我感受了你的感受

今天是开斋节前夕，明天就是开斋第一天，过去两天没on call，明天就有了！

今天很舍不得地把你送去你大姐那，让她载你回妈妈家。

知道你想妈妈很久了，尤其是怀孕之后。

毕竟接下来这星期有三个on call，陪不到你，还是让你家人陪你吧！

一早送了你走，感觉吉隆坡突然好寂寞，路上车子寥寥可数，餐馆没了平时的人潮。

朋友有些回家了，有些有工作，所以我一整天都没人陪。

你时常跟我说，我做工的时候你在家好寂寞，我想我感受到了！

今天我很乖，看了两部戏，睡了个午觉，就打扫家里，收拾房间，抹风扇，扫地抹地，之后还去游泳，间中还有读一下下的书。

午餐吃什饭，晚餐自己煮maggi和妈妈的粽子。

没关系，我会好好照顾自己，会时常打电话给你，你要好好照顾自己和baby噢！

看似很无聊的一天，就是因为无聊才会想要写下来。

今天，我感受到了你的感受。

今天，我学会更加要珍惜你在我身边的日子。

我爱你！

祝全马人民，Selamat Hari Raya Aidilfitri!!

外面烟花声响了。。。

Kind reminders to patients in primary care

It's the 4th day of 2014! Still having a chance to wish everyone "Happy New Year" live from Johor Bahru! After a week, i will be transferred back to Klang Valley, a place I always want to live and a work environment I always wish for, what a good start to 2014! This year also, she is starting her very own counselling center in partnership with her ex-colleague.

Leaving Johor Bahru, leaving primary care, it's time for me to work in hospital again. To cut short, here are the summary of the patients' behaviour in primary care (klinik kesihatan) that I encountered, generally.

1. Walk into the clinic unprepared. Even though patients were referred by another health personnel, they forget to bring the referral letter and also tend to not understand the reasons they coming for. Ended up doctors have to ask the chronology of events therefore continue the care.

2. Coming to government clinic asking for procedures that private sector has already consulted them to do. Yes definitely it is cheaper for Malaysian citizens for procedures to be done in government hospital, but bear in mind this subject to the doctor's judgement whether to do it or not and it consume times for the arrangement of appointment.

3. Walk into the clinic not knowing their previous medical conditions and medications taking. This apply to small group of non-educated and elderly patients, not to blame them but at least they can do some help by providing the packing of the medications or bring relatives or friends who literate.

4. Always forgot to bring OPD cards. This sometimes happen to people in group 3 and irresponsible MC seeking people.

5. MC seeking behaviours. Patients will act all sorts of drama to ask for a MC. Some will travel long distance from Hospital Sultan Ismail area to reach Hospital Sultananh Aminah to see doctor, reason? Because the former doctor didn't agree to give MC, so they throw away the former card and act more vigorously during the second visit.

6. Foreigners getting free medical service in goverment sector. Although they have to pay RM 15, that's inclusive of the consultation and medications for 5 days, so kind hearted our government. It's still ok for foreigners who worked here and they met accidents or illness here, pity them. But what about those people from the developed neighbouring nation asking for free supply of his/her diabetes or hypertension drugs? They said it's very expensive to get from their original country!! What worse is, those foreign workers do not speak Malay or English! I have to act all kind of sounds and move like a monkey to make them understand my questions.

7. Patients that behaving rudely. Especially in the young group of patients, they always quarrel with doctors when they are not given a MC or they are not satisfy with the management given.  Oh please Malaysians yang berbudi bahasa (polite), please behave politely and talk to the doctor nicely when you are not happy, doctor will be there to help you. We request for the things we want and there is no need to fight. And please do not back stab people by writing non sense complaints, if you really do not like this particular doctor, go back and talk to him/her.

8. First thing come into the consultation room, asking for referral to other specialty. Please don't think that doctors in primary care do not know how to manage your case, there are always criteria or guidelines to manage every problems and timing to refer. Doctors will never hesitate to refer if it is really indicated to. What more pathetic is, sometimes, after the patients get the referral letter, they don't even turned back and thank the doctor.

