2 years

Hey buddy.

It's been two years since you left our world for the next. I imagine you've probably been watching over us and you know, much has changed.

We have another child now. She turns 9 months today; and yes, you're probably laughing over how I'm outnumbered by the females. Even the other male in this household- the damn dog has been castrated. And so I'm the only one producing significant amounts of testosterone (yes, you know females make this stuff too, but in minute amounts). And so, it's ironic that your roomate of 5 years who was always complaining of the lack of women in his life during those pathetic years, is now surrounded by them.

The world seems to be a different place now too. Or perhaps it's just me- I've learnt to see things with jaded, saddened eyes. The recent elections in Malaysia. Even the ongoings here and the senseless gun violence, with people on both sides of the gun-control fence yelling at each other. You've probably met the little angels from Sandy Hook. And you probably shed some tears too by the recent Boston Marathon bombing. Why? Why waste these lives, when others who tried to fight their illness so hard, had to lose? Why does Man commit evil towards his Brother?

I can't believe how the last two years just flew by. It doesn't seem like that long ago when Kris and I got married, and you gave your Best Man's speech. Or when you got married; Nat King Cole's L-O-V-E still reminds me of your first dance- for a 'kayu' person you performed pretty well! I remember well that last night we met, when we had dinner at that food court in Penang. You were pretty nonchalant about it and pretended you didn't see the tears streaming down Kristin's and my cheeks. We knew that would be the last time we'd meet in this world- being the oncologist I'm sure you did, too. But I sure appreciated how you gave us that last chance to fly back and see you- I heard your condition worsened shortly after we (and Chairman) left. I'm not sure if the science backs this up, but perhaps you know if it's true- the dying sometimes have control over when they are ready to go. And perhaps it's presumptive of me, but it's heartwarming to think that you held out for us to see you one last time and to bid you goodbye. And Alli was under a year old, I tell her about you occasionally, and I'll make sure she remembers you.

And oh, did I tell you I met the family of one of your peers? He had metastatic esophageal cancer too, except he was much older, and was bitter of his diagnosis and couldn't accept things. Until he met you and was so inspired by your attitude and your peace. He passed away after you did, but I met his wife and daughter here in a strange twist. And we shared some tears talking about you and him.

We're settled in here pretty well. Perhaps too well; years ago I wouldn't have imagined myself in the midwest. Midsized city, in private practice. I always thought I'd be back in Malaysia. Or at least in some major academic institution like our Mothership. But sometimes fate leads you to unexpected places. Work is OK, I tell myself. There are things I wish was different- I miss the mental stimulation of being at the Mothership, of being involved in scholarly activities. I would have liked to have more involvement in the teaching of residents and fellows. But it's OK; I'm not complaining- I am a partner in my group, and I have some good colleagues. Though I wish I was less involved in the business aspects of things. I'm a doctor, a healer. I'm not an accountant, or a businessman, or a disciplinarian.

I miss our chats. As nonchalant or casual as we sometimes make it to be, I miss them. There aren't many I get to share my thoughts and fears and frustrations to. As a father and head of household, sometimes you have to keep a lot in. I miss our last-minute buffet meals at which we bitch and complain about the world. As minor and unimportant as those may be, it was therapeutic.

And needless to say, I miss my Halo wingman. You might have been proud of me when I finally completed Halo 4. Damn game took me a long time, and I was stuck many times on many levels. I still have your player profile on my Xbox, and I was saddened to see your name there when I logged in to play alone. And heaven knows my wife isn't a help; she'd probably end up killing us accidentally by dropping a grenade on us! And so, I played alone. Woke up at 6AM on weekends before the kids got up to play. And after 2 months, I completed it! Maybe someday I'll teach Alli how to play and be my new wingman.

Anyway, I know how you hate sentimental words. Didn't mean to embarrass you. Just that I wanted you to know that though you passed away 2 years ago, we haven't thought of you less. And know I look forward to seeing you again, I know it will be awhile. But do look over us in the meantime.

By the way, I found this old picture. This was our first ACP meeting. We looked so young back then, didn't we? Gawd.

Holy Shit!!

That's what my patient yelled.

Literally.

So loud that my nurse thought he was angry at me.

"Holy Shit!!"

 

When I saw him 3 months ago and did nothing to adjust his insulin program, he wasn't impressed. He wasn't happy that I instead suggested he spends some quality time with my diabetes educator.

