Friday, December 31, 2010

What’s next year?

Good morning the last day of 2010!

I'm excited! I'm excited that 2011 is just in ticks away. Though I never been a New Year Party people, neither have I gone out celebrating any (except last year – due to 2 months of sudden-hectic-life in the hospital), I am however very motivated forward for 2011 and excited about it! Why??

2011 – is where I have wrote long time ago in my long lost diary that "I have to achieve one of my foremost dreams, my wildest, most pathetic childhood dreamto become a doctor"
*blush* yes yes, in this particular year!

So, that's it!

More plans coming on 2012! Stay tuned!!! *winK winK*

Going off to Lawang now! Might be celebrating new year in the ambulance at the Pasar Baru Lawang tonight. Lol!

Monday, December 20, 2010

Thank God we got weekends!

The only time I can remember where I had a total break (after more than a year of bone-breaking-brain-squeezing of work) was the 36-hour in Malaysia, it was a true blessing, I had a blast definitely.

Yesterday was another idyllic time to spend – Surabaya gateway!

Ke Surabaya aja lah yang kita mampu… Apparently because I don't have that much time to travel any further than Surabaya. Second, because I didn't have any big budgets to spend, especially for a weekends break like this. Yet, it's way much better than just being stuck at home and sleeping the whole of weekends, right? After all, Monday awaits… *stress!*

I'm glad that Frente is on her Bangil outstation during the time I am still in Lawang. We planned for a few more outings where we can spend our weekends exploring Jawa Timur better (particularly the nearby attractions). Yesterday wasn't really an exploration of Jawa Timur, but we did something different in Surabaya than what we usually did (selalu pergi utk makan, lepak, shopping2).

Frente got her Lonely Planet Indonesia along, and I got my Google Map to GPS us around the town. DSLR and tripod are included in this what we called 'Surabaya Study Trip'. First stop was at Tugu Pahlawan. Actually we were heading to the China Town where we passed by this place and decided to stop. Managed to learn nothing, just to snap lotsa crazy photos on her DSLR.
Tugu Pahlawan of Surabaya
The China Town was somehow a disappointment. I was expecting a strident hectic market where red lanterns are hanging everywhere and people speaks Mandarin – just like how it is in Petaling Street or China Town in KL. It was much a disappointment after a long attempt to get there, the market is closed, left us only garbage and foul smells. So, the chinese in Surabaya don't stay for night markets I reckon. However, it was a success for us – to get to that middle of nowehere without any local guide but only Google Map. Congratulations Bil and Frente!

Next stop is to the Galaxy Mall for one specific reason – is to get our essential drugs where it is nowhere to be found in Malang. Next stop is… *drumroll* Starbucks! *euphoric mode*
Since it's Christmas season, they've got this minty taste Peppermint Mocha Frap *heart*
Move to Surabaya Town Square @ Sutos for a movie, first we had dinner at the Kafe Betawi. Jakarta food to our yummylicious! Tron in 3D is ok. But since we went for the midnight show, I was kinda sleepy somewhere in the middle of it. It's cool, though I'm not a big fan of sci-fi.

Back to the hotel at almost dawn. The road is clear! Maybe we can roll around on the asphalt for few minutes without being hit by a car! About the hotel that we stayed in, it's Majapahit Hotel – another thing to count in in our 'Surabaya Study Trip'. At the age of over a century, the hotel looks cool still. Something different than staying in business class modern hotel, it's antique, old-fashioned, homey, cozy and well preserved… It is one of the historical places in Surabaya.
Checking in one of the historical places
We're planning to get back to the hotel, majorly for the exoticness feeling of it and therefore we're going back for a spa! Martha Tilaar spa to be exact! One day… I'll blog about it! *loveeee spa!*
Another must-have!
The next morning we woke up, to Frente's dream come to reality. Particularly, she was so much aspired to stay in this hotel especially because the restaurant is uniquely situated facing the main road of Surabaya. Therefore, we opt for the window table during the breakfast. Yay, tercapai cita-cita untuk makan di 'tepi jalan'. And to my latest addict to Sour Sally came true too! We got froyo for three, together with Mbak Ninin whom we planned to meet at Pakuwon, thank you for the treat!!
Spectacular opening act of the circus stars
Another thing we've done during the 'Surabaya Study Trip' was to the circus! Yes, you heard me right – the circus, the acrobats, clowns and well-trained animals! The last time I've been to a circus was around the age of 10. I can vividly remember how spectacular it was at the Royal London Circus that time. Though this time at the Soviet Circus Stars was halved the size of Royal London and halved the excitement, I am still amazed that 80% of the performers were Indonesian. They are really that well trained and even the animals came from the Taman Safari Indonesia! Isn't that a wow?

To add to that, we finally managed to get to the Pakuwon area. Sebab dulu kita pernah nak pergi G-Walk, tiba-tibe tersasar masuk highway, terus balik Malang (dengan perasaan hampa dan perut yang lapar)! Haha!

Perhaps, that's something about it. Though I might not have holiday throughout this 20 months of Dokter Muda life, but I'm glad I have a bestfriend to go around and have fun with!

Friday, December 17, 2010

E.U

What I did yesterday was something beyond the most disgusting thing I've ever did in my entire school years.

For the past year I've had done numerous of unwholesome jobs where most non-medical people might find them nasty enough. Such as rectal touch̩ Рwhere I had to insert my index finger into (mostly) men's anuses to get feel of their prostates, sometimes to get my finger shitted in order to check on patients' feces, vagina touch̩ Рwhere I had to insert both my index and middle fingers into women's vaginas to get feel of (mostly) the presentation of their babies, I've even had my whole hand into a woman womb through her vagina to pull out her placenta and got malodorous blood all over, and I've helped around with the foulest, filthiest gangrene wound. Yet, none is revolting enough to erect these hairs on my hairy skin as what I did yesterday.

