30 April 2008

Malaysian Hospital series 0002

Dealing many times with the hospitals, both private and government taught me many things on hospital’s procedures. Even though people will say private hospitals will have everything to be done in a short period because of the money, and so I will deny.

In the case of a close friend, trauma case (trauma = accident), the whole family involve in the accident. Some were bring to government hospital and some were bring to private hospital by the layman. In ‘that’ government hospital (not to mention where), any emergency procedure were done only when the family members were confirmed to have the money to pay for the diagnosis and treatment.

Compared to private hospital where treatment comes first no matter what (they cannot assume whether the patient could afford to pay or not because it was an emergency case and the accident took place near to their hospital, thus the victims were just brought there). It was sad for me to know that the staffs of that government hospital would rather did not do anything in order to save the patient but they only wait till one of the family members of the victim who came to visit said something to the doctor. It goes like this,

“Awak ingat ayah dia ni orang susah? Gaji sebulan 15 ribu dalam tangan je!”

It was just to mention for them to make necessary actions (read: maybe dah geram, tahla), but that was true. Only then they make up something which is too late to be done. The other son was then being transferred from that government hospital to the private hospital. Once he arrived there, the private hospital quickly did the necessary diagnosis and treatments without bothering on other conditions.

The little sister also been sent to the government hospital. The doctor in charge at the A&E (the doctor was pregnant). She instruct to the radiology department to have a CT scan to the brain as the blood comes out from the mouth. But no abnormalities found in the brain. So the doctor just said,

“Kami tak dapat jumpalah kat mana bleeding dalam badan die.”

“Cuba scan badan pulak, mana tahu..” The mum replied.

“Doktor, cuba scan perut, bleeding dalam perut kot.” This little kid, her sister is a medical student studying at the university near the hospital requested to the doctor.

“No, kalau bleeding dalam perut takkan keluar ikut mulut, keluar ikut bawah je.” The doctor replied.

And she just leave the kid like that and said, nothing could be done as they cannot found the bleeding site. I do think rather than just waiting, it is always better to continue the diagnosis. The kid is someone’s daughter and someone’s little sister. Nyawa manusia ni, sangat berharga la…. After dah lama, only then the doctor slowly talk to the family,

“Betullah ade bleeding kat usus, sekarang takleh nak buat ape dah..” Best je inform the family members.

And the family lost the kid, she is only 7 years old and very adorable. I am really sad..yes I am. I am sad as she died sebab the doctor give up and did not continue further diagnosis, as long as she is still alive at the time even nyawa-nyawa ikan. That was my opinion, I don’t know what exactly should be done and what not to be done as a doctor. I mean the procedure at that time. Or is it only me yang sangat terpengaruh dengan ER drama series or what..??

Just a part of my friend’s story which I would like to display here for sharing, I don’t have the gut to share more on what had happened to other family members in the hospital. It was not the matter of money actually; it was the matter how keen you are in order to make patient’s life better and to make them alive. And not giving any extra harms. It was an issue of having this and this procedure, for the sense of giving trouble to others. But there was and always certain government hospitals which really have good conduct and practice. Yes, there are.

And for this case, I do not know what to say. Surely family members terkilan, and the doctor, maybe sedey, regret. And the brother of the kid keep blaming himself saying that he caused the death of her little sister. He himself received banyak2 jahitan kat muka, teruk, taknak jumpa sape-sape. And the family is in traumatic mode for few months. Tambah lagi, the kid, banyak shown up "tanda-tanda nak pergi..." before the accident. She goes just like that....I guess. There's always hikmah behind each things decided by Him. Wallahu khairul maakirin..

Clinician’s view: I myself cannot think what actually she is thinking, do you have any idea??

Patient’s view: I’m not giving up yet, so please don’t give up on me. Maybe she said like that or what..??

Wallahu’alam, a reminder for me and for you. Till then, wassalam.

P/s: to be continued on the next series, inshaAllah

29 April 2008

Malaysian Hospital Series 0001

Malaysian hospital series 1 - the IM injection

When I've been sent to the A&E (Accident & Emergency) department, again that morning, this early April, as usual they transport me to the critical/less critical observation room using the stretcher. Even though I am about in an unconscious condition, but I try to focus on their conversation in order to get the updates. The doctor asked me few questions and I hardly answered them, having to repeat my words few times, and end up with misunderstanding. I do think they could easily dig up everything from those who accompany me (Najwa & Bro Halim) to the A&E rather than asking me on my condition.

