Thursday, November 7, 2013

On Societal Excrement and Tertiary Educated Toilet Paper


Yieha !! I'm back !

After several months of writer's block, a period of social life stagnation, weeks of longing for home and a heart break, I am back. Yay for you ! Yay for me ! *applause PRN*

For those who have forgotten, I am a medical intern at the present time- 11 weeks of assorted rotations away from becoming a resident medical officer (whatever that means- the thought of needing to go back to med school bugs me more these days than it ever has).

I have survived 11 weeks of the emergency department- full of patients emerging from the cracks on the streets and of life. Work in an Australian ED, you'll understand what I mean- hey you intern! Pick up after these societal excrement and make them fragrant again ! Fix their problems ! I don't care if its a vague pain present for 10 years now- I want it fixed tonight ! I don't care if its a morose old migrant woman not getting any attention from her family members save her crippled old dog, I want you to understand what she's saying, and fix her abandonment tonight ! I want all these patients to be transferred to a non existent ephemeral ward bed within 4 hours of them presenting to this packed emergency department. I don't care if you haven't sat down to gather your thoughts, or had anything down your throat other than airborne microbes from your patients, work ! work ! work ! (ok this is unfair to my bosses- they were very very kind- despite their kindness- it was really stressful. Again, my bosses were really nice and helpful- heheh)

 "I donno, maybe you can teach me deep breathing techniques" said my shaking, sweating, agitated young male patient, who appears like he stuffs boulders under his skin in his free time and probably has no functioning gonads- hours after taking Ice and coccaine; and possibly years after injecting steroids. Hell was in my heart that night. *flushes down M&Ms with lemon pop*

It reminds me of this case of severe epigastric abdominal pain- complete with the pale face, sweating, tummy clenching, rolling around middle aged migrant male who is married to a GP. Enough to make one with experience as abundant (no) as myself rush to his boss- "this guy has an acute abdomen ! ". To which my boss- also my supervisor replied "right....~hold on...you're a doctor now, tell me your differentials"- to which my panicked self  was unable to answer fluently. Which is bad news for yourself- all non english speaking background, all flustered, with hair all over the place and possibly cracked lips from not having had anything to drink all day- the appearance, both of your panicked self and your panicked presentation- not great for your supervisor to remember you by.

My boss then went around- pressed around his tummy (with the patient just saying "ouch" all the time- and then saying it's not painful where he was being palpated- it was an ouch for his general pain) and the patient, all frustrated that he was being poked around and wanting to be seen "soon ! this may be appendicitis..right?" just said yes "it hurts there" when he was palpated in the right iliac fossa (which he didn't mention before- i suspect his wife has been educating him while I was away- curses! ).

My boss then called the surgeon and told him that this patient has appendicitis. Patient sold !

Severe epigastric colicky pain with tenderness on palpation in the right iliac fossa - diagnosis ?

If you answered appendicitis- congratulations ! You are fit to become an emergency physician !

If you answered - "i don't think this is appendicitis- sorry" then you are like me when the surgeon asked me "do you think this is an appendicitis ? Seriously? "

I saw on facebook today an ode by our much beloved modern age Malay Prima Donna- Siti Nurhaliza to another much admired Malaysian character Tok Guru Nik Aziz. A man well worth the praise and adoration of Malaysians- well known for his iron grip on principles and honesty- a gem amongst rocks.

It reminds me of a critique made by a Malaysian historical and cultural pundit- Farish A Noor on the Malaysian society; how we long to cling on to our ancestral practices of feudalism and dependence on demigods and kings and heroes to make life better for ourselves. A hero bringing salvation and answers to our plight. A hero to carry the burden of our sloth, our ignorance, our apathy, our impulsivities- a hero to be perfect; who will carry us across our oceans- as Moses did for the Israelites.

We make up our people- our rotten society is a reflection of our individual traits. Sure, that's a blanket claim- but isn't it true? Our societal negativities are all our apathy, recklessness, narcissism, pride - jumbled into one big mess. Fixing it must be by the hero of our collective narrative- our own selves.  

Dig out our principles- hold on to them, spread it to others. Practice it in life- God knows our society craves for some diamond age old principles.

I guess it's no wonder that it felt good when I told the surgeon what I thought (or didn't think) the problem was - how I wanted to say to my boss

I'd love to help myself and the ED out- and get this patient seen by the surgeon with a good and firm diagnosis within 3 hours of his presentation to ED- ridiculous the diagnosis may be.

But please let me keep for myself some integrity.

Yours sincerely
Azfar

p.s.: So how is my story related to all these ED presentations, my steroid laden patient, my boss, Siti's song and Nik Aziz ?

p.p.s: I wanted to say that, but of course I didn't say it- I'm not your hero.

Tuesday, October 15, 2013

Not Bullet Proof After All

Its ironic
The time taken to decide a matter of 2 years, in just 2 nights
After the second conversation

Its ironic
A call to end began with a question of how to move forward

Its ironic
The diary entry saying everything changes today, I now know what to do

Its ironic
The one secret fear I shared you made true

Its ironic
That day I was reading lots of stories about optimism and great reliance on God; about His decisions and fate as we know it. I  kept myself solid, I knew nothing could faze me. I thought I knew how to feel. I was wrong.

