Apr 3, 2017

Spotify Playlist #1: First Rotation

I have this Spotify playlist entitled "First Rotation" which strictly include only the songs that I love singing myself out loud alone shamelessly in the car and that I've came across while in my first posting as a houseman. I tend to compile songs into the time period I listened to them. It brings a hella mixed memories, both suppressed and missed. Well, this playlist is kinda short, but here they are in the order of encounter (except Adele songs, which are timeless yet instant):

Mar 29, 2017

Gaji Houseman Kontrak Cikai

I have precisely 40 minutes before having to go to work today at 5 pm. Funny, I haven't visited this dear blog of mine for weeks and reading back my last entry and that same worry of mine is still present. If ever, it is getting worse. I have now only three weeks before my supposedly end of posting date (EOP).

My phone keeps pinging with Whatsapp notifications from my work group chat. There is supposedly a departmental teaching and the MO is angry because currently only 11 of us are attending it now. LOL. I only need only one more teaching to go to in my logbook and there is very abysmal chance for me to waste it on my pre-night day.

A week ago the SPM results came out and as always, there is a lot going about people wanted to pursue Medicine and wanting to become a doctor. It's the same story every year. People look up to the profession and while we have been increasingly aware of the true working condition the doctors are experiencing and the public's general perception of it, a lot of you guys still, adamantly and vehemently, persist in wanting to become a doctor.

Well, for most of my part whining and wooing about my shitty experience being a lousy houseman, I will not discourage you guys to try. I still don't feel any special being a doctor - I think you are not meant to feel that way anyway; a doctor is not a superhero that can do everything and being a doctor doesn't entitled you to lord over anyone else (get the hint, malignant MOs). Being a doctor means you will sacrifice a lot of things, and by coming into terms with the inevitable future only then you can begin to settle down and embrace the hellhole of being a doctor.

Anyway, for those of you wondering about a houseman's pay, and still looking at salary as a factor to pursue Medicine in Malaysia, let me show you the pay slip as a bonus:

Oh shit it's 4.30 pm! I need to pray and start preparing to go to work! See ya!

Mar 16, 2017

Raining Thoughts

It is raining right now, illuminated with flashes of lightning and rhythmed with the gongs of thunder. As much as I dislike this kind of rain due to the melancholy it often brings, I began to learn to like it because of one sweet stranded situation that happened to Z and I a few weeks ago. Now whenever I heard the thunders, I remembered that brief time of us together.

Melancholy that it usually brings maybe in part comes because of the darkness it shrouds over the place and over the heart. One tends to dwell into their own darkness inside whenever the ambiance of the weather readily supplies the mood to brood. And in times like this my deep yet scattered thoughts are amplified to a slight degree that warrants me to write them down here today.

The first matter of the heart is the worry. I worry about a lot of things. I worry about my O&G logbook. There is still a lot of procedures I haven't jot down nor I asked signatures from. I am down to only five weeks to finish my rotation and I am very worried that I will be extended because of this incomplete logbook. Apart from that there is this green form that marks our performance based on wards rotation. We have to ask for the specialist in charge of the ward their signature at the end of the 2-week ward rotation where they, supposedly, will grade our performance and attitude. In truth, rarely the specialists know how well we do our jobs in the ward but oh well.

I still haven't got Dr K's signature because 1) every time I start new ward rotation I always start with a PM shift so I always cannot find the time to find the designated specialist to sign it 2) every time I approach her she will always scold me and then refused to sign it for various reasons (although admittedly one time I asked her at the main stairway so she kinda went all bull-like at me) so I gave up and stopped looking for her. The last ward rotation also is still unsigned and gahhh - what a pain this all is.

The second matter that rains heavily on my mind a lot for these past months working is about the issue of salary. This is quite a complicated thought of mine as I discovered because I tried to tell Z about it but the flow of it came out dispersed. I am not even sure if the gist of my thought was properly channeled out when I tried to express it. Maybe it's the speaking part that got tangled. Maybe, on paper, it will come without much derailment.

