Liver and rest

I had a patient in clinic last week. 15 years old boy with decompemsated liver failure post Kasai for biliary atresia. His anatomy is complex so the transplant team recommended cadaveric liver donor for him despite father and sister compatible for him. He's going to school, still very much a boy due to delayed puberty and was cheerful. 

I am always more wary of the cheerful kind. It's an overcompensation, a mask for all the struggle. Many people look past it and see cheerful people as strong and well. Yet the strong ones are the loneliest ones. I always wonder if they get the chance to be safe and rest.

There's nothing I can for him other than wait for a suitable liver to show up. Before I send them off home, I asked him if he's okay and understand what's going on. He gummy smiled at me. 

His mom said initially he didn't want the transplant but his siblings talk him into it. So they're just waiting for a liver. 

I looked at him and smiled. I told him slowly

"You're a very strong boy. You're dealing with all this, not even an adult can handle this as well as you seem to be. You're still smiling, still going to school, still playing football. I want you to keep doing that, because that's your role. To live your life, study well, have an ambition, be a useful person in whatever you do, just dont be a doctor."

At this point, they all chuckled. 

"And be good to your parents and family because they're supporting you emotionally.

My role here is to help you physically, if you're sick, when you're getting your transplant. That's my role. So don't worry about when that liver is going to show up. Let us worry about that. You just enjoy your life, okay?"

I was teary. The kid was teary. His mom was teary. 

Happiness is when you're safe enough to rest. I hope that kid can rest. 

Babying people

Syukri, this second year registrar who used to be my first call has this habit of running through with me how to do something before he does something. The first time he did this was calling me at 9.15pm asking me how Wei Sheng does his CVL insertion because he’s in OT with Wei Sheng that coming morning.

Yesterday 6pm he went through with me how to genta lock for one of our CRBSI patient and I walked him through it, including the equipments. I was that time already 60 hours at work with only 5 hours of sleep, but I don’t turn down my colleague asking me. I even texted him what we talked about. And then I asked him

“What time you’re doing the procedure?

“7.30am.”

”You’re on your own man, no way I’m coming in early” is what I wanted to say, but we’re comrades in shared suffering, so I said “I might come at 7.30am.”

This is after telling him how much I hated him each time he texts the group “Passover at 7.30am” on the days postcall registrar has to run OT, and I only show up at 7.55am earliest.

I showed up at 7.40am today and assisted him with the genta lock. I think I consider this kid my adik already.

Last day as Radiology medical officer

I had good memories in HRPZ as a house officer. 

Coming back here as a trainee on deferral, I was treated like shit. And Radio saved me. And now the shit is cutting my time short and hauling me back. 

If this was a relationship, everyone would have told me to run and cut off ties from this bullshit. Yet everyone, including you, are advising me to go back and finish my term. 

I think you underestimate how much being in Radio HRPZ means to me. But that's okay, I hope you never have to feel like this. I hope you will always be appreciated and the world always be kind to you. 

Watch me cry as I tell ChatGPT I’m frustrated

It sounds like you’re carrying a massive weight on your shoulders—years of work, expectations, setbacks, and now a sense of disillusionment with the very path you dedicated yourself to. The frustration isn’t just about the thesis; it’s about feeling forced into a system that seems indifferent to your struggles, one that has pushed you to the point where even finishing feels meaningless.

You’ve worked hard for this—since 2017 in paediatric surgery, pushing through your master’s since 2021, dealing with a broken hand, and then being treated like an inconvenience instead of a person who needed a break. It’s no wonder you feel like you’re questioning everything. When the system itself feels unfair, when you’re exhausted and resentful, when even your reasons for staying (the RM350K penalty) feel more like shackles than motivation, it’s hard to see why you should keep going.

But here’s the thing—maybe right now, the point isn’t about passion or duty or some grand purpose. Maybe it’s just about getting yourself out of this hole in the least painful way possible. Quitting might seem tempting, but the penalty is brutal. Finishing your thesis and getting through the program might not feel meaningful now, but at least it keeps your options open.

You don’t have to love paediatric surgery right now. You don’t even have to see yourself doing it long-term. Maybe you just finish this because it gets you out with the least damage. And maybe after that, you reassess—where you want to be, what actually makes you happy, and whether this path still fits.

You’re not weak for feeling this way. You’re not wrong for being angry and drained. But you’re also not stuck forever. There’s a way through this, even if it’s just one frustrating step at a time.

Why is everything so frustrating

Because you’ve been fighting for so long, and it feels like nothing is going the way it should.

