Saturday, October 31, 2009

A day to remember




My heart was beating fast...


When I saw the maroon coloured vomitus from him, I knew instantly that this is something that is DEAD serious..


He continued to groan and vomitting out 2 kidney dish full ..splashing all over the floor


" Uncle...are you okay..can you hear me? !" I shouted out at him..

His expression reflected one in agony.


THis is definitely upper gastrointestinal bleeding...I immediately alerted my Medical Officer.

Unfortunately he was not convinced...

come on..i thought to myself..abdominal pain..maroon colored vomitus..what else do you want..i muttered...


Then he went away...


I stayed with the patient..and saw that the blood pressure was coming down..

he looked to be anemic..

saturation was 95%...but deteriorating 94 - 93%...


"Staff nurse!! patient is about to collapse! ..Get me the emergency trolley.. HIgh flow oxygen now.."


I immediately called out my m edical officer once again

This time around,..he heeded..


REsuscitation was under way..2 large bore branulas were set..airway was cleared..he was on high flow oxygen...but tachypenic..and tachycardic...


ryles tube were inserted...huge amount of maroon colored contents kept filling in ..


Pack cells/whole blood orderd..crossmatch taken..


surgical team was alerted...and they attended immediately...


But just across the room, another family was in a frantic mode...

What now? I thought to myself


OH my...i sighed..another patient..was gasping for air..her eyes staring wide...

lungs had reduced air entry bilaterally...

saturation dipping down...


In the midst of the Upper GI bleeding, another one was im pending respiratory collapse..


At that moment, I felt so nauseated..I did not think that i was able to handle any more of collapsed patient..


we had to work together with the anaest and surgical team in view of inavailablility to handle both situations at the same time..


My colleague and Medical offcier attended the impending respiratory case while I and the surgical/anaest team handled the UGIB...


Both teams worked simultaneously...just across the room from each other...


In the end , one of the patient succumbed to death..the patient with UGIB, had nonstop bleeding..and luckily the other one was electively intubated and subsequently transferred to ICU...


I was shaken at the end of the day.. It was too much for me to handle..


Truly, It was an ujian from Allah...


WHAT DOES IT MEAN TO BE AN HO?


TO SOME WHO ARE NOT SO FAMILIAR WITH THE TERM H.O. ..

Well, it means house officer


why is it called house officer?

try and guess...


your house if basically the hospital

you are to work 7 days a week, inclusive of on calls..


previously it used to be that you get up early in the morning, before the sun rises to get to the hospital, and you go back to the hospital when the sun dawns...

but nowadays, it's not that bad, I guess ( this is what I am told or brainwashed by the senior doctors who constantly remind us of the luxury that we have today...)


you are the lowest of the hierarchy in the hospital

you are below the staff nurse, MO's and of course the specialists


our duties:

1) clerk patient

2) endorse medications as prescribed

3) sign prescription forms

4) prefill in the forms which are supposed to be signed by the medical officers

5) vampires -- blood thirsty people who constantly in need to poke people's arms to get out the blood

6) consent takers

7) literally clerk - write down every single orders by the MO or specialists

8) write down the progress of the patients and the physical findings

9) basically , just make sure everything ordered during the morning rounds are to be done

10) referral tasks

11) letters...letter..letters

12) to speak to the radiologist/hematologist to get urgent investigations and suffer the consequences..as it is ordered by the specialists..


whatever we do..we never get credit..

whatever we fail, we get the scoldings


well H.O..is Hamba Orang..

INSIDE THE WHITE COAT'S POCKETS


What is in your white coat's pocket?

( HOUSEMAN)
1) pens that seem to get easily lost somewhere...
2) gloves - i tend to forget whether it's used or not..
3) blood tubes that sometimes are filled with patient's blood
4) face masks that are half torn
5) COUPONS!! - the most important thing of all!!!

MEDICAL STUDENTS
1) pens of all colors
2) small notebooks
3) stetoscope
4) torchlight
5) snellen chart
6) tendon hammer
7) small pocketbooks
8) purse - with no money
9) candies
10) recorders
11) keys to the hostel
12) ..a cicak somewhere that got lost...

MEDICAL OFFICERS?
oh yeah..they dont' wear 'em anymore

Thursday, October 29, 2009

End of medical posting


Alhamdulillah, currently i'm in the middle of my end of posting holidays...

