Epidural block procedure, Bone cancer disease treatment in 21 Neurosurgery and Oncology clinics in Oceania

Yesterday, I had to have an operation at RPA. It was amazing service, and the staff were wonderful. All the nurses and doctors were fantastic, and I would like to commend them on their work and thank them again very much. Great job. Thank you 😊

The hospital is hit miss like all of NSW Health. The nurses have mental health issues so depending on which nurse you get, either you will receive good care or be subjected to abuse like having your meds not given, information not provided, details not passed to your doctors (who often review remotely so you don’t see them every day). The outsourced food is not relevant to your needs and not replaced with adequate nutrition if you have allergies etc. I saw one new father deliberately kept outside because the nurses didn’t like him then watched them laugh at the struggling new mum who was doing things without support and the nurses just watched, didn’t help her. Same with trying to get information from Doctors, they simply don’t talk to you. The information provided by the nurses is often half-truths designed to placate people not be honest with them.

I don’t know if they will see it but thank you so much to Maddie, Lisa, Eva, Greg, Todd and all of the other overworked nurses and drs who looked after me whose names I didn’t catch or couldn’t remember. I just had my appendix out and it was my first ever hospital visit and everyone was so kind and attentive. I really appreciate how hard you all work. Thank you so much ♥️

My experiences here aren't great at all. My partner had his appendix out here this year, kept cancelling his operation at 5pm then not giving him any dinner, this went on for 4 days. I was there for a scan for my pregnancy last week. Person doing it was male, and quite rude, ignored any questions I had. This morning we went again to find out our scheduled scan was already completed two weeks ago, that they had done two scans in one, so we went to have our bloods done. I'm not usually impatient ornride towards hospital staff at all, but the woman who pushed in front of us was seen first, and the phlebotomists, all 5 of them the. Left us sitting there and saw 9 other people ahead of us while we waited for over an hour, they just saw anyone else who walked in. It was so rude I eventually got up and walked out.

This is my second visit for surgery the first was a couple of years ago for a kidney stones I fasted for 3 days waiting each day for the non-existing surgery. Today I am in exactly the same position, day 2 of fasting. If you are needing emergency surgery, expect to wait, be frustrated and be hungry. PS they will give you a couple of sandwiches when the message finally comes in that the surgery will be tomorrow. Walk out get hit by a car and then you may get looked at

Alone mother with my child. We had the worse experience. Staff don't communicate, no catering for remote living transports. Indigenous just abuse the staff and ended up in our room also using their kid as a place to sleep the night. I hope to never be sent to this place again.

I had self funded surgery here 6 weeks ago. My surgeon and anaesthetist were amazing. 10/10. The nurses I had when I came out of recovery were great. Attention to detail, caring, wonderful. The nurses I had the following day were average. The surgery cost $11950, I was in hospital less than 18 hours. My admission was messed up, so after fasting from 9pm for an 8am surgery, I wasn’t admitted until after 4pm. Surgery went great and was out of recovery by 8pm. The next morning I wasn’t given any fluids or anything and was discharged not long after waking. I was given the wrong discharge papers and medication scripts too. Please do better in future. I would definitely think twice about having surgery here again.

All the staff at the Wesley are amazing. Even when staff are super busy, they are friendly, they make time for you and your every concern. The staff look happy and appear to work as a well oiled team. Comfortable rooms and great food choices (including Vegan options) and service. Remember, it is a Hospital not a restaurant. It really is the best! Thank you Wesley

Professional staff, every nurse and doctors were amazing at the Wesley hospital. Special thanks to Dr GOUGH who performed an excellent thyroid operation.

Saved my life (twice). Had I been anywhere else I would be 6 foot under. Thank you so much to all the staff who helped me and medical records in particular Ms Gee who was highly competent. I would like to thank the surgeon and staff who operated on me. I simple do not understand the negative reviews here, try going to other parts of the world and see healthcare others have. Thank you.

I recently had a positive experience at Canberra Hospital, and I'm eager to share my feedback. Dr. Phillip, the surgeon, delivered an outstanding level of care, demonstrating expertise and professionalism throughout. Nurse Manita was incredibly cooperative, ensuring I felt comfortable and well-informed during my stay. The follow-up care from Nurse '' ROSE'' was exceptional—her kindness, care, and sweet demeanor made a significant difference in my overall experience. I appreciate the dedication and compassion displayed by the medical team at Canberra Hospital.

