A fractured calcaneum.

Assalamualaikum wbt.

Dear oh dear apologies again for this long hiatus, busy with this thing called Life.

A lil update; I moved to another state earlier this year and my new jobscope involves putting people to sleep, making sure they wake up painlessly, and trying not to mess up while doing so.

Anyway this post is to tell y'all a story about my family and a fractured bone.

Late last April my dad fell while climbing a steep tembok and his weight got shifted to his right feet, the impact shattering his right calcaneum (which is basically your heel bone)

(not his xray, but pretty much almost the same)

It was an open comminuted fracture, which means there was an open wound, and the fracture was in pieces (not a simple crack). Dad underwent surgery to fix it, plates and screws put in. Now at post-op almost 3 months, he is partially weight-bearing with the help of crutches and still on leave from his job.

Those who knew my dad would know that he is not the kind who can sit still even for a minute. What we were about to learn when dad fractured his heel is, that he not only broke his bone, he broke all our hearts. My dad is a marathon runner, he cycles more than 10km every week, he gardens everyday, he's in charge of weekly runs to the markets, God knows how much he roams around at work, and his life is always always constantly on the move. 

So you can imagine how difficult it is to see our beloved ever-active daddy confined to the living room with a swollen occasionally uncomfortable foot. My younger brother and I were both not staying close to home so it sucks even more.

These past few months made us realized things we took for granted; namely:

1) How important my dad is in our household. No one to take out the trash, no one to water the plants, no one to run errands, no one to vacuum our carpets and sweep the floors (my dad's a dust OCD) and a whole lot more chores done by dad that we didn't appreciate as much.

2) How important my mom is in our household. Seriously, next to a frustrated husband, my mom is the most awesome wife to have if you ever got sick. When my dad felt helpless with things he couldn't do, my mom fills that void perfectly. She drives my dad everywhere, she took out the trash, she went for groceries on her own, you name it.

3) How dry our bathroom can be. Coz dad was on crutches so it gets dangerous when the bathroom floor is wet and slippery, everyone makes it a point to wipe the floor clean after use. Also how dusty our treadmill can be (coz the one running on it was always Abah. luls)

4) Our family cat Obi is awesome. As if he knows my dad is not well, for the first few days my dad on MC, Obi would linger around the house, as if trying to keep my dad company even though we know he always roams around the neighbourhood when my parents are at work.

5) Priority lanes for wheelchair-bound patients at the pharmacy sometimes wasn't really a priority. One time my parents went for the doctor's appointment and reached the pharmacy to retrieve some meds, the lady said no need to queue coz dad's on a wheelchair. In the end, the wait lasted longer than those in the queue.

6) Taraweeh and Ramadhan this year were different coz my parents couldn't break fast at the mosque like they used to, plus it's easier for dad to taraweeh at home.

Urghh maybe this fracture is a blessing in disguise, for verily with every hardship comes ease. In a way we're fortunate that no other broken bone was involved when dad fell. Also I learned a lot watching how my parents complete each other in their own special way.

To anyone reading this, can you please send in a little prayer so my dad can get back on his feet and to his own active self, marathon-running and all? Thank youuuuu we love you abah! Hang in there!

Freshies.

Assalamualaikum


Today as I walked down the hospital corridor, I passed by a few souls, clearly a newcomer in this harsh world of doctoring. Sparkly white coat, nametag on point, stethoscope around the neck, and above all, a face that screams "help me", "why'd I choose these path", "should I quit" on top of a skinny and exhausted physique, always running, as if chasing time and the unforgiving amount of never-ending workload. Yes, that was me 2 years ago when I first started as a first poster.

Looking back, sometimes it still knocks me into disbelief that I've eventually made it through. I rarely cried, but I gave in at one point after 5 days of tagging, I came home and cried and cried and cried into my husband's arms. The trigger point was simple; it was a patient's relative who scolded me for changing his father's medication dose (he thought he was a smart-ass and that change was not indicated). The breakdown was an accumulative effect; as a fresh doctor I faced a lot of bullying and verbal abuse that week from my superiors but I didn't cry until that one particular trigger. Funny when I looked back, I don't think I'd cry over the same reason now than I did last time.

My dad had to send me daily inspirational quotes to keep motivating me, he's cute like that.

Another time I broke down was in my 2nd year of housemanship. That was merely work-related, when I was at home with my parents and I received a call from a colleague. She questioned me on an unclerked patient presumably because she thinks I was trying to play truant by leaving work early and because she felt burdened by the workload I "purposely" left for her. She called and over the phone yelled at me so unprofessionally, I wanted to fight back but my eyes just welled up with tears of anger.

Imagine you've been doing your job diligently just tryna get through the day unharmed then somebody came along and said this shitty thing about you. It hurts. That day I learned that not everybody can work without being calculative. I became calculative towards her thereafter hahaha kidding

Working temporarily in my current department has made me realized how numb I have become to verbal abuse and sarcasm. If previously my day would be ruined by one simple scolding, now I can refer a case and get a verbal tell-off and can totally shake it off minutes after (although I would recall the story back to my husband with the same amount of annoyance). I realized that in Malaysia, our interdepartmental relationship are no joke. MO from Department A will tell off MO Department B for missing one tiny detail in his/ her referral and MO A would make a big deal out of it. I mean, come on, get over your ego. You're not the only expert in your field. If I get a dengue medical MO to induce and maintain ventilation in GA patient can she do it so perfectly? Seriously get over yourself.

