DOCTORING part II

M.O. : Did you know what happened with .... (something about the current news which I can barely remember)
Me : What?
M.O : Ooo I forgot. H.O. doesn't really have time to follow news
Me : *sigh*

I'd normally do not read news anyway. I usually prefer to watch the news. I read only news that does not come out on telly e.g. what says PAS/PKR or whatever non goverment party re some issues.

But since being a houseman, I rarely watch the news, let alone reading any. I always do turn my laptop on when I come back home, but most of the time ended up in the bed, falling asleep unplanned. I think I slept too much already, but my body is still aching, I have no idea what the causes would have been.

And lately I have this weird thing at the end of my meals - strong smell of liquor always stopped me from eating further. Lucky it always happened at the end of meals, or else I would have lost lots of weight already! I guess too much of ARM (artificial rupture of membrane) already! Weird, as I left labour room for 2 weeks now, and never had that problems when I was in charge before.

Anyway, today marks 2 months of my working life in O & G department. Things have been going better than before - I believe I have learned loads of stuff especially the practical ones, but I long for more teaching as I know there are lots and lots of things I still need to know. Especially thinking that I might be sent off to anywhere; where I might need to decide on everything and will not have M.O.s/specialists to consult - trust me there are loadssss of stuff beyond my shallow knowledge I am holding on to. The first viva is soon expected, and I can confidently say i am not yet ready for it.

And I still hate making decisions, being h.o. sometimes you have no idea when to decide by yourself and when to consult if something is so obscured but I guess that is just the simple rule of being a houseman. Every week we are being audited for mistakes we have done(which I believe in some cases, h.o. should not be blamed at all), but I do like being there when the audit was done as we learn so much from mistakes. (but despite saying this, I hope I will never be the one being audited *sigh* God I just hope this wont jinx)

So that is 2 months of working life - I still have not taken any leaves yet (I gave up the last time I tried to apply one). Please pray I will get some at the end of this year as I really badly need some holidays.

THE VICIOUS CIRCLE

by Ija (who I usually agree with, and whom I miss so much - we are working in the same hospital, but very rarely seen each other)

It has been a circle from the earliest of human developement. But as we are living in a community which demonstrates such a cruelty, it is a shame if we can't see it with our very own eyes.

It is not far from me, seeing what is happening in Terengganu, a state taken as an example. Known for its glorious culture,food and OiL it is also known as one of the poorest states. It is.

Truthfully, the federal earnings from our valued source-OIL is such of a great number. The federal earns multi billions from that. The people in Terengganu should actually at least get something in return - a proper education, facilities and at least a proper health service. But they are not.

So many people had realised and claimed that if the earnings are 'used' properly by the federal, each of us can at least enjoy a decent allowance monthly. The gas for cooking will be free! Education should not be a problem. The villagers can have a proper transportation getting to the hospitals. The students from remote areas can enjoy schooling as they do not have to wait for hours and hours to get a lift to the school. What a shame to the superiors who had let these happening.

Now that the earnings are being swallowed and smuggled into their own pockets, they are the ones who are responsible for the consequences of these poor people.

I want to show a typical example. It all started from being in an unstable poor family. Imagine a boy having to stop school because there is no breadwinner and he has to be one. He does not like school cause it's very hard to get to. Starts working catching fishes in the sea with fellow adolescents, eventually gets into drug abusing. It is very common here. Or they get into this popular social activity -they went merempit. Got into an accident, and admitted to the hospital.

These rempits got somone killed. The rempits got comatosed. The parents are worried sick everyday, taking care relentlessly with sleepless nights. The mother patiently cares for the boy who is now require an attention of an infant. And when they are conscious , they get back into their attitudes-being rude and not thankful to the parents. But the parents keep being calm,thinking their child is unstable hence letting them to be as such.

I am pointing out that if at least if these people get their proper education, the chance of them being a social junkie is much less. And why did they not get the education they deserve? Because those responsible in providing it is not doing their jobs.

The circle of social problem does not start with poor home education. It starts from the government. It starts from the way resources are being given to the people. It is even worse when the money is there, instead it is going to the wrong hands. This is a circle which should be destroyed, as more poeple will suffer the consequences.

DOCTORING part I

1. Requirement for a houseman.

This part is specifically for medical students who soon are going to do noble jobs of doctoring. If you think the main criteria you are obliged to have is to know everything especially the theory part of medicine - you are completely wrong. When your university said they want to produce a safe doctor who are able to treat patient, they are totally right with the aim. As a houseman, this is your job: You will be seeing many patients with various different presentations, either as referred cases or first hand patients then you have to decide what to do next and if there is need to ring the senior, just pray that they are in good mood (and not just woke up from sleep!).

