I think my theory sgt betul la Elly

Remember my previous entry of "attached girl" attract more flirt?

Elly, aku rasa theory aku betul la. By the way, ngko je la yg telah meng"iya"kan theory aku. Hehe.

Last week, I was having dinner with my fren Farra, when this heavenly looking Italian guy who sit across our table asked to take photo with us. Both of quite puzzled, but since we are sporting gals, so tak kisah la.

This is bad

I arrive home at 20:45 today. Finished helping my house officer at 19:30, later have a casual chat with Caroline, the friendly Rheumatology registrar while I took my stuffs from doctors room. Journey home takes 45 minutes door to door. Tired, but nonetheless I am still in a pleasantly good mood. Put in venflon with no trouble at all, struggling with the butterfly on Mrs T hands (end up with me and house officer taking blood together, her veins is sooooo difficult, and she screamed before we even prick her), do Mini mental test on Mr F, write up blood transfusion form, do dipstick & send urine for MSC,take blood culture and few other things.

My house officer still hasn't finished work by the time I go home at 20:00.

Tomorrow her routine will begin again.

Makes me wonder how my working life will be? No life at all, kan? I actually assume my working life in country side hospital will not be as busy as inner city London hospital.

Caroline said she has been working 12 days with no break in between. She already takes a pay cut (about a few thousands quid) to take more holiday per annum.

Dunno why I keep pondering about this.

On being busy

I think what gets me going is the fact I enjoy what I am doing now. I can honestly say I feel comfortable in hospital and GP surgery environment. I used to get very terrified when ask to take history, do examination, and presented it to more senior colleagues, but now no more. I like going to my part time job because i do learn medicine from it (and enjoy the earning, of course). Also, I like my workplace.

Like Prof. Kumar says, enjoy what you are doing. If you don't, there must be something wrong with it.

There is not enough hours in a day

These days, I always feel I am running out of time.

So many things to do, so little time. And I feel I am running behind.

Even jobs the house officer ask me to help with pun, I tak sempat buat cos I have to be in clinics to help Prof. Kumar. Every Monday when I did clinics with her mesti run until 7-ish petang. Today, I went to clinic 1 1/2 hour late cos I helped the house officer with ascitic tap. Am not ashamed to admit that I really enjoy doing clinic with her - makes me feel very involved, as in I am one of Gastro doctors.

Anyway (esp. Elly S :D), I will not bore you with another medics story.

I already missed the weekends. I missed the days (third year that is) when I can just be carefree, takyah study, watch DVD cam nak mati, literally do what I like. Now, I have to carefully plan my day, to fit in errands to do, when to go to work,what to study,etc. Weekends is time to catch up things that got postponed. Can feel my energy being drained.

Makin lama makin glad la pulak I will work outside London (more chance of 9 to 5 job, apparently!). Kesian tgk my PRHOs work, diorang nyer work rota - keja 10 hari straight takde cuti, work 8 till 8 (although suppose to finish by 5 pm), on-call 1 in 6 days. Overworked, sometimes underappreciated and bukan nye the trust bayar the extra hours diorang terpaksa buat.

Do you want to grow old?

Pooja the registrar said sth that struck the very core of my heart during our ward round - "This is why I don't want to grow old. I want to die young". I was attending this frail looking 90 year old Somali lady who tugged my hand when I walked pass her. She speaks no English and I have absolutely no idea what she wants - she literally pulled me to go into the toilet with her. I asked the nurse what she want -the nurse said,"She probably want toilet paper. Go check". I checked, and toilet paper is there. Nonetheless, she keep tugging me, Pooja then called a nurse to assist the lady. Mind you, I don't mind helping her in the toilet, but my action can mean that the ward nurses not doing their job.

Anyway, what do you think about growing old?

I honestly admit that I wish I will not live a very long life. Imagine if you live till you are 90, after retirement, you prolly spend 30-40 years of life do nothing, which will later may predispose to depression, feeling of meaningless life and when people all around you died, you wish you have died earlier.I have seen a lot of elderly patients with curable illnesses, some choose to go down the route of treatment and investigation, some said they rather not to. Some starved themselves till they get really dehydrated and malnourished, which is when we saw them in hospital.

