Second opinion

My lil' sis recently fell sick while we're at a relative hometown and we had to bring her to the local district A&E. It's not easy to see your family member lying in the sick bay attached with IV drip etc. while puking her guts out every 3omins and looking miserable.


Eventhough you knew it's just a simple food poisoning still you can't help but requesting extra blood tests.

"Err Dr Subra, perhaps we should order an amylase just TRO pancreatitis"

The young doctor look at me and gave his 'Oscar's -- Damn! You're a brilliant, how come i didn't think that diagnosis before -- best actor' look in his face.

I tersengih macam kerang busuk. But I can gauge what he had in mind would be more like "Yeah! yeah you're right ah BTW why stop there, you sure you don't want us to do a CT abdomen or diagnostic laparascopic surgery too while we're at it"


It's an always an art that a doctor has to master when one's going to another hospital and volunteer to participate in the whole management. You want to help out coz you're concern but at the same time you don't want to appear as being intrusive which may offend the attending physician.

(some smart-arse city boy doc is peeing in my A&E marking his teritory...huh!)

To cut long story short - my sis was fine and indeed the blood test showed nothing serious. A couple of litre of saline afterward she's discharged fine & dandy.

To the Jempol A&E crews... you guys were fantastic! And to the doctor sorry If I peed at your shoes that night :)

Lastly I wanna wish all of you fine people Happy 2008!!

*TRO - to rule out

Death by chocolate

I reckon the best dessert in town so far would be this 'ape ke bendanye' cool soothing ice-cream that melts slowly on top of a warm brownie cake - Ahh I forgot the name.

Absolutely gorgeous!

Too bad with the rate of its melting process - you have to devour it relatively quickly before you end up with only a cake with cream base on your plate.

So Bakerzin got it right after all - the taste linger on your palate a lot longer than a-similar-looking dessert from Vincenzo @ Bangsar which ironically pricier.

Kitchen confidential - revisited

My post on 1st May http://drfrappucino.blogspot.com/2007_05_01_archive.html where I briefly mentioned Kitchen Confidential by Anthony Bourdain (actually all I did was put a photo-cover of the book which I actually borrowed - but hey I did read it okay) was noticed by the TV-series DVD distributor based in USA.

{Oh yeah baby! Apparently 'Kitchen confidential' was turned into TV shows by the creators of 'Sex in the city'}

So the very nice lady offered to post me 'the complete series DVD-box set of the show' all the way from US for free. She thought I might wanna see it and perhaps mentioned in my blog if i want to.

Without hesitation I said yes... and a package arrived prompty 1 week afterward. I must say - I was thrilled by the whole thing.



Obviously they got the right recipe for a hit-show: the idea of some wacky and funny character (+ sexy ladies) in a 'steamy' setting of a fine-dining restaurant was wicked to begin with.

I thought the show was brilliant, alas too bad it was ended albeit prematurely by the studio maybe due to poor rating.

Know what? Honestly I think it's a lot better that Sex in the city (not that I watched the latter)

Dessert anyone?

Escape from Pangkor

It was supposed to be a 2 N and 3 D beautiful vacation. The plan was perfect. Even Danny Ocean would be pleased. Left KL with my favourite road trip CDs and head straight to Lumut and a ferry ride to Pangkor Island.

Within half and hour of arrival I got myself a nice deal at Nipah Bay Villa RM95 per night for a bungalow chalet (King size bed, hot shower and astro)

... and rented a

motor kapcai, while acting like a foreign tourist.

Lepaking at Nipah Bay beach while eating grilled corn and listening to MP3 was brilliant.

However when I got back to the chalet --- I realized my wallet was missing!!

"Damn where’s my wallet?? Arghh!!

Stay cool. Gotta stay focus".

I went to the receptionist. No one had found a wallet. It’s already 7.50pm, the sun had set.

I borrowed a chelait and went back to the beach, even trailed my route back to every stall I dropped by.

With my broken heart I head back to the chalet.

1001 questions invaded my tiny puny mind, and it’s not even income-tax season yet.

“ Shoit I got no cash with me. Who’s gonna save my sorry ass now?”... How am I going to pay the ferry fare? And whatabout the RM50 penalty for losing the carpark ticket at Lumut... Peehh how to pay for food?"

