Captain Obvious

Met Akram in the lift yesterday. He was with his Paed buddies. We were in the same PTM group and did our Surgery posting together. I was excited when I saw him so we chatted like normal.

He then turned to his friends and said "Ni anak Dr. Hanifah."

"Camtu kau perkenalkan aku?" I glared him. Cmon I deserve my own introduction.

"Nama dia Atiqah." He added as an afterthought.

My glaring continued. What the hell is this guy. But then I chatted away telling him I was postcall, only got to prepare my slides at 11am to present at 12pm.

"Dengue hypotensive tengah malam, tak ke sakit hati? Bye Akram!"

---

Walked pass my MO just after 9 that morning. I grinned at him and told him I was postcall! before he can make any comment that I was MIA.

"Tengok muka pun tahu," Dr. Afnan grinned back. Boss please don't be so obvious.

---

Speaking of Dr. Afnan reminds me of HDW and that I haven't seen Dr. Fazirah in a long time. I remember one of the last cases I last saw with her and she drilled into me how we need to explain procedures to patients without scaring them off.

"Minggu lepas ada houseman dekat Mahsuri kata nak tebuk perut makcik saya masa nak explain pasal PD. Terus makcik saya tak nak. Atiqah, cuba explain kepada saya macam saya ni pesakit. Camne awak nak explain PD pada saya?"

"PD? Okay. Sekarang ni, fungsi buah pinggang pakcik tak lawa dan kita kena cuci darah sekarang. Pakcik- eh makcik."

Dr. Fazirah burst out laughing and Dr. Afnan doubled over in laughter. Hahahaha bengong la AtiqOh panggil specialist makcik.

#blownails

I think I never wrote this down, but I stopped calling Luqman my MO/jiran Dr. Luqman ever since my sister-in-law told me he asked about me during her earlier days in Surgery and he was then referring to me as "Ika".

I have no idea how he grapsed that name and he never call me that in first person but only family calls me Ika. And prior to that, he called me "sis" when I PMed him.

AtiqOh: amassing bros since 2008.

News! I am not hyperthyroid

Minggu ni saya kerja di General Ward tapi dipinjamkan ke klinik untuk dua hari ni. I took blood for the first hour and since my colleague was testing whether her ID can now do Advance Order, I asked her to test out on me. Been itching to understand how does it really feel when we take patient's blood and to rule out my persistent tachycardia on the job (never got below 105 pulse rate haha), so I asked her to run a thyroid function test on me. (0.9 btw, normal)

It stung when she pricked me and stung all the time she was drawing blood. It really does felt like some angry ant bit me. I turned away the whole time groaning pitifully. It even stings as I am writing right now. Yeah yeah big sissy, shut up. And she was drawing too much blood that she had to threw away 0.5cc remaining into the bin! I threw a fuss and she laughed at me saying it was smooth drawing out the blood that she unconsciously drew out more than she needed. What the hell houseman nowadays. Haha.

Afterwards I went to see patients. I get to see about five patients guided by Dr. Saiful and Dr. Hayati our consultant, yeah slow. Dr. Saiful gave me the eye "Saya tengok dua dah patient, awak baru satu."

Habis klinik, makan, balik wad Medical. Dalam lif bertembung Luqman yang nak tengok referral di Wad Gynae, maka dia heret saya sekali. Burst abdomen day 10 post ELSCS. I examined the patient, he finished up his clerking.

L: Tiqs, tolong endorse Cefobid Flagyl.
Me prescribing: IV Flagyl 500mg stat and TDS, IV Cefobid 1gm stat and hmm BD kan? I think BD. BD right?
L: I'm disappointed in you. Kata minat Surgery. Dah lupa?

Me dalam hati "bro just tell me the frequency already" sambil bukak Blue Book where people go when they lupa things about drugs. Yup, BD. And I'm a Medical HO why am I doing Surgical round at a Gynae ward? One HO colleague saw me and gave me a perplexed look.

"Tiqah kau Medical kan?"
"Ye aku Medical."
Luqman laughed.

