Sunday, January 30, 2011

DU52 up DU54.. brain drain continues..

I've been with my institution for 5 years and loved the plan, ambition and aspiration. The inspiration and optimism grew and as a young member, I definitely had plans to make the institution great. You can call it utopian but thats where all dreams start right?
Being with the faculty thus far, is more challenging than what i can imagine. The institution thrives on a vision where those from the outside would think us to be totally insane! I dont blame them to think of us as such but its always the impossible dreamer who would achieve greatness. Having team members who i thought was selected based on their potential was another factor where i reckon the dream vision can achieve exceding expectations!
Unfortunately, the ancient set up of my institution seemed to somehow discourage the dream. Call it a curse, but it is very venomous. Money seemed to be the issue, but being in the 21st century, can you expect less? Money talks.. money is everything! Doctors cum academician are doing more things out of the job spec compared to everybody else. THe duty in ensuring patients do live in joy is a huge responsibility that one can imagine. Its the appreciation gesture which if it was taken into consideration from the start, would only attract more people to join the academics in rank.
I don't blame my big boss on this but my critique is sometimes he takes too much of the responsibility. When the plan is becoming bigger with time, the delegation of responsibility should be emphasised and the burden shared somehow. Some may say he is difficult to work with but each leader has their own way.. and the outcome would justify their action.
DU45 , DU 52, DU 54 .. So far we've lost few excellent colleagues to the lure of the "under" world.. but then can't blame them for their action. Its the big planner who should follow through and inspire.. thats what leaders are for.. to inspire others to greatness, and polishing the potentials of his men and make them greater than who he is..
I am still idealistic but i am not sure if i am too naive. I believe that i should support the vision and do my best to achieve it.

Whats my timeline then?

29 January 2011.. Welcome to the world!

MDQ4 ( macam nama prototype la pulak... hahaha) was delivered vaginally yesterday at 336pm, weighing 3.22kg in Pantai Hospital.
Alhamdulillah..truly a blessing and all praises to Allah for his graciousness.
I am really proud to accept his gift and i guess it struck me, as I was reciting azan as the baby was delivered. I stutterred out of nowhere.. i guess it can be overwhelming to one without realizing it subconsciously.
Again. thank you to all well wishers and please pray for him to be one of the sollehins..

MAfeitz Mamat

Monday, January 24, 2011

Resuscitating dilemma

Resuscitation is an art. It is highly stressful and definitely not for the faint hearted. I chose anaesthesia because i saw anaesthetists dealing with such ordeals in a composed manner unlike my discipline's registrars then. It is a combination of skills but most importantly a fast logical mind by the team leader to solve can be straight forward or it can be mind boggling, but need to think and ACT fast. Otherwise, CHAOS would be the order of the day.

AHA revised its guidelines last October. the emphasis for good CPR, push hard push fast becomes the main ingredient for a successful return of spontaneous circulation. Patient struggling between life and death is not a good sight. Most would not be keen to be responsible for that and i guess this gives us ( Critical Care) the edge to take the challenge.

Being a clinical specialist in Anaesthesia & Critical Care is not easy. Most of the decisions to continue, to stop, to act would be upon us. All Anaesthesiologist graduates are expected to master this skill and time and time again it will be tested.

I had 2 patients yesterday; both young patients collapsed and CPR commenced. One i stopped as it was about to start because there was absolute poor prognosis based on her current injuries. My MO initially refused to do that but being a young MO and seeing a young patient, i can understand why. I told her sometimes we as doctors must think as a whole especially the Critical carers; we are of a different breed. We dont compartmentalized our care and we always look things from a far and the bigger picture. Doctors tend to resuscitate more for to their benefit rather than the patient's. The guilt of being there and not doing anything will glare and becomes a nightmareto some. However, we are carers that will try to save lives with good quality and not to prolong death and suffering. The distinction must be clear and to do this, knowledge and experience would be the key.

