the foot note on my 30th birthday

 Assalamualaikum 

dear self, 

thank you for still spending the little time you have to keep this place alive after 16 years writing. though constantly you have always been in the midst of a new and a more profound responsibility.

dear Umi, 

thank you for still being here, probably my one and only avid reader. sorry for the lack of content in the last few years. its been hard to keep track what the heart and mind wants to write. too many things happens, so little time to react and to translate the true conjugation of the true perspective

and dear you ,

i hope by being here, you could be here with me on this wonderful time for a wonderful post. thank you in advance, and may Allah bless you all :)

*****

Ever since the global Covid pandemic started back in 2020, we were all hit hard and were forced to adapt in every aspect of our lives. from the smallest aspect of compulsory outdoor mask application and the everlasting Mysejahtera scans everywhere, to the awkwardness of  having strangers standing so close to us for no legit reason. im pretty sure that everyone has their own version of adaptation story. the ups, and mostly the downs that makes us realize that change is inevitable.

As for me, life's priority hierarchy was easy.it has always been family first, then realise that work is just work. and unfortunately, as 'peaceful' as Malaysia could be, the never ending drama of doctors are just a massive blackhole with no end. who to blame for newer generations of doctors, you're labelled as ' contract workers' with the same responsibility, more to lose, and lesser earning and career options.

PKRC MAEPS 2.0

and being the government, finding us contract doctors as exploitable and disposable, instead of pushing us to advance like any other doctors, they decided to keep us as the main frontliners to deal with the covid pandemic. hundreds of doctors were placed to take care of covid patients, more than 90% of them are contract doctors. if it was 5 years ago, a year of proper training makes a doctor more competent as you are facing with the all the variety of challenges. but everyday covid experience is no difference than being a factory operator, you are doing the same thing over and over again.

We have a short life, a very short life. With a lot of things that needs to be done. life doesnt pause as we wait for covid to go away.  Of course, politics are always the number 1 concern in any governing country. they are promising us things will get better when covid ends. but as we see, its not getting any better. and we are still questioning the same thing as we did since 3-4 years ago; will our rights finally be given? will the exploitation ever be banned ? 

This, and so many things regarding work has been bothering not only just me, but also my colleagues. btu at the end of the day, we have mouths to feed, a job to do, and an oath to fulfil. the ultimate oath that enforces us to do good to people that doesn't respect you, that thinks doctors are hoax and online content are a more suitable option.  we've become so low till the point that at the end of the day, we just hoped that we could get the job done, and dont harm anyone along the way.

Its a cruel and messy world. Jobs and growing up can be tough. but i always believe that a man becomes great when they can oversee beyond what is actually confronted upon them. and as i said, a job is just a job. get it done and focus on what is more important; the people that were there during your downs. friends and family

so during this covid pandemic, i got married to the woman that recently became the mother of my first born son. pregnancy is a journey that every mother will start with. and being a doctor, all these things are no stranger and its part of the work.

How wrong was i thinking that things could be the same when things happened to my self. as reality struck you realise things are different, and the surreal emotional that you never felt before engulfs you. and then you realise, how hard it must have been for our parents to actually do it from the day we were born until now. 

as for me, (alhamdulillah) Allah made the journey simplified. and i could not have ever be more grateful for what has happened. maybe some other time ill post on what really happened? 

at 8pm, on 6th March 2022, my beautiful wife, Nurul Nadiera, gave birth to a beautiful boy. and i witnessed how my wife, who used to be a stranger during undergrad study, a colleague during housemanship, a loving wife, and now she is also a caring mother. seeing how gracefully she has taken care of our Son made me realise,

that no matter how much i love my son, a mother's love will always be more beautiful and unparalleled,

that no matter how hard life is, family will always mean more than work

that as your family is growing  , so does your parents

so dear wife, im not sure will you be reading this or not. i will love you always, and thank you for teaching me so many things that i ralised i was wrong in  many ways. i dont have alot of women in my life, but im lucky enough to be surrounded by strong women such as you and our mother.

Dear Umi, thank you for everything, raising up 5 boys was never easy. but you did it, convincingly. i know you hide away your frustrations and tears so we dont see it. thank you for being the role mode, the ultimate mother that will always be beyond comparison

And finally, to my dear Son. Adam bin Ali Husaini. i hope one day you get to read this. i honestly thought you would be born earlier ( maybe on the same date as i was born). and ever since you were in your mother's womb, my prayers was for you to grow strong, healthy and will grow into a finer man than me. FYI, on the day you were born, you nearly scared me and your mother. but seeing you as how you are, despite all the drama of the day, i could not have wished for a better day. you are the best birthday gift that i could have asked for. everything was perfect. and, Indeed, we plan, and Allah plan, and He is definitely the best planner.

Its a cruel and a messy world. but surely your mother, and me, will love you more than we love ourselves, and strive beyond. so grow well, physically, emotionally, mentally, and most importantly, spiritually. have no fear. you are so loved by so many.

Primum non nocere ( Do no harm ), the irony.

