Thank you

I learn one thing as a doctor; never promise your loved ones except when you are on leave.

I seldom could make things on time with them i.e. wedding, meal, outing etc. Sometimes things just happened before you go back and you need to attend it.

I must be very thankful to my parents and siblings; who are very understanding and never complained about it.

They waited for me in hospital for about 1 hour yesterday (they were on the way home from Melaka); just to hand over 'pisang goreng' to me - as I requested them to drop by.

They would try to prepare special meal for me if I tell them that I'm going home for dinner - though having dinner at home itself is already something special for me.

They listened to all my stories and experiences with interest.

They woke me up early to go for work and prepared breakfast for me; which I rarely took if I'm alone in hostel.

They (my siblings) cleaned up my car; and of course I 'paid' them =D

Thank you for your unconditional support. Thank you for your valuable prayers.

Thank you Allah for your blessings.

"Ya Allah, please guide me to be a good daughter and sister."

71200 Seremban

Wad Patah dan Potong

Tergelak besar saya malam tadi. Bertugas shif malam di wad 5A; sesudah selesai semua kerja dan review pesakit mana yang perlu, saya sempat berbual-bual dengan seorang pesakit yang matanya masih belum mahu tidur. Muda lagi orangnya, baru 20 tahun; terlibat dalam kemalangan motosikal dan mendapat kecederaan - open fracture grade 2 of right tibia/fibula. Dua hari lepas wound debridement and external fixator insertion telah pun dijalankan ke atasnya.

Galak sungguh dia bercerita pada saya tentang macam-macam, sedangkan mata saya sudah mula kuyu. Bertanya itu dan ini, saya menjawab sekadar yang boleh. "Dr, ramai jugak yang masuk Wad Patah dan Potong ni ye." Tergelak besar saya. Mata yang berat sudah boleh terbuka luas. Saya menjawab, "Kalau macam tu, surgical ward kita panggil Wad Pecah dan Potong." Kami tergelak lagi.

********************************************************************

Saya masih terlalu hijau di orthopaedics. Masih banyak perkara yang perlu dipelajari. Dalam keadaan saya yang masih blur, saya ditugaskan untuk coordinate jadual untuk HO. Aduh, saya berjaya mengelak untuk beberapa posting sebelum ini, tapi untuk kali ini saya terpaksa untuk rela walaupun sudah berkali-kali menolak. Ia bukan mudah sebab sistem shif. Yang menguatkan semangat saya adalah kata-kata seorang kawan yag menyatakan saya sebenarnya membantu semua orang untuk menyediakan jadual yang tidak berat sebelah. Oh, berat sungguh tanggugjawab, Ya Allah kepadaMu aku sentiasa bermohon.

Paling lucu adalah, Miss Nora panggil saya kapten. Ada seorang MO saya tersalah faham, dia ingat saya Kapten (Dr) dan dia tanya apa nombor tentera saya...hahaha. Berat pun tak cukup dan badan pun rendang saja, mana mungkin saya diterima masuk tentera (jika saya berminat sekalipun).

Posting ini agak berbeza dengan yang lain sebab buat pertama kalinya saya ada senior UIA sebagai MO. Sungguh sedikit bilangan kami di sini. Masa saya mula-mula masuk dulu, hanya ada beberapa orang saja - Dr Wani (blood bank), Dr Shima (ED) dan Hud (masa tu dia HO lagi) . Sekarang ada bertambah tiga orang - Dr Nazimah (eye), Dr Munirah (ED) dan Dr Rizal (ortho). Saya cuma kenal kakak-kakak senior saya sahaja - in fact diorang yang tegur saya dulu masa diorang mula-mula sampai. Dr Rizal; saya cuma cam muka - macam budak UIA. Ape pun, memang ada rasa seronok bila kerja dengan senior sendiri. Masa saya buat A&E call di surgery, selalu jugak saya jumpa Kak Munirah; kadang-kadang seronok bila dapat referral dari dia. Dulu Kak Nazimah MO O&G; bila saya datang labour room untuk attend baby yang hypoglycaemic (masa tu saya di paediatrics), dia cakap "Ok lah, dia junior aku, dia boleh buat punya (masa tu HO O&G tengah struggled set branula untuk baby tu)." Tapi tu lah, a very few of us here =( Oh, saya ada 2 orang junior lagi kat sini - Kay dan Aswad.

Saya masih tak pasti arah tuju saya selepas HO ni. Setakat ni saya suka semua posting; tetapi ortho dan surgery sudah semestinya bukan pilihan saya. Masih terus berdoa pada Allah agar dilorongkan ke jalan yang betul.

Satu lagi, saya amat merindui kawan-kawan saya di UIA. Menanti ketibaan hari Sabtu ini (24/12/11) untuk berkunjung ke walimah Hawa Alias (kami buat research bersama-sama masa elective posting), semoga dapat bertemu dengan kawan-kawan yang lain.

Semoga dimudahkan segala urusan. Jom ulangkaji orthopaedics!

71200 Seremban

Salam aidiladha

Salam aidiladha buat semua.
Alhamdulillah, saya bercuti untuk 2 hari ini =)

Gelombang aidiladha pada tahun ini sedikit berbeza. Liputan di Tanah Suci banyak disiarkan di media massa; lebih daripada tahun-tahun yang lalu. Perbincangan tentang isu-isu Tanah Suci juga banyak disiarkan dan yang menggembirakan saya, ianya disiarkan pada slot-slot perdana. Tidaklah seperti beberapa tahun dahulu; siaran-siaran seperti ini hanya akan ke udara pada jam 6.00 petang. Bertambahlah azam saya untuk berusaha untuk menyahut panggilan tersebut.

