Upon further reading, my assumption right now is that she might have gastric carcinoma with secondary metastasis to the liver and neck LN (these are just my mere postulations since the results are yet to be known).
As I continue my reading, my heartbeat was drumming faster and faster. I find myself reluctant to know more, since the reality is too painful to swallow.
"Gastric carcinoma is a HIGHLY MALIGNANT adenocarcinoma” was the 1st sentence of the subtopic Gastric Carcinoma. I braved myself to read more.
"This aggressive cancer metastasizes early by way of lymph nodes, blood stream, and peritoneal spread".
As I scrolled more down the topic, I learned that treatment of this cancer involves radical surgical resection, either partial or total gastrectomy with resection of adjacent lymph nodes as well. It provides the only hope of cure and is also the best way to palliate the patient’s symptoms.
Unfortunately, the few last sentences were really heart-wrenching to me: “A palpable tumor in the left upper quadrant or an enlarged liver is an ominous finding, usually indicating advanced, inoperable disease. Radical gastric resection is contraindicated if liver metastases are present. These patients cannot be cured.” And in another book, “The detection of liver metastases often alters the surgical management of patients with cancer. Since most of these patients will have incurable disease, the primary goal of surgical intervention is to palliate distressing symptoms rather than undertake radical surgical resection. Overall, less than 10% of patients will survive more than 1 year after diagnosis."
Ya Allah… Beratnya rasa dada ni… Innalillahi wa inna ilaihi raaji’un...
"Setiap bencana yang menimpa di bumi dan menimpa dirimu sendiri, semuanya telah tertulis dalam Kitab (Luh Mahfudz) sebelum Kami mewujudkannya. Sungguh, yang demikian itu mudah bagi Allah. Agar kamu tidak bersedih hati terhadap apa yang luput dari kamu, dan tidak pula terlalu gembira terhadap apa yang diberikanNYA kpdmu. Dan Allah tidak menyukai setiap orang yg sombong dan membanggakan diri…” (Al-hadid: 22-23)
I began to wonder how am I going to explain these harsh facts in a patient so hopeful to be cured. Especially after I grew close to her 2 daughters. Everyday when I salam her to go back, she will hug me and whisper, “Doakan makcik sihat ye Hana”. But just today, she looked into my eyes and asked, “Dari bacaan laporan makcik ni, penyakit makcik ni dah teruk ya? Kalau dia buat lagi teropong tu, katalah memang asal ketumbuhan dari perut, jadi Dr nak buat macamana? Boleh lagi ke nak baik penyakit makcik? Kalau tak, makcik nak cuba rawatan alternative”… I felt like crying...
This patient is religious too, she is the only patient in the female ward whom I saw praying when she was sick. Sometimes when I visit her during my oncalls, she would ask, “Ni semua ni kerja tak tentu masa ya?” I replied, we have oncalls every week. Then she adviced me so softly, “Nanti dah kerja esok, sebelum keluar rumah tu niatlah dua perkara, nak cari rezeki dan redha Allah. Barulah dapat kedua2 perkara ni. Kalau nak cari rezeki je, dapat satu je.."
Antara cara yang dianjurkan oleh Islam untuk mengingati mati adalah dengan menziarahi qubur, dan menziarahi orang sakit. Just nak muhasabah semua medical students, nurses, doctors, etc… berapa ramai patients yang kita jumpa setiap hari? Ramai kan? Tapi, berapa kali kita mengingati mati dalam sehari? Bila kali terakhir kita mengingati mati sampai berdebar dada, menggeletar badan dan menitis air mata? Bila kali terakhir? Adakah hari ini? Semalam? Bulan lepas? Tahun lepas? Atau tak ingat bila last time kita ingat mati?
Atau, setiap kali kita jumpa patients tu, hanya utk kepentingan studies kita semata-mata? Nak cari case best-best, nak cover patients utk case presentations, nak cari case write-up, nak present case kat OT… macam selfish je bunyinya kan?
Friday, January 8, 2010
Emotionally Involved - Episode I
10th February 2009
7.45pm
As a medical student, I try very hard not to get involved emotionally with the patients I see everyday in the ward, especially those patients assigned for me to clerk, examine and follow-up. However, despite preventive measures, these attempts – of not getting emotionally affected – usually fail.
I was recently assigned a female patient who is 52y/o, nearly the age of my mother. Because this pt is sooo motherly and kind and caring, I grew sooo attached to her and began to love her more and more everytime I see her.
She presented with massive hepatomegaly (enlargement of the liver), so massive that the liver capsule is already stretched and thus causing her pain. Lower border of her liver could be palpated 18cm below the subcostal margin (imagine how big the liver span would be), and even the left lobe was enlarged, huge enough to be felt in the left upper quadrant, up till 10cm below her left costal margin.
