotel. Many Singaporeans shun a marketing and sales career as there are targets to be made and people to be convinced to close a sale. Yuan is now a very successful sales person and earns at least $5,000 per month. He still works for various corporations. Only for legal ones and he does not get involved with shady businessmen. He is very selective in making friends as many of his contacts just want to use him for his large network. He is the type who is afraid of starting up but he has the network and supporters over the past 15 years to support him if he knows how to be an entrepreneur. He has the guaranteed salary at the end of the month. So, why bother getting out of his comfort zone and being at risk of no income. He never takes kick backs when he works for the corporation. Nor does he go for the wine and women, con people or ask for personal loans. So, his reputation in the closely knit hospitality industry remains good. There is a great demand for experienced and successful marketers in his industry.
When the chips are down, Yuan started a food stall rather than borrow money from friends. Or con Singaporeans by promising them high returns on their investment. Or like the older lady who spiked coffee of older men with Dormicum and ran off with their money and Rolex watches for the 4th time.
He is the sort of the rare honest employee who is an asset to any business and was never affected in the 2008 recession. He had no university degree but he could perform much better in getting sales than his managing bosses because he had the passion to sell. And know how and what to do in closing the sale.
As to why he worked in Desker Road and had survived the gangsters there for one year, I will ask him the next time I meet him. I am sure 99% of Singaporeans will not be able to survive there. When the chips are down, Yuan did not go around looking for personal loans or stay at home. Well, you could say that he had no more home since his mother sided with his estranged wife and his HDB apartment was re-possessed. But he found a way to survive.
Today he is employed and as employees, he is exploited by corporations to make money for them as he has an extensive network of clientele. That is a reality of life. At the end of the month, he has a salary. And that is important for him. But I can see that he can make three times his salary if he is confident of coming out of his comfort zone. His supporters are there.
It is just like a successful songstress. If she has a good voice and good lyrics, she would have fans. They will increase in numbers over the years and she does not need to sing in seedy bars. If you have viewed the movie "The Runaways", you can see that Joan Jett was having setbacks in her early career. She persevered when her lead singer in her band gave up. She became the singer and started her own band "Joan Jett and the Blackhearts".
IMAGE: The Esplanade guitarist and singer. Labour Day. Singapore.
Sunday, May 16, 2010
How to identify an issue from its fundamentals?
Thin 2.5 kg
"Every morning, the cat will meow loudly for his breakfast. My wife will kick me out from the bed to prepare his cat food," the father told me when I asked whether the cat had been eating normally. I could feel the spines of backbones sticking out onto my fingers. The cat had two big holes in her left flank. Holes of 5mm x 5 mm.
The younger daughter said: "Two years ago, you said this cat would die of liver failure as she had not been eating for one month. She is very much alive!"
"If a cat does not eat for a long time, there is liver fat breakdown and soon the cat gets jaundice and dies. There must be some reason I said about liver failure."
"Yes," the father said. "The cat stopped eating because we got a small kitten in. You said to get rid of the kitten."
"Once the kitten left the house, this cat ate. So, it was stress."
Identifying an issue from its fundamentals is not easy.
"Every morning, the cat will meow loudly for his breakfast. My wife will kick me out from the bed to prepare his cat food," the father told me when I asked whether the cat had been eating normally. I could feel the spines of backbones sticking out onto my fingers. The cat had two big holes in her left flank. Holes of 5mm x 5 mm.
The younger daughter said: "Two years ago, you said this cat would die of liver failure as she had not been eating for one month. She is very much alive!"
"If a cat does not eat for a long time, there is liver fat breakdown and soon the cat gets jaundice and dies. There must be some reason I said about liver failure."
"Yes," the father said. "The cat stopped eating because we got a small kitten in. You said to get rid of the kitten."
"Once the kitten left the house, this cat ate. So, it was stress."
Identifying an issue from its fundamentals is not easy.
Preventive Medicine
SUNDAY CASE - May 16, 2010
Miniature Schnauzer, Male, 6 years
Annual vaccination + proheart vacc
Examination:
Bladder palpated. Body shivered when lower abdomen is palpated. The 17-year-old daughter saw the vibrations. "He has some abdominal pain" I said. "Maybe a bladder infection."
"Can smell his urine from far away," the father said.
"Does the dog urine-mark?" I asked.
"Yes. He would pee a lot first and then urine-mark every spot even if he has nothing to pee."
"Does he drink a lot?"
"No," the father and daughter replied. "How to make him drink more and how much he should be drinking a day?"
"Exercise will make him thirsty. Some dogs love iced water. Put ice cubes into the water," I said.
Advice:
Dogs over 2 years need a preventive programme, not just annual vaccination.
1. Complete Blood test
2. Urine test to check for struvite stones and bacteria.
Permission:
Much depends on the parents.
Urine test agreed. Urine catheter, collect dark yellow cloudy urine to be sent to the Lab.
3. Read about prevention of urinary struvite stones.
4. 3-monthly or 3-6 monthly urine test will be best but no owners will do it.
Questions:
How long after neutering will my dog stop urine marking?
"Now, 6 years old. It will take many weeks to a year."
1. Probably 1 year
2. Schedule. lst month - urine mark same area. Change to another location
Miniature Schnauzer, Male, 6 years
Annual vaccination + proheart vacc
Examination:
Bladder palpated. Body shivered when lower abdomen is palpated. The 17-year-old daughter saw the vibrations. "He has some abdominal pain" I said. "Maybe a bladder infection."
"Can smell his urine from far away," the father said.
"Does the dog urine-mark?" I asked.
"Yes. He would pee a lot first and then urine-mark every spot even if he has nothing to pee."
"Does he drink a lot?"
"No," the father and daughter replied. "How to make him drink more and how much he should be drinking a day?"
"Exercise will make him thirsty. Some dogs love iced water. Put ice cubes into the water," I said.
Advice:
Dogs over 2 years need a preventive programme, not just annual vaccination.
1. Complete Blood test
2. Urine test to check for struvite stones and bacteria.
Permission:
Much depends on the parents.
Urine test agreed. Urine catheter, collect dark yellow cloudy urine to be sent to the Lab.
3. Read about prevention of urinary struvite stones.
4. 3-monthly or 3-6 monthly urine test will be best but no owners will do it.
Questions:
How long after neutering will my dog stop urine marking?
"Now, 6 years old. It will take many weeks to a year."
1. Probably 1 year
2. Schedule. lst month - urine mark same area. Change to another location
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