Seniors

Dinner with IIUM seniors at the Filipino Market

Big reason for my choice of Kota Kinabalu for my housemanship is because I know there are good seniors from my uni there, though I never really knew how good us they would be.

Transportation and commuting was a big problem during our first few weeks. Big is perhaps an understatement. We traveled mostly with expensive taxis. During work time, tagging times when we finished late at about 11pm - 12am, even taxis were not available, especially at our Likas Hospital. We could only rely on 'pirates', hired cars, to bring us back home and come again the next morning at 6.30am.

Rozaimi was a big help especially. He showed us around, brought us to some place to eat and shop, and sometimes lent us a ride or his car when his A&E shift was at night when he couldn't come home.

For that we owe him a lot.

I realized that our bonds with students from the same Alumni runs deep. Perhaps its the university binding that kind of loyalty or just an individual's personality. But I know that a seniors' worth is a lot. Their wealth of experience to 'survive' during the first few weeks, months of 'life' is invaluable and most often unrepayable.

What I'm writing here is only a fraction of their contributions. Later there'll meet other seniors in the posting, regardless of the year they started. A first poster can be your senior even if he or she came in only a week earlier. Your medical officer is definitely your senior never mind consultants. They will be your teachers, in medicine and in life.

Respect your seniors, and you'll do well.


Tips:
- Respect, rapport with seniors from medical schools onwards. Don't be an asshole.
- Shop til you drop before you start your first time tagging. You might not see daylight for the next 2 weeks and starve. (Haha gila 30 days of night!)

Pilot

(retrospective)

I saw egrets through the windshield of the plane I came to Sabah on. They were the first birds I saw.

I came with my mom, God bless her. We arranged for a hotel to stay at for the next few days with the help of dad's friend who lives here.

What was my feelings then? Excitement was most of it. I was about to start real life. Working life. I'll be so far away from where I'm used to and I'll get used to here from now on, hopefully.

Met a friendly cab driver whom soon became our personal driver (at a cost of course). He was responsible for taking us around later and while we searched for a more permanent place to stay. I arrived a day earlier while Nadhir and Jazmi came in next day. I was ready to live alone but at the same time I am glad to have familiar faces.

Kota Kinabalu Sabah was my choice. My only choice. I hoped that I won't regret it. I can't turn back now.

My mother did not say it but I knew she needed me here. To start my own life and able to support my family later on. I know she is hopeful. That's the whole reason why she came all the way here with me.

Respect

As a housemen, or wherever you work, there will be someone (your superior) who's slow, garang, always makes lousy decisions, unusual or weird habits.

They make topics over meals or dinner of facebook notes (or status) where people start bashing them up.

Regardless I think this is not the right attitude (although I am guiltily sometimes a part of the bashing action).

Regardless of how that person is, I believe he deserve some sort of respect. Even if he is wrong, there's absolutely no need to downgrade the person. For all you know somebody is bashing YOU over lunch.

I think bitching attitude should be out of the circulation in working life. It would make working less stressful without all that negative thoughts and feelings (especially when you work with that hated someone). Besides, no matter who you are or where you are there are bound to be someone you hate that you'd have to work with.

Cope with it bah.

And stop bitching too much.

Sometimes You Gotta Be Hard

Saw my MO scolding a kid today becaused he refused to cooperate for chemotherapy treatment through his central venous line (Hickman's catheter).

Kid's a 4 year old boy with acute promyelocytic leukemia. He was due for chemo which he didn't want to cooperate as he wanted to continue watching Masked rider or something like that. He got a scolding from my MO which he then cooperated.

My MO told me that as a kid patient he had 2 roles, one a the sick role, and as the kid role. The sick role deserves to be treated, but the kid role must be disciplined. I agree with him in a way. Kids when left to be treated like kings, even when they are sick will become spoiled and ironically become harder to cooperate for treatment. This is made worst when the parents pamper the child more.

I suppose life goes on even for the sick kid with cancer.

How much privelege would one get being sick then? Later for that...

Whining on Oncalls

Its weird that despite me always getting stressed up for oncalls, I'm known to take someone's call without any exchange, payment whatever. And I'd get this look, "You crazy? Are you sure? You don't wanna swap with my call?" "No, lar just give me the call only." I have to admit I was inspired by a certain senior back in my university for this type of behavior. Though people take advantage at times. But oh well.

Even with RM100 incentive per calls for housemen, people would rather be back at home and sleep. A rare luxury for me indeed nowadays.

Funny how I wish that my oncalls would be cold (though they almost never are) and that I'd be able to get some sleep.

Pfft.

The reason why you are ON - CALL is so that people could call you up in the middle of the damn night to attend to - whatever. Wishing for a good night sleep is only WISHFUL THINKING.

Besides, the more you encounter during your oncalls, the more experience you get, the more procedures you are able to perform, subsequently building your personality to get over anything that work or life can throw at you. During my calls in O&G, I've had experienced red-alerts for post op intra-ab bleeding, bleeding miscarriages, high octane labour room calls, hordes of mothers coming into PAC to deliver, vacuum deliveries, ERPOC, caesarian section and for my most recent peds, I got to experience an intubation, exchange transfusion, and hordes of babies to poke and prick at 4 am in the morning. During these calls also I've picked up skills on management of certain common problems. I don't admit that I would know how to handle each of them again but the experience matters as it will most likely be stuck with you for the rest of your career.