Berusaha dari segi kewangan sudah menjadi satu kemestian. Mengerjakan haji diwajibkan ke atas mereka yang mampu sahaja. Saya perlu berusaha untuk menjadi seorang yang mampu supaya saya dapat menunaikan rukun Islam tersebut. Terima kasih kepada emak dan ayah yang telah memulakan simpanan untuk kami pergi haji sejak kami kecil lagi; gaji mereka dipotong setiap bulan untuk dimasukkan ke dalam akaun kami bertujuh beradik. Kini saya sudah bekerja dan sudah punya wang sendiri. Kini giliran saya pula untuk berbuat demikian. Tugas saya adalah untuk memastikan hasil pendapatan tersebut benar-benar bersih untuk ke sana. Jadi, saya kena bekerja dengan amanah dan bertanggungjawab di samping membayar zakat yang ditetapkan.

Berusaha dari segi kesihatan juga merupakan satu kewajipan. Walaupun masih muda, saya perlu berusaha menjaga kesihatan dari sekarang. Bermula daripada amalan pemakanan sehinggalah amalan kehidupan seharian. Oh, cabaran besar buat saya. Kadang-kadang makan pun tak tentu masa. Balik kerja sudah tiada lain di fikiran selain rehat dan tidur,. Jadi, apa yang saya buat sejak mula kerja dulu adalah mengurangkan penggunaan lif. Saya guna tangga. untuk naik dan turun. (Tapi saya hanya akan naik guna tangga hingga tingkat 3 - dan sekarang saya bertugas di tingkat 8..hehehe).

Berusaha dari segi ilmu adalah keutamaan. Walaupun sudah belajar sejak sekolah menengah tentang haji dan banyak program di televisyen berkaitan dengannya, saya masih belum jelas sepenuhnya tentang ibadat ini.

Berusaha mempersiap dan membaiki hati memerlukan ketabahan yang tinggi. Hanya kepada Allah saya bermohon untuk diberi kekuatan dan paling penting diberi petunjuk serta hidayah. Saya hanya manusia biasa yang tidak terlepas daripada salah dan silap. Saya hanya manusia biasa yang boleh tertewas dengan nafsu. Saya hanya manusia biasa yang terlupa dan terleka.

Saya doakan mereka yang berada di Tanah Suci sentiasa sihat untuk menyempurnakan ibadah ini. Semoga mendapat haji yang mabrur. Wahai Tanah Suci, saya merindui kamu!

43650 Bandar Baru Bangi

Berusaha wahai diri!

4 bulan yang panjang di Jabatan Pediatrik.

Semasa posting ini saya banyak mengeluh sendirian.Semasa posting ini saya banyak memujuk hati menahan sabar. Semasa posting ini saya banyak merenung kembali mencari kekuatan. Semasa posting ini saya banyak memohon pada Tuhan agar dimudahkan segala urusan.

Biarlah mereka yang berbaju biru itu selalu salahkan kami (HO) semasa meeting department sebab 'tak buat' discharge summary serta itu dan ini; padahal komputer di wad hanya 3, server selalu down, kertas A4 pun kadang-kadang tiada dan printer selalu tidak berfungsi. Selalunya semua sudah siap, tetapi tak dapat print sebab printer rosak. Banyak kali juga saya print semula discharge summary untuk pesakit yang sama sebab hilang. Salah siapa? Pasti jari dituding ke arah kami juga dengan pelbagai alasan lain.

Biarlah mereka yang lebih berilmu itu selalu marahkan kami di wad, lepas mesyuarat jabatan atau di mana-mana; tentang apa-apa sahaja; saya tidak mahu ambil kisah sebab saya tahu memang ada antara kami yang bermasalah yang membuatkan mereka jadi begitu. Saya juga memang tak gemar dengan mereka yang bermasalah disiplin sebab mereka juga menyusahkan saya. Biar saya belajar dengan cara yang pahit sebab memang mungkin itu cara belajar yang paling baik di hospital.

Biarlah sistem shift yang kelam kabut ini begini berterusan sebab itu yang pihak tertinggi inginkan; supaya kami kurang stress. Terima kasih atas pembelaan. Saya ada kurang daripada setahun sahaja lagi untuk terus berada di bawah pembelaan.

Apapun, saya tetap gembira dan teruja untuk datang bekerja setiap hari. Kerja saya adalah amanah daripada Allah. Saya bekerja hanya untuk Allah. Saya tidak bekerja untuk bos - bos saya. Mereka juga manusia seperti saya. Bukan mereka yang menentukan rezeki saya, tetapi Allah. Tetapi saya menghormati mereka kerana mereka lebih berilmu dan berpengalaman daripada saya; walau apapun cara dan gaya mereka.

Setiap hari merupakan hari-hari baru untuk saya belajar sesuatu. Setiap hari saya merupakan peluang-peluang baru untuk saya menimba amalan dan keberkatan. Setiap hari merupakan ruang-ruang baru untuk saya membaiki apa yang perlu. Setiap hari merupakan sinar-sinar baru untuk saya kongsikan apa yang saya ada dengan mereka yang memerlukan.

