Transferred....(brokened)

So.... an update....

I got my transfer... found out I will be going back to Kuching... to A/E to be exact. I won’ t lie... I was happy but a different kind of happiness. Not the YES!!!!... its kind of a melodic type. Why?... personally, this transfer is not a victorious one but a failure. Its a hallmark of failure in my life.

So forgive me for not jumping head over heels. Now every time want i think how did i come back?... it always come back to this... my stumbling block. While i guess i have to life through it and overcome it. The pass can’t be changed and the future holds a up hill battle. BIG SIGH....

So, what have I got out of this place called Kanowit. I try to sum it up its difficult. Lets see...
Pros
• Work wise i get to learn more of ward and clinic management
• I got to counsel patients
• OT cases
• Learn to make decisions (troubleshoot)
• The cost of living here is relatively lower
• I get to save petrol (i don’t travel much... the town so small)
• People are nice and friendly
• Work load is not as heavy
Cons
• There is only 3 MOs. Oncall almost 20 days a month. (10 active and 10 passive)
• Most of the oncalls are EOD (every other day) or ED (every day)
• I seldom have weekends off (oncall)
• I had a burnout episode from the frequent calls
• I got really bad with doctor patient relationship due to exhaustion
• Began to hate to see patients. Began to hate them and treat them like objects.
• Became more defensive
• Have a very calculative college (not helpful at all)
• I earn much less
• To have better food or the occasionall McD, I have to travel 60 km.
• For grocery I also have to travel 60 km
• Entertainment... close to non
• Don’t know what illness I picked up when I am here.
As one can see the cons list is far more longer that the pros. I guess in a nut shell I should be glad to leave this place. Wonder how would life be back in the city...

will keep this blog posted...

chicken run

Hello there, long time no write, well that’s because nothing happen, well nothing interesting happened so far. Until last weekend. I managed to experience cock fighting. Actually this was not my first time visiting the cock fighting arena. But this time I wanted to get some good pictures just for the heck of it. I was itching to click the shutter button every time I saw a fight. My canon 500D was calling my name, please press the shutter button, pretty please.

It all started the week before, my college brought me to one of the biggest cock fighting arena in my district. He was also a contender of cause, I mean his chicken. So with my camera and him and his two cocks, we entered the area. Its a secluded area under a huge tent where about 50-100 people there with their feathered companions, each hoping to win the fights and bring home some cash. As i entered the place, people were alarmed, staring at me. What is this white Chinese guy doing in this place. And what was even more distressful was the camera I was holding. Oh my, people were frightened, scared of the my “big” camera. (for your information, cock fighting here is an illegal activity but it has been around for years and years, since my grandfather’s time. But its a favourite pass time for the people here to just entertain themselves. They actually spent hundreds to thousands of dollar to feed, train and care for their precious 2 legged friend.)

So, as evil eyes stare at me, piercing into my soul, I got the message crystal clear. The boss there then approached me and warned me not to take any pictures (in a polite way of cause). With 100 to 1 I comply, packed my camera and watched as chicken fight to their dead, entertaining us. In my heart, I figured what a waste of precious camera time, well, better to be safe than sorry. After about 2 hours I took off, disappointed but determine I will get the pictures eventually.

Little did I know, after I left the place, the big boss arrived and asked for me. He wanted to see me but I was not there. He passed a message through my college that it was OK to the pictures as long as there was no faces involve. I felt “damn!!” I should had stayed a little longer.

Well, I manage to get the following week off and made plans with my college to go to another place where people knows me and they would allow photographs to be taken. I was psych. At last, I can get the pictures. A week of anticipation grew and grew. I also invited a friend of my to tag along, (she wanted to come). So on that faithful day, I got an unfortunate sms, “sorry can’t make it. Got family stuff to do” Errrrrrrrrr.... another chance wasted. ( I don’t know the place and to enter sure place, its better to be brought in by a person known by the people. Not a good idea to go there by yourself). My friend as also disappointed. Feeling disheartened and defected we planned to take a road trip just for the heck of it. While taking the drive to nowhere, we decided to drop by the place I when last week to ask if there were any fights going on. There, I manage to meet with the boss and this time he was much friendlier. We talked and he allowed me to take photos as long as no faces. I was head over heels. YES....

So we entered the arena. Same faces, same eyes. I went to the boss, he when announced to the people that I will be taking photos but only the chicken not the faces. People were sceptical at first my after a while, they got use to my presences and I managed to “bland” in with my tattoos and speaking in their local language. They got comfortable with me. I was then free to take as many pictures as I desired. I was in heaven. I try not to miss any million dollar moments. I was trigger happy. Click, click, click, click, click.

Hmmm.. side tracking abit. Some say cock fighting is cruel, bad, inhumane. Well, I don’t disagree with them on that. Its a cruel activity and no doubt about it , its illegal. I will not defend the activity but I have to agree, its very exciting. To see them fight, its an art. Even to train and to fix the blade is an art. I try to imagine if I were the cock in the arena. Its like Russell Crow in the Gladiator, thrown in the ring fighting for their lifes. To comfort myself, I would say, chickens die, people eat chickens everyday. Does it matter how they die????.... I am on the fence on this...

Anyway, I would like to extend my appreciation to the boss, the big boss, the people in the arena that day, my college and friend (partner in crime) and of cause my canon 500D... :P

More pictures visit my facebook : http://www.facebook.com/profile.php?id=607635825

little steps

So, what have I learned so far. I learned that I have to relax more and not let work take over my life or my temperament. I learned to do what I can and let God do the rest. I am still learning to take things one at a time. Its like a baby learning how to walk.

I also learned that I God is there and always there, its just that I had grown apart. I must learn not to be angry with God, not to blame others, its just the way it is. I need to trust Him more.

So, its all easier said than done.

