Time flies, really...
This year was an important year for myself.
Finally I had graduated after 4 years of endurance. Further studies when you are having other commitments is really tough. I need to juggle between work and family, to ensure a balance between both. If I had not took the leap of faith 4 years ago, I am still a rotting flesh sitting in a small place, waiting for time to past. If I never leave my comfort zone, I would have not known my potentials and my strength. If I choose to stay the way things are, I may have not known many great friends from around Malaysia and the World.
The arrival of the bundle of joy really makes a difference in my life. He has been my source of inspiration, my happiness and my motivation to go on. He makes me want to go home on time every day. He is a walking 'destresser', giving us joy and laughter.
I wish that year 2017 will be another great year, just like before.
Showing posts with label farewell. Show all posts
Showing posts with label farewell. Show all posts
Wednesday, December 14, 2016
Monday, May 28, 2012
If I Am Not A Doctor
If I Am Not A Doctor
If I am not a doctor,
My life would be free,
As I neither care for a stranger's life,
Nor about his itchy hives,
I wouldn't get needle prick,
Nor get prolonged cough and TB,
Nor jaundiced because of Hepatitis B,
Spending months in recovery.
If I am not a doctor,
I would be home by five,
Have dinner with my wife,
Spend time with my child
Missed the moments they grow up,
Missed their graduations,
While I am busy in OT,
Saving someone ailing heart.
If I am not a doctor,
I wouldn't have this heartache,
Of leaving everything behind,
And everything I loved.
Moving to another new places,
Meet strange people and new faces,
Only to find the city craze,
Nothing compares to my home,
My favorite place.
Sunday, February 5, 2012
MM Kills the Doctors
No. It is not Marilyn Monroe. And it is certainly not your M&M sweets (although some might argue that the high sugar content will cause harm). No, I am not talking about multiple myeloma either.
Its maternal mortality.
Just mention this term among your colleague, it will certainly bring chills to their spine. Some had nightmares of going through the painstaking process of being interrogated. Months of sleepless nights, loss of appetites, anhedonia, and suffers in term of performance at work. Some even loss their money and worse case scenario, losing jobs.
I want to share a personal experience of my recent encounter with MM:
Mdm Z was a 24 years old expecting mother. She enjoys good health previously. She had a loving husband, and a caring family. This was her first pregnancy, and she had lots of hope for it. The first trimester of pregnancy passed through like a breeze.
During her second trimester, she had fever for a week. To cut short the stories, she was found to have infective endocarditis of the native valve. She was told of the problem and treatment commenced. As she was pregnant, many drugs were contraindicated, so the choice of antibiotics were limited. After about a week, she developed heart failure, probably because the infections cause valvular insufficiency. However, as of many Malaysian, they have predominating mindsets that alternative medicines works, and refused the trial-proven therapy. So the family brought a Shaman at midnight to her cubicle (without our prior consent), chanting spells for 2 hours, spraying water all over (nevertheless, causing massive rain inside ward and disturbed the other patients). You know what, the fetus died the next day!
Couple of days later, she delivered. Treatment was continued (and many 'I told you so, yet you don't want to listen'). Finally she was discharged well after weeks of antibiotics and planned for operative management in near future. Just a week after discharge, patient condition deteriorated at home yet family refused to bring her to hospital. When we rang up to follow up her condition, that's when we knew she had met her maker.
Who's at fault?
Sooner or later, there will be inquiries regarding this maternal mortality case. We have to attend countless of meeting, fired with many questions and waste many time in between.
MM also created a culture of defensive medicine where managing team will priorities the non-emergent case over others to save themselves from this MM inquiries hassle. What do you think?
Thursday, June 25, 2009
The Homeless Nest
One fine evening, I took my camera out for a shooting. And I found this empty nest. I vaguely remember there were a robin with 2 chicks some 3 weeks ago. Guess they grown up already and left the nest for a better life.
