fecking shite

Gynae is not good for my health.

I cursed.
Impatient.
Angrier.
Stressed.
Tired.
Frustrated.
Grumbled.
Unhappy.

Its not the gynae itself that troubling. Its mainly the system i.e dealing with labs, radiologist.. The uncooperative staff nurses, who demand you to settle your job to ease theirs, but at the same time unwilling to help to make it easier.

And dont forget the annoying patients and relatives. And those who sulked at you because you wont discharge them earlier. Its kinda shit because these patients dont bother to take care of themselves and yet sulked at you for dealing with their problem slow.

Like those diabetic pregnies who dont bother to check their sugar levels, eat like its the end of the world when they already have foot and eye diseases, and to top that, few miscarriages..

Like those patients who dont bother to look for blood donors up til their operation is cancelled, then they shouted at you when they already called up few relatives to donate blood AFTER you told them their operation is cancelled..and you knew you've told that bodo sombong patient that blood has to be donated at least 1 day earlier, not few minutes before they're pushed to OT...

Like those husbands who demanded to know whats going on with their wives and whats the treatment plan is AFTER the specialist had done their round.. Yes guys, you think its easy enough to marah HO macam aku, konon tak pandai jaga patient...Kalau berani sangat, tanya la specialist depan2. Ini tak, masa specialist around korang buat muka bodo..

I hate this ward.
I hate being a doctor.

Arghhh...aku nak pegi backpacking!!!!!!!!!!!

I miss Galway...

revenge

SN L: "Dr M, there's one new case to clerk ah.."
Dr M: ...was busy on the phone, fighting over blood with the bloody blood bank....
SN L: "OK, Dr M noted, write in there ah..."
Dr M: ...still on the phone...

5 minutes later...
Dr M: "Wei, siut...bila masa aku noted pasal kes tuk???" (cilanat punya misi...)

REVENGE...

Dr M did a quick check on post-op patient's TPR chart. Noted one patient's temp was 39C. Not written in the casenote. No HO informed.

So, Dr M wrote this in the case note:

1620: Went to review patient. Noted temp was 39C!!! Patient's shivering and sweating. Clinically dry as well. Temperature checked 1 hour ago, and SN didnt inform HO.... (followed by full examination...)..

35 minutes later...
SN L: "Eh Dr M, how come you say this? Tadi I suda kasi tau you la pasal patient spike temp.."
Dr M: "Mana ada? There's nothing written, 'Dr M noted' kat mana2 in the case note pun..."

YES!!!

low apgars

Casenote 1:
One case from Betong, for breech n early labour. Which is so untrue. cervix was damn not favourable and os's closed. She's "low Apgar", and has difficulty understanding what we're saying, not conversing with others..

Me: Kitak mesti beranak potong kak ah, sebab palak baby di atas.
She: Auk
Later,
Bro J: You tau ka kepala baby atas atau bawah.
She: Tau, bawah... (????)

Me (after explaining all the risks of LSCS):Paham kitak apa klaka kamek?
She: Paham.
Me: Apa dipaham kitak?
She: Sik tauk... (?????)

Bro J: Kak you apa nama?
She: "S"
Bro J: Suami apa nama?
She: Sik tauk...
Bro J: F*#K!

Haha..should've seen his face man...

Casenot 2:
OMG, it was damn busy yesterday. Ditambah pulak dengan all this pregnies with false labour, and few stupid referrals, and some annoying patients yang entah la.. bila dia nampak doktor malam2 baru la nak komplen, sedangkan dah ada symptom during office hour... Takde keje malam2?? Tido senyap2 suda la..Palpitations during contraction? Epigastric pain when not eating??

Does the rain affect your contraction pain?? Too many false labour last night!

Casnote 3:
Yang aku bengang, A and the other HO was covering the back.. And it was as I said before, it was super busy in the front because Y has to be the runner, so me and one of the MO had to do the clerking.. Si A boleh plak suruh aku tolong jaga belakang and review few suspicious CTG kat belakang, because she's busy with one patient, and the other HO is preparing another patient from LSCS. Melampau seh.. takkan nak suruh MO clerk sorang2 kat depan?? Sepatutnya 2 person is enough to cover the back la...

Karang aku jadik macam Bro J, "If I can cut myself into 8 ah.. " Siap dengan hand motion lagi...

Cerita pun dah berterabur....arghhhhh.....

Casenote 4:
Oh ya... I hate GW. I dislike the SN's, especially those with annoying voice who kept reminding you of your jobs and that they're not suppose to do it and then start threathening you that how your bos will be angry if you dont do the jobs. Yeah, feck off... Just say you're lazy la. Full stop.

The girl who shout prolapse

Nyehehe..
Aku akan ingat 31/1 sebagai tarikh aku memalukan diri sendiri..

That day, around 4.30am, I went back to the Labour ward. I was just finishing clerking a case in Gynae ward (nasib baik patient tengah tido2 ayam jam 3am tu). I was in OT (4 LSCS & 3 ERPOC) from 4pm the day before, till1.30am that day. I'd managed to get 1 hour and half sleep at room 27 (Gynae Ward). Lepas tu baru tersedar yang ada satu kes kene clerk..ngeh ngeh..ngeh..

When I went back to Labour ward, it was really quiet la..BCY was at the back, Akak and A were at the front counter. Akak was pengsan-ing, while A was clerking the last patient. Aku jadik budak baik went to the back to do few VE review. Noted, already 2 patients for KIV LSCS on the white board (sigh) Akak cakap aku punye pasal patient kene LSCS, sebab pakai tudung warna pink, konon 'panas' la..huk aluh..khurafat seh..

