ending the year

ending 2010 in tanjung karang is sth new!

being in the public health posting was really eye opening.

1. i learnt to live in a community. i have a roommate, i live in a block of 16. i get to have my meals with a whole group of friends. never alone! lots of precious memories of seafood, cooking together, washing veggie :P, making tang yuan, bathroom gossips, truth or dare or rather dare or dare, binge eating together and making up for it by playing badminton and jogging.

ngan shan's door. her rat picture is hillarious! it looks more like a pig-cow. for some reason her room keeps getting rat visits.

jeram's ikan bakar. it come with a sauce that's superspicymegaawesomehot!

jeram's famous seafood place with the awesome bunch :D

ginormous ice kacang

2. i love fireflies.
everyone who passes by kuala selangor MUST go! they're like beautiful christmas lights blinking all along the river. and they fly to u and move around ur fingers. owh howww very lovelyyy! i rate it most romantic spot in msia. heheh.

this photo is totally from google images bcz i didnt dare to take photos of the fireflies in case they die of flash shock.

3. i saw how working in a district hosp and a district health office was like.
without the great equipment hukm has. and how important relations with ppl u work with are.

4. hands on fieldwork!
talking to villagers amidst the golden yellow paddy fields that are harvesting. fogging away Aedes mosquitoes. testing water quality. wow.

kill the mozzies!!!!

die die must take photo even under the burning hot 360 degrees sun

5. and of course having loads of fun!
visiting the funfair, screaming our lungs out bumping cars and flying through the night skies on a chair.
Happy Fun Park! hwever it has bn dismantled and relocated to another area goodness noes whr so kevin u wont get to go car bumping in jkm mwahahhaha..

the magic flying chair :D

we never want christmas to be over

i love this family

so much that i'm lost for words

:)

blessed be the world

i was thinking real hard about what i should write about this Christmas. i thought it would be great if my post was impactful. Christmas means a lot to me bcz its a great time to invite my friends to church and share the good news with them. but i finally thought i'll write exactly what has bn revolving in my mind.

"Life is already filled with everything we need. When we want to achieve something, we work hard for it ourselves and that is where the satisfaction and justification for success comes. When we fail, we do not blame others. We do not just shrug it off as God's will and think we are not responsible for it. We blame ourselves. but we grow stronger by picking ourselves up from our failures and moving on."

Those are reasons why many do not seek God. Why do they need God when they are capable of handling life in their own hands?

Think of it this way. If life is already so enriching, wouldn't it not hurt to enrich it further with God?

If God isnt real, why do so many people experience Him and lay down their lives, put down their once greatest ambitions to serve Him?

You must have at least paused for a moment to wonder:

1. How experiencing God feels like

2. What is the purpose of this life and

3. What happens in eternity? What happens when we perish from this world?

Put in a moment to think. Do you really not care?

Merry Christmas everyone :)

*My thoughts are in no way meant to cause hurt or harm to anyone, in case some readers might be sensitive about this. i am not condemning any1. i respect different opinions. i am just sharing my own. and in fact, all i want to spread is love. :)

on the job

i previously mentioned about adaptation.

being in the public health posting meant going to the district health office and gov health clinics in a slightly far from urban area.

pretty soon you realize the work culture in these places is different from that in hospitals and the urban areas. everything is slower paced. ppl are really easy going. punctuality means being 30 minutes behind schedule. and if u're that new medical officer who reports for work there on your 1st day, u're in for a culture shock.

now our 1st reaction would be to stare in total aghast and shake our heads at the lack of urgency in the people, instantly labeling them irresponsible, slack, unproductive, superrrrrr malaysian and you wonder how is it justified that the gov service sector have workers like these who never fail to miss Minum Pagi and Minum Petang sessions daily and let lunch break cut past into 2pm. esp when its the Health sector where we're dealing with sick ppl who need urgent medical attention and such.

Being in charge (cz ur scale allows you to, even though u're new and they've been working there for the past 20 years and are as old as ur dad), you might think of initiating a regime change. You can make strict rules about adhering to punctuality, meeting datelines for reports etc. You announce your intentions in the 1st staff meeting (that starts 30 minutes late). You demand for reports at your desk at 8.30am sharp the next morning. Time comes. Nothing appears on your desk. Your staff act like yesterday's meeting never happened. you're doomed.

Think again. It's not going to be likely that u can initiate any change in culture in the workplace if no1's going to listen to you. In order to get ppl to listen to you, you gotta build rapport, get to know them, speak their lingo, know their background, become more of their friend, less of a boss. You got to have that public relation skill. That... subject you had in medical sch called... what's that again? PPD. ah yes. personal and professional development. you need to strategize. to find a perfect plan / solution to get things going and fulfill ur job requirement WITH the help of ur staff. You cant make them resent or dislike you or u're in for trouble.

take this scenario (from one of my lecturers):

A Medical officer calls up an ambulance driver to help him send an urgent medical sample to a very far place in the middle of the night. the fella refuses, saying he's Tired. the frustrated MO tells him off, and gets another ambulance driver to do it. he signs off a letter transferring the 1st ambulance driver out the next day. if u think problem's solved and that fella deserved it, you're wrong. 2 days later, the fella comes back with a letter from the ministry of health Instructing you to take him back in. He wins. hands down. apparently he's got huge cables in political parties.

there are a few ways we can look at this situation. Irresponsible ambulance driver who got off the hook with the MO as victim.

or if the MO had good PR with the ambulance driver, the fella wouldn't have obliged to do the MO a 'favour' to work and drive long distances in the middle of the night even if he really was tired.

thus the importance of establishing good relationship with your colleagues or staff in your workplace. no 1 can work alone. as a student we can still survive studying and managing things on our own without much contact with the outside world other than our circle of friends, but things differ a LOT in the working world.

i was initially disgruntled about having to wait and stone for hours when joining fieldwork attaching to the District Health Office fellas, but once i got into the fieldwork, fogging and all, i realised that hey, even though they work at their own time (never missing a tea break haha), they work efficiently. they get their job done well. bcz they're experienced and they Are passionate about their job. the old fellas who have bn 20 years on the job LOVe their job. they enjoy what they're doing. and they dont need a strict boss to get them to perform their job to their best.

Thank you for the fogging experience and everything!

Don't Miss This

now when was the last time i joined in to cheer for my friends in a College Idol-ish kind of competition?

Um... err.. never...?

I hav2 totally come back to Hukm this friday!!!

It's ESZ Night featuring the grand finalists of the Talentime.

Awesome poster by Kevin

Darn i must come back! Don't wana miss a great show!

Hole in the ground.

community health survey started in sabak bernam today. amidst the beautiful paddy fields that stretched from end to end and nvrending-ness, were village folks that lived a simple semi urban to rural life.

in one of the houses my group surveyed, there was a lady with 9 children. left by her husband (for another wife) and surviving on a meager RM500 a month from gov social service.

