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Maria-Syamsi

From My Heart

Month

June 2014

Post-call

1. You could sleep while standing.

2. You feel numb. Well, that means you can’t really feel. Just seeing things around but not responding appropriately, or sometimes not at all.

3. Euphoria. That initial nice feeling when you see the sun rising, shining on to the hospital corridors, and then seeing your colleagues come in one by one, saving you from the wrath of the call. Sipping that small cup of vending machine mocha (which is surprisingly nice) while watching a dear friend walk into the building.

4. Extreme cheerfulness. When everything sounds so funny, or when you can crack jokes at almost everything. When you go around asking “can you speak French?” to ALL the foreigners who can’t speak your own language, wondering how you’d respond if they said, “Oui.” You know you don’t speak that language.

5. Giddiness. The floor seemed to rock up and down.

6. Hungry, like you could eat a horse, or that’s what they say. You wake up from that short nap looking for the best roti telur and kari kambing hefore starting the morning rounds. Or spend the whole day thinking of that burger daging special (beef pâte wrapped with omelette slathered with chilli sauce and mayonnaise with cabbage and toasted fluffy buns), or lasagne from Delicious, or anything cheesy, in fact. Comfort food is the term for it.

7. Wanna get cosy, like having a huge piece of moist chocolate cake with a generous scoop of vanilla ice cream with your loved one, talking about nothing and then fall asleep on his shoulder.

8. Like you could still do all sorts of things in this whole wide world: go shopping, gym, visit the sick, watch movie, go out for a late night drink. Especially if you’re young.

9. Headache. Pure headache.

10. As if you’re pregnant. With the headache and nausea and abdominal discomfort and bloatedness, good appetite but can’t eat much, giddy, irritable, sensitive. Oh, and body aches too.

11. Able to see and hear but unable to register. When you could see the car in front of you braking, the brake lights are shining, and your mind would just go “la la la” until it’s too near, or even asking itself, “why is that car slowing down…?”

12. Sitting in the car at the end of the day, praying that the 40-minute drive home would be safe and smooth.

* * *
I have felt all of the above. At different times and place. Depending on how hectic was the call, the total uninterrupted sleep I had, the condition I was in before the call, how much fluid I managed to drink the whole day (the more fluids, the better the outcome is, sometimes only feeling slightly tired), my health or even time of the month.

One thing for sure, the older one gets, the more tiring it becomes.

* * *
On call system is not shift system. When a doctor is on call, he’d be working from 8am the day he’s on call, up to 5pm the day after, or even longer. That means 33 hours of working, with no or very little sleep in between. Some departments allow the doctors to go home after 24 hours working, some may need to stay up to lunch time the next day, and the rest, up to 5pm.

I don’t have kids so I can’t imagine how ladies with kids do it, when they have to wake up every few hours at night even when they were on call the night before.

* * *
For all the doctors out there, let’s keep up the hard work and make it all worth it! 🙂

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Why Am I Still Alive

Two months back I was unwell, unwell for longer than I ever have been. I recovered after almost two weeks, but it took me almost one month to be back to my usual self.

I came back to work after almost two weeks of a planned holiday (which coincided with the illness), taking care of patients who had similar illness.

I was taken aback at the amount of worry we had for them. Well, I always knew that most people recover well even though they had problems during the illness, and I always knew that we always worry about this group of patients, because anything bad could happen anytime.

But the fact that I let myself take care of my own health, with nobody actually monitoring, just judging from what I felt, when we worried about others so much more, stunned me for a while.

I could have died.

Something could have happened quickly somewhere far from the hospital and I could have deteriorated rapidly.

But I did not.

My energy came back, and my appetite much later.
I could smile and laugh and play with the kids, big or small.
I could wake up at wee hours of the morning to travel.

I could go to work just to realise how lucky I was to be alive.

How it’s not meant for me to leave this world yet.

Why? Why am I still alive?
* * *

We were taught to see the good behind everything that happened to us, and I work in a field where this question keeps on being asked. Asked again and again and again.

We still have people we could serve, or should.

Or there are people waiting to help us, if we end up surviving in a worse state than we were before.

We still have to pay back some people, not just some money, but gratitude for the things they have done for us all this while.

People still love us and we have to love them back, even more than we ever did before.

It shows that there is still so much that we need to contribute in this life. Make others happy, help the needy, give more warm hugs and smile.

