Blissful Wedding Bells For Mike And Roisin..

Salam..

Just dropping by for a quick note.. As I told you earlier in the previous entry, I was exceptionally eager awaiting for this bank holiday weekend, purely because of the extended long-overdue break from hospital environment and to attend my first ever Irish wedding reception.. Yes, my lovely colleague Roisin's wedding..

Congratulations To Mike And Roisin!

Ina was oncall on Friday, only arriving home on Saturday morning.. I had thought of Roisin's wedding all day - how it would get on yesterday - as the weather was (unsurprisingly for autumn/winter) horrible.. It rained all day from the first sight of light to the arrival of night dark cloak! I did wish it all would go extremely well for my good friend though, regardless of the outside weather..

We arrived at the reception at Charleville Park Hotel, about 30km outside Limerick, about 8.30pm.. We didn't have any invitation card, so we were in a way, slightly clueless as to where to go.. Luckily for us, Roisin's dad saw us and invited and guided me in, straight to see Roisin.. I had met Roisin's dad a week before when he was having tea with Roisin in the hospital canteen..

Roisin was beautiful.. I thought she might have lost some weight between June (when I last worked with her) and last night.. She was glittering with joy.. She wore a pearl white corset wedding gown with multiple small glittering pearls.. She had a pearl necklace around her neck.. Mike wore the traditional Irish wedding shirt and tails, with yellow neck tie.. It was my first time meeting Mike, despite Roisin spoke of him a lot when we worked together in Milford..

We grabbed some Coke and we were noticed by Ruth Moloney from a nearby 'Doctor Who' table.. We joined her at the table, with Tom Kennedy, Catherine Peters, Eibhlish Ahern and Evelyn Kearns.. All of these people I knew quite well from the hospital scene.. There were other few that I barely knew - Omar (Orthopaedic registrar) and another surgical SHO, who came with Eibhlish..

We were lucky to arrive just about the time before the couple's first dance.. I did not actually recognise the song, but the couple obviously did.. The song was gorgeous and the dance was indeed so romantic..

Roisin and Mike's first dance

More Dance Afterwards

Of course, the usual culture would be more dance and this time the floor was for the guests to roam with the newly-weds.. The band played lovely songs to heat up the ceremony, although we might have been sitting to close to the speaker..

Unfortunately for us, we were spotted by Ev, who was by the way gorgeously dressed, and she had 'forced' us to take the floor and dance.. After much resistance and a lot of tugging, I gave in and took Ina's hand to dance - our own first dance! Never thought of that one! Ev got a snap and she will email me the picture later..

Wishing The Best Of Days Ahead For You Both

Unfortunately for us, we had plans to go to Cork Sunday morning, so staying back late was not a great luxury for us to have.. We went to find Roisin in the midst of the crowd and managed to catch both Mike and Roisin.. I congratulated Mike and Roisin and introduced Ina to them.. Mike thanked me for coming over and told me Roisin spoke highly of me..

"Oh, you are the Shaz Roisin has been talking about..
I heard a lot about you.. Truly honoured to meet you!"

I was lucky to have such a nice colleague in the first place.. Yes, Roisin and I got along very well at work..

I had hoped to get a picture of us and the new couple, but it ended up with Mike taking the snap of us with Roisin - after Roisin's suggestion..

With Mrs Roisin Dempsey-McMahon

Overall, I felt it was an honour to be given the chance to attend an Irish wedding, more so the wedding of one of my best colleagues here in Limerick.. It was a cultural exposure to me.. Yes, and Ina and I had our first dance too - thanks to Ev!

I wish the best of journeys to Roisin and Mike.. I thank you both for having us as guests.. I would also like congratulate Mike's and Roisin's family for the event held brilliantly..

Best wishes.. Salam..

Updates...

Salam..

I'm back again.. I've so much to tell but i'm not in a good mood to write it all.. probably I'll write about a thing or two..

I'll be going back to geriatrics!

My dear husband has told you that I got the SHO job in geriatrics.. To be honest with you, I never thought that medicine will be my 'thing'.. I never know what I wanted to do.. but since I started working in surgery,the answer became clear to me... medicine it is!! before I applied for the job,I was half-hearted because I was thinking of getting a few months off after this long internship that I do.. but on the other hand,I felt that i'll waste my skills & time as well.. I was really stuck.. I was worried that if I do work,I'll not be able to give my 100%.. I really didn't know how to decide.. My husband left it in my hand to decide.. I know he didn't want to put any pressure on me or to influence me in any way.. when I called my parents, I didn't have the strength to even mention the idea of being jobless.. so,in the end I decided to apply & let the 'nature takes its course'.. hehehe... I always believed that Allah knows the best for me.. I always believe in that..

