Rants, ramblings, musings, 'ngepek's, 'bebelan's of a not-so-young doctor about things in her life, be it happy or otherwise.
Friday, March 30, 2007
Childhood ambition revisited
Seriously.
Do you remember when in primary school, teachers keep this 'rekod pelajar' and at the back, you're supposed to write your top three ambitions? I can't remember mine. The earliest memory of ever having something near to one is after I got my SRP results. It was okay la, I think. I remember getting a P7 for something. Serioussss. It's something I'd rather forget, okay. I really wanted to go into the Arts Stream. I wanted to learn all about Literature and writing and touching people's lives with words. Corny, kan? Hehe.
But my teachers weren't having any of this nonsense. Not that it mattered anyway as I had already applied to an MRSM and have been wanting to get away from that school ever since I moved there from Sarawak after form 1.
I love writing - I guess it's just a natural progression from my love of reading. Ma said when I was younger I used to spend all my time browsing through our Encyclopedia Britannica. When I had gotten through the whole set, I would rummage through my mother's school stuff in the store and find her old school books complete with 'ayer' and 'enchik' spellings.
My first serious novel was Badai Semalam. I was 8 when I found it somewhere. From the moment Mazni walked out of her school compounds and went home to her sick mother, I was hooked. Zaki was the ultimate hero - his undying love for Mazni was an inspiration and heart felt. I didn't think Karim was a true baddie. I would like to think that he did really love Mazni but maybe he was just not ready to commit to a marriage.
But anyhow, I digress. So, even as I went off to MRSM Kuantan (the best 2 years of my life!), I still harboured hopes of getting into writing - authoring or journalism. I enjoyed languages and participated in the malay debate, worked with the newsletter team and wrote a script for the college drama.
After my results came out (which, surprisingly, isn't a gazillion A1s by the way! Even got two C3s tau...gasp, horror horror! Hehehe) I got an offer to do the MARA Engineering course and also applied for the JPA scholarship. Ma wasn't hearing anything about me pursuing my love of writing. She said, you study to be a doctor first, if you love writing, you'll find a way to do it later. So I concurred to the veto power that is my mother, :) and went off to UK to study medicine. The rest, they say, is history.
Moral of this post? Mothers are always right and me thinks SPM is getting easier...haha.
Itch
Not because I get to sleep late. I'm not a late waker-upper anyway in the first place - even during my studying days, I'm up by no later half eight - yet somehow, it's something about knowing you don't have to be anywhere which makes me so chirpy. Weird, I know.
The kitchen has been in a total mess for nearly a month. What with being on call and away for courses, I just haven't had the time to roll up my sleeves and get to what needs to be done. The window sill is grimy with gunk, I can smell rat pee from behind my plate rack and fish bones and what nots are scattered behind the microwave. The floor is slippery from cooking oil spattered during frying and don't even get me started on the state of my refridgerators!
Three hours later, my kitchen top is shiny and lavender smelling, my sinks are rid of the slime starting to colonise the grout and best of all, the floor is mopped! I even took the trouble to wipe off the glue from the rat trap on the floor. Ayah (dad in law) has been having fun with the rat traps we bought in KL. He's been laying them around the house and checking up on them everyday for the latest catch. The small ones get stuck alright but the larges ones just struggle off and leave horrible glue trail (complete with fur) all over. Did you know cooking oil works wonders on these gluey stuff?
I'm on passive call for 48 hours starting 8 am Saturday. Which means I have to come in and do rounds two days in a row. I'm supposed to do OPD call as well on Monday but I think I just can't be bothered so I'm letting kak TJ have it. I got so pissed off with this particular senior MO. Forever taking leave and letting us struggle to cope with her ward. Kalau dia amik cuti, org lain cover, takpe. Tapi god forbid if someone else takes leave, she will act as if we left the whole hospital for her to manage!? Mentang2 la you so senior, you think you can bully us meh?
My last break was in January. I think it's time to go off on another break. We were talking about a road trip to the northern part of the peninsula this time. Once we get this done, it's Sabah and Sarawak next. Finally found my passport so I can now apply for a renewal.
India was a blast and a total dream come true. One of these days I should really scan all my stuff from the 2 month trip and relive it here. I'm now itchy for another trip abroad. Abg has never been out of the country so I would really love to go travelling with him.
I'd love to go back to London - maybe we could do that when sis Yanie goes off for her dental postgraduate thingy - but Australia looks kinda fun. The thing with the travelling bug is that, the planning and poring over details and researching about the place you're heading off to is part of the fun. Well, to me anyway.
A fellow blogger up north in Ireland is travelling to Austria. Nak ikuttttt! Ah, the anticipation and planning and sleepless nights as you await for THE day.......*sigh* only another avid traveller will understand.....
Wednesday, March 28, 2007
Welcome!
Anyway, while jaunting along my regular haunts, specifically at Dr. M's, I discovered I've been added to the Doctor Blogroll at Malaysian Medical Resources. Waaaah, now more readers lah! I sneaked a few peeks at the other bloggers and some are pretty serious stuff.
Now I feel so malu - I write play-play only, can also ah?
Post call rant...
Once you get assigned with the task, you would need to call up all the other MOs and ask them for 'requests' - i.e. which days they prefer to do their calls and what nots. I've decided from next month, to do away with this chore and put a book in the casualty so that any MO can write down requests any time. The MO incharge of doing up the roster will then pick up this book and do up the roster based on the requests.
Then, on doing up this roster, ada lagi benda nak kena consider. For instance, preferably, do not put an MO on a passive call just before or right after his/her active call. Then, you're not supposed to put an MO on call (passive or otherwise) on too many weekends. Previously it wasn't much of a problem but since we decided that passive call MO has to come for rounds on the weekends, leceh la because you have to come in anyway.
Then, even after you've completed this complicated, headache inducing task and ON TIME some more, some will still be unhappy. Isy, tak grateful langsung....hehe.
Last night was rather quiet. Hari Sakit Perut Sedunia bersambung lagi. Had only 3 admissions and no referrals and that is seriously, NOTHING compared to what my hospital is known to be. Even the labour room was quiet. My labour room staff slept soundly from midnight onwards.
However, at around 5 am, one of my MAs informed me of a case of abdominal pain. He mentioned that the UPT (urine pregnancy test) was positive. So, bangun la MO ngantuk-mamai nie nak gi rule out ectopic pregnancy.
Turns out that my patient has indulged in some hanky panky with her fiance and has now gotten herself pregnant. She asked me to keep the truth from her grandmother but I told her, somehow or later, kena jugak beritau. I siap warning kat budak tu, you tak nak baby you, jangan buat benda tak elok pulak, baik bui (beri) ke saya. Initially I wanted to discharge her, but then she told me there was some bleeding, so kena la admit.
Later on, as I was pondering over my roster at the counter, masuk plak a male relative, probably wondering what's going on. When told that she has to be admitted, macam tak percaya la plak, sakit perut sikit pun kena masuk ward. Siap jeling2 kat I lagi.....Arrrgh, tension! Hehehe. Before I went off for my breakfast, I ckp kat fiesty grandmother, "Mokcik nok tau bakpo kena masuk wad, mokcik tanyo la cucu mokcik tuh...." Actually, ditujukan khas pada hanky panky girl tapi I think laser I kurang tepat la sebab apparently, sampai dah duduk atas katil dlm wad pun 'mokcik' masih tak puas hati kenapa cucu dia kena masuk wad.
Moral of the story, kalau nak hanky panky, pandai-pandai la protect yourself.
Hey, I'm not supporting free sex, okay...tapi regardless, every Tom, Dick, Harry and Jane is doing it. It's human nature to want something that is forbidden and tambah lagi portrayed as so pleasureable. Tapi, if you're too stupid to do something about preventing pregnancies, at least be responsible to your baby la. Sedap buat, pandai la tanggung.
Saturday, March 24, 2007
Rant rant rant...