It makes us think where should we spend our robust energy, to the good of others, or just to have more fun in the name of “living life to the fullest”?

There are people we need to seek forgiveness from, and it’s not too late for the moment.

There are people we really need to care for.

It makes us realise, who is it around us that truly care for us, worried about us when we’re unwell, do anything they could even when they themselves have limited resources.

Those people who gave us warm hugs when we really need it.

I’m still alive because there are so many of those wonderful people who made it possible for me to go through this life, and I need to give them back what they deserve, every single day.

I survived so that I could understand.
* * *

Obviously, I would not have survived without His Grace and Mercy.
Or the outcome would have been worse. But even if the outcome have been worse, I’d still have the above reasons to go on with.

What is this purpose of life?
To worship Allah in our entirety.

How do we do that?
By submitting to His orders, and to be kind to people around us, as much as possible.
For worship has two components – self, and social.

Bullying? What Bullying?

Recently someone wrote in Malaysiakini, asking us to stop bullying junior doctors.

Wait a minute. Bullying? What bullying?

A quick look at dictionary.com tells us that a bully is a blustering, quarrelsome, overbearing person who habitually badgers and intimidates smaller or weaker people.

I’m going to ask house officers, their parents, partners or big shots who claim to be their relatives/ family friends: which part of a junior doctor’s job could be defined as “being bullied”?

Reality check here, people.

(1) ALL of us came from that place called being a junior. A beginner. ALL the top consultants were once house officers, who barely know how to clerk a patient, assess how ill the patient is, put in an IV line (which can be quite a challenge and delay your other work), let alone make a diagnosis and properly lay out a plan of treatment. Don’t even talk about prognosticating, which means predicting the outcome for each patient, days, weeks, months or years down the line.
All this needs practice. A LOT of practice. Seeing patients upon patients day in and out. Talking to them, looking at them with your eyes, brains and heart.
You can’t achieve higher levels of competency and knowledge by just seeing two patients per day, spending hours on that particular patient only while your friends (or seniors) do all the work for you.
Trust me, all those top consultants in top private hospitals, earning millions per year, had it much worse than the generation joining the medical fraternity now. Trust me, they have gone through all that and more, and they still work hard. Because they understand its importance.

(2) One may ask, did these doctors not come from five to six years of training in medical school? Surely they were taught something?
As with everything with life, learning and applying are two different things altogether. Simple example, you can read a chocolate cake recipe, but trying it out will give different results with different people, or at different times. How many tries does one need to bake a consistently delicious perfect chocolate cake?

(3) If the junior doctors complain that they come home late everyday, and need to come earlier than the rest of the team in the morning, and they think it’s unfair, well, think about it again.
When the whole team does rounds, the senior ones would want to assess the condition of the patient to be able to decide on the treatment plans. As with point number one, a junior doctor will need to learn themselves on how to make this assessment, and report their findings to the seniors, so that the seniors may correct them and guide them if they are wrong.
If the house officer does not make this effort to assess the patients before his seniors come for ward rounds, then he would miss the chance to recognise his shortcomings, to discover the many things that he does not know, hence poorer performance, ending up being an incompetent and negligent doctor.
That is why they need to come early.

(4) Dear parents and the society, what kind of doctor would you want to have treating you? One who works hard to be a better doctor? One who has experience seeing more patients? Or the one who whine about the workload they had to face without doing anything to handle the situation?
Would you rather be treated by someone who was poorly trained just because he thinks all sorts of training equal to bullying?
Would you want to be treated by someone who does not run to save your life, because hard work is too much to handle?
Would you want a doctor who has so many “big shot” contacts that he reports any attempts to properly train him as “bullying”?
Would you want a doctor who has been too arrogant to admit his mistakes, and learn from it?

The training is gruelling and the workload is huge. But it’s for one sole purpose, for them to be competent doctors who are responsible, who can be released to the society without much supervision, who know what they don’t know and when to seek help.

(5) So nowadays the news reported that there are too many doctors around, and they work shift system so they wouldn’t be so busy. But have they told you how much our healthcare burden is, and how people are getting sicker earlier?
When the glut of house officers started, they were so jobless that they only take care of three to four patients each. Just imagine, how are they going to be adequately trained if this is the case?
So the shift system was supposed to give them a better quality of life on top of making them see more patients per day.