Very professional staff working efficiently and compassionately under enormous pressure due to a chronically underfunded hospital system. Many of the negative reviews reveal narrow minded attitudes and highly unrealistic expectations of a stressed public health system. We are lucky to have such a hospital in Canberra, which last I was aware is actually the second busiest trauma hospital in the nation- accepting patients not only from Canberra but transfers from regional areas and Sydney.

Waited since 11pm to be seen, at 5.30am was taken in to be seen by a doctor, 7am and still not seen by a doctor and asked to leave the room and bed as someone else needs it. Absolutely shocking. One doctor on. We are in Australia and cannot receive decent medical attention. Disgusted and will never return here. Triage staff rude.

UPDATE CANCELS Pediatric APPOINTMENT OF MY FIVE YR OLD NEPHEW A DAY BEFORE BY TEXT AND SAID ANOTHER APPOINTMENT WILL BE SENT OUT BY MAIL. NOT GOOD ENOUGH. Looking abit disheveled bc of lack of sleep and nurse looks me up and down with a judgey look on her face and rolls her eyes. Honestly the nurses are awful. Trainee nurses can't hit veins and be disclosing personal information about themselves (that they take Zoloft, while forgetting to tell drs I need pain medication, put hot tea in front of my face nearly permanently scarring my eye, also forgetting to ask Drs to check my cervix which nearly led to the loss of my baby and when it finally was checked baby was about to be born her head was past cervix expected to deliver baby on my own and i was unessasarly on heavy painkillers for longer which led to withdrawal symptoms for my child.) Honestly completely unprofessional if they're having a bad day. Old hospital is falling apart while private is upgraded. Honestly if your overworked you shouldn't be working. And that's part of your training. Completely alienated by the nurses looking after my child, it's literally fd up. No information on breastfeeding just yes or no and then a pump sent to my room. Resulting in potentially life threatening mastitis. Along with completely messing up my mental health the social workers seriously need to learn some decorum or at least basic manners.

80 year old woman sat in ED waiting room after botched abdominal surgery in regional hospital. Sat in wheelchair for about five hours in FMC ED after being hastily sewn up by regional surgeon. No pain relief given, eventually admitted into ED and given a bed around 11:00 pm, seen by doctor around 4:00 am the following morning… Eventually admitted to appropriate ward where the specialist and nurses have been brilliant!

A big shout out to the doctors and nurses at Dickinson south building level 2. Your care is elite. Your all angels that deserve amazing lives. May God bless all of you Doctors, Nurses and health care professionals.

I’ve been in the Emergency Department of Prince of Wales, a number of times in my life. I waited a very long time only once. I had only 1 bad experience where I was in observation in bed and I could not get a peaceful sleep as the doctors kept checking on me every hour and kept my light on the whole time. The next day, they forgot to remove the IV from my arm and sent me home. Overall, not too bad experience.

Tammy was an excellent night nurse who woke me up very gentle and made sure i was ok. She distracted me from my injury and made my stay very calm and comfortable. I am very thankful to of had her as my nurse :)

Gross negligence in patient care- avoid this hospital like the plague.. it’s an absolute joke. if I could give no stars I would. If you value your life and want a good chance of recovery and not to die due to poor nursing and “specialist care” - DO NOT GO TO GREENSLOPES… you have been warned.

Had private health cover for most of my adult life and one time I needed to use it, the experience was so horrible. I’ve triggered Ramsay rule 3 times without success, was told medical director was going to see me, but that did not ever happen. I was eventually transferred to a public hospital, and experience was so much better.

I want to express my heartfelt gratitude to the hospital and its incredible team for the exceptional support and care we received during my cesarean section. The nurses and Midwife were outstanding, the food was worthy of a 5-star hotel, and Dr. Melissa Mckenzie proved to be the best in the world. Every detail of our stay was handled with professionalism and warmth, making us feel cared for and comfortable. Even after 5 days, I would have wished to extend our stay because they made us feel at home. Highly recommended! Thank you all for making this moment so special and peaceful for my baby and me. 👶🌟"

Presented with chest/breathing problems. Directed to station to give all admin details and make payment. All very streamlined, then waited and was taken to a isolation room. They apparentley should not have sent me to waiting room as l am highly infectious. When in room lost all cell and wifi. Asked many staff none had any idea of hospital wifi codes. 6 hours later at desk again to make outstanding payment. I mentioned that maybe it was a admin role that they tell people how to access hospital wifi as this was an ideal momment. They certainly were able to take money and l signed for my insurance. The slim older woman wirh blond grey hair let me know very aggresively that it was not her job. While at the far end of the counter was a business card with wifi details..... Just appaling her lack of care. Surely patients maintaing contact with family, matters as the hospital phone also did not work in room, however she could not care less and let me know that. The rest of the staff are amazing. After tests l have Influenza A.

