I've actually been intending to update my blog for a long while now. But I can just never drag myself to get a proper entry written. I've told you before that there's regression of brain matter right?

Today, I wanna ngumpat patients here in HSNZ. A lot of times, I hate patients. And their relatives. I bet I can write one entry every day with different reasons to explain my hatred.

I hate having to shout 'tumpang lalu' when you're trying to pass through the crowd of relatives standing in the walkway. And no, they don't care if you're trying to push an unwell patient through while trying to manually bag the poor person (refer to figure 1). Neither do they care if they're sitting on the stairs (and taking up > 80% of the steps) while you're running to process a blood sample of a young 20 year old who collapsed after coughing out loads of blood.

Figure 1

I hate having to wait for the lift for sooo long because all these relatives are rude enough to use the ONE and only staff lift in the hospital instead of using the FIVE lifts provided for non-employees. And when these relatives take up all the space in the staff lift, none of them have the decency to make some space for one doctor who has just been at work for the past > 34 hours (ok, ni zaman oncall dulu). Kalau saya setakat nak naik tingkat 2 atau 3, bleh la naik tangga; tapi kalau nak naik tingkat 8, takkan saya nak berkorban naik tangga. Tercabut lutut nanti!

I hate patients who come to hospital and REQUEST for admission. As if without them coming in, we would just be swinging our legs and gossiping. Even when doctors are unwell, we still come to work so that we don't let our colleagues carry this heavy burden alone (my friend had appendicitis for 1 week before seeking treatment). So it slightly (I mean REALLY) annoys me when patients come in for fever for ONE day or feel SLIGHTLY out of breath. And within half hour of being in the ward, they've already called all their friends to tell them they're staying at an 8 star hotel near Batu Burok. And what's worse is these are the same patients who will nag you every 10 minutes to ask if you've done their discharge summary. Masa nak masuk wad merayu-rayu, bila nak keluar tak sabar2 pulak! Pernah ada sorang patient's father datang ugut saya nak report kat Dato' mana ntah sebab tak siapkan discharge summary anak dia within one hour of dia request discharge at own risk (i.e. they refused all treatment and nak keluar hospital). You seriously think I'm threatened by that random Dato' when I have so many very sick patients to attend to before doing a non-urgent discharge summary?

Itu belum cerita pasal kes2 mengarut yang datang A+E (Accident and Emergency) for things yang tak kecemasan langsung. Contohnya patah kaki tahun lepas, nak cek samada dah ok belum (dalam keadaan takde rasa sakit atau apa2). Ataupun saje nak cek paras kencing manis (nak medical check up pun datang A+E malam2!). Atau bisul dah 2 bulan, tapi sebelum ni tanak datang lagi sebab nak raya (so obviously la tak cemas langsung kalau bleh tunggu 2 bulan!). Tolong la faham, there's a reason why it's called 'Kecemasan'. Klinik desa dan klinik kesihatan kerajaan berlambak2 in their local areas, tapi nak jugak datang hospital. Kalau gatal sangat nak datang hospital pun, pergi la Outpatients Department which is open till 9 pm on weekdays. Nak jugak datang A+E. Tak rasa bersalah ke amek masa medical staff that would probably be better spent attending kes2 yang betul2 urgent seperti budak kecik lemas atau accident teruk dengan pendarahan otak?



And I hate how rude patients and relatives can be! Orang nak tolong dia, dia nak kerek2 pulak. Nobody goes yelling and scolding their children's teachers, so how come when they're dealing with medical staff, they think it's ok? Padahal cikgu boleh rotan lagi anak murid, doktor (as far as I know) tak pernah pun pukul patients yang kurang ajar atau sepak terajang dia. Even saya yang paling terkenal kat department saya sebagai HO paling garang kat patients pun (most of the time) marah patients yang memang patut kena marah, e.g. unmarried Muslim couples yang duk berpeluk2 atas katil, IVDU (penagih dadah secara suntikan) yang amek dadah pukul 4 pm then bawak motor and langgar orang lain pukul 6 pm, bapak patient yang pergi serbu (tanpa ketuk pintu) bilik rehat doktor oncall time diorang berehat (kerja dari kul 7 am, takkan 6 pm takleh duk rehat jap?).

Tak lama lagi ada orang akan komen suruh saya berhenti je kerja sebab asyik complain je. Haha.

Turn around, while you still can!

People probably think I'm being selfish by saying this. I'm not trying to be mean, I just want you to know the reality of working as a doctor in Malaysia. Think of it as a favour - I'm saving you from greater harm.

Allow me to tell you about my day to day life.

