The curse of the mobile

I was having my post call nap when I was woken by the shrill ring of my phone. I clambered out of bed, reached for it and looked at the display. It's the hospital.

Urgh.

Why is it that staff at the hospital think that just because I am reachable by dialling 10 numbers, that I would take the call?

Do you think I have nothing better to do?

Like for one instance, during a weekend when I unwisely picked up a call from the hospital, thinking that it MIGHT just be something important - and the nurse only wanted to ask me if she should remove the stitches on the patient's leg!

When I started to 'membebel', telling her off for disturbing me for something so trivial (after all, some patients turn up at the clinic with stitches STILL intact weeks after they were due to be removed - but that's another blog entry) - couldn't she have just asked the MO oncall? - she actually sounded 'merajuk' - as if I should be thankful for her!

So, now it's about an hour since the call came in and I am contemplating whether I should call the operator up and ask who tried to contact me in my post call daze. After all - it COULD be important.

On the other hand, it could be something silly and by not returning the call, I would be saving myself one telling off - I don't like telling my nurses off, despite what my reputation is amongst the nursing staff, you know.

Hmm - seriously lah....

Duit, do it...

My Abg teases me and say I love money more than I love him. I would deny it vehemently yet in a little corner of my heart, sometimes I think that is true.

Every week, I would log on to my internet banking account and check my account balance. Oncall allowance usually comes in about 2 weeks into the month, usually in with the medical report fees. Salary is usually 2 weeks after.

Al Hamdulillah, I've never found myself crossing off days on the calender waiting for the next pay day - but come salary day, I'd be jumping off the bed, switch on the PC and log on to my account. Seeing the increment in the balance would put me in a good mood the whole day. It's not much, but I know it allows me to spend things without wondering if I'd be able to survive till next pay. On top of that, it allows me to spend on my family without having to worry about credit card debts etc. Like getting a car with a driver while holidaying in Indonesia instead of relying on public transport. Or getting in Borobudur 'legally' - i.e. paying the tourist fees instead of trying to pass yourself off as a local - after all, they own it.

The secret - mainly because I've not much temptations over here. Shopping is limited to groceries and stuff for my furkids. Secondly, I personally think paying the 'zakat' helps increases your 'rezeki'.

But it is only money, I know. Money doesn't buy happiness but it sure does make life better.

and No, Abg, I do love you more than I love my bank account.

Somewhere, something

I've decided to go somewhere in life.

For the past 8 years, I've lived a life of a goal-less MO. I like what I do and despite being so exhausted at the end of some calls, I always find myself waking up and looking forward to go to work. I want to see what broken bones there are and how I can fix it. I want to see feet with abscesses and drain the pus away and make the patients feel better. Though I still do not enjoy telling patients that they need toes cut off, I actually savour the moment when the dead digits have been cut away, thus leaving the rest of the foot to heal.

I guess part of it is because I have a great colleague and an equally great boss and being in a small (albeit with specialist facilities) hospital means that I can at least still spend most lunch hours actually having lunch.

I remember watching my colleague plating a femur by himself for the first time and thinking, I want to do that too one day. I recall the day I had to do it on my own, how I was having palpitations and had to rely on my two MAs for traction before I could reduce the fracture site. Now everything comes automatically - skin, fascia, muscle, bone, screws, drain and skin again - that it feels like assembling a machine on a production line. I used to think 'Oh no not another femur, damn you silly teens and your motobikes!' but now it's 'Bring it on, I'll just fix you and throw you back into the water again'

I guess I'm kinda tired of coming home and living each day as I did the day before. Having holidays break up the routine a little bit but I'm getting itchy. I want a challenge! So, I have decided to do something with my life this year. Whether or not I will get the opportunity, I do not know but at least a few years on, I can't say that I haven't tried.

Who is the parent here?

Last weekend, a couple of scrawny 13 year olds was admitted to ward after sustaining a broken thigh bone each after getting involved in an accident.

One of them underwent an operating procedure to plate his thigh bone and was discharged this morning.

The other, who suffered an open fracture (meaning that there is a wound that communicates the environment with the insides of his thigh and the bone), underwent wound debridement and application of skeletal traction.

This morning, my boss was doing rounds and we were informed that the father wishes to bring his son home to see a traditional healer.

When asked why, the father said, "Because my son doesn't want to". He had no questions about what the chances are for healing or any risks of developing deformity - he is refusing the op because his scrawny 13 year old kid, who had no business riding a motorbike in the first place, doesn't want it.

No wonder I am living in a world where teens no longer have any respect for the elderlies.

Sometimes...

....I just want to grab Abg and my cats and live in a cave....

Cynical me

A baby was brought to our casualty one midnight - she was found lying on someone's porch. About a week later, another baby was admitted to our peadiatric ward after her stupid mother tried to flush her down the toilet.

Seriously.


How can I face the worst of human nature and still 'bersangka baik'? Can someone sprinkle some fairy dust and make the world better, please?

Heaven is.....

...sitting in an airconditioned room watching your cat chase a piece of lint.



How do you say "I'm sorry but we are letting your mother die" in any other way but that?