Thursday, March 22, 2007
Sweet as honey
But anyhow, I digress, as usual. The other boards that I frequent are Family Discussion, Sewing and Knitting, Movies and TV etc etc. So, in Family Discussion (FD), one of the moderators brought this topic up; Madu or single mother/janda? and of course a barrage of responses came in. Some say, if the husband makes a real effort to be just to both (or more) wives, better become 'madu' than left to fend for ownself. Tapi, kalau husband and furthermore, younger wife ntah apa2 and only contribute towards the hair loss on your head, then, cerai lebih baik la.
Some only-wife and recently married forumers state that they can't see themselves sharing their husband....so, dari 'menderita', lebih baik bercerai. Some forumers are divorcees and I particularly like one who said after being divorced, she felt like a leper. Gone are all her female friends, who now think that all she wants to do now that she is a janda, is to ensnare all things male into her trap.
I don't know that many polygamous couples. Most are Abg's friends. I had a specialist once, whose husband is someone Abg knew from work and she's a 'bini tua', though I don't know why because my specialist is one of the nicest, lemah-lembutest person and not to forget, so lawa.
I'm not sure what my stand is, though. I find that I might have an opinion in the beginning, but it usually changes when I am faced with the situation. I know accepting that Abg might fall in love with someone else will be difficult. I can't stand imagining that he will fall asleep with someone else in his arms, or that someone else will cook and enjoy seeing him finish off the food.
Three years into marriage life, I admit things have become somewhat monotonous. Not having our own home is somewhat making it worse. Not having kids might have something to do with it too. Lately Abg has been having some minor changes in his day-to-day activities and maybe I'm paranoid; but it makes me jumpy. Sometimes, as we lay in bed, I look up to him and the insecurities come close to being blurted out but I don't want him to feel as if I don't trust him. But at least I know by feeling this way that I'm not taking my marriage for granted.
Maybe it's time for that second honeymoon....
Wednesday, March 21, 2007
MC oh MC....
I dread Sundays and Thursdays because on these days, I notice the rapid depletion of my MC pages. Blame Sundays for the Sunday blues and people just can't be bothered to work on Thursdays anymore. Gaji nak, kerja asyik curik tulang.
The rationale is, if you're sick enough for an MC, theoretically, you shouldn't even be able to rise from bed. Tapi, people can still jump, hop and skip all the way downhill from my hospital, and they still demand one.
Take pakcik A, who works in a nearby estate. Came to see me at 10am for 'lenguh-lenguh badan' - belum apa2, mintak MC because, and I quote "rasa serba salah la pulak doktorrrrr"....my foot la serba salah....apa kerja kau habis pukul 10 stgh pagi ke?
Then there is teacher C, whose daughter had a teeny weeny burn on her calf after coming into contact with the exhaust of a motorbike. Requested for a 2-day MC....for a tiny burn? Logik sikit la teacher...When asked to see me, mula la keluar cerita that rupa2nya takde tiket bas untuk anak dia balik Penang on that Sunday. So, MC guna untuk cover sebab takde tiket bas, gitu? Firstly, takkan la tak cari tiket bas awal2.....and then, MC dua hari untuk luka seciput tu?
I've been told I'm among the most lenient when it comes to giving MCs. One particular MO tak layan pekerja2 estate nie mintak MC. She will give time slips, that's all. In fact, pekerja2 estate has known her so well that they will ask beforehand which MO they will be seeing, and refuse to see her. Banyak cekadak sungguh.
Today was an especially bad day at OPD. Somehow, people of TM has decided to turn up in massive droves at our OPD. A big portion of them, school kids with either demam (siap ada sound effect batuk and selsema hidung lagi as soon as they stepped into my room) or sakit perut. I figured, the 'mendung'ness of the skies has tricked their brains into oversleeping and now they needed an excuse for not turning for classes. Mana taknya, ada sorang mamat tu siap gel rambut pacak2 lagi nak dtg amik MC. Tell me how am I NOT supposed to be cynical??
Anyhow, at about one (with about 10 more people to see), comes in this young lady, siap pakai sweater (benda yang mandatory dipakai kalau nak mintak MC, kalau ada tissue kat tgn lagi bagus) berjalan masuk dgn penuh lemah longlai.
Patient: Doktor, saya dah demam lima hari. Saya dah jumpa doktor di Hospital Sungai Buloh dan dia pun tak tahu apa sakit saya. Mak saya suruh saya balik untuk berubat kampung. Jadi saya nak mintak MC.........
Me: (Membara ya amat dlm hati) *throws up my hands in the air in exasperation* - patient terus terkedu.
Me: Awak nie menyalahgunakan MC, tau tak?
Patient: Tapi saya sakit doktor....*sok sek sok sek* runny nose
Me: Pergi lah check darah and air kencing dulu...
Patient: Tapi saya tak larat doktor....
Me: Awak takde pilihan. Awak ingat saya boleh bagi MC tanpa justifikasi? Takde sebab, tiba2 keluar MC? MC nie sekrg isu sensitif, awak tau....bobebobebobe me going on and on......
I seriously don't know how/why/what some people are thinking. Minah nie tak fikir ke apa implikasi apa yang dia buat? She claims to be ill (aparently Hospital Sg Buloh pun dah bagi MC), YET she can travel from Selangor alllllll the way to Kelantan? Tell me, where is the logic in that? Tak fikir panjang sungguh. Siap ckp dia pregnant la bagai - so, what? Just because you're pregnant, I'm supposed to give you special treatment?
Org Kelantan pun satu, sakit sikit2 nak balik jumpa mak. Luka kudung jari pun sanggup travel from Kedah overnight nak jumpa mak...bawak jari luka berbalut dlm bas....yenadey.
Tapi segarang2 I, bab2 nak kesian kat org nie senang sgt. Garang tak serupa bikin. Last2, lepas dah letih membebel, melaser, bagi jugak la MC 3 hari. At least lepas dgr I membebel, she will think twice about doing something as silly as this....
Aaargh, this is why Suriana will never open a clinic......
Wednesday, March 14, 2007
Between ego and guilt
Seriously.
Just now, there was a female driver (not that it mattered what sex the driver is) in front of me. Depan dia ada lori sebijik, bawak jerami ke apa tah. Approachingthe 'ghe-tak' (jambatan aa), I nak potong (bukan double line tau), dia pun ikut sama. So, the other lane dah clear, I pun tekan accelerator, nak potong la dia plak.
Makcik tak bagi, ok.....tapi, I didn't care, tekan lagik to the max. Depan tu sayup2 dah nampak lori sebijik and makcik nie still tak nak bagi I potong.
Nak masuk balik lane, dah more than halfway overtaken her so potong la jugak. A few moments later, I pandang rear view mirror, dia dah takde. Kalau simpang dia dah dekat, takkan la beria-ia tak nak kasi org potong la kan?
Now, I'm worried that she might have swerved over the 'ghe-tak' - possible tak? I'm actually thinking about driving over to take a look. When I told Abg, dia bleh gelak pulak. Apa, kelakar ke menyebabkan org eksiden?
Nak gi tgk ke tak? Nak gi tgk ke tak?
Monday, March 12, 2007
Me - the Jakun...
A - Katak bawah tempurung!
and like a toad underneath a coconut shell I did feel when I went for my Effective Communication Skills in PJ Hilton recently.
The course was organised by NPC and there were about 16 participants - all from different walks of life. There was only one other doctor there and he was like the Head of Department! Yikes, but not the old and baldy type though - the young-ish and good looking-ish kind, haha.
I won't talk about what they were teaching and I must say the second speaker is more like a motivational speaker for Effective Customer Service rather than what they were supposed to convey. and As usual, chinese whispers was done, the one-way and two-way communication demo was done where you had to describe a picture with just words. I volunteered and at least one person got every diagram right!
There was a librarian from Bernama, a guy from the Fisheries Dept, two staff from a local plastic parts manufacturer, two people from another manufacturing company and a few from a local courier service....a serious eye opener and very refreshing.
The two things that I became a 'jakun' to were:
ONE
- the sumptuous, magnificient, way-too-much-food lunch buffet.