Little steps

from humble beginnings

Once a long long time ago, in the southern province of China, poverty struck the people of China. The land did not bear fruit and harvest was minimum. All they had was their livestock and the cows and pigs were also dying. So in order to make the best of it, the people decided to slaughter their cows and pigs. Then winter came. Everybody was cool and shivering. Hence they would boil the meat of pigs to make a stew. For taste they would just season with salt and pepper. Somehow, the Chinese knows how to enjoy themselves. Later, they started adding herbs and Chinese medicine and the taste of the stew begin to evolve. Little did they know, through all this hardship they actually started a food revolution. As any good practical practise, this style of cooking was handed down from generations to generations until now.

Introducing BAK KUT TEH

If you ask anyone about Klang, chances are one word, “bak kut teh”. In Klang, bak kut teh is not just a meal, a dish or some poke stew, its is a religion, a way of life. I can still remember my grandfather, every morning without fail, he would dress up and hop on his Honda cup and ride to his favourite coffee shop and order a bowl of bak kut teh before doing anything else. Yes, breakfast is important but having bak kut teh as breakfast is even more important.

For the past 10 years, the bak kut teh phenomenon as blown up. Now, there are 10s if not 100s of bak kut teh stalls in Klang. Why not 1000s? Because not all bak kut teh stalls succeed. In bak kut teh, there are 2 fundamental elements, the pork and the soup. If your pork is tender and moist but your soup is not up to par or the other way around, people would not come. But on the other hand, there are different types of soup in bak kut teh, there are soup that are strong with pork smell, there are soup that are strong in herbal elements and there are blunt soup and etc etc. Because the people of Klang have develop particular affinity towards different types of soup, so only certain ones would do well. I have seen people adding seafood in bak kut teh, it did not do well.

In regards to the pork, there are many parts in a pig that can be eaten and made delightful. There is the ribs, lean meat, fatty meat, the intestines and etc. Basically it depends on people’s preference. Some even love the stomach, intestines and what more pig’s blood. But all need to be boiled well to perfection. Personally, I am a lean meat person, either big bone or small bone, as long its meat and not fat, its fine.

Due to its popular demand, cost of a meat for a person can reach to about RM 10. The irony is that it started out as a poor man’s dish. But in this time and place, I guess if the more people long for it, the higher the price will be. Simple common sense. 10 years also, a meal would cost about RM4, now about RM 10. But people still go, people still eat, people still pay. This is how dedicated Klang is towards this humble dish.

So, as a Klangite, I love bak kut teh. I am glad that people are still going all out to continue the tradition. The way I see it, it would last the test of time. It’s so strong that families, business partners fight over recipes. Some even break from the current stall to set up another one right next to the previous one. Its amazing how one dish has changed people’s life.

Hmm... can’t to think of it, I am hungry now... until next time...

toys toys

Isn’t nice to be back home in your one bed, waking up nothing to really do or care. I am now currently doing that and will be doing that only for another 2-3 nights. (i am on a short break). Holidays are always great no matter how short or hoe redundantly short they are. But I’ll take it. There is much to do this trip back home. I have bought a dell mini 10 that is waiting for me at home. Its a white one. I have always wanted to get a mini for mobility sake. And after months of research and asking around... I decided to get one. Its a dell....  why... mostly for the support system that dell provide. Its one of the best if, like me, working in God knows where.

About my dell, before i bought it i knew the limitations. Its for basic function computer needs, office work, internet surfing, some music, some shows only. Its not a proper system as a laptop or a desktop. So far is ok. I just got to get use to windows 7 cause i only been using windows xp for the past 8 years. However there is one hiccup. The system operating it is windows 7 starter. Its the basic system maybe suitable for a small computer. But there limitation, i just found up. Because it is a basic system, most of the features such as personalization are removed to created space for performance. Thus its quite a boring outlook. Fortunately, there are ways to go around it. Huccips such as unable to change your desktop picture or change your theme. I am not a theme person but i am a desktop person. My desktop must be interesting. I manage to find a program to overcome this problem. Currently my desktop is super cool !!!. Next is to get a cool laptop bag to go with it.

This takes me to my next money bleeder. I bought a 4k camera. Hahaha... I don’t know I always liked photography but didn’t got into it. Financially not compatible. But now, I decided, life is short and I only live once..... so, splurge. I got a canon 500d with lens 18-200. Its within my budget. Its a camera for beginners. Huh, beginners,? Imagine how much the professionals pay. That’s why good photographer are paid so much during special occasions. Plus, its something to distract me went I go back to the “hell hole”. I don’t want to go down the spiralling stair again. So in my future posting hopefully there will be drop dead gorgeous pictures. Hahaha....

Till then....

options

So, after day and nights of pondering, I decided to fill in my transfer. I decided to still stick in clinicals no matter how horrible it is. But I also decided that I don’t want to do calls for the moment. I also found I would not mind to be exposed to the administration side. Hence this is my transfer application.

1. Polyclinic Bandar kuching
2. JKNS
3. Jabatan Kecemasan HUS

Hmmm… fingers and toes crossed.

tribute

I have been a reader in the citizen’s blog (CB) of the star online for quite sometime. Most of the time I love to see the bloggers bash each other and with their childish comments. Some have very strong opinions and some have lovely poems and life experience to share.

Today I was browsing through the blog reading the entries when I came across an entry. It was by a daughter of a blogger I use to read. His last entry to the blog was on 23/5/10. That entry was special, that entry was personal. I still remember I was in the airport reading the entry and tears started falling down. It was a blog entry of peace and farewells. Basically he was apologizing to his fellow peers of the wrongs he did on the net and all the tails he stepped on. He was straightening everything and saying his peace. As I read the entry, I learned that he had cancer and was scheduled for surgery. He was worried that he wouldn’t make it through the operation hence the blog entry. That was the last I heard (read) of him.

