Tuesday, January 30, 2018

2018

welcome to three series. gasp!.

2017. i really feel like a sloth. but then when i look again at the resolutions i wrote early last year, surprisingly?!! i achieved most of it. so now i see the important of resolution and target. when i feel down and feeling like rubbish, actually i achieved somthing. wehhuu!

so this year resolution. haha a little bit late. but lets do it!
since i just transfer back to semenanjung, finally! to start fresh and new all over again. lets do something meaningful this year.

1. to loss weight. i gained weight like no body business in sabah. so it should start from kitchen. i must cut down junkfood. and eat more healthy food. drink a lot of PLAIN water. target weight 65kg by june.

2. jaga mata. jaga hati. jaga iman, jauhi zina. jaga ikhtilat. (this is serious :|)

3. keep silent if u hv nothing good to say. jaga hubungan dengan manusia, jaga lidah. jangan cakap merepek bukan bukan takde isi dan menyakitkan hati org lain. kurangkan mengumpat, gossip, backbiting, etc.

4. financial. (we'll see later about this)

5. get a way from social media. i challenge myself to delete twitter/ig/fb the whole one month trial period in February. lets do it!

6. i still cant see my future in relationship and carrier. (we'll see later about this)

7.

8.


i may add on the list, but currently i cant think of any, i dont want to make a list just because it is a list. i want to make it happen. this is a promise to myself. my last year resolution on 6, and i achieved 4 out of 6. so this 4 things.. lets do this 1st.

Monday, January 8, 2018

of ethics

working here in this town beside the side, almost half (i think) of the residents are non locals.
so the big issues arise when they come to hospital to seek treatment.

this land below the wind has so many suku kaum which some, i only encounter few times and has so many ic color which i never see in west Malaysia. these people mostly are native people but somehow due to socio economic, logistic, non-legal marriage (kahwin kg), and too ignorant too i think they only have birth cert and dont hv ic.

mind you they have to pay a lot than local. for registration only it cost rm100. not include other investigations. they hv to pay every single of blood investigation and xray required.
but somehow, for us, the treating doctor, when look at the pt. see how they dress, and to the rest of the family members looks like, how low the socio economic they are, we just simply close one eye and send the necessary blood without payment.

more big issue when they need admission. for medical based they hv to pay deposit around rm1200 i think, and surgical based, rm2800. and it cost a lot more if admitted to icu.

so.
example if pt non local came in with mva (motor vehicle accident). for registration rm100. xray; cervical rm40, cxr rm40, pelvic rm40. if needed t&s rm300. if they dont hv money pt will stranded in dept for quite sometime, because we cannot discharge and cannot proceed with xray as xray need payment receipt before they will proceed.

chicken egg dilemma.
2pts impending respiratory distress. one local and another one not. and the non local one has worse condition. only one ventilator available. very limited bed available in ward and icu as level. and non local has financial issue as well. which one to intubate?

i lost count number of pts i extubate in the car as they couldnt afford admission after initial treatment given.

and  for peads cases too. somehow i think most of the non local rarely go to hospital unless they're seriously ill. we saw worse of the worse peads cases ever. peads pt with hb1, single digit hc03. and somehow they came with a chronic compensation. i dont know how they survived. thts y they said, these people hv 7 lives. their survival rate is very high.
we intubate peads pt almost every other day here. i kid you not.

just now i encounter one pt. young gentleman. alleged assaulted. sustained deep laceration wound on volar aspect near the wrist with tendon and vein cut. the wound was quite deep. funny thing, (not so funny) pt was assaulted by a cousin dt financial issue. they fought because of rm20. so pt came in afternoon around 4pm then refer to ortho team, medical advice given to admitted to repair in ot yada yada.. family members undecisive, try to find money 1st they said. untill midnight! only they give the decision. want aor discharge. the best ortho team can offer just for t&s under sedation in resus as they couldnt afford to be admitted. how much our PSA can last long, so ortho team just salvage whtver they could.
i feel bad to the pt. because of rm20. which i think is really meant a lot to him. made him fought for it. made him almost lost his hand because of it.

