tag:blogger.com,1999:blog-24689546424493808582024-03-12T21:15:26.156-07:00drhairiHairi Lasimhttp://www.blogger.com/profile/17192208752731688723noreply@blogger.comBlogger38125tag:blogger.com,1999:blog-2468954642449380858.post-26736666506425733932009-04-08T07:47:00.000-07:002009-05-10T01:54:58.822-07:00Wonderful Life!<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhcV9Fx2UafAGWOtP7Mp0h8KDWZlb63cI-bDv2RiRPDCTu36MflCG2QHAcZyZGcVHQshAXd8_7l4LyfKEqovefCtV5XuP_rArz22ySjAgpMF3uaiPNpaVFKY4kFXp9fgWK-RUdm_93Fvu_a/s1600-h/DSC_0008.JPG"><img id="BLOGGER_PHOTO_ID_5322333009483249506" style="FLOAT: right; MARGIN: 0px 0px 10px 10px; WIDTH: 320px; CURSOR: hand; HEIGHT: 212px" alt="" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhcV9Fx2UafAGWOtP7Mp0h8KDWZlb63cI-bDv2RiRPDCTu36MflCG2QHAcZyZGcVHQshAXd8_7l4LyfKEqovefCtV5XuP_rArz22ySjAgpMF3uaiPNpaVFKY4kFXp9fgWK-RUdm_93Fvu_a/s320/DSC_0008.JPG" border="0" /></a><br /><div>It has been a while since the last time I wrote in this blog. Looking back, I realise so many things have happened in my exciting life. After all the trouble, I managed to get a new car few weeks ago. Not so long after that, I was conveyed a good news that my beloved sister had just given birth to a beautiful baby girl, followed by a devastating news from my foster family in Miri, Sarawak that my foster dad had just passed away peacefully from old age. I supposed this is life. We lose and gain. We are happy one minute and sad the very next minute. A human being without emotion is lifeless. </div><br /><div><br />For the past few weeks, I have been very busy at work. So many interesting cases I wanted to document here but after about 12 hours a day at work in most days, by the time I got home, my enthusiasm to share the story had fizzled out due to pure tiredness.<br />With the encouragement from my friendly consultants, I carried out an audit on misdiagnosis of X-rays in our department. Little did I know the colossal task I had offered to take. It took a month to finish the project. Nearly every day, I had to stay back after work to review the medical notes. There were about 100+ of patients’ medical notes I had to assess daily. Therefore, sometime I got home at 2 am in the morning. In a way I did enjoy doing it, as I could see the mistakes made by our doctors, and I hope from the outcome of my studies I will find suggestions to improve our service.</div><br /><div><br />I was so relieved when the review of the notes ended last week. Mind you, this is not the end of my audit. What I have to do next is to interpret the data and of course to present it to the big boss. In few weeks to come I have to redo all of these again to see if any change in our practice has been made by our committed doctors. However, I have decided to defer the next stage of my audit to concentrate on my other project.</div><br /><div><br />I plan to take an examination for membership in College of Emergency Medicine in June 2009. It is like a master degree. Being in a field where it is so exam/qualification orientated, I find that the only way for me to progress in my career is to have a post graduate qualification. I did psychiatry before which didn’t work. Now, it is time for me to seriously try the emergency medicine.</div><div> </div><div></div><div>Again, it has been a gigantic effort. The subjects I have to focus on are broad and enormous. It involves anatomy, physiology, biochemistry, pathology, pharmacology, statistics,microbiology and of course medicine and surgery. It took three years to master all of the above subjects during my undergraduate period. Unfortunately I don’t have the luxury of time this time around. I have only 2 months to prepare for the exam. Gosh! Why oh why! .....concentrate, focus, and get on with the job, Hairi! If you fail to plan you plan to fail!</div><br /><div></div>Hairi Lasimhttp://www.blogger.com/profile/17192208752731688723noreply@blogger.com1tag:blogger.com,1999:blog-2468954642449380858.post-41043352392727930352009-02-28T14:20:00.000-08:002009-04-21T03:08:23.254-07:00The demise of his beautiful car<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi_rOiZezV_6I5l_SYAFNmKDcGX_gexw_EdFWxz8elGLhZ89i4A9f6MDbLX5382gPhUyDnWkMBJh0RdxVrkFQm7PZ-MR3F-2tovtacFA7yVaifdfPACIbXvC4Me_D4fLN0Gi2muekIrcx15/s1600-h/SANY0068.JPG"><img id="BLOGGER_PHOTO_ID_5307979757026441922" style="DISPLAY: block; MARGIN: 0px auto 10px; WIDTH: 320px; CURSOR: hand; HEIGHT: 240px; TEXT-ALIGN: center" alt="" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi_rOiZezV_6I5l_SYAFNmKDcGX_gexw_EdFWxz8elGLhZ89i4A9f6MDbLX5382gPhUyDnWkMBJh0RdxVrkFQm7PZ-MR3F-2tovtacFA7yVaifdfPACIbXvC4Me_D4fLN0Gi2muekIrcx15/s320/SANY0068.JPG" border="0" /></a><br /><br /><div></div><br /><br /><div><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEisU2okyZqyOjNbh28NgV59KV2L5swFxkOVEI33HsJhYPST9MJaTxhRexpCYDL8K5bIOlH49K4Wu7ReJ6IyM3wALtjyRq-yM9g272eJ5TK22o9b470LkRHbqKKdBSjfYWInQA0sNMFGcnYp/s1600-h/SANY0071.JPG"><img id="BLOGGER_PHOTO_ID_5307978389364066610" style="DISPLAY: block; MARGIN: 0px auto 10px; WIDTH: 320px; CURSOR: hand; HEIGHT: 240px; TEXT-ALIGN: center" alt="" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEisU2okyZqyOjNbh28NgV59KV2L5swFxkOVEI33HsJhYPST9MJaTxhRexpCYDL8K5bIOlH49K4Wu7ReJ6IyM3wALtjyRq-yM9g272eJ5TK22o9b470LkRHbqKKdBSjfYWInQA0sNMFGcnYp/s320/SANY0071.JPG" border="0" /></a><br /><br /><br /><div>Monday – 23/2/2009</div><div><br />I woke up this morning with a big smile on my face, looking forwards to having a happy moment in my life. The very first thing I did after my breakfast of a bowl of honey crunch cornflake was to call Anthony, the car dealer, telling him that I was going to collect the car today. </div><div><br />At 1pm, there I was on time at Carrol and Kinsella Motor Ltd, in Walkinstown Road to finalise the ownership of Toyota Auris 2007. After signing few papers and arranging the insurance, I was officially a proud owner of a beautiful car. It was dark blue in color, a hatchback with 3 doors, spacey inside with 16” alloy wheel. Zoom....I was off to work. </div><br /><br /><div><br />Tuesday – 24/2/2009</div><div><br />I was still the owner of the car. I was so excited driving it, passing through a heavy traffic in city centre to go to work which was about 1 hour away. I said to myself repeatedly ‘Eventually, I manage to own a proper car’. It had a stylish interior design with a good-looking exterior. I couldn’t be happier....</div><div><br />On arrival to my work-place, I found out that there would be a football match later that night in a stadium just beside the hospital where I was working at. As a result, I had some difficulty to find a space to park my car as the football fans started to arrive. Finally I found a small parking space behind an army reserved building about 300m away from the hospital.</div><div><br />It was a busy night at work that night. I could not remember how many broken bones or dislocated joints I saw. Nor do I remember how many patients I spoke to with trivial problems. Understandably, at the end of my shift, which was at midnight, I was exhausted, looking forwards again to being in my new car to enjoy the comfortable seat it provided, to drive with its powerful engine, to listen to my favourite radio-station Spin 108 which sound came from its 6 brilliant speakers.</div><div><br />After saying goodbyes and thank you to the night staff, I bravely walked through the cold night to my new beautiful car, slightly perturbed by the eerie sight of the graveyard beside the hospital. About 5 meters away from the car which behind was facing me, I used the remote control to unlock the car. To my surprise, it didn’t work. I thought, ‘Damned! I forgot to lock the car. I was hoping nobody had stolen anything from the car. There was an umbrella, a phone charger and a FM transmitter for my ipod touch for them to steal.</div><div><br />Walking closer to the car, with the help of dimmed lights from the nearby building, I noticed the back window was broken. ‘Oh! No! This is not happening!”, losing hope that the £90 FM transmitter would still be there. I quickened my pace to see the real damage. The very second I stepped beside the car, I was frozen, not by the chilling night, but by the appearance of my beautiful car which was not so beautiful anymore. I was so shocked by the unpleasant sight of the car. Nothing left inside. Literally, nothing! All gone! It was burnt out! The smell of it was nauseating.</div><div><br />The very moment I realised what my car had become, I was momentarily speechless, didn’t know what to do with so much mixed emotion inside. I was so upset that I wanted to cry my eyes out, I was so angry that if it was not a freezing night, there would be fire came out of my ears. I wanted to shout out loud to break the windows of the houses in neighbourhood as I believed whoever did it was/were from the area. </div><div><br />It was 12 midnight, in freezing cold, in semi darkness I was alone with a cemetery nearby, facing the leftover of my not-so-attractive-looking-now car. The first person I called was Andrew. With my cracking voice, nearly into tears, I explained to him briefly of my finding to his shock. Kindly, he agreed to fetch me. Poor sod, he had to go to his parents’ house to borrow his sister’s Mini Cooper to come to Drogheda.