Menjaga bayi-bayi yang tidak berdosa itu kepuasan saya.

Melihat kanak-kanak yang tidak tahu apa-apa tentang dunia itu kegembiraan saya.

Mendengar mereka menangis serta 'berlawan' dengan mereka semasa mengambil darah atau memasang branula merupakan satu kelegaan kerana saya tahu mereka masih 'sihat' dan bertenaga.

Yang pasti, semangat juang kamu semua melawan penyakit dan ketabahan ibu bapa kamu untuk terus berusaha dan berharap untuk kamu benar-benar mengkagumkan dan menginsafkan saya, betapa saya masih lagi tergolong antara manusia-manusia bertuah yang lupa untuk bersyukur.

Membesarlah kamu semua dengan baik. Semoga sentiasa dilindungi Allah. Semoga diberi petunjuk ke jalan kebenaran. Semoga kamu semua bertemu Islam yang sejati, jalan kehidupan di dunia untuk menuju syurga di akhirat. Kamu semualah pewaris dan pentadbir masa hadapan. Jadilah insan mulia kerana kamu semua jugalah yang bakal memimpin anak-anak dan cucu-cukuku nanti.

Teruskan berusaha wahai diri. Bekerjalah seolah-olah akan hidup seribu tahu lagi. Beribadahlah seolah-olah akan mati esok hari.

43650 Bandar Baru Bangi

God is like that...

"God is like that. He will just erase anything he wants if he wants to take away something." said one of my friend. At that time, we had a cute little baby who was just passed away due to severe congenital anomalies.

Congratulations to the baby - you are an ahlul Jannah (member of the Heaven).
'Congratulations' to the parents - your baby is in the Jannah (Heaven); waiting for you and will always pray for you. Be strong. Be patient. Reward from Allah is waiting for you.

Alhamdulillah, I am a Muslim. I believe in God. I believe in the world and hereafter. I believe in predestination as planned by Allah.

Dear my friend, my prayer is for you. May you find the right way.

43650 Bandar Baru Bangi

Pesakit, Bayi dan Saya

Banyak sungguh entry yang tertangguh. Semuanya saya tulis separuh jalan, sebab tertidur di pertengahan jalan :p

Dalam bulan kedua dalam posting pediatrik, masih terlalu banyak perkara yang saya perlu belajar. Saya akan menjaga SCN (Special Care Nursery) sehingga akhir bulan ini, jadi pesakit-pesakit saya adalah mereka yang berumur kurang dari 30 hari.

Saya menjaga mereka yang suci.. Saya menjaga mereka yang tidak berdosa. Sentiasa sejuk hati melihat wajah mereka.

Kagum melihat mereka begitu kuat mengharungi kesakitan dan melawan pelbagai insult yang menyerang dek kelemahan sistem tubuh badan mereka untuk melawan. (Saya tak dapat bayangkan apa yang mereka rasa; minta maaf banyak-banyak sebab terpaksa mencucuk tangan dan kadangkala (selalu jugak sebenarnya) kaki kecilmu berkali-kali sebab kamu sangat comel dan chubby).

Sentiasa berharap agar mereka membesar dengan baik. Sentiasa berdoa agar mereka berjaya mencari dan menerima hidayah daripada Allah. Bagi anak-anak single parent (baca: luar nikah) saya berdoa agar mereka tidak menjadi mangsa fitnah dunia dan keji masyarakat; semoga mereka membesar dengan baik di bawah lindungan Allah.

Sekarang ini, wad kami penuh dengan bayi-bayi; ada 50 orang semuanya, mungkinkah akan bertambah lagi (ah, tidak!). Jika saya kata saya 'suka' ramai patient, orang akan kata saya tak betul. Saya tak kisah ramai patient asalkan pesakit itu betul-betul ada indication untuk admission. Saya pun tak kisah ramai patient kalau masa office hour. (Tapi kalau masuk waktu on call pun tak kisah, terpaksalah saya belajar sorang-sorang, tak dapat kongsi dengan orang lain). Saya juga tak kisah ramai patient kalau semua colleague tolong jaga wad sama-sama (macam sekarang).

Setakat ini saya ok dengan paediatrics. Tapi saya tak rasa saya suka NICU. Saya tak suka tengok baby sakit (alasan). Bak kata Dr. Asiah (MO Medical), kita tak kan suka sesuatu bidang sampai kita berul-betul faham apa sebenarnya ilmu yang tersurat (masa tu saya tengah borak dengan Dr Asiah yang saya nak buat Medical tapi tak minat sangat dengan cardio).

Selamat membesar dengan baik untuk bayi-bayi saya di wad sana. Kamu semua sungguh mulia sebab tiada dosa. Semoga berjumpa dengan jalan yang benar dan diredhai Allah.

Satu lagi, terima kasih mak (dan ayah) sebab jaga kesihatan masa mengandung, lahirkan saya dan adik-adik dengan baik dan jaga saya adik-adik dari kecil sampai saya (dan adik-adik, kecuali Muhsin yang kena masuk wad sebab jaundice) tak pernah kena masuk hospital, tak pernah kena cucuk dan tak pernah kena ambik darah.

Nota :

1. Salam Aidilfitri buat semua. Alhamdulillah, saya sempat solat raya tahun ini. Dengan harapan semua amalan semasa Ramadhan dapat diteruskan untuk setahun akan datang. Semoga ditemukan lagi dengan Ramadhan yang akan datang.