Back to her case, suspicion of hepatocellular carcinoma was rendered unlikely by blood investigations of liver function test which was relatively mildly impaired and alpha fetoprotein which was normal. Hepatitis screening was also negative.
To cut the story short, the primary tumor turned out to be a gastric tumor. Biopsy showed atypical cells but the histopathologists were unclear of the exact diagnosis. Therefore gastroscopy was adviced to be repeated for a second tissue biopsy. However, currently the patient refused due to unbearable pain and discomfort during the process.
This evening I tried persuading the patient to redo the endoscopy and she asked a lot of questions regarding whether or not the agonizing process would affect her Mx later on. I promised her I would read more and explain to her again tomorrow, including the treatment options that the patient was so interested in.
To be continued...
Wednesday, January 6, 2010
Kisah Mama dan Umar
“Mama, kenapa Mama solat nampak leher?”
“Eh Umar ni, kan Mama pakai telekong ni!”
“Tapi Umar boleh nampak leher Mama. Ustaz kata kalau nampak aurat tak sah solat Mama”
“Sayang, kan Mama pakai telekong ni”
“Umar tau, tapi telekong Mama jarang, kira mcm tak tutup aurat juga Ma. Sebab syarat untuk tutup aurat, tak boleh ketat, tak boleh jarang juga. Solat tak tutup aurat, tak boleh kan Mama?”
“Pandailah kamu ni Umar. Mana kamu dapat semua ni? Tak boleh jarang semua ni”
“Ustaz ajar kat sekolah”
“Siapa ustaz tu? Ada tauliah ke?”
“Hmm, Umar tak tahulah apa maksud tauliah di mata manusia Ma. Tapi Umar yakin, sbb Ustaz tu ckp dgn sokongan ayat Quran & hadith. Nama dia Ustaz Amar bin Maaruf”
Mama terdiam seketika. Entah bagaimana, egonya luntur seketika.
“Hmm, jarang ke telekong Mama ni?”
“Mama, kan Mama juga yang ajar Umar dari kecil, menipu tu dosa. Umar tak tipu Ma”
Tiba-tiba Mama jadi emosional. “Tapi Umar… Selama Mama baligh sampailah sekarang, mmg Mama solat guna telekong ni Umar… Ni telekong hadiah dari arwah nenek Umar tau…”
Bergenang air mata Mama.
“Mama, Ustaz Amar cakap, kalau kita buat suatu kesalahan atau dosa sebab jahil, Allah itu Maha Pengampun Ma”
Mama terdiam lagi.
“Mama, cuba Mama fikirkan mcm ni. Katakan Mama simpan duit dalam bank setiap bulan. Lagi 10 tahun, Mama nak keluarkan duit tu untuk belanja Umar sambung belajar. Tapi lepas 10 tahun, Mama tengok akaun Mama kosong! Apa perasaan Mama?”
“Eh, kenapa boleh jadi mcm tu. Mama akan siasat, report polis, saman syarikat bank tu”
“Tapi, mcmana kalau Mama sendiri yang tersilap no. akaun? Jadi setiap bulan selama 10 tahun, duit yang Mama simpan tu tak masuk akaun bank Mama. Mcmana Mama rasa?”
Mama terkedu seketika. Kemudian menjawab, “Hm, takkanlah, mana pernah jadi macam tu”
Umar cuba beranologi lagi, “Mcm tu juga Ma, kalau kita dah beribadah setiap hari pada Allah, solat 5 waktu sehari selama berpuluh tahun kita hidup, tp bila tiba hari perhitungan, tengok-tengok ‘akaun’ solat kita kosong. Rupanya solat kita langsung tak diterima sebab tak sah! Mungkin sebab wudhu’ kita tak sempurna ke, sebab aurat kita tak tutup dgn sempurna ke, dan lain-lain sebab lagi.. Bayangkan, masa tu, takde siapa dpt tolong kita Ma.. Kita nak kembali ke dunia pun dah tak boleh…
Mama, kita nak buat apa-apa ibadah kpd Tuhan yang telah menciptakan kita, yang memberikan rezeki dan macam-macam nikmat pada kita, yang menjaga kita setiap masa… Pasti kita nak buat yang terbaik, kan Ma? Kita akan usaha sungguh-sungguh supaya ibadah kita Allah terima.
