2 years later...

Salam...

This is my first posting after being in a hiatus for 2 years...

The last post was written when i was a medical student...

Now, i already completed 1 year of my housemanship...

lots of thing had happened that changed me, that changed the way i see the world...

But i appreciated every moment that i've been through up until this second...

Moments that are worthy to be shared...

O’ Mother, I need ye consent…

The mother looks harmless isn't she? Just look at the child's face...

As I was doing ward round on one fateful morning, I came across a baby who was diagnosed with Cerebral Palsy, a movement disorder caused by the damage to the brain during its developmental stages. 

She was 9 months old and I thought the lady luck was smiling at me because her case was so interesting and it is one of the cases that are likely to come out in the exam.

As such, the temptation of putting your skill into practice on this baby was unbearable.

“Assalamualaikum, Mak Cik. Can I examine your baby?” I politely asked for consent.

The mother looked a bit shocked and confused, with her eyes cautiously looking for any sign of danger.

I try to use the it-will-bring-benefit-to-my-studies excuse.

But, still it didn’t break the silence.

Usually, whenever I want to examine a child there will be no problem in getting the mother to give her consent.

But, in her case it was different. The mother seems to be quite reluctant in allowing her daughter to be a sort of guinea pig under the hands of a medical rookie. 

It was a bit frustrating.

Sometimes, that’s one of the challenges that we, medical students, have to face every day. Not just in the pediatric ward but also in medical or surgical wards.

You just have to get consent from your patient no matter for what reason.

The fact is, without consent you are risking your future career as a doctor because if something wrong happened, there are lawyers out there who are more than happy to lead you to the court’s door.

Some patients are very easy in term of getting their consent. The moment they see you wandering around in the ward looking for a ‘victim’ they will call you while, at the same time, stripping their shirt off for you to examine (metaphorically).

But some patients are at the other extreme end of the spectrum. The moment they see you entering the ward they will immediately close their eyes pretending to be asleep.

Yes, even though you know that they are acting it out, never ever test your luck. Actually, you can tease them but, better spare yourself from any trouble.

Nevertheless asking for consent characterizes the uniqueness of a doctor-patient relationship. It symbolizes the respect that the doctor has towards his or her patient. It also shows that he or she has no other business encroaching into one’s private life (or body parts) except for looking for clues that may help that person getting better or, in my case, to learn.

Therefore, once the precious consent is given and the patient is willing to put his or her trust on you, the next thing to do is to keep that trust.

Alhamdulillah…after very much persuasion and a long pause, I managed to get consent from the mother, albeit half-heartedly.

“Excuse me, but what are you doing with my daughter?” Asked the nervous mother as I started holding her baby up.

“Err…I’m holding her up to see whether she can bear weight or not” I explained to the mother as I slowly put the pressure on the baby’s leg using her own body weight.

“For what…”

“I’m just curious to know whether her condition affects her ability to stand or not.”

“Are you a doctor?”

“Nope. I’m just a medical student…”

Her eyes suddenly turned rage. I could see the shocking stare coming out from her face. She didn’t blink even for a moment.

Sensing that something was not right, I quickly put her baby back lying in the cot.

After saying thank you, I took a few steps back and quickly disappeared into thin air. I just pray that my embarrassing experience won’t become a news item among the nursing staff on the following day.

“Did she know that I’m a medical student?” I asked myself while reflecting on the event that had transpired.

She should know because I’m pretty sure that I have my student ID tag on my white coat. But…

“Did I tell her that I’m a medical student before asking for consent?”…………………………………

Confession of a Motorcyclist...

When someone asked me whether I’ve ever involved in an accident while riding a bike I’ll give my honest answer ever.

“Yes. In fact, twice!”

The first one occurred a long time ago when I first got my driving license. I crashed, hitting the safety bar, while trying to negotiate a narrow lane at the Puchong Selatan toll plaza. I think something went into my skin just above my left knee, leaving a big gaping wound which scar is still visible today.

The second one occurred quite recently, about 2 months ago when I try to overtake a car which suddenly swerved and hit the front of my bike. I landed on the ground but there was no serious injury. Just some bruises on my left elbow and a small bump on my left shoulder. As a result I’ve to endure two weeks of tormenting pain while trying to put on shirt because the swelling won't yield.

