::: Tired

There are times..
I am just too tired..

- of being nice
- of being responsible
- of being friendly
- of being detailed
- of being helpful
- of being hopeful
- of being everything

That I can
- for my patients
- for my career
- for my future

Because I have missed and will further miss
- countless hours of my sleep
- hundreds of my loved ones' weddings
- hundreds episodes of my favourite tv shows
- thousands moments of my family gathering
- many opportunities to meet someone new

Just to care for some ill strangers

But one thing keeps me moving
Keeps me smiling
Is what I hold deep within 

"WHAT IF THOSE LYING THERE SICKLY..

ARE MY PARENTS, MY FAMILY, OR MY FRIENDS?"

I shall be thinking

"Would the doctor be
- nice
- responsible
- friendly
- detailed
- helpful
- hopeful
- and everything that is positive?"

+++++++++++++++++++++++++

3 minggu lepas, aku oncall EOD. Sikit lagi nak jadi gila. Setiap oncall pulak jonahnya Masha-Allah. Melampau-lampau. Selalunya oncall aku 60% cold.

Tapi minggu tu entah kenapala semua oncalls aku panas membara. Admissions tak henti-henti. Emergency OT sampai ada 14 open appendicectomies. Tak termasuk case laparotomies lagi.

That week, my total hours of sleep hanya 15jam. Hebat. Mata jadi panda.

Hari terakhir postcall, boleh pulak aku tertidur masa driving, Mak Jemah oi.. Sedar-sedar dah accident. Kesian. Dengan jujur aku cakap kat mamat tu "Sorry. Saya tertidur masa driving. Penat".

Gamaknya dia kesian. Or terkejut? Tengok muka persis katak aku. Yg berminyak tak bermaya. Pucat. Lepas 4 hari oncall sepanjang minggu.

+++++++++++++++++++++++++

My boys are both so lovely. I will love you till Jannah. InshaAllah. Semua ini memang sekadar pinjaman Allah. Tapi cukup. Aku syukur sebab sempat merasa. Disayang dan menyayang =)

| jonahness continues |

::: Life Is Not Equal To Career Only

Back in 2009, in one of Leicester's Hospitals. A very late afternoon. In the psychiatric building. I surveyed the surrounding alone. Just to familiarize myself with the wards. Bear in mind, when you are attached alone in a clinical setting, you do not want to be lost and late on your first day, next monday.

So I walked around, humming my own tune silently. Then I met a couple. Nicely dressed. They stopped and greeted me.

Mr C: Hi dear. This late alone, are you visiting someone, perhaps?

Me: Hi. Oh no. Just walking around. I am a medical student attached here.

Mr C: Great. Good prospective for your future. We are back from visiting our nephew.

Mrs C: He used to be very excellent, in study, in career, in everything. Now admitted for some mental disorder, as we have been informed. Stressful life, then he became alcoholic and miserable. Pity him..

Me: Aaa. Sorry to hear about him. Your family must be very devastated. (Well.. We were trained to show empathy. I think I did it well because that time, I was actually in a rush, catching the hospital hopper, and not really in a mood for a conversation!)

Mr C: So, we got to make a move. You must not forget to enjoy your life, dear. Career is not the only purpose of living.

Mrs C: Your future job is well known rewarding. But remember sweetheart, have some breaks, explore the world, before you regret it like what our nephew did.

Me: Thank you Sir, Madam. For the concern. Will sure to enjoy life to the fullest, despite this hectic requirement of life. All the best for your nephew.

Mr and Mrs C: Good luck. Bye then.

So I walked home. And my brain was mumbling, 'Well, if only they know why you are alone in this clinical setting now. You used to be in pair, but not anymore.'




| funny, how life is.. |

::: Dia Juga Mahu Mati Segera

Sudah lama aku tak menulis tentang kerjaya yang sedang aku usaha. Perjalanan terasa semakin pantas. Alhamdulillah, I think I have adapted 80% of the local style. But I choose to keep the remaining 20% for my past to fill in. Hopefully, I have chosen the right past.