I kept glaring at Luqman though. He stunk of cigs. I can smell it with every word he said. After a while I commented with a sideway glare "You smoke on the job."

He said nothing. He used to smell better actually, I wonder if he changed brand. But that's unlikely. Maybe I was standing too close. Pofin once asked me if I hate dudes who smoke. I don't usually like smokers but there are people I like who smoke, L here is a clear example.

L, Elle? Haha hai Kak Junaidah.

I should keep gums in my pocket for the next time I see him.

Feeling Hb 10

So tired. First meal of the day was after I called my dad to pick me up. I got home and sprawled dead on the couch. Mom called for dinner but I only answered I was too tired.

Dad later commented I should take my shower and sit up, be more active. I told him I was tired. He told me tired is part of life, I should fight my tiredness and go take a shower and whatnot.

I got up to go to my room because I felt pestered, muttering can you not say weird things. Then I went to shower, put on a face mask, gulped two Baraka pills and drank 250cc off my work water bottle.

Bye Nephro Ward

The other day I told my colleagues I enjoyed my Surgical posting and that I am still chummy with my Surgical bosses. Yati said "untung laa".

"MO Surgery friendly je kan."

"Diorang baik dengan kau sebab kau anak bos."

That stings. "I like to think it's because aku budak baik and readily do favours."

"Tak, sebab kau anak bos."

I like Yati. She really slaps me with reality. But if you keep saying that I'll be left with no friends, haha. And hey I'm likeable as I am, right?

That makes two of us Nedi

I was postcall waiting for my patient to finish his business in the WC to prick him for his coming morning blood. Nedi was reviewing her patient, so I sprawled tired on the chair and told her about my day and what Kak Ann told me.

Nedi: Haha sape bagitahu semua orang?
Me: No idea. (Though Luqman seems like a likely candidate)
Nedi: Mesti boyfriend kau.
Me: I have a boyfriend?
Nedi: **** la.

It's always fun whenever I see Nedi. She's under the impression that **** likes me and I told her once "Oh yeke? Aku tak tahu pun. Aku nak tanya dia sendiri la." To which Nasriq maturedly told her not to taunt this kid into asking people revolting questions hahaha.

Me: Hahaha kat mane dia sekarang? Aku tahu dia Kuching tapi tak tahu department mane.
Nedi: How should I know, I don't keep in touch with him.
Me: Me neither.
Nedi: Dia kan boyfriend kau.
Me: Aku tak sedar pun. (Turned to stare at the wall thoughtfully while sprawling lazily) So this is what it's like to have a boyfriend. Not aware of each other. (Turned back at her) So what's up Nedi?
Nedi with a grin: Still single.

There goes my chance of quitting. I think I'm trapped.

Dr. Ann and Dr. Ezzati came to ward to review one patient to post for surgical Tenckhoff.

Dr. Ann: Awak kan yang nak amik MRCS?
Me: Yes, plan September ni. Camne Kak Ann tahu?
Dr. Ann: Satu department tahu.
Me: My God camne satu department tahu?
Dr. Ann: Antenna kitorang kuat.

Next posting I am in Ortho

This week I am posted at Ward 6 which is under Nephrology but today lucky me I'm AM at one of my favourite wards Ward 9 (fave due to the friendly nurses). When I came to work today I was given heads up of one new case dengue admitted at 2am. The patient is one of our specialists in HRPZ.

I entered Room 4 and as I reviewed patient A and B, I wondered how should I deal with patient C. But then I acknowledge that I have been treating all my patients with respect, so specialist or not specialist, I should just act the same with patient C. And so I did.

"Assalamualaikum Dr. CW. Saya Atiqah. Apa khabar hari ni?"

Well with other patients I introduced myself as Dr. Atiqah though. Haha.

But do I want to?

"Atiqah awak dah kahwin?" My MO asked me suddenly while sitting in his chair, looking at his phone.

"Belum."

"Kenapa belum?"

"Hmm." I stared at the patient I was reviewing. "Saya pun tak tahu."

