Coarctectomy in children in 321 Cardiac surgery clinics worldwide

My sister’s appointment is at 4.15 pm with the pediatric doctor and I reached the hospital and specifically the registration desk at about 3.45 pm. The area was crowded as there were 2 angry employees assigned to register patients from 5 different sections and the queue system was not working so just imagine that the same staff who are registering the patients are making manual tokens and giving them to the patients. However, I finished with the registration at 4.30 !! So I spent about 45 minutes only to register. I went to the pediatric section but the doctor was busy talking on the phone 😂 the situation is completely messy in this hospital. if you are a person who respects the time please don't come here. put honestly Dr. Ahmed Tawfiq is a very professional and respectful doctor. So two stars for the Dr only the hospital does not deserve stars

This Hospital really went above and beyond in taking care of my wife during her pregnancy. The front office staff deserves a special mention for their exceptional service. They were friendly, helpful, and made the whole experience smooth and hassle-free. It's great to know that they prioritize patient satisfaction from the moment you walk in. I would highly recommend Zulekha Hospital to anyone in need of excellent maternity care. They truly make you feel valued and well taken care of.#zulekhasharjah🙂

From our OB Dr Hend to all the doctors who help her, nurses, cleaners and security, all the staff i can say is they are friendly, simple words like CONGRATULATIONS AND DONT WORRY from the security and cleaning staff helps while i was waiting for my wife's delivery. Nice and clean place. Great job everyone!

I have been coming here since last 2-3 years. It felt very good. But now I feel peaceful because of the Diwal decoration. It look nice . wish you Happy Diwali To all Hiranandani Hospital Staff and doctors / Team .

Doctors are awesome, one of the best in Mumbai. Service is pathetic !!! You go on pressing the call button for hours and no nurse comes in, highly miss managed, you will be going around without any help from here to there (as if it’s a govt hospital) and many such negative things … But again - doctors are really really great here!!!

Extremely clean and excellent team of Doctors available round the clock across all streams. The Hospital truly values Patients' waiting time and ensures speedy appointments and prompt medical attention.

This hospital is the epitome of atrocity globally. My father was admitted due to a heart-related issue, and they subjected his frail body to numerous tests and experiments, further weakening him. Despite his delicate state, they proceeded with the bypass surgery without assessing his thin and feeble condition or considering whether his body could endure the procedure. The experiments conducted by them ultimately cost him his life. The doctors displayed a complete lack of support and denied visitation. During my last attempt to see my father before the surgery, they refused entry, escorting him to the operation theatre without allowing a proper farewell. From a distance, my father kept looking at me, desiring to meet, but these heartless individuals denied us that privilege. The management is deplorable. My father meant everything to me, and now, we are facing financial hardship, finding ourselves on the streets. In just four days, they generated a bill of 8 lakh rupees. I earnestly implore you to refrain from choosing this hospital based on the harrowing experience my family endured. I wouldn't wish this upon anyone else, but the decision is yours. The repercussions of such suffering only affect the families involved, not others.

Recently i admit my dad in Metro Hospital under Gastrology, we have a worst experience, - The doctor in gastro OPD recommended , sleeping pills to a serious liver patient, my dad, which is wrong as per medical science. - OPD to Ward - Ward To HDU - in just 1 DAY - NO improvement only worse condition in 4 days - - The nursing staff is worse in ICU HDU , which is the main thing they do not have the correct knowledge. - Very much Money Minded Hospital .

Highly satisfied with my gynecologist Dr. Ravinder Kaur Khurana! She is excellent...Exceptional care throughout pregnancy and a smooth normal delivery. Professional, empathetic, and skilled. Would highly recommend. Also impressed with the hospital's cleanliness and affordability. A great experience overall...

This experience is even more disappointing than my previous encounters at government hospitals. I was admitted here through emergency last night, and after numerous tests, it was confirmed that I am positive for influenza B. I've been dealing with severe coughing and a sore throat, making it impossible to sleep. At 5 am, I urgently requested cough medicine and a spray for relief, but the nurses informed me that I had to wait for the doctor's morning check-up to prescribe the medication. Despite waiting until 12 pm for the doctor's arrival, the medicine still hasn't been provided, and it has been five hours. They explained that they are in the process of preparing the medicine. Honestly, considering the delay, I'm contemplating whether it would be quicker to go to an external clinic or pharmacy to purchase the medication. It's disheartening to face such delays in a hospital setting, and I wouldn't recommend this experience to anyone.