The 2nd patient collapsed and needed intensive CPR. He was shocked twice and given appropriate drug intervention and we got him back. ROSC would not be complete without a proper cooling and cerebral protection management. What was the cause? I am not sure myself but i have settled the acute problem. Now we pray that there was minimal insult to his brain during his collapse and we will see how.

It is never easy when decisions are in your hands. Just need to tawakkal and make sure that you do your job the the best of your ability.

Saturday, January 22, 2011

new frontier new challenge for my good friend

A good friend of mine, Shakti went to Melbourne yesterday. He'll be working there for a year hmm.. perhaps more! He brought his family there and i am sure it will be an experience of a lifetime! I must salute him for all his efforts taking FANZCA exams and all .. and look where he is now.
If you meet him on the streets, Im sure you wont reckon he is a doctor at all! He has the built of a bodyguard ( former Mr KL 2000 hehe) and he acts like one. He's a very "sempoi" man, wearing his CROCS slippers even to formal functions! Looks can be deceiving and I can tell you that he has exceptional brains because academically he is superior!
He is a workaholic, and it has been a priviledge to work with him. We click well and the things that we did during our medical MO days in HKL remains fresh in my mind. His change of heart into anaesthesia i am sure had something to do with me. We went seperate ways at one time, me joining UiTM and him into the private world. Fate has made it that he rejoined me in UM and again the partnership grew. Our sons were born a week a part and I guess to them I will hope to continue the legacy
To my good friend Shaktivel.. i wish you well in your endevour. Your antics will be missed and I really hope that you can join me when you're done with Australia :) or who knows it will be the other way around, me going there instead.. hehehe All the best bro! Live long and prosper.. :)

Wow.. i am actually sitting down blogging?

Its a free Saturday, I am actually sitting down in front of (my) laptop, and watching tv at the same time. Wow.. such a luxury as the past month had been so hectic that there was no quality time as such for me. Moving to Bidai from Jeriji was an experience i would not want to repeat in my lifetime! hahaha Just say that, I'll be moving again,'ll be lock stock and barrel for the new owner.. tak larat woo.. no wonder its been classified as a life event by PSY !!
Life has took a different turn. We've just employed a maid for the house. Having 3 ( anytime soon 4) kids is not funny to handle amongst the two of us. Wifey had come to the realisation that it can be quite impossible to do it on your own. It is still possible theoratically but like anything in life, you cannot get everything that you want. There will be certain things compromised. I reckon looking at how kids are today, it is vital to keep a constant look at them especially during the growing up years. We dont want to end up regretting what should have been done when what is important now is to DO IT and not risk it..

Talking about employing a maid, we did not go through any agents. All we needed was a maid to agree to come. We were lucky that Ihad ( mama's maid) suggested to wifey during her stay with us in December her sister. Its not difficult to employ a maid on your own and it saves a lot of money ( esp risk money if they run away) the downside about it us you have to wait and time has to be spent sitting down like an idiot in the departments where we have to register.

I'm almost 70% done and now waiting to do the FOMEMA thingy. I take it as a new experience and as somebody who did it.. IT CAN BE DONE!

Currently Im still waiting for Byond to be installed. ASTRO is doing their vintage thingy delaying the installation. I guess, being the ONLY COMPANY providing such a service, they can afford to muck it up and make people angry. Why? because whatever you do, people will continue to subscribe and nobody will back out.. BATTERED WIFE syndrome i call this.

I had issues with TM which i NEARLY BLOGGED .. but as it was resolved, then I'm not going to blow about it on my blog. It is really disheartening when people take advantage of the convenience. hmmmm...

