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I think it has been sooooo long since I actually write something here. Had been busy most of the time, adapting to the new demanding department, and at the same time, still trying to adapt now.

Entering surgical department is definitely an experience worth sharing. It is a place which the old school houseman training is still on the go. We have to be in ward as early as 6.30am (still considered late by surgeons), review our patients deep down to the details of how many piece of bread they eat and how much water they drink, and start the whole tedious rounds until late afternoon, complete the orders, and another round during the afternoon, and if we are lucky, it ends a bit later than 5pm, but if not, drags till 7pm, and later on a short dinner before yet another round of reviews, and night round, and if lucky, get my ass back to my room by 10pm, and if not, at least around 12am.

It is a department who seldom show signs that we are appreciated by the seniors.

It is a department where when you are in it, people will automatically understand why you have a stress face.

It is a department where you train urself to do things efficiently, fast and effective, and if you are up to the game, push urself to become more and more efficient.

Even thou it seems all sober and sad, but i do find something nice during this whole time and it comes from our clients.

They see us get screwed, they see us trying to be better, they see us struggle and in the end, when they got to leave home healthily, most of the time we get words of thank you, a friendly shake from the old auntie, or the grateful eyes of the family members. Even thou those moment doesn’t last long, but at least, it is something to soothe my already stressed up mood for the whole day. It is AT LEAST a bit of something.

No matter how busy, I think when I’m thinking back about all these experience later, I will still laugh about it with all my ward-mates who had been covering each others’ asses all the time. I think by the end of the day, this is exactly like what the bosses said, there is no compromise for such trainings, and it is a must.

Taking off this week end. Hopefully the coming weeks will be peaceful ones and hopefully I get through surgical without much hassle. And most important, I hope I could still maintain this blog as a place where I complain and hopefully, serves as a very good diary when I grow older later.

Hope that the host will still be there for this website. Haha.

Would want to post up second batch of Vietnam pictures and some nice places that I discovered in Melaka lately. Laters.

Woke up for breakfast and lunch, with another 6 HO. Quite good numbers right? Haha.. Too bad Karen sleeping :P

Later on went for paparazi tutorial with Gan.

A very sexy shot? LOL.

And pass over the panning technique to Gan.

Went kite-ing once again.

A very good chance to pick up photography again at where I left off. Tons to do but no time to accomplish. Damn.. I shall start putting deadlines for myself. Summon to pay, bills to pay, blablabla.. Hate adult life la, should have go back to kids and just play and be happy with simple things (just ranting).

Up & downs. These are just up & downs. One day later I wouldn’t even remember what I felt today.

Went to Hospital Jasin today. Even thou it is just around 20-30 mins away from Melaka, I still can feel the more relaxing side of servicing in a smaller hospital. during my short stay there n the very short trip out to town with my colleagues for the famous roadside cendol, i can say that Jasin is a small peaceful town, with enuf funding to make the place look nice n greeny. Even the hospital itself has nice design, unlike the congested GH back in town.

But even thou it is just 20-30mins away, the patients here are different. I do not see the distance as a big prob but some of them just refuse to go to GH for further treatment. Well, I can understand that there r transport probs but sometimes the word NECESSARY comes into play u see. It is not you can, but you should.

Ppl r obviously more lepak here. Less patient, less trouble, easier job right?

Don’t know why, i still think that this whole hospital is still under utilised. Maybe it needs time to grow.

Hopefully i get to have such trips more often in the future! ;)

Long time didn’t blog. Damn I think this blog’s hit is going down the drain.

Recently there are few things in mind. Well, as predicted by my famous tukang tilik add-math teacher, this year is gonna be a troublesome and a-lot-of-thinking to do year for me. Sigh. And since the start of this year, I had been thinking my brain off. Wondering when will all these end.

It is funny that you know the key to solving a lot of problem is yourself, and yet you can’t do anything much about it.

It is ALWAYS, easier said than done.

Trust me on that.

However, the most recent updates would be my sudden love to the kite and waiting for my 6 meter octopus ordered from HongKong to reach Malaysia and trust me, I’m going to fly it as soon as I get hold of it. And hopefully if you are driving on that fly over at Melaka this Sunday, you will see my black octopus in the air, hovering over the other small kites, tormenting their owners, breaking their beautiful dreams of flying a cute colorful kites!