If you study in the UK and pampered with the rules of giving feedback - that is to start with positive things and then only go on with the negatives - in which case, no matter how stupid or how wrong you are, most of the time you will still get credit and be motivated that way because people will start with 'the things that u did good was....' and end with '...but you can improve on .......', so if you are being pampered with this kind of feedback, please please please prepare yourself for a total 360 degree change where most of the time you might be criticised and the only means of learning might be through critics, or even humiliation. Especially if your brain works very slowly particularly under pressure (like mine), there is no other things you can do apart from you motivating your own self and continuous prayer asking for a better tomorrow if not a better you. I am sure all the seniors want you to be good doctors even when you are being told off by them - it is probably like parents scolding off the kids so they become useful people later on

In summary, if you want to prepare yourself to become a houseman, learn this:
1. Familiarise yourself with learning by humiliation/critics.
2. Do your jobs very very very quickly or you will be stuck in the ward forever.
3. Be able to present patient very concisely.
4. Know the name (especially specialists) of the person you are going to talk to before talking to them. Make full use of the committee chart even though the picture might be too small or too old for you to recognise the person you are yet to see.
5. Agree wholeheartedly that doctoring is a noble job and you are not to become a doctor because of the typical reason 'my parents want me to'. Holding tight to religious teaching and having Him who always listens helps.
6. Able to say no to jobs during your tagging duration because that is the only time you can learn even though patients are supposed to be your everything once you become a doctor. If you don't learn during the tagging time, you are in big trouble to learn
7. Familiarise yourself being called 'doctor' on your first day of placement.
8. Have lots of practical knowledge not just theory and be able to put them together quickly and be able to impress the consultants.
9. Appreciate that H.O = humble orang. If you did wrong, you are wrong. If you did nothing wrong, you are still wrong. If you did right and being blamed for, you are still wrong. Try not to answer back. This is the hardest thing of all I think, as human beings naturally have the tendency to defend themselves.

(to be continued, if there is time and mood)

I know the way I am writing this, it sounds so bad, but what I know is I am learning and trying to improve every day (slowly maybe, but getting there hopefully), and it is not actually that bad when you are enjoying the learning and jobs and the talking to the patients bits. I just hope I will survive my 5 consecutive EOD (every other day) oncall starting Sunday. Wish me the best!

PRE PROLOGUE

"I do solemnly declare that as a doctor of Medicine from Newcastle University, I will exercise my profession to the best of my knowledge and ability for the good of all persons:

- I will make the care of my patients my first concern, keep my professional knowledge up to date, and recognise the limits of my professional competence;
- I will treat every patient politely, with respect and dignity;
- I will treat my patients considerately, respect their views, provide them with information and involve then im decisions about their care;
- I will work with colleagues in healthcare professions in ways that best serve my patients' best interest;
- I will respect and aid those learning to acquire skills and competencies for the care of the patients;
- I will be honest and trustworthy, respect and protect confidential information, ensure that my personal beliefs do not prejudice my patients care, act quickly to protect my patients from risk, and will not abuse my position as a doctor.

In all this matters I will never discriminate unfairly against my patients or my colleagues. I will hold in due regard the honourable obligations of the medical profession doing nothing inconsistent therewith. Above all, I dedicate my professional life to the service of those entrusted to my care."

This is to remind myself the oath we all (the Newcastle students) have taken when we graduated as doctors.

THE PROLOGUE

I have just completed my induction and BTN course this afternoon. By right, I have already started working six days ago, as the pay slip for new doctors starts on the very first day they attend the induction. Induction was ok although I was expecting more talks about how health system works in Malaysia especially knowing that more than 99% of the participants were oversea graduates. And I do not have any intention to make any comments about BTN - loads of the government servants must have already known what it is all about!

I had survived my five years MBBS course which tortured me the most in my third year. I had survived the nearly two months well deserved break which had turned out to be too boring at some points that I had crazy thoughts haunting me (thank goodness Harry Potter books saved me from those thoughts - and by the way, raya and having a full house was great!)

I had survived the six days period of induction and BTN course, learning more about being a government servant in general or the so called 'house officers' in particular, and being proud to be a Malaysian, and not to forget the latest slogan that we have - the '1 Malaysia'. I had survived the long journey back to home, being the passenger for the first time at the backseat of the soon to be TAW 997. I had survived the very long thought about future life throughout the whole journey (minus two hours of the badly needed fine quality sleep, finally!) although practically I am still left with no wise decision.

After hibernating for nearly two months, today is very tiring! But I believe today is just the prologue. Tomorrow is chapter 1 - where the new era begins!

ps: to the patients coming to Hospital Sultanah Nur Zahirah, Kuala Terengganu, please beware of this new doctor coming to serve you.

MEDICAL STUDENTS, CONSIDERING ...

BUYING THE LATEST EDITION OF THE OXFORD HANDBOOK OF CLINICAL MEDICINE?

