Exams are coming and like many typical students, I am beginning to put in the hours. Its in times like this I wish I had been more productive earlier. Oh well.....
Last Friday, to protest the relocation of temple to section 23, 50 foolish assholes with nothing better to do paraded with a cows' head and cried for blood at the Selangor state secretariat. If I had been hanging around there, I think my head will be dangling next to the cow's. Scary stuff. ( bear in mind that I am not the type that get's scared easily)
The internet, mainstream and side stream media was flooded with comments of people and politicians on both sides the camp.
The Hindus and non Muslim were understandably upset.
Its interesting to see what the Malays said.
Some Malay Muslims did not mind a temple, some did. Some said Barisan was to blame for this mess, some said PR was to blame. Some said there were ample amount of temples around. Others said to let them be, most of these temples were there when the British came....
But an overwhelming majority of these same people with all the different opinions, political background and walks of life uniformly felt that the demonstrations were stupid, uncalled for and not in the spirit of Ramadan.
I originally wrote a different post on Friday itself tittled 'What's wrong with my country?' There is a saying in Tamil that translates; in every bad thing there is a good thing. After reading all these comments from facebook and many web sites, I do know that we have grown as a nation and there is still plenty of unity among the people despite our differences.
Salam Merdeka and happy Ramadan guys.
Sunday, August 30, 2009
Friday, July 17, 2009
A typical on call
Most of our life revolves around an 'on call'. Its a run -the-mill bread and butter of our lives. Life changing incidents take place during an on call, we are learning new things all the time and it conditions us for all kinds of emergencies and scenarios. Your innermost behaviour will surface during a busy on call; the hardworking solid guy n girl, the dumb ass, the talk-a-lot, the slow inefficient klutz, the uncaring bastard......they all come awake in us.
This was my typical call yesterday:
On arrival-big Nigerian guy with a gigantic slash wound on his back, lying on his stomach. There blood everywhere and he insist he just needs a couple of stitches and he will be on his way. Breath smells of alcohol, not the medical kind. Oh well, GA time! Slap in a a-line, turn him on his stomach and the surgeon gets to work. 4 pints of blood and two hours later, all is well.
Next case, stable patient coming from ICU for washout of his infected laparotomy wound. Simple washout and we are done. Its nearly noon.
SMO Hady and I converge in the team leaders desk to catch our breath and see whats next. In comes in a pregnant woman in labour who ruptured her uterus. Adeline shouts for help. Its a mad scramble to crash in on an operating theatre and we induce in less than 5 mins. Baby's out, surgeons do a good job and tragedy is averted.
Time to do a quick tracheostomy for a patient who is ventilator dependant. I help start the case, the ENT surgeons scrub in and its all left in my partners hands. She too has been having some difficult cases so far but still looks bright and cheer full.
We really need to get some rest but in comes a poor hungry child who has been fasted for some time. She has rhadomysarcoma and needs a CVL for chemo, bone marrow biopsies and lumbar punctures. Not a dying emergency but it needs to be done to expedite treatment, and the child can then break her pre-op fast.
Another couple of hours and the child can eat. I am hungry!
Hady kept himself busy doing a couple of nerve blocks of this nice gentleman who needs his leg to be amputated. He has such a sick heart, its barely beating. Hady and Wong did a good job, blocking the femoral and sciatic nerves. I throw my 50 cents worth by blocking the saphenous nerve!
While waiting for the block to work, we begin an ENT case on a patient with stridor, he had hypopharyngeal cancer and his trachea is stenosed. He can barely breath well and has a bad heart, needing bypass surgery at some point of time. An A-line, intravenous anaesthesia, jet ventilation and we are good to go. The surgeon dilates his trachea and we wake him up well.
I go to get food while Hady and Wong begin a laparotomy, a genltleman had a perforated duodenum after a difficult endoscopic procedure. 4 hours later and all is not well with him, operation done but I had been a bit liberal with fluid and now he's overloaded. Hady settles the problem with some Lasix and he pees buckets!
