Life we didn't know.....

It's 7am,a saturday morning.You wake up listening to the sounds of the ambulance outside your window.You ask yourself everyday why do i have to live in the hospital,of course ur voice tells you back,where else do you expect to stay,your not in the city your in some rural district in sarawak.You have no LIFE.

Eveything revolves around the hospital.Yesterday was friday a full working day plus you were doing passive call(standby for any emergencies,escorting unstable patients/intubated patients to the nearest referral hospital - sometimes upto8hours journey by whatever transport you can think off ambulance/boat/helicopter).

Even after escorting you come back to see a full outpatient clinic( 150patients all eyes staring at you ).You look at them in you head you cursing them,why must you come today/this week.But they don't know you only have 2doctors running the whole hospital,doing back to back calls because another MO is on leave/on course.Then u think again WHY ME,why was i sent here,to this place,why cant they give us more doctors,how do they expect us to manage.

Even before you can think or pity yourself,you hear the dreaded phone ring.SHIT i havent even brushed my teeth.It's your MA,"Boss ada RTA case",u say u'l be there soon,then in your head you start cursing again(why must there be holidays,why must they drink and drive,why cant they leave me alone).

Oh and by the way today i'm doing my active call(Need to see all the new cases,handle all the ward problems,do the dreaded c-section,refer the cases to the referral hospital's)basically the person incharge of the whole hospital.

You attend the case,send the patient off to the referral hospital for a CT-brain.Attend to a few more cases in the emergency.It's 8am you Go to the wards,finish ward rounds,dischage as many patients as you can,refer the cases.

At 11am you come back to your quarters,have a quick shower,eat as fast as u can,try and do some laundry.

1pm - Before you know it they're calling again,thank GOD i'v eaten,this time a 3year old with asthma and what looks like influenza like illness,you tell the parents you want to admit the child but they say NO,it's the holidays,after explaining/re-explaining(although on your head u just want to hit some sense into them)they finally agreee.Phew.....

You go home to try and get a short nap,because there's nothing much else you can do,ur constantly in fear of that stupid PHONE call,praying that there wont be more cases.

Just as ur about to dream of that house by the beach,your dream job taking care of an island like Ben Southall the phone rings."New case boss- Maternity".You think to yourself havent i been praying hard enough,maternity cases are the hardest,it may seem relatively easy but if something goes wrong it goes wrong badly,worst part is there's 2 lives in your hand.So once again you go,scan the mother,so far ok baby's not too big,her OS is only 2cm dilated.

Of course in the emergency there were a few more cases waiting.
By the time u get back it's 7pm - another quick dinner,quick bath,surf the net.Attempt to rest.Ringggggggggggggg,that damn phone again,by now your just too tired,your body is aching,u have a headache.Your nurse says it's the mother earlier,the delivery is not going smoothly.Immediately ur adrenaline is back,you tell them to call the poor passive call MO to standby and get ready for c-section.

After assesing yourself,consulting with the specialist via phone you proceed with the c-section in fear again.Your passive call MO looks exhausted,u feel guilty but then again tomorrow that might be you.Thank god everything goes on smoothly.Both baby and mother are good.

It's already 2am,now your literally crawling back to your quarters,fatigue just wearing you out.This is already my 4th every other day active call,i still have 3 more to go,how am i going to do this.Even the money is not enough to tempt me,i just need my rest.....Praying the phone doesnt ring....still thinking where am i heading to....Thinking the whole cycle will repeat tomorrow...zzzzzzz



#This post is dedicated to those in the district's,it's not even axaggerating,i havent even done district posting but this is what my freinds go through,this is through the eyes and ears of an observer,it's very real.It's not easy when there's no one to watch over your back and very scary.There is no such thing as social life,quality of life,your so overworked you start thinking is all this even worth it anymore,is this why i became a doctor,it's very sad but true.Hopefully with more doctors coming out the maldistribution will even out especially in Sabah and Sarawak,otherwise it's going to be the same all over again#

2 years later....

