Protective factors in my housemanship

Kuala Krai Hospital has been in the news a little too much lately for non-favourable reasons. One is the Peeping Tom doctor and, of recent, a houseman who unalived herself in her hostel room. As someone outside the organisation and the investigating team, I wouldn’t know the exact motivation that drives their actions. What I do know is that this rings an alarm of how organisations should play a proactive role in caring for their employees. Not everyone is bestowed with skills to cope with stressors within the medical faculty.

Indeed, counselling services are available to all levels of professionals working in this setting. But are they accessible? Not really. Even as a houseman, if you are taken ill, you are somehow expected to still turn up unless you can’t move from your bed. It is just a sniffle or a sorethroat, attendance is still expected.

Self-managing your own stress factors is not a skill that you get in one day. Considering the different levels of stress factors, they definitely require more than one method of troubleshooting your coping mechanisms. Combine that with your personality, socio-economic circumstances and organisation support, different people get access to different methods of stress relief.

When I was a houseman in Hospital Umum Sarawak back in 2008 – 2010, my strongest protective factors that prevented me from quitting the job, despite the severe swelling of my legs and lack of sleep, were;

  1. Government scholarship
  2. Parents expectation
  3. Really good friends in every posting

And may I add another overlooked factor that is often ridiculed by those who don’t have it, Resilience. Resilience that was put together by life experiences in childhood and teenage years. Those who lack it would often say, ‘dia senanglah, dia dulu bla bla bla’. Or ‘dia bolehlah buat mcm tu’. Or ‘zaman dan berubah, kalau dulu bolehlah macam ni macam tu‘. Resilience is not stagnant. It grows with time and a person’s willingness to learn. Your resilient past self may not be able to cope with future stress factors if you remain obstinate to live life as you did yesterday. This is because the world is moving very fast. Those who don’t improve themselves are bound to be left behind. This is not to say that all that was in the past is bad or kuno. We still have to remember that history is the building block of the present and the future.

Government scholarship

I was a JPA scholar. I was tied to a 10-year service bond upon graduation. To which, Alhamdulilah, I have completed my dues. I remembered having a few students from my batch who refused to come back after completing their studies. Instead, they stayed behind and pushed ahead to become specialist in their chosen field. I’m not sure how they negotiated their scholarship deals, but I am happy that they have attained success in their ambition. Understandably, Malaysian doctors earn less than their counterparts in developed countries. However, I, who comes from a non-medical family background with what counted as B40 status back then, am tremendously grateful for the opportunity given to step into medical school. Back then, this was almost an impossible dream.

Hence, quitting housemanship is not an option.

Diligence in my studies carved the path to medical school. The JPA scholarship was my stepping stone to earn a place in one. Hence, I served in the MOH well until now. I sucked in all the atrocities of housemanship and medical officer hurdles. Simply because I was grateful for the chance given to improve my family’s circumstances. I was able to give my late mother RM800/ month for her spending money. She was a housewife. I could buy groceries without fear of going over the budget. I get to go on holidays more often than I did during my childhood. Inadvertently, my children could benefit from my salary.

Parents expectation

It makes them proud that, despite their B40 status, they were able to ‘send’ their kid to medical school. I was the eldest daughter, the eldest cousin of my paternal side, the third eldest cousin on my maternal side, first from ‘the village’ to enter medical school. I was the perfect example. There was just no room for failure. I had to make it work.

Making my parents proud was the ultimate thing I could do as a daughter. Is this what they call filial piety? Generations of modern times would probably scoff at this concept. Especially when the world has taken a turn or more toward having greater exposure to champion individualism vs collectivism causes. Everything suddenly becomes toxic. Opposing advice from parents and learned adults is toxic. Stress is toxic. Some couldn’t even differentiate between good stress and bad stress at all. As a well-rounded human being, you have to learn to experience anger, sadness, happiness, etc., in varying levels to build your character and create a healthy emotional baseline for yourself.

Great friends

I met different levels of houseman ‘seniority’ in every posting. You get first posters and final year posters. Each of them carries a different perspective and values in their work, and I felt that it was a great opportunity to learn from them as well. Not just from medical officers and specialists. We get our ‘teas’ from our fellow housemen. For instance, which MO is malignant and which MO can we tag along with ‘feeling safe and less stupid’? What are the prohibited phrases you say in front of the specialists? What would make ‘MO Bedah’ less cranky and all? These are unspoken tips that are passed down from one houseman to another. But only if you choose to work as a team.

Thankfully, I have always had colleagues who help each other out. We watch each other’s backs. My honest advice is to make friends with everybody. It makes you seem like a favourable person, and people would go to great lengths to help you. After all, there is a saying that goes if you ‘mudahkan urusan orang lain, Allah akan mudahkan urusan kita. InsyaAllah’. Stop looking at being nice, receptive and supportive as ‘mengampu’ or ‘dipijak’. It could be a learning opportunity.