9. Never show appreciation to the primary care doctors. We always see in the wards that patient so and so sending a gift or cards to thank the hospital team that treated their illness, but doctors or teams in primary care never received a single card of appreciation. Don't forget, without the primary care doctor referred you to the correct specialists, your illness could hardly be cured.

10. Waiting with no patience. It is already well known that government clinics will be crowded with patients at all time and you have to wait to your turn, so why behaving so impatience? Doctors need time to ask, to examine, to think and to manage every single patient's problems, the management plans do not just pop up immediately the moment the patient sit down.

Despite all the sadness and stress a doctor in primary care bearing, these doctors never write a complaint letter to complain his/her patient's attitude. They continue to work to serve every patients, so that every patient gets the best treatment and the best of health. Yes, because KAMI SEDIA MEMBANTU (we are ready to help).

This is not a letter or what to complain about the patients, it's just my personal experience with the patients that i think need to be improved. Hopefully the patients will be more understanding. What if this doctor is your child and he/she has to face with such patients everyday? How would you feel then? Everyone should be treated with dignity, right? Any patient will think in the shoes of a doctor then?

yes, please smile, no matter who you are. I believe smile is contagious. 

Ayam Goreng Berempah (Fried Chicken with Spices)

Every time I go to do locum at Bukit Indah, Johor Bahru, there is always one mission bearing in my mind, and I have to accomplish it before going home, so as to satisfy my tiring day... To have to most delicious "fried chicken with spices"!!

Locating near the corner of Jalan Indah 16/5, with nearby prominent and favourite spots eg Am Bank, Moonlight, Tesco of Bukit Indah and Giant Hypermarket of Nusa Bestari, this is a location where you can find easily.

"Nasi Lemak Al Aisy", I believe it is the stall's name.

Actually been noticing this little Malay stall for quite some while, one day, its crowd during dinner time has attracted my attention, many people queuing for this nasi lemak (coconut rice), more importantly, for its fried chicken! This is not ordinary fried chicken, it is well marinated with local spices, evenly deep fried and well cooked. The skin is crunchy, the flesh is juicy, every bite of the meat brings the taste of the spices, deep to the level of the bone!! Mmm... so yummy and irresistible. I am not sure whether this stall has been rated by any of the food bloggers, but I would say this is one of the best fried chicken I have tasted in my life!

Oh my gosh look at the amount of spices on the surface of the skin, it taste so good!! probably nicer than KFC!!

Oh did I miss saying the nasi lemak part? For me the nasi lemak and its sambal actually just tasted so so (ordinary)... Besides its rice and sambal, the nasi lemak only comes with 2 slices of cucumber, and some peanuts, without cut slices of an egg or anchovies! There are many side dishes also like sambal fried kangkung, fried cabbages, fried chicken legs, beef and some other fried internal organs to intensify the taste of the meal. A piece of fried chicken sold at RM 2+ and a pack of nasi lemak with a piece of fried chicken sold at RM 5. Which means the ordinary nasi lemak cost about RM 2, that's freaking expensive huh?!!

A plate full of fancy fried chicken and the side dishes

The stall starts operating at 5pm till about 10pm, not sure which day they closed because I only be there on Sunday. So for those of you who want to try out some new local delicacies, this is my new recommendation! Cheers!

*To my memory, I think the best nasi lemak is in Bidor, Perak, my hometown, near the hawker center next to Bidor Market (Pasar Awam Bidor). I always have this nicest nasi lemak back during my secondary school years. (In fact the market located just next to my school) However, few years ago when I went back to this market and the place where this stall located, the stall no longer there, feeling so depressed that time.... hmm... nostalgic.

Failure

I am somebody who don't like to talk about my failure to the others. Today, this will document the history.