Then, when people asked whether I’m gonna stop riding my bike, I’ll tell them…

“Well, that’s not gonna be easy. I’ve been riding it for 2 years, have become used to it, and have gained lots of benefits from it”

“Benefits? Are you…like… serious...?” This will be the usual reply that I’ll get. Some people still hold the belief that riding a bike is not safe.

Sadly, however, that’s true.

According to a recent statistics from Ops Sikap 24 (2011), 289 deaths were recorded throughout the 15-days operation. From the number of deaths, motorcyclist and pillion riders made up 179 or 62% of the fatalities compare to others.

Over the years the trend has been consistent. Motorcyclist and pillion riders are always at the top of the list of the victims.

For those who are still trying to figure the reason, the math is simple. On the road, they are the most exposed bunch of people. Whether it is their fault or not, once there is a collision they tend to be the one who take the most bite.

So, there is no wonder that people, in general, tend to relate riding a bike with casualties. From thereon, it turns into a sort of pseudo-phobia that send shivers down their spine whenever the thought of riding a bike flashing in their mind.

But, as I said before, there are benefits that you can gain when riding on the two-wheeler.

For a start, you tend to save a lot on fuel. On average, I only spend about RM 20 for fuel every month. Yes, RM 20.00 (to be precise) every month.

Ask those who drive a car how far can they go with RM20 in their tank.

Secondly, the maintenance cost is wallet-friendly or for the ladies, purse-friendly. I don’t spare much of my yearly budget for the maintenance cost. RM200 a year will cover pretty much everything.

Next, I also don’t have to worry about traffic jam. Hence, if the lecturer accidently extended the class after the office hour you wouldn’t hold a grudge against him/her. On top of that, have you ever heard a motorcyclist grunting whenever there is a long queue in front of them? Fat chance.

Lastly, riding a bike is superbly convenient especially if you are constantly moving in an urban setting. You don’t have to worry about parking space as you can park your bike virtually anywhere as long as it is legal. Besides, there is also no issue with double-parking because the size of your bike will practically allow it to be squeezed through any opening.

And the list just goes on and on…

Nevertheless, I can't deny that riding a bike carries more risk than driving the other type of vehicle. However, I rather not to put the blame solely on it because I still believe that it is the driver’s attitude that make all the difference.

No matter what kind of vehicle you drive, if you drive it dangerously, you still make the ‘Grim Reaper crossing his fingers while waiting for your soul’.

So, drive carefully and think of others. It’s not worth dying or making others die due to your own carelessness.

You can make all the difference.

Lelaki itu Suami dan Bapa...

“Aziz, berapa pendapatan ayah kamu?” Tanya Cikgu Nurul. Guru kelas tingkatan 2 Budi.

Aziz terpinga-pinga. Matanya merenung tepat kearah wajah Cikgu Nurul. Lidahnya kelu.

Tahun lepas, bila Cikgu Nurul Tanya soalan yang sama pasti dijawabnya dengan pantas;

“RM8000.”

Ketika itu suaranya ditinggikan sedikit dengan harapan rakan sekelasnya dapat mendengar pendapatan ayahnya yang merupakan pengurus besar di sebuah syarikat swasta. Bangga.

Tetapi, sesuatu telah berlaku kepada bapanya ketika zaman kemelesetan ekonomi pertengahan tahun lepas. Bermula dengan pemberhentian kerja akibat daripada ‘company downsizing’, satu-demi satu kemewahan yang dirasainya ditarik balik.

Jika dulu dia tinggal di rumah banglo, kini ayahnya hanya mampu membayar sewa untuk sebuah pangsapuri yang lama dengan gaji sebagai seorang pemandu teksi.

Pulangnya kerumah petang itu, dilihat ayahnya sedang menjamu hidangan makan malam. Kejadian pagi tadi menerpa mindanya sekali lagi. Mukanya tiba-tiba mencuka menjadi masam. Dicampaknya beg sekolah ke atas sofa lalu likas masuk kebiliknya.

Ibunya hanya menggelengkan kepala. Tanda kesal dengan sikapnya.

Ayahnya pula diam seribu bahasa. Ini bukan kali pertama Aziz berkelakuan begitu dan dia memahaminya. Mahu sahaja dia menitiskan airmata.

Hatinya sebak, pilu memikirkan kemungkinan dirinya gagal menjadi bapa di mata anaknya.

…………………………………………………………………………………………………………………………………………………………………

Sekali baca kita boleh mengandaikan Aziz dalam cerita diatas sebagai seorang anak yang derhaka dan tidak menghormati bapanya.