</div><div><br />Next, I called the gardai who shortly arrived to the hospital for me to make the police report. That night, I was informed by one of them of what exactly had happened to my car. Apparently, around 10 pm that night, after the football match, there was a small riot. Some of the yobs, smashed the windows of my car, threw in petrol and set it on fire. Great! You burn my car and you will be burnt in hell. </div><div><br />The garda also told me that when it was still on fire, the attending garda tried to contact the owner. Using the registration number, it was traced to the car dealer, and it was no way for them at the time to contact them. </div><div><br />Well, I was fine the next day. Still shocked by the event but more forgiving. The support I got from the nursing staff, my colleagues, my friends either here or in facebook has been amazing. For instance, one of the nurses when she found one euro on the floor, she immediately gave to me and said, “ here Hairi, towards the fund of yours to get a new car”. Or the other nurse who wrote in a sympathy card which I received from them the next day “Dear Hairi, so sorry to hear about your loss. Our thoughts and prayers are with you at this difficult time, PS: Matthews Bus $12 return. Regular service”. Ahh... how thoughtful they are!</div><div><br />Finally I would like to express my utmost appreciation for the kind words of support and sympathy I have received from my friends.</div></div>Hairi Lasimhttp://www.blogger.com/profile/17192208752731688723noreply@blogger.com8tag:blogger.com,1999:blog-2468954642449380858.post-8782314378727751412009-02-08T17:03:00.000-08:002009-02-08T17:10:59.992-08:00The frogs! The frogs!It has been so long since the last time I updated my blog. I just returned from my well deserved holiday in Malaysia, so, understandably I am still in my holiday mood. My mind is still at home, and my oh my, it is so damned difficult to go back to my normal routine. My sleep pattern is still in disarray, my appetite is still for the authentic spicy malaysian food. I put 5kg in weight in 2 weeks. Luckily, I think I have lost again all the extra weight in a week except the fat on my cheeks...<br /><br />I have visited my blog nearly daily to find a wee bit inspiration of what I should jot down. Well, I think I was having a mental block. My live is boring, nothing exciting at work. The only thing that I have found exciting recently is the political scenario at home, specifically of what is happening in Perak. All this time I have tried to restrain myself from talking about politics in this blog as it was created with the intention to document my journey as a doctor. Somehow I can’t ignore the unforgettable drama in Perak. I feel I need to have my say on this desperate situation.<br /><br />Before I go ranting and criticising I have to admit that I am no expert in politic nor I have any preference to any malaysian party. U will know the reason why later on. What i am about the write is from my own observation as an ordinary impartial follower of malaysian politic.<br /><br />What is going on in Perak now is immoral, unethical, shameful and disgraceful.....unfortunately constitutional. All of this because of the frogs that like to hop. As a member of state seat or parliament, a crossover should be prohibited by law. A formation of any government with the help of those who crossover should be made illegal. What is happening now has tainted the meaning of democracy. Anyhow I am not surprised it happened. Do you really expect a dignified strategy from the BN? Corrupted, arrogant, power hungry and out of touch....<br /><br />I believe what should have happened was the four state seats currently being held by the frogs should be declared vacant, and by-elections should be held. If the seats are still 50-50, then it is the Sultan’s prerogative to elect the government which he deems would benefit the people and the state. A snap state election is not economically viable at present considering the serious global recession we are facing. But hey, decision has been made. Having said this, to avoid further uncertainty and instability, the sultan’s decision should be respected as I strongly believe he has acted within the law and constitution. This is another example of imperfection of democracy.<br /><br />I also have to mention that I never believe the opposition coalition party, Pakatan Rakyat will work. They all have different ideologies. DAP one end, Pas the other end, Keadilan in middle willingly being the pacifist between the two. DAP and PAS cannot mix. They are like cencaluk and tempoyak (Malaysian appetisers). On its own, it is delicious to some people. Mixing together, they are rotten. Keadilan is like someone in the middle of rope pulling competition (pertandingan tarik tali), whose hands tied to the rope, one end being pulled by DAP, the other end by PAS. Up till today Keadilan was strong enough to balance the force from either end. The advantage of being in this position is he can feel which one is stronger. If he starts to fell the strain and if he thinks one side is stronger than the other he can let the rope from the weaker end loose, leading either the fall of DAP or the loss of Pas. The disadvantage is if Keadilan’s strength weaken, and both end stronger, Keadilan will split in the middle leading to its own demise. I suspect the latter will happen. The crack has become apparent with the call from DAP Hercules Mr. Karpal Singh today for the resignation of Anwar as the opposition leader.