Apr 29, 2018

Chilling Things Wishlist

I'm gonna die here in Paediatrics, I kid you not. The mountainous challenges I discovered that are waiting for me here are quite scary, to be honest. I believe all of these stem from the fact that the posting in Paediatrics is very prone to being extended. Kau buat ini salah, hah, extend 2 bulan! That blood culture is contaminated? EXTEND! Clerking sheet's not completed? EXTEND! Tak approach assessor within the time frame? EXTERMINATE! It's like walking into a minefield blindly not with the blindfold but with your eyes blinded with fork jabbed into your already-blind eyes. So much blind. Much not see. Wow.


Anyway the reason I'm up so early in the morning is because 1) I'm an early riser (when I wanted to) and 2) last night I slept after taking a dump without performing my Isha' afterwards so I was awoken to pray at 5 o'clock in the morning and 3) today is my off day in this first week of my tagging in Paediatrics so I want to spend as much time that I have today waking up and not working. Lewls


So little time and so much things to do, as usual! I intend to just chill my ass off today, eating delicious home-cooked meal (I'm home now - just drove for an hour and half last night after work and arrived home at midnight last night) and planning to get my new pair of raya glasses (kelas kau Safuan ada spek mata raya hahahahoya). Being in the dreaded department with no guarantee of getting any leave makes you wishful for things that you want to do when given the chance of a time to do so, I daresay! There are things that I want to do in my spare time such as:



1. Go travelling abroad

My parents just came from a week++ holiday to Turkey whoahhhhh I am so jealous and happy for them! They brought home so many Turkish delights, baklava, figs and not to mention, souvenirs for all of us. Turkey was and still is one of my dream holiday travels. When I was a student blessed with a year in UK, I was fortunate to be able to travel to three European cities (Prague, Rome, Athens) and enjoyed my time there. I just renewed my passport and I intend to go somewhere abroad end of this year in sha Allah (hopefully by that time I will have finish this hateful Paediatrics!! AMEEENNN)


2. Reading novels


I have rediscovered my interest to read my currently-reading novel A Wrinkle In Time. I really do miss reading books. I have a modest collection of novels in my tablet that I have maintained for quite some years now. I always have this habit of rereading books that I love - it makes sense, doesn't it, with people who have library of books at their home? What else is the function of keeping the books for years if you're only going to read them once and keep them dusted in the bookshelves, serving as the food for the termites? Twice I have blogged about my novel collection over times - here are the links: Iqra' and Revisiting 13 Reasons Why.


3. Binge-watching seasons of TV series

Oh this is one of my favourite pastimes! Unfortunately I have ran out of series to watch except for a few that I'm waiting for the whole season to end first before I watch it all in one go. I used to keep track of my favourite TV series using Trakt.tv website (which is quite good but doesn't really serve any functional purpose, really). These are my current watching list:



These are the series that I LOVED but either it had ended or being cancelled :(



While these are the series that I used to watch in the past but I stopped watching because either they are getting boring and refused to die (as a series), I'm waiting for the next season as they are on hiatus, or I'm not liking where the story is headed LOL







Alright, my ass is getting more and more kematu from sitting typing all this. Gonna need to stretch my legs (to the fridge in the kitchen LOL) and spend my precious one day offday to the max! Happy Sunday people!! 

Apr 13, 2018

Spotify Playlist #4: SURGICAL

This is, perhaps, the shortest playlist of all the department rotation I have been through. I started my fourth posting Surgical with Feel It Still, a catchy song with mischievous Tarantino-vibe tune. I didn't know what to feel about Surgical when I first entered the department - I was a bit apprehensive and was fighting to be alive despite having to go to work with the team I was put in, having to stomach the many imposed stupid rules and not to mention handling the antics of the wards and superiors alike. 
We could fight a war for peace
Ooh woo, I'm a rebel just for kicks, now
Give in to that easy living
Goodbye to my hopes and dreams

On a personal growth, after months of numbing the break-up of my relationship, I began to open up and learning to tolerate listening to crappy stupid love songs. But being tolerant doesn't mean I enjoyed listening to them. For instance - I vividly, viciously, vehemently and venomously hate that Perfect song by Ed Sheeran. That song is rubbing salt to my wounded heart with every syllable that ginger bastard uttered. The very first line,
I found a love for me

is enough to make me cursed out aloud in the car at him before joining up and sing along to the chorus. The version of the song that is in my playlist, though, is the Perfect Symphony where Ed is singing duet with some Italian master singer. I was introduced to this song by my lil sister during our family vacation holiday in Port Dickson and I like it, despite the anger I felt every time this song came up.