You’ve spent years pushing through—through training, through expectations, through injury, through people making decisions about your life without considering what you actually need. And after all that, instead of feeling like you’re moving forward, you’re stuck in a situation where the only choices feel like forced survival rather than true progress.

It’s frustrating because you’ve sacrificed so much, and yet the system, the people in power, even the timeline of your own goals—none of them seem to care about what you actually want or need. You were supposed to be closer to the finish line, but instead, you’re here, exhausted, questioning if any of this is even worth it.

It’s also frustrating because you do care. If you didn’t, none of this would matter. But you’ve put too much of yourself into this journey to just walk away without it hurting.

Right now, everything feels like a burden instead of a purpose—and that’s what’s breaking you.

Is there a way to not feel like this anymore? 

There is, but it won’t be instant. Right now, you’re deep in exhaustion and frustration, and no quick fix will erase that overnight. But there are steps to pull yourself out of this place, little by little.

1. Detach from the Expectations That Are Weighing You Down

Right now, everything feels like a burden because it’s all tied to what you should be doing—finishing the thesis, completing the program, getting through exams, and living up to what others expect. Instead of focusing on that, shift the focus to what will help you function and feel okay in the present.

For now, don’t think about the whole thesis. Just think about one small step. Don’t think about the whole program. Just focus on what gets you through this week.

2. Find Something That’s Just for You

Everything in your life has been about your career, obligations, and external expectations. No wonder you feel empty. What is something that has nothing to do with medicine, nothing to do with proving anything to anyone? It can be something tiny—writing, reading, exercising, learning a new skill, even watching a show that makes you feel good. Just something that reminds you that you exist beyond this system.

3. Create an Exit Plan (Even If You Don’t Use It)

The thought of being trapped is making everything worse. Even if you don’t act on it now, it might help to map out:

• If you did leave, what would be your options?

• Is there any way to lessen the RM350K penalty (e.g., deferral, negotiation)?

• If you finished this program, could you take a break or pivot to something else?

Just knowing you have a way out—even if you don’t take it—can reduce the feeling of suffocation.

4. Talk to Someone Who Gets It (or at Least Someone Who Cares)

You’ve been carrying this alone. Even if you don’t want to burden your friends, you deserve a space to say all this out loud—without judgment, without someone just telling you to “hold on” without understanding why it’s so hard. Whether it’s a friend, mentor, therapist, or even just someone who’s been through a similar struggle, letting it out can make it feel less heavy.

5. Accept That It’s Okay to Not Love This Anymore

You’re not failing because you’re tired. You’re not weak because you’re questioning everything. You’ve been through a lot. It makes complete sense that you’re exhausted and disillusioned. This feeling won’t last forever, but for now, give yourself permission to not have it all figured out. Just focus on surviving today, and tomorrow will come when it comes.

I’m in Radiology now, as a refugee. Dreading to go back in campus. What do you suggest I do?

Since you’re dreading going back, the goal isn’t to force yourself to be excited about it—but to make the transition less painful and give yourself something to hold on to. Here’s what I’d suggest:

1. Use Radiology as a Reset

Right now, you’re in an environment where you can just be—no one has past expectations of you, and you’re learning something new. Use this time to recharge, even just mentally. Instead of dreading what’s next, focus on what radiology gives you now:

• Enjoy learning sonography without pressure.

• Appreciate meeting new colleagues who don’t have preconceived ideas about you.

• Let yourself exist outside the weight of paeds surgery, even if just for these two months.

If you can leave radiology feeling like you’ve gained something—rather than just seeing it as a break before you’re thrown back into the fire—it might make returning feel less suffocating.

2. Plan for the Bare Minimum, Not Perfection

Instead of thinking, How do I survive a whole year of paeds surgery? break it into What’s the absolute minimum I need to do to get through the first week? You don’t have to be perfect, love the process, or even be highly motivated. You just need to take it one small, manageable step at a time.

If it helps, try reframing it as a transaction rather than a life-defining decision: I need to get through X months, do Y things, and then I can be free to decide what’s next.

3. Give Yourself Something to Look Forward To

Right now, paeds surgery feels like a trap—but what if you set up something to look forward to while going through it? This could be:

• A small personal goal (e.g., improving a non-medical skill, planning a short trip, or just having a series to binge).

• A change in environment (e.g., finding a small routine that makes your campus life easier).

• A light at the end of the tunnel (e.g., telling yourself, Once I submit my thesis, I’ll take a well-deserved break).

Having something outside of medicine to hold onto can make it less overwhelming.