Today it was an entry from his daughter. Introducing herself to her father’s peers. As far as I know, the surgery when well. The entry was a sad one. Her father passed on. It was a shocker. Then I begin to search her father’s pass entry. Very very very interesting. He was a man of moderate standards. He really when through a eventful life. Life wasn’t a bed of roses or served on a silver platter for him. He had been through so many ordeals. Yet he turned out okay. (love the one that he taught how to cook prawn mee)

Reading his entry, his life experience, I can't help reflecting on mine. One thing what struck me was he was a traveled man and well learned person given his background. His was a person who was able to survive in many any situation. He was a cook, hawker vendor, an electrician, sound technician, guide, scuba training, boat shop owner and so on. He faced financial turmoil, family issues, so many stuff. Yet he lived. Yet he lived. Amazing!

I am not going to say much. Just that. I don’t really know him but I know he lived, that’s what ‘s important. Most of us don’t. You shall be missed “sjzhuang”

(if you wanna read bout his entry – check out http://blog.thestar.com.my/search.asp?page=1&search=sjzhuang&type=blogger)

crossroads

Decision, decision, decision…. So.. after my fiasco the past few weeks, today my hospital director and me talk a talk. Well I must say I found the chat quite relieving. She was motherly, kind, caring and most of all concern. Honest to God, I really don’t deserve her as a boss. She came across warm, no hostility, no claws. Thank you God.

Okay, I was suppose to become the next director of the hospital. I was suppose to take over the place in July. But things didn’t turn out that way. Mind you, its not that I wanted the post. I never wanted it. But because of seniority, I was “forced” to take it up. And when its “given” I really didn’t know how to say no. So that was the plan. However, ya it did not, will not happen.

What’s next??? The way I see it, its either I still say in clinical, or venture in to administration or in to research. As far as it goes, I have always been exposed to clinical work. Seeing patients, interpreting results are part of my life so far. The long working hours and not knowing tiredness as been my vocabulary. I am so called in tune with this or am I ? The truth is, I have always wanted something else. Something at involves office hours and public holidays and no on calls. I don’t mind seeing patients. Lots and lots of patients if there is a time out or a limited time is okay with me. So, if I were to go into clinical, its either polyclinics that involves lots of patients in the day and on and off oncalls. Maybe public holidays. There were be lots of referrals too. Another option is to go back to emergency and trauma. There is no on calls, there will be shifts and on nights. No public holidays. Frankly after a year in E/T, its quite only. Given a choice, I would like to do other things of cause I already know the life there and monetary value of it. I don’t think I would go into other fields cause, medical and surgical is hell, orthopedic has long hours of surgery, O/G is the mother of hell. And not interested in ENT or ophthalmology or psy.

In administration, hmmm… I have no experience in it. JKNS. As fas as I know is lots of meetings, paper work and etc. It would be interesting to see the other aspect of medicine. It would be interesting to see and understand paper trails of administration. It would be nice to go back at 5pm and have a life on weekends. It sound very very tempting. Of cause money would be slightly less. No oncall claims. But in exchange, a life. About future prospect?... hmmm I would likely be involve in public health.

The other is research. What is that???... I have no idea about research. So, a BIG KIV on it. 

My director asked me to be truthful to myself. To know my limits. Is clinical for me? not much of a confidence boost. The question is, will I be able to continue seeing patients. Will I get mad??? Will the demon turn up??? Then the next question is why am I like this when I wasn’t before. The stress levels in E/T were much more, way more then this but why now? I may be frustrated with my situation here. But what I know is that I don’t want to do calls. I want a life.

The other option is not to do anything. Stay put here. Right the wrongs I did. Deals with my demons. Be a better person. Be the person I was inside by myself and not dependent on the situation around me.

What do I do????? What do I do ?????

teacher vs doctors

Teachers must rest for two Saturdays in a month — D-G

June 5, 2010, Saturday

PASIR PUTEH: Principals and headmasters of primary and secondary school must allow teachers in their respective schools to go on leave for at least two Saturdays in a month to reduce their stress.Education Ministry director-general Tan Sri Alimuddin Mohd Dom said they (principals and headmasters) cannot force teachers to be involved in co-curriculum or academic activities every Saturday.

“A circular has been issued to all schools regarding the matter,” he told reporters at Sekolah Menengah Sains Pasir Puteh here on Thursday night when commenting on grouses and complaints from teachers that headmasters and principals were forcing them to conduct extra classes every Saturday.

Alimuddin said schools can have extra curricular activities on alternate Saturdays, based on a roster, to give time for teachers to spend some time with their families.

He added that if a public holiday happens to fall on a Saturday, schools cannot force teachers to be on duty.

hmmm.... what bout us... 24/7 no weekends or public holidays. haiz.... any comments?

success

Success is waking up in the morning so excited what you have to do you literately fly out the door. It’s getting to work with people you love. Success is connecting with the world and making people feel. It’s finding a way binding people together with nothing in common but a dream. It’s falling a sleep a night knowing you did the best job you ever could. Success is joy and freedom and friendship. And success is love.

-Fame-

the story so far...

So what happened to the boy?… He was giving and giving till there was nothing to give.He turned against his patients who all looked at him for help, for hope. Every time when he look into the eyes of his patients, pity turned to anger, love turned to hatred, the willing to help turned to “how can I make you suffer more”. The demon took over.

Eventually the staff got worried, worried for the boy, worried for the patients. The boy became a demon. Instead of helping, aiding, he made things worst, bad decisions, wrong diagnosis hence the patients suffers, the patients dies. It makes him to rethink, was he really a doctor, did he really cared, was he always like this, does he have a psy problem after all.

Then a psy MO came and meet him. Talked to him, asked him to take a few days off and to rethink everything. Did he had a meltdown? It feels like he was damaged goods, no more an instrument of help, a functionless person in society. Sigh!... a liability.

