hernia

Trying to demonstrate hernia in clinic.

"Boleh kau menangis kuat2?"

Kid shook his head.

"Should I break your heart and make you cry? No I shouldn't."

i cant explain, once a sweetheart always a sweetheart i guess

The other day my surgeon said something regarding xray comments that made me want to consult my favourite Radiology trainee. 

I contemplated few weeks before I finally asked him that question today before I started my oncall round. It was a simple salam greeting followed by my question. No dilly dally. 

He replied soon after. I thanked him. 

And then he said "Anyway lama tak dengar khabar".

I remember pausing at his words. Why would he say that after he turned down my confession? I guess he really meant it when he said he wanted us to remain friends as we were. Should I return his good will? 

I did. We chatted about our friend, his work, my work. And then few updates on his mom. That's it. I didn't really put that effort to prolong the personal conversation. 

Feeling really is a living thing. You need to work on it to sustain it. If you ask me now do I still feel what I felt, I'd say it waned down since I didn't work on it. I am less sentimental. You were wise to ask me reasons why I liked you. 

But would I say yes if, perhaps an overshoot and will never happen, if you suddenly revisit and return my feelings? I would ask for a reason and hear you out. 

Don't overthink. All is well. I hope you'll always well and motivated. I hope you'll always be happy, healthy and at peace. After all was said and done, still a piece of sweet memory in my heart. 

Getting rejected was a roller coaster of a good thing. I think. Or not. I don't know.

I want today's oncall to faster end. I want to go sit by a riverbank and look for buaya tomorrow. 

my chinese horoscope for 2021 said im at danger of an accident later this year

I had a dream last night.

I was sitting in the left back side of a purple MyVi. My friends were driving and at the front. We were getting up a slope on a muddy road and slipping. The driver hit on the gas and the car swirled up, making the horrific tire noise of non gripping. The car surged uphill and flipped onto itself.

We were upside down, stuck in the car. I had a penetrating injury to my left hypochondriac but I was still alert. I put pressure on my wound and when I took my hand off I could see blood gushing. I went into another car asking the driver to get me to a hospital.

The dream cut to my post op day. I'm not sure POD what but I was healing, standing already. The Surgical team and Anaes team were explaining what happened to me as I flipped the op note. I had multiple bowel perforations that was repaired. Syukri and one MO did surgery on me. I remember being amazed that he did an exploratory laparotomy and bowel repairs on me unsupervised. I hope I don't leak. 

I woke up and later texted him, thanking him for not stoma-ing me. He said are you sure you had no stoma? Or was it ileoanal anastomosis.

Turns out he's oncall today. I told him perhaps he's going to get an MVA with multiple bowel perf. He said he had 2 MVAs in ED already, intubated. 

jodoh dengan paeds

One time I was chilling with the Paeds girls and they started asking me about dad. 

"Ayah kau baik ke Atiqah? Ke dia garang?" 

"Tengok la Atiqah baik je mesti la ayah dia baik!" 

I was grinning. "Ayah aku baik. Dia yang teaching HO." 

And they asked if there was any time I called my dad because I was dissatisfied with Paediatrician management. 

Yeah I did in Lahad Datu. Twice actually. 

They referred me TRO biliary atresia but they didn't do the prolonged jaundice workup because "my specialist said it's a clear cut surgical cause" and I almost called the specialist up to ask did she biopsied the child already to confirm it's a surgical cause, but I called my dad instead and ranted. He agreed that we have to rule out all medical causes as well. 

Anyway I saw the kid. Bilirubin range yeah sort of like BA, but got transaminitis and the stool was effing pigmented. They didn't do ultrasound yet. Clear cut Surgical cause apa? 

I actually opened up the Paed Protocol in front of the MO to show the list of causes of conjugated hyperbilirubinemia. "Surgical cause 3 je, ni lagi 10 korang punya. Takkan la korang nak suruh kitorang terus buat invasive procedure padahal non invasively diagnosed condition belum rule out pun." 

And that one time they referred me an HSP kid with abdominal pain TRO intussusception. But they didn't start on steroid. 