Huk huhhhh.. I’m so crazy.

Listening to Hindi song now. Can’t understand a thing.

Hasn’t been taking much pictures as well. I think the need for the wide angle or a better prime lens will be the push. But I haven’t been traveling much as well, so I guess I shall keep that dream down the list, for the time being.

Otherwise, finishing Orthopaedic in a month time. And so I think I better buck up with some holiday plans before entering hell. OMG. Takut sia…

Was called by Chan to be judge for this St. John first aid competition today, for the secondary school level.

Seriously, I didn’t know or see anything like a first aid competition. And I never know that it can turn out to be so interesting. The idea is easy, a scenario will be given to the team (consisting of 4 members, one being the leader) and they will need to act out the scenario and show how they put their first aid skill into action.

They have both short case and long case. Short case well.. for a short scenario, while the long case is with a much more complicated scenario.

I was in charge of the short case for the nurse cadet, which means the female group and most of them are from form 1 to form 3 i guess. Being a judge, I was given a scoring sheet, and there are certain things that need to be done by the team in order to earn marks from me.

The case is the same for all. And it is about a female victim, who suffered an epileptic attack, and has abrasion wounds on her left palm and elbow. The location was given in the question sheet.

To score a full mark, first the leader need to tell the team members to..

1. control the traffic (acting out like a police traffic to direct the imaginary traffic),
2. assess the location (like moving the patient to the side of the imaginary road),
3. identify the problem (which is the acting of the victim, shaking her whole body as if she is having an epileptic attack),
4. note the abrasion wound,
5. describe the abrasion wound (by shouting out loud so that I could hear, by the way, the wound is some wax plus red syrup mix),
6. clean the wound and bandage it (act out the whole process, with real cotton and gauze and bandage),
7. comfort the patient (again shout out the comforting words so that I can know they do it)
8. call the ambulance (the conversation is with me, and I need to judge whether they mention the place correctly and describe the victim’s condition correctly)
9. and when the imaginary ambulance arrived, to prepare the stretcher and carry the victim and act out the whole process of transferring the patient onto the ambulance.

And on top of that, there are tons of details to evaluate. For example like whether they have checked her breathing, her pulse, her respiratory and heart rate, whether she has other injuries (involve performing a few test like flexing the leg and chest spring and pelvic spring), whether they got put the blanket to warm the victim up or not, whether they got tilt the victim’s head to the side or not, whether they got put the victim in recovery position or not and etc etc etc.

And all these need to be accomplished in 10 mins.

Well, it is a long list to do and remember right?

But to my surprise, some teams (all together 9 or them) with adequate training, can almost score full marks!!

It is definitely entertaining to see them act out, trying their best, and I feel sorry when they got so nervous when they stand in front of me. I’m not that scary after all right?

These are some funny moments that I share. I practically spent my whole morning smiling and laughing, well, together with the participants I wound say. This is not to laugh at some mistakes but I guess it is fun to share, and after all they are just at the start of learning and I think most of them don’t even want to be in the medical line.

Part 1.
Cadet 1 : Please stand behind, we have a patient here and she needs fresh air! Fresh air! (Pushing her hand out signaling for imaginary bystanders to step back)
Cadet 1 : (to me) Tuan, can you please help us to direct the traffic and control the crowd?
Me : (Thought she was acting so I continued to walk around observing other members)
Cadet 1 : (again) Tuan! Can you PLEASE HELP US to direct the traffic and control the crowd?!?!?!
Me : Oh! No, I need to judge. LOL.

Part 2.
As you already know, the question sheet clearly mention that the victim has epilepsy and abrasion wounds on her left palm and elbow only.
Cadet 2 : (calling the imaginary hospital) Hello is this Hospital Besar Melaka?
Me : (pretending to be the operator) Yes.
Cadet 2 : My name is Tan XX. I’m a member of St John and I would like to report that there has been an accident in Jalan Y and the patient has abrasion wounds on her left arm and FRACTURE OF ULNA!
Me : WOW!