So, he took the days off. Traveled the whole Sarawak, from Sibu, he took an 8 hour bus right to Miri, met up with his “rock”, it was nice. Then he took a 14 hour journey down to Kuching. Met up with his support system. He really needs it. A few days just to let everything go. To find his old self back. To rethink his life, to rethink solutions.

Nothing really came out of the journey. one would think that revelations would come after a long inspiring journey. Not... but nevertheless it was good. The boy now knows what is important and what's not, when to give in and when to give up. Only the future will tell if he made it or not. Baby steps to recovery...:)

Currently he is back in Kanowit fighting the battles day in and day out. And so the story continues….

spiraling down

Some days were worst than the others. If there was an emergency, or an operation case or an assort cese, the hospital would be down by one doctor. And if the other doctor was on leave or on course, then all hell breaks loose. Only one doctor to hold the fort. Its kind of stressful and scary when you are alone. At times I think God was taking a back sit and just amusing himself watching us running like cartoons.

The hospital was not a big one. There is no specialist, just blur MOs trouble shooting treating the patients. As long the patient don’t die, it should be fine. You can’t expect much cause non of us are specialist, non of us are specialisted MOs, non of us knows what the heck are we doing. We are just over used, multipurpose MOs thrown into the jungle and hopefully we function well.

The first 3-4 months were bearable. On call quite frequent. My calls were the always bad. But I was always like that…. HOT.!!!. As time goes by, tiredness and depression begin to creep in. Its funny, you don’t even know that you are tired or sad…. Cause you just work and work and work and give and give and give and work and work.

The MOs here does back to back calls. We very often do active then passive then active then passive and so on. If you have a bad passive call, its difficult to function as active the next day but we persevere. Not knowing the demon is actually raging within me.

So, more cases come, more referrals done, more bad calls I encounter. The days got worse and worse and my mood didn’t improve either. (You can read my facebook comments bout this place.) Until one day, I felt cluttered, cornered, unable to think straight, just want to break free. In the mist of the chaos, I got really irritated. So I started to be grumpy. Snapping at hospital staff. Scolding them, shouting at them like dogs. No one has the right to be treated like that.

Condition didn’t actually improve. The irritable level has gone up another level. Grumpiness increased, I got physical. Banging on tables, kicking chairs, breaking doors and breaking glasses. At that time, when I did it, I was like SNAPPED. I started to think about protecting myself, self preservation. I need to rest, need sleep, need to leave this place. I started to ask myself, why am I doing all this? Where is God? I take care of people but who takes care of us. Who takes care of our well being. Where is my support system here???

Perhaps my threshold was lower than others. How did the other 2 MOs survive? I need to learn from them. I think they have a good support system. One is from Sibu and the other one’s “kampong” was kanowit itself. I was alone. But I ignore it. Who needs support? Who needs all that? I did…. I had no outlet. The symptoms escalade, now I begin to turn against patient. That is the worst. I will treat them but I will give them a very hard time before that. Scold them, curse them, patronized them, I am evil. Because most of them were Iban, I realized I begin to develop hatred towards Ibans. Racism.

i was in a shit hole. It got so bad for me that I have phobia watching shows involving medicine. I startle every time I hear the phone ring. I feel like a cornered animal.

the phone call

Then one fine day while I was dealing with a road traffic accident, I got a call. A call what would nail the second nail in my coffin. The call said that I was going to be transferred to a district hospital… call Kanowit… where the hell is kanowit.

I just said ok, I was busy. It didn't sink in yet. What did I say yes to???... hmmm… later that day, I googled kanowit, its in sibu district. About an hour from sibu by boat or land. Not too bad. I heard that I was the third MO they offer the position to. The other two threatened to quit if they were send out. I heard that the MO's situation there was horrible, only 2 MOs in a place that big. So I didn’t reject it. My boss also said just go, get the experience and then come back. Hmmm… so I just packed and left. Looking back, this was not in my so called plan. It was a detour.

So, arrived in Kanowit hospital, not too shabby. The town was a single street town with shops at the side of it. There is a water front, a stadium, a fire station, couple of school, and of cause a hospital. Reported to the hospital director, she was a very caring lady. She was no doctor but a person who loved her work and was passionate about it. Meet up with my colleges, one whom I already know and the other who was very quite.

Started working, I was in charged of A/E at that time. So most of the cases were referred to me. I guess it was okay. To give the other 2 MOs a break. The out patient department was hectic. In average a day, there were about 100-130 patients in the clinic. On addition to it, there is also the wards. Hmmm… it seems a lot. Yes it was a lot. On calls were like 20 per month. I don’t know how the 2 MOs did it… amazing.!!!.

I did not know what I got myself into....

happy days

So back to becoming a MO. I was one of the lucky ones. I manage to get into the department that I was interested in since year 4. Emergency and Trauma. YES!!!! Why?? I love the adrenaline rush, I love the shift system, I hate to see patients for too long, I hate ward rounds, I love to go home and not be disturbed by doubts and similar patients problem tomorrow. You see, after housemanship you will more or less know what you like and what is cut out for you. For me, its E&T. Bosses were nice, colleges were great. And the best of all no on calls. Hehehe…. I am the lazy kind of doctor. I good doctor but the lazy kind.

In A/E, a MO has to cover green, yellow and red zone. Personally all was find by me. The doctor is the first to see the patient and to get the initial diagnosis and to initial the primary management. That’s the challenge. You will have diagnostic challenges and management challenges. You will face with angry patients, grieving families, drunks, gang fights and etc. It’s a “colorful” place to be. You will never get bored. That’s why I choose A/E.