Clean and nice place. But they are too freaking slow. it took more than 1h 30mins from the moment they told us about the ward number until my wife got into her ward. Ridiculous.

The doctors and nurses here are very helpful， understand my special identity and give me enough private space during my admission. Their service is also very attentive, I won’t say I wish to come back again , but I would say that if anything on hospitalisation, you are still my first choice☺️ Thanks !

Went to see ER doctor for emergency situation. My husband had been exposed to a fungus which affected other’s.. we already had a good idea of what was going on. A fungal infection of the lungs. We told him everything which he wouldn’t listen to any of our thoughts. Cough, severe weight loss severe pain in chest, couldn’t hardly speak or even walk! I could go on with the symptoms but the end result was. He said stop smoking… which he did instantly but only got much worse. Within two days I took my husband to another hospital where they looked at his throat/did ct scan and could clearly see a fungus covering his throat right off the bat! (the Adventist doctor could have also) takes 30 seconds to see. John is now in the ICU at another hospital extremely sick. I’m more than outraged! It would have only taken an open mind (LISTEN TO YOUR PATIENTS) Be careful because going here could possibly cost you your life! I felt the doctor was arrogant acting like he knew more about what his symptoms were than my husband! At one point even saying you have TB which has never been the case (20% of lung fungal infections are misdiagnosed as TB on lung x-rays), something I read later. I implored him to look into a fungal infection but he refused. Blaming John for being a smoker. We paid cash for this service which put my husband in a life n death situation. Read the complaints on here I’m not alone!

- Great body screening experience, with comprehensive type of screening. - Convenience as a open on Sunday. - suggest to come earlier before 8am, in order to complete the test earlier n avoid long queue. - Dec month usually is peak month n long queue, so try make appointment for other months

Attended my usual annual health screening as this is one of the best wellness centre in Penang. Superb satisfied with the professional service, friendly staff, comfortable environment.

My first visit to Manila Doctors Hospital was a positive experience, surpassing any hospitals I've encountered in Cavite. The facility even boasts its own food court, which aligns well with contemporary expectations and technology standards. However, in contrast to this modern amenity, the appearance and condition of the doctor's rooms left something to be desired. It felt as though they had been frozen in time, reminiscent of the 1990s. Small room, ventilated, yes, but crowded outside.

I don't know if all hospitals have become like this after covid, but at this hospital you will feel that everyone... from doctors, nurses down to their janitors have become unsympathetic towards patients and is only working for their own gain and the hospital is just making money. This hospital is not in the top 5 but it is still expensive. The price paid was not worth it, a life was lost and relatives had trouble from emergency room until claiming of the death certificate. Service wise, it was terrible. Emergency service where patient felt neglected. Companions also can't enter until 12 hours later you will know that patient couldn't breathe anymore (because patient practically had no immune system) and needed to enter the covid ward. Emergency nurses and doctors are digusted at the patient. A patient having more than 10 doctors and those are consultants. Diagnosis and Prognosis were unclear. Doctors who tend to pass the blame to the relatives ("Weren't you informed?"). Medical staff basically aren't pro-active and you have to ask every single thing. Interns who do not know how to talk to patient and relatives ( who would tell you to get the item needed and hang up on you) and are practically robots or who are doing things by the book. And then, you would just hear from other people, "Oh, we have that service." or " We have that item, we use it for..." but we never had these service. A patient who could still walk into the emergency room became bedridden and degraded into a vegetable in a month's span. Death certificate was problematic as the doctor didn't train the doctor in charge on what to do and numerous revisions done added insult to the grieving family. The medical abstract was a pain to obtain and didn't contain the detailed explaination as to what happened to the patient at the course of the confinement. Also, reading said document felt like it was written by a failing medical student. I personally do not recommend this hospital. Their on duty nurses ( probably the same as anywhere) are by orders and do not have compassion or sympathy for the patient. Their on duty residents are disappointing and felt if there is no physical problem seen then there is no problem... likewise executing traits of no sympathy to patients.

