One of those moments when I had total Tawakal to Allah …

Tawakkal (Arabic: تَوَكُّل‎‎) in the Arabic language, is the word for the Islamic concept of reliance on God or “trusting in God’s plan”. It is seen as “perfect trust in God and reliance on Him alone.”

I just had another moment betul2 tawakal last week when I managed a lady with dengue. A severe dengue. And she was pregnant.

It’s one of those cases when even the most bad ass sinner would turn to God seeking help. For all we know, there is no antiviral nor magic concoction to battle the disease yet. We could only provide supportive treatment until the virus weakens, as our antibody fights it off.

If you confront in with an already impaired health status – meaning for instance if you have diabetes or a pre-existing heart condition, it may mean you have to fight harder. Yet doctors and researchers remain perplexed as to why young, healthy individuals still succumb to death despite having nil medical condition.

In my case, I like to think that a pregnant mother gets their extra support to fight dengue from their fetus. Just like those pregnant doctors oncall who seems to have super strength doing their job even though they had to be on their feet and stay awake all night.

On that particular day, the moment the lab called to inform that her blood results were positive for dengue – I had cold sweats. My first thought was, what would my visiting specialist do? I used whatever insight and things I learnt from my boss from a case I consulted a few days before (also a lady who had dengue fever with very low blood pressure) and applied whats relevant in the current case. I kept reminding myself to document my actions and treatment plans properly because if other people do not see it on paper – that means you did not do it. Documentation has always been a problem for me because one, I am very slow in differentiating what is left and right. Secondly, my thought processes are so fast that my hands can’t keep up. However, it must be done for effective continuation of care.

I have been in a mortality case discussion before. Although no fingers were pointed (like, honestly!) – in retrospective, we always feel bad because in hindsight there was always that something you could do to hopefully shift the condition to a better outcome.

After initiating proper early interventions and consulting important people, I passed the baton to my more expert colleagues in the tertiary hospital. From what I gathered, they had a sleepless night too as they had to face several medical emergencies one after the other. But I was very hopeful because it was a strong team working that night. At that hospital.

My adrenaline and anxiety did not stop there. I actually made solat hajat and read Yasin for the patient that night. Which was something I rarely do. Even for those who are most ill. But I felt compelled to do so because during the last minutes prior to transferring her into the ambulance – I caught the face of one of her children. Her son, probably around 8 years old. Crying in the arms of his father who was also sobbing – worried sick for this wife who has bored him their  4 children and now carrying his 5th.

That made me very determined to pray to Allah that night. So this woman could stay strong , so she could return to her family and wipe away the tears of her crying husband and children. And that everything would be okay once more.

Alhamdulilah.. she is now out of danger.

Nenek Suraya

I rarely talk about my job because it is so medico-legal related nowadays. I worry that I would accidentally spill on sensitive and confidential information regarding the case. Even if I take extra precaution to not mention the patients profile or disease – there is always a fear that someone who reads my blog would know that patient and proceeds to condemn me for say, embarrassing the patient and what not. Sedangkan Wardina and syed Azmi who did not mention the name of a Madrasah pun kena kecam.. apatah lagi kita kan.. 

But I just had to share about my anecdote with an elderly patient I came across last night during my oncall.

She was in her early 90s, a foreigner from our neighbouring country. She is of Malay descent who speaks very good English. She was at the emergency department for a fall and her small, weakened body sustained an injury at her right ankle. She was seen by my colleague and while awaiting for the porters to transport her to the Xray department – she kinda beckoned me over to her bed. Probably needing more painkillers, I thought.

In fact, I have treated her before for a simple fever. It was a visit many years ago when her also elderly husband was still around. I don’t think she would remember and just made it seemed like our first time meeting each other.

She quickly grabbed my hand as I neared her and asked of my name. She smiled and volunteered her own, “I am Suraya (not real name). I’m a Singaporean and I just hurt my foot”. All this in clear, crispy Queens English.

Her husband and one of her sons had recently passed away. She was a mother of 9 and specifically mentioned how blessed she was to have one daughter. A daughter she raised like carrying a cupful of oil. This lady encouraged her daughter to get a good education – a tertiary education. Indeed she succeeded as later the daughter landed a high paying job in the immigration department. The daughter got married , had a child and that’s when Nenek Suraya mentioned, “she broke my heart”.

