Showing posts with label confessions of a House Officer. Show all posts
Showing posts with label confessions of a House Officer. Show all posts

Wednesday, May 25, 2011

“MEDICAL is a Challenging Profession, yet a VERY rewarding profession”



This afternoon, a group of pre-medical students came to our hospital for a visit. They were JPA scholars who came for exposure and to learnt more about the hospital life and career as a doctor.

The ward sister introduced me to them, ‘This is Dr Wu, our house officer here. In the future, you will become like her. Dr Wu, can you brief them about life as a houseman?’

ME: Sure, what would you like to know?

STUDENTS: We would like to know more about life as a house officer. We heard that it is difficult and would like some motivation.

ME: Are you all already enrolled in Medical School?

STUDENT: YES. We are from XXX and YYY.

(Mind: Meaning, those innocent students are CONFIRMED stucked in med school…) Everything that come out of my mouth now HAD to be POSITIVE.

And I couldn’t believe what came out of my mouth next:

“MEDICAL is a Challenging Profession, yet a VERY rewarding profession”

(very rewarding???) -YES, I said it!!

“You see results, like when you treat your patient, you see how he recovers and goes home”

“The moment when you first scrubbed in, your first baby delivery, holding those little soft fingers, your first appendicectomy, the feeling cannot be bought. The experience is somewhat special and you cannot find it anywhere else”

Sure, I pacify those students, motivate them more than I had ever motivated myself.

“Not just anyone can survive in the medical field. It takes a lot of strength, courage and hard work. If you can survive medical school, if you can survive housemanship, you can survive ANYTHING“

STUDENTS: What about medical school? We heard Medical is all about work and no play.

“Keep a balance between work and play. They say, study hard when you are student, it’s true… because those things you study, do come in handy when we work, especially those at clinical years. It helps in our work. But,  endless work and no play makes Jack a dull boy. Participate in research, join students association,  go out with your friends, enjoy, go travelling, yes, work hard but have fun along the way."

“ when I was a student, I participated in a Student Organization named : AMSA (Asian Medical Students’ Association) and we took part in many activities : Paper Presentation, Poster Presentation, Research, Cultural Exchange,.. We travelled to Taiwan, Korea, Hong Kong,.. meet students from other countries, understand their lifestyle, exchange views, hang out… it was fun"

And those students were staring back, like in disbelief that a medical student life can be fun.

Well, honestly, I did enjoyed my medical school life. The tough days were tough. Where the amount of facts and knowledge we have to study is not counted by how many pages, but is measured by how many feet high is those books and notes stacked up, per subject. It was scary, thinking back. But, the good days were good. And I had many, many, MANY fond memories of my student life. One thing was, I had very good friends. I was relatively active in school activities and student body, so, I had a great experience.

“You guys are JPA scholars, probably one of the brightest students in your high school. But in medical school, it is an all new thing altogether. You will be competing amongst yourself, the best students of the batch. And it can be very stressful at times. There will be two extremes categories of students. Those who just pass exams without much effort, A, and those who need to work EXTRA hard to pass exams, B. You might be in either of this category, A or B, or somewhere in between. If you happen to be in the B category, don’t give up, support each other, and put in the extra effort, you will reach the finish line.”

STUDENTS: How about on-calls? I heard it is terrible,….

“I have to say, you guys are VERY lucky now, as oncalls nowadays are VERY much better compared to those 10 years back, considering that nowadays, we have more house officers. Some departments in some hospitals even give post-call-off! ”
-I cannot believed I said that.

“The more reason you need to study as Students and house officers. The concept is simple. The better knowledge and skills you have to manage a patient, the faster you can finish your work, and the more time you have to rest. But is someone is Jonah, then, it’s just luck. Of course, a shift system would be much better for all of us. Unless the system change, oncalls have to go on. But remember, you have nothing to lose, every day, there’s something to learn. And those on-calls, they make you stronger”

The truth is, there are more house officers, but the work load has became more and more demanding. House officers have more scopes to cover. In some hospital, they need to do double entry for the computer system. Some HO has to function as MO. Some HO has to function as SN and PPK. Work is endless. You are the PPK, the SN, the HO, the MO- EVERYTHING! But of course, I couldn’t tell them that and scare them away.

