Category Archives: All in a days work

as a medical officer

Nice demeanor

Posted in All in a days work, Everyday Life by

A colleague of a specialized discipline from a different hospital passed a comment to me today. He said,

” wow.. you guys are pretty ‘relaxed’ for someone who is part of the anaesthetic team “

When he said you guys – it was referring to me and my one and only working partner in the field – and when he said we were relaxed.. I kinda knew what he meant. That means in face of obstacles and unpopular circumstances in the operation theatre – my partner and I rarely exhibit aggressive behaviors like screaming or rolling our eyes at the surgical team and stuff. Or cancel a scheduled elective list like it can be done tomorrow sorta thing without a two way and mutual discussion.

My determination to maintain a cool hat and ‘being nice’ to other people stemmed from when I was a houseman in Kuching. One particular oncall night stood out. I was in my 5th posting as a surgical houseman (HO) and I was posted to the neurosurgical ward. I was oncall with a very motivated and nice Neurosurgical Medical Officer (MO). At the same time, coincidentally – most of the other Medical Officers of various discipline that night including the Anaesthesia Team had genes of a Saint. Everyone was so damn nice, polite and kind to each other which was evident during referrals. Even to this little non significant HO!!!! As a HO I felt confident, safe and urge to do more for my patients. I wanted to please these kind MOs working with me that night. Anaes required at least 2 large bore branula, I gave them 3. You want me to trace the result STAT .. I will bug the lab technician to run it fast. My MO even sat with me at the pantry while we have our quick 5 min meal and asked if I had prayed – he did not have to cause he is not muslim but he did! Although most of our patients that night were critical and semi-dying – none died and hung on to the dear life until the coming morning. I couldn’t help leaving work the next day at 7PM thinking how nice the world of medicine would be for the patients if everyone can work well with each other and stress more on them rather than thinking, “ayo.. that lioness is oncall ah.. susahlah nak refer” or ” aiyo.. she likes to marah people one.. you lah refer” and the game of ping-pong begins in ED.

When I became an MO myself in the Anaesthesia department – I find that by being accommodating – people can cooperate and work better with you. As an anaes MO at the time especially when working in ICU, I’d be receiving referrals to intubate a difficult patient or asking for a ventilator or to review a potential ICU patient in the emergency unit or wards. When we are ‘friends’ with those from other disciplines, it is easier to discuss options and demands. It is easier to refer earlier for the health and safety of the patient. It is easier for these friends to understand why the operations needs a certain amount of blood products or why ICU cannot accept a patient. There’d be less bickering and pointing fingers. Plus, naturally we would want to do more for our ‘friends’ kan. And we want our friends to have an equally good call.

On top of that, if we exhibit concern and educate our supporting staff accordingly, it is easier to get a message across.To share and idea or sentiment. Thus reinforces on patient care. If the environment is conducive and pleasing, we will then be able to see how various people of different levels respond – the lazy ones left behind but the opportunist would learn more and better themselves. I will hear more of my porters being able to report to me saying ‘hey doc.. this patients white cells are high’ instead of just collecting the results and staple them. I am always happy when my nurses are able to point out a patients potassium level is deranged when the results reach them first and not just file them for us to review later. I am more delighted when my medical assistants with many years of experience are able to guide me through a difficult process – medicolegal aspects of things and such.

I hope to keep this ‘menyenangkan demeanor‘ around for long time. I’m no angel. I have lost my temper before – I have raised my voice before towards staff, patients and relatives but towards late.. the incidence have decreased tremendously. Perhaps I’m getting old.

A toast to a nice demeanor. cheers.

An unfavourable outcome

Posted in All in a days work, Ponderings & Personal Development by

I started my new year with a business trip to Lombok. Neh.. I wish.

Instead it started with me being oncall.

Assisting people in diagnosing their medical illness and while at it, solving their social issues. Honestly, if one decides to step their foot in the emergency unit – it must be for a very serious and urgent matter. Hence, they must be prepared for the outcome of the visit such as

  • for admission to stabilise the condition or observation
  • for a follow up consultation in the respective specialised clinic
  • transfer to a tertiary centre with relevant expertise, should they need one

Therefore, it is heartbreaking and at times frustrating when after the length of procedures and test we do prior to the above 3 solutions, you suddenly say

  • I want to be admitted at a private hospital – do they not realize that a similar battery of tests and investigations will be repeated at the private centre.. membazirlah test yg dibuat earlier from the RM1 payment.
  • I can’t be admitted to the hospital now – my birds at home needs to be taken care of or someone needs to cook dinner for my 25 year old son ..
  • or you did not honour the follow-up appointment we got for you the week after and make a return visit to the emergency unit – saying the previous ER doc that saw you did NOTHING and yet we found a referral letter folded neatly in between you BP trend notebook dated a year ago!
  • you refuse transfer to the best hospital (which is conveniently only 45 minutes away) because it would be difficult for your relatives to visit you – like hellooo.. if your distant relatives want to visit you, do it when you are well or during festive seasons..