Before I was called for the interview,unexpected things happened.. My original plan was to go for the interview without telling anyone & just tried my luck... (OK,probably it was not a good idea & it would be one of the 'mission impossible's;p) then one day,my ever-so-nice ex-SpReg, Catherine asked me where did I applied for my jobs & ever-so-clever me answered that I applied for the job here.. she was delighted & said that she will mentioned it to Prof Lyons.. And as I applied for the jobs,I asked Mr Waldron to be one of my referee & he also said he would mention it to Prof Lyons & Dr Clinch.. I was so touched by how good they're to me.. & I knew then that everyone in the interviewing panel would be expecting me & guess what,that actually made me more nervous! I knew they're all very nice & wanted to help me but what if I totally screwed up in the interview? that was my biggest fear when i walked into the interview.. It was my 1st interview for jobs & I was the 1st person to be interviewed.. It went OK.. I was so relieved when it was over.. and I think I did pretty OK.. I went home thinking,could I get the job? there were like 30+ of us and of which more than half of them that I knew (either from dublin or those who are also working here)..

The next day I got the news,1st from Catherine,then from Prof Lyons & I got the formal news from Ruth (human resources).. when Ruth 1st told me that i'm the 1st on the panel,I didn't quite get it.. I thought she meant that I was the 1st being interviewed.. and she said it again that I'm the 1st on the panel (meaning that I'm the 1st in the ranking),then only the message got through to me.. wow,I didn't expect to be the 1st in the ranking! Alhamdulillah.. being in the 1st interview & the 1st being interviewed,I didn't expect that actually.. Allah has ease my way & I knew this is whats best for me.. to continue my journey in my career.. and probably acute medicine is my destiny:) As for now,things has gone quite smoothly for me.. Alhamdulillah.. & thanks to those who have helped me along the journey especially my beloved husband... thank you!

This is just the beginning.. Although I am happy,I am scared as well.. starting as a SHO means more responsibilities & more expectations to come.. and how will I survive my oncall?? i'm really scared thinking of that.. I have more than 2 months to prepare myself & I will try my very best!

Good days & bad days

I guess it is normal for us to have good days & bad days.. and i have a few of them.. and I guess today is one of the bad days.. I came to work late (I didn't realise that I didn't set my alarm last night) & it totally ruined my mood.. and i guess everyone can see it in my face.. and then something good happened.. my consultant,Miss Merrigan praised me on my good work on updating the admissions list in the office.. She made my day.. Its not the praise that matters, but showing some appreciation do make a lot of differences.. it was a simple well done but knowing that she appreciates it makes me feels good & lifts up my mood.. it is amazing how a simple line can change your day.. and I learn today that being a superior not only involves giving orders but appreciates it when its done.. and I think it is very important especially when you're working under pressure.. It becomes a strong motivation to go on eventhough you're exhausted and nearly wanted to give it up.. Thanks Miss Merrigan! I do feel that I need some support.. probably because surgery is not my favourite.. I try to give my best but its kind of hard when i'm not totally in love with surgery.. It's very different from medicine.. but I do respect the surgeons.. its just that I prefer medicine,although its busy but I love it and makes me feel less stressful..

I guess I better stop now.. I'll write again soon..
p/s: my husband is bored when I'm 'entertaining' the laptop screen rather than talking to him.. hehehe..

Addiction To Blogging - A Disease Or Escalation Of Thought Processing?

Salam..

It has come to my obvious attention that my addiction to visiting this site, thus serving this blog with my entries has arrived to the point that I am almost blogging on a daily basis.. Not to mention, it has become an autocratic obsession, taking outrageous monopoly from a supposed-to-be shared blog.. Oh well, maybe this new hobby will lead me towards being a more open-minded critical and rational individual..

I have to say, I never intended this blog to be my online open-book diary for others to meal on my daily activities, but rather a place for me to vent my ideas and arguments and possibly re-evaluate my opinions after being commented by you fellow readers.. As atypical as one might think, I am not, and have never been, a keen diarist, not the very least..

Finishing My Series

I keep thinking about my three-part series of the doctors' life.. I am fully aware that it has now come to a stage where the final arguments should be available for you.. However, despite having had drafted the main points for the last episode, I have yet come to a 'feel' of needing to write.. One may loudly argue that the first two entries came indeed quite closely one after the other.. The dedication and urge to finish the series are still gloom.. I may well have to re-ignite myself to ensure a good quality and critical discussion at par with the previous two..

Hopefully so, that this slightly extended pause between the series would serve as a significant intermission for you to digest and evaluate the discussions so far before diving into the finale.. Every storm has its silver lining.. Maybe it is true..

Await the closing of the trilogy, and more importantly, I do appreciate all comments, arguments and criticisms.. Never fear to voice out your opinion..

See you all soon.. Wassalam..

Looking Forward To Bank Holiday Weekend

Salam..

Nothing much has happened in the last few days, but certainly nothing less than interesting despite that anyway.. Of course, everyday is a wonderful day and every day brings another challenge and another new experience, whether it be in my career, my social life or from my own evaluation and criticism of my own readings..