NEW fresh students, they reminded me of how I used to be. Like a clean sheet of paper, so innocent, so ‘un-touched’, so eager…

When I was at high school, I was motivated by a medical student who came to our school. His name was Dominic.

I think I like this. ‘Motivating’ these young souls. Pacifying them.

And I think that was exactly what I needed back then, when I was in their shoes –MOTIVATION...

Haha, they should read my blog... NO, THEY SHOULDN'T.


Thursday, April 14, 2011

A CALL WITH A FANTASTIC MO

*Disclaimer: Cerita ini cuma rekaan semata-mata, tidak berkaitan sama ada dengan yang hidup ataupun yang mati* This is a fiction story, not related to anyone dead, or alive.*


I remembered I used to read Darren’s blog on how miserable calls can get when you get ‘certain’ HO who calls you for many reasons. Sometimes, things can be the otherway round.

QUOTE:
Most of the time, your call’s quality largely depends on whom you’re working with, in the particular night. A good and reliable boss (who makes good and quick decisions) would definitely lighten your work, whereas the opposite can cause you a sleepless night. Just some examples of calls that HO received during an on-call night…


*phone ring* HO#1 pick up phone @ 2:37am:

HO#1: hello??

HO#2: Hello, I need your help with a branula.

HO#1: Okay

HO#2:  I was trying with MO for a very long time already but still cannot get venous access. Can 
you come to HDW to set a neck line?

HO#1: What? You are with an MO and can’t get a line? What case is it? How is the patient?

HO#2 briefly present the case.

HO#1: Okay, I am coming.

Upon arrival, patient was a C5-C6 compression fracture patient with C5 cord injury, ventilating on trachy. BP falling. Has one IV access. MO miserably trying to set another peripheral line.

MO: Good, you are here. This patient very hard to get line. You need to set a neck line.

HO#1: Isn’t he on inotropes, shouldn’t we insert a triple lumen?? (central line)

MO: You can insert a triple lumen?? I mean, can you insert? If not, we can call GA MO to insert.

HO#1: Okay, I’ll try.

Coagulation profile normal, in view to keep the neck in neutral position and not flex the neck, HO#1 decided for a subclavian approach.

HO#1 attempt failed.

HO#1: I think someone else should try. (Hoping that the MO will take over)

MO: Hmm… let’s call the GA MO to help. I'm not very good with lines.

HO#1: Okay. Please do then.

MO: Ermm… could you talk to the GA MO?

Apparently, the GA MO on-call was well known to be very ‘fierce’ and the MO had some unpleasant previous history with the GA MO.

SN took a peep next door: The GA MO is very busy in ICU, attending to a collapse patient.

Having no choice, HO#1 kept her fingers crossed and said: Very well, I’ll try again

*Thank God, Left Subclavian Central line inserted successfully, anchored at 15cm, no acute complication, good flow. Placement confirmed with VBG and CXR. Bloods sent for investigation. Patient resuscitated with fluids and inotropes, BP picked up and patient stabilized.


After documentation, the SN asked: Siapa HO#1? Specialist ke??MO ke?

.....silence....


-----------------------------------------------------------------------------------------------------------------
CASE II, later that morning,


* phone ring* HO#1 pick up phone @ 6:45am:

HO#1: Hello? I am reviewing patient, anything?

HO#3: Hello, there is a patient in wardXXX who collapsed. Asystole. I informed MO already, she asked me to ‘buat apa-apa yang patut’ and ask you to come stat. I tengah CPR now.

*Upon arrival stat, HO#3 was performing CPR, SN bagging, MO holding mask.

MO looked at HO#1 with an anxious face and said: HO#1, you boleh intubate patient, kan?

*HO#1 almost fainted when heard that. ^^|||

HO#1: SN, cepat prepare intubation set. ETT size 7 and 6.5. Prepare blade, suction. Prepare Midazolam 5ml.  

SN: Kena buka DDA ni …. (FAINT~!)

HO#1: Student nurse, tau bagging?

Student nurse 1: YA

HO#1: pakai gloves, ambil alih tempat SN. SN prepare for intubation.

SN kelam-kabut, busy preparing the equipment and drug.

