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After the Rain

After the rain, the world is more beautiful.

The grass is greener.
Fresh and new.

The fog blankets the world, and then it lifts, slowly.
The skies would clear up, bright and blue.

The sun shines brightly, spreading its warmth.

The birds chirp and sing and tweet even more cheerful than usual.
The cheer that makes us smile along.

The breeze is cool, the air cleaner.

Just stop for a while.
Listen.
Take a deep breath.
Smile.
Be thankful.

After the rain, the world is brighter.

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Posted by on April 19, 2014 in Poetic eh?

 

Dulu Tak Mahu Belajar

Dulu masa sekolah taknak belajar fizik
Katanya susah, tak mampu
Sekarang bukan main kuat bercakap soal satelit, soal ultrasound, soal radar.
“Kalau iPhone hilang pun boleh cari, kenapa kapal terbang yang besar tu tak boleh jumpa?” katanya.

Dulu masuk kolej taknak belajar geografi
Sekarang beriya-iya bercerita soal kedalaman Lautan Hindi, macam senang sangat nak cari barang hilang dalam tu.

Dulu masa masuk U, nak pilih jurusan senang, kelas seminggu dua kali, lepas tu tak payah berjaga malam untuk study, boleh lepak.
Sekarang bukan main melawan kata-kata doktor yang dah belajar bertahun-tahun, siang malam bertungkus lumus, sambil bekerja pun masih ada exam.
Macamlah semua penyakit boleh sembuh dengan satu dua ubat je.

Dulu bukan main lagi minta biasiswa kerajaan, nak belajar perubatan kat luar negeri.
Lepas tu taknak kerja kat Malaysia, sistem tak bagus, katanya.
Bila akhirnya balik Malaysia, merendah-rendahkan hospital kerajaan, katanya sistem kesihatan Malaysia tak bagus.
Sedangkan tak pernah jejak kaki untuk berkhidmat kepada orang miskin di hospital kerajaan. Macam mana boleh tahu apa yang berlaku kalau tak pernah masuk pun? Setakat jadi pemerhati sekali sekala, boleh menilai ke?

Dulu masa lepas SPM, pilih belajar akaun, belajar psikologi.
Taknak pergi belajar agama kat Mesir.
Tiba-tiba bila ustaz salah cakap, tahu pula tegur secara terbuka.
Eh, ustaz tu salah cakap ke?
Macam senang je berguru dengan alim ulama di Mesir tu ye?

Dari dulu sampai sekarang, tak pernah nak buka Quran. Nak tahu pasal Islam, cuma buka CNN, Aljazeera dengan WikiIslam.
Lepas tu nak kata Islam ajar keganasan, kongkong perempuan.
Pandang dan sentih Quran pun tak pernah, tapi macam arif sangat tentang ajaran Islam.

Orang sibuk-sibuk kata Nabi Muhammad SAW pengganas, kaki perempuan.
Tapi tak pernah pun baca buku tentang sejarah nabi, tak pernah ambil tahu pun tentang hidup Baginda yang aman damai tu.
Bila berkata-kata bukan main lagi memfitnah, cuba tunjuk sikit sifat kemanusiaan “semulajadi” yang baik tu. Ada macam Nabi Muhammad SAW?
I doubt it.

* * *

Marilah kita belajar betul-betul.
Cari informasi dari sumber yang sahih, yang asli, bukan internet, bukan TV.
Menuntut ilmu daripada guru yang bertauliah.
Bertanyalah kepada yang pakar. Tak perlu menuding jari semata-mata sebab “dah pernah baca di internet”, atau sebab “kat Amerika diorang buat macam tu.”

Tolonglah hormati mereka yang pakar, yang berilmu.
Menuntut ilmu dan pengalaman bukan mudah.
Bermandi peluh, air mata, kadangkala darah.
Bersengkang mata, berjalan jauh, berbelanja ribuan ringgit.
Mencari guru terbaik.
Kalau tak pasti, tanyalah dengan berhemah. Memang tak salah bertanya.

Hormatilah ilmu orang lain.
Kalau kita tahu sikit, mesti ada orang tahu lebih banyak.

Tanda orang yang berilmu adalah menghormati orang lain yang mempunyai ilmu yang lain, sebab mereka faham cabaran menuntut ilmu dan pengalaman.

 
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Posted by on April 17, 2014 in And So They Say...