Today had my second trial for Basic Science Examination in Orthopaedic Surgery, it ended up with a failure. After the failed first trial, I thought myself had put enough effort in studying towards a pass, however, there is too deep the knowledge, and too wide the scope medicine can be. My limited brain capacity could not bring me to a higher level of success. 

Extra concentration, extra effort, and extra mileage of traveling had put in. I know, my knowledge has improved compared to the previous attempt, however, it's just not enough for me to proceed.

Though knowing my weakness, I still feeling very depress of this. Feeling of helpless, despair, at one point of time I thought of to quit study and continue to be a general practitioner. On a second thought, this might be wrong as I am still young and there are always rooms for improvements! Third thought, maybe I am not destined to be an Orthopaedic surgeon?

Feeling so tired, had been having dyspepsia and palpitation for the whole month, at least what I can do now is probably taking a good rest, relax my mind, and perhaps meditation? Figuring out my future... What will my future be?

超人，不用飞了

话说大约一个月前，从家里出发去Bukit Indah 做 locum, 途径巴西古当大道(Pasir Gudang Highway)时，瞬间被路边一个大海报吸引（因为车速来不及放慢）。海报上看到的好像是一头散发，大露丰胸的女人！！第一个理性的念头就是，在这个封建的国家，怎么会有这么色情的海报？？卖的是什么广告？？

第二眼再望过去，原来是。。。

周杰伦的散发和他的大胸肌，还有柯友伦也似故意地逝开他的衣服露肌，这就是电影《天台》的海报。。。还好。。。（照片是在之后的塞车时拍的）

再放大来看，真的好大！

事隔了一个月，《天台》也上映了几个星期，昨天才去捧了他的场，看天台。（没得去看在吉隆坡的演唱会）真的，不得不佩服他创作的才华，电影的歌，音乐，对白话的歌词，恰到好处的舞蹈，真的很棒！仿佛是一场在电影院看的舞台剧。。。

在电影院看的舞台剧？？ 上个星期报纸的周刊，就写了这部电影的影评，说这是一部在电影院看的大型MV。。。好像没错啦！只是我觉得说是舞台剧会比较给面一点。

这次周董自编自导自演，实现了他多年想拍歌舞片的愿望，也证明了他多方面的艺术才能。周董的确想法多，念头大，可惜这部电影就是毁在他编剧的部分了，电影长气，迟迟未进入正题高潮，周董编得自己从头一路耍帅，挺英雄到尾，还要崇洋超级英雄的文化。。。话说电影的最后跟红毛头的逐车戏，周董本可以引诱红毛飞车过来自己掉入海，根本不需要把自己壮烈牺牲，搞得女主角可怜的“睹照思人”到老（也不知那个姜大卫是否就是浪子膏老去的角色）。还有还有，电影提倡兄弟情，到最后竟然连他兄弟们跟坏人拼命过后的结果是怎样都没交代，真是虎头蛇尾呀！

周董的导演实力其实已经是不容置疑了，如果这部天台找来会编剧的人来编，结局会不会不一样，会不会更有内涵呢？选角方面，人物的塑照，我也不想多长气了！本来带着《不能说的秘密》的期待去看这部电影，也变得落空了。

周董难道忘了他曾经有写过这样的一首歌，《超人不会飞》，谦卑的他说自己也会累，不是万能，所以可以请他再进修一下编剧，再继续加油呢？

他下一部电影，我一定会再支持的，毕竟他一出道时的《黑色幽默》早已牢牢地打动了我！（好gay）

今天是他在吉隆坡办的第三场《周杰伦魔天伦马来西亚演唱会》，希望他演出再创高峰！周杰伦还是唱歌的好。。。

Another locum day in JB

Hello everyone, and myself:

It's been a while since I last wrote in this diary, well life is as usual, busy with troublesome patients, exercising to lose weight (have weight gain of total 6 kg a year ago since I came to JB), dealing with new house stuffs, and also preparation for my wedding this December!!