“She wanted to quit her job. A job that puts the food on her table, a roof on her head.A job that makes her who she is. Why would she want to do that for her husband. You are supposed to think about your child – yang dia nak fikir pasal laki dia sangat kenapa. I can help cook for her. I can help care for her child. I just want her to keep her job and stand on her own two feet. And not having to ask of her husband for money each month for her own use! “

Honestly, I don’t see a problem in a woman wanting to do what she wants as long as she is clear about her plan and knows what she is doing. Long gone are the days where netizens debate on SAHM vs Working mom. In fact, it shouldn’t happen anymore in this era. Instead – we should move towards supporting fellow women with their decisions the best that we can and raise a community together.

But Nenek Suraya is heading to 100 years old. Perhaps there are pearls of wisdom I should pay attention to. I kept mum and kept my ears open.This was after all a woman who lived during the times when women were not as liberated and free to make their own choices as compared to what we are today. She experienced the whole world maturing and accepting women’s roles as equals when it comes to serving your nation. It seemed to her personal opinion that she failed to bring her daughter out from the traditional role as the one in the kitchen to the lady of certain power in the office. It was understandable . There was no need to be severely offended if say, you choose to achieve financial freedom by having a homebased business for instance or adopting homeschool to your kids full time. It was just her personal idea of how she chose to value her daughter. And I respect that.She’s not waging a war against women who makes informed decisions in quitting their 9 to 5 job for their family.

Because you see, I come from a similar background. Although my mother did not get to step foot in university – she was street smart and managed to command the household accordingly. It would be devastating to her if say, I chose to quit medicine despite completing my bond with the government to be at home. To her, it’ll be a waste of my ‘education’ because education was something she was deprived off in her younger years due to poverty and social circumstances. Although I yearn to be this mom at home , I still have second thoughts. out of respect for my moms wishes and her understanding of an empowered woman. Perhaps later, should I choose to pursue my freedom to dictate my own life – perhaps I could make her feel less sore by reassuring her that I’m replacing my income instead. At least she knows I’m not wasting my education but channeling it in a different manner.Kan? less mengejutkan… buat stationary based business ke apa kan.. 

At the end of the day, mothers just want their daughters to lead their lives better than how it was for them before. Who would want their precious daughter to go through hardship similar to theirs kan? After much sobbing and pouring her heart out, Nenek Suraya finally let go off my already numb hand. Again, she asked me of my name and returned the gesture with, ” “I am Suraya (not real name). I’m a Singaporean and I just hurt my foot”.

Retirement

Killing two birds with one stone.. 

Our trip to Kuching, apart from as an annual balik kampung thing – was purposely planned to coincide with my Anaesthesia Department HOD in my previous tertiary hospital’s retirement party. She was to retire after serving the community in Sarawak for  15 years. And she was not even a Sarawakian.

I remembered stepping foot into her office for the first time and was met with a lady who spells charisma as easy as ABC. Her voice was as loud as thunder but never far from dispensing an advice or two. Her knowledge of anesthesia itself was admirable but her understanding of life and death was eye opening. We not only began to appreciate the beauty of our vocation but were also disciples of life long learning for this world and the Hereafter.

She was never the one to give up. Never to say NO. Or cry impossible. She stands her ground but even so she would always find the middle path so more people would agree with each other to get the best results. A great leader must after all be prepared to be a great listener as well.

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A lot of people turned up for the event which was of no surprise. The food was served over 9 mini courses. Some were delicious, the rest were palatable. Being a mom of a kindie boy – I couldn’t help feeling glad it was over. I needed my rest that badly.

I managed to meet and salam some of my other beloved specialists. And of course held the hands of Yang Diraikan herself. Naturally, she would find it difficult to place a name on my face because well.. I was so young back then. This was like more than 5 years ago – a time when I was still skinny and not married? Ha ha..

I grabbed her hand and salam her. CIUM TANGAN okay!! I introduced myself as so and so. I let her know of what I am doing now (regardless of its significance). She was happy that I was still doing anesthesia although I see more of excision biopsies than say a laparotomy for an intra-abdominal injury or a Whipple. Just being there to be able to hold her hand and hear her say, “ok.. thats good.. thats good” was one of my best 60 sec in a lifetime. And you’d only feel like that if you treasure and respect a person dearly. Yes, I adore her a lot. Like MEGA much.

