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, well..it'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.
Dr MAFEITZERAL MAMAT,
Shah Alam.

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!! :)

Indo Gede(Pangrango)-Tangkuban Parahu

This Indonesia trip was planned since early this year. This was my first ever climbing trip out of Malaysia. Being fat and unfit, i dunno whether agreeing to go for this trip was a wise one. However, i missed nature and yearning to go back and enjoy the atmosphere and to find time in this last 6 months was not easy.

KLIA walk

warning from Bung Karno

We managed to fly with KLM and it was my first time on a 777-300. My trip to Salzburg earlier was on the 200 model and all of us were very excited to board the plane! And the fascilities.. hahaha imagine, most of our past trips were on Air Asia. Therefore, being on board a world class plane was an experience!

We arrived in Jakarta at about 830pm and we had our supir waiting for us. Amir( the group leader) specifically booked a minivan for the 10 strong entourage. All of the team members were senior otai2 maut punya hahaha I only hope at that time not to be the one left behind and limiting the group's progress forward!

We arrived at Freddy's homestay in Cibodas very late; in the early hours of the morning. He was accommodating receiving us and his actions certainly reminded me of Ketut(the guy from Eat.Love,Pray) hahaha I even asked if it was him !!

We woke early the next morning as everybody was eager to start off climbing! Usually December is not a very good month for climb as the wind (badai) and rain will endanger us. I guess we were trying our luck perhaps that we maybe lucky to enjoy both Gede and Pangrango. After getting te guide to confirm the trip, the 10 of us on daypack were ready to go. However, me and Hafiz were quite sceptical about not having this trip to be OT( as following the OGKL tradition) that we decided to bring extra things in case we had to sleep overnight in the jungle!

The trek started off smoothly. It was a pathway made of rocks. Gede was a volcano and the last eruption was during Independence Day and ever since, seemed to be quiet. Who knows, in years to come it will act like Merapi!

pose

and pose..

We were very casual in the beginning. stopping and taking pictures like tourists unnecesarily without knowing what was ahead of us! haahha the 12 to 4km marker on the start reminded me of Tambuyokon.. hhaha bukan senang maaa...

As the trek got steeper, the weather worsens. rain began to drop and reduced our group movement speed. I realized the trek was a bit different because it was more of rocks and sand as compared to the Malaysian jungle which forces us to climb on roots and soft soil.The trek got interesting when we reached Panca Weleuh where it was literally boiling hot waterfall! And to cross it ala Tomb Raider was really cool! I guess, because it was warm as well it became the highlight of the trek.

hungry...

We arrived in Kandang Badak quite late as it was pass 2pm.. The weather was getting worse as we could feel the hale rushing the raindrops!It became cold to stay still at one place and we proceeded to summit Gede. It was a torturing steep climb in wet conditions. Having to negotiate our way through a vertical rocks with rope in the wet can be scary! We were not fast at all and reached the Gede summit at about 530 pm! The journey to the summit was horrendous! The rain was blown away by massive wind speed where i myself with my weight felt as if it was trying to blow me away! It was so cold up there and of course there was no view! The weather was simply terrible for us to proceed and it was a worry as well to walk down!

Sampai di puncak yea!!!

Of course we were frustrated when we reached Kandang Badak, we were told by the Guides that they were not keen to bring us to the twin peak. The whole group felt demoralised but I guess safety comes first. As the pepatah goes.. Takkan lari Gunung dikejar!

Group pic

We arrived at Freddys at about3am in the morning! Our legs were sore as we were threading through a journey of stones non stop. The pain really got to us on our way down that we had to stop for a few times. Upon arrival everybody with their trekking atire just went collapse!

Therefore, the next day we travelled by our minivan to Bandung and straight up to Tangkuban Parahu. Itwas nice to really see a "live" volcano crater! The whole group enjoyed it very much!

Masya Allah

some shopping done..

We had to go back early on Sunday as we did not want to risk the traffic jam in Jakarta. It was Indo vs Philippines game in the evening and the whole road to Jakarta was totally stuffed! We were lucky to be in time and alhamdulillah ,back home .. tired but happy.. :)

Short weekend trip to Bagan Lalang

We were busy that week, I was oncall non stop and wifey was doing her locum here and there; we were not able to follow Yo for his engagement in Kuching.Both Qayyum and Qaisya followed my MIL with the rest of the family members. It was a lone weekend and we suddenly got the idea.. why not go and relax somewhere? Near but not far and nice?