Seriously....there must be about 200 types of food there, ok. About 20 types of dessert (three flavours of icecream with 8 toppings to choose from, hot-from-the-grill-crepes with 5 fruits accompaniment, kuih melayu, Indian Gulab Jamun and milk candy, rice puddings, strawberries in syrup, chocolate cakes and cheesecakes), about 100+ hot dishes - Malay, Chinese, Indian, Japanese, Western, more than 10 meats from the grill station, tak termasuk the cold salad and what nots. My jaw was like, on the floor, with drool all over - well, maybe not like that lah. Tapi close though.....hehe.
and as I usually am in unfamiliar situations like these, I stand still, act in the knowing and observe. Plates? Under the table top - check. Should I get rice? What? With all these luxuries? Atkins diet la wehh.... Where is our assigned seatings? Oh, over there - check. Now back to food. A little bit of this and a little bit of that. Baru half of the food hall and plate already full. Finished everything and went for dessert, ignoring plates that were shoved aside with things left uneaten. I remember now why I avoid food buffets.
Five star hotels make me feel small (and that's not an easy thing to do!) - maybe it's the inferiority complex in me? Somehow, survived lunch, made conversation and didn't fall while walking to and fro the food hall.
TWO
- how other people were networking like mad.
Cards were whizzing all over - phone numbers exchanged. I was among the few who appeared unperturbed by all this. Sesungguhnya konsep networking is something so alien to me. Which is why I think I'd be happy being a hermit (as mentioned in my profile).
and then, when we had a five-min presentation to make, while I talked innocently about my trip to India, this guy actually spoke about his Internet-Investment thingy and how by 5 months, he has already made RM100,000 and anyone interested pls give a him a ring (number written on white board)....
Eye Opening, indeed.......
Come in pairs - part II
Two broken wrists.
Two fractured clavicles...
and two resuscitated babies.
Basically that summarises my on call yesterday.
Seriously, Sundays are the worst. Sundays are when people with eye injuries come for follow ups, or MVA cases with abrasion wounds come for medical leave. Casualty medical assistants (MAs) will give appointments (aka TCAs - To Come Again) on a Sunday for cases of fever or loss of appetite or lethargy. and Sundays become worst when three of your colleagues are away for leave or courses. J has gone to Genting for the Annual Anaesthesia Conference (Genting?! Best siot...), L has gone off somewhere for a course and apparently is planning to take the rest of the week off. Weiii, dah dah la amik cuti tu.....org lain pun kerja gakk...and N is taking a well deserved break after all this time covering other wards.
OPD started really late. I thought I was assisting the Nephrologist at the Haemodialysis Unit but after waiting for more than hour, turned out that he forgot about his clinic. One MO went for the Renungan Pagi and the third MO was covering the female ward, Post/AnteNatal ward and labour room. So, obviously, clinic finished late.
At about 11, baby case number 1 arrived. Apparently had been having loose stools and vomiting for the past 5 days! Mother only brought child to a private clinic and even that morning, had gone to ANOTHER private clinic before being told to rush her baby to our casualty.
Seriously, he was a textbook case of severe dehydration - kalau nak tgk depressed anterior fontanelle and reduced skin turgor and dry oral mucosa, he was IT. Child was about 2 months old, a firstborn to a young mother - mother was understandably distraught beyond words.
Sedih tau bila kiddies pass away. Adults, you can easily accept, especially elderlies with bad premorbid condition or ex IVDUs who are 'well underway'....but kiddies? It's like the grief of the parents and grandparents wash over you in huge tidal waves.
Baby number 2 arrived about half five or six I think. Pale as sheet and in obvious respiratory distress. Mom was nonchalant about the condition of the kid, claiming the problems only started 'JUST NOW'......This is where my Dr House persona kicks in. Cannot laaa.....how come this pale only started just now? Called in my 2nd call, intubated the child and resuscitated her. BP managed to pick up but she looked ill. I'm still wondering if sepsis could have resulted in her Hb of 5.2. Stool watery but no blood, abdomen soft, no history of G6PD deficiency....
Only managed to grab dinner and bathe at 10pm, only to rush to casualty again for a case of UGIB (Upper GastroIntestinal Bleed), my long neglected post MI regular customer and ambulance-call SOB. Then Asri number 1 came in after allegedly skidding on his bike. Pecah habis bibir. Second Asri came in at half one, berlanggar lembu and also had a torn open upper lip. Dua-dua referred to Dental and ward nurses still managed to send him late to the Dental Clinic despite me writing in the BHT - DO NOT BE LATE....isy.
Today, there was hoohaa in the hospital as the new Pengarah has now come officially to take over. The Timbalan Pengarah Kesihatan Negeri was also there. So I don my white coat (specially reserved for occasions like these...hehe) and wait for the procession to come. Lama la plak duduk dlm bilik, TPK menanya makcik and her daughter about the complications of diabetes. I was silently rooting for them to know the answers, as if them getting the answers right is a reflection of me. Weirdo or what. Hooray for anak makcik who got the answers right! I could hear the new Pengarah saying something about why both fan and airconds are switched on at the same time...aiyak...and on the only day when I don't come in and switch off the fan plak tu.
Safe to say we are all waiting in anticipation (or in fear?) of the new Pengarah. Winds of change are approaching all right, whether bawak bau wangi sepoi2 bahasa or bawak tornado ala Katrina is what we would like to know....
Wednesday, February 28, 2007
The early years..
To tell you the truth, I seriously don't know how I managed to get through med school. I'm not sounding arrogant and truth be said, I almost DIDN'T. Failed my second year, I think and had to redo some of the modules. By my final days in med school, I was thinking in much disbelief that I, the know-nothing, most lazy final year student was going to be let out unto the real world and managing real patients.
Now, isn't THAT scary.
Coming back to Malaysia to work was an easy decision. Choosing WHERE to work was another story. I wanted to be near Abg; Ma wanted me to remain in the same state. I pondered upon the idea and discarded it instantly. Being away from home all this while: MRSM Kuantan, Walthamstow Hall and Belfast, I wasn't sure if I could adjust to being at home, if you get my drift.
Thankfully, HKB wasn't a popular choice among the final year graduates, so I got in rather easily. Ma actually drove from KL, just to get me there on my first day.
I was told to report to the Medical Department. Hah, little did I know what a life changing experience Medical Department HKB was going to be! :) Early next morning, I went to Ward 4 (Male Medical), all scared and excited at the same time. Met Roshaini who was busy zooming up and down the aisles, taking vials after vials of blood. To say I was overwhelmed on my first day is an understatement.
To give a better picture of how overwhelmed and so-thrown-and-floundering-in-the-deep-end I was, I'll let you in on a secret, something I never told anyone.....when my MO told me to review a CVA case, I actually went up to a nurse and asked her what REVIEW meant!
I had no idea what BHTs were and when my nurse wanted me to write medications, I was looking at her face as if she was speaking to me in Swahili.....
Gelak la.....I definitely snicker to myself whenever my mind returns to that fateful day...:)
I can laugh now but I definitely wasn't laughing then. It got so hectic and so mad that I didn't have time to be sorry for myself. Patients were lying on foldaway beds in the middle of the ward; some days, even right to the doors. Visiting time was like making your way through people at an exhibition or something. I lost 10kg in my first week (and unfortunately gained much much more during the next 2 years, haha) and on some days, only survived on drinking cold plain water in the pantry's fridge.
I remember being shouted at by MOs-particularly by pissed off Radiology MOs who just couldn't be bothered to get off their asses in their comfy homes to do an urgent CT scan at 11pm at night. Referring cases to other departments was another chore that I didn't look forward to. Maybe I sounded too much like a houseman who didn't have a clue what she was doing, haha....they could smell the fear! :)
A typical day would start at about seven (HOs had to come in early to complete the morning bloodtakings, you see); MOs would start their rounds at about eight and then Specialists would come by at about half nine. Rounds are usually done by ten or so when a fresh round of blood investigations have now been ordered, sometimes making your early efforts obsolete. While you struggle with the morning instructions, new patients would be wheeled in and you'd be the person responsible for 'clerking' them. All these new cases would have to be informed to the MO in charge and at the same time, discharges (patients going home) have to be completed.