2. Belum sempat beraya ke rumah kawan-kawan. Tak tahulah bila boleh pergi. Saya bekerja weekend ini dan akan datang dan mungkin seterusnya.

3. Selamat bekerja untuk para junior saya. Saya baru jumpa 2 orang dekat HTJS.

4. Bila tengok baby, saya jadi rindu dengan labour room. I really love labour room. Saya rindu conduct delivery. Saya rindu sambut bayi. Saya rindu jahit episiotomy. Saya tak kan menolak kalau saya terpaksa jadi MO O&G nanti =)

71200 Seremban

Ramadhan Kareem =)

Alhamdulillah.

Ramadhan is coming and I am still in tagging period in Paediatrics Department - to complete a total of 14 days (but today I am taking a day off - how nice is this department!)

Oh, 2/3 of the day to be spent in hospital ~sigh~

I am not sure whether I'll be strong enough to perform Terawih prayers if every night I've to go back at 11 to 11.30pm.

I'm not sure whether I'll be strong enough to wake up in early morning for Tahajjud payers.

Definitely, my sahur will be just before Subuh.

As in last year, my iftar will be just a simple one (as I'll run for my Maghrib prayer ASAP before the night round starts - or it will be usually in the middle of the round when I can just see other people eat and hope for the round to finish fast so that I'll not miss the prayer).

But, I am very sure that Allah will listen to my prayers, ease my way and be by my side.

I really hope that I'd have enough courage and strength to read more Quran and perform Terawih and Tahajjud in the middle of this tagging period during this blessed month. I don't want to miss the train! I shouldn't forget that my job is also actually an ibadah that I'll get reward from it - if I do it because of Allah.

I should also not forget my brothers and sisters in Palestine and other suffering countries who are in more critical condition than me. They are oppressed and fighting for their rights and for Islam. So, I should pray for them and be grateful - mine is just tagging, not fighting.

Keep moving forward. The rest is only in Jannah.

Ramadhan Kareem.

Waiting patiently for my turn

71200 Seremban

Kuantan dan Kenangan

Setahun berlalu.

Saya kembali ke Kuantan. Menziarahi tempat saya belajar tentang hidup; hampir semua tentang kehidupan.
Bersyukur rasanya diberi kekuatan oleh Allah untuk mengharungi 5 tahun yang panjang dahulu.

Berada di sini mengingatkan saya akan cita-cita dan harapan saya dan kawan-kawan - mahu graduate dan berbakti kepada masayarakat.
Tinggi sungguh cita-cita kami. Tetapi kesibukan dan kepenatan bekerja kadang-kadang membuatkan kami lupa akan matlamat asal kami.

Saya tidaklah merancang untuk ke Kuantan kali ini sebenarnya. Tapi perancangan Allah memberi peluang kepada saya untuk memuhasabah diri semasa di sini.

- Dahulu saya banyak tidak tahu, sekarang saya baru tahu sedikit, jadi saya tak boleh jadi sombong dengan orang yang tidak tahu sebab dulu pun saya macam tu juga.

- Dahulu saya belajar dengan pesakit, sekarang saya kerja jaga pesakit, jadi saya kena jaga pesakit-pesakit dengan baik sebab mereka semua 'guru' saya dahulu, kini dan selamanya.

Terlalu banyak untuk diceritakan, tapi banyak juga yang saya tak dapat luahkan. Yang pasti rindu saya terubat dan semoga saya diberi kekuatan untuk berusaha untuk menjadi lebih baik.

21200 Kuantan

Saya rindu UIA

Saya rindu UIA.
Saya juga rindu Kuantan.

Saya rindu kawan-kawan di UIA.
Bukan semua kami datang dari sekolah agama, tapi kami belajar agama sama-sama di UIA.

Saya rindu cikgu-cikgu saya di UIA.
Cikgu-cikgu saya yang penuh dengan 'wisdom' dan sentiasa memberi inspirasi dengan cara meraka yang tersendiri.
Saya tak tahu sama ada saya sudah buat mereka gembira atau tidak; tapi saya tetap berusaha ke arah itu setiap hari (walaupun saya amat penat dengan kerja).

Saya rindu suasana di UIA.
Biar apa pun orang cakap pasal UIA sekarang, saya bersyukur pada Allah sebab takdirkan saya masuk UIA. Saya dapat kenal orang-orang yang baik dan belajar benda-benda baik.

Saya rindu untuk pergi program-program kemasyarakatan walaupun hari-hari saya jumpa masyarakat.
Saya rindu nak buat program sama-sama dengan kawan-kawan.

Sukar benar saya nak solat berjemaah di sini kecuali kalau saya ke masjid.

Saya sedih sebab ramai pesakit saya masih tak solat.
(Mungkin salah saya yang selalu bagi alasan sibuk).
Saya lagi sedih sebab ramai staff dan kawan-kawan juga meringankan solat.
(Kalau tengah operation tu lain cerita. Saya pernah hantar kes ke HKL dan saya minta pemandu berhenti untuk solat maghrib masa pulang ke seremban; tapi tiada sape endahkan permintaan saya).

Saya doa banyak-banyak agar Allah permudahkan saya dalam setiap langkah kehidupan.
Saya doa banyak-banyak agar Allah sentiasa bagi saya petunjuk dan tak lupakan saya.