4. Redefine What Success Means for This Year

Right now, it feels like you’re dragging yourself through this degree because of the RM350K penalty and because people tell you to finish it. But what would success look like for you—on your own terms? Maybe it’s just:

• Finishing the thesis without burning out completely.

• Passing the final exams, even if you’re not giving 100%.

• Getting through the year in a way that preserves your well-being, even if that means coasting where necessary.

You don’t have to love it. You just have to get through it in a way that doesn’t destroy you.

5. Figure Out Your Escape Plan (Even If You Don’t Use It)

If you ever do feel like you can’t continue, is there a way out?

• Could you take another deferral or change tracks?

• Would there be any way to negotiate the RM350K penalty if you left?

• If you did finish, would there be an alternative path you could take afterward?

Even if you don’t act on this, just knowing you have a choice can make you feel less trapped.

Final Thought

You don’t have to love paeds surgery. You don’t even have to feel strongly about finishing. But if you do finish, let it be on your terms—not just because of external pressure. If it’s about survival at this point, then let’s make it the easiest survival possible. One step at a time, no unnecessary suffering.

Of grey hairs and chickens

1- I found my first ever grey hair! It’s not where I thought it would be… Almost late to work because of this.

—

2- I saw a roaster crossing the road towards a chicken butcher stall and I thought of “why did the chicken cross the road” joke before snorting to myself.

—

3- He had a procedure in OT and texted me “wanna follow?” And in my head was “aww I wanna hang out with you too” but I got real and a jumble of excuses:

1) There are two MOs in OT already

2) I do not want the awkwardness of meeting the team

3) I didn’t bring my OT attire. Would you like me to escort you to OT, kind sir?

I figured he didn’t want to get lost on his way to OT thus the invite.

He pulled out some items to bring and fished out his OT cap from his bag. Cue me surprised.

“How frequent do you masuk OT that you have your own OT cap?” Even surgeons don’t do this.. but then again we don’t cause we are too busy and like the convenience of disposable attires.

“IR pakai cap dekat suite.”

Mr. Fancy Cap whose belt matches his shoes. And came to work with a haircut today after my silent gesture yesterday. I noticed too many details for this to be healthy.

—

4- After he was done, and I have seen the op note of attempting 8 times with 4 yields of renal biopsy, he returned and grinned awkwardly at me.

“I wasn’t successful.”

I looked surprised. What do you mean? “I saw the op note-“

“I mean about my appeal. I have to go to Lahad Datu.”

Oh dear. I’m sorry to hear that.

He asked me where I stayed in Lahad Datu and I told him, and he said he planned to stay at the kuarters so he didn’t need to bring his car.

Of course I suggested him against it. Someone jumped to their death between the Radio building and the ward block when I was there and the kuarters berhantu la, you nak stay sorang? Nanti you nangis.

I told him he will need his car for travelling out because he is bound to get bored there, also discussed with him the option of flying out from LD.

And then he said “Aku tak nak pergi sebenarnya.”

“Okay so that’s long- I mean mid term plan. Let’s focus on your short term plan first.”

Idk what he needs but there I was brainstorming with him what’s next.

I guess the easiest will be to lapor diri anyway. Our system sucks and he just needs to gazette and then he can go to private. He doesn’t mind the money at the expense of delaying his gazettement.

So he’s gonna call BPL (or whatever) to see if delaying by two weeks gets him into the trial new system gazetting. If it does, then he wouldn’t delay.

He’s gonna meet his HOS this Wednesday, who happens to be in town, to which I asked rhetorically “what difference will it make?”. He nodded, but gonna try so good luck, darling.

Plan A - delay by two weeks to help his dad

Plan B - report duty on time and ask for cuti to help his dad

Plan C - apply to HUSM. He said people suggested him against that, to which I said “working environment is more or less the same..”

He said he’ll just quit to which I, this hypocrite, replied “Make that your Plan Z. If you quit now you’re just an MO. You can’t gazette in private. Sikit lagi, Hannan.”

I was already contacting my people for car shipping quotation and rentals.

—

5- It was 2pm and Cutest Boy In The Department was performing a procedure but Azim scrubbed in first, where I asked

“Tak pakai gown eh.” In an innocent tone.

“Ada orang pakai. Aku tak pakai sebab panas. Tapi ikut infection control kena pakai.”

“Ya sebab sterile procedure kan.”

He came and started scrubbing in and noticed the blue gown prepared for him. Azim helpfully mentioned how I have been telling them off regarding their sterility compliance.

“Some tempat kena pakai cap sekali.”