<br /><br />From my observation, Keadilan was formed initially to fight the injustice done to Anwar. Once he was released, the followers like lost souls momentarily. With the charisma of Anwar, together with the weakness of Abdullah Badawi’s government, Keadilan saw the opportunity to make a mark in malaysian politic. Unfortunately, they had no confidence to do it alone, so Keadilan gathered PAS and DAP to form Pakatan. Even so they, the Pakatan had no confidence to topple BN. That was why they were surprised when they managed to conquer 5 states. My conclusion is Pakatan had a great plan to beat BN but had no plan whatsoever how to form a government, hence they are in trouble at present. I was surprised with DAP and PAS for even agreeable to be in the same boat for the sake of bringing down BN government, sacrificing their own ideologies. If they think they can topple the government easier together, they could have done it years ago. Why wait for Keadilan? Why wait for Anwar who Pas used to call munafik and unislamic, who DAP used to call undemocratic, untrustworthy? I suppose this is politic. One minute you are the worst enemies, the next minute you are the best friend, all in the name of power.<br /><br />My problem with Keadilan is, it is too dependent on Anwar. Anwar=Keadilan, Keadilan=Anwar. What is Keadilan without Anwar? On paper Keadilan is a perfect party for me to support. It is a multi-racial party, a centrist party that champions itself to fight social injustice, discrimination and corruption. So why not? The reason I don’t support Keadilan is because of the same man why Keadilan was established in the first place. The man himself= Anwar.<br /><br />I respected him during his pre BN for what he was fighting for. I grew suspicious when he joined BN and with his meteoric rise in BN government. I believe what he did in the government during 1997/98 financial crisis was wrong, his sacking was right, his prosecution was wrong, his acquittal was right.....after that everything has gone wrong. He is an opportunist, a populist, two-faced and full of agenda. When he was released from prison, I was on his side with benefit of the doubt, hoping he had redeemed himself during his imprisonment. I was wrong. Following his speeches (ceramah), I notice he hasn’t changed much. He still talks like he was in BN. People have mistaken it as his charisma, I see it as arrogance. He never take the blame. He even blamed Abdullah Badawi for his own failure to topple the government. Come on Anwar! You could do better than that. Remember back then sometimes in August/Sept 2008 when he announced Pakatan would take over the government with the help from frogs? That was never materialised. He welcome Nasarudin to PKR but you can hear his opposition out loud against the party- hopping to BN leading to the fall of Pakatan government in Perak. Jumping in yes, jumping out no!??? Where does he stand on crossovers? Am I the only one notices his inconsistency in certain issues? I hope not.<br /><br />So where is my stand politically? BN? No way! DAP? May be. Pas? No way. Keadilan? May be- Anwar, No way+Anwar. Pakatan? No way. Perhap I should form my own party. It is called A Rhythm Nation Party. Manifesto: Shake ! Shake! Shake to the left, shake to the right, keep dancing.<br /><br />One more thing. Lompat, si katak, lompat. Lompat lah tinggi tinggi. But don’t you ever forget, Mr. and Madam Frogs, the higher you leap, the bigger impact you will have when you hit the ground! Spalsh!Hairi Lasimhttp://www.blogger.com/profile/17192208752731688723noreply@blogger.com4tag:blogger.com,1999:blog-2468954642449380858.post-58022875365923789492008-12-24T10:11:00.000-08:002008-12-24T10:12:43.526-08:00Santa 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!<br /><br />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?<br /><br />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!<br /><br />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.......Hairi Lasimhttp://www.blogger.com/profile/17192208752731688723noreply@blogger.com4tag:blogger.com,1999:blog-2468954642449380858.post-47546664565830518192008-11-27T09:30:00.000-08:002008-11-27T10:36:09.794-08:00Fingering..........24.11.08<br />At work now. Not busy.