However, I must say, I am indeed looking forward for the upcoming weekend.. For some it will just be another weekend, but for us here in Ireland, this weekend will be a long one.. It will be the Bank Holiday weekend.. Of course, not many (especially of people outside Ireland and the UK) know why it is termed 'Bank Holiday'.. As it stands, it is actually a public holiday.. The term 'Bank Holiday' is traditionally used as historically the Bank of England observed 33 saints' days and religious days as public holidays.. But after 1834, the number was decreased to just four public holidays.. Just by history, the term 'Bank Holiday' is kept until today, and has absolutely nothing to do with a bank itself.. So, because of that, Monday will be an off day for me and Ina.. Of course, whoever is oncall will be working, but a double hourly rate pay awaits as compensation for working on a public holiday..

As for the two of us, we might plan to spend the weekend in Cork.. We have never really spend any proper time in Cork other than visiting Erin previously.. Although, we have been to Cobh, Fota Island and Kinsale.. Maybe we will stroll around the city this time if weather permits..

Roisin Tying The Matrimonial Knot

The other reason for me being a little bit more excited about the weekend is because a good friend of mine, Roisin Dempsey, who worked with me in Palliative Care recently, will be tying the knot with his beloved fiance, Mike.. I met with Roisin recently and she invited me and Ina to her wedding reception on Saturday.. I have never been to an Irish wedding, so this might be the chance to experience one.. I am sure Mike, who is a garda (policeman) anyway, is a lucky man to have Roisin in his life..


I am so happy for both of them.. Abundant of congratulations and I wish them well.. I will take some pictures and post it in here later afterwards..

Well, I think I will keep this entry really really short.. Ina is oncall tonight so I am actually alone at home.. I should go to bed now or I might be late for work tomorrow.. My 'alarm clock' (Ina) is not home.. *sigh*

Till next time.. Wassalam..

I Need A Break!

Salam..

Ahh.. I am back again, facing the computer, blogging my way.. It is late now, almost 1am.. In the silence of the night, I am still awake and, for some reason, thinking!

My wife Ina is probably the one person who knows me better than anybody else.. She knows me in depth and in width.. She reads me like an open book.. Of course, these statements only mean how grateful I am and how special she is to me..

Thinking Too Much

I remember once she told me that I think too much.. I thought she was joking.. I realized now she was not, not by any chance.. Not that thinking is not good, but maybe my thinking habits have come to indulge me into issues that may not be of my concern that much.. For example, blogging about doctors and the collider.. I suppose the words I express through this blog on thoughts I process on those issues is in someway a gateway of venting my ideas for sharing..

Maybe that is why me and Ina are so meant for each other.. She is my 'pause' button when I am going on overdrive.. She is my ABS braking system when my foot is on the gas.. She is my safety net and my sanity net!

Ina lives her life as how I liked it to be - no less.. She fills my life in the process with every bits that I require for sustenance of sanity.. I need a break from 'heavy duty' thinking.. I need to chill out and relax and enjoy the news once in a while, not just being critical and argumentative.. Of course it is good to stimulate my brain with critical thinking, but I also need to rest my brain sometime..

I need a break.. At least for a few days.. That's all I am asking.. Before I go wacko or crazy! But, not to worry, I still have a few more up my sleeves.. I will still finish my entry on the 'Trust Me I'm A Doctor' series.. After all, there is only one chapter left to close the arguments..

So, await my entry eagerly, my dear fellow readers.. Maybe after that, I will mellow down a bit and release a lighter entry for the next few weeks.. Something lighter, something shorter, something simpler.. As of now, realizing I need a break from neuron-overdrive is probably my best achievement of the day..

Till next time.. Salam..

Trust Me I'm A Doctor (Part 2) : Why Trust..

Salam..

I am back again.. And this time I will attempt to dissect the facts on why should we trust a doctor.. I will not elaborate any further on why I am doing this three-chapter series, however I do hope that after this roller-coaster ride is over, my dear readers will have a stand, or at least a strong reason to entrust their lives in the hand of a doctor, or certainly otherwise..

History - The Ultimate Reason?

History is one tool that could be used to strengthen a belief, or even be used to negate a belief.. For a profession such as a doctor, history is certainly a strong point to bring up in any discussion..

Every person in the world knows that this profession has lived in the lives of mankind for so many years, certainly the undocumented history tracks back even longer.. Several names such as Avicenna (Ibnu Sina) and Hippocrates are among the famous ones written in history.. Even at this level, we are talking at the time around 370 BC.. For some cultures and ethnic groups, witch-doctors are the equivalent to the community general practitioners..

This is from a wide historical perspective..

Looking at a smaller scale, it is not uncommon for a person to return to their 'favourite' doctor everytime they are unwell.. The trust and rapport that has been built between the doctor and the patient is a strong 'historical' advantage to any doctor.. Of course, along the way, the doctor then becomes more and more familiar of the patient's medical background, the medications he is on and the small bits and pieces of the medical history, having taken them in depth at initial contact.. We often hear :

"He's a very good doctor.. He knows the best tablets for my pneumonia."