What I'm trying to say is it's okay to break down and cry. Some of the thoughts that stop me from quitting housemanship are; 1) I felt like I've wasted 7 years of grueling medical studies just to leave it hanging halfway incomplete 2) I don't know what else to do other than doctoring, seriously 3) Families, they took so much pride in my job that it feels like a huge letdown if I stopped halfway.

It's been harsh these days, with the contract basis employment. I have a feeling that those malignant superiors will use this contract thingy as an excuse to abuse fresh housemen even more but that's okay, let them be. It'll be tougher but tough times don't last, tough people do.


Random postcall ramblings as usual!
Till then xx

Housemanship: been there done that!

Assalamualaikum. Well hello 2017!


It's been an awfully long while. My last published post was almost a year ago. Actually there were many sudden blogging urge in between, but all of them were either written halfway incomplete or I was just too busy + lazy + tired to proofread and publish.

Oh well, not much happened in between then and now, except for the fact that
I CROSSED THE HOUSEMANSHIP FINISHING LINE UNSCATHED! *cue fireworks*
Alhamdulillah.

You know what they say, what doesn't kill you make you stronger.

Throughout these two years, a lot of things changed and sacrifices made. For instance:

1) Family gatherings. When there is a family function, at first people will ask our parents, "Where are Ika and Ali?".Then the question evolved into "Are they both at work?". Finally no more questions were asked because our absence to any events is by default. When we miraculously find time to attend, people would be surprised by our presence that the first question would be, "Both of you off today?"

2) Friend's weddings. We got married right after graduation so essentially most of our friends attended coz they were all mostly still unemployed. When our friends got married, we missed out on theirs coz we were both either working or our leaves were not enough to cover the travels. I know, it's pretty messed up. Invitations came at first, then it came lesser and lesser coz people stop putting hopes on you turning up.

3) Vocabulary. Oh my poor vocab. I barely read any books and blog these days. My English-speaking abilities has now jumped into the Manglish bandwagon. It's either "I oso dono worr", "he memang like dat wan","uncle u chuan bo" or "aunty vallikida". I know, we blended in pretty well. I can speak minimal 2-word hokkien and tamil now.

4) Health. We both put on unhealthy weight because of all the untimely late-night dinner and junk food. Mostly coz we think we deserved it after starving ourselves while serving the public. Maybe MOship is the time to get back in shape. Seriously guys, my 53 year-old dad's baseline heart rate is 50-55 coz he runs marathon and I get breathless after one freaking flight of stairs, NYHA class 3 right here!

And the list goes on forever.

May this be the start to the return of my blogging saga!
Will write more soon. A bit of word constipation secondary to blogging hiatus.


Till then!

Of Graduation, Marriage and Unemployment: Part 2

Assalamualaikum and helloo.

I know it's a bit overly posey dividing these posts into parts but I sort of wanna group these things together for future reminiscence (puii).

So according to chronological order my wedding comes next, so unemployment can wait. teehee
I hope you can pretend the mushy-mushy parts in this post doesn't come from me thank you.

*cue romantic cheesy music*

Much to our friends' surprise, we got engaged last year on the 10th of August, 3rd of Syawal. It was a small intimate event only attended by close family and family friends of both sides. Since we're both still studying, what more in two different continents, we decided to keep it low and just go about our lives pretty much like we used to before. Plus it's sunat to keep your engagement to yourselves coz it's like a personal period to get to know each other better. Since we spent our engagement away from each other, it's easier to focus on our studies and ditch the overly sweet period people used to associate engagement to. So when people asked if our engagement is true, my then-fiance' did a pretty good job at denying/ avoiding. hahah

We both met in college (KMB) back in 2007 and we're both classmates and mentor-menteemates. I first saw him during our orientation period when we sat in circles with the rest of our classmates and introduced ourselves. I never liked him then, the way he spoke, the way he sat, it was all too overly poyo for me hihiks. Nothing happened during the first year of college, it never went beyond 'just friends', plus he had a special someone back then so whatevs pfftt. We managed a lot of class activities together, we went hiking, island-hopping in Langkawi, later on furthered our studies in Dublin and a lot more fun stuff as a group. We were both so lucky to have the chance to study abroad, nothing widens your horizon more than travelling to places you've never seen before, and we did just that.

2009 Tasik Dayang Bunting, Langkawi. (someone can't swim..guess who haha)

If people asked me who took the first move, it was him. If people wondered when did he propose, it's slightly complicated because he kinda did that on the last day of college (it wasn't the classic 'will you be my wife here's a diamond ring happy tears loud yes' kinda thing but he simply told me to wait after 5 years and a medical degree) and the rest is history. Of course there were ups and downs that were probably worth a novel but nevertheless it brought us to where we are today, and I couldn't have been happier.

It was an elaborate and complicated story to tell, we both saw each other grow up from mere 18-year-olds to the young adults we are today, flawed or not. We've just approached our 2-months milestone (yayy fireworks please!). Marriage opens up a lot more and I learnt a lot everyday as a wife and as a daughter-in-law to a whole new family. We're blessed to have a smooth-sailing journey towards marriage as both our parents are so so supportive and understanding.