Saya tahu saya sedang berjuang di sini.
Menegakkan Islam dalam diri saya.
Mengamalkan nilai-nilai Islam semasa bekerja.
Agar Islam tidak dipandang serong.

71200 Seremban

My Patients & My Patience

"Patients are always like that. Never tried to understanding anything. Do they know that we are also human being?"
"But they are patients. They are sick."

"Why are they coming at this time 3 o'clock in the morning for not passing motion for 3 days?"

"Mr. X, please come to hospital. Your father is discharged today."

"Doctor, I cannot come today. I don't have the GL."

"We need the bed for someone else."

"Please doctor, tell the patient that we are not coming to pick him back home."

Grrr.

In the middle of night, around 1am - I was called to A&E,
"Doctor, the hernia (inguinal hernia) is disturbing me. Sometime it is painful. But I still able to pass motion and pass flatus."

"I think you don't need admission. We'll give you date to see us in clinic."

"But I couldn't sleep at night because of the pain"

"Ok then, we admit you to ward."

"But doctor, if I get admitted, I don't have money to pay for the bills. I only have RM50. I even borrowed money from my neighbour to buy my 6-months-old child's milk."

"So, what do you want for now?"

A police officer was treated for acute diverticulitis and he was allowed discharged as the pain improved.

"You can go home today and I'll give you MC until Sunday."

"Can you please write a letter for me that I am not suite for work."

"You can go to work after this. No harm."

"How can I work if I still have the pain."

"Please take and finish the medication and you can work as usual. If you still have pain you can go to KK to continue your MC."

"Doctor, when will my child go for operation? It's nearly 12 hours he's not eating."

"His name is in the OT list. Anaest will call the case. Our OT is quite busy today with trauma cases-more life threatening case. And if there is any EM LSCS, it is prioritized."

I explained to a mother of a gluteal abscess patient.

"I am just worried he's hungry."

"He will be definitely hungry but we are giving him fluid and sugar."

"Doctor, the gauze is soaked with pus. It's time to change."
"Doctor, now is the time for feeding."
"Doctor, when do you want to change my dressing? It's about lunch time already."

And the list goes on. Never ending list.

They are sick people. They are family members of the sick people.

I am not sick. I am taking care of the sick people.

It's the nature of taking care of sick people.

And they are innocent about everything in hospital.

Oh my patience, please always be with me.

P/S : not yet mentioning when dealing with other parties - friends, staffs, bosses!

Just be quiet when in anger.

71200 Seremban

Surgery?

Oh..only a few days left before finishing this surgery...and I still haven't done with my assessment ~sigh~

Compared to medical, surgery is simpler; at least at the level of houseman - proper history and examination, establishing diagnosis, optimizing patient for operation, assissting operation, and post op care so patient can be discharged. Above all, assisting operation is the easiest and taking care of the post op patient is the most difficult - taking care of drains, early mobilization, chest physio, incentive spirometry, nutrition etc.

But definitely performing the surgery is more challenging; but once we master the anatomy and well versed in the principle of surgery - everything is under control. Deciding on when not to go in OT is more difficult and that differentiate good surgeons.

But, enough surgery for me at houseman level. I don't want to go beyond it; maybe I can consider to be a surgery MO (if I have no other option) but I'll make sure it is only temporary. I just can't imagine myself doing the laparotomy, craniectomy, scope etc.

But surely, I'll miss surgery. There are still a lot more knowledge for me to explore.

Oh, I must be thankful to all my colleagues, cool MOs a nd surgeons. Thank you for the experience. Thank you Allah for giving me strengh, patience and passionate.

71200 Seremban

Around the ward 1

It was my first on call in surgery.

A rectosigmoid cancer with ovarian metastasis patient just came in to the ward after a long surgery since 10am; underwent total colectomy with ileostomy. She was on epidural analgesia.

I was greeted by the family members with, "Doctor! Why this patient is not sent to ICU? The surgeon has promised me that this patient will be nursed in ICU after the operation!"



"I see. Please hold on. I need to check the notes first."

I reviewed the note. It was a long surgery. Estimated blood loss was around 1.6L. She was transfused with 4 pints pack cells intraoperatively. There was also episode of hypotension and she was put on single inotrope during operation. In recovery room, the anaesthetist decided to send the patient to the ward as she was stable there.

I explained to the family members about the decision.

"I don't care about it! They have promised me to send her to ICU and I want to claim my right!

What kind of right was he talking about? huhu.

"The anaesthetist decided to send her to the ward. They knows better about in-and-out of the ICU."

"Ok. Fine! I'll come later and find your specialist!"

"Ok. You can discuss the matter with my specialist. For now, she is in ward and I'm going to take care of her tonight."

Then, I heard my staff nurse called me, "Dr. Su, her BP is 70/50!

Oh, really? I repeated it myself. It was vey low; I barely heard the Korotkoff sound. Narrow pulse pressure. She was tachycardic with very low pulse volume. Dry looking. Edematous. Low urine output. Stoma loss and drain loss was 800cc (after 1 hour of transfer!). Luckily, the anaesthetist reserved a big neck line for me. But that was the only one!

Every single minute following that was really a challenge for me. Adrenaline and noradrenaline remained at the peak of graph througout the night.

