Mask

I intended to pen down our journey rushing back to Temerloh using the alternative route before it became an island and totally inaccessible; which happened last Tuesday, after studying and frequently getting updates on the roads' condition. It was my first experience of brainstorming the routes while weighing between the pros and cons and the safety vs urgency of coming back to the place where I'm currently residing for working from my hometown in the heart of Kuala Lumpur.

What used to be an hour and forty minutes drive of 130km road via the highway turned into a 7-hour of 400++km journey via Kuala Pilah-Jempol-Muadzam Shah-Gambang-Maran to Temerloh. 2 cars, 3 drivers including my dad while frequently checking the road access.

The next day, the last leg of the journey had become inaccessible.
But at least Medical Department has another extra 4 physicians to mend the department including clinic, wards, peripheral referrals, covid wards, and on call.

The routes we took on Tueday, 21 Dec 2021

The routes last night, the highway has reopened and water receded in many places already

However, that is not the reason I'm writing today.

Today is one of the days when again I question myself as a physician.
The patient was so young, even less than half of my age. When my colleague passed over the case, we had that 6th instinct telling us this might be a complicated case... and true enough... the quick decisions made while weighing and thinking what's going on, the adrenaline rush while attending the rapidly deteriorating case, the added information that didn't make sense & didn't tally with the previous clinical judgment... you keep on thinking what's going on now and why is this happening?

I am grateful that the same colleague was oncall along with me; she was waiting for the never-arrived patient in critical care unit to do bedside scan and when she called the ward to ask where the patient was and got to know we're resuscitating the same patient, she came up and helped.

It was a while now, me almost breaking down while informing the grim news to the father.
But sometimes in this profession, you just had to put on that mask and wore that hat saying you're okay while delivering the gut-wrenching update in front of a large crowd.

Sometimes it made me feel like a heartless robot.

It was a very painful and difficult decision to call off the on-going resuscitation. But when we made eye-contact, we knew of the prognosis and to keep on going was probably causing more damage... At the back of our minds, what else have we missed?

As you climb up the ladder and you learn more things, you carry more weight.
You give your best maximum capacity and effort and then you pray for the best.

Today, that weight seems a little heavier. 
But you know that whatever happens, you still need to move on and attend to other cases.
So you tuck aside this case at the corner of your mind.

So that when you are all alone and the night has blanketed the world,
You can cry yourself to sleep at the incident and sift through the event to look for any pitfall or weakness on your side.

Rabbiyassir wala tu'assir
"O Allah the Most Merciful and the Most Benovelent, please bless our knowledge so that we become the tool of Your Mercy in serving the humanity regardless of race, creed, and religion"
-prayer taught by our previous lecturer and Dean, Prof Hatta S.

UKM 49th Convocation

Nov 28th, Sidang 2, Faculty of Medicine UKM

Because the date is worth a mention here.
The day we met each other day again after a while, those whom I partly owe the success to and those who walked the same paths;
The day we received our scrolls, names being mentioned, new title being announced;

Honorary mention:
Majid, JK, Agni, Ilham, Dalleen, Hema, Maryam, Ezzaty, Cheong, Hamizah, Amalin

The new norm, no guests (parents) were allowed in the hall, but families were able to watch the convocation live telecast online.

Took the opportunity to take family photos as well after the convo session;
After all, I owe my family A LOT for allowing and easing my Masters journey

And the day before, the girls took the opportunity to take photos together.
(The MDTs (MultiDisciplinaryTeam), Keep on Moving & TsumTsum girls)
These girls who were the pushers, motivators, witnesses, supporters, colleagues-came-good friends, and more like sisters in the fraternity
Each has a different background, different stories, and journeys, different struggles, different pages even though we walk the same path-

Missing Amalin

Looking back, all the blood sweat and tears, was it worth it?
Yes.
It was difficult, yes, but made easier when you had colleagues who were team players and mentors who guided you along-  
And now, each of us is walking a different pathway;
I pray the friendship lasts forever and that our paths will cross again someday.

New role, new commitments
Who knows what's in store for us in the future

Ending page "MMed Journey",
Turning to page "Physician Journey"

Rough Patch

Today is one of those days when you look back at the decisions you made and you question those decisions, wondering if you should have done it differently and if it would change the path and course that has now happened.

Today is one of those days when you question yourself if you have done justice.

I honestly don't like the day like today.

Boost(er)

A quick note.

