Encounters

Part 1
My goodness, it was so stuffy in the wards, which also happens to spot a slightly gloomy appearance. My 2nd ward round in 3 weeks, and 2nd time witnessing an emergency. An old man who presented with generalised swelling (his whole body was bloated due to chronic renal failure). My group just interviewed him last week for our bedside teaching, and yesterday morning his blood pressure (BP) crashed, and the MOs and nurses had to perform basic life support (ambu-bag), intubate and provide oxygen for him to breathe. He had to be transferred to the High Dependency Unit (HDU). Don't know whether it was the stuffy ward environment, lack of sleep the previous night, or it's just me having had too many people dying around me, coz I think I'm starting to become numb to such situations. I'll either just zone out or spot an expressionless look, despite having intentions to at least somehow show empathy / sympathy to the family members.

Part 2
At another different bed, there was this young Indian patient in his late 20's / early 30's, who got admitted with a stroke - as a result he is now a hemiplegic. His right leg had to be amputated from the hip down because it was already gangrenous. Initially, nobody wanted to talk to him because he looked scary. Even the nurses scolded him for apparently being irritating and complaining too much.

When he saw me from far away, he gestured for me to go closer. I was like thinking, "What? Should I? What if he turns out to be a psycho / gangster / drug addict who may end up beating me up / jabbing me with a needle?" Man, I think I'm becoming paranoid about the crime situation in JB lar. Stigmas.. He asked for our names.
"Gary."
"David?"
"No lar, Gary.."
"You ni orang Melayu ke Jepun?" (Are you Malay or Japanese?)
*swt* as colleagues laughed at me. He does speak some English and Tamil though.

He was a lorry driver. Apparently it was a stressful job. "You merokok ar?" I shook my head as a no. "Don't smoke. Not good for your body." I guess that was a painful lesson to him.. As I proceeded to do physical examination on him, one thing we realised upon auscultation was that he had a very audible gallop on the aortic and mitral valves sites (actually it can be heard all over, but was the loudest at those 2 sites). Patient chart has 'mitral stenosis' written on it.

"Itu kaki bila mau potong?"
"Err.. tak tau lar.. sorry ya, itu awak kena tanya doktor.."

"You Christian ar?" he asked me, making the sign of the cross with his hands. I wasn't expecting that. "Yes." "So you go church lar.." I nodded. "When my heart not feeling well, I go church lar.. I also got pray.."

It was abit unfortunate lar that we did not trust him enough to allow him to use our handphones to call and check his sister's visiting time. Another ethical scare almost arose when he took out his bank account particulars for his insurance claim apparently, I was afraid that he wanted us to do something or what.. but then I managed to just direct him to ask his sister to bring it up with the doctor / nurses in charge. Pity also lar, imagine being labelled as having no relatives when his sister is still alive. When we finished, we thanked him, shook his hand and apologised if we had caused him any discomfort. He stared at us and said, "Don't say sorry. It's your duty. I am just a patient. I have done my duty. Whatever happens from now on, it is up to you."

I don't know why God didn't heal him at that time, or not yet maybe.. but with what he has gone through, I'm just amazed that he can still cling on until now and is trying to accept things as they are. Not sure how I would have reacted in a similar situation. Well, I wish him well. (he still waves upon seeing me in the wards) Just another one of those little things that pass you by.

Part 3
There was a light moment when a Punjabi asthma patient told us when we were taking his history, "When you become a doctor, don't go for the money - go for the name. If you serve poor people, God will bless you with the money."

On the other hand, we asked a middle-aged patient whether he experienced itches, coz there appeared to be scratch marks and scars on his hands. He said, "No, I try not to scratch. I use the hair dryer. You know? I set it to maximum and blasted hot air over the area which felt itchy. When the slight burning feeling has masked the itch, then I applied some traditional medicative cream I bought from the sundry shop." *tries hard not to laugh; over the hair dryer - coz it's my first time hearing such things*

Part 4
A middle-aged patient from a particular group was trying to recommend me a book on self-healing. Then, I noticed a book on the table, which I picked up, and the title sounded weird. 'Letter to a Christian Nation'. Well, apparently it's a book on aetheism, and he proclaimed himself to be agnostic, having left his old faith long time ago. This guy seems to have problem with religion, believing in doing good and questioning, "How can some groups of religion (I won't mention lar which he pointed out) claim that they go to heaven while others go to hell? Not fair lar like that.. That is very selfish." Then he started making correlations to terrorists and stuff.. "What religion are you? You must read this book. It will really change your perspective on viewing things." Lazy lar I wanna argue with him. He is entitled to his own opinion. But interesting to see that so many different viewpoints exist today.

1st lame joke of 2008

Ben was sharing one of the worst pick up lines ever..
Guy: Hello pretty girl, is your phone number 012?
Girl: What if I say yes?
Guy: Oh, so is mine. I sense the Hotlink connection between us.

Then I went and continue it:
Girl: And what if I said no? Mine is 016.
Guy: Oh, then I won't follow you.

And would you believe what was my 1st Word for Life / CDS class today in church?
Christian speech.
Lesson 2a: Talking nonsense.