Some specialists do afternoon rounds as well and if you're lucky, maybe get to trudge along home by six. Some housemen even come in later to finish discharge summaries and what nots.
The Obs&Gyn posting was another matter; definitely eye-opening. EOD (every other day) on calls! How on earth did I manage to survive a full month of EOD calls?! :)
I do think, though, that the best decision I made was to postpone getting married till after I completed my housemanship. I don't think I would've made a good wife when I was either on call, OR too stuporous to even eat...! Having Abg for support definitely helped, as well as having gila-gila fellow housemen.....:)
Seriously lah....if you have relatives who think doctors are glamorous, and want to shove your kids into med school, think again. Semangat kena kuat, telinga kena tebal and muka kena selamba. Kena marah tu perkara biasa, and I strongly believe that whatever/whomever doesn't kill you, will only make you stronger and a better person.
On a less morose note, :)....congratulations and a Yippe-dee-yay tu Dr. M who is now a proud father of two! MDQ no.2 rolled out all pink and nice on the 27th February, 1952H (hours, bukan Hijrah..hehe).
Monday, February 26, 2007
Update

Yes, I still keep my Boots card even after all these years....sentimental or what...
Saturday, February 24, 2007
Five minutes of eternity...
Normal finding in an on call room: Owner-less toothbrushes....
There ends my last call of the month. Perhaps, no more PH calls for at least 4 weeks. Working for 24 hours straight is seriously inhumane, I tell you. Even when there are no cases, you can't sleep. Not properly anyway. At least, I wouldn't call 'tidur ayam' proper sleep. You keep waking up wondering if the phone had rang and you were too tired to hear it.
I am writing all these down, perhaps as a documentation of what had happened during my calls. Maybe for when something does decide to crop up later, y'know, as things usually do.
Labour room started busy early that day. Thin meconium liquor in a 43 y.o. gravida 5 I think. Eventually delivered rather uncomplicatedly but alas, her baby showed rather strong features of a Down Syndrome. It was left to me to inform her of her baby's condition, since he was to be admitted for observation anyway.
I was prepared for shock, I was prepared for unconditional acceptance - but I was not prepared for downright rejection. Was I being naive? Had I taken a mother's love for granted? She was shocked, alright but she was so shocked to the extent of refusing to hold her baby. Apart from his physical features, he was totally fine. But later, he developed hypoglycaemia and despite feeding, still required infusion of dextrose. I went to check on him later that night and he seems to be doing okay, despite the minor hiccup of a blocked intravenous access that had me in near tears.....frust, occccayyyy, kalau tak jumpa urat nie tau...:) in the end found one on the foot. Phew!
Then, a case of fall from height arrived. Ada apa tah kat tangki air kat rumah dia, that she had to check for herself....complaining of pain at the back but could move her legs okay. Xray showed a wedge fracture of the L2. Last I checked, she still didn't exhibit any neurological deficits, so I hope she'll be okay, at least until Mr S checks her out tomorrow.
Then I had two MVAs - siblings who both sustained fracture of the right femur. I don't know about other people, but I seriously have issues with underaged people who ride bikes as if they were racing in a GP. Serious. They are the worst in tiny, bendy kampung roads which only allow one car at a time. Seriously la, if they were to fall and the bike were to fall on them, serious tak larat nak angkat okay. and it's ALWAYS the car driver's fault. Tak percaya, gi tanya mana2 victim MVA yg bawak motor. I've never heard one admitting that it's their fault.
My weird case of the day came in form of a 19 y.o. chinese girl who, from what I gathered, had initially complaint of stiffness of the jaw, which progressed to numbness/cramps of both hands, SOB (shortness of breath) and then suddenly fainted. Her concerned mother and sister immediately came to the nearest hospital. Mother and sister claimed little sis had no medical problems, not on any medication apart from panadol for her gum pains but denied any possibility of overdosing. This had never happened before and there was no history of fall or family disagreement.
Her BP was normal, her oxygen sats were perfect and her blood sugar normal. There was no neck stiffness, no jerky movements, and her CNS were normal. I was totally stumped. There were no signs of infection, ECG was normal, her serum Calcium was normal and so was her renal funtion.
I rubbed on her sternum till my knuckles hurt and there was no response. Serious! and I rubbed extra hard some more but still nothing. Hish, kabar ke dok mek nih? She opened her eyes for a while but did not seem to register anything. I honestly admitted to her mother that I have no clue to what was wrong with her daughter and since she wanted her child to be admitted to a private hospital, she wanted us to send her.
We managed to send her eventually but I got temporarily pissed with a certain MA on call who was supposed to escort her. I clearly stated that he didn't need an attendant; he was supposed to come here and whoosh, go off. Tapi, on hearing that an attendant was not called, he PURPOSELY delayed leaving by, I dunno, pretending to check on resus kits and what nots until his 'best friend' magically turned up without any of us calling him. Why why why???? If he insisted on having a helper, he should have approached me or the other MAs on duty. If he sounded reasonable, I would have agreed. Nie tak, kau biar patient ngn mak dia yg already so flustered on the ambulance, pestering my driver who didn't know squat.
Then I had a young male with a history of rather uneventful asthma who suddenly had a bad episode of SOB and wheeze. He took about three hours of stabilisation before I could transfer him to ward. Seriously, I thought he was going to collapse on me. Young male with no history of ventilation before - major caution needed. This morning, I dropped by to check on him and he was fine.
Tapi, was my call ever going to be uneventful? Nooooo....of course it just had to end with a bang. and a Big Bang it was. Young mother of three, delivered 13 days ago came in with symptoms of shock. Pale as sheet and complaining of dizziness. BP registered at 77/33 with a heart rate of 80-90. Admitted to having PV bleeding since 7 pm the night before (she turned up at casualty at 5 am); lochia before this was already decreasing in amount and she denied history of fall, sexual intercourse (at 13 days post delivery? Ada ke?) or massage. Blood was literally pooling underneath her clothes. After pushing in fluids, BP picked up to 90/40. Vaginal examination revealed more and more and MORE blood. Abdomen had a mass of about 16 weeks pregnancy (when there shouldn't be at 2 weeks post delivery - uterus should have been impalpable) and scan revealed a bulky uterus. What was in there? A retained placenta?
Blood was ordered for transfusion in progress and I alerted the Gynae MO on call that I'm sending this patient. Now I need an escort. MO 2nd call was on call the night before and had OPD duty this morning. It was already half 6 in the morning. If I went, the ambulance could leave straight away. I know I had done all I could in my setting. She needs to get to HRPZ asap. Plus, MO 2nd call lived about 45 minutes away. Dilemma and decisions. On call money doesn't pay enough for dilemmas like these.
The ambulance journey took only half an hour, zooming through the morning mist which is occurring quite often nowadays, but it felt like ages. Five minutes were set between each BP readings and those five minutes felt like an eternity.
The patient still wasn't out of the woods when I left her. Her BP was still on the low and dangerous side. I prayed for her well being as I passed her case to the Casualty MO (all fresh and wangi and possibly wondering what she did to deserve a bad case of PPH so early in the shift..:))
Tied up all my loose ends, checked up on the patients I admitted last night and drove home. Ate my nasi pagi in silence and went to bed. Pukul 3 baru bangun balik. Which means, pasar malam dinner....hehe.
On a more cheerful note, Hooorayyy for sis who officially became a salary receiving staff with KKM last week. May you turn up for work with joy in your heart and always be at your table and not having never endings 'minum2' - dpt gaji jgn lupa belanja...hehe...
Monday, February 19, 2007
I'm IT.....
Thanks Mafeitz for tagging me....tagging nie usually means shadowing in our line of work. For instance, kalau ada budak hingusan baru masuk kerja, he or she's supposed to tag for a few days just to get a picture of what the job entails. Usually up to 8 pm la, but of course, nothing exciting happens before 8 in the job so....
Well, I digress....
I'm supposed to list 6 weird things about me...