Also when you get married you tend to learn a lot from your elders. I noticed I was being super observant when I saw how my cousin's wife treats her in-laws and how they laugh a lot and make jokes at each other like bestfriends, or when my aunt visited my dad's mom-in-law eventhough she's practically not a relative, and a lot more trivial things I wouldn't notice that much when I'm single. I think marriage brings you to adulthood more than anything can, and makes you value the ties your parents have with families and in-laws close and far.

Apart from the heavy responsibilities that come with marriage, it was still the happiest ride so far. Having someone you could trust and love and make fun of is both entertaining and therapeutic in nature, although he yawns when you talk too much hahah

Before I overdosed myself from too much mushiness or before my beloved suami texts me and jokes at my attempt of being romantic, I'll probably stop. Till then, xoxo lovelove muah

Doctor.

Assalamualaikum.

Up to this point it was all too surreal.

Alhamdulillah thank you everyone for your sincere prayers, my five years of medical school ended with a heartfelt gratitude and huge relief last Thursday. I haven't felt such sense of accomplishment in a very long time, almost like a little baby hitting her first developmental milestone. Allah has been so so generous with me sometimes I feel embarrassed thinking what I gave Him in return.

Thursday the 1st of May sent me into two extremes of emotions, at one end I was at the verge of tears in front of my examiners, determined that I had to repeat my long case, but by the end of the day I was jumping in tears, blessed with a thing I've been longing for.

I think this day deserves to be painted into this blog. A day I will remember for a very long time.


How Thursday, 1st of May 2014 changed my life forever:

12am
Went to sleep with a million things running through my little memory box, I couldn't sleep but I had to. Every time I shut my eyes I remembered a topic I haven't read or a chapter I haven't finished. It was disturbing.

3.30am
Subuh was at 4am. Woke up with a sudden adrenaline rush, knowing my final exam as a medical student is in less than 5 hours. Flipped through random notes, hoping my last minute effort will still count.

7.15am
Cycled through the light rain to the hospital. Numb from anxiety and sleep deprivation.

7.45am
Everyone gathered. Instructions given and phones taken. At this point I merely stared into blank spaces leaving everything in the hands of Allah. I was told I was in the last group to go. So I waited and felt a tension headache developing around my head.

9.30am
Called to get ready. Stethoscope checked, patella hammer, tuning forks, pen torch, notepad all checked. My white coat was literally loaded with tools, much like the pocket of doraemon. I was assigned to a lady in L***'s ward. I knew by heart that the ward was for respiratory/MedEl patients.

9.40am
Escorted to my patient, Mrs X, an 80-plus years old lady. Alhamdulillah the patient was extremely pleasant and helpful.

9.50am
History-taking went smoothly for the first 10 minutes, until she said, "I'm so sorry I'm gonna have to leave you for a minute, the medication I took last night is really working well, I need to go to the loo..." with an apologetic face. She struggled with her walking stick, taking small steps to the bathroom. I assured her that she can take her time as long as she's comfortable.

10.00am
She was still in the bathroom, I was back to my nervous state again knowing I only have 40 minutes with my patient before the examiners came, and I've now lost a good 10 minutes. Mrs X came back apologizing for taking away my time, and determined to tell the examiners later that I was short of 10 precious minutes.

10.10am
Mrs X's symptoms were a mixture of ambiguity and broad possibilities, she simply said she had "fibrosis". She came in with shortness of breath and night sweats, I was thinking along the lines of a respiratory case. I examined her, and heard a really loud murmur with an irregularly irregular pulse. "Mitral regurg and Afib," I thought. But none of her medications were treating those two. I panicked to the point that I had to listen to her heart a couple times. "I'm so sorry but can I just have another listen to your heart one last time.." Being the lovely person she is, she understandingly obliged to my every request without a fuss. Bless her.

10.20am
I was confused. My thoughts went from cancer, to fibrosis, to pneumonia, to God-knows-what. It was really cute seeing how nervous she is on behalf of myself, reminding me a million times that I'll do well.
"Oh by the way I think they mentioned a faulty valve in my scan yesterday," Mrs X said, trying to help me out. I dismissed the 'faulty valve' as something overlapping my respiratory differentials, and merely reflect the mitral regurg she had, and begin organizing my thoughts. At this point both my examiners were late by 10 minutes. Alhamdulillah for the extra time, again Allah is indeed the best planner.

10.30am
They finally arrived. Two sharp-looking superiors/consultants, I knew one examiner from my GP rotation, the other was a lady from my viva the day before (my horrible viva is a whole other story, which I won't dwell on now, except for the fact that the very same lady crushed my knowledge and confidence into a pulp of stupidity during my viva). You can imagine how anxious I am to be presenting to the exact same examiner again.

10.40am
I finished presenting Mrs X's history to my examiners. The lady paused for a moment, looking confused and coldly said, "Hmm, that's quite a broad differentials you gave us.." and she spent the next 10 minutes doubting my diagnosis and trying to get me to think of the exact problem that Mrs X had. She asked difficult questions, gave out confusing hints, until I finally came to my senses and said, "Infective endocarditis," with a silent "omg how can I not think of that.." in my head. Only God knows how low I felt at that moment, my eyes almost teared up but I know I need to buckle up for the next drill of questions from the second examiner. Alhamdulillah the second set of Q&A went well, I remembered each and every bit of acute AFib management (since Mrs X has AFib) from our study group discussion the day before (thanks guys love youss).