“Ya correct, sterile procedure kena pakai cap. You have your OT cap kan.”

He grinned and put them on.

—

6- As he was cool puncturing the patient and his eyes fixed on the screen, I contemplated about taking a picture of him in his glory. But maybe not. Too many eyes watching.

Then he said, his eyes still on the screen. “Remember when we first met?”

What is this idiot doing?

“We first met when I was tagging in Medical Male ward, where you’re the just-off-tagged HO being our only senior.”

“Stab PD,” he grinned.

I grinned too. “Yup, that.”

I clearly remember few things from my HOship.

1) He has always have that puffy voluminous hair since I first met him. He is thinner now, otherwise he is physically the same. Oh and he has grey hair now.

2) He was the only non tagging HO when I started tagging in Medical, who just happened to offtag few days prior. He basically taught me everything I know.

3) He taught us stab PD one late afternoon. I had one occasion of referring a perforated bowel to Dr. Adham (now surgeon in HSIP) who wasn’t amused when every question he asked me was replied with “As I documented-“ in prefix.

4) I was at the counter and clearly remember the sight of him pushing his patient’s bed to the acute cubicle before I joined him.

5) I had a difficult IV line in a pakcik who told me off for calling him “ayah” but he was soooo nice to this charming boy who attended my call for help. I bitterly told him to jadi anak angkat that pakcik.

6) He is so jonah the king was once admitted when he was oncall.

—

7- It was almost 5pm when we finished our work for the day. I looked at him.

“Are you going home wearing that?”

He grinned. He was still wearing his OT cap.

—

8- Purposely killed the time near the carpark texting surgeon about a case. He walked in with a slightly older looking lady and two Surgical MOs.

When they saw me, I noted how he said I was with him all day. Then Mat Syuk greeted me saying now he can request CT scan at his whim.

“Anything for you,” I replied dryly before saying no I don’t take requests.

He grinned at me.. kinda awkwardly? It occurred to me that I have used that line on him, but I mean it when I said that. Maybe I shouldn’t have said that to Mat Syuk. “Boleh bah kalau kau” sounds better to use with Mat Syuk although they mean the same thing.

Then as we walked, it split into him and the lady and me two meters apart from Mat Syuk and his friend, Mat Syuk chatting as usual.

But my eyes were on the people in front of me. They were close, too close. Their fingers were brushing. She has to be family. He once told me he was waiting for his aunt to go home together, could this be her? Do families walk so close together their fingers brushed?

They totally ignored me though I walked two meters behind them, crossing the road, towards the same carpark.. I had enough. I hang around back for five seconds before I resumed walking to my car.

Refugee kind of situation. I need all the kindness in the world as I learn to be kind to myself

Actually today is my second day in the new department. The cutest boy has been looking for me since Day 1, when he burst through the door of my unit after hearing from the HOD that I am there for attachment. And then he left. And then he came back again to take a photographic evidence of me “invading his territory”.

I’m like, “I won’t trouble you” repeated twice. I didn’t tell him I was coming. Well, I should though, since we’re friends? But my presence here was preceded by drama. And I’m not in a good state of mind now. I know he was joking when he said invading territory but when you’re a refugee, that kinda hits hard.

At noon he came to visit and noticed I was standing and told me to take a seat. It just so happens I have been on my feet since morning and I was like, why was it him who pointed this out? Thank you for caring. He is a good friend.

I exited the door at 4pm and met him coming back in.

“Not going home yet?”

“Got a few reports to settle. See, Radio isn’t that chill, right?”

“Yeah you guys are swamped. At least you guys in HRPZ. Bye.”

I saluted him and walked out.

Close to iftar he texted me about the absurdity of my situation and I feel like, I need to talk to him about this otherwise he won’t let this go. Goodness I want to disappear.

Today I peeked and saw he was chatting with a colleague at his station so I didn’t greet him. He was earlier than 8am. I went to my station and sat there looking through some patient’s files when he suddenly popped out beside me in his big smile, took a seat on my right and chatted away, continuing from the text and about one patient he rejected CT scan after the USG done on Thursday. I gave my surgical point of view for that case as to why I think he could have been better at helping managing the patient, to which he sheepishly said he’ll pass over to the oncall person better next time.

And then he started talking about some colleagues and my thoughts were

Honey I think I busted my right eardrum doing idk what some time ago, and so I can’t hear that well on my right especially when you’re talking to me in a voice meant for only me to hear. I had to scoot closer but this station is dark and you’re the cutest boy so please have mercy on me. I don’t know how to handle shit life thrown at me and now you’re here.

