aku hanya manusia

being a doctor in this era is a great challenge.
we have such a big competitor --> Mr. Google Who Knows It All had been a reference for everyone.
it is OK if my patients learn about family planning from Mr Who Knows It All.
sometimes i asked them, have you ever heard of family planning?.... or have you ever heard of eclampsia?
you will be amazed on how people never heard of family planning or how much they had learn via Google.
OK, that is awesome, actually.
but when they start to diagnose themselves with a weird diagnosis that didn't even exist in Malaysia, or when they prefer to meet bomoh instead of me, i am hurt.

hello, what is the use for me to study for five years and then learn from my specialist if all of you can easily be ME?

there is one girl who proudly claims that she knows more than doctors by just referring to the Internet.

KAU KALAU BELAJAR AGAMA DARI BUKU ATAU INTERNET TANPA BELAJAR DARI KELAS AGAMA, BOLEH SESAT TAK???

aku pun boleh je belajar macam mana nak pasang almari atau pasang lampu dari internet. tapi tak bermakna aku 'expert' dalam bidang tu. 

nak cakap tu fikir dulu boleh tak? kan aku dah marah ni... *cekak pinggang*

i hate stupid arrogant people. orang bodoh sombong memang menyakitkan hati.

ada satu insiden lain, dimana seorang ibu mengandung yang menghidap preeklampsia cakap dengan aku 'dokter, saya dah sihat. saya nak balik' dengan muka menyampah dan pandang ke arah berlawanan dengan aku. aku membelek 'observation chart' yang penuh dengan tulisan merah yang menandakan tekanan darah masih tinggi dan belum stabil
wanita bertudung labuh itu berkeras mahu pulang walaupun pelbagai nasihat aku berikan kepada beliau. tapi dia masih berkeras dan tak sudi pandang muka aku langsung.
HOW RUDE!!!
"encik, kalau bawa isteri encik balik, isteri encik ada risiko kena sawan yang boleh membahayakan nyawa. tekanan darah tinggi dan ada protein dalam urine berisiko untuk dapat sawan semasa mengandung. ada orang boleh meninggal disebabkan sawan tu" kataku kepada suami pesakit.
lelaki berjubah dan berserban itu marah kepadaku "Dokter, kuasa hidup mati bukan di tangan dokter. itu semua ketentuan ALLAH"
"saya bukan nak cakap saya ni TUHAN tapi, saya cakap isteri encik sekarang ni belum sihat sepenuhnya. tekanan darah masih tinggi. ada risiko boleh dapat sawan yang boleh menyebabkan kematian" tegasku. 
akhirnya, sebab dia nak jugak balik, pakar bagi dia AOR discharge (balik atas risiko sendiri/ at own risk)
"kalau dia tak sayang nyawa dia dan nyawa baby yang dia kandung, kenapa kita kena kisah?" kata pakar kepadaku..
"tapi semua nyawa pesakit penting, boss. takkan kita nak bagi dia balik walaupun kita tahu dia boleh dapat eklampsia bila2 je" balasku..
"kat hospital pun diaorg boleh dapat eklampsia atau baby tu boleh IUD (Intrauterine death). kita tak boleh paksa pesakit" jawab pakar.

masih banyak yang perlu aku belajar. 
masih banyak kesabaran yang perlu aku pupuk.

if i care too much, i will be hurt too.
but if i don't care, pity all of my patients.

but i am just a HUMAN.
kita hanya mampu berusaha, selebihnya terserah kepada ALLAH.

the tale of a tiger who wish to repent

Hye. it had been almost six months I left my blog untouched. 
work had been hectic and tiring. not just physically, but mentally as well.

