Wi's logbook

DoRaeMon

2012-02-04T07:45:00.000-08:00

Genting Highlands is having a roadshow for Doraemon and co.

Its a exhibition of the characters, the objects and the building of one of my favourite childhood comic book.

I remember that I'd buy the Malay version of this comic everyweek ( yes, I dont know how to read Chinese. Truly Malaysian eh? )

I have the whole set of it, but eventually I passed it over to an orphanage.

I hope they take good care of it as I did when I was a child.

So , me and Joanne went for a day trip to revive our childhood dream - which is to enter Nobita's world. :)

Extreme cases

2012-02-04T07:33:00.000-08:00

During a recent night shift , I got a call from a fellow medical officer referring me a case for ICU admission

He started off with this line,

"I have a very "kick" ( complicated in cantonese) case for you

Me : huh ? tell me about it

MO : blah lah blah lah....with a HB of 0.8g/dL

Me : FOR REAL ? ALIVE ?

I guess it was some chronic blood loss , but zero point eight would now be my record lowest hemoglobin level that I've ever encountered in an alive patient

On a different oncall,

A lady came in with multiple fits

I asked the family member(FM) ,at what age she started fitting.

FM : since childhood

Me : not seeking medical attention?

FM : Nahhhh..shes being like that for a long time

Me : Huh ?

FM : She fits two to three times EVERYDAY. Its just that today she fitted more than TWENTY TIMES .

Me : #faint#

No I did not forget you

2012-02-04T07:29:00.000-08:00

Dear blog, the channel for my inner voice

I did not forget you, its just that I was busy with work, / plain lazy

and all the CNY gathering , and the huff and puff and a start of a new relationship

You know I'd come back to you

Challenges alone

2011-12-11T06:20:00.000-08:00

In district posting, equipments are limited. Even if they are there, they might not function well.

For those who came from well equipped hospital, it's a different world.

Things that are quite unacceptable, happens here. Regularly.

I don't know, but I have a feeling Sabahan are very accepting. They take it as ," tak apa bah" and things go on forever and ever.

They are more content and seldom look for trouble in work. They will tell you, "it's Sabah". As though it's an accepted fact that things can be suboptimal .

Next Step

2011-11-29T21:35:00.000-08:00

Medical Officer.

Being a MO means, more responsibility , means more work lah !

Am posted to Lahad Datu (what? where?)

Ya, thats what the Timb Pengarah of JKNS told me.

His exact words for new MO is to do some district time.

" I dont expect you to sacrifice yourself, you just have to make some sacrifice "

With these kind of words threw at me , I was stunned and speechless for a moment and accepted that , why not take up the challenge.

I had nothing to lose at that time , no attachment , no responsibility..so why not ?

And so there goes ....a new chapter of my life .......

A break from work

2011-11-29T21:14:00.000-08:00

Finishing housemanship was a relieve

6 postings in 2 years was a good time to hone one's skill

The teachings and the late night oncalls was truly an unforgetable experience.

Some stories were not told , but I had to admit I fell asleep on my way home afew times and lucky for me nothing serious happened.

At the end of my housemanship, I decided to take a month off for travelling.

Some might say that I'd lose out in my "seniority" , but I felt that I needed something away from medical line.

Went Korea with my family.

Had too much of korean food that my dad mentioned

"No more Korean food for the whole year"

The DMZ was the highlight..I kinda like war-related places

I went to Singapore to find YY .

Then travelled to Vietnam and Cambodia with Joanne

AngKor Wat is an amazing place. Especially during the sunsets and dawn .

It took us 2 days just to explore the temples

Felt like Tomb Raider for a moment :)

Learn to cut loss

2011-08-26T03:07:00.000-07:00

When the boss sell , it should trigger a red flag.

Why did I went in that time ?

Because...

Bought on rumour , but didnt sell on news.

FAIL!

Did not cut loss early

Waited and waited.
Ego and not wanting to accept failure.

FAIL!!

End result -40% loss. Shiatz

Hidden beneath

2011-08-20T11:26:00.001-07:00

To reach for another is to risk involvement, to expose your feelings is to expose your true self, to love is to risk not to be loved in return.

Rest in peace

2011-08-09T04:00:00.000-07:00

I blogged about this memorable patient a year ago.

I've met him while I was in my medical rotation.

And now , after some bad turn of events . He was warded in ICU. Without both his limbs , and was mostly dependent to others. He developed more infections.

He looked more frail than he used to be. He had lost the positive self he had once .
But he had never complained. Always grateful towards the nurses and doctors who take cared of him

He told of writing a book. It was a good idea and an inspiration for most of us. But never could complete it....

He succumbed to his diseases today.

But it might be the best thing for him right now..May he rest in peace

When the time call for you

2011-08-07T09:12:00.000-07:00

Back in OT , sometimes it can be cold straight forward cases , and I'd just warm myself by the corner with a thick blanket while I wait for the surgeons to finish their job.

But when disaster strikes, and you wont know when. It strikes hard.
It pounds hard on you.

There was this one occasion, when Ooi had to open 3 emergency OT (with 2 emergency Caesar) , I would take care one of it and poop......the baby came out lifeless.

Pale
Not moving
Not breathing

LIFELESS ~

I was looking out for the paediatric doctor ..nowhere to be found yet ....

The only thing I heard from the surgeon was...Channnnn...take over !

I rushed over.
My fading memory of Neonatal resuscitation came back to mind ,partially.

After a few bouts of direct suction , intubation was the only option

Not working ..still no heart beat

Start CPR . My only assistant was a junior postnatal nurse.

The baby got back pink after a while . More help came . Pediatric team came.
She was ushered out in an incubator to NICU .

Phew!
That was adrenaline pumped.

It was always scary to do emergency Caesars .

If the little ones come out fine...then its okayy. I'd go by and pinch their little face and hug them .

But if not...it'll be red alert.

A month off ?

2011-07-24T09:41:00.000-07:00

Housemanship is coming to an end soon.

Am considering to take a month of unpaid leave off just to go travelling

Maybe Philippines - Vietnam - Cambodia

But a sure major attraction will be the Bataan Nuclear Plant tour. Not sure whether its open to public yet.

