Saturday, November 28, 2009

My post Raya on call rant...

Being on call on a Raya in Kelantan is just an invitation into insanity, but someone has to do it, and I'd rather be on the first Raya than the second.

Kelantan, being the Malay dominated state it is, has absolutely NO clinic open on Raya. It is equally impossible looking for an eating place as looking for a private clinic. Hence, the madness that is the hospital's casualty department.

It was rather quiet during the day - funnily enough on other days when you may have up to ten yellow babies waiting to have their levels of jaundice checked, on Raya there are absolutely none. All we had were people with abdominal pain and headache and giddiness.

The madness started about half eight-nine pm. People popping by would have thought that we were having a year end sale or an open house judging by the number of cars and patients and kids jumping about in our waiting area.

I heard people who registered at 9 were only seen at midnight. and they ALL waited. For mundane trivial things like a runny nose and an itchy foot and an upset stomach. My poor MAs finished seeing them all at about 4 am.


This has become the norm that no one complains anymore. Of course we still do see a few unreasonable idiots who insist that their relatives are more ill than the kid who ended up being intubated but making a fuss WILL NOT make us see you any faster, so unless the patient is blue in the face, that kid will be our priority and not you and your three week cough and not taking your heart medication for the past 5 years. If you cannot be bothered to care about your health, tell me if other people should?

On an even more depressing note, Ibu Milo's litter has now been reduced to only three. The three smaller kittens have died, for seemingly no apparent reason. I have seen watery stool with worms in the cage so maybe that is the cause. Six was too many for poor Ibu anyway.


Sunday, November 22, 2009

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.

Friday, November 20, 2009

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.

Tuesday, November 10, 2009

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.

Monday, November 02, 2009

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.