Knowing I have nil in cash, without hesitation the chalet owner gave back my room deposit even I haven’t checked out yet. Since I told him I have to return to KL the next day – he happily refund my 2nd night room fee in cash (even earlier I paid via credit card).

Gosh! He even offered to cook me dinner if I haven’t had one yet.

So with some cash to help me going, the very next morning I jumped on my bike and head back to the jetty and greeted "Good Morning" to everyone I came across!!

Once I reached Lumut – even the carpark jockey lemme out for without paying the lost ticket fine... Fuhooo!

To the owner of Nipah Bay Villa En. Sabtu and his staffs.

Thank you so much!! And highly recommend this place to everyone.

1 night chalet = RM95

Grilled corn = RM2

Missing wallet: IC, driving license, cash = big headache

Help from stranger = priceless

Goosebump!

Tingg!

I walked out of the elevator on the 6th floor heading toward the ward. This will be about 7am every day. As I'd have expected, he is sitting on his favourite chair outside the ward.

This man in his early 40's medium built has been hanging out in the ward lobby since the last 6 monhs - even from the time I started out in this new place.

I came across him at any random hours of the day or even in the wee hour of morning.

Who is this man?!

He's not a hospital staff. Never wear any kind of uniform. Unlikely to be patients' relatives coz they would come & go with patients which rarely warded up to 6 months.

I asked around but nobody seem to know or noticed this guy before.

Curiosity finally got the best of me at 1am one early morning when I happened to share an elevator with this mysterious man.

"Excuse me, I noticed that you're always here in the hospital... err are you visiting someone"

Stupid! I can hear my own carotid pulse slaping my neck. What if he took out a chain-saw from his back-pocket. My mind ran amok.

An awkward silent passed between us.

His voice was crisp and clear "I scout around for dying patients, hoping to sell casket to the families".

A faint of smile cracked at the corner of his right lips.

Padan muka aku, feel like an idiot whereby Mr Curiosity just killed the cat in the lift with a candlestick.

To be or not to be?

A 66 year old woman heart disease, diabetes, hypertension with end stage renal failure and bilateral above knees amputation collapsed while having her regular "3 - 4 hours a day, 3x a week for the rest of her life)" dialysis.

The paramedic were called in and quickly intubated (LMA) her, and she ended up in ICU.

The 'morning-after' had lotsa docs debating wheather intubating her and put her on life-support was the best course of action.

After all here is a person who have multiple chronic medical problems with no legs, now in semi-vegetative state depending on a life support machine.

Question:
Is it necessary to prolonged her life in this sort of manner?

or should the gung-ho emergency personnel let her slipped away peacefully following natural course of life & death.

Whadayexpect?

Last night a 40 year old lady with no past medical problem presented with fever, vague abdominal discomfort, painful small joints, hair loss, mouth ulcers with reduced blood counts (pancytopenia) and raised liver enzymes.

Guess what, here is the list of blood investigations & etc. that were ordered by the on-call team:

1. RP


2. Blood culture


3. FBP


4. ESR


5. RF


6. ANA


7. dsDNA


8. C3, C4


9. AFP


10. CEA


11. CA 125


12. CA 19-9


13. LDH


14. Coomb's test


15. Serum iron


16. TIBC, Ferritin


17. B12


18. folate


19. UFEME


20. USS Abdomen

...and those are just the beginning. Trust me!

Morale of the story: You don't get sick.. you dont get prick ( and stay away from those ciggies will ya mate)

Atorvastatin

Do you know that during near-death experiences, there are reports saying that people literally see their whole life flashes pass in front of them (before they were resuscitad back to life of course (otherwise how would we know rite? D'OH!).

Does this mean that human in their final moments of life on earth would re-experience these thousands of happy and sad time of their life in a split second manner.

In my countless hour witnessing these 'do not resuscitation case' deathbed scenario, the number of those who died with dramatic ending out-numbered the peaceful demise by a greater margin.

Hmm I wonder if their life were full of sad moments then?

On another note, I got both Saturday & sunday free this weekend, what a bliss. I can now enjoy what I do best on my extravaganza weekend-noon spree...

... which is post-lunch long hours of sleeping -- dozing off with Norah Jones singing in the background.


At least that's my strategy to regain back a few pound of missing fat during Posa month - my weight had dropped from 76 to 68kg.