I remembered Dr. Nik Nas taught me "HSP kalau sakit perut, it is intus unless proven otherwise. Start steroid." So I asked them why didn't they start steroid. The MO told me if I wanted to start steroid, I may start. I blinked. Is that my decision? Aren't you guys better at managing HSP than a Surgical MO. I opened up the Paed Protocol and sure it was written there first plan under the heading of severe abdominal pain for HSP was to start oral prednisolone. I called my dad to confirm and he confirmed. 

So I wrote there "for USG abdomen. Suggest to start prednisolone."

The referring specialist saw my plan and did start on prednisolone after my review. 

The girls then asked me why didn't I become a Paediatrician when my dad's a neonatologist.

"Because I was still in medical school when he said I'm not calm enough to become a Paediatrician."

The yelling started. "KAU INGAT PAEDIATRICIAN NI SEMUA TENANG?"

They then listed all the names of their Paediatrician and told the stories how kalut they were when patient deteriorated in front of them.

"Pulse volume! Pulse volume!"

"Dr. Heng je yang cool. Patient fitting depan dia, dia tengok tenang je. 'Diazepam.'"

Hahaha. One would think Surgical are more ganas than Medical based, but you should see how these people do BMAT. Literally drilling into concrete. 

prokofiev is playing in my head

Got a boy with Prader Willi in clinic attended by his mom and sister. Anthony shaked my hand, talked and greeted me in Chinese.

"Oh no, I'm sorry I don't speak your language. I can only speak Malay." was exactly what I said while I rubbed my hand with alcohol. And then I clerked the case.

At the end of the consult, I waved them goodbye and Anthony kept saying "xie xie" to me. 

"Baik lah aku balik study Chinese. Bagaimana mahu sebut sama-sama?"

His sister answered me but I didn't catch that with him non stop "xie xie". I just replied him with a "sama-sama". 

missed ARM is always a shame

My recent oncall Tuaran called me at almost 11pm to refer "an imperforate anus."

"Okay."

"Day 1 plus 19 hours of life boy-"

"Oh no." I muttered softly. 

"... started on cup feeding at 2pm..."

"Oh no." Again, just softly, not interrupting her presentation. 

"... abdomen is distended..."

"Oh no no no no no." 

At that point I was just singing in my head. 

how to stop thinking, help, tell me how

Post cbd insertion

Frank blood

Whatever you think

Need tro bladder injury

Do usg

Slow infiltrate sterile water

And see

Small can go non operative

Abx

Drain urine

---

RT for surgery always nasogastric

So it wont dislodge during intubation or baby chewing 

---

Allow pseudomembrane to form

Don't kacau it much

---

Sudden abdomen distension

AXR not so good penetration

Might be pneumoperitoneum 

---

There's a webinar tomorrow night

On how to suppress traumatic memories

I wanna attend

But I'm effing oncall

Help

you dont get to choose who cares about you

Last night when I was doing rounds Luqman texted me a picture of the moon so clear he spotted with his new spotting scope. Bro been flexing nowadays. So I told him I was stuck in PSICU with Alep attending the burn kid.

Then I told him one of my bros is leaving cm and I felt mellow.

He asked which bro.

"From LD. Fadhly. Great guy, you'd like him."

"Oh that fella. Where's he going."

I told him Pali going for his 1st year training in HSB. And then I asked how did he know Pali. Was it from me gushing about him?

"You told me a lot of good things about him. Regarded him with disctinction."

I laughed. "I guess I'm a fan. Once a fan always a fan."

"Lucky him. He should know about it one day."

"I think he knows."

Ah if Pali doesn't know I respect him and think he's the shit. I don't think I was ever subtle about my admiration for people. He doesn't say anything about it to my face when I compliment him in public, but I know he knows. He's an idiot but he's not stupid. 

Or perhaps Luqman meant in depth? I feel like sometimes people need to hear that they are appreciated and respected and made an impact in someone's life and left a lasting impression, especially when they themselves are having a down time. So I concurred and said

"Although yeah, he should know."