RE: new edition (Oxford Handbook of Clinical Medicine Feedback Form)

Thursday, 20 August, 2009 4:36 PM

From:"Ox Med Comments"

To:"afifah jaafar"

Dear Dr Jaafar,
many thanks for your email (and congratulations on your recent
qualification!). You've done right to ask, as the eighth edition is just
around the corner - we're working on the proofs now, and will expect to
see it in the shops early next year. I would recommend waiting until
Jan-Feb, when the new edition will be available for purchase. Many
thanks for your interest in the book, and we hope you will like and
enjoy the new edition.
Best wishes,
Mark Knowles


Systems and Online Development Manager
Tel: +44 (0) 1865 35 4024
Fax: +44 (0) 1865 35 3817
Email: mark.knowles@oup.com

-----Original Message-----
From: afifah jaafar [mailto:fifa_0304@yahoo.com]
Sent: 19 August 2009 04:22
To: Ox Med Comments
Cc: fifa_0304@yahoo.com
Subject: new edition (Oxford Handbook of Clinical Medicine Feedback
Form)

------------------------------------------------------------
Comments sent via OXFORD HANDBOOK OF CLINICAL MEDICINE Feedback Page
------------------------------------------------------------

COMMENTS:
Hi,

I am just wondering if you are going to publish the 8th edition any time
soon, and if so, when? It is just that the last time I brought the 6th
edition, the 7th one came out a month after that and I was a bit
frustrated as the 7th one is much better I have to say (well done!). I
am thinking of buying the 7th one, but thought it is worth asking and
waiting if the 8th one is coming out very soon. Please could you advise
me on this matter.

Thank you.

Afifah Jaafar
Newly graduated medical student

THE GROWING ALARM

A few days ago when I was reading the NST, an article by Koh Lay Chin, "Growing alarm over sexualisation of young girls" caught my attention. She had been watching how girls as small as 4 years old, dancing like a grown up with all those sexy moves. She speaks her concerns over the topic wisely, and I would have to agree 100% to what she was saying.

"But there was something hinting at sexiness in those tiny moves, and I was not the only one who felt an awkward twitch by it. Apparently, parents and adults are getting more of those awkward twitches every day by the sexualisation of young girls, who feel the need to look, act, move or speak in a certain way to get attention or keep up with their peers."

May I also quote her last paragraph of the article:

"I can laugh about all this now since I don't have children, but I dread what I'll do in the future should I see my young child doing the provocative "booty shake". Summoning a crowd or videotaping it for posterity? Nay, I may just have to blow up the television set and lock Buttercup in a room forever. And ever."

I have been watching some ads on the telly promoting a tv show called bintang kecil or whatever equivalent (can hardly remember what the show was). Presumably, it is a singing competition between the young children since there were short clips of them singing in the ads. And dancing to the song, of course! Well, maybe I am just exaggerating the show, but I am sure there are lots of tv show nowadays that encourage kids to do some very provocative acts and I wonder what the parents think when they allow their kids to do such things.

May I quote again Koh Lay Chin last sentence:

"I may just have to blow up the television set and lock Buttercup in a room forever."

THE GRADUATION

I knew this is too late already, but just to thanks all that have made it all possible. Especially the batch, the family, housemates and friends, the teachers and most importantly The Lord of course. And thank God all Malaysians in our batch graduated this year!

*missing in the Malaysian batch picture: Iris, Nithia and Su Ann.

So that was the end of the student life, and honestly I do not really look forward to the working life that quick. At least not at the moment. I am back in the hometown now - but everyday, I wake up thinking that it is no more holiday this time. Unlike the previous summer holidays, I am not going back to Newcastle, not within few years time at least. And that makes me miss Newcastle so much, especially that I have no clue to when I will be seeing the people I love there.

But yesterday has gone and all I have is today.

OSCE 2009

Glad I have finished it now. Currently am sitting in the library cluster after picking up an EMQ and MCQ book for medical finals - to prepare for the next two papers. I feel like giving myself a rest today, I deserve one at least. Weather does not let me to wander around in the city centre - it is raining today, so here I am in the library writing up my blog.

Just to recall the OSCE stations I had this morning (and I will save this post until tonight so it will be fair for all the students in morning and afternoon circuit, just in case people do google for the questions). It was quite fair, although I agree with Helen, are we not supposed to take history anymore? No history station at all, apart from the suicide risk assessment.

STATION 1: EXAMINATION - respiratory system

STATION 2: PROCEDURE - blood transfusion, prescription, cannulation

STATION 3: EXAMINATION - Praecordium: not sure what murmur it was but there was definitely a murmur, loudest at mitral area

STATION 4: SUICIDE RISK - stressful;the actor was really reluctant to speak, the examiner was not smiling or as friendly either. I think I might have failed this one, although I hope I did not

STATION 5: EXAMINATION - Hand. Obvious psoriatic lesion on elbow, painful DIP PIP joints, onycholysis. This gave me wide smile, definite psoriatic arthritis. But I did not manage to finish all the function and movement test as not enough time. Probably spent to much time describing the psoriasis. Hope will pass this one.