If not , i might just go visit poor Kien in Sydney. LOL .

Locum..ehem ehem

2011-07-17T08:40:00.000-07:00

Got my registration letter , which mentioned that the appropriate documents are filed and I am currently a fully registered doctor.

Bottom line - LOCUM $$$$$

One shot

2011-06-26T09:23:00.001-07:00

Alot of times we only get 1 opportunity, one shot .

In anesthesiology , this is even more emphasized.

It goes from the feeble artery to get an art line , the moment before we miss the ship , the spinal anesthesia to work and of course intubation itself

I am junior and inexperience

At times , my failed procedure did cause harm

But even said so , there are ways to go around it to savage the situation , and of course much backup.

Friend's wedding

2011-06-09T09:55:00.001-07:00

Swee Meng & Mei Kee Wedding Cinema from Filming Art Cinematography on Vimeo.

They made it a great event.

Ssh..Dont tell anyone I was part of the Ji-mui team.. :p

27 still going

2011-05-22T07:21:00.000-07:00

Had a good outing recently,

Celebrated my 27th bd which was 300++days ago . But still ! If you were to wish me today , it still counts into my 27th.

Ngek ngek ngek

Lepto

2011-05-18T06:08:00.000-07:00

These few recent ICU calls wasnt so smooth.

The recent two, had very severe leptospirosis cases . Very virulent , not typical clinical signs , and patient deteriorated fast after intubation.

And the others are starting to "chop" my oncalls as Lepto-day ! Which is not a good thing being tagged on the forehead

Gateway

2011-05-11T05:41:00.000-07:00

Encountered extremes of situations in ICU

Seen the lowest Hb level I've ever encountered. 2g/dL (TWO) in a 2 year old kid

He went on ...

And then there was this very bad status asthmaticus patient . Silent lung on auscultation. SILENT .
Everything was pump in up to Ketamine and vecuronium.

He looked good today, he survived.

I got bliss by a few words of comfort . :)

Always beautiful

2011-05-08T07:20:00.001-07:00

10th of 8th

I wish that you walk a beautiful path

I'll have my memories embedded . Always the special one.

Operation theatre

2011-05-03T21:04:00.001-07:00

OT can be a very relaxing place if the op goes smoothly.

Or it can be very hectic if one is on call with loads of emergency cases and baby wanting to come out eagerly

I encountered 2 very contrasting situation.

If I were ib elective OT, after spinal or GA, I could sit by a side with my MO, specialist and nurses and chat till the surgeons are done.

Ok once in a while we adjust the settings , lights or the table position. Life sounds great right?

But..

If the patient is unstable , we have to make sure he withstand the whole operation, that include giving different meds , inotropes , order for blood, and constant staring at the monitor for the slightest changes is the patient's vital signs.

Like the other day I was oncall OT, i started at 8am and end my day 730 the next morning. It was hectic but I managed to do alot.
2 intubation, 6 spinals and 1 LMA.

I went home collapsed....

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What Are Words

2011-05-03T09:15:00.000-07:00

Unfair world

2011-04-24T06:16:00.001-07:00

Fairness never existed in this world.

I got another reassurance of this fact recently, when I got to know of someone who saved a couple stuck in an accident. But was however he himself hit by ongoing traffic and succumbed to injury

I still hope there is still some reason to do good.

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Final posting

2011-04-24T05:53:00.001-07:00

Last internship posting , I'd be attached to anesthesiology for the next 4 month

I have a group of very capable , motivated and effective group of houseman colleague, boss who treat us like peers rather than subjects, a department who is no stranger to adrenaline rush and a blend of all knowledge

The first day I tagged in OT, I had to attend to the limp newborn as the Paeds MO was not there when the baby came out.

Luckily the NRP knowledge did it's justice.

With more knowledge, the responsibilty gets heavier :)

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CHAGE & ASKA - 男と女

2011-04-14T11:57:00.000-07:00

One of my childhood favourite songs

Guidelines

2011-04-13T21:26:00.000-07:00

This few days I have some time to tinker of some lingering issues that I had.

They had been with me for quite some time , and its due long time ago....

1. career path

2. relationships

3. finances

Crack

2011-04-13T10:03:00.000-07:00

When you hear that during sports, It means only 1 thing...........BAD

Damn its painful

Damn I cant walk up the stairs.

Damn its swollen

Damn

Damn

Damn

I twisted my ankle

Now I need my ortho skills

And some Voren gel and tabs

Dive 2011 : Tenggol Island

2011-04-12T03:10:00.000-07:00

April 8-10 this year around I was away for diving. The first of the year .

Bought myself a mask and a pair of nice fins . Wet suit will be next (hopefully)

Traveled by road with Alex and Alvin. Hian Yow was on another car . Emily was there too.

Hoped of Dungun for a 2 hours boat ride to the island .Very basic facilities there , a secluded island indeed

Dive wise , nudibranch , turtles , scorpion fishes.

The corals are very much intact, thriving reef species around with great visibility on the first day.

Did my first wreck dive on the second day

Azad

2011-04-12T03:05:00.001-07:00

He stayed with his foster mum who beat him , broke one of his tibia .

He got his way out by someone calling the helpline (it really works)

I was assigned to help him get a skeletal scan. Initially it failed as he wasnt cooperative in the xray room.

So, thoughts of sedating him was in mind, but to pump so much drugs into him would be so unnecessary.

So, I accompanied him to the room , wearing the plumbum vest (minus the thyroid protector, gosh!) to complete the scan.

No pictures shall be posted to protect identity.

Putrajaya Hot Air Balloon

2011-04-12T02:57:00.000-07:00

This was sometime in March. I am doing backlog blogging.

Mesmerized

Thought of going to watch hotair balloon, though they didnt rise it up at night , but got to see a spectacular firework display.

HDR via Iphone

8th

2011-03-07T05:03:00.000-08:00

Day : 8th
Time : 0000

Its the 8th of the eight month

Just a thought, if you tilt the number 8 sideways..it becomes ∞

It was a busy clinic day

I was hungry..