So we decided for Golden Palm Tree resort in Sepang Gold Coast. It was a purely internet search and booking. we had no idea how nice itwould be and the special weekend offer was reasonable. And so we went! Ofcourse, the way to go there can be a bit dodgy as you're not too sure your way there.

walking to the pool

But upon arrival, wow... not bad the ambience! loved the area... loved the room.. the sea water.. hmmm.. standard la selat melaka.. hahaha but overall... puas hati! Marissa was so excited as she was alone and had all the attention! We managed to have dinner by the seaside with excellent choice of seafood.. though i regretted for not ordering the crab!

marissa enjoying her pool day!

best woo gambar..

resting..

myspace pose..

Exodus

Wow.. my last entry was in November. Such a long time before I can sit down like now to write something on my blog. The blog-neglect syndrome is bad in 2010. I reckon my resolution for 2011 would be to reactivate my passion to write and blog again! It is definitely an outlet for venting, realizing, imagining ie a personal diary of things done.
Of course, my hectic schedule would be the thing to blame ; it was extraordinary one month. I've been involved with a lot of work-related stuff that I lost the zest to blog. Taking care of the wonderful 3 kids is another major factor; spending time with them is priceless! I've been travelling around the country and abroad in this time. I guess the life event that will be happening really soon which is this weekend, moving out from our Park residence home. Imagine, I did not even have the time to inform my neighbours regarding this decision!
I'll try to find time to write about my Sungai Petani workshop, Indonesia Gunung gede trip and the leadership short course by AKEPT in due time.

Sports day n birthday

Once you have children, whatever they do especially in the early years matters so much and takes priority. Nothing they do is not insignificant and you live to witness this moment : to enjoy and savour it as its always them who makes everything that you do worth it.

It was again Salsabiila Sports Day and both Qayyum and Qaisya are involved. I'm pretty confident about Qayyum especially after his surprise last year but with Qaisya, we're always sceptical whether she can perform when asked to.

Qaisya was involved in an event where she was supposed to start the race. However as soon as the whistle was blown, she freaked out!! hahaha she just went beserk and cried! hahaha we thought so this would happen.. i tried to coax her to try, and with force she was pushed on the small tricycle but of course, she did it in her upmost disgust! hahaha.. i managed to video the went beserk moment.. classic!

Qayyum did well in his events and we are very proud of them..

Later in the afternoon, we celebrated Dzaeff's 5th birthday at home.. small scale but it was a surprise to him! I'm sure he will remember this ultra-birthday indefinitely! :)

new wear

I bought few scrub caps online via sukascrubs -I believe they are based in UKM because i know one of the models! The caps looked cool and I'm sure if their marketing is good: bule jadi kaya wooo. Well, baru je order then nanti tunggulah delivery and I'll model it out for you!

p/s only for the eccentric narcicists.. hahaha kalau tak yg disposable tu dah cukup dah sebenarnya..

Forgotten but remembered

I managed to catch P Ramlee's bio profile on History channel Astro 555 last night. I'm a big fan of History channel and to have a Malaysia-related icon life being opened up is a must see for me. I am a big fan of his movies: Hang Tuah made me want to be a hero, Antara Dua Darjat made me realize the reality of class, Ali Baba Bujang Lapok made me laugh from start till the end. His movies are excellent that when we watch it again and again, despite knowingh the storyline as well as the dialogue: i will not move away from the TV.
It was a fresh presentation: featuring interviews with his friends, ex wives as well as his wife (Saloma) who died in agony many years later : unable to accept his death. Nobody really knew especially my generation that he died as a pauper and unappreciated then. He was at his downfall and nobody cared. He became an outcast; trying very hard to repeat his former glory days. It was good for History channel to focus on this so that we know the real story; that at the end of his greatness; he was depressed and forgotten.
I must say I was impressed with Saloma- who really loved him till the end of her life. She was distraught and remained that way. Her love for P Ramlee was so obvious that everybody talked about it - not pretencious nor publicity searching. She was sincere and cared for him in the days when it looked gloomy for P Ramlee. i managed to catch P Ramlee the musical early this year, and it was certainly the element which was emphasized in their scenes together Remy and Sally :) well honestly, i never looked up upon celebrities' relationships as I feel they are always looking for glam & publicity rather than sincere marriage. Whoever would have thought that Remy and Sally's love were real? Being highly educated does not equate to happiness in marriage life isn't it?
Thank you P Ramlee for showing the world Malaysia Boleh then.. and you are the man!
Alfatihah...

