Wonderful Life!

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.

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.
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.

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.

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.

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!

The demise of his beautiful car

Monday – 23/2/2009

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.

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.

Tuesday – 24/2/2009

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....

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.

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.

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.

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.

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.

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.

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.

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.

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!

Finally I would like to express my utmost appreciation for the kind words of support and sympathy I have received from my friends.

The 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...

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.

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.

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....

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.

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.

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.

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.

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.

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.

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!

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.......

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!

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....

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?