Staff...urghh... Patients :)

Will you bloody MO just fuck off and leave us alone?!! Mind your own business la... I wasn't even bothering you or asking you any questions or touching your patients. I was just looking at the bloody case note. Doctors, if you are not going to teach us anything or be nice to us, just fucking leave us alone, will you?! And the physiotherapist, who acted so condescendingly and arrogant, trying to tell us how important and great physiotherapists are and that a surgery wouldn't be successful without them to rehabilitate the patients post-op. And constantly stressing that physiotherapists are working ALONGSIDE doctors, not FOR doctors. Pleaseeeeee.....tell it to the doctors who have pissed you off in the past by dismissing the importance of your work. Don't take it out on us because I sensed you have been holding a grudge onto doctors due to some past bitter experiences? I don't know...but hello, we're innocent here. Okay, to be fair to you, Thanks for telling us, so that we will learn to appreciate and respect the work of physiotherapists from now on. Happy now? Jeez...!

Okay, I am cool now. Otherwise, first day of Paeds was good. Even got to present a long case. Played with a cute friendly baby boy. I was so amused by his hypotonic limbs, he was stretching like a gymnast, I was just happily looking at him stretching and putting his foot into his mouth when he couldn't grab anything around him to put into his mouth. And who cried when he accidentally hit himself on the head with a toy. Hahaha... As usual, the staff pisses me off but the patients brighten up my day. Oh, what will we be without our patients?!

Shaken

I sense I am going to be blogging more frequently in the next 2 months. Paeds hasn't officially started and I am already affected, emotionally. Went to the Paeds ward today and saw this chubby baby boy who looked so sick- hooked with nasal prong, Ryle's tube and just lying there so lifelessly. And then I read the case note.

"Traumatic brain injury, suspected NAI." (NAI stands for non-accidental injury, meaning deliberate injury, meaning abuse)

"Shaken baby syndrome"

"Terson's syndrome"

As soon as I saw those words, I started forming judgement. I know we are not supposed to, but I am only human. Many thoughts formed in my mind as I stole many suspicious looks at the mother from my peripheral vision. I was trying to detect any underlying sign of an abusive behaviour or any cruelty in this lady, as if there would be. Sorry Ma'am, I couldn't help but judge you. The mother was like any other mother in the ward, loving, and trying to soothe the irritable baby. Although according to the case note, the baby is said to be taken care of by the grandparents, I couldn't help but judge the mother too. The mother was probably 10 times more shocked and sad, and would probably dismiss any possibility of abuse. After all, it's not any stranger, her baby boy is being taken care of by his grandparents. 

I felt so sad looking at the baby boy. I feel sad even now, just thinking of him, the possibility of his injury being inflicted upon him deliberately by the people who are supposed to love and protect him unconditionally. I feel even worse now, in fact, after looking up the information online about Shaken baby syndrome. It is a triad of subdural hematoma, retinal hemorrhage and brain swelling. The estimated mortality is 15-38%. The non-fatal consequences include visual impairment, motor impairment such as cerebral palsy and cognitive impairment. To think that a previously healthy baby could be at risk of DEATH and all these morbidities because another human being did this to him. Tell me how can I not feel sad. I am shaken as well, to be reminded again of the cruelty that exists. 

I pray with all my heart that the baby boy will recover fully, with no permanent sequelae. I pray that his injury would actually turn out to be an accidental injury and not because of abuse. I pray that he will always be blessed with parents, grandparents, siblings, family members and friends who would truly love him, care for him and protect him unconditionally. 

I'm lovin' it

How am I these days? I have been alternating between lying on the bed with a book and watching movies or sitcoms on the laptop everyday...plus mustering enough effort to get out of the room for food and an occasional (or should I say, rare) swim or jog. I am officially a slob but I'm lovin' it! 

                                 
                              New sitcom that I'm currently enjoying (Thanks Kenneth!)

Can't bring myself to finish the last few episodes of The Big Bang Theory. 

You can still pretend...

"Don't pretend to be somebody else. If you want to pretend, then pretend to be somebody better." 

Father Cosmas Lee during Sunday sermon. 

LOL...