11.10am
My final exam wrapped up with a simple nod from my examiners and I was done. I shook hands with Mrs X, at which point my eyes swelled up again as I bid goodbye. This is a lady who came in thinking she was dying, and said she'd be happy to go as God had blessed her with a wonderful family and a blissful life. Such a lovely lady. I spent a few minutes thanking her for all the things she helped me with, realizing that she is my last patient as a medical student.

I looked at my watch and realized my long case exam went over the time limit. A 15-minute Q&A session ended up with a 30-minute torture. I suppose the intern who accompanied me to the ward was right, he said "the last person always has extra time but the session with the examiners will always be a bit longer". I almost choked for freedom as I left the ward. I arrived to our quarantine hall only to find my bag was what's left in the empty hall. Everyone else left, and I was indeed the last student.

11.15am
I went to the prayer room and met Pika. We exchanged our long case details, both worried of what tomorrow may hold. Some of our classmates were celebrating with champagne outside the hospital, some even went straight to the pub, while I cycled home full of anxiety and uncertainty. We were told to wait for an email confirming that we passed and do not have to resit the next day, by 6pm today. The next 6 hours were one of the most difficult wait in my life. These 6 hours hold the answer to my prayers.

2.50pm
Woke up from a long afternoon nap to brush off my disappointment from my long case that morning. Instead of feeling refreshed, I was exhausted and nervous at the same time. Whatsapped Mama, to ease my worry and asked for a little doa.

4.00pm
I went to Yan's room finding Suha and Ecah together. We sat and talked but I know deep within everyone was anxious about the email.

5.00pm
Pika barged into the room, and gave us the look that tells "The email is out." Everyone urgently grabbed their phones and ipads and within minutes, one by one showed a smile of relief, a smile of accomplishment. We group-hugged and in that instance, everyone was sobbing uncontrollably. It was a moment I would remember forever, because only we know how hard it was to get to this point. It was emotional, it was intense, it was surreal. We are finally, doctors. Sujud syukur alhamdulillah. There were happy tears everywhere.


I immediately called Mama and Abah, although they were groggily woken up from their slumber, I just had to share the good news.

Looking back, it was amazing how Allah put us through hardships to give us a sweet little ending. Five years went by so very quickly, and I still wonder how I passed the finishing line.

I still think about why my examiner did not fail me, and how it was not all about getting the one right diagnosis but the whole case was judged by the way we approached it, from history to physical examinations.

Within 24 hours, I went from really sad to extremely happy I felt like I could cartwheel around the globe. SubhanAllah, Allahuakbar. All praise to Him.


I've been waiting to add these alphabets to my name since 5 years ago, and I'm finally allowed to, so...

Dr Nur Zulaikha Zainol MB Bch BAO, University College Dublin.

Here's to many more alphabets inshaAllah! ;)

Alhamdulillah.

My patient patient.

In a mundane hospital ward
I sat by the window
On my creaking bed
In came a young lady,
In a blue blouse, a stethoscope and a note pad.

"Hello Ma'am, how are you?" she said.
Another medical student, I thought.
A smile so eager, eyes so bright
"Feeling much better today," I replied.

I've had a few of those blessed young souls,
Fervently seeking a piece of my story,
Some a little shy, some downright bold,
The chat we had, kept me company.

Questions asked, answers replied,
"Any chest pain?" "Have you diabetes?"
Answers of which I almost memorized.

I never said no, I never refused
For deep down, I knew
My story is put to good use.

They'll learn, they'll make great doctors, I thought.
With a smile as sweet, heart as warm,
In my weakened health of an 80-year-old, their help, I sought.

"Thank you very much for helping us out," said the young lady, feeling sorry,
"I'm sorry we've been bugging you with the same questions everyday."

The pleasure was all mine indeed.

...

In a mundane hospital ward
I peeked nervously yet hopeful
Searching for a willing patient
A story, to learn, and gain a thing or two.

Patient A looked away,
Avoiding my expectant gaze,
Patient B refused, for she had a few students before me,
There she was, patient C,
Sitting by the bedside, with a welcoming face.

The questions I asked
Were the same thing she's heard a trillion times
By ten different students, almost like a task
But there she was,
Her sweet little self, patient and polite
An exhausted smile, making my stressful day bright.

Whenever I looked back,
From the start of my journey
It is not only Allah, my mom or my dad
It is this group of people I call "patients"
That made this journey even more special.

Every murmur I heard
Every stoma I saw
Every surgery I learnt
Every cannula I failed
It was all thanks to them.

A patient group of people I call "patients."

Alhamdulillah.

The mother of all finals is just 14 days away. Doakan :)

Sleepless night.

Assalamualaikum and hello.

This post is overdue but I feel like writing anyway before I hit the sack.