 

Its been awhile. And I decided to dedicate the first post of this year to my fellow comrades, those who decided to keep pushing until justice is served , those who decided that our lives matter as much as those who came before us, and those whom we treat wholeheartedly.

 

The contract workers ( read:  the contract doctors )

 

Ever since long time ago, the core of every doctor’s principle from the day they they’re called ‘ Doctors ’, was implemented into the Hippocratic oath. The infamous well versed oath that highlighted that the main principle as a doctor during practice was not to treat, not to cure, but instead,

 

to do no harm. ( original latin word: Primum non nocere )

 

And this great principle has lead many of us to be so unselfishly willing to go beyond to do what is best to those in need of medical attention.

They were spoken about not to do harm to patients, and many have benefit from this principle. Unfortunately little did we noticed, how the flaw in this principle is that despite it prevents harm to patients, it has caused harm to us doctors, specifically speaking; contract doctors.

Where to begin? It’s a long standing issue that the ministry failed to address up to the point  the harm has been inflicted in so many ways. Here are some of them.

1. The inability to pursue further career for specialization

One of the main criteria in order to be accepted for post graduate study (to be able to attain the ‘doktor pakar’ level) is to be a permanent doctor. And it’s safe to say 30% of all the practicing doctors are now not eligible. And the numbers are rising.

2. The stagnant payment and rank progression

Government officers will have a steady inclination of rank within the hierarchy and with that, the raise in pay grade. But being a contract officer, your pay is stuck with whatever that was given in the contract. And instead of having the contracts being upgraded, they are just renewed annually until to a point the government decided that enough is enough and its time for you to go. I guess that is the nature of all contract workers? Of course there will never be a change to permanent status in the near time as some of our colleagues in the pharmacist’s and dental department had to go as their contract expires.

Not to mention the immediate termination of contract is always hanging upon us should we fail to deliver the task as a doctor, or a minor error is done. We have so much to lose, and so little to gain. But here we are, still trying our best, hoping to treat, and along the way, having to please unnecessary people.

3. The disgraceful discrimination

So often during practice, we encounter the kind of people who only sees the value of a person from what they see on paper rather than the person himself.

‘you pangkat apa? UD41? SAYA UD52 TAU! Saya nak cakap dengan UD52 sahaja. Saya nak UD52 sahaja yang rawat saya!’

People like this makes you realize how useless an ego to a person may be.

And of course, the discrimination among peers with different grades, but with similar working environment and job scope. How they thought just because we were born late and became a doctor later than them gives them the right to scrutinize and bully us. As naïve at it sounds, it’s hard to dismiss when the phrase keeps on echoing in our head everytime they speak as such:

‘u all kena ingat, u all ni contract je’

 

_____________________________________________________

 

But generally speaking, people don’t see how this affects the overall healthcare system. Because we are doing our job as doctors similar to the doctors given the permanent status. Except that we have more to lose than to gain during our daily jobs. And by doing our work mainly for the sake of our patients, we continue to keep on doing our works with little hope of having what is rightfully ours; a fair treatment among peers and ministry.

But that ends now, hopefully with this peaceful movement will shake up the authority to realize ignoring the rights of its doctors is WRONG. Some of us left the ministry knowing that there is no hope for future doctors. And then there are us, staying, hoping that in the near future something will change, and everyone gets the fair treatment.

And should this statement fail to trigger the ministry to do something practical rather than just whispers of false hope, surely there are more to come. This is nothing personal, this is for the future generations that deserves a better future, and for the patients to receive better care. And with this post, with this subtle movement, we hope that changes will come in the near future.

Being a doctor may be a dream to some people (or their parents). But the current reality is that is it has not been the most glamorous or most glorious job there is.  But rather a constant struggle with what you need to do, what you deserve, and what the patient needs. And usually it’s the latter. It’s a sad reality, a reality that reflects a worrying future. Hopefully this ends soon.

 

Here’s to a better healthcare system, for a brighter future.  

 

 

(flower was given by one of the Covid patients in the ward prior her departure. one of the little things that kept us going )

new year resolution: Lets break the barriers of disbelieve!!

 

How did we get from nowhere, to now-here?

well apparently

since we were small, we watched dragon ball and all sorts of TV shows expecting one thing : 2020 is the year where great things will happen. Perhaps there might even be flying cars and other amazing advancements in technology. And since we were little, we were looking forward to 2020, and hoping how our lives would change for the better.

Unfortunately (or fortunately?), 2020 came and hit everyone right in the face unlike what we have expected all this while. COVID 19 hit us so hard and is still hitting us without giving anyone a proper answer on how to overcome it and all the problems that came along.

We thought there would be flying cars to allow ease of travelling and better means of transportation. Instead, even the aeroplanes that were already flying for the past century are not able to operate and we are still using the same modes of transportation, with less efficiency.

We thought that there would be better job opportunity and more job scopes. But sadly, it’s the opposite. Small time resellers and big companies relying on community marketing had to narrow down their business approach, turn over a new leaf, and worst, shut down

We thought that the education system would improve with a more practical approach and better interactions. Instead we are bound by video calls and feeble internet connections to provide the basic education for the future generations.

