Doing medicine : Intentions and challenges

Prior to entering Medical school – we had to write a 100 word essay on why we want to become a doctor. We even had some sort of ‘coaching session’ just so we could convey our message in the essay appropriately since English was not our first language. After all we are applying for a place in an oversea medical school.

The coach was giving us tips and hints and when he randomly asked the group “anybody want to share why they want to be a doc?”

A young man proudly put up his hands and shouted ” I want to win the Nobel prize!!” It was innocent and well meaning.

The answer probably caught the coach by surprise. He let out a gentle smile and I remembered him vaguely saying…

… that while he respects individual motivation to pursue medicine – be it sole altruism, money, ranking up the social status etc… he feels that medicine should also be done with the spirit of serving humanity , to treat the ill and make them better so they could go back to the society and serve them back…. we are dealing with human lives you know ..

He went on to describe how Einstein and Marie Curie did not do what they did just to get the nobel prize. In fact he thought they were just doing what they were passionate about in the best way that they can – all so the community could benefit from it. Because their effort changed so many lives on a huge scale in a very positive way – that’s why they were awarded the Nobel prize. It’s a form of recognition for something so noble and selfless.  

Of course practising medicine nowadays has its own sets of challenges. In the olden times, science was witchcraft or an act against the will of God. We are still seeing that today only that now we are described locally by a minority of the religion-driven group as ‘konco2 Yahudi’.

Yes, I had someone mention that to my face in a so called ‘joking manner’ saying that medicine is ‘ilmu yahudi’ just because I cannot translate pancreas into Malay language as opposed to heart into ‘jantung’ or spleen into ‘limpa’. I did not proceed to give him a speech because I was pressed for time but if I did.. I would say that…

Muslims were once pioneers of the science and medicine. Most prominent figures I remember are like Ibn Sina & Al Razi. If we were so called the Zionist secret armies – Allah wouldn’t have bestowed upon us the knowledge of science. That particular era would not have been known as the golden age. Where people are enlightened. And know more. Sad enough, these figures were also called apostates by other muslims during that time.

Salah ke nak jadi orang berilmu? And when we try to give you simple health education – patients maki. When we try to tackle obesity – we were labelled insensitive and argue back regarding every body is beautiful regardless beso ke kecik. Ada aku kata ko tak lawa? I just want you to be healthy. Im just giving ideas so you wouldn’t get another asthma attack and brings up a panic in everyone when we have to intubate!

I even had a patient who does not believe he has a problem with gallstones because the man he went to see for his ‘berubat kampung’ said that he doesn’t have it. Only renal stones – and a procedure has been done to remove it. Pffftt..

Sometimes I wonder why am I still here despite these incidents. Because among them empty vessels and difficult patients – there are still those who are seeking for help and needs a helping hand. Who needs a voice to guide them. Who believes that Allah’s Help comes in the form of proper medical practice. And I still believe that medicine is the best ladang pahala one could ever wish for.

InsyaAllah..

the word is hectic

My schedule has been very hectic lately and honest be told, I am not getting any younger to tahan being oncall. Gosh – need a way out of this. Ha ha.

Yesterday, we had a meeting discussing mortality cases that occur within the department. Indeed, there was a lot to learn. My brain was theoretically searching for the files in my brain on certain subject matters. for instance, how is a U wave formed and all those things.Ironically, nak jadi specialist ko kena back to basics sebenarnya.. like mitochondria punya level sorta thing. Then only you can talk about journals and scholarly articles. Kalau basic pun susah nak grasp – how can I understand HFOV or BILEVEL vent settings right?

Apart from being in the hospital, I also went to court for the first time. Its considered a milestone for any medical officer I suppose. It means you’ve been around long enough to treat criminals or have their DNA taken or something. In other words, you’ve seen enough of the ugly things that happens around you  – shielded from the public. It’s like sampai satu tahap you know a felon is faking an asthma attack just so he could breath the fresh air out of his cell by making a visit to the hospital. Cam y lah…

On a different note – I saw a bouquet of flowers dying on one of our lockers in the room. I am tempted to bring them home but I have yet to ask for permission. From the receiver. Fresh flowers often reminds me of the time I studied in Manchester. There, fresh flowers are cheap and affordable – sold at ASDA or TESCO. I’d often buy them once in a fortnight and have them on my window sill for they are so pretty to look at and some smells nice too. How I miss the pretty sight of carnations and scent of a rose ..

Speaking of flowers – my new stamp collection came through the post. pics in the next entry.

 

to go or not to go

A : Are you going?

B : I don’t know – are you?

A : Don’t you want to go?

B : Do I have to go?

A : Jomlah… takde geng..

That kind of persuaded me to rethink my initial option of ‘buat bodo malas nak layan majlis protokol bagai macam tak nak pegi’. Although I’m a loner  – the type who can go to the movies alone and enjoy a wholesome dinner after that – I don’t subject other people to that.

The last time I attended a formal majlis was last year.Not as a guest but as a personnel in the medical team :P.