"I always go back to her.. She's very gentle to me and my children.."

"He's the best doctor.. He remembers all my details and knows all my health problems.."

The trust was built between the doctor and a patient holds a very significant bond that you would actually literally trust your life to him.. This is not unusual, in fact, that even outside his surgery practice, we still consult to a doctor, not just about our health, but also about our day-to-day issues unrelated to medicine.. Why do we do this? Is a doctor worth that much of our trust? The answer is in the history - whether it comes from our reading telling us about the intelligence and superiority of mind of the doctors, or from our personal experience knowing a doctor and having a contact with him.. History has ultimately provided us a massive platform to stand on even before we gain any trust on a new doctor we never actually met before..

Take a moment to evaluate this scenario : You feel unwell and you present yourself at the hospital.. You don't even know the doctor working that night, but subconsciously you have already decided that you will entrust this unknown doctor to 'fix' you and make you feel better.. Where is the logical explanation in that? The answer in none.. Just trust.. As you always had, as you always have..

Hippocratic Oath And Primum Non Nocere

A sacred transcript from many years ago guiding doctors in practice pertaining to the morality and ethics in their service.. As we know by now, Hippocrates was a great Greek physician around the year 370 BC.. Indeed, the Hippocratic Oath was named after him.. The modern version of the Hippocratic Oath was written by Dr Louis Lasagna (1923-2003) in 1964.. The oath is still at least a ceremonial salutation for newly-graduates of medical school all around the world before being released in the 'real' practicing world of medicine.. The fact that this oath is not a compulsory exclamation for all doctors does not by any means translate to not adhering to the code of conduct outlined in the oath.. Certainly, despite the lack of us hearing the oath being religiously and formally performed in every medical conferences or physician gatherings, the spirit of holding to a conduct and ethical value within the practice of medicine is until today a must and now a second nature to all doctors..

On the other hand, the Latin phrase Primum Non Nocere literally translates to 'First, do no harm'.. For this phrase, the history behind it is still of uncertainty.. Some believe that this phrase is of the work of Galen, a protege of Hippocrates.. However, this does not explain the phrase being in Latin rather than in Greek.. Also, contrary to popular belief, this phrase is not in the Hippocratic Oath.. To explain the significance of this simple Latin phrase is not a hard effort altogether.. It is significantly self-explanatory : First, do no harm.. As simple as that.. Behind all the logic and simplicity, it is not at all an easy practice to do no harm in the first instance..

Worldwide community expect the doctor to 'do something' about them when they present to a hospital.. More often than not, acutely unwell person will have the 'do something' they search for.. An easy example would be presenting with a urinary tract infection.. The patient will expect the doctor to prescribe paracetamol to control the fever, an anti-sickness to manage the nausea, and an antibiotic to clear the infection.. However, medical practice has developed so widely and deeply that the dilemma to an attending physician is no more as straight-forward as a simple infection case.. Consider a lady presenting with a breast lump.. An ultrasound is booked and reveals suspicion of a tumour.. After deliberate discussion and consent, a biopsy was taken proving the sinister presence of the tumour.. A further workup is done with a CT scan and reveals presence of tumour in multiple organ sites.. At this stage, very minimal harm had been done apart from a needle biopsy.. But the next question is : Do we start chemotherapy? Do we offer surgery? The answer now is no longer available in any textbooks.. The dilemma is what will doing all these treatments result? Putting through a person under the scalpel is not without its risks - anaesthetic complications, surgical complications, cosmetic changes to the lady.. Is the answer for surgery 'No' or 'Go'? What about chemotherapy? Immune suppression is well-documented in all trials with cytotoxic chemotherapy, regardless of combination therapy.. Hair loss, nausea and vomiting, feeling lethargic after treatment - all are harmful.. So, do you expect doctors to make the decision for you? Most of you would expect so.. And the burden is back to the doctor - first, do no harm.. If, on the balance of treating versus not treating favours treatment with a (for example) survival benefit of 18 months, then the agreed decision would be a 'go ahead' despite the casualties of medication-induced side effects.. If not in favour, then why torment a person to such gruesome side effects of medication when the outcome is invariably dismal?

Always remember the next time you see a doctor : He has a code in his practice, a guide he holds strong to, and a reservation to not harm..

The Good One In, The Good One Out

People has long believed in a doctor even before they remember seeing one.. Obviously enough, the title 'Doctor' is a label hard to discredit even during out of working hours.. This phenomenon is not unusual, especially in the Malaysian community.. Even during weekends, when a doctor wishes to spend his time with his family, there would be phone calls from an anxious mother asking him about what to do with a feverish boy, merely because the mother is good friends with the doctor's wife.. Unwilling to be harsh and arrogant, the doctor leaves his family, goes to the boy's home and examines him and even possibly sends him to a nearby clinic..

