The End

The day will come when my body will lie upon a white sheet neatly tucked under four corners of a mattress located in a hospital busily occupied with the living and the dying. At a certain moment a doctor will determine that my brain has ceased to function and that, for all intents and purposes, my life has stopped.

When that happens, do not attempt to instill artificial life into my body by the use of a machine. And don't call this my deathbed. Let it be called the Bed of Life, and let my body be taken from it to help others lead fuller lives.

Give my sight to the man who has never seen a sunrise, a baby's face or love in the eyes of a woman.

Give my heart to a person whose own heart
has caused nothing but endless days of pain.

Give my blood to the teen-ager who was pulled from the wreckage of his car, so that he might live to see his grandchildren play.
Give my kidneys to one who depends on a machine
to exist from week to week.

Take my bones, every muscle, every fiber and nerve in my body
and find a way to make a crippled child walk.

Explore every corner of my brain.
Take my cells, if necessary, and let them grow so that, someday,
a speechless boy will shout at the crack of a bat
and a deaf girl will hear the sound of rain against her window.

Burn what is left of me and scatter the ashes
to the winds to help the flowers grow.

If you must bury something, let it be my faults,
my weaknesses and all prejudice against my fellow man.

Give my sins to the devil.
Give my soul to God.

If, by chance, you wish to remember me, do it with a kind deed or word to someone who needs you.

If you do all I asked, I will live forever.

- Robert N. Test (1924 - 2002)

Anaesthetist vs surgeon

07:45

"All the drugs syringed up yet? You never know which one of these elective cases might pulling your leg around" the boss sounded extra cheerful today. Ahah! He musta got himself lucky last nite.

Well lemme see... the 4 epitome of life:

1. atropine -- in case the heart rate goes down


2. ephedrine -- if the BP drops


3. thiopentone -- in case you need to gas them down


4. scoline -- to paralyze the body, if needing rapid sequence induction

07:55

1. gas machine aka GA (general anaesthetic) machine checked --> no leakage


2. intubation trolley all prepared


3. M.A.L.E.S (err just happen so): mask, airway, laryngoscopes, ETT, suction - checked

08:00 Patient is on the operating table. Waiting for surgeon to show up.

08:15 Still waiting for the surgeon

08:30 Idle mode switched on :(

Finally, I can't take it anymore, this is worse than waiting for RAPID KL bus
Me: "Nurse could you check up on dat surgeon... Dr Seymore Butt, whether he's on his way? Thanx"

Nurse: "Well.. he still stucked with his ward round, he's sending down his registrar Dr Buttkiss instead to do the first case"

Me: "Well he better quick! Or he'll be seeing his butt on my shoes instead!"

Wel there you go... great tales of heroic surgeons and their ever-loyal sidekick anaesthetists are so over-rated in Hollywood these days. Their tricky relationship is somewhat similar to a married couple.

The fact is one needs the other to fulfill the meaningful purpose of one's own existence in the operating room.

"...for thy shall neither cut open an awake patient, nor gas him for fun"
--- dead pond scrolls, Jurusalem 586BC

Yet there are times when the two do not get along well. In the eyes of a patient, usually it's the surgeon who stands out. No wonder in the private sector, anaes gotta claim only 30% of surgeon's fees.

+++ EPILOGUE:
11pm
Seymore Butt (phone call): "Allo dude! We got a very bad MVA (motor vehicle accident), 16 year old, Mat Rempit had an argument with a tree and lost. GCS 6/15; small subarachnoid bleed with no midline shift, intubated in ER, diagnostic perioneal lavage was positive ?Intra-ab injury, probably spleen rupture, vital signs stable we're pushing him straight into trauma OT!"

Me to OT team: "Ok guys lets have it all.. I want the whole enchilada! Central line, arterial line, 6 pint pack cell O-ve standing by.. and make sure Dr Butt's ass comes in with the boy! ....and in the meantime could someone make coffee??"

**4 hours later In ICU**

Seymour Butt: "Heh the boy might make it .. He may live to remp-it another day"

Me: "Well the heart lives my friend, we'll just hafta wait and see whether the brain survives, as the great Morpheus once said.. one cannot lives without the other".