RM500 divided by 10 ppl = RM50

divide that by 30 days in a month.

that leaves every individual in that household with less than RM2 a DAY to survive on.

:S

when we asked about her diet, we found out her family only eats chicken / fish ONCE a MONTH.

fruits and vegetables: also ONCE a MONTH if they have extra money.

*dumbfounded*

i look into my own lifestyle and find that i have taken everything in my life for granted.

the way i manage my finances and the ppl who love me.

Transitioning

how good are you in dealing with transitions?

transition here refers to any situation whr u're out of ur comfort zone / am in a new place / far from ur very close friends for a period of time for say, more than 2 weeks.

some face transitions with excitement, zeal, enthusiasm.

some fall into a temporary state of depression / emo-ness before picking themselves up on their feet once again and looking forward to potential opportunities.

as u journey towards the new unfamiliar setting, the adrenaline builds up and u feel urself pulsating, heart beating hard and fast.

the series of events that follow now depend on how well u can identify with the place / people. how much you were made to feel at home / how occupied you are / how exhilarating the events in that new place are.

if u're undergoing a transition, all the best! :) i am too. just a v small one lol. its day 1 in tanjung karang, my public health posting. a pretty far from urban area 1.5 hours from cheras. i miss the hospital and the house mates chatter and the cicak screaming / cicak acting ppl already. haha. bt am looking fwd to a taste of public health and the awesomely cheap seafood ard here as well.

we're going to satay hut tonight! now that must ring a really loud bell in some of you. :P

Not Your Average Superhero

You've come across articles of Everyday Superheroes in the Reader's Digest:

- not so ordinary ppl who have saved a person's life, ppl who devoted themselves to the community serving others, ppl who touched lives in one way or another. the community is blessed with more warmth and care with these ppl.

i found superheroes in the heart of somewhr in btwn Cheras and Kajang today. at a shelter home for pregnant teenagers.

ever wondered how it's like to make a mistake as a teenager, something irreversible and comes with societal taunt and emotional trauma. to suddenly one day realize your urine pregnancy test tested positive. u're 15 years old, madly in love with raging hormones, i blame the current societal scene for the lack of exposure of teens to contraception. ur world feels like its being torn apart. u feel lost, u don't know what to do, you're paralyzed with fear.

http://search.independent.co.uk/topic/teenage-pregnancy

or u feel that no one understands you, your family neglects you, you decide to run away from home with your boyfriend. 1 week later, u find out it is the biggest mistake of ur life when you were forced into prostitution with no means of escape. ur body, mind and soul is tormented by the sexual abuse u're made to live through every single day. when you tried to protect urself, u were beaten and tortured. u can only cry urself to sleep each day as a means to comfort and express urself.

u were just, a teenager, who made that mistake bcz at that moment, adrenaline and sex hormones overpowered your capacity for rational judgement.

now how would you survive that ordeal?

someway, somehow, these teens have to move on in life, pick themselves up, put the past behind them and have a future plan for themselves. bcz their life doesnt end thr. there's still at least 75% more of life to go.

if u're lucky, u have a shelter home whr you receive protection and rehabilitation. you have a support group consisting of other teens like you who understand what you're going thru. you have a family that supports you, counselors to give u advice, ppl to guide u in picking up the pieces of ur life and start anew.

but even with that so called 'luck', it takes great courage to forget the past and move on. esp if you were betrayed and forced into prostitution. will you be able to start trusting ppl again? you are fragile. another storm can easily shake you and tear your foundation apart.

we have not even considered those teens who did not step forward to seek support. they went thru the whole ordeal alone. probably surrounded by darkness and a sense of hopelessness.

i herald these teens as superheroes for being able to brush away the dirt, stand up strong and say, I can do this, because life goes on. and these teens are the ones who propagate the message of hope to the rest of teens like them.

what the society needs to do, is to stop the stigmatization, discrimination, embrace these teens with open arms and tell them its alright we know you made a mistake and give them the emotional support they need. what ppl are doing to shun pregnant teens is doing absolutely Nothing to help the situation. i respect religious and cultural point of views (i am in no way promoting teen pregnancy) but hey we need to solve the problem that's in front of us now: pregnant teens exist in the country and we need to help them.

focus efforts on rehabilitation and protection.

if u want to reduce teen pregnancy, 1. promote abstinence. 2. increase education on contraceptive methods.

our country actively does no. 1.

No. 2 is swept under the carpet bcz ppl are afraid that it will promote sexual intercourse.

but sexual intercourse is happening among teens bcz raging hormones are beyond the control of the government or society for that matter.

start spreading the word on contraception!

http://www.healthofchildren.com/C/Contraception.html

heck i had no idea morning pills are safe for consumption until i entered medical sch. i used to think it was toxic or sth. (yes i was a pretty blur case but i'm sure i'm not the only one.) everyone laughs when u hold up a condom but there is a dying need to educate ppl on putting them on the correct way.

if we want to create a change in society, we need to change our mindsets 1st. then only start claiming that we want to sincerely help these teenagers.

Life isnt easy as a teen. we all know.

When to Hit the Panic Button

i always admire ppl who handle stress reli well.

those ppl who when challenges come, they think of a solution on the spot, have plan A, B and C, and they just carry it out and sit back and wait to see what happens. The outcome, whether good or bad, they seize it as an opportunity, think of another solution, and have more Plan As, Bs and Cs.

and in that process, no worries, no getting agitated, no binging lol, maybe just bouts of adrenaline rushes that comes but goes.

heck i wish i were like that!

but i guess thru time, my stress-in-crisis level has declined from the 1st time i set foot in university while i take up some responsibilities here and there, was forced into stressful situations and learned to handle them. i used to be reli uptight about punctuality, meeting deadlines, ppl being responsible, but no thankfully i'm not such a perfectionist for details. i get reli stressed up when things dont work out the way i expect them to.

but i learnt that nobody's perfect, anything that possibly can happen can happen, sometimes things u thought impossible can also happen, and i myself aint perfect. so sometimes ppl also have to put up with my imperfections.

so i need to give leeway for mistakes, expect ppl not to be punctual for the time set but still on time for the real time lol, set very early deadlines for ppl to not meet that deadline but still adhere to the real deadline, and allow the possibles to surprise me and challenge my ability to think fast and act quickly.

i still get reli stressed and panic in as-defined-by-me-crisis situations.

but i thank God for ppl i work with who are not like me haha. i learn from them to remain calm, take things easy and hope for the best. save the panicking for when things REAlly dont work out and there are no possible Plan As, Bs, Cs. :P

well thr isnt anything impossible with prayer. God I want to not panic. :P

on a 2nd thought, does panic bring u away from danger? is there a mild sort of panic thats enough to scare u to do sth but u stil maintain enough calmness to think properly and execute. is that considered panic? Maybe its called Super Acute Panic. or Subclinical acute Panic. ok i need to stop ranting.

