Kebanjiran Pakar

Siapa kata negara kita kekurangan pakar perubatan? Sebenarnya setiap hari kita dapat melihat kemunculan pakar-pakar perubatan baru, terutamanya dalam bidang kanak-kanak.


" Saya tengok dia okay saja, tak perlulah ambil darah"
" Dia nampak penat, tapi kat sini tak buat apa-apa pun, saya nak transfer ke private hospital lah"
" Kenapa, awak tak pandai ambil darah?"


Kenyataan di atas adalah antara komentar yang dilontarkan oleh pakar-pakar ini. Saban hari mereka cuba sedaya-upaya untuk mengetengahkan pendapat mereka yang sangat profesional itu. Mereka buat keputusan sendiri sama ada ingin membawa anak yang sakit ke hospital segera, ataupun tunggu sehingga lewat malam, ataupun tunggu sehingga dapat cuti, ataupun ketika anak sudah nazak. Kemudian mereka juga yang pilih sama ada mahu masukkan ke wad atau tidak. Kemudian mereka juga yang pilih sama ada mahu diambil darah atau dimasukkan branula atau tidak. Kemudian mereka juga yang membuat pemerhatian ke atas pesakit sama ada rawatan yang diberi mencukupi atau tidak.


Wah, bayangkan jika setiap lima puluh pesakit di wad itu mempunyai pakarnya sendiri, bukankah negara sudah mengalami kebanjiran pakar-pakar pediatrik?


Pada suatu pagi Sabtu yang tenang, sedang aku dan MO buat morning rounds, seorang nurse memanggilku untuk membantu oncall collegue ku di dalam bilik rawatan. Dia tidak dapat mengambil darah daripada seorang kanak-kanak perempuan yang dirawat sebagai dengue fever. Aku masuk ke dalam bilik rawatan, keadaan agak tenang, kanak-kanak itu baru habis menangis. Dengan izin Allah, hanya sekali cucuk, aku berjaya mendapatkan FBC itu.Bapa kepada kanak-kanak itu membuka pintu walaupun prosedur belum lagi habis. Dia masuk untuk mendapatkan anaknya walaupun sudah jelas tertulis di pintu bahawa ibubapa dilarang masuk.(kawanku kata sebelum itu dia asyik buka-tutup pintu saja, memang mengganggu konsentrasi)


" Ni cucuk berapa kali ni???"
" Saya cucuk di sini, kawan saya cucuk di sini." Rakanku menjawab, cuba mengawal keadaan.
" Kenapa, awak tak pandai ambil darah?"
" Kadang-kadang memang susah sikit, encik."


Lelaki itu membawa anaknya keluar. Mulutku terkunci tapi hatiku hitam terbakar. Walaupun kenyataan pedih itu ditujukan kepada rakanku, aku tetap terasa. Apa agaknya pekerjaannya? MA dekat OPD yang selalu dan pandai ambil darah kah? Kalau pandai, lain kali encik ambil sendirilah ye.Peristiwa itu sampai ke pengetahuan MO dan nurses. Rupa-rupanya dia memang kurang bertamadun. Panggil staff nurse sekadar bersiut-siut. Apakah mahal sangat suaranya? Atau dia terlalu keliru sehingga tidak tahu apakah yang patut dipanggil terhadap wanita beruniform putih , bertudung dengan lilitan biru di kepala?Esok paginya jangan haraplah kami nak "sentuh" anak dia lagi. Ada juga manusia begini, entah bagaimanalah anaknya bila besar nanti jika bapanya berperangai begitu.


Malam yang lain pula, juga malam yang tenang, oncall dengan MO dan specialist yang baik. Ada satu new case referred from LWEH. Datang ke wad pukul 8 malam.Bila specialist buat rounds, dia clearly introduced herself, dan kemudian bertanya, kenapa mereka datang after 5 pm? Bukankah seizure tu dah berlaku pukul 1 pm? Mereka tidak menjawab. Tapi yang aku tak puas hatinya, bila specialist dan MO dah habis rounds di ward, dan pergi ke CICU, tiba-tiba bapa budak tu datang kepadaku.


