Kuli

Our system in the medical field in Malaysia is of total hierarchical dominance. HOD's words are final, and housemen are dogs.

Nope. You can't question what you are asked to do. You must do it. It must be done. Specialist orders the MO to get it done, MO orders HO to get it done. Not getting things done will get the MO screwed and will get the HO screwed by the MO.

Some things that are requested are so absurd that the houseman's job is practically suicidal ie. requesting an URGENT MRI that is NOT INDICATED. The houseman will definitely get screwed by the radiologist.

That's the houseman situation: lose - lose. He gets screwed up and down, front and back.

Sure you can speak up and speak up your mind. But unfortunately we live in a system where questioning your superiors might be disrespectful and outright RUDE.

What you say doesn't matter.

In meetings, houseman gets screwed left and right and asked to pay for fines (denda saman) they don't deserve, "Apa boley buat? Bayar sajalah"

Then an angel (a special specialist) speaks up on behalf of houseman saying that we don't deserve this shit. We should stand up for ourselves.

"You guys are doctors for God's sake! Leaders!"

I smell the wind of change.

I'm not going to start rebelling. But perhaps the next generation of MOs and Specialist can change the system where we really do work as a team. Where opinions of team members matters! Where working might actually be fun and motivating!

Because this life of kuli is certainly demotivating. I hate my job for this reason. But I am not giving up on it yet. Hopefully I'll be a part of the tide of change that will be sweeping the old ways.

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Rooftop Adventures

Sometimes you just need to explore a bit of your hospital and you'll find secret passageways to wonders beyond =D


Welcome to Rooftop of Sabah's Women and Children Hospital, or Hospital Likas.

Where people come to chill, smoke or in our case, take a few pics.






Thanks to Nadhir for acquiring the KEY.

(This is after working hours folks. Dont ponteng-ponteng. We are good boys :D )

IIUM Reunion in KK (2 July 2011)

Prof Nasaruddin came down to see his kid here in Kota Kinabalu while he and his gang did their electives here. So we decided to hava little get together at a local halal seafood restaurant (No Pork Served!)

Yes, I'm the usual loyalist, always feeling attached to something I once belong too. It was nice to see my fellow graduates dining together here far from home (except for Jai), gathered again for a temporary reunion. There's a lot of us I realized and we are all scattered all across the country, east or west side. Aishah, Fateha and Saiful Ehsan were absent here, along with some of our IIUM medical officers in KK.

All of us have one thing in common: we carry the name of our university we came from, the university that trained us to become who we are today. I guess its true when they say we reflect how our uni had trained us. I am proud that I came from IIUM and I intend to continue to set a good reflection of our university, and hopefully do it justice for all the training and teaching I have received from our teachers. I hope others feel the same way too.

It was nice to catch-up with Prof whom we noticed have lost quite alot of weight (diet ka?). He told us that rarely will you ever see one table filled with Malay Muslim doctors during his time. He is happy that times has changed for the better and hopefully more improvement will come from this.

After lobsters and buttered prawns, we parted ways. Insyallah that might come another day when another reunion will occur, perhaps in the west, in the East Coast, and this time we have changed into different persons.

Weekend Offs - Off

"Weekend off is a privilege, not a right"
Dr Suthagar, O&G Medical Officer (dunno why this quote stuck)

Orthopedics department was the latest department to have it's weekend off taken off following O&G, Pediatrics, Surgery (I'm not so sure about internal medicine). Reason given by Mr Nahulan, the Orthopedics head of department was that the replacing houseman (those covering patients on Sunday) could not perform well enough to present their cases. He feels that continuity is needed, in other words, the same houseman who had been taking care of the patient should be around to present the case when the MO or specialist does rounds.

It seems that the competence of housemen are in question. Despite having the numbers (even when halved, the current numbers still exceeded the amount of HOs that had to cover a ward a few years back) we still could not meet up to the expectation of our superiors. Why is that?

I refuse to believe that housemen are incompetent. Such labels are a disgrace after going through the trainings we had from high school to med school.

So what went wrong?

I believe it all comes back to attitude. I believe there is a lack of will for self-improvement. We took things for granted hoping that we could cover our tracks and hoping still that nobody finds out. There's no motivation performing better than what we could. As long as the job is done, nothing else matters.

Sadly this had to happen. With the weekend-offs gone, its back to 7 days a week work. No more early morning birding, no more over-time weekend sleep, no more weekend exercises, no more proper breakfast... In short, that's the end of 1 day of normal life.

The only thing to look forward to is that at least it's half day of work (although this might extend to the evening as in the case of O&G or if there happened to be additional unfinished work). At least its better than nothing.

I suppose we deserved what we got. Perhaps its for the best.

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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!)