I was oncall last week, working with the medical intern (let's name him SB) from 8pm-6am. I arrived around 7.30pm, changed into scrubs, and went to the doctors' room to meet SB. Another fellow medical intern oncall was there so we planned our 'route' for the night, delegating which wards to go etc. There were only two medical intern oncall per night, and trust me, the amount of workload divided between these two poor souls are beyond absurd.

SB was always busy attending patients and charting medications. So I was the one responsible to answer the bleeps. The moment I clipped it onto my pocket, it went off crazily, almost every minute.

"This is Nur, I'm calling on behalf of the medical intern on-call. Any help needed?" was my default answer everytime. And I would list down all the pending tasks for SB to prioritize.

It basically went like, "St James' ward- temperature spike", "St Luke's ward- need cannula for antibiotics", "St Paul's- patient is confused and verbally abusive."

It went on and on and on the whole night, probably with a few pauses for a drink to prevent us from dehydrating.

On one instance, SB was handling a catheter when the bleep went off. I picked up and it says, "Doctor, this patient in ward X has vomited three times, could you please come down to chart for antiemetics (anti-vomit drugs)?"

"Ok we'll try our best and reach you shortly thanks" was my answer, although I knew very well that we wouldn't make it anytime soon as there were other patients who needed urgent review.

We went off to see other patients when the bleep rang again. I answered, and it was the same nurse who called regarding the vomiting gentleman. "I bleeped you earlier, this patient is vomiting now we need to give him something, come down, right now!" And she hang up without a word, sounding pretty annoyed, which is totally understandable as she was worried.

That was basically the whole night, annoyed carers or nurses who needed urgent help but we couldn't do much as our hands were full all the time. I can see how hard SB was working to fulfill everyone's demand. We kept saying sorry on the bleeps to let them know we're not ignoring their requests.

Imagine at 4am in the morning, a bleep came with regards to a patient who had severe headache. We went to see her and SB did a full neuro exam (poking the upper and lower limbs etc), to which the patient irritably replied, "Doctor, is this really necessary? I only have a headache."

huhu. Penat + sangat menguji kesabaran. Also shows how much good deeds you can gain if every intention to help people were set right. It was a really good experience, I definitely learned a lot.

p/s: My first cannulation on an old lady with poor intravenous access at 3am in the morning went unexpectedly well, here's to many more successful cannulation! #lol

Difficult.

Assalamualaikum and helloo.

Sooo.... it's November and I haven't written anything since forever. Not only had this blog gone abandoned, my brain's writing centre had gone rusty too. October flew by so quickly, which means I have safely turned 23, alhamdulillah. The Hijri calendar is starting a new year tomorrow so you can consider this my 'end-of-hijri-year' post lols.

My final specialty exams for Paediatrics and Obstetrics+Gynae are just around the corner, (when I say around the corner, it's really that close you can see 'em coming after the traffic light seriously if you divide the time I have by the amount of reading we all have to do)

Sometimes with all this exams, and endless whining we put on facebook or on the phone with loved ones about how difficult life is blabla, I wonder how non-medic people perceive it. If I'm in some lucky non-medic shoes, I would definitely think 'seriously dude other courses are difficult too don't pretend like you're so busy you're not the only one suffering so build a bridge and get over it ughh'.

But then again, you can't blame them for thinking so. No one can understand your definition of difficult in Medicine unless they face it themselves. I don't understand how difficult are accountancy or economics or engineering either.

So what is so tough about being a medical student? What makes us so busy that our social lives sometimes only revolve around grocery-shopping on weekends? (from a below-average medical student's point of view)

Time. The way my university arranges our clinical modules is that we have exams every end of rotations (eg medicine, surgery, o&g, paeds, psychiatry). Sometimes we have 6 weeks for each rotation to cover everything under the sun and tadaaaa, "here have a delightful exam without any study week". So it's like you're asked to cook a set of nasi briyani from scratch in 5 minutes but at the end of 5 minutes you only get as far as straining the rice under tap water. Tak sempattt.

Exhaustion. Everyday of the week you had to go to the hospital and especially if you're on a hectic rotation, you left the house at say 8am and with all the loooong bus rides you'll reach home by 6-7pm. By the time you had your dinner, showered and prayed it's already 9.30pm. Unless you can remain motivated 24hours a day, by 10pm you're already exhausted and the bed is your only friend. You can't stay up too late either cause tomorrow's an early start.

Accumulation.  If you're attached to a team and the reg/consultant is overly motivated, you'll be drilled with questions at ward rounds or clinics. If you can't answer, you feel stupid and make a mental note to study Case A. Then you rushed to tutorials and the tutor talked about something alien to you so you make a mental note to study Case B. By the end of the day you have a dozen of topics accumulating for you to review.

Communication. You're constantly communicating and taking histories from patients and sometimes it's not easy. Try randomly talking to 20 strangers a day and each of them gave you a 1000-piece jigsaw puzzle to solve.

Nevertheless, all the above are exactly what I love about Medicine. Constantly on-the-go and learning and understanding the most peculiar cases, it's just amazing in a weird way.

Doakan :)

Rewarding.

Assalamualaikum and helloo kittyyy.

My desk lamp just decided to burn itself again so I have no adequate light source to continue studying, hence the blogging hahaha puiii alasan

Anyways, I really feel the need to share what happened yesterday. I'm on my delivery week, which means I'm a 'stork' for a week, delivering babies to mummy daddyy. Interestingly, it was also my first time working with an amazing amazing group of people, called midwives. Amazing because they did a noble job, although sometimes they can be quite, errm, quite a character.