We had a patient who was admitted since about one month ago. She had been bed bound for the past 3 months and had developed massive ulcers over her buttocks. Any doctor would know, 'bed bound' - isn't a good thing to hear when it comes to actively resuscitating your patients.

We dressed her wounds, and at one point she seemed better. But she succumbed late last night, passing quietly in her sleep.

She started to deteriorate earlier that morning - and I knew what we were going to say to her isn't what I would want to hear from a doctor who is treating a member of my family.

You may lace it any way you want, but I know what I will understand is that you are giving up on that patient. You are saying that this patient's life isn't worth saving just because she is old, and she has gazillions of things wrong with her.

I find myself saying this to the patient's daughter, and I am reminded of how unfair life can be.

A query

I can understand a medical officer with a stay-at-home-wife and three kids doing locum, but why does a couple who are both doctors, would want to do that?

I don't mean to sound judgemental - but two doctors would easily make 8-10k (and even more depending on the number of oncalls) per month - what do you possibly need the extra money for?

Some people say when you are young is the time to work hard - but why would anyone spend 4 hours at a clinic with strangers when you can spend 2 hours with your kids? and when you are old, you'd be too exhausted to enjoy your money anyway.

Am I being simplistic? Should I be putting myself in other peoples' shoes more? I guess it's easy for me to talk since I only take care of cats and have yet to be in the position of crossing out days on the calender waiting for the next pay day. (Al Hamdulillah)

But I think people nowadays have their priorities at the wrong places. We strive to get houses in popular areas at the expense of spending most of the weekends working. We pay through our noses for a more luxurious car at the expense of sending kids to babysitters so that both husband and wife can work.

But at what cost?

A worthwhile call...

One radius, one ulna and one femur.

Albeit the plate on the radius was a little skewed and the blood was spattering everywhere during the K-nailing of the femur and I am almost sure I dissected the wrong plane when exposing the radius but I got them done.

Mine and mine only.

Bleurgh

I had a really difficult op this morning. It was a femur fracture and I actually took three hours to do it! Seriously lah, I was a huffing and a puffing and almost literally squeezing brain matter out to figure out how I should go about it. The fact that Boss and partner was away on a visiting clinic didn't help either.

The only thing I don't like about doing ops by myself is that I don't have anyone I can wring ideas out of. The fracture was extra difficult because it had a big fragment in between the fracture sites and the fracture itself was rather high up. So basically I don't have that much space to manoeuvre (can never spell this word) my implant - and the fracture line was almost three quarters of the length of the bone! Tension la.

However, it was only when I've scrubbed out and sitting in the pantry when the idea hit me - of course by that time, what's the use lah!

Sheesh.

I want my holiday to come now......

Who says white men can't dance?

...and if they do, then they obviously haven't seen Jakob Karr dance.



I don't know whether I like the coreography or the soundtrack better. Quirky, twisted, dark - just the way I like it....

Exhaustion

I reckon not many things can be more exhausting than coming into work at 8 am and doing your usual job till about half 4 and then continuing work till the next day. I can get so cranky postcall that I can spend the whole day speaking in sign language to Abg, that is if I'm not snoring my head off in bed.

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.

Hm.

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.....

Truth be told.....

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


Denny summarising how I usually feel postcall period.


Seriously.

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!".

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.

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.

Sometimes....

...this is what I feel like doing.




I think I am turning into a demophobe.

Main Entry:	demophobe
Part of Speech:	n
Definition:	a hater of people, esp. in crowds
Etymology:	Greek demos 'people'

But sometimes, I really can't stand people. Which, I guess, explains the cats.

Hmm.

Wanna hear something tragic?

Coming back from work - transporting cows - only to have your eye injured after being involved in a car crash with a - COW.

Seriously??

...and as of one minute ago, highest bid of RM135......

Weekend pondering

I wonder what changes people. Especially in matters of principles and religion.

What, for example, would change a demure conservative kampung girl into a wine-drinking, pissed-at-the-pub type. NOT that I know anyone like that. It is, an example, like I mentioned.

What drives a person, to do or decide to do something that has been instilled into him/her as wrong?

Stealing is wrong. Killing is wrong. - so you know you won't do it.

Is it any different with drinking or sleeping around? Surely the principle is the same.

Was it hard the first time you took that glass of wine in your hand and drank it, I wonder? For surely you have been raised a good Muslim - if not by your parents, then you were taught by your teachers.

Was it the pressure of friends, or were you simply curious or were you ashamed of being labelled a prude for not drinking? Maybe if you didn't join in the fun, bosses would pass you over for the promotion or project you were eyeing.

It is a hard thing to do to be a good Muslim nowadays.

Do you remember....

...when your parents start to appear a little bit smaller than how you used to imagine them to be?

My parents were always the people I looked up to when I was growing up. I remember being so proud when Ma would come to school to pick us up because I have always thought that she is way prettier than all the other mothers.

I remember how strongly Pa would grip my hand in his while we were crossing the road. I remember how strong he looked when he would sit by his desk at work and we would be in the pantry eating 'biskut kapalterbang'.

They appeared so sure and so tall and so big.


I went home recently and gave my mum a hug. She looked so sad and so frail, that I was sure I could hold her in the both of my hands.

I wondered then how it is that I could not see how fragile my Ma has become....