Temptations

2011-03-03T08:56:00.000-08:00

Another new model launched recently.

2 door..

Something for the soul

2011-02-28T11:22:00.000-08:00

I grew found of Daisies

Time : 0330

On call tmr

Month of February

2011-02-28T10:43:00.000-08:00

Date 1st March 2011

Time : 02:50

I would say, this year's February is something different from those of previous years.

There were lots of ups and downs.

Although its the shortest of the month , it has been a long one for me

Lets talk about the happy ones first

First of all , its CNY and Grandma's 81 birthday.

I got myself 4 days off, and another day as sick leave. I was really sick and took a course of Azithromycin. (was in respi ward)

Then time wasnt on my side. Or should I say time-ing

One downslope let to another , and when the ball starts rolling , I could only hit rockbottom.

And when I was at my lowest, a stone came from the sky to add salt to the wound .

There were alot of "if-s" that ran through my mind at that time and you know it.

Sometimes fear of being hurt is so strong that you dont dare to try it anymore. Even though you know that its true.

It'll take time..I hope it wont be long.

No strings attached

2011-02-27T07:23:00.000-08:00

Watched this movie of the above title recently in Gardens Signature.

It cost me RM23 per pax, and I think it deserves a review. I'll try to make it short .

Emma (Natalie Portman) is a Doctor

and Adam (Ashton Kutcher) works in a production house.

They knew each other since young but things just didnt meant to happen till they bump into each other later in life.

They started off with no strings attached , as the movie of the title . Getting sex without all the other attachments of those in a relationship , the so-called "Friends with benefits".

Eventually the guy started to fall for the girl .

But as time passed, Adam knew it was much more than sex and wanted something more in the relationship ,but Emma would draw herself back , citing that she is comfortable alone.

He would date her out

Buy her balloons

Then one fine day , they agreed to go out for a date on Valentine's , and when Adam wanted to show his affection to Emma by her doorstep in the car, she would then break his heart.

Adam told Emma that he would not see her again.....

During a night in with Emma's sister, she realised that she had missed him all these while . As she would never find someone else who is as true, as jovial , as tall and having a big heart as Adam ..

But then , Adam is already starting to move on with a colleague at work ...but some feelings won't just go away so easily even though he wanted to be firm to erase her from his life..

The ending ?

You have to watch it to know

This is kind of a reversal of the traditional plot whereby the girl wants a steady relationship and the guy would just crawl away after the night in bed

Lessons learnt

2011-01-31T05:49:00.000-08:00

This is about a company that I encountered a few months back (Tiger Synergy)

Very erratic price movement.

From a progressive jump , showing good earning prospect from June to Aug, to a sudden drop in the month of August (jaw drop also )
and then it took 3mths for the price to slowly climb back to its usual baseline.

So, lessons learnt :

Equity market is controlled by big boys

If you think you had a good deal , thousands other had thought of that

Its a matter of patience / Holding power. (easier said than done when one is looking at the downgoing trend)

Another lesson learnt :

" If you dont want to get burnt or bang your head to the wall , dont put too much of yourself into it "

But eventually ...some things are meant to be "blind"

Muthusamy

2011-01-21T16:14:00.001-08:00

Just abit snippets.

Am post call now having breakfast . 4A calls are generally easy . Its basically to back up your colleague , if they are free then I'd be relaxing too.

So, lets talk about muthusamy . He is old, he is fragile.

He lived in a cage he called home.

I wonder if he knew his parents.

He was lucky he was picked up by a good samaritan when he was young.

Now he is now old and fragile, lying there waiting for The Death angel to come.

His caretakers are sad to face this truth, but they knew it was coming.

Muthusamy

Muthusamy is a hamster reared by a young boy.

Haha.

Not bad eh for a family pet.

I've heard this story 5 times or more. Each time giving a laughter and a big smile.
The laugh is for how the teller emphasizes on the name of hamster- MUTHUsamy.

The big smile is for how the teller enjoyed sharing this story over and over again.

I shall call my dog -Peter ,next time . :))

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Blogging on the go

2011-01-12T03:33:00.001-08:00

Just installed blogpress on my iPhone . Now I can blog while I m on the move (p/s while at work or halfway during rounds. LOL)

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my ex !

2011-01-09T08:46:00.001-08:00

I meant, my ex-blog got some attention from German and Brazilian publisher of this photo !

Link to original post

And its reminiscing to read back some of the post back then , here is a post before I started work. Its just 2 years ago. But at times , I had already lost my way where I should be making decisive decisions

And I had forgoten my wordpress password. Crap!

5th posting - Pediatrics

2010-12-27T05:17:00.000-08:00

Peads is fun!
I have to admit it from the first day of work

The working environment is totally different from my previous department.

Its like breathing fresh air - again.

Its like being reborn, finding the long lost joy of working ( did it existed anyway ? )

I seriously think a part of my decision on my future undertaking depends on how my superior and how the working environment was during my housemanship.
Although this doesnt apply to every department , but a bad experience will surely dampen a person's aspiration.

I'm starting to read journals again after a hiatus .

Can i blog through Iphone ? Is there such app ?

(pssstt.. tagging is so not strictly enforced here. LOL)

Of holiday break and Wish list

2010-12-05T08:11:00.000-08:00

I took 5 days off.

Had some good rest. Sort out my insurance stuff , jailbroken my Iphone. (did 3 times with 2 different version and almost burnt my phone , called Maxis for help but they keep telling me it will void my warranty ....So I lied to them )

Went to motor show with Daren the other day I was on leave.

This one looks shinier than those at work :D

Also went to Turf Club at Sg Besi. First time, the VIP box was nice .

Car wise - I now have a wish list.

Since I was so good this whole year long , except for the lying to Maxis part. I think Santa should give me an early present :D

OnG

2010-12-05T08:02:00.000-08:00

There had been a gap in my blogging entry

Mainly as usual the old reason is ...i was busy with work and life. (yes, i do have a life)

Other than that , I didnt had much interest in OnG since I was a medical student.
Mostly because I disliked my professor.