Can't believe it's almost the end of my housemanship,ermm yeah it seems fast,but towards the end it felt a little too long,i truly enjoyed my housemanship in sibu and i learnt a whole lot in every single posting.But no matter how many houseman's there are it's still not easy being a houseman,coz ur still at the bottom most.

I just thank god whatever horror strories i'v heard about housemanship before starting most of it didnt come through.It's a difficult process no doubt but if ur willing to learn and be humble,u can go a long way

Here's a recap

1st posting paediatrics

Learnt a whole lot,worked very hard,fell in love with the kids,and laid the path to my future.

2nd Surgery

Somehow worked even harder,did the compulsory 5 appendicectomy,hated running the ward all alone,but somehow survived,all of us worked very hard together,not many complains.Managed to go on my first medivac experience.Went for a crazy day trip to a nearby district





In Mukah

3rd O&G

I hated the 10tagging days,kept telling myself i'm not made for this,the calls,oh gosh was one of the worst.Eventually got through as well.The feeling after my first c-section,was fear,adrenaline,happy(thank god the baby got out).

4th Ortho

The best posting ever,great specialist,wonderful mo's,we all worked very hard and played hard,all the lunches,long surgeries(the feeling of drilling screws into bones is something everyone should experience for themselves).





5th A&E

Working 7hour shifts was no piece of cake,especially in the green zone and on weekends,but was there with all my close friends,so we really had a blast.Worked hard,went a bit crazy exploring sarawak.







Finally ended with medical

Learn lots and lots,and still so much i needed to learn,a real good posting,tiring at times but was a good 4 months.

Finally done with housemanship where we had no worries,someone there to always look over your shoulder,hmmm once you get too comfortable it's time to move on,i guess it's finally that time.So hoping things will get better,we'l see:)

2010

2010 is proving to be a pretty good year so far,i guess it's with my resolve that i should keep whatever happened in 2009 behind and start living my life,i'm so happy i'm slowly able to let things go,and start focusing on other things in life.I can't believe i'l be 30 in another 2years,where did all the time go,i guess what people say is true,time never waits for us.


But whatever said February is coming to an end,and if no one else is proud of me,i'm proud of myself and what i'v achieved so far in 2010



1.Started blogging:)

2.Went home for a weekend in january after escorting a patient to KL

3.Got my JPA loan converted to a scholarship(even if it's a 10year bond,it's still a financial relieve not to have to pay the loan back)more money for travelling

4.Paid for MRCPCH exams in May,trying to study as much,although not much

5.Will be finishing housemanship in 3months.


I think it's not too bad considering the year has just started,i'm just glad i was strong enough to face things and life didnt turn the other way.Well i'v learnt a lot over the 2years,guess i'v grown up a little as well.hopefully it'l sustain for the next few years and months.Guess being single again is really not that bad at all.

Hopefully in the process i dont forget why i wanted to be a doctor and persevere as much.good luck to me:)

An old man

Currently into my third week of my medical posting.I'm absolutely loving it,i guess if i didnt like paediatrics so much i would have actually done medical.It's really busy,but there's so many new things to learn,so stimulating.


Well just wanted to share a funny,sad case.

This old man,73yr old,from an interior of Kapit,was admitted to sibu to rule out a hemolytic blood disorder,as they couldnt transfuse him while in Kapit,his blood kept on getting hemolysed(self destructing).his hemoglobin(part of the red blood cell) was very low.


So when asking him about his social history,he said their really poor,only has one daughter who's unmarried,whom also is a farmer,wife also quite ill.His diet history is so poor,can only afford to eat rice with vegetables,they cant afford fish and meat.


During rounds my specialist was talking about probably need to send out some investigations to the private lab,because they cant do it in the hospital.But we all knew he couldnt afford that.So just for completiton sake my mo asked if he could pay about RM 60-70,we were quite surprised when he said smillingly "oleh"(can).


