Most of us would try as hard as possible not to step into the hospital, to have nothing related to it. Hospital is synonym to sick, death, dirty, and all sorts of infections. Admission to hospital is suffering.
Yet, some will find all ways to get admitted to the hospital. I have seen quite some diagnosis such as " Poor oral intake and patient requested admission". Those 'patient requested admission population' are generally from the low socioeconomy status group, prisoners, intravenous drug users, and those with very poor family support group.
The first one, Ah Tat is his name. Every time we discharged him, he will return to our door steps on the third day without fail. Every time with the same complaint. He was not able to control fluid intake, subsequently taxed the ailing heart, ended up with heart failure symptoms. Despite giving the best medications, he did not want to take because he believed taking too much medications will do him more harm. So if I am on call and he is admitted, I do not need to clerk him, simply give him some advice and a nice bed. That's all.
The second case, 77 years old elderly, initially having acute renal failure, requiring dialysis. But the children strongly believe dialysis will do more harm than good. By going against doctors advice, the patient was going downhill. Currently, her kidneys is damaged beyond repair. But her will to live is strong. She had multiple episode of severe ulcers bleed, the next day I come, she is still alive. The daughter refused to take back the mother because apparently no brothers and sisters will take the responsibility to take care of the mother in the care towards the end and there were no maid at home. The best option is to let the staff nurse to take the responsibility of the children to take care of the mother. So until now, we still can't discharge her.
The third case, a 30+ guy, actively injecting drugs, despite went in and out institution, still unable to stop this habit. He would come in every other week for worsening abdominal distention. His liver was already cirrosed, because of viral hepatitis. When he was in the second home, he wreaked havocs. The staff nurses loathed him because he stole their ketchup. However, he has passed away unfortunately due to severe liver failure.
Hospital is not only the place for the sick. It is also the place for the unwanted, the lonely, the leftover, the unemployed, and those who wanted free food with some hospitality. My hospital door is always open (because there is no door!). Welcome to our second home.
Sunday, August 24, 2008
Wednesday, August 20, 2008
Length Doesn't Matter, or Really?
I was doing my respiratory rotation when he admitted to the ward. Pretty advanced cancer of the oesophagus spreading to the lungs. He was breathless all the time. Chest tube was attempted by me and the initial drain was like a water hose spurting out the putrid greenish fluids. Afterwards, his breathlessness was gone.
Two weeks later, I learned from my friend that he passed away. Cause by failed ventilatory support system. Sad, nevertheless. But I learn something from this gentleman.
You can learn a lot from the patient if only you see. Whenever during visiting hours, the bedside is full with concerning friends and relatives, you know either he has a good social support or second possibility is that he has a lot of money and the will is not made yet. If you see a bouquet of flower on the desk, there is someone care enough to give the well wishes for the patient.
This patient of mine was a teacher. A secondary school teacher. What is peculiar about him was if you speaks malay with him, he will answer in english. Maybe that was his style. He will question every management plan we had for him, like why is this medication on, why is this procedures carried out.
With his death, his teaching life came to abrupt full stop. But many had learned from him, and become a useful person to the society. He may not teach anymore but his teaching still passed on. On the day of his death, there were a crowd more than 50 that came for him, the largest I've seen so far. The wife came up to me with teary eyes, thanked me for taking care of the husband. It stirs my inside, and I loss my speech. I just return her a sincere smile.
You may say he live a short life. Nevertheless, it was a meaningful and purposeful life, I say. Does the length really matter, huh?
Two weeks later, I learned from my friend that he passed away. Cause by failed ventilatory support system. Sad, nevertheless. But I learn something from this gentleman.
You can learn a lot from the patient if only you see. Whenever during visiting hours, the bedside is full with concerning friends and relatives, you know either he has a good social support or second possibility is that he has a lot of money and the will is not made yet. If you see a bouquet of flower on the desk, there is someone care enough to give the well wishes for the patient.