 

I Love You Mama and Papa

Of all the joys in life, the ones that we really need to be thankful for, no matter what, are our parents.

Even more if they live to reach old age, if they have seen us graduate, get married, and felt how it is to be grandparents.

It gets more challenging when they get older, with health dwindling, movements slower, not too keen to listen to children’s advice about their health…but then again, those were the things they had to face when we were young.

Let’s care for them as much as we can.

Let’s show them our love and gratefulness.

Before it’s too late.
For there’s no greater regret in this life, than regret of not doing enough for our parents.

There are no greater gifts in life than the gift of our parents.

* * *
I’ve just watched a Thai advertisement about a deaf father and his daughter who wanted a different father, a father who is not deaf.
It is so deep that it touched my heart to the core.

Everyone should watch it.

* * *

Quite often, I bring lunch from home. Usually they are my own cooked/prepared food. But sometimes it’s something my mom or dad made for us.

I’d feel very sad if something happened to the food that they prepared for me; if I didn’t get to eat them, or they’re spoilt, or simply went missing. It rarely happened, but it could. Because I’d vividly see their faces when they were packing the food for me that morning.

That love on their faces.

I remember once my grandmother made some fried rice in the morning and packed some for my then-single uncle. My uncle was so busy that afternoon, he did not get to eat them.

Late that afternoon, my grandmother passed away.

That night I saw my uncle staring into the container, still filled with the fried rice his mother cooked that morning.

* * *

I have a confesssion to make.

Once, a few years ago, I asked Dato in an email, “I feel like my father is too proud of me, and I don’t think I deserve that pride. Why is my father so proud of me?”

He said, “All fathers are proud of their daughters, Maria. You know I’m proud of mine.”

* * *

 
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Posted by on April 3, 2014 in Embah, For the Soul

 

I Don’t Know

If you have a doctor as a life partner or relative, or if your children are doctors, it is most likely that you have experienced the following. While some of you may have stopped asking, some will still pretend that they have never had the same answer before.

Ask a doctor the following questions, and the answers that follow:

1. Are you joining us for the wedding next month?
“I don’t know.”

2. What time are you going to finish work tomorrow?
“I don’t know.”

3. Will you be able to join us for dinner Wednesday next week at 7pm?
“I’m not sure.”

4. When will you be free to come over to the bank and sign the agreement, within next week?
“I don’t know..I have to check with my colleagues, that is only if I’m not too busy.”

5. If we plan for a holiday overseas in 6 months time, would you be able to come with us?
“I don’t know.”

6. You’re working this Saturday? Will you be able to make it for my mother’s birthday lunch?
“I don’t know.”

7. Will you be the photographer for your cousin’s wedding in 4 months time?
“I’m not sure.”

8. Will you be around for the family gathering during this coming public holiday next month?
“I don’t know. I didn’t work previous public holiday so they might put me on call the next public holiday.”

9. How many days off can you get for your wedding?
“I don’t know.”

10. When is your exams going to be?
“April 23rd.”

Heheh.

 
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Posted by on March 28, 2014 in Poppy and Friends

 

Affected

I don’t know why I am so affected. I don’t even know any of them.

My tears flowed steadily when I first read about it last night, before trying to get some rest in the on call room.

I cried the whole way back from work, which was about 40 minutes. I reached home, switched on the TV and cried even more.

I’m sure many of us Malaysian are affected by the lost aircraft MH370, even when we don’t know the passengers or the crews. Many of us organised prayer events for ease of searching the plane and strength of their loved ones in facing these troubled times.

Personally for me, there are many things that went through my mind.

I love traveling, and I love flying. There are times that I wish I could take flying lessons and be a pilot.

It doesn’t mean I don’t get worried everytime I fly, or when my loved ones travel.

It reminded me of all those days spent praying for the safety of my loved ones – my mom, my dad, my brothers, my dear little sister, my grandparents – whenever they travel.

Dad used to fly almost every week, doing what he did. No, he’s not a pilot but he visited Sabah and Sarawak so often those days. I used to wait at the airport whenever I could, for him to come home. It was nice to hear his stories about the flight crew, the pilots he spoke to, and now I wonder whether he knew any of the crew involved in that fateful incident. As nice as it was, I knew he must have had a few scary moments on board the airplanes he rode.

I could still remember all those moments wondering whether those were the last moments I see them. Alhamdulillah, up to this day, with His mercy and protection, they are still alive and well.