I saw a very lovely childless couple in their 80s the other day - I just could not imagine if one of them passed away, how the other half will cope. I remember one elderly lady I saw in clinic, telling me about how her husband died. They were preparing a charity party. She was home on that fateful day and her husband went out to invite some VIPs. When a police knocked on her door, she thought of nothing bad. They said,"Your husband gone now". She replied,"I know he is gone. Where to?". Her husband was found dropped dead in the street. She is still traumatised by the incidence - every time someone knocked her door, it reminds her about her husband death, and that was 5 years ago.

Sometimes I wonder if my choosen career has steal my zest for life?

What will you do in this situation?

- Mr M, 70s - has been starving himself to death. Refuse us taking blood whatsoever. Very malnourished. He wants to live no more.
- The 90 year old Somali lady, has refused eating since one of her daughter passed away.
- Mr A, 73, refused colonoscopy, and don't even care if he has colon cancer.Said he is old, no need for all these fussy.Although it is a known fact that we can cure colon cancer by surgery in patients of age 80s.
- Mrs W, 83, with Crohn's and severe OA, has started seeing goblins, and strange phenomenons. Now she' telling me she regret telling her son that, otherwise she will not be shipped to hospital.

P/S: Ed the PRHO (btw, remember my previous entry of Ed? Yes, he is the junior doctor in my team. Of all the people, he ended up in my team, what a coincidence.) said he is not keen staying in London for SHO job.

The soul

You Are a Dreaming Soul

Your vivid emotions and imagination takes you awy from this world So much so that you tend to live in your head most of the time You have great dreams and ambitions that could be the envy of all... But for you, following through with your dreams is a bit difficult You are charming, endearing, and people tend to love you. Forgiving and tolerant, you see the world through rose colored glasses. Underneath it all, you have a ton of passion that you hide from others. Always hopeful, you tend to expect positive outcomes in your life. Souls you are most compatible with: Newborn Soul, Prophet Soul, and Traveler Soul

What Kind of Soul Are You?

Social night

Went out for dinner with Prof. Kumar, Dr A Balinger, Pooja the registrar, the clinical attachment, 3rd year students. I actually just come back now, at 11.30 pm. All of us are having such a good time, not realising how late it is.

The more I know Prof. Kumar, the more I admire her. Salt of the earth, she is. All of us didn't believe her when she said she is not really that ambitious when she was young - all she wants to do is finish her degree and work in a village in India. She took BSc in case she could not finish her medical degree. She climbed the career ladder rather slowly,did the family things, and only successfully became a consultant in her 40s.

About 10 years ago (I wonder how old she is actually), to help her devise junior doctors timetable, she decided to swap her consultant role with her house officer for one day. Her bleep went off about 10 times in the space of 2 hours she started her PRHO job; she realised she didn't know how to prioritise her job, so much to do -taking blood, see patients, put venflon etc...and ward round is about to start. Since then she developed "bleep-free" lunch time for the PRHOs, realising how busy it was. She is very much in the Modernising Medical Career committee, it will be very interesting to see how changes going to occur in our future training.

She hates arrogance and limelight.

Listening to her story really soothes my worries and lifts my rather dampened spirit. Lately I feel I am not as ambitious as others. I am about to change my priority in life - putting my family first. I will enjoy medicine as it comes, taking my time.

Now I know I will be ok at the end.

To all of my lovely friends (especially those doing medicine), you all will be alright and I pray for our success in the future. Time will pass and all the pieces of our life will come together at the end. Be patient, love.

Resolution

Man, the power of a good night sleep definitely do wonders to me. Manage to catch a proper 7 hours sleep, get up, feeling really fresh, instead of yawning and feel exhausted.

I try to take good care of myself these days:-

- Try to eat properly. Those hypoglycaemic attack that happened when I missed lunch does no good to my brain.

- Rest.

- Drink milk everyday.

- Make sure there are fibres in my everyday meal.

- Take Cod liver oil. I feel less tired, and better appetite.

- Read at least a paragraph of medical book and memorized & understand the important facts everyday. (I have been very bad with my way of studying medicine and revising for finals).

- Have one day of the weekends to myself = rest, watching DVD, do what I like, read story books

Please don't make me feel bad

I have become less and less happy to tell my London colleagues (medics and non-medics)that I choose to work outside London.Somehow they make me feel that I am making a wrong career decision. I know I am not.

So unhappy that when Prof. Kumar complimented my history taking and notes writing,it fails to cheer me up. I smiled though (but my heart still feels heavy).