" Misi, saya nak minta bawa balik anak malam ni boleh tak? Saya takut dia tak selesa, tak boleh tidur di sini.Lagipun malam ni takda bagi ubat apa-apa kan? Esok baru Neuro team nak tengok dia kan? Lagipun dia cuma fits bila kena hot bath saja."


Erk!!! Tadi masa rounds tak nak tanya, sekarang dah takda specialist baru nak tanya. Dah la panggil aku misi. Malam tu aku dan partnerku dan MO pakai blue scrubs, nampak macam misi eh?Baiknya misi ikut rounds,lepas tu tulis-tulis pula dalam notes patient. Okay, boleh dimaafkan, mungkin mereka selalu dapatkan rawatan di private hospital, di sana kan doctors cuma rounds pagi, waktu lain semua cuma ada misi,so mungkin dia fikir begitu.Aku inform MO dan sudah tentulah dia tak izinkan. Aku explained sebaik mungkin dan mereka tak jadi balik. Mujurlah mereka pandai berbahasa.


Satu, mereka ada delay untuk datang ke sini, after office hours baru sampai, tatkala bilangan doctors sudah berkurangan, Neuro team pun dah balik. Kedua, mereka tentu kecewa kerana kena duduk di wad dengan pesakit lain, maklumlah, mana ada single room- double room macam di private hospital. Ketiga, mereka lebih pentingkan keselesaan anak daripada kesihatan anak, sebab tu mereka nak selesa di rumah, sedangkan mereka tak tahu, bila-bila masa saja budak tu boleh fit balik.


Kesimpulannya, banyaklah keputusan-keputusan bombastik telah dihasilkan di wad ini, hasil kerja keras pakar-pakar bertauliah ini. Banyak lagi, sampai tak tertulis  di sini.Pengajarannya, ibu bapa perlu berilmu dengan ilmu yang betul, dan gunakanlah ilmu itu untuk kesejahteraan anak-anak, bukan untuk mencari kesalahan dan kekurangan manusia lain, kerana anda juga adalah manusia.

Credit Card Syndicate

To those out there who owns a credit card, please be careful. Widely used tactics nowadays -- you will get a phone call from someone who sounded like a good person, either using a private number/ landline number/mobile number. The person will mention your name and explained that she/he would like to send you a VIP card to those using credit card, or she/he would want to confirm with you regarding delivery of credit card, or any other reasons involving a credit card. He/she would introduce him/herself as someone by mentioning a name, as to appear more real. Then she/he would start asking your credit card's expiry date.

Please, do not ever mention your card's expiry date as the real credit card officer will not ask you this information, she/he already have it! Only if you were the one who made the call first to change or ask something then only they will ask your credit card number [not expiry date] for confirmation.

Last week, an Indian guy called my brother, telling that he wanted to confirm a delivery of credit card. Immediately my brother suspected him a scam, as he collected the card himself from the bank, there was no delivery occurred. The guy requested for the expiry date and of course my brother refused to give, so the guy threatened to block my brother's credit card. My brother challenged him back, and after several more conversations, the guy cut off the line. My brother phoned his bank immediately and confirmed that the guy was not an authorised credit card officer from the bank! So the next day my brother called me to warn me about this...

Two days ago, a woman introduced herself as Shila, called me using mobile number 0162627544, saying that she is sending a VIP card for all Mastercard/Visa card holders. She asked my card expiry date...I was like, uhh..she is asking the question? So I asked her back, why do you want to know the date? She said, she wanted to confirmed the card,before delivering the VIP card.I paused for a few seconds. Then I asked her back again, why do you need the date? She gave the same answer, then I quickly said, bukan apa, sekarang kan banyak sindiket tipu kad kredit..Then she hung up.

