Saturday, March 27, 2010

Jom Heboh and of being non-judgemental

Look, what big paws I have!

Aci tak kali nie nak buat entry bahasa melayu? Aci kottt....

There is a Jom Heboh event in KB this weekend. People have been talking about it since about 2-3 weeks ago, like it's the best thing since sliced bread. Mana-mana aku pergi org kata, "Jom Heboh nak mai Kelantan..pergi ke?" (of course la diorg tak ckp macam nie, tapi dalam loghat Kelantan diorg la).

So, of course, they just had to have it in the worst place in KB ever, in the stadium which is a shout's away (sepelaung jauhnya) from the hospital.

Serious, tak leh nak bayang macamana district hospital nak hantar kes. Macamana panicked first time father-to-be nak hantar bini nak bersalin kat labour room yang dlm 10 langkah dari stadium. Macamana org nak gi melawat saudara mara yang sakit. Korang nie tak leh ke considerate sikit.

Orang Kelantan pun satu - nak kata jakun, marah pulak. Tapi benda macam Jom Heboh pun nak heran. Best sangat ke queue carik parking and then berjalan dalam panas nak gi tgk org jual kopi Power Root dengan biskut Munchies? Dengar-dengarnya, nak keluar dari area Jom Heboh tu ambik masa berjam-jam stuck dalam traffic.

Of course, allergic-to-crowds me had absolutely no wish to be even 10km in proximity of it, tambah-tambah pulak postcall today. Even the green cases at the A&E were considerably less than usual - campur kes orang dah dapat gaji pulak tu.

Esok letih nak dengar cerita orang yang dengar cerita orang yang pergi pulak. Orang tu tak pergi, tapi dia dengar cerita dari orang yang tak pergi jugak, tapi orang tu dengar cerita dari orang yang pergi - betapa teruknya jam di KB hari tu.


Anyway - just contemplating yesterday's call - I really think that the one thing that I find hardest to do is to be non judgemental.

When you see two scrawny 13 year-olds with wounds and bruises after falling off a motorbike - how irresponsible their parents are. When you see a case of a young malay male who fell off his bike at 3 am, that they must be rempits. When you see a 17 year-old unmarried girl coming to labour room - that how morally loose she is.

I personally find it hard to accept things as they are - two boys with wounds for dressing, or a fracture to be splinted or a baby to be delivered. How uncomplicated would life be if we could accept things without making our own assumptions.

But that is how we are, I guess. Or, that is how I am - my sisters think that I tend to think bad of people (bersangka buruk) - I suppose it's because I often see bad things - or perhaps I have become too jaded to see the good in people.

Yesterday morning there was a police case where they had brought in a young girl and a young man whose car skidded as they were trying to get away from being nabbed. Apparently the accident happened at about 6 am and someone had written down in the red medicolegal card that the reason policemen gave chase was that they were acting suspiciously in the car.

Immediately I made an assumption about what happened.

The girl ended up with a dislocated hip and had to endure the excruciating pain for 5 hours before I saw her and suspected the injury. She told me that she had just completed her assignment and was getting a ride home with her (male) friend from childhood - 'Dia kawan saya dari kecik lagi'. The reason he sped away from the police was because he didn't have a valid driving license.

So, as I was clerking her case - I thought WHAT IF what she said was the truth? That the boy is her closest friend from young and their relationship is more of a brother-sister type and that he is just doing her a favour by picking her up in a car despite not having a valid driving license. She could be lying to me but I would have been a better person to assume good rather than bad.

But of course, benda yang baik susah nak buat.....

Friday, March 19, 2010

Truth be told.....

...sometimes I think I have become too old to be a doctor.

Denny summarising how I usually feel postcall period.


It was a really bad call last night. Clinic was unsatisfying due to the fact that due to the absence of the boss, I couldn't really decide on whether I should get the procedure arranged or whether the patient needed further work up. It was pretty quiet in the afternoon, which should have warned me that a rocky night lies ahead of me.

So I ended up with an intra abdominal injury, a guy who broke almost all the fingers in his hand and both bones of his forearm, another who basically smashed his shin bone, a guy whose bone of the big toe peeped out of his wound and the icing on the cake, a 'mat lalok' who broke basically half of his jaw.

It was at 3 am this morning when I was contemplating that perhaps I should take a different pathway to what I am doing now. Maybe I should give being a KK (Klinik Kesihatan) MO another try (urgh, I take that back - nggak mungkin walau seribu tahun lagi [no way, not in a thousand years]) - working office hours and having passive call can be rather attractive. I had just spent 5 minutes trying to elicit cervical tenderness in the almost unresponsive mat lalok and the xray was actually taunting me. I was exhausted to the bone, my throat had a bitter taste and I can barely keep my eyes open.

It is at times like these that I contemplate, 'Surely there is more to life than this!' - but as it has all the times before, the statement is thrown into the void that is the dark of the night - unanswered as it has been before.

Because I know, despite feeling that way at 3 am this morning, I will still wake up excited about getting to work. I love looking at an xray and figuring out ways I can make it better. I love the thrill of working out where I should place my incision, which plane I should be dissecting on and how I choose to close my incision. Despite having staples, time permitting, I would always prefer suturing my wounds. All these run through my head as I scrub myself clean.

