I want to say something, yet my heart is disheartened. So I'm not going to, because too many people are voicing out the same views, yet it is still unheard by the eardrums of our 'leader'. Currently reading through blogs (too many to list down) and forum (www.mykmu.net) with hubby, updating with the current news, looking for signs of changes.
The only thing that made me smile is the cynical jokes posted, and my little baby. Pray to God to save this country, because there are many who works and pray hard for the love of this nation.
Showing posts with label tragedy. Show all posts
Showing posts with label tragedy. Show all posts
Thursday, March 13, 2008
Tuesday, December 25, 2007
Death
...is INEVITABLE.
That's the most important thing I learned in medical school I think. I've met so many people who ask me, how can I prevent from having... renal failure, hypertension, diabetes, stroke, cancer, etc. And I've also met people who told me, I'm ready to go.
Death is inevitable, either by illness, or by sudden death from other outside sources/forces (e.g motor-vehicle accident). Yes people...we are going to die!!! We can delay those diseases, but I would say, if you've been well (i.e no chronic illnesses) for half a decade of your life, then you should be expecting it soon. You WILL GET IT, sooner or later. You may die of heart attack at age 45 years old, and yes, by standard statistic that is a young age indeed, or you may die of the same cause at the age of 85. And many factors play into that role. Important thing is, don't make it any faster.
'Dying of old age' is a term we used for those who died above 70 y.o, undiagnosed, i.e - no post mortem done, so we assume. If you want to know the real cause, then we send the cadaver for investigation, and from there we'll conclude that he/she have certain organ damage, usually a stroke, or a heart attack. We often see this people die 'peacefully' in their sleep, and I do hope so. And just because we don't know the real cause of death, doesn't mean we have to send everyone to the mortuary to be investigated. There are times when 'conditions' are 'accepted' as death by old age.
This is my third on-call since I moved to Cardiology, and this is my second death I've encountered here during my calls. Here's something I've found while waiting for the mortuary to pick up a patient's body...
Adios...me going back to sleep...
That's the most important thing I learned in medical school I think. I've met so many people who ask me, how can I prevent from having... renal failure, hypertension, diabetes, stroke, cancer, etc. And I've also met people who told me, I'm ready to go.
Death is inevitable, either by illness, or by sudden death from other outside sources/forces (e.g motor-vehicle accident). Yes people...we are going to die!!! We can delay those diseases, but I would say, if you've been well (i.e no chronic illnesses) for half a decade of your life, then you should be expecting it soon. You WILL GET IT, sooner or later. You may die of heart attack at age 45 years old, and yes, by standard statistic that is a young age indeed, or you may die of the same cause at the age of 85. And many factors play into that role. Important thing is, don't make it any faster.
'Dying of old age' is a term we used for those who died above 70 y.o, undiagnosed, i.e - no post mortem done, so we assume. If you want to know the real cause, then we send the cadaver for investigation, and from there we'll conclude that he/she have certain organ damage, usually a stroke, or a heart attack. We often see this people die 'peacefully' in their sleep, and I do hope so. And just because we don't know the real cause of death, doesn't mean we have to send everyone to the mortuary to be investigated. There are times when 'conditions' are 'accepted' as death by old age.
This is my third on-call since I moved to Cardiology, and this is my second death I've encountered here during my calls. Here's something I've found while waiting for the mortuary to pick up a patient's body...