Such a trust to a doctor to the extend that he is a doctor despite the hours.. He is not anymore perceived as a husband, father or just an ordinary man.. He is a doctor - full-time, full stop! People call other people by their first names in the community, but by no means it goes the same to a doctor.. He is referred as 'Doctor', in the village, in the supermarket or at the petrol station.. The noble seat being granted to a doctor outside his practice is huge..

Does the title bring so much respect and declares so much intelligence to the bearer of a scroll from a medical school? I believe the respect comes with the title so much more than it does from the person himself.. I believe the title, in some way, re-defined intelligence, that a doctor is perceived as the all-knowing of all areas, not just in medicine.. And this is true as we can testify how many times we have asked a doctor for his opinion to such an issue totally unrelated to medicine.. And we refer to him for our psychological needs and even spiritual supports..

The doctor is seen not just as the good one in the hospital, but also as the good one outside his working hours.. He may well have the character and personality in keeping with his code of practice as per Hippocratic Oath, he may well have been historically good to you treating your child's fever.. Inevitably, we still see him as a nobility in the community and an expert in his career..

So Many Reasons To Trust

As I have laid to you the reasonable reasons for trusting a doctor, I am almost certain that the examples I have given can well relate to our daily lives.. As I conclude this second part of the series, I believe I have given enough reason to justify doubting a doctor (in Part 1) and indeed subsequently debated convincingly on why to trust one..

The next chapter, the last entry of the series, will be a dissection of a doctor's daily life under a microscope - laying to you the working hours, the environment of working and the difficulties of doctors face everyday to ensure that they hold to the trust given to them by the patients but not jeopardising the care just because of the reasons and possible propaganda working against them.. At this stage, your views should be somewhat balanced with enough reason to trust and not to trust.. The final episode will then decide whether you tip to the trusting pack or otherwise..

Till we meet again soon.. Salam..

Trust Me, I'm A Doctor (Part 1) : Why Not To Trust..

Salam..

Long have I awaited and, indeed, I have undoubtedly postponed my intention to write at length about a specific group of people called DOCTORS.. I have now lived a life as one for just over two years and, at current, still living this life as it is.. As a matter of fact, it is not just me in my family who have committed our life to such a profession, but also accompanied by my wife Ina, my sister Erin and not any longer my other sister Intan.. Within a very short span of time, there will be four doctors in my nuclear family..

But the inside story and drama surrounding the ups and downs of being a doctor is far from prime time soap opera available to everyone.. For those who find out, the life as a doctor is not without its own hurricanes and monsoons.. Yes, other professions have also their unpredictable climate changes, but for doctors, when the rain comes, it seldom comes light..

I will try to dissect the life of a doctor in some detail, that hopefully, by the time you finish the three-part entry under this title, you would have a fairer idea of the life of a doctor, and maybe empathize or even criticize the life we have chosen..

Prepare yourself to know some truth about doctors - the ones who comes to you with answers and ideas you never thought explainable..

* * * * *

Doctors have been a profession widely respected by people from every level of dwellings, being put in such a high place and rank in community, saluted for their width and depth of knowledge not many men can achieve.. History have shown the great minds of the Arab worlds were indeed doctors, or thobeeb.. For example, Avicenna (Ibnu Sina), the great Persian physician who wrote The Book of Healing and the Canon of Medicine.. Hippocrates, on the other hand, was a great Greek physician, known today as the Father of Medicine.. The widely known Hippocratic Oath is still a valued trust emblem that binds a doctor to humanity and ethics.. Even today, commoners (namely in Malaysian culture) still address their doctors in their community as doctors and not by their names.. Such a noble seat to present for a man..

But with time, comes its own tribulations.. Along the way, despite the promise to serve mankind, few have stained the trust and neglected their duties, and subsequently tainted the whole family.. Indeed, raising doubts and giving reasons WHY NOT TO TRUST DOCTORS..

A Scalpel Is Not A Knife

Harold Shipman (1946-2004) was a graduate from Leeds School of Medicine in 1970 and worked his way up the professional ladder until he became a general practitioner in West Yorkshire in 1974.. Nobody knew where in his path he went astray when he started killing his patients with lethal dose of diamorphine.. An inquiry was held, he was then convicted to killing 15 of his patients and later sentenced to 15 concurrent life sentences.. Shipman however was found hanged in his cell on the eve of his 58th birthday.. A report in 2002 concluded that the number of Shipman's victim may well be around 215..

Thomas Neill Cream was a debonair gentleman who graduated from medical school in McGill University in 1876.. Unlike Shipman, Cream's favoured method of killing was with strychnine tablets.. Ingestion of these tablets resulted his victims to convulsions and gasps for air as their throat swell.. His victims were mainly female as his selling line was that the tablets he prescribed would protect his patients from sexually transmitted disease..