I was at that time vomiting non-stop and having terrible pain in the brain. I cannot lift my head even a bit and need to be in recumbent supine position (baring kepala mengadap atas) in order not to cause greater pain in the brain. Mengiring pun tak boleh, duduk pun tak boleh, ape pun tak boleh. Hanya baring sahaja dibenarkan oleh kepala selama hampir 3 hari. That was actually due to a procedure i received few days before in the ward.

Then, I heard they wanted to do the IM (intramuscular: which means within the muscle) injection as the first procedure to reduce the pain I suffered of.

“Please, no...” I refused slowly right before they take out the drug (sambil geleng-geleng kepala kot). Few times I refused as they kept arguing with me.

Firstly because it will lead me to vomit, this is the effect of some drugs to the body. At that particular time, I already vomited non-stop every minute. Hence, considering my own QOL (Quality Of Life) for not giving extra harm, so I refused to. Even I did not know what type of drug they wanted to give, but I don’t care. I am afraid it will become worst, I will vomit more. I prefer to bear with the pain rather than having some more drug and keep vomiting.

Secondly, as you know, IM injection is very much painful, during and after, even this is not realy the reason why as Im used to the injections. IM is not like the pain with IV (intravenous: within a vein), it is very much different. Instead, IV is actually not painful at all. I am not really sure why IM is much more painful as I’ve seen many people end up with tears after IM injection. And I myself have experienced of IM many times, previously it was given to me at least every month.

In addition of that, the night before, the doctor on duty already did the injection for me through IM at the A&E. After that she let me go back to UIA and requested me to come back tomorrow morning if it’s becoming worst. It did. Thus, there I am the next day with the half conscious condition. I went only after a very bad condition. The bloody-minded me (read: degil).

So, that was the third reason. Even though, the doctor still argued with me. For sure I did not give any reasons, just refusing (read: geleng kepala). I do think the doctor should understand why, just by looking at my condition and applying the patient’s QOL without having to ask to. If not, after the injection of the drug through IM, they need to give me another injection to reduce the vomiting (fast action rather than orally) [please correct me if I am wrong].

I wonder why IM injection is painful. For some people, the pain is still there for two to three days later. From logical assumption with some friends, it might be due to the reaction of the drug as IM would not caused pain if it is done properly (read: ye eh..? What does it mean with proper technique?). For IV, logically it would not cause any pain as it goes through the blood vessel. Aite?

Just logical assumption, I tried to search, but did not found any information. So, this is only one part of it which I wanted to share. I guess I’ve talked a lot about needle, syringe and so on in my previous post. Yet, this is not the last, there will some more soon, Insha’Allah, in another sharing corner, because sharing is caring.

The moral value? Maybe before taking any further actions, we have to consider patient’s condition. Something which is looks necessary is not always right. This could be applied not only in the healthcare field, but also in our daily life. Again, patient is a living entity. Thus, please beware!

Wallahu’alam, a reminder for me and for you. Till then, wassalam.

P/s: to be continued on the next series, inshaAllah

Declaration on Malaysian Hospital the Series

Declaration :

I will create posts on the Malaysian Hospital in series, slowly. This series is specially devoted to all healthcare-professional-to-be, everyone who deal with patients (i.e: Doctors-to-be, Dieticians-to-be, Radiographers-to-be, Nurses-to-be, etc). Basically it is based on my own experience as a patient and my understanding as a healthcare-personnel-to-be. My experience, how I deal, what the procedure, what they did and anything regarding the issue. With the main aim to improve the quality of a personnel, and for patients to understand.
Dan bukan untuk mencari kesilapan. Kemarahan itu langsung tidak wujud, sekadar perkongsian untuk yang lebih baik, akan datang. Dengan izinNya.

If you are a non-medical-related-person, Insha’Allah you could understand this Malaysian Hospital series. May this series gives benefit to you especially to the healthcare personnel. I will display the cons instead of the pros, for us to value and to avoid the unnecessary procedures, Insha’Allah (sebab yang bagus-bagus sume ade dalam buku, yang tak okay maybe tak terjumpa, thus, here it is, in this continuous series).