HO#1: How’s the patient? What happened? (HO#1 asked while putting on gloves and mask)

MO: I tak sempat access lagi

HO#3: Patient asystole, pupils dilated, BP unrecordable,..

HO#1 quickly accessing the patient and asked: How long CPR?

HO#3: about 15 minutes

HO#1: What was given? How many atrophin , adrenaline?

MO quiet (…)

HO#3: None given.

HO#1: SN2, syringe out adrenaline and atropine, give 1 atrophic, 3 adrenaline.

Apparently, SN2 was so slow… HO#1 started breaking the ampules and syringed out herself and gave the drug while the SN prepare intubation set. HO#1 took over MO position and intubated the patient. Condition was bad. More Adrenaline and atrophin given, still no response.

HO#1: Ada siapa-siapa call medical? call relative?

SN: No.

HO#1: Make sure panggil. Suruh SN3 yang tengah serve ubat kat tu call.

After 45mins CPR still no response.

HO#3: MO, do you still one to proceed?

MO: Huh? Kita dah buat semua kan? Ada ape-ape lagi?

HO#3: MO, do you think we should pronounce death?

MO: Erm…
(pause…)

MO: Okaylah

*documentation done*

HO#1: What’s the cause of death?

MO: Kena bagi cause of death ke?

HO#3: I think it is APO secondary to CCF and CRF. Maybe it’s time to call the medical team and our specialist to discuss.

MO: Okay.


After discussion: Cause of death: Acute Pulmonary Edema secondary to CCF


--------------------------------------------------------------------------------
MORAL OF THE STORY: Dear HO colleagues, HO life is not all fun and relax. Sure, we will always be covered by MO, but remember, we will become MO (or even specialist) one day. It is very important to learn the most from your housemanship days. Otherwise, it will be regrettable. 


And NEVER EVER GIVE INSTRUCTIONS: buat apa-apa yang patut.
Do ask what has been done, and give further plans of what else can be done while you are on your way to see the patient.
When  a HO calls his MO, means he needs help. (or he needs to be covered)
Imagine documenting : 
S/T DR XXX, case and progress and Investigation noted. Plan: To carry out all necessary procedures. (apa-apa yang patut?) 


Please, be a safe doctor.

Wednesday, March 16, 2011

Love isn’t everything, Work isn’t everything, Then, WHAT IS EVERYTHING???

They say,

Love isn’t everything, 

Work isn’t everything,

Then, WHAT IS EVERYTHING???




Say we wake up at 6 in the morning, get to work at 7, plus minus the traffic jam, starts work at 8am, be very lucky enough to leave at 5pm, reach home in more or less 6pm… that is like 7am-6pm, which makes about 11 hours which is 45% of our day (11 out of 24 hours), EXCLUDING on-calls, studies, etc…  furthermore, if we were to minus 8 hours of sleep,  our job makes up 68% of our life… (i know, it is a sad fact, isn't it)

So, whatever JOB we choose, seriously, we MUST LOVE (LOVE, not just like, yes, deep-down-inside-L-O-V-E) it, right??? 








Then, we get home, we spend the remaining 13 hours with our love ones, whether friends, family, or the other half… laughed about what happened at work... share each other's experience, give each other comfort, give each other a pat in the shoulder, encouragement, love, smiles, support, surely, we SHOULD have a home to get back to, shouldn’t we? shouldn't we enjoy the other part of life to the fullest??

So, if we were to have a life partner, we SHOULD LOVE (LOVE, not just like) him (or her), right???





Imagine, if you had to remove that first half… so like I had to go to work, doing something I don’t like, 11 hours a day, for lets say, the next 2 years… how would it feel like?? Living that daily routine, dreading to get up for work, being blue all mondays and throughout the week.... Horrible. ain't it??? Well, at least I get to come home to people I loved… maybe that will make up for the 45% of the day, maybe not enough...
On the other hand, imagine, if you keep the first, and remove the second half… so like, I do something I like very much, live my passion, follow my dreams… but at the end of the day, I come home to an empty rented home… cuddle myself to sleep, treat myself when ill, dapao food home or called for delivery, watch VCD on my laptop until i doze off, …  is that happiness? 



So, 
when forced to make a decision,
i was torn apart between two worlds...