The big three

I rarely get really obese pregnant mums for caesar.. of course pregnant mothers will always be overweight but to have a normally obese lady becoming pregnant is an upmost challenge! I've done quite a few previously but none matched the one I had the day before.. 150kg mother, primi.. just ate two hours ago and came for her usual antenatal follow up.. they can't detect her fetal heart rate.. the scan did not look good so : decision for LSCS..

when she arrived in OT.. hmmm... wow.. airway can be real bad if one opts for GA and the option is for regional.. i don't see any other way to ensure both mother and baby safety... "fat chance" hey? hahaha

you cant feel anything behind there.. totally fat up and below... so how ah? well..i took the longest needle i can find and the only way to do it was the "ada rasa karen tak?" method.. it was not easy nevertheless but alhamdulillah.. i got it.. and LSCS with baby was well.. :)

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I was in cardiac OT again.. and we were doing a fairly simple "pericardial stripping" case. This unfortunate gentleman had gut TB few months back and had since went into cardiac failure symptoms. The cardiologists thought it would benefit him to have the fibrosed pericardium to be peeled off so that the heart can contract better and perhaps improve his failure symptoms. He was otherwise healthy before that bout of infection.

It was a simple sternotomy with the heart visualised directly. it looked dirty and very typical of infection like lesion around the heart. of course, with such fibrosis you can never predict the friability.. and yup, to make the story interesting the right atrium pun TER-BOCOR!! waaa... major resus done as the cardiac output was literally off the drain! it was impossible to close the defect immediately and the heart stopped beating almost immediately. The trainee cardiac surgeon had to commence the direct cardiac massage with the main surgeon busy trying very fast to establish a fem-fem bypass to the CPB machine.. And of course, the anaesthetists all working overtime as manual "Level-1": pumping as much blood and volume into the circulation to maintain it before one can define death phsilogically! We could lose the guy anytime.. he was at the verge of death due to no more blood in his circulation!

We managed to put him on bypass and that geve the surgeon the time to repair what was damaged.. but it was not an easy task.. They did not close the chest as the possibility for reopening the chest was there! The success for the episode was; we were able to get him of the bypass machine... and such release. Till date he is still in CICU and I'm not sure if he can make it..

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Adrenaline rush on the go? only crazy people would yearn for a career like this... hahaha so am I in that category? haha

Books i bought

In the last few months, I've been buying books - actual books which is not related to medicine or aanesthesia. I dunno why i was compelled to do so..but since its with income tax relief thingy.. why not fill in my library? And for my birthday yesterday.. i bought another 2 books which i hope i will be able to read and finish..as the earlier books, macam sketches la..here and there.. haha

I've always had this thingy about NLP.. i don't really know what it is and i cant be bothered to go for the course. one because it is expensive. two.. i don't have the time. Therefore the opportunity to read and teach yourself was something i thought was a good thing to do.. but till now.. still reading it.. hahah

I bought this after watching the theatre. I'm always a history buff therefore history recollections like this is a must to have! I've yet to browse and read it thoroughly but I've managed to flick through the historical official papers.. I collect Malaysia history books tau!

I bought this book as a tribute to my idol..Prof Emeritus Alex Delilkan. I should have taken the autographed paperback during last year's Anaesthesia day but never got to do that.. so i recently bought this mainly as my Malaysian reference ..for my review article that he reviewed!

Yup... This is what i got for my 34th birthday! the 8th habit.. I didn't read the 7 habits and now i go straight into the 8th habit. Typical of me eih.. hahaha ilmu sesat kang..

I thought this was interesting.. but wifey went WTH???? hahahaha

CVL workshop 23/10

I must thank Dr Lim for inviting me to be part of the faculty in organizing the CVC workshop in Sungai Buloh Hospital. It was an opportunity I would instantly take up as I've always enjoyed to organize and present. Talking about our bread and butter, putting in central catheters is not something difficult to do and as ever to share with the young ones.

The day started with lectures and my lecture was about CVC insertion via landmark technique. And as always, I could not resist the temptation to present it my way.. with pictures and graphic which anybody would enjoy. Mr Reindhart from Bbraun Germany complimented my presentation where he thought the germans themselves would be smiling when looking at my slides!

