serving the government

working for the government might be the safest job in malaysia
coz our government is very stable
and the political party which is running the government right now looks like gonna lead the country for like forever.

but then, working for malaysian government may not be the luxurious job....
- just enuf to pay ur bills and have a decent life..

as a government doctor, i do not earn much.
some people thought that doctors rich
for those who works at private sector - yes, they are super rich

but us, we just earn maybe rm 10 more than teachers
no kidding

if u compare the money with the job rate we did everyday ,
it's kinda ridiculous actually
for example , we earn rm 110 for 24 hours oncall in weekend..
so, it's about rm 4.50 per hour....
guess how much does the bangladesh labour earn per hour? rm 4.60....
hahahha...

well... that was just a gross picture about a real life as a government doctor...
it's a n0ble job..
and i'm sure our government did the best for us.
maybe this is our value to the government..
i have nothing more to say
just being thankful the government who employed me.

i'm so tired

I'm so tired
i'm at the end of my medical posting
cant wait to go to the emergency department
which i wish will be my permenant department in the future
i love all the action, thrill and the fast thinking situation in saving life

i dont really enjoy doing the ward round...
it's kinda boring
i would rather spending the day doing all kind of procedures rather than writing discharge summary and referral letters..
my colleague called me " procedure maniac"
coz i would eagerly do all the procedure - central line cvp, the arterial lines, the chest tube insertion, the lumbar puncture..
normal blood taking already bored me to death

hence, really looking foward to be at the emergency department..

tiger wood in the making part 2

yes,
trying hard to be as good as tiger
i even went to play golf at night
no kidding,...
yes... what to do..
day time... i'm stuck at the hospital..
hence, the only free time i have ... in the evening

nowdays, the golf set is always in my car
just in case of emergency...
should anyone invite me to play,
i'll be there...
heheh...

well, actually, if u are in kelantan,
and want to play or just started playing golf..
come n join me..
i still dont have a sparing partner as good ( bad ) as i am..
heheh..
if u are,
do not hesitate to call / contact me...
golf - connecting people

tiger wood in the making

sorry,
no update for few days,
was busy doing on calls!
yes, i was oncall on thursday,
then i was oncall again on saturday
life couldnt be better...

i'm starting to enjoy my new hobby - golf.
it's a sport actually,
require a lot of skills and energy.

i'm still new, still learning,
looking for friends to come n play along with me
apparently not many golfer around in my age

so, most of the time i ended up playing with grandpa and uncles
which is good ;
hanging out with older group ,
make me wiser
and learn new things
and a few tricks in life
something that u wont find in any book.

who is sya_zazoo

to sya_zazoo..
1st, thank u for visiting my blog'
but after reading ur comments,
u r not very much welcome here.

i dont know who the heck u are ,
but i'm sure we never met ,
and i definitely never treated u.

yes, i'm still a young doctor , only work for nearly 2 years....
but i'm proud of what i've done, and i'm grateful
let me ask u sya zazoo..., when u are at my current age , 25 years old..
how much do u achieve?
how much do u make a month???
not trying to show off here,
but u are very irritating

i do not intend to find out who u are,
but a a few of my readers apparently know u
and some of them work at the same office as u do sya zazoo
they did write to me about you
apparently , according to these few people
" u are not very like-able at ur office because of ur attitude"

and u are very famous due to ur not so nice action and words

which, explain all ur rude comments here.

I'm sure even medical students have better view than u are

honestly, just go away

if u dare to make comments here, x payah la letak gambar anak kat profile tu
show ur true face..
letak gambar anak pon orang tau...

truth about the complaint

I'm not sure about what is "sya_zazoo" problem ,
but i'm sure she had a bad experience at the hospital

to sya zazoo..
may i know what are u?
are u working? own a business?
or whatever?

u are expecting a doctor to give a 5 star treatment at the government hospital?
r u kidding me?
it's not us who made the rule that we have to work extra hour everyday
but we did that becoz , if we didnt? who gonna suffer? the citizen right?
we do have the right is we dont want to work extra hours,
but we are human being..
knowing the fact if all doctor refuse to work extra hours at the government hospital,
how many people are going to die everyday?
hence, we doctors - sacrifice our time to serve the people..
and yet we dont write to newspaper - asking why are there so many sick people out there?