I dont know whether its the high estrogen level involved or the stress of it dealing with 2 life in each situation that made things so hard in this department.

And ya, and all the monthly audits. It can be so stressful.

They said its not to look for fault but to learn from mistake.

But ITS ALWAYS looking for someone to swallow the fault.

ALWAYS!

Okay , i got myself what the necessary training and knowledge that I need. Thats what housemanship is.

So, if you happen to be on a plane and you are delivering , I am capable of doing it (with equipments of course...pls dont PPH (postpartum hemorrhage) can d)

So, to cut the story short. In this 4 months here, i delivered babies , do the same other HO jobs . Nothing significant to mention

Private life wise - met a decent girl . Okay, i like her. But things are complicated.

Things to say

2010-09-19T03:55:00.000-07:00

I have something to say and it is just me

I try to care..but it doesnt always prove successful. But at least i tried

I try to make plans and stick to it. Unless I am too tired to honour it

I dont like wasting time, cause I dont have much of it.

I try to multitask, while giving 100% for each of them.

I dont judge , cause we all learn from mistakes.

I try to understand , cause that makes this world a better place.

I dont like being fooled , cause it makes me look dumb.

Well..those are just me

Babies

2010-09-07T04:26:00.000-07:00

Wouldnt you want to pinch his soft tender cheeks...

Next step

2010-09-07T04:10:00.000-07:00

There shall nothing to stop me. not the uncooperative staff nurses , not the lazy PPKs , not the scoldings from specialists.

I am now into my 4th posting , OnG .

OnG wasnt on my favourite-list of subjects during university days but I am having these chills and goosebumps that people always end-up happily with what they hated initially.."CHOI" "CHOI". Touch wood !!

If these happens years on. I shall call it fate.
But lets hope not lah...

Looking back I've gained alot of confidence and knowledge after a year on . But the passion for work was also not burning as it used to be,
Waking up early 7days a week , the dreadful oncalls , the lack of personal time for family and friends.
I wonder it is to train one's perseverence or to brainwash us into robots.

But what the heck !
I want to finish HO-ship and get on with whatever brings me to.

Souled out

2010-08-03T06:54:00.000-07:00

I was in medical clinic today

I saw this middle age man who came in for his follow up

I took a quick browse of his discharge summary, and it was noted there that he had a heart attack , and his heart stopped at one moment and we had to shock him back to life.
Then we had a bit of a chat and he related back his experience.

He told me , at that moment, he could hear his wife and children crying.

He could see the staffs in action.

And ....he could see himself lying on the bed AND his late father in law.

He was relating to his out of body experience , a very much documented experience in patient who is at death's doorstep.

Anyway, it gave me goosebumps...

He related to me he was given a second chance in life and he would change his habits (smoking).
...sometimes it takes bad turns to change a person

This whole thing made me wonder , is it real or just made up stories?

A brief respite

2010-08-03T06:52:00.000-07:00

Was on leave during the weekend.

went to Penang with friends.

Ate like madness

Not much good sleep though coz i only had the couch.

One day , one life

2010-07-26T02:53:00.000-07:00

A few weeks back , I encountered a middle age man during my Medical ED call.

He came with chest pain.

And same as many other that came through the doors of ED, after their pain got abit relieved , they go into denial phase.
They think it is transiet

They think it is no big deal.

They think heart attack is nothing

And this is what he told me when I told him to be admitted

"I dont want to be admitted"

Me : "why?"

" I have things to do"

Me : "what is more important than your life?"

"Tomorrow I have a football match " p/s this happened during the world cup football fever season

Me :....(boiling)

"Its just a ONE day thing"

Me..(burst)...you only have ONE life!
LOOK AT YOUR WIFE! LOOK AT YOUR KIDS!
IF YOU DIE WHO IS GONNA LOOK AFTER THEM...

I think i'll get hypertension very soon. And all this happened at 2am..

Gosh

Apart from that , I've gone through a week of Medical attachment in ED. It was fun working in ED. The staffs are helpful, everyone jokes around during non critical times and goes into action when the time arrives.

The choice for ED or Anaest posting is coming. I guess I'd choose ED.

The big comparison

2010-06-30T06:15:00.000-07:00

This is a ranting post

Dung just gave me a call out of the blue

Apparently he called and texted me afew days back , when I was too busy to reply (and forgoten)

We chatted abit , updated each others .

And I brought up some issues that oral surgery never ( I mention , will NEVER) be the primary team of a motor vehicle accident patient.
They'll come, wash up abit , and say goodbye . (and review in the ward of course).

Apparently , he is making more money, having more free time, getting weekend offs, getting more life than me despite us working in the medical field , he being in dentistry me in medicine.

And since this is a ranting post............
.
.
.
.

SOOOOOOOOOOOOOOOOOOOOO UNFAIRRRRRRRRRRRRRRRRRRRRRRRR

What do you need?

2010-05-21T03:41:00.000-07:00

Heres a conversation I had with my friend lately.

Fren : Do you want a tie for your birthday?

Me : I have alot d

Fren : shirt?

Me : alot d

Fren : belt?

Me : alot d

Fren : watch?

Me : I dont wear watches

Fren : so what do you need most?

Me : buy me "Time"

Fren : Okay, I'll get a bangla to chop off your leg, and you'll get all the time you want.

Me : Good idea. But make sure I can claim insurance.

Fren and me : HAHAHAHHAHAHA

Dengue ward

2010-05-21T03:38:00.000-07:00

Was assigned to the dengue ward for about a week .

Time flies when you dont realise it.

Basically my job in the ward is to

1. take blood
2. review blood
3. change ivdrip
4. and take blood again.

Averagely, i am sucking ppl's blood about 20times a day , and 50times if i am on call..

Dracula loses.

Memorable patients

2010-04-15T10:22:00.000-07:00

Every now and then, I'll come across patients who made a mark in my medical life.

In my Surgical posting, some survived and walked out healthy like Makcik E

Some had went on to another world , and even though their names seems blurish to me, their looks are still fresh in my mind and the face of their living relatives at the patient's last moments..