We forge friendships, watch movies, go on trips/ holidays ( Bako Island, Semantan Beach, Bali), and eat meals together. As someone who doesn’t take alcohol, eventhough I tag along their ‘clubbing’ activities, I would stay by the side and just watch friends dance horribly while being slightly drunk. And have my glass of Coke. Sometimes we have lunch together at the nearby pondan cafe. Or on our days off, at fancy restaurants – to remind ourselves that we are doctors and we can afford this. Ha ha. We create fun at our workplace too. For example, betting on which TKR patients in our respective teams would ambulate first and be discharged? Hence, everyone would be motivated to encourage our patients to move their limbs. Or which patient farts first, kind of thing.

Mengumpat is also a good activity to do with our friends. Mengumpat dengan hati-hati. It’s a good outlet to vent out your frustrations, madness and everything else under the sun. But please do this with trusted colleagues only. Our mengumpat sessions have the mimic muka, tone of voice, everything.

Until now, I have kept in touch with several friends during my housemanship years. It is nice to see how great (specialists) they have become, despite how nerdy or lousy we all were during houseman times. The innocent mistakes we make, the tiredness and the frustration all become laughable once we’ve completed that phase. Should I splurge their names? Ha ha. Neh, they will reveal themselves as those who ‘once knew Minci’ in due time.

6 days off

Melaka was very fortunate to have 6 days off work during the Chinese New Year celebration. I did not have to think about work for 6 days, and what a blissful week it was. Furthermore, the 1st of Ramadan also falls in this same week, and I thought it was great for the kids to have 4 Ramadan days at home. No school, nothing.

I made caramel pudding.

Tanghulu.

Brownies.

6 days off

It is only a matter of time for me to have the courage to try to make cinnamon rolls. I have saved a few recipes on Instagram. I just need that ounce of energy to do it.

Craving asam pedas in Muar

I was not a fan of asam pedas. Until I had my MIL’s asam pedas. The visuals of her dish are mouth-watering with its bright red colour, but it is not spicy at all. Since then, I have discovered asam pedas tetel and other proteins in asam pedas. I tried making asam pedas, but the balance seems to be off. You need a good mix of chilli and tamarind paste.

Before Ramadan, my father was craving for a particular asam pedas in MUAR. It was Asam Pedas Kak Yah, located near Masjid Jamek Nurul Iman Parit Bakar. The journey was an hour’s drive from our house. We ordered 2 portions of mayong, 2 portions of pari, 1 portion of vegetable, 2 portions of telur dadar, 4 plates of rice and 4 drinks. The total amounted to a reasonable RM80.

We reached there just after 11am. The crowd had not arrived, so we were able to have our meals peacefully. Overall, it was a great lunch.

The morning before KKOM-ing

I had to substitute a colleague at Klinik Komuniti the other day. Klinik Komuniti (KKOM) has odd working hours of 12noon till 9pm. There is no lunch break, but there is an hour break during Maghrib at 645pm-745pm. It is usually manned by a medical doctor, a medical assistant, a registered nurse, a pharmacy assistant and a health assistant. KKOM was established as a means to provide services for minor ailments, wound dressing and emergency situations outside office hours for areas at the periphery of the main town.

I honestly think that KKOM is already out of touch.

We have plenty of GP services sprouting in these areas, providing care out of office hours. Some clinics even open 23 hours. The government should look into providing incentives for shared care between the GP and KK. Of course, cost is an issue, which is why patients still prefer going to KKOM. However, this is where the thinkers need to reconsider the said options. Furthermore, people are treating KKOM as a retail pharmacist. Some would straight up request paracetamol or mmt as standby meds at home.

Enough of that.

I am usually prepared on days I have to go to KKOM. Meaning I would arrange for certain errands to be done in the morning, like going for longer brisk walks or to the bank. This time I wasn’t. I have quite forgotten my own schedule. Hence, I find myself undecided on whether to go for a walk or stay inside with my kettlebell. Then, should I go for mamak or just have toast at home? Should I watch a TV series or do online CPD? Brunch with asam laksa maggi or go for a bite at Aeon. My decisions led to this.

  • kettlebell at home
  • toast and hot coffee at home
  • online CPD to collect enough points for my APC renewal
  • a bite at AEON

I had a lovely brunch of Beef Stroganoff Pasta and GIGI Coffee. Lucky me, GIGI was having a promotion. All drinks were priced at RM6.90. I ordered an Iced Pecan Latte. It tasted awesome.

Losing a colleague to functional medicine

Do not get me wrong. Functional medicine is good. Especially when it is practised ethically. I hope my colleague will be able to integrate his passion for functional medicine with the current practice well. What is more important is to do no harm to the patient. When a colleague like him, who is a senior and in a permanent position with relatively good wages, decides to leave, that’s when we know he is going for Self- Actualisation. Good for him.

We wish him all the best.

And like any badak ceremony, we saw him off with a farewell party. This time the theme is Oriental. So there’s a hotpot with an Oden-ish broth, siew mai, pau and many others.