So I went on my morning shift as usual, and fortunately after an hour of waiting, the unsmiling senior midwife sent me to a room. I stayed with the patient, and it was a slow labour since that was also her first pregnancy. In the end, she went into a C-section so I waited again in the office to be assigned to a new patient.

"Excuse me, do you have any new patient I can go to?" "None at the moment." She answered shortly and sternly.

So I waited for another hour, staring blankly at the digital clock, hoping someone would allocate me to a room. I asked again, and was brushed off with the same answer. My shift was supposed to end at 3pm, and it was now 2.55pm. It was getting really really frustrating, as I feel like I'm wasting my time by just sitting there waiting. I made a mental note to leave at 3.15pm if nothing happens.

Added to the fact that an incident earlier that morning made me feel completely ignored. I won't go into details. But it was a really stressful morning and my patience was tested. Felt like screaming "HELLO I'M HERE CAN YOU SEE ME at least spare me a smile pleaseee" to everyone who come and go at the office.

Anyways, when I finally gave up and decided to grab my bag and leave, the senior midwife came and said, "Go to Room X." Off I went.

And it was my most hands-on delivery ever alhamdulillah. It was a lady who's on the verge of giving birth, I introduced myself to her and the lovely midwife in charge and automatically grabbed an apron and a pair of sterile gloves.

The senior midwife came in, saw me, and said, "Are you going to do the delivery?" "Err, no." "So why do you have your sterile gloves on?" "Oh sorry I just thought I could assist..." I answered timidly.

"Ok you need to wash your hands before putting the sterile gloves on. If you wanna do it, do it right." She said with the most gut-wrenching tone ever. Determined although slightly palpitating, I did what she told me to do.

Gloves checked, goggles checked, apron checked. I approached the patient and subconsciously placed my hands over her knees while she was in her contractions.

Again, the senior midwife turned to me and said sternly, "What are you doing?"
"No no no, you don't touch the patient with a sterile glove like that, understand? You need to get a new pair now, go."

If I were an ice cube, I would totally melt and evaporate into panic-stricken air. The only thing in my mind was that my day couldn't be any worse than this.

Just when the baby's head was almost out, the senior midwife turned out to be the best teacher ever. She guided my hand over the head and let me hold the baby, clamp the cord, deliver the placenta, and all that jazz, while enthusiastically explaining the bits and pieces of labour.

Plus, the baby was born to a Muslim mom, and was given a truly beautiful name. Double joy for me :)

In the end, the senior midwife was the kind of person who was willing to teach you if you proved that you're there to learn. She was all smiling and cheerful, which was truly the opposite character I saw earlier.

Sometimes perseverance can be rewarding. I regretted throwing tantrums in my own head, when all I should do was just be there sincerely to learn. Ikhlas. Rileks sudaa. Kalau memang ikhlas nk blaja mesti x kesah apa org cakap n x emo kann.

how cute is my preggy mommy?

p/s: "kalau saba and tunggu, mesti learn something new" ;)

Trial and error.

Assalamualaikum and hello awesome peehpul.

Ok I know rarely keep this place updated but urmm sorry Medicine seems to be quite an overly attached boyfriend lately so most of my times are spent completing my logbook cases and all that boring stuff. Pffttt. The past few weeks were a roller-coaster ride, dragging myself out of exhaustion each day. Oh well, the present still is.

Usrah this morning talked about Allah's tests. Allah has His special way to put each of us through difficult times, mainly to see how we pull through.

I think myself was tested differently although in fairness everyone has their own challenges. God sifted me from the main pool, throw me into the big blue sea, to see how I swim in different waves and temperatures. Allah tapis keluar, untuk bagi ujian berbeza dari orang lain. To see who Zulaikha truly is. Like they say, the truth is always bitter. Zulaikha is flawed in many ways, and struggling to improve and swim like the rest. Doakan :) (al-Hajj 22:35)

All seriousness aside, here's what happened last week:

1) I've recently moved houses, and loving my new room! Although another Tullamore posting doesn't really give me the chance to sleep on my own bed. I'm getting a lift from one of the girls tonight so cheers to saving on train tickets.

they helped a lot. Thank youu!

2) We sent the PMC lads home for good last Monday. A really sad day. But I'm used to being left behind so yeah we'll be fine. Hopefully Penang treats you guys well!

bye miffyy :(

3) Logbook cases are a pain in the gluteal muscles. I know it should benefit students in many ways but to choose a suitable case to write is really time-consuming and actually turned us into insensitive monsters. We flipped through medical charts much like hungry customers flipping through pizza menus at PizzaHut. "Chest pain?" Already had one. "Anemia?" Not interesting. "Collapse?" Chart not readable etc. And Mrs Minah or Mr Mamat had already turned into "Oh that patient with DKA in bed 16 etc" =.='

Ok pray for my good health and study. Byee

Until proven otherwise.

Assalamualaikum and heyyy.

From my rookie's point of view, Medicine has always been a field that plays with certainty, suspicion and statistical figure. And through many years of meddling in diseases and mortal affairs, humans finally came up with a range of possible diagnosis merely by a glimpse of the presenting symptoms.