As I am now in the Public Health department and operating at the suburbs in the community health center (or what we called 'Puskesmas'), we are supposed to do home visits, school visits and as such. Yesterday was my first school visit. I went only with Dr.Iza the dentist, mainly to do health screening (e.g : hygiene, vision, hearing) on the primary school pupils.
Excited!
Screening is totally a fun yet exhausting work, especially on little rascals. The catch of it is, we are (with our competency) expected to help those in need, such as extorting those loose teeth (this was Dr.Iza's job), and… extracting cerumen a.k.a earwax – and this was obviously my job! OH MY GOD!
The standard one class, with the gorgeous doctor *wink*, their principle and class teacher!
Let me describe it in 2 letters and an exclamation mark – E.U!

Eeewwh~ I seriously felt goosebumps all over me whenever I had to peep inside their ears. Some kids really have bad bad bad nasty earwax obstructing their ear canals. Yellowish, brownish, slimy, some are as hard, small and sandy, some are as big as pebbles, Eeeeuu!!! It really gives the nasty horrid feelings and it kills me slowly inside. I hate this job!!! Sebenarnya, saya geliiiii korek telinga kamu semua! *muka kena control, be professional*
Yang pakai white coat tu tibe2 terasa femes mcm Kim Kardashian sbb menjadi rebutan and request utk bergambar bersama. huuukk*
I couldn't think of anything else that would sicken me better everytime I had to pull out their ooie gooie waxes, but to repeatedly saying to myself

"Oh Allah, please make me strong, please make this nasty job worth for the kids. May they listen better and class and excel in their studies"

*tarik nafas panjang*
(yes it is still nauseating me everytime I had to re-call it)

Dear parents,
If your kids aren't doing well in school, don't blame on them or anyone else, don't need to rush them for extra tuition classes. Well, check what is there in their ears, and if they can see clearly.

For now, with high possibility, I can assure you that I will not (by any circumstances) pursue to become an ENT specialist.

Dear papa,
Thank you for always checking out our ears and pull out our earwaxes (though we might hysterically scream and someone had to help you in holding us still), in order for us to hear clearly and listen better to our teachers (though mama likes to assume us having 'sound trouble' whenever we didn't response to her call). Now I know how horribly disgusting the job is. Nak termuntah tau! Dah hijau2 muka tahan geli… E.U!


Tuesday, December 14, 2010

The cost to breathe

I can't believe that I just fell into the engrossedly-search-for-Magnum craze! Following the much much salivation on Wall's Magnum new advert, the whole Indonesia is on Magnum crave I reckon, consequently, it is nowhere to be found in any of the Wall's box in any shops nationwide! It is the hottest thing that's 'in' now (though it was already in the market for years… hmm, the advert really works!).
Siapa yang buat advertisement Magnum yang mengliurkan tu? That person is to be blame for this search-for-Magnum-craze phenomenon! Btw, this stick goodness cost Rp10,000.
It is so good to get to hangout with Frente after weeks and unloaded this almost exploded laugh box. Catching up with her is like getting an amphetamine injection, we can find everything around us humorous and the moment we realized, all the stress is gone! Yayy!

This evening, she brought me to Coffee Time. She's been planning to show me to this place of an awesome live band performance since months, but considering the pathetic-ness of inconsiderate Indonesian who likes to in-door-smoking, our plans were usually hampered. So today, we went there a little bit early before it gets crowded with inconsiderate smokers, but too bad it was too early that the band hasn't started yet. It's alright, at least we got clean air to dine in, or else I'll be getting my asthma attack due to excess smoke inhalation.
Hazelnut caramel latte at Coffee Time, same price as the Ventolin for nebule.
Talking about asthma, I had a patient who came into the clinic this morning looking so distressingly suffocated, as if he got a rope strangled around his neck. The way he walked, his bend, even without hearing him wheezing, I can certainly see that he's having an asthma attack. As he came in front of me, he could barely talk, so I checked him up and found a full wheezing on all area of his lungs.

Oh pity bapak… from my findings, he's a severe persistent asthma patient. According to him, he has been given different types of medicine but none works so well on his asthma. Checking on his medical record, I think it's time to add in some steroid to go with the bronchodilators. However, I was still concern about his present condition, it must be very hard for him to barely walk home, thus I suggest him for nebulization.

"Kalau pakai uap (nebule) yang lima belas ribu itu langsung enak saya dok, tapi ga apa2 lah, cukup minum obat aja"

Wondering why he refused to be nebulized although he knew that it was the best treatment for him, then I came to a conjecture that he had to pretend that his condition is not severe as he chose to only be treated in the walk-in clinic rather than to be sent to the UGD (Unit Gawat Darurat @ Emergency) because he knew it would cost him much more expensive there.

"Kenapa kok bapak ga mau pake uap?"
I insisted,

"Ga cukup uang dok, cuma sisa lima ribu buat ambil obat…"
he honestly answered me in his shortness of breath.

Damn, this cannot be happening! As an asthmatic I am, I've been on a few events of asthma attack that papa had to rushed me to the clinic in the middle of the night for nebule, therefore I utterly understand how suffering it is to bear breathing in a constricted bronchus – like hell!

I decided to get him nebulized, he has to be nebulized before he walked off this puskesmas. So I got him nebulized… For a considerably price to pay to make him easier to breathe, I hope it did not resembled my sympathy, but just an empathy.

And then again, thinking that a Rp15,000 is such a hefty amount for some people who couldn't even afford to pay for his own breath, I wonder what he is going to have for lunch. I wonder if he ever tried the nasi lalapan bebek penyet at the warung in front of the puskesmas, it cost Rp16,000. Alhamdulillah, I at least got enough money to eat, though I always in short of cash.

Nonetheless, a range of fury creeps through my vein. How can this be happening? How can someone so poor and so sick live in this country where someone else can afford to drive a Porsche, when he is there suffocating because he only have five thousand rupiah in his pocket?! Where did the taxes go? Why can't the government spare some of the taxes to make salbutamol nebulization free of charge? Some poverty don't just literally need to breathe, they indeed really need help to breathe.