And personally, being the doctors of current generation, we expected there would be a solution to the nowadays doctors who are mistreated by society and also the ministry itself. They want us to pursue future studies. But they don’t allow us to do so as we are all now ‘contract’ workers working year to year basis. Our actions are very closely monitored and any action that doesn’t pleases the superiors ( such as petty complains from patients or non contract government workers ) will lead to termination. And during this covid pandemic, apparently all the contract doctors are the 80% frontliners as we are all ‘disposable’. The long term daily dose of COVID 19 management makes a dull mind and difficulty to maintain a standard practice and care that a doctor needs.

 

 

It’s a very sad and depressing times to every respective personnel regardless of their social status or income. And its not right to put a blame and start pointing fingers. So What do you do when you are unable to provide for your loved ones?? What happens to the future generations? Where is the just in the system? A year has gone by. And a hollow year it has been with no solutions.

But in the midst of all these piling mess, there is this one beautiful feature of being human that stands out. And that part is what allows us to be part of evolution. And that, is the ability to adapt.

We adapt and adjust accordingly to the new surrounding. The new harsh environment that teaches us to be better. And of course, everyone learns and adapt to different things, based on their surroundings. And this, is what ive learnt.

For starters, I was in a dilemma initially. After being transferred from Perak to Selangor, I was placed in a district hospital that I wasn’t expecting. Initially I was placing all my bets on a placement to the hospital next to my house and thinking that I planned everything correctly. And if everything goes according to plan, I could plan the next thing in life easily. Little did I knew, it was 2020, the year where you can’t expect everything to go according to your plan, and uncertainty will be certainly happening against your favour.

I was placed in a district hospital where the distance is the same if I drive home or I drive back to Ipoh. And by some chances, a few friends who got the same place as I did, managed to go to other hospitals nearer to their home.

 

That affected me in a way that I kept questioning, where is the silver lining in all of this?

And on my way home, driving through the long hour drive, I tuned up to this podcast of a person, who was not a figure well known by many, but the content that he elaborated are the things that I needed to hear at that current moment. Here are the top 3 lessons that I would like to share J

( yeah, not much of a podcast, but this youtube video is my reference)

1.    First and foremost: 

Its not about the person, its about the content. 

      Everyone has a story to tell, and everyone has a lesson to share, we just have to listen. Of course you’d be expecting a lot of great things coming from a great person. But sometimes, greater things come from people you least expect.

2.      2.  Be firm with what you want.

There are times where there are things that we do because we thought it would be good because of what other people said it is good, without them realising how difficult it is to achieve it. Like parents might say ‘ hey be a doctor, be an engineer, its good for your future ‘ And then there are those things that we cling on to because we are in dire need of finding that sense of belonging through that achievement. Like how nowadays ‘flex’ culture is terribly affecting us. And with all this it made us wonder, why nobody is asking us are we happy?

For that here’s a saying ive said before that is self explanatory;

so when i see people who have had success, i see boredom for the most part in them, and i see a tombstone. Circling back to what trophies and it represent,
Usually when you get what you thought you wanted , The fire goes away. So if there's anything, just find joy in what you do for the sake of it and then recognize how you're being shaped in the process and hopefully youll become a better man through it.

 

3.    3.    Be at peace with what you want .

And then there are times, you get frustrated along the way. You feel irritated and somehow angry doing things you thought you liked.

Remember,

 ‘that is the nature of love, it has a little bit of hate in it. And a little bit of pain as well’

 No matter how frustrated you are, or how much you hated a certain thing / someone, it still draws you back to it. And with that, you learn to appreciate more than you hate.

 

And after listening to this podcast time and time again, I realise theres more message that the speaker wished to enlighten to those who understands the indirect message that he is trying to convey. And to counclude all of this, and as I correlate the content to myself. I realised that all I ever wished for, is to spread the goodness in whatever form I could. And this c ould be achieved regardless of in which ever hospital I am. To those who knew me ( and those who don’t ) I can assure you that I am not the best in all the things I do. But it get easier and better, once I realise what is the greater goal, the end goal, and how it helps me in being a better person.

So what is this greater goal? I guess we’ll have to take it to another page of post. Most importantly after the repeated sessions of listening to the same thing. Im being reminded to be thankful for what I have, although the circumstances was as how I planned, it was exactly how Allah wanted it to happen. And I couldn’t be happier knowing that somehow, if He plans, then I should do my best with what I have now and leave the rest to Him.

 

 In a nutshell, we say goodbye to the harsh 2020, expecting harsher challenges ahead. And to prepare for it, the basic necessity to taking the first big step for 2021 is to find the correct solution, one step at a time. But this time, with the right mindset, . The right mind set to ' break ' the barriers of disbelieve, and help us go beyond. We should start believing in ourselves, and if we still fail to do so, believe that Allah put us where we are, is because He sees the ability for us to overcome it. Guess what is left is just to trust the process. His process.