Memang benar Aziz tidak patut berkelakuan begitu. Tetapi ini tidak bermakna kita terus menjatuhkan hukum tanpa mengkaji puncanya.

Hal ini kerana sesetengah anak-anak cenderung untuk mengukur tahap kejayaan bapanya dengan jumlah wang ringgit dan juga kemewahan yang diberikan kepadanya.

Jika si bapa dapat memenuhi kehendak tersebut maka, ia akan mendapat tempat di sisi anak-anaknya. Si bapa akan diangkat menjadi idola dan jasanya akan disebut-sebut dikalangan rakan anak-anak.

Tetapi, sekiranya si bapa gagal untuk memenuhi tuntutan tersebut maka si anak tadi akan mula menunjukkan tanda-tanda kekecewaan yang pastinya boleh mencetuskan konflik antara si bapa dan juga anak.

Anak tidak lagi menghormati bapa. Bapa dipandang rendah dan lebih teruk lagi, diperlekehkan.

Buatnya si bapa tadi tidak mempunyai sifat sabar, pergaduhan anak beranak mungkin boleh berlaku. Jika tidak terkawal, konflik mungkin berlarutan menjadi lebih teruk seterusnya membawa kepada adegan simbah asid ataupun tikam menikam yang semakin menjadi-jadi dewasa ini.

Namun, untuk menyalahkan si bapa 100% dalam permasalahan ini sangatlah tidak adil. Didalam masyarakat yang masih lagi kuat bertaut dengan dogma materialistik, tentunya si bapa tiada punya pilihan lain selain menurut ‘sunnah’ masyarakat yang meletakkan kemewahan duniawi sebagai KPI kejayaan seseorang itu.

Selain itu, si bapa pula sudah tentunya terdesak untuk berjaya kerana ‘success’ dan menjadi idola di mata anak-anaknya mampu memberikan ‘sense of completeness’ dalam ‘karier’ kebapaannya.

Tekanan perasaan ini dicampur dengan tekanan dari tempat kerja mampu membuatkan si bapa yang lemah mentalnya kemurungan.

Apabila si bapa mula murung, ruh kebapaan sedikit demi sedikit boleh luntur dalam dirinya walaupun dia kelihatan masih lagi mampu melaksanakan tugasnya dalam memenuhi keperluan harian.

Akhirnya, si bapa tadi mungkin bukan lagi seorang bapa dalam ertikata yang sebenar.

Sebab itu dalam filemnya, The Company Men, John Wells cuba menggambarkan betapa susahnya menjadi seorang lelaki, suami dan bapa di zaman moden ini. Beliau cuba menyedarkan para penonton kepada hakikat betapa keperluan hidup yang menekan masa kini menyebabkan segolongan kaum Adam sangat-sangat bergantung kepada kerjayanya.

Tagline cerita ini ‘In America we give our lives to our jobs. It’s time to take them back’ sudah cukup untuk menggambarkan betapa kuatnya pergantungan tersebut. Sebagai contoh, untuk mendapatkan rawatan kesihatan di Amerika, rakyatnya perlu memiliki insurans kesihatan yang hanya mampu disediakan oleh majikan.

Malangnya, insurans hanya mampu dimiliki jika anda menjadi ‘hamba’ kepada kerjaya anda. Akibatnya, konflik kekeluargaan tercetus akibat tumpuan berlebihan yang diberikan lelaki, suami ataupun bapa terhadap kerjayanya.

Malangnya, saya masih lagi mencari-cari jawapan yang sebenar untuk permasalahan diatas. Mungkin saya masih lagi mentah untuk menemukannya.

Namun begitu, saya percaya bahawa anak-anak harus dipupuk dengan nilai kasih sayang yang tidak hanya dibuktikan melalui memenuhi kehendak kebendaan semata-mata semenjak kecil lagi.

Selain itu saya juga percaya yang seorang lelaki, suami dan juga bapa tidak boleh lari dari hakikat yang mereka memerlukan sokongan moral dari ahli keluarga mereka untuk menempuhi cabaran hidup yang serba mencabar ini.

Tetapi, perkara ini melibatkan hubungan dua hala. Maka, untuk mendapatkan sokongan mereka maka kita kenalah tunjukkannya terlebih dahulu. Jika perlukan sokongan isteri maka buktikan sokongan dan cinta kita padanya. Jika perlukan sokongan anak-anak maka pamerkan kesungguhan anda dalam menyokong mereka dalam setiap keadaan, samada senang mahupun sukar.