So yes – nak sembuh pun I kena merayu masuk wad. 

And I haven’t even listed the grandiose, bongkak statements some patients make regarding the health that Allah bestowed upon them. Perhaps I shall leave you with one ..

“Tak payahlah nak cuci2 darah doctor, tengok saya nih umur masih panjang dan sihat”

(there’s no need for a dialysis doc, look at me, look at how I am still very much alive”

Yet your Urea is a freaking 51, Creatinine a horrifying >900, potassium of 6.2 and an acidotic blood gas? And you came to the emergency unit for being lethargic. *sigh*

I woke up with a plan ..

Posted in All in a days work by

I woke up with a plan knowing that today would be horrendous. We are still short of people at work. 

I envisioned that my little Hazeeq would wake up without a fuss. That he would gulp down his bottle of milk before 630am and voluntarily strip off his pyjamas for his morning bath. After wearing his day clothes that he chose for himself – he would then get into the car with his chosen toys for the day so we could arrive at grandma’s house by at least 650AM – this will give me time to say HI to the mother in law – make some small talk before rushing to work at 7AM.

I then hoped that traffic would be fine – that the traffic lights would be all green shortening the pit stops I have to make before arriving at my supposed destination.

So far so good.. 

Then plan continued with me going up to wards to check if the patients have been transferred over from the tertiary hospital for their operation here this morning. I feel blessed for both of my patients were in and adequately fasted.This means I can have a quick breakfast at the cafeteria before the surgeons come to the operating theatre (OT). Quick is 7 minutes eating time of nasi lemak and a bottle of mineral water. Otherwise, I’d just wait to have my proper meal during lunch or if the emergency unit is awaiting the arrival of this emotionally labile princess than I’d skip lunch and bear the hunger till dinner.

I did skip lunch and delayed my Zuhr prayers – felt guilty afterwards and prayed to ALLAH that he wouldn’t give me a difficult resus case in the midst of this busy-ness. My cases in the OT finished a bit late and I was so worried that my colleague would be left alone to manage the emergency unit. He turned out fine and cheerful.  

The plan also included a short trip to the Record Office to collect my pending medical reports. And also to hand in my leave application form to the administrative office.

Both chores did not happen. 

I planned to leave sharp at 4PM so I could fetch my son promptly and we both head to Giant Hypermarket and do some meaningless grocery shopping. And also fuel up the car since the bar is already at 1.

That also did not happen. I ended up having dinner at my MIL’s house and arguing with my boy of who must get into the shower first. I had to be first. I need a change of plans tomorrow. A better one. 

Simple detective work – to look for people

Posted in All in a days work by

How do you find a particular someone in a sea full of people? Well.. I was put on a test today.

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A few weeks ago, a middle aged lady was referred to our centre from a private GP for subsequent management. After this lady was assessed by an attending specialist, Specialist M, at our hospital, it was decided that she needs further investigation at a tertiary hospital where the facilities were more advanced – in this case, they had a CT scan machine available.

After the patient was transferred there, I have quite forgotten about the case until Specialist M wanted to see her again – for educational purposes. *gasp*

I did the easiest thing I could imagine, I traced her Casualty card to get her number. I then met Panic & Horror as the phone number belonged to someone else. Patutlah tak angkat.  The first thing that crossed my mind was, “OMG.. do I really need to get the police involved in this – to track her down and get her number?!!!” That is like so dramatic right..

I suddenly remembered that she brought along a relative who happened to be working as part of the private cleaning company in our hospital. Too bad I don’t know her name since she is not working in our unit. I tried my best to describe this particular relative to the other workers but alas, they are unable to recall who this lady tembam2 with tudung is. I was at wits end, I even tried to google her name in case someone mentions her on the web. Or if she by chance has a Facebook account. kerja gila.. I know. 

After much silly effort within that long 30 minutes, HELP came in the form of a friend.

“She was referred from a GP right?”

“Yes”

“Why don’t you call the GP and ask for her details. When patients register for the first time, they usually get their contact number and all”

OH bless him! And indeed he was right. I spoke to the GP owner herself, explained my predicament and voila.. I managed to give the patient a call and confirmed an appointment. Now that is one way how you find a person in a sea of people.