 

So, to the lost and wondering souls and minds out there, i know you are struggling. dont worry, take a deep breath, and stop looking outside and beyond the horizon to find answers for the ongoing difficulties, sometimes the answer is best within the notion of looking inwards and self-reflect. I wish all of you who read up to this point, a blessed year ahead with a stronger mind, and bolder hearts. Take care, be safe.

Hello 2021 :) 

get. it . done. and. carry on. with. your. life

 

 

  Ok imagine this,

You work at a beautiful lake. And like any worker, you have an employer. And one fine day, the boss asked you to make a field garden in the middle of the lake. And being a good employee you start to build it as ordered. It wasn’t easy. It was time consuming, to a point seemed impossible to be done. Surely a lot of blood sweat and tears we’re used of course. And apparently, on the other edge of the lake, it seems like a lot of other employee are doing the same thing. Just making sure the soil and stones are properly placed so it is as how the boss wanted it to be. Everyone had the same thing to do, but apparently some thinks its too hard, and decided to quit and do something else. Some thinks that maybe if they help that fella to get his garden done, that person will help me out too? Apparently some are willing , some are not.

 

And after a few years, its finally done. Laid out beautifully. A garden full of flowers and plants. Some employee thought that a barren land would be suffice with no proper gardening. Some decided to use other people’s crops for the job. And some just decided, its best to do everything as instructed, and also do something else more, for the sake of self satisfaction.

 

And of course, the day ended as the employer evaluates all the garden. Satisfactory or not, later on he gave one final instruction: now build a house that suits you on top of the garden, and you will live there for the rest of your life, if permissible, the land should be good enough and large enough to build a dream house. If not, then the person will have to do some extra works to build up more space and build more house

 

Im guessing this explains housemanship in a nutshell.

It was the period of starting a career. It wasn’t an easy one. We sacrifice a lot, some barely manage to survive, some cruised through it without any problem. And some manage to put extra effort for the future that is obviously uncertain.

After completing housemanship, you thought you could take a deep breath and rest as the toughest period of your life has ended. But little did we know, its actually the toughest period in the career ‘ so far’ . a lot of other things that needs to be planned and more obstacles needed to be overcome. And apparently all the hardship for the past 2 years plus seemed so little in comparison to what lies beyond. All the hardship to survive, was actually just to build a foundation for the future career.

Some managed to go through it alone. Some realised, that its actually better to go through with other people along the way to assist and motivate you accordingly. regardless, the better the foundation, the more confident we are to face the future.

 

I spent 8 months in orthopaedic department, and along the way, I see so many flaws that everyone had, regardless of the age, seniority, or rank. But some of them decided to keep it low, stay humble and work as needed. While others feed on their ego and hope to rise higher than the height of their ego. As for me, I just want to do my work for the patient, while hoping to be improve myself along the way, both professionally and personally

And for that, I have to give credits to the bosses and dear colleagues that were along the way with me throughout the past 8 months. 

 

“ who you know is better than what you know ‘

 

This is a saying that I believe will help me now and in the future. Yes, the journey and the destination during a trip is important, but as some may forget, that the company along the way plays a very important role as well. and honestly ive learned from people more than i learn from books. 

 

And for this, I would like to thank everyone who has been a part of my journey. its good to know that there is always something to learn from people around you. From how they talk, how they react, and how they teach. But most importantly, is how they deal with unanticipated problems. I guess there always room to learn and improve as long as we don’t let our ego in the way.

 

I cant thank enough to everyone who has been there for me through my deepest fall into the pit, and the time where I was over the moon. Hopefully everything that I’ve encountered before this will be the constant reminder to be positive and strive forward to be better regardless of where I am after this.

 

So here it goes,

the real start of the journey,

despised by many,

 bismillah,

 

  

lets strive for a better future shall we? J

once and for all, and once in a life time,

Finally, finished housemaship with orthopaedic posting. it was a mixed feeling. that self relieve for finishing something that seemed like an endless journey before, suddenly ends abruptly. suddenly you feel unprepared, but if theres one lesson you could take from the past 2 years , its that life goes on, and by hook by crook, we learn to adapt. little did i know, the lesson in life goes beyond what i expected, as always.

You can start being a doctor for a numerous number of times. take a break, quit if you wish, and take a fresh start. but you can only finish housemanship once. and surely everyone has a tale to tell, but not everyone possibly has a take home message. and surely, finishing housemanship during this pandemic mayhem, is a burden to be carried till God knows when. on the side note, finishing houseman ship in non elective posting, i was still able to mingle around with different people from different postings. some are freshies, some are seniors by duration in the posting, and some are just getting used to work as housemanshipregardless of the number of posting they are. and this opens the eye to the different types of houseman and see how time has molded a person to what they are.

generally speaking, as a first poster, instead of learning to what the posting has to offer, you are getting use to the nature of working after a veeeery long period of 'holiday'. the brain is recalling back all the lost memories of undergrad studies, but instead of recalling and trying to apply it to the practice during work, you are too busy adjusting to the system, and knowing what is right and what is wrong. apparently, knowing how to work as a houseman is prioritized rather than knowing the facts of a disease and management. someway along the way, youd realise you could get the hang of it, some stumble and say its too much and succumb the pain of not knowing how to work is too much and throws the towel.