Part 3.
Cadet leader : Victim is having epilepsy! I must secure the airway now! Let’s prepare a cervical collar for her!
Me : -__-”

Part 4.
Cadet 4 : *saw victim having epilepsy* Ma’am, please calm down, you are having an epileptic attack.
Me : (Hmmm.. okay laa.. considered comforting words, add marks)
Cadet 4 : Ma’am, can you please stop VIBRATING! PLEASE CALM DOWN!!
Me : ??
Cadet 4 : Ma’am, it is okay. Don’t worry. It is just an epilepsy. It will happen again in the future one so please don’t worry too much.
Me : -__-”

Part 5.
I notice they like to use this word very often.
Cadet 5 : (Calling to imaginary hospital operator) Is this hospital Melaka? This is Lim XX calling from Jalan Y. Got a girl is having epilepsy and she has been vibrating non stop!
Me : *Smile*

Part 6.
Cadet 6 : Leader! I’ll help loosen up her clothes and shorts to make her more comfortable! (And after that proceeded to take off the victim’s short.
Victim : (who is suppose to act like she is in an epileptic attack) NOOOOOOOO!!!!
Me : *Terkejut*

Part 7.
The new team comes in front of me and saluted.
Me : *Look up at the leader*
Cadet leader : *Look down at me*
Me : *Stare back*
Cadet leader : *Stare back*
Helper : Introduce yourself!
Cadet leader : OH!! Good morning Tuan we are from Team NCJ is ready to perform the task!

She was so nervous she forgot what to do.

These are only some of the moments which I enjoyed. Anyway, full marks for the effort. Full marks for the shouting and acting. And definitely full mark for the spirit!

Bravo!

the fact that I’m in my 2nd posting.

I’m happy that I still wake up in the morning wishing that I could do some good today.

I’m happy that I still could stand there and ask how are you to my patient each day.

I’m happy that I actually have these thoughts that this all is a happy start of a day.

Despite the fact that I have things to do,

I’m happy I go to clinic and see more people.

I’m happy I’m picking up things.

I’m happy that I come back and I would want to revise things that I read and learned.

Despite the fact that social life is given a big discount.

I’m happy to learn how to deal with myself.

I’m happy some people still support this backbone of mine.

I’m happy that it is actually not that hard to take the first step.

Despite the fact that all my theories that I developed in the past few years didn’t really stay in my mind anymore,

I’m happy that I’m actually more or less doing what I wanted myself to be.

I’m happy that I still have a certain power and influence over my own mind.

I’m happy I’m shaping something different.

So, it is not that bad after all. I think I have my own plan already.

The story below can be merely fictions. Read at your own risk.

Scenario 1

In clinic during one day.

Patient : Doctor, I got pain on my left arm.
HO : *Look at x-rays* Uncle how long ago you had this fall? Your arm last time was broken la..
Patient : That one 20 years ago.
HO : Ooo. 20 years ago until last year no pain? Now only pain?
Patient : Yealaa, don’t know why this year start pain. Sometimes so bad I kenot take things, kenot work.
HO : Ohhh..
Patient : Last time I can carry 2 gas tong at one time, now can only carry one!
HO : Wah uncle, I can only carry half. Haha.
Patient : *Very serious face* Doc, I think I wanna apply for OKU lah.
HO : *Amazed* Why?
Patient : Because I kenot work sometime due to the pain.
HO : Uncle you know OKU is what or not?
Patient : I know laaa, I need help. I got a lot of responsibilities.
HO : Uncle you need to be cacat to apply to OKU.
Patient : Yakah?
HO no2 : Yeala uncle, if we do a BKA on you, take off your leg, then you can apply for OKU.
Patient : *Serious face, kept quiet*
HO : *Sigh*
Patient : Nevermind laa, I still want to try.
HO : Uncle! You understand or not, you are simply not eligible for that! You got all 4 limbs on you!
Patient : I know, I just want to try… Give some face lah.
HO : *Sweat*
HO : This is your TCA paper. See you in 6 months time. Bye bye.

Scenario 2

HO : Uncle, how is your left leg?
Patient : All right all right!
HO : LOL.

Scenario 3

8am in the morning.

HO : Boss nak buat round?
MO : Habis? Jalan jalan?