We worked together for 2 months plus? I told him I was in Lahad Datu sent by my Boss because Pali was there. Earlier on I felt this inferiority complex with him and needed Syukri around to navigate me around him and he thinks I'm annoying. He called me "nyekit" many times and at one point I got self conscious about it because the last thing I want is to be a burden. Well my boss sent me out here and name dropped you so I can't have you not tolerate me now can I. 

My awkwardness died down that time I needed my wiper changed so I called Syukri for it and he told me to come to Arif's place where the three were hanging out. Pali was the most worked up at fixing my wiper though turned out I bought the wrong one and it wasn't a fit, ah typical bimbo. We ended up going for sate and had this best sate in the entire Lahad Datu at Arif's place plus ice cream and juice. I learned that Pali's soft spoken voice would hitch up an octave higher when he got excited, he was excited about gaming and his PUBG avatar was a lady. He actually told me to master this game and by the next game session my avatar must have levelled up with clothes on. I grinned realizing he was an actual idiot. They also told me to get a bigger memory phone. I bought a new phone the next day. 

I realised he's being depended on by the surgeon so much on the admin part it reminded me of my responsibility in Likas, but his was on a way different caliber. Ms Doon actually told me to call Fadhly if anything comes up during my oncalls and pointed out he is always alert and responsive even when you call him for opinion at 3am. Arif told me the same thing. I felt sorry for him and vowed to never call him for help, haha. I actually mostly called Syukri or Hadija, and I remember calling him only once and that was for his post op patient. 

He always said that he picks up juniors call on the third call but he always picked up my calls on my first call whenever I do call him. Which I mostly do to ask him where was he at, come let's eat. 

I have this bad habit of laughing awkwardly and got in trouble with Ms Doon for that once and Pali covered me by suddenly saying "Eh sape di klinik? Takde orang kan, gi cover klinik Tiqah." The other times I did so Pali exasperatedly said "Atiqah ni selalu tetiba je gelak" and I gave him my what-do-you-want-from-me face and Ms Doon said "okay la dia asyik gelak, habis you nak dia asyik nangis ke" and he was lost for words. 

He covered my ass a lot. I once drained a pleural effusion too fast the patient ended up SOB and needed high flow oxygen for that time. When Ms Doon came for rounds and saw the patient, I barely opened my mouth to explain before I got cut off by Pali and Arif shooting streams of explanation on why the previously stable patient suddenly needed oxygen support and didn't drop any names. I had never seen anyone cover up for something so fast and it was my ass they covered, not even theirs. 

That time Pali, Syuk and I had dinner before my first oncall ever and they insisted I try the siput tarik. I ended up nursing an AGE throughout my jonah call the next day. I kept vomiting and purging and couldn't hold down any food. They both brought me out for KFC that evening where I sat in the elevator ride down and when a stranger joined us in it I said "Saya AGE. Ni abang saya, ni ayah saya." and when we got to the KFC they ordered for me and I ate and then vomited in the toilet. I remember the disapproving worried look they both gave me but hell this was my first oncall and I will see it through. They even bought me extra food for the night but I was busy and had no time to worry about vomiting so I never ate. Cm they came to work bringing more food and saw the last night's food was untouched and the nurses snitched on me vomiting out my ORS and I had never felt so babied in my entire adult life. They aptly called me baby since then. 

I transected a cystofix during that same oncall and Pali went in for that patient instead and never said anything to me about it. 

We once talked about our juniors dealing with their hardship where I was thinking how to actively help whereas Pali said they should just deal with the hardship like a man. Which wasn't how he dealt with me. Maybe he thinks I'm an actual wuss who needs a bit more tender care.

That time he actually tried to cheer me up when Mr Ashok kicked me out from Likas group. I had a whole post on that. A sweetheart he actually is, this Pali. 

Once he was scrubbed in during postcall for a perforated appendix with a ruptured liver abscess and I stood on a stool observing behind him over his shoulder. He changed position and stepped onto my foot. I didn't bat an eyelid. After a while he turned around, stared at me, stared at his foot on mine and then back at me. We exchanged no words. I understood his exhaustion from first assisting a complex laparotomy procedure on a postcall. He went back to operating with his foot stepping on mine amd I remember smirking whatever keeps you awake old man. 

