Doktor Pemarah

One patient came and sit in front of me " doctor, I feel dizzy". I try to dig some more history however something is fishy.
I asked her " do you have fever?"

She answers, " yes."

Do you have nausea or vomiting?

She again answered "yes".

Any abdominal pain?

Yes.

Any blurred vision?

Yes.

Chest pain?

Yes.

Are you working tomorrow?

"Yes, I think I can't go to work, doctor." Case solved. Diagnosis - MC seeker.

Some people/patient is really a pain in the ass. Sometime they can make me lost my patience. For every question I asked, I did not ask it like those worker who are conducting a survey. They have fixed question to ask without using a single brain cell. For me, at 3 am in the morning, I was so tired plus aching in my head thinking of a diagnosis of a patient with dizziness, blurred vision, chest pain, abdominal pain, nausea, vomiting..... Sound dangerous.. But she is 20 years healthy looking female. I hate when it came to this situation.

The thing is, we can give medical certificate if you want it. But 3 am in the morning and you are in emergency and trauma department where MC is not as easy as it look to give making my headache worse.

Another patient came," doctor I want to get dermato appointment for my body itchiness".

I tell him politely , " I'm very sorry but you can't cut the line. You have to wait. There is another 10 more patient waiting for their turn".

" No doctor, I can't wait. My body is itchy. I forgot to bring my medication at home"

You have medication? Where you get it from?

" I memang under follow up in private clinic but I cannot manage to pay rm30 every visit. I want to be follow up under goverment now. Just open a file for me to see dermatologist".

Its 3 am in the morning, why the hell you came for appointment at this hour?

" I went to dermatology clinic this morning, they asked me to come to casualty deparment first so I can get appointment".

#*#***!

Why the hell you came at 3am in the morning if they tell you to go here yesterday morning! And you can't cut the line!

That patient eventually get scolded by another angry waiting patient and he absconded...

Another patient came, "doctor I was having epigastric pain. I vomit 1 times while waiting for my turn, now I have no more epigastric pain"

Do you feel nauseated now?

"No."

#*#//)@!

You are 15 years old girl. Aren't you supposed to be at home with your parent now or whoever I don't care. Why are you here?

Then that girl mother came in... "Doctor, can give MC for my daughter? Already 4am, we wait for hours just now. Tomorow I think she cannot go to school.

"No!" I did not gave further explanation but her daughter is perfectly fine. Gave her some syrup magnesium trisilicate and she shud be fine. I almost reach my limit of coolness.

Later another uncle came, "doctor, I'm having cough for 1 week. I took cough medicine I bought from pharmacy but it only reduced my cough. It is still not resolving".

Any fever?

No.

Any loss of appetite, weight, blood in sputum?

No.

Difficulty breathing?

No.

With a dull face, gave him so cough syrup, entertained him with some common antibiotic, go home! Please go home and sleep! Its 5 am in the morning!

Another patient came. A young girl, with headache. No need to tell details history, I diagnosed her with tension headache / migraine. Discharge with some pain killer. But then eventually she is a private nursing college student. And her tutor came upon me. "Doctor, I think she need MC."

" A time slip for her to rest for few hours should be fine"

" No doctor. If you give time slip, she don have place to rest here in hospital. Better gave MC so she can rest at her hostel. Here in hospital no place to rest"

You are right. No place to rest. And I'm tired than you. I need more rest than her. That is just a simple headache. Even the girl did not want an MC as she told me earlier. She just need a time slip for few hours rest.

Someone please give me a time slip to rest.

For the whole night, there are more than 30 patient with weird attitude and problem coming in to casualty department for some minor2 problem. I don't know why they came.

If you have dizziness or headache. Take a rest. Drink water. Hopefully the next morning you will be fine or if not then go see doctor in the clinic. You don't need to go to emergency department for that.

If you a having fever. The same thing. Rest first. Why you have to torture yourself waiting for hours in an uncomfortable place in hospital? It will make you feel worse.

If you have diarrhea, drink a lot of water.

If you are young I mean less then 1 years old or old enough = more than 70 years old then you are welcomed if you feel unwell cause we know you may need more attention. In between that, go sleep and go clinic tomorrow morning.

I almost lost my cool each time working in green zone. Day by day the patient become worse and worse. The one that did not need urgent medical attention are filling the green zone area. The one that need attention sometime left out behind.

Lot and lot patient will request for us to see them first cause they said they cannot tolerate the abdominal pain and everything, while an old auntie just sit patiently outside and she may have heart attack inside, we don't know cause they are not like those eager bloody fool young people who think that they are the only one who are sick in this world.