It must be super stressful to really be a doctor in this country. Knowing that your patient's life could actually be saved, if only he/she is not that poor. Or shall I rephrase, 'knowing that your patient's life could actually be saved, if only whoever those rich bastards who corrupt the people money is burn directly in every level of the hell, and revert the money to the hospitals and to the poverty'.

Then I again count my blessing, to be born Malaysian, despite of anything they said!

When a person walk to you for a help, be glad. God is answering his prayer, through you.

Monday, December 13, 2010

My first ambulance ride

Turn the siren on and glide along the road smoothly*

It was an exciting way to start my Sunday morning. Going onto an ambulance!!! Sorry for being excited about it (maklumlah, orang first time… jakun skit!), I'm sure it was a bad news for the patient and her family to have to ensued an advanced check out in the general hospital.
Since Pak Man our puskesmas driver was off on Sunday, we got to call the red cross for an ambulance.
The patient, an 85 years old woman came into our UGD the evening before with a chief complain of an acute dysarthria with very high blood pressure. Therefore, we diagnosed her with emergency hypertension with neurological disorder (cranial nerve XII), and admitted her. Without any other apparent symptoms of lateralization and normal findings on her neurological examination, we exclude the possibility of stroke. The next morning we woke up, her condition got worse. The family in panicky went haul over the coals at the nurses. Not taking any risk, we decided to refer her to the hospital.

In the ambulance, I had a chat with the patient's daughter. She seemed to cool down and relaxed. She told me about her children and how she wished she could marry one of them with a doctor.

"Anak saya yang bongsu lulusan blablabla, sudah bekerja di blabla. Sekarang lagi di Singapore untuk urusan blabla. Anak saya yang ketiga itu, lulusan blabla, bekerja di blabla, sekarang sudah ada rumah sendiri di blabla… and blablabla…"

Then she continued

"Adik saya juga punya anak cowok belum menikah. Dia lulusan dari blabla, sekarang kerjanya bagus di blabla, maunya adik saya itu menantukan dokter juga"

And suddenly, not surprisingly but unanticipated questions came out (I can bet you 1 million rupiah for this question!)

"Dokter Nabilah sudah menikah?"

Dah agak dah… So I said "Belum"

"Kalau dapat orang Indonesia mau?"

HuAargh! Over betul makcik ni

Sternly, I said "Ga mau"

"Kenapa, sudah punya pacar ya?"

With a clear voice and a firm smile I said "Iya, sudah!"

Hmmm… kenapa tiba-tiba rasa macam ambulance ni slow sangat eh?

Arriving RSSA, after handing the patient, she came to me with watery eye ponds. Oh no makcik, please don't get emotional with me. I'm bad at this! I had the time of my life riding on the ambulance for the first time, don't spoil this excitement…

"Mintak nomer HP nya dokter bisa ga?"

Eeer… ok

"Ini alamat rumah saya, nanti kapan2 dokter datang ya?"

Eeer… InsyaAllah. Then she hugged me. *startled*

And so that was my first time riding on the ambulance!

*the road wasn't as smooth as I imagined it would be. Indonesian drivers are selfish, reckless, and deaf perhaps. OMG, benci gila tengok kereta2 degil yang tak reti nak give way for ambulance! Stupid a55hol3!!

Thursday, December 9, 2010

Mf la pulv dtd no.X

Day 4 at the Puskesmas is still giving me the 'honeymoon mood', despite the rumors saying that my puskesmas is the busiest of all, but so far I'm good – at least it's not as busy as our general hospital, pergh! Hitherto I've got good sleep. Even last night during my on call, everything went smooth (Alhamdulillah!). From the seizure patient, to the acute gastritis, to the suspect of SOP (space occupying process, e.g: brain tumor), everyone had at least a safe and sound night to rest to.

For the last 2 days, I was attending the pediatric clinic. If I had to describe it in one word, I'd say 'Cute'. Notwithstanding the goosebumps I got everytime a patient walked into the office, I kept my prayers recited over and over

"Ya Allah, please please make this easy for me"

"Please, demam je lah… batuk or selsema je lah… please don't tell me any sakit2 yang pelik2"

Thus, the most confusing case I've got that needed me to consult the GP was 'Phimosis' where neither of my differential diagnoses had stated it. Ish! Tu pun taktau ke?! It's ok, first time handle case without supervision, ok lah kan if I thought it was urethritis or rupture of posterior urethra?
Juling mata nak mencari ubat...
Today, I started my pharmacy posting in the puskesmas. Since it is a puskesmas (community health center), the pharmacy doesn't prepare a complete list of drugs like those hospitals have. Therefore it is a challenge for us in prescribing patients with uncommon drugs, as some preferred drugs might not be prepared for free whilst the community there is economically-challenged.

A day in helping the pharmacists preparing drugs has brought me to the idea of how selfish most doctors are. Burok giler kot tulisan korang! I couldn't even read 'Paracetamol', like what symbols on earth did you guys wrote??!! Is that wormy even looked like the letter 'P'? Even Najat's writing is one millionth times better than those 'drugs prescribers' (kena guna istilah 'drug prescribers' sebab malu nak mengaku 'doctor' dgn tulisan mcm orang tak reti pegang pen).

So so so… enough of tangling my brain's fold, I chose to do the pulverization. Duduk diam2 sambil tumbuk2 ubat pakai lesung. Before I studied pharmacology during the 5th semester, I never knew there was such thing as pulverized preparation of drugs. It is particularly prepared for children whom are not (yet) trained to swallow pills/tablets/capsules, so we put 2 or more different pills and clout them together into powder like, and divided into several amount. I think it is funny, and worse, deteriorating the affectivity and efficacy process of the drugs. As far as I remember, I only had medicine in syrup preparation when I was a kid or papa himself would pulverized the pills by himself so I could swallow. Thank you papa! *love love*
Masuk ubat ubat dalam lesung
Tumbuk2 sampai hancur
Finally, divide and bungkus!

