convocation!

Date: 15.08.2009

Venue : UKM, Bangi

Event: Convocation

Weather: Sunny

Mood : Extremely happy

Thank you all for attending my convocation...

for those who came despite exams...

Thanks to all...

for spending time, making the effort....

Thanks for the wishes, cards, gifts and flowers...

and those who came via air-mail...

Special thanks to Mum & Dad

who made all this possible...

and my beloved coursemates who fought it through with me...

p/s: i know, my jubah super ugly....

and for those who missed the convo,

yes, i still except belated wishes and gifts... hehe...

^^

p/s: more pics to come... ^^

i just thought i'll make this post specially for mum & dad...

erm... dad hates the camera, he dont usually smiles at it... hehe...

H1N1 inching closer, hitting the statistic...

A(H1N1): Malaysia records 4th death, more schools closed (Update 3)


PUTRAJAYA: A 20-year-old woman suffering from Influenza A(H1N1) died on Tuesday, the fourth person to die in Malaysia due to the virus, while more schools and campuses were closed when students exhibited flu-like symptoms.

The woman, who had contracted the virus through a local transmission, died at the Malacca Hospital from “severe community acquired pneumonia” at 9.40am.

Health Ministry director-general Tan Sri Dr Ismail Merican said the woman, who had suffered from obesity, had only sought treatment at the hospital on July 26, 11 days after contracting the disease.

She suffered clinical complications on July 27 and a throat swab was taken on Tuesday.

“The deaths reported affected victims between their 20s and 40s. They had early symptoms but sought treatment late and doctors did not suspect that they were infected by H1N1.

“This is discomforting to the Ministry,” he said after chairing the National Pandemic Preparedness Plan technical committee meeting here Wednesday.

Asked why the ministry was not alerted on the case on Tuesday, he said the doctor had only discovered she had H1N1 infection after her death.

Dr Ismail said he was informed of her death after the Institute of Medical Research got the results on Wednesday morning.

On whether the ministry would take action against hospitals for failure to detect H1N1 cases early, he said, “We don’t want to resort to the blame game. We advise patients to go to hospitals if they have symptoms.”

He said members of the public were still taking H1N1 lightly even after four deaths, adding that the latest victim had not heeded to her parents’ advice to go to the hospital for early treatment. He also said that doctors should be more alert.

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you can imagine what happened next...
today, an extremely different whether took over my ward...
all the sudden, everyone in my ward was wearing a face mask.....
the doctors who were previously exposed to this patient, are like super anxious...
the other staffs (me, included) who were previously exposed to these doctors,
are super anxious too...

you think they'll close down hospital melacca and quarantine everyone???
finally, a long break... haha...
~in your dreams~

i wonder, will the workload reduces when people gets paranoid... even my patients are asking for early discharges... haha, yeah, for the first time... an EMPTY bed in the ward... wow!

i know, i work in a high risk environment, sometimes, i do wonder, is it worth it?
risks of needle prick injury, TB contact, dengue contact, and now this???

p/s: guess what? even KTSN was closed down because of H1N1... sometimes, to think about it, when somebody gets infected, you close down the institution and send everyone home, those with (and without) fever... how smart.... i wonder....

deceptions

23.07.2009

I lived in a world of lies.
Deceptions.


And so, I wore a mask today.
Hoping that it would hide all emotions.
Secrets.
Hoping to numbed those feelings.
To shadow them away,
The slightest clue, the minute hint,
Perhaps, everything.

It had not been raining for quite a while.
Until today.

They said that one will grow stronger with time.
I doubt I’ll ever will.
The emotions, greater than what my heart is able to contain.
The burden, heavier that what I can shoulder.
No one told me it was going to me like this.
No one told me that I was to be less human.

I do not want to get used to seeing this,
To get used to being less emotional,
To be accustomed to seeing illnesss, disease, deaths and loss,
When hopes shattered, love is lost,
And we could not even say that we had done our very best,

I learnt 3 new words:
1. FATE
2. LIMITATION
3. PURE UNLUCKYNESS

there has been a death in the opposite house

picture by enchantress

Date: 23.07.2009
Time: Post-Call 36 hours
Weather: Raining heavily

Problem List/ Chief Complains:
1. Menstrual Day 1
2. + a terrible headache
3. + temperature spiking
4. + a really bad call...
5. + a really, really, discouraging, demotivating, spirit-breaking, on-call MO


i thought things could never get worse,
but it did...

Let me shared an old poem with you by Emily Dickinson.
Perhaps, it could best express the dark feelings in me...
together, let's say a silent prayer...



There's been a death in the opposite house
As lately as to-day.
I know it by the numb look
Such houses have alway.