And today my fiancé is away from me in Jerantut doing her counseling campaign, and I am here in this relaxing locum in Bukit Indah (Lee, hehe...). Oh yea, nearly forgot, to study for my external examination in September soon!

In fact JB is a place with not-so-many attractions, so people who stay here be them working in JB or Singapore, they do not have many places to spend their money, so do I. Furthermore, its population creates more opportunity for locum. So dear doctors out there do consider come JB to earn extra ahha...

And mission for today, to study and relax.

Not to forget, Happy Father's Day to all, and especially my dad.

爸爸父亲节快乐！永远爱你！

*Typing using an IPad is actually quite troublesome...

A new start 2013

Happy New Year 2013!

Although it is now already 26th January of this new year 2013, this is my first ever post in this new year.

I actually started writing this blog since 2nd January 2009, which was already 4 odd years from now (please refer back to my first ever post ~ "Let me introduce myself"). Time flies, I started this when I was a 22 years old medical student, and now I am already a 26 years old medical officer.

"The time has come, the previous S Sized Guy is now grown up to be a doctor who sees lives, and saves lives, documenting his memories here"

This was the quote just under my profile picture previously, so precious, and i will still continue to serve the above quote and my objectives of starting this blog. Although today, I have already changed the e-mail address to my newly created Google+ account. Nothing else changes.

The journey of "My diary, my life, my blog" continues...

Fireworks that welcome 2013... taken at Putajaya Flora Parade 2011 (again an old photo from my gallery)

我的新工作地点

从2009年开始，新加坡政府开放了让马来西亚的马来亚大学和马来西亚国民大学（现改称国立大学）的医学系毕业生到那里去当实习医生，我的很多朋友早在两年前都过去了！

很多吉隆坡中央医院的朋友都问我，“你是马大生，为什么不去新加坡啊？我要去都没有！”人各有志，当初没想到要去新加坡是因为想在马来西亚发展，在这里当一个外科医生。

常常有开自己的一个玩笑，“如果要下新山做，不如下新加坡！”
在吉隆坡实习的两年就这样过去了，该我出外服务，偏偏就让我中到新山，还要派我到政府诊疗所去，我要留在大医院的梦想，碎了。

如今，在这间政府诊疗所也当了整三个月的医生，服务了新山的民众，外劳，还有新加坡的人。因为这诊疗所也是隔壁中央医院的外诊部，所以难免要看很多奇奇怪怪，无谓，普通伤风感冒的病人，很多病人更是冲着MC而来的，所以，病人好像一直都看不完。

“一天工作八个小时，看一百一十一个病人，
一个病人看平均四分钟多，可是一个病人平均不止一个问题。

午餐的时间也牺牲了，可怜的病人陪我一起等，等着让我看他们。
我能够一一为他们解决他们的问题吗？

好累，脑子想了又想，当MO就是怕出事故，
只能希望他们的问题能被解决，
毕竟我不是神 ”

这是我在八月二十四日post在facebook的留言，从以前当医生就有一个理想，就是每当每一个病人来到我面前，不管他们的病痛了多久，都能在我这里得到解决。可是，这想法毕竟也太理想化了，事实上在外诊部（primary care）有很多病是没有诊断（diagnosis）的，毕竟我真的不是神！

从一开始的细心问候，到现在的给了药就算。

从一开始的有求必应，到现在的吝啬MC。

从一开始的闷和显，到现在的没感觉。 

从一开始的没有朋友，到现在有几个，还算不错啦！

现在的日子，过一天是一天。说真的不是我不爱我的工作了，不是我看不起在诊疗所做工的医生，只是我觉得我的那份热血少掉了，从前的那种刺激感再也找不回了！唯一能让我心跳加速的，就是跟时间追逐，在我有限的时间里看完所有的病人。Primary care 的医生可是很重要的哦，他们能隔掉许多无厘头的“病人”，从而决定哪一个病人到哪一个专科部门看诊。