We looked at each other in unison and in that brief moment the spirit of camaraderie runs thicker than our blood.

+++

Tagged?! Oh no!

"I used to be a front-page model in Play-cat magazine"

I got tagged by Dr M!

Being a new kid on d blog, this tagging is sorta new concept to me. Gee now I have to tell 6 weird things about me huh.

1. My nickname at highschool was 'straight'. I didn't know that i was a geek back then... hmm?

2. I'm a right handed person, but i'm a lefty when it comes to writing.

3. My first trip to Penang, Langkawi & Cameron Highland was last year.

4. I quit smoking in 2nd year med after seeing a lung-cancer specimen in pathology museum.

5. Although I loveee mocha, I always got bloated after drinking it.

6. As i grow older i become more terrified of getting a needle injection.."weii smallerr needlee 24 gauge tadak ka"

***Uhh dats it ya.. too much of confession isn't a good thing :P

The man who drank too much

BEEP ! BEEP ! BEEP !

What aa... what's dat? Silent. Darkness.

BEEP! BEEP! That sound again....

whadda .. where am I .... oh it's the holy

pager -- #5658.

Reaching in the dark I almost knocked the phone over. Bugger.

"Yaa, who's thiiiss.. " My voice hoarsen due to gallon of Nestea's green tea.

"Hey u gotta come to ER stat! I got a guy here who almost drowned himself by drinking too much water, and i can't intubate him " a desperate female voice echoed on the other line.

I knew the voice, one of my close buddy in the emergency room got herself in a shitty position, and unless u're in a ER's toilet, that's never a good thing.

"Gimme 2 secs, I'll be der.... watever u do make sure u can ventilate him !" reminding her what she already knew.

A 100m dashed to the ER at 2am was never recognised as an extreme sport, i wonder why but 2 shakes of a lamb's tail later I arrived at the crime scene and only to find it as bloody as a battle-field.

"The tube just won't go in" Linda's voice shaken, i could almost see the agony of frustration in her light brown eyes.

BP 75/40....Pulse rate 30/m - someone yelled in the background

"Start CPR! 1 mg adrenaline & 1 mg atropine IV bolus" my voice widely awake now while positioning myself at the patient's head relieving Linda.

I snapped open the laryngoscope blade and shoved it into the man's throat, hunting for his vocal cord - but the view was obscured by a litre of his own frothy tracheal secretion.

"Suctionnn pleasse" PSSRRRRFTTTTTTT !!! The yonker suction made a screaming noise while suctioning a 1/4 litre of secretion resulting in a clear view of Mr Vocal cord.

Thank God it's a Cormack Lehane I and with a bit of magic from cricoid pressure that Linda gave.. steady steady... my right hand maneuvered the ETT tube and gently tuck it home beyond the cord.

"He's in V. tachy... no pulse" She yellled.

I grabbed the defib paddle, charged it to 150 Joule... "CHARGEED! CLEAR !"

*ZAPPPPP!!!* -- no response --

CPR continued with multiple boluses of adrenaline.

"He's in V. Fib". "CHARGED! CLEAR !"

-- no response --

"agaiin" No movement. Flatline.

It's been 40 mins. His pupils were fixed and dilated, no spontaneous breathing, BP unrecordable. Pulseless. We decided to call it.

"Time of death 02:44" .

Linda broke the bad news to the family.

Silent. Followed by anguished cries from his loved ones.

Apparently, this 30y old guy overdosed himself with illegal drugs 3 weeks ago resulted in liver and kidney failure. He was treated for 2 weeks and was discharged well a couple of days ago.

However, despite advice from his doc he overloaded himself with water up to a point where his recuperating kidneys can't take it anymore and he went into acute pulmonary oedema (wet lungs) as if he had jumped into a river and drowned himself.

The first attempt was not a cry for help after all.

*gambar hiasan*

Human & car.. any similarities?

"Ini bulan 8 awak punya next service 60,000 km, kene tukar itu timing belt $1700, campur itu drivebelt, spark plug airfilter, auto transaxle fluid dan brake fluid.. sume skali plus itu diskauuun ---- pit pit pit (pressing a calculator as big as my palm - takot salah kira kot) ... hmm u kena bayaa $2500"

"Waadafak" the green goblin inside my stomach shouted back at me.

