圣诞节的感恩和感慨

Hohoho!! Merry Christmas, Merry Christmas boys and girls...

这是我在圣诞节里最爱重复的一个句子，见到谁都会用这个来打招呼，就好像在农历新年里“每个人的嘴里，见面第一句话，就是恭喜恭喜..."

圣诞节，其实就是庆祝主耶稣的诞辰，是一个感恩的节庆，大人会送小孩礼物，或者大家互相交换礼物，就是意味着耶稣的诞生带给了世人这一个那么好的宗教信仰，那么和平的世界！这就是那份珍贵的礼物，所以送礼物和收到礼物的人都回报着这一份感恩的心去庆祝这个日子。

昨晚是平安夜，她回了家乡，我也很平安地在家里睡了一个晚上。圣诞节大早，我又要回到医院当班了，现在做的是急诊部门。

一到了紧急部(Yellow Zone)，看到有几个病人躺在床上，待前个晚上当班的同事把案子交待给我们早上的医生，才知道这些病人发生了什么事。。。
第一个病人，平安夜，喝了醉酒后，在酒吧的厕所晕倒撞伤了头，必须留在医院观察可能会发生的脑震荡，醒来后平安无事让他回家了。
第二个病人，平安夜，狂欢醉酒后，驾车遇上车祸，结果脑溢血(extradural bleeding)。
第三个病人，在Pavilion KL外，喝醉酒，被不明人士及不明原因被打，结果断脚和脑溢血。
第四个病人，是第三个病人的哥哥，也是被打，在同个地方，结果轻微脑震荡。
第五个病人，在云顶下山途中，因为下雨和地面滑，车子打滑撞上了路敦，车子半天吊在山崖，幸好病人没事，只有轻微脑震荡和视线变弱。

这些只是今早还存在的病人，还没听到非常紧急部(Resuscitation Zone)的故事呢？不知昨晚有多少人因为这些醉酒，闹事，殴打，车祸而死，或被救活，或被送去深切治疗室(ICU),或者那些只有少许问题而被送到我们的非紧急部(Green Zone)。但可以肯定的是我们的骨科和脑神经手术科医生昨晚真是有得忙了。

刚刚说的第二个病人，是一个二十二岁的华人男子，在醒来后还算意识清醒，可是当他起身要走去上厕所时，屁股尽然露了出来还不知道（因为病人有必要被脱光光以被检查，所以会被穿上病人袍，在后面绑线那种），当他回来后尽然把病人袍索性脱掉，剩下三角内裤躺在那晒灯光。好几次被我的上司劝告了后，才乖乖的盖上被单。

这是Yellow Zone，之前拍的照片，今天早上可没有那么清静哦！

笑话，丑态百出的一个晚上，马来西亚，或吉隆坡的人，你们到底把圣诞节当成了什么？为什么非要把一个平安夜搞到那么不平安和不安详？对你们来说这是圣诞夜还是灾难日？虽然本人不是基督徒，可是请你们用尊敬的方式去庆祝这个节庆，不要因为凑热闹而搞到大家都不开心！

要记住，这是silent night... holy night...

吉隆坡人啊！是时候反省了啦！

Merry Christmas!!希望这小小的礼物能带给吉隆坡人一些反省！

Come come donate blood

My first experience in joining blood donation team, happened few days before Hari Raya, which was on 28 August, in this small tiny old Jusco Shopping Center at Taman Maluri!

the blood donation booth, located at the side entrance to the mall and next to the Vincci, but did not shop there, ahha!!

Because it was still a fasting month, so there were no many people taking parts in donating blood. Though it was a busy day screening over patients, we only managed to get 50 packs of blood back to the blood bank, due to not many Malay participating, but still there were some Malays that really impressed me that they still willing to donate blood in this Holy Month despite they were fasting.