(surgical suturing workshop)

and after finishing the first posting, we have that first sigh of relieve and somewhere inside us, we are able to say to ourselves, life wasnt that bad. and surviving is bearable. without knowing, the ego rises. some thinks that passing a small portion of housemanship entitles them to the seniority and unfortunately, their ego rises beyond their seniority, and knowledge. and from afar, these kind of people will always seem to amuse you. their pompous personality of downgrading people lower than them makes it more obvious. and what they say has a greater magnitude than the amount of work they accomplished. ofcourse, to some of us, its just another phase of life, you lay low, stay humble and learn as much as you can. after that you go on with the next posting, and keep on learning, ( and earning. lol)

and after the 2nd posting, we start to realise, rather than being a good houseman who knows what and when to do the job, the essence of working as a doctor slowly sips through the thick skull. we realise that, caring for the patient is actually a part of the job, and hence we incoperate the responsible as a doctor together with the responsible as a houseman. and along the way, the realisation of the nature of the work starts to become more clearer. and as the subsequent posting passes, the fatigue and soreness becomes a vicious cycle and we desperately wish that the cycle could just end so we could move on to the next phase of life; MO-ship. becoming a legit, independent doctor. so you start to think for that goal. how to think like one of them, and how to work like one of them. and as time goes by, you reach to that point. with a pat on the back, and a smile on the face, we congratulate ourselves on the last day of housemanship, ' congratulations for making it through ' and the nostalgic feeling of finishing SPM during high school rushes in back in you.

( the reunion with the lovely seniors during a friend's wedding )

personally??
as i said, wishing to end the housemanship with a bang,  everyone has their own story to tell,  especially being the first batch of finishing housemanship during this COVID season.

we all hope to finish housemanship in an elective posting ( postings with only seniors, and batchmates in the posting, ) and my preferred choice would be emergency department. but you cant always get what you want right? so there i was, in the orthopedic department. being a senior poster, so called impending legit medical officer, with 20 bunch of us.

normally, each posting will require at least 4 months of duration to complete, at least. but being a 6th poster, the last posting before becoming a medical officer, there is more pressure during working. as boss's expectation is for us to know how to work as a medical officer, and every petty mistakes will be considered unacceptable. i guess i dont mind that, as there is a room for improvement in every mistake made. and then there are those who became houseman after my time. and these people are probably aint that far in age, but experience wise, surely the newcomers have a lot to learn and catch up in comparison to us.




but hey, the sin of those who doesnt know is forgivable. if the newcomers doesnt know, its the duty of those who knew to teach, or atleast to tell. some may not have the decency to have a common sense to see things thoroughly. and for that, a lot of teaching, a lot of patience and ego swallowing situations must be endured. at some point, you are being taken advantage of.  but hey, its not my loss for other people's future sub-par endurance. haha

back to the story, early of March, on the early exposure of the COVID 19 pandemic, all of a sudden a patient was found to be positive in the least likely ward. and as per protocol, anyone in contact with the patient was forced into quarantine. including half of the medical officers and a number of housemans. it almost crippled the department's oncall system. and the solution for that problem was to absorb a few of the 6th posters as functioning medical officers.

there i was in the clinic doing the elective OT list for the next day, all of a sudden the following day, me and a few friends were already needed to function as a medical officer with 3 months training only, incomplete logbook, and unsettled assessments as a houseman (being a last minute man, i planned to study on the last month and get everything done by that time) and suddenly this happened. i wasnt quite sure how to respond to this calling. then i realise,

' YOU. DONT, HAVE, A, CHOICE'

i guess its just like any other hurdle you face before as houseman. realising that the only way to get things done is through, you take a deep breath and get it done. all of a sudden you are seeing cases in clinics instead of clercking them, coming for ward rounds instead of doing the morning reviews, and the scariest part was recieving emergency department's referrals for orthopaedic cases. No tagging period, no heads up. the responsible was different as you are now responsible for your own actions, and apparently your subordinate's action. a patient's management is under you, and making sure housemans dont screw that part is also on you.

non of us was ready for that sudden transition. bosses and former houseman colleagues are expecting us to know and function as if we have been doing all these level of job for a long time despite it being 1st day of working. and all of a sudden, the phrase ' life after housemanship gets better ' doesnt sound as assuring as it was. and all of a sudden the memories of the past came into thought

( Back to back champion of the annual surgical futsal cup. 

Last year won with peads, this time with ortho : )

a fond memory of my biology lecturer during foundation study of whom i couldnt really remember the name, but i can surely remember her habit. everytime before she starts her lecture, she will ask us;

' dalam kalangan kamu ni, siapa yang lepas ni nak jadi dokter?'

and quite a handful of people raised their hand, including me.

and soon she'll be telling the things that is not probably 'recommended'

' awak semua yang angkat tangan ni, tak payah la nak jadi dokter. awak penah ke tanya diri sendiri kenapa awak nak sgt jadi dokter? sebab parent? atau sebab memang awak nak? masa awak kebanyakannya untuk orang lain bukan untuk awak. keluarga awak lagi la.'