Converse rules

We should be allowed to wear sports shoes or sneakers in the hospital. Who cares about the 'professional appearance' when your feet and back are aching all day for wearing 'professional-looking' but not occupationally-friendly shoes. Sneakers and sports shoes are so comfortable. One of the advice we give diabetic patients regarding foot care is wearing the right shoes, namely SPORTS SHOES because they are the best with wide toe-box and comfortable in-soles. So why are we not practising what we are preaching? Okay, sneakers don't really have a wide toe- box but they are comfortable.

                                            My favourite-est shoes in the whole wide world

My adorable cousin, Anna is in BP. Want to see her so much!!! 

The Nightmare Patient

Me: Ingat lagi tarikh haid terakhir?
Patient: Tak ingat... pada bulan 1 lah...
Me: Bila tarikh bersalin?
Patient: Tak tahu lah...tak ingat...
After insistent prompting,
Patient: 8? 8 Oktober... macam 8 haribulan  (And when I checked the case note later on, it wasn't 8th!)
Me: Okay, bila scan pertama?
Patient: hmm... 7 bulan?
Me: Sounding incredulous and trying to keep my calm ... 7 bulan? Puan berdaftar di Klinik Desa pada 8 minggu kandungan kan? Tiada scan pada masa awal kandungan?
Patient: Tiada.
Me: Ok, apa keputusan scan? Apa doktor bilang? Baby ok ke?
Patient: (Blur look) Tak tahu lah...Doktor tidak beritahu apa2.

And the 'Tak tahu' went on.... This is a 23-year-old lady with SPM qualification I'm talking about. Not the 16-year-old girl or 40-year-old mak cik from kampung who has never been school.

Jeez!!!! There's nothing worse like getting a patient who doesn't know a damn thing about her disease or her baby's condition or her child's illness. Like, how can you not know? It's your body, your disease, your baby in your uterus. Don't you care? Or do you trust the medical personnel here so much that you feel 100% sure that everything they do is the best, the most appropriate treatment for you that you don't feel the need to question or know anything?

I couldn't help but overhear these 2 housemen bitching about their patients the other day. They were gossiping about how rude the patients talked to them and how rude THEY acted back towards the said patients. I was listening with a poker face but inwardly, I was like "OMG...what kind of doctors are they to be talking like that to the patients. It must be their fault that the patients were rude to them in the first place. How can they be so rude to patients?" and bla...bla...bla... all my disapprovals... Little did I know that I would be bitching about my patient now.

Most of my patients were really nice and cooperative. Most of the time, it's really easy to get a decent amount of information from them. But there are times when I face this group of challenging patients, which really try my patience. And at times like this, I always, I mean ALWAYS IMMEDIATELY, make a silent prayer to God that I not get this kind of patients in the exams because then, I would certainly burst into tears in the middle of the exams or do desperate things like kneeling down and pleading to the patients to tell me something, anything. With exams less than a week away, this patient I clerked today is giving me a nightmare.  

Wisdom comes with age, for a selected few

Another way of disputing "The lesser of 2 evils". 

"Though it is true that sometimes it is lawful to tolerate a lesser moral evil in order to avoid a greater evil or in order to promote a greater good, it is never lawful, even for the gravest reasons, to do evil that good may come of it."  

Humanae vitae, Roman 3:8

Had an awesome SGD with Dr Soon. He is amazing; so inspirational, pleasant for a Head of Department, humorous and an excellent educator. And his repetitive eye-blinking just makes him more 'normal' rather than like any high and mighty, arrogant consultant. Why can't all his doctors follow in his footsteps?! The things that he has taught us can never be found in the textbooks. His knowledge of Islamic laws makes all my Muslim friends gape in amazement. And he said something about The true spirit of One Malaysia is not about tolerating one another, but to ACCEPT each other. That is why, we have to understand about other religions as well. That will make us an even better doctor. He also said that it's important to have a strong faith so that we will not be easily shaken, especially by all the many moral and ethical dilemmas that so often surround our profession. If we are weak, that's when we go crazy (literally, crazy). I can go on and on about the wisdom he has imparted but I would rather not because that will just make me sound like an infatuated student. haha...