Alhamdulillah, Allah gives me the advantage of having both understanding and experience as a healthcare personnel and also as a patient. Thus I wanted to share the things which is not in the book, I guess. Trying to have the empathy, understand others and to be understood. Both sides, the healthcare personnel and patients.

It's hard for me to reveal my stories, but inshaAllah for our benefit and for us to change the view in the future. I hope from this series, we can try to avoid giving extra harm to patients and avoid unnecessary procedures. Because what's being learn is not necessarily applicable to all conditions, and also what's being learn is did not been applied, for many times.

I hope Allah will guide me and ease my path, helping me to benefit the ummah even with a very small contribution. Moga dalam redhaNya. May Allah gives me the strength as it cause me in great pain even to type the posts. Huu..inshaAllah I will try, continuous, but not so often. Various issues, but in random. InshaAllah.

I have no intention to show others' mistakes, or pointing hand to others, this series is just for sharing, as sharing is caring. Manusia melakukan kesilapan, itu pasti, namun harapnya, selain belajar daripada kesilapan sendiri, kita jua belajar dari kesilapan orang lain. InshaAllah.
I am ready for any critiques from you guys, and please correct me if I goes wrong. Thank you very much. Wassalam.

P/s: I hope KKM wont sue me, hehe.
(KKM = ministry of health -> in msia, it is known as KKM among healthcare personnel)

Wallahu’alam, a reminder for me and for you. Till then, wassalam.

23 April 2008

Malaysian Car Boot Sale..??

Car boot sale boleh dikatakan pasar tani British, yelah sebab Malaysia pun ada pasar tani juga. Jualan bonet kereta ini adalah untuk orang perseorangan menjual barang-barang baru dan juga barang-barang terpakai. Tetapi kebanyakan barang-barang tersebut adalah barang yang sudah digunakan tapi tidak lagi diperlukan oleh pemiliknya. Jualan ini bertujuan untuk mengumpulkan sejumlah besar orang awam di satu tempat, supaya mereka dapat menyahut seruan kerajaan dalam kempen kitar semula (erk, ini jika di Malaysia), dalam konsep membeli atau menjual barang-barang yang masih berguna tetapi tidak diperlukan lagi, yang sebelum ini mungkin dibuang begitu sahaja.

Ini hanya berlaku di United Kingdom (UK) dan mungkin United States (US), tetapi saya rasa Malaysia juga sangat patut mengadakan jualan seperti ini secara besar-besaran. Sikap rakyat Malaysia yang suka membazir memeningkan kepala Jabatan Alam Sekitar. Terlalu banyak barang yang masih berguna dibuang begitu sahaja. Mungkin susah hendak mencari siapa yang mahukan barang tersebut, mungkin kerana itu nasibnya berakhir di tong sampah. Jika adanya jualan seperti ini, kan lebih mudah, barang terpakai dijual kepada yang betul-betul memerlukan dengan harga yang murah. Semua rakyat jelata akan belajar untuk berjimat, tidak membazir, dan menghargai barang-barang terpakai. Malah, rakyat yang kurang mampu juga boleh mendapatkan barang-barang yang diperlukan dengan harga yang murah.

Saya banyak kali berbicara dengan teman sebilik yang lama menetap di UK mengenai perkara ini. Seringkali isu yang diutarakan adalah mengenai buku-buku terpakai. Satu lagi sikap rakyat Malaysia yang sangat banyak sudah buktinya, suka bersikap protektif (baca: protective) dalam melindungi buku-buku lama. Maksudnya di sini, buku-buku yang digunakan untuk belajar dulu tidak kira di mana-mana peringkat sekalipun, akhirnya buku-buku tebal itu berakhir nasibnya di dalam stor. Asal-asalnya, sayangkan buku untuk diberi kepada yang memerlukan, ataupun dengan sebab mereka masih akan memerlukan buku tersebut suatu hari nanti dan berbagai-bagai sebab yang lain.