So the thing about salary is, as I supposed that occupies my mind for a long time, begins during the first three months of housemanship where I did not received monthly salary. Oh, no, it's not the amount that I am worried about. It's much more complicated than that, remember?

I further supposed, that it begins much earlier than that.
Much, much earlier.

Okay here comes the dull narrative..

To start with, maybe I should begin with my family and how I was brought up. See, my family is not the rich type - big house with airconds, maids, going travels or whatever rich people do or have as I have no clue. I am also saying that my family is not 'not well off' either - we have a house, two cars, and enough allowance for me and my siblings to go to school and etc.

But there are some defining moments in my childhood that I never taste of that other children had experienced. When kids are obsessing over Digimon or Playstation or going abroad travelling with family or having handphones or even owning a Pilot Shaker mechanical pencil (hey, it's a valid envy of mine way back in primary school. It's a cool pencil okay), I have none of that. First of all, my allowance money I spent it all on food (yes, even way back then). Second, my parents won't allow for such things. Not that I am whining or anything here, please don't get me wrong. I am ever grateful for what I have but it shapes what kind of person I am today.

And what kind of person exactly am I? The one who always dream of something better and making plans on how to achieve it. I daydream so much everyday for years on things that I plan to do or buy 5, even 10 years ahead in the future. I planned for months to buy this and that, like for an instance, my car which I paid the down payment with my own money when I started my year 4 of medical school.

The scary part of much daydreaming and plotting planning to buy things is when you actually did it. Yes, first comes the feeling of achievement. The realization of what you have done has not sink in yet, and when it does, sometimes it makes you think about it for a long time. And that is exactly what happened to me.

Coming back to the first three months of finally working as a houseman, I am left with no monthly salary yet. The obvious solution for me at that time was to use my lifelong savings, which I have linked the account with another bank for easier transaction. Being a planner as I am, I already calculated how much I should spent and how much I will get back when the first pay came.

I guess this is all what being an adult is about. With that much savings and little restriction put on me, I am free to do what I want with what I have. Granted, there are consequences for every action that we do, and that is I think the overall gist of basically, being a human. The first step of it is the control. I exercised that very little control of what I have by first purchasing an expensive smartphone on just the third week of working.

Yes, I justified my actions very well and even up until now I haven't regretted my purchase. I rarely do. My phone is serving me very well and I am in need of a good phone for daily activities anyway. But this is the first decision that I made without any need of permission from my parents. There are and will be more big decisions in the future that I will make or already made, and it got me to think about something.

Yes, that something is the matter I wanted to write it down actually, not the whole nonsense thing that you have been reading for the past 10 minutes wahahah. I already feel tired from sitting my butt on this stiff plastic chair to write this down and there is still a lot I want to say. That something is still not coming out properly yet - I don't quite actually know how to proceed with it. I will continue talking about it in my next post, or in another one much later, but eventually I will write it down because this is not something I can easily forget.

The sky has brighten up and the thunder has quietened down already. The veil of such intrusive mood has been lifted and with that, the melancholy of such intriguing matters of the heart as well. The sound of rain is heard still, and the weather is ever changing like it often does. So surely just like the rain, these thoughts will surely visit me again and again in the future. Ceh apasal poetic sangat tetiba.

It's time for lunch, and perhaps a short nap, before I begin to prepare myself for work today. Wish me luck!

Mar 8, 2017

Work Diary

[0700 hour]
Jolting myself out of bed in a frenzy. Yesterday I accidentally slept at 8 pm on the floor and woke up at 12 midnight, feeling woozy but hungry. In a dazed I ordered some McD chickens online and could only go back to sleep at 2 am. With no time to spare I had a quick shower (more like a splash, really. I don't think my body had even dried properly before I rush to the hospital), gulped some water and out of the room. Subuh prayer? Ke laut.

[0715 hour]
I remember the nurse in the MFU (Maternal Fetal Unit) of the O&G clinic asked me to come again and help Mr R today. No such luck. As soon as I stepped into the Ward 1A, the nurse called me and asked me to review this one patient I had met briefly yesterday.