Macam tu juga dgn solat Mama. Kalau kita hanya solat ala kadar, asal buat je, laju pula, takda tama’ninah, tak perhatikan syarat sahnya, tak usaha utk khusyu’ di dalamnya, Mama rasa mcmana? Rugi kan Ma, kalau kita solat 5 kali sehari, tapi akhirnya tak dapat apa-apa melainkan ‘exercise’ semata-mata (silap-silap sampai 'peluh nece' sbb solat laju sgt, mmg exercise sungguh!). Di hari pembalasan nanti, tengok-tengok solat kita tak diterima rupanya, Na’uzhubillah… Jadi alang-alang kita buat, biar buat yang terbaik, dgn ihsan, agar Allah sudi menerima solat kita, insyaAllah…”
Umar menyambung lagi, “Tak susah kan Mama, Umar tengok cara solat Mama insyaAllah dah ok, rukun-rukun lain dan sempurna, cuma tinggal nak usaha utk khusyu’, dan lengkapkan dgn pakaian yang menutup aurat dengan sempurna… Mama pakailah tudung ke dalam telekung tu, baju lengan panjang supaya tak nampak tangan… Atau Mama jahit je 2 lapis kain semayang tu, Mama kan pandai jahit”
“Ok insyaAllah, tapi kamu cakap senanglah Umar. Kamu tu lelaki, bukan kena pakai telekung mcm Mama ni”
Umar telan air liur. Kali ni apa nak jawab ya. Fikir Umar, fikir…
“Mama, tak semestinya kena pakai telekung untuk solat Ma. Kadang-kadang, kalau pakai tudung biasa yang tak jarang pun lebih sempurna berbanding telekung yang jarang, betul tak Ma?
Umar pernah baca satu hadith: إن لك من الأجر على قدر نصبك ونفقتك
"Sesungguhnya bagi kamu ganjaran pahala berdasarkan kepada kadar keletihan dan belanja ikhlas kamu" (HR Ad-Dar Qutni dan Al-Hakim)
Hadith ini Nabi pernah sebut kat Aisyah pasal umrah yang Aisyah buat: إنما أجرك في عمرتك على قدر نفقتك
"Sesungguhnya ganjaran pahalamu (wahai Aisyah) ketika umrahmu ini adalah berdasarkan kadar kesukaran dan wang yang dibelanjakan"
Imam An-Nawawi ulas, zahir hadith ini menunjukkan ganjaran dan pahala dalam ibadah akan bertambah dengan bertambahnya keletihan dan belanja yang dikeluarkan…
Jadi, memanglah Ma, Umar boleh solat pakai kain pelekat je. Tak pakai baju pun takpa. Tapi, Mama lagi untung tau. Kesusahan Mama nak pakai telekong, nak kena tutup semua, kalau bukan kat rumah, Mama nak ambil wudhu’ pun kena bukak tudung, pastu basah-basah kena pakai tudung pulak, etc… Kalau Mama ikhlas, pahala Mama lebih besar tau, lagi best! Betul tak Mama?”
Friday, November 13, 2009
An Experience as a 'Doctor' - The Lessons
#1
A lot.
#2
Dr. KMK did not actually do any teaching for us last Friday during his clinic. But amazingly, we learned A LOT from him. How come eh? Inilah yg dinamakan Dakwah bil hal. Dakwah dgn perbuatan, dgn akhlaq yg baik. Ia jauh lebih memberikan kesan berbanding kata-kata semata. Sebab tu sbg Dr nanti, akhlaq kita, tutur kata kita, cara kita bawak diri, cara kita berkomunikasi dgn org lain, dgn colleague kita, dgn staff nurse, dgn patient sendiri, yang tua dan yang muda, yang miskin dan yang berada.. kalau kita buat semuanya dgn akhlaq Islami, berpandukan Kitab Suci dan Sunnah Nabi, semuanya akan menjadi teladan yg baik utk dicontohi..
Dan "Bila seseorang menerima hidayah dari Allah SWT disebabkan kamu, nescaya hal itu lebih baik dari unta yang berwarna merah,” (HR Al-Bukhari dan Muslim). Rasulullah SAW menyebut unta merah, sebab unta merah adalah unta yang paling baik masa tu. Mungkin mcm ferrari merah la kot skrg ni. I dunno lah keta-keta ni.
#3
Mak patient yg colour blind tu ckp, “I know it can’t be rectified, I know it can’t be cured. But is there any way he could be helped? Any sort of enhancement or something?”
Silence. Utk seketika.
“Not at the moment, unfortunately”, Dr KMK jawab dgn penuh rasa empati, dgn nada suara yg berbau simpati. Dengan body language dan gaya tangan yg seolah turut sama mengerti. Tp kemudian disusuli pula dgn sesi motivasi. Yg sungguh menyentuh hati. Sehinggakan patient yg pd mulanya slightly depressed, (or rather his mom yg seemed more worried), akhirnya keluar dari bilik consultation dgn senyuman yg terukir di bibir.
They did not find any solution for the chief complaint of colour blindness. Nor did they gain any therapy that could correct this particular genetic defect. But what they received was a ‘therapy’ far more precious. The smile on their faces emerged as if their problem has been solved, as if the defect has been cured. Suatu kepuasan yg luar biasa setelah menerima kata-kata nasihat dan pemberi semangat dari seorang Dr. Kata-kata nasihat yg lahir dari pandangan positif seorang hamba Allah yg sentiasa husnuzzon dgn Tuhannya.