Volcano pls don't erupt anymore. i wana go to Bali.

too much. or not.

why do i always end up doing multiple co-curricular activities during my study and exam week. the trend hasnt stopped. i wonder when it will. then again i've learnt lots from doing things this way. but at some point u tend to feel agitated and u just want to rant it out loud, take a breather and go back to doing it again.

Aaaaaaaaaaaaarrrrrrrrrrrrrrrrrggggggggggggggggghhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhh!

there. done. sigh... study.

Thank God for good cooling weather today. :)

Before the 1st half ends.

it's the last day of O&G posting today. and i cant believe that wow time flew and i've gone through 2 postings already.

as i look back, i truly thank God for blessing me with smooth sailing postings and granting me what was the best to mold me / shape me in my education in the beginning of this clinical year.

i thank God for

1. having surgery as my 1st posting.

it was a stepping stone, a cushion where i could take time to adjust myself to clinical year lifestyle and schedules. although it was only in week 4 that i sort of started to get the hang of it, i had 4 more weeks to catch up on things.

balancing between the 101 different advice from seniors and friends, in the midst of confusion between 'u should stay in ur room the first few weeks and study 1st b4 going to the wards' and 'u should go to the wards everyday and learn from the patients. they are ur books.' and 'just clerk one case a day then go back study' etc.. it was pretty confusing trying to balance out between everything. whn in surgery u have clinics, wards, OT, teaching. u can do anything u want, anytime, at ur own expense.

clinical years throws u an 8 week syllabus at the beginning of ur posting, and its up to you how u wana finish studying / mastering all the 'must knows' etc by the end of it. gone are the days of scheduled day to day classes and lectures and syllabus. it's totally flexible and entirely up to you how you wana study.

you get reli lost in the beginning bcz u're overwhelmed by the 8 week workload thats thrown to you in the beginning. but as time passes and u slowly cover the syllabus bit by bit, the pressure wears off.

surgery posting was a platform for me to build up my confidence.

i thank God for

2. very nice supervisors.

Ms. Farrah and Mr. Azlan both gave teachings once a week throughout the posting, and were very approachable and friendly. it spared me brain cells needed to overcome intimidation and gave me more confidence.

3. O&G posting

being my 2nd posting gave me a 1 week's holiday in the middle of the posting. whr i could use the holidays to be oncall and finish up the deliveries i needed to conduct. phew no more oncalls after hari raya hols.

4. a great supervisor

whom i feared from week 1 and actually still to a certain extent until now but lesser hehe. Dr. Rahana was strict and i was really fearful of uttering silly things or asking silly questions or presenting horribly in front of her. and the fear made me study and study and study and gave me insomnia and drove me to maximum will to study even when my eyes wanted to shut themselves after 7pm at night. i would force my eyes to stay open and my brain to accept information and retire to bed thinking what i have not covered. n jump out of bed at 6am before my alarm even rang to run to ward to cover beds everyday for her ward rounds.

the fear was good. it pushed me to work hard.

waking up at 6am was good. it gives me an early head off start of the day.

ward rounds everyday was good. i had more chances to present cases and brush up my presentation skills.

4. for manageable cases to present.

case presentation was a bit rough here and there but still alright.

there was a time that the patient in the bed i was not covering , but i covered for fun bcz i was looking for a Placenta Previa case to present, suddenly appeared in the bed i was suppose to cover the next morning. so i didnt have to prepare anything much that morning, and just had a brief look at her updates. wow talk about miracles.

5. for my short case

under Prof Hatta. who was nice and very pleasant and helpful and that took away my nervousness.

6. for great groupmates.

both in surgery and O&G. i enjoyed the teamwork and in sharing the anxiety and fun together. i am grateful for the opportunity to get to noe my coursemates a lot better by being in the same group as them in these postings.

7. how could i forget? for finally understanding a childbirth's / labour pain.

i salute all mothers in this world. just looking at how much they suffer, the face of agony and nearly giving up when having contraction pain for 8 hours before delivering the baby is enough to make any teenager abstain from premarital sex. i tink? lol. the but yeah, it looks reli reli painful...! gosh, thank you mum..!

8. very helpful 5th year seniors

who are reli very competent and i reli look up to them. the way they carry themselves, the knowledge they have and the time that they're willing to spend to give out pointers and teach lost juniors.

9. very helpful coursemates

from the same posting who have helped me so much in sharing knowledge, opportunities, going through it together. for close friends in a different posting who gave me so much advice in going through the posting they have been through. wouldnt have made it without them.

thank God for bringing me through the first part of yr 3.

it's study week now and exams are in 1 week's time.

happy studying everyone! :)

after exams:

Bali trip! EAMSC paper! then Tanjung Karang..!

confidential?

i walked out of clinic day today feeling slightly bewildered over an uneasy patient encounter.

Miss A was a single 22 year old lady living with her parents. She has pseudocyosis (false pregnancy) and hepatomegaly (liver and spleen enlargement). She has an abdominal mass that has been increasing in size leading her to believe that she was pregnant. it was reli an incident of lots of coincidences bcz when she started missing her period, she was tested positive on the urine pregnancy test, scanned positive for pregnancy and had morning sickness of vomiting. and her abdomen has been increasing in size. and it was js not long after she had sexual intercourse. weirdly, she's been having intermittent pain n distension over the umbilical region over the past 2 years. the fact that she suspects herself to be pregnant and all the supporting facts were unknown to her parents and all the while they thought she was just suffering from the abdominal pain due to a complication from an appendisectomy 2 years ago.

she was accompanied by her mother to the clinic.

upon being interviewed by me in front of her mum before seeing the doctor, she did not disclose any facts about her suspecting herself to be pregnant. later her mum left us and twds the end of the clerking, i asked her the routine gynae question on whether she has had intercourse before. she replied yes. n i proceeded with routine ques of dyspareunia-pain/post coital bleed. and the history on her being positive on urine pregnancy test, the scan etc spilled out. n she told me her parents were unaware of all these. upon viewing the emergency unit admission clerking sheet i also thought it was reli weird for her to have a dating scan and positive urine pregnancy test and all that and proceed to enquire further about it.

i was wondering how i would present her history to the doctor in front of both her and her mum in the clinic later when it was her right to have all these information remaining confidential betwn doctor n patient.

in the end bcz her history was weird with the false postivie UPT and wrong scan done at GP and all that and the false pregnancy, i didnt get to present my case, but the doctor proceed to obtain history on her own. there was information on the false pregnancy blah on the admission clerking sheet at the emergency unit.