After a 6 hours sleep, having a good dinner with friends, I manage to tone my anger down. Tomorrow, will go to work again with a smile. Will keep my anger inside and be polite. But you know, sometime it hurt myself with my anger burning inside.
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Battle of Modern and Tradisional Medicine

"I have cured my hypertension. My blood pressure never high anymore. I checked. Always normal. Doctor also said I do not need medication anymore" says a patient on a hospital emergency and department bed with an ECG beside him showing T wave inversion in all lead, he is complaining of chest pain, his Trop I was high and his blood pressure... 260/135. I'm imagining his head explode with that pressure so high.

What can cured hypertension? Diabetes? Even cancer? You won't find cure for this disease in a thick well recognized medical textbook, but you will find this all over the place here in our country. Traditional practioner still gaining point after long way of battle with modern medicine and somehow they always win or they never lose.

People tend to believe something or someone can cured them. Imagine of you go to a hospital and you are diagnosed with Diabetes. In the beginning the medical doctor will stand in front of you and says " your disease will never be cured. You need to take medication and change your lifestyle.. For the rest of your life." How frightening is that. If you go to a traditional practioner in contrast they will says " with the permission of God, you will be healthy as soon as possible.

Without enough knowledge, even myself will choose to go to someone that can cure me. But how far is the truth? Closer to the lie it is.

I, standing with the modern medicine and evidence based medicine I learn for years did not deny completely the Traditional medication. Somehow, maybe, at certain point, the substance they used in the herbal medication they prepared could really be an active ingredient that can cure your disease. The question is, would you risk your precious life in 'maybe', 'somehow', 'at certain point'.

Modern medicine originated from Traditional medication. After thousand years studying and filtering all the side effect that the herbs can cause, born a drug that is safe that can be use with full knowledge on its effectiveness, side effect and how to reverse the effect. This is the only difference. If you take the herbal medication, how do you measure how much is the dose that you required before the thing become poisonous? You can't tell.

A patient with a heart attack, still firm on his stand that his blood pressure is cured by the traditional medication in front of me. If it really cured then why is he here complaining of chest pain? Why is his BP shooting up high now?

With the best effort and the fullest energy, casualty doctor play their role, medical doctor throw away their weekend plan, the nurse leave their children at home, the pharmacist have to work extra time, cardiologist have to wake up at night from a deep sleep, just to treat and cure this patient.

Within few weeks, he is a normal person again. Escape from his death. His life is prolonged, another chance for him to be with his family. Now he is happy and he feels healthy.

In a few months he began to feel that the medication is a burden. He is handicapped with all the medication that he need to take. The burden cannot be tolerate anymore. He wants a cure.

And the one that can provide the cure is not the doctors. The cure is from God ( yes it is ) and from traditional medicine practitioner. Once again the cycle restart. We will never win, and they will never lose.
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A concern to Malaysia Government

I try not to talk about politics in my blog. This is not like a politic post but more like a citizen post who sit under the middle class group of Malaysian.

I have observe a lot of wind of change flying everywhere. I don't like to be involved in politic but I do have my right to vote. I never against government and I never reject opposition. Which one that make sense would be enough for me.

I just feel that from my point of view, talking to a lot of patient, a lot of middle class goverment servant, private worker, coffee talk, pedestrian, stranger in a cinema, ear dropping them all.. I guess I have not met one person that agree that the current government should continue ruling this country?

Why? We did live peacefully. We are much more peaceful compare to other country in south east asia. What is wrong with the government?

It is actually not the policy or law that concern this middle and lower class group of citizen which make the most of voters.. It is the person who are on the top that they concern about. Maybe this class like me and the rest not interested enough to study the details of law and rule that government made but for them the person that they don't like will shape their vote.

Why they did not like our politician? Not because of the law, or the project or road not completed, but they now more to looking at those politician spending money, appear very rich while they struggle to live. Nobody care if a road is terrifying if the politician walk the road with them. With us.

Simple minded like this sometimes make sense in shaping this whole country. Day by day since previous election, politician never stop gaining wealth and living these people behind them. They forgot to turn their head to look at these people who start talking, start walking away.

I've met a few uncle and auntie from rural area of Sabah, even them said they don't like government. I ask is it because their life condition did not improve, they don't care about that cause they live they life like that for a long time. They hate the government because of the people up there... They are arrogant, they rich, they took our money..

I don't know what will happen in the next election. Even in a state like Sabah which I am pretty sure BN is strong but people here start talking. From this talking, it can generate a wind, a wave, later a tsunami of change.

Should pay more attention to this...

I did not believe people in Sabah start talking about changes... But this is it. It can happen.

Hope we made a right choice. I just want Malaysia to be peaceful like this forever.

P/S: I did not need to talk about my hometown Labuan. It's a war of thought and idea there. Sabah could remain without a wave, but in labuan, a wave is already generated.
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