So, 
when forced to make a decision,
 I asked,

 WHY CAN’T WE HAVE THE BEST OF BOTH WORLDS??








WHAT IS EVERYTHING???












so, we live only once, heck it!

Wednesday, January 12, 2011

BABIES DO NOT GROW ON TREES. PLEASE LOVE YOUR CHILDREN.




I was on call in the operating theater (OT) last night.

It was quite an eventful night. Very taxing, both physically and emotionally.

Then, there was this case which was put up at about 4am in the morning.

There was this 4 year old boy, let’s call him XY, 13 kg, with total amputation of the left middle finger and amputation of the tip of the 4th finger with open fracture of the middle phalanx. Are they going to resuture the finger? – I asked Khalidah. She was not sure either.

The child arrived at the OT. Small and fretful. I could not imagine how mischievous he might have been, to be involved in such accident. He held on to his mother.

Further history from the mother, XY was playing alone when his hand, in her very own words, ‘tersepit kat pintu’. How did it happened?? I blurred, she replied ‘tak tahu lah’. DENIAL. I quickly ran through some short medical and surgical history and examined the child, then pushed him to OR6. (Operating Room 6).

The child was put under general anesthesia and the orthopedic team planned for a refashioning on his fingers, which means, no they were not going to reattach his fingers. This was obvious right from the start – we did not have a hand surgeon in hospital Melaka.

I went through the case notes later, only to discover the hidden agenda. The child was the youngest out of 4 sibling. He was playing alone at home, at the door, when the accident happened. His parents brought him to the hospital only FOUR hours later. The ortho team initially planned to refer and transfer them to Hospital Serdang for reattachment, however, the parents refused for referral because of ‘domestic issues’.

WTF!


I mean it is difficult to salvage a finger which had been amputated for 4 hours, but if you were the mother, and you know that your kid still have a chance to reattached the amputated limb, wouldn’t you go all out??? And they say mother’s love is the greatest love of all… I cannot be too sure. His father wasn’t around for opinions either. Just because you think you can have as many babies as you like, it does not mean you get to neglect them.


BABIES DO NOT GROW ON TREES. 

PLEASE LOVE YOUR CHILDREN.           

It pains my heart so very much when seeing incidents like that. What if the child grew up and wanted to be a surgeon? What if he wanted to be a pianist? Of course, there is prosthesis and all, but why not give him a chance? It is such a sad story….

To add salt to the wound, rub it in, there was another unfortunate case last night, following that case. 10 year old girl, let’s call her XX, came with amputated right ring finger, case put up by orthopeadic team for refashioning of finger. From the history, it was an accident, the child was riding on a bicycle when her finger caught between the wheel and amputated. I feel sorry for the girl. She would never wear her wedding ring perfectly again. It is so sad.

I think I will not like my next houseman posting – orthopeadics. It is a ‘BRUTAL’ department, I think, with lots of amputations which I could not bear to see. Amputation of finger, or fingers, toes, limbs, BKA, AKA, etc…. I wonder how would I ever survive the OT then.

My GA MO, Soon, newly wed last month, apparently, he shared similar opinions, he said disappointedly, ‘I really cannot understand these parents, how could they leave their kids like this’.
I replied, ‘Soon, when you have kids, please take good care of them’


i think parent-ship can be one of the biggest challenges... 
sometimes, i wonder how my parents did it...
they must have been like SUPER MOM and SUPER DAD...
how i missed you...
will be home soon...



(p/s: names and demographic data had been modified to preserve confidentiality)

Friday, October 29, 2010

My first Spinal Anesthesia Experience



‘First give-PUSH, Second give- STOP’

‘First give-PUSH, Second give- STOP’

‘First give-PUSH, Second give- STOP’

The thoughts rolled through my mine, repeatedly, again and again, as I scrubbed my hands. It had been quite a while since I last scrubbed into the OR. My head goes through the process again, picturing myself doing it. Briefly, swiftly. I have seen this many times, I can do it – I tried to deceive myself, or rather, encourage.

The emotion tensed. My MO pat my shoulder, as if giving reassurance.

I am ready.

I have to be.

I put on my surgical gown. Glove size 6 and a half. Latex.

I spread the sterile set, arranging the instruments the way I liked it to be.