Currently staying over night & I’m blown away by the staff. They were all very attentive & reassured me before, after and during. Was laughing through my whole experience which has never happened before! Lovely people who do an amazing job.

If there is 0 star, I will give it to Cabrini. Back in early Jan 2023, I was referred by my GP to Cabrini to receive intravenous antibiotics due to swelling in my foot. The reception in the ED asked me to complete a form, provided my Medicare and Medibank information, and I paid $485. At that time, I inquired about any additional out-of-pocket expenses as I was covered by private insurance, and I was clearly told there would be none. I was then placed on a bed in a ward. A doctor examined my foot and, after assessing it, decided not to administer IV antibiotics and no treatment is required, but asked me to take an ultrasound test on my foot. Since there will be no treatment plus I had several meetings that day, I specifically asked whether I could return home first and had the test later if still needed. The doctor told me he would inform me of the expected waiting time; if it was lengthy, I could leave and have the tests done at my GP, but if it was short, I could have them done at the hospital. Later, he informed me that the test could be done quickly, so I proceeded with it at the hospital. It took me more than 6 hours to finish the test and wait for result. In the end I was discharged without any treatment. During the checkout process, I once again inquired at the front desk whether there were any additional out-of-pocket expenses beyond the $485 I had already paid, and I was told there were none. A few weeks later, I received the test invoice, after discussing the matter with Cabrini accounting team, I was informed that I had never actually been admitted to the hospital. Does Cabrini expect an ordinary consumer to identify the difference between an outpatient ward and an admission ward? Not to mention I was informed by your staff there will be no additional out-of-pocket expense, plus no treatment at all, totally misleading!!! Even worse, after I raised a compliant to CRM Cabrini, received feedback telling me the invoice will be put on hold until review is done. Since then, no one from Cabrini has communicated with me. Last week, I got a letter from collector chasing payment, what an arrogant and disgraceful act! Stay away from Cabrini!

If you ever need to go to hospital I suggest you don't go to this one, one of the worse hospitals in Perth. 1. My grandmother was dying in hospital so naturally all of her family were there to be with her for her last breaths, the staff were rude and wouldn't let us all be with her, these were the last moments we will never get back. Thanks for your compassion Fiona Stanley. 2. My dad had triple bypass surgery after waiting one or two weeks for one of the best open heart surgeons. Surgery all went well apparently. One week after, the hospital called my family to say he was being discharged, my mum and sister got there and the paper work wasn't ready and said they could post it out so they didn't have to wait any longer, which is all fine but... No doctor came to see my family to let them know what kind of care my dad would need or any other information necessary for when he's home. Two days later he died. What was the point for the government in spending so much money on surgeons when patients of major surgery get kicked out of the beds too soon and left to fend for themselves?! The lack of care and compassion for patients and their families is disgusting, I really hope this hospital gets better for the sake of the people of Perth.

The medical support is great. However, more cultural awareness trainings are needed for some of the staff. For the 1st time, today, I've heard a very inappropriate conversation which could negatively affect patients of certain background. I've reported the incident to the Dr in duty who I hope will take care of it for a better well-being of the hospital patients and staff

I gave birth via c section because my son my breech and the whole team were amazing. I felt so comfortable through the whole process. They talked us through everything they were doing as it was happening and our son arrived happy and healthy. We received the best care in the days after giving birth, I couldn't fault the team. Every appointment I had throughout my pregnancy was amazing. As a first time mammy, it was a lovely experience.