My parents (and the rest of the family) make a huge deal of goodbyes. We make sure we hug everyone before leaving, and the person who’s left behind would at least stand at the doorway and wave until we’re out of sight. Of course there are days that one of us may have left feeling angry, flustered, sad…but thankfully nothing very bad has happened so far.

May this be a lesson for us, to mend everything before we say goodbye.

I remember the days before the long distance trip I made with my little sister. All those moments praying that all will be well, making the effort to say extra prayers anytime I could. I remember the anxiously-happy (if that is even possible) feeling when we step on board Etihad Airways, knowing that anything could happen, also knowing that the risks are rather low. Yes, our prayers were answered, with His Mercy, the trip went very well, and we escaped a horrible storm by a few days.

I remember my grandmother’s final wave at us, longing and sad at the same time, when we left to meet our parents in Kuching. That was the last time we saw her alive, as she passed away suddenly a few days after.

I am lucky that I started flying so early in my life that I can’t remember when my first flight was, but there are flights more prominent than the others in my memory. Like the first time flying alone (with some strangers supposed to be my classmates) to Ireland.

Then I wondered whether any of those passengers were first timers. Imagine the excitement, the anxiety, the expectations; packing for stuff hoping that you don’t miss anything, planning to get souvenirs for the family, plans to spend more time with loved ones after the trip, wondering about the weather there at that foreign country, hoping for a better future at a new work place, wishing for more recognition in another country, dreaming for a more peaceful life…I could only imagine what the loved ones are feeling right now.

I remember the time when almost all of my family flew to Miri for a wedding last year, and I was left behind for a few hours because of work commitment. I was extremely worried, should anything happen to them all in Miri, i would have been devastated. There must be at least 20 of them and they were my pillars of strength, they still are. I flew in to Miri and we spent one of the best weekends of my life there. 20 of us flew back in one flight and that was probably the most beautiful, the happiest flight I’ve ever been in.

I was brought back to the same period of time five years ago, waiting alone, being in the dark, uncertain of my future, dizzy and drowsy all lumped together, receiving news from people whom I don’t know whether I could really trust them, and finding out they could not be trusted, sadness and anger and confusion all playing in mind….only to find that hopes are crushed and sweet memories are gone.

But none of those could compare to what the loved ones are feeling right now.

Therefore, I pray so that the loved ones of the crews and passengers of flight MH370 will stay strong in facing this life.

 

Palliative Medicine: More Than Just Morphine (Part II)

Assessment and management of patients with advanced cancer involve physical, cognitive, psychosocial and spiritual aspects. A holistic approach would ensure that the aim of care is achieved. Much of the assessment would require the physician to spend time with the patient, asking relevant open-ended and specific questions, listening to the related as well as seemingly non-relevant answers. Effective communication skills will point us towards the hints and signals that the patients give away.

Physical management involves symptom control – pain, difficulty breathing, dryness of mouth, early satiety, as well as the ulcers and wounds as direct results of the tumour itself, side effects of medications or from the disabilities caused by the cancer. Since many of the patients need to be treated with opioids and steroids, careful approach need to be taken when starting, maintaining and counselling the patients about these drugs. Education need to be given to each patients to encourage them to manage their symptoms, learn about the drugs they use and undo the stigma that comes with those medications. There is still much to do in terms of training physicians regarding their use and safety as well.

Advanced cancer affects the cognition and mental capacity of a person in many ways. Patients may have metastatic brain lesions, hepatic encephalopathy, uraemia, hypercarbia, acidosis, anaemia or simply lethargy or depression. Even when the disease is incurable, and the solution of many of the above is “treat the underlying cause”, there are much to be done to control those symptoms.

It is an art to be able to draw a line between searching aggressively for the cause of symptoms, and controlling the symptoms, without compromising patient’s quality of life. This makes it useful for future physicians to have early exposure to palliative medicine, as this is a skill needed in practice, especially in General Medicine when it’s too easy to list down a line of investigations despite the patient being terminally ill.

It is also an essential skill to be able to make it clear patient’s loved ones why certain investigations and procedures are not carried out, as they may not be of patient’s best interest at that point of time. It takes a combination of sound knowledge in medicine, genuine concern for the patient and good doctor-patient-family relationship. Despite all the years in palliative medicine, I still am pleasantly surprised on how much understanding some patients and their families have on death, dying and futility; at times with more comprehension than the average physicians themselves.