1. I must have my books lined up according to height. and if possible, according to length as well. But height gets priority, for instance, if i get a book which is shorter than the one to the left of it, and it juts out, usually, the height wins. I'll most probably just find another shelf for it. or buy books which are roughly the same length (length, from the spine to the edges of the pages).
2. I'm a sucker for Hindi movies.
I know.....! Weird, right? It must be embedded in my subconscious or something, maybe Ma watched a lot of Hindi movies while carrying me. When I was younger, Hindi movies were something else, weren't they? Bobby, Sangam, Qurbani, Dosti Dushmani, Chandni, Amar Akbar Anthony - these were what I watched and remembered, apart from the sing-a-long Disney movies. At MRSM, I was in the TV room at 2 pm on a Friday (the boys would be out for Friday prayers and the girls were either doing laundry or sleeping) with Kak Safilah, religiously watching Hindi movies even when I had to be content with Govinda. (No offense, Govinda fans)
Heck, just to illustrate how weird I am about Hindi movies; I even went to Coliseum Jln TAR ALONE just to watch Khal Nayak, ok???
Till now, Hindi movies still get me. Even when they feature ridiculously impossible stunts or death defying heroes and illogical plots. It's just something about the haunting melody of the sitar and wonderfully thick manes on the heroines I guess.
3. I ate a couple of lizard's eggs once when I was younger. I actually thought they were sweets.
4. I hate seeing hair in the kitchen. I mean, on table tops or in the sink - not on top of people's heads where they belong, of course.
5. I wake up earlier in the morning during the holidays then when I'm working. I'm a morning person, so usually waking up isn't a chore but during working days, I seriously struggle to get up and shower tapi come weekends or holidays, tak payah alarm pun bleh bangun pukul enam. I'm like the kid who wakes up super early and goes into his parent's room and bug them. In this case, Abg gets poked and bugged to get up and entertain me.
6. I seriously LUUURRRRVE onions. Yellow, red, big, small, uncooked, cooked - but I stop short at biting into them like Shrek did in the first movie. and to think that Ma used to have to force me to eat them when I was younger.
I'm tagging -
Yaya, RedBeanBun, Zetty, Zaiti, DBI and SuperWomanWannabe - all among my must read blogs.
Rules of the game: Each player of this game starts out by telling 6 weird things about themselves on their own blog, as well as state the rules clearly. At the end, you will need to choose 6 people to be tagged and list out their names. After you do that, leave them a comment on their blogs letting them know you tagged them.
Tag, you're it!
Sunday, February 18, 2007
I love....
I must be the only person in Kelantan who would drive alllll the way to Kuantan to catch a movie. Seriously.
Three hours and a half journey, 300+kms...all for two plus hours of Ghostrider.
Well, actually, it didn't really matter what film it was. I just wanted to get myself into a cinema, and my other choices were a film where Eddie Murphy plays multiple characters and something with Erra Fazira.
I love making road trips like these. It gives me a chance to just lay back and catch up on stuff with Abg. Get away from that bangun pagi-mandi-gi kerja-balik kerja-masak-makan and go tidur routine.

View finder misted sebab baru keluar dari air conditioned room
View from our room
We checked into Gr*and Contin*ental Ku*antan, a stone's throw away from the MegaMall. Had lunch and Abg went off for Friday prayes. Movie was at 3.10pm tapi the hall was full, ok? Where did all these people come from? and it wasn't school holidays or anything. Maybe I'm NOT the only person who drives from Kelantan to Pahang for a movie, huh?
MegaMall is the building on the right.
Abg didn't fall asleep, so I guess that said something about the movie. On the way out, I saw this middle aged makcik - wa, makcik tgk Ghostrider, okay. and some people had kids of about 6-8 years of age. Okay la movie tu graded U but do you think a kid of 7 would actually appreciate a film like Ghostrider?
The next morning started with a leisurely buffet breakfast - 4.0 for variety; they had porridge, pancake, chicken sausage, baked beans, nasi goreng cina, nasi lemak and meehun plus the egg station and bread section and about 3.5 for taste - the sambal ikan bilis was nice. I still think MS Garden serves the best breakfast though.
and before we headed home, a short stop at Giant for our shopping. There are a few things that I keep a tab on with regards to prices. Kuaci Chacheer and Shokubutsu shower gel. Pacific KB sells the 300grammer kuaci for rm5.30 and it was only rm3.88 in Giant. I used to get rm5.99-rm6.50 for a packet of shokubutsu but lately I've been forced to buy them at RRP of rm8.50. At Giant they were selling it for rm14.28 for two and you get a cute soap dispenser. So guess who ended up with three cute soap dispensers that she now does not know where to put....hehe.
Anyone want one?
Thursday, February 15, 2007
Come in pairs...
Like for instance, one morning in OPD, I had two cases of per vaginal bleeding. I had other examples too, but I can't remember them now....
But anyway, my call last night started quite busy after five. A family brought their mother who had been unconscious since 10 am okay? I understand la korang takde kenaikan and all, but 7 hours? Seriously?
She was breathing alright but was as if in a deep trance. Her arms were making random movements but she didn't respond to my calls. She DID however respond to me rubbing my knuckles on her sternum (the bit of bone in the middle of your chest. Cuba try tekan situ - sakit woo). When a case of unconsciousness like this comes into your A&E, if you're lucky, it's a case of hypoglycaemia (low blood sugar), kalau kurang sikit itu nasib baik, it's a case of haemorrhagic stroke and if you're really unlucky, it's something else.
I wasn't feeling very lucky that night, so of course, her blood sugar was normal. Her oxygen saturation and blood pressure remained stable. I was sure it's a haemorrhagic stroke but must have something to back my story up, yeah? Nanti susah aa MO Neurosurgical in USM nak terima...:) Then, after checking her pupils for the second time, I noticed that the right one is oval in shape. When I reported this to the MO on call, he accepted my case and off she went to HUSM.
As I was having my dinner and Maghrib prayers, I wondered if there would be a 'twin' of the earlier case. and I was not disappointed. At about 8, came in this case of a 71 y.o. male who apparently overdosed on his schizophrenia medication. After vomiting once and had some loose stool, became unconscious. He was actually snoring like a baby when he arrived. His pupils were pin point. Besar sikit je dari saiz noktah at the end of this sentence. Off he went to HRPZII. Selamat.
The rest were MVAs, fevers and the run of the mill epigastric pains.
Woken up at three for a bronchopneumonia. Mother actually surprised I admitted the 3 year old. What...? You come at three in the morning, must be something serious kan? Of course need admission la! :)
Laid my head for a split second (or so it felt) and it was already half five. A case of G4P0+3 (means currently pregnant for the fourth time, yet no live deliveries. +3 means three abortions) at 31 weeks complaining of having contraction pains. She had cervical circlage done (meaning stitches were made in her cervix to keep her baby inside) but I guess that isn't working. My prayers went with her as she boarded the ambulance. I'm not sure I would be as strong if I were in her shoes.
Tuesday, February 13, 2007
Along the way...
Hannah enjoying her cream of mushroom soup at S*hakey's Pizza after we 'abducted' her from kindy. Her teacher was telling telling us that once she was telling them about cows and Hannah went to her and asked 'Teacher, kenapa cow ada tetek?'. Macam manaaa nak jawab tu?
View from our room at E*quatorial Melaka during our road trip to the south of Malaysia last year.
Something I wish to see in the future, with one of our own. Buat masa sekarang, takde rezeki lagi la kot.
Hannah in a contemplative mood while Mak Long, Pak Long, Mummy and Babah were having lunch at Orie*ntal Restaurant, K*ota B*haru.
One of those increasingly rare moments when we could get away as a family. Taken at Pang*kor Island.
Korunnnnnnkkkkkk!!!!!!!!!????????????
and guess what I found????????
Twenty two messages (well, satu tu tak kira sebab spam)!!!!!!!!! Where have they all been all this time? Kena sembunyi ngan virus ke?
So anyway.....my silver lining today is, I ACTUALLY HAVE READERS!! *lol* Can that be considered a silver lining?
So all those people leaving comments for me, wow...thanks! Waaa, rasa macam Mawi dapat award Bintang Paling Popular la plak.....
