One of those moments when I had total Tawakal to Allah …

Tawakkal (Arabic: تَوَكُّل‎‎) in the Arabic language, is the word for the Islamic concept of reliance on God or “trusting in God’s plan”. It is seen as “perfect trust in God and reliance on Him alone.”

I just had another moment betul2 tawakal last week when I managed a lady with dengue. A severe dengue. And she was pregnant.

It’s one of those cases when even the most bad ass sinner would turn to God seeking help. For all we know, there is no antiviral nor magic concoction to battle the disease yet. We could only provide supportive treatment until the virus weakens, as our antibody fights it off.

If you confront in with an already impaired health status – meaning for instance if you have diabetes or a pre-existing heart condition, it may mean you have to fight harder. Yet doctors and researchers remain perplexed as to why young, healthy individuals still succumb to death despite having nil medical condition.

In my case, I like to think that a pregnant mother gets their extra support to fight dengue from their fetus. Just like those pregnant doctors oncall who seems to have super strength doing their job even though they had to be on their feet and stay awake all night.

On that particular day, the moment the lab called to inform that her blood results were positive for dengue – I had cold sweats. My first thought was, what would my visiting specialist do? I used whatever insight and things I learnt from my boss from a case I consulted a few days before (also a lady who had dengue fever with very low blood pressure) and applied whats relevant in the current case. I kept reminding myself to document my actions and treatment plans properly because if other people do not see it on paper – that means you did not do it. Documentation has always been a problem for me because one, I am very slow in differentiating what is left and right. Secondly, my thought processes are so fast that my hands can’t keep up. However, it must be done for effective continuation of care.

I have been in a mortality case discussion before. Although no fingers were pointed (like, honestly!) – in retrospective, we always feel bad because in hindsight there was always that something you could do to hopefully shift the condition to a better outcome.

After initiating proper early interventions and consulting important people, I passed the baton to my more expert colleagues in the tertiary hospital. From what I gathered, they had a sleepless night too as they had to face several medical emergencies one after the other. But I was very hopeful because it was a strong team working that night. At that hospital.

My adrenaline and anxiety did not stop there. I actually made solat hajat and read Yasin for the patient that night. Which was something I rarely do. Even for those who are most ill. But I felt compelled to do so because during the last minutes prior to transferring her into the ambulance – I caught the face of one of her children. Her son, probably around 8 years old. Crying in the arms of his father who was also sobbing – worried sick for this wife who has bored him their  4 children and now carrying his 5th.

That made me very determined to pray to Allah that night. So this woman could stay strong , so she could return to her family and wipe away the tears of her crying husband and children. And that everything would be okay once more.

Alhamdulilah.. she is now out of danger.

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.

 

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 …  

Sayonara to you my precious friend

Perhaps my hospital is best known as a transit hospital. A place where doctors wait and serve until it is time to move to greener pastures. While it is a lost to our patients for losing such great minds and love, as one of those chronic people who are still holding on to our comfort zones, I see it as a great opportunity to meet lots and lots of people. From different walks of life, of varied medical experience. Yup, I’m still here going on to my 4th year.

Another colleague is leaving by next week. We are organizing a farewell party for her tomorrow. Earlier this month she already belanja a few of us a meal at the ikan bakar area in Duyung. I heard it cost her a leg. Ha ha. So I guess its time to return the favour on a larger and more formal scale.

I have been asked to get her a gift. Hence, for practicality sake I bluntly texted this colleague and asked her if she wanted anything special. She cheekily replied, I want a new water bottle, to replace my orange one.

So a water bottle it is. But since I have like nearly 200 to spend, I’d probably end up getting something that she doesn’t use as well. On top of the ciput water bottle of course.  I mean, what do you give someone who has everything. Someone who drives a Mercedes Benz, a beetle.. someone who owns her own practice.

If it was me, I would like my farewell gift to be;

  1. a cute box filled with faber castell black ink pen sampai penuh
  2. stuff like stickers and sticky pads for my planner
  3. a good story book
  4. a small handbag

ha ha ha. Now this sounds like a birthday gift.