STATION 6: ILS - as expected. A bit disappointed though coz it did not feel real, did not have to attach the machine, a bit blurr and kept asking the examiner do I need to do this or that, is the help here bla bla bla.

STATION 7: EXAMINATION - Diabetic feet. Glad I had a look at his footwear as he was wearing special one. Borderline pass/fail - I think I missed a few stuff. There was no obvious abnormalities that I can comment on. This came out in third year and I remember failing it despite the obvious findings I found on the patient.

STATION 8: PROCEDURE/EXAMINATION - Cervical smear and bimanual examination on dummy

STATION 9: EXAMINATION - abdominal but just asked to only examine the abdomen. Definitely a lump, very vague. Examiner not looking too friendly

STATION 10: EXAMINATION - Asked to examine the eye. VERY vague and unspecific instruction. And worse, I DID NOT NOTICE THAT THERE WAS A SNELLEN CHART PROVIDED, neither did I mention it. It was only when Kate asked how the Snellen chart should be in reality - then I went "Was there a snellen chart????". Arggghhh.

STATION 11: DEATH CERTIFICATE - straight forward case. Bronchopneumonia due to R anterior circulation stroke. Even had extra time drink, it was the last station for too. I will be very upset if I fail this one.

STATION 12: KARDEX - 3-4 pages of patient's notes. Asked to write down new cardex as it was lost during transfer to ward. Also to add Abx. My first station, was bit blank coz didnt look up at the instruction (as it was pasted on the wall/door and I was sitting looking down reading to the notes). But got there eventually except no time to prescribe any drugs on the plan list. Might have failed this one too.

STATION 13: VIDEO - Ward round notes. LOTS and LOTS of details, really impossible to listen and write down all of them (for me). Hope I will get marks for all the simple details on the sheet.

STATION 14: VIDEO - psychiatry video SAME as OSCE IN THIRD YEAR!!!!! Did not expect this was going to come out again, so did not pay much attention to it. Failed the one in third year, not sure how I did this time.

STATION 15: KARDEX - patient with NON STEMI. Was asked to prescribe 3 drugs (cant remember) but not sure if I need to add others. The only one I had time for was clopidogrel - not sure if I will be penalised to have prescribed that as it was not on the list.

So there you go. One fourth of the assessment of the five years torture in medical school. Can hardly wait to finish the other three...and to qualify! (insyaAllah if thats best for me)

OSCE TOMORROW

I have received some texts from few people wishing me the best for tomorrow - BIG THANKS to all. Yesterday, I wished the OSCE was this morning, coz I can hardly wait to finish OSCE so that I can move on to do some readings quickly. Today, I cannot believe it is tomorrow - the day we have to put in everything that we have learnt (or not) in the past 5 years of medical school.

I had a nervous breakdown far too early this time. I think it was between 2-3 weeks ago. Then, alhamdulillah it has been alright so far although frankly, at the back of my mind, there is still this worry that **** (but I am not gonna say this - I always, always throw this away as far as I can).

"Kalau Iffa buat camni, macam Iffa sangka buruk kat Allah, kan tak baik. Exam pun belum, kita usaha lah dulu". Yes. I had a moment of a serious breakdown, and I know that was bad. Shame on me.

Thanks to a friend who has always been there for me.

Everyhting that I have said previously is all coming back to me. Whether I pass or fail this one, it has all been written. All that I need to do is to put some effort into what I am doing, so to gain His mercy and as it is one important rule of sunnatullah. I have a few hours left before OSCE tomorrow - and to me, all I really need at this moment is to keep telling myself that I can do it. We all can do it. InsyaAllah.

I am just hoping and praying that we will all be very calm and able to understand the questions and finish it in 7 minutes each time. And hopefully I will not have that horrible sleep tonight where I will wake up every hour or so, looking at the time, worrying that I will be late for the exams. (I am sure lots of people do this too).

Okay, please pray for us.

ps: Hoepfully I will be able to take Dr Dark's advice til tomorrow; everything is in your head. You are going into the exams knowing that you will pass it. It really boosts up the confidence if you keep saying that. Try it!

RAHMA

I bought this CD so that I can play it in the car while driving around at least 35 miles every weekdays of my placement in Wansbeck General Hospital. Yes, I have to buy the original CD - the CD player apparently only accept ori ones.

It was worth the money. I like all of of the nasyeed in this album. Not a lot, only eight. But all have very deep meaning - and just today, I was paying attention to the lyrics of the fifth track (I think) - knowledge is light. Hit me straight to the heart.

Shakautu ila Waki` su'a hifdhi
wa arshada-ni an tark al-ma`asi
wa akhbara-ni bi anna ilman nur
wa nur Allah la yu`ta al-`as

The great Imam ash-Shafi', he went to his teacher Waki`
Complaining about the weakness of his memory.
He told him, 'abandon rebellion, for knowledge is a light
And the light of Allah is not bestowed upon a rebel.'