you see, when you are a house officer, you just do what you are told to do.
but as a responsible medical officer in a surgical department, you need to:
1. re-clerk a patient's history
2. examine patient
3. think of a plan before patient is seen by a surgeon
4. guess whether a patient need a surgery or not (decision of operation can only be made by a surgeon, but you need to know what type of pt that need to be operated now, urgently, emergency or elective, or even may not need operation at all.
5. prepare patient for procedures or operation (ensure blood is taken, imaging etc)
6. do procedures (chest tube, pleural tapping, peritoneal tapping, central line insertions, intubating, cystofix, change ETT, .........)
7. teach houseman (sometimes u even had to teach them the most basic thing, but first posters sometimes had to be taught from A to Z).
8. when a patient collapse, you had to act as a team leader and conduct the resuscitation.
9. see patient in clinic and discuss with  either surgeon, radiologist or even pathologist regarding your patient (today one radiologist asked me to sit next to her and I am amazed of how humble she was when we discuss about a patient. she definitely had changed my previous perception of her!)
10. assist specialist operating. when I was a houseman I don't have any idea what my specialist is doing. Now I need to know the steps, the anatomy, instruments, close wounds and write the operation findings and steps. can I just go back into being a HO and just retract the wound, please?
11. refer cases. some people may scold you when you refer a case, but i hold on to what my boss said "some people may scold u but at least you do what your specialist asked you to do or what you think can help the patient" and "if you did not know how to manage, just refer!"

and many more...

truthfully, I still need to learn a lot.
sometimes i feel inadequate when i can't make a decision like my boss did. 
but then again, they are a specialist with lots of experience. 
their amazing skills makes me inferior.
and though I did not want to be a surgeon, i did feel comfortable in this department.
though my boss keep on asking me why I did not want to be a surgeon, and my answer is always the same "it is too difficult and the scope are too wide, la boss. I don't think I can be a surgeon"

Honestly, I am not a good doctor.
I pray every single morning that I won't scold houseman so much. 
I used to hate MO who are so damn impatient and always raise their voices. 
but it seems that I am becoming one of them too *sigh*
I even tear up a piece of paper and criticize my housemans. 
once, one houseman walk slowly in front of me like I am a tiger and I said to him "I know that I am so scary but I didn't eat human, OK?". then both of us laugh but he laugh so cowardly and said that I am indeed a scary MO.
oh my. what had I become?

my boss said that we were trained that way, and it is not our fault  to be like that.
I keep on telling myself that if I did not scold my HO they will not learn and thus will do a bad thing to our patients. but not all of them are bad, ok? some are reliable and may even tell me if I am wrong.

I may not be a good teacher. I may yell, scold and condemn HO. I know that I was once a HO too so I definitely know how they feel when they were scolded.

so to all housemans out there, forgive me for being impatient. forgive me for shouting at you in front of patients. forgive me for being so damn agitated.

we work for the sake of our patient. so let's strive to do more, okay?

p.s. I am leaving surgical department soon. finally I am free from my one year bond (which is exactly one year and 4months). Yay ! \(^o^)/

Hopefully I can pursue my dream at a new place and new environment. I am looking forward to a less stressful place so that I can be a better person and more skilled in my favorite department (which is definitely not surgical. I wonder how can someone be a surgeon. so many anatomies. so many regions. so many skills. wow. definitely not for me)

you can see that I have lot's of respect to surgeons, eyh?
yup, salute to surgeons. their work are simply amazing.

One day a patient was screaming, rolling on bed, that she even need a PCA fentanyl. The next day after a successful operation, she smiled happily and even request to go home!

A near death bleeding patient survived after a lengthy operation.

A patient who had underwent 4 major operations and was in ICU for many months, makes me shocked when he speaks and he can even walk home. (even  the GA MOs were shocked when I told them about the patient's progress!)

My uncle who was intubated due to respiratory distress, noted had a perforated diverticulum, operated, complicated with a wound breakdown, suffered a stroke as a post operation complication, is now working again and able to support his family.

Lots of cancer patients live like normal person after operation and chemotherapy.

A patient with sepsis so bad and she was so weak that we had inform D.I.L (death in line) to her family, is now pulling my bag when I was examining the patient next to her and showing me her black teeth and blabbing happily  (she is a psychiatric patient).

Those are only some of amazing things I have seen personally in this department.
Luckily, no  one who we said might be dying but somehow had survived, did not sue us.
ahaks.

I love my job. as crazy hectic depressing tiring as it is, this is my job, and I enjoy doing what I did =) 

HANYA Doktor Wanita di WAD&BILIK BERSALIN? Mampukah kita?

Tadi saya membaca link ini https://www.facebook.com/laborroom sebab rasa ingin tahu yang meluap- luap setelah membaca komen kawan sekerja. Tapi malangnya, saya tidak mampu untuk membaca semua komen- komen di situ. Bagi saya, semua orang saling menghentam dan tidak berfikiran terbuka.

