living for the sake of You

I have a patient with Down's Syndrome, 60ish years old, under our care at the moment with right sided lobar pneumonia. When we first saw her there were these 2 old ladies present by her bedside. Attending her everyday I learned that they are her elder sisters. Later I learned that they have been spending their lifetime looking after their little sister with Down's Syndrome (and its complications). Not married, no other family, nothing else.

It's amazing how selfless people can be. You talk about sacrifices and what drives you towards them. As Muslims we open our eyes everyday in the morning with out niat to do everything for the sake of seeking Allah's love and mercy. Innasolati wanusuki wamahyaya wamamati lillahi rabbil 'alamin - Sesungguhnya solatku, ibadahku, hidupku, dan matiku, hanya untuk Allah Tuhan sekelian alam. The strengths and drives will then bud from those. And you wonder what drives these people for their actions. Pure moral? Pure love? Which all will expire once reaching their limits. Interesting ain't it?

On another note, it's hard to keep things in one piece when you're living in this dog eats dog world. I just realized that my intern colleague (the one in the old team that I hate so much) has just added another reason for me to hate him even more when I found out that he has been hogging all of the research by himself behind my back. A perfect male biatch.

It's this kind of thing that shatters my passion-driven reasons to stay in this alien land furthermore. Hospital politics. Yucks!

he's gone for real, after raining there shall be sunshine...

Just to let you know that Mr Smith died that night at 3.30AM. The next morning I went up to the ward seeing an empty bed 11. Heartbroken I was. I knew I shouldn't be attached to my patients but I simply can't help it. I threw away the request forms and letters I wrote to order his home oxygen from my folder. He never got a chance to use it. I will always remember the good times spent with him.

People come and go. Oh well..

(you'll never know when's your turn gonna be)

Our long list of patients after team on-call last week has gone shorter again. Phew. We have this one old patient this time who seems to be staying with us for a long time in future. I saw her by myself in the morning. It was a bright morning and nice predicted weather throughout. She suddenly said in a low and slow monotonous voice while staring blankly to the wall,

"It is very nice and sunny today. Everyone will go out today and tomorrow. What they don't know is tomorrow's gonna be raining heavily. They'll be wet. And frustrated. Because they don't know this. And I know."

Me in my medically tuned head had some big question marks of ??acute confusion ??acute delirium or she might be or used to be a ??fortune-teller ??clairvoyant??

After a long pause she then told me that she just rang the hotline for weather forecast and has been doing that everyday just to know what's the weather like for the day or the week.

Ha ha kene tipu ngan makcik tua..

(maju betullah makcik ni..aku pun taktau nombor hotline weather forecast..)

Motivated by her 'prophecy' on the day, I decided to take a short evening trip to Howth with my housemate cum colleague afterwork. A soft vanilla ice cream cone and a fresh fried cod with fries to fill in the hungry tummy.




Glad it's weekend..

please don't go tonight

The head nurse (sister) in the Respiratory ward said to me before I left for home today.

"I'd be taking my hat off if he survives till morning tomorrow."

It's Mr Smith. He horribly deteriorated furthermore today. I admit that I've been very busy lately and skipped my usual little chats with him in the morning like I always did, taking his confusions and deteriorations for the reasons to not trying to make the usual morning conversations with him. Clearly it was a big mistake. You'll never know when is your last good moment with your patient's gonna be.

So I went to see him before I left. His daughter was there, whom I know well too. I asked her to leave for a moment so that I can resite his IV cannula. I called his name out loud and he didn't reply. I remember the last sane moment of him in the morning we found him in pain he refused to talk to my SHO and wanted only "the Muslim doctor" to attend him. I could guess by having the look at him - thin chance he'll make it through the night.

Slowly I whispered syahadah into his ears, hoping he'd hear me and say and actually mean it. It saddened me to think about what's awaiting him in coming moments. I scared myself coming to think about it too.

I am utterly devastated by this.

just another manic Monday it has been..

It's amazing how PR exam (per-rectal that is - sticking your finger into somebody's ass in a very frank way) can kill your appetite big time.