Akhirnya tinggallah buku itu tidak digunakan dan tersimpan begitu sahaja. Masa makin berlalu, hati pun telah terbuka hendak memberi pada saudara mara dan kenalan, sayangnya buku-buku tersebut telah keluar dari masa (baca: out of date). Tidak lagi selari dengan pendidikan terkini kerana ia edisi lama tidak dikemaskini. Dan pengakhiran sekali, terpaksa mengucapkan selamat tinggal kepada buku-buku tersebut di penutup tong sampah. Sayang sekali ilmu tidak digunakan.

Antara sebab lain berlakunya pembaziran seperti ini adalah kerana tidak tahu kepada siapa hendak diberikan, tiada yang nampaknya memerlukan. Ada juga yang memberi begitu sahaja kepada siapa-siapa, akhirnya yang mendapat pemberian itu tidak menghargai apa yang diberi. Di sinilah kepentingan adanya jualan seperti ini di Malaysia. Banyak sangat kelebihannya jika hendak disenaraikan. Malah, sesiapa yang mahukan sesuatu barang seperti buku contohnya, akan lebih menghargai kerana buku atau barang itu dibeli, bukan didapati secara percuma. Diguna dan dijaga sebaiknya walaupun barang terpakai.

Siapa yang mahu cadangkan kepada menteri-menteri ya..? Walaubagaimanapun, sukar untuk membuat perubahan di Malaysia, tetapi tidak mustahil. Sementara berlakunya perubahan itu, sebagai rakyat yang berhemah, banyak yang boleh kita lakukan untuk mengelakkan pembaziran. Bersikap lebih memberi, lebih pemurah. Jangan terlalu sayangkan sesuatu yang tidak lagi kita gunakan. Selagi mana ianya berguna, hulurkanlah kepada yang lebih memerlukan.

Pesan untuk diri yang sentiasa alpa.


20 April 2008

My prayer

My prayer for my future career

Ya Allah,
Give to my heart
Compassion & understanding
Give to my hands, skills and tenderness
Give to my ears, the ability to listen
Give to my lips, words of comfort

Please, give me Ya Allah
Strength for this selfless service
And enable me to give hopes
To those I am called to serve


It was my prayer for my future career, for my future patients. I hope I could be among the best healthcare providers, who will always give comfort and no extra harm to patients. I think my experience as a patient taught me lots here. To treat not only physically, but also spiritually.

Please give me the strength Ya Allah.

Being offered by my HOD to change to any other courses at the end of the previous semester, I do think a lot and still now. It was due to my sickness that he afraid I couldn't cope with the future career. I think this what been fated by Him. We couldn't always get what we want, but try to adopt first and then adapt the thing we get now. That's the best we could do.

It is not necessarily for me to be involved in what I am doing now (my course), I can always make a master in any other fields which is course-related or not. That was only an option, but for now, I am glad to serve for human health, for a better life. The clinical part taught me lots, and I am looking forward for the other one very soon. It doesn't mean we have to make them very healthy, but at least, healthier and better life.


19 April 2008

Kata mereka..

Mereka bertanyakan keadaan diri saya, saya jadi bingung, cara apakah yang terbaik untuk saya khabarkan.

"Macam mana sekarang, sehat?"

Ini soalan pembunuh (killer question) buat saya. Tak dikhabarkan pun ramai yang tahu, entah dari mana. Biasalah, sahabat-sahabat banyak yang mengambil berat (concern), mungkin. Tahu mengenai musibah, dikhabarkan kepada yang laen, harapnya beserta doa.

Saya tidak khabarkan, tetapi saya menulis di blog pula. Tidak mengapa, sekurang-kurangnya saya berkongsi, dek kerana suka memendam rasa. Terima kasih buat yang melawat setelah saya diletakkan semula (warded) setelah baru sahaja dibebaskan (discharged) dari penjara di katil putih beserta jarum di tangan yang setia. Ia begitu setia, kemana-mana sahaja bersama saya. Tidak dilupakan botol normal saline (NS) @ sodium chloride yang sentiasa berganti, patah tumbuh hilang berganti.

Duhai doktor, saya tidak perlukan pengganti NS tersebut. Saya telah dipaksa menelan makanan oleh sahabat-sahabat. Saya cukup kuat untuk hidup lagi, sodium chloride boleh saya bancuh sendiri di rumah. Itu kata saya, kata doktor..? Susah untuk mereka percayakan pesakit. Melainkan seorang doktor yang saya temui di katil putih sebelum kali ini. Dia doktor atau malaikat..?? Tanya saya di dalam hati.