The dead will leave peacefully, but sorrow lingers with the living.

As for orthopedics, there isnt much mortality, but more into immobility.

Mr S is a 30 something gentleman. Has juvenile DM. Lost both his legs in the process. Currently in medical ward for disseminated MRSA.
But yet, is more cheerful than most who walks. That attribute of him I truly respect.

3. Medical

2010-04-14T03:24:00.000-07:00

It seems like just awhile ago I started work.
But to think about it, it has already been 8 mths, and lots of hardship in btw.

I'll be finishing ortho this saturday and entering medical on Sunday.
Yes...on SUNDAY

The cycle has been completed and its a new round once again.

I enjoy the new things that I'll learn, new experience ..but I hate the 'start from beginning' part, especially the tagging part.

A new journey once again. Wish me luck !

Fresh blood

2010-03-30T03:43:00.000-07:00

Last week, there was a group of SPM high scorers touring the hospital.

They came with high hopes, I can see ut from their eyes.

Here is why I said so.

I was checking out a post op patient whom I was wondering why her curtain's was closed. And quickly left.

Then this enthusiastic girl came to me and asked...

"can I observe what's going on inside?"

Me : , " Are you sure you wanna observe how someone PU?"

It was a program to introduce to them how a life of a doctor looks like.
To show them the real picture and not the glamoring scenes in TV shows, and neither do they drive Ferraris too.

And then after , I was scrubbing for an implant removal with my specialist and MO, together with the observant "tourists"

I believe this program is to show them the real scenario. Not to demotivate them.

But that's what they were told, every corner of the hospital they went.

They were told things like ,

" if you wanna be poor and serve the poor. Then by all means be a doctor"

"try not sleeping for 3 days"

"you dont want a life ?"

I didnt have the time , nor the will to motivate them...So, I didnt left my footprint.

I wonder how many of them will really walk the path after such an agonizing trip.

Updates

2010-03-30T03:25:00.001-07:00

It has been 2 months since I last updated anything.

No, I've never forgoten my blog.

Nor am I very busy.

Actually I am enjoying my free time most of the time. (thus the lack of time in front of the pc..hehe)

Alright , in this 2 months.

I've /am :

1. Progress through the ranks of ortho HO.
2. Did Ray's (I was hoping for an amputation though)
3. Went for regular badminton sessions.
4. Still single
5. Went diving in Lang Tengah
6. Got myself a table and chair in the room.
7. And a 20" LCD
8. Made some profit/savings with dad
9. Still hasnt found my calling.
10. Less stressed up in ortho

Ahh~ CNY

2010-02-13T01:21:00.001-08:00

Today I woke up by the chirping sound of birds ( I was self auditory hallucination) rather than the beeping alarm clock early in the morning.

I can afford to give myself another 15mins of snoozing before I really get my ass up.

And I could take a comfortable long shower without worrying that I'd punch in later than my specialist.

Today is HOLIDAY!!

I think i am much more happier to get a break rather than the CNY festive .

But of course, I am looking forward of celebrating CNY at home since I was away for 6years .

So, I did some last minute shopping at Pavilion.
Cant get anything decent, its either too pricey or I dont like them.

Just manage to get a T-shirt that shouts , "Thats a limit to one's growth"
LOL.

I'll wear it out tmr.

Shooting

2010-02-05T07:11:00.000-08:00

Shooting!!

Its not playing paintball or airgun.

Its the voice of the radiological assistant pressing on the C-arm machine.
Its something like a mobile Xray machine used in surgery.

For today, its for the orthopedic surgeon to know that their metal rods are not elsewhere where it shouldnt belong. Their implant will be at the perfect dot.

And for each "shoot", i felt I lost cells. I cant quantify. Maybe a million cells per shoot.

So, I think I sacrificed alot of cells today. Even though throughout the day today I was wearing the radiation protection clothing .

And that "bullet proof" cloth weights more than 5 kg.

*rubs on my aching shoulder*

Sleep

2010-01-24T07:17:00.000-08:00

I used to love sleeping (i still do), but nowadays i choose not to use my time to sleep.

Maybe because work has been so busy, if i used it up for sleeping my life would just be a plain cycle of sleep and work.

Of late, I am getting 3-4hours of sleep during weekends and abit more during weekdays.

A year ago. This would be totally impossible!

This proves how work life force changes..

Angin sahaja

2010-01-12T03:32:00.000-08:00

He was 17.

A school football player.

But then he got something growing on his leg.
He thought it was no big deal.

Went for some traditional massage and oil application.

Until it was too big too noticeble

So he came

With a lump 20x20cm . I'll upload the pix later

And with a lung like this !

We repeatedly told him its cancer and deadly.

What he replied was...

"ini disebab oleh angin ke?"

And he opted for traditional therapy AGAIN and discharged against advise.

I also masuk angin d..!!

Gajah sama gajah berjuang

2010-01-05T02:14:00.000-08:00

the next line would be.

" Pelanduk mati di tengah tengah"

This is a story of a HO

He was on ED call one night. It was peaceful till..

a man who had a slash wound came bleeding non stop.

His radial artery was severed.

And so he was referred to another hospital with hand microsurgery specialty.

This HO went along for the transfer.
He has enough ammo if anything happen to the patient.

On the way , patient seem stable. So he had a chat with him.

HO : Why they assaulted you la?
Pt : Rob my money
HO : What you work as la ?
Pt : Money collector
HO : Wah! so you are taiko la.? Hows the payout?
Pt : 60-40..sometimes 50-50.
HO : (good money wei.....)

And so they reached safely to destination. Pushed him to his ward . Met the specialist there and they went on to examine the patient and smacked this line to this HO's face.

"He doesnt need to be managed here. Send him back"

HO : err..so, whats the plan now?
HOD/Datuk : The plan is..LEARN HOW TO REFER PROPERLY NEXT TIME and SEND THE PATIENT BACK
HO : ........

Then of course this HO has to report back to his MO , who reported back to her specialist who reported back to his HOD
(see the hierarchy)

Minutes later , Patient BP 100/60. Pale. HO's face also pale.