<br />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 <span style="color:#000000;"><u>said</u> </span>"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 <span style="FONT-WEIGHT: bold; CURSOR: hand" bab_id="3">couldn't</span> help myself. At least the nurses they all were on my side. I have to be careful with my mouth next time.<br /><br /><br />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 <span style="FONT-WEIGHT: bold; CURSOR: hand" bab_id="4">unforgettable</span> <strong><u><span style="color:#ff0000;">situation</span></u></strong>.<br /><br /><br />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 <span style="FONT-WEIGHT: bold; CURSOR: hand" bab_id="6">patient</span> first how. Half naked, lying on the <span style="FONT-WEIGHT: bold; CURSOR: hand" bab_id="7">trolley</span> 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.<br /><br /><br />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."<br /><br /><br />I still laugh <span style="FONT-WEIGHT: bold; CURSOR: hand" bab_id="9">every time</span> 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 <span style="FONT-WEIGHT: bold; CURSOR: hand" bab_id="10">xray</span> <span style="FONT-WEIGHT: bold; CURSOR: hand" bab_id="11">comfirming</span> 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. <span style="FONT-WEIGHT: bold; CURSOR: hand" bab_id="12">Don't</span> asked me how the vibrator got in up there. Again, use your imagination, and please don't be judgemental. Accident happens!Hairi Lasimhttp://www.blogger.com/profile/17192208752731688723noreply@blogger.com1tag:blogger.com,1999:blog-2468954642449380858.post-1808402031335102932008-11-17T15:33:00.000-08:002008-11-17T15:36:02.424-08:00Work? 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.<br /><br />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......<br /><br />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....Hairi Lasimhttp://www.blogger.com/profile/17192208752731688723noreply@blogger.com2tag:blogger.com,1999:blog-2468954642449380858.post-69560894288576147712008-11-13T04:52:00.000-08:002008-11-13T11:05:29.627-08:0034 and counting.......13.11.2008<br /><br />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.<br /><br />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.<br /><br />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.<br /><br />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.<br /><br />“A man is not old as long as he is seeking something” – Joan Rostand<br />“Age ... is a matter of feeling, not of years” – George William Curtis<br />“Life is a long lesson in humility.” -James M. Barrie<br />“Life can only be understood backwards, but it must be lived forwards.” - Soren KierkegaardHairi Lasimhttp://www.blogger.com/profile/17192208752731688723noreply@blogger.com4tag:blogger.com,1999:blog-2468954642449380858.post-13258108356578478992008-11-13T03:41:00.000-08:002008-11-13T03:45:36.164-08:00The 'sleepy' beauty11.11.08<br /><br />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.<br /><br />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.<br /><br />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.<br /><br />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?Hairi Lasimhttp://www.blogger.com/profile/17192208752731688723noreply@blogger.com0tag:blogger.com,1999:blog-2468954642449380858.post-71069815738140351622008-10-31T13:55:00.000-07:002008-11-01T16:02:43.667-07:00Halloween 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.<br /><br />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!<br /><br />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!<br /><br />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!!!!!!!Hairi Lasimhttp://www.blogger.com/profile/17192208752731688723noreply@blogger.com1tag:blogger.com,1999:blog-2468954642449380858.post-14212842696917722532008-10-18T08:02:00.000-07:002008-10-18T08:06:41.183-07:00Needles, 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.<br /><br />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.<br /><br />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!<br /><br /><br />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!Hairi Lasimhttp://www.blogger.com/profile/17192208752731688723noreply@blogger.com1tag:blogger.com,1999:blog-2468954642449380858.post-49125575485709430592008-10-15T11:45:00.000-07:002008-10-15T11:59:50.468-07:00FRom Dublin to Liverpool to Dublin to Edinburgh<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgng3aMqc3C9llQJXNX8HS_wc__srfnQlZ5sfKd_atIynf_QjzNFH5YuzrsMKN7c8-SQ-qDTvFjjTTS6ae5z6h0TJb_ssYvqGIgsyjRdDh8xhodrrJtBbmia5WV0mIuik6BvINA9wIMRjHz/s1600-h/DSC_0102.JPG"><img id="BLOGGER_PHOTO_ID_5257456081423502850" style="FLOAT: right; MARGIN: 0px 0px 10px 10px; CURSOR: hand" alt="" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgng3aMqc3C9llQJXNX8HS_wc__srfnQlZ5sfKd_atIynf_QjzNFH5YuzrsMKN7c8-SQ-qDTvFjjTTS6ae5z6h0TJb_ssYvqGIgsyjRdDh8xhodrrJtBbmia5WV0mIuik6BvINA9wIMRjHz/s320/DSC_0102.JPG" border="0" /></a><br /><br /><div>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.