#4
Kadang-kadang juga, kita asyik je duk tengok org ni lebih kat sini, org tu pulak kelebihan dia mcm tu. Tp diri kita sendiri dilihat penuh kekurangan. Serba-serbi tak kena. Tapi kita lupa, Allah itu Maha Adil dan Saksama. Pastinya setiap insan akan punyai kekurangan dan kelebihan masing-masing. Kelebihan yg sudah tentu akan dipersoalkan kembali nanti, bagaimana ia digunakan dlm menunaikan hak Allah. Mungkin org ni kelebihan dia lukis kartun, mungkin org tu pulak kelebihan dia menulis. Org ni pandai masak. Org tu pulak pandai hias rumah. Org ni terer ingat Anatomy, org tu pulak hebat dlm Pharmaco. Org ni kalau exam medic mesti distinction, tp org tu pulak cepat hafaz ayat2 al-qur’an. Org ni maybe colour blind, tp VA 6/6 both eyes. Org tu pulak, walaupun tak colour blind tp VA 6/60. Sebagai contoh la.
Bila kita gagal utk melihat kelebihan diri kita sendiri, maka kita juga pasti akan gagal utk mensyukuri apa yang Allah bagi pd kita. Sebab kita tak mampu nak menilai nikmat pemberianNya.
But beware, in recognizing the gifts Allah has bestowed upon us, let it be just enough to make us count our blessings, and channel it to gain Allah’s pleasure, not too much of acknowledgement to let riya’ appear.
#5
Bagaimana sabarnya ibu bapa menjaga kita sejak kecil suatu ketika, begitu jualah sepatutnya kita layan mereka bila mereka sudah tua, bila dah ada cataract kat dua-dua belah mata, bila kaki mula menggigil2 kerana osteoarthritis kat lutut sini sana, bila jalan sgt lambat sebab cepat letih dan susah nak nyawa… Sebagaimana mereka mencuci dan menyalin lampin masa umur kita setahun dua, mampukah kita nanti melakukan perkara yang sama utk mereka?
A lot.
#2
Dr. KMK did not actually do any teaching for us last Friday during his clinic. But amazingly, we learned A LOT from him. How come eh? Inilah yg dinamakan Dakwah bil hal. Dakwah dgn perbuatan, dgn akhlaq yg baik. Ia jauh lebih memberikan kesan berbanding kata-kata semata. Sebab tu sbg Dr nanti, akhlaq kita, tutur kata kita, cara kita bawak diri, cara kita berkomunikasi dgn org lain, dgn colleague kita, dgn staff nurse, dgn patient sendiri, yang tua dan yang muda, yang miskin dan yang berada.. kalau kita buat semuanya dgn akhlaq Islami, berpandukan Kitab Suci dan Sunnah Nabi, semuanya akan menjadi teladan yg baik utk dicontohi..
Dan "Bila seseorang menerima hidayah dari Allah SWT disebabkan kamu, nescaya hal itu lebih baik dari unta yang berwarna merah,” (HR Al-Bukhari dan Muslim). Rasulullah SAW menyebut unta merah, sebab unta merah adalah unta yang paling baik masa tu. Mungkin mcm ferrari merah la kot skrg ni. I dunno lah keta-keta ni.
#3
Mak patient yg colour blind tu ckp, “I know it can’t be rectified, I know it can’t be cured. But is there any way he could be helped? Any sort of enhancement or something?”
Silence. Utk seketika.
“Not at the moment, unfortunately”, Dr KMK jawab dgn penuh rasa empati, dgn nada suara yg berbau simpati. Dengan body language dan gaya tangan yg seolah turut sama mengerti. Tp kemudian disusuli pula dgn sesi motivasi. Yg sungguh menyentuh hati. Sehinggakan patient yg pd mulanya slightly depressed, (or rather his mom yg seemed more worried), akhirnya keluar dari bilik consultation dgn senyuman yg terukir di bibir.
They did not find any solution for the chief complaint of colour blindness. Nor did they gain any therapy that could correct this particular genetic defect. But what they received was a ‘therapy’ far more precious. The smile on their faces emerged as if their problem has been solved, as if the defect has been cured. Suatu kepuasan yg luar biasa setelah menerima kata-kata nasihat dan pemberi semangat dari seorang Dr. Kata-kata nasihat yg lahir dari pandangan positif seorang hamba Allah yg sentiasa husnuzzon dgn Tuhannya.