"Why can't you just tell me what dose of insulin to use?"

 

Because things change. Diet and meals. Activity levels. On a daily basis. So rather than making a change for him, it's often best to provide a person the knowledge and tools of carbohydrate counting, and insulin adjustment principles. It was clear Mr. D would benefit from it as he had little insight on how to adjust.

 

And so when I saw him the other day and handed him his bloodtest result, and it showed his hemoglobin A1c to be 6.4%, that was his reaction. From a previous 13.3%.

 

As they say, give a man a fish and he will eat for a meal. Teach a man to fish and he will eat for a lifetime.

Well done, Mr. D.

Happy Nurses' Week!

Because I could never listen to a patient, to comfort one, to hold his hand when he's afraid, to change his clothes when he is diry, to cry a few tears when she passes away, to protect her and be her advocate when she isn't able to take care of herself, or do countless other tasks, as well as a nurse can.

Happy Nurses' Week!

This was the pancake crew of doctors working the 630AM shift, serving breakfast to our nurses!

The aftermath

If you're Malaysian, you're well aware of the outcomes of the elections. Thousands of miles away, we followed the updates online.

Naturally, I was disappointed. Disappointed that the outcomes were not different. But even more disappointed by the tactics some parties used to 'win'.
If these allegations are true (admittedly social media is not always correct there appears to be video and photographic evidence)- in simple terms, they cheated.

I'm heartbroken as many of you are. Saddened and in mourning over what seems to be the lack of democracy and fairness.

And outraged by the seemingly arrogant and irresponsible remarks the man who is supposed to be the political leader and representative of all Malaysians, suggesting or accusing a certain race for the outcomes of the elections.

With even the PM stoking the fire, what future is there for the minorities in Malaysia? Who will protect their interests? And does anyone still look beyond skin color? I am fearful.

But, if there is a silver lining in all this, it was heartwarming and encouraging to see how most, regardless of skin color, was united in this cause. How, despite the reports of threats and violence, good people helped each other out.

Yes, I'm heartbroken; I still am. But this will heal, as I'm sure yours will. And perhaps someday, there will be enough who will say no to greedy, racist and corrupt leaders.

I shall remain optimistic.

The day of reckoning

I left Malaysian in 1998. Have since spent over a decade between Canada and the USA. But the saying that you can take the boy out of Malaysia, but you can never take the Malaysian out of the boy, hasn't been truer than today.

It's Sunday in Malaysia. Thousands of miles away, I am glued to social media sites, reading updates every minute. I am pacing the floor, anxious. I am outraged reading about the ploys and the tricks some resort to. And when dad sent me a picture of his finger after he voted; the amazingly undefeatable indelible (invisible) ink:

 

Malaysia, though we are far away, many of us still proudly call ourselves Malaysian, and wish the best for you. I pray for a peaceful elections, and that the party and its selfish goals that has been poisoning the nation and dividing her people will finally be toppled. I hope to wake to up good news tomorrow morning.

Historic GE-13

Whatever the outcomes this weekend, the 13th Malaysian General Elections will be a historic event.

For far too long, Malaysians have put up with a ruling government that emphasizes cronyism, corruption, racism and personal gain.

For far too long, powers-that-be have held on to that power, and signs indicate that the powers-that-be are fearful of losing that grip on the Malaysian people.

 

I tell my patients you can't believe everything you read on the internet. But with social media and all you read about, you can't help be worry and be disheartened about the desperate moves the ruling party appears to be resorting to.

 

Open vote-buying, bribery. Subtle threats of racial violence, or playing the racial card to divide and conquer. Phantom voters, even to the extent to apparently flying in foreigners to vote for them.

 

Whatever the outcomes, this will be a historic event, reminiscent of the Arab Spring movement. If nothing else, this highlights the power of the internet and the social media. The corrupt leaders and their illegal or unethical practices are no longer hidden. Someone, somewhere is watching, and if they see a wrong, somehow it will be exposed. Perhaps it might be too slow and too few to affect the outcome of this election (though many of us wait with anxious and open hearts that the ruling party will finally be toppled), eventually the movement will gain enough momentum.

 

If not this time, perhaps the next. But, oh, please let it me this time.

 

Ini kali-lah, Malaysia. Vote wisely; the rest of us who are abroad hope for the best.

Patient Art

A patient of mine came in with his arm in a cast.
I asked him what happened, but before he could answer I was paged out of the room.