"Rectal bleeding means colon cancer until proven otherwise."
"Headaches are subarachnoid haemorrhages until proven otherwise."
"New onset nystagmus in adult is MS until proven otherwise."
"All women are pregnant until proven otherwise.."

A very high index of suspicion, you may say.

I'd rather say it's a 'positive' negative. People always say look on the bright side first. But now, you have to start at the very bottom of the list- the worst expectation- before ruling out everything bad and climbing your way up.

I suppose we have to throw aside our own negativity first for us to get a grip on positivity.

The same goes if you're a Muslim, means you're a Muslim, until proven otherwise.
And as long as we hold on to what we believe is unmistakably true, nothing will prove it otherwise.


p/s: You and I, until proven otherwise. :)

Back to school

Assalamualaikum and hey.

Consultant: What should you worry about if a patient presented with haematuria (bleeding urine)?
Ikabimbo: Err..bladder tumor?
Consultant: All haematuria points to cancer until proven otherwise.
Ikabimbo: Okay...tsk

A part of me says it's good to be back. A part of me says oh crap I have to go through all of this again. That feeling when you're not wrong but you're also not 100% right. Unfortunately, we're all expected to be 100% right, or people die.

As you might've guessed (or not), I've started lectures and rotations yesterday. I was attached to Urology this week, so all things to do with people's 'water work', yes I'm your guy (not really). For two days only, because next week they're kicking me off to the Eye&Ear hospital for ENT.

Anyways, this afternoon was spent in the Urology clinic. I was tailing the Registrar (Dr. Abu bukan nama sebena pls) for an hour when he finally said, "You know you can actually leave if you want to, right? I don't mind."

But of course, I need to meet the consultant to get signed off before I sneaked out. So Dr Abu brought me to the consultant since he had a case too.

Dr Abu: Blablabla *presenting case
Consultant: Alright. So you, *suddenly points at me* what kind of imaging would you do?
Ikabimbo: Err..CT?*dumbfounded because that was unexpected ok pakcik
Consultant: Hmm well yeah ok. Can you be more specific? What if the patient had haematuria on dipstick (bleeding urine)?
Ikabimbo: Err..urine..cytology? Maybe?
Consultant: Fine. What do we spend our whole lives looking at?
Ikabimbo: Err..urine?
Consultant: No.What do we spend OUR whole lives looking at? *more emphasis this time
Ikabimbo: Oh yeah BLADDER! *as if I was suggesting a touristy place to visit
Consultant: Yes! Ok then..what kind of imaging for the bladder?
Ikabimbo:....
Consultant: We put a scope...
Ikabimbo: OH YES CYSTOSCOPY! (camera in your bladder)

I feel like a kid finally succeeding in guessing that B comes after A.

All praise to Allah for the chance to learn, in ways you can never expect, both fun and challenging at times.
It's definitely good to be back :)

Changes.

Assalamualaikum and hello.

I went shopping for household items and ended up buying this amusing little book. What's not to love about Waldo Pancake's dry sarcasm splashed all over its products, right?

Anyway, 2013 seems to approach quicker than I'd imagine. Next 'month' suddenly becomes next 'year'. With each added digit, some resolve in new changes, some remain the same, some couldn't care less. Some people change for the better, some change because of loved ones, some change backwardly, while some stay as stagnant as ever. 

But humans are weird beings. When people change to the better, they applauded and gave a standing ovation, to tell the world they helped too. Come on la. When people change negatively, they criticized and nobody did anything to help that person bounce back.

May twenty-thirteen be a year of change for everyone. Sebab Saidina Ali r.a cakap, "Beruntunglah orang yang hari ini lebih baik dari semalam, terpedayalah orang yang hari ini sama dengan semalam, tetapi celakalah orang yang hari ini lebih buruk dari semalam."

Write again soon. Goodnight peeps

Painkillers.

Assalamualaikum and hello.

What would you normally do if you're in pain? Painkillers.

Yeah I fainted in the OT and the last thing I remembered was lying on the floor with my surgical masks and gloves still on. My back is sore because I hit something hard. Panadol 500mg, two tablets. Solved.

If you can't imagine what an operating scrubs look like, it was something like this:

And yeah, that was my exact attire when I fainted. Stylo ennn. (Image from The NHS Reforms blog)

Physical pain is easy. You feel it aching, stabbing, or cramping. 'Kill' the pain with the so-called painkillers. I've seen numerous prescription of painkillers or analgesics as they called it in the wards and clinics. Pakcik sakit tulang? Paracetamol. Makcik sengal sendi? Paracetamol. The Panadol (one of paracetamol's brand names) developers must've been filthy rich by now.

I wish people would acknowledge the pain we can't usually see and feel. The pain felt deep within the hearts (not literally), the mind and soul. Heartache is something painful, but nobody talked about its remedy. I'm not talking about love-induced heartache, that you can find in all those "motivational break-up books" while crying over a tub of "break-up" ice-creams. When you sinned, your heart aches. When you shouted at somebody, you feel bad. When you missed your daily prayers, by right, you should feel that aching guilt of not thanking God.

But because people don't feel or see it physically, nobody cares. People missed their prayers because they don't feel guilty, immunized from the pain of not having God by your side.