for some people kfc is like a normal meal, but for others it is a luxury food.
:'(

Tuesday, November 28, 2017

Long to belong

I love being alone. There's a huge difference between being alone and being lonely. I do feel lonely sometimes. How much i keen for a company but I completely loathe people who rob me off my solitude but provide me with no meaningful company. I do not like wasting time to explaining myself or speaking meaningless issues that brings no good to the self or others. Just for the sake you dont look pity all alone by urself eating outside, drink coffee, shopping or watching movie, i opt for a good company or just by myself. Most of the time is the later. I dont mind and i dont care what other people think. 


I have very small circle people im comfortable with. I know i can be very defensive too sometimes. Its for sake of my fragile heart. I dont like intrusion and im just happy and comfortable in my bubble.Surprisingly, I made new friends and met new people a lot more when I was a houseman in kl. I only have small circle of people here. Which consist of my colleagues, in the same department. I'm glad we hv quite a lot outdoor activities together; playing badminton, hiking and running, occasional roadtrip. Otherwise I would die of boredom. I still remember 1st few months in Sandakan I'm so depressed of being alone with nothing to do after work. Went back home, staring at the wall, sleep and going back to work again. This seaside small town has nothing much to offer compare to kl. Which I only found the hidden gems much later. 


And yet, colleagues still just a colleagues. I dont find my person here. The one you can talk everything to, the one you just call randomly without any occasion, the one you can rely on at the time in need, the one you can trust. 

I wonder if im trouble or falling sick, who i can count into?


How much I love being alone, and regardless how independant i am, it just good to know, actually you have somebody to rely on at the time u need the most, esp here in this foreign land, away from ur families and away from ur beloved one.


Tsk. The thought is sucks.

Land Below the Wind

Hi. Woahhh it's been awhile. Last post was almost 2years ago. While im still a very junior mo. In this land below the wind. 
No. Not so junior anymore. But still alot to learn, to improve, to improvise. 

So currently I've been here for more than 2years already.  2years 4months to be exact counting. I've learned a lot. I grow up a little; less clingy, more independent, but still immature. Still emotional. 

I still remember the day i came to Sabah, for the 1st time in my life. My sister and Mom sent me to the airport only at drop off area. Im already started the journey on my own. Too ignorant I have no idea where is sdk and definitely I didn't do any research before I came here. My friends back in kl keep asking me when are you leaving? Where u gonna stay? Are u gonna stay at kk 1st? How you will go to Sandakan?
As impromptu and impulsive I am, I definitely don't have the answer. I don't make plan. And  i'm avoiding to answer the questions esp from aunty because I knew they will throw a farewell party for me and I'm really sucks at goodbye. I feel bad to receive random act of kindness from others.

Funny story, I almost missed my flight. It's been a while since the last time I travel by air I don't remember when should I be there for boarding. My flight at 630. Already settle check in and everything at 4am. So I took my sweet on time at the airport and heading to gate at 610am. Im surprised the gate was empty! No one there. Then I realized they close the gate already. Find the crew but they don't allow me in. Begging persistently and I almost cry at the gate. By some luck manage to contact the captain and they allowed me in. What a relived. Arrived at Kota kinabalu airport around 9am in the morning. Fetch my sister's car at her friend's, went to lapor diri at JKNS. Silly my sister, the road tax expired on the day i arrived at KK. So find JPJ to renew the roadtax. Settle everything and later in the afternoon i met Jaz. he's in kk outstation, hes been here for almost one week already. We went to watch sunset at tanjung aru. Omggg I'm so glad finally I met someone I know in this foreign land. Later I met Fazila and we went for dinner with her housemates and I stay overnight at her place. Thats all the story and drama of my first day in this land below the wind.

The real journey start the next day. To go to Sandakan. By car. Alone. I knew it takes roughly 5-6hours but I don't know how is the road takes me. Leaving kk at 5am in the morning. The road is really bad. Like really bad. Like all the way to cameron highland in all 6 hours journey. Im surprised manage arrived in one piece at Sandakan on my very 2nd day in Sabah by driving alone from KK. Pheww. Im surprised how on earth my sister allowed me to drive alone from KK to Sandakan all by myself. If im at my sister's place i definitely wouldnt allowed it looking of long hours of journey, geographicly and so bad road condition. 