Of course, there was also the infamous Jack the Ripper of England, who until today many thought that he might be a doctor, or at least someone with the knowledge and expertise of one.. These are the names we know, but how many others do we not know? There are around 9.36 million registered doctors worldwide.. Even if 0.1% of them are the bad guys, we are indeed in doom!

Enough with the examples.. The question now posed is : Do these men have the right to called Doctors? Regardless of what your answer may be, bare in mind that they did go through the difficulty and strain during their training in medical school.. Despite their actions, they did have the capability and intelligence to achieve such standard in life to become a doctor..

Misses, Mistakes And Misdiagnoses

Recent events in Ireland have put doctors in a very hot seat and indeed a tight spot on top of that.. The cancer missed-diagnoses of two patients in one of the general hospitals in the West of the country have alerted every single person in Ireland to the level of competence of every doctor.. Of course, with the row about breast cancer and the availability of information in the internet, many women are becoming very sensitive and protective, possibly to a level of paranoia in my opinion..

AM and EK were both diagnosed with breast cancer.. The media attention was that the cancer diagnoses for both patients were missed at the initial contact with a doctor.. The two unfortunate ladies hence were subsequently diagnosed with breast cancer at a stage where the tumour had spread widely to other organs.. Such a row has happened that the hospital attributed to this event is evidently on the verge of being decommissioned and shut down!

Several facts were possibly manipulated, either by the media or people with interests, that the story is now a drama on the television.. Of course, the initial mammogram scans were re-examined and old patient medical record notes were stripped apart.. But, it is factually easy to point at the most minute of defects in a scan of, say, five years ago when we know today where the tumour is.. Whereas, the doctor at that time of examining the scans may not have felt the minute spot as more that an arbitrary scan artifact.. Tearing through the patient notes to read between the lines of records, of course due to the known fact now makes every single word so significant that even a note of fever could be extrapolated as "rise in temperature due to infection secondary to immunosuppression caused by cancer".. At this stage, anyone can point their finger to a doctor and put the blame on him..

Even recently enough, a lady died of an aortic dissection - where the main artery in the human body tore and caused massive internal bleeding that the patient died of shock.. The x-ray was examined by a experienced respiratory physician (who spends most of his medical career looking at chest x-rays everyday) and concluded that it was no more than a pneumonia.. Could you possibly expect a spot-on diagnosis from a more junior doctor to come with that exact diagnosis?

What about giving an antibiotic and causing an anaphylactic reaction? This is certainly not uncommon.. Dose mistakes happen so frequently, but whether it was life-threatening or not, depends on the medicine itself and the patients..

Misses, mistakes and misdiagnoses happen.. But the nature of the world today is that of blaming culture.. When something 'bad' happens, somebody has to take the blame.. And because a doctor's job relates so closely to someone's life, it is so easy to point the finger to a doctor.. Very seldomly people sue a veterinarian after their cat died, but a doctor is readily to be sued for breaking a chest bone in his possibly attempt to resuscitate a person after drowning.. It's because he's not competent, he didn't do it correctly.. I'm save and alive but the doctor is still wrong.. This is the world we live in today..

Medical Politics And Political Medicine

Medicine today is not as politically neutral as we all had hoped for.. Political hands influence all decisions made in the hospital even at a very basic level.. For example, a person presents to the emergency room with a chest pain.. History and examination were consistent with muscular pain.. Man was sent home for general practitioner follow up.. Two days later, man ended up having a heart attack..

Here's the scenario.. If the man was admitted, the admitting doctor would be stared at because of admitting a muscular chest pain patient which could easily be dealt by the patient's own doctor in the community, hence the doctor had wasted one bed for a sick patient.. If the man was discharged, the doctor will also be stared at because was careless and missed a heart attack.. Either way, most doctors will admit the patient regardless of how 'soft' the admission was..

Political influences in Ireland are looking even grim at this stage.. Cutbacks mean that smaller county hospitals may be closed down and the service being diverted to a bigger regional hospital.. Despite that cuts, the number of doctors are not being increased, the number of beds in the hospital are not being increased.. Hence, the same number of doctors will attend to possibly double or triple the number of potential patients.. Of course, as explained above, if anything goes 'bad', point the finger at the doctor for his incompetence..

But not many from the doctors' profession are well versed in politics that they could stand up and fight for the cause.. Most doctors become doctors with the intention to use their given ability to help and serve the community.. At the end of the day, the trust that people put on their doctors fade because of all the wrong reasons..

Tainted Trust

Such a great profession that there are indeed so many reasons not to trust them.. Some are worthy of not to be trusted - at the expense of the global trust towards doctors are tainted by the doings of few.. Furthermore, mistakes and misses, whether big or small, become a talking point, to a level where when people talk, the trust on a doctor, the confidence towards a physician is makedly crushed that the profession itself may be at stake.. Of course, political agendas led by politicians - whose interests are not within the hospital or patient care directly - influence the media and swing the confidence vote in favor of not trusting the medical profession..