( foundation in science PI 060 2011/2012)

and this was her routine every-single-time before starting her lectures. and imagine having to listen to this 2-3 times a week for 2 semesters. surely those words got into some of our heads. and day by day, the number of hands raised get smaller and smaller. to a point its countable with the number of fingers. and among those that remained raising the hand persistently was me. probably that made me one of those people whom she remembers ( despite my grade in biology wasnt my best subject. haha) .

but hey, its just her opinion. and im not going to let anyone's opinion to become a fact just because most of the people agrees. if she could stand on her opinion, then i should also be entitled to my opinion as long as it makes me a better person. and surely along the way throughout the years , the frequency of this memory being recalled has been increasing. and at times, the thoughts of agreeing with her comes and goes. but it occured to me.

just because she was right, it doesnt makes me wrong. and that was then, and this is now. as humans we learn to adapt and move on. as easy as these words slips through my fingers and mouth, going through it surely is harder. but things get better when you get to choose on what really matters and what is not.

In the medical field, it is always a life long journey of learning from books, papers, and most importantly, what you go through day by day. and im thankful enough to know that i finished my housemanship with a group of people who are still eager to learn and help each other in time of needs and the latter. probably having each other is the main reason that eases the day, sparks the little joy that is enough to keep the day going and start again on the next day.

but the sad part is probably knowing the day that we have to go our separate ways in just around the corner. and again, the cycle to start anew is inevitable. and before that time arrives, probably the best way to deal with life is to just embrace every ups and downs. ending housemanship deosnt mean that you stop working or learning, it just made working and learning more crucial and life saving. and in addition to that. you are added with a task to nurture each other, and those who are in need.

So, does life really gets easier after housemanship?

 Unfortunately no, life wont get easier. but fortunately, it gives you more reason to go beyond.
have faith, with God, and His plans, always. have a blessed Ramadhan and take care everyone :)

(the last monthly department birthday celebration 

before the covid pandemic prohibits any mass gathering)

being better for those that really matter.

the rocky parts of a trip, the rough edges that bothered at the end of a clear streamed paper, the tangled and twisted ties on a long rope.
life gets harder as more and more of them being added . and i have to admit,

at a point it was rough.

facing the demons and fears that hindered people from progressing.
some of them are in the form of a flesh
some are just the devastating mind games that bothered more than it should.
you pushed it aside, at least most of it. but some stayed like a stubborn stain. and will always be there till we confront it

to a point, you turn to a new leaf and say: instead of refraining, lets try casting it aside. and all these insecurities at a point will be a hindrance or obstacle instead of a permanent barrier.

and after all this while you wondered what went wrong. you also wondered what was the right thing to do..
how could things be better instead of getting yourself whorled into the abyss that sucks the joy and life out of you.

but then again, as we long for the search of something that couldve actually solve all of our problem,
we forgot what(read : who) was there that made us able to bear everything up to this point..

the people that were there before, will be there now, and then.

those we tried to keep alongside us but are not there when we thought they would will just be a shell of hopelessness of something we thought we needed, but serves nothing rather than a burden to keep. some demands to be kept, but rains the life out of you until the point you said to yourself, let it go, and let yourself heal from the unnecessary burden.

and at that point, you look to the opposite direction and see, how vast the lands were. how the grass is truly greener. and how stupid you were for not looking into that direction before. youre not looking into a new direction. youre just going the where you were once where. where people genuinely cared, where people made it easier instead of asking you to make things easier for them.

and for some reason, it saddens me that some of them will probably not be there in the future.
though certain deeds are given and taken, exchanged on a daily basis, some can only be repaid by whatever goodness God may provide, or you doing it to there people ( just dont be mistaken by doing it to the wrong people )

i believe in goodness keeps a warm heart and steady mind throughout difficulty, and i hope everyone (including me) will be able to give more than what we got. Hopefully with age, comes wisdom. and with wisdom, youll try to be better for the right people that matter..

pampered for a closure

Remember during those high school days. where we/d be scared by seniors who said that additional mathematics are super hard? to a point where single digit marks in exam seems acceptable. and failing is a norm. to a point where  you start questioning yourself, is it that hard? is it that scary? but when you actually go through it, its just like any other subject. you put effort to it. its actually doable. pretty sure the teacher wondered the same back then. haha..

and that is probably the easiest example i could give to express on how i felt regarding entering the emergency department (ED) . most of those entering this department, entered as a final poster. the last pit stop before the housemanship era ends. but for some of us, we entered as the second last pitstop. making us a bit vulnerable and inferior in terms of exposure. and seeing how the seniors relentlessly complain about the lifeless life in emergency department made me wonder on how to survive in such a high intense, adrenaline pumping situation kind of place.

but hey. Im a believer. always remind my feeble self,
in every cloud there's a silver lining
Allah puts you in the hardship that you are now not to show you your capped limit, but to show what you are capable of, and if you believe in so, maybe you were meant for more right?

the gloomy clouds..