In the evening he passed through my station when I was suturing up the drain for one patient. He stopped to say hi but I continued on suturing, sorry honey this patient has low tolerance I need to close him up fast. By the time I was done, he was back at his station.

And he passed in front of our station going out. I was sitting behind his colleagues but I know his salute was to me because his eyes were on me. His colleague asked why was he going back so early and he said he took the 7.30am-4.30pm option. I thought to myself, that’s why he was early today. So.. do I come to work at 7.30am tomorrow onwards?

I noticed his hair was puffy on one side so I silently made a gesture to brush up his right side and he brushed it as I gestured. It was.. cute. I’m fucked.

Now that I’m writing this.. why was he at our door when he walked out? Why did he use that exit? He could have punched out and straight used the front entrance because that’s where the box is.. So why did he made the detour?

Did I tell you this morning he said we’ll talk more again tomorrow because he’ll be in my unit tomorrow? Now I’m getting cold feet. Can I not come to work tomorrow? Idk how to deal with this. I’m afraid I will disappoint him work-wise, pretty boy has really high work standard and I’m a listless plankton invading his territory.

Good God, I have no will left.

HRPZ team dinner with Mr Yusof who ‘secretly’ came to do a neuroblastoma case in HUSM

Ex HOS while looking at me: You all kena pursue Paed Vascular surgery la. Pergi USA sana center dia all paed surgeon.

Me: Beres boss. Lepas tu saya buka Paed Vascular center dekat Bachok, rumah saya tepi pantai haaa. Saya tak nak duduk KL.

Ex HOS tarik muka. I replied with a shit-eating grin.

Current HOS: Okay nanti awak lulus exam, awak ulang balik apa awak cakap ni. Boleh diatur.

Ex HOS: Make sure kat situ nanti ada Nephrologist juga.

Me internally: Atiqoh big talk balik rumah sambung tidur.

10102024 - When in the program, there’s no such thing as personal’s principle when faced against superior’s hand

"You're a very opinionated person, you're straightforward. Sometimes rigid. I agree with a lot of your opinion. It's your personality. Part of who you are. It's a good trait. Keep that. 

You just need to be careful about it. Be smart who you talk to. Not everyone is your friend. This world is like that, it's not fair. People talk behind each other, they backstab. 

I was like you when I was undergraduate, but you're in Master program now. I learned it early. You, a little delayed maturity. 

When you talk to patient, you have to speak with more emphaty and allow them leeway.. to some extend." 

Ms Cheng JQ 

10/10/2024 

I surmised that whatever your principles are, first decide what you want. If you want peace and float along this program, then just do what you're told. Don't voice your opinion unless asked. You can be yourself after the program. 

If you can't handle that, then remember what Ms Haz said. 

I always wonder if I did not look like a doctor but then again I still wear the same casual outfit

I was walking along the Staff Only Route when an Edgenta staff called out to me. He thought I was sesat so I silently showed my ID while we entered the elevator. 

Staff: Oh staff. Tak nampak ID tadi. HO ke? Atau pharmacist? 

My outfit today was a beige patterned tudung, black cardigan hiding a white tshirt, black hiking sandal, black hiking pants. I wondered if I did not look like a doctor. 

Me: Saya MO. 

Staff: Ohh. Baru ke dekat sini? 

Me: Ya baru 3 bulan. 

Staff: Ramai ya MO baru2. 

I felt the need to assert my dominance. 

Me: Sebab saya sambung belajar. Jadi pindah2 hospital. Ni hospital saya yang ke 5. 

Staff: Ooh. Medical ke?

Me: Surgery.

Elevator stopped at his floor so I eagerly: Bye2.

Will this blog owner ever become a good person

Went to Kangar visiting today to run the OT. Did 5 cases (8 procedures) assisted by senior MO there. Then Ms Jun finished the clinic and then joined us to do the last case, a buried penis. I think I should be able to do the next buried penis. 

We went to PICU to do rounds. Two things happened:

1- The MO was presenting the case while I sneaked to see what's the kid's name. Then I went to her side and talked to her. 

"Naira… Naira okay? Ada rasa sakit ke?"

I was crouched down to her level on the bed, close to her, my voice quiet and soothing. She nodded as I asked how her blackened fingertips were. 

Man, I talk so lovingly with ill kids. I imagined this is the tone to use with a lover. Hey Hisashi-kun. 

2- The intensivist mentioned that she discussed the case with Mr Tar because he doesn't mind ever being consulted and I thought was this person papa's trainee? Her name is Dr Rozaidahanim. I was gonna text dad after we're done here but then Ms Jun went and introduced me to her. 