She is a 40 years old lady, Para 5 (meaning she just delivered her 5th child) who delivered her baby some time yesterday around 4 pm. I was working AM shift this week, meaning my shift starts from 7 am till 5 pm. In some, rare good days, I can finish my work on the dot and can go back at 5 pm. On bad days such as yesterday and today? Not so punctual. 

I received a call yesterday from the Microbiology lab informing that the lady's viral screening is reactive for Hepatitis C. At first I thought oh okay maybe the patient hasn't delivered her baby yet or that she is in her first trimester (because I haven't seen this patient yet) but no, she is a postnatal patient.

Bewildered, I soon noticed that she has never went for antenatal booking or any antenatal check up at all throughout her entire pregnancy. That means, she is an unbooked, unscreened mother. Those two words alone can cause a headache to any doctor, made worse if she is already delivered, became worse still when her blood is positive for antibody HCV, because we don't know anything about her and her pregnancy at all or whether the baby is also infected or not.

Why antenatal check up is important? Because a lot of things can go wrong during pregnancy. There's high blood pressure with protein in your urine that can trigger seizures called pre-eclampsia, diabetes during pregnancy that can cause baby to grow big and developing low fetal blood glucose neonatally, miscarriages that come with bleeding and pain and passing out blood clots and pieces of the undeveloped foetus. The baby could be upside down or even horizontal, the baby could have deformities, the baby could be already dead but the mother didn't notice it.

In short, antenatal care is important. We have good antenatal care system in Malaysia, you know. Just ask your mother or any pregnant friend that you know to show you their "pink" antenatal book. Every health aspects of the pregnant woman is being assessed, beginning with scan dates to confirm the gestation of the baby, the woman's blood group and viral screen for HIV, Hep B, Hep C, her weight, height, etc, blood glucose monitoring, blood pressure monitoring, anaemia check-up, baby's kick activity chart, and many more.

Heck, if I have to describe everything that is in that pink book, I won't finish it by the time I become an MO. Just go and have a look at it yourself. I once met a patient who had her antenatal care in freaking Australia and she only have documents (no antenatal book like us) with her that she compiled in a folder. It was disorganized and we had to rummaged through them all and even then there is a few key information missing. Granted, seeing as she is not an Australian she only went for a private check up but hey, in our lovely Malaysia yang pemurah, all warganegara and also bukan warganegara who are pregnant can do their booking in KK (Kinik Kesihatan) and get the antenatal book. After this please la don't be so quick to condemn Malaysia teruk la itu la ini la ni benda bagus depan mata ni korang takpernah nak guna elok-elok.

[0720 hour]
The staff nurse had informed me that the patient is complaining of abdominal pain. She went to the toilet a few hours before and noticed that her pad was soaked with blood and blood clots. She didn't report it to the nurse. She only mentioned it when she had the pain.

I was cursing in my head. Blood clots and heavy bleeding pun takkan nak diam je? Tu kan benda abnormal it's not natural after delivery to get bleeding that much. Dah ada 5 orang anak kot takkan tak reti-reti lagi. DISCLAIMER: THIS IS ALL IN MY HEAD. I AM A PROFESSIONAL AT WORK. I TALK TO MY PATIENTS WITH SMILES AND SOFT TONE OF VOICE. Then I hurriedly informed an MO while getting ready to prepare speculum and a torchlight to figure out what the heck is causing the bleeding.

[0730 hour]
I took some blood from the patient and sent it to the lab. 

[0745 hour]
The MO asked me to insert the branula for the patient. I failed. But the needle is still there and the MO took over. She godek-godek the jalan and it went in. Wait. I am talking about a different patient here. By this time there was a number of patients I attended simultaneously. And by the word 'attend' I mean running here and there doing errands ordered by the MOs and the staff nurses alike.

[0745 hour]
Got the result of the blood. Haemoglobin is 8.0 which is a 4.3 drop from yesterday before delivery. The MO asked me to change the GSH to GXM and get 2 pint of packed cells for the patient to get blood transfusion. I filled up the request form and hurriedly went to the Blood bank.

[0750 hour]
The guy in blood bank said the blood can be collected in half an hour's time. I went back to the ward.