The practice of burying the dead may date back 350,000 years, as evidenced by a 45-foot-deep pit in Atapuerca, Spain, filled with the fossils of 27 hominids of the species Homo heidelbergensis a possible ancestor of Neanderthals and modern humans. Never say die: There are at least 200 euphemisms for death, including "to be in Abraham's bosom," "just add maggots," and "sleep with the Tribbles" (a Star Trek favorite). No American has died of old age since 1951. That was the year the government eliminated that classification on death certificates. The trigger of death, in all cases, is lack of oxygen. Its decline may prompt muscle spasms, or the "agonal phase," from the Greek word agon, or contest. Within three days of death, the enzymes that once digested your dinner begin to eat you. Ruptured cells become food for living bacteria in the gut, which release enough noxious gas to bloat the body and force the eyes to bulge outward. So much for recycling: Burials in America deposit 827,060 gallons of embalming fluid—formaldehyde, methanol, and ethanol—into the soil each year. Cremation pumps dioxins, hydrochloric acid, sulfur dioxide, and carbon dioxide into the air. Alternatively . . . A Swedish company, Promessa, will freeze-dry your body in liquid nitrogen, pulverize it with high-frequency vibrations, and seal the resulting powder in a cornstarch coffin. They claim this "ecological burial" will decompose in 6 to 12 months. Zoroastrians in India leave out the bodies of the dead to be consumed by vultures. The vultures are now dying off after eating cattle carcasses dosed with diclofenac, an anti-inflammatory used to relieve fever in livestock. Queen Victoria insisted on being buried with the bathrobe of her long-dead husband, Prince Albert, and a plaster cast of his hand. If this doesn't work, we're trying in vitro! In Madagascar, families dig up the bones of dead relatives and parade them around the village in a ceremony called famadihana. The remains are then wrapped in a new shroud and reburied. The old shroud is given to a newly married, childless couple to cover the connubial bed. During a railway expansion in Egypt in the 19th century, construction companies unearthed so many mummies that they used them as fuel for locomotives. Well, yeah, there's a slight chance this could backfire: English philosopher Francis Bacon, a founder of the scientific method, died in 1626 of pneumonia after stuffing a chicken with snow to see if cold would preserve it. For organs to form during embryonic development, some cells must commit suicide. Without such programmed cell death, we would all be born with webbed feet, like ducks. Waiting to exhale: In 1907 a Massachusetts doctor conducted an experiment with a specially designed deathbed and reported that the human body lost 21 grams upon dying. This has been widely held as fact ever since. It's not. Buried alive: In 19th-century Europe there was so much anecdotal evidence that living people were mistakenly declared dead that cadavers were laid out in "hospitals for the dead" while attendants awaited signs of putrefaction. Eighty percent of people in the United States die in a hospital. If you can't make it here . . . More people commit suicide in New York City than are murdered. It is estimated that 100 billion people have died since humans began.
Adios...me going back to sleep...
Monday, January 22, 2007
Black Book
I wish for this blog not to be my little black book...stories of my downs and no ups.
But I need to 'pen' this down. I hope I'll forget about it once I throw the thoughts out of my brain. The start...Saturday night, a patient admitted from Accident and Emergency, suspected acute appendicitis, and one of the order for her was KIV op under E (E for emergency).
Sunday morning round, my team wanted to observe the patient first, as the clinical signs is not strong enough to suggest acute appendicitis. So I wrote the orders, KIV op under E, and continue observation. When the round almost over, they asked me to cancel the patient's name under the list. Hmm, if the pt was put KIV under op, why did they list the patient for op? But I did as they ordered. And what do you know, when I got to the list, the nurse told me patient was under GA (general anaesthesia) already. I called the OT, talked to the anaes to stop the op. The surgeon must be angry, and called my team doc. I didn't know what the conversation was between them.
But pt went for appendicectomy eventually. She did have inflammed appendix (the doc told me, lucky me!).
This morning, my doc told me the consultant knew abt the case and the miscommunication (mismanagement?). He asked me what I note down in the notes the day before, and what I did with the list. I told him exactly what happened. He said next time I should write down properly, 'Not for op yet'.
I felt the blame was totally put on me. Stress was mounting today, but life continues. I really feel they are blaming me.
And then, my current team leader told me that I'm probably the next team leader for next month replacing him. Common la, I'm not a good leader. I've already put my name on the 'caution!' list in the Surgical department...today made it twice!
I don't want this extra responsibilities. The medical officers would just laugh if they announce I'm the next team leader, the person who made big mistakes twice in 2 months.
Being a houseman here sucks. 4 months in Obs and gynae, never been able to do forceps, vacuum, mrp, evacuation of POC, DnC and LSCS. It's already a good thing I've voluntered to join their OT. And being 2 months in Surgical, I only watched appendicectomy twice, and a colleague of mine in a district hospital already performed the operation in less than 2 month!
I feel like an attendant with a price in signature. We are here to run errands, take blood, trace notes, trace CT scans, trace folders because it kept missing, sending the patient down for radiological procedures, sometimes because the attendant is missing.
They say the MOs in GHKL would treat the junior MOs from this hospital like House officers. I understand why.
I hope this phase pass. I sure don't have the mood to go to do my 'routine' tomorrow, but we just have to early, 630 am because it's op day.