With my right hand, I shaked the 0.5% heavy bupivacaine, to-and-fro. Then, break the vial.

I carefully attached the 21G green needle to the 5cc syringe. 2cc was syringed out from the vial.

I added 0.5cc fentanyl, making it a total of 2.5 cc.

In another syringe, I syringed out 2cc of Lignocaine 2% (Local Analgesia).

I folded the the sterile green gauze into triangular shapes , neatly and placed them into a galipod as my assistant poured some disinfectant inside.

I prepared the spinal 25G Pencan needle, putting it through a 21G needle.

Then, I took a deep breath.

It is time.

My patient was seated up on the operating table, with straight back, head looking down, arms hugging a pillow.

‘Encik, doctor nak cuci belakang ya. Sejuk sikit. Cuba relax’ I said, with my awfully broken bahasa, with attempts to comfort the patient.

With a sponge forceps holding the green gauze, I cleaned the procedure site in circular motion. I repeated this procedure again, and then draped the site with a grean cyst towel.

I run my fingers by the sides of the man, trying to feel for the protruding bone (PSIS) and palpating for the intravertebrae space, locating for L4-L5. I marked the area.

‘Doktor nak bagi ubat tahan sakit ya. Sakit sikit macam semut gigit ya. Encik sabar ya.’ I said and injected the local analgesia.

Then I took a deep breathe.

‘Encik relax ya, badan tegak, kepala tunduk bawah. Doktor nak injek ubat ya. Cuba jangan gerak’

I rechecked the marking and space.

With the 21G needle guiding my 25G spinal pencan needle, I inserted the needle into the marked area, towards L4-L5.

I felt a resistance at first, then a give. –THE FIRST GIVE, I reminded myself.

Then, I inserted the spinal needle further, then I felt some resistant, gritty sensation, then another give –THE SECOND GIVE.

YES, this should be it!

I removed the trochar (inner needle).

I felt almost euphoric when I saw what I saw.

Clear CSF flowing out, driping out at the end of it, drop by drop.

Thank you GOD! My heart shouted.

I reconfirmed the flow with a syringe, slowly. Good flow. Then, slowly, I injected the prepared anesthetic solution in.

With a breath, I removed the needle.

The Staff Nurse sprayed the operation site and plastered it with a gauze. ‘Bolehlah jadi MO GA nanti’, she teased me.

The patient was layed flat again.

I monitored the blood pressure, making sure it do not drop drastically.

‘Encik okay tak? Boleh cuba angkat kaki’ I said.

‘Tak bolehlah,' he said. 'Kaki berat’ he replied.

‘Jangan risau, Ini kesan daripada ubat bius. Kalau rasa sakit, beritahu ya’ I said.

The surgeon rechecked with a forcep. –No pain

‘You may proceed’

He made an incision –No Pain.

YES, the spinal worked.

The surgery went well, completed in 49minutes. Patient had good anesthesia. Thank God for that.

I documented – No difficulty during procedure, single attempt, atraumatic tip, clear CSF, good flow.

My MO teased me, ‘There, wasn’t that hard, isn’t it?’

YA RITE! (sarcastically)

THERE – my first spinal.

The satisfaction & feeling – PRICELESS!

Gee, I think I am starting to like GA!! (well, maybe)

----------------------------------------------------------------------------


-For the benefit of Non-medical related fields reader,below are some terms and  abbrevations used in the above article:
OR = Operating Room
MO=Medical Officer
CSF = CerebroSpinalFluid
PSIS =Posterior Superior Illiac Spine (at the level of L4-L5)
L4-L5 = Lumbar spine bone level 4 - 5
heavy bupivaccaine = anesthesia solution
Lignocaine = local analgesia
euphoric = high peak of joy, happiness
-------------------------------------------------------------------------------------------------------
DISCLAIMER: The author will not be responsible if this article or part of this article is used as a guide to one's medical practice. note that this is the author's personal experience and should never be used as a guideline.

