Just passing time...

Of all the names you can come up with for a supplement....



By the by, I was doing wound debridement and insertion of a Steinman pin on a 16 year old who was carrying a friend on a bike and ended up breaking a femur each, when Abg called to tell me that Ibu Milo's smallest kitten has died.

I sort of expected it - it has been having a wet bottom the past few days and Abg said it vomited this morning - but it still doesn't make it less painful. Having 5 other bigger siblings and being the smallest of the bunch doesn't help with your survival chances, I guess. But life sure is simple in the animal world. Being strong and big and healthy means you live and vice versa. There are no sly tricks or cheats to help you along.

It certainly makes it hard when you are always rooting for the underdog.....or in this case, undercat?

Musim banjir sudah tiba wehhh....

This was the view that greeted me yesterday morning as I opened my bedroom window. and It is even worse today. I wonder if that small road overlying the small calvert that passes water from one paddy field to another has collapsed yet? Then I might have to abandon my partner and let him plate that femur by himself.

Ibu Milo

I am postcall, though by right, I don't think what I had last night should be considered being oncall. All I did was insert a peritoneal dialysis and escort a 28 weeker to NICU and after lounging in the oncall room for about 20 mins, went to see what my oncall partner is up to.

Turns out he was just lounging around in the drivers' room and we spent the following hour yakking about nurses and student nurses and such.

The baby's bilirubin which had been 430 previously came down to 379 and I went to bed a happy cat and woke up with the Azan before freshening up and doing rounds for the Ortho cases.

It is the monsoon season again. Sometimes, when I am in my car, with the airconditioning on, I look at the grey skies and feel the chill on my skin and it's almost as if I am back in dreary Belfast.


View from the 2nd floor in HTM.

The holes which turned up during the last monsoon which was resurfaced has turned up again - with even more vengeance than the last, I seriously think - and because of the rain water covering the said holes, one has to be even more careful when driving; I had a headache focusing on holes and avoiding pools of water on the road.


I brought back a family of cats about two weeks ago.

I was in a course when my nurse called me up and mentioned kittens. When I went to look, they were in fact mummy cat with 5 newborns, looking much like giant baby rats. The box they were in was already soggy from the rain. I left them be, only periodically coming by to feed mummy cat with the kibbles I keep in my car for purposes like these.

A few days later, staff at the A&E Department called me and told me about 'the most beautiful bunch of kittens ever' - maybe if they stressed on the word beautiful, that I would immediately take the cats home. Turns out it was mummy cat relocating, sans one kitten. We searched high and low for it - luckily a Radicare worker found it in the bin. Talk about having nine lives.

Incidentally, another staff mentioned that she saw kids playing with kitten in a box in front of the Peads ward. Out of curiousity, I went to look.

It was a tiny kitten, about the size of my palm and it was just sleeping in the box. I didn't see any mummy cat around. So I brought it home and now mummy cat has 6 kittens.



They have opened their eyes and just discovering that they have legs. Occasionally I see them playing with each other, unaware of the fact that mummy cat is still restless surrounded by my other cats that she still snarls when one of them comes over to say hello.

I've called the mummy cat Ibu Milo - she is white with splodges of chocolate. I don't really know why I name my cats - they don't respond to their names anyway.



Happy Aidil Adha everyone.

Post call rambling

Nothing is as satisfying as seeing the two bits of bone clicking into place as you manipulate a limb.

Seriously.

My partner in Ortho and my boss went off for a symposium in KB today and the boss had posted a case of fracture femur on the elective list. Now, I had done plating of a femur before but always with my partner and in all the previous times, he had done the reduction.

One never realises how difficult it is to reduce a fracture site until one does it him/herself. My partner makes it look so easy. I am starting to feel the dull ache in my biceps and triceps after pulling on the two parts of the broken bone. Thank goodness I had my two trusty MAs who, unlike me, were not postcall and were in a better shape to do all the traction and countering.