#4
Kadang-kadang juga, kita asyik je duk tengok org ni lebih kat sini, org tu pulak kelebihan dia mcm tu. Tp diri kita sendiri dilihat penuh kekurangan. Serba-serbi tak kena. Tapi kita lupa, Allah itu Maha Adil dan Saksama. Pastinya setiap insan akan punyai kekurangan dan kelebihan masing-masing. Kelebihan yg sudah tentu akan dipersoalkan kembali nanti, bagaimana ia digunakan dlm menunaikan hak Allah. Mungkin org ni kelebihan dia lukis kartun, mungkin org tu pulak kelebihan dia menulis. Org ni pandai masak. Org tu pulak pandai hias rumah. Org ni terer ingat Anatomy, org tu pulak hebat dlm Pharmaco. Org ni kalau exam medic mesti distinction, tp org tu pulak cepat hafaz ayat2 al-qur’an. Org ni maybe colour blind, tp VA 6/6 both eyes. Org tu pulak, walaupun tak colour blind tp VA 6/60. Sebagai contoh la.
Bila kita gagal utk melihat kelebihan diri kita sendiri, maka kita juga pasti akan gagal utk mensyukuri apa yang Allah bagi pd kita. Sebab kita tak mampu nak menilai nikmat pemberianNya.
But beware, in recognizing the gifts Allah has bestowed upon us, let it be just enough to make us count our blessings, and channel it to gain Allah’s pleasure, not too much of acknowledgement to let riya’ appear.
#5
Bagaimana sabarnya ibu bapa menjaga kita sejak kecil suatu ketika, begitu jualah sepatutnya kita layan mereka bila mereka sudah tua, bila dah ada cataract kat dua-dua belah mata, bila kaki mula menggigil2 kerana osteoarthritis kat lutut sini sana, bila jalan sgt lambat sebab cepat letih dan susah nak nyawa… Sebagaimana mereka mencuci dan menyalin lampin masa umur kita setahun dua, mampukah kita nanti melakukan perkara yang sama utk mereka?
An Experience as a 'Doctor' - The Story
"Dr siapa yang tengok ni tadi? Oh, Dr Farhanah!"
Gulp. Telan air liur. Selama ni kalau patients panggil Dr, boleh lagi ckp, “Makcik, sy student je, belum jadi Dr lagi,” sambil tersengih...
Tp, bila yg panggil tu adalah Specialist sendiri, maka terkedulah seketika… lebih-lebih lagi depan private patients, takkan nak sengih-sengih ckp “Eh sy student lagi…” Jadi, tidak dapat tidak, muka pun diusahakan utk di‘control’ supaya kelihatan seprofessional yg mungkin.
Saat tu, baru tersedar.. Seolah terkena renjatan elektrik. Tak lama lagi kita tak boleh dah berada di zon yg selesa. Tak lama lagi title DOCTOR tu bakal menggalaskan suatu tanggungjawab yg bukan sembarangan di atas bahu kita. Tanggungjawab yg melibatkan nyawa dan emosi manusia. Tanggungjawab yg sgt memerlukan keikhlasan, ketabahan, kekuatan, serta ketahanan mental, fizikal dan emosi yg kuat.
In the Ophthalmology Clinic...
My 1st 17-year-old male patient complained of colour blindness which he just started to notice a year ago. But he wasn’t really sure until his doubt was answered 2 months back during JPJ test when he faced difficulty in eliciting the numbers during colour vision test.
Dr. KMK first explained briefly regarding the pathophysiology of the condition. The cells are there, but for some unknown reason, they are not functioning. But the cells are present.
The patient however, wanted to become a pilot. But because of the strict colour codings used for pilots in landing planes especially, it was not a safe choice.
So, Dr counseled both the patient and his mother on the choices he could alternatively take in pursuing his dreams.
"This colour blindness should not stop you from achieving what you dream of, from doing what you want to do, or from being what you want to be. There are however certain fields in which colour-coded instructions may cause you slight difficulties, and may even be harmful to you. But there are sooo many other courses and paths you probably have never even thought of.
Remember, this is not the end for you. But this is the beginning for you to open up your heart for a wider range of choices, opportunities which are perhaps better than what you initially targeted for. There’s a better fate out there which Allah has destined for you, and He thus made this colour blindness as a turning point to diverge you to achieve the path which He has chosen for you, the choice which He knows is best for you…Believe me, you are going towards something better. You just need to look at it positively"
Sang ibu dan anak mengangguk-angguk. Mungkin terkejut dan kagum dgn kebolehan Dr utk memberi motivasi yg begitu mengesankan.. Bukan patient je yg terkesan, 'Dr.Farhanah' yg tengah diri kat tepi tu pun sama-sama terkesima jugak.
Betul ckp Dr kan. Kadang-kadang kita tak dpt pilihan yg kita nak. Tp rupa-rupanya, Allah dah sediakan sesuatu yg jauh lebih baik utk kita, sebab sebagai Pencipta, tentulah Dia yg Maha Tahu what’s best for His creations. Mungkin kita suka sangat kat seseorang ni, tengok agama dia baik, keturunan dia baik, family dia baik.. Tapi sayangnya dia dah berpunya. Aduh, kecewa di hati hanya Allah yang memahami. Tapi kita tak tahu. Jodoh kita rupanya seseorg yg lebih baik dan lebih sesuai utk kita. Malah, dialah yg terbaik yg Allah dah taqdirkan utk kita. Sebab mcmana baik pun seseorang itu, tak semestinya yg terbaik utk kita, kan?