Oh dear, Mr Smith deteriorated furthermore today, poor man. Now we're at the point of discussing his resuscitation status in the case of cardio-respiratory arrest/further deteriorations. Not looking good :(

I slave and I slave, yet I was still given some harsh responds from some groups of people. Kalaula aku jahat dah lama aku doakan diorang mati terbakar kemudian dibakar di neraka kelak. Oh Tuhan..

On another note, Ramadhan is coming very soon. Let's pray that this year's Ramadhan will be one of the best months we've been through inshaAllah..

In times like these it's easy to miss the dearest friends and hope that they're here with you..

it's weekend y'all

2 days ago Mr Smith was found in pain and confused on the bed, cursing and all. I examined him and found a huge inguinal hernia with his abdomen distended and tense. OK, full blown sub-acute small bowel obstruction?! Then the same morning my other patient passed away peacefully in front of my eyes. Apparently my quiet week is not so quiet anymore.

The on-call last night would've been better if not for the computer system crashdown. Why on earth would you create a system without any backups?? And I thought this is a "developed" country when I applied here.

So all bloods had to be ordered manually by filling in forms and all. Results were told on the phone. The works estimated to be finished in 10 minutes now take an hour to do. Oh Tuhan berikan kesabaran...

The morning after at breakfast the SHO from my previous team said "I want to tell you something" and took the post-call ward round notes from my hand. I got this when he handed the paper back to me.



Ha ha enough to bright me up all day. It is SO Friday and I am SO done with work this week.

*sense of relief*

Oh yes, all the very best to freshly employed Aneesa, Ika and the rest of the crew. You'll be a bunch of tough weeds surviving working at home *salute*

amazingly unoccupied

I have been working with the other respiratory team for a month now. Although I miss my fatherly Big Boss whom I always look up to as a very good professor, teacher, mentor; I must say that I'm not regretting my switch of team to the new one at all. So my new boss now is Prof Horatio (imagine a younger version but very much alike Horatio Caine from CSI Miami, most smooth and thoughtful when talking and most irresistible when going all-youthful with sarcasms and cheeky grins ha ha). I have promised my friend that I'll try my best not to fall in love with him just in case ha ha ha..

On a serious note, it's actually more about the dynamics of the team that I like most. The new SHO is the most brilliant senior member of the team one could asked for. She gave me hopes when I thought I will always be at the downside of the learning curve. The registrar is superb too, plus a very sophisticated and radiant woman who actually kills my appetite for the fattening slice of cream cakes by just admiring her figures. Don't worry I bake my cake at home instead.

More importantly is my new intern colleague. Not that I don't have to work with the full-of-himself, ego-centric, holier-than-thou-attitude, not good looking at all ( a little bit mean here but who cares) intern from the previous team, I now have a new colleague who's very nice, humble and helpful. She's the best. I wouldn't asked for more than this seriously.

And most importantly, the team has created a history for having the least number of patients ever. Seven patients, with four long term patients who don't need that much of daily care. A total bliss. Oddly, I found being unoccupied put me in a very lagged phase. Prof H, noticing the situation gave me a very wise advice - "If you ask a quiet man to do a job, he won't be able to do it. If you ask a busy man to do more jobs, he'll be able to do them fine." Or something like that. He's dead right.

So the intern and I spent the day mostly finishing our research jobs, browsing through journals and going through the list of cute guys in the hospital and calculating the chances of flirting with them. OK the latter is a total make-up. And of course, more learning opportunities were opened when attending consults with the SHO and discussing about managements of patients. All of those made me feel like a real doctor rather than someone who's doing jobs blindly for the sake of completing what's being ordered by the 'above' members.

For a complete turn of the table, I am grateful for every opportunities served in front of me. Thank you dear God and don't stop guiding me through this.

Issue: waiting is a torment, missing you is a growing pain.

Good Morning Mr Smith!

I have 2 favourite patients from my team in the Respiratory Ward whom I always see first thing as an opening routine to my morning ward round. They're the few long term patients we predicted will always be on our list until the longstay ward in the other part of the hospital agrees to take them under their care, which won't be in any near future.