Buat mereka yang masih lagi bergelar anak-anak dan mempunyai bapa, hormatilah mereka kerana tiadalah lengkap hari seorang bapa melainkan persoalan “Adakah aku berjaya menjadi seorang bapa.” akan sentiasa bermain di benak fikirannya.

Persoalan ini bukannya sengaja dibuat-buat. Sebaliknya ia lahir di sebalik rasa tanggungjawab besar yang harus dipikulnya sepanjang membesarkan anak-anaknya.

Kadangkala, ia juga terbit tatkala timbul kerisauan dalam dirinya samada dia mampu menjawab ataupun tidak amanah yang telah dipertanggungjawabkan ke atas dirinya sekiranya dipersoalkan di akhirat kelak.

Justeru, buat anak-anak, tunjukkanlah penghargaan yang sewajarnya kepada mereka. Tidak kisahlah bagaimana rasa penghargaan itu harus dijelmakan, kerana yang penting bukanlah bentuk penghargaan itu tetapi impak yang dihasilkan daripada usaha tersebut. Impak tersebut boleh jadi amat signifikan kerana ia membolehkan seorang lelaki merasa menjadi BAPA…

…dalam erti kata BAPA yang sebenarnya…

The Story of a Little Girl and How She Taught Me About Life

A Ward in Penang General Hospital was as busy as ever. It wasn't suppose to be the place where you should be looking for a patient especially at this period of time when the final meds are busy flocking and desperately competing for good cases.

However, that also happens to be the only place where I can find a case of deliberate self-harm or worse, attempted suicide.

There was a teenage, little girl whom I had met recently in the ward. The Ward Sister told me that she was admitted due to suicide attempt by ingesting a fatal dose of paracetamol.

I've tried to interview her but I failed. She kept mum on everything and held herself from saying a single word. She even avoided eye contact with me.

As a solution, I went through her medical record. After finished reading her story, I know that the life she had went through was not the life that every one would have been wishing for.

She has lived the life of that a loner.

To make matter worse she was conceived out of the wedlock. Her mother and her father are somebody's wife and husband.

According to a note in her file, she seems to be deficient of love because her parents put more commitment on their 'legal' family.

In order to fill the vacuum, she looked for love from a boyfriend. Initially, she thought that the boy would be the answer to her problem, but in the end, after all the 'sacrifices' she had made, the boy did something that she ought to expect. He dumped her for a new girl!

That hurt her too much that she thought the only way to put the pain away was by taking her own life. That was when she decided to swallow a huge amount of Panadol pills ( It was reported that she ingested 40 pills in one go! ) in order to achieve that.

As I tried to communicate with her to assess more about her suicide attempt, a smartly dressed, Indian, male specialist came by.

I stood up to give him some room or privacy with the girl but he insisted on me continuing my job.

The kind specialist even invited me to discuss about the patient's condition. We communicated using medical jargon as to disguise our conversation so that the patient won't be anxious about her condition.

But still, it is not ethical for medical practitioners to discuss the patient's problem in front of the patient.

He told me that the girl was presented quite late. That means the toxic effect of the drug was already pervasive before she got the treatment and the damage done was quite severe.

Well, since I was doing psychiatry at that time, I wasn't interested in knowing the biochemistry profile of the patient. I asked the specialist if he knew anything about the girl's background. Something that we can change or improve to make her life better.

After asking that nonsense questions, his face started to change. It was as if there is something big and difficult in his heart for him to let it out.

Then, he went around the patient's bed, grab my shoulder and led me to a more seclusive spot.

There, he told me one thing that made the girl's future seems to be as good as gone.

The girl's liver had failed completely. She won't live long.

She only has, approximately, 6 more months to live and her only option to survive is to get a liver transplant.

"Can she get a liver transplant?" I asked the specialist. Hoping for a fairy-tale ending.

The specialist just shooked his head, as I expected.

In this country, if it happens that you had attempted to commit suicide and was lucky enough to make it into the recipient list, the chance is your name will be down below on the priority basis. There is a strict criteria that governs on who has the priority of getting a transplant organ.

With the current shortage of vital organs, it's a common understanding that sometimes, even those who are at the top are likely to die first before the transplant organ is finally available for them.