Aduh, ni contoh yg sangat jauh menyimpang dari tajuk sebenar ni.
Masa Dr ckp mcm tu, berkobar-kobar rasa. Kalaulah satu hari nanti dpt jumpa ubat atau solution yg boleh ‘menghidupkan’ atau membangunkan cone cells kat retina yg mungkin sedang tidur atau tak aktif, dan boleh solve the problem of people with colour blindness, kan best. Mungkin boleh guna genetic engineering and correct the defect at the molecular level, sebab dia genetic kan. Wah, tingginya cita-cita kan.
Tapi, bermimpi itu tak salah. Never stop dreaming, but you must also work for it. Pemikiran yang besar melahirkan cita-cita yang besar. Dan cita-cita besar bisa melahirkan semangat dan tindakan yang luarbiasa besar!
Gulp. Telan air liur. Selama ni kalau patients panggil Dr, boleh lagi ckp, “Makcik, sy student je, belum jadi Dr lagi,” sambil tersengih...
Tp, bila yg panggil tu adalah Specialist sendiri, maka terkedulah seketika… lebih-lebih lagi depan private patients, takkan nak sengih-sengih ckp “Eh sy student lagi…” Jadi, tidak dapat tidak, muka pun diusahakan utk di‘control’ supaya kelihatan seprofessional yg mungkin.
Saat tu, baru tersedar.. Seolah terkena renjatan elektrik. Tak lama lagi kita tak boleh dah berada di zon yg selesa. Tak lama lagi title DOCTOR tu bakal menggalaskan suatu tanggungjawab yg bukan sembarangan di atas bahu kita. Tanggungjawab yg melibatkan nyawa dan emosi manusia. Tanggungjawab yg sgt memerlukan keikhlasan, ketabahan, kekuatan, serta ketahanan mental, fizikal dan emosi yg kuat.
In the Ophthalmology Clinic...
My 1st 17-year-old male patient complained of colour blindness which he just started to notice a year ago. But he wasn’t really sure until his doubt was answered 2 months back during JPJ test when he faced difficulty in eliciting the numbers during colour vision test.
Dr. KMK first explained briefly regarding the pathophysiology of the condition. The cells are there, but for some unknown reason, they are not functioning. But the cells are present.
The patient however, wanted to become a pilot. But because of the strict colour codings used for pilots in landing planes especially, it was not a safe choice.
So, Dr counseled both the patient and his mother on the choices he could alternatively take in pursuing his dreams.
"This colour blindness should not stop you from achieving what you dream of, from doing what you want to do, or from being what you want to be. There are however certain fields in which colour-coded instructions may cause you slight difficulties, and may even be harmful to you. But there are sooo many other courses and paths you probably have never even thought of.
Remember, this is not the end for you. But this is the beginning for you to open up your heart for a wider range of choices, opportunities which are perhaps better than what you initially targeted for. There’s a better fate out there which Allah has destined for you, and He thus made this colour blindness as a turning point to diverge you to achieve the path which He has chosen for you, the choice which He knows is best for you…Believe me, you are going towards something better. You just need to look at it positively"
Sang ibu dan anak mengangguk-angguk. Mungkin terkejut dan kagum dgn kebolehan Dr utk memberi motivasi yg begitu mengesankan.. Bukan patient je yg terkesan, 'Dr.Farhanah' yg tengah diri kat tepi tu pun sama-sama terkesima jugak.
Betul ckp Dr kan. Kadang-kadang kita tak dpt pilihan yg kita nak. Tp rupa-rupanya, Allah dah sediakan sesuatu yg jauh lebih baik utk kita, sebab sebagai Pencipta, tentulah Dia yg Maha Tahu what’s best for His creations. Mungkin kita suka sangat kat seseorang ni, tengok agama dia baik, keturunan dia baik, family dia baik.. Tapi sayangnya dia dah berpunya. Aduh, kecewa di hati hanya Allah yang memahami. Tapi kita tak tahu. Jodoh kita rupanya seseorg yg lebih baik dan lebih sesuai utk kita. Malah, dialah yg terbaik yg Allah dah taqdirkan utk kita. Sebab mcmana baik pun seseorang itu, tak semestinya yg terbaik utk kita, kan?
Aduh, ni contoh yg sangat jauh menyimpang dari tajuk sebenar ni.