What superb care my darling 95yr old Dad received in their A&E dept!!!! The Male Nurse, 'Nappy', was so kind, compassionate and approachable and so gentle with my Dad. Thanks to him, I was able to take my Dad home later this afternoon, problem rectified and my Dad in much better spirits too! The triage Nurse was really lovely and the clerk, Julie, was also incredibly kind, calm and compassionate. They are a shining example of what all A&E Department should aspire to! So very grateful! God bless you all. 🙏🏼🕊🙏🏼

It's disgraceful for a hospital that holds itself out as one of the premier hospitals. They are not equipped to care for elderly and frail patients who as we well know often suffer from poor appetite and require more intensive attention. . My wife who in her 80s, is frail and weak, has been in there for two weeks and no one has checked her food intake. During the two weeks she only had mostly soup. I had to point this out to them and request for food supplement to be provided. The nurses explain that they are understaffed and can only provide the basic attention and care. On the other hand the nurses are polite and kind but obviously stressed.

After severing an artery and nerve at my workplace, I was directed to attend SJOG Murdoch for reparative surgery by Dr Sharon Chu. From the moment I set foot in the hospital, the level of kindness, care and competence was exemplary. Orderlies were extremely kind and attentive, the nurses and doctors were super efficient and lovely, I couldn't fault anyone I came into contact with. My anaesthetist, Dr James Miller was similarly amazing, taking my past history with genersl anaesthesia into account and ensuring I did not wake up sick and vomiting after the GA as I usually do. I woke up in recovery feeling great, with no hint of nausea. Dr Chu was similarly impressive, not only by doing a great job on the repair, but by being kind, attentive and very reassuring. Her smile lit up the room and completely put me at ease, it made all the difference and eased my pre-op anxiety! My breakfast the next day was superb and ordering off the room service menu felt as though I was in a 5 star hotel! It was delivered promptly with a smile by another lovely hospital employee and was hot & delicious. I truly felt that I was having a lovely holiday, with just a bit of surgery thrown in for good measure! I cannot fault my experience at SJOG Murdoch and give my heartfelt thanks to all imvolved in my care!

Treated at the old Peter Mac many years ago and it was beyond excellent. But my experience at the new Peter Mac includes a lost referral, lost history, lost blood results, lost u/s results, relevant medication information not given, existing medical conditions potentially impacted by proposed treatment not considered or discussed, and incorrect information documented that contradicts what my GP sent to them AND which contradicts reports from when I was there before!. Trying to get it sorted out - impossible.

Subjected to absolutely disgusting treatment at this hospital. Elective Surgery Manager was rude , terse and has no people skills what so ever. As expected when I lodged a request for explanation the Cancer Surgery Manager chose to disregard key facts and dismissed me completely. Patients aren’t just Medicare numbers . Avoid this hospital at all costs .

The peter mac staff are all awesome from the security and domestic staff to the teams of surgeons and nurses who helped me through the whipple procedure i had back on 15th March . I cant say thankyou enough. The ongoing post operation treatment has also been fantastic.

I want to express my deepest thanks to the doctors and nurses at RCH, particularly the nurses in Possum ward, for their exceptional care of my daughter Ophelia Low. Your unwavering attention and support truly alleviated our stress during her stay. Thank you sincerely once more.

I was at the emergency with my child today and we saw Dr Kae. He was very knowledgeable. He put me at ease with the concern I was having. I was very worried coming in and waiting long but the 2 hour wait went very quick. I was offered something to drink from a volunteer and when my child’s name was called, the nurse even helped me pushed my pram for me. I’m very happy with my first time experience at RCH today.

Salute to all the doctors and nurses working at this hospital. You guys were awesome! I cannot thank you enough, the amount of support and love show to my 4 year old son who had an Asthma attack. Very professional and friendly. You saved my sons life and il be forever grateful. 🩵💙

Worst worst experience ever in my whole life. Brining my child to the emergency and surgery ward, kept him fasting for unexpected hours. My poor child was asking for food Was no updates and everyone was coming we can’t give him drink as they gona take him to the surgery Nothing happened even after waiting 13 hours in without food😡

After having a great experience at the NICU for numerous weeks, my wife and I were looking forward to spending time in 9B as we were allowed to stay the night until our baby boy was discharged. However, that, the care from our surgical team and the allied health team was the only great experience we had at QCH. We did experience a couple of great nurses throughout our time there though, but unfortunately we both felt the nurse care and support was not there. The change overs each day were completely different and wrong, it took a long time to get help when we buzzed (luckily they weren't any emergencies), things were often forgotten or we were told wrong times for when things will be done, we were told cares would be very 4 hours (but this was rarely completed), there was also less optimal/hygienic technique with certain procedures and to top things off, we were given someone elses milk when we were discharged (See the image). Obviously, for confidentiality reasons I blacked out the name. Thankfully, my wife and I both work in the health care system, and we both knew what to do and looked after ourselves. We both hope that no one ever experiences what we went through and that the staff improve their values, procedures and care.