ACKNOWLEDGEMENT:
Acknowledgement to Datin, The HOD, for permiting and encouraging House Officers to perform procedures under supervision and provide a good learning environment.
Acknowledgement to Medical Officers & Specialists for teaching us with patience and giving us the opportunity to learn and grow into better doctors.
Acknowledgement to my collegues and other House Officers for helping one another, and encouraging each other as we go through housemanship.
Acknowledgement to the hospital staff, staff nurses, PPKs, for being supportive.
Most importantly, Acknowledgement to patients, for having trust in us.

THANK YOU














Wednesday, September 8, 2010

raya surprises! and a touching petronas advertisement...

when everyone is happily looking forward to the raya holidays...
 all i have is a series of standbys, precalls, on-calls....
will be working throughout the raya holidays EVERYDAY till late night!
siGh...
:(
work, work, work....

nevertheless, to the rest :

SELAMAT HARI RAYA AIDILFITRI~~
MAAF ZAHIR DAN BATIN....


please drive carefully home....
do not speed...
biar lambat asalkan selamat...
stay healthy,
stay VERY healthy...
and NEVER visit me in the hospitals during my calls....
do not drop me surpises...

just stay home and enjoy the festival! ^^


here's a very touching petronas advertisement....




Wednesday, May 12, 2010

The truth of a doctors' life.... in despair and disappointment....

my mind has been very undecisive lately... tired and exhausted... heart heavy and disappointed...
and today i came across this article... which reflects my daily working life 99%!!
i wonder whether our superiors knows what is going on... and i wonder how they can allow it to continue going on... life as a housemanship is like sh*t... and MOship is no better... even when i see the specialist, they are having a hard time... it's the system, it really needs improvement...

i would like to share that article by MS Mohamad with you... it speaks the mind (and heart) of a number of us serving the government...
---------------------------------------------------------------------------------------------

Why we left and why we will continue to leave...
Posted by: MS Mohamad
I read an interesting article today about a few prominent figures addressing their concern over the increasing UKM and UM medical graduates who have left the country to continue their medical practice overseas.

After reading the news for 3 times, I called a very close friend, an MD (UKM) graduate to ask his opinion on how the news might have affected him. He has been working in Singapore for more than a decade as a Consultant Surgeon with a certain sub-specialty

"Why be a slave in your own country, when you are a king in another?" He replied.

Indeed, if anybody would want to find a reason why all of us left, either after housemanship, after being a specialist, or even after sub specializing, and now, even prior to doing housemanship, they need not look at our payslip, or the wealth that we have gained overseas, but only to the Medical System that has been rotting in the ignorance and politic-based stupidity that Malaysia has been well-known for (in the medical field).

I have served the system for nearly 2 decades of my career, waiting for it to improve for so long, and only finding myself in despair, quitting with a 24-hour notice and serving abroad. The system is, in my opinion, keeping doctors, since the beginning of their career as House Officers to the end of it, in the lowermost priority. When I was working there, doctors are so ill-treated, while the nurses and the medical assistants are overpowering us.

I still remember the days when I was doing seeing patients and rounds as an MO, while the staff nurses would mind their own business, having breakfast in the pantry, or having gossip chats at their own leisure. My House Officers would then have to do merely all the labour-work, up to the extent of setting intravenous drips, and serving medications. If I am to expect the nurses, my patients would have been dead, or the work would have been too slowly or incompletely done.

When I was a House Officer, I had to run down 4-5 floors just to review a blood investigation of a dying dengue patient. The ward staff would either be nowhere around, or will say that he is busy (busier than the doctor?) or the answer I got at that time:

"Doktor nak cepat, doktor turun sendirilah, gaji doktor lagi banyak dari saya"

Even when I was a Specialist, the staff nurses had to be called again and again just to make sure the management plan for the patient would be done. I was already used to answers from them:

“I’m busy with something else"

“My shift is already over"

...it was routine for me.

The Medical Assistants were worse. They would hide behind their so-called boss, the Head of Medical Assistant. They feel hiding behind him would make them not under our jurisdiction, that we have no power to instruct them in managing the patient, that they have power to manage own their own. I've seen them giving medications not as we prescribed, performing procedures without our knowledge, as if they are the actual "Doctors". They are in their own world, and we have to do their job, taking blood, labelling samples, and even cleaning gadgets from the procedures that we have done.