Next we start 100 kg lady who had ruptured an ovarion cycst. She looks ill and severely septic and my partner and I get get to work. Induction is smooth, the surgeons open up and there is about 200 mls of smelly pus in the abdomen. She is much better post op. And its also early in the morning.
I get a spinal anaesthesia going for a young forklift driver who wrecked his ankle. Nothing to it, pretty straight forward.
The neurosurgery team tells us to get a theatre ready, the have a little baby with head injury coming from Seremban and he needs an operation. I get my little drug book, check the doses, prepare the drugs, organise the theatre, machine, warmers and fluid, have a quick shower, a strong coffee and wait. And wait. And wait. Neuro surgery calls and says they will do him later.........
We just get in bed when the surgeon shouts for help. He's doing a gastroscope, the patient bleed half his total blood volume and needs resusitation. We get our half sleepy asses in the the theatre and begin work. An hour later, the surgeon found the bleeder and injected adrenaline. Patient stable for now. Anaesthetist are in good spirits, its morning and our call is over!
This was my typical call yesterday:
On arrival-big Nigerian guy with a gigantic slash wound on his back, lying on his stomach. There blood everywhere and he insist he just needs a couple of stitches and he will be on his way. Breath smells of alcohol, not the medical kind. Oh well, GA time! Slap in a a-line, turn him on his stomach and the surgeon gets to work. 4 pints of blood and two hours later, all is well.
Next case, stable patient coming from ICU for washout of his infected laparotomy wound. Simple washout and we are done. Its nearly noon.
SMO Hady and I converge in the team leaders desk to catch our breath and see whats next. In comes in a pregnant woman in labour who ruptured her uterus. Adeline shouts for help. Its a mad scramble to crash in on an operating theatre and we induce in less than 5 mins. Baby's out, surgeons do a good job and tragedy is averted.
Time to do a quick tracheostomy for a patient who is ventilator dependant. I help start the case, the ENT surgeons scrub in and its all left in my partners hands. She too has been having some difficult cases so far but still looks bright and cheer full.
We really need to get some rest but in comes a poor hungry child who has been fasted for some time. She has rhadomysarcoma and needs a CVL for chemo, bone marrow biopsies and lumbar punctures. Not a dying emergency but it needs to be done to expedite treatment, and the child can then break her pre-op fast.
Another couple of hours and the child can eat. I am hungry!
Hady kept himself busy doing a couple of nerve blocks of this nice gentleman who needs his leg to be amputated. He has such a sick heart, its barely beating. Hady and Wong did a good job, blocking the femoral and sciatic nerves. I throw my 50 cents worth by blocking the saphenous nerve!
While waiting for the block to work, we begin an ENT case on a patient with stridor, he had hypopharyngeal cancer and his trachea is stenosed. He can barely breath well and has a bad heart, needing bypass surgery at some point of time. An A-line, intravenous anaesthesia, jet ventilation and we are good to go. The surgeon dilates his trachea and we wake him up well.
I go to get food while Hady and Wong begin a laparotomy, a genltleman had a perforated duodenum after a difficult endoscopic procedure. 4 hours later and all is not well with him, operation done but I had been a bit liberal with fluid and now he's overloaded. Hady settles the problem with some Lasix and he pees buckets!
Next we start 100 kg lady who had ruptured an ovarion cycst. She looks ill and severely septic and my partner and I get get to work. Induction is smooth, the surgeons open up and there is about 200 mls of smelly pus in the abdomen. She is much better post op. And its also early in the morning.
I get a spinal anaesthesia going for a young forklift driver who wrecked his ankle. Nothing to it, pretty straight forward.
The neurosurgery team tells us to get a theatre ready, the have a little baby with head injury coming from Seremban and he needs an operation. I get my little drug book, check the doses, prepare the drugs, organise the theatre, machine, warmers and fluid, have a quick shower, a strong coffee and wait. And wait. And wait. Neuro surgery calls and says they will do him later.........