She is at the moment ranking as NO 1 on my list of favourite female bosses. I look forward to adding a NO 2 on my list and yes, I have spotted someone.

the word is hectic

My schedule has been very hectic lately and honest be told, I am not getting any younger to tahan being oncall. Gosh – need a way out of this. Ha ha.

Yesterday, we had a meeting discussing mortality cases that occur within the department. Indeed, there was a lot to learn. My brain was theoretically searching for the files in my brain on certain subject matters. for instance, how is a U wave formed and all those things.Ironically, nak jadi specialist ko kena back to basics sebenarnya.. like mitochondria punya level sorta thing. Then only you can talk about journals and scholarly articles. Kalau basic pun susah nak grasp – how can I understand HFOV or BILEVEL vent settings right?

Apart from being in the hospital, I also went to court for the first time. Its considered a milestone for any medical officer I suppose. It means you’ve been around long enough to treat criminals or have their DNA taken or something. In other words, you’ve seen enough of the ugly things that happens around you  – shielded from the public. It’s like sampai satu tahap you know a felon is faking an asthma attack just so he could breath the fresh air out of his cell by making a visit to the hospital. Cam y lah…

On a different note – I saw a bouquet of flowers dying on one of our lockers in the room. I am tempted to bring them home but I have yet to ask for permission. From the receiver. Fresh flowers often reminds me of the time I studied in Manchester. There, fresh flowers are cheap and affordable – sold at ASDA or TESCO. I’d often buy them once in a fortnight and have them on my window sill for they are so pretty to look at and some smells nice too. How I miss the pretty sight of carnations and scent of a rose ..

Speaking of flowers – my new stamp collection came through the post. pics in the next entry.

 

spending the last 10 seconds of the hour.. contemplating

minci in orange

This was me a few hours ago. Waiting to go home. I just managed to send a few of my patients for Xrays, wrote a few referrals and discharged a patient in the observation bay in the last hour. In other words, trying to clear off as many cases from the morning shift before the PM shift colleagues punches in. We want them to start the shift as motivated and peaceful as they could because it ain’t nice having to stay till 12MN only to come back to work the next morning at 8AM. And you live like.. 45 minutes away. Balik rumah nak bersihkan diri, gosok gigi.. makan.. zzzzzzz

Its halfway of March and already I’m thinking about booking a holiday – but what are the odds of doing that with more colleagues leaving this year. Ntah2 cuti tidak diluluskan. The most number of medical officers leaving from our place in a year was 5/year. Perhaps we can break that record this year? Since 2 is quitting KKM and another 3 has sent in transfer letters. All for greener pastures.

In the meantime, I just need to FOCUS and PERSEVERE. 

FOCUS with the end in mine. Meaning I’d still end up in government service. It’s like how one of my specialists put it – if all the good ones go to private , sapa nak jaga mereka yang tam mampu ke private. So yeh.. despite the caci maki and accusations of gomen docs being tak ikhlas, I believe that by knowing what your priorities are and being IKHLAS would help one a lot in staying in the service and serve. Takpe, yang maki sorang dua.. the appreciative ones will never make it to Facebook or the news – but you can feel their gratitude through prayers they ask from ALLAH for you.

PERSEVERE still through the days when your are physically drained simply because you are too, undergoing the aging process and becoming old or merely being ill. Being persistent on days when your referrals are rejected or ridiculed by MOs in the tertiary setting. Or having to dig back the medical knowledge of yester years and the future as you have no clue as to what is wrong with the patient in front of you. Persevere too through the hurtful remarks patients and relatives throw at you simply because you are unable to entertain their requests for instance. Meh.

Because at the end of the day – apart from CARING for the patient, I have come to realize that my job is also my ibadat. My field of pahala if I do it right. I should make my salary count. If I am paid RM5/hr for the job, then lets make it a worthwhile RM5. I do not want my HALAL rezeki to become HARAM for me – meaning I make money from something that I did not earn rightfully or without amanah, kerja 8 jam tapi batang hidung cuma muncul 2 jam. Camya lah …