Wednesday, December 24, 2008

Santa is coming to town....

Again, I am doing my night shift this week. The first night it was quiet at the beginning so my registrar left early. I don't know what happenned after that, like a punishment from God, after midnight patients started to come in continously. I was like 'Why! oh! Why!, Get a life, people, go to bed!'Some of the patients didn't need to be there at all. For example, there was a young guy, why on earth he came in at 2 am, waited for hours in AE with 2 years history of unchanged presentation of haemorrhoids/piles. He needs to go to a school of common sense with his GP, who had been treating his piles, who also should have sent him to a surgical clinic rather than wasting his time coming to AE. They all expect for magics to happen in AE as easy as saying 'zoom zoom ala ka zoom, 1,2,3, it's done'. Not a hope. Not even during Christmas time. Ask Santa!

Talking about common sense, it also reminds me of another patient, a foreign national, who kicked and punched a window after finding out his beloved wife had been sleeping with his neighbour. He ended up with a cut on his hand and a broken foot. To make matters worse, it was an open fracture on his foot (broken skin with a broken bone underneath it) which meant he needed a surgery and a course of antibiotic as the wound is at high risk of infection. I thought my work with him ended at that stage...to be taken over by the orthopaedic team. NO! No! No!. That was not the case. I had to spend 10-15 minutes to persuade him to stay as he refused any treatment. Eventually he discharged himself against medical advice. He was more concerned about getting back to his home country next week. He may have lost his wife, and now beacause of his stubbornness, he might lose his foot. Where is the common sense? Would you blame his wife for sleeping with another guy?

Dealing with a difficult patient is one thing, with a difficult relative of a patient is another thing. Different approach, hoping for similar result, preservation of my own sanity. Both need patience, abundance of it. I didn't know I had it until I work in AE. Being patient and calm is vital in order to survive in this crazy environment.I had one relative of a patient 2 nights ago, who kept aproaching me every hour, asking for different things either for her husband or herself despite the fact that I was busy dealing with 3 different patients at the same time right in front her eyes. Among the many of AE staff, she somehow managed to grab my attention. Why me? Am I that good looking? I was like 'go away, your husband is not the only patient here'. But of course I didn't say that to her. She was the same woman, few hours earlier, threatened to sue a nurse after her husband fell from the hospital trolley. Poor nurse, it was not her fault at all. It just happened the nurse was first came to rescue her husband from choking of his own vomit after the fall. Due to this person's selfishness and being inconsiderate, the nurse was worried all night and couldn't concentrate on her work. There were many more patients for the nurse to see, and many more hours to go. Thanks, madam, for your wonderful gratitude!

I really hope santa is coming early this year. I know what I want to wish for. The return of common sense to humanity. If only he exists.......

Thursday, November 27, 2008

Fingering..........

24.11.08
At work now. Not busy.
I have to write down this story. I am not sure if I should but I will. Yesterday at the end of my shift i examined a guy, way beyond 50 of age, complaining of chest pain. He came in wearing a cowboy hat with zebra printing, yellow in color, looked hideous on him. Noticing his large plastic bag which contained clothes I asked him where he was going. "From A to B, doctor". I asked what for, out of curiosity. Bluntly he answered "because i am looking for a woman, doctor. Each time i see a woman my penis got an erection." He said it out loud . Shocked by his answer I said "You are a dirty old man" straight to his face. Likewise he was speechless for a moment but managed to grin at me which surprised me. I expected him to punch my face or swear at me for calling him that way. He then continued the conversation about how much he liked sexually women from different ethnicities which disgusted me. I had to walk away from him to avoid further irreverent remark about women. Some of the nurse came to me right away to get confirmation of what they had heard. They all looked disgusted and in agreement with me for calling him that to his face. Thinking back I shouldn't have uttered that remark to him but I just couldn't help myself. At least the nurses they all were on my side. I have to be careful with my mouth next time.


This is the thing working in a&e where I get a chance to see different kind of people from different background which requires me to adopt different ways reacting to situation. Good communication is the key to get things done the way it should be done. Lack of it we could end up with unforgivable mistake. Sometime unforgettable situation.


I remember two days ago, I saw this guy with a swelling underneath his scrotum. After examining him I found out the severity of his condition which needed a review by the surgical team. So came in the surgical house officer. He put his glove on and told the patient he wanted to see the lump without telling the patient first how. Half naked, lying on the trolley he grabbed his thighs with his hand and pulled it up to his belly and spread it open like a woman trying to give birth. And there you go, looking at him exposing clearly a large lump between his balls and his asshole (we call anus), dark red color and bleeding. Not a good sight. The problem is, that was not the way to do it. The surgeon could have explained it better.


This reminds me the incident 3 years ago when I was a registrar in psychiatry. I was asked to do a rectal examination on a guy with an anal pain. Right the minute I said I wanted to examine his back passage, without waiting further instruction, he quickly pulled down his pants while standing, bent down, put his hands on each butt, spread it open and said "I am ready doctor". I immediately said "No, no, not that way. You have to lie down on the bed on your side curled like a baby and I will cover you except your butt then I put my finger with a jelly on it."


I still laugh every time the incident cross my mind. The same effect it had on me when a friend of mine, also a doctor told me he had to see a patient complaining that something stuck in his back passage. After an xray comfirming the location of the foreign body, the surgical team finally managed to extract the thing. Guess what, it was a vibrator and it was still vibrating when they took it out. Yes i said it right, it was a he. Don't asked me how the vibrator got in up there. Again, use your imagination, and please don't be judgemental. Accident happens!

Monday, November 17, 2008

Work? Nothing exciting. Same old story. Overcrowded. Understaffed. Same talk, no action. I am doing 8am to 4pm shift till Friday then 8-8 for the next 9 days. Sure. No problem. Bring it on. I think not, but I don’t want to think about it a lot. Just get on with the business.

On the way back I did a stupid thing, still laughing now when thinking about it. I refilled my car fuel tank when the fuel indicator started to blink. While doing the refuelling, I was thinking about getting a Chinese take away as I was so hungry. At the same time, I was thinking about the next project at work. In addition to that, I was thinking that I was still angry at my so-called friend for the event that happened yesterday. Too many things in my head, you know. By the time the price for the fuel on the pump hit $40, I decided I was not getting the Chinese food, decided on the topic of the work project and contemplating to forgive my friend. Put the pump back and drove off......

Well, that half of the story, the other half is this. By the time I got back, while parking my Opel Corsa, out of the blue, I remembered that I might have forgotten something. I checked my wallet, and there it was, confirming my suspicion. The $50 was still there. I had forgotten to pay the petrol. I cursed myself with every dirty word came across my mind. I ran upstairs. In the apartment, I tried to act cool. The first thing I did was to open my computer to Andrew’s annoyance. While he was having a conversation with me (I can’t remember what!) I was trying to figure out what was the best way to contact the premise. The problem was I couldn’t remember the name of the petrol station, and what road it was on. Eventually I told Andrew what happened. He laughed first at me, then suggested what we should do. While he was searching through the Google map to find out the name of the street where the shop was located, in my mind, I was thinking, I was screwed, dead pan!. They probably had called the gardai, and now the gardai were on their way to arrest me, the next thing I was deported home. Such a drama queen. Finally, I managed to call the petrol station apologised profusely for my absentmindedness. And she was (sound like someone east European) so nice and agreed that I pay them tomorrow. I left my name and phone no with her. OMG! What have I become? Demented and I am only 34......need to eat lots of antioxidant-containing food to slow down my brain disintegration....

Thursday, November 13, 2008

34 and counting.......

13.11.2008

Finally, I had a proper sleep last night. Now I am feeling fresh and more alive. What a way to start my 34th year in life. Yes, I am 34 today. A big number? Not really, just a number. Deep inside I feel much younger.

Despite my reluctance to celebrate my birthday for the past few years, today I have decided to cherish it by visiting my past, pondering on the bad, the good, the failure, the success, the gain and the loss.

I have come a long way. Not so long ago, seems like yesterday, I was a little boy in a small village from the other side of world, undernourished with a tummy full of worms, underprivileged whose parents struggling to keep 9 children together, running around without shoes/slippers/shirts, looking after cows, goats, buffalos, living in a house lighted with oil lamps, using water from a well to clean myself, collecting woods in the forest for my mum to cook our meal, dug a hole each time I needed to do the business to empty my bowel, was chased by wild boars on the way to school which was 30 mins walking in the dark early morning, was so scared of the ghosts on the way back from reciting Quran at night.