Sekali I went to VE this patient, dengan kepala separa-mamai.. I was like, "Eh, amende ni??" ALAMAK, cord ke?? So I shouted out, "CORD PROLAPSE!!!" hehehe..

Bila aku rasa2 balik, la..swollen anterior cervical lip la.. Tapi by that time everyone, seluruh isik Labour ward, has already arrived di pintu bilik itu. Aku sengih sorang2.... Pacik SH dah muke bengang, bila aku cakap false alarm la..eheheh.. Tetiba patient tu full os, so, bila placenta out, dia tanya aku, "Hah, where's the CORD??"

Hehe..matila aku kene laser hari tu.. Tapi aku cakap la kat diorang, "Waaa...you guys punye reflex bagus la..Next time I'll shout out shoulder dystocia pulak.." And everyone was like, "Wei.. Marisa, jangan main2.."

Kamon la Marisa, patient tu sah2 dah ARM brapa jam lepas, os nearly full, takkan la prolapse..DANG!! Yang aku bengang, BCY cakap dia dah notice swollen tapi dia tak tulis dalam case note..hulamak, stupid, idiot, kuang hajau..

Aku patut jadik jahat dan stay tido di Gynae ward sahaja...

absurdity

If I'm a 31 years old, para 5, diagnosed of ovarian ca stage 3B and I'd to get a staging laparotomy +/- proceed, the first few things I'm gonna ask will be:

1. what are the chances that I'm going to survive post-op, or died on the table during the operation?
2. with 5 kids, who are going to take care of them while I'm sick in the hospital, or died..?
3. if my mortality rate is high, have I done enough as a good muslim to secure a place in heaven?

The last thing I'm gonna ask the surgeons again and again and again.. will be, "will I be able to have sexual intercourse with my husband after the surgery??????????"

OMG!

Thats the most absurd thing/question I'd come across from a patient throughout my medical years... I mean its OK to ask once, but 7, 8 times? Aku jadi malu as a perempuan. And she asked me again (while I was getting the operation consent) in front of her husband.. WTF...

Come on la lady, think about your own life first la.. If you're dying, nak bernafas sendiri pun tak larat...

Death do us Part

When I woke up from pengsan around 7pm just now,mum is already back from Sibu.

She was celebrating CNY in Sibu with her mum and sis. Because of CNY, mum didnt bring back roti kompia :(

We were having dinner dan dia tiba2 bukak cerita.
She boarded the flight to Sibu, together with a prisoner who was sentenced to death penalty, escorted by 2 police officers. It was a drug case, where this fellow guy was caught when he was at the courier office, collecting a parcel containing ganja. He was with another guy at that time, but story tells, the other guy surrendered and testified against him in the court. So, this poor fella,tried to appeal to the high court in Kuching but with no luck. According to dad, he'd made few mistakes leading to his sentence. He uses false name when he was getting the parcel, he ran when he saw the police, and he threw away the parcel when they were chasing him. All the GUILTY sign. So dad advised, if we're to drug trafficking, make sure we act cool and act innocent when we're caught. Nice one dad, thanks for the advice.

Then both mum and dad start to reminisce all the criminal cases they knew in Sibu. One of the cases happened in 1970s, when mum was in Form 6. There's this one murder case in Kpg Biduk., aroung Sibu la.. There was this young couple, where the boyfriend was going to further hi sstudy in Taiwan. The girlfriend was afraid that this boy will leave her, and so she decided to wait behind the bushes with a huge parang. She knew this boy will pass that bushy area on his bicycle. So, when this budak lalu, she came out from the bush and stabbed him straight into his tummy. He bleed to death. That girl was then caught, as she was the prime suspect in that little Kpg Biduk. However, her parents managed to get one of the best criminal lawyer in Sibu to defend her, and she ended up free from the murder conviction. Scary thing was, that lawyer married that girl, and has few kids together. Ewww... I cant imagine what kinda deal they had.

"Marry me, and I'll make sure you'll win."
"Yeah sure, but dont leave me, or I'll stab you in your sleep."

life and death

An unknown female was heavily intoxicated and was hit by a truck. Her face was heavily disfigured, her left eyeball bursted, her skull fractured causing severe diffuse cerebral hypoxia. Family opted for euthanasia after explained of poor prognosis.

A 13 years old boy was in a passenger seat when his father tried to overtake another car at a sharp corner. Luckily for the seatbelt, he suffers no head trauma. However, due to high impact from the seatbelt, his large bowel perforated and needed emergency laparotomy and bowel resection.

A 27 years old guy was driving at 120m/hr. Failure to wear seatbelt resulting him being thrown out of the car upon head-on collision with another car. He suffers from severe brain damage and currently dysphasic and unable to swallow.

A 31 years old guy was half asleep while driving early a.m. Hit a truck and ended trapped beneath it. Now, he's spastic quadriplegic, urinary and faecal incontinent.

A 24 years old lady was driving back from work when another car hit her (hit and run). She fractured her left femur and severed the femoral artery, led to haemorrhagic shock. She died few hours later due to cardiac arrest.

This is not a public notice about safe driving. This is a reminder to everyone, how life and health is precious only when it's gone. True, death is inevitable. But failure to appreciate life is not excusable.

- surgical internship reminisced -