Thursday, December 28, 2006

Musings

Since when have I become this terrible human being when I am with my patients? I tried to deny it at first yet the truth has turned around and made a head on collision with my conscience. So I've been asking myself, since when have I become this jaded, disillusioned, cynical human being when it comes to dealing with patients?

Does Dr House ring a bell? Hmm, I don't watch it much; a lot of people have been telling me what brilliant tv entertainment it is (I'll just get the DVD compilation) but what little I have managed to catch does make me think that I must be the female, Malaysian version of him. The jaded, disillusioned, cynical part, that is. Not the the brilliant diagnostician part. Unfortunately.

It wasn't a particularly bad on call last night. Only managed 2 hours of sleep - itupun tidur ayam, as you usually get during on calls, tapi biasa lah tu. Up at half two attending to a sudden barrage of labour room cases from Jeli (their 6-(apparently) bed ante-postnatal ward were full - tambah la katil weii) and had this TOS (trial of scar) that I had to keep a close eye on. After she delivered (lega!), there was another first time mother who had trouble bearing down. She finally managed to deliver (with 15 mins to spare) and I trudged off to my on call room at 6 am.

Thursdays aren't usually busy at our OPD tapi today it was particularly bad. Maybe everyone wanted to stock up on medications in view of the long weekend (long weekends are really bad for OPDs, I think). I was getting through the cases as fast as I could and couldn't spare much time for pleasantries. and one of my patients took offense.

Making a long story short, I just kept quiet while she lectured me on such poor service I am giving. I wasn't even listening to what she was saying. The pounding headache blocked out much of it. Normally I would have given some back to her, tapi post call punya pasal, kita diam aje lah. I told her, 'Nama saya Dr Suriana. Komplen lah kalau awak nak.' Dengan nada yang selamba gitu. Macam gangster la plak bunyinya, kan. Tapi seriously, I was so tired I really couldn't care less. I could deal with whatever later but not then.

Bengang, memang la bengang, tapi now, hours after the incident, I am thinking - I somehow deserved that. Regardless of how tired I am, I should have shoved that all aside and treat my patients as if I have all the time in the world. It doesn't matter that makcik Semah has turned up for registration at 7.55 am and still haven't managed to be seen at 10, tapi if a mak datin wanna be comes into my room and demands her BP be checked despite getting hundred-ringgit-per-visit-consultations at a private specialist hospital, I guess I must hide my contempt and trudge along.

I must sound as if I'm making excuses for my behaviour but I'm not. This is just me thinking myself out. I wish there is a way for me to turn up for work and not assume anything of the person sitting at my desk. Not assume he's just here to get MCs so that he can get off for Raya. Not assume that pakcik Mat tells me that he takes his diabetic medication yet scoffs on nasik berlauk three times a day complete with fat laced sup tulang and extra sweet teh beng.

Because all this assumption is just making it worse. I mean my jadedness, my disillusionment and my cynicism.

*sigh*

*Another Big Sigh*

I seriously am not liking myself much right now.

and I'm on call Raya Haji.

Selamat Hari Raya Qurban.

Tuesday, December 19, 2006

Bummer

I did a verrrry bad thing today. Though at the time I did it, I didn't know it was bad.

Now, I realise what a huge mistake I did and I really feel like an idiot.

I wish I could turn back time.

Saturday, December 16, 2006

Oncall - bleurgh......

Post call - yeay!!!!!!!!!!!!

I remember when I went for my induction course, a fellow medical officer listed 'benda yang dibenci - oncall. benda yang disukai - postcall'. Ada gak another fella who said, 'benda yang dibenci - oncall. benda yang disukai - claim elaun oncall' - hehehe....smart alec la tu.

Yesterday I had my first oncall in 17 months.

My senior MO gave us a month to get used to managing patients, since the roster had been set up and it would only be a waste of time to reconstruct it just to accommodate us two new MOs. I had the good intentions of 'tagging' - some call it shadowing - but of course, my good intentions remain as intentions, hehe.