* * * * *

I believe I have said enough for chapter one.. I have laid to you such strong reasons why not to trust a doctor.. Remember, the trust we are talking about is not of monetary value, but alas the value of life.. Have a think about my debates and await my second entry on why do you trust a doctor..

Sleep on this one.. Salam..

And I Survived The Weekend On-Call!

Salam..

I'm back! And I survived the 41-hour weekend call without a scratch mark, another pyrexial episode or gastritis pain!

This weekend call was probably the one I would remember long in my medical career.. Why? Because it was a "Weekend with Dr O'Hare" oncall.. Everybody in Limerick Regional Hospital knows Dr O'Hare as a great physician, with his own likes and dislikes in medical practice.. He might not be people's favourite person - one reason or another - but nobody can argue his great ability in managing his patients..

I started off the weekend call on Friday night with a busy night.. We admitted quite a few.. In fact, I think we took in 17 patients all together, before the 'hand-backs'.. I was long gone before on Saturday morning before Dr O'Hare even arrived for his post-call ward round.. (I may have deliberately avoided to be in the ward round - BAD ME! I'm not a big fan of post-call ward rounds..)

After 24 hours of break, I stepped into the hospital again and started my second half of my oncall at 9am Sunday morning.. Alhamdulillah, it was not as busy as I had anticipated.. We kept going admitting patients, but we were never slumped with uncontrollable numbers to see.. I had a bit more hours than usual to sleep during the night, so I was a bit more fresh for Monday morning..

Also, Sunday morning, I had a small pep-talk by Dr O'Hare - talking about discussing patients with the oncall registrar and a few other tips.. In a way, I was glad that happened as it opened an opportunity window to work with Majella (Dr O'Hare's registrar) easier..

So, that was in summary the whole weekend in small few paragraphs..

Now, let us do a little mathematics :

Working on Friday (day job), 9 to 4 = 7 hours
Oncall on Friday night, from 4pm Friday to 9am Saturday = 17 hours
Oncall again from Sunday 9am to Monday 9am = 24 hours
Working Monday (day job), 9 to 5 = 8 hours
Total hours of work this weekend between Friday and Monday= 56 hours!

That includes two parts of a stretch of 24 hours and 32 hours!

Hey, that's my life! A doctor's life! Nobody knows the hours, but everybody expects doctors to be PERFECT and SHARP while during their job.. So, the next time you go to the hospital, take a good look at the human who is trying to keep you and all the patients happy and well, not the doctor who has to be perfect for you only!

Till we meet again.. Salam..

Call, Fever & Another Call

Salam..

I'm back.. So much to tell, yet so little opportunity at this stage.. I will try to sum the major events that took place since the last entry.. So, here goes..

I was on-call for the whole night on Tuesday.. It was not that bad, in fairness.. I admitted a few, yet Dr O'Hare only ended up with a low seven for the night.. That was good! Given that we are on-call again this whole weekend..

Call being call, it was not that bad.. However, post-call day Wednesday, I was not feeling a 100%.. Head woozy, body aching - just not sharp! And I hate when I am not 100% at my job.. Went back home that Wednesday, had a bath and then straight to bed.. Yes, I did not have any dinner - I just was not feeling very well, what else my appetite..

11.30pm, Ina woke me up.. I was burning, mounting a temperature of (probably) somewhere in the region of 37.5-37.8 degrees Celsius! Yes, that is still technically low-grade fever, however given that I will be at work again in the morning, it was not helping at all.. Plus, Jenni (my colleague in Haematology) was away Thursday and Friday, so I was covering both the day-ward and the ward.. It was a lot of stress on the body.. 4.30am, Ina woke me again, again another temperature spike! This time we actually did take the thermometer and slipped it under my left axilla (that's armpit in medical term).. It was 37.4.. I knew Thursday was not starting off well at all..

Day-ward was busy that Thursday, more than ten patients to see, plus I had to cover the ward too, since Jenni was away.. Alhamdulillah, it went quite well and thankfully Johnny (my registrar) helped a lot.. It did eased a whole load off my shoulders.. He probably didn't do much more than he used to, but I felt even the small helps to my advantage..

Got the Job

Alhamdulillah, Ina was called for the interview on Tuesday and she got the job.. The next step would be signing the contract (once they arrive) and she would be secured a job starting January.. As for me, I will still be in the same hospital but doing another specialty rotation.. It would be a great advantage as both of us would still be working in the same venue..

I am not going to say more about this.. Suffice to say, I knew she got the job before she even did that Wednesday! I was at the coffee dock having my morning tea the day after Ina's interview day, when Catherine (Ina's previous registrar in Geriatrics) walked in and saw me.. She came over and told me that Ina got the job.. I said thanks and said that I would keep this a secret until Ina officially knows from Human Resources.. Of course, Catherine send Ina a text message shortly afterwards and also Ina saw Prof. Lyons before she got the call from HR.. So, as much as it was a surprise for her, not so much for me.. Hehe.. Sorry, honey! I got the news first!