Moga Allah berkati kesemua doktor-doktor, kerana mereka sibuk untuk pesakit. Saya faham, saya mengerti, tetapi ini jalan yang dipilih kalian, maka mengapa menidakkan..? Kamu memilih, kamu patut mendalami, bukan lari. Moga generasi kesihatan dan sains perubatan (health & medical sciences) akan datang lebih mengerti hakikatnya seorang pesakit yang juga seorang manusia, punya hati dan perasan. Merawat bukan sahaja fizikal, malah apa jua yang di dalam.

Saya berkata-kata kerana, saya juga bakal menjadi seperti mereka.

Mengenai kesihatan, alhamdulillah, makin baik makin diberi nikmat, walaupun masih dalam kesusahan untuk sujud padaNya..


13 April 2008

the story after..

When children learn that suffering is not eased by self-pity but overcome by spiritual strength..and that even though time and hardship may ravage one's outer shell, they can enhance one's character and perspective. When children learn these ideas and how to practice them in the art of good living, they will no longer be as child..

I'm a child before, and still now.

This time around i've been warded, i learned something which made me wanted to know the stories behind. But i know my limit, until there, full stop. Let Allah take care the rest of the stories.

I've met lots of doctors since I were a kid, many more after secondary school until now. But, this one doctor i met in the ward impressed me very much (instead, not only me..). Till the day i said,
"Ya Allah, aku dah tak sangup nak melihat kebaikan hambaMu ini.."

Dia bukan lagi manusia, bagi saya. Tapi saya kehilangan kata-kata untuk mengambarkan dirinya. Dia memegang utuh amanah menjadi seorang yang merawat pesakit secara fizikal dan spiritual. Until one of my friends said,
"Doktor ni takde life ke, 24 jam ada kat ward..dahla sangat baik..3-4 pagi busy layan patient lagi.."

Heh, is it 'that' doctor acting like an angel, or we actually lack of 'good' muslim's doctors till we've been so impressed when we meet 'this' kind of doctor..?? I think i need to interview my friends. What's your say..?

It's not to say that you doctors out there should ignore you own needs and just focus to the patients, you know the limitations aite..? But rather you are dealing with human..benda bernyawa yang ada hati dan perasaan..i think there's no need for me to talk more, you know better what i mean. You learn medicine, not me.

JUst macam a bit kelakar jugak, warded, discharged, then not a day yet admitted back. One thing I learned, DONT EVER BEEN WARDED, AGAIN! It's painful to be there, seriously. Everytime warded rase pressure amat. But till now I'm stressed. I hope at least I can stand on my foot for few hours without having that terrible pain inside my brain. I do hope, but from Allah everything comes and and only to Him it goes.

Luckily my mum was'nt always at home which she cannot predict how pale I am (even she did ask when i just lying flat all the day, i did just say im tired driving alone). Alhamdulillah she cannot detect how suffer I am right now, nothinng could be eat, cannot get up for long and rarely talk. I did not say she abandoned me, she did care to me very much until I am very much worried to tell her that I'm sick. I will inform her, but not now..

Along the line until now, I pray that Allah will give me strength (which decrease and decrease right now..), provide me path to hold on and take the pain out of my soul. I really hope so as I have many more things to do. And the most important thing, I don't want my mum to see me sick. I wanted to be in a good health to help her.

For those people who blame me since yesterday, THANK YOU for the pressure you give me when I am still in the ward. THANK YOU for the'nice' words even though you did not know anything...ah..I am very mad to you all guys. Yes I am. THANK YOU VERY MUCH. I dont care who you are, but if you are really human, you will think of my conditions at that particular time before your word goes out!


Ya Allah, for at least, please makes me bearable to the pain. Please makes me able to walk, I dont care if the pain still goes on, but at least, I hope I am able to get up. Please Ya Allah, aku pohon dengan sangat...pohon dengan sangat..la hau la wa la quwwata illa billah..
I know I always ask for many things Ya Allah, but for this time..i reall hope I can get up as usual. Please, please, please....ameen..

p/s : DO forgive me, everyone..memang i dun wanna tell anyone i'm warded, but then still spread out, do forgive me as it did not come straight away from me myself.