It's darn hard listening to patient's chest with stethoscope when my shirts keep sneaking out from my mengelebeh Docker pants every few seconds.

Life

'Live life to the fullest' is something that I yearn all night long to believe in.

Yet as time passes by, I could see every tiny moment of my life slip away into a permanent state of oblivion.



There are many idealistic people out there.



I am certainly not one of them.

It got me to think of those motivational pin-up posters they make. How about this "If you need this RM8 poster to make you feel good about your life, then it's time for you to get some serious help"

Whatever

What would happen if one day, you just wake up and feel that your job is not satisfying anymore?

Is there any greater purpose out there? ... Maybe not... but hey who cares! What the heck there are many things one can do out there anyway without sacrificing your lungs to potential TB infection.

Bla bla bla.

Alone

The 3 year old boy stood silently at the corner.

He stood there watching the adults gathered around his dad whom just passed away.

His somber posture tells me that he knew something bad had just happened.

****

You can't never be too young to lose someone you love.

Independence

3... 2... 1....

31st August came and went with a bang. People from all walks of life celebrate it in many different ways. I was at the Curve to catch the fireworks which was ain't that bad.

The free open concert was a bit dissapointing though. I reckon there should be more patriotic song. But nope, the promoter thought it would be more spectacular to put on a half a dozen semi-naked dancers bouncing off their tushie to Michael Jackson's "Beat it".

But hey who am I to argue with 7,800 other people out there that night? They seem to enjoy the show.

The highlight of my 'little tour' at the midnight celebration was to see my own fellah bangsa'man posing his merdeka spirit.

I'm sure Tok Gajah, Dato' Bahaman and Mat Kilau would be proud to see our generation's mentality at the peak of our 5oth national independence.

Well Malaysia... Happy Birthday!

Reminiscence

April 2003
Peadiatric oncology ward

I was freshed out of medschool. Perplexed by the unknown and fear of uncertainty. The four month rotation in that ward changed the way I looked at human spirit forever through the eyes of dying innocent children.

I remember their faces vividly even as I share with you this story.

Too many young souls were lost within that short space of time. They showed me great strength and courage at their death beds. Those hours I spent with them in their final moment of life linger in my mind long after they had gone.

These children who live their life in hospital beds find solace with each other until one by one they would see their play-buddies died of sepsis or organ failures.

Sometimes charity groups drop by with gifts & meals, and clowns with balloons and all would lighten up their face. But behind those laughs and smiles.. most of them knew that they wouldn't probably live long enough to blow the candles on their 15th year old birthday's cake.

One of them is Sarah a 7 year old girl from Sabah. She had a primary liver cancer which is rare in children. Her sweet angelic face is unforgettable. Her laugh & giggle would lighten up the room. She fought a good fight, she survived 5 months than we had expected.

Her demise hurt me the most, with blood coming out from her every orifice she looked at me in agony. All we could provide was pain relief and blood product to stop the bleeding. She looked very thin, fragile and frightened. She passed away at 3am that morning.

***

Every now and then, when I'm alone by myself in a quiet empty place. Their faces would come to my mind and I'd find myself wept quietly for them.

Living the memory

Fantasy #57:

Performing solo piano / guitar gig, maybe Blunt's 'Goodbye my lover', now that would be wicked!

Or.. maybe deep inside, part of me still wanna become a multi-platinum rock star, singing 'You wanna make a memory' while sharing the stage with Bon Jovi.

"okayy Richiiee... 1 and a 2 and a 3...

Faded jeans and broken heart

do go well with a poet in pain.

Blues skies and midnight rain accompanied me

walking down your street in my soaked white tee while staring at your window hoping you would be there... looking at me"

...hmm but would that make me a stalker instead, or worse a potential serial killer?
Oh crap!

Boleyy ( ...boley blah!)

Hahaha!

This one really cracked me up good. At wee hour in the morning we sometime have to order 'portable' x-ray (meaning the radiographer technician have to bring the x-ray machine up to the ward) coz patients are most of the time too sick to be send downstairs to the radiological dept.

I guess the doc who ordered this x-ray really pissed off the techy guy big time, maybe the patient was gulping down his soda when he came with his big heaavvyy machine at 2am.

View from the top

Some people are so self-obsessed that they think this world should only revolves around them and quit spinning once they leave the room.