Giving 3 stars because we had a mix of good and bad experience at this hospital. This is our hospital of choice, atleast if you compare them with Chinese Gen or Manila Med, I can confidently say that they are better. Our outpatient experience here was very good. From HMO office, Lab, Nurses, Doctors and their secretaries, all gave us a pleasant and warm service. We always go back here for our outpatient medical needs. Their facilities is good and the vibe is almost similar to Medical City. It's a different story when my partner had to rush his mother to their emergency at the wee hours. Their staff posted outside the Emergency Room were bad discriminating profilers. They gave warm assistance when you look rich or arrived with a private car. But if you look poor, they will just stare at you. We arrived on their emergency room using a barangay ambulance. My partner is wearing his everyday home clothes, shirt with holes, shorts with holes. It is a an emergency so ofcourse we didn't have the time to dress up. When we arrived there, no one came near to us, to assist us to unload the patient. The guard just stayed at his pedestal, unbothered by the ambulance siren. I was the one who even grabbed a wheelchair from their door to the ambulance. Maybe they thought we are just a barangay health worker or "tambays" because of our clothes and it is okay. Until, I witnessed how they assisted someone who arrived on a Toyota Fortuner. All of the staff including the guard went to the Fortuner to assist that patient. The guard urgently grabbed a wheelchair and they are all energetic. Very different when we arrived on a barangay ambulance. Inside the ER, my partner told me that their behavior changed when they found out her mom (the patient) and him are platinum members. They were all of sudden fast, caring and attentive. They probably got surprised how a beggar looking guy with holes in his shorts is a platinum plus member. This will still be our hospital of choice despite that incident because of proximity. Although, I hope that they give the same treatment to anyone regardless if they look poor or rich.

Why does a hospital labeled "World Class" provide an ultrasound schedule a month later? This issue isn't recent; they could have addressed it by adding more machines to handle the patient load. St. Luke's moved Maxicare to their HMO Concierge, despite the limited space in the small building. Only a few individuals can enter the office, leaving others waiting outside in the sweltering heat.

The service when checking in is quite nice and welcoming, unfortunately, for me it's downhill after that. Very very noisy nurses, it takes minimum of 10 minutes before a nurse comes to my room after pressing the red button because my dextrose kept beeping since it was almost empty. this happened several times. What if it was an emergency?!

I’d say majority of the staff are very well mannered and trained. Everytime I ask anyone that works there some information, they guided me immediately. I’d say the art building though is a bit old and dirty but the main building is pretty clean and sometimes confusing to navigate. Better to bring in cash or card because unfortunately their gcash doesn’t work. One of the downsides in some of the services here are usually packed with people so best to call in advance. I do love the service and the professionalism but this is definitely a very expensive hospital. Besides all this, there are food places inside where they serve really good food.

Better triaging system in ER than other hospitals like Asian hospital. The staff in ER have truly taken care of us. The room (regular private) is also very clean and frequently being taken care of by the housekeeping. The doctors and nurses are also very accommodating and have truly taken care of us during our confinement. Please continue to be a patient centered facility.

Felt like we were in a Hotel than a Hospital because of how clean the building is and the staff were very courteous, friendly and accomodating. Even though we went there for a walk in accommodation, the service was fast. Parking was a bit confusing though, so glad there were signs in every corner that guided us to B4.

The hospital itself is organized and beautiful, the nurses and staff are nice and attentive to my inquiries. While waiting the hospital offers snacks and drinks like water, coffee, and some juices. Place is clean The toilets are clean everything is good. You can't say bad about St. Lukes of course except for the price LOL😅. St. Lukes no.1

My doctors were helpful, skilled, professional and provided me a lot of information. After operation services and information is complete with high priority to the after operation services. The urgence for post opération patients was fast and of full service. The nurses when I came before the operation were too busy, they let me in, gave me my wrist tag and gave me 3 medicines but let me waited 2 hours and no one came back to me to update me that the operation will within 2 hours of waiting . I came at 8h50 and the actual operation is at 11h15, in between the waiting hours, no one has came to re assure me and update me of the schedule that made me nervous and worried for 2 hours. All nurses were so busy that morning and talks a lot to each other without double checking or just to give a quick short words to me for 2 hours in the waiting room before the Anesthesist picked me up. Thank you.