When I came back, this is what I saw.

Pretty self-explanatory.

The "crap" was a nice touch. I would have used more choice language.

 

And they say patients have no sense of humor.

Clearwater, Florida

After a long lapse since our last vacation, we took a short trip to Clearwater, Florida. Just a 4 day trip, but this was also a good warm-up for the impending Malaysia trip- good to see how the girls would put up with the flight.

Well, this was my first trip there. We wanted a beachfront hotel; location was the priority, not the room. And so we stayed at the Hilton Clearwater. It was an older hotel; its age was apparent from the outside though the rooms were modernized and tasteful if not a bit small. If you were unlucky enough, you might get a room facing the ventilation system- section of the hotel which was something of an eyesore. Thankfully we got a harborview room.

The beach, now that was something else. Long stretches of soft white sand. Right outside the hotel. It was easy to get to the beach, and back.

 

We loved it. The kids spent hours playing on the sand. Kris and I got to relax, and also went out on the jetski.

It was fun, right up to the point when she asked, "Are there sharks in the Gulf of Mexico?". I told myself I could swim faster than her if one ever came for us!

This was Ava's first trip to the beach. One we hope to duplicate in July when we go to the Jersey Shore. And again in November when we make our family trip to Pangkor.



One extra bonus was our visit to the Clearwater Marine Aquarium. It's resident Winter inspired the movie Dolphin Tale, and it was exciting enough for Alli to see some of the resident dolphins, and the other marine wildlife. But it was a treat to be able to see Winter as well.

Though the facility was small, and does not at all compare to the larger aquariums out there, and the cost adds up pretty fast, considering this functions primarily as a marine rescue facility, it was pretty entertaining for the kids, and the money goes to a good cause.

After a fun 4-day visit, and what felt to be a never-ending flight, we're home, just in time for me to start call this week.

Oh well. At least I have some tan lines to remind me that we had great trip before work resumed.

Winds of Change

Though I'm far away from my native Malaysia, every single day for the last 15 years I've been away, I have checked the local news. I wonder about her ongoings. And I have to say, like many Malaysians, have become more disillusioned about her leaders.

The circus that is going on in the recent weeks and months is a testament to how far some groups will go to retain absolute power.

And with one of the main opposition groups possibly off the ballots and its leaders possibly needing to go on the ballot of its ally, some are concerned if this will lead to confusion especially amongst those less aware of the recent events.

Some might also say they would never vote for a candidate under the PAS ballot.

Indeed, growing up, the Chinese have often seen PAS as a radical group.

But perhaps one of my good friends put it best: "Maybe this will show the real spirit of muhibbah in Malaysia".

Voting for a candidate not on the basis of skin color, or race, or religion. Instead, voting in the hopes that this candidate will have honor, honesty and integrity. Voting down corruption. The Chinese and Indians (and of course the Malays too) willing to back up PAS simply because of the dream that someday, we will be rid of the corrupt.

Malaysia, though many of us may be far away, I have high hopes for you.

I usually don't take offence at what a patient might say.

Today was an exception.

I saw a 62 year old woman for the first time- she had seen my colleagues in the previous months for her diabetes. She came in with no glucose logs (she hadn't been testing). She had not been taking her diabetes meds. Indeed, her blood pressure was 160/90 mm Hg; she had also deferred her ACE-inhibitor, and had refused treatment with a statin for her LDL of 168 mg/dL as well.

Not surprisingly, her hemoglobin A1c was 9.8%. And so, I urged her to consider changing her ways, and to take her prescribed medications.

To which she said, "I wonder how much commission you make prescribing these medications?".

I was rudely surprised at that question.

I firmly answered: "Nothing. We make zero dollars prescribing a medication".

Unlike some parts of the world, here we doctors prescribed and the meds are picked up only at the pharmacy (plus the medications she was supposed to be on are generic, anyway).

So I gently but firmly told her that if she wasn't willing to take our advice, and thinks we have ulterior (financial) motives, why was she choosing to come for her 3 monthly visits anyway? What good were these visits, if she didn't heed our advice?

34 years!

I found this in my album the other day. Yup, that's me in the back seat, with my older brother. Me, with the same stupid grin. And yes, I'm aware I look effeminate as a kid.

Gosh, that was the home in which I grew up (mom and dad still live there. I still call it 'home' despite us owning our house here- guess some things never change).