seriously, sya zazoo... u have issue here
i dont know what's ur problem
but if u have personal issue, go and take it somewhere else.
i'm saying the truth about the free health care that our government provide
but hardly appreciated by the citizen.

and one more thing,
i realize - those who made complains about government hospital,
are those who came and visit their relative for 5 minutes at the hospital
for those u stay and wait their sick relative / family member by the bedside - they would see and understood how hard does the doctors work, day in and day out

I once asked by a mother of a patient ,
"doctor, bile abes keje? semalam mak cik tengok doctor dah keje dari awal pagi, tengah2 malam pulak dok ambik darah patients, pastu pagi2 dah masuk ward balik.. doctor x balik rumah ke? , ni dah petang dah? mak cik pon dah 3-4 kali salin baju... "

i just smiled..
and yet people like sya zazoo are so critical about doctors...
hell...i dont care about this kind of people.
i did my job and i'm happy when patient get better

my reply

well,
there were many comment regarding my previous entry

occay,
here are the fact about medical service in Malaysia

The government hospital serve the citizen for free. The patient only pay a minimal amount.
hencefoward, not everyone appreciate this.
A simple blood taking would cost about rm10. If u are admitted for dengue fever, there will be more than 10 blood takings...
and that was just blood taking alone..
other cost? did any of us realize how much health care is really costing the government???
and yet, nobody appreciate the government hospital.
sigh

regarding the previous issue
i'm sure the "cucu" has communication issue with the doctor from the private hospital.
Any doctor would understand , that stage 4 cancer has no definite cure.
hence, he's not actually referring the grandmother to the government hospital to be cured.
Just for palliative care.
therefore, that particular case is not on top of the list for the oncologist in HKL

Do you have any idea how many oncologist we have in Malaysia?
how many of them work in HKL?
there are less than 20 oncologist in malaysia.
and most of them works at private hospital.

and guess... how many oncology patients we have in Malaysia??
A LOT!

from that big amount of patients with cancers ,
there are a big fraction of them who are in early stages and still have chance to be cured..
and these people are the priority to the oncologist

for those with stage 4, even the best oncologist has nothing much to say about it.
which explained , why the oncology at HKL was not in rush to see the grandmother.

HKL is a government hospital. It's a very busy hospital
there are many emergency cases there.
be patient,
it's free after all.

doctor would prioritize the patients that we are able to cure and save.

for example , in case of pregnant lady - the mother is the priority coz the mother is alive. the baby is not alive yet in the real world.

so, be considerate.
we doctors, always do the best we could.

we came early to work , came back home late everyday , but we never claimed overtime..
and u all still call us inconsiderate?
funny as it is..

if u have someone works as doctor in ur family,
then u would know how hard life as a doctor is.

to those medical students who read my blog...
life as a medical students and real doctors are totally different.
just keep reading ur book.
u have long way to go.
when u start working, then u'll understand what i really meant.
u have no idea how is it in the real world as a doctor.

kecewa dengan perkhidmatan hkl?

the other day,
i was reading the e newspaper , and i came across this article, a complaint about another government hospital , HKL

in this article, the writer complaint about a very bad treatment given to her " nenek saudara "

SAYA ingin berkongsi pengalaman pahit nenek saudara saya selaku pesakit di HKL baru-baru ini. Sabtu lalu, nenek saudara saya yang disahkan menghidap penyakit kanser paru-paru Tahap 4 dipindahkan dari sebuah hospital swasta di Petaling Jaya ke Hospital Kuala Lumpur (HKL) untuk mendapatkan rawatan susulan.

Pemindahannya dilakukan atas nasihat doktor di hospital swasta tersebut dengan alasan HKL menyediakan rawatan khidmat Onkologi terbaik bagi pesakit kanser.

Atas nasihat tersebut, pihak kami sekeluarga pun bersetuju dengan perpindahan itu. Pihak hospital swasta berurusan dengan pakar Onkologi HKL untuk kemasukan pesakit. Namun, apabila pesakit dipindahkan, beliau dimasukkan ke wad kecemasan untuk beberapa jam. Kemudian, beliau hanya dimasukkan ke wad biasa dengan alasan doktor akan memeriksanya sebelum dimasukkan ke wad Bahagian Onkologi.