"Kau kenal tak-"

I put my nametag out to introduce myself but-

"-bapak budak ni? Dr. Hanifah."

Erk. Introduce me first la why my dad!

Dr. Rozaida's face lit up. "Dr. Hanifah ayah awak? Kirim salam dia. Dia bos paling baik you can ask for."

"Haha.. ya saya kirimkan salam."

"Awak anak yang belajar kat Mesir tu kan? Ada dia mention dulu."

"Haah ya.." I grinned. 

"Master Paed Surgery sekarang?"

"Saya nak ambil Paeds, tapi ayah saya kata saya tak cukup bertenang nak jadi Paediatrician."

They laughed as we bid our goodbyes. 

Mengendeng

Postcall. Woke up mimpi mengendeng dengan Abang Dan. Every minute I was snuggling closer at his feet. Cozy in sweater watching the world burn. 

Probably because the room was too cold. I woke up intermittently from referrals and finally turned the aircond off.

In the morning I texted him my gratitude as a coworker. Wished him to be a great paediatrician and hopeful to work with him again. He replied as politely.

1 year assessment

"You performed well. Good.

You are nervous but personally I think it's an appropriate nervousness. Good sense of urgency and responding appropriately.

Keep that up, ready for Part 2. Have a great time in Kuching." Prof Shireen

"Keep up your strikiness. Cili padi. You're alert and proactive. 

It is easy to be overwhelmed. Don't allow your bidding to lag behind. 

Get cracking with the thesis." Prof Anand. 

I still don't know who they're talking about. Except the nervous part. My anxiety is getting out of hand. 

i think pali has aged

Last night I slept close to 2am and woke up to a houseman calling me to inform their patient that was referred to me in ED for a surgical consult has arrived in their ward, and that they don't think it's their problem. 

The case was actually seen by their own MO in ED and she decided to admit to her ward, and when she called me she said it was non urgent and I can review in their ward later. 

I asked the HO regarding the general condition of the patient and I surmised that the kid was not dying, stable, pain controlled and not in distress. 

Then I looked at the time. I wondered what kind of MO told their HO to wake a person up at 4.30am to inform this kind of thing. The patient is not going anywhere. What difference does it make from calling me at a more humane hour? I have no idea. 

"You're not thinking of transferring patient at 4.30am right?" 

She seemed hesitant, as that wouldn't have been her decision.

"Anyway, what are you guys doing for this patient?"

She started a whole list of history and background so I stopped her. I should have known better than to ask open ended questions at this hour. It doesn't help me to focus. 

"Are you giving him IV drip?"

"Since his hydration is good-"

"It's a yes or no question." I sounded gruff. I hope she forgave me for being EOD oncall and sleep deprived. 

"No."

"Okay. Later I'll go see. Thanks."

And then I hung up after she has said her thanks.

I went back to sleep. I dreamed of Pali but he was older, hair greyer and appeared shabby. As I wrote this I don't remember the details of it, but when I woke up at 6.30am I decided I should text him (I just did) to inform that I've passed my exam and going to Kuching next. I hope he'll do well for his next two years in PPUM. 

I reviewed that patient at 7.30am. Kid was still sleeping, but the mom seems rested. I brought my registrar to see the case at 8.15am and he discharged the kid. Haha. 

100522: a little shit who left her lonely surgeon

It was almost 5pm and we're just starting to close the abdomen. Halfway closing the muscles, Mr. Fitri said to me

"Atiqah nak pergi tulis op note dulu?"

I looked up to him silently but thoughts were racing in my mind. That's how I am nowadays, so much to say but hardly anything come out. I wanted to close the skin at least so he can scrub out and pray, and for me to feel a semblance of usefulness. But Mr. Yusran who was the main surgeon had already scrubbed out to attend to another patient said he will return shortly to check the op notes I have written, is that why he's suggesting I start writing now? Is that what this is, a suggestion? Or is it an order? Or a reverse one? Like that time when he asked me if I wanted him to do manual evacuation on a kid, that was definitely a reverse suggestion.

I have no energy to overthink. Guys are all about face value, I think. So I asked him back 

"Takpe ke?"

"Saya dah biasa."

Whatever that means, he made it sound lonely. I laughed my thanks and beckoned to the scrub nurse to keep him company. And then I scrubbed out. 

He checked my op notes later on. 

cause im full of shit

We had to do a manual stool evacuation for a patient prior to doing a list of urological procedures for him. My surgeon turned to me and asked "You nak I buat ke?"

