My Teacher, Then My Patient, Then My Teacher Again

Nothing touched me so much compared to this.

One fine day, my brother rang me up, told me that a patient had handed a note to him mistakenly, (as we share same surname). It was a small piece or parchment, apparent scribbled in a hurry. Each and every words were misaligned. After reading the note, there was a warmness spreading from the heart. Thus my tiredness bubbles. At least I know there is love in this world.

Read on for the content of the note:


Sometimes, a word of gratitude is more valuable than expensive gifts. His gratitude lights up the healing heart of mine.

Working is fun, all along.

A Different Perspective

Staying grounded for too long for me, is not good.

Sometimes, I need to fly. Above the ground more than 30,000 feet. Then you will understand what is perspective. I like the clouds beneath my feet. The sky, bluest of the blue, melt with the horizon. The lush green of the forest, dotted with buildings, and the river snakes around to reach the open sea. The sea, seems to be permanently marked by the ripples, and the ship frozen over the blue sea.

That is the way with life. Problems seems magnified when we look at it heads on. When we stand at a different perspective, sometimes the solutions seems to be the there in front of our eyes.

I just love flying.

Reflections: Medical Posting

Four months had passed, just in a blink of eye.

I had completed my first rotation in Medicine posting. It seems like yesterday, a fresh grad, half trembling, half confused, make his steps into this biggest hospital in the biggest state of Peninsular. Countless of sleepless night, exhaustions beyond words, pressure from superiors, ragging from peers, finally, yes finally I reached the end of the steps.

I learned a lot. Stuffs that I don't learn throughout schooling years. Stuff like interpersonal relationship, teamwork, overtime, and overwork. Not that I am not expecting all this to come, but the culture shock it gave to me. If I wasn't strong enough, I would have been a total failure. I would not be considered bragging when I said I am excelling in Medical posting. Most of the supervisors gave me an approving nod. (some even going to the stage to extend me so to help them out with work) I think to summarize it all, hardworking and honesty are the values that everyone values.


Next, I am going into Obstetric and Gynaecology. Hope I still have the passion to go on. I just love this job.

A Tale of Resurection

Today miracle happen to me.

After more than 30 resuscitations, today I am able to revive a patient, after he went into asystole.

He is a 70 year-old Malay, came in with congestive heart failure, very poor ejection fraction, and came in with fluid overload. He had pitting oedema up to knee, shortness of breath and congested lungs.

Initially, he was well. After going to toilet, his son rushed to me, when I was taking blood for another patient. He had fainted in the toilet. He fell squarely behind the toilet door, obstructing the only way out. Fifteen minutes passed of struggling to moved him away from the door. When I able to get to him, he was already unresponsive. No pulse. My adrenaline gets into action.

Immediately he was pushed into the acute bed. Cardiac monitoring put on. Flat line, no pulse. Barely any effective breathing activity. CPR started. After about 3 minutes, he regain pulse, with an extremely bradycardic pulse that is. Medication to increase blood pressure started. Blood pressure maintained. He was intubated and ventilated.

It is not all lost hope when the patient went into asystole (or not heart beat). But the chances that we are dealing is pretty slim. For an average Joe with no medical complication, the chances or revival is about 15%. However, the percentage dropped to almost 0 if the patient is having multiple medical illness. On top of that, the patient after being revived, requires intubation, ventilation, Intensive Care Unit admission and nontheless complications to multiple organs. That is why we always take into consideration patient's wishes for resuscitation and family views with regards of this matter. Sometimes, it is not prolonging the life, but prolonging death.

Think about it.

Life isn't smooth sailing, as always.

I had a bad day, today.

My patient died under my hand. She came with septicaemia. Down with DIVC. Needed a central line. However got oedematous peripheral limbs because of overload. Lower limbs were inflamed. Trial of Short line through internal jugular would only stress her limits as her INR was 5. My boss said:" Proceed, I trust you."

So Short line tried, but got stucked at 5 cm. Then I got it removed at once. Bleeding was mad. Haemostasis secured only after 15 minutes of compression. 15 mins later, she went into asystole. Resuscitated for 1 hour. Unable to bring her back. Thinking back, was it my mistake? Probably. But her premorbid status was not well, either. She would need the High dependency ward back-up the very least, or intensive care unit. But none were available.

Sigh!

Working in such a tight resource, is really stretching the limits. You have datelines, you have urgent things, you have sidelines, all coming to your face at the same time.

Time to ease out a little bit. Life goes on.

Insider Vs Outsider

"Chinese are the immigrant, squatters"

I can't believe I am still hearing such a low mentality statements being made.

Despite being independent for more than half a decade, the fundamental mentality is still stopping at British colonial times. As a Malaysian Chinese, we had rooted here for such a long time that we have little or no memory that we originates from China. I am born as a 'Malaysian'.I do not have a place in China for me. My mainland is here, Malaysia.

Despite all the moves to recognize every entity as 'Malaysian', there are people who still can't get over the overwhelming feeling of their own race being the greater one. Understandable. When we are equal, lost are the special privileges, unfairness, and foul play. Having a divided race entity is important in this context.

We may be independent at the outside, but inside, there is still a long way to go.

The Doctor With Fxxxed Up Teeth

How do you feel, if a doctor walks up to you, when you are sick, lying down on the bed. She oped her mouth: "What brings you here to the hospital?" You almost fainted with the stench of an unmanaged teeth.

This reminds me of a colleague of mine. Whenever he is post-call, he never care to brush teeth. He will carry on with the next day job. While this may be good as responsibility towards his job is high, it doesn't help in term of his personal image as a doctor. When he speaks, I stood 3 feet away.

Halitosis, or commonly known as bad breath, is a under-addressed issue. It doesn't affect only doctors, but people from all walks of life that doesn't find it necessary to brush their teeth. It is as bad as having a body odour.

Being in this field, talking sometimes play a therapeutic role. Having a bad breath does not help the situation at all. Not to mention the yellowish stained teeth and what it can do to the doctor's image. So a reminder to myself and my friends: Take good care of your oral hygiene.