Anyway, it's surreal finding these, and then realizing that 34 years later my kid has the same stupid toothless grin. This was Alli 1.5 years ago. Before she grew fangs with which she devours everything.

These pictures were taken 34 years apart.

Except she's a lot cuter than dad way (digression: does ANY parent truly think their kids are ugly?).

In a follow up to my previous post about physician burnout, I read this on Medscape recently. As a specialty, we are not doing the worst- ER and Critical care are up there which isn't too surprising given the high-stress job and the long hours.

What I found surprising (and yet not surprising) was that family medicine was up there at number 3.

 

 

And then when you look at the causes that the surveys pointed it, it kinda made sense. The top reasons many feel burnt out is the bureaucracy, and the hours spent at work.

Speaking from personal experience, I know the amount of time I spend on paperwork drives me crazy.

Each day I try to squeeze in time between patients to fill out:

• Prescription refills
• Prior authorizations (a taboo word for our MAs)- filling out questionaires for the insurance carriers explaining why my patient needs insulin, or calcitriol, or Pill X or Y.
• Diabetic shoe prescriptions. This one boggles my mind; I'm not a podiatrist. Medschool, residency and fellowship do not train us to decide who needs diabetic shoes and who doesn't. I haven't the foggiest idea if they need "Plastizole inserts" or widened shoes. For that I trust my podiatry colleagues. But for some stupid reason, the Feds have determine that it is the endocrinologist that needs to sign the forms. Even if the podiatrist deems it necessary (but yet in a brilliant ploy- also recently determined that I cannot bill a foot exam if their feet have already been checked by the podiatrist within the last 6 months- but yet they need an endo to examine the feet within a 6 month period)
• Letters stating why my patient with diabetes on basal-bolus insulin need to check their glucose more than 3 times a day (I don't know which genius sits on the Advisory Commitee for Medicare, but EVERYONE on basal bolus insulin should be testing 4 times a day or more to be safe!)
• Forms to testify why my patient can do this, or can't do that. From driving, or certain physical activities, to just plain working
• Letters stating why my patient needs that pituitary MRI

Between my medical assistant and I, we spend 1-2 hours a day on these. So yes, I'm not surprised. I imagine the family doc would have much more than I do

 

Appears though that other factors were at play. Money being one of them (personally I am not complaining though with the changing climate our office has taken a huge hit in pay in the last fiscal year). Interestingly, the Affordable Care Act  and EMR were listed as number 4 and 5- this certainly has been causing a lot of angst and concern amongst my colleagues. And while many would be surprised by EMR (Electronic Medical Records) as the use of electronic records is supposed to make things better for patient care and physicians, the truth is many systems are prematurely jumping on the bandwagon to tak advantage of the federal stimulus package. And so what happens is medical systems adopt a poorly designed EMR that adds little to patient record keeping (aside from some quality improvement parameters) but instead churns out patient notes that lists 3 pages of diagnoses, medications but has nothing useful at all when it comes to the clinical impression and plan of care. I see this every day, since our system adopted an EMR- I get more asking the patient why they're there to see me, than to read the referral notes that were sent to me. Not to mention learning a new EMR, especially for physicians who are not computer-saavy (but are otherwise excellent clinicians) can be particularly harrowing. I know of at least 3 internists in the area who retired early because of this; they were spending 2 hours every night trying to catch up on documentation.

Anyway, I thought this was an interesting, thought-provoking piece of news. And as if to add more headaches/bureaucratic crap, I received notification from the American Board of Medical Specialties just yesterday that they're changing the way we do our Maintenance of Certification (MOC)- something about needing to do some MOC activities every few years (in addition to our CME requirements every 2 years) and on top of the exams every 10, just to maintain certification. Geez. Something tells me these activities have costs involved, too.

And people wonder why physicians are getting burnt out.

Dear medical student readers: if there is anything I want you to learn from this, look at the first diagram- and consider training in pathology, psychiatry or ophthalmology if you want to be happy!

Magic Treatment

This is a true story- I didn't make this up.

A young man went to one of my colleagues complaining of erectile dysfunction. Apparently, he was wanting to get a prescription for the little blue pill and testosterone.

He was going on about his total inability to get an erection, whether it was stimulated or physiologic (morning erections).

After the history taking came the exan. By my colleague, a dainty blonde young woman. At which time, he spontaneously sprouted a huge erection.