In my one year in A/E there were bitter sweet memories. Because A/E is not a primary medical team, it’s just a support team. Referrals are important. Correct proper referrals are vital. So there will be lots and lots of argument and disagreement among MOs and specialist. Don’t get me wrong, because there is more that one cook in the kitchen so, there are many ways to cook a chicken I guess.

List of pros in A/E
- no on calls
- can do locums
- in general earn more
- shift system
- no ward rounds
- get to be exposed to all disciplines
- not boring
- sometimes can relax when there is no patients
- you become a diagnostician (so call)
- you can have a social life

List of cons in A/E
- you will get your hands dirty
- first to touch a case (anything goes wrong somehow you are involved)
- have to deal with family members
- the front liners (it’s a disadvantage in SARS or H1N1 season)
- all hells breaks loose when there is a disaster
- you learn wide not deep
- you have to refer (its horrible if you are suck with shitty MOs on the other line)
- socially you have to make new friends cause your other colleges are working when your are not and are not when you are

Long story short, I loved A/E. Of cause again, its not all a bed of roses. Green zone can be overwhelming. And on weekends and public holidays all zones will explode. But no matter how busy you are there always a time to punch out and leave your troubles in the hospital (not to bring them home).

On a personal note, I think this was when I begin to develop the demon in me. Hmmm… all the while the demon in me was always in checked. I know how to suppress it, I know how to distract it, I know how to deal with it, I know how to ignore it. But sometimes when things go out of hand mostly work related it tends to manifest itself. Its always been swearing and swearing and swearing but that’s it. ( I think I have learned most of the words available in the Malaysian vocabulary).

I assume it’s the stress. A/E doctors need to work at a pace to clear patients as fast as they can. So the more patient pour in the faster we have to work. And work correctly, diagnose it correctly, treat it correctly. Its part of the job.

I ok with it, I liked it, I loved it.

the evil faces of medicine

Now, hahaha… entering another era… becoming a medical officer. What does that mean?... more responsibility, more work, more hours in hospital…. Not a very good idea. By this time, I have friends and colleges leaving the profession. Most of them, just can’t take the long hours, the stress, the burden.

Looking at my friends who left the profession, I really do understand their sentiment. I do understand their disappointment, I do understand their lament. Its not easy to reach a decision to say “ I throwing in the letter” after the time and money spend. Many who stayed on was either very passionate about the work or they have just have no other choice, they can’t do other stuff. They were just stuck.

I admit that thought did cross my mind more than once. Why suffer to people? Why suffer for people who you don’t know? Why sacrifice yourself, your time, your soul, your energy, your emotions on people that you don’t really care???... come on… how many patient do you see will actually come back and thank you???.... for me maybe 2 or 3…. Yes, there is the moral question of being “ikhlas” but how much can one take? How much and how long can one be sincere. Mind you, in this profession, people won’t remember you of the good deeds that you do, just the mistakes that you make. THAT”S THE SAD TRUTH. Try asking a doctor college about the patient you safe or help last week? Chances are no one remembers. Try asking about the mistake you make? Most will remember it till kingdom come and trust me they won’t let you forget about it. In a way is good (not to repeat mistakes) but its like a torn in doctor’s life that can’t be removed. I have my fair share of torns. This is the ugly face of medicine.

Coming back to doctors who stopped their service in the government or just stop serving people, personally I really admire them. It is a very courageous thing for them to do. To say the hell with it, screw you.

I mean, first of all the money is not that great. True the government has increased the salary and the oncall claims but is it enough? As a MO, my take home salary was about the range of RM 4500. (I am in Sarawak, colleges in peninsular earns less). On call claims for me is about RM 2000 to RM2500. It looks a lot but remember I am oncall 20 days a month. The work put in is not reflected via the money entering my bank account. For me, I am single, only one mouth to feed. How about married couples? You figure the math. The reason people say doctors in sabah and Sarawak earns more is not because of the high salary but because of the less expenditure. (this is only in some cases – this is untrue about the doctors in the rural area, cost of living is higher – why – do you thing the transport of goods are free?). By less expenditure, I mean where the hell to I have time to spend money when I am oncall 20 days a month?.

Secondly, time, time, time. You can’t turn back time. The time you loose, you loose. That’s that. Doctors quit because they can’t take the hours. Hmmm… sounds selfish? Not at all. Imagine if you are a houseman or a medical officer (I can’t say specialist – I am not one yet – I write only what I know or think) when you are oncall you can't go anyway, you are tied down. You missed the delivery of your child, your parent’s birthday, reunion, celebrations, your anniversary and other important events in life. Events that only comes once in the life time. I have colleges that his son don’t even know he exist. Why, he missed his birth?. Sad? Very sad… I personally missed 3 Chinese new years reunion dinners. I have cousins and nephew and niece that don’t know they have an uncle. Go figure. My grandfather don’t recognize me. My grandmother don’t even bother asking me if I am coming back for Chinese new year. Haiz….. yet we still do what we do… kind of stupid.

Labour laws, has no say in the medical profession. Doctors work everyday 7 days a week, weekends and public holidays. Ever wonder everytime you go to a clinic, you see the same doctor?.... hahaha… its like the doctor live and breath hospital air and water. Pathetic isn’t it?. Yes, the government has came out circular that post call doctors can rest the next day and doctors get 1 day off for every 6 days of work. This might be doable in peninsular, not in Sarawak. The shortage still hunts us. No breaks, no days off, just work. The only breaks for doctors are the leaves that are entitle to them. 25 days in a year. (that is if the leaves are approved). Senior consultants say doctors are professionals. What does professionals mean? A person who works and does his best for the patients, a person who don’t know the meaning of tiredness, a person who has prefect judgment after working 24 hours sleep. Hmm… that describes a robot. Well, doctors are robots then. So people quit.