I got in trouble because of him once on his postcall but I took one for him and he apologised to me privately for that matter. 

He was assisting my herniotomy I think when my hand shook while dissecting. I have fine tremors even on a good day but that day I didn't even had breakfast yet. He grabbed my instrument and my tremor stopped. Then he let go so that I could continue. I told him I need to lean on something when this happens, so I put my whole arms on the patient. 

One time he opened a craniectomy in a bad brain with urea 30 and blood was gushing like hell. The front of his gown was red and soaking, it was that bad. He kept muttering "fuck" under his breath and I was on his left so I heard all of it. I told him "Pali istighfar" but he didn't hear me so I istighfared for us instead. I noticed his hands were shaking and I told him to lean his hands on something and offered my knuckle which he didn't take. We CPRed the patient while Pali and I closed hurriedly and wheeled the patient back to ICU. He died 4 hours later. 

That time ED screwed him and he was still so angry venting to us during his postcall how they referred him what sounded like a typical traumatic diaphragmatic hernia while he was in OR suturing up some other guy's head. He said if the ED team thinks so then ED team should get a CT thorax. The ED MO then used his name requested for said CT and the radiologist called up Ms Doon about it because the clinical didn't add up to a traumatic diaphragmatic hernia. Ms Doon said Pali wouldn't carelessly request for a CT. Only later did the EP saw the patient and he didn't think it was a traumatic diaphragmatic hernia and Pali then confronted the MO and also the EP and the radiologist to clear up his name. I remember standing at the counter while he sat and cursed in that non intimidating voice and being listless and I thought I didn't know what to say when he gets like that. 

That time he stamped his chop on my arm for no obvious reason and I dryly thought that was the first time anyone has ever stamped on me and what a way it was to lay your claim on someone.

Also that time he happily poured out chocolate crumbs onto my phone. I laughed awkwardly speechless trying to wipe the crumbs away. He grinned innocently and said it was okay, he poured out empty contents anyway. You idiot the chocolate got all over my phone small cracks! I don't remember how I got them off, probably licked them idk. 

When he broke the news to Arif and I that his transfer was approved in the pantry while we had KFC. He hadn't told Ms Doon yet. I remember telling him he deserves the transfer and he should go. I effing planned out what the team should get for him, pestered Ms Doon at the last minute to buy a watch for him from free duty, and Arif and I picked and printed photos of Fadhly to frame. I think three of the five pictures were from my phone. 

And when he got accepted into masters programme. Boy was I ever proud. He's skilled and he has great attitude and deserves it. 

That time Ms Doon gossiped that Pali got in trouble with the HPB consultant who found out OT staffs complained he was rude to them and thus hankered him with theoretical questions during operating, which he couldn't answer. I stood up and said there's no way Pali would ever be rude to OT staffs, he looks tough but is an actual cupcake. Mr Sharif must have mistaken him for someone else. I then messaged Pali on the spot and asked him about it and true enough Pali said it was someone else who got hankered by Mr Sharif during operating and that Mr Sharif always mistook him and called him that guy's name instead. See I told you, Ms Doon la how can you not know how abang is, you worked longer with him than I do. 

All in all. What a joy to have known this guy. And today he left Sabah for peninsular to continue his training. 

I messaged him yesterday asking what time was his flight and he said it was an early flight at 7.15am. I told him I lamented the fact it was too early and told him I was oncall and wanted to see him off, safe trip and I will see him when I see him. 

But man I actually felt self conscious, what if he thought I was clingy af. Which I wasn't actually not. 

He actually replied "sokay la, tq2". 

And I learned that I should always reply people politely, because you never know the anxiety the asker had and the immense courage it took for them to ask. I'm sorry everyone that I have brutely brushed off in the past, and I mean you Chip and Nabil. 

Today while waiting for Meryem to arrive for passover, I sat beside the window watching the sky for his flight to pass by. I was in the middle of passing over that neurogenic bowel in 4B when I saw it and ran back to open the window and snap a picture. With naked eyes you could actually see it was an AirAsia flight flying above at around 8.11am.