One of them is Mr Smith in his mid-80s. He was already an in-patient when I started working 1 month ago, came to the hospital with spontaneous pneumothorax secondary to COPD, complicated by bronchofistula formation. I remember when I was first asked to resite an IV cannula in his arm, I found him sitting on the chair by the bed site with a chest tube coming out from his right chest attached to the continuous wall-suction. He was listening to the music on the earphones while singing along with the tunes in a moderate tone.

He greeted me with the sweetest smile I have ever gotten from a sick patient. Very cute old guy (not in a flirtatious manner, this is really cute cute). He chatted me through about his chest symptoms while I was putting the IV line. Then he spoke about his Parkinson's Disease and chronic leg pains. Later when I finished and passed by his bed I could hear him singing again. What a pleasant old man I thought.

Then it became a habit to go and see him first thing in the morning. It really made my day by just talking to him. Always smiling though in pain which mostly came from his legs, and always that nice voice singing from the corridor. One morning the patient next to him answered my routine question of "How did the night go?" with "It's well for him, but certainly not for us when he's up and singing at 3 in the morning!" I got to learn that when he couldn't sleep from the leg pain at night he just spent the night awake and singing! Well, the cool Mr Smith answered his friends with "Are you certain that was me singing and not something else? I'm pretty sure I wasn't!!" Cute old man I know..

Today the team made a decision to send him for a mini-rehabilitation in another hospital to help him getting back on his two feet soon, after deconditioning from the chest presentations and Parkinson's. I broke the news to him and was surprised that he wasn't too happy about it. He told me about his wife who used to be there for rehab as well not long time ago. Then talked more about the wife, who has Alzheimer's dementia. Poor lady. I was more surprised when he suddenly fell into silence and there were tears coming down from his eyes. He told me how his wife changed from the lovely one who baked nice cakes to someone who switched on the stove and left it burnt. I feel sorry for him. He then broke the sappy mood by saying "Oh well if I was sent for rehab there I will escape!!" He he like you can walk very fast Mr Smith..

Part of me was sad that in a week's time I'll lose one of my favourite patients, the other part was just happy knowing that he's heading to the good end of this healing process. I will surely miss him..

it's Monday and why am I not complaining..

Did I mention that we got a long weekend this weekend. For once I don't have to work on Monday. Wee~~ Apart from the rains all day, it has been a great day as a home-maker for me. I'm not complaining, not at all.

This entry is to commemorate the best moments during Summer last year. One of them is the Cambodian Mission. I'm very pleased that our baby project has its continuum this year, probably came out better than what we did last year but hey, every achievement has to start somewhere right. Good job guys!



Speaking of which, I remember around the same time last year when I decided that I want to immerse into the world of photography. Never a single regret about that, well probably a little from my failed continuous efforts of learning and becoming better in it (I blame the final exam for that). So a year later I'm still where I started from. Probably a little better but no good really.

Frankfurt Main Airport, Jun 2007

Rainy Bank Holiday Monday

I would say this is the time when photography is reborn. Decades ago when it was almost alien to some and only the apeks from the photo shops would have the big camera with flashes like a big bulb of lightning when activated. Later came not years ago when people go for handiness, where you get the slimmest camera that can fit into your small pocket or purse. The slimmest the handiest. If it is integrated with the phone then it's a plus plus. Now we are back to the old-school method that go for quality rather than look. It doesn't really matter how big and hideous the camera is, as long as the product is of fine quality. Yes when I say hideous I mean that. 5 years ago you'll be laughed very hard for bringing the almost identical to one-eyed alien fish-eye lomo wouldn't you?

This is to Miwqa, Yusuf and those with their newly found passions.

honey, how was on-call?

*my imaginary future greeting from the hubby in my perfect (imaginary) future life

Oh dear! (3rd person auditory hallucinations)

You see, I love to talk about my work. I know I sounded a bit narcissist, but I actually do love my field. Well not fully now as I'm at the bottommost of the hierarchy doing dog jobs, but deep down I know I will eventually fall for this wholly.