It is so frustrating to read the same topic all over again, yet not to be able to answer or explain when being asked about it. Very, very frustrating. Please help us all, Allah.

My CURRENT FAVOURITE NASYID

Kalimatan habibatan ila ar-Rahman
Khafifatan `ala al-lisan, thaqilatan fi al-mizan

Subhanallahi wa bi hamdih, subhanallahi al-azim

"There are two phrases which are beloved of the Most Merciful, light on the tongue, yet heavy on the scales (of reward): glory be to Allah and all praise to Him, glory be to Allah, the Mighty."

MY IMPORTANT DATES

STAGE 5 (MBBS)
EXAMINATION FOR THE DEGREES OF
BACHELOR OF MEDICINE AND BACHELOR OF SURGERY

Provisional Timetable

JUNE 2009

Friday 5 June 2009
9:00 AM OSCE


Thursday 11 June 2009
2:00 PM Paper 1


Friday 12 June 2009
2:00 PM Paper 2


Tuesday 16 June 2009
8:00 AM MOSLER

Wednesday 17 June 2009
3:00 PM Pass list published to LSE and noticeboard

As usual, please please pray for our success, may that be the best for us. Congratulations to those who have already passed your finals - I have to admit I am so jealous (but happy too) for you guys and girls. I can hardly wait for this to finish, yet I am very reluctant to sit for the exams considering the very little knowledge stored in my brain now.

Pray that we will put our best effort in this before leaving the decision solely to Him, and pray that we will accept whatever the results are.

***panic attack has now begun***

THE HIPPOCRATIC OATH

I swear by Apollo the healer, by Aesculapius, by Health and all the powers of healing, and call to witness all the gods and goddesses that I may keep this Oath and Promise to the best of my ability and judgement.

I will pay the same respect to my master in the Science as to my parents and share my life with him and pay all my debts to him. I will regard his sons as my brothers and teach them the Science, if they desire to learn it, without fee or contract. I will hand on precepts, lectures and all other learning to my sons, to those of my master and to those pupils duly apprenticed and sworn, and to none other.

I will use my power to help the sick to the best of my ability and judgement; I will abstain from harming or wronging any man by it.

I will not give a fatal draught to anyone if I am asked, nor will I suggest any such thing. Neither will I give a woman means to procure an abortion.

I will be chaste and religious in my life and in my practice.

I will not cut, even for the stone, but I will leave such procedures to the practitioners of that craft.

Whenever I go into a house, I will go to help the sick and never with the intention of doing harm or injury. I will not abuse my position to indulge in sexual contacts with the bodies of women or of men, whether they be freemen or slaves.

Whatever I see or hear, professionally or privately, which ought not to be divulged, I will keep secret and tell no one.

If, therefore, I observe this Oath and do not violate it, may I prosper both in my life and in my profession, earning good repute among all men for my time. If I transgress and forswear this oath, may my lot be otherwise.

ps: for medical students, this might be part of your job interview questions.

THE WAR

Balai Newcastle organised a wonderful program last weekend and one of the activities was paint balling. I have always wanted to play it to be honest. I thought of not playing while on my way as I was soooooo tired and exhausted I couldn't describe it, and I arrived there a bit late too. And I do not like the fact that they put us as a mixed team (girls and boys). But the moment Amni came up to me and told me that she just realised that she is actually not brave enough to be in the war, then I too wanted to feel and know how brave I am. So I played one last game and my group was left with only a few bullets.

I did achieve my objective of playing - I now know I seriouslly am not that brave. Of course I can give excuse that it was my first game, I had no clues how to play it when everybody else was immensed with the game. Only after that I had that adrenaline rush of wanting to go back and fight as much as I can, get the strategy on route etc, and that was only when I knew it was not so painful being hit by the paintballs. Otherwise, I believe I'd still be scared to death.

Before playing, I was a real coward. When I test my first shot, I saw and heard how hard the fake bullets hit the target and I was damn worried if they were going to hurt and bruise me. The trembles, the worries, the panics etc - I seriously can't describe it in words. I can flashback my act during that fake war in my head now and I hate myself for being such a coward.

At one point during the short game, I wondered if it was a real war. I started to imagine that it was the war in Gaza and I was left with only some bullets to be used PRN. How frightening that would be!!! And paintballing was nothing as compared to real war - the most horrible thing you can get out of it are short term stinging pain or worse, bruisings that will eventually heal (unless it is your time to die at that time anyway); but in real war, you know if you go out and careless and have nothing to protect you, it is death that you are looking forward to. I repeat, D.E.A.T.H.