I feel like cursing her with all my heart, I sent her text message, saying that I will make a police report, and the message was delivered. After that, the number was uncontactable till today.

I thank Allah for making my brother to warn me fast, or I would have trusted the evil "Shila" and uncover my card expiry number, then she would have enjoyed online baking to the maximum before I could realized that my bills has reached the maximum.

So for all card credit holders, be super extra careful...and to those who are evilly involve in the syndicate, please repent before it is too late. Anyway, the money you obtained is not halal, regardless you are a Muslim or not.

I hate people who just like to be evil opportunists and make other people's lives miserable.And things that I wonder now is, how do these evil people know that we are holding a credit card? They know our names and our contact numbers.Did they get it from the bank? Or they themselves work in the bank? Hurmmm...

Post call

:(

RESPIRATORY

Alhamdulillah, I completed 5 weeks of Respi last Wednesday, plus I got 2 days leave after that. What a beneficial experience, and great knowledge I had obtained. My specialist is my own supervisor, at least she knows me, knows my capability. I feel comfortable working with her, she is a young specialist, perhaps her pathway in her career was smooth. We were oncall together a few times, and we felt comfortable and easy working with each other. My consultant is a Kelantanese modern Malay woman. She is unique, can be nice and can be stunning as well. During oncall, all the MOs and HOs are afraid of her especially during rounds. That day she ignored the new MO (as she was unable to present the case and didn't know how to prescribe the right antibiotics) and asked me to present the case. I heard she is usually okay with house officers.I did learn something important from her : "remember your case well".


My MO...uh,hard to say about her.She had always been on leave, leaving me alone doing her job and my job. People said she is @#$%^ but with me she seems okay, she trusted me and told me her personal feelings. She warned me earlier if specialist was in bad mood. She needed my help in translating to Malay several times, I needed her help in inserting difficult branula several times.Yet, everyone was horrified by the way she poked the patients.The nurses said, even HOs are better aka more humanly...


I learnt about the metered dose inhaler...from salbutamol, to budesonide, seretide, flixotide etc. From simple MDI to easyhaler e.g. giona, buventhol etc...nebulisation - from 0.5:3.5 salbutamol to AVN to budesonide 1 mg BD. I listened to all kind of lungs - crepitations, ronchi, biphasic stridor (prolonged inspiratory sound), wheeze, prolonged expiratory phase etc. Learnt about anti reflux for GERD - omeprazole, ranitidine, domperidone...learnt about sleep study and pH study...learnt about BIPAP - the IPAP/EPAP, rate and oxygen..went to radiology department many times to get barium swallow appointment and HRCT appointment...counting respiratory rate every reviews..


All patient under respi follow up who presented to casualty will be admitted, they are chronic patients, so better be safe than sorry, admit them for at least one day, then discharge the next day if well.My specialist called me lucky as I discharged many chronic patients once I joined the team the week before Raya.But I was the one who suffered to finish the long and complicated discharge summaries...Also the stacked of census in clinic...unsure who will do it next month as there will be no more HO in respi...


My favourite respi patient, Adam currently just re-admitted for aspiration pneumonia...poor that cute little baby.So adorable, I feel like hugging him, of course I can't do that...My second favourite is of course Cingi, who was acutely unwell and pushed into PICU when I was oncall there for the first time. Now she is very well in the ward, so friendly, she likes to touch people's hands and always smiles..


My good friend took over respi for 2 days when I was on leave, and she had been complaining about the workload and environment to my other good friend. I thank her for her presence, but imagine, how I suffered for the past one month, being alone and stress?? Despite all the hardships, I considered lucky for not being sent to oncology or nephrology...because that is even more difficult.


Thank you Allah, tomorrow I'll start general medicine with most of my good friends in the same ward with me :) And tomorrow I am going to be oncall and off the next day. Now we have new rules, whoever oncall, tomorrow will get day off after pass over to the morning persons.So now we work for 24 hours, no longer 36 hours.They can't practice the shift system, so this is the best they can do...