Oh, but the ministry loves this group. They even let them run a clinic now, instead of upgrading the clinics already run by doctors. The government feels that the MAs are very important and should never be ill-treated by those big bad doctors. One time when I was a District Hospital Medical Officer, I was conducting a delivery of a baby. An MA insisted that I remove my car which was block-parking his car. I answered through the phone that I was busy.

He came to the labor room and yelled "Semua orang pun sibuk jugak, macamlah doktor seorang yang sibuk!”

It is insulting that an MA or a staff nurse claims that they are BUSY, as busy as a doctor? As a Malaysian Doctor, I have even worked for 72 hours straight. I have experienced working until my 6 month old daughter did not recognize me at the end of the week.

Is that how busy they are? I am very sure that they are so busy, that they can only spend 2 hours at the nearby Mamak stall, or can only leave at 5:10 PM instead of 5, or can only have 1 hour of lunch.

The management staffs are worse. I have to beg and plead so that I can get my on-call claims, of RM25 per 48 hours of work. While sitting in an air-conditioned office, they will at their own leisure, process my call claims so that I will receive them by the next decade.

The state health or Hospital Director would just give another inspirational talk (of bollocks) on team effort and beauty of teamwork.

That is how Malaysian doctors are treated in the government sector: without respect, without dignity and without significance. Why?

It is because we are bound by ethics to try our best to save lives, despite how ill-treated we are. We hardly have time to complaint because we are too busy or tired, and we would rather spend the precious time resting or seeing our loved ones. The burden of trying to save lives is on our shoulders alone. No MAs or Staff nurses would shoulder it with us. They have their own bosses: the Sisters, Matrons, or Head of MAs, which job description is to ensure that the big bad doctors will not ask their underlings to do extra work.

This is how the Malaysian Ministry of Health have treated their doctors. I am very sure that in each and every doctor, there is a slowly-burning patience in serving the Malaysian people, which will eventually fade and cause them to surrender to serving a place that treats them better.

A few colleagues who graduated from UK choose to serve there:

"The pay is more, and we get the respect we deserve"

Another works in Brunei:

“Here the staff nurses respect Malaysian doctors, and they are very co-operative" (He ended up marrying one)

A few are consultants in Singapore (working with me):

"Here we are treated well, we spearhead the management, and every else do their work to the best of their capabilities".

A few even enjoys working in Indonesia:

“The work-load is horrible since there are a lot of patients, but we are well respected by every hospital personnel" (They have migrated there for nearly a decade)

I am sure that people will see doctors as power-hungry individuals who want to be the boss in the hospital. Trust me, after having graduated 6-7 years of medical school, earning a DEGREE, and subsequently MASTERS, and SUBSPECIALITY, you would expect a degree of respect and being considered important. We are trying our best to improve patient's quality of life, or making sure he lives another day. Is it too much to ask from the system that we are important?

I find that Malaysia is the only country that is making doctors' lives miserable and treated like rubbish. It was never about the pay in the first place. It is about the treatment we are getting and the false political-based promises. Do you know that the so-called circular about doctors can have the day off after working 24 hours straight released JULY 2009 is not yet implemented? Do you know that the raise of UD 41 to 44 does not involve every doctor in the government service?

We are waiting for improvement. We have waited a long time when we were working in the system. Somewhere along the line we decided to leave and wait outside the system. Until the system changes, we will continue to work overseas, in countries which are appreciative of us. Trust me, Malaysian-graduate doctors are considered highly skilful and competent in neighbouring countries, and the 15 % brain drain is more significant than you think.

We will return when the system prioritize us and gives us the quality of life we deserve.

If it stays the same, Malaysian Hospitals would end up having Staff nurses and Medical Assistants as "Doctors", and we would have to send patients to Indonesia for an appendicectomy.

Hear our voice. We hardly speak, but will usually fade away from conflict (and fly to another place).

original article here

Author's Note

Dear friends and readers, Thank you for dropping by and leaving comments/ shoutouts. More importantly, thank you for being there... please accept my apology that, lately, i may be busy with work and not have time to reply youir messages/comments, but rest assured, each and everyone is read, and highly appreciated :) have a nice day! ^^

of love

Today, i heard a story which was not a story of falling...
of living in the dark end of winter turmoil..
instead, it was a love story..
of a couple who did not live happily ever after...
but they live, loving each other..