Maybe it is true, I'm not ready.
My services to my family
My own prayers
My own thinking
May own thoughts

Wake up buddy !

You're not bullet proof after all.




Thursday, May 9, 2013

A Letter from A Youth Without Heart



To the most honorable Ustaz Hassan al-Banna

Assalamualaikum warahmatullahi wabarakatooh

Have you ever heard of the man with a dead heart? Nay, if the heart mentioned here is one of the organs of the body made of red flesh, which withdraws and ejects blood, he would certainly have it. This heart that enables him to live and continue living. But unfortunately, the heart that contains his passion, strength and livelihood,  is absent.      

He knows good as small it may be, he knows evil even if elusive. And oft he truly feels and comprehends a person from their faces and would respond appropriately as such. But he doesn’t have a heart.

Meeting an old friend after a long time, he would grasp his friend's hand ever so tightly, indeed, he would even hug him. But his heart remains frozen, unmoved. He advises others; "be, you, this and that" and mentions various propositions and evidences for his advice, yet his heart further hardens and remains unswayed.

He smiles to good news. He wrinkles his forehead at bad news. Yet his happiness and sadness are only his reflexes, while his heart stays silenced and unwavering. He states love and hatred towards  people. Yet looking at his heart, it remains quiet without words.

He stands up for prayers, giving it his all, reads the Quran and tries hard to concentrate. He reads the verses of his prayers such that people would say "He is definitely concentrating". Yet, feeling his heart, he finds it deaf and unfocused, even when he understands everything that he reads.

This is the picture of this man's heart. I have not added or omitted anything from it. Would you suggest that his heart is similar to the usual hearts of others?  

I am given a mind, but my heart is defunct. I can feel my mind thinking, working, living and making its presence known. But when I try to feel all that in my heart, I can never find a way to.

Know that, now, in this moment, you have heard about the man without a heart.

He has made a pact with you and you have taken an oath of allegiance from him. Would you stand to have a soldier of yours living without a heart?  Can you help him reignite his heart so that it will again be able to be moved and feel what his tongue says? This is a disease in one of your soldiers, that would sadden you upon knowing it. Thus I shall not name him till I can tell you that he is cured.



Waalaikumussalam

In reply to the youth without heart

Waalaikumussalam warahmatullahi wabarakatooh

I have read your correspondence and am deeply affected by the sincerity of your language, the beauty of your courage, the finesse  of your conscience and the livelihood of your heart.

My brother, you are not of those whose heart is dead as you may think. But you are a youth whose intuition is keen,  spirit pure and soul tender. If not so, you would have definitely denied your feelings. But the magnitude of your  enthusiasm and your goals (purpose of life) have made you perceive the big matters in your life as small and you feel the need for supplementation in regards to them.  There are no problems in that, it is how it is meant to be.  

I feel what you feel, I walk as you walk *(I think it means, "I hear you" and I can see where youre coming from) and I will try to give you some advice. If, these advice benefit you and by obeying them your thirst is quenched and your illness cured, then all praise is to Allah/Alhamdulillah for His Guidance. But if it fails to do so, I would be happy to meet with you so we can together work to recognize this disease of yours and find a cure to it.

 To make companionship with the khushu'/solemn/focused, who are always in deep thought, to mingle with those who always contemplate in solitude, to be close to those  that are righteous/ God conscious and pious, whose from faces rays shine and from hearts you will gain more makrifah/knowledge of God/intuition about God- and these are few- is a good remedy. Make effort to be friends with these people,  to always be in their company, make them a point of return and connect your soul to theirs, connect your spirit to their spirit and spend most of your free time with them. Be wary of those who are pretentious. Find people who lift your spirit, whose actions lead you to do good deeds and upon seeing them you will remember Allah. Befriending these people would be a potent cure, because the nature of man is that they constantly steal, and so a heart is affected by another heart, and a soul  takes example from another soul. Hence, try to find these good souls for your companionship.

My brother,
Contemplating, dzikr (glorifying God) during blessed moments, supplicating while observing the beauty and magnificence of nature, uncovering the secrets of the charm and grandeur of the universe, to scrutinize with the heart and dzikr/glorifying God verbally about these astonishing signs of majesty and this august brilliance, are one of the things that gives life to the heart and shines it with faith and confidence. Allah swt decreed;

Indeed, in the creation of the heavens and the earth and the alternation of the night and the day are signs for those of understanding. (Ali- Imran: 190)

My brother,

Subsequently, thinking about society, witnessing misery, happiness, plight and peace, visiting the ill, comforting/cheering up those whom misfortune had befallen and knowing that the sources of misery takes the forms of anarchy, disbelief/denial of the truth,  cruelty, disobedience, self centeredness/narcissism, egoism, being beguiled with the trivial; all these are the strings acting on the heart that will reunite its shattered pieces and resurrect it from its demise.
Hence, strive so that your presence brings cheer to those who are sad and affected by misfortune. Nothing is more potent for your heart other than doing good for those in need, helping those who are victimized, or sharing feelings with those in plight or in sadness.