Here I am today, in front of a computer browsing through the internet, sitting on a leather chair with my mobile phone HTC touch pro beside me, have a wallet containing bank cards, credit card, in a large apartment I co-own containing all the luxurious items that I never dreamt 20 years ago, have a great job, a wonderful companion, supportive friends, and have the opportunity to travel to many countries. Every so often I had to pinch myself, is this real, how this could happen. 34 years, so much has happened during that time. I was sent away by my family to have my education for free, lost my 2 brothers, one was murdered, the other from an illness when he was an infant, lost my mother from a tragic accident, received awards for my academic achievements, the self destruction, the redemption, and many more and I am only 34. I hope I have grown up to be a better person, older and wiser.

“A man is not old as long as he is seeking something” – Joan Rostand
“Age ... is a matter of feeling, not of years” – George William Curtis
“Life is a long lesson in humility.” -James M. Barrie
“Life can only be understood backwards, but it must be lived forwards.” - Soren Kierkegaard

The 'sleepy' beauty

11.11.08

So tired, So exhausted. I need some sleep desperately, but here I am in a London underground finding my way to Princes Royal Hospital, Bromley, an hour away from Heathrow Airport. I ended my 14 days working nonstop (except only for sleep) yesterday. Most of those days I only manage to sleep 3-6 hrs a day. Being a bad sleeper, that was definitely not enough particularly when I had to sleep during the day. The light, the noise was unbearable. It was a struggle to keep my eyes open, let alone to concentrate on whatever I was doing at work. Last night for example, I felt asleep while writing a patient's note. That is how bad it was. I woke up from the doze just before I hit my head on the table, and there I was trying to make sense of what I had written. For the first seconds I tried to figure out whether I couldn't read the note because of my sleepiness or because of my nonsensical writings, more like a scribble. It was the latter, so I had to reread and rewrite it as it was a legal document. That kept me a awake for a while.....well, not for long, about for 5 mins, and then I dozed off again.

The same problem I had to endure on the way back driving home from work. Few times I fell asleep, only to be awakened by something (my guardian angel probably if it really exists) before I hit something or someone. It was a painful effort to concentrate. I shook my head every so often, like someone who has tourette syndrome, controlling my breathing, breath in breath out, as oxygen deprivation can worsen sleepiness, scrolled down the car window albeit a freezing, cold wind coming in, turned up the radio volume to the max and sang along with my awful tone of voice....The tricks gave me a little help to reach home safely. Thanks God for that.

I got home yesterday at 1030, didn't go to bed till 12 midday, slept for 4 hrs, then got ready to travel to London, flight was delayed and I didn't get to the Ibis Hotel till eleven p.m., then I went frantic when I discovered there was no internet access and i didn't know the way to the hospital. As usual Andrew came to the rescue and texted me all the information I needed to get there on time. By the time all done, it was nearly 1 am, got up at 6am and here I am in a battle to keep myself awake and I still have 8 hrs of lecture to attend. Dont know how I am going to keep my head up for the lecture.

All I want to do now is to sleep, hoping someone will wake me up tomorrow with a kiss. Ah, well, aren't we all living in hope?

Friday, October 31, 2008

Halloween night!

Halloween Night! Afraid, be afraid! I returned to work early this week, doing day shift for a week after being absent for two weeks for a supposed study leave. It has been comparatively quiet at work, strangely. For the past 4 days most of the cases were minor injuries. I can’t remember how many times I had to endure the unpleasant smell from patients’ feet while examining their injured ankles. I don’t know why so many people twisted their ankles this week, and none of them actually had a broken ankle.

Today, there were many patients came in after involving in RTA (road traffic accident). I saw about 5 patients with neck pain from RTA. I was not really surprised with the statistic as it was a very cold day and it was raining making the road icy. One girl who was the driver told me all the sudden her car skidded and spun several time before the car side hit a lamp post. To make matters worse another car hit her car on the other side. Luckily, she only suffered a whiplash. Another pretty girl (yes! She was very pretty....and a drama queen), walked in and started to tell me how her car was hit by another car. “Any pain”, “No, doctor, no pain, perhaps a bit sore here” pointing to the area below her shoulder blade. I pressed the area “Now, any pain here?”, “No, doctor, just a bit uncomfortable”, After series of questions with ‘No’ as the answer, and physical examination was unremarkable, I asked her “Anything that you are concerned about that I probably have missed?”, “No, doctor, I think I am fine, I just want to get checked, I will take neurofen (a painkiller) if I have pain later on” “Sure, come back if you have any problem”....but in my mind “You! Now get out! Waster!”......and I did smile back when she smiled at me while leaving the cubicle...Ahhh, you sweet devil!

Tonight is the Halloween night. I don’t envy at all those who work night shift tonight in A&E. It is going to be a mad night, having to deal with many stupid drunken people with injury related to the Halloween party. I remember the last time I worked on Halloween night last year I couldn’t believe the type of injuries I have to manage. Many with head injuries either from an accidental fall or being hit by someone, all alcohol related. I remember a guy, a non-national, was beaten badly on the head while sitting on the side of a field watching a bonfire. He was kicked and punched without provocation by a group of drunken youths. They also stole his wallet and his shoes. Another fella had a burn on his face after it caught fire when he was throwing gasoline from a bottle to make a bigger bonfire.....great party huh!

I have been invited to two Halloween parties. I really want to go but I have to be at work tomorrow from at 8 am to start my 12 hrs shift a day for 9 days in a row.....well, next year, maybe. I will dress in a French maid uniform. That would be a gas!!!!!!!

Saturday, October 18, 2008

Needles, threads and wounds!

Gosh! Finally the course is over. On the way now to Edinburgh Airport, coming back to Dublin. I thought Dublin was cold enough for me but Edinburgh is even colder. Despite the fact that Edinburgh is a beautiful city I just can’t wait to be back in Dublin. Emm....strange to say that.

I swear to God, for the past 2 days, I have done sutures so much that I feel sick looking at needles and threads. For nearly 8 hrs a day I was sitting on a chair, looking at wounds or pseudo-wounds. I did sutures on sponges, wires, pig legs and feet, turkey thighs and probably rabbits bowels. Pulled up, pulled down, tied and tied, cut and cut for 8 hrs. I started to have a neck pain. A Nigerian female doctor sitting beside me chuckled when I said I felt like to vomit, sick with the same thing over and over again. She smiled when I said that this reminded me of my late mum when she spent her free time weaving a mat from rumbia leaves. Thanks God I am off for a week next week so I don’t have to see anymore needles, threads and wounds. Another female doctor from Glasgow laughed when I said this. She thought I was kidding but I was being serious. She laughed more.

I have to say though that it was an excellent course. The demonstrators were very helpful, and they made sure everyone got a chance to do the practical parts. The director of the course was not only a brilliant teacher but he also had a wicked sense of humour. The only problem though he really liked to talk a lot. Many times while I was busy concentrating on my suture practice he would come to my table talking about something that had nothing to do with the course, like he was talking about Scottish traditional food, one of those is a boiled pig bowel, stuffed with sausage and pig stomach....emm, delicious!, I think not!


He also told me a story, when he was in China with his wife few yrs ago (why everyone assumes I am from china? M.A.L.A.Y.S.I.A!), he was asked to eat fish eye balls as an honour, of course he didn’t eat them. Instead, he offered the big fried eyeballs to the host wife as a return of the honour, and she gladly ate them. I thought that was brilliant, a smart move but I forgot to mention to him that I also like fish eyeballs especially the ones that deep-fried. Another story from him was, he was so horrified when a chinese vendor cut off the legs of a chicken when it was still alive after he agreed to try a chicken leg meal...well, only happens in china. He also mentioned that it was true that there was a legal brothel running in the building beside the campus, and he made a point that he had never been there.....emmm..I still can’t see the funny side of this story but few participants did laugh. Perhaps I just didn’t get the joke. Whatever!

Wednesday, October 15, 2008

FRom Dublin to Liverpool to Dublin to Edinburgh



At the airport the very moment, going to Edinburgh to attend a 2 days basic surgical skill course at the Royal College of Surgeons, starting from tomorrow. It is an essential course for me in order to secure a 6 months job in surgery as part of my training to qualify as a physician in emergency medicine.