There are semi-VIPs or even worse.. perceive themselves to be one just because he's the third cousin of the Sultan's driver - would march straight to the ever-busy ER doctors and demand that they be seen by someone quick because they have an itchy dick.

I say screw these people and they just hafta to wait in line bcoz they are kids who right now need some stitches on their bleeding head.

Another kind would be the obnoxiously irritating 'loud people' who think that their presence need duly attention and every of their spoken words need to be followed. Oh they are just so loud!

On another note for those of you who need breakaway from the killer evening rush-hour jam - (one of my cheap/free ad with no bloody commission) why not head on to the Trader's hotel skybar at 6pm to catch a nice cast of sunset empowering the city in its glistening light...

...and if that doesn't help... maybe those tiny mini-me burgers will make you forget the obnoxiosly loud VIPs.

Soul-searching

Have you ever found yourself too consumed by the moment that you no longer feel like you're part of this world? It was absolutely silent and the only sound I could hear was my own breathing.

I was utterly mesmerised by the perfect loneliness which I deemed to be an effective remedy for any wounded spirit. For just about 15 hours ago, I had to deal with 3 ill-patients in the Resus room, with one of them tried to hit me in the face with his literally bloody hand while cursing my ancestors with every breath that he could mustered.

None of the remarks was taken 'cos he was sick and probably would be the nicest 90 kg 15 year old around if he wasn't poisoned by his own rising acidosis in his bloodstream, a typical picture for a diabetic ketoacidosis (DKA) in Type 1 diabetes.

Having said that, still my mind was frantically searching for other perfect ways to spend one's Friday night.

Anyhow, let those be bygones and all I wanted to do right now there and then was to indulge myself in the quietness of the moment while feeling for my radial pulse so to be certain that I'm still a regular cast in this troubled world.

1, 2.... 4!!

2am somewhere in Klang Valley...

St John: ER, coming over.

ER: This is ER, go ahead St John.

SJ: We have a 22 year-old male with SOB, over.

ER: What's your ETA? over

SJ: ETA 10mins, do you copy?

ER: Roger that, we'll be ready for you, over and out.

By the time the ambulance pulled over at the main door, the whole resus crew had already scrambled to the trauma room with the drugs syringed up, locked and loaded.

A senior emergency physician who acts as the team leader will be doing the bird-eye view on the whole resuscitation procedure and coordinate the team members to act as a unit. The rest of the team will be busy securing the airway, providing ventilation and inserting IV lines.

Phew! With that huge sudden amount of adrenaline rush who needs coffee anyway.

But what interest me though is this is the only hospital in Malaysia that address its Accident & Emergency unit as ER.

Which make me feel like I'm working in Chicago ho ho ho!

"Hey where's the GSW victim?!!"

**

SOB = shortness of breath

GSW = gun shot wound

Hidup bebas atau...

YEHAA!

Dunno what to put here anymore to be honest. Lately I've been running amok around the wards with empty thought and loaded balls. Hey it could be vice versa and that would be briliant.

Btw it took me the whole weekend to move my stuff into the new apartment. Dang! I love the place, the smell of fresh paint, the fantastic view I laid my eyes on moments before I kiss the night goodbye -- Oh the whole enchilada!

At least this new place could rejuvenate my dying moral and would be something I look forward to at the end of any given post-on call day.

Psstt! I heard a story, a doctor got a heart attack and complicated by a rhythm abnormality (arrhythmia). However, seconds before his impending collapse, he reverted the arrhythmia himself by coughed-up forcefully.

Thought that may come in handy - when you are all alone and miles away from SJMC :)

Oh btw.... MAMPUH KERAHH is bloody awesome. Willis maybe bald but he still got some nasty moves left in him.... more sequel puhlessss!

What was that again?

It had been quite busy days and weeks for yours truly. The amount of cases need to be seen just keep climbing up by the days. Most often than not, I find myself lost somewhere between the huge amount of patients and this ever-busy hospital. Huh! The situation can be even more baffling than comprehending who's who in LOST season 3.

Not to mention, the need to open up books and read around cases is a must if one need to survive in a post-grad world.

Everyone else appears to keep their composure quite allright. For some reasons that I'm yet to found out, the other docs seem to be able to breeze through their daily routine without any problems. They seem so cool and have it all suss out well within their cerebral capacity.

Am i missing something?