No wonder Allah lifts up those who went to war because of Him. No wonder it was not easy for the munafiqun to be in the war during the past time. No wonder those who went for Badar were promised the jannah. I am amazed with all of them. I am amazed with the people in Gaza, the people in Palestine, in Iraq, elsewhere - I am amazed with the kids there - they have no weapons and they are really brave, throwing the small stones toward sthe illegal occupants when they are facing the heartless soldier holding real machineguns, knowing the bullets could go through their heads anytime. May be they have no world to live for anyway, so they are never afraid of the death which hopefully will lead them to the eternal lives.

I guess there is no such word as empathy, as you can never really be in someone's shoes and fit in the way that person is putting them on. Even if you be in their shoes for three days, a week, a year. I really don't think it is possible. But of course the least thing we can do is to show empathy and help praying for them. I just hope that I am not going to back up if I am going to be in that situation.

Let alone the physical war, we have to bear in mind there is a war that all muslims are facing now and that is the mind war with very obscured booby traps we can fall into - I can hardly face it and work my way through if I don't have people reminding me to be on the best path, always. And other than that, I am struggling to concentrate on the war in my student world - my exams is in 2 months time (plus minus). Pray for the best for me, please!

ps: after exams, paintballing again? girls only though (it will never be fun playing whilst being conscious to make sure you do not run into a guy, even harder when you have no idea who are behind the masks).

UDARA DALAM PARU-PARU?

'Pneumothorax' ialah udara yang terperangkap di sebelah paru-paru. Kebanyakan kes berlaku secara spontan (tiada sebab yang dikenalpasti) kepada lelaki belia yang sihat walafiat. kadang-kadang ia berlaku disebabkan oleh kecederaan pada bahagian dada ataupun disebabkan oleh penyakit paru-paru yang telah sedia ada, contohnya lelah (asthma). Simptom yang biasa adalah sakit dada yang tiba-tiba dan sangat spesifik di mana anda boleh tudingkan dengan jari anda di mana anda rasa sakit tersebut. Kadang-kadang sakit dada terasa bila anda menarik nafas, kadang-kadang anda boleh jadi lelah (tidak cukup nafas atau susah bernafas). Kebiasaannya, penumothorax tidak memerlukan rawatan selain daripada ubat tahan sakit seperti paracetamol (panadol). Jika perlu, doktor anda akan berbincang tentang rawatan lain.

Satu ketika dulu saya pernah tulis tentang penyakit talasemia dalam bahasa melayu. Ramai juga yang buka entry tersebut, mungkin disebabkan kurangnya website lain yang menerangkan tentang penyakit-penyakit fizikal dalam bahasa kebangsaan saya.

Sepanjang bergelar pelajar perubatan, memang saya sering ditanya tentang penyakit-penyakit oleh sahabat-sahabat dan sanak saudara, walaupun banyak kali rasanya tak mampu untuk saya terangkan dengan baik, tapi inilah hakikatnya - hidup sebagai seorang pelajar medik - soalan-soalan begini sangat common dan akan common untuk sepanjang hidup saya.

Sebentar tadi, saya telah ditegur oleh seorang sahabat yang bertanyakan tentang penyakit 'udara dalam paru-paru'. Saya copy dan tampal perbualan tadi kalau-kalau ada yang ada soalan yang sama, inilah jawapan ala-kadar saya yang hanyalah seorang pelajar perubatan.