Next, the ever feel-good Macklemore graced me with the song These Days by Rudimental to be put in my playlist. The song is gentle and soft to the ears - it's a slow rap song that seemingly innocent at first listening but it's actually a fucking cutthroat song that kills me in my sleep.

Oh, I know it ain't pretty
When two hearts get broke
Yeah, I know it ain't pretty
When two hearts get broke


And when I thought this song couldn't kill me more, here comes the bombshell chorus:
I hope someday
We'll sit down together
And laugh with each other
About these days, these days
All our troubles
We'll lay to rest
And we'll wish we could come back
To these days, these days

There's no fucking way it's gonna happen. Not in any near possibilities nor in any future. I am in the process of healing myself. I want to forgive myself, more than anything, and to this to happen I need to let go of everything. Let me start anew with myself - away from everyone I know and everything I had known to love.


Okay enough with all that depressing matters. What's done is done. 


Lastly, from the same ginger bastard I mentioned earlier I came across the acoustic version of the song Ciao Adios by Anne-Marie. I love it, love it, love it. You'll be surprised how different the tone of the song changed when it is sang in acoustic. Cheating is never the theme of my fucking break-up (sorry I'm getting emotionally unbalanced) and in actuality there's nothing that I can relate to with this song. However, there is this part that really sums me up when I had to deal with all these flash floods of miserable memories (such as this moment):
Ciao adios, I'm done

Apr 6, 2018

Sensational Surgical Stories

Per rectal is the surgical fave like how VE (per vaginal) is for O&G lol


Can't believe I'm near the end of my Surgical posting. I remembered I was feeling restless working in the ward during the first three months. At the beginning, that feeling of having to get accustomed to new environments, new bunch of people, and new stressors at work is something I truly hated. Not all wards are unpleasant - there's one I really like working with because the staffs are a bit better than the other two, but I was really counting days to leave ward work and to start peri work.


For the record, any surgical-based posting is not something to my liking. It's not that I hate it - I just don't prefer it. There's something about surgical that really does not resonate well with me. In the first place, I hate being in the OT (operation theatres) because it's freaking cold and I had to lower myself when assisting the surgeons because I am quite a tall person. It hurts my back and I am not a fan of wearing scrubs and rubber boots. Secondly, I am really bad with anatomy so it goes against everything in Surgical to be poor at identifying which arteries or nerves supply which organs etc. 


But ultimately I am bad with anything and everything huhu. I just know how to do work - just a functional houseman but not really a lighted bulb person. I'm not even a hardworking doctor. I just do my job diligently without causing any issues to my bosses. The keyword here is: be a safe doctor. That's the minimum that you need to achieve.


There is a few cases throughout the four months in Surgical that have an impact on me. I never had the time to properly dissect each event and do a reflection on it, so this time I'm just gonna list them all out and briefly remind myself why each of them is important to remember them by.



1. Confused man yanking his catheter out

A male person with severe head injury after getting into motor vehicle accident - he was not fully conscious, in a lot of pain, and he sensed that a rubber tubing was inserted into his penis (it was a urinary catheter as he couldn't control his own urination) so in such a confused state, he proceeded to remove his hands from the restraints he was on in bed and savagely tried to pull the catheter out. 


Because a catheter is designed to have a balloon at its tip that can be pumped in the bladder once inserted (so that the tube won't come sliding out on its own), it can't be removed by pulling it out without deflating the balloon first. So that person tried yanking it out. The tube was stretched and stretched and when he couldn't get it out, he let go of it. Yep, it retracted back like any rubber does - straight into his penis and abdomen. He grimaced in pain and I couldn't do anything. Blood started to come out from his penis because of the self-inflicted injury and I was left with my mouth open, wordlessly gaping as I silently cursed in bewilderment.