Nevertheless, I love helping around the pharmacy particularly because of the friendly pharmacists. Wait, everyone in the puskesmas are mostly friendly, especially the nurses. They have somewhat revived my judgment on nurses, not all nurses are a55hol3 like, some can be really smart, helpful, friendly and nice, just like those in my puskesmas *peace*. They are so nice that they've always bring foods and snacks to share together that make me pig myself out and gobble up, yes, a guilty pleasure!


Tuesday, December 7, 2010

Donat gula

This morning I woke up by a soft kiss of the tender morning sun that seeks through the translucent curtains over my windows. 5:50am, ah, lovely. It's holiday, and I got 24 hours for myself today. No work, no call, no patient, no exams, no datelines *deep breath and smile*.

Alhamdulillah, praise God for this exquisite feeling of sovereignty.

I indulged deeper into my blanket with my eyes refuse to close, I knew I wouldn't want to just waste this 24-hour for nothing. I grabbed my life (phone) safely tucked in my palm and begun to text Zuffy and then I checked out the daily news (which is Twitter). Zuffy called, my heart starts pumping, a smile is carved on my face, I got my essence of life, sun shines brighter, and then I started to jump out of bed, bouncing! Happily!

Good morning and Happy new year 1432 Hijrah everyone!

I haven't had any decent meal since the day before, I must have been starving but I wasn't really that hungry, I just craved for some sugary donuts instead. If only I know how to make big fluffy donuts and have the ingredients before me, I'd make holy amount of donuts and stuffed myself like how Doraemon stuffed his on dorayaki. I must get that donat gula that I imagined! So I went out to the pasar to help myself looking for that very particular donat gula or something virtually almost like one in my imagination.
These cuties are for my tummy. However the donat gula is nothing close to the one in my imagination. Still, it's a donat gula, I can't afford to put so much hope to my dream when it comes to food.
More than five years in this first estranged place, my tummy has been through a lot of frustration and longing for some particular foods which are nowhere to be found around here, it has been trained to accept foods which are not similar to my imagination. It is now a more grown up tummy, it has learnt about acceptance and tolerance, it is now a matured tummy that I think I have to start calling it 'stomach' instead.
Sunbathing babies~
After breakfast, I started my habitual holiday room cleaning session. It feels so good to at least start my morning to be a productive one. I put my sleeping gears for sunbathing for a few hours. From the mattress to those tiny babies I sleep with. Everyone has to go for sunbathing! No excuse!*muka garang*. While they're out grilling under the scorching sun, I chase out the dust bunnies that has been hanging around on my furniture for some times.

Then it was almost lunch time. My housemates decided to eat out. We actually eat out everyday, for every meal, it's just today we decided to find something nicer, in other word a little more expensive and exquisite foods to enjoy together.
We can do better than these! Percayalah!
Yes, it has been ages since we prepare respectable meals in the house. It has been ages since you can find fresh poultry and vegetables in our refrigerator. But hang in there! don't get us wrong. It's not that we didn't want to cook, it's just that time is not allowing, you see… we're students whom are prepared to become carrier women. If we could turn back time, we would desperately want to become housewivesWe are not anak dara pemalas or anak dara yang tak reti masak. Says who?!! *muka serious anak dara ayu*

If you're looking for anak dara to make your isteri, or attentions makcik pakcik if you're looking for calon isteri for your anak bujang (yes, we only accept bujangs, no duda, no suami orang, boyfriend/tuning/bekas orang also we tak hingin), we will still show you our CVs which we proudly state that 'saya pandai memasak', betul tak tipu! So, stop labeling anak dara orang as pemalas or tak reti masak before you try us!

Masak apa? Itu rahsia rumah tangga kami!

Oh before that I have to add this, out of the six anak dara in my house, one is engaged, three is happily in a relationship (including me), and two are still available and looking for someone suitable. Saja bagitau, takde makne nya!

Okay, I think I'm done blogging.

Actually, no. Initially, I wanted to share about something important I've learn today from my Guru Zhafri *love love*. I promised him to take a very deep note about the lesson and that is why I wanted to blog about it. But it's okay, maybe next time! Apa yang penting? Kerjasama~ wonderpet wonderpet kami datang!







Note to myself : Love change. It grows, it doesn't always have to show. Just open up my heart and try to feel it from deep inside. It's there, don't worry!

Sunday, December 5, 2010

Hey community!

I'm taking this few minutes to drop by a few words, particularly of how I feel right now, before I proceed to my next department.
Next department (which has already started since the last two weeks) is Public Health or in short known as PH.

For the past 2 weeks, I've been at the campus, attending Public Health lecture (again! We've actually had PH lectures for three semesters), but this time we were emphasized on motivation to serve the community and reminded us (again) the importance of community service is. It works! As I've always love to do – community services, health promotions and prevention of diseases, but least on the analysis, data collecting and statistical.

Tomorrow onwards for the coming six weeks, I'll be leaving the hospital for the Puskesmas (a.k.a Pusat Kesehatan Masyarakat), precisely in Lawang, an hour drive from home. There will be five of us interns (Dokter Muda) where four are girls and a guy.

Puskesmas Lawang – was the most talked about Puskesmas out of the seven. And what they talked about Lawang are mostly the awful stories, their dire and all the harsh harsh. They said, it's the busiest puskesmas compared to the other seven. They said it's upgrading the standard from a community health center to a hospital. They said it can have up to one hundred patients in a day. They said most of the cases are severe and referral rate can be up three cases in one night, in which mean, we have to back and forth mobilizing severe cases patients to our referral center (our teaching hospital) by ambulance.

Well well well… those are just what they said. What's important now is just for me to be prepared, mentally and physically to face all those glitches and hitches, and pray hard for everything to turn out well, relishing and most importantly sanctifying – aminnn!

Right now however, I'm feeling so much unenthusiastic, or shall I honestly say 'very reluctant'. Thinking that there will be no wifi connection around the place, I have to travel every morning as early as 6am by angkut on an hour journey, spending so much on transportation, wasting so much time on the road... *sigh*
Okay Bil, think positive!