in the end obviously the mother found out she had intercourse before marriage, and her antenatal visits to the GP and all that.

even though she's 22 and working but it can be observed that she stil pretty much depends on her parents and are under their shadow. erm.

subsequent conversation proceed with the doctor discussing the case with the mother with occassional/very hardly references to the daughter. i was feeling very very uneasy at that point and wondering what was going to happen to the poor girl when they left the clinic.

i guess it was not going to be possible to keep the information from the mother as she had accompanied her daughter to the clinic. it was also probably safer for the mother to find out as she can advise her daughter about precautions drg intercourse etc. and the mother has the right to find out all these as her sole guardian.

but patient's confidentiality is also at question. the patient has the right to disclose all the above information to her mother herself instead of her mother finding out about it through the doctor. the patient has the right to have 1st hand discussion with the doctor instead of being just an occassional reference like a 3rd party. she has the right to obtain information on the risks of unprotected intercourse from the doctor without family intervention.

perhaps i'm not in the position to comment on this situation. sometime doctors cannot protect a patient's confidentiality if the patient themselves have brought their family members along with them to the check up. n in the clinic u have like 4 medical students tagging a doctor in a clinic, listening to every patient's details and management.

just felt reli bad for the girl. she was treated like a child and she was reli uneasy when being questioned about having SI and her reason for suspecting pregnancy. SI before marriage doesnt make u a criminal, but in Msian society you can get stigmatised quite badly and even be shunned by ur family. :(

Do we have enough safeguards to protect a patient's confidentiality? it's a two way thing i guess. it's the responsibility not of just the doctor but the patient herself. :S

on a brighter note, palpating an abdomen with polyhydramnios (excessive amniotic fluid) today has made my day. :) postive fluid thrill! blubb.

it didnt end just there. :P

i say, the belated bday girl is ecstatic she has these girls as housemates!

when the clock struck yes twenty two and the lizard ran down,

the poor door was hammered upon and voila~ bijoux cupcakes took the stage in front of my room. tho they were lit with medical students' pen torches (bcz the lighter was in my room). lol! so candle lighting ceremony commenced with pei sun's ringing laughter in the background :P

my mind instantly flashed back to the time we celebrated wendy's bday in 1st year by sticking the huge blackout wax candle decorated with sequins (w UHU glue) into a minuscule butter cupcake (the 1 that you buy 6 in 1 pack from the hostel cafe muahahah so she could light up n blow out her candle more than 10 times n it still doesnt finish melting)

- the huge pink ribbon pei sun inherited from her strawberry loving almighty make up council.

the Chillis runaway-to-san-francisco-steak-house-cz-Chilis-queue-too-damn-long-and-we-were-hungry ppl.

thank you Crazylife for being in my life and celebrating from afar.

the ancient 1st year freshie photo. with the awesome girls who drove with me ard cheras taking wrong turnings to get me to that-awesome-chinese-restaurant-with-crazily-juicy-prawns-that-i dunno-the-name.

Running out of ears already. :P

the youthful youths who never fail to surprise!

a gecko on a pencil from Faidhi. *pei sun screaming her lungs out*

maybe 1 day she wont detest the poor reptile so much. >8)

ok that ends my syok sendiri bday blog posts for this year. :P

O&G short case sumtime in the next 2 weeks!

managed to get a hand in doing a Pap smear today. hope i didnt ruin the sample. heh. thank you Dr. Pravin!

owh and on a random note, a socket burnt in my unit today. huge flash of light of fire n poof! smoke. time to buy a new extension cord.

Of 22 years.

Before the world began, you were on His mind.

God has a purpose for each n every one of us, even before we stepped into this world.

before the clock strikes 12 into my 22nd year in this world, i have received tons of surprises from my beloved friends, brothers n sisters and family. wow. in today's advancement all surprises come in advance as well. hehe.

just want to leave a note of appreciation to everyone who has dropped in a thought or two in making my 22nd another special one. i am truly blessed!

my church youth surprised me this morning by victimising me and karen who shares my bday to finish eating asam in 20 seconds, our taste buds screaming for their lives the whole way. n then gave us a lovely celebration.

tons of handprints w words of encouragement from my care group.

and lovely gifts. =) from Kai Xian and the life group.

a toucan of appreciation from the debaters. thank you Darryl!! >8) Arwk arwk!

i love the blingy ear rings from Cher.

and celebrated with beloved friends at San Francisco's Steak House few hours back.

n wow! a suplaise note by Kevin to surprise me with a surprise bday celeb asking me to invite my friends to join it. lol! >8D

thank you u guys for the handbag! :P

moving into another year makes me reflect more about my purpose in life and my role in the vision for God. knowing Him more, serving Him deeper and impacting His ppl more. He has been gracious and i pray i continue to experience Him each day.

looking forward to a joyful day tmr. good weather, minimal trauma and a fruitful day please! :)

How far does the barrier stretch?

on and off our brains get fired with ideas and our fingers fly to the keyboard to pen them all down and share them with the world.

the zing of thought can be a creative spark of idea to do or create something, a new discovery or a life philosophy that struck you. or it can be emotionally driven and u long to lament ur sorrows or tell the world you're on cloud nine that particular time.

but as the world becomes more liberalised and we're granted more freedom, rights and means to pen down our thoughts and ideas, there is still an area of restriction to say everything you want to say.

what you say can affect just 1 person, your small circle of friends, or spark a nationwide propaganda, or impact a whole race. you do not know how far your words spread and bring up a reaction to how many ppl the moment u click publish and share your ideas in the stream of digital media.

that said, it comes down to 2 main aspects. of why our words need to be restricted. its either about yourself, or the readers. on your part, its protection. protection against physical or literal attacks from ppl who either disagree with you, or are unaffected by your words but can potentially use your words against you. sometimes u need to protect your thoughts and not appear to be too transparent for the whole world to see. its called private / personal space. every individual defines his personal space and how much he wants to reveal to others. our words translate our personality, mindset and ideology. words however can be misunderstood or mean different things to different ppl. all the more the reason to speak wisely esp when writing on the cyberspace becomes a form of documentation hence proof of whatever you say. its hard to track back or reverse damages done.

the other aspect is of what readers feel and think about your words. the advantage of reading rather than listening is that readers get to digest the material, analyse and ponder upon ideas b4 generating a full blown reaction. not always. but stil happens. the churning of more and more ideas on the net which are pro democratic or liberal ideas tends to shift the world to that end of the spectrum as well. it doesnt have to be so big scaled. happens within a community as well. whn ppl started going green, reading loads of articles and pro-environment perspectives got ppl to be more environmental friendly. vocal speakers / persuasive writers impact the world with their words. words are enough to generate peer pressure to be pro- say..purple! sth as small as that. the idea of restricting what you write is to avoid generating negative impacts in certain groups of ppl (imagines little mine fields blowing up whn being stepped on in random places).

heck why am i writing all these. it just started from me being apprehensive about me being sucked into another emotional whirpool of feeling down, worried and sad but not wanting to vent it all out on my blog bcz i need to protect my personal space, myself and contemplating its effects on others reading about it.

how much of yourself you want to reveal to the world (yes practically the world) lies in your hands.