So, (berapa kali 'So' daaaa), I hope I got this glitch sorted out and keep leaving comments!
p/s: i think i know why lah - me thinks me's supposed to click at 'moderate comments'? Hmm?
Monday, February 12, 2007
One Year Old
Boo.
Very bad past two days, but I will not dwell on it. Suffice to say I hate some staff nurses who are so kiasu that they would actually do something unethical like alter their reports (which aren't that useful anyway - sikit-sikit: pesakit dalam keadaan lemah tapi stabil. Ubatan diberi. Bla bla blaaaaa....) so that they will be free from blame.
BUT, it's my birthday today. Not that I'm glad I'm older yet no thinner than last year. Well, at least, not heavier, yeah? Hehe.
Abg got me a gorgeous gold locket for our anniversary cum birthday present. I actually first laid my eyes on it about a month ago while I was getting my niece Hannah her first gold locket. P*h K*ong just launched their latest range of lockets which are shaped like mini heart shaped 'cages' and in some of these 'cages' are semi precious stones. The one I particularly fell in love with had two blood red biji sagas in them. One side's yellow gold and the other's white gold so you get to wear it with either necklace. Cool, eh?
But at that time I thought it was a bit too pricey so I longingly left it in the hands of the sales assistant. I never spoke about it after that. So, when it appeared in the box that Abg gave me, imagine my surprise. Yes Abg, you exceeded my expectations....next year, must do better, yes....? Heehee. I love you Abg. I love you and all your jiggly bits....:)
Saturday, February 10, 2007
Two down, two to go...
and when I say bad, I meant, death happened.
and it's bad because it was preventable.
How could I have not remembered that I ordered a repeat ECG and then forgotten to review it? Why didn't my staff nurses remind me that I ordered a repeat ECG and that I was supposed to see it?
Bengang and terkilan.
The thing is, I HAD gone to the ward for a quick round at 8 pm before attending to cases at the casualty. I spent half an hour there reviewing my unstable angina cases and not one of the staff said to me, Doc, you ordered a repeat ECG, would you like to take a look?
Aaaarrrghhhhhhhhh!!!!!!
Tuesday, February 06, 2007
Multiple bleuuurghs...
I haven't felt good about myself in a long time.
First, I thought moving back into a hospital environment would help. It did, for a while. But my ugly dragon reared its head again and started to cause misery for the people around me. I have lost interest in life, in my home - no longer indulging in my hobbies. Anhedonia, I think is what it's called. I'm sleeping more yet the more I sleep, the more tired I get. I've even started to lose my appetite, and THAT is not good. Food tastes crap (but then that's because I'm cooking, kot) and tears are incessantly welling up.
*SIIIIIIIIIIIIIIGGGGGGGGGGHHHHHHHHHHHHHHHHHH*
Where is a silver lining when I need one...?
Thursday, February 01, 2007
A special dedication.
Soft heavenly eyes gazed into me
Transcending space and time
And I was rendered still
There were no words for me to find at all
As I stood there beside myself
I could see you and no-one else
When I saw you
When I saw you
I could not breathe
I fell so deep
When I saw you
When I saw you
I'd never be
I'd never be the same
Only once in a lifetime love rushes in
Changing you with the tide
And dawn's ribbon of light
Bursts through the dark
Wakening you inside
And I thought it was all untrue
Until there, all at once, I knew
When I saw you
When I saw you
I could not breathe
I fell so deep
When I saw you
When I saw you
I'd never be
I'd never be the same
With no beginning
And without an end
You are the one for me
And it's evident
And your eyes told me so
Your eyes let me know
Happy Birthday Abg.
With oceans of love,
Your wife.
Friday, January 26, 2007
I wish I wish...
As I go through my simple life, I see so many wrongdoings and faults around me that if I spend my time thinking about it, seriously, I would get so depressed and lose my appetite (buleh ker....hehehe).
But occasionally, these so called 'wrongdoings' may sometimes be perceived as human nature, or behaviour and I don't want to come across as being judgemental.
I have so many opinions in me, yet I fear from speaking out because I realise how 'jahil' I am and I don't want to speak out of ignorance.
Tapi, if you are faced with an aged mother who goes around carrying her disabled child, who tells you that she has gone twice to a local KK but been asked to leave as the doctor is too busy to write her a short letter on her child's condition so that she could apply for financial help, and then travels 30 kms to the district hospital in hope of getting someone to help her....what would go through your mind?
What do you tell her when you wish you could help her and write her that letter yet there are 50 patients waiting to be seen and they have been waiting since the clinic opened and that was 3 hours ago?
I want to be angry but to whom do I direct my anger? To the M&HO at the KK who was probably unaware of her in the first place? or to the KK staff who could spare time to help some bigshot see the M&HO regardless of how many patients there are waiting yet could not spare one minute to assist this helpless nobody? Am I angry to the government who seems to ignore the plights of the poor - the gap between the rich and the poor seems so far away nowadays. Am I angry for my fellow doctors who choose to work overseas therefore contributing towards the lack of medical officers here? I am outraged, I want to blame everyone yet in reality there isn't really anyone to blame.
While I was in charge of the Paeds ward a few years back, I had a case of a child with CP (cerebral palsy). She was 9 I think, I can't remember. Her parents are in KL, from what I gathered, working in 'kilangs' and they have left this child to the grandmother. and this grandmother, a frail makcik, weighing probably at about 40 kilos, actually CARRIES her grandchild to appointments and physio and god knows what else at home. Even when they are waiting in the waiting area, she was carrying her. Her muscles are too limp and she can't even sit stright in a wheelchair. and how long are waiting times in a typical govt hospital?
Makcik tells me she travels 40 kms everytime her grandchild has a specialist's appointment, with a 'kereta sewa' that sometimes comes to rm20 one way. and Pakcik is suffering from stroke at home, mostly bed bound. So tell me, who do I get angry with? Especially when it is this Makcik who suffers through her hardships.
I try to help once in a while but there is only so much I can do as one person.
I wish I wish.....
p/s: Do you know what 'kuaci's (sunflower seeds) are called in the Kelantan dialect? I learnt this from my niece Asilah Husna not long ago and I thought aptly described what they are.
Butir ralik.
Ralik means leka, as if in a trance. and do observe people who enjoy eating kuacis. Note their almost trance like action of putting one seed after another into the mouth, extracting its crunchy insides.
Interesting isn't it...? :)
Sunday, January 21, 2007
Sniffles
Came back to work on a relaxing Thursday and discovered among others that in view of Maal Hijrah on Saturday, Sunday has been proclaimed a public holiday! Yippeeee!
Kelantan and Terengganu have been having their govt officers in a muddle before this. Sekejap cuti, sekejap tak cuti. In one instance, Kelantan cuti tapi Terengganu tak cuti. So I'm not sure whether this will be a permanent thing or not.
Wanted to go for a family trip with Abg's family but they weren't very enthusiastic plus SIL had her classes this weekend. So ended up doing basically NOTHING - which, isn't really bad you know.....:)
Plus, suddenly developed a case of the sniffles on Saturday. Pergi K*B M*ll pun takde mood. This morning managed to do some tidying up and vacuuming. Abg did lunch, what a sweetheart.
I'm on call Wednesday. Booo.....
Friday, January 19, 2007
A well earned break
We (my sisters and I) decided that we must must MUST go for a family trip this time round. I said I'd pay for accommodations, and sendiri2 bayar duit minyak and duit tol. So, sis number 2 said she'd pay for dinner at a Medan Ikan Bakar. Originally wanted to go to Melaka but sis number 2 already went so she was not keen. After lingering on Bagan Lalang (no suitable place to stay) and Kuala Selangor (Tok Mama does not want to ride on rickety boats at Maghrib time regardless of how beautiful the kelip2 looks), we later decided on Lumut. I came across *Lumut Valley Condo Resort* - RM148 for a studio deluxe, RM268 for a 3 bedroom apartment - good deal what? - among the advantages of holidaying during off peak seasons.