Is this whole thing happening because I skipped that late afternoon lecture given by that boring lecturer 6 years ago?

Sometimes I wonder if that lecture was entitled "How to look damn cool like Travolta even when you know diddly-squat about this patient in front of you"

Fever

He's 26. year old.

Professional.

Single.

The fever was abrupt in onset, accompanied by headache, muscle ache & joint pains. he went to a GP and got treated for flu instead, no blood was taken and all he got was a pain-relief injection for his headache.

At day 3 of fever he checked himself into the ER with a blood pressure of 60/40. He was already in septic-shock.

Approximately 3.5 litre of fluid in ER was infused rapidly into his veins and managed to bring his BP back up.

However the blood-vessel leakage was so great that he lost most of his circulating fluids into his abdominal cavity and lungs causing him to deteriorate rapidly in the wee hour of the morning.

He was intubated and put on rapid fluids along with inotropic drug to sustain his dying vital organ's perfusion.

Less than 24 hour after he came to the ER, his body laid lifelessly in the ICU.

One of many blood investigations that were sent to the lab came back positive that morning.

It's dengue.

typical

0500 wake-up

0530 books (sometimes channel 40)

0630 head for hospital to grab limited staff carpark

0700 ward round

0800 grand round / teaching

0900 ward round with specialist

1000 referral from ER "Hey new guy, whadayathink of this ECG, can we thrombolysed him?"

1030 call up respiratory for consult (give up after 3rd unsuccessful unanswered pager)

1100 Bed 8 chest pain --> "Lungs clear - ECG no ischeamic changes, order cardiac enzyme and repeat chest x-ray"

1200 another referral from ER -- "okay - okay bring him up to the ward"

1300 clerk the new admission

1400 quick bite in pantry

1500 Bed 3 drop her blood pressure ---- JVP reduced, looks dehydrated, low urine output fluid challenge with 1 pint gelafundin

1600 meeting with cardiothoracic surgeons

1730 pass-over ward cases to on-call docs

1800 library

2100 home

2300 bed

0200 nightmare --- 'in ward resuscitating collapsed patients'

0345 morning pee

0500 "watttt where am I?"

Killing me softly

"From now on you have to cut down on your social obligation... do tell your families and friends that they will see less of you this year...."

Hafiz the 4th year spoke with a tinge of British accent acquired during his undegrad years in UK. Mat kelate lagi tuh.

"....You're expected to do rounds on weekends too unless if you're based in coronary unit, high-dependency or emergency room...."

(insert silent pause for dramatic moment)

".. which means you will have to come to hospital everyday including weekends for the next 9 months".

He finished off his 'not so-welcoming' welcoming speech with a dry smile.

I could imagined myself stangulate him like what J.D would do to Cox in 'scrubs'.

Each team or ward is headed by one specialist, followed by his right wing man @ a registrar (4th year/final year) and the very least a first year MO aka 'freshie' aka 'newbie' aka 'bambi' aka me.

The specialist enjoy having the newbies for breakfast by giving quick quiz during morning ward rounds.

"You!... Yeah you in black tie... What are 10 common causes for atrial fibrillation??"

"Errrrr.... hmmmm..... stage fright.. hehe".

Someone quick pass me the cyanide.

Day 1

The registration day!

The new place is ain't bad. In a nutshell, fresh faces with well... fresh body odour. It's like taking a trip down the memory lane back to standard 1.

Lotsa things to do e.g security pass, name tag, new hospital car parking sticker for collection.

The new bosses are super nice, that's good to start with.

The bad news is I have to start learning about all 16 patients whom are all new to me, in 15 minutes passing-over session. Hoho it's just too early too stress out...

..arrgh where's my java chip venti???!

Silent departure

30.5.2007 Wednesday 9 am

To my surprise, my last day and on call in the ICU was uneventful. It was a good 4 hour-sleep. All patients were as stable as a sunday morning shift in Kuala Kerteh outpatient clinic. I was both delighted and sad.

I was lucky to have the opportunity to work there and to be among the few good doctors/teachers whom had taught me the importance of work ethics.

For example it was the only time in my life have I came across a consultant AKA the Head of Department who came as early as 7.15am sharp every morning beating everyone else when it comes to attendance and ward round. And this is a government hospital we're talking about here.