I was at that time, holding his other hand and body from falling out of the bed. It happened so fast and that's the best I could do. It taught me that with people having severe injury to the head (and brain), they must have a lot of extra safety precautions. I have to anticipate the things that may go wrong and to be alert with the changes. It happened during the first week of entering Surgical so it really did nothing to improve Surgical's first impression to me.


2. Four foreigners being shishkebab-ed with parang

I was working in ward when my leader asked me to become a runner for a multiple MTP (massive transfusion protocol) cases in ED. Without missing a beat I agreed (anything to get away from the ward) and I started running to ED. Long story short, four foreigners were assaulted with parangs. All of them sustained bad penetrating injury with lots of blood loss, so MTP was activated to all of them. Runners (there's four of us) are tasked with the job of getting all the blood products from the blood bank as quickly as possible. In this case the transfusion is required direly to replace the blood loss. It was very tiring. I think I lost some kilos from running up and down the stairs many times that day.


I am making a mental note to never, never, ever set foot in Klang again once I'm finished with my housemanship. There is so many weird cases that I am certain won't be happening in more peaceful area.


3. Man choked on fishbone

A young man was choking on a fishbone during meals at a wedding. It was a big one based from the drawing he made. Apparently following that he took a page straight out the old midwives' tale - he pushed more rice down his throat in an attempt to relieve the choking. It didn't work, obviously. He vomited blood the next day and was admitted for an upper tract scope assessment (OGDS).


After the morning rounds in the ward we all started to do the morning tasks. For that patient, we had to get his consent to do the scope. As I was available at that time, sure, let me do it so I can tick him off the ward job list of the day. I was busy filling up the form at the cardiac table in front of his bed so that all the patient needed to do is to sign the front and the back page of the form when a student nurse interrupted me to inform that the patient is vomiting blood.


I already know the patient's case. So I said to her that it is expected to happen. It was a small amount, we are planning to do scope anyway, bla bla bla. I was a bit crossed for being interrupted. I just wanted to finish my work fast so I can move on with another patient after that. Then the patient vomited again. And again. AND AGAIN. He was holding the yellow plastic bag to contain the vomit but the blood he vomited was wayyyy to much. I was still holding the stupid pen and paper form in my hands, watching him as he bled all over the bed and onto the floor (and my pants and shoes too).


I quickly said to her, go get help. Now. I straight away called my colleagues as well and we attended the patient. He was in a dazed and not responding to our calls - a sign of shock due to blood loss. My internal bell is ringing with frantic alarms. The patient was pushed to acute cubicle, we ordered first stage blood for transfusion straightaway and patient was pushed for emergency scope. I was so caught up with wanting to finish my work I had neglected the thing that mattered most - the patient. Sufficed to say this is the biggest lesson I learn throughout this posting. After the incident I tried to stop any work I was doing when I need to attend to patients. I also avoided from eating fish for weeks afterwards. Seram mak.



4. Elderly lady with low blood pressure.

I kinda make it up when I met this elderly nenek who were admitted because of surgical site infection. Her thick abdominal skin was infected and was removed, leaving muscles exposed. One day when I was reviewing her in the morning, again one of the student nurses informed me that she had a low blood pressure. I asked her to repeat the measurement and the reading remained low.


This time I properly took my time and examined her thoroughly. She indeed had low blood pressure, and together with such a big wound across the belly, I suspected that she was in shock due to blood loss. Her gauze packing under the vacuum dressing appeared to be soaked, so I thought there must be some active bleeding happening. After ordering for a pint of run-fast crystallloid resuscitation, putting her on high flow mask oxygen, ECG and cardiac monitoring, I straightaway called my MO to inform him.


I felt good when thinking back of my plan at the time when I saw the patient. I was able to think calmly and did the right thing. My MO didn't correct any of my continuation of the plan - we both agreed to it and worked on doing them all. But after that he forbade me from touching any high-risk patient because he said if I started touching the patients sure more issues will come out of it afterwards HAHAH. The sad news was unfortunately weeks later I was informed that the patient passed away eventually. I was a bit saddened because she was such a softie and I tried my best to comfort her when she was in pain. Inalillah.