all the previous places during working in the ward had an organised working flow. you settle the patient's issue in the ward, once they get well enough. they're allowed to go back, and we can arrange for another patient to be admitted in the ward and the cycle continues. with the limited beds and extra temporary beds allocated, we could roughly estimate what needs to be done and by when the 'chores' would be done. and to make things easier, the works are well distributed accordingly among colleagues, nurses, bosses and everyone understands and knows which work is theirs and which is another. a cog in a well lubricated clock, moving at its own expected pace, sometimes it gets a little rough. sometimes. but the job ends when the day ends.

but the emergency department proved that work ward is not comparable. showing the true nature of what this field has to offer. its a messy and chaotic place. people just keeps on coming in regardless the time. some are on the verge of dying. some are on the verge of anger, some are just there because of the sick leaves they wish to apply on the following days. to make things worst, many cant go up to the ward because of the ward is already full, hence they're stranded in the emergency department. an you take care of them as how you have to take care of them in the ward, in addition to the work you already have.

theres no such thing as fully occupied emergency department. everyone is entitled to healthcare. hence we have to accept all the patient. 3-4 patients will come in every 1 hour. (too bad patients dont get sick only during office hours)and you still have to see all of them and make sure they are all treated equally, and on time. in addition to that, the number of patient sometimes, can exceed more than the number of the total bed an chairs we have in the department. i feel bad for the patients who can only sit because of we dont have enough bed. i feel bad at times when a mother brings a sick baby, but no privacy for breastfeeding. and most of all i feel bad for myself for neglecting my basic needs for time to pray, eat, and family because of what im doing.

staffwise?

the ratio is obviously inappropriate. due to understaffed, sometimes you have to do all the works yourself most of the time. this includes the nurse's job, the PPK's work an etc. in short, youre responsible for everything to keep the place running. what ever 'systematic distributive flow' you knew in the ward means nothing in the emergency department. an ironically, should anything goes wrong, youre held responsible and the blame cannot be shifted to other personnel. how wonderful. and to certain family members of patient thinks that its like a nursery, where they drop off their parents, "orders" us to take care of them, and should anything go wrong, tax payers has every right to complaint later on. oh well.

the hippocratic oath,
finishing medical school we took the oath of " do not harm " and to treat as must. and this oath haunts us in everything we do, knowing everything that we do may affect the quality of life of a patient, and the death or cure of a person can sometimes makes us stutter and doubt our own mind.Not to mention, forcing to make decisions with an overworked brain in long stretched working hours, an empty stomach, on a daily basis makes more room for error that could affect a person's life or death matter.

patients?

ill be lucky to have a patient who understands whats happening in the department. those who actually knows that what we are doing there, are what we are supposed to do. and on very special occasions, and if im lucky enough, ill get patients who actually thank us for our effort. but most of the time. Everyone that comes to the hospital thinks they are the most sick person that requires immediate treatment and every second attention. and seeing so many other patients in there, they could casually ask us questions that could test our patience, repetitively.

"doc, bila saya bole balek?" ( auntie you just came, i just took a few blood of of yours,process takes time )

"doc, bila saya bole naik ward? sudah satu jam saya tunggu: ( pakcik, org lain ada tunggu 2 hari tak naik naik. )

"doc, knpa xray lama sangat tunggu? kaki saya lama dah sakit ni ( theres only 1 x ray room, and theyre doing xrays for unconcious, and more fragile patients, is it not obvious who is priority?)

"doc, pakcik saya apa cerita? ( so now i have to tell everything to EACH family member, and you cannot discuss among yourself? as if i dont have other things to do )

"doc, tolong tukar kan pampers ayah saya, dia dah berak: ( and changing diapers are not part of the healthcare system as i recalled? wew )

"doc, saya batuk dah 3 hari, nak mc boleh?" ( and you decided to come at 3am for this?) 

If only the patients and their family knows, we are doing what we could. If only they know we treat everyone the same because everyone matters. just because you have a certain person in higher hierarchy above us, it doesnt change your privileges in the emergency department, simply saying, just because you pay taxes, the place doesnt change from a hospital to a hotel.

let me try to explain one thing that i think, most of the community failed to understand. and that is the rationale and how the emergency department functions, Its called emergency for a reason, it is something that you have due to emergency problems. up until today i cannot understand why people still come because of something that has happened last week. but regardless, if you come, we will treat you accordingly. part of the system's job is to identify which zone youre supposed to be in , green, yellow or red. each with different waiting time. and to allocate the patient, is not the patient's decision but the ED's staff. everyone will claim they're be the most sick person to get attention. my guess is that if we do entertain them, then its not fair for those who really need more critical attention right?

imagine, 1 person comes, and after asking the necessary questions an we took a few bloods and other investigations, it should take time before all of the results came out and in the mean time, the medications and treatment that can be given has already been given. though after the blood results came out, there may be additional medications and further workups must be done. then afterwards, doctors from the ward may need to see the patient to see if the patient should need to be in the ward or can be treated at home. and when theres an indication for admission, then the patient must await his/her turn until there is an empty bed in the ward. in the meantime anything can happen. a stable patient may deteriorate. suddenly a patient's conciousness can drop, or other complains from the patient may require urgent attention.
for 1 person that comes to ED may be processed within 15-20 minutes, things aint that swifty when 2-3 patient comes every 15 freaking minutes.