"Sorry, tu flight aku tunggu. Flight tu ke Kelantan."

"Kau patut balik tapi tak jadi ke?" 

"Tak la. Kawan aku dalam tu. So anyhow budak tu-" and continued my passover. Life goes on. 

Have a breeze through your training and may happiness always be with you Fadhly. You're in my prayers. 

idiots from kb

We have a new burn patient with a mother so guilt stricken and anxious. She was on the floor crying begging me to help her child when I first saw her in ED. I only took a concise history and most of it was spent consoling her and telling her to eat and drink while we took care of the rest. 

That night the child was in PSICU. Boluses of propofol, fentanyl and morphine given but he was still cranky in pain, wouldn't sleep. Alep was soothing the child with more morphine and increased his infusion rate, what he called "Alep infusion". The mother was still so anxious and half begging Alep to do his best.

We then decided it was best to separate the mother from the child, at least until she could calm down and help us help the kid. We didn't want her hypo on us and Code Blue the hospital.

Ever the chatty person, Alep made small conversation with the mother while he held the child's hand, eyes sharp looking for a visible vein. 

"Mamak kau dari mana." 

"Dari Kudat."

"Oh Kudat kampung aku tu."

"Iya kah doktor itu dari Kudat?" The mother turned to me and asked.

"Tidak la dia dari KB tu. Orang kampung aku. Kami dari KB." I said with a smirk. 

Alep was half grinning half smirking at me. The nurses were struggling to hide their laughter. 

"Oh dekat sudah tu Kudat sama KB. Orang Bajau kah doktor?" 

"Aku Bugis mak." I said, still smirking. To be specific I am half Minang, quarter Bugis and quarter Jawa, but I relate to my fighter Bugis lineage for some badass reason. "Kau orang Bajau kah Alep?" 

The nurses burst into laughter. We're actually idiots from Kota Bharu, not local Kota Belud as she thought. With the mood lightened, I escorted the mother to my ward to get her rest before I went back to continue my rounds. 

please eat

Atiqah, shall I remind you what happened yesterday.

I was postcall. On the oncall day I was in OT and Mizah brought us food and left it in the ward pantry. I went looking for it once I scrubbed out to see whether I should put it in the fridge since I still had to do PM rounds and no time yet to eat. It was nasi kerabu packed with this memo

I love her. In another life I would marry her. 

I didn't have time to eat, but heeding her reminder I went through my bag and found the salmon onigiri I had from 2 days ago. I sat down and had the onigiri. 

Later at 6pm I had the nasi kerabu Mizah bought me.

I settled work almost at 1am. I was hungry so I made myself Korean spicy cheese ramyeon with grilled sausage. That was all the food I could find at that hour. 

So anyhow. Postcall day. Woke up, showered, I skipped coffee from home and straight away did my rounds because I was feeling nauseous. One of those postcall nausea I sometimes get, it gets better after I vomit. Probably spicy food past midnight caused it. Or was it the 2 day old onigiri? Didn't matter anymore. I posted my case, did my quick rounds, grabbed a yellow bag and went to oncall room to puke and a cup of needed coffee. 

But I saw Meryem walking up into ward so I met her halfway and passed over to her. And then surgeons arrived and we started our rounds. 

And then patient got pushed to OT and I had to go there. By the time I changed into my OT attire the kid was wheeled in already and I haven't even pee yet, what more my coffee. 

I scrubbed in facing the clock. And timed myself. 

At 9am I was still hyper. It was compensatory, I know. 

At 10am the headache started. 

At 11am my head splitted. I totally went quiet at this point. 

At 12pm I wanted to scrub out already, please I need to bang my head onto something and I need to vomit. But my surgeon was closing the tight muscles and I couldn't bail out now. And then she asked if I was okay to close the skin. I nodded, asked her to scrub out and got the job done while clenching my teeth. 