After 4 yrs in psychiatry which I found later was not for me, I decided to change speciality. At the beginning I was a bit lost 2 years ago, not exactly knew what I should be doing after leaving psychiatry as I always wanted to do psychiatry during my intern year. I was interested in learning human behavior, their actions and responses to situation. I wanted to know in depth why they behaved in certain way in certain circumstances. I wanted to know what was the line between normal and abnormal. Therefore I signed up for 4 yrs training in psyhiatry with Dublin University Rotational Program attached to Trinity College, a prestigious university in Ireland. During those 4 years I had the privilege working under the supervision of the country's top psychiatrists like Dr. Anne-Marie O'Dwyer , Professor Brian Lawlor and Dr.Conor Farrell. I was also given an opportunity to teach medical students when I was a tutor during my last 6 months in the field. So, why changed? So many reasons. Although I had learned and experienced so many things during the period, i also discovered that i was doing it for wrong reasons. At the end i realised that partly it was for personal gain which nothing to do with psychiatry. From this point my interest slipped down the hill, nearly lost my faith in psychiatry itself. To preserve my insanity i opted out.




"What is next" I wondered. Taking into account my experience in psychiatry i decided to pursue a job as a GP. Along my journey to achieve my initial plan i found emergency medicine. So far, for the past 2 years I have enjoyed it so much (well, most of the time!), and it suits me so well. Having said that, I still have so much to do- study, conferences, courses, researches, audits, teachings - to be fully qualified as a physician in emergency medicine.




This week has been hectic to me. Only yesterday I return from Liverpool after attending a 2 days course in Paediatric Emergency Medicine course at Alder Hey Children's Hospital. It was an intensive course and at the end I was struggling mentally to retain all the life-saving informations and facts. Although most of the time I deal with adult emergency cases, every so often I have to deal with paediatric patients particularly if they are presented with traumatic injuries. For medical problems, they will go directly to a Paediatric team, or in some hospital they have a paediatric emergency team. I have to admit that I have little experience with children/paediatric group, hence the course was quite beneficial for my post.

Thursday, October 2, 2008

The Confession

Enough is enough! I can't do this anymore! It is disgusting. It is self destructive. It is not worth it. Now, it is time for me to call it a quit...it's about time...

Well, some may wonder what all the ranting above is about. I will tell you now. Finally, I have the guts to spill the bean. For 12 years, it has been with me. For that 12 bloody years I have been battling it, to stop or to continue, always lost the battle when I thought I was winning it. Now I am ready again to strike back, with my will power as my armour.

I suppose I have an addictive personality. I must admit that I have many addictions, some I like, some I don't, but the addiction I despise most is my smoking habit. To b honest, I started smoking about 12 years ago. I remember vividly the first time I smoked a ciggarette. At that time I was working part time in a fast food restaurant during my student years. I did a night shift and everyone was smoking. During my break, with my rebellious instinct, I bought a pack of malboro and started smoking. I just wanted to try how it felt like. It was one of the biggest mistakes in my life. Well, to make the story short, I enjoyed it and was hooked since.

Funny enough, when I was in high school, I hated smoking. I hated the smell, i hate people smoking it. I was an anti-smoker. I thought innocently that it was one of the roots of evil. My dad was super anti-smoking when we were kids. He used to say to us "If any of you are caught smoking, I will lash your back with rattan until it bleeds". Ironically, all the boys in the family ended up as smokers, me included, and no lashing occurred.

For the past few years, particularly after my graduation, I have tried to stop smoking. I havent enjoyed it as much. As a doctor, I am also a health educator, so I have been burdened with a huge sense of guilt everytime i smoke. I dont do what I preach, that's the shame.

I have tried different methods to quit the habit. I have tried nicotine-containing chewing gums which had disgusting taste. I have tried nicotine-containing inhalers but they did nothing to me. I have tried nicotine-patch but I developed skin rash from it, which lingered for many weeks. Few times I went cold turkey but somehow I managed to find an excuse to started smoking again. The longest I was off cigarette for the past 12 years was 4 weeks.

Why now? What is the difference now? I don't know. I suppose I have to try again. I believe, with the support from my friends, including from FB, I can do it. I am ready to fight it again. I know it wont be easy. Like any war, sometimes you win the battle, sometimes you lose but I hope I will triumph.

Last but not least, I want to offer my apology to those who are disappointed with the level of the revelation as it is not as scandalous or spectacular as one may expect. A confession is a confession, right, no matter how small it is. Thank you anyway to those who were waiting for my confession (wink! wink! mrmanager, wink!wink Al-Razes). I am also sorry for failing to confess sooner. I should have said 'the next post' rather than 'tomorrow'. Keep smiling and please give me the support I much need. Selamat Hari Raya. Maaf Zahir dan Batin

Thursday, September 25, 2008

A rollercoaster ride....


This week, beginning from the weekend, has been a rollercoaster ride for me. Emotionally, it has been high, up to the sky, and down, beaten to the ground. Holiday, sickness, death, fighting an addiction, all within a space of five days. Some people might say, well, that is facts of life, just get on with it.....I am trying, and i am sure with the support of my friends including from FB, I will get through this.


It was a great holiday in Berlin. I had a great fun with my close friends. There were 10 of us: me, irish Andrew, Batch, Dan, english Ricky, Chris, australian Paul, belgian Darius, and canadian Jeff. I will tell more about the trip with pictures in my album.


Returning back from Berlin, I started to feel unwell. I have been feeling an extreme exhaustion for the past 4 days with pain and aches all over my body. It feels like I am carrying a block of concrete on my back or like I have just finished running a marathon. I can't do anything. Today is the worst. I lied in bed all day. Last night I couldn't sleep with stomach cramp. I felt so down. So many things I wanted to do today but the whole day was wasted trying to figure out what was wrong with me. I thought I had been having a flu but the feeling or symptoms like nothing I had before. Later this evening I found out actually I had been having side effects from the medication I had been taking for the past week. I am still not feeling right but I have decided to discontinue taking the tablet. I will tell you why I took this medication.Yes! tomorrow is the day of revelation! I hope you all ready!


After suffering from dementia for many years, my paternal grandmother passed away yesterday. I got the sad news from my younger sister, Midah, last night. Only yesterday she posted pictures of Atok (my grandma) which were taken 4 days ago. She looked so ill. As much as I am sad with her passing, at the same time I am relieved that she had been released from her suffering. For many years, her memory was fading away, for many months, she couldn't see, couldn't hear, for many weeks she had stopped eating. It was heartbreaking for my father, who was looking after her in her final years, to see her withering away. It has been hard for him. He, who previously buried 3 of his own children and a wife of 30 years, now has lost a mother and sister in the same year. This has reminded me of my own mortality....when and how, only God knows.


I promise I will reveal it all tomorrow!

Thursday, September 18, 2008

Berlin! Berlin!

I haven't done much for the past 3 days. As i mentioned earlier, it takes 3 days to recover from 1 week night shift. Only today I started to go back to my normal day routine. I woke up early to drive back to Drogheda, not that I wanted to, I had to. Few weeks ago, unaware of the new parking rule in Drogheda I parked my car in front of the hospital, and at the end of my shift I found the fine ticket worth 40 euros, sticked on my car window. Great! Hence, I was where I was today to pay the fine, 5 days before they increase the amount of the fine. Damned you Drogheda Town Council!

Enthusiastic initially to take pictures of Drogheda I walked around with my Nikon 40 SLR after paying the damage. I found out that actually Drogheda was a boring town. The road lay out was horrible, and not much activities going on. So many old people around , not that I am ageist but I think it is pity that an old town with so much potential has been abandoned by young people. Yes, I was a bit disappointed not able to practise my skill in photography.

I was a bit pissed off yesterday. On Tuesday, I did an online order for a new HTC Touch Pro (a smartphone). The next day I got an email from them saying that they were not able to deliver the phone because I gave a different address from my credit card billing address for the delivery. I had to give my friend's address for the delivery because I would be in a different country when it arrives. Anyhow, I replied immediately, giving them the green light to sent the item to my current address, I called them as well as sending an email. The next day, through the tracking file, I found out that they wanted a proof of address. They could have told me on the phone when I called them. Pissed off, I called them again and cancelled the order. With my not-so-easily-give-up attitude, as I need a second phone right now, I went to city centre, and tried my luck to get a hold of Iphone 3G. I went to 3 different shops and they all said the same.......out of stock! Come back in 3 weeks time! Great! Thank you for your help! I was so pissed off, I ended up buying a nice pair of diesel jean and a diesel shirt. Felt so much after that.......Gosh! I have a problem here! Help!

I can't wait to go to Berlin with my friends. Few of them have been there since yesterday. The rest will be the in the same flight with me tomorrow morning. It is gonna be a good fun. I will be there for 3 nights 4 days. I will post pictures of Berlin...........Berlin, here I come..