after all of this day in day out. im lucky enough if i get to pray ( luckier if able to pray ontime ), maybe ill get something to munch in between, maybe ill get to sit once awhile. maybe ill get to end my daily 12 hours shift on time. but here i am, compensating all of that. as long as all of the patients we treat, doesnt die, as long as theyre unharmed by incompetency and sub-treatment.

some people break at some point. some required extra time to adjust. some throws a white flag and decides" i dont care, i cannot care anymore "




But the silver lining is somehow, worth the menace and trouble.

 through all the troubles i went through, i didnt went through it alone. i went through it together with other people whom has been through with me since day 1 of working. in other words, we have each other to get things around easily and help each other. non are a stranger, and non is a foe at work. and most importantly, the essence of ' lets get this done and move on to another' felt more approachable  when you're working with friends, instead of colleagues whom youd probably known and worked with ever since you started doing this kind of jobs 1 year ago. the comfort zone that understands how painful it was not being able to adjust accordingly to the pressure of work, and how it gets better when you go through it together,.

and this train of thought was similar to the ambient that the bosses try to provide. knowing how stress wok can be. the bosses adjust accordingly to try and minimise the daily punishing mind games. cut the nonsense crap of scolding, and embrace the teaching part. we did mistakes because of something we dont know, not because of negligence. and for that the cure is to teach, and to tell instead of scrutinise.

and experience, it comes from a lot of other place if you let it. and this kind ambience indirectly says to you " its a messy place. but we could all work together to keep the good vibes and survive another day" sometimes in the deepest stress your having during the day, a good vibe and a person to come to you and say "its okay, we'll do this together" is all that you need to hear to keep you on track.

and of course, the best way to beat the stress is to get out of it once in awhile. The understanding, and flexibility of the schedule allows you to take a breath outside, reconcile and enjoy the moment. The best part of it is able to do it together. By the Grace of God i was able to travel, the best part was not about the destination, but the company. i could not have asked for more.

but the past of a journey is always the take home message that you could gain.

so often a phrase is popped out in my head everytime i get pissed of something.
" every decision that you express during anger, will always end up in shame. "
and i learnt it in the hard way.
as how i recall it, i remembered that i was in a pressured place and time, as a few patient that needed consultation in a time. then comes an old man asking me, " dokter, saya kene tunggu berape lama lg ye??"
and i raised my voice while replying to him;
" encik, kalau semua orang lain boleh tunggu, encik boleh tak tunggu kejap? sampai masa saya akan panggil encik, ok?"
" oh, ye ke, baiklah, maaf dokter, saya bukan apa, saya datang dari teluk intan naik teksi, teksi masih tunggu. saya dah takde duit nk balek kalau lmbt sebab tambang teksi sekarang mahal. " and this conversation occurred in front of everyone in which the conversation ended up with a glaring of stares from everyone to me.

at that time it struck me awhile. i know ive seen insensible people who would just ask us to see them fast because they just hate waiting. and most of the time they think  that the doctors are just sitting and not doing anything.
but this guy is actually needing me because of something  that is troublesome to him. of all the people for me to snap to, i ended up snapping to the wrong person. probably Allah just wanted to remind me one thing. be tolerable, be understanding, as you know you also would want the same if youre on the other end. hence, everytime i almost snap, ill try to find 1001 reasons not to. and believe me, once you realise how to keep the temper cool, you'd thank everyone for being a part of the journey. it was not easy. and maybe at some point requires all the help you could get from your surrounding.

and for all the mentioned reasons, ill say that i was pampered with what has been bestowed upon me, during and after work.. i see the blessings of what time was able to provide despite the hectic schedule.to a point ill say to myself, " trust the process, and trust God with His plans more than you trust your plan. and see how miracle unfolds. "

So if theres anything important that i could take note from this year is, to keep an open mind. everyone can define what is happening to themself and reflect their understanding to you. but that should not affect your judgement as you have your own conscious and surely you hold no accountability towards their opinion, a steady conscious with a right mindset is possibly all you need to keep on going even if the whole world is possibly saying no to you.

for all the blessings i had towards the end of 2019,
i hope that i may be more understanding towards other people, give chances, and listen to people. some of them just needs a set of ears just to be heard.
i hope ill be able to retain all the good values that has been reflected towards me. and not let it rot with whatever bitterness that the world tries to pollute me with in the future. people learn to adapt to a point they think they matter more than other people. such toxicity. such disgrace.

and last but not least, I hope i can pray 5 times a day and prioritise what is needed to, and realise there are things that you need to do, and what you want to do. if you keep doing what you need to do, the end the process of what you are doing is not a journey. but an expected routine.

lets go beyond, lets go for more shall we? :)

(P/s: sharing a few pictures during the 4 months of of working. happy pictures only, pictures during work can spoil the mood xD)