Erupting Wisdom

i'm currently suffering from an ulcer due to impaction of my right upper wisdom tooth onto the gum in the lower jaw.
to my utter surprise during my visit to the dentist 2 days ago, ALL four of my wisdom teeth have already fully erupted. am i that blur or plain ignorant? *hits forehead

have been thinking for the blissful past 3 years that none of them have erupted yet. not that it matters.

i have been left with absolutely no choice but to undergo a surgery to remove that ulcer-inducing-culprit as soon as possible after finishing the dose of antibiotics that will magically kill the bugs of highest evil that have caused me to suffer from pain drg swallowing, tender lymph nodes, chewing on one side of my mouth, drinking water like thr's no tomorrow and not being able to talk properly, hence silencing me to a 200 word per day quota for the past 3 days.

either the surgery, or to suffer from recurrent ulcers and the above in days to come.


in conjunction with my future wisdom tooth removal, i've set up a survey on wisdom tooth removal lol. do participate. :D


and on wondering WHY the tooth deserved such name, i googled and this is what i found:


the tooth erupts around 18-21 years of age, the age whr we are deemed 'mature', given the badge to walk into adulthood. hence earning all the priviledges that come together w it.

it differs slightly in other places:

Turkish refers directly to the age at which wisdom teeth appear and calls it 20 yaş dişi (20th year tooth).

In Korean, its name is Sa-rang-nee (사랑니, love teeth) referring to the young age and the pain of the first love.

In Japanese, its name is Oyashirazu (親知らず), literally meaning "unknown to the parents," from the idea that they erupt after a child has moved away.

The Indonesian term gigi bungsu for the last teeth a person cuts refers to bungsu, meaning "youngest child", because the teeth erupt so much later than the others, implying that the teeth are "younger" than the rest.

In Thailand, the wisdom tooth is described fan-khut (ฟันคุด) "huddling tooth" due to its shortage of space.



painfully interesting indeed.

express plans

and today was the end of my 3rd year surgery posting.

i had a lot of fun, the doctors were nice, the wards and clinics were welcoming. i'm sure going to miss this posting in weeks to come.

the coming hols although 1 week, has been filled with a substantial amount of things to be done. planned at least haha.

- start reading up on O&G.
- research / lit review for eamsc paper / poster on adolescent's health.
- spend time with family.
- meet up with eugenie, tim, ang
- join cg
- cont to update myself on God's words
- think of ideas for esz

cant wait to get home :D

Are Msian Elderly Getting Enough?

when we first embarked upon the journey of a thousand miles looking for a suitable research topic to focus on for the coming AMSC 2010 themed Geriatric healthcare last march when the guidelines were out, all we knew about geriatric healthcare was (at least what I knew was hehe) palliative care for chronically ill elderly, elderly care in nursing homes or old folks homes and the fact that everyone knows it is best to care for ur parents urself when they age, not send them to nursing homes.

little did i noe that geriatric healthcare comprises of a whole broad range of aspects, from physical health to social support to socio economic security to problems like polypharmacy (taking multiple doses of the same drugs from diff clinics thus experiencing horrible side effects from them), the lack of specialised healthcare for elderly bcz of lack of geriatricians in the country, the rising need to attend to the concerns of the elderly esp their emotional well being bcz they're prone to depression due to their loss of active lifestyle and loneliness.

we consulted Prof Rahmah from the public health dept and she gave us input on carrying out a research. a questionnaire dubbed SF-36 was used to assess the QUALITY of LIFE of elderly. it has 36 questions that fit into 8 domains of quality of life: and the answers are subjective to what the elderly feels based on a Likert scale (1 to 4 or 1 to 6)

the 8 domains

1. General health perception : do u feel healthy?

2. Physical functioning: can u walk 500m, do vigorous activities etc.

3. Role limitation due to physical problems: do u need more time to achieve doing sth due to physical problems? etc.

4. Role limitation due to emotional problems: do u need more time / effort do do sth due to emotional problems?

5. Bodily pain: how often/ severity of bodily pain.

6. Social functioning: do you face problems that limit ur interaction w others?

7. Vitality: how often do u feel tired, worn out, full of energy etc

8. Mental health: how often do u feel happy / sad / down in dumps etc.

we carried out the survey in two gov old folks homes and in the Sabah community.

we compared the quality of life score for every domain in terms of

a) place of living : nursing home vs. community

Result: Quality of life is better in the community

Social functioning is worst in the community.

Vitality is worst in the old folks homes.

b) Gender:

Result: male elderly are more affected by physical problems, females more affected by emotional problems.

this suggest diff intervention methods in addressing the needs of male / female elderly. phps for males, creating opportunities for them to involve themselves in more physical based activities to decrease the sense of depression bcz of the drop in active lifestyle compared to their young age bcz of physical limitations. for females, phps more support grps to address emotional distress.

c) married elderly have better quality of life.

are we suppose to encourage elderly ppl to get married then? hehe.

phps more attention can be paid to those who are single / divorced / widowed.

d) Quality of life increases with higher education level.

e) Physical health correlates with emotional health.

despite our country having 15 gov nursing homes to care for the elderly etc, thr is still lack of workforce in these homes. the elderly to carer ratio is extremely high and the needs of the elderly cannot be met ideally. there are currently only 9 geriatricians for the 1.4 million elderly in the country.

any1 interested to specialize in geriatric healthcare? :P

as u walk around the wards in hospitals, u can gauge that 70% of the patients are elderly ppl. many express their wish to just perish bcz they cannot take the suffering from the illnesses they have any longer, they feel uncared for, they are depressed and feel they have no hope for recovery. it bcums normal that u will fall sick n suffer when u're old.

as much as the country advocates for the rights of the elderly thru the policies and NGOs like the NACSCOM and GeM and USIAMAS helping in uplifting the elderly in the country, the emphasis on elderly well being is still not enough. there is not enough awareness being pumped into the minds of the community, esp rural areas on active healthy lifestyle for the elderly, the importance of seeking treatment bcz illness is NOT a must in aging, and most importantly, dealing with the change in trend of more women working and a career centric society that cause the family support for elderly to drop tremendously.

in the end we find that the pool of elderly in the country are chucked into nursing homes or are mostly sick suffering depressed individuals.

with the advancement of medical technology leading to higher life expectancy and a growing aging population, the challenge in ensuring the well being of elderly in the country increases.

but as the challenge grows, it isnt a reason to back off. thr's more of a reason to look into the issue critically. bcz 1 day as well, we're going to be part of that aging community.

how can u play ur part? start understanding and show love to the elderly ppl ard you. :)

*a huge beam dedicated to Pei Sun for leading the AMSA academic team in completing and presenting this ppr in the conference and winning 3rd place. thank you Kevin Tan, Seng Wee, Grace, Chia Ying, Kevin Chin and everyone else who were directly or indirectly involved for making this achievement a success. :P huge thanks to Mr. Jaya Raman from the Jabatan Perancangan Pembangunan Negara for graciously helping us to speed up our proposal approval and the insight into the country's old folks homes given, all staff of Rumah seri Kenangan Cheng Melaka and N/Sembilan and everyone who helped us in the survey, and the support from the RC Hau wei, Chin Kimg. and the public health team for organizing an awesome geriatric health promotion. Yay! :D

extension of this morn's Ischemic Limb seminar

Found a pretty good powerpoint on Acute Limb Ischemia.