Beliau telah dimasukkan ke wad kelas tiga bagi tujuan pemantauan oleh pihak doktor 24 jam. Pihak kami telah meminta untuk dimasukkan ke wad kelas pertama kerana ingin memberi keselesaan kepada pesakit tetapi tidak digalakkan oleh pihak HKL kerana pesakit terlalu kritikal untuk wad kelas tersebut.

Pemantauan pihak doktor di wad tersebut hanya dari 8 pagi sehingga 12 tengah hari pada hari Sabtu dan Ahad dari 8 pagi sehingga 5 petang pada hari lain. Saya memang tidak faham dengan dasar ini. Adakah doktor tidak memantau langsung pesakit selepas pukul 12 tengah hari atau 5 petang?

Ketika berada di wad tersebut (kelas ketiga), pesakit tidak berasa selesa kerana keadaan wad terlalu panas, sesak serta bising selain berada dalam keadaan kritikal. Saya terpaksa membawa kipas meja sendiri untuk mengurangkan keadaan panas pesakit. Malah, katil yang digunakan pesakit tidak berfungsi dengan sepenuhnya disebabkan bahagian kepalanya tidak dapat dinaikkan atau diturunkan.

Jururawat yang bertugas juga kelihatan tidak tahu apa patut dilakukan terhadap pesakit. Saya terpaksa meminta ubat-ubatan berkenaan seperti ubat batuk dan ubat tidur untuk pesakit. Doktor kanan (senior) hanya datang pada lewat petang dan akhirnya membenarkan pesakit untuk dipindahkan ke wad kelas pertama.

Malangnya, wad tersebut telah penuh dan hanya ada pada keesokkan harinya. Saya amat kecewa kerana pesakit kelihatan semakin lemah dan tidak selesa. Pakar Onkologi juga tidak muncul langsung untuk memeriksa pesakit. Apabila saya memaksa doktor bertugas untuk menghubungi pakar Onkologi, beliau menyatakan bahawa pakar tersebut menganggap kes pesakit tidak penting dan hanya akan datang pada keesokkan harinya.

Bayangkanlah pesakit sudah berada pada Tahap 4 kanser paru-paru dan ini dianggap tidak penting oleh pakar Onkologi.

Pada awal pagi keesokannya, kira-kira pukul 5 pagi, hati saya tergerak untuk menghubungi pihak hospital bertanyakan status keadaan pesakit. Pihak yang menjawab panggilan meminta saya menunggu sebentar kerana difahamkan pesakit sedang berada dalam keadaan tenat dan sedang dirawat.

Sementara menunggu, saya kedengaran pihak yang menjawab telefon terpinga-pinga tidak tahu untuk berkata apa kepada saya. Dia bertanyakan kepada rakan sekerjanya dan berkata: "Nak cakap apa ni? Nak cakap apa ni?" Setelah hampir seminit saya menunggu, dia meminta saya untuk bergegas ke hospital. Saya memarahinya kerana tidak menghubungi saya secepat mungkin.

Bayangkanlah, kalau saya tidak menghubungi hospital, agaknya bila mereka akan menghubungi saya? Apabila saya tiba di hospital, keadaan pesakit sudah terlalu tenat dan saya meminta doktor bertugas untuk menyelamatkannya dengan apa cara sekali pun.

Beliau hanya berkata: "Saya bukan Tuhan dan pesakit sudah bersedia untuk 'pergi'." Saya hanya sempat membisikkan ke telinganya memintanya jangan meninggalkan kami namun tiada tindak balas. Saya kemudian membacakan surah Yasin dan 'mengucap' untuknya. Pesakit kemudian 'pergi' dengan tenang.

Walaupun saya menerima kenyataan bahawa ajal dan maut di tangan Tuhan dan reda dengan pemergian nenek saudara saya, tapi saya amat kecewa dengan perkhidmatan yang diberikan oleh pihak HKL.

Saya amat menyesal kerana membuat keputusan untuk memindahkan arwah nenek saudara ke HKL. Kemudahan yang rosak seperti katil tidak dapat dilaraskan memburukkan keadaan lagi. Saya bertekad untuk tidak menghantar ahli keluarga saya atau sesiapa pun ke HKL lagi.