 

Needless to say, he didn't get the medication. And my colleague left the room a dark shade of red.

You never know

Sometimes you never know how a patient sees you.

I saw K today for follow-up of her diabetes. I last saw her over a year ago; she is a 20-something year old woman on an insulin pump for her type 1 diabetes. In the past, I've always had the sense that she was not too interested in what I had to say. I wasn't sure she actually followed my insulin instructions. And so, when she waited that long to come back I just assumed she didn't want to be here.

Turns out she and her husband moved north, and she had been under the care of a different endocrinologist. Except she didn't like her and didn't think their personalities matched.

And so today she drove 4 hours to come see me (with another 4 hours home).

And said she didn't think the new endo cared about, or listened to her as much as I did. Said she missed the great care our clinic provided to her over the years.

I was flattered- and on a crazy busy day with quite a few other uninterested patients, this was refreshingly very encouraging words.

And from her, of all people; I would not have thought!

I can't believe how fast these kids grow.
Monster 2.0 is now 7 months old. And looking back at Alli's old pictures, we are reminded of the wonders of genetics- their resemblance to each other is clear (or maybe it's because infants all look the same?).
That's Alli in the picture frame.

My Precious

My parents will tell you that a long LONG time ago, before I was dumb enough to want to be a doctor, my original ambition was to be an astronaut.

Yes, an astronaut.

It all started with two books my dad bought for me when we were up in KL for something-or-the-other. I remember being captivated by some books I saw in a bookstore and made a hell of a fuss over it. Spaceflight and Astronomy. Dad relented and got the the books, and I was hooked. I remember lovingly wrapping the books in plastic wrap.

I devoured them, and then reread them over and over again. And read whatever I could on space, astronomy, even UFOs. I was fascinated by all things related to the cosmo (I still am, but practicality prevails).

I remember the ecstasy when my dad's ex-boss gave me his old 50x zoom refractor telescope. I spent countless hours moon and stargazing. I learnt to pick out the constellations, and could name spacecrafts. Learnt how to rig the telescope into projection the image of the sun and sunspots (NEVER look directly at the sun, if ever you're dumb enough to think about it).

When I was older, I eventually founded the astronomy club in highschool (but sadly left for college before they eventually purchased their first telescope).

Oh the dreams I had.

But sadly, that was before the time Malaysia had a pseudo-space program and there was no such thing as buying a seat for yourself on the next rocket to orbit.

And so this silly boy went into his other calling instead.

But after a long lapse, my wife talked me into taking up this hobby again. Perhaps it was her way of getting me to rid our garage of junk.

"You can buy your telescope if you get rid of your tires. Maybe this is something you and the kids can do..."

So, I finally sold my 5-year old hardly-used winter tires. After all, since that first year I haven't driven the Porsche in the snow.

And with the extra change I got, I bought a telescope.

Nothing too fancy, but a Nexstar 4SE 4" Maksutov-Cassegrain reflector telescope. As tempted as I was to consider the 5" or even 6", I couldn't bring myself to blow $800 on a hobby I haven't pursued in over 15 years. Who knows, maybe I'd get bored after 5 mins. So I don't expect this to be hardcore, and probably isn't going to be too helpful for deep-space observation or photography, but it's a start. And I got a 8-24mm eyepiece to go with it.

It's on transit now, and I expect to get it this week. But admittedly, like a boy anxiously waiting for Santa on Christmas eve, I've been looking out for the UPS truck every night.

Except, this is a boy with a Visa and astronomy gear is not cheap and he's going to have to show a lot of restraint.

Will let you know how things pan out. But I'm excited. And maybe something I can change my job!

Har Mee!

 

I was ecstatic when I found this in our local Asian store!

Malaysian prawn noodles. And while it was nothing close to the real stuff, it was pretty damn good (then again it's been 2 years since our last trip back).

Problem is, the smell of shrimp really puts my wife off. So I'm going to need to find some extra strength mouthwash next

Job Satisfaction

I read an article the other day of a survey of practicing doctors. This included questions related to job satisfaction, salary, and if one could do it again, would they pick the same specialty.

I wasn't terribly surprised with much of the answers for endocrinology. Close to half of those surveyed stated they would have picked a different specialty. Many reported a lack of satisfaction with the work.

Though this field deals with all kinds of hormonal disorders, due to the current health climate, most of our day is spent seeing people with diabetes mellitus.