Marilah kita semua berbincang mengenai hal ini baik- baik. Duduk semeja, menghadap masing- masing dan tidak meninggikan suara. Boleh tak?

1. Pada pandangan saya, wanita- wanita yang memohon aurat dijaga di kamar bersalin itu adalah mustahil. Sebab wanita dengan wanita pun ada auratnya kan? Jadi kalau nak jaga aurat, boleh tak kami ajar suami puan- puan dan suruh dia yang lahirkan anak kalian?

2. Kenapa aurat di kamar pembedahan tidak dipertikaikan? Tapi kalau aurat di kamar bedah dipertikaikan, macam mana nak memastikan 'sterility' dan kebersihan?

3. Apalah agaknya nasib pakar O&G lelaki kalau anda hanya mahukan perempuan. Penat2 belajar jadi pakar, akhirnya di'reject' di negara yang katanyya kekurangan pakar. Haish. Kesian.

4. Saya bekerja di bahagian pembedahan dan pesakit saya banyak lelaki. Kadang- kadang, saya juga terpaksa memeriksa alat sulit lelaki. Adakah setelah ini saya akan di'ban' dari wad lelaki?

5. Saya pasti kebanyakan dokter adalah profesional. Kami tidak pernah berbincang mengenai aurat pesakit. Trust me, we are so busy with our work to gossip about your 'aurat'.

6. Kalau dokter lelaki tidak diberi peluang untuk belajar, macam mana kalau nanti di 'district' yang kadang- kadang hanya ada dokter lelaki sahaja? Padahal 'aim' kita adalah untuk mengurangkan 'maternal death?'. Kalau 'emergency' macam mana? Nak tunggu dokter perempuan datang baru nak bersalin?

7. Tolong jangan memaksa kami bekerja lebih dari dokter lelaki. Contohnya dalam senario di klinik payudara minggu lepas:

Suatu hari, hanya ada dua dokter wanita dan enam dokter lelaki. Ramai pesakit meminta dokter wanita untuk memeriksa mereka.
Apabila melihat kawan saya yang lelaki menyanyi sambil goyang kaki, saya jadi 'stress' sebab pesakit masih ada tetapi hanya mahukan dokter wanita sahaja.
Hal ini membuatkan sahabat saya yang perempuan yang 'postcall', tidak tidur dari semalam menjadi bertambah 'stress'.  "Kan boleh staff nurse perempuan 'chaperone!" ujarnya.
Akhirnya sahabat saya memberi cadangan agar dokter lelaki tersebut berjumpa pesakit tersebut tetapi dokter perempuan yang memeriksanya.
Bunyi macam mudah. Tetapi untuk memeriksa pesakit kami juga perlu mengetahui 'findings' dan pemeriksaan sebelumnya. Kerja dua kali ini membuat klinik berjalan agak lambat.
Jadi, tolong jangan bising kalau terpaksa menunggu lama di klinik kami, ya.

8. Ramai sahabat saya yang telah berumah tangga stress kerana kurang masa bersama keluarga. Menurut pandangan saya, permintaan anda hanya akan menambah beban kerja dokter wanita.

9. Saya bekerja di wad pembedahan wanita. Setiap kali memeriksa pesakit, kami akan menutup tirai dan menyuruh pelawat untuk keluar wad. Jadi, pelawat harus memahami dan menghormati waktu melawat. Tidakkah anda melihat kami berusaha untuk menjaga aurat pesakit?

Setiap orang ada pandangan berbeza. Tetapi anda harus faham kenapa banyak dokter tidak menyokong petition anda.Ramai juga dokter yang marah dan berkata "Kalau nak pilih, pergilah 'private hospital!".
Bukan apa, kebanyakan pesakit sibuk mengatakan tentang hak pengguna dan marah kerana terpaksa menunggu lama. Padahal kadang- kadang saya nak 'lunch' pun tak sempat. Breakfast pun memang dah selalu 'skip'. Nak pergi bilik air pun kena tahan sekejap sebab kesian pesakit menunggu lama.
Tapi pesakit marah- marah kami tanya bila giliran diperiksa.
Tolonglah. Bukannya saya buat kerja sambil lewa.

OK, mungkin hujah yang terakhir dah 'off topic', tapi rasa penat dengar orang asyik 'complaint' dan 'complaint' dan 'complaint'.
Can you put yourself in our shoes for one day? I bet you can't even stand for one hour.