CUCU SAUDARA YANG SEDIH

Kuala Lumpur

occay,

here's the thing wahai cucu saudara...

ur grandma has stage 4 lung cancer... i'm sure the doctor at the private hospital has told u the prognosis of the disease. No one ever survive the stage 4 cancer. hence, i'm sure the doctor at the private hospital, asked u to send ur grandma to HKL - mainly for palliative care

even the best oncology has nothing much could do on an elderly patient with stage 4 cancer.

PLUS - it's a normal procedure that every admission has to go thru the emergency. dear cucu sedih, at government hospital, there are many critically ill patient need to be saved at the emergency room, hence ur grandma had to wait for quite sometimes.

sorry about that, but our country still dont have enuf doctor and the ER is still not big enough.

well, there are many more i have to say here

but what u experience at HKL is a standard procedure, if u want a VIP service... just stay at the private hospital. the choice is urs if u have the money. that's all.

tiger wood is my idol

i finally got my hand on the golf club.
yes, after being influenced by my brother who played before behind our backyard ,
i decided to follow him to the golf course today.

i managed to hit 100 balls today,
it was fun... and it was quite an exercise too.

now, i have backsore and shoulder pain
but it was worth it.

I used to wonder why people play golf,
and i used to be critical to those people who are in love with golf

until u play the game, u wont understand it.
yes, it's an expensive game,
the golf clubs cost a lot, the balls, the membership

but then, it's a game...
one set of golf clubs costs as much as a new set of sport rims

another story

here is another true story that happened to me in my daily life working as a coolie a.k.a doctor at
the government hospital

occay, true fact about me.
young patients loves me... coz we speak the same language...
the untie and grandma age patients likes me coz they want me to be their in law
the pakcik and atok2 age patients enjoy having doctor like me coz i listen to their story

but, not everyone likes me...

.. One fine day at the ward..

a patient was admitted due to end stage renal failure , and he's planned for peritoneal dialysis..
it's an invasive procedure, where doctor poked the abdomen, put a drainage system and clean the abdomen.. it's an alternative to hemodialysis

Apparently this patient is very arrogant...
when he was planned for the procedure, he requested for a senior medical officer to do the procedure on him, and refused on me doing the procedure as he claimed i look too young to be a doctor,
so fine - i was irritated, but i did not care, less work for me.

I told the pakcik, that particular medical officer that he requested wasnt available..
so , i told him to pick someone else..

he saw a chinese doctor in the same ward with me, and asked for the chinese doctor to do the procedure on him

I said "fine " , let just get it over it...

Little that he knew, that chinese doctor just started working , and only done the procedure once before - under my supervision

and... since the patient requested , that chinese doctor , did the procedure on him - unsuccessfully.....

and i had to take over ... eventually..
hehhee...

after the procedure was done... a nurse told that patient that i am a senior doctor in the ward...

before he was discharged , he said he was sorry ....

and yesterday he was admitted again , and we became good friend... :)

the end....

am i getting old

came back from work quite early today
luckily nobody is dying in my ward.
had a calm day'
just another at work

reached home, then turned on my lappy
checked my email, fb... then read the news..
then went out to jog..

came back home from jogging..
made myself ceasar salad for dinner..
watched a movie while having dinner alone..
it was a funny movie.. was laughing alone..
i dont care..

then , finished movie ,
decided to do the laundry ,
then went up to the bedroom ,
i ended up reading the emergency medical book.. ( wow)

and here i am currently... feeling asleep..

well..
i guess this is it..
i reached a point..
where being home , is better than being out with friends
am i getting old... mmmm..

congratulation dear students

today our government announced that - 1500 excellent students , we'll be getting the national scholarship
congratulation to those who'll be chosen :)

2 thumbs up for 30 lucky students who got their special scholarship, they totally deserved it.
no arguement.

i was one of them back them
so happy with my spm result , got the JPA scholarship, then went to overseas to get my MD...
dream came true babeh!
living a good life..
yes, all the hard work during SPM paid off!!!
totally..

so, to those who excelled in the spm ... cheerish the moment.. u r on top of the sky....
for the moment.
just remember , it wont last forever,
this is just another hurdle in life
many more to come.