At 1.10pm I scrubbed out. Straight away went to make my coffee and then to PSICU asking for PCM. My voice was low and I clenched my teeth. I downed 1g with my coffee and went to write the operative note. It took me longer than usual because I had to intermittently slam my head onto the table to block out the lights and gain my bearing. I replied my messages and oh please can I have someone massage my temples for me please, it hurt so bad. It was terrible. Why am I terrible at taking care of myself. I retched once at the recovery table. And then another one in the changing room. I ran back to the oncall room and vomited in the sink. 

Fuck. Why did you do that to yourself. Should have had that coffee and vomit earlier instead of passing over to Meryem. Would have saved me from that effing splitting headache. 

I didn't have food and I was late for PM rounds. I was silent for the most of it. Went back to ward and carried out the plans. By 5 pm I was in the surau praying and felt feverish. I downed another 1g of PCM. It was about 4 hours apart so I should be good.

And then the right sided abdominal pain started.

One of these days you're going to die and I hope you trouble no one when you do. I imagined us getting another bout of cholecystitis and getting admitted. Can we do that without anyone knowing? 

Well the team will know because I'd be absent from work, they will wonder if my parents know but that's it. 

My only housemate will wonder where I'm at these days and I won't lie if she asks. 

Will Mizah find out and tell others? I wonder. 

Anyhow. We'd be admitted and on our own we will die because we have no motivation to even drink, let alone build up good enough appetite to get us off IVD. So let's not get admitted, shall we. If you wanna die, go die somewhere far in the forest or die sudden and a quick one. 

So after Asar prayer, I went and found food. Bought nasi mandi ayam because that's the tenderest rice and chicken Kingfisher had to offer. I would get us porridge but McD was out of the way. Put on my softest Twoset hoodie and forced myself to eat. And then I fell asleep just after 8pm and woke up with the lights still on at 4am.

In conclusion. Please don't make me go through that headache again. It was too terrible you stupid idiot. There are billions of ways to die, please choose something quicker and less painful. 

Also, please eat. I'd buy you anything, just as long as you eat. 

make better decisions if you really want to live longer

If I can turn back time, I would relive that time I was stuck covering Kumaran's oncall when I was postcall EOD, in ED clerking that intus from Keningau while Pali was seeing a triple A after he got drenched from jogging in the rain.

I'd ask him what he had to do next. I'd ask him to pray Maghrib at the surau upstairs and I'd ask him to accompany me for dinner. I'd take him to Ratu Selera for bakso because soup was probably all I could stomach when I was tired as shit. Probably just hand him my car keys because let's face it, I was in no position to drive. 

That night I didn't eat anything. We parted at ED and I went back to ward for rounds and then to COVID OT keeping update. I went home at 1am and passed out until 10am the next morning thus missing my supposedly 3rd straight OD oncall. Hell I didn't even get paid for covering that oncall. 

I need to take better care of myself. I don't eat properly when I'm oncall and more so when I'm alone. I'm always at danger of overworking myself to collapse. That time in Lahad Datu when I was admitted, I think I presented that bad because I wasn't eating (I puked when I eat so it was only logical to keep NBM, but I had no drips on so I brilliantly dehydrated myself) and working through a week with 2 oncalls. The only good decision I made was when I ordered 2 pint NS for myself, which Vic and Rayner had difficulty to insert line for me because my veins were all collapsed. And when I finally noticed my deep jaundice and surrendered to ED. 

Writing this, I realize writers are lonely people. Awfully lonely. Living in memories, not grasping the moment. If I don't have Haru, I think I'm long dead. 

what makes a good day

It was Chinese New Year and I woke up at 8am. Ahh I'm oncall today. Texted the postcall person informing I would be late.

Showered. Downed a cup of coffee. Still sleepy. 

Punched in at 8.25am, started my round. Surgeon came at 9.40am. Continued round. Still so sleepy. 

Pali messaged me at 10.09am.

Mano mg? 

I kyaaaaaed so loud (inside). He's leaving for Semenanjung this 20th and I've been meaning to ask him out before that. Him messaging me this could only mean one thing. He was oncall today in Likas! 

Roundddd

Lipak lalu

Teman aku breakfast

Boleh keluar tak? 