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Posted by on March 22, 2014 in Poppy and Friends

 

Searching for the Unknown

Searching for the Unknown

First and foremost, I would like to express my utmost gratitude to those involved in the search and rescue mission for MH370. Their hard work and sacrifice for the sake of those unknown to them is highly appreciated.

Although I do not know the nature of a search and rescue mission like this but after much listening and watching, as a doctor, I could empathise and feel for what they are facing.

I’m sure most of my colleagues have similar experience.

For us working in hospitals, patients would come in unwell, for one reason or another, we diagnose them with certain conditions, give treatment and hopefully in a few days time, we could discharge them home, in a better shape.

However, for some people, it is not as easy as that.

There are patients who have persistent fever despite having given antibiotics, even when the antibiotics given are changed to stronger ones. When it persists, we’d need to start investigating again, to search for the source of fever and give the right medication or treatment. We would need to take more blood samples, do some scans, sometimes proceed with other invasive, more complex procedures, even with surgery, to be able to get the answer.

Sometimes patients might have abscesses but despite drainage, the fever doesn’t come down. At times we could not find the type of bacteria causing the infection, making it difficult to decide on which antibiotics to use, sometimes empirically given.

At times we could not even find the source of infection, even after two or three weeks in the hospital.

The same goes as cancer. After doing some scans, some growth could be seen but biopsy may be inconclusive. Or even when the biopsy says cancer, we could not get the actual origin of cancer as the cells were so badly mutated.

Believe me, we would ask for other expert opinion, from different teams, and even different hospitals, to make sure that all possibilities have been explored and all areas have been covered.

Sometimes time would run out, patients get more ill and somehow we could not get the answers we wanted.

No, doctors don’t know everything, and even with current technology, we can’t say we could detect everything that has gone wrong.

That’s not the only problem. Conveying the message that we couldn’t find the answers to patients and their families could be difficult. They would be more and more frustrated as their loved ones become more unwell.

Those who understand the mysteries of life and limitations of human capacity would be able to accept our shortcomings, but not all of them do. Some become angry, demanding quick answers that we wish we could have given to them, threatening to sue or lodge a complaint. Some become anxious and unable to let the doctors do their jobs, asking the same questions every few hours despite given the appropriate explanation.

Some would give unreasonable suggestions that is not suitable for the condition or situation, and some might refuse investigations, thinking that doctors were treating them as “guinea pigs” when in reality, we’re trying to search for the answers via various means.

Even worse, some might resort to other methods, other opinions which could be from non-medical professionals trying to sell them expensive supplements and wonder drugs, or “bomoh” (shaman) who, most of the time, have better communication skills than many doctors but no idea what they were doing.

Some patients and family members refuse certain treatments or investigations because of advice given, or stories heard, from people around them. Most of the time, they thought they know medicine just because they frequently visit the hospital or have friends who have similar diseases or they are member of multilevel marketing companies selling wonder drugs that could cure all illnesses.

Sadly, some refuse to comply to therapeutic medications just after reading a few hadith from Prophet Muhammad SAW, claiming that all they need is “natural, Islamic remedies”, while not even being aware of the basis of Islamic medicine. They are not aware of how people like Ibnu Sinna, Ibnu Qayyim Ajjauziyah (and many other Islamic medical scholars of old) did their researches. They are not aware of the complexities of human body that could not be cured by “just depending on honey and habbatus sauda”. Much of the modern medical research (without them realizing it) is evidence based, the similar way that Prophet Muhammad’s Hadith are researched.

* * *

Back to searching for the lost aircraft.

I notice that not only people are sad, angry and frustrated, they try to speculate and if they could, intervene with the search and rescue mission. Many think they could have done better, even better than those experts who are involved in the mission. Many make unreasonable speculations and inappropriate remarks about the loss and the mission. There are those who have sceptical response to everything our national leaders are telling us, or even when the professionals speak.

I wish, and urge my fellow countrymen, to leave it to the professionals in searching for the missing aircraft. Although some sources are not reliable, but I’m sure they are doing their best to look for the missing plane as soon as they could.

Last but not least, I would want to extend my prayers for loved ones of the passengers and crew of the missing MH370, so that they will stay strong through this ordeal.

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Posted by on March 16, 2014 in And So They Say...

 
 
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