The on-call was a great one. I had a solid 5 hours sleep. Beat that, ha ha. It's just one of those quiet nights and it was just purely my rezki it fell on my night. I was carrying the cardiac arrest bleep being the first intern on-call. So you would imagine I went to bed reluctantly to turn off the light, wearing my tudung, white coat and shoes on, and managed to keep in semi-REM semi-deep sleep mode. He he. Well yeah, just in case the arrest bleep went on.

It didn't surprisingly! Phew..

I got bleeped few times through but managed to pull out my "yeah will go up now to put the IV lines" card and eventually went up after 3 hours. Sorry I was too tired to gather myself up. We had a good run on the corridors and the stairs earlier in the morning when the arrest bleep went on loudly, the whole team ran like mad, arriving at the Neurology ward with the patient coming back to vitality. False alarm, she probably had a seizure and collapsed but didn't lose any pulse. Good run though *puffing like mad*

Well Yanie if you're reading this. Remember the Indian Rheumatology registrar who taught us once in WRH, well he's now in BH. I cannot stop smiling whenever I meet him, thinking about we once thought he has the charm to be in a Hindi film, but probably as the brother of the hero, not quite there yet to be the hero though, or probably can be the goody Inspektor Sahab! One time he came near me speaking Hindi to his friend on the mobile phone and I swear I had tears in my eyes trying to contain my nearly bursting giggles from my own thoughts (imagining him in the khakis brown policeman uniform singing Hindi songs with backup dancers). I probably did if you were there with me. He he.

Oh yes, there's this new Psychiatry registrar around. I think he's German. Tall and tanned (they said, I initially thought he's from the Down Under), additional points scored on the nerdy metal framed glasses and scruffy curly hair (I love scruffy curly hair!). Suddenly the infamous side of the hospital (psychiatry that is) became more eyed on. And suddenly almost all of my respiratory patients are in needing some degrees of psychiatric consults, and I, as the responsible intern of team, will try my best to meet their every aspect of psychiatric needs by sending a lot of consults and discussions with that Psychiatry registrar. That's my vow! *devilish grins*

Well I probably lose some point already (do I ever have any points at a first place? - grandiose hallucinations) this morning upon finishing the jobs in the A&E, I, in my most sloppy look of different coloured scrub suit (all good scrubs gone since morning, damn surgeons!), skewed scarf (from sleeping with scarf on), and a white-coat almost off-white from the bloods and ball pen stains, approached him to talk about our 2 new patients with what seems like auditory and visual hallucinations on top of their respiratory complaints. No no they are the REAL case believe me now..

So honey, my call wasn't that bad. Not at all..

of smelling like Euro

My very matured 8 years old nephew once told my mum,

"Nanti Akib dah keje gaji Akib sebulan 900. Pastu Akib kasi Mak 600 OK!"

300 kau nak makan apa la kat KL tu..


I remember my first ever pay in life was the allowance I received for playing archery for KL in 2000. Though not much I still consider it a good sum for a secondary school kid like I was, being paid to skip classes for a month for training and the rest having a jolly good time in Penang after the tournament. I remember spending some of them buying a new pair of pants, saved some and gave some to my parents. The blissful youth..ahh..

Today I received my first real payslip. Hard earned, I must say. Now I know why my parents are so careful in spending unnecessarily and managed to save enough for the 5 of us. I have to learn from the wise of the old people I do.

So my first ever paycheck was spent treating a friend the most delicious Indian food in town. I wish my parents were here so I can bring them to a posh eatery now that I partially can afford this. Partially I said, not for long, I have loans to pay if you don't know (loads of them). Nevertheless, I'm grateful for what I have. Thank you dear God!

Mom said, the first pay I must clear my loans first. Don't worry about them, if I were to pay them back for whatever I spent from them - sampai mati pun tak habis. Painfully true. Nuff said.

Oh well, ngeheee *sengih macam kerang busuk tanda gembira..