Tiba-tiba tadi aku teringin nak bace balik posts lama aku dalam label 'Career'. Rindu pada masa lampau. Terlalu banyak cerita yang aku simpan. Mahu saja aku buka satu persatu. But you may only get my meaning if you read in between those lines..

++++++++++++++++++++++++++++++

9 malam. Sabtu. On an evening shift di A&E. Hajat di hati nak menunggu hingga mid-night walaupun selalunya hajat tu susah sikit nak menjadi. Heh. Mencuba itu tak salah.

10 malam. Patients mulai ramai. Ada sorang patient dekat bay paling tepi. Perempuan lingkungan awal 30-an. Senior doctor suruh aku pergi clerk. Katanya kes simple-simple saje. Aku tahu diorang selalu tipu aku! Cis!!!

Aku datang dekat, aku boleh bau arak yang maha kuat. Tahan je lah kan. Nak tutup hidung depan dia, nampak sangat tak sensitive dan tak sopan. Perempuan tu tunduk. Sedikit pun tak dongakkan kepala.

Aku panggil, "Evening Miss, may we spend some time conversing?"

Dia jawab, "As you wish. But I doubt you can offer me any help."

Aku tarik kerusi. Duduk dekat dengan dia. Daripada suaranya tadi, aku tau sedikit sebanyak apa dia simpan dalam hati.

Aku diam seminit dua. Bagi masa untuk dia build trust kat aku. Aku perkenalkan diri then aku lancar berkata, "Feeling on the edge, perhaps? Mind sharing some?"

Tak aku jangka, dia terus dongak kepala. Pandang aku tajam tapi sangat redup pada mata. Seolah-olah dia membaca kisah hidup aku yang lama. Dia balas, "Out of a sudden, I feel like dying. So I tried committing suicide. You do understand, right?"

Dia diam lagi. Terus tunduk dan berbisik, "Or maybe you never will."

Dalam hati aku balas sendiri, "If only you knew my real story..."

++++++++++++++++++++++++++++++

Dah selesai clerked dia, aku pulang segera. Entah. Hati rasa bercelaru. Sejuk malam langsung tak terasa. Antara fakta dan pengalaman. Dua-dua aku mahu cerita pada mereka, especially patients, yang aku jumpa. Kadang-kala wujud satu garisan halus yang menjadi sempadan antara aku dan dunia. Professionalism and rationalism. Sometimes they are just opposing each other.

Many times, in this medical field, the commoners and even the professionals terlalu memandang pada darjah kepakaran seseorang - yang pastinya letak pada results peperiksaan. But friends, dont you ever forget, real experience is the actual key of understanding a patient.

"Kau tak akan tahu betapa seksanya nak berak keras,
jika kau tak pernah merasa berak keras itu sendiri..."

Betul? Iye, aku tahu itu jijik. Bye.


| pasti ada di kalangan kita yang hampir serupa... |

::: Bakal Kerjaya Entah Ke Mana

Dalam belajar, dulunya aku suka kongsi perihal apa yang aku belajar.

Aku punya koleksi peribadi. Menghambur kata mengikut kata hati. Itu pendapat sendiri.

Gembira rasanya bila mana aku boleh menulis waima sebaris yang mampu buat yang membaca merasa. Merasa apa yang aku rasa. Kalau tak mampu merasa sepenuhnya, cukup untuk mereka tau itu yang aku sudah rasa.

Namun kini, entah, mana pergi rasa itu? Buntu.

Kerjaya. Masa depan.

Jangan mati duhai semangat. Jangan mati. Aku sayang engkau sangat..




| jauh lagi |

::: My Future Career 10 - Dia Mati Di Depan Mata Aku

1st time real experience.. 1st April 2010. The date I probably will remember forever.

At about 4.45am, the doctor in charge in the A&E mintak aku pegi Resuscitation Room. Katanya ada patient with cardiac arrest akan tiba in 15 minutes time. So she was looking for some help from doctors, nurses. & I guess, she knew that I may be interested to see how they do life saving. So there we were, 3 doctors, 3 staff nurses, 2 paramedics, 1 medical student. Prepared for the worst.