Scenario 4

A boy with laceration wound with nail hanging at the edge of his finger.

Patient : Kena jahit ker doctor?
HO : Yeala, abis tu takkan nak biar berdarah jer.
Patient : Habis kuku macam mana?
HO : Jahit la.
Patient : Kuku boleh jahit ker?
HO : Hehe *wink*

I think a lot of none medical field people will think that it is quite impossible, but weirdly, it is quite easy to accomplish.

Scenario 5

HO : Patient on backslab.
MO : Apsal on backslab pula?
HO : Errr…. (after 1 minute).
MO : Apa la kau ni. Nak back slap? Disappointed.

Even thou being an Ortho houseman has relatively better working time, I still think that their on-call is perhaps, the more taxing one.

You got lotsa ridiculous things, and you will be surprised by what people can do.

My friends always listen to me rant about the bad sides of being a doc. I think it is very normal. Because nobody will rant about the good things kan?

But good things are meant to be kept to ourselves. As I’m a person who likes to complain.

Patient comes in middle of the night with a fractured arm. Why? Because they were running around at the taman permainan. When? At 2am midnight. For what? God knows why.

Patient comes in middle of the night complaining about leg pain. Why? Because they have bad controlled diabetes, giving them bad diabetic foot, and with lotsa slough and discharge. For how long? Pain for almost 2 weeks already. Why not get yourself admitted in the morning or afternoon or even the evening? Blink blink. Why must you come to hospital in the middle of the night? God knows why.

Patient comes in with a fractured finger. Why? Mat rempit.

Patient comes in with a fractured femur. Why? Mat rempit.

Patient comes in with a fractures humerus. Why? Mat rempit.

Why am I getting busy? Mat rempit.

It was so bad, that everybody who comes in at night with the age of younger than your middle age looking man, if they have a helmet with them, they are mat rempit.

This is what Malaysians like to do. Generalized thinking.

Whoever can ride a bike is a mat rempit.

At the same time, you will found out that actually a lot of people suffer the same back pain like you do.

A patient said to me yesterday

‘Aiyo, doctor, pukul 3.30 pagi you pun kena kerja ka? Kesian kau’

What can I say?

*smile*

If I’m to write my own case history, it would look like something like this.

25/c/male

Premorbid : nil

p/w -
fever x 1/7, low grade, a/w arthralgia, myalgia, no chills and no rigors.
cough x 4/7, productive, minimal greenish sputum. on & off since last month.
sorethroat. lost of voice.
no SOB, no orthopnea, no PND.
no dyspepsia, no dysuria
BO+PU normal

PMhx - nil
PShx - nil
Family history - not able to assess since no voice
Social history - HO in melaka GH. Known contact with PTB patients. Known contact with possible H1N1 patients.
Drug hx - not a fan of medications.

o/e :
lungs clear, air entry equal.
cvs - DRNM
abdomen - SNT
cns no abnormalities.
throat - injected, no enlarged tonsils
no regional LN palpable.

Ix - FBC, Busec, throat swab c+s

Refused for H1N1 throat swab as pt scare of hospitalization (I’m already ‘hospitalized’ what). Refused for blood C+S. Refused for CXR as patient is not keen for radiation, lazy to go to xray room. Sputum AFB and C+S not seen because pt could not cough out the sputum.

Imp : TRO Pneumonia. TRO H1N1. TRO PTB.

FBC taken by Dr. Gan - super painful.

Gan.

FBC - 146/13.5/295/43
neutrophils increased.

Given T. Augmentin 675mg tds, T. PCM 1g tds, Thymol gargle.
T. EES still on the way.

2.1.2010 and I’m already sick!! Only 3 more days to end posting. Duh.

My new year resolution?

I don’t know. Quite empty lah.

If anything, I hope I can be richer. LOL. And other things will come after that. Haha. Next month no oncall, how to be rich -__-”

Had been analyzing why am I so miserable nowadays.

I think it is in the blood.

I hope for a cheerful year next year. And hopefully, it comes from deep inside :)

And so I wish for you, my blog readers, for a better coming year.

Raising sun from the highest spot I can get to in the hospital at 7am in the morning one 1.1.10