Then, the air of silence predominated our surrounding. The specialist and I were quiet as we reached an irreversible conclusion. Even the sound of the trolley's wheels screeching and the hustling noise of shouting nurses were hardly noticed. All seemed to stand still for a moment. Dead.

That was the moment when that natural, naughty thought of 'life is unfair' kept on whispering and 'kacau' in my heart.

I really didn't know what to do except to leave her fate to Him. I just realized that my limit has been reached.

But, I refused to giving in to the 'life is unfair' thought.

The question of fairness shouldn't be brought forward. The darkness only prevails when there is no light.

I honestly do wish to have somebody to be blamed for this but as a doctor, we were taught to try our best to resist the temptation of being judgmental.

In the end, however, that little girl had, at least, taught me and made me realized how fragile we are without love.

Most importantly, she was also a living example of a worst consequence that can be if we neglect our responsibility in mistakes that we have done.

Especially, if that mistakes are the results of our own wild lust.

..........................................................................................................................................................................

As the specialist walked away, I once again looked at the poor little girl.

She was laying on the bed while hugging a white teddy on her chest.

Tightly.

Her eyes looked straight out of the window possibly with her mind wandering what would be the next thing that can happen to her.

Sadly, no one in the ward at that time had the gut to tell her the bad news.

A reminiscent of the past...

Just taking a break from psycho thingy...

I'd like to share this video, a performance, which was shot during my first few months in Dublin...



I suppose we were performing for MASAI which is an acronym for Malam Seni dan Aspirasi Islam in 2008 which was organized by PPIMI which is another short form for Persatuan Pelajar Islam Malaysia Ireland.

Reminiscing the past is actually a recognized sort of psychotherapy especially for demented patient. It may help to improve your mood, memory and quality of life.

So, go reflect on your own past...

P/s: Only works if you recall happy past events only...

A Story of Broken-hearted Mother...

This fiction was inspired by a true story told to me during an interview with a psychiatric patient's guardian...

My name is M. I'm a single mother. I own a small business which earn me an average income to continue support my family. I have a son and a daughter. My daughter is a sweet little girl currently studying in a primary school but my son...

My son was diagnosed with autism since he was 5 years old. He couldn't read or learn language and lacks social skills. He also has a short temper. Whenever he gets angry he will seek to destroy anything within his reach. That includes a RM 3000 machine I recently bought for my business and me, his mother.

I think the problem affecting my son didn't come by itself. I think I'm the source of his problem. Over the years I failed to become a mother he wishes for. I failed to heed for his call when he needs me. The fight between me and my ex-husband only made things worse.

Although, it takes two to tango, I can't really put the blame on my ex-husband. If I knew his true nature, I would've reject his proposal to marry me a long time ago.

All I have to blame now is myself.

Putting the dark past behind, I'm now seeking a better future for my son. I wish to see him to become a better person and to be able to fend for himself when I'm no longer around. Although he is resentful towards me, I don't mind. Maybe Rumah Sinar Harapan is the place where he belongs to.

Upon retrieving information about the place, I immediately contact the administration office. After telling them about my son and my wish to send him there, they seems to agree to accept my son. So, I follow all the procedures that have been told to me in order to get my son into the place.

For one week, I went from one agency to another to get the proper documents needed for his registration. I even took a day off and skipped a compulsory business course just to obtain a Government doctor's report about my son's condition.

Sadly, when the registration day finally came, I got a phone call from Officer A***** telling me that my son case was not approved.

Did he know how devastated I was when I heard that news? My feet were all trembling and I was about to faint. How could he tell me that at the last moment, especially after all the effort that I've put through?

When I asked for further explanation, he told me that they have figured out that my son's aggressive behavior is a risk to the other occupants in Rumah Sinar Harapan. He also told me that my son problem is so severe that he might no get any benefit from that place.

Just to get the point straight, I replied to them that my son is not an aggressive person. Yes, he had hit his mother once but he did so out of his resentment towards me. Being his mother I knew him inside out. He WON'T hurt anyone else!

I know his learning difficulty is so severe but I swear to God that he got an exceptional talent in computing. He can do wonders with the machine. You just have to give him a chance and let him prove his capability to you.

I beg them to accept my son because that's the only safe place that I know he can go. He he can no longer live comfortably with me. Even if he stays, he will always go out and only God knows what he does out there. I've tried other places, but he can't be accepted due to various reasons including his age.

Please...

Anybody out there, I need help...

The interview had to be terminated because the patient was suddenly overwhelmed with emotion...