Monday, September 15, 2008

Yeah! Yeah!

Finally! Finally! It's over, for now anyway. It is time for me to relax and do other things. I am getting bored talking about my job, as if I have no life apart from work. I am sure some people (if any), who read my diary, are also getting bored with my writings...always about work. Last night was my last night at work before my two weeks holiday. So, eventually I will get a chance to explore my other interests....well, not many, but enough to keep my life exciting.

But not too fast. I have to write about few more other interesting cases. Moreover, I wont be able to talk about my job for two weeks. Isn't that great! YEAH! YEAH!

Saturday night was the busiest night for the whole week. I had to call my senior to give me a hand as it was nearly out of control. Kids crying, people complaining, nurse demanding, patients keep coming, nearly drove me into rampage. I had to attend no less than 4 patients at any time. I was like a cockroach, running from one patient to another and another before going to complete my first task. Non-stop for 12 hrs straight. Even when I was taking my short break, I was still writing notes.

The worst hour was around 4 am, on my own, the only AE doctor, when 4 patients literally came in at the same time, all by different ambulances. All needed urgent attention. One was a heroin addict, so out of it, not able to give a proper history apart from telling me someone had bitten off his ear. Half of his one side ear went missing and it was bleeding heavily. The wound was heavily contaminated, that he required HIV and hepattitis screening , vaccination and antibiotics. He was referred to a plastic surgeon in a different hospital but few hours later he did a runner..with a bleeding ear, high and stupid! We never found him.

While I was attending the ejit, the department night manager, the lovely AD (that is her name) called me to examine another patient who had a neck injury. He was completely drunk. Apparently, he was assaulted by a group of people while trying to help his sister from being attacked by the same group of people. He was in a room, shouting at the attenders, his head was strapped with a neck collar to protect his spinal cord from further injury. During the spinal check, he did exactly what I asked him not to.'Dont move your neck', he moved his neck! 'Dont nod' he nodded! 'Don't shout' he shouted. So frustrating! We, me and the nurses were looking at each other like 'yeah, I know exactly what you are thinking'. Thanks God, xray showed no damage to the back bone. However, one of his eye lid was cut into half and it was bleeding. He actually was also punched right to his eye. I was not able to examine if there was any actual damage to the eye ball because of the wound on the eye lid. I had to give him intravenous morphine to relieve the pain. I can only imagine the excruciating pain he was suffering. He was later tranferred to a different hospital to be assessed by an eye surgeon.

While I was in the middle talking to him, an elderly lady arrived by an ambulance with severe pain on the shoulder. She had a dislocated shoulder. After confirming the dislocation with an xray I managed to put it back in .......not before high dose of morphine for the pain, and midazolam to sedate her. Apparently, she had a spontaneous dislocation while climbing up the stairs in her house. Poor old lady!

Before all of the above, I had just finished seeing a lady, mid 50's looked like 100. She was so skinny and weak, as a result of her condition. She would fall backward easily if you just blow her face, I am telling you. She, who was later put on assisted ventilation, had a respiratory (lung) failure.

Ok, that's enough. No more talking about work for the next two weeks. Hooray! Time to have a simple life......eat, sleep, relax and holiday! Berlin, here I come!

Friday, September 12, 2008

privileged......

I know, i shouldn't be counting the days when my night shift gonna end. I don't wanna sound like I dont enjoy my job. I do, absolutely I do! But sometimes it can be too much when you have no more energy left to carry on. I am not there yet but i was at the brink of emotional collapse. Somehow, i managed to pull myself together to get through it. Hahahaha, I am talking like I am facing a life or death situation. Well, it was not that bad last night at work.

It was another crazy night. Total madness! I saw about 16 patients with various complaints in a space of 12 hrs. I felt like 'why am i doing this, why am i torturing myself'. I am sure there are so many jobs out there with more money and less hassle. Perhaps i love this job. You have to love a job like mine in order to keep going. Otherwise you will be suicidal.

Yes, I enjoy what I am doing. Despite the shortcomings, the stress, the horrible hours, the unpredictable cases, the ungrateful patients, the inappreciative employer, I know I can make a difference in somebody's life for the better, and that is fulfilling enough for me.

Sometimes I learn more about myself from the patients. For example, few days ago I saw a father in his mid 50's, dislocated and broke his shoulder, asking me so many questions, some stupid ones after learning his predicament. Normally, I can be easily annoyed with this kind of patient, as if they dont trust me. But with him, I was extremely patient after knowing his situation. Apparently, he was about to start his new job the next day as a truck driver which he had worked so hard to get the position. He had been umemployed for a while. He was looking forward to starting a new life and his daughter's wedding was in 6 weeks time. The wedding in Ireland is very expensive, the cheapest would be about 10000 euro around RM50000. Now he wouldn't be able to work for at least 6 weeks. Although he tried to hide his disappointment, from his eyes I can see the mixed sad emotions - anger, frustration, self blame. Looking at him makes me appreciate the life that I have. I have a good job, never have to worry about the bills, can afford good food, enjoy my exotic holidays and have somebody to share my life with.

I also met an elderly patient who came regularly to AE with different simple problems each time. He usually came in after 12 midnight. Basically there was nothing physically wrong with him but I soon found out why he was there. Recently his elderly sister, who was looking after him, had been sent to a nursing home for a long term care, so no one cook for him at night. So he came to AE for some food whenever he felt hungry in the middle of night (he had social service sent him food during the day). He is also a lonely old man....he is in his 80's.

Another patient, a lady in her 60's, also out of loneliness comes to my AE every single night, never fails, usually after 8. She has a nice house provided by the social service but she is scared to live on her own at night. She has refused to go to a nursing home. She comes in and sits at the corner of our waiting area with her blanket. Later she will sleep on the chair. Around 8 am the next morning, off she goes and the pattern repeats itself. Patients like this really put my life into perspective.

Thursday, September 11, 2008

Thumb......

3 gone 4 to go.....yes, I am talking about my night shift. I have just arrived home. Tired but not sleepy yet despite my 12 hours shift. While waiting for my brain to tell me to sleep, somehow I got some inspiration to write this. Today I got 2 emails from malaysia regarding the content I wrote in my blog. I am delighted with the emails which mean someone actually read my blog. So thanks mrmanager (www.mrmanager.blogspot.com) and al-razes (kudiksenyum.blogspot.com) for you comments. I promise you that the truth will come out. Please be patient....

It was fairly quiet night last night at work. So most of the time we, me and the nurses exchanged gossips and were bitching around....and some serious conversations as well.

One of the patients I saw last night was a young guy with an attitude, absolutely drunk, most likely a spoilt brat, came in with a thumb injury after being bitten by his partner. Apparently he had a row with his drunken partner who later hit him with a metal piece from a hoover before biting his thumb. Human bite, particularly on the hand, is a serious injury no matter how small the wound is. There are so many bugs in the in mouth that can cause serious infection, which if not treated properly the patient may lose the hand/finger. We have to consider HIV and hepatitis infection. This particular patient needs surgical exploration of the finger to determine if any ligament or nerve injury and he has only a very small cut on the thumb. He was also given immediate vaccination of hepatiritis and series of blood test including HIV test.

Although I do have sympathy for this boy but his attitude made me wanna slap his beautiful face. He was rude, loud, demanding and ungrateful. Despite the anger I had inside, of course, as a medical professional, I managed to contain myself from the outburst, instead, I smiled and kept smiling....which cooled me down. Don't underestimate the power of smile!

Friday, August 29, 2008

Umbrella.....

Despite the continous flow of patients coming to AE today, nothing particularly interesting until the end of my shift when a young girl, accompanied by her mother and grandmother, came in with the hook of the handle of an umbrella stuck in her mouth. It was one of those cases that I would never see again in many years to come. Of course at the beginning nobody knew what exactly had happened. Obviously she was not able to give the details as the thing fully occupied her mouth. She could only cry. Apparently, her cry was heard in another room in her house, and the next thing the mother found her in that state. My consultant tried initially to remove the umbrella but it stuck firmly on her lower soft palate and there was a bit of bleeding. Worried that by removing it would cause more damage, my consultant contacted a paediatrician from another hospital. After much explanation they agreed for a transfer. An anaesthetist was also present and he was also worried about her airway. Later, a junior anaesthetist bravely attempted to remove the umbrella just before she was transferred to the children hospital. To everyone surprise he did it succesfully and there was no serious damage. I would never forget the relief that her grandmother showed.