As the old tradition goes, it is usually the Houseman who do the 1st morning round, followed later by medical officers, specialists and then consultants.

As I close the main door behind me, a quick final glance of the place reminds me the faces of those people I had helped and also those who I could not.

"The unbroken morning! The sweet surrender of the past shall cast away the pitiful soul of regrets and

bring tears to the devil himself" - drfrapp

Goodbye my friends!

Trash talk!

You wouldn't believe weird things people would do late at night when they think other people don't see them. The thrill of doing crazy thing and being caught red handed or get away with it.

EXHIBIT A: During my heydey in down under, me and my buddies didn't mind taking a leak next to a side walk at 1 am -- hey u gotta go when you gotta go rite?

On another note people become a bunch of 'clown' when they consciously disinhibit their cingulate areas, cerebellum and the medial frontal regions of the brain bla bla!.

Oh yea! Those areas are the 'ground zero' hit by the A-bomb (alcohol... cute eh!) when one's dead drunk.

EXHIBIT B: The countless fights that happen between drunken Maori and pakeha gang at your friendly 24-hour Burger king joint where I used to work part time.

Not to mention the countless time I had to clean the toilet sink by scooping out their vomit using the burger king (TM) extra large cup.

----IS DAT YOU JACK SPARROW ??---

Question: Would a person shows her true colour (in public) when she is drunk?

Perhaps most hidden-racist would only display their charm' out-loud in public when they lost control of their action.

EXHIBIT C: I only got shouted "Go home asian boy!!' While being thrown at with Steinlager bottles at 6am after my graveyeard shift by some local kids in their speeding cars, when they're totally piss drunk.

Shocker! They could tell that I'm asian even though my uniform was XXL size with a cap on at the wee hour in the morning.

Huh maybe it's the same mat salleh kid who worked at Harvey Norman where I bought my stereo from. Dang I gave him the bloody commission for that transaction too.





AAH! THE REAL CAPTAIN JACK!! FORTUNATELY IT WASN'T YOU WHO SAID

"WELCOME TO SINGAPORE!!"

HOHO IT'S TEMASEK BACK THEN YOU HOLLYWOOD PRICK!




OOHH AAH! McCLANE SEE YA SOON 'OLD' BUDDY!

seriously mate...

Last night was my last 'on call' ever in this hospital operating theatre, soon I'll be moving out to a new place.

However, my sentimental kodak-moment during the last operation at 2am was interupted when the surgeon decided to play his favourite collection on Window media player.

To my horror it was none other than the dreadful The best of Hanson, starting with its gayish 'Mmbopp'.

Has the world gone schizophrenic... a male orthopaedic surgeon listening to that crap!

If it was me I'd play this piece... a nice powerful ballad from My Chemical Romance.!

(oh BTW, for those of you who haven't seen the clip can click on the Youtube --> right side panel).

When you go
So never think I'll make you try to stay
And maybe when you get back
I'll be off to find another way

When after all this time that you still owe
You're still, the good-for-nothing I don't know
So take your gloves and get out

Better get out, While you can

When you go
Would you even turn to say
"I don't love you Like I did Yesterday"

Sometimes I cry so hard from pleading
So sick and tired of all the needless beating
But baby when they knock you
Down and out
It's where you oughta stay

And after all the blood that you still owe
Another dollar's just another blow
So fix your eyes and get up
Better get up, While you can

When you go
Would you even turn to say
"I don't love you Like I did Yesterday"

Well come on, come on

When you go
Would you have the guts to say
"I don't love you Like I loved you Yesterday"

******
Next tuesday will be my last 'ICU on-call'.

Which will also mark my last official duty at this hospital which I've grown fond of these past 2 years.

Two years eh! Time flies.

Anyhow according to the old tradition, usually it's 'all hell break loose' on your last day . I think that's what the TV folks refer to as 'Season finale suspense ending'... Hahaha!

** Sigh**

Dengue! revisited

Once upon a night.

All ICU patients were stable. So I went up to surgical ward on the 7th floor to do a quick follow up on a newly discharged patient. The elevators on the east wing sometimes went cookoo late at night.

"Dang! the lights are not working again, this is just what I need... alone at 12am, inside a dark hospital elevator" I chuckled nervously.

Suddenly my handphone went off Justin's SEXY BACK tune.

It's the ICU. "Doctor, turun cepat ke ICU, adik Nizam berdarah keluar dari ETT... restless!!"