I work 7 days a week, from one Sunday to the next. No, it's not considered overtime, it's your duty. If you want a weekend off, it's almost like asking for leave - you need to request for it and ensure other people will keep your patients alive and managed well while you're away. Which means extra work for your colleagues, so you feel kinda guilty when taking a weekend off. Itupun you're only limited to two weekend days off per month. For example, I'm off today, which leaves only four of my colleagues to cover two wards (i.e. anywhere between 50-80 patients). I would never survive if I was one of those four, so I still went to take the morning bloods and now I'm taking the rest of the day off. Sad innit?

Oh, and you only get 8 week days off per posting (4 months), with a maximum of 2 per month. May I remind you that this includes sick leave, because it's a known fact that house officers don't deserve anything, including being ill. My friend was admitted to hospital for 12 days for a bad lung infection and she now has no days off for this posting and has the remaining 4 days deducted from her next posting's allocations.

You do 6-12 oncalls per month, depending which department you're in (in some hospitals, it's up to 15/month). So on weekdays, it means you'll work from 7 am on one day to (at least) 5 pm the next. To make it slightly worth it, you get paid RM100 for all those hours of work and sleep + food deprivation. I've survived many times of working for more than 24 hours without food (only sips of plain water), once to the extent that I almost fainted while assisting an operation. I don't see how RM100-RM110 is worth the trouble.

And you know how 'appreciated' doctors are at work? I'm not even gonna go into the frequent scoldings/rude remarks and behaviour from patients and relatives.Let's just talk about parking. Everyone knows how bad it is to get a parking spot anywhere in Malaysia, but for doctors (maybe just in HSNZ, I don't know), it's even worse. The only parking spaces allocated for the hundreds (more than 1k maybe?) of doctors are the spots for specialists and 5 parking spots for the berpuluh2 doctors that are oncall each night. So dari pegawai perubatan UD41 (i.e. house officers) hinggalah kepada pegawai perubatan UD54 (senior medical officers), kita semua kena berebut tempat parking with all the staff in the hospital + patients + relatives, EVERY SINGLE DAY. Sweet! Itupun tempat parking yang 5 bijik untuk oncall doctors are sewenang-wenangnya taken by staff nurses, patients and relatives, without any consideration for the poor souls who have to work from 7 am till 5 pm the next day. And guess what? What I fail to fathom is how an admin officer who's my age can get a designated parking spot opposite the spaces allocated for two heads of departments, whereas medical officers who are really senior and are grade UD54 have to berebut just like anyone else!

Oh, and don't forget the daily upset and disappointment with the system, the society and so many other things - e.g. the education level of patients and parents, the horrible number of teenage and premarital pregnancies, the difficulty in getting help for those who really need it etc. Try explaining to a 15 year old mother about how to care for her premature baby who was born at 29 weeks and weighs less than 2 kg. Or discussing + consoling a mother who has been brushed off by the shariah court and police when reporting the abusive and paedophilic behaviour of her (ex)husband. Or persuading a young couple to keep their baby (who is critically unwell) in the ward despite their misguided belief that their child is well (and then having to deal with them again when the baby is readmitted).

Career-wise, you have to work really hard to prove yourself or in any way get yourself noticed/heard/appreciated. A lot of times, the principle is "you're crap until proven otherwise". And sometimes, once you make one simple/foolish mistake, that means you're doomed for the next 7 months (4 months + being extended for 3 months) - you'll kiss people's feet to get redemption. For some house officers (usually senior), they have the skill of looking good in front of more senior doctors, and it seems to work for them to get through each posting. But I personally prefer the hard way - you earn your merit by striving for it.

Despite all of the woes of working, it's not all gloomy days. You have to strive to be happy and try hard to look for blissful moments that can be enjoyed. You also need to find things to take your mind off work during the few hours a week that you're not at work, like swimming, the movies etc.

So, like I said, you gotta really think about it. I don't want you to become a doctor and then just regret it for every day of your miserable life. And then end up taking many days off because you can't cope, or coming to work but not performing up to par and compromising patient care.

And to those who have the misfortune of ending up as my patients, I beg for your patience and understanding when I'm being sarcastic or impolite. I may have been working since 7 am the day before with little sleep, so I really cannot be all smiles when you come in at 2 am in the morning for something minor, only to request discharge at 7 am. And I cannot be attentive when you want to ask me about something if it's disrupting me in the middle of something more urgent. We house officers have to work hard all day so it really is slightly annoying when we have to deal with petty things - it really isn't an emergency when your baby's wrist band tertanggal!

I can't believe I let my blog rot for so many months!

To be honest, it's not like I've been occupied beyong limits since I started working, but I believe there has been some brain matter regression going on up there, resulting in a lack of ideas and words to write.

How have I been doing?
Fairly average.

How's my social life?
Almost non-existent.