However, nothing is as irritating as having your patient sent back to ward because a caesarian section trumps everything else in OT land, and then having to wait 30 minutes before that patient finally arrives and having to listen to her scream for 10 mins because she wanted to pee in a toilet instead of into a bag.

And also, having to wait 2 hours for an appendectomy to finish because your makcik had been fasting since 4 am and it was already 6 pm and you just didn't have the heart to cancel her case. So, there I was suturing a piece of skin graft on a diabetic foot at 7pm on a postcall day.

You just have to love your work, I say.

A holiday story

I was in Indonesia recently, for my final holiday of the year, and on my last day, I managed to watch something on their local TV.

Basically, they had this actor going around asking passers by for a cloth in exchange of a bundle of old newspapers that she had.

Apparently she has a child at home and she needs it to protect her child from the cold of the night. They recorded her approaching these people and they all gave an excuse or another; one just simply changed the topic completely and totally ignored her request.

The actor was never pushy, and always said, "It's okay if you can't help me." and none of them did. Until the last person she came to.

This lady was carrying her child in a 'sarung' wrapped around her body, like you may see some Indonesian bibiks do with children under their care.

When the actor asked to 'borrow' her sarung, in exchange for the newspapers, she hesitated for just one moment before saying yes. When the actor asked her, "But won't your child cry?", she shook her head and proceeded to untie the cloth from around her body and gave it to the actor.

These two chatted and we discovered that the lady is a single mother (Don't know where my husband went, she said) and she makes a living by selling rice in her kampung. It is obvious that she was also poor and did not have much.

Her child did cry and so this pretender wanted to give it back but this lady said "Ngga apa, ambil lah" [It's okay, just take it] and turned her child and distracted him with something from her basket and passed the sarung from behind her back.

Seriously, here my eyes started to well up. I had a microwaved instant meal in front of me and immediately lost my appetite.

The actor then left the scene and the generous lady walked home. The camera crew followed her home and then showed a staff from the TV show knock on her door.

When she came out, he asked her if she had indeed given away her sarung to a stranger? When she said yes, the guy asked her, "Did you just lend it to her or simply gave it to her" and she replied "She told me that she wanted to borrow it, but if I don't get it back, it's ok".

Then the TV staff took out a bunch of bank notes and just pushed them into her hands and said, "Because you are so generous and helped a total stranger, this is some money for you" and quickly walked away.

and Do you know what this lady did? She actually ran down the lane, chased after the guy and wanted to return the money!

"Apakah maknanya ini Pak?" [What is the meaning of this?] - She kept repeating as she tried to return the cash.

"It's a little token of appreciation for your kindness and generosity" the guy said before leaving.

As the TV programme ended, it showed how she used the money to buy 'keropok' to sell around her neighbourhood and some rice and treats for her child.

Basically, I was in tears, and Abg was speechless.

In a world where people die after wanting to help people after they're mugged, where politicians only care for the size of their pockets and you think everyone is out to cheat you (or maybe that's just me, hahaha) - this really gave me a wake up call.

One, I am really lucky. I am lucky that I have great parents who gave me all the comfort of life and guidance so I may make the right decisions in life. I had great teachers who inspired me to do well and taught me how to. I have friends who made the journey so much more enjoyable. I found my soul mate (who may be suffering quietly and I know is reading this - despite all that, I love you Abg!) and I have a job that I (most of the time) love.

Really, if I think about it, there is nothing else that I need!

(Well, a smaller number on the weighing scale wouldn't hurt, hehe)

Secondly, poverty is some thing that people tend to take for granted, especially when you don't come across it on a day to day basis. While I was there, they even had reality TV shows where they feature three people and showed the state of their homes, and let the public vote via SMS on who should receive a new house!

Kids, as young as my niece were hanging about factory outlets, selling newspapers - and on rainy days, held out umbrellas to shield you from the rain as you walked from one store to the other for the smallest amount of money.