看似很消极的一片日记，其实，我真的没什么感觉了！初心？好像离我越来越远那样。唯一能够让我继续拼下去的理由，就是新山有着赚不完的钱(locum)，还有等待着我回大医院的那一天。

唯有珍惜当下的每一个缘分，尽量做到最好，那应该不枉此行了吧？

期待我回大医院的那一天。

期待我重拾初心的那一天。

听筒，笔，药单，MC book， 电筒，和我所见过的病人的纪录，这样就要开始我工作啦！

从前的欢乐，不能再回头了！只有寄望当下和未来！毕竟回头看到的都是倒影，触不到。

很想念以前在HKL有一个肥仔朋友，常常载我出去吃东西，当然包括快餐，现在我惟有独享咯！

I had a dream

Few days back, in the eve of the morning...

"Three of us, myself (as the spiderman), iron man, and a female superhero (unspecified superhero) were caught and prisoned by the bad guys in a castle on the hill. Though not being tortured , we were finding ways to escape and to get help.

I managed to get a flying device which shaped like a bow and the wings can be kept inside, when opened up the length of the whole flying device can reach up to 1 metre.

So we decided to send that female superhero to fly out and get help. (Why in the first place Iron man couldn't ask for help since he has all the latest communication technology and he is able to fly?) However the girl was too afraid to fly with that flying device which has not been tested, so I did the testing for her.

I asked Iron man to fly with me in case the flying device not functioning and I drop down, so he agreed. I held the device, standing at the window of our prison, with the push of my leg I was flying out of the window successfully with the device while winds blowing. Both my forearms and my chest were supported on the device and the rest of the body was just hanging. Enjoying the breathtaking view around this hill and the castle, no enemy was actually noticed that I had escaped. Iron man who was flying with me in the beginning returned to the prison after I flew safely. (So obedient right? The Iron man could actually bring that  girl out and together three of us could escape.)

After a fly circling the castle, I also returned to the prison. On my way to the window of the prison, the bad guys saw me flying outside so they were trying to attack me. With the aids of my spider web I kicked them and got to the window very quickly....."

Oops I awoke out of sudden!! The time was 6.50 in the morning. Jumped out quickly from the bed and brushed my teeth ready myself for my work... as a MO.

Ahha.... What an illogic and funny dream I had, maybe my life was just too relax, or perhaps I watched Avengers quite recently?? Although this was quite meaningless, I just feel like to take this down, to make a little joke out of something I have in my simple life. Cheers!

The Avengers that was released last month. 

I prefer movie with more superheros, the spider man is just right in the front (always my favourite character), hope the next Avengers can recruit as many superheros as possible not to forget spider man and X-men.

A transition through time

my right hand: Raynaud's phenomenon?

What happened to my hand? Raynaud's phenomenon? Peripheral cyanosis? I am not a smoker nor second hand smoker, no chance to get Chronic Obstructive Pulmonary Disease (COPD), never had any congenital heart diseases, never had history of asthma....

No, no, it was the blue ink stained my fingers when I used the brand new cartridge pen for the first ever time, when I was a houseman working in Surgical Department of HKL. Being a houseman there we had to do patients' reviews three times in a day, meaning that the ink in our pen will finish up very fast. Too many pen that I bought were used up very fast, ended up that I had to use this cartridge pen which was a door gift by a sales representative during a seminar. Because of not familiar how to function the pen, I had stains on my fingers, aiks.....

Times flies, after Medical, Paediatrics, Obstetric and Gynaecology, Orthopaedics, Emergency Medicine and General Surgery, thankfully I was able to finish all these postings as a houseman in the shortest given time, which was 2 years. Now that I am a Medical Officer, currently waiting to be posted out of Kuala Lumpur or Klang Valley, which is good, because I have already feeling bored with this city, enough with the egoism of the patients and bosses.

The sunrise on my daily route to HKL, stopped by to appreciate and snapped this. As a medical officer, I tend to wake up late and I only need to reach hospital by 8am (used to be 7am as a houseman), so truly happy for being able to see this kind of rising "egg-yolk" sun at this hour.