When you feel sad for no apparent reasons, you feel even more heartbroken because no physical painkillers can lighten that vague pain. Nobody took panadol after a break-up to specifically relief a heartbreak, unless they wanted an overdose and a dysfunctional liver. Omg aku putus cinta, makan panadol jap.

Having no solution for sadness is a myth because we have one very awesome Painkiller, and that is Allah. Let Him know when you're in pain, his remedy has no side-effects whatsoever, unlike paracetamol, which causes gastrointestinal complications in some patients.

Alhamdulillah for an Almighty Painkiller, who's even wealthier than the panadol company :)

Doktor jangan belagak naa.

Assalamualaikum and helloo

Ok I should really be studying right now but if I didn't type this out it would just be collecting spider webs at the back of my head. Few months back I read an article on Medscape written by a medical student from the University of Texas on "Arrogant Physician". As I spent my days with various clinical encounters, I couldn't agree more to this element in the medical profession that often appears so naturally, arrogance.

Perhaps it comes with the package, the profession itself needs confidence.  Senior doctors and consultants often deserve their bit of arrogance, seeing to the fact that their vast knowledge of medical mysteries is where patients trust their lives with. Some people think "arrogant" is too strong a word to describe such competence displayed by certain doctors.

I was once in a surgical team in the Mater Hospital, and I was standing in the theatre minding my own pointless business. The specialist surgeon was stiching up a wound and a scrub nurse helped out by cutting off the sutures. The surgeon suddenly blurted out, "Hey hey! Don't cut MY knot!" and literally grab the scissors from the poor lady's hands. Tekejut mak noks. She seemed really annoyed by the fact that the nurse didn't cut her knot the way she wants it. Haih.

And then I was in another theatre, the registrar and intern are really nice. I use the word 'nice' for all doctors who didn't ignore students, although in real life all doctors are nice because they save lives. Hahah. They were both working on a patient, no problems arise, when the consultant suddenly walked in like a boss. He went to the operating table and started saying no to everything that his team is doing, scolding people like mad and in the end, grab his own scrubs and shoo people away so he can get it done the way he wants it done. Lol. Also, he did not give a single glance to all timid medical students standing around the corner. Siapalah aku.. Sobs

So what say you? My story is a little bit biased, and it only happened once or twice during my entire clinical rotations. Generally, the rest of the doctors and consultants are really into teaching students and helping out on areas too difficult for us to comprehend. But this little group of physicians with an attitude so 'complicated', really place an impression on mere mortals like us.

If I were to become a doctor one day inshaAllah, I pray that I won't be the kind that only thinks about how right she is and how wrong everybody else are. The fact that your knowledge itself came from God, who are we to deserve such pride in our careers.

Beloved.

Assalamualaikum and hello mortals.

A few weeks back, on my first hospital rotation, I witnessed a tremendously heartbreaking moment. I went to my department, to join Dr. Eamonn's clinic. In came a patient, an elderly gentlemen, with his daughter. Politely greeting Dr. Eamonn and I, I don't know why but I noticed a hint of sadness behind their genuine smile.

The man was very thin, very frail. His daughter anxiously mentioned that her father had been losing a lot of weight recently. An awkward silence proceeded. Noticing the sad look on their face, I guess Dr. Eamonn was waiting for the right moment to continue.

Then the man spoke. "I lost my wife last week..." He did not look up, fixing his heartbroken eyes to his walking frame.

When he lifted his face, I have never seen such a mournful pair of eyes, genuinely explaining the loss of his beloved. Doctor asked how long have they been married, and he answered, "62 years, doctor."

And then he said the shortest sentence that almost brought me to tears, "I miss her very much.."

I was trying to fight my own tears at these words, looking away whenever possible. (Oh God nobody wants to see a busybody medical student crying in a clinic)

His daughter tried to hide her own tearful eyes, blinking off tears at her father's bereavement. She was heartbroken as well, watching her dearest father left by his beloved, also hers.

from here

A lovely 62 years spent with the one you love, and when God took them away from you, how can you adapt to this sudden change, waking up in the morning to what's left of the love they left behind. In this man's case, his wife is no longer there to cook his favourite breakfast, no longer there to take an after-meal walk with him, no longer there to look back on the memories they shared since they first met.

When it comes down to moments like this, I am hopeless. Hati yg mcm batu salut besi pun jadi tersentuh.

Hence, treasure your beloved. I have learned this throughout my years growing up with mom and dad, both fit each other like a matching pair of jigsaw puzzle, amazing how their love grows exponentially each day.

Looking back, when my Tok Awang and Tok Jeed passed away, I've never wondered how my Tokmas and Tokteh coped with their beloved's demise, but I know both of them are strong at heart, and luckily the genes are passed on to a very lovable couple I'll look up to forever. (especially when I enter the married phase myself inshaAllah)

Alfatihah to Arwah TokJeed, TokAwang, and Tokteh.

"To love someone is to see a miracle invisible to others"- Francois Mauriac (1885-1970)

To all married couples, tell your spouse you love them (Your own spouse la LOL). And to all the single ladies (ecehhh), God promises that good women are for good men and vice versa, so let's be the best so the good ones are saved for us! hahah. k bye