Back to real life, my sister is leaving the hometown for good, for the future. What she left to is an empty nest. Grandpa used to be dependent of her. When she is gone, this old man will be lonely. Yet, true to the sayings, old man are stubborn. I just simply can’t him to stay with us (me and mother) for he has things that he can’t leave behind. But most of all, he is afraid of change. Any trip to unfamiliar place will pose a treat to the stability.
Soon, there will be the ‘Empty Nest Syndrome”…
Tuesday, June 23, 2009
Reflection: Surgery
It had been a tough 4 months in Surgical internship. I had made it! I had made it to the end. With all the bad remarks regarding the department staff, the rotation itself and all the no-nonsense attitude in the posting, I am surprised myself for being able to go through it.
First, the department head gave a lot of pressure to us. He is treating us all like an army recruit. “You may do this with written permission; You are not authorized to do that; You must submit your form by 0800 on every 2nd of the month and bla..bla..” Working hours was from 7 am till 8 pm. Gosh! I had so little time for myself, my girlfriend and my family. All devoted to the ward and the sick bay. His style can be described in one word…unpredictable.
Next, the ward staff are bunch of back-stabbing monster. They will do anything to sell you out for the sake of their own good in front of the Big Boss. I had it once. The Sister of the ward once file an invalid complaint against us, saying that the House officer were not doing their job for discharging patient. It never occur before because discharge is our level 1 priority when doing the ward work. I was in rage when the boss came to tell us that we need to have schedule for the HO to do discharge. All for the sake of Sisters…
Yet I find a lot of fun in doing surgical stuff. All those logics in managing patient, decision-making and the thrill of hands-on is so nice. I like the feeling of holding the scalpel, carving the lines, and remove, repair, and remodeling the disease parts. It feels so real, so myself.
Now, the time is gone… I am already into my next rotation. Emergency department. Now it is a better time for me.
Tuesday, June 2, 2009
A Selfless Act
This case happened during my on call...
It was midnight. Rainy nights. And he is just another typical boy. Young and bright boy, and just finished school, waiting to go to college. Let's just called him Ali. Ali was riding his bike down the street. He just finished work and was rushing to go home. The watch on his wrist shows 25 minutes past eleven. The street was quite deserted, only few cars cruising down the road. Like him, they are going home too.
Out of no where, this cyclist dart across the road. Spinal reflex kicks into his action. His right hand jam into the brake, and his left hand quickly steer to the left to avoid the imminent crash. Alas, the wet road does no help. In no time a all, his bike skidded and he was dragged along. It just won't stop. With a loud 'crack', he hit head on into the road divider. The last thing he ever saw is the flash of street lights. Then he went into unconscious state.
I attended him in casualty department. His Glassgow Coma Score was merely 6/15. CT scan done, There were extensive skull bone fracture with massive intracranial bleed. A ring to the neurosurgeon on call realized my worst fear, his condition is beyond the help of modern science.
This piece of news was broken to the Ali parents. Naturally, they were in the state of devastation. I wasn't expecting anything less than this. Having raised this child, seeing him rocking the cradle, to his first word to his first graduation, there is more than just memory. There were life, joy and there were pain. There is no grieve worst than a white-haired sending away the black-haired, as the chinese saying goes.
"I wish to give away the organs of my child to the needful person." The mother said to me.
"What?" I replied. This was not what I would expect in a typical parent in such situation.
"I don't want him to die like this. I want him to be remembered as someone brave. And I want his spirit to live on in people that need it the most." The mother added.
I was taken back of her decision. It seldom happen in this country, what more in this small hospital. Her generosity to donate organ is genuine and pure from the heart.
A couple of phone calls and paper work later, the organ harvest team arrived from Kuala Lumpur by plane with all sorts of equipments. Finally, he was lay to rest at 1 am the next day. Physically, he is no longer here but his spirits and organs lives on in the other people.