14 Oct: Was informed that tomorrow there would be slots opened for staff who opted for booster dose; those who received their last dose at least 6 months ago, voluntary basis

15 Oct: Took the opportunity to do so, even though the next day I was oncall... better now than never yes?
So, just wanted to put this here, as a reminder.

Side effects of this 3rd dose? Pain at the injection site for slightly more than 72 hours, muscle-ache mainly at the injected arm and left chest area that lasted for 72 hours or so, a bit of flu-like symptoms but resolved within 48 hours. 

Overall symptoms were much less compared to the 2nd dose, Alhamdulillah not needing ant analgesia this time. I was still able to do oncall the next day; my MOs had a bit worse side effects and it showed on their faces during oncall, poor fellas....

The booster dose is on a voluntary basis given to higher risk groups including the frontline health care workers, the elderly, and patients with comorbid.

Afternoon Nap

I was stationed at the clinic a few days ago. And one of the patients came in. Sometimes, my opening question would be, “So, how are you today?”

And this patient suddenly burst into tears.

Putting the papers aside, I positioned myself to face this patient directly, I knew the disease follow-up questions had to wait, there’s a more pressing matter to attend to- to find out the cause of this unexpected turn of events. It’s not unusual that this kind of episode to happen, but it’s also not frequent.

This was one of the people who still must come to work throughout the pandemic. Due to the increased workload, staffs were rearranged, more work coverage for them and less off-time. Those factors and key-in other personal and non-personal factor(s), life can sometimes be too overwhelmed.

When this patient described what’s been going on leading to the sudden outburst, it was as though I was looking at myself a while back, not too long ago, recurrent in different timings & situations. It all felt too real, I needed no further probe to understand what’s going on.

I was that person.
I was in this person’s shoes.

I had no courage to call or contact Psychological First Aid back then. But I know this person needs it, and an MC to rest at least for the day.

Work burnout is real.

If someone indicates that he or she is stressed out, on whether they realized that it’s a burnout sign or not, do take a little bit of time to listen to them. Sometimes, just having someone to listen would be a great help. 

Especially now.

Filler 3: Reflection

Certainly, I didn’t plan to wake up on my birthday to being informed I misdiagnosed a patient.

However, I’m grateful to meet a few people who distracted me from being down the whole day. Conversations upon conversations later made me realize perhaps it’s not the issues of confidence and competency, rather the perfectionist side of me that’s making me afraid to take the next step until I’m ‘perfectly’ ready. That in turn discourages me from calling the shots until I have all the facts in my hands and remember everything in my mind.

It’s probably the reason I’m being too hard and too harsh on myself- that every mistake, small or big exposes my weakness and vulnerability. And this in turn drags me down further, unable to move on and got stuck at the “fact” and “conclusion” that I’m not good and I’m incompetent. That mantra kept on playing at the back of my mind until I believe that it was who I am.

Forgetting that I’m human and that human err.
Forgetting the fact that I have achieved success in the past, no matter how small they were.
Forgetting that I overcame the trials and tribulations in the past.
Forgetting that I got up from many falls, with the help of numerous people and the strength that God lend.

Maybe the fact that God sent a senior officer to point out the miss I made was meant to be. Maybe if I didn’t find the weakness and “confusion” that the patient had, we wouldn’t even diagnose the stroke, and maybe if that happened worse things could happen.

And to realize this now, finally putting the pieces together after such a long time, we came to the conclusion what’s meant to be was meant to be and if we make mistake, learn from it and don’t make the same mistake in the future.

And that I’m not perfect.
No one’s perfect.

Filler 2: Permission to-

Settling into the new place, environment, and working routine,
This will probably take some time.

In a way, it's perhaps physically slightly less taxing;
But in terms of the weight of the responsibility, and mentally, it's more and heavier.

First active general medicine on call as a physician, okay not so bad...
First passive covid on-call, so far still okay.

If there's anything that resurfaces from my ever-so-existing weakness,
It's my own insecurities and sense of incompetency and feeling unsure about everything
This, I need to "fix" it myself, and I need to improve.
This, I know will take longer than expected.

But for someone who has trouble adapting to new places,
I probably purposely jeopardize my own sanity by choosing to be deployed for the pandemic mobilization, not knowing where I'd be placed when I signed up for it...
And now they assigned me to a whole new place, I'm wondering if I'm pushing myself beyond what I can chew and if I just like to get myself into troubles.... -.-;;
Perhaps I should have just sat quietly here to adapt and get used to the new environment D=

Let's see what will happen in the next 6 weeks...