Oh! Yes! I said yesteday I had a confession to make....well, not today....some other time

Thursday, August 28, 2008

Another day off

This week I work morning shift, the first time for the past 6 weeks. It has not been bad at all. I haven't got time today to write down some of the interesting cases I saw like : bilateral broken arms, pancreatitis, anaphylactic reaction, CVA, pregnant woman with thrombosis and a heart attack. I will talk about them tomorrow.
I also have a confession to make but I will wait till tomorrow..see what happens.
Going to bed soon.

Saturday, August 23, 2008

My week off.....

It was supposed to be a week off work, doing nothing, just relaxing.....well, that has not been the case. Usually, it would take 3 days to recover from a week night duty to get back to a day routine. Unfortunately, this time I didn't get a chance to recover that quickly as on Wednesday I had to attend basic paediatric life support course, which was a day course, being held at Children University Hospital, Temple Street about half an hour by Luas and a short distance of walking from the nearest Luas station.



It was an intensive course starting from 8am, finished at 6pm. There were about 20 of us from different specialities, whose job involving children, including nurses and doctors from emergency medicine, paediatric medicine, intensive care unit, orthopaedic and anaesthetic. We all were taught how to do a proper basic life support to a child in an emergency situation. Later that day after lunch each one of us had to perform in front of a small group of people, of what we had been taught. Although I deal with this nearly everyday with adult, it was quite nerve wrecking to lead the team when I was being judged and criticised. Overall, I enjoyed it, and I passed the practical test which was done at the end of the course. It was a simple test but I am proud with myself for being able to do it calmly and systematically. One of my principles in life is to enjoy every success, and to learn from each mistake, no matter how small it is. Having passed the test, I am in a better prospect to get a job in Jan 2009.



After the course, I went straight to the gym for nearly 2 hrs and by the time I got back, I was so exhausted that i went to bed early. The next day, thank god, I had the all day for myself, so I went to city centre and had my hair cut.



Friday, yesterday, I had to be at work starting at 8am. I was not supposed to but Samuel asked me to do his shift for a day as he had to go for a driving test. So there I was, got up early in the morning and drove for 1 hr to get there on time. The morning started with 2 hours teaching Session which occurs on friday morning only. Dr. Kelly, one of the AE consultant was there. Irene (a south african doctor), Esosa (a nigerian doctor) were also there. We were taught how to detect fractures or broken bones from xray. For adult, it can be quite easy, but in children, it can be quite tricky, because their bones are still developing, and certain fracture can be easly missed particularly on the hands, wrist or ankles/feet. At the end of the session we were shown by two representatives from a company which produces fibre layered backslab.



There are two common types of material used in AE to stabilise broken limbs before further review by the orthopaedic team. One is plaster of paris which application is quite messy and the other is fiber material which is much easier to apply. During the session we were taught how to apply the material properly.



It was fairly quiet afternoon in AE yesterday. Nothing interesting. One patient, he cut his upper lip after falling. The thing with a cut on the lips, I have to be careful in stitching it, otherwise it will leave a scar that could affect their social lives later. The wound needs to be closed precisely, and the patient needs to be warned about the comestic complications including the scar. With this young man I was quite happy with the result.



The other patient, came in with severe vertigo, which is a sensation that the room spinning around. It was so bad that she could not stand up or walk properly. Poor sod!. In vertigo, first of all we need to determine if there is a peripheral cause which is not that serious, or central cause, which means from the brain, which can be serious and needs urgent attention. With this lady, with previous similar episode and elevated lymphocytes, it seemed she had viral labyrinthitis, inflammation of the inner ear caused by a virus, which is self limiting. Considering the age and the severity i decided that she needed medical admission. Off she went under a medical team.



The last patient I saw yesterday was an elderly guy with non insulin dependent diabetes mellitus (NIDDM) or Diabetes type 2, came in referred by the hospital chiropodist, who is a person who is looking after toes and nails particularly in diabetic patients or in patients with peripheral neuropathy. The patient, apparently had developed peripheral neuropathy or loss of sensation, on his feet. It is quite common for a diabetic patient to have peripheral neuropathy as a late complication. The other complication is foot ulcer because of poor blood circulation. The combination of the two (peripheral neuropathy and foot ulcer) is disastrous. Because of he had loss sensation of the foot, he became less aware of the ulcer on the foot and he kept the pressure on the ulcer which made the ulcer worse. On examination the foot was swollen and red - signs of infection - and there was a small ulcer on the sole just near the big toe. It was oozing with pus, producing foul smelling. According to him, it had been there for 6 month. Just imagine how bad it was! It appeared that he had chronic ulcer with peripheral neuropathy and cellulitis which is infection of skin. I was worried about the bone which also might have been infected (osteomyelitis) and if so it is a serious condition. Regardless, he needed admission...



After work, I was rushing home with a plan to go to the gym and later to have a dinner with a group of friend to say goodbye to Liam who is moving to Australia. When I got back, I was too tired to go to the gym, but I managed to bring myself to the dinner. It was in Tante Zoe's restaurant, an american food restaurant in Temple Bar. It was ok. Nothing spectacular about the meal. Funny enough, Liam who is leaving, who organised the dinner had to leave the table even before the food was serve after he fell ill. We toasted, saying goodbye to Liam without his presence.

Tuesday, August 19, 2008

Finally......

Eventually, the 12 hrs night shift for 7 days in a row ended yesterday. Another 4 weeks before i have another one. Now, I have a week off work...well not really, I have to go back for 1 morning shift on Friday after swopping with Samuel, the other AE sho.

The whole week last week was an interesting week. Few interesting cases I had to deal with, each one with different level of difficulties. One of them was a case involving an elderly man with multiple medical problems, came in by an ambulance with acute onset severe abdominal pain. The pain was initially located centrally, and it was very severe that I had to give him a small dose of morphine, which relieved the pain partially. He was sweating profusely, looked clammy with drowsiness. Vital signs were stable at arrival. Immediately I moved him to the resus unit, a special room to deal with a very sick patient. At first I thought he had bowel obstruction because the abdomen was distended and he had colostomy bag for rectal removal few years ago. During further assessment, he complained that the pain now was more severe on his back. The blood pressure dropped below normal value. At this stage I knew that he had an abdominal aortic aneurism (also known as AAA, triple A) which may had been leaking. I expressed my concern immediately to my senior colleague, who organised an urgent CT scan of abdomen, which later showed as expected, a leaking AAA. Subsequently, he was tranferred to another hospital, 1 hour away for emergency surgery. Everyone congratulated me for the quick action.

Working in emergency medicine can be daunting sometimes. It is a stressfull job with so many things to do at the same time. Time is the essence, and as a medical officer in AE you are working against it. Anyhow, with a case like the one mentioned above, it is all worth it. I know I make a difference, and it is, of course, fulfilling.

Most of the cases I dealt with in Drogheda during last week were traumatic injuries, particularly after midnight. I don't know how many I saw with a head injury and most of them were drunk. I just don't understand this drinking behaviour in Ireland. It is their culture alright, but why on earth they go out drinking until they can't stand up on their feet. Some of them become very abusive and aggressive when they are drunk. I had several cases like that last week. One of them was assaulted with a hammer. He was so drunk that he couldn't remember what exactly had happened. He sustained mutilple lacerations on his bald head, and on one of his ears. He was quite abusive against us while we were trying to clean the wound. After calming him down, we continued to clean the wound. Unfortunately we found he was bleeding profusely from the injured ear, and we could not locate the site of bleeding source. Ct brain was arranged, and luckily it was normal. We planned to admit him for neuroobservation and for ENT review because the ear was still bleeding. Frustratingly, once he was more sober, he walked out from the department with a bleeding ear. In a case like this, we only could watch him walked away as he was an adult......stupid adult! This only one example of the many....and we have just to put up with it.

Another case was an anorexic lady, fell in her house, complaining of very severe back pain. She was given high dose morphine, later difene per rectal but the pain persisted. The initial xray show no broken vertebrae nor pelvis. I was puzzled initially. I suspected it was psychogenic pain as the pain was inconsitent to the injury. She looked so thin, like a ghost. She came in with full make-up on her face and this was 4 am. I couldn't take proper history from her because she was shouting, roaring and crying. She kept calling, like a child, for her mother, who was beside her. She was in her 40's but looked much older than her own mother who was also dressed immaculately. I decided to keep her in AE for further review by my senior colleague. The next day, I was told she created a drama in AE after MRI scan showed normal results. The orthopaedic team didn't want to do anything with her because there was no broken bone. Eventually my consultant organised physiotherapy for her. Initially she was resistance to the intervention. After much persuasion she was discharged home the next day.