This is her story, so I will not say much.. I know I did say that she would write a bit about the interview and all, but she didn't get the chance, so I will not barge in and take the mic.. I will let her tell her account..

On-Call Again Tomorrow - Can't Wait For Monday To Be Over

Well, I will pen-off now.. Sadly, I am still not 100% for the call tomorrow, from 9am Sunday to 9am Monday.. But that's not all, we doctors are among the world's greatest workaholics! I will then continue my usual day job from Monday at 9am until 5pm before I am allowed to step out the hospital front door again! That is 33-straight-hours working! How do we function? We don't know how to explain that, we just do! And if things went wrong, oh, it's the doctors fault - he didn't do this, he missed that! Simply because he's the doctor! (Probably not in the human category once we walk in the hospital with a stethoscope around our neck!)

I am sounding so bitter now.. I need to stop! But I think I have planted enough seed for you to (hopefully) eagerly await my entry on the doctors life..

I will write again soon.. Bye for now.. Congratulations to Ina - I always knew you would get it! Have a bit more faith in yourself.. Wassalam..

New Month, New Team, New Experience

Salam..

The last entry I scribbled in was indeed short and not more than a drop of an ink to wish Eid to all of you readers.. Much has happened since then, and yes, it was only a week ago since the last entry.. I will try to share a bit about the happenings of the past one week.. Although I have promised to write on 'Trust Me I'm A Doctor' heading before, it was only recently I managed to compile enough material to attempt a good discussion about it, so I decided to take some time before laying down my debates and rebuttals..

New Team

For me and Ina, the arrival of October meant more than just Eid.. Of course, nothing is bigger than Eid in this month, but another significant change for this month is the change-over to a new team for almost all doctors here in Ireland.. for me, it is a swap to Haematology after a six-month stretch in Palliative Medicine.. As for Ina, it is a swap from colorectal surgery to breast surgery, but mainly almost the same as both teams do general surgical call..

Haematology for me meant a new area of specialty that is quite alien to me, in a way that - ever since medical school - I have only the faintest idea about Haematology! Hence, being granted the opportunity to have a 3-month experience should give me a fair idea about this very sub-specialised area of medicine.. I am so happy and fortunate that my registrars are very nice..

Unfortunately, though, that on day-one of the new rotation, I was put to be on-call, covering the A&E (accidents and emergencies) for Dr O'Hare.. Yes, it was general medical call and usually it is busy, but we were lucky that I admitted only two patients, and Dr O'Hare only ended up with seven from the whole call! Rarely happens - almost unheard of! Yes, it was unfortunate because 1st of October was also 1st of Syawal, which meant I had to spend my Eid in A&E! Luckily, it was only up to 10pm..

Well, a new team, back to the usual hectic life of general medical call - this is all part of the medical career.. I miss Palliative Care already.. I met Dr Conroy (my old boss from Palliative Care) yesterday and she told me "We're missing you there in Milford".. I told her I missed Milford too and hopefully our paths will cross again sometime..

Palliative Medicine Team dinner & iftar - 11 Sept 2008, Copper 'n Spice
From left : Along, Ev, John (Jodie's boyfriend), John Curtin,
Mairead (John Curtin's girlfriend), Jodie and me
(Pic : courtesy of Evelyn 'Ev' Kearns)

Tracking Mr Grant

This morning, Mama texted me and asked a favor to try and track a gentleman by the name of Donald Grant.. This man was a government officer in then-Tanah Melayu and Tok actually worked for him at some stage.. In fact, Tok and Pakcik Suri had once visited him in Scotland (where Mr Grant is originally from) some years ago..

During Hari Raya recently, Mama and few of her siblings actually 'ransacked' Tok's closet and found some treasures of significant memorabilia.. They found 2 raya cards dating about 4-5 years ago from Mr Grant to Tok.. Also they found a book of stories produced by the former foresters at the time of the British occupancies, including Tok's story.. Mama will make a copy and send it to me..

I tried to Google the name in the internet, and to my utmost astonishment, there is a man by the surname of Grant with the exact address given to me by Mama.. It is possible that this man is Mr Grants's son (or even grandson, given the time of departure between the two old comrades) and he is running a tourism service in Scotland.. I have emailed this gentleman and maybe he will be able to help re-connect the two old friends again..

* * *

Well, I guess I'll pen off now.. I will certainly keep you updated about the progress with my investigative work.. And maybe Ina will script a word or two about her upcoming job interview next week! I will not say much - I'll let her tell you..

Today, few things need to be done :

1. Book flight ticket home in November
2. Call e-flow for charging me with toll that I did not use!
3. Buy suit for Ina's interview
4. Beraya at Shikin's house!

Adios, people! Salam..