</div><br /><br /><div></div><br /><br /><div>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. </div><br /><br /><div></div><br /><br /><div>"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.</div><br /><br /><div></div><br /><br /><div>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. </div>Hairi Lasimhttp://www.blogger.com/profile/17192208752731688723noreply@blogger.com0tag:blogger.com,1999:blog-2468954642449380858.post-80525884074941554132008-10-02T15:27:00.000-07:002008-10-02T15:31:10.502-07:00The ConfessionEnough 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...<br /><br />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.<br /><br />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.<br /><br />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.<br /><br />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.<br /><br />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.<br /><br />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.<br /><br />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 BatinHairi Lasimhttp://www.blogger.com/profile/17192208752731688723noreply@blogger.com3tag:blogger.com,1999:blog-2468954642449380858.post-32037621750467506082008-09-25T14:07:00.000-07:002008-09-25T14:14:50.842-07:00A rollercoaster ride....<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgr3mU-qglaxrzmNzKjHL7wNa2ahKr2X_RHYEbRybdOTf_si0hR_sy9n61QPZL2QF9IlguWKLSx32R9oCBtbduwBXCwtknEPuRJfs3e_YUDFGEE4ChcV0EgJoggLdhGuRGYxL_K8GmJ40wG/s1600-h/CIMG1326.JPG"><img id="BLOGGER_PHOTO_ID_5250069657671127266" style="FLOAT: right; MARGIN: 0px 0px 10px 10px; CURSOR: hand" alt="" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgr3mU-qglaxrzmNzKjHL7wNa2ahKr2X_RHYEbRybdOTf_si0hR_sy9n61QPZL2QF9IlguWKLSx32R9oCBtbduwBXCwtknEPuRJfs3e_YUDFGEE4ChcV0EgJoggLdhGuRGYxL_K8GmJ40wG/s320/CIMG1326.JPG" border="0" /></a><br /><div>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.</div><br /><div></div><br /><div>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.</div><br /><div></div><br /><div>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! </div><br /><div></div><br /><div>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.</div><br /><div></div><br /><div>I promise I will reveal it all tomorrow!</div>Hairi Lasimhttp://www.blogger.com/profile/17192208752731688723noreply@blogger.com4tag:blogger.com,1999:blog-2468954642449380858.post-16684836974805561032008-09-18T15:05:00.000-07:002008-09-18T15:08:34.784-07:00Berlin! 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!<br /><br />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.<br /><br />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!<br /><br />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..Hairi Lasimhttp://www.blogger.com/profile/17192208752731688723noreply@blogger.com1tag:blogger.com,1999:blog-2468954642449380858.post-47664470082477596242008-09-15T03:51:00.000-07:002008-09-15T03:56:16.135-07:00Yeah! 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.<br /><br />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!<br /><br />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.<br /><br />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.<br /><br />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.<br /><br />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!<br /><br />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.<br /><br />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!Hairi Lasimhttp://www.blogger.com/profile/17192208752731688723noreply@blogger.com1tag:blogger.com,1999:blog-2468954642449380858.post-61969458387841002952008-09-12T04:31:00.000-07:002008-09-12T05:30:02.304-07:00privileged......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.<br /><br />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.<br /><br />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.<br /><br />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.<br /><br />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.<br /><br />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.Hairi Lasimhttp://www.blogger.com/profile/17192208752731688723noreply@blogger.com1tag:blogger.com,1999:blog-2468954642449380858.post-45239607657951979362008-09-11T02:51:00.000-07:002008-09-11T02:56:07.846-07:00Thumb......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....<br /><br />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.<br /><br />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.