Then the ambulance arrived. Paramedics sepantas kilat datang tolak the patient yang dah pucat lesu hampir biru. Transferred from trolley ke katil, terus start CPR. I was standing beside the doctor in charge, observing how calm she was & how effective all of them were. Aku just mampu membantu sikit-sikit - angkat the patient into position, tolong nurses sana sini, pass barang-barang to doctors yang buat cannulation & ABG then send the blood to lab.

15 minutes of CPR but nothing. Masih tak bernafas, masih tak ade heart beats. Injected Adrenaline. Still nothing. Then 2 minutes later, the doctor in charge said that hey better stop trying since dah sejam patient to kena cardiac arrest from the moment her family members found her collapsed in her house till that moment where we tried to keep her alive.

We pronounced her dead at 5.28 am. Agreed decision.

3 minutes later, the nurses noticed some signs of life - patient started to show some breathing. Immediately, everyone kicked in & CPR dimulakan balik. Semua masih mengharap that the patient can still be saved.. 2 minutes later, she got her heart beats & breathing back although extremely weak.

We kept her comfortable. Everyone stayed quiet around her. Bad prognosis. Peripheral supply dah shut down. Kaki & tangan semua dah pucat & sejuk. macam ais Although she was still breathing & having pulses, we did not expect her to survive. Not more than an hour. Perhaps less than 30 minutes. Nonetheless, we did not stop having hope.

As what we expected, she did not make it to the end. She died 15 minutes later. The heart stopped beating & there was no breathing effort at all. Having had other significant morbidity - end stage motor neurone disease - we knew her prognosis was just too bad. She can now rest in peace. Let her be in a better place.

The doctor in charge offered me to follow her & another staff nurse to break the bad news to the family. Aku ikut je. Jumpa 2 orang family members si mati.

'We are very sorry to inform you that your mom is dead (long paused).. We tried our best But she could not survive..' Tears. Emotional. Silence. They accepted it calmly sebab sudah menjangka itu mungkin terjadi.

20 minutes later, I went home. Berjalan dalam subuh yang tenang. Satu persatu kaki aku melangkah. Bermuhasabah. Walau tak banyak aku menyumbang, tapi aku tau ini satu permulaan.

Ini kerjaya yang aku pilih. Arieza, jangan menyesal. Hidup mati mereka di tangan Tuhan. Kita berusaha, biar Dia menentukan... Tapi yang aku pelik, aku terlalu tenang di sepanjang kejadian - dari saat patient tu sampai, pronounced dead, till the moment we delivered the news to the family. Emotionless kah aku? Aku tak mau begitu..~




| nyawa itu sementara |

::: My Future Career 9

Night Shift di A&E department memang menakjubkan, dari segala segi. Macam-macam sungguh perangai manusia - patients, relatives, doctors, nurses, OTs, HCA, medical students.. *sigh*

Now I wonder how long can I remain 'normal'. Bila in the middle of the night shift, mata bertukar menjadi merah, sepeti vampire dahagakan darah! Oh sungguh nikmat mencucuk mereka...~

Incik Macha, jangan pengsan....!

| bloodsucker! |

::: My Future Career 8

sambungan dari this post...


Semalam. Seawal 9 pagi di hari Sabtu. Ward round dimulakan tatkala suasana masih sunyi.

Ward attendants ada 4 orang - sedang menukar cadar katil-katil patients. Nurse ada 2 orang. Doctors pun ada 2 orang. Medical student ada seorang - sangat jelita dan penuh dedikasi tapi hadir dengan mata bengkak kemengantukan serta kepala otak masih di awangan...

Tiba-tiba..

'Klank klunk klank klunk..' Bunyi meja di ketuk-ketuk dengan sudu besi.

'Hurry up! I want my money! Stay away. I dont want any..' Kedengaran seorang nenek tua 90% nyanyok menjerit tanpa henti sambil diiringi irama rock meja dan sudu besi. Habis terjaga semua patients. Mujur nenek yang ada heart attack kat bilik sebelah tak kena cardiac arrest.

Bijik mata aku pun terus celik segar. Mau tak terkejut & lemah segala urat saraf ni. Aku ingatkan Hitler sudah hidup kembali.. Cis nenek!! Buat remuk paru-paru betul la di pagi hari!