Ever wonder that happens to the doctors that quit? I asked my colleges that resigned. Its scary no doubt, its full of uncertainty, its exciting, its feels like a burden has been lifted up, its like you are free, its like you live. Wah!!!!!!! This responds was directly quoted. No sugar coating what so ever. I can’t really say because I am still suck in the system. I have no balls.

Okay, not all my colleges quit because they can’t stand the pressure and the lifestyle. Some of them really really hate medicine. I am referring the doctors who sacrifice but yet throw in letter. Some of them when in the private, some of them open GP clinics, some of them when in to pharmaceutical, some of them when in to direct sales, some of them just got married. Those in the private setting, life is good. Office hours, weekends off, some of them do on calls (not that hectic). They still see patient but a different demographic, the paying kind. Who can blame them, no one can, no one has the right to do so. IF YOU DON’T TAKE CARE OF YOURSELF, NO ONE WILL…

Example – a very good friend of mine, he actually hate, loath medicine. (did it for the family). After a few months of housemanship, he threw in the letter. Then, he when in to direct sales. Suffered a few months, suffered rejection, persecution but he really hates medicine. Now, long story short, he is laughing all the way to the bank. Working hours are according to him. He is the boss. Life is good. Always a smile and always fresh everytime I catch up with him.

Another story, quit after becoming a MO. Start own GP clinic. Starting was rough. Built connections. Got other doctors to partner with him. Continue to see patients. Currently owns his own string of GP clinics. Working flexi hours. Paying other doctors to locum for him. Able to go to long holiday trips with his family. Sleeping well. No regrets.

Couple of my special also left. We all it “jump boat”. These are people that already when throw the hellish housemanship, becoming MO and sat the exams and passed it. These are people who are passionate of their work. Yet, they leave. Why? Numerous reasons, money, working environment, acknowledgements and so on. Can’t really comment on this cause haven’t gone through it yet. But I understand why they leave. One would definitely want a better future after sloughing day and night. One would want a better paying job with better working hours. By that time I presume that they would have children to provide, bigger mortgages to pay and higher expectations in life. It would be weird to see a specialist driving a bit up car and living in a run down place. Call me traditional but its shameful. And so they quit.

I guess different people have different threshold and endurance level. Some can take it, some just can’t but I guess all have something in common. They all want to help but they need to take care of themselves first. The working environment actually hasn’t changed to the past 50 years. Previously the pay was even less and the on call claims were close to nothing. Yet, there are people that survive it. Ask the veterans, the consultants, they actually went through hell over and over and over again. Have the current doctors became too pampered, became soft. Or have the current doctors woke up and realize that they have rights after all.

housemanship (part3)

My third posting was O&G. yuck!!!!!! It’s the posting I hate the most. I hate the smell of liqua, the screaming mothers, the shouting nurses and the crying babies. But its compulsory of everyhouseman to go through it. I was lucky, because of the system making everybody going through O&G, we have more than enough of houseman in this posting. I was talking about 20 housemen at one time. Hahaha… So my calls weren’t that frequent. Maybe 4 to 6 calls a month. It was a drastic culture shock. I use to spend most of my time in the hospital. Busy and running about like a cartoon character. But here, I won’t deny it was busy but we had enough people to cover the business. Enough people in labour ward, in maternity, in gynea ward. Life was good. First time punching out at 5pm if I was not oncall. I actually had a life. I could go shopping, to the gym, hang out with friends, eat proper meals. WAH.!!!! This was heaven.

On call days, of cause was hell. In O&G, the labour ward does not sleep. Babies don’t actually have a schedule went they want to be delivered. They just come out when they want to. So on call days were hectic, emergencies LSCSs, big baby, TMSL, SMSL, cord prolapse (I had 2 cord prolapse) etc will happen when I am oncall. I am beginning to notice that I am “hot” (meaning – shitty thing will happen on my watch – even my MOs were afraid of me). But no matter how bad the call was, by 7am, an army of houseman will turn up at the door to relief us. So life was relatively better.

As much as I hate O&G, I enjoyed this posting. I got close to my MOs. Found my “drinking kaki” and my “clubbing kaki”. (as I said, u need a good support system). I guess I didn’t learn so much of O&G in the 4 months but more of life and there was much more to life rather than hospital life for a fellow doctor. I saw the light and got a glimpse of life.

Thank you.

a day in my shoes

This is an account of a normal day in medical (oncall day). Wake up at 6, ask myself – why am I waking up in sure ungodly hour. Sigh. Bath, brush my teeth and got ready. Drink my coffee. Head to the ward. By 6.30-7.00, in the ward, do blood taking for the cases that was suppose to the taken (hemato patients), try to do ward rounds before my MO arrives. (never in my medical posting I was able to finish my own rounds. I had 30 something patients). By 8am, my MO and my specialist arrived. We start ward rounds. Round and round and round the ward we go. I would take care of the patient that was admitted that day so between calls I would disappear to attend to the new cases. At about 12 to 1pm, finally round finish. Next was the blood taking. Quickly grab the specimen bottles, lab forms, fill them up and start the blood taking. Sigh…. Most times it would like take 1 to 2 hours just to complete the taking (I was good at blood taking. No matter how hard the vein was, I will get blood somehow, don’t ask how). Quickly run the blood to the lab, quarrel with the lab staff, I need the results fast. (typical argument that occurs everyday). Rush back to the ward to do referrals to other departments. Get scolding and undermind by other MOs but as long as they come and see the patient my job was done. Then carry out complicated procedures. (this was the best part) lumbar puncture, chest tubes, peritoneal dialysis, IJC insertion and etc. Everynow and then there will be patient decided to collapse on you (die)… rush, call the anas, start CRP, intubate, start the inotrope. Frankly hoping the patient dies so that there is beds for other patients. After half an hour of resuscitation, pronouns dead then continue my work. By 3 to 4 pm, we start pm rounds, hoping the results are back from the morning rounds. In between grab a bit or a drink. Very seldom I get to eat a proper lunch. After the pm rounds, maybe 6 -7 pm quickly bath and eat dinner and get ready for hell. Check the list, who is my MO oncall today. Complete my blood taking. Get handovers from my other colleges, what to look out for, what investigations needed to take or to be trace after office hours. And pray, pray very hard. Never wear red underwear. So as the night goes on, do rounds on acute patient, get referrals from nurses and do referrals. Attend to the new cases. Being medical ward, cases will come in almost every hour until the ward is full. Try to get pockets of sleep in between cases. Try to last until the morning. Try to keep patient alive until the next morning. Just keep trying to do the best I can.