As a consequence, I was stucked in this traffic jam along the exit of Sprint Highway to Jalan Duta, not too long the jam, just taken up my 5 minutes. Still managed to snap this photo and enjoyed the sun, yet not being late to the clinic.

There is an end to everything, so does the place that I have worked in for 2 years, and the route taken everyday. All the sorrows, hard time, fun time, escaping time, sleeping time, sharing time will be deeply remembered and become a boost for me to carry on.

I will be back, KL,when I feel bored towards another city.

龙年行大运

今年的农历新年过得特别精彩，上山过海，一家团圆，吃尽山珍海味！怎么过呢？让我用照片来说故事吧！

"龙年发财“隔壁家的铞饰，恰恰好在天公坛的上面！


爸爸买回来的大吉，一盆才十多块而已！好大粒（利）呀！


年三十的团圆饭，有“盆菜”在中间哦！


新年新村烟花大汇演！在我家拍到的烟花！


仁仁与烟花，新村路口燃放烟花的地点与盛况！这里可是新村人跟外地人聚集的地点哦！

可是就在燃放烟花的当儿，发生了一些小状况，一名外地人驾的车（黑色赛加）先后跟新村人的摩哆和车子（白色vios)磨擦，可是那司机（箭头者）态度嚣张，又不道歉，可怜的他被团结的新村人围了起来，最后还要被捱上几拳，可怜！而本来看烟花的焦点，都被移到他的身上了！他的新年还蛮倒霉的！


年初一，我们家的早茶！都是新年糕点！


吃过了早点，就是红包的时间咯！看小孩们穿得多漂亮！


礼品和新年糕点！

大年初二，爆竹一声响连天！发呀!


年初二的大餐，左下是“琵琶鸭”，左上是“五福临门”，和右上的“治士虾”


“法护槟城”， 年初四跟她的家人上了槟城极乐寺！


小孩玩乐！


好庄严的观音圣像！在灯光的照射下更显得金光闪闪！

左右护法，我非常喜欢这两尊神像的神态！在傍晚七点左右拍的。

观音圣像和八宝亭

槟城夜景！

极乐寺全景！美哉！

年初五，在回美罗的路途中特别去了怡保一趟，跟即将要去新加坡工作的雯姐聚聚，还不小心遇到了《阿炳心想事成》的影迷聚会！开心一下!

回到家，又是跟小孩玩乐的时候了！可是我只是摄影师哦！

年初六，跟爸爸妈妈和二姐夫上了云顶，他们去赌博，我们去吃风，顺便冷冷一下！


小声说，其实我还很好运的从赌场赢了一百块钱出来，请家人吃饭后，剩下的钱就买她喜欢的咖啡，看她多开心呀！在Times Square 那还有小叮当的摊位呢！

今天是正月二十二日，农历新年过完了，但就是好想保存当时的喜悦！

才刚刚开始我的外科部实习，这下是我发挥的时候到了！
接下来还要筹备情人节，忙啊！

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).

the price of a "chicken"-pox

Chickenpox is caused by varicella zoster virus infection, a virus from the human herpes viruses group, sounds very medical isn't it? Every people says that every person will have at least once of contacting chicken pox in his/her life no matter how young or how old he/she is. After the primary infection, it can offer life long immunity until the immune system declines, then secondary infection will reactivate as "shingles".

I got this chickenpox at the age of 24, it happened last week, when I was working in SCN (Special Care Nursery- for premature babies and newborns). I was oncall on 8/12 and my fever started at night of 9/12, my post call day. My fever persisted until the next morning, considering that I was taking care of newborns which are susceptible to infection, I took a day off from works so that I won't spread my infection to them. In the evening, She noticed that I was having rash on my body and was confirmed to be chickenpox by a private general practitioner, actually went to him just for the seek of getting a MC for that day... ha! And lastly I got my MC for a week from outpatient department HKL, because I have to stay away from the babies!!