Setengah jam lepas tu, kecoh pulak semua staffs dek kerana seorang patient (minah omputeh berusia hampir 30-an) melarikan diri dengan cannula/drip masih terlekat kat tangan. Boleh plak dia senang-senang hati lari main polis sentri. Dengar cerita minah tu masuk ward malam semalam sebab overdose macam-macam ubat. Moderate risk patient with history of depression plus deliberate self-harm.. Memang serabut.

Mula la berdering-dering non-stop semua jenis telefon kat dalam ward tu - security guards, polices, admins, nurses, doctors - semua dok kalut mencari.

Ditambah lagi dengan 'klank klunk klank klunk..' Nukilan nenek tadi...

Argh! It was supposed to be my weekend - SATURDAY! Hari ini pula SUNDAY. Kena pegi ward lagi!

Oh nenek, jangan la dikau ulangi lagi semalam punya memori~



p/s: untuk Encik Kulanz and Asada, maaflah, tag korang tu belum mampu untuk saya jawab. sedang dilanda ribut kesibukan.


| Sabtu yang saiko! |

::: Menjahit Kaki Babi Dengan Yakin

cantik? itulah kaki babi. hari ini kami belajar menjahit.. sudah mahir ni.. sapa mau tempah aku jahit baju raya? silakan. borang permohonan dah start masuk pasaran.

kenapa kaki babi? katanya struktur kulit dan daging babi adalah yang paling hampir menyerupai stuktur di badan manusia. huh. keji?

tidak mengapa.. aku pakai double glove. pegang pun tidak. semua pakai foceps and needle holder sahaja. lagipun, session ni wajib. demi ilmu, Allah pasti mengerti..

walaupun, dalam hati aku yang beropol-ropol ni, wujud perasaan teramat geli!!! euwww!!!!



oh ya, sekarang ni dah tiba musim untuk jadi busy. results exam minggu depan baru keluar. but at the same time, we have to proceed informally to the 5th (final) year. later on, the results will determine whether we are formally qualified to go to the final year, or we have to take the 2nd attempt for the 4th year exam again. well, tawakal sahaja buat masa ini. dapat tak dapat, itu terletak pada rezeki..

ape-ape pun, masa-masa busy begini la baru kita tau sapa yang betul-betul berkunjung untuk membaca, atau dulunya berpura-pura rajin datang sekadar untuk mendapat balasan. heh. terkantoi sudah di situ kan?

korang tak datang pun, blog aku ni tetap jalan. sebab ni rumah aku. even in reality pun, takkan sebab takde orang datang ke rumah korang, makbapak korang pegi panggil jentolak Dewan Bandaraya mintak robohkan ruma korang tu ala-ala di kawasan setinggan? buang tebiat ke ape?

tetamu yang datang, aku layankan. musuh dalam selimut datang pun, aku tibai senyum jugak. kalau musuh nak datang sekalipun, lagi aku manjakan.. massage mau? (pinjam quote incik macha)



terima kasih daun pandan. yang datang, seribu penghargaan. yang tak datang, aku tak heran. incik Macha, jangan kerinduan! hikhikhik..~



| esok bermula.. |

::: Di Penghujung Nyawa

For Shockable Cardiac Arrest (VF or pulseless VT ONLY!), please do as follow...

Step 1 - Use ABCDE approach then come back to initial A.
Step 2 - Cardiac Arrest? if yes, call for help then proceed to Step 3.
Step 3 - Do Basic Life Support (BLS), use 30:2 technique.
Step 4 - Wait for Resuscitation Team to arrive while continuing Step 3.
Step 5 - Setup Defibrillator then check safety, charging and shocking.
Step 6 - Continue Step 3 for 2 minutes. Recheck rhythm.
Step 7 - If not settling, repeat Step 3 to Step 6 - take note of Adrenaline and Amiodarone.
Step 8 - Patient improving? Congratulations.
Step 9 - Still not settling? Biarkan dia pergi. Call for the time of death...


p/s: the above steps are me-simplified. all steps, excluding step 9, are shits. sila cuba kalau mau jadi pembunuh.




| teringat memori 2008 yang penuh dugaan... *tears* |

::: >>> My Future Career 7

sambungan dari this post...



anda rasa anda kurang akal? sila ikut laluan di bawah...