Do I regret coming back?
Most days.

Like I always say - tis better to regret staying than regret coming back. But with whatever self-dignity that I have left, I'm gonna suck it up and face it all like a man woman.

Induction and BTN done! And now, I shall report for duty tomorrow morning at 0800 hours. So this may be my last post in the next two weeks, at least. Tagging is horrible - every day for two weeks, the hours start at 7 am and end at 11 pm. Every. Single. Day. I really don't know how I'll survive that.

As some of you may know, I was first posted to HUSM, Kubang Kerian. Now, it really is a much better hospital than HSNZ in so many ways, but I only put HUSM to fill in the three spaces on the form. I came back to Malaysia to be close to home, so if I was going to be living anywhere more than half hour away, I might as well have applied for Hospital Sg Buloh or UM. At least naik flight sejam je compared to 3 hours driving between KB and KT. Or I might as well have stayed in the UK. When we found out, I wasn't really upset. I was just shocked since so many people applied to HUSM as their first choice and didn't get it, and yet, I, who wasn't very enthusiastic did. Apparently the way placements run is in this order:
1) Hospital needs and requirements (i.e. hospitals get to choose who they want)
2) Vacancies (tipu la HSNZ takde tempat untuk saya since so many people got it)
3) Pilihan pemohon --- Apparently, they don't really consider 'ikut suami' as a good reason anymore. Mak ayah sakit pun, hanya cancer akan diconsider.

The only time I felt like crying sebab dapat HUSM is when I found out I'd have to take a bus to KB on Saturday afternoon after arriving in KT on Saturday morning. Naik bus? Esok plak nak keje dah? Tidak!!!!!!!!!

So I wrote an appeal letter (despite Kadir saying I should really contemplate deeply on whether or not I should, since HUSM is a better hospital). I should have just gone through the same procedures as everybody else, i.e. tarik tali siap2. And that's how kawan2 yang bercable besor macam tiang elektrik, semuanya dapat first choice terus in the first round. When dad offered to intervene earlier, I thought I should go through the normal application process first (sebab ingatkan konfem la dapat HSNZ!). I kinda forgot that this is Malaysia, and if you're a nobody, then nobody cares. At least it would save me the hassle of writing surat rasmi dalam Bahasa Melayu dengan tulisan tangan!

I was 9 when mum gave birth to the youngest. When they were both still in hospital, mum and dad were busy coming up with names for the little nigga. And I, in my eagerness to help, remembered one word from the Quran that I often came upon. So I said, "What about Jahannam?" Mum and dad half ignored and half scolded me. Living in the US at the time and never hearing of people cursing using that word, it wasn't until a few years later that I found out what it meant.

What's in my make up bag?

Now there, gentlemen, you don't have to read this one.

I have two wedding receptions to attend this weekend, one is a reception for a friend who got married in June, and the other is having her solemnisation ceremony tomorrow! And I so want to attend, but unfortunately, I have no transport! Boohoo.

Anyway, I was trying some make up to choose the best look for tomorrow and Saturday. And I always thought I had quite a good collection, but when I laid them all out, there's barely anything, which made me quite sad. And to think that my sisters always complain that I spend too much money on make up! Although I do admit I have an unhealthy addiction to eyeshadow. I already have 17 different shades, and yet, I still go gaga everytime I see eyeshadow on eBay (that's my only shopping option now). It must be the lovely colours!


Now if there's three tips I can give on make up, it's this:
1. Invest in good brushes. I got this tip from my darling Hani, and considering she's a make up goddess, I believe everything she says. But it's true, there is a big difference in cheap brushes and proper ones, like how well the make up applies - even the feel of the bristles against your skin is enough to convert you into a believer!
2. Cheap eyeshadows don't stick properly and don't last. Paling2 cikai pun Maybelline la at least. It's not the quantity of shades that you have, but the quality. Less than 10 shades that match your skin tone are far better than a whole palette of cheap stuff.
3. Learn from the pros. Well, sort of pros. These are two people I love: Asma for the similar skin tone to mine and Michelle for the similar sepet-ness.

Toodles!

I am soooo ANGRY!!!

I know you're gonna think this is an absurd excuse for such anger. But still!!!