Google:

clinical features to assess severity of ischemia

and hit the 1st link on the search results. :)

This page offers good stuffs. Bookmark it :P

http://www.medicaleducationonline.org/index.php?option=com_docman

err

i find myself spiralling along the course of extreme emotions these few days. its pretty freaky.

its a mixture of hvg self confidence but thinking you're not good enough, standing tough but also being scared, filtering influences of emotions from those around you. its enough to make you go from being very happy to anxious to being lost to getting your senses stabilized again.

maybe its the whole stereotype painted picture by seniors or friends, all well meant to let u noe what u're getting into or what to expect. but it creates this destabilization and at some point you wonder whr your own opinion stand or should stand or how u shud be. lol.

i'm in my 6th wk of Surgery posting. its dubbed most easy going compared to the other 2. although i'm less blur, more confident, hv more knowledge compared to like 1st wk lol, i feel like i'm stil so inadequately equipped. stil lack of so much knowledge n skill, stil so incompetent. n probably not hardworking enough. am i hardworking enough? do i have a definition or std to compare myself to? i nvr reli savoured the thought of comparing myself w others. bt then again without a benchmark u can get lost. i dont have a schedule or target or i dunno, sth along that line. i woke up this morning feeling reli alarmed. just a sudden shock n feeling of fear that i'm in week 6 bt stil so far from being prepared to leave the posting soon. and fear, is not a nice feeling at all.

swinging along the lane. i've starved myself of feelings i don't even know what to feel right now.

its not entirely negative. its just, so swing-ish that u're knocked into a different spectrum b4 u know it.

its probably exam jitters thats affecting ev1's mood. the medicine n O&G ppl have short/long cases coming up n the nervousness is sucking into me as well.

lalallalalallalla

it started as an Obligation. thereafter,

when Jesus looked upon the crowd of thousands who had gathered in front of him to listen to his teachings for days, his heart was filled with compassion for the hungry people. and through the breaking of loaves and fish, he performed a miracle that fed all of them and additionally filled up 12 baskets of the fish and loaves from an original 5 loaves and 2 fishes.

now. compassion. love. obligation.

when we look at our purpose in doing things, some are done based on obligation. some based on compassion and love. some based on obligation at first, but as time passed, you developed compassion twds it.

sth simple for instance. u enter this new school as a stranger. u obey the rules, u dun throw rubbish ard its compounds, u greet the sch officers bcz its ur obligation as a student to do so. but after 3 years, u've come to become so familiar with the sch that u noe ur teacher's favourite parking spot, the menu at the canteen everyday, the distinct off-pitched keys of the piano played drg assembly and without realising it, u have grown to be so fond of ur sch. u no longer pick up rubbish bcz its an obligation but bcz u love ur sch and simply cannot stand the sight of some1 littering or abusing its facilities.

some institutions use community service as a way to penalize their members for failure to abide to the rules n regulations of the institution. whoever started this system is a genius. the punishment becomes a contribution. and from this form of retribution comes err what's the word.. repentance? not exactly repentance but the 'turning over a new leaf' with changed life perspective that sort of thing.

bcz the individual starts off by say, washing the sch toilet very very grudgingly (bcz no1 likes washing the toilet) and he is embarrassed by the fact that he is subjected to this form of punishment. the 'pain' is thr (the agony of a bunch of cute guys walking past n seeing this girl washing the sch longkang - no that has nvr happened to me hehe) n at the same time, the cleaning is done, and when this so called 'horrifying' job has been done a tad too often, the person hvg been in that institution for some time would probably be doing it voluntarily. maybe not washing clogged drains, maybe beautifying the environment, or some form of community service like helping out in old folks or charity homes etc.

i used to enter hospital wards thinking 'okay, so today i will clerk 1 patient at least and do physical examination on 1 patient at the wards'. i want it to be convenient and fast and i hoped for patients to give their cooperation. i complained to friends when patients say they're tired / sleeping / wave me away. a day with mostly unhappy tired sleeping patients would be a 'not so good' day.

1 day someone's words struck me. 'if i see any medical student taking history from a patient in a hurried manner, doing it for the sake of taking history and not being genuinely concerned for the patient, i'll fail that student.'

whoops.

that kinda stuck in my brain even days after.

last week i happened to have a so called very free morning, waiting for teaching in the ward or sth, and i sat down to take history from a patient. not reli to take history, but just chat with the aunty (cz dunno y i was so free that time). and as i let her talk about different aspects of her life, telling me her job, her life, concerns etc, i found out more about her background and stuff pertaining to her current conditions in a way that i definitely wouldnt be able to understand if i were to skip to short questions like 'what did u used to work as b4 this? *answer* 'where're u staying now?' *answer* etc. and after the long chat, in subsequent days, i felt not to say compelled, but genuinely interested to find out how she was doing and feeling. and she opened up to let me ask anything at all about her condition. and when she was going to be discharged, i felt very happy for her.

in reality it is of course not possible for doctors to build rapport to this level with every patient they hav in hospitals or else they would be treating just 5-10 patients a day with 50 more waiting in line.

but i captured a little essence in caring for a patient not bcz it was mere obligation but out of compassion.

yes it might make a difference in her life, but also importantly, it makes a difference in your life when you do so. the wards bcome more alive, in a way. =)

i got that person to thank for his words. lol.