I know my heart is not in London anymore, I have stopped wanting to be here - I want to go somewhere else. I yearn for a bit of country side and fresh air. Here, every where I stare are buildings, buses, and cars. I used to live with my grandfather and grandmother in a paddy field village, and it has been one of the best time in my life. I still remember the feeling of freedom and free when I cycle as fast as I can in the jungle path. No one care if you are wearing a branded clothes or watches like in the city, we all just want have a good time - fishing, cycling, picking fruits.

Working in London is seriously busy (by admission of a SHO Dundee graduate working in London) - most PRHO work really hard, sometimes go home at 12 midnite (since need to clear all the backlogged documentation), and have to turn up 8 am the next morning. Patients are not always friendly, well, prepare for a huge load of drunken antics, stabbing, victims of attack, and overdose when doing on-call. Some of them have difficulty understanding any English at all. - I remember try taking history from this Viatnamese woman and her rather unhelpful son. Patients are often a lot more sicker (almost like in 3rd world countries, honest!).

Don't get me started on living costs in this city.

Bad mood - don't read

I am sooo fucking angry right now...I think I could smashed someone's face.I know I know, I shouldn't blog about it, but I need an outlet.I am supposed to pretend to be nice to X, am I not? Next time remind me la, menyusahkan orang betul. I, Miss Remember Everything sometimes forgot.

Well, X is a nice good girl.Except when I with her, through no fault of her own, she somehow manage to make me feel less, and why I can't be as nice/mature as adult/ambitious as her. Its a tiring friendship - I can't really go suddenly bust, crying or be angry and let my emotion takes me when I am around with her - it makes me feel weak,and not helped.

I missed Elly S & Belinda.You know,with them I don't have to pretend when I am angry or bad mood or tired. I can just be myself, then apologise later. Same goes if they are angry or bad mood or feel the need to sumpah/crying about someone, I don't mind.

I missed my hubby.

You Are 20 Years Old

20 Under 12: You are a kid at heart. You still have an optimistic life view - and you look at the world with awe. 13-19: You are a teenager at heart. You question authority and are still trying to find your place in this world. 20-29: You are a twentysomething at heart. You feel excited about what's to come... love, work, and new experiences. 30-39: You are a thirtysomething at heart. You've had a taste of success and true love, but you want more! 40+: You are a mature adult. You've been through most of the ups and downs of life already. Now you get to sit back and relax.

What Age Do You Act?

My ward

I went to my first ward round with Gastro team last week. It is quite something.

More than half of patients we saw have serious alcohol and liver problem.

There is one patient of ethnic minorities (who I think Muslim btw) who has a serious alcohol problem to the extent the consultant no longer bothered to put him into Detox programme. Everytime they started him on Detox, he come back running to the hospital with a bottle of vodka in his hand. Mind you, doctors rarely want to give up on their patients. It has to be really bad. I don't know how many times they have tried Detox; I didn't ask. And he has proper delirium tremens.

I also saw encephalopathy secondary to chronic liver disease due to gain, alcohol. She has proper reversal of sleeping pattern.

One interesting case where patient developed septic shock secondary to E.coli. Rare.

Uh,uh...I was fortunate enough to saw hereditary haemorrhagic telangiectasia (Osler-Weber-Rendu) case - in fact, I clerked her in Prof. Kumar clinic.

Mr X is a real gentleman. He has recurrent DVT and PE due to Protein C deficiency. I did encounter some similar cases in the past.

I am going to miss this place.

P/S: I bag the PRHO post that I want (not in London, of course) ! Alhamdulillah.

Not a very good day

This morning, an elderly Bangladeshi "berkopiah" patient shouted bloody murder at me and took the whole room by surprise. I was putting in venflon in his hand, and since the registrar was the one who assembled the equipments, I thought she had the stopper with her. I had to held his hand up to stop the blood trickling while waiting for the registrar to come back with the stopper. And he rudely keep shouting, "You don't know anything, you don't know anything".My reaction? - being totally professional, I just gritted my teeth, and smiled. I did not do any fault at all, am I not? The consultant, Prof Kumar (of Kumar and Clark) & the registrar said that I am doing great - it took me only one attempt to prick his atherosclerosed vein. The patient was so stubborn. He was not allowed to have any breakfast, and yet he ate the morning before his endoscopy. His endoscopy is so difficult that even enough sedation was given, he still trying to kick everyone around his bed. Prof. Kumar took 5 attempts just to get the endoscope passed into his gullet. It took 5 people to held him down so that we can proceed with the procedure since he had varices that need banding, otherwise he will end up with massive haemorrhage. The food have camouflaged some bits in oesophagus that make banding more difficult. The clinical attachment doctor who was with me as well in the room said, "Don't bother with what the patient says. I was once slapped by a patient and my glasses broke".