[0900 hour]
Finished clerking the subacute cubicles after being interrupted multiple times to do here and that. Saw that MO is fishing out a huge chunk of retroplacental clot the size of a songkok from the patient yang bleeding tadi tu. Oh em gee where the heck the clots came from?

[1030 hour]
Saw a new case coming in and no one else to clerk this patient. So I went to clerk, because that's my job. Oh, early labour. Simple enough. But she is supposed to be check for vaginal examination half an hour ago, which means I'm already late. Then the HOD (Head of Department) came to the rounds. That means I have to drop everything I'm doing and follow the round. Shite.

[1130 hour]
Just finished the round. I had to ask a colleague to do it instead.

[1300 hour]
I lost track of time. Did prostin review template and awaiting for the MOs to asssess the Bishop score for the patients ongoing prostin.

[1600 hour]
Still haven't eaten anything today. The only meal I had is that sinful McDs from last night. Oh, got some free time! Went to perform Zuhur prayer.

[1620 hour]
A patient that is supposed to be electively admitted this afternoon just came.
JUST GREAT!! Why waste your time when you can waste mine??! There are three discharge cases to be done. IOL list is still not done. I kept looking at the watch and sigh in defeat.

[1715 hour]
The PM shift housemen came to work. Whew. But I can't go back yet my work haven't finished. Then there's a shout for an emergency Caesarean case. I tried to ignore the case because night housemen are there but... sigh I had to help. So I helped called the Paeds housemen and inform them about the case.

[1800 hour]
Another new case that arrived before 5 pm but went unnoticed until now. Great. I grabbed the BHT and start clerking the patient. Nasib baik case senang ceh ceh

[1900 hour]
Performed solat Asar. I know I know I'm such a horrible man oh God forgive me for praying so late. Went to confirm that everything is settled. Okay, looks good.

[1917 hour]
Punched out the card. Now thinking about the Western restaurant that I found a few days ago. Looking forward to stuff my face with much food.

Mar 2, 2017

Of much ado but said nothing

It was my intention to write something at the end of Feb as to make it looks like I am consistently blogging from time to time like what a responsible person would do. But alas, I failed to do so, leaving February, a month of great but dreadful happening, to be marked with only a single entry of how in despair I was in.

Correction, I am in.

It is such a despairing topic to talk about, much so to type it out, and very much equally loathed to read about I'm sure. Everyone hates their job, me included, but to wallow in sadness for a long time about it is emotionally draining to me. So let's talk about other aspects of my life this time, and yes, as now that my life is nothing but being a houseman, let's talk about it.

Already I have strayed so far from what I originally draft my post to be like. I have so much to tell, only to be hampered down by inconveniences of mismatched time and situation. Surely life of a houseman is more than just being depressed all the time, isn't it? But it is hard to write when you are underwhelmed or in need to cocoon yourself away tightly in your shell, away from everyone and everything.

But as every story can be easily told in a simple manner, I should strive for that. And so, let's do this in a chronological way of story-telling of how I'm trying my best to keep my shit together until now. I won't be talking about what's happening at work because I am so sick of thinking about it. Let's instead turn our heads into ways I did / still doing to keep my sanity in check.

1. Binge-eating

I'm sure I have told you guys before that for the first three months working I did not get the pay each month? I only got my first salary on Thursday in the third week of Feb, which is the accumulation of those three months. Sure, once I got it you guys must think, "Wow, that's stinking awesome! Kaya beb!" because I got the lump sum of 11.7k. But while waiting for those long three months, how did I meant to survive with no pay? Luckily I have savings, so I splurge on that meager amount with buying (a lot) food.

Even now, I am not shy to spend my money on food. I need that comfort. Stressed time calls for more food, and it's not just quantity that I go after. There is this pathological need to eat something lavish or grand, although at most all I did was to eat at fast food eateries like McDonald's or Sushi King. One time I even went to IOI Mall to try myself a plate of Tony Roma's. 