I've finally finished medical posting.. coming up..surgical and Accident and emergency..

I know it's something unbelievable, but, I did like medical posting, in a way...
It's definitely nonstop action..with the adrenaline rush whenever patients collapse simultaneously..

In the midst of the rush, we at time tend to forget the single most step..which is to ensure whatever happens, the patients need to end their lives..or continuing breathing, for that matter.. with the kalimah syahadah.

Since recently, I've been tested with so many patient suddenly collapse in the ward. Up to the extent that I had developed some sort of a trauma whenever i enter the ward.

The event had taught me a very important lesson, no doubt..Always be on your toes. never take granted of anything.


One of the most important lessons i've learned during my medical posting, is definitely, how to deal with emergency situation in terms of how to deal with collapsed patients, myocardial infarction, hypoglycemia and such...


First and foremost,....

#DO NOT PANIC

#BE IN CONTROL OF THE SITUATION

# KNOW WHAT YOU ARE TO DO


AND ALWAYS ..ALWAYS FOR ALLAH'S HELP..FOR HE IS THE CONTROLLER OF ALL THINGS...




Sunday, October 11, 2009




Setiap tahun, Royal Swedish of Science, Stockholm Sweden akan mengumumkan penerima-penerima Hadiah Nobel dalam bidang yang terpilih dalam Sains Tulen dan Sains Sosial. Masyarakat sains di seluruh dunia kebiasaannya tertunggu tunggu dengan pengumuman pemenang hadiah paling berprestij tersebut untuk mengetahui tokoh-tokoh penting yang tercatat dalam sejarah sains dan teknologi di atas sumbangan mereka terhadap ketamadunan manusia.


Tahun ini hadiah Nobel Fizik dikongsi bersama tiga saintis iaitu Charles Kuon Kao (warganegara China-England-Amerika), William Sterling Boyle (Kanada-Amerika) dan George Elwood Smooth (Amerika-Syarikat). Ketiga-ketiga mereka merupakan saintis yang bertanggungjawab dan berperanan penting dalam perkembangan teknologi maklumat moden. Media-media di seluruh dunia melaporkan bahawa ketiga-tiga ilmuan tersebut dikenali sebagai ‘pakar cahaya’ (Master of Light)


40 tahun dahulu, Kao membuat andaian bahawa gentian optik mampu menghantar maklumat dengan sangat pantas menghampiri kelajuan cahaya (halaju yang paling tinggi yang diketahui setakat ini). Banyak teknologi canggih yang kita nikmati di saat ini adalah hasil dari kemajuan yang datangnya dari teknologi gentian optik menggantikan logam kuprum yang digunakan meluas suatu masa dahulu. Peristiwa di seluruh dunia setiap hari dapat diketahui dalam masa yang singkat melalui internet merupakan nikmat yang diperolehi dari penemuan gentian optik.
Teknologi Gentian Optik


Boyle dan Smith menggunakan gentian optik dalam teknologi Charge-Couple Device (CCD). Teknologi CCD selalunya ditemui dalam kamera digital moden, di mana setiap gambar yang diambil dapat dilihat pada skrin kecil di bahagian kamera tersebut. Teknologi CCD ini juga kadang kala dikenali sebagi ‘mata elektronik’ (electronic eyes) yang membuka lembaran baru dunia fotografi dan perfileman. Bagi memudahkan pemahaman masyarakat umum, teknologi CCD ialah suatu cip semikonduktor yang boleh menyimpan cahaya sebagai data digital atau dikenali sebagai pixel untuk kegunaan digital kamera.


Boyle ketika ditemuramah oleh wartawan tentang perasaannya apabila mendapat khabar tentang penganugerahan tersebut menyatakan bahawa, beliau agak sangsi dengan panggilan telefon dari Sweden tersebut. “Saya belum minum kopi pagi ini, sebab itu saya agak sangsi ”. Ujar beliau yang telah berusia 85 tahun. Namun lama-kelamaan setelah diyakinkan tentang anugerah tersebut, beliau mula percaya yang ia merupakan satu kenyataan dan penghargaan atas sumbangan beliau.