t: assalamualaikum
iffa: wslm wbt
t: kalu x bz, nak tanye sket ttg hal2 medic
iffa: boleh nsyaAllah
x: tau tentang sakit, paru2 masuk angin?
t: ada udara dlm paru2
iffa: pneumothorax?
iffa: ye kot
iffa: tu je yg buleh fikir
iffa: ye kenapa ngan ade angin
t: camne bleh terjadi nya udara masuk dlm paru2 ye
iffa:t ke yg kene
iffa: byk sbb dia
t: x, adik ana
iffa: lelaki?
t: ye
iffa: ade asthma?
iffa: ie lelah?
t: setau ana xde
iffa: spontaneous biasanya
iffa: kalau young male
iffa: 20-30
x: aa.. dr 2 kat sini pon ckp camtu jgk
x: menyebabkan kami adik beradik x dpt bertanye lebih lanjut
iffa: http://www.patient.co.uk/showdoc/23069039/
t: camne bleh jadi spontan?
t: x paham..
iffa: rasanya dia panggil spontaneous
iffa: sbb tak jumpa sebab dia lagi
iffa: mungkin satu hari nnt jumpa dah x panggil tu la
iffa: takleh nak explain and kaitkan dengan apa
iffa: so far spontaneous ni sgt common esp in male 20-30 yr
iffa: dia dapat chest drain tak?
t: maksudnye?
t: tebuk lubang ke?
iffa: aah
iffa: nk keluarkan angin tu
iffa: oo lagi satu smoking tak
t: x
t: x merokok
t: so besanye treatment camne?
iffa: depends on symptoms
t: tebuk lubang, dan salurkan keluar..
iffa: kalau kecik je takde symptom eg shortness of breath
iffa: chest pain
iffa: biasenya bg pain killer je
iffa: seminggu lagi xray dah takde pape
iffa: tapi kalau makin teruk patutnya buat drain tu la
t: adik ana kena kali kedua
t: dah lebih 2 minggu, dr suspek ade leakage
iffa: die ade symptoms tak
iffa: ke dr tahu tu tru chest xray je
t: simpton and xray
t: dah 3 kali xray, tgh xde perubahan dalm paru2, udara mcm sama je kandungannya
t: jika kena buat opration, camne ye prosedurnye?
t: operation yang besar ke?
iffa: yg tu tak sure sgt
iffa: takpenah experience surgery ni
iffa: so taktau
iffa: chest drain dulu la patutnya
iffa: before surgery
iffa: keluarkan dulu angin tu
iffa: unless kalau mmg dr tu rasa buat surgery terus
iffa: masa surgeyr tu terus buang angin tu
t: dr ckp mmg bocor, bila tgk xray
t: cuma kena scan, nak confirmkan bocor katne
t: based on site yg iffa bg td, ada 2 kaedah buat opertion
t: yg 1, remove 'bleb', bleb tu ape?
iffa: bleb tu mcm bulla
iffa: aduh
iffa: camne nak cakap aa
iffa: die macam patutnya str8 je lung surface tu
iffa: tapi macam ade balloon out
iffa: kalau kat kulit tu mcm blister
iffa: blister = ??kulit yg ade air kat dlm
iffa: mcm kalau tangna kena air panas tu
t: oo
t: ok la, tima kasih kerana sudi explain

Mungkin tak membantu. Paling penting, tanyalah doktor anda, kerana selain Allah al-'Alim yang pastinya Maha Mengetahui, doktor yang merawat anda lah yang ahli dalam situasi tersebut.

[ada satu ayat quran yang cakap tanyalah orang yang ahli jika kamu tidak mengetahui...tapi tak ingat ayat mana]

DISCLAIMER:

1. Penerangan di atas adalah tentang 'pneumothorax' yang bermaksud 'udara di antara 2 lapisan paru-paru' yang mana 'udara dalam paru-paru' adalah sedikit misleading. Mungkin penyakit 'udara dalam paru-paru' yang dimaksudkan oleh 't' adalah penyakit lain, jadi mohon dimaklumkan jika istilah tersebut tidak sama dengan pneumothorax.

2. ID YM sahabat saya itu saya tukarkan dengan 't' untuk tidak breach confidentiality.

3. DO NOT rely solely for information on this post, especially the surgery bit. Tanyalah doktor anda.

4. Maaf, bahasa rojak. ada yang ambil masa lama sangat nak translate.

muhasabah: am i really a final yr student? and am i ready to go back to malaysia? and will i be able to give good explanation to patients, in malay? eee cuak. nak pass exam tapi cuak nak start keje. tak sabar nak start keje tapi takut tak dapat jadi doktor yang bes.

COMMUNICATION IS AMAZING

Last winter, we (yes, 12 of us, as in the picture) went to Turkey. The one thing I thought was amazing is the communication. Frankly speaking, I think I spoke Malay more than English when I talked to the people there, and obviously I used Malay more with my 11 Malaysian friends that went with me. Not that they were able to understand Malay, but I guess unless you know their language, it will not make any difference to what language we use up there. Most of them do not speak English. Istanbul was ok, but Bursa? Although I like Bursa people more - they definitely are more friendly, in general.

It was amazing. I guess sign language became the most significant mean of communication while we were there. Writing and drawing too! There are few other things I learned for my own reflections, but in this entry, the focus is just on how amazing communication is.

Anyway, the funny bit was when we were communicating with the taxi drivers who were about to bring us to Uludag. There were eight of us talking in Malay and English and a group of friendly taxi drivers trying hard to understand what we were negotiating. At one point, Aina asked them something about the timing in Turkish language, as she happened to know that word (I can hardly remember the word now). And I can still remember all the taxi drivers came closer with hands indicating to their watches, answering enthusiastically to Aina's question - I supposed. Those delighted faces... it was as if they were saying "finally, there is someone who can speak Turkish". The hilarious part was when Aina made a blurry face (obviously she didn't understand a word they were saying), so she turned around looking at the rest of us, and we started laughing. Then the taxi drivers started laughing as well. They knew Aina didn't understand that - again, I supposed. LOL. That was hilarious. And it was just amazing how the communication worked, but it did!