<br /><br />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!Hairi Lasimhttp://www.blogger.com/profile/17192208752731688723noreply@blogger.com1tag:blogger.com,1999:blog-2468954642449380858.post-60258081881013602332008-08-29T14:08:00.000-07:002008-08-29T14:32:48.593-07:00Umbrella.....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.<br /><br /><br /><br />Oh! Yes! I said yesteday I had a confession to make....well, not today....some other timeHairi Lasimhttp://www.blogger.com/profile/17192208752731688723noreply@blogger.com2tag:blogger.com,1999:blog-2468954642449380858.post-39912735793851267232008-08-28T15:43:00.000-07:002008-08-28T15:50:15.294-07:00Another day offThis 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.<br />I also have a confession to make but I will wait till tomorrow..see what happens.<br />Going to bed soon.Hairi Lasimhttp://www.blogger.com/profile/17192208752731688723noreply@blogger.com0tag:blogger.com,1999:blog-2468954642449380858.post-24429813997666052082008-08-23T04:58:00.000-07:002008-08-23T06:31:59.023-07:00My 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.<br /><br /><br /><br />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.<br /><br /><br /><br />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.<br /><br /><br /><br />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.<br /><br /><br /><br />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.<br /><br /><br /><br />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.<br /><br /><br /><br />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.<br /><br /><br /><br />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...<br /><br /><br /><br />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.Hairi Lasimhttp://www.blogger.com/profile/17192208752731688723noreply@blogger.com1tag:blogger.com,1999:blog-2468954642449380858.post-84994621350179147812008-08-19T10:26:00.000-07:002008-08-19T14:13:15.059-07:00Finally......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.<br /><br />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.<br /><br />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.<br /><br />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.<br /><br />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.<br /><br />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.<br /><br />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.....<br /><br />(ps: for confidentiality purposes, I deliberately omitted the name of patients, their exact age, and the exact nature of injury including the exact site)Hairi Lasimhttp://www.blogger.com/profile/17192208752731688723noreply@blogger.com1tag:blogger.com,1999:blog-2468954642449380858.post-36247127064399804282008-08-15T10:34:00.000-07:002008-08-15T10:44:43.799-07:00work...work....workFeel 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.<br /><br />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.<br /><br />Ok.....have to go to work now. Tomorrow I will talk about AAA.Hairi Lasimhttp://www.blogger.com/profile/17192208752731688723noreply@blogger.com0tag:blogger.com,1999:blog-2468954642449380858.post-24938875025737647902008-08-11T05:14:00.000-07:002008-08-11T05:33:33.451-07:00A 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.<br /><br />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.<br /><br />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.<br /><br />I had a great time. Everyone seemed to enjoy our food. Great company, great food.<br /><br />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.Hairi Lasimhttp://www.blogger.com/profile/17192208752731688723noreply@blogger.com0tag:blogger.com,1999:blog-2468954642449380858.post-89369067839325041222008-08-08T05:00:00.000-07:002008-08-08T06:01:45.343-07:00Something 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...........<br /><br />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.<br /><br />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....<br /><br />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.<br /><br />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!<br /><br />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.<br /><br />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...<br /><br />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......<br /><br />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....Hairi Lasimhttp://www.blogger.com/profile/17192208752731688723noreply@blogger.com0tag:blogger.com,1999:blog-2468954642449380858.post-46661297138616663612008-08-07T17:44:00.000-07:002008-08-07T17:45:15.792-07:00Anwar Ibrahim was charged yesterday. Olympic Game will start tomorrowHairi Lasimhttp://www.blogger.com/profile/17192208752731688723noreply@blogger.com0