2. Watching movies

The first time I tried this method is when I failed my first year in Newcastle and having learnt that I had to repeat my year. After I got out from the Student Office building, I called my mom to tell her about my predicament. After I finished the call, I found myself walking in the city centre (I have this annoying habit of never sitting still when talking over the phone). I saw the cinema and went inside it to watch any movie that was available at that time. It was a shitty movie called Hangover 2. See, I still remember it because despite being a trashy movie, it managed to make me chuckled to myself despite me feeling the lowest of the low.

Anyway, it is still a habit I do whenever I feel my life is fast rolling down the gutter. I will periodically check for any good movie now showing and will spontaneously found myself buying the ticket for me to watch alone. It's not a really good way of comforting myself, so what I did next is much simpler.

3. I bought a Broadband line

I can't rely on my phone's data alone if I want to survive here. I do live in the hostel, after all, so the concept of WiFi has never registered in my mind in the first place. So in the first two weeks here, I surveyed all the telco plans and decided Digi Broadband offers me the most data plan per month. So I signed up for it and use the data extensively to binge watching tv shows and movies from my laptop.

Now that I'm using capped data instead of unlimited one, I don't bother downloading any tv shows. Now all I do is stream them online. I found a couple of site with English subtitles that are really good, so all is well. The only problems are to find good tv shows to get hooked on and also the agony of waiting for the next episode (or rather, the next season) to be aired. 

4. Play games

This is quite a new hobby of mine. I don't really play it for long, because I find it to be a little unhealthy for me. So I play in moderation. Playing games really do keep me entertained, so I am grateful I still have something to do other than looming about my stupid job.

5. Typing this down and post an entry about it

Woah, this is a bit meta, isn't it? After so many years of blogging, I still find it a really good hobby to invest in. Sure, I do sometimes feel disheartened when I think nobody is reading this blog because who doesn't want their words to be read, kan? That is why I really appreciate all the comments you guys wrote, even if I never reply to any of them. Sometimes all I need is to see the blog statistics and when I see that there are people (and yes, stupid bots from Russia or US included) stumbling into this blog daily, I cannot help it but to smile.

So here's the end of my entry this time. I do have other things to talk about, but they are all still half-formed in my mind. The connections are still jumbled up and disoriented I fear it will make little sense to those who are reading it, me included.

That's it for now.

For your information, the title of this post I picked is from something I've once heard or read in the past. 
It is "Of much ado about nothing", a Shakespeare play.

Feb 1, 2017


Medicine is unbelievably, a very lonely path for me.

Maybe it is because I'm the only one from my university that chose to work here. Or maybe because I stay in the hospital accommodation alone most of the time. Or maybe now I feel this is not really what I wanted to spend my whole life doing after all.

But in essence, I feel so empty all the time nowadays.

What is life outside work? I hardly know. I don't see any way around it. I really don't. Counting days to be free just for a very short while. Just for a day, stretching it a bit further by several hours at most. No trips planned. No activities in mind. Just repetitive tasks of waking up forcefully by the blaring sound of the alarm, fighting against the chill shower, dreading all the way to work with fast palpitations and no excitement whatsoever. To return, every day, with more fatigue and disappointment? To be back in bed, feeling crushed and lonely more than ever each passing day?

Honestly, this is killing me.

I don't know what I want to do anymore. I don't have any clue for any alternative. I don't have any strength to change my course or to back down and let it all go either. I hate going to work with the fear in my heart and the unknown in my head. I hate getting chewed up by people who don't even try the shoe that I'm in. I hate that I make mistakes. I hate that I am liable for it. I hate that I will do more and more mistakes. I hate being wrong. I hate who I am now. I hate it with all my heart.

But some days are better than the others. But not necessarily improving.

Nobody seems to understand about the predicament I am in. All they know is that I must never give up. My parents are worried that I might crack under pressure. I don't see why shouldn't I be. It is not like I never know or never predict the life of a doctor is. I know it years ago. But knowing and living it are very different. And now I don't know what I want to do with my life. The direction I'm going to. I don't see it. I'm very much afraid I won't see it.

I'm this close to drowning.

The hails are storming in and the mountainous sea is crashing down. And I'm the one-legged Captain with the crooked hook for a hand in this miserable ship with the broken rudder, helplessly carried along the current to wherever the hell I dragged myself into.

Curse it all.