It never crosses my uninquisitive mind that after 5 free services in
the past 2 years, the 1st car-service that i'm required to pay would
butt-slap me with a big 2.5 grand. What happen to foreplay... can't we start with something small like $200 - 300??

Grrr.. don't make me angry Mr car-service man, U don't like it when I'm angry. Hmm I wonder what would happen if docs would start be telling this to their patients.

"Hmm since now you have reached age 40 y-old, we need to change your Mitral valve, left kidney, right eyeball, and those are gonna cost you only $20,000 with our Raya promotion. Plus we'll throw in a nose-job for free"

Well you folks ever heard preventitive medicine?
The basic tenet is maintaining wellness, and maximising the quality of life during the ageing process.

It involves scheduled check up on healthy people, making sure that the 'brake fluid and oil filter' still in good shape and anticipate any future illness that may lurk around in near future. Rather than waiting for the car to break down and towed to garage for repair i.e a sick people brought in by ambulance for a heart failure, that by then it might be too late.

You throw in a combo of preventitive + rejuvenation medicine (e.g. Omega Three, CoEnzyme Q10 are sum of the proven supplements in fighting anti-oxidant and heart diseases).

Now those have the potential to be the next big thing that our private medical service has to offer to Malaysia's own baby-boom population.

You savvy matey?

Retrospective mode

1 st hour at work:
I'm starting to feel this mind-numbing throbbing sensation between my eyes. PHB aka post-holiday blues is at its worst, gotta get sum prozac to ease things out! Argh the pain -- killing me softly

Objects in the rear view mirror may appear closer than they are

2 KM approaching Karak toll, heading towards KL:

Black clouds ! Darn it i hate when it rain along this treacherous (doesn't quite fit in - but whadaheck) highway. In the background, Bono is almost at his top vocal form -- old age creeping on ya mate~!

See the stone set in your eyes

See the thorn twist in your side

I wait for you

Sleight of hand and twist of fate

On a bed of nails she makes me wait

And I wait without you
With or without you

With or without you

Through the storm we reach the shore

You give it all but I want more
And I'm waiting for you

What a beautiful world...

3 days ago @ beach:

I could almost see the naked ocean breeze blowing gently on my face, the sun almost dissappearing somewhere beneath the endless purplish horizon. This holiday is coming to its end, one could always wish it wouldn't. If i could only summoned my remaining energy to lift up my feet toward the beach and dive into the cold water for the last time... well there I say one more for the road.

Sayonara Cherating!

Patriot games

Phew! NO SWAMP. I also found out that I could still beat the crap out of sum 25'sters in jogging 2km under 18 mins. Not bad for a couch 'pringles' potato eh!

The place was nice, lots of cool landscape and for a city dude like me, i consider the basic facilities were waaay above average (unlike sum stories i heard).

This is where the fox screamed during 'flying-fox'

I was wrong. Those BTN people were not there to brainwash us toward any political party's interest. We were given real facts about the bad old days on how hard it was for Tunku and the others in gaining our independence.

We were colonized for 446 years + 7 days. From the days when atok-nenek moyang of Christiano Ronaldo, van der Westhuizen, Beckham & the Japs invaded our shores, our nation had suffered tremendously, oppressed and robbed of her freedom.

The participants were reminded about the importance of Unity and partnership and the origin of Social contract that begets our national constitution. How Tunku, T.C Loke and T. Sambathan formed amazing partnership in claming the ultimate victory for our nation from the brits (unlike the way of the indons vs the Dutch).

The truth is the Malays, Chinese & Indians will always co-exist in this country. Malaysia is for us to share with & live together. The new generation has simply forgotten about this while enjoying Beyonce's "to the left2" and shake their bon-bon showing some crack and their midriff. I know I had (although not the latter bit.. shucks!)

I'll be eastward bound tomorrow morning. And while I'm at it, patriotism is in the air.

PS: Strange.. we all thought our group facilitator looked exactly like Tun Abdul Razak.. how appropriate.