5. MO getting into a motor vehicle accident.

One of our MOs was involved in an accident and was admitted here. Long story cut short: this incident had prompted me to have a Takaful. I have a friend who is a Takaful agent and after a very short consideration, I took a Takaful with a few adjustments made that I think will benefit me the best. Takde kuasa aku nak kena admit kat hospital gomen, lagi-lagi kat tempat kerja aku ni. Kalau betul terdesak for operation, maybe yes, but afterwards nak mintak transfer balik ke private for better nursing care. Hey, that's my two cents anyway.

_________________________________________


There's only a week or more left for me in Surgical. I just need to complete my logbook, present my slides on next Friday, planning on what to do during my four-day EOP leave before return to the vicious cycle of hellhole tagging in the worst department of all - Paediatrics! NIGHTMARE OKAY. I AM SO NOT READY. KILL MEH

Mar 13, 2018

Tranquility


There is a quietness in the soul that softens the beats of the heart to bring it near purring stillness. The breath of the air becomes tangible - it runs silky cool all over the body as it washes the very sweat that usually linger with the heat. Time does not slow down as contrary to the popular beliefs. It merely became less important, the mechanics of its passing now turned to abstract, carelessly measured in relativity and its insignificance.


It is a satisfaction that is indescribable and very much unlike other pleasures ever perceived in this Godly earth. I craved for this peace very much more so than the aches that I bear. Or maybe it's the other way around - there must be a dressing for every wound cleaned. The worse it gets, the greater the need for that peace. The dark hollow penetrates even deeper, clawing and gnawing at the roots, slowly loosening the foundation I called desire to love as it sends bitter dirt and blackened soil around.


But it's more than just a peace to get rid of the misery. I had tasted the soothing moment of tranquility. It was instantaneous, fleeting, and gone without the company of time. It was like a gulp from a sip of icy water drank in the mindless strike of heat storm. Thirstily, rabidly, to the point of near insanity - I drank the elusive elixir as much as I could and when it left me, the loss nearly tore my heart into pieces.


I have the map that leads to it, though. The blueprint on constructing palace of peace and the compass that can guide me as I sail across the starry-filled seas. It's not even riddled with puzzles or blinded by intricacies. But the path to tranquility, the journey that it will cost me will take a lot of time and decisions. It might not even come to fruition. But it is alive at the moment, glowing best with possibilities in deep slumber of my dreams and hovering just so, unsinkable still even when caught in the waking moment of tumultuous roaring reality.


I finally know how I am going to spend my life. It will not be glorious, merry, or known to anyone. It will not be shared. It will not be influenced by anyone or anything else. It is not even static. The final end is fixed yet I will make the paths connected from checkpoint to checkpoint of my life to be springy and unbroken. I will wield this spear staff of mine, this way of life that I have chosen, privately and with utmost care. I will protect the happiness I rightly deserved after so long with every ounce of my strength, the tip of the point sharpened and the handle polished.


In the process I will hurt myself. There will be moments of weakness and doubt seeping in. Every weapon can turn towards its master. I might have crisis in the years to come about my decisions now. But in the end, every life will end and so will mine. What miserable short years I think I only have I wish it to be filled with my efforts to search for my own tranquility. For the sake of my life and for my soul in the afterlife. This might be the last time I talk about love and the pain I caused and received, but in the end, we are all just beggars in the world. May Allah blessed this path of mine.


Amin.

Mar 5, 2018

Jonah

The first time I've heard of this term when I was in final year of medical school. I naturally didn't understand much about it because it's hard to understand things if you're not part of it. Siapalah aku kan time tu, just a medical student yang blur blur dan tak paham apa-apa. But in essence, I roughly deduced it means someone who when at work will attract incidents that will make their work shift eventful.


Kata-kata orang yang bangga dengan dirinya yang jonah

The term jonah is a slang word used exclusively among healthcare professionals in Malaysia and is very popular among housemen and staff nurses. Medical officers used the term less, and it is almost unheard of among specialists to utter the word in conversations. It is often used to tease colleagues who often appear to have very eventful work shifts when compared to other colleagues. We usually tease them in light-hearted manners, although I've once witnessed a staff nurse throwing a bitchy temper when she learned a 'jonah' MO is oncall during her shift.