People were so happy to receive a 37sen tip that I was ashamed that that was all we gave them.

I kept thinking of the green-shirted Ibu, and remain touched by her kindness. I wonder, if I were in her shoes, would I have done the same?

and I become hopeful, despite my jadedness of what the world has become, knowing that there still exists kind people who are willing to help other people for nothing in return, in the world.

Sucker for a lost cause

Another of my little strays died today.

Hmm.

As bitter and jaded as I can be, I'm just a sucker for abandoned cats. Everytime they die due to some illness, I tell Abg that that will be the last time. Abg will just look at me with a little twinkle in his eye for he knows that the next time I come across a mange covered scruffy little thing at the hospital's walkway or at the canteen, it will be riding in my silver Kenari home.

Two weeks ago I came across a small kitty near the lab. It was about half six and I had just finished operating on some limb. She came running to me as I called to her. She was as ugly as anything - thin, bloated worm-infested tummy and covered in scabs of mange. I put her on the front passenger seat and there she sat quietly as I drove home.

I applied the mange medication that I always have ready at home, gave her a bowl of kibbles and placed a hot water bottle to keep her warm in the cage.

In the course of the next few days, most of her scabs fell off and she looked much much better. Once I let her play in the house and she spent an hour pawing at a piece of string hanging from the ironing board.

As we were leaving for a holiday, I left her for boarding at the clinic nearby.

When I went to get her, she just looked ill. Foam was dripping from her lips and she resembled nothing like the kitten I left a week before. The vet assistant actually had the nerve to reassure me, saying it was a natural reaction to a deworming medication.

She died the next morning.

So I cried a few tears and apologised, as I always do with all the kittens I couldn't save. and I vowed to never take in another stray for it to break my heart again.

Aksi kucing terlampau

I always tell Fizzy (yes, I talk to my cats) that he is one of the luckiest cats around. To think if we hadn't stopped at the Pasar Ramadhan three Rayas ago - it was drizzling and usually we'd avoid places like that during bad weather - we wouldn't have found him huddled up under a car which had just driven away from a parking space we were eyeing.



Now he is an extremely fat cat who likes to sleep in between our legs. Anytime he catches us sleeping in the prone position, he would immediately plop himself there and make himself comfy till we push him away.



All he does is eat, sleep, walk around the house like he's the boss and then eat and sleep some more. He sleeps on our bed at night, unless Abg's sister is back for the holidays and then she drags him to sleep with her instead.


With our other sweetheart, Bubu who is no longer with us.


Tidur lagi.


Tidur jugak, tapi posisi tutup muka.


Nie tak tau posisi apa - posisi peluk kaki kot.


Fizzy accompanying me FaceBooking.

Did I not tell you he loves to sleep?

Kitty update

It's been a while since I last wrote about my furkids. Sometimes work can be overwhelming that I start to neglect everything. I can't remember the last time I ironed Abg's shirts, in fact sometimes, he does the ironing for me. I am spoilt.

Seriously.

Anyway, a staff nurse at the labour room offered two of her kittens to me about 2 weeks before Ramadhan. I was hesitant at first. I've always made it a point to not take in kittens who already have homes, but on the other hand, I was pretty chuffed that she would consider giving her kittens to me. I know I wouldn't be able to give away any of my cats - regardless of how anti social, or untoilet trained they are and even if I had to, I would ensure their future owners would adore and love my cats as much if not more than I do.

So, Qisty and Betty joined our already mad household.


Qisty - the tortie


Betty - the black spot is not a grease stain by the way.

Betty fell very ill during the week after Raya. She was moping and refusing to eat, and whenever she was resting, her third eyelid would cover almost half of her eyes. We took her to the vet and I made sure she was drinking and kept feeding her high calorie gels. I put her indoors, in a box with hot water bottles to keep her warm. Every night I would say to Abg, "I don't think Betty will make it to the next morning" and every morning she would still be alive.


Muka budak sakit.