I would burn the hospital for you, of course I could and would go out! 

I told him to give me 15 minutes. But we had two septic patients and my surgeon was thinking and considering and I had never been so restless to get out from round. 

He was done updating our HOD. I told him I was cold and need to pee. He told me he was going home. 

I was late 15 minutes to meet Pali. He was in an unrecognised car at the lobby. He rented it out because his car had been shipped back. 

We went for brunch for an hour plus, my treat. It took me the same amount of time to finish my iced coffee and toast as it took for him to finish his plate of nasi lemak ayam cutlet with sambal sotong. It was 11am and I actually was still sleepy. 

But it's Pali! I'm a fan!

He was wearing the same Kunak sunathon shirt he was wearing on his last day in Lahad Datu. I was wearing my current favourite good fitting Uniqlo shirt and my favourite pair of hiking pants (because it fitted well and had many pockets) and I have never been happier for not being shabby dressed. 

I think we should make it a habit of being better dressed. It does make me happy.

He said they're competing cases with gazetting surgeons. 

I told him I feel like a HO here and my skills are rotting. I wanted to transfer back to Peninsular but I'm stuck at the reason for transfer. And I told him I told Syukri to go back HRPZ better than he comes to Likas. Though I empathise with Mr Khaz for not letting him go. 

He asked me if Arif is still in ENT. 

I realised they haven't been in touch. 

Also we've been mostly talking about work it was painful. I wanted to know how many siblings he has and I still haven't ask that. 

He's been here past 6 years. 

Supposed to go climb Akinabalu last week. 

Didn't do much diving in KK because of the MCO. 

Pointed out that teachers go back to Semenanjung with contenna filled with jati furnitures. We're closer to Indonesia so jati furnitures are cheaper.

We had our silent moment where he was on his phone and me playing with my phone keyring (I don't touch my phone when I'm with company, but I do pick up if I have a call or heard a message chime in since I'm oncall). 

I used these moments to stare off space. 

I was comfortable with the silence I might fall asleep there. I was comfortable with him. And was also sleepy. I don't know what happened to me that morning, I overslept because apparently my alarm wasn't even turned on (how did that happen) and by then I already had two cups of coffee. So I tried to keep talking. 

He's still as soft spoken as ever. Bit hitch in his pitch when he gets excited. Sometimes he does that exchange knowing glances before he hands me whatever. Like the first OT we did together in Lahad Datu where he opened a paediatric hydrocele. He dissected the sac from cord structures adult style (read: shredding it) and we exchanged glances (me "whatchudoin" with a not so subtle eyebrow cocked in disapproval and him "wanna help me or what" and an eyebrow cocked hiding a smirk behind his mask) before he passed me the instrument he was holding. I took over, completed the dissection and passed it back to him. All without a word. 

His hair was neatly trimmed on the side. His eyebags were not bad, I kept looking at it to confirm. Yep, I have more undereye wrinkles and my eyebags are worse. Why is that so? What eyecream he's using? Heck I could barely comply with my moisturiser. I'm jealous that he's sleeping better than me. 

He was wearing a tortoise shell rimmed round glasses. I haven't seen this before. He had to have at least 3 glasses now. How many glasses does a person need? He had a Seiko watch on and I think he has at least 4 other watches? We were both wearing green. Him a mint and I a forest. I didn't eye his footwear. 

He said he's mostly supervising juniors doing laparotomies and such nowadays. I see that he's still the dedicated senior he is. Although he has his melipak moments. Still doing the if-I-dont-pick-up-they-will-get-the-message-and-call-someone-else and if-they-call-more-than-three-times-means-they-really-need-my-help. 

Although he picks up my call for help at once back when I was oncall in Lahad Datu.

 

He sounded like he'll become a HPB surgeon.

His place in Alor Setar is just across the hospital, walking distance.

He wanted to go back to Kelantan but there was no opening for trainees there. 

Anyway. I'm gonna miss hanging out with him. 

He sent me back to the hospital. On the way back I asked again about the car. He said he rented it off this Kelantanese assistant pharmacist who had stayed in Sabah since ever. He said the guy was quite well known among other Kelantanese around here. 