"jalan lurusssss je ye pakcik.. jgn tension2.. laluan tu mmg panjangggggg.. pakcik nak naik beskal sambil wheelie pun dapat la dlm 20-30saat. sabar ye pakcik. saya tau fikiran pakcik runsing.. jgn tension2 ye.."

"kat hujung laluan ni nnt, pakcik akan jmpe pintu... nama dia Bradgate Unit, masuk ikut situ okay pakcik... ramai kawan2 ada dalam tu.. jgn risau.. pakcik takkan sunyi.."

naik hilang akal aku masuk tpt ni! masuk2 je sane berteriak tak pasal2, sana bergaduh, sana menangis, sana tibe2 tegur aku sambil menyanyi.

erk? dulu2 aku penah gak masuk ward2 gini, xpenah plak sekecoh mcm ni, mgkn hari ni diorg dpt sampukan Wednesday Madness kot.. dah nama pun kurang kewarasan... kesian~ itulah dugaan & ujian Tuhan..



p/s: kalau begitu la rupa jalan nak menuju ke ward sakit mental tu, org yg tak mental pun boleh jd mental! punye pjg & tak frenly.. kusammmmm je!


| pakcik jgn lupe mkn ubat!! |

::: >>> My Future Career 6

sambungan dari this post...


8th situation..

in the operating theatre 7. patient was already on the table.
everyone was there.. the Specialist Registrar (SpR) Vascular Surgeon was there too.
except the Consultant Surgeon..!

Mr A the SpR : may i have the shaver please. i need to shave our patient's pubic hair..
Anaesthetist : A, i think we need to insert urine catheter to this patient. he hardly passed any drops since 2 days ago..
Mr B the SpR : sure. will do it.

he continued doing his shaving & catheterization.. silently, all on his own.
suddenly, while Mr B was holding a urine catheter on his right hand & holding the patient's penis on his other hand.. he said (with high volume)..

Mr B : huh. while im doing THESE, my boss (the consultant) is happily sipping his hot cup of tea in the coffee room..! hahahaha (sarcastic laughs, they were!)
Anaesthetist : that's why we call him our boss! dont worry, your time will come soon..

Mr B cracked a bitter smile, perhaps for himself..
the higher you climb up the ladder, the less (dodgy) works you are ought to do..
yek?




| climbing for powers! |

::: >>> My Future Career 5

sambungan dari this post...


7th situation..

Mr B : although this pain is getting worse, i just want to be with my family..
Arieza : did the doctors tell you anything about the next treatment plan?
Mr B : they said nothing can be done anymore. im afraid that this pain is staying with me forever, young girl..
Arieza: erm...
Mr B : this morning, i woke up feeling sick of this pain. but then i looked upon the bright blue sky. in split second, i knew that i must keep on going. i must be strong..

along with those words, i could see his eyes were getting red. then tears started to run down his old cheeks. but he kept on smiling. a smile that i will never forget.. he reached for my hands and said..

Mr B : however sick you are of so many unsolved problems, you must remember, there are someone out there who still love you.. so keep on walking! this tears of mine, is tears of hope.. i will never give up.. you must not too.. ok, girl?
Arieza : yes sir. i know you will always be strong. and so will i..

and i squeezed his pale hands softly.. the hands of the man who is optimistic about eternal happiness.. and he who believes on hope...




| pakcik B, engkaulah inspirasi.. |

::: >>> My Future Career 4

sambungan dari this post...


5th situation..

Doc T : hey N.. read this article (& passed the BMJ magazine to Prof N)
Prof N : hermm.. interesting... a Professor is charged for some ethical issues? certainly NOT ME!
Doc T : how much did it cost him?
Prof N : (keep on reading... then after about 20secs...) he is paying 20,000 pounds for that!
Doc T : only 20k? i got that amount last few weeks from on-calls! he shud be charged more..

damn! he is earning that amount in less than a month?? oh my!!! consultants are the freaking super-rich-insane geniuses!




6th situation..