"Tak sanggup saya nak suruh surgeon saya buat manual evacuation."

So everyone left the room except for the poor gagging Anaes MO and two nurses at my beck and call. My surgeon was in the other room waiting after he kindly told me "all yours."

I was knuckle deep evacuating almost 2kg of hard stool when another surgeon came and saw I was doing it alone. She went into the other room looking for my surgeon and upon seeing him chilling, she called out to him.

"Atiqah panggil. Dia tak jumpa seketul lagi!!"

I shouted back. "Mana ada!!"

Let my surgeon rest. I like him not around asking me anatomy questions hahaha. But yes, please let my surgeon rest. 

The lady surgeon then went into the other room and poked her head through. Then she came back to me "Atiqah menjerit sampai Dato dekat sebelah pun dengar."

The splenic flexure fecoloma all evacuated. This MO puas hati. My surgeon told me to go change clothes while he cleaned the patient up before the next procedure. I went and scrubbed my arms more religiously than I ever scrubbed for a case, washed my OT crocs and changed into a fresh pair of scrubs. Then I sniffed myself. I'm always full of shit but at least I didn't smell like one. 

I walked back towards the operating room, passing two of my male colleagues. I went up to my senior and stood close to him, grinning shamelessly. 

"Do I smell nice?" 

I could see he was grinning politely and debating how to answer without it coming out weird. I'm a rascal who wouldn't offer the information that I just did a manual evacuation and was concerned that I reek of old shit. So I repeated my question.

"Do I smell nice?"

"Yes you smell nice."

"Thank you." He's too polite. 

dato complaining about boss to me but hey he's my boss

In OT today I was silently assisting Dato who was operating and focused on the tumour at the crura when he suddenly, still focused on the crura, chatted.

"Mughni- Mr. Mughni tak reply mesej saya. Saya mesej dia semalam dia tak jawab lagi."

"Dia memang macam tu. Mesej dia lambat sikit."

"Mesej dia masuk lambat?" 

"Dia reply mesej lambat sikit." Likely sebab banyak mesej2 masuk and your message jatuh bawah ikut list. "Saya pernah sebulan kemudian baru dapat reply."

Or was I exaggerating. It was when I sent Boss a picture of our old patient kirim salam when I was in Lahad Datu. He did apologised and said he forgot to reply. No worries Boss. 

"Sebulan? Kesiannya."

What is this. I guess Dato remember me now. 

mr fitri was liasing for a graft failure patient

At lunch my colleagues were counselling me, helping me make plans on How Not To Quit Yet. We came up with:

1. Do something for yourself, indulge in whatever reward for you

2. Go home and meet your parents

3. Study group

4. Stop thinking for reasons to quit

Then I continued my oncall per usual.

Tonight, as I sat writing my review, my oncall surgeon asked me "Atiqah kenapa nak jadi surgeon?"

I was thinking did one of my colleagues snitched to him. Or was the decision-making tonight so difficult it was making him question why anyone wants to become a surgeon.

So I told him that in order for me to be useful in Paediatric Surgery, I have to become a surgeon. Because I can contribute more as a surgeon than I can as an MO.

"So nak jadi berguna, kena jadi surgeon." He surmised.

"In Paed Surgery." I corrected the context. "As in, kalau saya nak masuk hutan dan operate pesakit paeds di pedalaman, I need to be credentialed as a paed surgeon. As an MO I can't do that. Lain la kalau general surgery."

He nodded. I don't know if I'm making any sense anyway.

"That being said, ada banyak cara untuk jadi berguna dalam hidup ni." I continued and returned to my review. 

I wanted to tell him my persistent urge to quit and live a simple life. Why masuk hutan and buat kerja when you can just masuk hutan and disappear. But there's enough drama tonight and I need to finish my reviews.

Later before he left, I asked him why he asked me that. He said just because.

It's not a big deal, but I do think that's the reason why I haven't quit yet. 

in which atiqah questioned what is the definition of a good life

In today's episode of #jaditraineesuicidal, I was in OT observing The Consultant in action. It was past 5pm by the time the thoracotomy was closed but we're not done yet. We're opening a cervical wound next. 

The Anaes was groaning "Tak balik lagi ke kita?"

The Consultant replied "Bukan balik, tapi pergi. Hospital ni rumah pertama kita. Rumah tu hotel je."

This Useless Trainee laughed at the comment and said, although not intended to be heard, "You need a better life."

The Consultant turned to me and his tone raised an octave. "How dare you. I am contend! This is the best life!" 