I was very well looked after for my first pregnancy. The team was superb, whether it was for the pregnancy follow-up, the day of the birth or the aftermath of the birth. For this alone I say bravo! But above all, I love the student nurses we met, who were full of compassion and kindness, much more than the nurses themselves. I don't give 5 stars because there is still a lot of room for improvement: - at all my pregnancy follow-up appointments, the wait always lasted more than an hour even though we were told to arrive 30 min before the appointment 🙄 - cold administrative reception - a lady at the analysis laboratory shouted at an old man who didn't understand the process (taking a ticket, waiting etc.) when he had just asked nicely what to do - we were scared when our baby was born, that he couldn't latch on, that he was going to starve to death, that we had to go to the osteopath...when a few days later our baby gained weight. We didn't understand the point of scaring us so much when in the end everything was going well.

I am impressed with the level of the hospital, attitude of medical and medical care. Grateful my surgery was handled here with great professionalism. Merci bien!

I had a day surgery in this hospital. It was my first time to have a surgery with general anesthesia, so I was quite nervous. However, it didn't take much longer to figure out that there was no need to be anxious at all, as all the medical staff who treated me were so kind and friendly. They naturally eased my anxiety. Each time I interacted with each of them, I was quite impressed by their professionalism. After detailed explanation of what would happen, my surgery started on time and went well. I am so greatful for their dedication and hard work. Thank you so much.

My dad just had a quadruple bypass, the care and attention he receiving is incredible and putting us all at ease. The surgery went perfect and he's doing very well. We can't thank you enough, after a few not so great experiences earlier after his stroke at other hospitals in the east end (not all their fault staffing issues are brutal) this has been a night and day difference. Thank you from the bottom of our hearts 🙏🏽🙏🏽

We are having our first baby here. We've been going frequently(due to our high risk pregnancy). They are amazing, and accommodating!! They have helped so much....every need, and question has been addressed and taken care of. In my opinion, one of the best labor delivery floors, ever!!! Keep up the fantastic work! Oh...and see you in a few, on our way to have our daughter....today!!!!❤

I would like to express my deep gratitude to the gastroenterology department and all the staff. To the doctors - Fedoruk Oksana Stepanovna, head of the department and attending physician Sinyavskaya Alexandra Vladimirovna. These are people who are in their places. Caring, attentive, always on the lookout for our interests and health. All procedures are prescribed and carried out comprehensively and in a timely manner. Additional examinations are sought to be carried out with other specialists. Open, honest and professional. This department is like one family. Cleanliness, attentiveness to patients. All the staff tries to make our life more comfortable. We wish there were more departments like this)

I would like to express my deepest gratitude to the radiological department from my father Vladimir Ostapuk, who received treatment from you and from me personally! Thank you very much to all the staff and the head of the department, Valentin Eduardovich! Good health to you and thank you for your concern!

I have been in the anti-tuberculosis dispensary since April 25, of these 16 days I was treated (examined) for only 4-5 days. The conditions here are terrible (the best word I could find). Cockroaches, food, as well as the negligence of the attending doctors and staff, is worse than ever. If it were possible to put stars in minus, then we would have collected all -5. I don’t advise anyone to come here, or even end up in the hospital.

I had a great experience giving birth at UKE. everyone working there was super nice, cooperative and friendly at the registration and at the Kreißaal as well as in the postpartum care. We requested the family room, which became available in few hours post our request ( you do need to keep following up the availability status of the room til you get it though ) For the mom, you need to get a shirt/ dress to give birth in. And pjs for afterwards as well as the bathing supplies For the baby, you will only need to have the go home outfit and maybe a pacifier. All else will be supplied by the hospital. The meals served are really good too. Not the typical tasteless hospital food .. you will need to have some snacks with you for in between the meals especially if you’re planning on breastfeeding. All in all, i had a really good experience and highly recommend the hospital

Waste of time! I got food posioned and waited for hours! Nobody checked me and I had to leave because another patient came and told us she was waiting for 7 hours. I mean this is an emergency, it shouldn't be like that. Aside from all these stuff there was very rude. I was fighting with pain and with the people at the same time. Not even talking about the money I paid for the taxi because I thought I can get help here. I don't know what I am gonna do if I ever have more risky situations like that. This has to be changed.

18 year old friend of mine has been hospitalized due to a tumor. because of a so called "emergency" a vacation had to be cancelled and he didn't even make it into the infirmary. during the operation they managed to injure the liver (which isn't exactly spottet on the head) and he was in a critical state. he died less than a week after the operation and the doctors had the audacity to say "have a nice evening". worst hospital ever. will make sure none of my loved one's ever go there again.