The other day, a patient refused to be clerked by medical student (me!) and shouted to both me and the horrified nurse. It's not like he doesn't know the hospital is a teaching hospital! He then refused to see the consultant and asked to be referred to another consultant at Royal London (which is another teaching hospital). My consultant said, " You can't really make everyone happy, can you?".

Like Prof. Kumar said - your patient is your God. You give information about their choice and do what they want. That is simply being professional and you protect yourself from unnecessary litigation... Unless they physically the staff, then a complaint about patient is justified.

It is not like other professionals, if you don't like your client, you can just hung up, scold them back, or cancel the deal. We have the rudes, nutters, criminals, aggresive patients come to our door. We try our best to help, but when they start muttering swearing words or hurtful comment like I had this morning, doctors can only say nothing. Most A&E I have frequent in the past will have a big poster saying if any of the patient start being abusive to hospital staffs, they will be persecuted. It's sad, isn't it? Where is manners and common senses?

Quite a lot of medical students/doctors/clinical attachment docs in London have had this kind of experience where patient is just plain rude. We just put up with abusive comments, aren't we? Who want to get sued anyway?

Oh btw, on my way back home, I was sitting with this young Brazilian looking bloke in the bus. And this perverted guy keep touching my thigh! I put distance between him and me, pulled my jacket over my thigh, sit really close to the window, (still doesn't get my message - don't touch my thigh!Brain size of chickpea agaknye) and somehow his finger slowly creeping to my thigh. Mind you, I was wearing a thick long brown corduroy skirt. I try not to make any scene in the bus (there is one nutter in the bus as well, quarelling about why one of the passengers doesn't say please when he wants to open a window). Finally I have enough, and got off from the bus. Bangang tolol sial punya mamat (kena kau aku mencarut dalam bahasa melayu).

P/s: Prof Kumar is a real nice lady although she is a bit "ladish"(not in a bad way, in a GOOD way). Her English - one word to describe, polished and posh! I wish I had her during my 3rd year.

Achievement!

This must be some sort of record (of myself) - I washed dishes and cooked nasi minyak & exotic salmon curry and wash delicate lingerie with softener in 45 minutes. Done!

From ES Magazine

My star prediction for 2005:

Obstacles: Watching everybody else make progress while you must wait.

- To some extent, it's true. Green with envy to those yg dah dpt PRHO job and people yg ada 2nd degree.
- Watch everyone else ada babies, and me still no babies. Even, my best fren-used-to-be-very- grunge-and-teasing-me-abt-my mum-is-an Avon dealer I.S. pun is pregnant. Btw, I am truly happy for you. I hope you will get the happiness and family stability that you always yearn for, and truly deserved. I really2x missed our friendship.
Anyway, it's not like I am trying to have one. I am the queen of contraception.

In 2005:
- With so much going on, you worry that you're missing worthwhile opportunities. You're not. (Phew!)
- It is not until Jupiter moves into Scorpio late in the year, begin a year long cycle of opportunity, that you'll know just how far reaching and exciting changes can be. (Hopefully this is one to look for. I am making a big career decision, and have started to wonder whether I make a right decision). Whatever patience this requires early in 2005, it's more than justified by the amazing personal, romantic and professional developments that appear as the year ends.

Inspirations: Knowing you'll be relinquishing numerous burdens.

Not that I totally believe in astrology, but reading this in ES Magazine, it gives me a hope that everything will be alright at the end. Sometimes, all you need is reassurance.

One of the romantic gesture my husband throws me, is during our driving trip to KL from Shah Alam. I was driving (me just learnt how to drive an Auto - so easy peasy). He was so happy with me being able to handle the car calmly during the really heavystorm and traffic jam. Masa tgh in the traffic jam, he just pulled and kissed me on lips. It was so sweet. :D

I hope 2005 will be a better year for both of us, and everyone. Amin.

P/s: One of my friend, Z, is a very impressive walking book of astrology. Just say your date of birth, she will tell you everything from A to Z about your zodiac. You have to speak with her to believe.

Bugger!

Still tak tau camner nak post photo on the blog. Nanti la I read blogger help tu...byk keja lain yg berguna nak buat.

Got my wake up call to revise for final....Bloody hell! Nak kena panggil my status quo frens ni.