As a Muslim we believe in qada and qadar (takdir dan ketentuan) and accept that no such thing exists - no person is unlucky and to truly believe in jonah is a thing of khurafat. To just tease each other with it is fine. No harm done.


In a working environment where there is no consistency in the form of work load, I find that it is peculiar that such a word is coined to describe people who bring 'troubles' to work. If you work in the ward, yes, there are jobs that are a constant - a work routine that we do and follow as standard operating of procedure (SOP). For a houseman, that would be to do morning reviews, trace the blood investigations / formal imaging reports / formal lab reports, follow ward rounds, and performing the tasks ordered by the MOs or specialists. That much is expected.


What is also expected is that no two patients will present identical workload to the doctors / staff nurses. Similarly there is no two days that are identical. We expect that the number of new admissions to the ward differ from day to day and that different patients can collapse or deteriorating at any time. There is simply no consistency in that. We cannot say that a day which has 12 admissions and two patients desaturated of oxygen as a 'troubled' day because no matter how bad any day is, it is all within expectations when working in a hospital. Dey, kalau kau tengah attend CME hospital then tetiba ada orang collapsed kena heart attack itu baru eventful, macha.


Nevertheless, it is a culture I enjoyed to be a part of at work. More than once I have been labeled as jonah (even though I think some people had it worse than me). I used to hate it very much being a jonah when I was in Medical because working night shift in Medical means you will be busy working clerking a handful of new admissions and taking patients' blood for the whole ward. Granted, during my time I always have a colleague working with me and we don't have to rely on the runner for blood taking, but I absolutely loathed it when other things happened like relatives wanting to speak to the specialist to make complaints, patients making a scene or developing blood transfusion reaction at midnight (hence it is imperative to not transfuse blood after 6 pm unless it is absolutely necessary!).


I don't mind if things like patient developing a temperature or a low blood pressure or even an active patient (as opposed to a DIL) collapsed and needing CPR - it is within my responsibilities. But to handle things that are time-consuming and irritating in nature? Things like wrestling with a severe head injury patient to prevent him from yanking out his urinary catheter and failed, then watching in horror as blood dripping out from his penis due to the injury he himself inflicted, or trying to calm a patient down as he angrily shouted at us wanting to sign an AOR (At Own Risk) discharge form (which then my specialist said go and refer him to psychiatrist for delirium at freaking 9pm WHICH IS NOT THE CASE! HE JUST WANTS TO GO HOME, and which we did discharged him close to midnight eventually after calling the patient's whole family for a psychiatry evaluation and conference), or attending a staff nurse who had an ankle fracture after she slipped on the floor in the ward (yes, I even pushed her on the wheelchair to do the X-rays at 11pm, gosh that was funny and annoying at the same time) next to a patient's bed who late at night we heard a loud bang as the patient also fall to the floor as he tried to get up from his bed (and failed). LOL thus an incident reporting was issued.


That is what I personally think what a jonah is about. Sometimes all I could do is to gape open-mouthly at the absurdities of what is happening in the ward. Other times I would find myself grasping at my hair and screamed silently in consternation - being jonah is absolutely a true exasperating moment you have to experience it yourself. You will come to be proud of yourself at the end of your work shift - either because it finally ends or you managed to emerged unscathed with no harm to patients done - and calmly accept the fact that yes, despite dah mandi segala air mandian bunga, avoiding all red undies and clothes, dah sembahyang cukup-cukup siap tambah solat hajat tolak bala - you are indeed a jonah.

Mar 4, 2018

DeLonghi



I went to IOI Putrajaya to look for a coffee machine. I've decided that I need to have one after my sister showed to me her French press coffee maker. I had no idea how coffee machine works but I had a rough idea on how it should serve my caffeine needs.


Between HomePro and Harvey Norman, I chose HN in view of them having a coffee promoter who really knows his stuff and can demonstrate on how to operate the machines. I was introduced to the world of espresso coffee machines, coffee grinders, the differences between espresso and latte, and also various technique to brew your own coffee.


Everything that I have come to love, and subsequently that prompted me to embark on the quest to become a barista of some sort, began on this day when I decided to purchase a DeLonghi Dedica EC685 M espresso coffee machine.