Bravo to such a selfless act. Only wish that there were more people that wiling to take such steps to help the people in need. Anyway, death is just a path that everyone has to walk down alone. Why we need to carry all the organs that will eventually rot or cremated along while it can help people like those haemodialysis dependent or external cardiac machine and give them another ray of hope? Time to think, people...
It was midnight. Rainy nights. And he is just another typical boy. Young and bright boy, and just finished school, waiting to go to college. Let's just called him Ali. Ali was riding his bike down the street. He just finished work and was rushing to go home. The watch on his wrist shows 25 minutes past eleven. The street was quite deserted, only few cars cruising down the road. Like him, they are going home too.
Out of no where, this cyclist dart across the road. Spinal reflex kicks into his action. His right hand jam into the brake, and his left hand quickly steer to the left to avoid the imminent crash. Alas, the wet road does no help. In no time a all, his bike skidded and he was dragged along. It just won't stop. With a loud 'crack', he hit head on into the road divider. The last thing he ever saw is the flash of street lights. Then he went into unconscious state.
I attended him in casualty department. His Glassgow Coma Score was merely 6/15. CT scan done, There were extensive skull bone fracture with massive intracranial bleed. A ring to the neurosurgeon on call realized my worst fear, his condition is beyond the help of modern science.
This piece of news was broken to the Ali parents. Naturally, they were in the state of devastation. I wasn't expecting anything less than this. Having raised this child, seeing him rocking the cradle, to his first word to his first graduation, there is more than just memory. There were life, joy and there were pain. There is no grieve worst than a white-haired sending away the black-haired, as the chinese saying goes.
"I wish to give away the organs of my child to the needful person." The mother said to me.
"What?" I replied. This was not what I would expect in a typical parent in such situation.
"I don't want him to die like this. I want him to be remembered as someone brave. And I want his spirit to live on in people that need it the most." The mother added.
I was taken back of her decision. It seldom happen in this country, what more in this small hospital. Her generosity to donate organ is genuine and pure from the heart.
A couple of phone calls and paper work later, the organ harvest team arrived from Kuala Lumpur by plane with all sorts of equipments. Finally, he was lay to rest at 1 am the next day. Physically, he is no longer here but his spirits and organs lives on in the other people.
Bravo to such a selfless act. Only wish that there were more people that wiling to take such steps to help the people in need. Anyway, death is just a path that everyone has to walk down alone. Why we need to carry all the organs that will eventually rot or cremated along while it can help people like those haemodialysis dependent or external cardiac machine and give them another ray of hope? Time to think, people...
Friday, March 20, 2009
Twenty Nine Days
It not right to feel for the patient you are treating. It is almost wrong when you are emotional connected to a patient that you are treating. They says it affect your judgment and the clinical acumens. Despite all the teaching saying so, I still made the mistake.
Dasuki was a very unfortunate boy. At the age of twenty, almost all of his fellow at the peak of their life. Everyone venturing into working, busy with marriage, but this poor boy was bed bound. Not only he had to depend on his father for the simplest chores as to personal sanitation, he had become the increasing financial burden of the family for his medical need and disabilities.
After a freak accident one day where he lost control of his motorbike and skidded, his life changed. The motorbike hit a sand dune and he was thrown forward and landed head on. On arrival to hospital, doctors pronounced that he had a spinal segment T8 and T9 fracture, which translated into paraplegia for the rest of his life. He lost feeling of both lower limbs. Anything below umbilicus feels numb. Both legs were heavy and felt disconnected o the torso. Passing urine and bowel habit became automatic event, and he has no control whatsoever towards it.
Studying the family dynamic, he is the youngest of eleven siblings. As if to add salt to the wound, his mother is a stroke-surviving patient with hemiplegia as well. Father earn a meager pay by doing plantation work in small scale. He has a sister he used to mention quite a lot. This sister is closest to him, bathing him, feeding him at regular interval. But what to do, his sister has to get on with life. She need to work. She need to take care of her family. After her marriage six months ago, she had moved away from Kuantan to Johor Bharu following the husband.