Aiyayayaya! It's the dengue shock case.

Nizam is your typical high-achiever Malay boy from Cheras who's also in his school's hockey team. A decent lad.

As I reached the 7th floor, I hit the button back to the ICU floor.

"Double Dang!! another trip in pitchblack darkness"

Yaikkks! I almost jumped out of my skin when I feel a soft tap on my left shoulder. I moved my back against the wall. Wadefak was datttt?

*****

"What happened?? He was okay 20mins ago" I asked the nurse who's looking after Nizam. She gave me the "YOU'RE THE DAMN DOCTOR... YOU TELL ME!" look.

Smart arse!

After taking my own pulse and practice my speed-yoga. My eyes running amok over Nizam and the ventilator trying to fit the jigsaw puzzle together. Blood soaking his bedsheet turning it into dark crimson shade (nice colour hmm.. D'Oh stop it!!)

"...well Holmes, it looks like most of the blood came from his mouth and his breathing tube. So the bleeding must have originated from his own lung, huh the clotting system is screwed big time. And a blood clot must have blocked the tube hence the ventilator can't generate enough pressure to ventilate him - Eureka!"

I felt like patting myself on the head and say Good Boy! --> Now do something about it!!

I grabbed a laryngoscope and shoved it into his mouth. Sure enough a blob of blood clot was blocking the end of the tube and to make it worse the tube was at the tip of the vocal cord which is as good as being dislodged.

A double whopper! We gotta do something fast or he's gonna die!

"Quick get me sux 100mg " I need to paralyse this boy again before i can re-intubate him.

It took 4 people to hold him down as he was coughing up blood and restless at the same time. I wait until the paralytic drug kicked into action before I use the scope again to look inside his throat but my view was blocked by a pool of blood hiding the vocal cord.

PSSSRFTTT!! -- the suction catheter screamed like a burst old tyre.

BINGO! The enemy was in sight. I changed the breathing tube in one swift motion. His heart rate suddenly dropped to 30/min.

"Quick someone start CPR!"

Nora 'the feisty 90kg' Intan, a very reliable staff nurse jumped into action and start pumped away the boy's chest with all her might. Cracking noise of adrenaline & atropine ampoules being broken filled the night.

3 minutes passed...

"We got a rhythm...!" someone yelled almost sounded like heaven!

I'm so overjoyed that I almost yelled "Do the hustle!" duh da duh da duh da duh duh da!!

That night we all stayed next to his bed correcting his clotting problem like nothing else matter. True enough, that night nothing else did matter.

*****

2 weeks later a smart-looking young man on a wheelchair accompanied by his parents visited our ICU. He brought some pulut kuning for the staff.

From a distant I knew right away that it was him.

We almost lost him that night...
... and boy! That was a close one.

Here's looking at ya kid

I went to No Black Tie for the 1st time 2 nights ago.

The place had a 'cool' feeling to it. Lemme see, in ala-ala casa impian wordings "the moody noir ambiance was dominated by low-key lighting creating deep shadows, fusing the feelings of melancholic, loneliness and entrapment".

Something like Bogart's Casablanca in technicolour... and yeah minus the beige trench coats (oh stop it u silly romantic sod!)

Did someone just whispered "Play it again Samad"?

It was May13 and the showcase was on 'unity' to commemorate that incident which happened phew!... 38 years ago. A mixture of live poetry reading intermixed with guitar acoustic gigs.I can't make any comparison to any other shows alike, because I was pretty much a virgin (Oh be gentle!) to these artsy-fartsy.


But in a nutshell it was all right, despite the fact that a BoB Marley's hair wanna be dude took nearly 20mins reading a newspaper excerpt and a guitarist who mumbled his way through 3 songs. Someone gotta be honest with him, y'know for public sake, to please improve his p-r-o-n-o-u-n-c-i-a-t-i-o-n (macam aku punyer baguss sangat kui! kui!).



Exceptional pieces include a voice over poem by Lisa Zahrin (darn one sexyy voice - too bad she wasn't there in person -- potong stim betoii!) and a new talent called Otam who has a deep husky voice as if you put Gary Moore & Louis Armstrong into a blender... HAHA! I shit you not man... this thin Malay boy can strut his stuff like a Motown veteran.

Encore!!