My hospital experience has been flawless from the beginning. The whole process from admission to going through surgery to paediatrics ICU and back to the ward has been carried out professionally and faultlessly from beginning to end. The Neurosurgeons, ENT, Paediatric, Infectious Diseases and all the wonderful nurses have worked tirelessly to make sure my son fully recovered from his infection. I can’t praise the hospital enough on its amazing service. Well done and I am forever grateful. Thanks Jane

The best experience ever… thank you so much level 3 birthing unit … I loved every bit of my delivery and the care was the best thank you to my obstetrician dr margie harpham … and all the nurses.

Due to h to he doctor rupturing my spleen during a routine colonoscopy I now have had to stay 2 nights & have extra tests- all at my cost! The food is appalling I haven’t seen a piece of fruit & none offered-just sweet biscuits & muffins! So much healing foods. Nursing staff have been fantastic though hence some stars. Any other business the client would not pay for doctors mistakes! A bit upset !

I had minor surgery there last week which required me to stay 3 nights. Service on arrival and admission was friendly and efficient. Post surgery, the care from Lee in Recovery and the team on Level 5 was excellent - very caring and kind. Thank you so very much to all including; Tate, Georgina, Hema, Ricky, Miguel & Sarah and two other lovely nurses whose names I can't remember. Your kindness was greatly appreciated.

The staff were very attentive and helpful. Arriving at midnight after a workplace incident they adequately took details and then immediately took me through. The staff member was very courteous and reassuring throughout my treatment.

A big thank you to all the staff for looking after my husband. You have done a wonderful job, from the orderlies, food staff, cleaners, nurses and doctors. Everyone has been so kind and caring. Thanks again from all of us.

A beautiful modern hospital with modern fixtures a mall-like atmosphere. The main thoroughfare is lovely but some waiting rooms are small and the multi-stage waiting room system often seems somewhat unnecessary as it is less efficient now that you are unable to check yourself in for an appointment. Instead, you still have to line up to speak with a receptionist - just like you did at the old hospital. The outdoor plaza and the garden areas are a nice touch; hosting community events and providing patients with some much needed respite, and fresh air.

I don't know where to start from,I had a fall on Oct 7 2023 and ambulance took me to ED,I was attended fast and though I was high with green whistle but I can still say all the staff who attended me was very supportive. Mind it I never been to hospital in my full life. After I came out of theatre, I moved to orthopedic ward,some ward5 ..sorry don't exactly remember, but the Nursing staff there was so helpful and supportive they really tried there best,they talk positive they listen you ,understand you and took care of your dignity and privacy,after a week I moved to.plastic OMG the Nursing staff there was like an angles sorry I can't name anyone as they all were the best including an Asian uni student.what a great level of skills and patience the staff have.thank you very much all doctors and nursing staff to fix me up and taking a great care of me.will surely visit in person to pay my gratitude and to say thanks to all once am completely recovered. Wish you all a very merry x mas and a happy new year. Regards

You've been fantastic! Your positive attitude and kindness reassured my family that I was being looked after, and throughout my stay I felt I was in good hands. I am now feeling stronger, and I am feeling much more hopeful about my recovery. Kind regards, Saba

We were ask to attend for an elective planned surgery. This is a second procedure follow on from the first. The 1st admission process was smooth with minor hiccups that we overlooked because we were happy with the surgical outcome. The second procedure we were aware that we might be the 3rd listed for surgery. We were advised to attend for pre-admission procedure at 6.30 am. We did as we were told. The nurse advised us that we might be called in at 1130hrs to get ready to be taken to theatre. We waited, waited and waited and no call for theatre or a decency of an update on the delay. We attend RMH at the surgeon request which we know is best with the expert in the field here. We attended as private patient in a public system. We don't have any problem with that arrangement either. But someone who is highly anxious with heighten anxiety and a delay such as this is entirely unacceptable. It further exacerbated with such appalling poor communication. Providing the best health care does not stop at surgical outcome alone, but how the patient and the family made to feel the entire experience will be what constitutes best health care. I don't know this is a result of poor training where empathy is out of the window or complete complacency of the public system. If one were to admit to ED, with no bed within 4 hours will be a red flag. Not until we approached the reception staff we received an update. What has been a good encounter is tarnish by such lack of attention to basic courtesy of good communication. Very disappointing today.