Actually, I know. If you see my life nowadays, you will doubt that I am fit to marry anyone. I wake up on my own but refuse to get up until my parents call for me. I shower, pray, get ready, eat whatever mom prepares for me then sleepily wear my socks in the car and shut my eyes as dad drives me to work. Then I punch in and start my day. For lunch I will have whatever mom packs for me.

My parents pick me up and I will tell them about my day. I get home, find the will to go for a ride but most of the time overthinking the routes and decide not to. After Maghrib I will be lifeless on the couch thinking of studying and those sort of things and retire in early.

And the next day comes. Life outside work isn't very productive. For example, yesterday I took a leave for the sake of it but went to the hospital anyway. Dr. Afnan and Aizat said I was dedicated, kept making references to my "level of dedication" when really, I was just too bored alone at home and have no one to make plans with. I haven't read a proper book in a long while.

I have to change myself before I invite anyone in. There is no guarantee I will change after I meet him.

Good Kids Don't Lie

Sunday I had round with Dr. Fazirah.

Monday I was postcall and as per previous post, covered the cubicle and got blasted by Dr. Mat.

Tuesday Dr. Fazirah did her rounds in the PM with Dr. Afnan because I was having my viva.

Wednesday today, Dr. Mat came and did his round at my cubicle. Dr. Fazirah came a bit later and obviously she wanted to dibs the first cubicle but Dr. Mat totally ignored her. So she settled for cubicle 3 and 4.

I wanted to cry. Hahaha...

Anyway. Dr. Mat is a good specialist because he teaches and expect high expectations from us. He doesn't sugar coat or be cynical. He serves the reality as it is. I am grateful that I'm learning from following his rounds but I won't push my luck so much because I'm not denying it hurts. And I was rendered speechless.

I miss Dr. Fazirah. Tomorrow Thursday I am on a two-day leave for the sake of it, so I won't be having rounds anymore unless next week I am still in HDW. The nurses in my cubicle obviously noticed I was having a hard time and SN Syazwan somewhat consoled me. But really I just want to cry, study and get over it.

I should have answered him "I'll get it done" instead of a simple "okay". But I don't want to be seen as cocky, and he doesn't look like a person who cares what you plan, more like what you execute.

Later I picked out that Dr. Afnan was highlighting his positive points.

"Dr. Mat anti kalau orang tak pernah buat pleural tap."

"Other people might lie, but I can't do that. Saya akan mengaku je saya tak pernah. Dulu pun kena dengan Dr. Asiah sebab camni jugak."

"Good. Baguslah."

I'm a good kid, I will cover for a colleague but I won't ever lie to save myself. And tomorrow despite on leave, that pleural tap is going to be done successfully by me, Allahumma ameen.

Esok viva dengan Dr. Hasnul, study la budak please

This post is a reminder that I screw up but I'm not totally dumb too.

Today postcall. Semalam ganas gile oncall. 3 CPR, all died. Sakit belakang tak habis lagi dah CPR next patient. Dengan tengah malam patient desaturated lagi.

Paginya, new case masuk. Patient on nasal prong and low dose Norad. Pergi dekat dia nak clerk sekali patient restless, cabut line dia. Desat. GCS drop to 8/15.

Aizat jaga my cubical harini. Immediately we put on HFM, tiga orang cari line serentak sebab susah la tangan patient tu. Aku tak dapat cubital so terus attempt femoral. Dapat pulse, terus amik ABG and run.

Severe decompensated metabolic acidosis, bicarb 8. Kena intubate ni.

Lari balik kat geng. Dr. Afnan tengah review kes dengan Aizat. I inserted grey dekat femoral and that was used to run his Norad and one pint gella.

Pastu another patient kena accompany pergi CT. Aizat tanya aku nak gi ke kalau tak dia la. Aku postcall kan, tapi wad tak cukup HO ni. Aku pun accompany patient lagipun aku dah tahu kes.