Oh, come on...this is not my first on call...I've had enough collapsed patient before...this is not the first time for me to resuscitate a patient.

Pushing fluid challenges and at the same time struggling in setting the line as she was very edematous; and doing these while the family members were watching me resuscitating her as they were so 'stubborn' to stay outside the curtain were really a challenge - to remain confident-looking, calm and at the same time to think and do things fast.

Meanwhile, other patients in the acute beds were in pain needed attention that I just couldn't attend stat. The least I did was to ask the staff nurse to give analgesics and maxolon before I could attend them. I also had enough marathon from 8th to ground floor that night. I used to do all those things but that night it was just too much for me.

Managed to stabilize her before my MO came (I've informed the condition beforehand - remember, calling for help and informing MO for emergency case are very important - every houseman should know where is our limit). Plan of management was improvised.

12 days later...

The patient was better. So much of improvement. Able to sit up. Able to take soft diet. No more oxygen, IV drip, TPN, drain, CBD, CVL etc.

"Doctor, I would like to thank you for taking care of my wife."

Smiled. "I was just following order from my boss."

"And I would like to appologize from being rough and rude to you that day. I just couldn't control my anger."

Smiled. Satisfied. Syukur.

"At that time, I have to put myself in your shoes. I have to try to understand if the patient is my family member."

"It's good doctor. But still, as a human, I felt guilty for that. If you are not a doctor, what would you actually feel?"

"Pray hard so that she will recover faster."

Prof Nasser used to say, "Treat your patients as if they are your mother, father, sisters and relatives. Don't only serve your specialist, serve your patient."

It is very very true Prof. But it's not that easy to do it. Thanks for teaching me the value.

43650 Bandar Baru Bangi

Note : I write this because I want to remember it for life and I want to remind myself about the value that I should possess. This is only a small piece of everyday life stories...but this one really gave an impact for myself.

Semoga Berbahagia =)

Tahniah Ili dan Azlan!

Saya bagaikan tidak percaya yang saya berjaya menjejakkan kaki sekali lagi ke bumi Cik Siti Wan Kembang pada saat-saat kesibukan dan keletihan yang memuncak; dengan satu niat-memenuhi hak seorang Muslim ke atas Muslim yang lain; memenuhi undangan apabila dijemput.

Saya bersyukur kepada Allah kerana memberi peluang kepada saya untuk bertemu kembali dengan 'ahli keluarga besar' saya semasa di Kuantan. Sungguh tidak disangka yang kami semua dapat berkumpul. Dan lebih menggembirakan kerana saya dapat bertemu roomate yang tersayang- Puan Marlisa yang sudah berbadan dua dan 36 minggu rupa-rupanya =)

Tidak terungkap dengan kata-kata akan perasaan saya. Bagi saya Ili amat bertuah kerana kami semua diberi peluang berkumpul bersama walaupun lokasinya nun jauh di pantai timur.

Melihat mereka semua, masih terbayang-bayang dalam kotak fikiran saya akan susah senang yang kami hadapi semasa memerah buah fikiran dan keringat untuk menyalur khidmat masyarakat kepada adik-adik pelajar sekolah di sekitar Kuantan. Khidmat masyarakat yang diberi adalah bukan untuk mendapat kredit merit, bukan juga sebagai platform untuk sekadar membantu meningkatkan kredibiliti diri. Ia lebih daripada itu. Ia bukan sekadar sebuah program untuk pelajar-pelajar sekolah. Ia datang daripada hati yang letih dan risau akan apa yang terjadi kepada masa depan anak-anak bangsa jika mereka tidak dipandu dan disuluh dengan kebaikan. Saya rindu akan semua itu pada saat ini.

Perjalanan pulang saya di dalam pesawat ditemani dengan memori-memori tersebut. Kereta rosak, duit tak cukup, kejar bas, bermusafir bersama-sama, kena 'pancung' oleh ketua fasi dan sebagainya akan saya kenang sampai bila-bila. Susah dan senang berprogram dibayar oleh Tuhan dengan kemanisan nikmat berukhuwah yang masih kekal sehingga kini.

Apa pun, tahniah sekali lagi lagi untuk Ili dan Azlan. Selamat berjaya dan bersabar dalam menghadapi cabaran alam rumahtangga. Semoga melahirkan mujahid dan mujahidah untuk meneruskan perjuangan ini.

Selamat berusaha untuk Wahid, Jepa dan kawan-kawan yang akan menduduki Professional Exam tahun ini. "Wahid, berusaha dan terus berusaha. Semoga kamu sentiasa dirahmati dan dimurahkan rezeki."

Irwan, Pejal, Syibi, Jah dan yang seangkatan, "This is the road not taken by others. But, believe me, it is worth it. Please take care of the Team for us and for the ummah. After all, don't forget, academic is always number one."

Oh, kena ucap terima kasih pada Ilman dan Q juga sebab hantar ke airport tempoh hari. Perjalanan yang penuh suspen. Dan kalau nak tahu, akak adalah orang pertama yang masuk flight hari tu. (I checked in at 6.40pm for a flight scheduled at 7.15pm-what a great relieve!). Kalau tak memang akak terpaksa tumpang NCJ **** balik Seremban =)

43650 Bandar Baru Bangi

p/s : Saya tidur di sepanjang perjalanan kerana saya post-call. LCCT-PC-Pasir Mas. Semasa di airport, saya tunjuk pada pemandu teksi alamat Ili dan minta dia kejut saya bila sudah sampai. Nasib baik dia tak bawa saya sampai ke Golok. (It was definitely dangerous but I just couldn't help it! - and I don't want to do it again).