Masa Dr ckp mcm tu, berkobar-kobar rasa. Kalaulah satu hari nanti dpt jumpa ubat atau solution yg boleh ‘menghidupkan’ atau membangunkan cone cells kat retina yg mungkin sedang tidur atau tak aktif, dan boleh solve the problem of people with colour blindness, kan best. Mungkin boleh guna genetic engineering and correct the defect at the molecular level, sebab dia genetic kan. Wah, tingginya cita-cita kan.
Tapi, bermimpi itu tak salah. Never stop dreaming, but you must also work for it. Pemikiran yang besar melahirkan cita-cita yang besar. Dan cita-cita besar bisa melahirkan semangat dan tindakan yang luarbiasa besar!
Friday, November 6, 2009
Diary of Serdang FORENSIC Graduates - The Lessons
Above all, what I learned from Forensics, especially in Serdang…
Lesson #1
You need not be a fierce, arrogant, egoistic, bigheaded person swollen with pride to be called a BOSS. You need not humiliate, underestimate, degrade, put down or disgrace everyone else around you to become a LEADER. You need not yell, shout or ‘bark’ at those working under your supervision once you become a PROFESSOR or a CONSULTANT. You can still be humble, nice, friendly, soft-spoken, and you can even drink and make jokes with your fellow colleagues, but still be a respected, appreciated, well-loved, BIG BOSS.
Lesson #2
Allah can take our lives anytime, anywhere, without any warning, without any sign. He has innumerable ways of ending the lives of His slaves. One minute you may be well and healthy, driving your car to a friend’s place, or back from your college.. The next thing you know, you are already in a different world altogether, a ‘world’ with no means of turning back. No more chance to perform taubat, ibadah, or good deeds as much as you possibly can. No more opportunity to apologize to the people whom you are guilty towards. No longer able to settle unpaid debts, no more chance to repent over the countless mistakes and sins you may have repeatedly done. We do not know the manner of our death, dan di bumi mana kita akan mati. We can only pray that Allah will grant us with husnul Khatimah, while trying our best to achieve it, insyaALLAH..
Lesson #3
Suicidal attempts are quite common rupanya, we had 3 suicidal cases in a week. 2 of them were Chinese, another was Malay, but schizophrenic. Any form of depression, stress or sorrow, if we do not return and humble ourselves to our Creator and seek for help and solution from Him, anyone can end up taking his or her own life to leave the world and the problems in it behind. Tp kita sebagai org Islam, kita kan ada Allah, and the simplest way to put it, like they say, a man who kneels in front of Allah and gantungkan segala harapan kpd Dia, can stand up in front of anything… Instead of saying "Oh Allah, I have a big problem", why not we say "Oh big problem, I have Allah".. Apa2 pun yang terjadi, gembira atau sedih, musibah atau nikmat, kembalilah pada Allah…
Lesson #4
Most of the suicidal and murder cases, were believed to have a relation with WOMEN based on the suggestive histories. Even the 1st murder case ever recorded in this world, Qabil who killed Habil, was also due to women factor. Rasulullah S.A.W. pun pernah bersabda, "Tidaklah aku tinggalkan fitnah yang lebih besar bagi kaum lelaki melebihi fitnah wanita” (HR Bukhari dan Muslim). Lelaki, berhati-hatilah. Wanita, usahalah dan jagalah diri, jangan sampai diri kita menjadi fitnah buat mereka…
Lesson #5
I heard before, the concept of tawakkal can be likened to a mayat yg dimandikan oleh pengurus jenazah, the body is incapable of doing anything, hanya berserah bulat2 pada si pemandi mayat… Amru Khalid ckp salah satu anologi tawakkal ibarat kepasrahan hati di hadapan Allah sebagaimana pasrahnya mayat di hadapan org yg memandikannya. Macamana org yg memandikan mayat membolak-balik tubut mayat seenaknya. Begitulah kita katakan pd Allah, "Ya Allah, lakukanlah semua yg Kau kehendaki, aku pasrah dan redha dgn apa yang Kau lakukan terhadapku, aku bertawakkal padaMu, kerana aku yakin Kau tidak akan sesekali menjerumuskanku menuju kemudharatan".. Tapi tak bermakna kita tak perlu usaha, ya..
Lesson #6
Bila tengok mayat, terdetik dalam hati, “Wahai arwah, aku jua insyaAllah akan menyusulmu suatu hari nanti…”
Lesson #1
You need not be a fierce, arrogant, egoistic, bigheaded person swollen with pride to be called a BOSS. You need not humiliate, underestimate, degrade, put down or disgrace everyone else around you to become a LEADER. You need not yell, shout or ‘bark’ at those working under your supervision once you become a PROFESSOR or a CONSULTANT. You can still be humble, nice, friendly, soft-spoken, and you can even drink and make jokes with your fellow colleagues, but still be a respected, appreciated, well-loved, BIG BOSS.