Post holiday blues

Spent Saturday at City Square (kind of like a smaller version of KL's shopping complexes). Ended up going on an 'emo' shopping spree, spent more than RM200 on story books and autobiographies. Then, went and nearly drown myself in the swimming pool (I can't swim. Problem is; That did not go down well with me, so I insisted on forcing myself to learn.. still learning)

Last night, I slept late coz i had to do the roster for my group members. Super hard to squeeze people in different weekly slots to avoid overlapping of tasks. Did not really have time to read up for today's ward rounds, so was feeling rather stressed about it that I could not really sleep (although it's already 1am). Woke up at 7am feeling tired, sleepy, sick (on the 1st day of clinical years), and cranky, as if I'm the most miserable person on the face of the Earth. Was expecting to be roasted in the medical wards (by the super fierce head of department, whose reputation precedes her, if we ever bump into her lar) and tutorials (since I did not read up anything).. turned out to be better than expected though.. we got a very good Pakistani doctor who really knew his stuff, and managed to explain everything in detail. Physical examination; not the best, could use more practice.. we were looking for a patient with COPD, and turned out to be a Chinese patient. I was like thinking, "Aiyoh, I have to speak Mandarin with this fella??" Fortunately the guy was from Perak, and was able to speak Cantonese, but mine is still abit broken here and there lar.. And we had a good laugh during the clinical skills tutorial. Tired, but I think it's an ok start..

And it finally rained in JB after more than a week or so. Nice weather to sleep..

Those who have an ear let them hear

I'm in Hope JB now. Apparently it was said to have the highest mobilisation rate (evax, shepherding and prayer meeting attendance >90%) among all the Hope churches in Malaysia. Intimidating at first glance to me.

I won't comment much about the part where I don't understand 99% of what is being said coz I'm a banana who doesn't know much Mandarin. Neither will I say much of people asking Ben (who is going to Church of Praise) and myself why in the world do we have to go so far away and to all the trouble to attend church when there are 2 located nearby where we stay (it's actually 20 minutes drive - which can become 2 hours during rush hour [ie prayer meeting and caregroup time])

But what I want to say is that their prayer meeting (PM) is pretty different from PJ. In PJ, its once every fortnight, and starts at 8.00pm with some pre-PM prayer, then praise and worship, then comes a little bit of scripture sharing, then leaders / pastor will share what to be prayed for, and we will go on praying for the next hour plus or so. It normally finishes at around 10.30pm.

In JB last night, we finished at 11.00pm after starting at 8.00pm. Apparently, if pastor was there, it might go beyond midnight every week! And instead of praying, 80% of the time was spent listening to pastor's sharing (like a lecture), which, for someone who doesn't understand Mandarin like me, is tedious, and can sometimes become boring as it stretches on:p

It was at this time, however, that this piece of advice came to mind;
"Anybody who has a mouth can pray. But being a good listener is a skill which not everybody has. We need to hear more from God to know Him better. The same goes for medical students and doctors. How will you know the patients' feelings and problems plus how to manage them properly if you don't pay attention?"

John 10:27 - My sheep listen to my voice; I know them, and they follow me.

Moments

During one of my mock patient interviews in JB clinical school, a young Chinese female simulated patient (SP) was laughing / giggling 3-4 times throughout the session, and it kind of interrupted the flow of my history taking, so after it ended:
Dr: I want to ask the simulated patient, why are you laughing at your doctor ar?
SP: No, coz the previous 3 students who came in earlier looked very serious. Then out of nowhere came this guy who sat in front of me like abit 'siao' wan. During the interview, maybe coz he was nervous - and therefore make me nervous. He keep on saying "Ok lar", make funny gestures lar when he asked about whether I was dizzy. So because of that I could not stop laughing lor..
Me: *swt* *don't know whether to laugh or cry* So did I pass?

Away on a short hiatus

until after Chinese New Year, and at least until my accomodation's internet connection has been sorted out when semester starts. So going to die in the first few weeks for neglecting my notes and books..

Don't Jail Doctors blog campaign

Now why do I have a feeling that doctors are no longer a profession many look up to as the good old days?

Calling all doctor and student bloggers and anyone who can help. The Government has begun to arrest and jail doctors on a technicality - not registering their clinic with the PHFSA. This act treats doctors like common criminals. These are community doctors who have not committed a serious crime but instead face an incredibly harsh sentence for their technical lapse.

Dr Basmullah Yusom, a family practitioner, is the first victim of this legislation. He was sentenced despite not having legal counsel representing him, despite pleading for leniency (he had wanted to sell the clinic anyway and is in financial trouble) and as he could not pay the hefty RM 120,000 fine, he is now in Kajang prison.

You can read more about it in Malaysian Medical Resources

The 1st clinic doctor convicted under the PHFSA (I)

The 1st clinic doctor convicted under the PHFSA (II)

More background info on A Doctor in Jail

Support? What support?

Dear NST, it's not enough

The ex-Health Minister had promised that the Act would be used only against Bogus doctors and Bogus clinics. Yet, we see that legitimate licensed APC holding medical practitioners are now being targeted.

Facts about the PHFSA:
- this was implemented in 2006 without adequate prior discussion with the medical profession
- it is excessively harsh in its punitive aspects : up to 500,000 ringgit fine or jail which seems to be over the top
- it has huge potential for abuse of power
- it criminalizes doctors for “infringements” which include trivial issues like the dimensions of one’s clinic, direction in which your toilet door swings and dictates whether or not you can sweep your floor!

In support of Dr. Basmullah, we urge all of you to put up this logo in your Blogs and Websites until this travesty of justice is reversed.