The neighbors rustle in and out,
The doctor drives away.
A window opens like a pod,
Abrupt, mechanically;

Somebody flings a mattress out,--
The children hurry by;
They wonder if It died on that,--
I used to when a boy.

The minister goes stiffly in
As if the house were his,
And he owned all the mourners now,
And little boys besides;

And then the milliner, and the man
Of the appalling trade,
To take the measure of the house.
There'll be that dark parade

Of tassels and of coaches soon;
It's easy as a sign,--
The intuition of the news
In just a country town.

-by Emily Dickinson

*happy*

20.07.2009, 10:56am, General Hospital Malacca,

rounds with Dr Gary Lee,

Mah Jah blood pressured was well-controlled,
i must have been the wishes and prayers from the fellow readers,
fit for discharge...
TCA nephro follow-up

*shinyin happy* ^^


p/s: going to find BoonLee, or rather, BoonLee is here in Malacca... yippie!! *happy*

So this is love…

“But of the tree of knowledge of good and evil,

thou shalt not eat of it:

For in the day that though eatest thereof

thou shalt surely die”

MakCik XYZ, lets call her Makcik Jah, 52 year old lady with hypertension, diabetes mellitus and End Stage Renal Failure (ESRF) was admitted to the hospital for acute pulmonary oedema secondary to hypertensive emergency.

Okay, let’s turn this story into more fiction, less academical. This is not another PBL session.

You know, there is this saying that you can have any disease in the world, but never ESRF, end stage renal failure. (a condition where the kidney malfunction is so bad that you need either a renal transplant or long term dialysis to prolong life) ESRF... Not only is it financially burdening, time consuming, but also emotionally exhausting. Imagine, dialysis three times a week, each time about 4 hours. The transporting time, waiting time, not yet included. It cost an avarge of about RM200 weekly for dialysis, RM12,500 to make an AVF (fistula for dialysis). (related article: the man in the next cubical)

Makcik Jah had been in the hospital for the past 2 weeks, under my care. Although I prayed very much that she would be fit enough to discharge, her blood pressure is simply too high to allow it. She had been maximized on most hypertensive drugs.

And everyday, she would ask, ‘boleh balik doctor?’ and I had to look back in her eyes, ‘sorry Mak Jah, hari ini tak boleh la, tekanan darah masih tinggi’… I hate having to give disappointment to patients. ‘tak apa la makcik, cuti di sini sajalah, kan ramai kawan-kawan baru’ trying to pujuk her a little… then she would let out a giggle… showing some gaps in her row of teeth...

Every morning, at the bed of Mak Jah, is her husband, let’s call him Pak Jah. I really salute him. Seriously. Every morning, his daily routine would be going to the wards, bringing breakfast to Mak Jah, wait patiently until visiting hours starts, cheer Mak Jah up, teman her for dialysis, weight her after dialysis, carry her around... he would supervise her medication, pronounce those medication names as fluent as the pharmacist, stating the dosage and function of each... he would put up with her unusual temper swing, sometimes, her stubbornness... what patience he had...

I guess it is not easy to care for one who is on ESRF, with dialysis on every other day. Mak Jah also had a right below knee amputation secondary to diabetes. So, Pak Jah, had to carry her around, as she was already ADL (activity of daily living) dependant.

I mean, isn’t that a big commitment? i had never seen their kids visiting. Very often, it is just Pak Jah. everyday, every morning, every evening, every moment. It was as if he lived half his life in the hospital.

And I guess, the saddest thing is that, she had some degree of Alzheimer disease. She does not remember many things, and will not remember many things. correction: she could not. I wondered how it is like, taking care of someone who do not remember much of you, and will not remember much of the time you spent together.

Pak Jah would come up to me from time to time, asking me how is Mah Jah’s progress. He would ask for favours like to spend time to pujuk and advice Mah Jah to take her medications, and not to skip meals. Sometimes, despite our hectic schedules, i guess we tend to obligue.

As you see, Mah Jah tend to reject food when she is a little upset, and she would go into an episode of hypoglycemic attack. Each time Pak Jah would buy outside food for Mak Jah, a few options, and coax her into eating. And he could feed her, care for her, love her.

I think he could have abandoned her, at any point in time, but he didn’t.

He could have gave up on her, but he didn’t.

He, being a muslim, may indulge in the luxury of having a second wife (maybe third, or forth), but he didn’t.

Their life savings went into providing better care for Mak Jah, and dialysis is not cheap, mind you.

I think the hospital can be a very sad place.

But sometimes, if you look hard enough, just around the corner, you may just spot happiness.

Perhaps, so this is love...

*apple-ized*

p\s: had my first on-call, will find time to blog about it ^^

(related article: the man in the next cubical, a sad story)