Yesterday I wanted to cook my campak2 chicken and mushroom soup pasta (apparently it's called Alfredo sauce) for my first day of puasa enam (I know, I'm so late). But obviously, there were no ingredients for it at home, apart from garlic, milk and potatoes, so I had to go grocery shopping. Mum came home quite late so I only had the time to go to one shop for my needs and I chose Sabasun (easier parking, closer to home). There weren't even that many things that I needed: some form of pasta, chicken, a can of mushroom soup, a carrot, button mushrooms, cream and mozzarella. And all I could get from Sabasun were the first four things on the list. Itupun they only had chifferi rigati (which is basically macaroni) and penne. Mushroom-wise, they only had oyster mushrooms and dried shiitake. The only cheese they had was Chesdale brand cheddar slices, the kind you put in sandwiches. I get that they want to boycott American products (because of their support towards Israel), but mozzarella is Italian!!! Well, if they don't have cheese, they don't have cream either, obviously. I was quite upset because the owner is a California graduate, so I expected better!
[Side note: Mum thinks they stopped selling mozzarella etc because tak laku.]

So I ended up making beefball soup for iftar.

But my quest did not end there. Today, I went out again, in search of button mushrooms, cream and mozzarella, and this time to Mydin and Giant. Mydin's stuff are usually cheaper than Giant (Philly cream cheese is RM1 less in Mydin), so I went there first. Still no button mushrooms!!! But at least, ada mozzarella and cream... tapi mahalnya! Mozzarella costs RM14+ for a 250 gm bar (obviously the grated ones cost more) and I needed to use half, and heavy cream costed RM10 for a tiny box (less than 200ml perhaps?) and I needed the whole box. I lingered there for at least five minutes to decide how to work around the circumstances (while also taking peeks at parmesan, edam and blue cheese, only to frown bitterly at the price). I almost opted for cheddar instead, but I compromised, and decided not to buy the cream and substitute it with loads of milk (so I bought another pint because I'm sure my brother wouldn't appreciate me using up all his milk).

Then I went to Giant, with definite hopes that they would have button mushrooms - it's Giant after all! Again, utter disappointment. I asked one of the staff if they had button mushrooms, going to great lengths to explain what it was and what it looked like. She just said "tak tau la, kak" without getting up from her chair. Bukannya nak tolong cari/cek! Something like this would never happen in Asda! Lepas tu, dia sambung main phone dia. So I went round the whole vegies and fruit section for the third time, and still no luck. I ended up getting 2 bananas instead (I wanna make marble chocolate banana cake tomorrow), and when I went up to the weighing counter (the unhelpful girl mentioned previously was there), I didn't even say thank you to her for weighing my bananas (I always say thank you kat jurutimbang and cashier kedai). That's how upset I was at her (I was already emotional for not finding the mushrooms at the third place I went to, she should have at least made a little effort!).

While I was there, I checked the prices for mozzarella, cream etc as well. The same brand of Mozzarella was 60 sen more expensive than Mydin, but what shocked me the most was the price of mascarpone cheese. First of all, they sold it in packs of 1 kg - who needs 1 kg of mascarpone? You only need half of that to make a reasonable size tiramisu (enough for entertaining guests). And I'm sure someone who actually needs that amount (tiramisu business maybe?) would have their own supplier and would not be buying it for RM32.49 from Giant! And to think my mum says I should learn how to make puff pastry and croissants - tobat bankrup aku!

I bought shiitake mushrooms eventually from Giant, but I knew it wouldn't taste the same. So I don't know how I came up with this idea that Astaka (the Chinese community in Terengganu usually shops there) might have it. So I went all the way to Astaka, parked and put 20 sen in the metre and went in. Only to come out 5 minutes later with nothing.

Kenapa saya marah sangat takde kedai jual button mushrooms? Because I know people use it. For sure, sapa2 yang nak buat pizza or spaghetti or many other Italian/Western dishes must need button mushrooms, no? And this is proven by the fact that you can get canned button mushrooms by so many different brands in every grocery store in Terengganu. Yang saya sangat geramnya is that you can get condoms (I thought this coz they had a variety of condoms kat kaunter bayaran Giant) in so many different types all over Terengganu (all 7-Elevens, Mydin, Giant, Watson's, Guardian and all other pharmacies). I mean, who uses them anyway??? Budak2 tak bermoral tak guna, coz otherwise Terengganu wouldn't have the highest rate of teenage childbirth in Malaysia; and orang2 yang dah kawen pulak, it would be most peculiar to use them. And to think that no one has the decency to sell fresh button mushrooms anywhere in Kuala Terengganu! I feel this is a rational enough reason to make me wanna live and work in KL instead!

I don't know how to express how agonising it is to make your signature dish without the right ingredients. Everyone said it tasted ok (and everyone had seconds), but I just loathed the taste of shiitake (it tastes just like it sounds, shitty) in an Italian-themed dish. I kinda wish I just bought the canned mushrooms (mum used to use them when she made pizzas).

I was so angry today that I didn't even stop by at Each-A-Cup (in Mydin) to buy my favourite hazelnut coffee with pearls or even at Killiney (depan Astaka) for my favourite fries and cole slaw. Grrr!!!