Lesson #2
Allah can take our lives anytime, anywhere, without any warning, without any sign. He has innumerable ways of ending the lives of His slaves. One minute you may be well and healthy, driving your car to a friend’s place, or back from your college.. The next thing you know, you are already in a different world altogether, a ‘world’ with no means of turning back. No more chance to perform taubat, ibadah, or good deeds as much as you possibly can. No more opportunity to apologize to the people whom you are guilty towards. No longer able to settle unpaid debts, no more chance to repent over the countless mistakes and sins you may have repeatedly done. We do not know the manner of our death, dan di bumi mana kita akan mati. We can only pray that Allah will grant us with husnul Khatimah, while trying our best to achieve it, insyaALLAH..
Lesson #3
Suicidal attempts are quite common rupanya, we had 3 suicidal cases in a week. 2 of them were Chinese, another was Malay, but schizophrenic. Any form of depression, stress or sorrow, if we do not return and humble ourselves to our Creator and seek for help and solution from Him, anyone can end up taking his or her own life to leave the world and the problems in it behind. Tp kita sebagai org Islam, kita kan ada Allah, and the simplest way to put it, like they say, a man who kneels in front of Allah and gantungkan segala harapan kpd Dia, can stand up in front of anything… Instead of saying "Oh Allah, I have a big problem", why not we say "Oh big problem, I have Allah".. Apa2 pun yang terjadi, gembira atau sedih, musibah atau nikmat, kembalilah pada Allah…
Lesson #4
Most of the suicidal and murder cases, were believed to have a relation with WOMEN based on the suggestive histories. Even the 1st murder case ever recorded in this world, Qabil who killed Habil, was also due to women factor. Rasulullah S.A.W. pun pernah bersabda, "Tidaklah aku tinggalkan fitnah yang lebih besar bagi kaum lelaki melebihi fitnah wanita” (HR Bukhari dan Muslim). Lelaki, berhati-hatilah. Wanita, usahalah dan jagalah diri, jangan sampai diri kita menjadi fitnah buat mereka…
Lesson #5
I heard before, the concept of tawakkal can be likened to a mayat yg dimandikan oleh pengurus jenazah, the body is incapable of doing anything, hanya berserah bulat2 pada si pemandi mayat… Amru Khalid ckp salah satu anologi tawakkal ibarat kepasrahan hati di hadapan Allah sebagaimana pasrahnya mayat di hadapan org yg memandikannya. Macamana org yg memandikan mayat membolak-balik tubut mayat seenaknya. Begitulah kita katakan pd Allah, "Ya Allah, lakukanlah semua yg Kau kehendaki, aku pasrah dan redha dgn apa yang Kau lakukan terhadapku, aku bertawakkal padaMu, kerana aku yakin Kau tidak akan sesekali menjerumuskanku menuju kemudharatan".. Tapi tak bermakna kita tak perlu usaha, ya..
Lesson #6
Bila tengok mayat, terdetik dalam hati, “Wahai arwah, aku jua insyaAllah akan menyusulmu suatu hari nanti…”
Diary of Serdang FORENSIC Graduates - The Narration
A week in Forensic Department, Hospital SERDANG was like a week in Orthopaedics, in a sense that we had to attend seminars, lectures, case presentations/department CME, hospital CME, and at the same time assist autopsies, prepare for our own CME presentation, and finish a report by Friday which was like a case write-up.
But the best thing was, all the staffs, from the PPK to the ‘small’ big boss, were all very very friendly, down to earth, funny, cooperative, and everyone was willing to teach and share their knowledge.. They spoke and borak2 to us as if we were their staffs and kids yg dah kenal sejak sekian lama, and they all regarded us as their fellow colleagues who are therefore permitted to use some but not all of the basic facilities, and... obliged to treat them makan-makan at the end of the week!
We were given a new logbook, not for RM3 but for free, and the rule was simple. Each student had to observe 10 cases, and perform/assist at least 2.
So, we divided ourselves into pairs, so that each group will have the chance to assist. On the very 1st day, the ‘breathtaking’ experience started. Wah, breathtaking indeed. Sampai tak bernafas dalam autopsy room tu. Yelah, 1st timers kan. In the morning of our 1st day, we had the 'joy' of observing 2 cases after our brief orientation by MA Hairi.. And in the afternoon, dah takde observe2 dah. Wear your gowns and assist!
Each case had its own storyline and history. Histories which I’m not sure if I should reveal. Looking at death notes left before suicidal attempts, the cries of their grief-stricken family members, the ways or methods they had chosen to end their own life, the faces of shocked relatives during pengecaman mayat… All seemed to be like a drama in front of us. But we were quickly reminded, it was real. We dealt with police and investigative officers for the 1st time.
Alhamdulillah, by Allah’s will, we had the chance to encounter a variety of manners and causes of death. From natural causes, to suicide, murder, and accidents. We also had a lecture on Gunshot injury by Prof Karim with special police guests to demonstrate on weapons.
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