Filler: Voice

Previously while waiting for gazettement placement, gazetting specialists were allowed to choose their floating placement. Not this year, the pandemic limited that options and I decided to go to Hosp Sg. Buloh, for a few reasons. Part of it is because I wanted to see how's the situation there and learn from the team managing the pandemic fully for the past 1 year and a half.

Although many people were surprised by the 'brave' decision I took, I never regretted it but feeling much grateful and thankful for the given opportunity.

I learned and gained a lot more than expected, I worked with hardworking and helpful teams and driven consultants, I was given the chance to meet and work with hardworking albeit tired MOs, most being contract MOs & medical registrars, reliable nurses and Sister and efficient MAs and PPKs. It was a short one month but I am honoured to be given this chance.

One of the backbones of the team apart from the nurses were the MOs. I feel the pain of their uncertain future amid the heavy workload on their shoulders. Their worries are always at the back of their minds, some have lost hope and motivation even. While I can support the campaign and movement for their fair treatment, I am not in their shoes. 

But one thing is for sure: How can one work with a peaceful mind not knowing if they will be terminated by the end of the year or once they are deemed no more critical for the service?  

To these junior colleagues of mine, I pray that solutions will be there for you guys.

This issue isn't the only one that plaques the HCW during this time when the number of cases keeps on increasing. The cry of the burnout colleagues resonates through and through and every day I pray those involved, these frontliners' journey will be eased and they are given strength to trudge through the coming days.

Everyone is looking forward to the day when we can finally breathe with ease and a smile.
Never stop praying, never stop hoping.
The journey is still ongoing;

And for me, tomorrow comes another new page, a new chapter, and a new phase in this book of life.

Epilogue: The Beginning

This is just yet a prologue for the next chapter of life.
Completing MMed meaning a new role, new job scope(s) & extended responsibilities.

Peeking into the next chapter already

You know how I am with commitment.
So taking this new step is... nerve-wracking.
The effect has not yet made itself known because, amidst the pandemic, this role perhaps is paused to concentrate on the worsening situation of Covid-19.

The past 6 months have been anything but a new learning experience- admin work, coaching/leader-role, clinical work, managing covid, thesis writing, data analysis and thesis defense and balancing a whole bunch of responsibilities, handling different kinds of stress and stress level and the list go on. However, it's probably just a teaser of what's coming in the next phase. Being here for the past 4 years was.... a sheltered life. And stepping out, I don't know what's waiting... only endless possibilities and vast scenery of anything and nothingness ahead.

There's so much to say and so many things running in my mind. The different chaos happening at the same time frustrates a lot of people at so many different levels and the different reactions as the result of this could be so mind-boggling that it didn't make sense and you wonder if we have learned anything at all entering 2nd year of the pandemic.

10 years ago, it didn't even cross my mind that we'll be at the stage where we are now. 10 years ago I was beaming with the hope that one day I will walk a pathway of becoming a medical officer and maybe working my way to becoming a specialist. In what, I didn't know yet back then- maybe internal medicine, maybe psychiatry, maybe emergency medicine. But never did I imagine us living in an era of a deadly pandemic that's taking the lives of so many people. Heck, it didn't even cross my mind living like this 4 years ago- back then I put on hold almost everything I love (including traveling and volunteering work) with the hope that I would complete my studies on time and then planned to travel right after the last part of the exam to celebrate (kononnye), never did I imagine being stuck here and not being able to not just travel, but even our movement outside is restricted!

Just like that the table turned at the end of 2019 and continued to do so up till today. Until when? Only God knows.

So yes, the different reactions as the consequences of these life events that's been happening is.... kinda expected. But surely.... surely it's also an eye-opener to a lot of things, no?

Heated discussion there... XP

The silence I carry is not because I do not care.
But rather a continuous observation from inside and outside the box
Because saying something, forwarding something, and writing something carry some amount of responsibility. You're accountable for every word that you utter- it can be the truth, or it can be misleading information, so you decide which one you want to be- the spreader of truth, or the spreader or lies (although perhaps to you it's "presumed" truth) 

If you don't know and unsure, please seek the truth by asking the experts and reading from the correct, credible sources.
If you don't have anything nice to say, hold your tongue and check your fingers before typing nasty & filthy comments.
And if you don't agree with a certain opinion, just stop there but don't spread lies and misinformation.

It hasn't been a beautiful year.
Every day looks gloomy and we're at our wit's end and ready to collapse 
We may even wonder why things happened the way they are?