Think positive!
Be optimistic!
SEMANGATTTTTTT!

Saturday, November 13, 2010

Live Sinetron

*flash back 1 week previously*

"Ya Allah dokterrrrrrrrrr!!!"
Itulah ayat pertama yang saya dengar dari ruang CT scan. Dalam keadaan kelam-kabut dan gelabah-gelabah saya mencari Dr.M untuk lapor diri bahawa saya koas (a.k.a dokter muda) yang jaga UGD (unit gawat darurat) pada petang itu. Sebenarnya bukan gelabah sebab apa, takut dokter tu bengang je sebab I datang lambat. Takde lah lambat pon, on time sebenarnya tapi saya ke belakang dulu untuk sign attendance tapi sebenarnya Dr.M tu pon lambat jugak, sampai dokter yang stase pagi ketika bertembung ditengah jalan, dia sempat mengoperkan (meng-hand-in kan) patient yang time tu tengah gawat dekat UGD kepada saya, sebab dia cakap Dr.M tu belum sampai lagi! Kantoi!!! Kwang kwang kwanggg… tapi takpe, selambe! Nasib baik Dr.M cool je…

Kembali ke sinetron tadi, sebenarnya saya dah tau dah patient yang baru di CT scan tu keadaannya memang gawat. Mula-mula sampai dekat ruang CT scan tu, dengar isteri dia macam hysteria, saya ingatkan patient tu 'sudah berangkat' (ke Rahmatullah). Tapi rupa-rupanya masih panjang umur dia, cuma isteri dia je yang agak slow sikit dalam memahami keadaan suaminya yang 'sudah tidak lama' itu.

Memang saya difahamkan oleh anak tiri patient, bahawa isteri baru bapaknya itu slow. Kata anak lelakinya itu dalam keadaan yang menggelikan hati

"Emang begitu dok, orangnya itu 'telmi'… ngedeso, ga ngerti blast"
(Memang macam tu dokter, orang tu (ibu tirinya) lembap… orang kampong, tak tau apa2")

Sebenarnya saya rasa macam nak tergelak je bila budak tu (umur sekitar 18-19 tahun) mengumpat mak tirinya, tapi seperti biasa saya harus tetap maintain cool… control~

Prognosis untuk penderita stroke haemorrhage memang buruk

atau seperti yang sering dikatakan orang Indonesia 'jelek', lebih lagi yang perdarahannya sudah menekan otak sampai terjadi herniasi sampai ke bahagian pons (brainstem), memang jelek habis lah! Survival rate untuk hidup dalam 24jam memang sangat tipis (kecuali dengan izin Allah).

Jadi, keluarga patient berkali-kali (memang kena bagitau berkali-kali sebab bak kata anaknya, mereka 'telmi') diinformasikan tentang betapa jeleknya keadaan patient ni yang memang tak ada harapan untuk hidup. Tetapi tiap kali bertembung dengan isteri patient, pasti isterinya mem-begging supaya suaminya diselamatkan. Bukan tak nak selamatkan, tapi cuba cakap sikit macam mana… semua ubat-ubatan dah masuk, vital sign dah dikontrol ketat, nak operation? Mana boleh, herniation dah sampai brainstem tuh! Neurosurgeon mana berani? Kalau berani pun nanti kena saman sebab bukan indication.

Yang penting sekarang, tolong lah pergi berdoa, sembahyang hajat, baca Yaasin, minta dekat Allah. Tak faham betul lah orang-orang ni, jarang betul saya nampak ada ahli keluarga di ruang tunggu yang pegang surah Yaasin atau naik ke musholla untuk solat. Bukan jarang, memang tak pernah pon!!! Geram betul tengok ahli-ahli keluarga yang duduk melangok tercangkuk melalak-lalak meraung-raung tertonggeng-tonggeng dekat luar UGD tu sebab tak boleh terima kenyataan yang ahli keluarganya dalam keaadan kritis (memang scene emosi melampau macam dalam drama/sinetron mereka).
Gerammm!!! Macam mana dokter nak kerja selamatkan patient kalau tanpa bantuan Allah??! Cakap sikit!

Untuk memendekkan cerita, umur patient ini agak panjang sehingga dia sempat diusung ke ICU (sebab selalu patient jelek macam ni memang meninggal dkt UGD). Waktu dia ke ICU, kebetulan sama dengan waktu saya shift di ICU. Okay, sabar…

Sepanjang di ICU, Isteri patient yang menunggu di luar meraung-raung memanggil suaminya sehingga dia harus ditenangkan bukan sahaja oleh ahli keluarganya, tapi oleh orang-orang sekitar juga.

"Ya Allah, aku memohon mukjizat mu!!!"

"Ya Allah, suami ku memerlukan mukjizat mu ya Allah toloooooooooong!!!"

Dari jam 11 malam sehingga jam 3 pagi, itu sahajalah yang kedengaran dari luar ICU. Bukannya perlahan, orang dah melalak! ICU kita pula bukannya sound proof pun!

Adoi… betul-betul rasa macam tengah tengok sinetron yang penuh emosi, rasa macam nak keluar, pegi sound ibu tu je…

"Maaf buk, tolong jangan teriak-teriak ke Allah, Allah itu maha mendengar. Silakan berdoa dengan tenang"

Tapi tak sampai hati pula nak kacau orang yang tengah dalam keaadan jiwa kacau. Silap-silap saya yang masuk ICU kena terajang dengan dia! uuuu takuts~

Pukul 3 pagi, mata saya sudah 90% tertutup, otak dah 99% on hibernation, badan letih lesu, tiba-tiba nurse panggil saya dengan tenang (yes, dia memang sangat tenang)

"Mbak, Pak S (nama dirahsiakan), sudah apnoe"

relax je nurse tu cakap dengan muka mamai-mamai dia…

"What?! Apnoe? Ayo resusitasi!"
Walaupun dalam hati saya, mungkin resusitasi tidak akan berhasil, tapi kita tetap harus resusitasi. Saya terus menelifon resident untuk melaporkan keadaan patient. Sementara menunggu resident datang, sebelum para nurses menyiapkan diri untuk resusitasi, saya pun memanggil keluarga patient. Isterinya sudah pengsan di luar.

