do you believe in love at first sight it's an illusion i don't care
it's all an illusion there's too much confusion down down down with your heart find find find the secret turn turn turn your head around baby we can do it we can do it alright do you believe in love at first sight it's an illusion i don't care do you believe i can make you feel better too much confusion come on over here can we get together i really i really want to be with you come and check it out with me i hope you i hope you feel the same way too...
Saturday, April 29, 2006 :::
DON'T SWALLOW THAT
A patient comes in with dysphagia (difficulty in swallowing), and a clinician you order a barium swallow test - sounds perfectly logical and responsible doesn't it?
But consider this.
The patient is a 90 year old man. He swallows with some degree of difficulty. He doesn't understand cantonese and can't communicate with you.
Bear in mind that a barium swallow test involves the following:
1. A barium 'meal' that looks like thick white glue. You need to feed the patient, and the patient has to take a big gulp.
2. A lot of instructions from you: Don't swallow it yet; Swallow it now; Please please please swallow it; You can go after you've swallowed it; Good job, keep swallowing, don't stop there; Please swallow a bit more, you can do it; Now turn to your left; Right now face up again; Now turn to your right; Good face up again; Now hold on to the handle; Oh here's another cup of barium meal for you;
3. Then it's repeating the whole thing again, if necessary. Until you get enough images to demonstrate the site of abnormality, if there is one. And if the patient doesn't cooperate, you have to wait. And wait. Until he/she swallows.
Of course, if you're out of your mind, you may try yelling 'Now fucking swallow if you want to leave this place!', after the patient's been there for half an hour already but you still haven't got the images you want, and you still have to attend to a long list of patients who naturally wouldn't be barium meal lovers.
But you know deep inside that the thick white substance is not the best thing to swallow, so you just swear to yourself instead and hope that white thing goes through fine, take a snapshot of that very moment to prove that the esophagus is indeed very patent and very hollow without clogging meatballs or $5 coins, then you spare the patient from another shot of barium.
So now, do you really want to send a 90 year old patient for such a test?
And let's see what can happen after the patient swallows the white potion:
A. No lesion is found. Patient should be happy but probably not too happy because he's been forced to drink it for no reason.
B. Lesion is found. Probably a tumor. But let's see, oh since the patient is 90 years old already - who can operate on a 90 year old patient? So a lesion is found, but treatment is conservative.
C. The patient chokes, and some of that barium meal gets into the lungs. Oh oh - pneumonia, or even more dire outcomes.
Smart, isn't it.
But sadly in reality patients like these do get sent to the radiology department. Because all it takes is for a clinician to scribble a few words like these:
Hx - Dysphagia for 2 weeks Ix - Ba swallow
And who cares who actually does the swallowing and who does the yelling, right?
On music news, first let's see what albums are receiving top spin from me, apart from the aforementioned Aqua debut. This time perhaps with a little bit of substance involved: Released on 2 May on Atlantic label, this might be Jewel's finest work to date. Her last album 0304 was a departure from her own sound, but now she's returned to her roots and Goodbye is a very poetic, very autobiographical and very acoustic album. Lead single Again and Again and the title track are brilliant. I especially love the title track. "Growing up is not an absence of dreaming", and "there's a difference between dreaming and pretending". I might just buy this album for this song.
Tara is from Ireland. And guess what, she's managed by John Hughes - the one who discovered and managed The Corrs (needless to say my favorite band of all time), and this is Tara's debut. The singles are quite nice, although the other album tracks are too mellow for me. The 2nd single 'The Three Degrees' is particularly nice. The album is produced by Olle Romo, so you can hear the slight resemblance to The Corrs' Borrowed Heaven, which was also produced by Olle. (The beginning of Paperback Cliche reminds me of Summer Sunshine). Basically they even share the same musicians, like guitarist Anto Drennan. I think her voice is too soft and vulnerable for rock numbers like Paperback or The Three Degrees but she's got some nice songs nonetheless.
I've introduced you Mat's album when it's available for full preview on AOL music. Now it's leaked. I haven't listened to the whole thing yet, but it has a great start. As I said it's a hybrid of Coldplay (because he sounds like Chris Martin), Uncle Kracker, Beck, Jack Johnson and Johnny Cash. Very 'adult contemporary'. Here's his myspace. And thank God he doesn't have a weird voice, like James Blunt or Daniel Powter.
Speaking of weird voice - both Powter and Blunt have made it big in the US. Let's see, Powter is currently no.1 on Billboard's top 100. Actually 'Bad Day' was released so long ago, it must be sometime last year, and I loved that song instantly. However I never thought it'd make it to no.1 in Top 100. It's a good thing I guess, to see something non rap/hiphop/r&b taking the no.1 place. The American music scene has become so boring that I don't pay attention to Billboard anymore.
Another reason is because billboard has had a makeover some time ago. And ever since I haven't been a regular anymore. I like its old, rather crude, layout much more than the current 'fancy' layout. Somehow the new layout makes the chart difficult to look at, and the site design makes it difficult to jump from 1 chart to another. Oh well, a few things that surprises me:
1. I was checking how Mat Kearney did for his debut - and oh, he's in Billboard 200 but out of the top 100 places. He debuted at no. 161. Boo. I think when Powter and Blunt can make it that far, Mat deserves some attention too.
2. Shakira's Oral Fixation vol 2 has actually climbed to the top 10. Must be her 'Hips Don't Lie' saving the album from tumbling down the charts. But wow, I never thought Hips Don't Lie can revive the longevity of her album like that.
3. Dixie Chicks' Not Ready To Make Nice, sees them making a statment after they were being boycott by fans after their infamous comments about president Bush infuriated them. It's nice to see them back, with a vengeance - I like the way they speak their mind and is not giving up. They debuted at top 30 on Hot 100, which is a great thing.
4. Perhaps the most shocking of all, is seeing what is occupying the top spot for the album chart. It's a band called Rascal Flatts - with their CD 'Me and My Gang'. And when I logged on to the official site, I found out their debut single is this:
"WHAT HURTS THE MOST".
WTF? Isn't that the song released by ex-S Club 7 member Jo O'meara for her debut CD? WTF? A band doing that song? Who is covering whom? WTF? After looking further on the net, that song was originally performed by country singer Mark Willis. Then Jo covered it for her debut CD. Of course that didn't do so well, I think. And now, Rascal Flatts, is doing this song. And they have a no.1 CD. WTF? The video involves a lot of crying.
Conversation between boy and girl: "What's wrong. Is it your dad?" "No. Do you ever think about the future? What do you see?" "What do you see?" "I'm serious." *pause* "You. I see you"
And then. Was there a car crash? Why did someone have to die in that video?
Gee. I totally don't get it. That song. By a country band. The video, with a story I don't understand and people dying for now obvious reason. And the CD topping the charts. If you're interested, log on to their official site and watch the video, see if you can make that out for yourself. It's not a bad song.
it's all an illusion there's too much confusion down down down with your heart find find find the secret turn turn turn your head around baby we can do it we can do it alright do you believe in love at first sight it's an illusion i don't care do you believe i can make you feel better too much confusion come on over here can we get together i really i really want to be with you come and check it out with me i hope you i hope you feel the same way too...