Oncalls are then more valuable than the money earned, as in medicine, nothing is as important as the experience one gains during work. It's sort of unfortunate with the excess of housemen nowadays, calls are getting less. This may not be a good thing in the long run as we, young doctors won't be able to get the necessary experience needed. But I guess then one has to make the best of whatever they have and benefit from it.

People tend to get grumpy whenever they hava bad call. Me included. I can become a nit nastier than I usually am when faced with a bad call though I'm still generally nice :p But I'll try my best to be professional during my next call and do my best to go through them with a level head.


PROMO: If you need to switch calls, or need someone to take your calls do ask me. If I'm ok with it I don't mind the extra call. It'll only be beneficial for me.

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Mothers

I haven't worked in the hospital a very long time. But what I've seen amaze me time and time again. Working in O&G and pediatrics, I've seen durability or mothers, the immense sacrifice and time they take to nurse their kids. Heaven is at the footsteps of our mothers. Witnessing all this, it is justified to have mothers have at least a step in heaven.

I've seen mothers bearing child, while at risk themselves, harbouring life-threatening hypertensive disorders. These mom's are like Tamil Tigers suicide bombers carrying bombs. They can blow up at any moment. That's a metaphor. What I really mean is they can die just because they are carrying their precious child.

Labour comes. Along with the pain. Vaginal delivery, caesarian section. It doesn't matter which path both again carries risk of death. I've seen torrentous bleeding in both cases where the mothers life is just a few minutes away from death. The probability of mothers suffering post labour is like playing Russian roulette.

Then when the baby is out it's not all well yet. If she's the majority of the lucky mother, she'll have a normal baby that will grow to become you or me or better. But if fate has it that she is not, the baby ends up in the NICU for months, nursed til in good shape, if the baby's lucky. Ive seen twins nursed for 3 months for prematurity. And with patience, and support, mama and baby comes home well. And I've also seen baby with stormy post natal period ending up with a hypoxic brain. The baby is bound to grow with neurological defects, unable to live a normal life like you and me. Again the mother will suffer from the extra care the child will definitely require.

But she won't care. Because she's the child's mother. It's an inborn thing to care for her child. Whether her baby is diagnosed with Down syndrome, cerebral palsy, a restrictive lung disease with very poor prognosis and life span. She'll stay with the child until the end. Because that's what she does.

I've seen mothers spend almost half a year caring for her child with meningitis with hydrocephalus. She's in a hospital so far away from home with no nearby relatives. Her husband's earning is below average. Yet she stays. Coping with her whinny kid whom complains of everything. Her only company besides her kid is the nurses and the housemen. She'll be around for a long time. Along with other mothers with kids with tracheostomies, leukemia, and kids with malnutrition.

I've also seen mother's with kids whom are fat and thriving but still feel that they do not have enough. Kids whom whines for everything gets into trouble with everybody. Whom shouts back at their mothers when being told off about something. Despite all that, momma endures. For better or worst.

No I haven't seen everything. What I've seen are only fragments of what mothers are made of. Not every mothers are like this I concede, but most are. You don't a 'Mother's Day' to celebrate. That's because everyday is mothers day.

As long as she's around she'll care for you. Whatever you attempt to do to pay back for all that she's done will never ever be enough. But for her it will always be. Because you are your mother's sons and daughters.

Virgin Posting: O&G

Exhausting
Intense
Frustrating

Some of the various emotions one (I) experienced during my O&G posting here in KK, Sabah.

I knew it would be hard but never really knew how hard it would be.

First few days during tagging, I was depressed, tired and severely demotivated. Tagging puts us to work from 6.30am - 11 pm / 9pm. And during those times without transportations of our own, we were stuck in the hospital going back later than we meant to hithcing rides from Jai (MANY THANKS, UNREPAYABLE), and pirates (drebar keta).

How we suffered then.

Learning curve was steep. You were meant to learn to present cases well, refer early from PAC, post case for emergency caesarian, refer cases to pediatricians, collect information for statistics presentations, work fast enough. HORDES of mothers burst through the doors, and more offsprings burst through their *ahem* with some ending up not so favourably. And I was almost constantly screwed left right by my superiors. I was in constant fear. Of screwing up somewhere. Leaving a baby dead or ill, not acting fast enough to prevent a threatening maternal condition, not documenting enough, not presenting well enough in morning prayers missing information. I screwed up a lot.

Sometimes I felt like quitting. Alot of times I felt like quitting.

But I didn't. Not like I could.

So I held my head up high, because my pride demands me so, and do my best in whatever I could do. Which I believed later resulted in trust, respect and friendship among my superiors.

The posting also required teamwork and this put a tight bond among us, at least during work which forged new friendships. A lot of the people I met were of variable races, ages and in the midst of work, they matter not. Helping each other out was rewarding a lot of times whenever I can.

Despite what others say about O&G, I found it ironic that deep inside, I sort of enjoyed the posting. I built me up, toughened me somehow, and provided with a lot of experience I needed even though personally I did not think i learned enough.

If I could go back in time, I would like to spend more time doing a lot more Caesarian sections, cuz my current skill sucks. I'd like to perform more ERPOC on my own, and perform pipelle samplings and deliver more twins and breech. Not just for the fun of it, but because the skill is essential later on in the course of my work whether I'll end up in O&G or not.

My personal thanks to everyone I met. Nurses, fellow housemen, medical officers, specialists, consultants, patients, never ever forget the patients I've met. Without them, I would not come this far although I haven't actually gone anywhere far at all.

The last few days were fun, with O&G charity and O&G night.

My prayers that O&G dept, SWACH will continue to prosper and improve.

PICS

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