Ok, good! Kalau isterinya tak pengsan tentu dia akan meraung lebih kuat dan mengganggu patient-patient lain di ICU.

Tak sampai 5 menit, patient itu pun dijemput…

Innalillahiwaiinailahirojiun.

Saya pun… ZzzZzz~

* Telmi – telat mikir (slow thinker)

Wednesday, November 3, 2010

Ordinary working day

I'm glad… I'm glad to have started my fingers running on this keyboard and begin to blog again.

It's raining kittens and puppies outside. Such a nice weather to have a hot cup of tea and a piece of chocolate. Not just an ordinary chocolate, but this pieces of chocolate are especially made for me, and have a picture of my face on it! No kidding! Thanks to my thoughtful aunt whom I called Mak Teh for the box of sweetness.
Box of sweetness

On the other hand (of this lovely raining kittens-and-puppies), my plan to shed these nasty fats and dream of having a well-toned body is hampered to accede myself enduring for some rest and relax time at home… It was raining cats-and-dogs when I came back from work this afternoon, it was unbearable if I must walk to the gym in such weather, therefore I succumbed, took a shower and made a cup of hot tea.

Today, was an ordinary working day…
The word 'ordinary' in my job scope does not match the definition of any 'ordinary' you may find in any dictionary. I don't do the same worksheet everyday, I don't count on the same problems everyday. As what I am doing now, everyday is a surprise. I never knew what may come, and how I am going to solve it, but I just have to work it out anyway… However the ordinary I mean here is conferring the arrangement of programs and that's all.

Today, as we entered the clinic, there were only a few 'fresh pink folders' under the sign 'OB' for us to 'settled'. The fresh pink folders mean new medical records of new patients, while 'OB' stands for 'Orang Baru' in other word 'new patients'. All new patients are first handed to Dokter Muda to 'try' to solve, and next handed to the resident for supervision. I am very honored that our education system is being very lenient to us as medical students that they give us this opportunity to handle patients on our own, as many other centers do not allowed their students to even land their hands on patients, oh kasihan kepada anda anda yang hanya dapat melihat!

Alright then, I called in my first patient… suspecting her with vertigo, besides the general neurological examination, I performed extra vestibular examination on her (the Romberg test, Tandem walk, Halpike maneuver and motor-coordination test). I am so pleased that my patient was cooperative! Phew~ 


At the same time, Zana had an almost same case patient, but in an elder age and came with her daughter. The daughter who happened to be a worker in the hospital cafeteria and wearing the cafeteria uniform, seemed to get frustrated that her mother was held to a Dokter Muda instead of the resident. She insisted Zana to hurry on her examination and very not cooperative during the examination.

While in Tandem Walk Test, the mother grumbles and oppose, claiming that she was too dizzy to be performed with all the examinations, and she insist to be consult to our resident as soon as possible. Eeeee mengada-ngada!!! So Zana has to explain to her that however she refused the examination, she still has to wait for her turn to be consulted to the residents (since there were quite a few patients in the row). Nonetheless the daughter, on her assertion of being a very important person in hospital, in her so-proud of (cafeteria) uniform claimed that she should get the privilege to be attended before other patients. The next annoying thing was that she couldn't leave us alone in the room and remained eyeing on what we are doing. Konon kau macam supervisor nak inspect pekerja la tu eh? Tak takut pOn!

Ek elllleehhh!!! Pooodah-cit! Kau ingat dah up sangat lah tu kerja dekat hospital yang kau patut dapat privilege? Please deh, kau kerja dekat kantin jer, takde beza dengan orang lain yang kerja cuci pinggan dekat warung tepi jalan! Ingat kite orang nak sangat la tu check mak kau yang konon pening kepala, padahal tension headache je! Patut pun mak kau tension, sebab dapat anak macam kau...

Saturday, October 30, 2010

The precious 36 hours

Around this time last week, I was at my utmost glee of the highest dose of ecstasy – I was home (finally after 390 days).

Although I only spent approximately 36 hours to breathe the darling air of Malaysia, I am so thankful to be blessed with a chance to escape from here, from the nerve-racking life of a doctor-in-the-making, working in wretched. It was the most pleasing 36 hours following the 9360 dreadful ones.

That Friday afternoon, amid the hefty feeling of leaving the ophthalmology department (I ought to blog about the wonderful one month later), I hurried back home to start packing and dash to the airport. I finally got the jumpy feeling that has long been abandoned

"I'm going home" as I thought to myself.

Disembarking Malaysia right on time. As usual, I had quite a long chat with papa as he drove along the way home. Right after I reached home, I jumped on the bed where mama was still awake, reading – I had been waiting for that moment to hug and kiss her. Still snugging myself in her bed, we had a long chat about my never-ending-story.

Home sweet home…

my house itself is never failed to surprise me – especially the Unify 5Mbps internet speed! Ya Allah, memang I jadi jakun macam katak keluar dari bawah tempurung sekejap. LAJUUU babe! Tengok video takdenye nak buffering2, takyah nak tunggu2 terus siap, nak kelip mata sekejap pon tak sempat. Agaknya kalau tambah lagi skit speed internet tu memang kena surfing sambil pakai helmet. The gist took me hours til I finally got off my bed (as I was surfing the internet from my iPhone and lying on the bed) to bathe and get ready to sleep. To almost dawn, after a reviving hot shower, in an air-conditioned room, contentedly tuck my head on double goose-feathers pillows, and neatly wrapped my wear off body in a comforter beside my drooling sister Nawal, I bid good night to my lucky self.

The morning I woke up early, so I could catch more time to spend with my love ones. I got a little confused of what to wear that morning since I parted with my wardrobe for more than a year already. I picked up a long sleeveless rainbow-combination dress – where the hell did this dress came from?

"tu Along punya, dia bagi sebab dia dah tanak" said mama.