Patience

Is patience congenital or acquired?

there're many people of whom i simply marvel at their level of patience. patience in tolerating madness. the madness of traffic, people's attributes, annoying flies, longggg menial work, long hours of listening, practicing something to perfection, learning and trying until getting it, the list goes on.

somehow patience is linked to the amount of passion you have for something, or someone. the threshold level you have for different things and people differs.

the amount of time you would spend teaching your younger brother, the hours you would spend listening to your best friend complaining and offering words of comfort or just a listening ear, the lengths you would go to make sure your mother gets the best medical treatment, even if you had to travel miles and journey hours long to get something done, you would do it because your heart is in it.

the amount of time a doctor spends to listen to medical students present cases, correct them nicely, listen attentively and give constructive feedback, even though he noes he could be better off doing something else at that time and he wasnt reli obligated to guide and teach them anw. despite their lack of presentation skills and knowledge that equal to nothingness in comparison to the perhaps 10 years of experience down the medical line of his, he takes in all questions, drills and explains concepts even with tired watering eyes.

at that point i was wondering if this doctor had the patience to do all that because of an inborn strike (not error :P) of patience or bcz he had the passion to teach or sth along that line.

its a remarkable trait that truly inspires students. sometimes a part of the reason that you are motivated is bcz u dun want all that patience and time invested to go to waste. and it also challenges you, to give back that kind of patience to society, acquantainces, ppl you hardly or dont noe and to do things that you dont like doing.

Unintentional harm

Ppl were born with the natural instinct to do wrong. If u realized, we weren't taught to carry out actions that are by society's standards or universally accepted as immoral i.e. lying, hurting others but these were inherent, as if a human nature. No one taught the 3 year old child to lie but he did so to save himself from perhaps punishment or repercussions of his actions. Sensing danger, he by all means tries to run away. Another illustration. The 4 year old boy refuses to admit he scribbled the wall because he was afraid of being scolded. Obviously no one taught him 'to lie to get away' prior to that. He did it by human instinct. You get what I mean. (if u beg to differ u're welcome to share ur opinion of course) but that isn't my main point here today anw.

 

When we do something that has unintentionally hurt others, we hope to clarify things, clear doubts and make amends to the person, to let him/her know that it was unintentional and we're sorry. Of course this doesn't give us the right to continue being ignorant n to hope for mercy each time we unintentionally hurt others. Bcz when it happens too often and repeatedly, ppl get tired of it and you know sth isn't right (with the way u're handling things). Whnever we're given the benefit of the doubt or are spared of our mistakes (or not), we take a lesson out of it, make a mental note and continue to mature and learn to be more and more tactful. In that process, we continue to salvage on open and forgiving hearts of ppl ard us to look past our misgivings.

 

Becz the point here is: None of us (well most of us anw) inherently wish to hurt others.

In whatever aspects and by whatever way.

 

So that brings me to the main point lol. Sorry for being sooo long winded.

Ppl around us (our friends / associates / family mbrs) who have caused hurt to us / our loved 1s / our friends / others could have done it unintentionally. Certain actions that we think are unacceptable by Our standards, may be acceptable by another person's standards. It differs bcz we were brought up in diff fam backgrds, a layout of society with diff expectations n needs and diff levels of tolerance.

 

The individual, did not realize he/she has caused hurt to another fella bcz:

1. If he/she were to be placed in that situation / commented w the use of certain words, he/she feels its alright n wouldn't be offended bcz he/she has a higher threshold level in accepting criticism.
   
2. He/she feels it's alright to be messy / borrow things without permission / leave things around etc. bcz he/she wouldn't mind for others to do likewise to his/her room or things.
   
3. There was a communication breakdown whr sth said meant a different thing/ Is interpreted differently by two diff individuals.
   
4. His/her standards of 'normal' differs from everyone else in our clique.
   

Brain jam. There are a 101 reasons that can be listed out.

 

Therefore, before we start judging / condemning / labeling a person for an action we disapprove of, we need to remind ourselves that:

1. No1 likes hurting others. (the definition of none is of course not absolute, well you know what I mean cz I'm lazy to list out exclusion criterias lol) It could most likely be unintentional.
   
2. Humans inherently have a tendency to do wrong, but as we mature and bcum educated, the norms of society/our surroundings and our conscience determines to what extent we inhibit sinful tendencies and do the 'right' things.
   

 

In order to evaluate that person, we have to rightfully

• Clarify matters, find out reason he/she did that blah
  
• Find out if it was intentional or otherwise
  
• Let the person know how and why his/her actions were hurtful or deemed to be wrong by others.
  
• And of course doing all the above in a very very tactful manner at a correct time.
  

 

If I had hurt sum1 unintentionally and did not realize it even til much later, I would appreciate it very much for ppl to tell me that and how was I wrong by the 'standards'. Not to be spoken of behind my back and deemed to be horrible by everyone else.

 

Well yeah, most ppl in society however prefer to take the shortcut and skip right to spreading juicy gossips about others. I dun deny this shortcut is easy and tempting to take (by inherently sinful nature hehe).

 

I therefore stil need to continuously remind myself to walk the longer road, take that extra mile of reflection and at the same time, try reduce unintentional harms towards others. J

 

We don't just need communication. we need effective communication.

 

*this post was written by random thought and is not linked to any specific personal encounter/experience.

filling the air

i realized fresh bloody images were a test for me when

we were shown pictures of a brain tumour removal surgery this morning. i cringed at 1st at the sight of the crimson red bloody face, could still take it, and as the day passed, it was forgotten.

later on this evening, i spent 1.5 hours observing a wound dressing being done for a patient with a severe pressure sore at the sacral area.

it was a super huge wound of 10cm x 10 cm x 4 cm. with 4 more smaller wounds beside it, some of which connects to the huge wound in the centre via a tunnel.

as i walked back from the wards to my room, i could still smell and see the image of the wound in front of me. the image isnt so bad. it's the putrid smell that filled the air the moment the wound was exposed. (wore a mask but it didnt help)

at that very moment, my mind was filled with amazement, wonder and awe for all eternity for all nurses in this country, who spend their days in wards through all stench, blood, pus, ammonia etc. to tend to the needs of esp frail patients.

i will never ever in future question the intensity of the job of a nurse, and the passion she/he has for patients! not that i have ever been questioning it before this. lol.

n i brace myself for tougher moments in houseman years as i watched a brannula being inserted relentlessly into the femoral artery of a patient with more than 10 tries and still not succeeding, n few more attempts to draw blood from that area which also failed. (the patient is paralyzed from the umbilical level thankfully, thus not feeling any pain)

wow.

GIT

i need more

Indigestion, colicky thoughts, constipated ideas, altered actions that differ from the heart.

there is no way, no way at all (in my opinion lar i think i could be simply exaggerating) any medical student can excel without

-the guts to ask what they think are stupid questions

-the guts to overcome inferiority complex

-the guts to appear dumb

-the guts to persist even though u noe u're gonna face rejection

-the guts to call doctors even though u anticipate being yelled at or getting a reli annoyed answer

-the guts to try out new things even though it means being ridiculed when making mistakes and looking reli bad in front of patients

becz everyone starts out from somewhere. n we need an essense of humility to overcome that pride in us that doesnt want to face embarrassment or humiliation or unpleasantness.

i need an extra dose of guts. i'm not there yet. i stil hesitate when i contemplate the chances of looking bad in front of others. but then again. its a personal feeling of insecurity. come to think of it, no one is going to rmb your mistake or your face for that matter. patients come in n out of wards all the time. they're like hundreds of students n nurses dun bother rmbering ur names or how u look like. its a place whr ppl are stil forgiving when u make mistakes n ask dumb questions. n yeah. thr's an advantage of being a student who is still learning.