Thank you so much for everything you do for your patients. It was a long wait but everyone was kind and kept informing us of wait times and set expectations appropriately. It's such a tough job but you guys are really amazing. I can't say enough kind things about all of you.

Although we are in zone for Middlemore Hospital, we have travelled to the birthing unit here twice. The birthing rooms are clean and tidy. The staff are very helpful. You have your own dedicated nurse while you are in labour. The nurse does an amazing job taking care of the birthing mother throughout the entire process. There are family rooms, and tea facilities for spouses and extended family. We also went to the Tamaki ward for after birth Care for two nights. They have sleeping arrangements available in the room for your spouse. Staff in this ward were fantastic and helpful. Again there is a family room and communal kitchen. Overall the hospital is pretty up-to-date and tidy. My only concern is parking. The car park tends to get full quite early and the parking fees are astronomical. If you are a genuine patient, you should be offered some sort of parking subsidy.

Thumbs up for all the doctors and nurses of Ward83! My dad stayed at room 3 of the high dependency unit, so touch of how hard all staffs taking their duties and so proud of your job and the kindness and loving heart!!

Fantastic place to have surgery done - the staff are friendly, the hospital well equipped and you know you’re in safe hands. Delicious meals too! Thank you to Mr Fred Phillips, Anna, Jenny, Gorica, Maggie and the many others behind the scenes for what you do!

From the Receptionist, to the Nurse's and Specialist, and being apprehensive about the procedure I was to undergo, was put totally at ease, and was listened to and treated with the upmost care. Thank you for the wonderful service and care shown to both of us. Regards Barbara (Barb) Sharpe

My partner has been waiting nearly two months for a specialist recommendation letter from Anup George. We have called around 5 times, emailed 3 times and have received nothing. Not good service for someone with a life expectancy of 10 years at 27 years old.

I hade a spine surgery 2 days ago. Thank you Dr Barnes a fantastic job. and Dr Graham .thanks all hard working nurses, they are very friendly, and always look after me. It was absolutely 5 stars

Excellent service and very satisfactory! I had an open heart surgery here and I feel like home . Everyone who works there take good care of me and always there when needed. Thank you for your service ❤️

Had hip replacement surgery and Mercy made it an absolutely top experience. Thanks so much to the nurses, surgery team, physio, caterers, cleaners. Everyone made the procedure as painless as possible.

Got seen very fast for a simple broken ankle. All the staff were super nice and professional. Couldn't have gone better. Other than the broken bone part.

Absolutely amazing staff. Every single one of them. The nurses are wonderful especially Sheridan or Sheri as we called her. She is one of the best nurses I dealt with. Sharon is also a wonderful nurse. The surgeon Dr Segar is the best around and the anaesthetist as well. The best hospital I've stayed in. Big rooms, great food and lovely staff.

I went To this facility. For A asthma attack that was Induced by A infection The wait time was very long though. This is understandable as they were Short-staffed. The nurses were lovely. And took good care of us. The issue I came across. Was the doctor? At this point I had been Coughing to the point of not being able to breathe and almost throwing up for 2, maybe 3. Hours The nurses moved me to a room by myself so I wouldn't disturb. Other patients? But when the doctor finally arrived. She looked at me with a raised eyebrow. And accuse me of faking it. I was In shock Not 5 minutes into talking to the doctor. She says "Your coughing has picked up a lot since I came here." She called it convenient. She sat there looking at me not giving me Instructions But she did give me a asthma inhaler. Something a nurse had already done. She proceeded to interrogate me. And ask me what I was trying to skip out on. This was because I had asked for a medical notice To give to my strict school. This blatant disrespect completely ruined The experience I was already exhausted from a being late. And having coughing fits every 5 seconds. And then I had to deal with that. To be honest, it seems like a decent facility. I think I just got unlucky with either a too tired or too unprofessional doctor.