My brother,

The heart is in God's Hands. He flips it by His will. For that, be zealous in your prayers so that He gives life to your heart, expands your chest with faith and showers you with confidence as rewards and bounties from Him. Say your prayers in propitious moments and during suhoor as prayes during suhoor is like an unstoppable arrow flying towards the Arasy.
I do not doubt your sincerity in achieving your purpose and the honesty of your confession. Allah swt decreed

"Indeed, Allah only accepts from the righteous [who fear Him]." (Al-Maidah: 27)

Your brother,
Hassan Al Banna

Dear readers, I have promised you this a long time ago. But things came and occupied my head, this got thrown to the back of the pile. 

For those who are wondering what this is about, you may refer to the blog post:

Well...truth be told, no one actually responded to the contest ! Surprise !!! Not really...~ I'm not entirely sure why, possibly because no one would bother that much about this....~ 

Oh well ! by the time I posted the competition up, I actually have come up with the translation myself. Later, I asked a friend to look at it and give me feedback, but he seemed to have looked at it using his bum...and sat on it for...forever.

So here it is !!!! For your reading pleasure. Please send me corrections/ comments as you feel appropriate.

Friday, March 1, 2013

On The Second Cannula That Nearly Made Me Cry



It must have been three or four months since my last entry on this blog. For those who have been anticipating my writing for the duration, I apologize for two things; firstly for the silence, the presence of which has always scared me for I've always feared the unknown. Secondly for the upcoming silences that I predict will happen over this next year as I ease myself into this new and exciting part of my life.

Given the chance, spirit, time, and a swanky new keyboard, I would love nothing more than to type my experiences away for a shameless expose' of my life over the past few months. The current circumstances though, dictate otherwise. Most nights I get too tired to open my eyes after the clock strikes ten and my fingers crave nothing more than just a handful of blanket while my mind whirled into sweet respite, trying to forget the expectations of tomorrow and the mistakes of today.

I am not by any means trying to relay spite or hatred towards my occupation, in fact, I love it ! Yes, I get to do nothing more than secretary work day in and day out, answering to superiors about things I cannot and could never control, things I don’t fully understand about; but I find the successful difficult cannulas, the prescribing of aperients to constipated patients to good effect, explaining situations to people about themselves and families in ways that make them feel calmer and safer, and supporting fellow interns on days when things get just too much; absolutely joyful.

And during these thirty days that I have started working; there have been days when things go smoothly, expectedly, and unexpectedly  so. And these days make me feel grateful. On the other end though, there have been days when shit happens, expectedly and unexpectedly, and so much so; I felt that I was just barely keeping my head above the water.

This short period of time has also shown me so much in practicality about the ethical issues that were discussed in Uni.

Don’t get emotionally involved with patients. That is what they have always taught us. And this self has always been reluctant to follow this order, as wise it may be, as easy or logical it is, as he sees the unforgivable  flaw of being objective when dealing with human beings.

However I got a smack in my guts and a cut in my heart only the other day for my stance; when a patient of ours developed a surgical wound infection after waiting so long for the operation, after countless stabs and tests. I felt I was responsible for her, and as I tried to put a cannula in for the intravenous antibiotics; and failed the first time, and as I saw her expressionless face, cursed by this thing called Parkinson's disease, wince in pain, and those eyes shed tears for all the pain she has been through, being so old and fragile; I just nearly lost it. With a face full of regret, absolutely inappropriate for a doctor, I told her I needed to put another cannula in. And she replied with  a reluctant "fair enough..if it needs to be done..."

The second cannula went in quite easily (it was unusable the day after though) and I nearly laughed at myself for being so emotional about a cannula. Admittedly, it was a tough day that day, I was on the edge, anything could have pushed me over.

This kind of just reminded me of a bad habit that I have. It is the wanting and the feeling that I need to cater to other peoples' problems and emotional burdens. That I have this divinely appointed task of having to keep people happy, and if they don’t feel so, it is my fault. This must be a weird complex. And I am sure many people experience the same thing as I do; and to myself first and these people second, I give this advice.

It is not your responsibility to carry other people's emotional burdens.

You can try to do your best and treat others well, but know that you can try only so hard; in the end, those people are responsible for their emotional burdens. They are responsible for themselves. You can try to solve their problems, but you must not take responsibility of having to carry their emotional burdens.

For each their own tribulations; God tries those whom He  loves.

Aaand...On a happier note, I am buying myself things after things as a treat for my hardworking days at the hospital. Nizam did remind me to rewards myself, haha…because otherwise I won't be able to keep it up. Well, not that I mind spending my hard earned money on stuff for myself…seriously…not at all, I am going to buy a new tablet computer and a desktop.. but..give me a choice, the hospital is, at this point in time; still the place I want to work at.

I have no regrets. =)

Surgical intern (where is Isobel (reference to Grays Anatomy)???),
Azfar