'it may be my fault but pls forgive me bcz i'm still learning *kesian look*' n u kinda get away w it. if not for that day, the next day is a brand new day.

hrm yeah. i guess.

How far can your guts take you?

How far u want ur guts to take you.

*rats what am i doing here??? i'm suppose to be studying!! *groans

taste of clinical year

it took just 3 hours for me to stumble over my block of will power.

i realised i cant study continuously for 1 whole day.

hmmm... shouldnt i have known that by now? like by at least 5 years ago??

what a naive idealist. -_-

a little drop of ink on how i fared the 1st week of clinical year.

thr is certainly no doubt, No doubt at all that clinical year is 100x more interesting than preclinical years. real life situations at last!

however, u get swamped with the ugliness of reality. interesting, but a little tough.

problems i am currently facing:

1. i have not finished reading the basics of surgery related diseases, so am perpetually blur when a patient tells me she has err.. lets say an enlarged thyroid. questions that pop up in my head were: main symptoms of thyroid disease, differential diagnosis for that chief complaint, questions to ask to exclude the differentials and come up w a provisional. then, physical examination to confirm the provisional. then what investigations to be done to further confirm and what management should be done.

n then b4 i finish reading up on how to answer all the questions above, the next day i clerk another patient, and its a totally different scope of disease, say.. hernia. n i go back n put hernia on my list of 'things to be read' and still stuck reading on thyroid bcz i was too tired the last night n fell asleep instead of studying.

so the aim now is to faster finish studying all those stuffs! easier said than done. argh. takes me hours n hours to finish 1 topic. n thr're at least 15 topics to cover.

2. if the supervisor says we should focus on a certain topic this week, so its another different topic to cover altogether.

3. n if i'm scheduled to enter clinic for say.. hepatobiliary that week, then its different again. (diff type of clinics everyday)

i tink the baseline for now is to finish studying the basics as soon as possible.

n finding out how to stay awake at nights to study instead of perpetually collapsing/fainting on my book at my study table. hehz.

ok gotta hit the books!

*on top of everything is finding out how to be nice to patients so that they let u interview them even tho u might be like the 5th person who has interviewed him for that day. n for them to let u examine them even tho u're like the 10th person to ask.

poor patients. imagine staying in the wards for 2 weeks.

1 day = minimum 5 interviews/examination by medical students.

multiply this with 14 days.

the patient would have repeated his history of illness and was examined at least 70 times by the time he gets discharged from the hospital. hehe. got 2 really thank them. some patients are reli nice. some pretend to be asleep when they see u walking twds them from far. i dun blame them. heh.

Sleeping at my own risk

1st shout out on the start of my clinical yr:

i need tips on

How to not fall asleep while studying at night.

Feed me with tips on how to stay awake ppl!! thank you!

emotions, communication, where they come together.

i came across this template n voila! decided it was nice n used it. :)

just back from ppd camp in neg sembilan at a btn camp area. the food was spicy aggravating my sorethroat, but much better than ppd camp 1 in 1st year. other than that, everything else was good.

i learnt thr's more to medical ethics than 1 side of the story.

i learnt thr isnt a clear cut yes no solution in being ethical.

i learnt to humble myself, even at times when i feel i'm not wrong.

and the importance of give and take bcz no one is perfect. i am not perfect. we gotta give space to ppl to make mistakes and look forward from thr.

its about getting through and around the system, while earning respect and respecting others.

I say this, because i am touched that a person forgave me for a huge mistake. to me it was a huge huge blunder. but there was no 'HARRR HOW can you do thisss??' or 'Crap.. now i have to do this / that bcz of ur mistake' or 'WHy din u realise earlier??' and not even an 'OH Noooooo....'.

just a simple reply of 'Its ok. no problem. dun worry bout it. it can be settled.'

This reply not only reassures me and takes away my guilt, but makes me feel a lot better knowing i hav not angered / troubled sum1 else bcz of my mistake.

i truly respect this person, and it was a solemn reminder to me to practise this sort of courtesy to others as well in future.

speaking of medical ethics, a few scenarios in the grp discussion session in the ppd camp spurred me to think further and look at both sides of things b4 making accusations or forming my opinion on 1 side.

When a doctor is charged or accused for negligence, ie. not attending to the patient properly/timely, patient getting contradicting explanations about the cause of a complication that arose in the ward, we need to consider both sides of the story. from the medical staff or system point of view, as well as that of the patient.

there are loopholes in the healthcare system. bcz no system is perfect, and in reality Msian gov hospitals still lack staff. the unfortunate thing is when the loophole compromises a patient's life, resulting in unneccessary deaths at times. its sad. but it happens. doctors missing out on significant vital signs of a post op patient such as severe hypotension, an alarm indicating a flaw (such as inserting a branula into an artery instead of a vein) that goes unnoticed, the exhausted houseman making a mistake in administering medicine in the middle of the night etc.

while the system constantly being improved in order to reduce mistakes by doctors or patch up loopholes in the system, the danger of being that victim plunging into that dark abyss is stil present. in certain countries, pharmacists accompany doctors in ward rounds to reduce mistakes done in the administration of drugs. it brings up the issue of credibility of doctors being questioned (which could injure some pride), conflict of interest, burden on healthcare system. but it's been proven to be successful.

another issue is about communication. its probably something that's still lacking in our healthcare system. patients feel uncared for bcz the doctor doesnt explain to him/her about his/her condition and management. the patient has actually been managed, but bcz he/she was not informed by medical staff about it and given adequate explanation, therefore they feel like they're neglected. communication is important. it prevents lawsuits. according to my Dr. facilitator. true. its a patient's right to noe what's happening to their body and what u're doing to their body.

another area is language barrier. they're lots of cases in gov hosps esp whr the patient has no idea what illness he has been diagnosed with and what or why he is taking this drug bcz the Chinese elderly cannot speak Malay or English and the doctor is unable to converse in Mandarin or Cantonese. i therefore, have to BUck up to improve my Mandarin. like seriously... ! gosh.

in the end its about every member of the healthcare team working TOgether to ensure the well being of patients.

i believe no doctor wants a patient to suffer. no normal person for that matter, wants anyone to suffer. but for now everyone has just got to play their part in trying their best to meet the needs of patients and learn to communicate effectively, in assuring him / her that he/she is in good hands.