We just get in bed when the surgeon shouts for help. He's doing a gastroscope, the patient bleed half his total blood volume and needs resusitation. We get our half sleepy asses in the the theatre and begin work. An hour later, the surgeon found the bleeder and injected adrenaline. Patient stable for now. Anaesthetist are in good spirits, its morning and our call is over!
Saturday, June 20, 2009
the big one is nearing
exams are coming soon and its really spoiling my happiness. the workload is horrendous and tiring, and now things are a bit more complicated with family and all.
anyways, just sort of servicing the blog. will write more next time aroung
anyways, just sort of servicing the blog. will write more next time aroung
Tuesday, May 26, 2009
Shukor Adnan
Our family driver who has been with us for sixteen good years died suddenly today. He arrived through an uncle's recommendation sixteen years ago for rural Kelantan and become proficient in his job.
He was loyal, hardworking and extremely dedicated to his job. He hardly seemed to tire despite my dad's hectic schedule and played a large role in our family. Work certainly wasn't easy but he stuck through it thick and thin.
He displayed the characteristic honesty and sincerity Malays are known for. He saw me through most of my secondary education, marriage and became friends with my two boys. He was with my family before my youngest brother was born and watched him grow.
His large family migrated to Kuala Lumpur and he did a good job as a family provider. He also recently became a grandfather.
He saw my dad through 4 general elections and was no doubt a big help to him.
As expected, there was sadness and tears all around.
May he rest in peace.
26-5-2009
He was loyal, hardworking and extremely dedicated to his job. He hardly seemed to tire despite my dad's hectic schedule and played a large role in our family. Work certainly wasn't easy but he stuck through it thick and thin.
He displayed the characteristic honesty and sincerity Malays are known for. He saw me through most of my secondary education, marriage and became friends with my two boys. He was with my family before my youngest brother was born and watched him grow.
His large family migrated to Kuala Lumpur and he did a good job as a family provider. He also recently became a grandfather.
He saw my dad through 4 general elections and was no doubt a big help to him.
As expected, there was sadness and tears all around.
May he rest in peace.
26-5-2009
Friday, May 8, 2009
Back again
The whole month passed in a blur, we we nearly as busy as I used to be i HKL. The department was chronically short wit many candidates going for exams, there was the pressure of doing a short charged rooster and tempers did fly more than once. 8 calls, plus occasionaly coming back on your off day saw the month through fast.
Hopefully this month is a bit easy.
I am also starting to feel exam stress and wondering if I can make it through the big one in november. Time will tell.
I do seem to be spending more time with my elder son shastri. He is growing bigger and stronger by the day and more and more defiant when he gets upset. From time to time, he does need a firm hand which only a dad can possess. I am also learning that as a dad, you need to earn respect and lead by example. The baby Arditya is starting to grow. He is much healthier now and really loves me. I just wish I had more time for him.
Hopefully this month is a bit easy.
I am also starting to feel exam stress and wondering if I can make it through the big one in november. Time will tell.
I do seem to be spending more time with my elder son shastri. He is growing bigger and stronger by the day and more and more defiant when he gets upset. From time to time, he does need a firm hand which only a dad can possess. I am also learning that as a dad, you need to earn respect and lead by example. The baby Arditya is starting to grow. He is much healthier now and really loves me. I just wish I had more time for him.
Wednesday, April 1, 2009
The end of obs
I just finished my two months of being an amature obstetrics anaesthetist. Other than the sad maternal death, it was fun and gratifying.
I inserted more than 30 labour epidural. Being a person who always seeks instant gratification, a working epidural is highly rewarding, both for me and the patient. I may have inserted for more epidurals in my old place(close to 70 in the same duration), but I actually learned more here. I could hang around each patient longer, troubleshoot and actually ensure better patient satisfaction. I visited my patients through their labour and made adjustments in my epidural drugs. Talking to them through the process and telling them what i am doing seemed to helped.