i had some frens who excelled in SPM,
but screwed up on the later part

not saying u all shouldnt be celebrating this glorious achivement..
as a matter of fact ,
just have a hell of party out of it..
coz,
u'll be facing a bigger test in the future

whatever it is..
enjoy the moment..

i miss those time...

why?

another true story .....

in ward today ,
a "pakcik" was planned to go for operation by the urology team due to his bladder stone ;
which already causing damage to his kidney

he actually was given so many chance to go for operation before , nonetheless, he's not very keen for it.

due to the latency, the condition got worsen , the kidney is failing...
and he has to be admitted for dialysis

Dialysis is only a temporary solution for this pakcik, the real solution is to go for op and remove the stone... the bloody batu karang...

nonetheless, despite of his worsening condition, he still refused to go for operation, regardless of thousand of explanation being given to him by so many doctors.

and currently, he's under my management. everyday i told him, he needs to go for operation - but he still refused, asking for more time to think about it. Yes, we gave him enough time - almost a year !

I dont know what to do with this pakcik...

seriously, some people have to pay thousand of RM to go for op to remove the stone from kidneys or bladders.
but this particular pak cik , even for free... he still refused...

this is one of the weakness of free health care.
the citizen takes everything for granted.
they dont have any idea how much an operation really cost.
sigh...

i need a bloody holiday

i've been working non stop for the past 1 month...
literally..
no weekend, no day off..
i just realized it
was body was exhausted
weekend, if i'm not at the hospital, i'll be at the clinics
i really need a break

unfortunately, i couldnt.
i need to stay sharp and focus at least for another month
then i could have a "little" break

damn.. being a doctor is so tiring...
well... work is tiring
keje buat rumah lagi letih...

jadi startrooper lagi letih...

braveheart

a teenager came to my clinic just now,
complaining of "pain in the ass"
apparently he got gluteal abscess
before he left the room,
he asked me " was it hard to be a doctor ? "

i smiled at him and said " to become a doctor is easy , being one is hard..."
if u want to be a good doctor,
u must be brave
yes.... extremely brave ... but u must be knowledgable as well

one of the most difficult bedside procedure is to insert the cvp or ijc at the internal jugular vein as shown in the diagram above..
one wrong move, u could end up with pneumothorax..
and if u dont do chest tube a.s.a.p
the patient could died.....
just like that

currently i'm in charged at the high dependency ward
so, this procedure is a must do procedure ...
not all doctors could do this one..
some are afraid of the complication..
the bleeding.. the pneumothorax
but then, if u do it the right way,
everything will be just fine.

i didnt say i told u so

a few days back, i was writing about how dangerous was the dengue fever.
that was before the country was shock about the news on the famous comedian in malaysia was admitted to ICU due to dengue hemorrhagic fever
and today, again we were shocked by the news that he just passed away

al fatihah for him...
and condolence to the family
before i start making my points , let's me remind all the reader here - i'm not trying to be critical to anyone
but just stating the truth

most of the people didnt take the dengue issue seriously
as we all witnessed today, it could easily caused death

according to the Din beramboi family members and friends , he got the fever about more than a week ago, nonetheless, he refused to see the doctor
but opted for traditional medicine instead.
no arguement there , it was his life, he decided what best for him
he only presented to the hospital when he was critically ill..

well, it's a normal situation , malaysian doctors have to face everyday.

most of the people , especially the elderly - not very keen to go to the doctors when they are sick at the first place.
their first line of treatment would be the bomoh , tukang urut , dukun, pawang , bobozihan and whatsoever
in the year of 2010 , people still chose traditional medicine as their treatment of choice.
this pattern are common , especially in malay tradition.

and when the condition worsening , and the traditional medicine didnt show any improvement ,
they finally decided to come to the doctor ( after a long discussion and meeting with all family members )

As they finally agreed to see the doctor , these kind of people who already sought treatment from traditional medicine practitioner, they came with renal failure , liver failure and other organs failure - most likely due to the traditional drugs which mostly are toxic to our body

hence, with that critical and chronic condition, there is nothing much doctors can do.
and we are to blame when these kind of patient died at hospital.
sigh

i'm not saying that all traditional medicine are nonesense and irrelevent
what i'm trying to state here,
if u are sick, please come to us , doctors :)