Stopped at Teluk Intan for lunch. Gu*lam Ras*ul is so famous there...! it's like THE nasi kandar place to be and I saw at least three different branches of it roundabout Lu*mut/Te*luk In*tan.
We reached Lumut about 4 and after checking in and checking out each other's rooms, Hannah immediately wanted to go to the swimming pool. What is it with kiddies and water, huh? The moment they see any amount of water in a container, they develop this uncontrollable urge to jump in and splash around. Hannah was so excited, she insisted on wearing her goggles in the car. Kiut sangat.
By the by, her mummy has enrolled her in a kindy called Kri*sta. Very nice location, very nice headmistress. I think they have branches all over. After classes in the morning, they also have daycare. Nice lah, siap ada uniform lagi. Hannah has been taught to say "My name is Hannah" whenever she is asked the appropriate question. But then, she has also developed this knack of saying "Oh mak kau" at no particular time of day; I'm worried her babah will say her aunts are becoming a bad influence on her.....hehehe. Janji bukan kitorg yang ajar tau......
Lumut's a nice place. Very well developed. Clean. It's small, yes but only because most ppl just use Lumut as a stopover on the way to Pangkor. Excited sgt sampai lupa nak ambik gambar. Later that evening, Abg and I went to Tel*uk Ba*tik to survey for dinner. The beach itself is average, but just before you reach the beachfront itself is a sign towards Medan Ikan Bakar (apatah - tak ingat). We chose and ordered food and told them to prepare it for half eight. So, kot bila nak makan karang, takde la nak tunggu sejam baru dapat food. Preparation is the utmost when you are travelling with 9 other adults, ok...:)
Ramai jugak org kat Medan Ikan Bakar tu later that night. Nearly full and they had quite a lot of tables. Luckily our tables by the water had been reserved and food came not 5 mins later. Perfect. Taste wise, hmmm, not that great lah. I've had better tapi boleh la....
The next day off we went at nearly 8 to get a ferry to Pangkor. Biasa lah, tourist spots macam nie byk lah ulat2 berkeliaran, insisting that their ferry is the best option around. Since going to Langkawi last year, I've learnt my lesson and not grab the first thing that comes hovering near my face. If there are no better options about, I can always get back to him, huh?
We were loitering around at about quarter to 8 and this ulat approached sis number 2, insisting that the next ferry was only at quarter past. He is offering RM10 perhead (return ticket). I said no, I want to check out other options. Ye lah, we're not really pressed for time ke apa, kan..kalau betul dah takde ferry, nanti kiotrg dtg la beli tiket you. Tapi as we walked towards the jetty, he loitered with us, siap buat small talk with Tok Papa. and Lo and behold, an 8 am ferry is waiting and we paid only for 8 adults (we got 2 FOC), so ended up only paying RM8 per head.
I sound calculating, kan....? but it's not the money, it's the principles, people! :)
Pangkor was marvellous!!!!!!!!!!!!
A sea of pink vans waited as we unboarded the ferry (journey took 25mins). Take note, these are the only means of travelling. It fits 12 adults so just nice lah untuk the Sukeri clan nih. They offered us RM60 for a 2 hour trip and they will bring you to 4 sights - 2 tourist spots, a kilang ikan and the beach.
Next time I go, I'll just get a 'taxi' to Teluk Nipah. Snorkeling there is highly recommended and you don't even have to know how to swim! I saw a family of makciks siap dgn tudung labuh ngan baju kurung lagi okeyyyy......sense of adventure sungguh.
Hannah had fun destroying the sand castles her mak long made (apa la punya anak sedara) while her mummmy and babah went snorkeling. Nasib baik baby Hariz slept soundly all the while his mummy went. I told Hannah mummy gi kerja cabut gigi kat tgh laut...hehehe....
At noon, we trudged back to the apartments with big bags off fish products and made our way back to KL. Reality sank in as we got caught in the Sungai Buluh traffic crawl. Ahhh, nothing like a traffic jam to jolt you to your senses, huh....
All in all, a fun and mostly hassle-free family outing. Where next people????
Sunday, January 07, 2007
Birthday Girl

Hello!!
Nama saya Wan Nadiah Hannah.
Hari ini, harijadi saya yang ketiga.
Saya sangat happy sebab Mummy dan Babah belikan saya Barbie Beautiful Bride dan Prince Derek yang ada 12 pasang kasut.
Saya ada seorg adik. Nama dia Wan Nazmi Hariz. Dia saaaaangat gemuk sebab tiap2 hari dia minum baaaanyak susu.
Tok Mama dan Tok Papa pun ada belikan saya pressie. Mak Long saya tinggal di Kelantan. Mak Long kata dia akan balik minggu ini. Saya takut dengan Pak Long sebab dia ada janggut. Babah takde janggut. Mak Long suka belikan saya hadiah tapi kadang2 Mak Long suka marah saya sebab dia kata saya cepat nangis. Tapi saya tau Mak Long sebenarnya sayangkan saya.

Mummy kata Mak Long nak bawak Tok Mama, Tok Papa, Mak Teh, Mak Su, Pak Uda dan Pak Su, Hannah, Mummy, Babah dan baby Hariz pergi jalan-jalan. Mak Long, Hannah nak pergi tempat yang ada swimming pool!
Saturday, January 06, 2007
Post Call Post Mortem
APO (acute pulmonary oedema) is a condition when there is a sudden onset of chest pains associated with shortness of breath due to fluids in the lungs. Your patient will definitely not be able to lie flat - if he/she is forced to do so, he/she will complain of feeling 'lemas'. They get very restless and to a fresh MO on her first on call at the district hospital, can be very scary. Ye lah, previously, masa korang housemen, most likely case APO nie MO korang yang settle kat casualty. By the time korang tgk kat wad, makcik or pakcik tu dah stable.
My on call last night (speaking of which, on calls on back to back weekends are sgt meletihkan la. Hari tu on call raya haji-the following weekend, on call lagi..) wasn't too bad in terms of patients coming to the casualty. Well, not in the first half of the day anyway. Patients were basically non existant apart from a barrage of jaundiced babies which, most, thankfully could be discharged. However, the previous night a male patient with fever and low blood pressure was admitted. His BP only picked up after commencement of dopamine. The staff nurse in ward kept calling me with one problem after another. I think, though, it's just a ploy to get me to refer him so that they won't have to be bothered with his once every 15-minutes BP monitoring...hahaha.
First his BP was shooting up and down. Adjust dopamine pun payah nak stabilise. Then he developed vomiting and abdominal discomfort with some difficulty in breathing. Finally, he stopped producing urine after 12 noon. Waaa, manyak tension oo. Then I had the unfortunate luck of having the most annoying night staff who kept pestering me to refer the patient. Weh, aku doctor ke mu doctor....that was what I wished I could say to her.
On top of that, the casualty started to become busy. There was a PV bleeding, two MVAs (motor vehicle accidents) - one of which claimed and cried when he was unable to move his legs, tapi tetiba kecoh and menjerit mintak seluar jeans dia balik. One kid got knocked down by a motorbike, NOT by the aforementioned though, hahaha. A stroke case got in and an acute abdomen who had come several times the night before. and ON TOP OF ALL THAT, my male ward has become full. Aiyo, where to put patients lah?
Luckily, a former colleague in Machang was also on call. I gave him a quick call and asked if I could 'borrow' a bed or two if needed. Nasib baik boleh. So one of the MVAs was shipped to Machang, his friend was referred to HRPZ II and the stroke to Pasir Mas. The PV bleeding got admitted, as with the child with the closed fracture. The acute abdomen was a clear cut case of intestinal obstruction but refused to be referred. Letih la. If I keep him, his condition might deteriorate. Honestly, ikut hati memang tak nak simpan la cases like these. Tapi what to do, if patients refuse to go, there is nothing you can do.
Labour room kept receiving cases, thankfully, nothing serious that needs urgent attention.
About midnight, just when I thought I could finally go and clerk my labour room cases, masuk la this 88-year-old lady. TYPICAL presentation of APO. Tambah2 lagi, already has a history of previous admission for APO. According to son, though premorbidly quite active, very difficult to persuade to take medications.