Uneventful. Naik balik wad diorang tengah intubate pakcik tadi. Aku tolong refer Anaes for ventilatory support.

"Salam Dr. Arif. Saya Atiqah HO Medical dari Temenggong, nak refer Anaes for ventilatory support."

"Slow-slow. Patient dah intubate?"

"Dah."

"MO dah sampai?"

"Dah."

"So no rush. Takyah laju sangat. Saya tak dengar awak cakap ape."

"Okeyy. Saya Atiqah, HO Medical-"

"Dik laju la."

"Alaa saya memang dah slow down dah niiii. Okay semula."

Dr. Arif saje troll aku pagi-pagi ke ape. Aku tahu memang aku cakap laju tapi serius la dah slow down bila over the phone. Nampaknya my slow is still too fast.

Masa tengah tulis surat referral, specialist datang round cubicle. Aizat tengah bagging patient tu, dia tak sempat reciew pun kes. Dr. Afnan ikut round and present and aku ikut jugak bagitahu latest update yang jadi semalam and some crucial blood aku dah trace awal pagi tadi.

Pastu Dr. Mat Zuki datangggg argh I don't want to round with him because he teaches and ask questions and I don't think I can answer any of it sebab aku tak habis study Respi lagi. And yeah he asked! And tak boleh jawab. Dr. Afnan nak tolong tapi sebab Dr. Mat dah lock on target maka terkapai la mangkuk ni dalam round.

"Make sure awak tahu benda ni sebelum keluar Medical ya. Kalau tak nanti memalukan saya."

I'm sorry boss. But I'm sorrier that I don't remember the answer. Pernah dah study benda ni dulu huhu kenapa tak lekat?? Dosa banyak!! Kerja tanpa faham!! Oh God aku postcall please. Kenapa aku kerja macam orang AM dah ni.

Dr. Mat pergi next cubicle. Aku stay cubicle aku/Aizat and document properly ape yang Dr. Maznah round tadi. Pastu Anaes datang round. Dr. Arif ada. Dia confirmkan aku ke yang refer kes kat dia tadi. I said yes. Patut la adrenaline awak ni tinggi sangat, he said. Aku pun tergelak oh God nak balik please penat la layan orang pagi-pagi.

Diorang ni macam tahu-tak-tahu specific detail untuk kes so aku top up sebab dah specialist Anaes tu tanya.

Dr. Arif: Bagus la awak ni, hafal kes. Awak posting ke berapa?
Me: Dua. Sebelum ni Surgery. (Dude I know you since Surgery.)
Dr. Arif: Sixth posting nak masuk mana?
Me: Saya plan nak masuk Anaes.
Dr. Arif: Bagus. Saya cop dah awak. Nanti stay Anaes.
Me: Saya nak masuk Surgery.
Dr. Arif: Boleh ke awak jadi surgeon. Surgeon garang la.
Me: Sini best gile. Diorang baik je.
Dr. Arif: Dr. Mulianis baik?
Me: Dia best. Dia ngajar.
Dr. Arif doubled over in laughter.
Me: Kena tahu macam mana nak tolerate dia la.

And he turned to his boss and announced this kid is joining the team soon.

Pastu I updated Dr. Afnan pasal plan Anaes and ENT sebab this changed our plan as well. As I was briefing Dr. Afnan with Dr. Aizudeen standing in silence, Dr. Arif came and tepuk bahu Dr. Afnan.

"Aku cop dah dia ni masuk Anaes lepas habis HO."

"Eh dia ni stay Medical."

"Aku cop dah Anaes."

"Medical cop dulu." Dr. Afnan turned to me grinning. "Atiqah camne ni pagi-pagi lagi dah berebut awak?"

"Hahahaha." Medical best je and I know Anaes pun best jugak. In fact I think anywhere is fun so long you take pride in your job, tapi aku nak masuk Surgery please.

But first saya nak balik tidur dulu. Pukul 11 dah niiiiii. Nurse dah gelak kata "doktor balik pukul 1 kan?" Hahaha.