He came to us with prolonged bed bound, 12 months after the accident. Instead of a young and vibrant boy, we saw a nutritionally-deprived boy, dirty and unkempt. The bed sore already formed over huge area over sacral, the heel and even elbow. A sigmoid colostomy had been made to accommodates faeces passed through anterior abdominal wall. This could prevent soiling of faeces and the sores.
At the last 11 days of his life, we have to open him up, to find the bowel is a mess with adhesion and perforation. Everything necessary had been done. After the operation, he was going down hill. On the other hand, we are giving stronger antibiotic and nutrional support for him.
The day before he is intubated, I was talking to him. There were very few visitior for Dasuki. The father seldom came as to take care the other needy one at home. We talked about many things. All I want is to set a long term goal for him, to make him ambulate by wheel chair. At least he is less dependent if he can whelled to the toilet or to reach for things. He said that he missed his sister, and asked me to called up the sister. He wanted to see her badly. On top of that, he says living has no meaning for him anymore. I just kept quiet as did not respond.
The defence finally breached on the last 3 days. His lung and heart had gave up on this battle. We intubated him and put him on inotropes. Blood pressure on few instances were unrecordable. Most of the time, it was lowish. We rang up the father, told him that his son was not doing well. Soon after that, the relatives, family members came.
The last word he said to me was I am tired.
On his last day, his sister came to see him. After twenty nine days of long winding battle, he finally passed away, fulfilled his last wish. Rest in peace, Dasuki.
Dasuki was a very unfortunate boy. At the age of twenty, almost all of his fellow at the peak of their life. Everyone venturing into working, busy with marriage, but this poor boy was bed bound. Not only he had to depend on his father for the simplest chores as to personal sanitation, he had become the increasing financial burden of the family for his medical need and disabilities.
After a freak accident one day where he lost control of his motorbike and skidded, his life changed. The motorbike hit a sand dune and he was thrown forward and landed head on. On arrival to hospital, doctors pronounced that he had a spinal segment T8 and T9 fracture, which translated into paraplegia for the rest of his life. He lost feeling of both lower limbs. Anything below umbilicus feels numb. Both legs were heavy and felt disconnected o the torso. Passing urine and bowel habit became automatic event, and he has no control whatsoever towards it.
Studying the family dynamic, he is the youngest of eleven siblings. As if to add salt to the wound, his mother is a stroke-surviving patient with hemiplegia as well. Father earn a meager pay by doing plantation work in small scale. He has a sister he used to mention quite a lot. This sister is closest to him, bathing him, feeding him at regular interval. But what to do, his sister has to get on with life. She need to work. She need to take care of her family. After her marriage six months ago, she had moved away from Kuantan to Johor Bharu following the husband.
He came to us with prolonged bed bound, 12 months after the accident. Instead of a young and vibrant boy, we saw a nutritionally-deprived boy, dirty and unkempt. The bed sore already formed over huge area over sacral, the heel and even elbow. A sigmoid colostomy had been made to accommodates faeces passed through anterior abdominal wall. This could prevent soiling of faeces and the sores.
At the last 11 days of his life, we have to open him up, to find the bowel is a mess with adhesion and perforation. Everything necessary had been done. After the operation, he was going down hill. On the other hand, we are giving stronger antibiotic and nutrional support for him.
The day before he is intubated, I was talking to him. There were very few visitior for Dasuki. The father seldom came as to take care the other needy one at home. We talked about many things. All I want is to set a long term goal for him, to make him ambulate by wheel chair. At least he is less dependent if he can whelled to the toilet or to reach for things. He said that he missed his sister, and asked me to called up the sister. He wanted to see her badly. On top of that, he says living has no meaning for him anymore. I just kept quiet as did not respond.
The defence finally breached on the last 3 days. His lung and heart had gave up on this battle. We intubated him and put him on inotropes. Blood pressure on few instances were unrecordable. Most of the time, it was lowish. We rang up the father, told him that his son was not doing well. Soon after that, the relatives, family members came.