After safely arrived my very 1st stop i went straight away to hospital. Lapor diri etc, met a HOD and then only im search for a hotel. I know. Im very at a moment very last minute person. I stay at Sunbay Hotel at the town. Quite dodgy hotel actually. I dont know why i choose that. Whtever. So damn tired i just wanna rest. Later in the evening, i met Anati, Farhana and Aqilah for dinner. Former colleagues from HKL. Thank god for another familiar faces. Thats the end of the stories of day2 in Sabah. And my very 1st day in Sandakan.

And the next day househunting begin. Start the day with breakfast with Abid. Jr back in Alex. He's among of few i keep in touch with before coming to Sandakan. Househunting alone, I think i saw about 4 houses before decided to choose the house i like to rent. The house to feel like home. Quite far from hospital but i like it. It cozy, and comfortable to live alone. And i think the neighboorhood is safe.

Long story short... now 2 years++ already. Time flies so fast.

Wednesday, December 23, 2015

Rejection

After bad day at work, i really wish, at the end of the day, i have someone to talk to, to hug, to listen my random ranting and  just to keep me company.
Live in kl, offered me all those things. Without im the one who have to ask for it, without feeling rejection. They were there, all the time.
I miss. A lot.
5months, and still struggling.

Tuesday, November 17, 2015

Frustrating

recieved a phone call from colleague. hani siapa kerja malam ni, and i asked her why? And she said, If i've got angioedema i have to go to ed is it?

-.-'

i asked her where she is now and rushed brought her to hospital. too worried and anxious so i dont think that im the best personal to treat her though both of us are medical officer. few hours at ed till she fully recovered and later brought her back home.

Thing makes me ponder, if something like that happened to me, who i can count into? Text few of our close ?friends about my colleague just now, i know they're oncall, but arent you guys worried? Because i am worry like hell! Their reply not as i expected, and how disappointed i will be if someone that I thought we're close not even there at the time i need them the most.

Sigh

It sucks. Really. Know that actually you have nobody that you can rely into. I mean here, at strange place, you're alone on your own, away from your family and beloved one.

Sidenotes.
Recently, I let my guard down for a brief time and let new people into my life and stepped into my bubble. I let myself fall in love and trust others. Worse decision ever, with wrong person.
It is hurt, really.
I think that is the reason why i am selective and defensive. Who else gonna protect our heart if not ourselves.

Monday, November 9, 2015

Im alone in this battle

https://youtu.be/GlZxZ2n2zpw

Friday, November 6, 2015

M&m not Chocolate

Second d*ngue m&m (mortality and morbidity) within a month. It getting worse day by day. The strain more difficult to treat. Both cases 14-15 years old girl. sigh. Too young to die, and because of infectious disease summore, which is preventable. They're not supposed to die.

I wasnt involved directly in both cases but some things make me ponder.
The second girl, she just passed away last week. 14yo post delivery 6 months, coming alone to ed because of fever. Initially was treated as throat infection and discharge well after hydration that night, and to repeat again blood coming morning as borderline suspicious of d*ngue. The next day when she's coming, the platelet drop massively to double digit. Then when my colleague ask, where is your family members? Do you hv your parent's phone number that we can call? she said, I dont remember. She's admitted to resus, intubated in ward and later passed away in icu few days after admission.

Was she thrown away by her family? Does her baby has a father? Does the family/parents know now that their daughter has passed away? What happened to the baby? How her life before actually. Come alone to hospital, and eventually die. Shes too young. Poor girl. :(

You will never forget the pt passed away on ur hand, and under ur care. I still remember mine, my very 1st case. Not yet a mo. But in my 1st week in final posting as a houseman in ed. 27yo young man mva. cause of death: pulmonary hemorrhage. He passed away 2days later in icu. The moment started from pass over by my colleague uptriage from yellow zone as they noticed the unequel chest expansion. I still remember his name, his face, his expression, when i examined him, treat him. And recently, accidently come across his social media account page. You know the feeling.. Its like the lightning strike over your chest. Speechless and im almost cry. Cant help myself not to think.. what if?