Come the next day, blow a sign of relieve seeing my colleges arrive at the door step. What a relieve. Go take a bath. Go eat breakfast. Start my ward rounds then wait for my MO and specialist to come. Once my bosses arrive, again ward rounds starts. The cycle repeats itself. The only difference, I don’t have to attend to new cases admission that day and I can go home after pm rounds. Of cause I was working at half or maybe a quarter of my capacity (depending on my calls – still remember one of my calls.. had 2 lumbar puncture, 2 CRP, one lumbar puncture and one peritoneal dialysis – all of them were after 10 pm – the next day was a walking zombie)

That’s my typical day in medical. Somehow at the end of the day, yes you feel tired, yes you feel drained, yes you feel numb and you just want to hit the sack and go to wonderland but I don’t know, as a houseman, I felt I was doing something, I was helping, I would give and give and give. And if I am down, I would give somemore. I don’t feel angry, I don’t feel sad, I don’t feel taken advantaged of. I think if you ask me to continue to do calls I would do it. (weird and dumb). Why???? I guess at that time I was inspired via my specialist, my MOs, my colleges. ( I had great great great people around me)

I was tired but happy.

housemanship (part2)

My second posting was medical, the most chaotic place in every hospital. But it was bread and butter of medicine. Unfortunately we only have 4-6 houseman at the time. You can imagine my calls in a month. 12 to 14 calls a month. It was crazy…. We cover everything. At a time one houseman would have 20 to 30 patients under him. I had 20 to 30 patients under me. It was scary. I can’t imagine my MOs feeling. Drinking coffee, coke, latte, mocha, they were my driving force during calls. But no matter how busy one was, it was still fun. (I know, u you might think I am some kinda nut, but it was fun – why – because of the staff here, my colleges, my bosses – all of them made a huge difference. I thank God that my specialist that was in charged of the housemans was very very very understanding. She had even implemented shift system because she saw us tiring and burning out. But that did not work out. However it’s the thought that counts, the acknowledgement that we were working hard and the appreciation that keep me going).

Of cause there were screw ups here and there, scolding every now and then, arguments and quarrels, break downs, its not a bed of roses, rather a bed of torns with one or two roses in between. Quoting my cardiologist – you learn through your mistakes but better if you learn through other people’s mistake. (one thing I wanna stress is that you need a very very very good support system if you can’t take it. It doesn’t matter if its ur family, friends, girlfriend, boyfriend, wife, husband, fuck buddy, porn, smoking, alcohol, drugs. As long if it get u through the day sanely. Now I know why the doctors in greys anatomy are so horny)

housemanship (part1)

As a houseman in this country, its basically a learning period given. Either you learn, be good and find your place in the medical field or your are screwed. Housemanship is like a legal torture period allowing senior medical officer to screw you and we accept it. We will be physically drained due to the oncalls and work thrown to us. Its either to break or be broken. BUT I was up for the challenge.

I still remember standing in front of the mirror, taking a moment, staring at myself wandering. Is this a face of a doctor? Maybe? Maybe not?. Put on the lab coat, hang the stethoscope around my neck and visualizing hmmm…. doctor… cool!!!. The next question was where to do housemanship. I knew if I wanted to serve, I wanted it to be a place of needful, with vase opportunities to learn procedures and my work to count. I thought east Malaysia (Sarawak and sabah). Fortunately, I had a bunch of friends who also felt the same way. More like 6 of us. So we applied to Sarawak and all of us got it. Yahoo!!!!!!! (mind you I had never been anyway close to Sarawak, do they live in trees, do they even eat similar food?)

I was happy.

I knew the life of a houseman, I knew the hardship that was before me, I knew the shitting things I had to go through. (kinda stupid knowing all that yet jumping in head first). I went. Packed my stuff, transferred my car and to Sarawak I went.

The first few days, I had wonderful help from a church paster bring us, (me and my friend) going house hunting. The paster was an angel. Thank God for him. By the second day we managed to secure a house, a 4 room banglo with a compound. It was nice. All 6 of us shifted in. For us I think we were use of packing and unpacking. During our student days it involve lots of traveling from uni to hospital to disctricts and so on. This was nothing new.

Day 1 – We meet the director of the hospital. He greeted us and charmed us with the prestige of working in that particular hospital. Whatever all I heard was bla bla bla bla…. I was nervous for my first day. Got the news, I was in surgical rotation. Went to the ward, meet my colleges, introduce my self to my bosses and then threw myself at work. Usual first days' dilemma, what the heck am I suppose to do?. Basically I was blurrrrr. Thank God there was a tagging period. It’s a time to pick things up, blood taking, clerking, ward rounds, procedures, oncalls, referrals, red flags to look out for and etc.

I was happy

Days, months,… work, work, work…. I admit it was tiring.DREADFUL As a houseman, one will get physically tired. When you are oncall, one will work for close to 32-36 hours straight. I would come the hospital before the sun raises and leave after the sun sets. I missed the sun. But I had good colleges, good medical officers that helped and teach, good boss that was considerate. (we were lacking of man power in Sarawak. Thus, housemans were doing about 10-13 calls a months. Meaning if you are oncall on Monday, you go back on Tuesday and bout 6pm and the come back on Wednesday to do calls again). Somedays were worst than the others. People were doing calls 1 in 3days, or 1 in 2 days. But its all for a good cause. So I ignore the tiredness, the pain in my joints and muscles, the tiredness of my eyes, the soreness of my back. Chin up and continue working.