The saddest case or most tragic case was a case involving an elderly lady who fell from stairs in her home. She was found by her husband. On arrival, she was already on intubation, still breathing on her own but both eyes widely opened with non-reactive, dilated pupils. At this stage I knew she had a brain injury- more specifically brain death. On arrival the trauma team had already been contacted. During the assessment she stopped breathing and resuscitation was initiated and she was brought back to breathing on her own again. Eventually my consultant decided, with consent from her understandably distraught family to end her misery by stopping the life support.....she died in the department surrounded by her large family. I cried a little later during my break, thinking about my mother who also died tragically 10 years ago.

Life is so short and yet it is so precious. Appreciate what you have in life no matter how little it is because you never know when you are going to lose it. Appreciate the love you have from your family, your friends and of course your partner. Live to the fullest, and that is what I am going to do.....

(ps: for confidentiality purposes, I deliberately omitted the name of patients, their exact age, and the exact nature of injury including the exact site)

Friday, August 15, 2008

work...work....work

Feel like a long time ago since the last time I wrote in this blog. I started my 12hrs shift a day for 7 nights straight on monday 11/8. It was not as bad as I thought before I started. The problem is it is totally an anti-social shift to do. I can not do anything else like going to gym, meeting friends, cooking, and of course writing something on the blog.

It takes me about 3 hrs driving back and forth, so in total it is 15 hrs off, 9 hrs left which are used for basic things like sleep, eat, clean. In fact, I just got up about an hour ago and now ready to go to work again....Am I complaining? Not really. Just finding an excuse on why I haven't up-dated this blog as frequent as it should be.

Ok.....have to go to work now. Tomorrow I will talk about AAA.

Monday, August 11, 2008

A great weekend...

I did 12 hours shift working from friday night till saturday morning. It was raining heavily the whole night. Unfortunately it didn't deter people to come to AE. It was a chaos. As I was the only AE doctor there, and it was my first time working at night shift, so it was crazy. Anyhow i manage to survive.

I got home around 10 am and forced myself to sleep because I had to wake up early to cook dinner for a group of friends. I woke up at 2pm and ready to cook. I cooked Indian mee goreng and sweet spiced chicken wings. The kitchen was a mess afterward but hey, I have andrew to clean it up......sorry andrew, not my intention! The dinner was planned by Haiyu and I to say goodbye to Cindy and Paul who are going to emigrate to New Zealand at the end of the month.

Syed collected us at around 7 to bring the food to Haiyu's apartment which was located at Aungier Street, city centre. We were already late. Haiyu had cooked beef rendang which was nice. Manu, Haiyu's french husband, and his french friend was also there. Others were Cindy, Iban sarawakian girl, Paul, Cindy's Irish fiancee, Syed, my dear malaysian friend, Nico, syed's jewish argentian-spanish friend, Andrew, and Mitch, my other malaysian friend.

I had a great time. Everyone seemed to enjoy our food. Great company, great food.

Later that night, I went to Jeff's apartment for a small party. I was so tired so I spent lying on the couch listening them talking shit until 8 am sunday morning.

Friday, August 8, 2008

Something is missing....

I feel completely worn out today. Don't know why, can't figure out what. I am tired. No motivation. Feel like I have to push myself hard to do anything. Can't sleep. Signs of depression? Don't know. Missing my family? Hate my job? Need a major change in my life in every way? Don't know. I also have a premonition that something bad is going to happen, and I am scared of the unknown. Feel like everything right that is happening right now is not right. I have a great job, good money comes with it, have my own place, have someone that I love dearly to share my life with, but I feel that all that is too good to be true. I feel that something bad is going to happen to screw everything up so that my entire life would make completely different turn to start a new journey...........

I feel like lately I am consumed with work again. It is in my head 24/7. I hate doing things half way but lately that is exactly what I have been doing. I want to be the best, and I have been quite competitive but I have lost the drive lately. Although I think I am good at work, considering the responds I got from my colleagues, but I still think I am not good enough because I have failed to carry out the goals that I have set up myself to achieve.

Emmmm....such a relief to be able to release the tension in my head by writing them here. I already feel a bit better now. I should do this more often. I don't care if people read this blog or not. I do this for me....

It was a very busy night at work last night. The department is too small for big population it has to provide. It is crazy, considering Ireland is a first world country but the hospital's condition is like a hospital in 3rd world countries. I was shocked when I first got there. Too much politic in Irish health system but too litlle being done.

Last night I saw a guy whose anal muscle was weak that he couldn't shit properly for 2 weeks. Sent to the surgical team and the SHO was complaining about the referral. What am I supposed to do? The patient had problem shitting!

Then there was another patient, young enough, complaining of chest discomfort consistently for 2 weeks. all investigations revealed nothing and she was informed about the results. Not surprisingly, because I got this type of patients every so often, she was not happy. It sounded like she wanted something bad to happen to her.

Then, I saw a middle aged woman with a lung disease who came in with shortness of breath. She was nasty and snappy. She was like 'who the hell are you asking me all these questions, just fix the problem'. I was boiling up inside but keeping it calm on the surface. Smiling and be nice. It appeared she still smoked and didn't take her medications as regular as it should be. She wanted me to fix the problem that she created........but hey, I am just a doctor.....I only can give advices...

Before I left and that was nearly midnight, I saw a patient, a foreign national, who took overdose of benzodiazepine after finding out her foetus didn't have a heart beat on the same day she found she was pregnant..basically she had a miscarriage. That was sad......

On getting ready to leave the hospital, I bumped into my consultant, and he reminded me to be here by 8am tomorrow to attend the tutorial. No word on how are you, how are things. Fun and exciting work huh? I dont think so. Ok, I should be there tomorrow because I have missed the tutorials a lot due to the shift hrs. I got home at 1am , went to bed by 2am, set the alarm at 630am to go to the tutorial but I had difficulties to sleep. The alarm went off and I was so exhausted. I couldn't even lift a muscle. As a result I missed the tutorial again.......That what pissed me off....

Thursday, August 7, 2008

Anwar Ibrahim was charged yesterday. Olympic Game will start tomorrow

Wednesday, August 6, 2008

News from home...

I got a message from my baby brother, Amy, today at work looking for some financial help to get a new printer for his new laptop which I bought for him few months ago. I was busy at work to reply the text message, so the first thing I did when I got home at 1am was to call my baby sister , Midah, using Sykpe. She was already at the school where she was teaching, SM Teknik, Klang.

Apparently, Amy is in IKIM college in Kuantan at the moment, having registered last weekend to start his 3 years diploma course in accountancy under UTM. I am happy for him. He had a difficult childhood and teenhood having lost a mother who was very close to him at a tender age of 10. He was a lost soul for few years but he managed to pick himself up. I am proud of him for his strength and his fighting spirit. After SPM which he didnt do well enough to earn entrance to university, I sent him to politeknik to do Hospitality course which he seemed to enjoy. After obtaining his certificate, he decided to be independent and took a year off from his studies. With a help of my 2nd cousin, he got a job a sale assisstant which he extremely enjoyed that he decided to continue his studies in bussiness related course, hence, he is where he is now.

Another good news I received from Midah was, my other younger brother, Aboy, had just been accepted to start his training to be an inspector police. He will commence his training on September in Pulapol, KL. He had to undergo a long process of interview before being accepted. He has been recently engaged to a girl from the same village. I can't think a better job for him. Physically he is just perfect for the job. He is the most kind and honest member of the family. I wish him good luck with the 9 months training.

My granny, from my dad side is not well. She has dementia and physically she is getting weaker and weaker. We all don't know how old she actually is. In her ID card she has the same birthday as her first two children, and my Uncle is nealy 80 so she must be near 100. I can only pray for her wellness.....
This is what I sent to one of the NST editor last year. It was not published, and in a way I was glad because firstly, although the article had good points to ponder on, it was badly written in term of construction and grammar. I was in such a state at the time I was writing it, and I have no intention to reveal in what way. Secondly, some of the points were considered sensitive to many, and I am sure I would have trouble if it was published. Anyhow, the editor kindly replied the email.

"Hi yap,

I read your article (What's the point?: What maketh a Malaysian, anybody?) today with so many questions about myself, my race and my country and how frustrated I am with the current political views regarding racial interaction (relationship?) among Malaysians. It feels like we have moved backwards as a nation in terms of racial integration, and we as Malaysians have failed to progress mentally (and socially) in unity and in harmony.