HO: So how now?
MO : Where are you?
HO : Going to step into the ambulance. The patient is on the ambulance d.
MO : STAY WHERE YOU ARE!!
HO : ok lor..

Minutes later. BP lowish. Actively bleeding..(HO in stress mode)

MO : Our boss talked to their boss . Send the patient back to them
HO : Ok ok

(should have did this since the beginning la....Boss talk to boss.)

p/s Hosp hierarchy
1.Pengarah/ Ast Pengarah
2. Head of dept (HOD)
3.Consultant /Specialist
4. Medical officer (MO)
5. House officer (HO)

I hope everyone enjoyed this short fictional story

New Year's eve

2009-12-30T14:37:00.000-08:00

Its 630 now. getting ready for the last day of the year and also going to be on call for the night.

Just a short note here to wish everyone Happy new year .

2010.

What lies ahead ?

12 things from surgical days

2009-12-25T01:46:00.000-08:00

Let me recap what i achieved or learnt this first 4 mths of surgical life. A newbie in the business.

1. Learnt how to present cases..the first few days kena kao kao from specialist. Dont even know the sequence of presentations at the beginning. Foreign grad mah..

2. Got STAT orders..gave STAT orders.

3. Worked 120hrs a week during tagging period. Crazy

4. Never knew how to find time for lunch till the middle of my posting. Only then I realised, I should be a true gomen servant.

5. Drop tears for patients. Palliative care is no easy job

6. Some patients will stay in my head forever.

7. Love and hate the intensity of preparing patients for emergency ops.

8. Resuscitation is tiring. I get leg cramps after that.

9. Hate to go back to fall asleep and get dreams of work. That sucks!

10. Learnt alot about inter-dept relationship (aka how to push/reject cases) while doing peripheral . And also about other disease la..

11.Got to operate on 2 appendicitis, the 3rd one was abit complicated so my MO took over.

12. My HOD love this line "do justice for your patient" for whatever actions we make.

Of course, there are much more experiences that plain words cant describe :)

Holiday season

2009-12-10T05:02:00.000-08:00

Everywhere feels like jingle bell all the way.

Was in The Curve meeting up a new friend

Not bad settings..

I am counting the days to my Phuket trip..woohoo

Backtrack post :

Dont know why that other day, super semangat to go travelling , at least out of KL. And I was post call at that time.
Drove to Melaka to find my ol' housemate , ate supper and went back.

Jonker street rocks with its laid-back bistros. Should go there sometime again.

Naloxone effect

2009-11-21T07:44:00.000-08:00

Gave a patient IV Pethidine to control his renal colic pain.

The effect, IMMEDIATE. His pain, gone within seconds. But its more of a sedative rather than an analgesic effect (pls correct if I'm wrong)

Later on I reversed it with Naloxone , due to fluctuating saturations.

And you could guessed what happened next......

Peripheral

2009-11-21T07:32:00.000-08:00

Starting peripheral rotation for 2 weeks . Its a new thing in our department and I was chosen to be the first HO to do it (note : lab rat)

Basically, I'll be helping my MO to cover all the referrals from other discipline.

The good thing is , i wont be confine to one ward. I'd be more mobile .

And no need for blood taking except for paeds patient going for op ( oh no...)
And it'll give more exposure to those HO doing this rotation, other than the normal appendicitis (dull) , UGIB 2' to NSAID (boring) ,abd pain(yawn), MVA ..

Now i get to see, appendicitis in pregnancy, UGIB in non Hodgkin lymphoma, abd pain with dozens of differentials..(note : time to read up)

But on the other side , I have a feeling I have to write all the clerking notes for my MO (who would previously do this themselves), and rounds would finish LAST.

Fidel's day

2009-11-21T06:27:00.001-08:00

Post call and went for Melissa's birthday.

Drinks and good company..

The next day, which was suppose to be my first day in surgical peripheral. ( i would be covering ICU, paeds, OnG, Medical and haemato referrals)

Dead and gloomy at work..haha.
Luckily I dont have to enter OT that day.

Getting credit

2009-11-16T06:20:00.001-08:00

Some updates:
The hospital I am working with is undergoing accreditation .
With surveyors coming in and out everyday, alot of things have change

Its so nice to have each bed with hand antiseptics.

So nice to see the nurses' desk neat and tidy.

So nice to see things getting done in a split of a second.

So nice to have the operator picking up the phone immediately.

But when things get done according to the book, it might not be so practical at times, ;)

Hopefully the hospital gets the credit they deserve la...

Going on to the next topic, mmm...

I got another opportunity to slice ..ehem..operate on another patient the other day.
Yeah. another appendicectomy.

This time around , it is much better , and it took lesser time too.
OT time is precious.
From one side, the anaest was crossing her arm, looking at the clock ticking. Tick tock tick tock..
Another side, the scrub nurse was repeating , " Dr ..sudah lama la.."
And my MO is also adding to the pressure by saying , "Be fast, but gentle"

Not easy...

The thing about operating on someone is that one has to take full responsibility. The patient was discharged home soon after the operation. I really hope she lives until 100. :D and not coming back for anything like...err...hernia

Anyway, I am also looking forward for another chance . Greedy me. But practise makes perfect right ?

Other than that..not much . Social life has been . NIL. (fullstop)

A cycle

2009-11-08T06:32:00.001-08:00

I am now near to working 3 mths in surgery and its when patient comes back for follow up.

And patients do remember their doctors well, even a HO.

There were a few occasions some patients came to approach me, just for me to stare back blankly. It took me afew seconds to remember them, but as memories of the patients came flowing back , it feels good to see them well and upgoing and following up on their health.

I do wish my patients well :D

Being dumb

2009-11-07T07:49:00.001-08:00

After 3 mths working , I realised one thing.

Work never seems to finish. There is always more.

I dont mind working, but sometimes one can multitask up to a certain extend only.

And I realise ar..sometimes, during lunch hour, I'll be left alone in the ward.

And nurses are very smart people, once they see a problem, the first thing in their mind is to inform the doctor, usually the FIRST IN VIEW, because they have to document it down, if not they'll kena scolding.