The picture on your left was to tell that we needed two taxis and to confirm the charge was 120 lira for each taxi for a return journey. The other one was to tell them "we are not going to pay you until you bring us back here and we want to stay there for a while, taking pictures". Taking pictures - although we actually ended up skiing; or at least learning how hard trying to ski was =P. By the way, the taxi drivers actually understood what we were saying before we even drew these pictures. Amazing! (ouh, and these were not the real drawings - I must have thrown them away)

"O men! Behold, We have created you all out of a male and a female, and have made you into nations and tribes, so that you might come to know one another. Verily, the noblest of you in the sight of God is the one who is most deeply conscious of Him. Behold, God is all-knowing, all-aware."

[Hujurat; 13]

KEEN REMINDER FOR MESELF

Yahya related to me from Malik from Ibn Shihab from Said ibn al-Musayyab from Abu Hurayra that the Messenger of Allah, may Allah bless him and grant him peace, said:

“A strong person is not the person who throws his adversaries to the ground. A strong person is the person who contains himself when he is angry.”

{Book 47, Number 3:12 : Malik’s Muwatta}

But angry for the right reason is ok, right? Like getting angry when seeing Palestinian people being killed every day. I do agree though, that one should still contain him/herself appropriately... and that is really hard in practice. Seriously need to be really strong.

PALESTINE

May I begin this entry with a question to myself; if I am now in Malaysia, would I ever know or even care enough to discuss the current world issue - Zionist attack on Gaza?

Honestly I doubt that I will. The reason is partly due to my ignorance [read: individuals] of course, but the media is another.

I remember back in summer 2 years ago, when the war in Iraq was the current headline of the news - front page of one of the mainstream newspapers focused on Siti Nurhaliza's wedding instead. *sigh* And especially now, with all the political war and problems in Malaysia and small election in my hometown, I bet that it shed the news even more? Make it as small matter that is easily dismissed in our lives. well, at least, the government does allow the students to go on with demonstration (read: without FRU as the prev demos), so thats a good start.

Although I might not be one who is suitable and perfect to promote this,but may I remind and promote to all including myself, to go against ignorance. We muslims are one - their sufferings are ours too.

Hadith: Sesiapa yang berpagi-pagian tidak mengambil berat perihal orang Islam maka dia bukan dari golongan mereka. [taksure source]

And of course we can talk about it, we can watch from a distant, we can read the news, we can condemn the zionist and their illegal occupation, their illegal state... but there are always better options which might seem small efforts, but at least these ARE some efforts.

1. Doa of course
2. Online action - petitions etc
3. Media - eg reply to bias report
4. Dakwah - tell other people, let them too take actions, let the people out there know the truth.
5. funding action - they need money,they need financial support,they need medical treatment
6. Boycott - one might say this would do nothing, but if everybody plays action,it might. Allah looksat the effort and not the effect. Some groups of people here too seem to agree that it wont do any good,but they came up with resolution that we should focus on the top 10 israeli goods: Coca cola, MacDonalds, Nestle, Nokia, Starbucks, Disney,Johnson's johnson, L'Oreal, Selfridges.

It is a shame if at this crucial time, we cant help boycotting. I have seen even the christian society stood up in front of mark and spencer entry, giving flyers to the people around, promoting the boycott. Apparently, according to them, ALL the net profit gained on saturday by mark and spencer is distributed to Israel. So yes, it is a shame.

Pernah dengar ayat ni (taksure hadith ke famous saying): Islam itu terdiri dari banyak penjuru. Tugas setiap kita adalah untuk menjaga Islam itu supaya tidak diceroboh dari penjuru kita. (lebih kurang camni la maksud dia, or please anyone care enough to correct me).


Ya Allah tuhan yang menewaskan bala tentera ahzab, kalahkan mereka musuh-musuh Islam, menangkanlah kami umat-umat di jalanmu ke atas mereka ya Allah. Selamatkan dan tabahkanlah mereka di Gaza, di Palestin. Ameen.

LEARNING FROM THE KIDS [again]

Yesterday, Balai Malaysia (Malay community in Newcastle) had organised its first camp for the children - it was Kem Pemantapan Solat i.e. a four hour course to teach children how to pray and improve their prayers.

When those children were asked why do we have to pray, some of the answers were:

1. Because we are muslims
2. Because Allah asks us to pray
3. Because this is the way we thank Allah as he created us
4. Because we must do good things and want to enter heaven

[source: balai mailinglist]

And masyaAllah, one of them answered because we want to save GAZA people.

And I asked the students in my group to list up three things they like the most, because they can have them all in heaven if they do good things. At least one of these came up their list:

1. Allah
2. Rasulullah
3. Parents

Ya Allah, I am so proud of them. Mind you, they were all 6 and 7 years old (those in my groups), and the whole group of children was comprised of those from age of 4 - 12.

When I was asked to list up 3 things that make me happy in one of my p4p sessions, I listed down the 3Fs - family and friends, and food. Also money hehe (I was so broke). Shame on me.

Save people in Gaza, and Allah and rasulullah on top of the list. What more can I tell you. Learn from them. The little caliphs...