Went back hometown for a week. Rashes developed at whole body after 3 days of fever, felt so upset when I felt that my face became uneven with raised vesicles. My mother and sister kept telling me that these rash will disappear once recovered as they saw me looked sad, so caring right?? I also had bad sore throat and wisdom toothache, made me suffered to all kinds of food including water, some more mum said I have to stop eating some "toxic" food eg eggs, seafoods, black coloured food, green beans, bean sprouts... basically i really felt boring towards food on that few days la.

Chickenpox on face, felt so upset when my face was felt uneven with raised vesicles, felt so ugly that time...

All the fever and rash became settling approaching day 5 or 6 of fever, and I returned to work on day 11, which was on Sunday, when I was called to do the on call, when nobody willing to replace me for my weekend call.

Although my symptoms might not be as bad as what other people having (after shared by my MO, he even got varicella keratitis, vesicles inside the eyes and has got to be admitted to hospital), and my recovery was quite fast, I still have to pay for the loses I have for this "disaster":
1. I lost 8 days of leave because of MC, plus the 3 days off I took during my 4th sister's wedding, which mean I have to be extended for 3 days in this posting.
2. I suffered from it.
3. I have to lost around RM 100 to buy some beauty products so that the post-chickenpox marks on my face will be disappeared as soon as possible, and hopefully my skin will become better after using products as expensive as this!!!
4. I got a warning letter from my consultant for not telling the office that I was on medical leave, hello I have informed my houseman colleagues and I thought it was still be valid if I informed to the lady consultant via SMS.

What did I earn from this? I got special care from my mother especially for whatever she cooked for me for that few days, although I did not show interest towards those food, but I think those were the best food I could have during the illness, and I really appreciate it. Not to forget also my darling who has always been supportive to me to fight my illness. I love you all!!

Story in Internal Medicine

Has been quite free for the past 2 weeks, ever since I joined Paediatric Institute, Kuala Lumpur Hospital (HKL), for my new and second posting as a houseman. At least for the past 2 weeks, i was able to enjoy my weekends at home, finished watching my favourite Hong Kong drama series, and restarted writing my diaries here.

I first started as a houseman in Medical posting of HKL, the 3rd largest hospital in Asia and the largest in South East Asia, where people call it a "mad house". Somemore I was in the busiest ward (ward 18) in HKL, another "mad house", which mean i was working in the "mad house of the mad house"! Accomodating 60 beds, and sometimes extension beds might add up to 100 beds in total in this single ward, with the fastest turn over rate of admissions and discharges, and working 7 days a week, it made me felt that my life was very measerable at times, i used to ask my nurses "kenape hidup ni susah ye??" (why is this life so difficult??), and they could never give me any answers, I even thought of quiting my medical life. Haha quite a stupid thought wasn't it?? Whatever it was, I went through it with all the blessings and hard works i had to give.

The day I studied for my viva in the ward, we have to pass this assessment before we could be freed from medical posting and proceed to the next posting.

relax la... have a narcistic shot first! haha... during this time I was taking care of the first class medical ward, so a bit free to do revision in the private empty room. Basically, the so-called first class in HKL with single rooms, double bedded rooms and 4 bedded rooms are equivalent to the "3rdd class" in UMMC.


night view in HKL, taken during 1 of the on calls... hoping the night will be calm and safe, staying alert, waiting the sunrise of the next day...

Thanks to everyone who helped me out when I faced difficulties,
thanks to those who forgive my mistakes and gave me a chance to prove myself that I never will repeat the same mistakes again,
thanks to those who really been sarcastic to me, so that I could improve myself better,
thanks to my patients who always have confidence in me,
thanks to my family that always understand that I was busy that I might not be calling them very often,
and also thanks to my darling who always understandable, caring, loving and do houseworks for me.

And now I left this troublesome medical posting with pride, continuing my journey in looking after children, picking up my confidence and competency every day...

小儿科啦。。。（广东）