So...

Those who are in the ward have to attend to the patient la, on top of the work they are suppose to do.
Recently I kena alot from the nurse la, they inform me things, but me having to handle more urgent things and getting frusfrated being bug from 10 different sides at the same time (as sometimes, noone else is around for them to pass over), I'll just ask them to call the doctor in charge of the patient.

Then they make those kinda face like this fella doesnt care, and gossip about me. Sienz..

Ai..dunno how la.

As work cant be finish,
and if one stays back to do work.
MORE work would pile up

So, should i just...
being "smart" rather ?

Sick treating the sick

2009-11-03T02:16:00.000-08:00

This is a story of a sick doctor treating sick patients

So what ? many senior doctors would say. Housemen are suppose to be made of steel.

And so, this houseman who was down with fever, have to stand in cold operation theatre for long hours ( wondering would this be a risk of infection to patients) , work triple EOD calls with bad non stopping pertussis like cough in front of patients who would be thinking they are healthier than the doctor treating them.

Irony? But thats the truth.

Tough ?

-No..

because often the test of time, get the better of us

Fuiyo moment v1

2009-10-04T04:21:00.000-07:00

I performed an appendicectomy.

skin to skin.

Fuiyo!!

A small step to this big surgical world

Grandma stories

2009-10-04T04:12:00.000-07:00

So many things happened in the ward everyday.
There is no lack of stories.

There were afew occasions I was called up at ungodly hours with the other end of the phone shouting , " the patient is gonna pull off some tube"

There goes my sleep and I have to rush to the scene to calm the old grandma to assure her its for her own good that the long uncomfortable tube stays in her belly.

Another case was this grandma who taught that we illegally kidnapped her and lock her up , demanding to be release out, search high and low for her cloths.
She was so irritated she started by scolding me , threatening to go to the press , and went on to pull out her branula ( for drips infusion ) and then went on to pull off a tube from her genitals for urine monitoring.

I have to calm her down by sitting in front of her, let her scold as much as she likes . And then try talking to her about her younger days (she didnt bought that, kept on scolding me for detaining her in this awful place ) , until she felt sleepy.

The best part was...the next day,

when I asked her what happened last night, she gave me the best answer in the world.

" What happened? I was sleeping soundly what the whole night ! "

The moral of the story is , be vary of old grandmas....they might look innocent. But , THEY ARE NOT!

Institutionalized

2009-09-28T05:12:00.000-07:00

the process of becoming accustomed to life in an institution so that it is difficult to resume normal life after leaving.

I really want to write something outside of the hospital I am working.

But after sitting in front of my laptop for 5mins, I accepted the truth.

That my circle is inside the hospital. ONLY. And that scares me alot

Even when I was in a movie the other day, I was thinking of my renal failure patient going for op the following day. (and she is a fussy one)

I think...

I AM INSTITUTIONALIZED!

Dang Dang Dang..

Aura

2009-09-18T05:43:00.001-07:00

Had some kind of an informal meeting , *but in a serious tone* with our specialists.

Basically, its to boost our confidence as a HO, because as day pass , I have to agree with them that we are losing our "macho-ness" as doctors.

Need a booster jab from time to time.

I always think, surgeons have their own aura.
Some kind of an invisible wing or a force-field surrounding them .

Of course , it comes together with their experience and confidence.

I've met some surgeons, with their cool faces, you can feel wind swiping over your face when they walk past you. No joke!

Currently , my aura is only as bright as a matchstick burning towards its end. Anytime can go off . Haha

Gotto start shouting...

Burn baby burn!!!

Gifts of patience

2009-09-14T01:16:00.002-07:00

She wasn't the easiest patient to satisfy.

Throwing tantrums was a daily routine.

Blood taking was a nightmare.

Maybe because of her condition

But then after 2 weeks, she became well.

And left with some gifts.

So, I guess, those are the gifts of patience

Loving and loyal

2009-09-04T21:44:00.000-07:00

After working for about 3 weeks, I see patients come ill , but go back better, if not healthy.

Its true for all but one patient in my ward.

She had an accident afew months back. It was a hit-and-run case.

She underwent multiple operations that saved her life. But , it was too bad, she was totally paralyzed. All she could do is to open her eyes and mouth .

Some people might term her as a vegetable, but not for her husband.

He was well aware that she would be like this for the rest of her days. But he never ran away.

I see him quite frequently, he would come whenever he has time. Sometimes late at night, sometimes during the day.

He would just come and sit by her side, wipe her saliva, suck out mucus from her throat, feed her , care for her.

I dont dare to ask how he sustains himself. It would be too cruel to ask. And it would just show how superficial I am .

Once when I cleaned her bed sores with some staff nurses, we talked about him.
All of the nurses were very touched by how loving and loyal his husband is.

We all agree that most men would have jumped ship.

But there are always exceptions.

Medicine has kept her alive till today.

Lets hope for a miracle to happen someday.....

*any similar character might be just coincidental

Maiden call

2009-09-02T06:05:00.001-07:00

Yesterday had my first on call

Was on the 2nd call, meanings covering a ward and ED (Emergency)

As my colleagues got to know that its my "maiden-call" , each of them gave a smirk and wish me good luck.
"I wonder why?"

Only then that my MO told me, usually the first on-call are very "sueh" aka unlucky aka busy.

True to it, it was a busy call

There were afew cases of upper GI bleed, some vague appendicitis, some abscess, a stab wound some idiot coming to take painkillers, and a patient's condition in the ward deteriorating fast. Nurse kept bugging for lines, and drug orders, and blood to take, and documentations to do.

"Ahhhhhhhhhhhhhhhhhhhhh..."

Oh my gosh!! I finish my work at 5am. Slept an hour and went back to work till 6pm today.

Its a bit scary to drive in such state of consciousness . Very very dangerous

Hopes the next one gets better.

I met a orthopedics HO who was on call with me.
She said she was resting since 730pm till morning..@(&@$!!!!

Not fair lor..