This patient of mine was a teacher. A secondary school teacher. What is peculiar about him was if you speaks malay with him, he will answer in english. Maybe that was his style. He will question every management plan we had for him, like why is this medication on, why is this procedures carried out.
With his death, his teaching life came to abrupt full stop. But many had learned from him, and become a useful person to the society. He may not teach anymore but his teaching still passed on. On the day of his death, there were a crowd more than 50 that came for him, the largest I've seen so far. The wife came up to me with teary eyes, thanked me for taking care of the husband. It stirs my inside, and I loss my speech. I just return her a sincere smile.
You may say he live a short life. Nevertheless, it was a meaningful and purposeful life, I say. Does the length really matter, huh?
Saturday, August 16, 2008
The Final Step Between Learning and Earning Years
Last week I finally attended my graduation. Five years of hardship turning into something rewarding. Walking up on stage, getting the scroll, snap-snap, meeting friends and talking dreams. Now I am a degree holder, haha!
Somewhere before the convocation, we some couple of old friends met up to chit chat. When I thought I worked so very hard, on call almost 10 times per month, there is someone else worse than me. My friend in Sungai Petani had to do calls up to 15x a month! That is equal to doing every other day calls. Phew! Some had significant loss of weight. Others are doing easy calls like 5 to 6 times a month with not much patient to care of. But some did not live to the good name of the University. I heard he left the hospital during his call to meet up with his partner and the whole hospital was looking for him. Irresponsible.
People come with many faces, and many behaviours. What separates us is our attitude. If we have positive attitude, then we will survive well. On the other hand, if we give the impression to other people that we are lazy, then working will be like living in hell. When you manage patient, you can't be lazy. That is what my Prof Emeritus Dr Adeeb favorite quote. Lets give it a deep thought, my friends.
Wednesday, August 6, 2008
Monday, August 4, 2008
This Old Man, He Play One, He Play Nick Nack...
I came to know an old man. A lonely old man.
He loves to wait by the telephone for her daughter to call, but they seldom do.
He loves to watch movies on big screens, yet no one has time to accompany him.
He loves to cook nice dishes, sometimes the taste can go awfully wrong, and no one there to eat the food.
He loves to travel, yet no one would look after the house for him.
He loves to talk, yet walls is the only listener for most days.
He loves to try his luck on the scratch ticket, yet no one share the joy of winning with him.
He loves to sleep during noon time, because time is easier to go by to fill up the absence.
He loves to learn English, asking his grandson grammars and pronunciation, because that is the communication link between both of them.
He loves his family, and do not know how much love the family gave returned to him.
He is
My grandpa
He loves to wait by the telephone for her daughter to call, but they seldom do.
He loves to watch movies on big screens, yet no one has time to accompany him.
He loves to cook nice dishes, sometimes the taste can go awfully wrong, and no one there to eat the food.
He loves to travel, yet no one would look after the house for him.
He loves to talk, yet walls is the only listener for most days.
He loves to try his luck on the scratch ticket, yet no one share the joy of winning with him.
He loves to sleep during noon time, because time is easier to go by to fill up the absence.
He loves to learn English, asking his grandson grammars and pronunciation, because that is the communication link between both of them.
He loves his family, and do not know how much love the family gave returned to him.
He is
My grandpa
Saturday, July 26, 2008
Goh, can you do me a favor...
Into working life for about two months now. Start to see things clearer. And I start to know people.
There are a type of people, who is genuinely being a friend with you, helping you out, guide you and cover your back. They treat you as a team, working together towards a common goal.
On the other hand, there are also people who likes to take advantage on other people, thinking that everyone else is stupid and they are the only clever one on earth. Every time a challenging task is assigned to them, they will start to find every one else:" Can you do me this favor?" "Can you help me with this?" "I am really rushing home. Can you manage this case for me?" All sorts of excuses, to evade from work. These people haven't grown out of their cocoon world, still living in the student years, where there is no need for responsibility. In the student years, you can leave the ward anytime you want, throw aside the branula for the houseman if you can't set it and have plenty of holidays. Not anymore since I ventured into housemanship time.