I might be crucified to say what I am going to say next but I need to tell you personally how I am glad to have u around and challenge the mindset of the few (the many rather) in public (I assume they are from my race, the malays).

Let me tell you my story. I was from a small village. A malay village (very malay) somewhere very remote in negeri Sembilan. My family lived in proverty as rubber tappers. I was lucky (very indeed) that I was sponsored by yayasan sarawak to further my secondary education in Miri, Sarawak under student interchanges programme that my family didn't have to pay a dime for my education from that point. My mother let me go (out of our proverty) although it meant I could only see my family for one month a year. I have to tell you that I had one of the best years in my life. There I had the opportunity to know people from different races and religions but unfortunately it lasted only for 3 years before i was sponsored to study in a college which students were exclusively malay (namely MRSM) and had a chance to further my studies abroad under a government scholarship.

Having had a chance to visit many countries and learnt many different cultures in the world after my graduation, I have had difficulties to accept my position professionally in the name of fairness and justice. I had discussion with Malaysians (malay , Chinese, Indian) and my western friends about my background and how I end up to where and what i am now and it makes me wonder what if I were not malay. Would I be in the position where I am now if I am not a malay malaysian? Many would say you should be grateful, because you are malay and a malaysian, you have been given the 'special treatment'. Of course I am grateful but do I deserve it when probably (a fact likely) many Malaysians who are not malay and poor (but have the same potentials) continue to be at a low level of ladder of social hierarchy.

Live is about survival and only the fittest will survive but the situation (politically and socially) in Malaysia seems like its programmed based on who you know and what your race is. This is a social injustice and understandably (considering where I came from) I am propelled into dilemmas in trying to understand the whole situation. Am I proud to be Malaysian or should I be proud to be a malay? But what is a Malaysian when it is divided socially, economically, politically
(emm..sounds like in every sense) based on races? What is the meaning of being a malay? A muslim who is born in Malaysia and has chance better than the others to gain everything from the government? What do I know about a Malaysian? Malay, muslim and born in Malaysia? Doesn't sound right, does it, when you can physically see the varieties that exist in Malaysia? Why should the meaning of being Malaysian be divided by races and religions? Should not it be on how much you have contributed and want to contribute to your own country?

Young politicians today apparently haven't learned a lesson from history - May 1969 in Malaysia. I read with shame the recent news on the malay supremacy and why they think (the malay mainly- forget the other bumiputras!) are better than the others to deserve the 'special treatment'. They might incite the same racial confrontation but in a different context. The politicians are mainly to blame for all the fiasco. But again they are the product of an ideology that was established to purportedly correct the social injustice that existed just after the independence but is it (the ideology) relevant now? Should the definition of a Malaysian be changed now? But what is to change if we can't understand or accept what it is truly meant in the first place? Many more things I want to say but I will save them for the next time.
Terima kasih"

This is Mr Yap's reply:

"Hairi,

Thank you very much for sharing your story with me. I wish more people were as open. I too, have many Malay friends who ask me and themselves very similar questions. It truly is a shame that people have trouble accepting themselves and others for what they are - people like everyone else.

Thank you so much for taking the time to write and I'm glad that the piece touched you in such a manner. I was very nervous about the kind of response the piece was going to get because experience has taught me that not everyone likes addressing this issue.

Take care of yourself and sorry for the late reply."

Well, something to think today.........

Friday, August 1, 2008

Another day at work....

It was a hectic day for me yesterday....which was my last day off work for this week. Got up early...well, not that early, about 10am, and without breakfast went straight to city centre to my bank to get a bank draft. I need to send the cheque to Liverpool children hospital for Paediatric Emergency Course which is going to be held in October. When I sent an email to them last week, they replied telling me there were only few places left....so I had to send the application with the cheque ASAP. It costs me £279.....In addition to that I had to pay £250 for basic paediatric life support course which is going to be held at Temple Street Children hospital, Dublin on 21/8/08. I managed to post the letter to Liverpool but for the one in Dublin, I had to cancel the delivery because at the very last minute, I realised I forgot to enclose the application letter....damn! So I rush to get home before the post office closed. And you know what I did.....on the way back, I bought a new bicycle.....hahahahaha....typical me, so impulsive!
I need a bike anyway to make a trip to the city centre from my apartment. That bloody bike costs me £350 including the side bags, locks and a helmet. Once I got back to the apartment, it was just too late to post the second letter. To fill up my day, I decided to go to the gym with my new bike. Apparently, I quite enjoyed riding my bike. It is obviously faster than walking, and it's good for my health.....emmm.....I am gonna have good legs in a month time if I continue to use the bike.
My hectic day finally took a toll on me. By 9pm I was so exhausted,....and what did I do? Go to sleep....

Thursday, July 31, 2008

A mess........

This is my comment that was published in malaysiakini portal (some important points surprisingly were edited): (the one in bracket with bold letters is the one that was edited)

"Dr Hlasim: As a medical practitioner myself, I am shocked by the publication of the medical report on Saiful, Anwar's accuser. It has violated a patient's confidentiality with is the fundamental right of a patient who is seeking treatment or assessment from a medical practitioner.(Saiful might be lying on the whole process but he still have the right to the unsaid agreement of confidentiality. When we take an oath to begin our career as a medical doctor, we agree to this agreement to respect the right of a patient. I believe he, Saiful, didn’t give his consent for the publication. It is unethical for the doctor involved to reveal his finding without Saiful’s consent. It is a gross professional misconduct if it is true that the doctor voluntarily allowed the medical report to be published. I haven’t read the report published myself and I have no attention to, but I was informed it was quite graphic and this is not acceptable).Even if the medical report is true, Anwar's legal team should use it in the court to squash the charge rather than using the media to win the war of public perception. I am not sure now if the report can be used in court if Anwar is charged because of this irresponsible publication.I really hope the doctor will come forward and reveal the truth. (Whether he provide the website voluntarily with the information ? If so he should be ready to be stripped off his medical licence for professional misconduct) If he didn't give his consent for the publication, then shame on the media that published the report. It is a disgrace to fight for the justice of one person but violate the rights of another person.If Anwar's team is talking about justice then an injustice has been committed by the publication of the medical report. I am not a government supporter nor an Anwar supporter.Yes, he was wrongly jailed for a crime he did not committ but he fought hard, and he gains my respect for that. This time, I am not sure if I am able to give him the same respect.He should fight the accusation in the court and if he believes there is conspiracy against him, then he should reveal it in the court. Berani kerana benar, takut kerana salah.The truth always prevails!"

This is what I sent to Oyin, my friend in malaysia, who commented on my comment above:
"well, as you can see, I am impartial. Not on either side which is fair. I sent the same comment to the star and NST. I am so sick with malaysian politic at present. I dont trust Anwar as much as I dont trust the government. What is left for me to support...DAP? PAS? no way! The pakatan wont work because of their completely different ideologies. People have made their choice...BN won. They are not perfect but they won. Wont win my heart though. We have to deal with it. That is democracy. Anwar is impatient. Insteads of rushing asking BN MP to cross over, if he want to be PM, he should have worked to strengthen Pakatan and show the public they can work together for the benefit of the people, to win the next election. By forming a government, with involvement of MPS who cross over, he will taint the name of democracy. If you want to win you need to win it fair and square. And with economy suffers globally, whatever happening in Malaysia now is not good. God helps us! In term of this sodomy thing, I also dont believe it happened involuntarily and I believe there is a personal vendetta by saiful for something only both of them know. Of course the government and police use the issue to their advantage which is wrong itself. However, the rights of both, Saiful and Anwar, should be protected, no matter who is right or wrong. I always believe that we should fight for the human right of any individual even though he is wrong."

Wednesday, July 30, 2008

I have just posted pictures from my recent trip to Lisbon in a new page. I discovered today that it would take a while to download photos and post them here. Insteads, I found it is much quicker to download the photos into my picasa web album. So, if anyone is interested to see what I saw and experienced during the 5 days trip, you are most welcome to visit the page (http://picasaweb.google.co.uk/hlasim74) or just click the url on link. I will download more within the next few days. Enjoy!