Another reason for this not-so-good achievement was, we as a medical practitioner there had to defer a lot of people who were really enthusiastic in donating blood but in fact they were not qualified to, such as old age, taken antibiotics, not enough breakfast, feeling unwell, not enough sleep, history of sexual promiscuity etc...

Sadly to know the level of knowledge of blood and organ donation programme among Malaysian are still not that encouraging, and many of the regular donours still do not know the appropriate interval between blood donation (which is 2 to 3 months depending on center), hope the conditions will be improved days after days! I don't mind to become busy entertaining you all, if I have another chance following this blood donation team! Malaysia boleh!!

the blood bank staffs, together we "suck out" more blood!!

The letter to the head of Department of O&G HKL

Dear boss,

It is my greatest honour to join O&G department of HKL. Many things that I didn't do or didn't know, now I have the chance to learn and perform it, eg: vaginal examinations, Pap smear, endometrial sampling, episiotomy etc. My only regret will be not being able to perform a Caesarean section or evacuation of retained product of conception (ERPOC).

Actually this is an enjoyable and exciting posting, we get to go through 4 different "sub-postings" ie labour room, PAC/Clinic, Obstetric ward and Gynaecology ward before ending the posting, therefore maximising our learning opportunities. Besides there were too many on-calls and tiredness, I really enjoyed the learning here.

My some constrctive criticisms about the psoting:

1. Blue scrub clothes are not allowed to be wore outside labour room and operating theatre (OT).

- although I understand this is a hospital policy, but I don't understand why we can't wear the blue scrub outside the labour room and operating theatre, to me as long as we keep it clean and change it whenever we enter OT, I think it shouldn't be a problem.

-blue scrub is a comfortable outfit when we are doing oncalls, so that we can avoid wearing white coat and become less heaty. I hope this can be allowed in wards or PAC during oncalls.

2. very senior staff nurses in labour room order us to work as if they are the boss.

- I don't mind if they are reasonable in doing so, but they order us to send some investigations which are not necessary (thus wasting money and time). eg: RBS and RP in patient tocolysed with nifedipien and contracting 1:10, I think it would only be appopriate if we KIV to convert to Bricanyl tocolysis.

3. the MO like to humiliate HO.

- some unfriendly MO like to scold houseman for small little matters eg: patient's name not written in capital letter in the consent form, the consent form is not completed (in areas of surgery's risks, benefits and by right the MO should fill up themselves.

- everybody is learning from the mistakes, and the problem should be solved by teaching but not by humiliating people, I wonder if the MO was so superb that he/she never done any mistakes or he/she was so knowledgable when he/she was a houseman.

- I think if the condition keep going on, I am scared if 1 day this particular houseman is on called with a particular MO he/she scared of, he/she wouldn't feel like to consult the MO because scared of being humiliated, and the housmean will make the decision him/herself in case of problems arised.

- although Dr. Noor Haliza (consultant) is well-known for scolding, I loved her scolding actually, because she scolded for reasons and she will teach after the scolding intended to impove us. I think myself improved a lot from her.

4. useless postnatal review in K5 and KK8 ( paeds ward)

- there is no proper documentation for mothers in K5 and KK8 for us to review.

- if the mother is just discharged from maternity wards and the baby is under paediatric, I think the mother's BHT should be in the paeds wardto review so that we know what are the antenatal, intrapartum and postnatal problems, to continue the care for 1 to 2 weeks postnatal.

- it is very difficult to trace back the old notes for mothers whose babbies get admitted few days after birth, the documentation for this group of mothers is very poor because no speicalfolder for them. (what more if the mother delievred at other hospitals??)

- to me, the mother can always come back to PAC/A&E if they have any problems after discharged.

After all these long winded complaints, I still got to leave O&G posting, I really want to thank the staffs in clinics/PAC/ward 3B/Gynae ward for being helpful and respecting us. The oncall foods are not too bad, I just hope that we can have an oncall pantry in the future so that we can go the have tea/bread/Milo whenever because we tend to skip meals especially working in clinics, labour room and PAC.