Suraya,Tie,Shymala and Suzana did their bit and the excellent team about this team was we all did our presentation on time! e had loads of extra time before the afternon session which was about demo using ultrasound and the insertion of CVC via models. I had fun with the GE phantom models to play with.. and i guess everybody should have this to practice with especially for those keen on the ultrasound guided regional anaesthesia.

Later in the afternoon, me & Tie demonstrated on how to insert CV line for ICU patients. My patient looked Ok but somehow i could not thread the guidewire in!! hahaha really went haywire not according to plan! I was sweating all over for the inability to do it in 5 minutes.. hahahaha it had to be me isn't it? but in the end, after the failure of Right subclavian and then to left internal jugular( which surprisingly under u's guidane totally collapsed!!) and to the left subclavian which maybe in retrospective i should have attempted the first time.. hahahaha

3 and 4 does not make 7..

Wow.. I am really neglecting my blog! Look at my last post which was last month! I guess its the thought block period and somehow i could not get myself to sit down and write.. like i previously did,how i used to... hmmm... need to get back the blogging spirit somehow..

Im 34 today.. Happy birthday to me.. hahaha Honestly, i cant believe I am at this age.. progressing towards 4-o which is not that far away. I am getting older.. and older.. and maaannn... betul2 rasa cam midlife crisis!

I am currently fitting in well with my Sungai Buloh environment, started doing OT and enjoying every bit. I must thank Dr Lim for his generosity and courtesy to take us to be part of the KKM family. I enjoy working my new colleagues here who I've met previously, either in HKL and UM.. an excellent working group! Of course, Jeya "Chief" is my highlight as everyday is a good day for us .. hahaha why la chief???!!!!

The challenge as a specialist now is to train my young ones to be future anaesthetists! Its totally different from my previous 4 years in UM..where most of the MOs on my side and others are experienced enough to handle ourselves.

UiTM with our "mega-super" plan is progressing under KY. And being a part of it is a challenge by itself. To set up my own anaesthesia department with my limited experience can be daunting but if i don't do it..then who will?It is ironically something that i enjoy and dont mind doing because charting my own future will be my own responsibility. I am glad that I'm slowly going into cardiac anaesthesia with Mondays and Tuesdays being in Um with Prof Wang and Prof Marzi.

to 34 and infinity.. and beyond... :)

Celebrating raya MDQ style..

Alhamdulillah, i had a comfortable raya leave this year. In fact, as far as i can remember maybe the longest ever!(not being oncall after 1 week of raya!!) For the first time, I could celebrate Raya slowly but surely; but hey..with three kids it is never easy!

*credit to pelangibonda for pics..

This year's raya was memorable because of my 3 kids. They are bigger now so they can appreciate the joys of raya. To see them enjoying themselves is a big plus for me & wifey. Dzaeff really enjoyed going from one house to another; as he himself can explore the house! hahaha Every house that we go to in Muar, he went straight to the kitchen and as how he is, helped himself for water or food etc.. hahaha and of course, Qaisya will tag along with his brother.. and of course, the lovable Falx( the little cute fox beanie..)

Qystiena herself is slowly showing her own personality. She can be fiesty at times, opiniated and nobody can mess with her. Dzaeff and Qaisya lost their battles to her due to her strong personality! She now enjoys dressing up, even asking for baju kurung to be worn to sleep! She definitely likes her raya shoes, elegant and nice :) Seeing their eyes glimmering is a bonus and that makes this year's raya more special.

Boxing Piala Malaysia 2010

I had the great opportunity to experience something new before ramadhan. I am involved via Pak Ya from last year to be part of the Malaysian Boxing Federation but never got to be active because of exam year. However, when i received the letter of invitation to be a ring physician this year.. hmmm... why not? Of course, i had no whatsoever training or information on how to be a ring physician, as to the Malaysia spirit of Malaysia Bole.. so.. hantam sajalah!! hahahaha

my hotseat..

had a go in commentating? haha

To my surprise when I arrived on the first day of job in Keramat MSN, i did ask whats the plan for medical cover. and the reply was.. mmm.. you lah.. ahaha and literally me alone! I was quite shocked in the beginning as this is the national championship and not a district level kind of a tournament! Shakti ( thanx foryour help bro..) who I recruited to help me on the first day was very unhappy with the setup. He as how his usual self showed his opinion strongly and tried to arrange something with MSN. Of course, last minute jobs will never be well done.

the distinguished R&J

with Mr Hisham.. cool bro!

my view..

with Fairuz.. Laos 2009 Sea Games gold medallist..