Everyone is getting the same pay. Why would one answer so many favours while the other one just wait and see? Between giving fishes and teaches a person to fish, I would rather go for the latter. As the time comes, our service will be needed to do the daunting task in the middle of the night without any guidance. Only pure skill will help us through. I don't mind sharing the skills, which I did most of the time. But I hate people taking advantage by asking favor everytime the same problem arise.
And the third type of people are those who only work within their working boundaries. They did their job perfectly well, no question asked. But when it comes to do a little bit more, they will be calculative. Team spirit is never existence. These people are hard to work with as well. In the end, the one that works alone will be suffering more.
Which types are you belongs to?
There are a type of people, who is genuinely being a friend with you, helping you out, guide you and cover your back. They treat you as a team, working together towards a common goal.
On the other hand, there are also people who likes to take advantage on other people, thinking that everyone else is stupid and they are the only clever one on earth. Every time a challenging task is assigned to them, they will start to find every one else:" Can you do me this favor?" "Can you help me with this?" "I am really rushing home. Can you manage this case for me?" All sorts of excuses, to evade from work. These people haven't grown out of their cocoon world, still living in the student years, where there is no need for responsibility. In the student years, you can leave the ward anytime you want, throw aside the branula for the houseman if you can't set it and have plenty of holidays. Not anymore since I ventured into housemanship time.
Everyone is getting the same pay. Why would one answer so many favours while the other one just wait and see? Between giving fishes and teaches a person to fish, I would rather go for the latter. As the time comes, our service will be needed to do the daunting task in the middle of the night without any guidance. Only pure skill will help us through. I don't mind sharing the skills, which I did most of the time. But I hate people taking advantage by asking favor everytime the same problem arise.
And the third type of people are those who only work within their working boundaries. They did their job perfectly well, no question asked. But when it comes to do a little bit more, they will be calculative. Team spirit is never existence. These people are hard to work with as well. In the end, the one that works alone will be suffering more.
Which types are you belongs to?
Friday, July 18, 2008
The Meaning of Life
Life...
Life is between this breath and the next. Are you aware of the breath you are taking now? Are you consciously believe that you are alive now?
Many don't. Many take for granted for this life. Some even wasting their life now.
Without knowing it, the next breath that we take will be more effortful, more difficult. Every breath we take brings us closer to death. whatever said, it is not the destination that matters. The journey through this life is the things that bring colours to our life.
I work along with death. I see him many times a day. In the morning, during ward rounds, when I am having lunch, and especially in the middle of the night when everyone is fast asleep. I particularly remembered one event, seeing Mr. Death in the resuscitation room. He brought along a boy, in his early twenties, left a lifeless body with many fractures and scars. At one glance, most probably high velocity motor vehicle accident that cause his demise. Another glance, maybe he is someone that I mentioned before, someone who wasted their life by racing illegally. Cause of death - polytrauma and spleen ruptured leading to hypovolaemic shock.
Today, 364 days to my 27 birthday. War of the the middle earth has ceased. The race to the end has already begun.
Life is between this breath and the next. Are you aware of the breath you are taking now? Are you consciously believe that you are alive now?
Many don't. Many take for granted for this life. Some even wasting their life now.
Without knowing it, the next breath that we take will be more effortful, more difficult. Every breath we take brings us closer to death. whatever said, it is not the destination that matters. The journey through this life is the things that bring colours to our life.
I work along with death. I see him many times a day. In the morning, during ward rounds, when I am having lunch, and especially in the middle of the night when everyone is fast asleep. I particularly remembered one event, seeing Mr. Death in the resuscitation room. He brought along a boy, in his early twenties, left a lifeless body with many fractures and scars. At one glance, most probably high velocity motor vehicle accident that cause his demise. Another glance, maybe he is someone that I mentioned before, someone who wasted their life by racing illegally. Cause of death - polytrauma and spleen ruptured leading to hypovolaemic shock.
Today, 364 days to my 27 birthday. War of the the middle earth has ceased. The race to the end has already begun.
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