Thank you boss for reading my letter, really appreciate it. Hope my humble opinions can make some little changes in the future, not for myself or other houseman, I think it is better for the delivery of the health care.

Yours sincerely,

a leaving houseman

23/5/11

I hoped i have convinced him, not confused him! ahha!!

你以为我没听见吗

2011年4月9日 星期六 晴


最不喜欢你变不开心了，每次都要我哄你！
最心疼你变不开心了，把工作压得自己那样！
你知道的，我不会说哄人的话，
每次都要把我考倒，
知道你因工作不开心了，
好吧今天就顺你的心一些！
不要每次都说我不让你吃！

“辣子板面真是好吃，辣到把不开心的事都辣出来了！”
知道你一定会很满意这一餐了吧？
虽然是很便宜的一餐。
“我知道你是最好的。。。”
“吓？”（我听不到）
“我知道你是最好的！”
“吓？”
虽然稍微大声了一点，可我还不过瘾。
“风吹走了咯。。。”
“吓？”
其实本意是“你说什么？！”
“风吹走了！”


你以为我没听见吗？^^

To some egoistic medical officers

"What makes a difference between a medical officer and a house officer?? not knowledge, not the age, but TIME..." quoted from my paediatric consultant Dr. Irene.

Recently just shifted from paediatric posting to Obstetric and Gynaecology (O&G) posting. Whenever there is a change of posting, we will be treated as "freshie" in the new posting although we were used to be a quite senior and trusted one in the previous posting, and that's why "tagging".

For all new housemen in O&G HKL, we will have to carry a tagging log book with us so that we know how to perform some essential procedures and recognize emergencies in O&G. Thankfully to the training i had during medical school time by my beloved University of Malaya, I can finish my job quite easily. Then before off tagging, we have to go through another viva test from either medical officers or specialists. After a week of tagging, I came across this Dr. S (a MO) in my ward, so I asked her for the off tagging viva. She asked me regarding a "uterine rupture" case, this is a case i never met during student time or during this 1 week of tagging period, with logical thinking and basic knowledge that I have, I was able to answer some although it's been almost a year ago when I revised my O&G stuffs for my final MBBS examination, and tagging is just too tiring for revision. Later when I could not answer some other questions, she started became frustrated and did not pass me in this viva in the end, saying things like "stop giving me stupid answers..."

If she can put herself in my position, I would like to know how does she will feel when being humiliated like this. We are all still learning, from HO to MO even to the specialist, why these so called "seniors" like to humiliate their juniors like this?? They were HO before this, were they not as stupid as us when they first joined O&G? Even if they are so "experienced", they still give stupid answer to the consultant "post-operative patient who have paralytic ileus is due to electrolyte imbalance caused by anaesthetic agents..." what a joke seriously. If I do not know something after I learned about O&G in the 4 months period of O&G posting in medical school and 1 week period of tagging, so what have you learned, my MO, in your years of practising O&G?

Even if the MO are bosses to us, we are still working together, we are colleagues, why they have to act so bossy and say something directive to us??

I respect the seniority of MO and their knowledge or experience (only if they have), and I accept constructive criticism from the bosses, but please prove yourself that you are knowledgeable to scold people. And before you do so, please put yourself in others position, are you actually doing a right thing? Is it beneficial? To you? Or to the one you are going to hurt?

"I bother to teach just because when I am old, I am might be be treated by you, or my children or my grandchildren are going to be taught by you, so I must make sure the knowledge is passed on, there must be continuation!!" This is the last talk I got from her, my ex-specialist in paediatric, Dr. Farah during my last few days in paediatric, whom I thought she always made my life miserable. Thanks for telling me this, it makes me even more faithful in this route of becoming a medical academician.

"Please be humble to everything in this world, as we are human, human do make mistakes, and is learning from time to time..." a scenery from one of the window of Maternity Hospital KL building, taken during my paediatric posting when I was oncall for SCN (Special Care Nursery).