Tak larat sangat dah nie.

After the 4th day, I opened my bedroom door and Betty just ran right in! and now, about a week after, she's been running all over the place. Still a bit thin but at least she's eating. She is now very attached to us and would never leave our sides for long.

Qisty on the other hand, runs away like lightning when we approach her. We have to resort to bribing her with freshly boiled fish in order to get her into her cage.

Anyway, apparently my 'anak-anak dara' - Nafas, Malisa, Mini Me and Cinta - has been seen socialising with the stray tomcat. Me thinks its time for a visit to the vet soon.

Of being non-judgemental....

I haven't forgotten to blog, really. It's just that the hospital has blocked certain sites on the server including the blogspots.

Thoughts usually come to me during the lull in between dawn and the end of the oncall period. I like to ponder upon the patients I saw and how I was with them. Not having an internet connection for me to put my thoughts in cyberspace has been such a damper.

I have to admit, I am not the friendliest doctor. I used to be, when I just joined the hoolabaloo about 7 years ago, all naive and innocent; sometimes I wonder whether it was really that bad that I have become so jaded and disillusioned by it all.

I had a patient last week, who had a history of heart problem. She had been followed up at the Physician's Clinic and had been advised for bypass grafting but she had refused.

She was brought into our casualty at 5 am severely distraught, literally screaming for every breath. Apparently she had had two days of on and off chest pains and had persevered at home. Fifteen minutes later she flatlined. Her son adamantly ordered us to stop our resuscitation efforts.

Later, her daughter approached us and told us that they had gone to the KK and no one responded. I wasn't really sure what she wanted to tell us actually. Was she implying that if someone at the KK had seen and attended to her, that maybe her mother could be saved? I told her I couldn't comment but she has to understand, by refusing the operation, her mother was simply a walking time bomb. The daughter did not look appeased, I have to say. I never had the magic way with words.

When I was working in the OPD, I met many patients who had been admitted time and time again for chest pains and was advised for angios and further work up of their heart problem. They would smile at me and say, "Takpe la doktor, berasa segar lagi nie.." and I would say, "No, it is when you are well that you should get everything checked out. When you are grabbing your chest and could not even lie still for an ECG, you are basically leaving your life to chance."

Yet, they would smile again and say thank you after I have written their monthly medications. Thank you for what I wonder. For letting you leave my room and wait for the next attack of chest pains?

In a way, I have a lot of respect for MOs who are in charge of OPDs - those who are really committed towards making sure that their patients are thoroughly educated and making an informed choice. How do you cope with stressing the same thing over and over again and still have your patients come in with hay wire blood pressures and blood sugars? At least when I plate a femur, I can see the proof in the check x-ray post operatively.

HTM's Ortho team have been pretty washed out the past week. We expected it to be bad, but not this bad. Broken femurs (thigh bones) have been wheeled in almost daily and my boss have resorted to doing them 2-3 days post trauma rather than have the patients on traction as we normally would. I can still feel the ache in my arms after reducing the fracture of this 80+kg man a few days ago.

Yesterday, a scrawny kid of 12 was riding his motorbike and collided with a jeep. He broke his femur rather badly and sustained a HUGE wound over his shin with his broken shin bone peeping nicely under all that mess. He was whining as I was changing his blood-soaked bandages; saying how I was rough and pulled his leg too hard. You can safely assume that I had many things to say at the tip of my tongue, all with complaint-letter-to-Pengarah inducing potential. I was rather proud when I left his bedside in silence. I honestly think one of the hardest things about being a doctor is to not be judgemental.

Never mind that another kid who broke his wrist last week was riding a motorbike and ran through a red light. I bluntly told him to run though another red light and get hit by a trailer next time; I attempted to soften my sentence with my sarcastic smile but it was lost on both kid and his mother.

Ho hum.

I'm sure there was a point of this blog entry but it seems to have gotten lost somewhere. Perhaps I will make better sense in my next entry, whenever that will be.