Now.. let me sit down and enjoy playing SONIC on my XBOX.. with my new TOSHIBA 42 inch LCD.. hehehe

The Star 21 Jan 2011

My title for the article was Lead us and Inspire! but i guessed the editor wanted to make it juicy; so it became a title demanding for reformation. Looking back, everything i sent to the press had that theme, again and again suggesting things to improve the healthcare. This time around, i took a poke to senior bosses to come down and do the district posting as well. Im not sure how this will turn out, but an interesting one i hope.. (so that i can blog it out.. hehe)

Friday January 21, 2011
Revamp our current hierarchal system for doctors
WITH reference to “MMA: Send the young ones to rural areas” (Sunday Star, Jan 16), I agree that Malaysia should not depend on foreign clinical specialists to serve in remote areas.
This supposedly short-term remedy will not address our chronic problem.
The suggestion for junior specialists to serve in remote areas is an ideal one. Ironically, though, it is due to this scheme that we are losing government doctors to the private sector.
Urging young doctors to serve the public dutifully is utopian as we are all trapped in a system which was never properly planned for individuals to develop and fit into “the big picture”.
The juniors are pawns in a confused chess match without strategy. The problem will remain if we continue not to plan holistically.
A special human resource and talent identifying unit at the Health Ministry or at Pemandu is needed to revamp our current hierarchal system.
Reforms should start from the time aspiring doctors enter medical school. We should stream our future doctors according to the needs of each state.
Entrance into specialty should take into consideration where the specialists are expected to serve once they have acquired the necessary qualification.
Since junior doctors and specialists have always been viewed as suspect in their commitment to the Hippocratic oath, I would urge the senior doctors and consultants in both the public and private sectors to lead the way. Walk the talk and guide the young ones.
It is sad to note that an idea mooted a few years back to have private consultants help the public service did not kick off.
A short-term commitment by senior doctors to offer their expertise in remote areas should be the way to go. Treat this as your corporate social responsibility and share your wealth of experience with the young ones.
The Malaysian healthcare scene is evolving at a rapid pace. A holistic transformation is needed.
Again, my call to my respected senior colleagues is, lead and inspire us, please. Help us improve our healthcare quality.
Shah Alam.

Sunday, January 16, 2011

2011 first blog post

This is my first blog post for 2011. 16 days late, but better late than never!
There was a lot of life events happening; primarily my move from Jeriji to Bidai in Bukit Jelutong after Christmas. TM was not being efficient therefore the delay of streamyx at home. At work, it was impossible to blog as KKM banned its users from posting blog pages from its premises!
Its good to be back and i hope my blog will continue its legacy. The second half of 2010 was bad for my blog as i can hardly find the time to do so. I am more settled now and there is a lot to tell for 2011! A lot of adventures planned as well as places to go.. a new addition to the family baking in the oven; waiting the right time to pop! Wow.. it'll be an exciting year and please bare with me :)

Malaysia..the Champions!

I've been waiting for this moment for a very long time. To see the national team play football at its best, winning in glory.
I am glad that my kid had the opportunity to cheer ( eventhough he had no idea why people were celebrating) the Malaysian team in mamak instead of the foreign football league teams. He enjoyed that bit and i know he will remember it for the rest of his life, the joy of supporting Malaysia. We've heard from our parents and from their generation, how they were excited in supporting the national team then. I thought it would take another generation to have that feeling again.. and I am glad, i witnessed the moment of glory for the National team.

This current batch certainly proved their worth ever since winning the gold medal in SEA Games last year. Nobody gave them the chance or hope to win this cup. I was in Kallang stadium in 1996, watching Malaysia lost 1-0 to Thailand in the first ever edition of this competition. I went back home dejected but proud then, because i knew we played well and it was very unfortunate to lose the game with a slim margin.I missed the finals in Bukit Jalil because it was impossible to go because we've just moved into our new place. But i never missed the opportunity to watch the game; eventhough I was in Indonesia last week. Now Vietnam, Singapore, Thailand, Indonesia will not look us as minnows anymore. And i can tell you.. we are PURE.. and we don't need IMPORTS to bring us glory.. pure local talent. SYABAS!!Kudos to Rajagobal.. and kudos to the whole team. Malaysia di hatiku!! :)