Teknologi CCD
Bidang astronomi dan kosmologi juga dapat mengambil manfaat dari penemuan CCD ini. Teknologi CCD telah digunakan oleh teleskop angkasa Hubble untuk pemetaan dan pemahaman tentang alam semesta. Dengan penemuan teknologi CCD ini telesokop Hubble dapat mengambil gambar bintang-bintang, planet serta mencerap fenomena-fenomena astronomi di angkasa lepas. Kamera teleskop ini juga telah membuka jalan baru untuk manusia moden melihat peristiwa-peristiwa besar di sebalik kejadian alam semesta berjuta tahun yang lalu.
Tahniah dan terima kasih kita untuk ketiga-tiga saintis ini atas anugerah Hadiah Nobel Fizik 2009.


Biografi Ringkas
Charles Kuon Kao dilahirkan di Shanghai, China pada tahun 1933. Beliau memperolehi PhD dalam bidang kejuruteraan Elektrik pada tahun 1965 dari Imperial College of London. Kao memiliki kewarganegaraan China, Amerika dan England. Sepanjang kerjayanya, Charles Kao pernah memegang jawatan sebagai Pengarah Engineering of Standard Telecommunication Laboratories, Harlow, United Kingdom dan wakil Canselor Chinese University of Hong Kong. Kao bersara sejak tahun 1996 dan menetap di Happy Valley Hongkong.


Williard Sterling Boyle dilahirkan di Amherst, Nova Scotia, Kanada pada tahun 1924. Beliau menuntut di Universiti McGill, Kanada sejak Ijazah Pertama sehingga Doktor Falsafah (1950) dalam bidang fizik dari universiti yang sama.Boyle memiliki kewarganegaraan Kanada dan Amerika Syarikat. Beliau pernah memgang jawatan sebagai Pengarah Eksekutif Communication Sciences Division di Bell Laboratories, Murray Hill New Jersey Amerika Syarikat. Boyle bersara dari kerjayanya sejak tahun 1979 dan menetap di Wallace, Nova Scotia, Kanada.


George Elwood Smith berasal dari White Plains, New York Amerika Syarikat. Beliau dilahirkan pada tahun 1930 dan menraih gelaran PhD dalam bidang fizik pda tahun 1959 dari Universiti Chicago, Illinois AMerika Syarikat. Smith pernah memegang jawatan sebagai ketua VLSI Device Department, Bell Labs, di Murray Hills, New Jersey Smith bersara pada tahun 1986 dan menetap di Bernegat, New Jersey Amerika Syarikat.


Nota Editor//: Penulis kini menetap di Kanada dan blog beliau boleh dikunjungi di http://www.mundarmandir2.blogspot.com/

Monday, October 5, 2009

MASJID UIA..AGAIN


RINDU PADA - MU


I MISS THE DAYS OF RAMADHAN...THIS YEAR ALHAMDULILLAH, ALLAH GRANTED THAT I WAS ABLE TO SPEND MOST OF THE 10 DAYS OF THE RAMADHAN AT THE UIA MOSQUE...
IT FELT SO DIFFERENT..IN THE MORNINGS, AFTER THE JAMAAH SUBUH, I QUICKLY RAN TO THE HOSPITAL..DOING THE ROUTINE DUTIES...( CURRENTLY, I'M TAKING CARE OF H1N1 WARD...ALHAMDULILLAH, THERE WERE NOT MANY PATIENTS, THUS I WAS ABLE TO GO BACK JUST IN TIME)..AND AFTER WORK..THEN RUSH BACK TO THE MOSQUE..IFTAR TOGETHER AND PERFORM THE TARAWIH..
THE FREE TIME WOULD BE SPENT RECITING THE QURAN, READING THE TARJAMAHAN..AND OF COURSE DUA..DUA AND DUA..
IT FELT SOMEWHAT DIFFERENT IN A WAY..AT THE HOSPITAL, YOU WOULD BE ABSORBED WITH THE WORK ENVIRONMENT..WITH THE PATIENTS, SPECIALISTS, STAFF NURSES AND MEDICAL OFFICERS...
AND THEN OFF THE MOSQUE..WHERE YOU WOULD INVOKE NONSTOP DUA'S AND PRAYERS TO THE ALMIGHTY...
...BUT NOW.. AS THE RAMADHAN HAS PASS AWAY..THERE IS NO MORE RUSHING TO THE MOSQUE..NO MORE SLEEPING AT THE MOSQUE, IFTAR TOGETHER..TARAWIH TOGETHER..... :<