I started the initial medication, put her on bladder catheterisation and called the medical MO on call. Suara macam letih aje. Nasib baik dia tak ckp banyak, terima terus kes tu.
By now, it's already past 1 am. Makcik looked increasingly distressed. My second on call was away somewhere else which would take an hour to get here. What to do, what to do?
Future doctors, if you're on passive call, please la don't be so irresponsible as to be so far away from the hospital. It beats the purpose of putting you on passive call in the first place.
Makcik's oxygen level dropped to 80. She looked near collapse. I contemplated intubating her. Tapi karang takde ventilator, susah plak aku. I gave her another shot of frusemide, put her on high flow oxygen and decided to escort the case myself. A quick call to my senior MO who lives nearby and I was off.
Surprisingly, makcik survived the 45 min journey. Siap bleh sengih2 kat aku lagi. "Mujur selamak sa-pa, deh? (Mujur selamat sampai, kan?)" Ye makcik, mujur..... Her condition made a complete turnaround. Must be that roller coaster-like ride on the ambulance.
Balik ke HTM at three, sembahyang isya and collapsed. Slept till 5 am and trudged to casualty to look at this IHD case. He came in at half two tapi apparently was stable. He was sleeping soundly on the stretcher. Kalau aku tau, aku tidur sikit lagi. Hehehe.
Penutup of my oncall was a BID (brought in dead) case. 57 years old, background history of heart problem and had earlier complained of shortness of breath. Apparently, became still about 10 mins away from the hospital. Sedih la tgk anak dia. Tak sangka la mak dia dah meninggal. Apa nak buat.
and BTW, the guy with hypotension and no urine? Referred him at 8 am. My morning nurses must have been jumping for joy as he left.
Thursday, December 28, 2006
Musings
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
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......
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
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....?
Open for a month a year
Tuesday, November 21, 2006
Familiar faces
But anyways, it's been three weeks since I came back to HTM. I just love being in a hospital. As bad as being on call is, the quietness of the corridors and the sleeping patients (as long as they're not restless or gasping la) calms me. At least I've firmly decided on where I would like to work.
I had said before, during one of my farewell speeches, that whenever I leave a place, I only remember the good stuff. and when I left HTM, I kept missing the good natured ambience that the staff has. I forgot about when I whined about colleagues who took advantage of us junior ones or when it got so busy that I ended up escorting a patient twice in 12 hours. So naturally, the moment I spent my first day, they all come flooding back in a huge tsunami...hehehe.....and long suffering colleagues all rolled their eyes as if to say 'Macam la kau tak pernah kerja sini...'
Not only the staff are familiar, even some patients I still remember and they, in turn still remember me. Two chinese girls and their grandmother and aunt came to see me one day. The last time I saw her, she was this scrawny, pale thing who was stuck on oxygen and her mum. She had been my patient while I was in HRPZ II (formerly HKB) too. and now.....she's still scrawny but she's all grown up! :) Sadly her mother had died about 2 years ago.
Two days ago, my colleague referred a case which had equally saddened and enraged me the first time I met her. She was taken care of by her aunt. Her father, an IVDU had passed away and the first time I met her, the mother had passed away as well. The next I heard, her other two siblings also had died. Tell me, what other types of sadness and grief can you possibly wish on this unfortunate being? A year and half ago at least she was well. I could barely recognise her that day. Her limbs were like matchsticks, her tummy distended and her skin had multiple rashes. She looked exhausted; maybe she had finally given up on fighting for her life.
I've a hunch she might not return to Tanah Merah....and perhaps that is for the best.
Sunday, November 19, 2006
Saturday, November 18, 2006
It was a cold and rainy day....
Why are men so idiotic sometimes? She cries silently. Husbands in particular....! Is it so hard to show your appreciation towards your wife, whether it by words or by actions...? Teasing you may be but the word still smarts.
A muffled sob escapes her lips. She drives slowly pass the silent schools, the small roadside sundry shops and looks for a place she can stop by. She needs a moment to think.
Her phone rings. She glances at the display. Let it ring, her heart says. Serves him right for treating you this way. He's probably calling to admonish you for leaving the house without permission. He probably just wants to tell you off for letting him face the puzzled expressions of his family members, for he, does not know where his wife is. He, who ALWAYS knows where the wife goes. For she does not go anywhere without him.
But that was before. It's time to teach him a lesson. Let him know that he cannot treat her like chewing gum he accidentally stepped on and now wants to get rid off.
The beginnings of a headache throbs in her head. I need to get home. Regardless of how angry I am, I miss him already.
She starts her car and makes a three point turn. The rain still falls but already the clouds look a little less grey to her.
The house is empty. His car isn't parked at it's usual spot. Her heart lunges to her feet and beyond. Sampai hati.... The tears start to fall again. The throbbing becomes more intense. She should really get some sleep. A couple of paracetamols should take care of the pain. Her last thoughts as she dozed off was of him, laughing as he enjoys the weekend lunch at his sister's home. Happy to be rid off her.
Two hours later she wakes up. His arms are wrapped around her, his breath consolingly warm against her neck. She turns around and he opens his eyes. She starts to pull his arm away from her but he resists.
Stop it! Do you know what matters of things have been going through my head the past four hours? Do you know the moment I realised that you'd left, I rushed out to find you that I left my wallet at home and when I got to where I thought you'd be, I still couldn't find you and now the gas tank is empty and I didn't have money to fill it up?
She ponders upon his words, deciding if she should believe him but deep down realises that he has never lied to her so why would he start now?
Do you know how worried I have been, and how sorry I am that I'm such an idiot and please not do that to me again?
She turns to face him. She knows he's telling the truth and that he indeed has gone round and round all the usual spots they frequent, hoping to catch a glimpse of her silver Kenari. She knows that for everything that she thought was bad about him, there are 10 other things that are wonderful about him.
She pulls him close and embraces him. I didn't go far, no matter how mad I am at you, I wouldn't dream of leaving you....I didn't go far. I'm sorry.
Hush, it's ok yang, it's ok. Now come and eat lunch with me, I'm starving.
and that day, she had the best ikan goreng she has ever tasted.....
Monday, November 06, 2006
Rut rut rut
and I don't know how I'm going to get out of it.
Yesterday was my first day back at work. It was nice in a way, starting in a place where you've worked before. Now and then ppl kept stopping and saying things like 'Macam pernah tgk je muka nie...' and I don't resent that. It was nice of them to say that. But I don't think I'll be making myself comfy here. I'd like to advance at some stage.
But most of all, I'd like to get my own house.
With my own things and where I don't have to tread softly everywhere I go and get permission with anything I use.
Bleeuurgh.
I'm back to sharing spaces for just 2 weeks and already I'm resenting it.
and I'm resenting it so much that it's taking a toll with the people around me.
Someone tell me how I should get myself out of this rut...
Saturday, November 04, 2006
Overwhelmed
That is precisely what dr bekeng has been attempting to do for the past 2 weeks, bar the few days she had to celebrate raya.
and now she is totally overwhelmed.
She has tried putting some stuff at Ma's house in Pengkalan Chepa. A single seater sofa, the bed, the ironing board, the fan and the TV cabinet resides there now. The TV, on the other hand is currently sitting in a corner of the kitchen at FIL's house, a sad reminder of my currently (proper) homeless state. In her room, she has set up the PC (complete with her printer) AND another TV (albeit a much smaller one) and the DVD player. Some stuff has been replacing older equipments in FIL's house - the fridge, the washing machine, the ASTRO decoder (thank god no more interrupted dialogues!) and SIL will now be getting the microwave oven that used to sit on the kitchen counter because another microwave oven will be sitting there now.
BUT I still have about a tonne of other stuff that seriously needs a new home. What about my books - leisure and medically related-? What about my collection of DVDs? What about my stationeries? I now have two sets of toiletries and my lovely stainless steel, heavy bottomed crockeries are just sitting there in boxes....OUTSIDE, NEXT TO MY CAR......
Sorry, but I did say I'm overwhelmed...............