There I was for 1 week, covering as the ring physician by the ringside. Guidance by Mr Hisham, the senior International AIBA ring referee was excellent as I sat down and learnt what technical amateur boxing is all about. It is kind of ironic that this is a very safe sport I must say! Strict guidelines on boxer's safety is practiced and with that objective in mind, it was not difficult. I had to make certain decisions to disqualify boxers.. but its a must to ensure that the boxer can continue to box! I had my moments of glory too as the whole tournament was shown live on TV via Astro Arena 801. hahahaha a really godd experience i must say and i cannot imagine how one cannot be an expert after sitting through more than 100 bouts!! hahaha

Thank you everybody !! Hidup tinju Malaysia!!

Aidilfitri 2010

Salam Aidilfitri to all!

My family pics in our different coloured themes this year!!

Round 1 - retreat

We had our first meeting with the management committee yesterday. The Daycare MIS working group worked hard to prepare our working paper in realising the surgical services in CTC Sg Buloh. Our team is very young; but not without vibrant energy and push. Of course, Initially we were told that they will only meet us next month. Hashim got a friendly phone call from the Secretary, telling us to prepare for the meet in the afternoon.! Of course, we were not ready as we thought we had time to strengthen our presentation.
So there we were, managed to get most of the team members to sit in that room. We were waiting for 2 hours when I decided to continue and not postpone my teaching with the orthopods students. And the brave 4 musketeers went in the room quarter to five.
The good news: there was no NO-NOs from Dato'.
The bad news: unlikely for daycare surgery to start in November. They want a more comprehensive planning and lots of details in the proposal.

Obviously our working paper was based on our own limitations and abilities. I am a practical person and I model my management based on what works. I know the management team has their own mega plans to do but sometimes it may not be feasible. Im not being pessimistic or non committal but our situation is very different at the moment. We were not involved in the earlier planning stage and here we are thrown in the middle of it. Some things were planned then but who i really don't know. And for what we have at the moment, we should use it to the max rather then waiting for it to be another white elephant.(which is a common sight and practice in Malaysia) I believe on doing things that work and with an objective in mind to expand as we go. Managing OT is not easy but i know that certain things do and can work in a short time.
Never mind, we will be back in the board meeting room with a band and renewed enthusiasm.

Unfortunates vs Deservability

model view of Sungai Buloh Hospital complex

Working in a centre which boasts on Neurotrauma specialty brings a mixed reaction to an Intensivist. The majority of the patients are young; often involved in a motor vehicle accident which may impair the future of their lives. Emotional prejudice to the mat rempits maybe there amongst the carers ( doctors and nurses). "You deserve it" may cross our minds indefinitely but it never became a determinant factor of continued quality care to "fix" the patient up so that they can wake up from their coma.

Eventhen, the sight of their family members who came soon after can be very emotional. The grief and anxiety is obvious especially when explaining to them what happened and what was about to happen in deeming consent for anaesthesia and surgery. The sigh of having to sign the form which life may depend on it is a risk which they cannot avoid. The confrontation can be brutal at times, but its never easy to cope with such a stress. It is common to have doctors vs relatives to argue but i guess the role of effective communication is vital to ensure smooth information flow for understanding. Anaesthetists are often caught in middle; but it is a role that we should take to show what we can do for the loved ones.

The unfortunate ones are the "good" people who were unlucky to be involved in such a catastrophy. A religious teacher who just got married during the weekend, a pregnant mother who was on her way back home from work, a 7 year old child who was hit by a passing lorry, a 24 year old who rammed behind a small truck who stopped suddenly because the driver was drunk, a young student pushed aside by mat rempits .. endless unfortunate ones who died despite intervention made certain dark history in certain people's lives.

All this during oncall can be a mental stress which may drain your energy. Coping with the controls in intracranial pressure during cerebral resuscitation can be tricky as there is no straight forward textbook cases on hand. I guess this experience is something i appreciate and perhaps should train to make me wiser in trying to preserve what is left of what may have gone.

p/s tracheostomy contract is on the go.. hahaha not complaining about it at the moment.. :)