I told him the only Kelantanese I have in my bone was the fact I love keropok and I need nasi kerabu periodically. 

We arrived at the lobby. I thanked him and told him to take care. And that I'll see him again. 

He thanked me as well. 

What I didn't say but hoped he understands was that my gratitude came from him making time to see me. Or allow me to see him, however you see it. He could have just gone off to have his meal alone but he sought my company and waited for me although I was late. 

I respect him a hell lot and I like his company a lot. Even though we only worked together for two months plus but I would choose his company over most people I've known longer for. Had I not see him before he leaves Sabah for good I'd lament it for a very long time. 

So yeah. Thank you Fadhly for today. I want to see you again. 

I closed his passenger door and walked inside the hospital. I didn't look back to see him off. I didn't sneak any picture. And I know he wouldn't turn down a selfie if I had asked. I dedicate this post to him instead. 

Then I raced to discharge ward patient and see how my septic patient in PSICU doing with a happy spring in my steps. Hahaha. #priorities 

cancers are terrible

One time when I was oncall in Lahad Datu, ED referred me a non local lady with fungating breast mass.

I looked over her blood investigation results and CXR before I went to see her. Diagnosing was relatively easy with the mass and that kind of CXR. It was a case of metastatic breast cancer. The hardest thing to do was counselling for what's next to come.

I went and see the patient. She was around my mom's age but she looked way older. Hardened by age. She was accompanied by her daughter. I introduced myself and asked questions to ascertain her functional status and social background. And then questions regarding the mass and symptoms.

She hid them for years. Only came in today because her daughter accidentally saw it. Typical mothers. 

And then I asked to examine the mass.

I then took a seat beside the daughter and broke the news. Her daughter cried. 

I gave them a minute and told her we need a tissue biopsy to see what kind of tumour it is to decide on chemotherapy and CT staging to see the extent of progression. But eyeballing, it was stage 4 already. The mass was infected already. Her lungs didn't look good. And I told her we will treat symptomatically but investigations and treatment will cost her a lot of money, we will arrange for aids as much as we can. 

She didn't want to do anything and trouble everyone. I knew she would say that.

Her daughter wanted to do everything. I knew she would say that too. 

I held her hand and looked at the patient in the eye. I told her it was probably too much to take in and I suggested we meet in clinic after they've spoken with the rest of the family. I told her there was no right or wrong decision. What was important was everyone had time to come in terms with this disease. In the mean time we will address the foul mass. 

She was still politely adamant and wasn't even keen for TCA. I would so too, if I'm the patient. Working in Lahad Datu and exposed to all these adult diseases made me realise I'd rather be dead then be bedridden and a burden. If I was diagnosed with a terminal illness I'd be taking a long leave away from people. 

But if it was my own parents, flesh and blood. I'd do anything for another extra minute with them. 

So I told her that she had done a great job at raising her children, so let this be the time for them to take care of her as much as they can. Let them have their sorrow, because I would want that too.

And at that point my voice cracked and my eyes became blurry. I sniffled my apology and smiled. She understood me and agreed to come to clinic next Monday.

I missed my mom so much that time. 

hello there readers, it is i the blog master

Hi, this is Atiqah writing from the laptop.

To be honest I've been writing from the phone for as long as I can remember. I barely use the laptop except to do presentation and truthfully the last time I used this was during quarantine after coming back from Lahad Datu to binge on Netflix.

But today I'm writing from the laptop because there were some posts on Facebook that deserves immortalization in the blog. So I've been copy pasting some backdated posts since lunch, listening to Debussy.

This blog has been going on since 13 years. I've changed, matured I guess in a way. Or maybe I haven't. There's the idea of publishing it into a book, mostly just for my sake, but it's a bad idea considering the cost and let's admit, I don't think I'll touch it anyway. 

I also realised there are some traffic on this blog. Majority from US. I've disabled the Google searching for this blog long time ago and I wonder why would I get traffic. Unless it's a bot or some people actually read this with interest... but why?

Drop me a comment below will ya?