So he started looking into his bag,we thought he was realling hunting for money.but he pulled out this card folder,it was gold,my friend beside me said,"Wah is that a GOLD card",haha we both laughed....



Unfortunately it wasnt,it was an ex-army card,this old man thought that the card would also pay for the tests,bacause with it he doesnt need to pay the hospital bills.



Somehow that moment really tugged my heart,i mean in the first place i never actually thought he would be an ex-soldier,he looks like any normal slightly senile old man.To think he is so poor because he cant even afford a decent meal,would bring tears to anyone with a heart i think.



So many question's crossed my mind at that time,how much compensation does he get each month?how much should he get?Does the country,the government and the people forget them just because they're in the remote interior?Are there many more like him?does he deserve this?


This man probably helped us achieve our independence,but here he is so poor eating only rice with veg.


I'm sure it happens everywhere and everyday,but it's small things like this that jolts me from my comfort zone,thinking there is so much that can be done even in the smallest way.


As for his condition we're still looking for clues,and no matter what we'l find alternatives for him to do the tests.thank god there are still some good people around.


"Empathy is still very much needed in our profession,strive for it"

Escorting a patient to KLGH

I was taking care of this patient who has hemophilia B with a pathological fracture of the femur.We finally decided to send him to KLGH as sibu was lacking the factor 9 concentrate.

So when my mo asked me if i wanted to escort him,i jumped at the oppurtunity,plus i can see my family,even if it was for a day.So everything was done immediately,the social worker referral,the month long discharge summary,as no one bothered to sumarrize earlier.There was a glitch as he didnt have an IC,he said it has been in process for so long and he's yet to get it.So that required extra time to get a letter from the longhouse headman(such things are still common in sarawak)

They had to book a 9seater because he had to be in a strecher,as he isnt able to walk or sit,it also included a flight ticket for his mum and me.It was such a long day,by the time i finished the discharge sumarry was almost 11 at night,plus the ward was really busy.I was actually quite exhausted as i have been tagging(initially when u start a new posting),the only thing to look forward was i get to go home:)

Woke up at 4,got to the hospital by 5.My patient and his mum were ready,both very anxious,as this would be their first flight and the first time going out of sarawak.She even packed her basket of foood,drinks,i couldnt help smilling:)She only speaks iban and she is so afraid of getting lost,and not knowing where to find food.

My patient was relatively cool,he shares the same birthday as me only a year younger,but so many differences between us,i feel humble and thank god for the good life i'v had

The ambulance picked us up,we were actually very early at the airport,flight was at 7.Finally they told us to go in,the ambulance drove us straight into the tarmac,i was thinking how cool,i was actually worried about my immigration clearance and all as the social worker gave me many letters for them here and for the flight back but we didnt even have to go through.

Me and the MA had who escorted even had time to pose for picture's while waiting for clearance to put my patient into the plane





So finally we we're boarded and strapped in.Patient's mum was so scared,she kept on looking for me,she was mumbling to herself,proabaly praying.Once we were on air,she was more settled,put on her socks kept on telling me celap mai(very cold).My patient on the other hand just decided to sleep the whole way.

His mum kept on looking at him,even kept the food for him so he could eat later,so much of love,very heart warming:)


Eventually reached KLIA,and of course the ambulance from KLGH was waiting at the tarmac as well,felt like a real VVIP:)

Along the way my patient and his mum were so chatty.....i overheard the mum saying "Eh such a modern place they still have so many oil palm estates,thought there would only be buildings"

Reached the casualty at KLGH,it was actually my first visit there,although i'v lived in KL/Selangor practically 1/2 my life.Very impressive and so huge,somehow i still felt like a foreigner,haha probably been in Sarawak for too long.The doc's were quite shocked tht i came all the way from sibu,i guess it's not everyday we send a patient across the south china sea over.