I was so so happy

unidays

Entering uni was a whole new experience for the boy. new people to meet, new people to hate, new task to undertake,new enlightenment about one's self to be discovered. the first 2 years was about theory. basically its just hitting the books, memorizing, vomiting it all back to the lecturers. thats part was easy. so to speak.

Along the way there were make ups and break ups. Unbreakable friendships made from unlikely personalities that the boy would cherish till this very day. he and his fellow friends suffered to thick and thin. Literately sheared tears and blood. medical school was awesome...!

Come third year, he was send to a teaching hospital, the very first time exposing him to his future life as a doctor. This was what he see saw

-tired houseman
-overworked staff
-wards that was packed to the brim
-no enough working space
-36 to 48 working hours

Oh my gosh... was this the life he signed up for. Hmmm…. But the boy just ignored his heart’s lament. He often stayed over in the hospital with his friends overnight learning, reading, observing and getting scolded by the staff. (for your info – medical students are regarded pest in the hospital. They know nuts, they do nuts and they are just objects hanging around in spaces in the hospital with no apparent value). But its okay…. The boy persevered. Though he wasn’t the best in the class…. Still he managed to pull through year 3, 4 and then 5.

But somehow there was a little voice behind his head whispering and doubting his decision applying for medicine. Was it the right thing to do? Was it worth the sacrifice he made to continue studying. The celebrations he missed, the moments with his family he missed, the birthdays he missed, the reunion he missed. Was it all worth it? While his other non medical friends were enjoying life at their prime of their life. Is becoming a doctor really that important?

Honestly, looking back now he should have done something by then. He just doesn’t have the “ball” to do so. Hmmmm… should his parents be blamed also? “Hang in there, it will get better later….”. The only thing that was running in his peanut sized brain of his was the “financial security” that he might obtain once he completed the course. Sigh, how wrong he was….

Long story short…. 5 years passed, final exam sat, results not too bad, manage to get a “dr” in front of the boy’s name….. medical life here he comes…

the decision

following the "incredible" results in STPM, as usual the boy's parents and teachers were so so so so proud. can't deny the fact that the boy was also quite happy. but what then? typical malaysian thinking, the most logical think to do is to apply to a course that had a good prospect in the future. course such as medicine, law, accounts and engineering were the top of the list. well, from day 1 the boy was incline to science courses, biology. with this logical deduction, its natural to apply for medicine.

thus, like a lemming, first choice - medicine, second choice - medicince, third choice - medicine, forth choice - medicine, fifth choice medicine. little did he know, he was nailing the first nail in his coffin.

anyway, at the time it was exciting. medicine!!! it was a big thing. growing up watching ER, chicago hope. wah.... the boy was going to become one of them. helping people, saving lifes. posted the application and waited

in 3 months, results were out, yes!!! he manage to secure a place in a local uni. this meant that his parent don't have to spent a fortune on him. he was also glad that his parent's savings was spared. what next??? to uni he went...

the teens

entering secondary school, it was a weird transition. the boy was still a nerd in many ways. still stick to the books. still sits a the first or second chair from the backboard. finishes at least 3 workbooks a week. still is teacher's pet. (so to speak)..

social life hmmmm.... he has friends, i would say a healthy balance of nerdy and cool friends. had a few crushes, discovered girls are way more cooler than hotwheels and tamiya cars. :) discovered that he likes hittng the drums, actually love banging the drums and was pretty good at it. found out that sometimes the bookworm gets the girl. who says nerds don't get the girl... in the real world they do...

in these times, the boy accidentally discovered porn. mostly via the norms, internet and friends. discovered about tits, breasts, vagina, g-spots, french kissing, mastubation and the list goes on.... its a weird and stressful era for the boy, so confusing and so much distractions.

by this time also the boy discovered that he has a temper. he gets all worked up if things don't go his way and or don't go as plan. unfortunately, anger and rage usually takes over when these happens. stuffs from pen to clocks to plates will be flying across the hall. not really something to be proud of. it gets worse later...

despite all this, the boy was still focused and maintain good grades, very often top 5 every year. infact he was involve in every prize giving ceremony except form 4. eventually he got into form 6 and As it. typical fella...

about a boy

there was once a boy who lived in klang. he was a timid little guy. goes to school, does his homework, love to watch tv, not so much of a sports person or a video game guy. just a simple timid guy. in primary school, he use to be the bookworm, listening with eagerness to the teacher, absorbing knowlegde like its his like.got his first spectacles at primary 3. after school his grandfarther will be waiting under the tree with his honda cup and a red helmet for him ready to take him home.

i can still remember that this little boy was so afraid of the rain. why??? its because if its raining his grandfather can't fetch me and he have to wait all alone till the rain stops. tears will fall as he watches heaven crys down on him. however like every school going boy, this boy out grew the fear for rain and thunder. because he had to make room for other more important dismays.

from primary 1 to 6, nothing much was going for this little boy. both parents were teachers, grandfather was a self-taught english speaking and writing clerk, so its only natural that education plays a vital roll in his life. eveyday the timetable was about the same. school, homework, tuition, abit of tv, actually alot of tv. not so much of sports. he always was the top 3 from primary 1 to 6.... (predictable little nerd)

errr... no love life then, was still playing with hotwheels and tamiya cars and think girls suck. :)

introductions

hi... first and far most i would like to clear that i am no blogger or a person that writes or keeps a diary. however i think i need this to keep me sane from all the things happening around me lately. i don't expect much to come out from blogging but will try it anyway. so here go nothing.... by the way i am dyslexic