I did my best to save the patients life, and yet, still, things happened. Death happened.

Oh i hate myself when too emotionally involved.

:|

Tuesday, November 3, 2015

Missing home.

We have totally different personality, character, point of view and have sort of weird kind of relationship and chemistry that somehow, somewhat, it clicked.

You have no idea how much it hurt me more!

Saturday, October 31, 2015

Rainbow after the rain in my heart

Last few weeks, i got a pt. Shock in front of me and i failed to detect it earlier. Young pt, no co morbid complain only 2days hx of fever and urti, coming with tacypneic. Bp normal, slight tachycardic. Chest equal ae, crepts at left mz. Dxt normal. Ecg sr. But i noticed the pt is not in a good condition, so i upgrade to resus for close monitoring after given antibiotic and hydration as wbc slightly raised, no drop in plt or hb. 2 of 4 sirs so i treated as sepsis 2ry pneumonia. Pt gcs full. At that time, no other result come back yet. Later in resus, abg shows severe compensated metabolic acidosis with single digit NaHO3, and aki features. After 20cc/kg/h hydration, ivc distended and urine only in tubing. Somethings wrong. i called my boss. Ask wether to intubate pt or not as no other senior colleague on the floor. Because honestly, i dont know what else to do.

The answer i got; hani case macam ni pun tak boleh manage ke? You cannot ask to intubate or not via the phone.

ok mayb i should not. Then, tell me and guide me what to do. You know what i feel at that moment? And the worse part, he came and saw the pt as he was at hosp that time, and he called up everyone to resus and told me in front of everyone; even houseman can do better than you hani.

Can you imagine how i feel. After all, the management he did only give more hydration and escalate the antibiotic. So what in term of management i did  wrong? is there any negligent? Or did i do any harm to the pt? If i dont care and concern about pt, i dont even want to call him to ask what to do.

Later pt expired in ward after 6hours of admission. That made me even feel more bad of myself.

went home and cried all night. That is one of the day that you just want to quit to be a doctor.

Life is sucks.


********

i missed my ep back in edhkl even more. I know im new, still a lot to learn and improve myself. But discouraging and underestimate ur staff and humiliating  wont help to provide a good environment.

and more and more discouraging words from him afterward almost everyday.

now i dont know if i hv interest in ed anymore. Very stressfull working environment now.

I cried to my friend over the phone who're willing to listen. Desperately need a hug and a shoulder to cry and a comfort. Im fragile and clingy like that. I wish im in kl now. And she said to me, dont be sad, insyAllah something good will always happen after this.

And indeed, she's true. The next day i went out for breakfast with my colleagues to find a comfort. But then accidently bumped into my other specialist, and awkwarly i invite him to join us. we had breakfast together for 3hours of inspiring words and talk about life somehow put my foot back on the ground. Thts really what i need at the moment.

Last few weeks, i got a text from old friend who are concern. She's reading my blog, and she said it quite depressing. Haha!. Somehow you glad to know that you have someone who still have faith in you, and remind you back who you really are with so much courage and uplifting words, and you know you're not alone in this world.

I met my hkl specialist in one of the ngo event last few years. But actually i never work with her before in hospital. And somehow we become close after that. I think its a quite an awkward conversation to discuss with ur boss but, what not? She's been in this field longer than i am, and truly speaking from brain and experiences.

You're glad when you meet all these people.You feel like you're all alone in this world, that the whole world is against you (exaggerated) and you feel so hopeless. And Allah send these people to you to remind you, that you're not all alone, and to still have faith in Him.

You never know how a simple word or a simple gesture or a simple act of kindness can motivate and inspire those around you.


These people, i dont meet them by accident, they're meant to cross our path for a reason. 

And i wonder what did i do to deserve them in my life :'(