Enter O&G

Retrospective Entry:

After settling a few more video orientations, we took the shuttle to Likas Hospital to start work. Then we met Dr. SuthaGar.



Initially we thought of asking for a few days grace to settle 'stuff'. But once he heard that we already had a place to stay (even though he also heard we did not have any of our own transportations), we started tagging (work) straight away.

I was put in the obstetric ward. Everyone so busy, so alien, I was lost. I remembered getting scolded for just standing around and not doing anything by a fellow senior houseman. I was taken a back because truth was, I really didn't know what to do, how to start.

I felt really bad, not knowing what to do...

It was so different from med school. I remembered depression slowly creeping in... I wanna go back home...

But eventually with a few helpful colleagues I began to learn the ropes. Informed of some MOs to avoid pissing off and to look out for. And learn the routine life as a houseman.

Welcome to becoming a doctor.

Tagging in O&G lasted for 2 weeks, assuming that you passed the tagging assessment. It was med school exams all over. And tagging last til 11pm alternate with 9pm. We were required to deliver 10 babies, assist 3 C-secs, and repair 3 episiotomies.

Sad thing was, there were times when we finished at 11 but still went back at 1am as we didn't have our own cars then... We depended on a 'pirate', drebar for hire charging RM 20 for the ride back only to wake-up again at 5.30 am to start work again at 6.30am... For some of us, we couldn't sleep well either due to constant nightmares of hordes of babies coming out...

Somehow we survived the ordeal. All of us studied what we needed to and passed our assessment. But that was only the beginning of the toughest posting in KK.

Tips:

- For tagging assessment, know your CTGs and Obs emergencies. These are basic knowledge needed when you are oncall.
- NEVER piss your staff nurses. They are your best-friends and potential worst enemies.
- First postings are hard but tough it out and you'll survive. Don't go through it alone. If you came alone make new friends.

New World

Retrospective Entry:

I felt like an immigrant the first few days I was here.

When I first arrived I had mom and a hotel room. When mom left, I still had the hotel room but we just had to find a more permanent place to stay.

I was lucky that I had Nadhir, Jazmi and later Nurliyana. (poor unfortunate souls, unlike me, was thrown to KK, Sabah for their housemanship [Liyana didn't stay with us ok, she managed on her own:p]) around which made life less lonely. We stayed at the hotel a few days longer depending on Pak Tri (our cab driver remember?) to drive us around town, back and forth to the hospital to settle first few days of orientation.

We were also lucky we had Jai, our senior by a year who also happen to be in A&E rotation where their shift rotation makes it easier for him to help us out by showing places and lending his car.

KK didn't provide any permanent quarters for their houseman. Even their hospital looks like something out of Silent Hill. The only quarters at a nearby flat which they provided for a few days looked like something out of a Japanese ghost story where Toshio can just suddenly come out. We spent only one night.


All the while we have been looking through newpapers, mudah.com.my, advertisements on boards for any place to stay.

Again thank God Jai was around.

Food here is more expensive, and the local cabbies slit your throat (fares are minimum RM 20 per ride regardless of how near it is to your destination).

We couldn't move freely and food supplies were short as we didn't have places yet to place our groceries if we bought any.

In the end, I contacted a landlady and rented a fully furnished apartment located right in between all the three hospitals we were destined to rotate. Besides the furniture, the place also had a swimming pool and was surrounded by a few nearby churches. The nearest mosque was a bit to far to walk on foot. Oh yeah, no elevators and our apartment is on the 4th floor. Moving in was tiring but at least we had a roof. All we need now are wheels... My car is being shipped and is due to arrive in 2 weeks time...

In the meantime we still depended on Jai and Pak Tri.

Orientation week was heaven. Well not really but it sure beats working life. We still get paid while filling in tons of forms and listening to orientation presentations (I slept through most of it as usual).

Then we knew our postings.

Me, Nadhir and Jaz - O&G
Liyana - Pediatrics (though she had Trevors coming along, another fellow colleague from Manipal whom came along with us).

Reputed to be the toughest postings in KK. We were warned on day 1 that extension rates for both postings were high.

We started work on day 4 of the weekdays.

That was the start of everything new...

I remembered...

Depression.

Tips:

- Mentally prepare yourself for things to come even if you don’t know what. Me being mentally prepped to come work here helped a lot.

- Bring cash. You're like a UR over here. You don't belong. Not yet.

- Shelter, food, car, contacts. Contacts. Contacts. Fast. I can't stress how important.

- Bring lotsa pen and passport sized photos (like 30) cuz you'll need them during registration time.

Sorry you're not in the pic Liyana, tula sampai lambat. Meant to take a pic of us 4 before starting work but dunno why I didn't do it.

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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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