Today, my off day from work, has been quite unproductive. I had planned few activities but I only managed to execute small percentage of them. For the past few weeks I have been having trouble with my sleeps. I am not sure what, but part of the reason is my stomach. I continue to have epigastric pain, and every so often, if not every hour, I am awakened by the discomfort. I have got it checked with urea breath test to find out if I had H.pylori associated ulcer disease after being in trial with proton pump inhibitor, but the problem persists. It never bothers me during the day, only at night when I am in bed. I have started to take Zoton FT again to see if it would resolve the problem. If not, I guess I have to have OGD. As a consequence of this epigastric discomfort, I have not been able to have a proper sleep, hence, my energy level has been greatly affected. Instead of getting up at 9 pm as planned, I woke up late, nearly 12pm. It took a while for me to start doing anything.
When I woke up there was James in the second bedroom in his deep sleep. He met up with Andrew last night, and ended up at my place. He woke up soon after me and off he went again. Typical James.

Then, I had a chat with Rizal , my new buddy from KL, via the msn messenger. Small talk and he sounded like a nice guy.
After much contemplation, I decided to go to the new gym , Crunchfitness Gym, for the first time after signing up with it last week. I guess I had to do something productive, otherwise another day would be wasted which I hate.

The gym is marvelous but it was very busy. I couldn't use the equipment I wanted to use, and I had no patience just standing around to wait for my turn. It was quite frustrating. So I ended up trying my Yoga. While doing it, I realised how unfit I had become. I found it now quite difficult to do all the bending and stretching after abandoning the exercise for a while now. Somehow, I am glad that I have started doing it now. I also learn a lesson....do not go to a gym after office hour.

On the way back by walking which took me nearly half an hour, I decided to buy a whole chicken to cook. I miss malaysian food, and of course you wont get it unless you cook it yourself. Therefore, malaysia green curry played in my mind on the way back.

While waiting in front of a lift in my apartment block I bumped into Brian who happened to drop in to see andrew. Nice to see him again. Lately I have drifted away from most of my friends. Don't know why.....emmmm, something that I have to figure out in bed tonight. Brian was in a good form. He likes to travel. So far, he has been in nearly 40 countries. Only 3 weeks ago he was in madrid with the other lads, and he has already booked a flight to Barcelona next weekend to meet up with Stephen who I haven't seen for few months now. Miss him too.
After eating my green chicken curry which is also Andrew's favourite, I tried to study anatomy for my exam in december but my brain was not working. I dont know why....perhaps, I am getting old or I am just to tired with so many things going on in there. So many decisions to make, so many goals to achieve....hemmmmm..I am a dreamer..

Tuesday, July 29, 2008

Another day.....

Well, nothing interesting went on today. Just like a typical working person. Gets up, goes to work, comes back from work, eats and sleeps and the pattern repeats the next day. I felt like a robot....and the batteries were dying off...I am sure this is just another of those days that you feel numb. Everything goes around you doesn't not matter to you as everything has its own pace and no matter how fast you do thing, it still doesn't guarantee the result you want. Hopefully tomorrow will give a different story....

Sunday, July 27, 2008

Back to Dublin

I was not looking forward to today....heading back to dublin. I managed to sleep only for 3 hrs after late night out. The flight was at 1035 so I had to woke up early......The Lisbon international Airport was a chaos....

Saturday, July 26, 2008

Belem, Lisbon

Woke up pretty late today but somehow I managed to force myself to make a trip to Belem, another tourist spot about 30 minutes away from the city centre by underground and train. Again, the weather was fantastic, around 25c. I'll post more about the the trip and some pictures once i get back to dublin. What i need now is some rest. My calves are aching from too much walking...I am such a wimp!

Friday, July 25, 2008

Lisbon

Relaxing in the hotel at the moment after spending the whole afternoon at Cascias about 45 mins by train from Lisbon City Centre. It was beautiful despite cloudy wheather. I bought a lovely pair of short that I would be wearing tomorrow. I will try to post some pictures later. Going to have some rest.

Wednesday, July 23, 2008

A night with my beloved friends

















I had a lovely dinner with my friend last night at Milano restaurant, an italian restaurant on Baggot Street. Lovely interior and I enjoyed the food. I love italian food particular the pasta dishes. The dinner was arranged by Hazel whom I haven't seen for many months and she looked pretty as always. I was also glad to see Liam after being missing from the scene for quite sometime. He just got back from a holiday in Thailand. I was also sad when he told me he was imigrating to Australia to be with his loved one. He will be leaving in a month time after a trip to Montreal with Jeff and to Las Vegas with Eamon. We will be missing him big time.




The other lads were Andrew, Brian, Paul and Eamon.




For the dinner I had Avacado with spinach and peppermint leaves with italian sauce. I had twisted pasta with mozarella chest as a main course which was delicious. Andrew couldn't help himself to tuck in some of the pasta. My favurite part of the meal, as always, was the desert. I am a desert person. No matter how full I am there is always a place for desert. For me a bad restaurant is the one that serves deserts without


any thought in them. I had strawberry fruits top with honey mixed with yogurt and nuts. Delicious!






















Tuesday, July 22, 2008

2nd day of annual leave. As planned I got up early, well, at 11am (I am not a morning person, ok!). So many things to do before the trip to Lisboa (Lisbon), Portugal tomorrow. First of all, I have to fix the car. The exhaust was just hanging down there, ready to hit the ground. Don't know what happenned but for the past week or two , the car has been making odd sound. Andrew checked it yesterday and found out what was wrong. The exhaust has become loose and it needs to be fixed. I will be returning from Lisbon on dublin so I would have no time to fix it and I need the car to go to work on Sunday. That bloody car.....need a new one!
I send it to Fast Fix Car Shop....and they are really fast. It appeared that a rear box (don't ask me what it is called) attached to the exhaust also leaked and needed to be changed. Whatever.....costs me £80 (bloody car!).
After having my lunch, a green chicken curry which i cooked last night (yummy! yummy! love it) I went to town to:
1. have a look at Crunchfitness centre (www.crunchfitness.ie ) at Aston Quay. I was so impressed by it cleanliness, high tech equipments and large swimming pool, I signed up right away. The entrance is so grand, so camp! The fee is reasonabe. £100 for registration, 1 month free membership and the £64 permonth, significantly cheaper than Iveagh Fitness Centre (in term of grandeur, Crunchfitness is so much better). Now the challenge is to have self discipline....The last time I signed up for Gym, I went there in binges....two months intensive ttraining 4 months nothing. No wonder I didn't get any benefit.

2. send a form for Insurance renewal. I had to send ASAP before they increase the premium. I had a car accident last week and now I am awaiting the paperwork to b completed for the claim. So I hope they would receive the renewal form and proceed with it before I complete my claim. Smart move huh!

3. Get contact lenses. So much cheaper in Specsaver than the last place, nearly half the price. Cekik darah punya company (bloodsucking company!)

Looking forward to dinner with Hazel and the gang tonight.

Friday, June 13, 2008

Awake!

Dan, Brian, Steven, Chris
Sergei, Jeff
Steven, Chris
Sergei, Paul, Jeff

I finished my night shift yesterday at 8 am. Hooray! No more night shift for St. James Hospital. Now, I have the whole weekend off till Tuesday. It's now 5:10 am, I still couldn't sleep. Well, I went to bed yesterday at 10am and sleep through till 7 pm, had my dinner and went to bed again at 11 pm. Big Mistake!

I woke up at 3am, and here I am, fully awake, wondering what I should do. After surfing in the internet, reading all the online malaysian newspapers ( http://www.hmetro.com.my/, http://www.bharian.com.my/, http://www.utusan.com.my/, http://www.bernama.com/, http://www.malaysiakini.com/), then I remembered I had signed up to start my own blog. Hence, here I am, looking for ideas on what I should write.

Perhaps, I should write about my plan today........God! Only now I realise I actually have a boring life. My work has consumed me greatly.

Recently, I started to learn spanish through an online website (http://www.rosettastone.co.uk/). It uses immersion method which I find quite interesting. Its aim is to allow the language to be assimilated into your mind naturally like a child learning a language without thinking too much about the grammar. It has been few months now since the first day I signed up but due to the constraint of time I hasn't done it regularly as it suggests. So I think I should plan everyday on how much time I should spend to learn the language. A little time daily but I believe consistence is the key.

One may wonder why spanish. Ahak! I will tell you a secret. I have a dream. My dream is to retire early in a small village in Spain looking after animals and growing my own food. I love Spain. I like the weather, the food and the people. Well, that is the dream anyway.


Sitting here on my own alone gets me thinking that I haven't been out for a long time. The last time I met my friends (Jeff, Brian, Steven) probably nearly 2 months ago. So, I think I should go out tonight to meet them.


I haven't seen a movie in a cinema for few months now. So, I should see a movie tonight. Which one? Indiana jones, Sex in the city, Priceless or Mongol?

Thursday, June 12, 2008

checking

so many stories to tell....