-----
COMMENT:
AUTHOR: Ahmad Salman
DATE: 01/24/2007 06:12:16 AM
yeah... i know it sumtimes is hard being a leader. u n i have the same lack of leadership skills. but we have to lead one day kan? i always tell myself this. but i dont do much about it. hmmm. that is what really worries me. well, if it makes u any better, u've always lead me, eventhough u dont boss me around like other sisters do. ooop. i drop the 'pin' didn't i. hehe. (nasib baik kak chal n kekman x layan friendster ni)...hehe. i guess i would say that ur leadership would be in ur kindness. that's y u were never meant to be a true leader. look at along. i could imagine problems and considerations he has to evaluate that comes from all sorts of angle. but he clears his mind and focuses on his objectives. sure it doesnt satisfy all parties but what the hell. leaders need to be brute sometimes. i'm learning step by step on how to be like that. focused and determined. and with adik2 yg macam kite ni...eee xtau lah.heee.
well, arriving at my point... u're leadership is in ur kindness. that's y u were never good at LEADING. but u are the best at ADVISING. look at ur friends. they're always going to u to voice their problems as if u had more than 2 ears.
well, next time a problem calls for u to make a decision, clear ur head, be focused on ur goals, and shoot. ofcourse u miss once in a while and of course that is vital when it involves a person's life. but remember that u have considered, and ur inaccuracy was the result of ur inexperience. of which i could say is the span of only five years of trying to understand the whole system of the human body and only months of housemanship. begin with His Name and all will be well. insyallah.
panjang niiiiih!!!! canne canne?(kamil dgn muka risau) bye... ceklat dah habis blum?
-----
COMMENT:
AUTHOR: Ici
DATE: 01/25/2007 02:53:08 AM
smalam mama cakap Kamil pujuk Kak Chal to dokong dia. Dia kata, alalalalala, alalalalala. , dengan mulut comel n pipi tembam dia tu. Hehe. Geram!
-----
But I need to 'pen' this down. I hope I'll forget about it once I throw the thoughts out of my brain. The start...Saturday night, a patient admitted from Accident and Emergency, suspected acute appendicitis, and one of the order for her was KIV op under E (E for emergency).
Sunday morning round, my team wanted to observe the patient first, as the clinical signs is not strong enough to suggest acute appendicitis. So I wrote the orders, KIV op under E, and continue observation. When the round almost over, they asked me to cancel the patient's name under the list. Hmm, if the pt was put KIV under op, why did they list the patient for op? But I did as they ordered. And what do you know, when I got to the list, the nurse told me patient was under GA (general anaesthesia) already. I called the OT, talked to the anaes to stop the op. The surgeon must be angry, and called my team doc. I didn't know what the conversation was between them.
But pt went for appendicectomy eventually. She did have inflammed appendix (the doc told me, lucky me!).
This morning, my doc told me the consultant knew abt the case and the miscommunication (mismanagement?). He asked me what I note down in the notes the day before, and what I did with the list. I told him exactly what happened. He said next time I should write down properly, 'Not for op yet'.
I felt the blame was totally put on me. Stress was mounting today, but life continues. I really feel they are blaming me.
And then, my current team leader told me that I'm probably the next team leader for next month replacing him. Common la, I'm not a good leader. I've already put my name on the 'caution!' list in the Surgical department...today made it twice!
I don't want this extra responsibilities. The medical officers would just laugh if they announce I'm the next team leader, the person who made big mistakes twice in 2 months.
Being a houseman here sucks. 4 months in Obs and gynae, never been able to do forceps, vacuum, mrp, evacuation of POC, DnC and LSCS. It's already a good thing I've voluntered to join their OT. And being 2 months in Surgical, I only watched appendicectomy twice, and a colleague of mine in a district hospital already performed the operation in less than 2 month!
I feel like an attendant with a price in signature. We are here to run errands, take blood, trace notes, trace CT scans, trace folders because it kept missing, sending the patient down for radiological procedures, sometimes because the attendant is missing.
They say the MOs in GHKL would treat the junior MOs from this hospital like House officers. I understand why.
I hope this phase pass. I sure don't have the mood to go to do my 'routine' tomorrow, but we just have to early, 630 am because it's op day.