Because diabetes is one of the unique conditions where direct, hands-on self-management by the patient is vital to success, endocrinologists have very little control over outcomes.

It's a concept scary to many patients: You want me to self adjust my insulin doses? Why can't you just tell me how much to use? (Because I see you only every 3 months but in the meantime, if your glucoses are consistently out of your goal range, it needs to be adjusted periodically. And because I am not there when you are eating; so you need to count your mealtime carbs to properly dose the prandial insulin).

I liken it to driving. You can't tell someone over the phone how to drive. You provide them with the teaching. And then when they are on the road, they are required to turn left, or right, or brake or speed up, based on what they see real-time.

And so, to do well when one is on multiple daily insulin, regular glucose self-testing and relatively independent self-adjustments are necessities. It's a tiresome and expensive process, unfortunately. But it works, and until technology evolves, this is the best we have.

Herein lies a tiresome phenomenon I see repeated daily. Patients very frequently walk in with no glucose data, and very frequently missing their insulin shots. Often they just shrug their shoulders, or smile guiltily. Or some who test and have been consistently hyperglycemic for the last 3 months but have not increased their insulin.

It's a pleasant enough visit- I enjoy seeing my patients again, hearing about their family. Professionally though it is frustrating; hemoglobin A1c 9%, 8%, 9.2%, 9% over and over again.

And I imagine many are like me; I don't see patients as dollar signs walking in my door- rather (believe it or not) I do want my patients to do well, to remain healthy despite having diabetes. And so, I know I for one do personally take it as a sign of failure on the healthcare team's part, when things remain uncontrolled.

Despite reminders, numerous visits with the doctor and the diabetes educators.

There are days when I come home beaming because I feel that I made a difference; but there are often days when I come home feeling like I did nothing.

One factor is obviously cost and inconvenience. Another however, which is the real silent killer, is the lack of urgency. When a doctor tells a patient "You have cancer", or "you had a heart attack", people jump. They know it's dangerous and something needs to be done.

When you tell someone their diabetes is badly controlled, many ask: So what? Why do I need insulin if I feel good now, never mind my bloodtest? Uncontrolled diabetes is the leading cause of blindness and kidney failure, and a major contributor to heart disease. The disconnect is that we are talking about the future. It's not a tangible risk.

But the greatest tragedy is once the complications set it and they start to worry about it and try to get things under better control, the damage is done. You can prevent it from worsening, but you can't undo it.

Thus, am I surprised that many endocrinologists find a lack of satisfaction in their careers? No. It reminds me of some good friends, great patient people, who surprised me when they quit practicing medicine to join a pharmaceutical company. Maybe it was the hours. Or maybe they just got tired working with patients.

No, I can't see myself doing that; I love the patient interaction too much and would hate to give that up. Have I been tempted to do something different? Definitely.

Miracle Oil

Speaking as a Malaysian Chinese raising an American daughter with a Caucasian wife, I have to say it makes me immensely proud to see my little munchkin reaching for my good ole' Minyak Angin Cap Kapak whenever she complains of a tummy ache.

There are many things my little girl will never understand or know. Things of my heritage. But she seems to have picked this up on her own (as mom absolutely abhors the smell).

Ah, the minyak angin (literally 'wind oil', or camphorated oil) is something every Chinese household would never be without.

We've used it for migraines, gastroenteritis, nausea, sprains.

Heck, I bet it'd even work for my diabetes or thyroid patients!

It's like the miracle oil. I've even seen people ingest this when they're ill (I wonder if that high school friend who routinely did that is still alive?)

It reminds me of Toula's father's obsession with using Windex, in My Big Fat Greek Wedding.

Now, I wonder if there are published randomized controlled trials out there?

Self Check-in Kiosks

I saw this in one of my rounding hospitals the other day when I went in to see a consult. Self Check-in Kiosks?!!

I was so curious I just had to ask the receptionist who was nearby. Apparently, it's a newly launched program, mainly for elective procedures and things like that.

Outpatient surgery, endoscopies.

Obviously, this won't work for the patients who have to be admitted for some unexpected illness.

But these apparently have been adopted by numerous medical institutions to make things (supposedly) more seamless and quicker. And it has the ability to scan personal ID.

And though there wasn't any takers for these when I was there (the lines were for only the manned reception), I have to say I left fascinated by the prospect.

What will they think of next?

(Drive-though colonoscopies?)