Gambar : Kredit untuk Jepa@Facebook

"1,2,3...Push!"

"1,2,3...Push! Teran panjang-panjang. Curi nafas. Sambung. 1,2,3...Teran! Sambung Puan. Kuat semangat." No where else would you listen to that command.

At last, O&G posting has ended. Surely I will miss it very much especially the labour room; which was my passion and where I found most of my satisfaction in O&G.

90% of my on-calls were labour room calls. I really didn't mind with it. Conducting deliveries, encouraging moms to bearing down, resuscitating the newborns and suturing the tears plus teaching the taggers on those matters are my passion and satisfaction. Red alert is a never-wanted-situation but experiencing it gave me of course points of learning on how to deal with it if I'm the leading person.

Respect and humble are keys to survive in labour room. Facing and dealing with the midwives are truly an art of living. They are years-experienced than you. We can ask their opinion but never forget our MO for any decision. The two lives are always the priority. Once the midwives have confidence on you, live is much easier.

My last call was the most peaceful I had with 1 hour interval of empty labour room (so, around 1 hour of sleep!). I never had that situation before as my labour room was usually full with extended beds. Owh, I must thank my MOs for always be patient with me when I woke them up for difficulties I faced and also special thank to my staff nurses for helping me a lot!!!

I just can't imagine if I'm the one who is in labour or whose perineum being sutured. It must be very painful. That's why I would always try my best to treat my patient with gentle; but once in a while I just couldn't maintain it =(

My usual advice to my patients before I discharged them to ward:

"Lepas ni Puan nak berpantang di mana, dengan siapa? Saya tak kisah Puan nak berpantang dekat mana atau dengan siapa, yang penting minum air banyak-banyak; bagi luka cepat sembuh, najis lembut-tak dapat sembelit dan banyak susu untuk bayi. Lepas ni Puan kena bincang dengan suami macam mana hendak merancang keluarga ye."

They said every husband should observe their wife delivering their babies; so that husband would appreciate wife better. For me, every child should also observe how difficult and struggling were their moms to deliver them so that they would at least not hurting their moms' heart.

"We have man kindness to his parents; in pain did his mother bear him, in pain did she give him birth," Surah Al-Ahqaf (46) : 15

Narrated by Abu Hurairah; a man came to Allah's Apostle and said, "O Allah's Apostle! Who is more entitled to be treated with the best companionship by me?" The Prophet said, "Your mother." The man said, "Who is next?" The Prophet said, "Your mother." The man further said, "Who is next?" The Prophet said, "Your mother." The man asked for the fourth times, "Who is next?". The Prophet said, "Your father." (Sahih Al-Bukhari).

After all, goodbye O&G. I know there are a lot more knowledge that I haven't gained but I hope that my little experience would be beneficial for me in the future. Thank you to all my consultants, specialists, MOs and colleagues for the guidance. I wish to all colleagues who are really interested in O&G to go for it. It is a sacred job; helping honoured and noble persons on earth - wives and moms.

43650 Bandar Baru Bangi

Lesser Time to Live - Revisited

"We have enjoined them concerning his parents - his mother carries him in her womb while suffering from weakness upon weakness and then weans him in two years - That's why We commanded him to: "Give thank to Me and to your parents, and keep in mind that to Me is the final goal."

Surah Al-Luqman (31) : 14

My mother; Puan Wan A'sah is at the left side

To my mother,

I still remembered when you had once said, "The birthday is for the children to thank and dedicate their appreciation to their mother after all the difficulties that she had gone through the pregnancy and labor. It is for the mother to be praised."

It is very true.

So, thanks mom for being such a good friend and example for us.

Thanks for always being by my side since the past 26 years.

Your prayer is very precious for me.

Please pray for my success in the world and hereafter.

You are indeed the greatest mother for me.



To my father,

The one who sacrificed a lot for the family though it was hardly apparent in the eyes of the children.

Thanks for your continuous support to me for the past 26 years.

You are indeed my hero in life.

Two pampered daughters in the family (they 'fought' each other to get attention). The rest would blame the date of delivery of them for their behavoir =p

To Madihah Naim,

You are a teenager right now.

So, please act like one =p

You need to learn on how to stand on your own (do not wait for me if you do not understand in your study, try to solve it first)

In any way, I enjoyed 'bullying' and 'fighting' with you since the past 14 years =p

Happy Birthday, Madihah Naim Mustapa (and to me) =)

"Indeed, We've created man from an essence of clay,

then placed him as a drop of semen in a firm resting place,

then changed the semen into a leech-like mass, then leech-like mass into a fetus lump,

then a fetus lump into bones, then clothed the bones with flesh,

and then We brought him forth as quite a different creature

so blessed is Allah, The Best Creator of All.

Then, after living for a while you shall die,

then most surely you shall be raised to life again on the Day of Resurrection."

Surah Al-Mukminun (23) : 12 - 16

43650 Bandar Baru Bangi

O&G in February

O&G in February...

I was in gynae ward for 3 weeks. I was exciting learning new things but at the same time was very tired with it. Physically tired with work and emotionally upset with the 'outsome of social illness'. I felt upset with all the extramarital pregnancies that I met. I felt more upset when I couldn't do much about it...I could only slowly talked to them (hardly found suitable time) and the least I did was offering my prayer for them.