-----
COMMENT:
AUTHOR: Ahmad Salman
DATE: 01/24/2007 06:12:16 AM
yeah... i know it sumtimes is hard being a leader. u n i have the same lack of leadership skills. but we have to lead one day kan? i always tell myself this. but i dont do much about it. hmmm. that is what really worries me. well, if it makes u any better, u've always lead me, eventhough u dont boss me around like other sisters do. ooop. i drop the 'pin' didn't i. hehe. (nasib baik kak chal n kekman x layan friendster ni)...hehe. i guess i would say that ur leadership would be in ur kindness. that's y u were never meant to be a true leader. look at along. i could imagine problems and considerations he has to evaluate that comes from all sorts of angle. but he clears his mind and focuses on his objectives. sure it doesnt satisfy all parties but what the hell. leaders need to be brute sometimes. i'm learning step by step on how to be like that. focused and determined. and with adik2 yg macam kite ni...eee xtau lah.heee.
well, arriving at my point... u're leadership is in ur kindness. that's y u were never good at LEADING. but u are the best at ADVISING. look at ur friends. they're always going to u to voice their problems as if u had more than 2 ears.
well, next time a problem calls for u to make a decision, clear ur head, be focused on ur goals, and shoot. ofcourse u miss once in a while and of course that is vital when it involves a person's life. but remember that u have considered, and ur inaccuracy was the result of ur inexperience. of which i could say is the span of only five years of trying to understand the whole system of the human body and only months of housemanship. begin with His Name and all will be well. insyallah.
panjang niiiiih!!!! canne canne?(kamil dgn muka risau) bye... ceklat dah habis blum?
-----
COMMENT:
AUTHOR: Ici
DATE: 01/25/2007 02:53:08 AM
smalam mama cakap Kamil pujuk Kak Chal to dokong dia. Dia kata, alalalalala, alalalalala. , dengan mulut comel n pipi tembam dia tu. Hehe. Geram!
-----
Sunday, January 14, 2007
I killed someone
Not deliberately, but I feel that I've contribute a lot to it. So a colleague told me that I shouldn't feel bad because 'she' wouldn't help herself to get better. But it was my fault she didn't recieve two days of IV Pantoprazole. I should have told my lecturer that the Pharmacy wouldn't let deliver the stock to the ward.
If I had given that two days dose, she wouldn't have rebleed. Probably? Mr Y said I may not have been the cause of the rebleed, but I feel that I am. So the OGDScope said that there was no more bleeding after that episode, but she did bleed a lot even for that one day episode of melena. Because of that, she didn't have to go for partial gastrectomy.
But she did have acute renal failure, and then suddenly develop pulmonary oedema. And 1 week later after I got transfered to another surgical team, I found out she had been sent to ICU.
I didn't saw her today. I saw her son. I saw a troly for a dead body came in the ICU this morning, and my heart sunk. I knew it was her. I need to find out tomorrow what she died of. Was it the bleeding duodenal ulcer? The massive pulmonary effusion? That would have been prevented by pleural tap, and we've done that for her already. Or is it the acute renal failure just worsens whatever her underlying condition?
I remember how difficult it was to take her consent...for any type of procedure. We had to console and persuade her for every procedure, and it would take hours. I remember when she came, she said she wouldn't mind dying, she just want to go back. We wanted to do an emergency laparotomy, and when she finally agrees at 6 pm (she was admitted since 10 am), it was a perforated duodenal ulcer. We had to call for relatives who can persuade her again and again. She kept wanting to go back to Kedah. She was only in her 50s.
Is it because she didn't believe in us? Maybe so. Maybe I should have visit by her bed more often even after I change team, but that's the past I can never go back to. Sometimes I go back to her notes, to see her progress, but this last week, I didn't.
I just feel bad about it. The thought was clouding my head even when Rusydan took me the movie to see Eragon, when I'm riding the lrt, and even when looking at Primavera shoes! The worst thing is, I saw the family in the hallway, but I didn't know what to say to them. I didn't even say 'sorry'. Guilt, I guess.
-----
COMMENT:
AUTHOR: Ahmad Salman
DATE: 01/24/2007 05:26:46 AM
dont feel bad for urself ici. u did ur best. even the greatest doctor in the world could not stop death. but this is not the question is it? u're asking urself did u do ur best... well, take it this way. guilt is good to feel the sorrow so that we may live a more meaningful life. luv ya sis.
-----
Subscribe to:
Posts (Atom)