Doc C : how do we operate this ECG machine so that it prints out something? urgent!!
Doc A : ok cool down. let me read the manual.. do we have time for that? hahahaha..
Prof N : well i believe that sometimes, things can function better with a big heck of smack..!
Doc A : maybe not this time, Prof.. (sambil terus tekun membaca manual book itu)
Doc C : (sigh) i am certainly a lady.. we ladies can do organizing but patience & rationalizing are not ours..

whoopp whoopps!! sungguh tepat kan? perempuan tak la seberapa penyabar sebenarnye.. i do admit the facts tho.. too bad, guys! not THAT bad if u guys plan to marry guys too..

ish ish.. luar tabiee tu nyah.. jangan weh jangan~~!




| moral of the story : alcohol makes you go stupid! |

::: >>> My Future Career 3

sambungan dari this post...

4th situation..


Doc P : we are certain that this problem is due to your drinking habit. so may i know how much do you drink?
Mr H : not much. i dont lie.. really not much.
Doc P : how much is not much?
Mr H : everyday. but why do you want to ask? it is not important. but i live with my mom.
Doc P : ok. so why are you telling me about living with your mom?
Mr H : i dont know. i just live with my mom. i drink with her.
Doc P : i heard that your mom has alcohol problem too, doesnt she?
Mr H : i know, we live together. where am i now?
Doc P : so how much do you drink everyday? 1 bottle? 1 can?
Mr H : my mom... my mom... errr... my mom..
Doc P : it is ok then. we maybe need to talk to your mom a bit later.
Mr H : nuts. who are you? i dont have drinking problem. im just turning yellow!
Doc : that's what we call jaundice. it's ok. you have a rest.
Mr H : you nuts!
Doc P : (senyum je...)
Arieza : (berkata di dalam hati - indeed, doctors are all nuts! yes we are! these nuts help you!)




| moral of the story : alcohol makes you go stupid! |

::: >>> My Future Career 2

sambungan dari this post...


2nd situation..

Doc J : Hi, good afternoon. How are you today?
Mr M : Too bad too bad.. Not feeling well. Everything is out of control.
Doc J : So, tell me more about it? Is your tummy pain getting worse?
Mr M : That day i went to my GP, he said this is nothing serious. But...
Doc J : Hold on hold on.. I wanted to know whether the pain is still there or getting any worse?
Mr M : You should know it! Dont ask me..
Doc J : *sigh... long sigh.....*
after Mr M left...
Doc J : Do I have anything written on my forehead saying 'Do not answer my questions! OR Ignore my questions!'




3rd situation..

Doc J : I have a medical student with me today. Do you mine if she sits in with us?
Mrs K : Well, I normally say no. But I guess today, I am quite alright with that.
Doc J : Are you sure? No pressure, really.
Mrs K : Yeah. I mean it. I normally say no. I usually say no. But it is ok now.
Aku : *blur..... ape kes? ulang benda yg sama byk kali. nk bagi hint suruh aku kuar ke?*




erkk.. macam2 kerenah!~


| kena ke jd saiko time sakit? bawak2 la mengucap.. |

::: >>> My Future Career

1st situation..


doc J : hi Mrs H. how are you feeling today?
mrs H : not too bad. feeling much better & hope to be home by this weekend.
doc J : erm.. actually Mrs H, do you know why we had to scope your bowel last week?
mrs H : nope. no one tell me anything.
doc J : why didnt you ask?
mrs H : well, will it make any difference?
doc J : do you want to know?
mrs H : yes, tell me about it please.
doc J : we suspected that you may have cancer. but at this moment, we couldn't do much about it.
mrs H : owh? that's it?
doc J : are you fine knowing that? i'm sorry i have to tell you so.
mrs H : don't worry dear. i'm fine & will be fine. i accept whatever that's happening in my life. Lord gave it to me because He loves me more. He knows i can handle that. so why must i feel bad?
doc J : you are a strong lady. if you need anything, please give us a shout. we are here.
mrs H : thank you so much for taking care of me. doctors are great humans. they care for strangers. sometimes your own kids never want to wipe your tears away. but doctors, they are too kind..




| will i always know which way the wind blows? |