Very nice and bigger hospital in the kingdom Saudi Arabia...and many ofw Filipinos work here...

Best professional medical staff (DSU)I’ve seen, honestly they were treating me sooo kindly. So Proud of you.

I worked in this hospital form 2012 to 2021 as electrical foreman and I got good experience from this hospital and i bleev as per my knowledge this is the number one hospital in Gulf.

Cardiology sent me to ER for a heart issue (atrial flutter). Dr. Garabetyan totally ignored that, and ended up fabricating a non-existent pneumonia. She then IV’ed a fluoroquinolone (floxed me) w/o my knowledge or consent. I now have permanent disability (FQAD), which includes peripheral and small fiber neuropathy, tendinopathy, vitreous detachment (floater) and myriad other disorders and symptoms. Nobody cares, they gaslight you. Be careful.

I visited emergency room in this hospital. Had an acute abdominal pain. I do not speak Spanish well and was afraid of misunderstanding but all hospital staff, physicians and nurses, were very polite and tried to speak with me in English. Also all analysis, CT and medicines were done in a timely manner. Finally, I went home with required treatment. Thank you All!

Thank you very much for safe my life, ZABALETA CARVAJAL, IVAN ANDRES🙏🧚🏻‍♂️and hospital very nice clean comfortable convenient

I booked an appointment via their online platform with the Diagnostica d’imatge department, because I needed to take a MRI exam for my leg. In the online platform I uploaded my traumatology doctor’s referral where it says I should have two MRI exams taken, one in a rested state and another one after running for 20 minutes to see the difference in my muscle. I even sent the referral via email to the Diagnostica d’imatge department in order to make sure they knew about the fact that I need to make two exams and not only one. They didn’t answer to that email even though I asked for confirmation of receipt. I had no luck reaching the right department via telephone because I don’t speak Spanish or Catalan so well so I gave up on trying to get a confirmation that way. Anway, when I arrived on the day of my appointment, the secretary in the Diagnostica d'imatge department told me that I should have booked two appointments instead of one and it was a problem, but she will try her best to find a solution. I was afraid because I came to Barcelona only for this appointment (I live 3 hours away from the city). After waiting for around 20 minutes the secretary (her name was Andrea, I think) called me and confirmed that I can take the two exams one after the other right away! Eventually everything turned out well and the staff was super friendly, even when I only spoke English. Big thank you again Andrea you saved my day!! :)

Excellent service . Professional doctores and they take care of their patients in a very human way

Im calling all day to cancel an appointment with traumatology, no answer all day, it's been always like that i have to keep calling for hours maybe they pick up the phone, but today no one pick up the phone.

Awful. Patient Management is closed when it have to work. No response via phone to ask why you must pay specific amount of money and for which services. Huge respect for doctors, but management of clinic is awful and they deserve even less than 1 point out of 5.

After almost 30 hours, they still don’t know when they can perform surgery on my kidney stone. They only gave me 5 glasses of water! When I asked them about my situation and the plan, nobody answered! I’m thirsty, hungry, and in pain from the stone for more than 1 day. This is simply the worst hospital I have ever seen in my life!

Unfortunately but I have a pleasure to have surgery on pancreas cancer here. UK NHS said its noopetatable😬. The rooms 10 stars out of 5🙂, super clean, staff constantly checking on you, everything went smooth and pain free(thanks to epidural and painkillers). I have been sent home when I was ready, no complications and, 7 month out and good so far. Highly recommend, plus beautiful town which I was able to see before surgery.

I waited for 1h40min for an appointment and it got to the point where they wait was ridiculous, I had already had to cancel my next thing, and felt absolutely frustrated for coming all the way for a consultation, waiting so long to then desist as I don’t have more life to lose on this. The only reason I don’t give it 1 star is that the receptionist was nice and helpful and that the check in was easy. I don’t plan on going to CUF for help ever again.

They performed the surgery well. But was too expensive, they took far too long for a private hospital and they didn't explain costs. I cannot dispute the charges without making an account but I can only make an account by going in person. Not sure if it would be better than a public hospital in most countries

Just want money, no more than that. They told us to pay an amount of money regarding an appointment in the hospital and we already paid it then found a higher invoice to be paid later while we confirmed in the hospital several times that there would be no extra cost.

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.

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.