So I persevere with being awake at 3 am when I have been working since 8 am the previous day because there is always hope that my next call will be a cool one. and even if it turns out to be equally 'jonah' - I hope to still have a sliver of hope and sense of humour to laugh it off and say, "Tis life!".

Friday, March 12, 2010

Clam Up, Zip It, Pipe Down

The reason I don't talk very much in the company of strangers is that I've learnt that people don't necessarily understand what you are really trying to say.

People hear but whether or not they get the real message depends not only on the words you are uttering but on the expression on your face, the volume of your voice and the speed you are saying it.

The other reason being that I've noticed people sometimes ask questions without really wanting to know the answer. Some call it being friendly or being sociable. It's called small talk.

Now me, I'm really bad at small talk. When I call people up, I don't spend 3 minutes asking how you are, how was the drive to work and all that rubbish. Unless THAT's the reason I'm calling you. So people think I am unfriendly or unsociable.

People can be rather fickle. They say they celebrate honesty. HONESTY IS THE BEST POLICY, they say - yet when it smacks them in the face, and God forbid it if it was something that they don't want to hear - they call people who say it to them TACTLESS or BLUNT or INSENSITIVE.

When I was a houseman, I was called an idiot a few times. But I took it with a smile and brushed it away because I knew that I was an idiot back then. Afterall, I'd rather be called an idiot than irresponsible. The only time I cried after I was told off by a specialist was when she called me to her room asking for an explanation to why the discharge summary isn't ready. I remember that I had already completed it and I insisted that I did. She didn't believe me and told me to rewrite the discharge summary by asking for the history of the patient.

It turned out that I HAD completed it and they later found it somewhere beneath the paperwork. I actually went to see her and showed her the completed discharge summary, proving that I was not making excuses.

But I digress - so we humans are fickle and are almost always ruled by our emotions - which I guess is what makes us humans in the first place.

So I've learnt to never volunteer an opinion unless it warrants me to do so or when I am in the midst of people I really trust. The latter being that I hoped that these people will accept that regardless of what ZINGS may have flown from my mouth that I don't really say it with malice but more of letting of steam.

Monday, March 08, 2010

A rant of a disillusioned person...

I've started a few blog posts only to stop midway and scrap everything. How do I write something that won't show how disillusioned and bitter I am about how I find life and human nature is?

Optimists must be either deaf and blind because they sure aren't reading the papers or listening to the news. Kids as young as 11 have allegedly been found to force an 8 year-old to perform sexual acts. Babies are being dumped like yesterday's newspapers. We see a 3 year-old kid being kicked like a football and we do nothing - no one cared enough to get to know this family and now the kid is dead, suddenly EVERYONE has an opinion on who should have been blamed.

Sometimes I wish I am more oblivious to the goings on in this world.

Just digressing a little bit - I was on my way back after escorting a case of possible head injury and have not had dinner so we stopped by a roadside stall for a bite to eat. It was nearing midnight and the other tables were mostly young folks. However, the table nearest to us had a 2 year old kid with them and I was thinking, should a kid that young still be awake at this time of the day?

The case I escorted was a 12 year-old girl who was riding a motorbike with a friend. It was near Maghrib already and apparently was going out to buy a book. She fell off her vehicle and never regained full consciousness. We intubated her and sent her to HUSM for a CT scan. I told the mother that there is a reason licences are only allowed to people of a certain age - but as I left the mother in the waiting room near the Red Zone - I think I had again let my emotions get the best of me. I am sure she is already regretting letting her daughter on that motorbike that evening.

In the last week, we had a 13 year-old who came to us with his foot torn off at the ankle. I spent three hours reducing both bones of his ankle and another three fixing his loose joints and putting a skin graft on the wound. Everytime we had to inspect his wounds he was whimpering like a baby. I bet he felt like a hero riding on his motorbike before the accident.

In that same week, a 14 year-old was admitted for breaking his thigh bone - also due to an accident while he was riding his motocycle.

I know being a doctor means that I shouldn't be judgmental but being impartial is the most difficult aspect of my job. Most times I just want to shake some senses into parents who allow their young kids on motorbikes. I especially hate it when they claim to not realise when their child have creeped out without them knowing. Come on!

In the ward at the moment, there is a 17 year old boy who is basically a vegetable. He had been involved in a motor vehicle accident and suffered a traumatic brain injury. He is now on a breathing tube on his neck and takes feedings via a tube from his nose into his stomach. When I received a request for a medical report involving a boy whom we intubated for poor GCS and had sent to HUSM, only did I remember that this was the same boy who was knocked down after going to buy breakfasts for his family.

His bed is covered with personal items from home. Often I would find a soft toy in the clutches of his motionless hands. Here is a boy who's just waiting to explore what life has to offer and he is now bed bound for the rest of his life. Instead of being able to take care of his parents, he has to rely on them still for the most basic of human functions.

I guess we never consider that such a thing can happen to us until it does happen.