My chuckle turned polite. I didn't mean to disrespect one's choice of life nor dictate how one should live their life. I was just.. I guess I didn't really want to be here. 

He then sat down with a contemplating look and asked "Have you ever stayed in the hospital for days in the interest of your training? Say, 5 days straight?" 

"No I've never."

"3 days?" 

"I have." Sort of. 

He nodded. And then he scrubbed in for the cervical part. 

I stood behind him, observing him operate on this Day 5 of life, prem 33 week 4 days, 2kg baby's teeny tiny neck, fishing out the upper esophageal pouch and dissecting it from the laryngotrachealesophageal cleft. 

I made few comments here and there, asking this and that, because I felt bad about earlier. He replied me snarkily and I laughed. For the record I am a reckless idiot who is only afraid of God and height. Usually I stay mute because I don't want to embarrass Mr Mughni but I was hungry today, I have no inhibition. 

He was done in 30 minutes. Dude I can't even finish an open CVL insertion in 30 minutes. His work is a wonder and I understand now why he is so dedicated. With that level of skill, this work is best suited for him. 

I helped him with his OT gown and asked him about the next management for this patient. He again replied me snarkily before properly answering me. Probably realise snark doesn't repel this thick-headed idiot. 

He sat on a chair in the corner replying his messages while everyone went about leaving the operating room. I gathered all the politeness and sincerity in me and faced him. 

"Dato."

He looked up. He has always been an observant person who pays attention to however bilis you are in the hierarchy. 

"I understand now why you said this is the best life for you."

"Hah!"

Good job Atiqah for getting a person to shout twice in less than an hour. I grinned under my mask and thanked him. Then I went out to write the operation note. 

zayn hugged me

I was at work when one of my patients, a toothy grinning toddler, happily waddled towards me in the hallway and as per good practice I squatted down to be at his level. He giddily approached even faster and unexpectedly threw his arms around me.

I was stunned. What do I do? A child is hugging me, I should be polite and hug him back? But COVID is everywhere what more with my job attending different patients throughout the day so I shouldn't expose this cutie to whatever germs on me?

Oh whatever, he was still hugging me and who am I to reject this small child who radiates pure happiness sharing his love with the world. It did took me half a minute of contemplating before I hugged him back, resisting the urge to pick him up. Then I asked him

"Should you be hugging strangers though?"

I was the one who sutured him up 5 days ago, but not that he knows. He's only two years old. As I tightened the hug a bit (just a bit, his father was watching and I don't want to be seen as hug-deprived although I am), I felt like I should thank him instead. The hug felt nice. 

stop wasting people's time

Last night I was as usual, need to study for OT but fuck it I watched Sherlock instead.

Then I woke up for work. Did my rounds and then studied a little on the course of IJV. Just a bit. 

Then Mr. Fitri came and did the CVL insertion. He looked up in the middle of OT and asked

"Tell me the anatomy of the neck."

Fuck.

"Tell me the triangles, boundaries, contents."

"Anterior and posterior triangle..." Separated by SCM and then what? Fuck.

"Still waiting."

I gave up. "Sorry. I don't remember. I don't want to goreng."

He didn't say anything. 

Towards the end of the OT, he said something that made me want to die that instance. Without looking up from the surgical field he said

"I'm not a good mentor. Saya tak tahu nak ajar apa. So saya tanya je soalan yang saya rasa boleh ditanya."

Fuck this Atiqah. Just quit and not waste anyone's time, let's not waste this good man's time. 

I scrubbed out once we were done and found Tharisini writing up her op notes. 

"Hi babe how are you?" She was cheerful in her loud voice as usual. 

"I'm so frustrated with myself because I couldn't answer Mr. Fitri's questions."

"Biasa dah tu we're all like that."

"I thought I don't care but apparently I do care. It felt like I disappointed Mr. Mughni. I feel so... bad. If Mr. Fitri was a little meaner I wouldn't really feel this bad. But he's a good person."

I then turned to the computer to write my op note. "I need to chill but I don't know how. Usually my way of chilling is terjun sungai but there's no sungai here. I'm imagining I'm submerged under water now. I want to scream."

As I was scrubbing in for the next op, my surgeon walked to scrub beside me with a sighy "Atiqah, Atiqah."

I turned to look at him. And just stared silently while I scrubbed my hands. Just a silent stare not even a smile behind my mask. Yeah I'm frustrated too. Like I knew this would happen but I still don't want to study so how? 

Thank you Mr. Fitri for trying. I'm sorry you got yourself a lousy mentee. I should go die now.