Today tgk ear syringing kat my GP. Punya la jahil tak penah tgk; dah la ENT teaching kat med school pretty crap. Nurse L says I can try do ear syringing if we got a chance, yeay! Sonang yo.

Have a lovely chat with hubby at a really good timing. Susah tol nak budget a good time for us to talk with these 8 hours time difference. Need to start thinking when is the best time to start our family. Hmm, another good reason to not to work in London - I do have competitive nature, so I prolly will feel left behind by my career orientated London colleagues (this apply to most of them. Everyone doing audit, doing research based work, take extra degree, do charity work, organised bone marrow clinic - even the people in the lowest league of my year). They work hard and party hard as well. I will rejoin the rat race when my personal life is a bit sorted. Balance, balance, balance.

Elly, I would love to leave msgs to ur blog. Your writing is soooo you. As does my dearest Bel. I don't know if my blog reflects me well, not that I really care what people say. You know when I read some blogs of people I know (none referred to the my links, in case anyone wondering and start think bukan2x) - they all sound ok/funny/entertaining/extroverted kan, but in real life is either really introverted/not funny at all/really bossy/annoying nature. Not that I bother anyway, I am just saying.

hmmm..

When my fellow colleague make this unexpected joke, it makes me uncomfortable, more than seeing the funny side:

Me: Hi, S, I have a question for you.

S: Well, if you ask me to marry you, that is one thing I can't do right now.

Me: (hilarious rasp of laughter follows, rather nervously) That is hilarious.

S: he..he..he

London transport fee naik lagi...

I was quite shocked when I found out that my monthly bus fees has an increase of ~£5. Bloody hell, that is waaaayyyy too much increase in the space of one year. And that is after 33% discount from adult price. Oh, don't even get me started on tube fares. Shit, just remember that I need to travel using train to my surgery firm (King's George Hospital) and tubes (to Newham Hospital) in coming months.

One way bus journey has increased from £1 to £1.20.

Bus saver is currently £ 6 instead of £ 3.65 (well, it used to be).

One day bus pass is £3 instead of £2.50. It was £2 in previous previous year.

One way tube fare is £1.70 (with Oyster) and £2 (without Oyster).

Tube Carnet is now £17. It used to be £11 .

That's it. I am leaving this city.

Donating money

Natwest Bank has lifted the levied fees for sending money abroad from the UK to ALL the countries affected by the tsunami - Indonesia, Sri Lanka, India, Thailand, Malaysia, Kenya, Somalia and all.

Time to get going people!

Tsunami

It seemed I can't drag myself out from browsing about the tsunami.

Have a look at these photos. Its too depressing and scary to what happened in Aceh.

http://www.nytimes.com/packages/khtml/2004/12/28/international/worldspecial4/20041228_eq_INDIA_FEATURE.html

Friends

Feel sooo lazy today. And yet have so much to do.

Am doing job application thingy. Filling forms. Been researching UK map online, living costs. Somehow the prospect of having to move up north doesn't seemed too daunting now. After all, most of my good old college friends live upnorth (including new ones I have bonded over the holidays). Most of my friends in London are soon to work colleagues or work related...Guess I am not having much fun here, eh....Good old ones in London have either move on with their life in Malaysia or left the city.

I am ready for a new beginning.

Sheesh, reading previous paragraph make me realised one thing - I do classed my friends:

1. Good old friends - they know you in the past, the bond is already there. Even if you haven't meet them for years, you just reconnected almost instantly. I have been given a chance to rekindle the friendship over the hols, alhamdulillah.

2. Shopping friends - they assisted you finding bargains, and spending money wisely without guilt. :D

3. Emotional punch bag friends - This is what girls do to their friends to get over relationships. Emotional punch bag friend doesn't usually last long. Till she meet a new guy, you will be the one she had coffee with. Then, you will be lucky to be in her party list or invited for a meeting up. I never do this to anyone. Honest.

4. Status quo friends - Work related - enuff said.

5. Chemistry friends - New friends who you bonded almost instantly. Love them.

6. Hi friends - you say hi to them when you meet up for the sake of being polite, and that's it.

7. Favour friends - admit it, whether you like it or not, all of us do have friends we always asked for a favour.

8. Revision friends - OSCE that is.

I guess this is all parts of the process of becoming adult. I have learnt that even I am with a person I don't like, I just make my peace and be a good friend to that other person.

That is all I can think of rite now.