I had my share of screw-ups which contributed to the learning curve!
Of course there was more to the posting than epidurals but to write about everything will fill many-many pages. I guess there are always two attitudes we can have when we are doing the same stuff; been there, done that or lets see what i can learn/re-learn.
I inserted more than 30 labour epidural. Being a person who always seeks instant gratification, a working epidural is highly rewarding, both for me and the patient. I may have inserted for more epidurals in my old place(close to 70 in the same duration), but I actually learned more here. I could hang around each patient longer, troubleshoot and actually ensure better patient satisfaction. I visited my patients through their labour and made adjustments in my epidural drugs. Talking to them through the process and telling them what i am doing seemed to helped.
I had my share of screw-ups which contributed to the learning curve!
Of course there was more to the posting than epidurals but to write about everything will fill many-many pages. I guess there are always two attitudes we can have when we are doing the same stuff; been there, done that or lets see what i can learn/re-learn.
Sunday, March 22, 2009
The most efficent army
During a hiking trip(another story) I was talking to my friend, a Burmese, about the conditions back home. I am always interested in the lives of people in other countries and I like to ask basic and silly questions like "do you guys have traffic lights" or "what do you eat for breakfast".
During the course of our conversation, I discovered that the whole country is run by the military. They have their own cabinet, their own departments and their own state run companies. The burmese army is multi-talented.
They can control agriculture, telecommunications, the banking system, the health and education system and about everything else in the country.
They can also deal with naughty people well. Trials don't run for ages-ages like they do in many countries. Almost all trials are short and sweet, almost like formalities.
The army is running the country on its own and it must be an uphill task,since they are facing economic sanctions. Their health care system is not bad, basic but providing pretty much all the medical needs of the population. There are many well trained burmese doctors working in our country and they can attest to that.
They had one major problem in 1990, when they lost the elections. They dealt with the problem in a novel and original way, they didn't hand over power and the head of the coalition that won is still under house arrest.
I just wonder whether all in the ruling party are of one mind, or do they have their own internal power struggles and strife's? Who inherits the position of the head of state and how is the selection process?
We are an open democratic country. But do we have our pride intact? We and pretty much
every other small nation have to face human rights accusations from the mighty and oh-so morally superior US. They got very angry when one of our politicians was subjected to a police investigations.
We so very spoilt and dependant on their buying power to keep us comfortable. I am not saying and over authoritative government is good, but sometimes I think our government lacks a strong backbone.
Soft parents breed rude spoilt children.
During the course of our conversation, I discovered that the whole country is run by the military. They have their own cabinet, their own departments and their own state run companies. The burmese army is multi-talented.
They can control agriculture, telecommunications, the banking system, the health and education system and about everything else in the country.
They can also deal with naughty people well. Trials don't run for ages-ages like they do in many countries. Almost all trials are short and sweet, almost like formalities.
The army is running the country on its own and it must be an uphill task,since they are facing economic sanctions. Their health care system is not bad, basic but providing pretty much all the medical needs of the population. There are many well trained burmese doctors working in our country and they can attest to that.
They had one major problem in 1990, when they lost the elections. They dealt with the problem in a novel and original way, they didn't hand over power and the head of the coalition that won is still under house arrest.
I just wonder whether all in the ruling party are of one mind, or do they have their own internal power struggles and strife's? Who inherits the position of the head of state and how is the selection process?
We are an open democratic country. But do we have our pride intact? We and pretty much
every other small nation have to face human rights accusations from the mighty and oh-so morally superior US. They got very angry when one of our politicians was subjected to a police investigations.
We so very spoilt and dependant on their buying power to keep us comfortable. I am not saying and over authoritative government is good, but sometimes I think our government lacks a strong backbone.
Soft parents breed rude spoilt children.
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