The last word he said to me was I am tired.
On his last day, his sister came to see him. After twenty nine days of long winding battle, he finally passed away, fulfilled his last wish. Rest in peace, Dasuki.
Thursday, March 27, 2008
The Last Banquet, Seperation and Farewell
There are many types of tears. We cry when we are sad, we cry when we are overjoyed, we cry when we feel embarrassed. Yesterday, I shed the tears because me and my dearest friend is going their own way. 天下无不散之筵席。I do not know of any simile for this Chinese proverb but direct translation means every banquet must come to an end and everyone going their way.
Life is a sea, we are the one charting and sailing through. Along the way, we met friends that would help us through stormy weather, even help us when our boat capsized. Some are pirates, trying to rob you, make you weep, and lost is the vast sea. There is one friend of mine that had been with me night and day, help me sail through the choppy sea. Her name is Apple. If there is anyone that I would missed after this, it would be her. She made me cry yesterday.
She is a person who speaks directly, straight on the face. Never bother or feel over controlled by the authority. She has a loving heart, never fail to care for those who lacked behind. She is also down to earth, seldom show off. To me, she is the type that you can rest your shoulder on, sharing your thought and problem. We have close friends since second year, even more from then onwards. There had been crisis before, because of my closeness to her, caused a lot of unnecessary suspicion and talking behind our back. Although she is married, I always treated her as the very good friend of mine, nothing more.
Just wanna share the lyric of 'I'll Stand By You' from Pretenders
Oh, why you look so sad?
Tears are in your eyes
Come on and come to me now
Dont be ashamed to cry
Let me see you through
cause Ive seen the dark side too
When the night falls on you
You dont know what to do
Nothing you confess
Could make me love you less
Ill stand by you
Ill stand by you
Wont let nobody hurt you
Ill stand by you
So if youre mad, get mad
Dont hold it all inside
Come on and talk to me now
Hey, what you got to hide?
I get angry too
Well Im a lot like you
When youre standing at the crossroads
And dont know which path to choose
Let me come along
cause even if youre wrong
I just can't fight this overwhelming feeling of sadness. The uncertainty of when to meet again is strong. We will live our life, and head our own way for sure. Till then.
Life is a sea, we are the one charting and sailing through. Along the way, we met friends that would help us through stormy weather, even help us when our boat capsized. Some are pirates, trying to rob you, make you weep, and lost is the vast sea. There is one friend of mine that had been with me night and day, help me sail through the choppy sea. Her name is Apple. If there is anyone that I would missed after this, it would be her. She made me cry yesterday.
She is a person who speaks directly, straight on the face. Never bother or feel over controlled by the authority. She has a loving heart, never fail to care for those who lacked behind. She is also down to earth, seldom show off. To me, she is the type that you can rest your shoulder on, sharing your thought and problem. We have close friends since second year, even more from then onwards. There had been crisis before, because of my closeness to her, caused a lot of unnecessary suspicion and talking behind our back. Although she is married, I always treated her as the very good friend of mine, nothing more.
Just wanna share the lyric of 'I'll Stand By You' from Pretenders
Oh, why you look so sad?
Tears are in your eyes
Come on and come to me now
Dont be ashamed to cry
Let me see you through
cause Ive seen the dark side too
When the night falls on you
You dont know what to do
Nothing you confess
Could make me love you less
Ill stand by you
Ill stand by you
Wont let nobody hurt you
Ill stand by you
So if youre mad, get mad
Dont hold it all inside
Come on and talk to me now
Hey, what you got to hide?
I get angry too
Well Im a lot like you
When youre standing at the crossroads
And dont know which path to choose
Let me come along
cause even if youre wrong
I just can't fight this overwhelming feeling of sadness. The uncertainty of when to meet again is strong. We will live our life, and head our own way for sure. Till then.