(6) Ask junior chefs or junior accountants all over the world. How do they work? As busy, or maybe even more. Much much more.

(7) I have to say, there ARE true bullies out there. There are bullies among senior house officers, medical officers, registrars, specialists and consultants. They bully their juniors, and they bully each other. Yes, EVEN among the consultants!!
It’s not right. Personally, bullying in medicine simply means asking a junior to do what is not within the scope of their duty, example buying drinks (when they could have bought it themselves), making coffee for department meetings (on top of the thousands of things the house officer needs to do), filling up on call claim forms, or other personal things that’s supposed to be done on their own. Some call people rude names, which is uncalled for in any situation.
There are those who are gender biased, racists, or simply angry all the time, scolding everyone without reason, being totally unreasonable with their treatment plans.
These people exist in ANY profession.

(8) To tell you the truth, none of us in our right minds will scold a houseman eager to learn, competent ( or increasing their competency by the day), humble and caring. Bearing in mind, “the right mind” may mean differently according to their upbringing, as doctors are all human beings.
But having said that, don’t brand all your seniors who scolded you as being “not in their right minds” because a lot of time they were correct, or maybe they are scared because the mistakes you have made could have killed the patient, or worse, already killed him.
You really have to look into yourselves, why are you treated this way? Is there anything to make things better? Were the patients lives affected by your actions, or lack of it? Did you cause more pain to the patient? Or simply delay their discharge for another day which in turn exposes the patient to hospital acquired infection that is much much more difficult to treat?

(9) Reality check, EVERYTHING in life needs hardwork.

(10) To those house officers who drive daddies’ expensive cars and expect to be treated like a queen, who expect to have less work compared to Kancil-driving colleagues, who expect to cry and run to daddy saying “my specialist scolded me” and daddy will scold the specialist back, let me tell you something:
MONEY CAN’T BUY LIVES.
Money can’t even buy experience and competence.
Money can’t bring that poor man’s wife back to life when she’s dead because of your negligence.
Money can’t do all that.

(11) Dear parents, don’t force your children to be doctors if they are not interested. Anyone interested with something will work hard with all his heart and passion, does not mind spending days and nights to learn and perfect their skills. Those who are truly interested in what they are doing will continue to greatly contribute to that field.
If they do well in their exams, they don’t need to do medicine or engineering. They can do fine arts if that’s what they love.

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Lesson of the Day

We might be strong now
Standing straight and walking briskly
Going around getting things done

But one day
We may just fall ill and meet our demise
That big tough built no more
Just lying flat on the bed

We may hold on to him so close
He may not let us go
Never wanting to

But before we know it, the time has come
One of us will have to leave first

Appreciate your health
Stand straight for the benefit of others
Give without expecting return

Look around and see
Those who cared for us deeply
Who are there when you need them
Even when you don’t know that you do

Look around with gratitude
Be there for each other
Use our strength for those who don’t have it

Life is too short
And we are powerless
If even the small mosquitoes could kill
Or wreak havoc to the world

You, You, and You Too

It’s been a year since you left
You, you and you

Did I survive?
Well…depends on what you define as having survived.
Did my life change?
I’m still here.

What have we done this past one year?

Me and you, we still speak about the same things.
Our dreams and hopes.
Our worries and happiness.
It’s like you never left.

You, with whom I’ll spend some lunch time together
Or even Saturdays when he’s away, doing things he love
Sneaking here and there
Not doing anything wrong, just trying to fit in some free time

You, chasing your dreams, one big step after another
Happy, content
We barely spoke
I refuse to
At times it’s just awkward
Maybe it’s just me

You
For some reason I’m unwell everytime you see me

You
Still remembers me even when you’re away from home

You
Who likes someone because he sounded like me. Which is funny, but it’s nice to know

You
Whom I remember everytime I’m away
We used to travel a lot together

You
Would try to get me to all the courses you are attending
Trying to sneak me in

You
I’ve lost all the words that I wanted to say

When prayers are returned, with tears in our eyes
When jokes are exchanged, and the laughters that followed
Brought us springs in our steps
When desserts are shared, with pregnancy stories, and horror stories
And when Batu Feringghi became the most beautiful beach on earth, even if it’s just for 5 minutes

I missed you, you and you
And I still do

* * *

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