I've long learnt that particular MOs are 'jonah' - which simply means, when these jonah people are oncall, the worst and the most bizarre cases will trudge, be rushed or be wheeled into the A&E that day. We have one of those in my hospital. Thank goodness she is only oncall a day a month! Imagine, during the one weekend that she was on duty, she referred a total of 12 cases! From upper GI bleeds to severe metabolic acidosis to multiple fractures. Surprisingly she remains good natured about it. Pass a cup of that positive thinkin' my way, kak TJ!

I've noticed that even though I'm not generally jonah, I'm not that particularly 'cool' either. One lucky MO once told us envious lot, that one night, she didn't get a single call from casualty and slept very soundly from 9 pm till the next day. How come I'm never that lucky?

I turned up early on my oncall day. The fact that I couldn't get much sleep and was wide awake by 5 am didn't help either.

We don't do rounds per se; usually we just do the discharges for post natal cases and then review cases that have been passed over by the MO in charge or oncall the previous day. Apparently it was rather quiet the night before and I was crossing my fingers and my toes that the quietness will extend to my period of duty.

and in a way, it did. The labour room only started receiving cases at about 5 pm. Staff syif pagi lepak siot. There were no life threatening cases - only a bunch of epigastric discomforts and two cases of multiple bee stings. The makcik I saw was stung about 20 times and still had stingers on her face! Nasib baik no anaphylactic reaction.

Tapi, at night it became busier. I only managed to drag myself to bed at 3 am and itupun, bukan boleh tidur lena. I kept anticipating the phone to ring. So, again, at 5 am, I was wide awake; must be the adrenaline. So, a quick shower later, I dragged my sore feet and very sore and now callused thumb for a quick round of the cases I admitted. While waiting for the next MO to take over, I even managed a quick discussion of a case of afebrile seizures that I admitted last night.

Tapi, yang pelik sungguh tu......there were NOT A SINGLE motor vehicle accident case at all last night, which is maha weird for HTM.

Tired as I am (still unable to get any sleep since returning home this morning. Even managed a leisurely shopping trip for beads in KB), I have no complaints. This is my job. This is what I've been trained to do and I love it. but of course, not as much as I love the sensation of being post call.......

Sunday, December 03, 2006

Odds and Ends

I made a big decision today.

However, whether my big decision becomes a reality or otherwise remains to be seen. But I guess, something has to be done. Things cannot stay the way it is, regardless of how content I feel I am right now.

An unfortunate case came into casualty today. Sundays are never a good day. It seems like a majority of ill patients like to 'ok' - kelantanese for persevere or stand ground - in the moments of illness during the weekend and then turn up in droves on Sunday. This guy was doing some wiring job on top of a ladder about 10-15' high and subsequently fell to the ground, hitting his head. He seemed like he was awake and at one time attempted to get up but when we asked what his name is, he appeared not to hear us.

We thought he could have been mute or maybe a foreigner - Siamese ppl look a lot like Malays over here in Kelantan, you can hardly tell them apart - but his friends tell us that he isn't. I left him to the care of the MO in charge and went to tend to my OPD patients.

Apparently later he fitted and had to be intubated. Poor R had to deal with the difficult intubation - it must have been one hell of a difficult one because she has a year's experience in Anaesthesia and still had to call for help!

On a more bitchy note - I just hate ppl who throw rubbish out of their car window. Why oh why do ppl do this??!! I guess these same ppl are the ones who nonchalantly throw rubbish out their house windows as well. Why can't parents be more responsible and teach some good manners to their kids? Buang keluar tingkap pun still kotorkan rumah sendiri apa....? Eeee,....rasa macam nak kutip balik sampah tu and buang masuk balik dlm rumah aje.....

and Last but not least, a special mention to one of my oldest friends (I've known him since I was 17, my god I just realise how ancient I am...) who has passed his MRCPs!!!!!!!!!! Yeay!!

Friday, December 01, 2006

Cuba teka....?



This is taken in Permaisuri. Abang and I always have a good giggle everytime we pass by the shop.

Any ideas what it's selling?

Open for a month a year

This is the gerai makan that I was talking about previously. As you can see, siap ada tempat jual air lagi. Seriously, this was taken at 11 am okay. Who buys air for buka puasa at 11 am?



The second picture taken after Raya. Noticeably vacant.



Only Allah knows....