Well my patient's mum still looked very worried,so while waiting for the various doctor's to decide where to admit my patient(although everything was clearly written in the referral letter & detail discharge summary) i took her to the most important place in the hospital








-THE CAFETARIA-

haha,even bought her lunch,no one understood her languange,i just hope she won't get lost the next time.Showed her the mini grocery shop.

So after 4hours in the casualty they finally decided on where to send him.So i said my goodbye's and reminded as many people as i could to take of them,bout the immigration,and just to keep an eye.

Finally took the train home,although very tired but extremely happy that i left him in safer hands and i get to see my family of course,even if it was just for a day:)

Who start's studying at 57 ???

Why my dad of course :)


My initial reaction when he told me he was going back to school to do A-Levels after retirement,was "I'm not surprised,if people know my dad they wouldnt either ".He can never stay still or at home,he didnt want to work either, after nearly 30years working in a bank i think he had enough.

He was telling me the first day they went to register for A-Level's,he went with my mum.



The lecturer was like "So mam who would be registering today your daughter or your son "
My mum : "Ehmmm actually it's him,(snickers quietly)pointing to my father"
Lecturer : Eyes wide open but,covers very well "well sure you've come to the
right place,i'm sure we can find a suitable class for him"



So that was the start of my father's back to school campaign , imagine a class full of 17 - 18 year olds.Even the lecturer's called him sir.

So each time i called home he would have another funny interesting story to tell me about

Dad : "You know geet,the other day the lecturer gave us homework,thank god i finished,imagine they actually sent those who didn't out."
(It was so funny to imagine something like that,the person who all my life told me to finish homework,study hard,was worried he hadnt done his ....I just couldnt imagine him standing outside the class)


Well my sister was also studying at that time so he they practically could relate to each other.
There was once he told her
"Mala,going back to school is very different,u all have so many different problems we never had last time(sis rolling eyebrows,finally now u understand)
You know yesterday on of my friends this boy asked me,uncle i dunno la,i'v been going out with this girl for so long but the relationship is not progressing,what should i do.

Haha my sister who usually isnt short for words was positively shocked,what an awkward conversation to have with your father who naturally is a traditionist at heart.

So sis said "emmmm tell him to find another girl:)"
Father "But he's been with her for so long,what about the moral obligation"
(So sister thought oh boy this is going to be a long day)




Well most of the stories continued,i cant remember most of it,but at that time it was really funny.


But whatever said,i am so proud of him for actually going back to school,because not many people at his age would.He has truly been my best inspiration for me,if he can do it so can i,he still jogs,does tai-chi daily,badminton,the list goes on.he was the greatest support to me growing up.thank you daddy,all the best

Earthly wisdom from a houseman who's almost completing the 2 year housemanship

1.JOGGING ( My personal fav,other then being healthy,it clears the mind especially after a hard day with your patient's,their relatives(some 1st yr medical student that conveniently forget she's in a gov hosp,thinks of u as her personal slave)

2.Best time to exercise is when your post call - so that you wont feel guilty sleeping the whole day through

3.EAT - contrary to what we think,we should eat,i don't believe those who say they're so busy they cant find the time,once in awhile i understand,but you really have to find time,nobody saying a 3course meal,but it's better to just grab a bite.So stop being hypocrite - start eating it's good for you

4.Study when you can - There's always not enough time,too tired.But studying is really important.If we just work daily,we're really not improving ourself.The number of doctor's are increasing,the reality is competition is stronger so it's wise to read a bit.

5.Read the news - Please know what's going on around you,do not be a ignaramous

6.Take a break - you will need it

7.When u feel what the hell are u doing,working 36hours,not getting paid enough,not appreciated....just think u helped save a life,it could have been your father,mother,siblings or grandmother( it helped me )


Housemanship isnt as bad as it sounds,not like 10years back....learn as much before we become responsible for all our actions,and there's no MO/Specialist to back you up.