The best moment was when I was in-charge of all the onco patients. In the first 2 days, I mixed up the cases while presenting to the specialist...I was not sure which patient was which...ovarian ca? cervical ca? endometrial ca? peritoneal ca? For what I knew, they came for chemotherapy. I was also very blurred with all the chemo regimes - cisplatin, carbo-taxol, ECO, EMACO, gemcitabine..etc and which one is for which cancer..huhuhu...luckily I have SN Siti, our experienced onco nurse to help along the way =). After a few days, I found oncology is very interesting though very challenging (including inserting branula for them =P). I was always inspired by their spirit to fight with the cancer. Most of them came for chemo with smile and hope. It was very few looked depressed or in tears (maybe they have enough of it until they have no more tears). I missed my onco patients...I really meant it. For all of them, my prayers are for you. Be strong. Be strong. If you can be that strong facing life, I must be able to do so.

For all I know, I never like working in OT since student time...but I could never run away from it. I just can't imagine if I'm the want who perform the operation. But so far, I enjoyed working in OT with all the cool MOs and surgeons =) Hopefully, no more OT after housemanship..hehehe..

For my on call, as usual...busy till next morning regardless of ward call, what more if labour room call.

Now, I'm in clinic. Life changes a bit. But still many things to learn though I'm approaching my final month in the posting (oh, I haven't plan for my leave =p). So, keep moving forward!

The challenge during housemanship is to maintain the enthuthiasm to learn despite unmerciful working hours and burden. Learning is the motivation to continue working. Otherwise, I must have been collapsed since long time ago. Why sacrifice life for others? But that's the way I've chosen. No regret about it. I learn because I want the knowledge for my work. I work because of the trust on the limited knowledge I have...and I am accountable for it.

After all, the ultimate reason why am I living and doing things in this world is because I'm going to die. Once I died, I have no more chance to do something to protect myself from the hellfire in the hereafter.

43650 Bandar Baru Bangi

p/s: I missed my IIUM friends and lecturers very much!

Ward 1A

This week; being in the 4th week in antenatal ward, my working life is full of excitement;

First and foremost, of course with all good colleagues, MOs and staffs in ward which make the working environment and atmosphere less stressful. Credits to my fellow colleagues: Nithiya, Fadilah, Izni, Khairie, Fitri, Azrin, my MOs : Dr. Brintha, Dr. Teoh, Dr Iram.

Secondly, I learn a lot of lesson in obstetrics. I am so happy as I started to appreciate what I've learnt in medical school. I thank my MOs, specialist and consultant for the guidance.

Thirdly, I went back early during my turn for night round...thanks to the cool MO for the understanding.

Many more exciting moments during this week, but I'm just too tired to jot it down. Anyway, I love working in ward 1A =)

Tomorrow I'm on call in labour room. I really hope it will be good call. I don't mind if patients come and we have double beds; and we deliver all the babies safely. I just don't want any deceleration, non reactive CTG, poor progress, secondary arrest or instrumental delivery...and if possible to leave all patients with intact perineum =p

43650 Bandar Baru Bangi

Next Graduant

Congratulation to my sister.

First class honour - Degree in Library Science, UiTM

I was not there as I was still tagging in O&G department that day...quite difficult to have a day off..huhu

43650 Bandar Baru Bangi

Ladies, mothers, babies

One good thing working in O&G department is I seldom see a truly ill-looking patients except for cancer patients in gynae ward (or maybe I haven't seen enough). No intubated patient, no ventilator machine sound, no continuous SPO2 monitoring, no nebulizer, no nasogastric tubes, no stab PD seen. Everyday when I walked into the ward, it was so chill with the pregnant mothers patiently waiting for delivery.

I like O&G. I like the subject itself and I like to serve the mothers, babies and women. Among other rotations in the posting, I just like working in labour room though it is full with mixture of many sounds and voices. The satisfaction of helping the mothers in giving birth for the babies is indescribable with words. I prayed for every baby that I handled for them to be a good child to their parents.

I'm now in antenatal ward with all the good and sporting colleagues. But, TDS rounds really make me sick...it is funny to review post SVD patients or PP patients during night rounds. The MO also did not see the patient like other patients. Nothing much change the night rounds. New cases and acute cubicle patients are more worth it to be reviewed. Regardless how much or loud we talk about it, nothing will change. So the best way is to change our mind setting about it so that works do not seem so stressful (but it's really tiring). Though I'm approaching 4th week in antenatal ward, there are so many things that I need to learn for the sake of my patients.

My aim before graduating from O&G department is I must learn and know the proper way of doing TAS. I need to work for it.

After all, up to this point, I don't think I want to pursue in O&G, just because I do not have full interest in working in OT (I can do it but I don't think I want to do it forever)...huhuhu...my mother must be still praying for me to do O&G (she hopes so, but she doesn't stop me if I want to do other things).

To all my patients and mothers-to-be (regardless which gravida you are), please behave...i'm on call on this Sunday; being on 4th call; covering both antenatal wards...please no non reactive CTG, no high BP, no pre eclampsia, no PPH, no jaundiced baby. I just want you to stay safely in ward or I safely send you to labour room for delivery =)

43650 Bandar Baru Bangi