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....

My bimboish moment...

We had just checked out of the hotel room where we spent the night courtesy of Abg's membership and Abg had gone to check us out and had told me to go to the car.

I got into the elevator and pressed B1 and a teenage boy got in and pressed 7 but the light didn't go on.

"You kena ada card kalau nak naik ke bilik" says I.

"Oh, kena slot mana?"

So I proceeded to show him and the lift door opened and I stepped out. With a reassuring, "Alright?" I strode purposefully towards the car park.

I turned left where I was sure Abg parked his car last night, stopping to admire a double digit plated, blue Mitsubishi Evo. Walked a little bit more and still couldn't find it.

'Must be in the other direction then' and so I walked.

Still no car.

I walked again in the opposite direction. 'Abg must have parked a bit further than I originally thought' - but no car.

A moment of panic rushed through me, 'Abg's car have been stolen!'

As I walked towards the elevators, it struck me - I should have gone one floor down in B2 where Abg REALLY parked his car.

Duh.

Bimboish moment over.

Love is.....

...coming back from work and finding your husband bent over a tray of roasted peanuts, shelling them individually (because you've never done it before and don't know the way to do it) because he knew you wanted to make 'kuah kacang' and you won't have time to start from scratch....

...stopping by your wife's 'oncall house' with two cendols, rojak perut and rojak buah because you know it will make her day...

...removing the prawns' shells before cooking meehun because you know your wife finds it cumbersome to do it while eating...

...cooking fried eggs with soya sauce and cili padi when your wife is too tired to cook post call...

...not minding ironing her clothes or when there are three whole baskets of laundry waiting to be folded because you know your wife is doing EOD calls...


....all the little things you do that you think I don't remember or think is significant enough..

Happy 6th Anniversary Abg.

On a more cheery note

Dedicated to a colleague who is so excited at seeing S/B preceeding his name for the first time ever. I know you will see how funny this clip is.

Egotistical me

How ironic it is, I was thinking this morning while I was having toast in the OT's pantry, that the brand name of the sweet prune 'asam' sitting on the microwave was EGO.

Because that was what I was called by a patient's relative in a heated discussion that ended up with me slamming the ward's door.

In fact, I slammed it with such rage that my colleague had difficulty opening the door when he was called to resuscitate a patient.

Sometimes I think I'm such a hypocrite. One moment I am a supporter of confrontation and laying it all out, yet sometimes when faced with such situation, all rationale goes out the window and I blame everything under the sun but the person I see in the mirror.

What I decided to do later that night was an easy decision to make, because I knew it was the right thing but in all honest truth, was one of the hardest thing I had to do. Even as I approached the patient's bed and reached out to tap her on her shoulder, I was in half a mind to turn away and run.

But I am glad I didn't because that would've made me a coward, one who zings people yet can't take the truth when it hit her on her face and I didn't want to be that person. My parents did not raise me to be that person and I would've woken up this morning ashamed of myself.

Yes it was painful and I was humbled - perhaps he was right, that I am an egotistical human.

Hooray!!!!

Kudos to the Selangor govt for taking this initiative. I've always believed that Malaysians tend to use more plastic bags than it is good for the environment.



Of course IKEA started their Save the Environment campaign much earlier by charging for their bags and TESCO gave incentives in the form of points when customers reused bags when grocery shopping.

It is sad though that we need incentives in the money form before actually getting off our butts to do something about it. I've always heard people saying, "Ah, if you're the only one who does it, what difference will it make?" - maybe not but at least I will have a clear conscience.



My shopping trolley - bag from Popular, Molnlycke, Toko Tiga Bandung, Marks and Spencer (good for the wet stuff) and GSK.

But I do have to gloat that I've been reusing bags for quite some time. All those drug companies are just giving away good sturdy bags at conferences and symposiums. Why not put them to good use?

If you had magic powers.....

......don't you ever wonder what you would do?

I would make it so that rubbish that get thrown out of windows of cars fly back into the vehicle and preferably get stuck on the face of the person who threw it in the first place.

I would magically drain out the air from all the tyres of cars who stupidly park right at a junction, or even facing a junction.

I would make disappear cars who double park and obstruct the flow of traffic.

I would make a sign appear on the windshield, for people who don't signal before deciding to decelerate - which says, "Bagi signal la moron!" Similar to slowpokes who decide they just can't be bothered to drive on the left hand lane - "Ikut kiri kalau bawak macam siput!"

Whether or not I add an expletive will depend on my mood that day.

If you had magic powers, what would you do?

Bye bye 2009

I wonder what it is that compels us to be reflective at the end of the year. Perhaps it is the increase in the number that shocks us into realising that time has passed by and we haven't done as much good as we possibly can in the past 365 days.

To me, the year has been a pretty good year. I don't remember a lot of downs - but maybe that's just me, despite the grumpy person I am, I tend to forget bad things rather quickly.

Career-wise has been pretty good. Despite still not wanting to pursue a masters programme, I can finally plate a femur bone myself (did one - skin incision to skin closure - within an hour, a personal record which I haven't been able to break since), K-nailed numerous femurs, and can totally be left alone doing carpal tunnel and trigger finger releases.

After about 8 years of working in various specialties, including a stint in a KK, I can safely and surely say that SHOULD I decide to take a Masters programme, it will be something that I enjoy rather than something that I had ended up in just because it was my final posting of my housemanship. Or, even worse, something I am taking up just because the work is easy and allows me to be home when oncall.

I am thankful that I haven't had much trouble financially. Finally got myself to acquire a property, much to Ma's relief. This year, money seems to come in from unexpected sources, Alhamdulillah. I have been able to travel a bit, something that I hope can continue this year.

On a more personal level - there's still only the two of us. I am happy with my uncomplicated life - so far. I hope my relationship with Abg for the past year had been more than simply two adults tolerating each other just because they're married.

Yup, it has been a very good year indeed, and here's to an even better one in 2010!