Tears and joy

2009-09-02T06:01:00.001-07:00

Hospital can be a happy or a sad place

Depending what is happening, and how it affects you.

Anyway, I think I am institutionalized ...

ED cases

2009-08-23T02:45:00.000-07:00

The other day I tagged along with my MO to ED .
The first one was a elderly lady with a dislodged PEG tube ( percutaneous endoscopic gastrostomy tube).

Reinserted. My first ED experience.

Second time to ED was to attend to a yellow zone patient.
She was shouting and crying with pain. She has IO due to impacted stool.

So how ?

The MO told me and Izan , my fellow HO to digitally evacuate the stool.

Meaning ?

Korek tahi with my finger,

I was like : hah ??
Then he said : I do this routinely during my HO days.

So I put on gloves. 3 layers!

Put my poor finger in. Korek korek korek.
Most of it came out. Then there was one very small stubborn one hiding inside. Like playing hide and seek with me . Then I decided to push my finger ALL IN to get it out.

Dont mess with me.

..........now u can start "ewwww-ing"

But the patient was very much relieved of her pain.

So, at least I helped.

what day?

2009-08-20T06:53:00.001-07:00

Today is ...
thurs.

3rd day in my surgical posting.

1st day trying to learn how to use the pc.

2nd day presented a case and scrub for appendicectomy

3rd day went to ED ..

thats all for now.
Need more rest

Ciao..

First working day

2009-08-17T06:55:00.000-07:00

Today mostly consist of driving, driving , driving and EPF.

Woke up early , left house at 645am to Shah Alam. Even at this time, there was traffic. Gosh~
Then back to the hospital to report myself and filling of forms. Lots of them.

By the time everything is done in the hospital , its way pass noon. The officer asked us to try our best to get a EPF account and let us have the rest of the day off. :)

Tomorrow the real thing starts .

Once upon a time .

2009-08-16T20:00:00.000-07:00

Dad came to pick me up after induction , I dropped by grandma's.

I told them about my soon-to-be long working hours, grumbled and complained alot about the meager day offs I'll be getting as a houseman.

As grandma heard about my working hours, she said . " oh, poor you . You got to suffer for the next 2 years . " I cant agree more with her.

We left for dinner afterwards

Then , dad told me a story .

Once upon a time , a woman rented a small place by the roadside with her husband to run a small coffee shop business. The husband would start the shop from 4pm and the wife would take over from 1am till morning .

Business was slow at first, just about to cover household expenses.
Because of that, they took another place by the market to run another coffeeshop by the roadside. That means, they basically took shifts for 24 hours.
Business there wasnt that great either because the location wasnt that ideal .

Soon, they stopped their business at the market because the profit was just enough for rental , but continued the earlier one.

Soon, customers increased and the family can afford some spending . But still, they worked very hard. Day and night without rest , for more than 20years , even on Chinese New year.

Then , dad told me.

"The couple is your grandma and grandpa."

"They never grumbled nor complained even in dire state. "

If I could do half of what they did, I'd be the best houseman in the hospital :)

A day with BTN

2009-08-14T08:12:00.000-07:00

Hmm, I am not sure how to put today's experience into words because the contents of today's talk are different from those organized by the Health ministry.

BTN ( Biro Tata Negara ) took over and gave us some insight in various topics

I'll just give a hint.
The topics that were discussed today are :

All sensitive issues in Malaysia

Anyway, it was an experience. Also a good way to channel information in a controlled situation, way better than open talks.

In the afternoon, I took time out to meet up with Amy. Just manage to chat a bit .
I wouldnt say I lack time, it would always be an excuse.
I would say it all comes down to time management :)

There will be a test tomorrow and I'm done with this induction. Gotto report to the hospital next Monday. Wish me luck.

If I dont write anything , it might be a good sign. It means that I am occupying myself with work or sleep, and not wandering around in the ward. :)

Graduation luncheon pic

2009-08-13T10:26:00.000-07:00

The event was a week ago.

Here are some of the limited pictures that I have.

with grandma.

I am not trying to act sombong(arrogant) here, but I was quite occupied. I have to remove the whole robe and attend to other stuffs immediately after the short photosession.

With director of russian cultural and science centre. This was a funny moment actually. He presented me the photobook as part of the graduation committee , and then we changed places , me pulak gave him the same book as a souvenir. Hehe

Efficient right?

Induction Day 1,2,3,4

2009-08-13T04:13:00.000-07:00

I'll compile all the 4 days into a short post.

Basically, the induction is to prepare a new HO into government service

First day (on the day of registration) was about the organization inside health ministry.

On the following days were talks on career progress, integrity, drugs prescription , dress code, professional code and related topics.

The government really treats us well. They feed us up to 6 times a day, give us comfortable chairs in a well functioning aircon ballroom. That really promotes a "healthy" waistline. :p

There were some talks which were more serious, touching issues of national interest , like this one on "secret documents" .

I like this speaker's opening speech most. It reads , " Rahsiakanlah rahsia kita" , meaning keep our secrets safe.
But we "small fishes" in this big ocean of civil servants wouldnt be given such enormous task. But nevertheless, we still have a responsibility to keep our patients information confidential .
Thats the aim of the talk I guess.

Thats all for now.

Going out for a crab meal with friends.

Being inducted

2009-08-11T10:03:00.001-07:00

My letter came on the day I least expected.

The date for my induction was even more shocking, it was on a day before the graduation that I am organizing.

But then , they changed it to the following Monday, and so I attended it .

We had it in a hotel in KL, a 5 days course which used to be 3 weeks previously. Thats why , the schedule was quite pack, from 8am to 11pm everyday. Well, since my pay starts the day I report for the induction and I get to stay in a hotel. So, I guess its not too bad.

First few days was mainly about introducing to us the organization of health ministry and much was put onto emphasizing that we are part of the family.

Then some talk about finance, human resource in health ministry and a speaker from anti corruption bureau. It can be interesting and boring at the same time, depends which topic attracts you most.

Well, since I am sitting for 15 hours a day on my posterior and eating 6 meals a day, I am expecting some gain in weight. I shall take it as my storage for future housemanship usage. LOL