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!
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