I bid Aizat goodbye. He thanked me for covering the cubicle for him. Biasa la, kita kan colleague.

On another note, I remember Aizat once told me dia nak amik cardiothorax or paed surgery. Aizat tak posting surgery lagi. I told him I want to take up paed surgery.

"Oh ye? Kau jadi rival aku la nanti."

"Colleague la kenapa rival pulak haha."

Encouraged

My MO Dr. Afnan is excellent. He is a cool chap who covers for his HO and encourages us. He is big-built, smiley, wears baju batik every Thursday. Graduated from UIA, HO in HUSM, MO at Machang for a while then he was transferred to HRPZ. He told me he regretted taking Medical and wished to pursue Surgery, but "Dato' Mahiran suruh stay la Medical sekejap, empat bulan, empat bulan, amik la Master.."

He failed his first year exam and then he quit. Too tough, he said. Now he's taking MRCP "sebab boleh study ikut suka hati."

See how cool this chap is?! Hahaha.

Yesterday I did my AM review as usual. Dr. Afnan came and we did our round on two patients when our specialist Dr. Fazirah arrive.

Dr. Fazirah: Patient semua stable?
Dr. Afnan: Saya tak round lagi. Tapi Atiqah dah round.

That moment I grinned and inside I felt so proud. He basically implied that I am reliable, right? I vouch to be as encouraging of a senior as he is.

Once we attended a fitting patient together. He vivaed me the acute management and nudged me towards the diagnosis. The patient had an INR of 1.6 and like always, I am silent when I am focused and I think he noticed that (or maybe not).

"... Another differential? Come on Atiqah, bleeding, what's on your mind?"

"Acute hemorrhagic stroke." While I jotted that down in our assessment.

"Good. I think I like you." He said with a smirk.

"Bwahaha buang la 'I think' tu!"

Dr. Afnan and the nurses in cubical one have been pulling that joke on me. On my first day in HDW, during the very first patient of my first round with Dr. Fazirah, she lectured me because I didn't remember the case well. But I enjoyed and appreciated the lecture, especially now that I think of it Dr. Fazirah was sitting down looking up at me and I realised it was a non-threatening position, and I believe I responded well and positive to her lecture at that time. So she said this to me

"Nama awak Atiqah? I think I like you."

To which Dr. Afnan and the nurses chuckled and didn't let me hear the end of it for the next two days. According to them it was hard to get Dr. Fazirah to like someone, especially not on her first day.

When I told Dr. Afnan I wanted to pursue Surgical, he said

"I think you should take Rheumatology. Awak dah kamcing dah dengan Dr. Fazirah."

And another one when some of the HOs were gone from the ward to attend a meeting with the deputy director of the hospital. Dr. Afnan asked why didn't I attend as well.

"Sebab saya bukan diplomat."

"Sebab awak consultant (and thus bukan HO maka tak attend la HO meet). Consultant Rheumatologist."

Hahahaha.

---

The first time I was oncall with him it was Puteri during an active night. I overruled ED diagnosis and planned out my management. Then I showed him the case. He concurred with me, taught me the difference between ESRD and advanced CKD and downright said

"Bagus la awak ni."

On three separate times that night! He even did that in front of my fellow HO. But I kept quiet and did not respond because I'm not good when people praise me. I liked it better when Dr. Suzila told me

"Atiqah awak ni bagus. Saya tahu awak bagus. Tapi awak kena review semua patient, see the patient as a whole..."

Basically she was dissing me. That was more like it hahaha God I am such a sadist XD

Did I tell you Mr. Zaidi is my favourite surgeon?

So my dad was telling me of one day he met Mr. Zaidi our surgeon at the hospital surau.

Mr. Z: Dr. Hanifah dekat mana sekarang?
Dad: Saya dekat Kuala Krai.
Mr. Z: Eh tak haha saya maksudkan anak Dr. Hanifah. Nama.. Atiqah!

Hahaha comel gile Mr. Zaidi tu la sepanjang saya duduk Surgery panggil saya "Hanifah" jeee XD