Wednesday, March 19, 2008
Seperation Anxiety
March 19, 2008, 743 AM
Broken Clouds, 24 degree Celsius
Finally, I have reached this day. Many had anticipated and waited eagerly for this day. Not long ago, I was among them. I had never thought the end would come so unexpected, un'enigmatic', so anticlimax! It is just like a movie come to a sudden end. It feels like a piece of my heart had moved out of me, because there is sudden emptiness and loneliness that is gripping me. I had early awakening today because the feeling of loneliness was just overwhelming. Coffee seems tasteless. Maybe I am not a person that is used to do nothing. Nothingness means laziness to me.
There are boxes lying around. I had already packed my belongings. Books, pens, photo albums, clothings were put in boxes. They were just lying lazily around. Memories were tied up properly. Five years through this gruesome learning curve, there were more than just plain knowledge that I gained. I learned to 'see' friends. There are friends that I can pour out secrets, while there are not-so-few of those 'Hi & Bye' friends. Some plainly what to get a piece of me, I know. True friends are hard to look for, because they come to you with time.
I used to have cheap tears. They were easy to produce. Now my heart is made of steel, or rather casted in steel. It is the environment that shaped me. You don't expect a doctor that shed their tears when patient told about their agony, do you? It is such an irony, that I am expected to care for the patients, yet not to feel for them. This is what they called 'empathy', not sympathy. At times, I don't feel like 'me' anymore.
Many people had help me stand up when I fall down. I still remember when I am in my first and second year, I embrace myself to be a student council. It was a hardship, dividing between the time of study and the long meetings and many projects to plan and accomplish. I was glad, that I found 2 true friends, Julian and Guang Hong, that gave me and still giving me moral support and be my loyal fans. Without them, I would not have reached here. There were fine teachers like Dr Shahrir, my ex-college master that help me be myself today. I don't know how to repay them.
I am leaving tomorrow. Maybe this is my last goodbye to this college, this university and my friends that had make my life more beautiful and more meaningful. I will definitely missed everyone and everything.
Broken Clouds, 24 degree Celsius
Finally, I have reached this day. Many had anticipated and waited eagerly for this day. Not long ago, I was among them. I had never thought the end would come so unexpected, un'enigmatic', so anticlimax! It is just like a movie come to a sudden end. It feels like a piece of my heart had moved out of me, because there is sudden emptiness and loneliness that is gripping me. I had early awakening today because the feeling of loneliness was just overwhelming. Coffee seems tasteless. Maybe I am not a person that is used to do nothing. Nothingness means laziness to me.
There are boxes lying around. I had already packed my belongings. Books, pens, photo albums, clothings were put in boxes. They were just lying lazily around. Memories were tied up properly. Five years through this gruesome learning curve, there were more than just plain knowledge that I gained. I learned to 'see' friends. There are friends that I can pour out secrets, while there are not-so-few of those 'Hi & Bye' friends. Some plainly what to get a piece of me, I know. True friends are hard to look for, because they come to you with time.
I used to have cheap tears. They were easy to produce. Now my heart is made of steel, or rather casted in steel. It is the environment that shaped me. You don't expect a doctor that shed their tears when patient told about their agony, do you? It is such an irony, that I am expected to care for the patients, yet not to feel for them. This is what they called 'empathy', not sympathy. At times, I don't feel like 'me' anymore.
Many people had help me stand up when I fall down. I still remember when I am in my first and second year, I embrace myself to be a student council. It was a hardship, dividing between the time of study and the long meetings and many projects to plan and accomplish. I was glad, that I found 2 true friends, Julian and Guang Hong, that gave me and still giving me moral support and be my loyal fans. Without them, I would not have reached here. There were fine teachers like Dr Shahrir, my ex-college master that help me be myself today. I don't know how to repay them.
I am leaving tomorrow. Maybe this is my last goodbye to this college, this university and my friends that had make my life more beautiful and more meaningful. I will definitely missed everyone and everything.
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