Okay, pakai baju ni! Then I followed mama and papa to Carrefour for some groceries. Holy brilliant! Standing ovation applause to the Carrefour management for their effort to save the environment, they don't provide plastic bags, instead used cardboard boxes, but mama bought her own huge shopping bags. After Carrefour, papa dropped us at the SS15 wet market. Ok bagus, masuk pasar pagi2 pakai dress warna warni, sungguh ceria! Nasib baik I ingat lagi cakap Melayu... walaupun masa dekat Carrefour ada tersasul cakap Indon dengan abang India yang timbang tomato, pastu buat2 bodoh and terus cabut bersama tomato.

"Pakcik, daun kesom ada?"

"Tapai ni berapa ringgit makcik?"

Baking with mom
Potato pie
Mama's signature mihun singapore
After pasar, we went for breakfast at the warung in SS19. I had both roti telur and nasi lemak, and teh ais. Yay, happy hajat untuk makan roti canai termakbul. Right then, mama ordered the pakcik to make me 20 pieces of roti canai segera to bring back to Indon. Yay, happy lagi!

Anak-anak papa + cucu papa + Ilman
Ice-cream make over (Bil, Naufal & Nawal)
At home, I spent the whole afternoon in the kitchen with mama. Preparing so much food (which at first I had no idea why she wanted to cook so many kinds of food), she first made a potato pie with minced chicken and macaroni, then her signature mee hoon Singapore, I must say that mama is truly Singapore-born, she made the World's most luscious mee hoon Singapore ever, ever, like EVER! And then we bake muffins too! Yeah, mama loves baking – cakes, cookies, pastries, you name it!
Najat, Bil, Adam
The evening, we went to Along's house. I was so excited about meeting my darling nephew Aaron Adam for the first time. He is the cutest thing on Earth! I never imagined Angah could produce that kinda adorable thing out of her tummy! Oh yea, without any idea, they actually held an October-fest at Along's – no wonder mama cooked so much. I was so not looking forward for it as I was supposed to have a more important date with a more important person that night. It didn't surprise me people! However, the party was cool, I got to meet half of the family members at the short of time, especially Mak and the aunties.

After party, I insist to meet Zhafri, eventhough it was already almost midnight. Don't you guys know that Zhafri is the 4th person in my MUST-meet people, after Mama, Papa and Adam? I even told papa that I want to meet him that night that I didn't even want to go to Along's in the first place. Thank God I have the coolest parents on Earth, they still allowed me to go out that night, and Abang Dd my brother-in-law being so kind to drop me to Zhaf on his way home. Yayyy sangat sangat sangat happy x 1000! *smiling ear-to-ear* (senyum je sebab kalau melompat-lompat kegumbiraan nanti mama marah sebab gatal sangat).
Mi Ciccino
Finally, meeting my Ciccino after 8 months of only virtually dating. He is cuter, he grows cuter by time! His smile is the miles longer than the Nile River. Okay cukup memuji kekasih sendiri, nanti dia kembang pula. One of (another) contentment was that I finally got to meet The Yan's. I've been hearing a lot about Yan (the best friend) and his wife Nurul and their adorable daughter Mia from Zhaf. Although it was only for a brief of time, I'm still glad.
Najat, Bil, Adam & Nawal
Fast forward to the next morning, I sipped the hot tea at home for breakfast. Rumah I memang best, air teh pon sedap! Semacam je rasa, macam lychee ke? Peach ke? Wangi macam rose, apa2 pun, home is next to heaven. I woke up to one happy family – since Adam slept over our house that night, I ran down into his room to catch his bucuk smell in the morning, meanwhile mama was busy cooking asam pedas, while papa was busy updating my laptop, the kids were doing their own stuff upstairs, and Wawa was nerd-ly studying (get a life!).

Zhafri pick me up to the airport after lunch. He dropped me at Mak's for a while so I could bid goodbye to my cute grandma and Mak Su. At the airport, we got some chocolates and a couple of coffee before I depart back to Indonesia.
See you again darling :'(
So, that's quite a bit of last weekends. Malaysia, home, family and Zhafri, in 36 hours *hearts*

Alhamdulillah.

Friday, October 29, 2010

Old folks

As typically a girl can be, I put my favourite things in a list – pink, furry, glittery, rainbow combination, blings, butterflies, jewelries, hair accessories, shoes, soft toys, beanie babies, babies, perfumes, and… old folks.

I have a thing for old men, some attraction, something about them that fascinate me. I realized that old men are charming in their own way, cute and adorable. Just like babies – delicate, sensitive, feeble, helpless, and they speak of deceasing IQ that constantly sniggers me. It's just that old men come with precious experiences and loads of wrinkles, which babies have none. I mean, old folks, not necessarily men, but women as well.

Last week, upon meeting Mak (my grandmother) I realized that she grew cuter by time. Her subtle smile puts her wrinkles into finer lines which blunder for a pair of tiny dimples below the corner of her eyes. Her cheeks are still firm slightly above the cheek bones when she grins, and when she speaks, her soft voice makes everyone heeds to hear. Just like how parents are excited to hear their baby's first word.
Mak and I (October 2010)
Old men however never fail to make a reminiscent of how arwah atok was like. Especially when the old men walk with their little grandchildren, always envy me! I cannot recall any of my childhood memory without the picture of atok in it. Arwah atok was never out of my sight and was always around me for my entire life since I was born, til his decease when I was 15 – then was the greatest flood of tears I've ever had in my entire life.

Well, back to the old folks story. I first realized that I had 'old folks' in my list of favourite things perhaps during my clinical attachment in HKL years back. Since I was a tagging student and nothing much I to do in the hospital, I prefer to sit by old patients as they always have a lot of stories to tell. Yes, the 'grandmother story', but I find their stories motivating, encouraging and full of first-hand experienced (some are saddening though). Having some old folks around make me feel ease or some how comfortable. Even their smell is soothing, just like how babies smell like.