I have quite forgotten the fun and joy it might bring. Gosh.. I feel old already.. lets just hope theres no poco poco beramai-ramai. ngeee…

I think I dislike attending these events because one, of its formality and second that fake smile you have to plaster on your face to get through the hours – not to mention the numerous photo taking session – like omg.. can you stop already?! But this event I’m going is supposed to be of one that honors myself – to appreciate my efforts and stuff.

I suppose I should attend it for the love of Allah – for the pride of my husband and son. So they know that my times in this district hospital is not a waste, that I am making a difference to at least one life I tend to. That those nights or weekends I’m not home are worth every second. That they’ll understand that I still love what I do. It’s like how an MO in one of Dr. Johan Siows stories put it,

“Johan, I may never get to be a specialist, but even as a service MO, if I can give the BEST CARE to my patients, then I’m already satisfied with my life.”

spending the last 10 seconds of the hour.. contemplating

minci in orange

This was me a few hours ago. Waiting to go home. I just managed to send a few of my patients for Xrays, wrote a few referrals and discharged a patient in the observation bay in the last hour. In other words, trying to clear off as many cases from the morning shift before the PM shift colleagues punches in. We want them to start the shift as motivated and peaceful as they could because it ain’t nice having to stay till 12MN only to come back to work the next morning at 8AM. And you live like.. 45 minutes away. Balik rumah nak bersihkan diri, gosok gigi.. makan.. zzzzzzz

Its halfway of March and already I’m thinking about booking a holiday – but what are the odds of doing that with more colleagues leaving this year. Ntah2 cuti tidak diluluskan. The most number of medical officers leaving from our place in a year was 5/year. Perhaps we can break that record this year? Since 2 is quitting KKM and another 3 has sent in transfer letters. All for greener pastures.

In the meantime, I just need to FOCUS and PERSEVERE. 

FOCUS with the end in mine. Meaning I’d still end up in government service. It’s like how one of my specialists put it – if all the good ones go to private , sapa nak jaga mereka yang tam mampu ke private. So yeh.. despite the caci maki and accusations of gomen docs being tak ikhlas, I believe that by knowing what your priorities are and being IKHLAS would help one a lot in staying in the service and serve. Takpe, yang maki sorang dua.. the appreciative ones will never make it to Facebook or the news – but you can feel their gratitude through prayers they ask from ALLAH for you.

PERSEVERE still through the days when your are physically drained simply because you are too, undergoing the aging process and becoming old or merely being ill. Being persistent on days when your referrals are rejected or ridiculed by MOs in the tertiary setting. Or having to dig back the medical knowledge of yester years and the future as you have no clue as to what is wrong with the patient in front of you. Persevere too through the hurtful remarks patients and relatives throw at you simply because you are unable to entertain their requests for instance. Meh.

Because at the end of the day – apart from CARING for the patient, I have come to realize that my job is also my ibadat. My field of pahala if I do it right. I should make my salary count. If I am paid RM5/hr for the job, then lets make it a worthwhile RM5. I do not want my HALAL rezeki to become HARAM for me – meaning I make money from something that I did not earn rightfully or without amanah, kerja 8 jam tapi batang hidung cuma muncul 2 jam. Camya lah …  

An unfavourable outcome

I started my new year with a business trip to Lombok. Neh.. I wish.

Instead it started with me being oncall.

Assisting people in diagnosing their medical illness and while at it, solving their social issues. Honestly, if one decides to step their foot in the emergency unit – it must be for a very serious and urgent matter. Hence, they must be prepared for the outcome of the visit such as

  • for admission to stabilise the condition or observation
  • for a follow up consultation in the respective specialised clinic
  • transfer to a tertiary centre with relevant expertise, should they need one

Therefore, it is heartbreaking and at times frustrating when after the length of procedures and test we do prior to the above 3 solutions, you suddenly say

  • I want to be admitted at a private hospital – do they not realize that a similar battery of tests and investigations will be repeated at the private centre.. membazirlah test yg dibuat earlier from the RM1 payment.
  • I can’t be admitted to the hospital now – my birds at home needs to be taken care of or someone needs to cook dinner for my 25 year old son ..
  • or you did not honour the follow-up appointment we got for you the week after and make a return visit to the emergency unit – saying the previous ER doc that saw you did NOTHING and yet we found a referral letter folded neatly in between you BP trend notebook dated a year ago!
  • you refuse transfer to the best hospital (which is conveniently only 45 minutes away) because it would be difficult for your relatives to visit you – like hellooo.. if your distant relatives want to visit you, do it when you are well or during festive seasons..

So yes – nak sembuh pun I kena merayu masuk wad. 

And I haven’t even listed the grandiose, bongkak statements some patients make regarding the health that Allah bestowed upon them. Perhaps I shall leave you with one ..

“Tak payahlah nak cuci2 darah doctor, tengok saya nih umur masih panjang dan sihat”

(there’s no need for a dialysis doc, look at me, look at how I am still very much alive”

Yet your Urea is a freaking 51, Creatinine a horrifying >900, potassium of 6.2 and an acidotic blood gas? And you came to the emergency unit for being lethargic. *sigh*