There was a time when I came across thinking of becoming a geriatrician, or perhaps a physiotherapist where I can work with most geriatric patients. If I knew I would love to toil with old people, I would have had accepted the offer for physiotherapy course in UiTM years back before I went into medical school – wait, no, I wouldn't!
Anyways, I have cancelled the plan. I just don't see myself that persevering to endure my patience to that limit (maybe someday I'd just help around at the Rumah Orang Tua like that…). Then I came back to stick to my childhood dreams once again which was to become a pediatrician.

And then again… Since last 2 months, I have put that childhood dream of mine as just a dream, because I don't think I want to become a pediatrician anymore.

I am so firmed that I already told mama about it! Well, as how papa always describe me as

"kalau dia nak, dia tak kesah orang susah ke senang, dia nakkk jugak",

but this time Bil dah tak nak, for once I can cancel my dreams just like how I cancelled my dream of marrying Taylor Hanson – boo me loser! (at least I move on). Ok, apa dah merepek sampai cerita tok kaduk zaman Taylor Hanson plak nih? (!@#*$*^

I was supposed to write on my experience during my Pediatric Department posting here… but since it was too sucky, maybe next time!

Wednesday, October 27, 2010

Surgery comes to an end...

Bismillahi rahmanirahim…
Ok, let’s get started. No, I’m not going to write something like ‘it’s be ages since I last blogged *cry out loud*’, yes for crying out loud, it is obvious! So, no, not going to mention that on my epilogue this time.

There are redundant of events and matters occurrence during my last few months of blog-less. Too many to write, too many to tell, too hurt to remember, too sorry to be forgotten, too little to be kept and what matters is I was too busy to blog.

To start from where I stopped. Sounds like a real devastation to have failed my surgery pre-test uh? It was a big deal, but seems like almost 80% of those who have gone through the surgery department didn’t absolutely pass every exam, and consequently have to repeat at least one division. I’m not alone! Haha. Conversely, surgery department is the best major department (I must say). Am I into surgery? Yes, maybe.
First day - DONE
14 days - DONE
The best part of my surgery posting was the 2 weeks of internship. Everyone would have imagined of nightmares and themselves turning into zombies whenever they heard the word ‘internship’. It wasn’t that bad people, it was great indeed, trust me! Who said interns don’t get enough sleep? How much is ‘enough’ when you’re dealing with patients in their battle of life? Who said interns don’t get to bathe? I bathed twice a day and I even get to go to the saloon during my 8-hour hiatus. Now, let me tell you what me as a surgery intern got during my 2 weeks of being refugee in the hospital…

1.    1.  When the A & E (accident & emergency) is flooded with traumatic patients, the hall is horde with trolleys/beds that left the doctors with no space to run, so we literally had a little but quick brain game – to map out our way to avoid ‘cross-roads’ or stump upon vomits or blood on the floor.

2.     2. After inserting catheters into countless of urethras, I am now good at holding penises to semi-erection and distinguishing vaginas and urethras by locating the clitoris first.

3.     3.Inserting NGT (naso-gastro-tube) is no more a big deal. After getting the patient’s consent and prepared with all the procedure, all we have to tell the patient is

“Pas dirasak no sela ne nang tenggorokan, di-lek pak ngih? di-lek! Di lek pak! Di lek!” (agaknya kalau patient tu mat salleh, kita kena ajar dia pakai English and it’ll sound something like “when you feel the tube is already at your throat, just swallow okay sir? Swallow! Swallow sir!”)

and keep on pushing the tube through his nose into his throat until his stomach, and at the same time to encourage him to swallow

“di lek pak! Di lek! Ayo, di lek! Ya pinter, di lek lagi, ayo pak!” (again, if patient tu mat salleh, kita akan bagi dia semangat untuk menelan “swallow! Come on sir, swallow! Yes good, swallow again, come on sir!”)
Raw piece.
In progress.
Done!
4.    4.   Hecting / suturing / sewing is however my all time favourite! My first procedure was on a patient’s foot where he got skinned in a bizarre stellar shape. It was like connecting puzzle pieces and sew them back into a piece. The resident came to checked out my work and said

“dasar cewek! Hecting-nya rapi puol!” (“Typical girl, very neat suture”)

and of course I take that as a compliment. And that actually permitted me to start sewing on more delicate skins e.g face.

5.      5. Since we have orthopedics in our hospital, and the residents are not so affable to the interns or probably they are more independent, interns don’t get the chance for casting (you know, putting the bulky white cement on broken arms or legs…)

6.     6. I encounter bloods and broken bones with a straight face. I never thought I would react as such. It is no “Whoaaa” or ‘Aaaa!! Whattha?!” anymore

7.      7. I especially got irritated when they don't prepare the right size of glove. My hands are big I know... I need extra latex to cover them up.
I did a few lipoma excisions. (read my glove size)
 8. Besides smokers, rempits and reckless drivers are next in my hate list! Idiots! You guys should have thought of the people in the hospital who are trying to get some rest at night. We prefer to be served coffee rather than your bloody heads.

The next best thing about surgery are the residents and angelic nurses (at the ICU). Although some are snob, but most of them are helpful, friendly, approachable and just nice. I find myself still talking and never missed to say hi whenever we bump into each other along the aisle in the hospital or at the A & E or at the cafeteria or just anywhere. They ethically make good human relation.

Observing surgical procedures are one of my favourite part too. Awesomeness!
Surgeon-come-carpenter during cranioplasty

However, this is the part which is most probably will hold me back from becoming a surgeon. First, I don’t like to put on the green scrubs, so not sexy! Second, I don’t like the hectic working hour because I don’t think I’d like to wake up in the middle of the night to cut off someone’s scrotum to untwist the twisted duct at their testicles. Thirdly, I don’t like the unsociable cold life in the operation theater.

Thus, there was a bit on my surgery posting. Two months is too short, but I just had enough. After all, I rate this posting 7 ½  out of 10. The 2 ½ points were taken by my frustration of failing the inhumane pre-test results, and the ridiculous ‘absen malam’.
Sila sengetkan kepala anda
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