Perhaps there is a different path and future for each of us

Perhaps there will never be an answer
Perhaps we will only find the answers 10, 20, 50 or perhaps 100 years down the line
Perhaps it's a preparation for something bigger
Perhaps it's a reminder for the future
Perhaps it's to unravel hidden things and the ugly truths
Perhaps it's to highlight certain hidden issues
Perhaps it's a consequence of our OWN actions and words
Nobody knows...

Nobody knows.

Nobody but Allah.
Wallahualam bissawab

So I'm closing this chapter with a blank canvas for the next chapter.

Turn the page, Wani

Your new chapter is coming soon.

~*~

The Aftermath: Blood, Sweat and Tears

May 3-5th, 2021: Part 3 MMed Exam, Viva- Thesis Defence
4th May marked the day where a huge weight was lifted off my shoulders. Closing yet another chapter which was literally was blood, sweat, and tears.

Like literally.

MMed Batch June 2017- May 2021 (Incomplete quorum)

I started off this journey with a lot of hesitation. The experience as a house officer vs medical officer in general medicine was different; the more I walk this path, the more I don't know, the more difficult I felt, the more intimidated and unsure I became. But Allah has different plans for me- He diverted me back into medical and then into Masters of Internal Medicine where I knew it would be one of the toughest journeys yet. And MMed was literally blood, sweat, and tears no matter how much mentally prepared you thought you were. It would either make you or break you.

And it had almost broken me multiple times, especially during the last leg.

Nevertheless, what did make the difference are the people you met during this journey.

Part of the study group members

Allah eased my journey by letting me befriended friends who watch out for each other, lending shoulders to cry on, ears to listen to, and being keen reminders to each other. Allah allowed us to meet remarkable, impeccable, and impactful teachers, mentors, seniors, and colleagues- people whom we look up to, admired upon and they taught us many, many things from different aspects.  

Not only that, Allah gave me more than what I asked for:

- supportive family and friends outside the MMed circle and to be honest they are one of my strongest pillars of support and buffers

- challenging cases and incidents but full of lessons and wisdom and although they almost make me fall to pieces each time, I was supplicated by many hidden mechanisms to pull me through them  

- new opportunities and welcome distractions 

Ending one chapter means the beginning of another.
Successfully climbing one hurdle means facing a bigger one.

I honestly don’t know how the next chapter will be and what challenges it will bring.
To be honest, I'm more nervous than excited, especially to leave this comfort zone.
But if anything past 5 years has taught me, there’s always, ALWAYS reasons and meanings behind each event.

I just hope that in the future I will be able to look back into this post and this episode to remind myself of this.

Bismillah...

"We made it guys!" Sincerely, Tsum Tsum Girls

Pin: The Sprint, The Battle & The Truth

Enter: the last 10 nights of Ramadhan,
Key aim: gain as much as possible, re-connect, lots and tonnes of dua, the sprint

Enter: the last 48 hours before part 3 viva- the thesis defence
Key aim: survive that grueling 45-minute presenting and grilling, the battle

Enter: the last month of the masters programme
Key aim(s): finish this programme swiftly, pass over my unofficial job(s), ensure some systems are in place for the next batch to continue to manage covid cases smoothly, take a little of a break, and settle pending personal plans that I've been postponing, the sprint

Enter: Less than a month before deciding where to gazette
Key aim: Will depend on what's the next step and what's in line for me, the unknown

Enter: To be honest, at this rate- the impending coming wave
Key aim: Bracing mentally (and perhaps for the whole frontliners as well) and physically
Shortfall(s): Tired. It's been more than a year without a break. Critical care units that are always full... the struggle for optimum care- only those involved know. To be honest, we don't even have the energy to argue with those who don't believe; so pray it doesn't befall unto your loved ones.
Counter-act(s): I have to remind myself this every time- find small wins, small gratitudes and make a lot of sincere dua

Pin: Ramadhan Kareem 2021 & (throwback) 2nd Dose

Another year welcoming Ramadhan

Let this graceful month enlighten all our darkness, wash away our sorrows and ease our pain.
May the blessing of Ramadhan be on all of us and may our prayers and deeds get accepted.

Ramadhan kareem, everyone!

---

The April series photos part 1: the incomplete quorum

April 11th, lunch with them, an incomplete quorum of the Zenols

April 10th, brunch with them, an incomplete quorum of Funtastic 4 + the aunts

April 9th, dinner, and coffee with them, an incomplete quorum of MDTs

---

Throwback to 2nd dose of covid-19 vaccine, Thursday 1st April
- it was the day before the submission of our thesis/dissertation manuscript, so we decided to go slightly later in the afternoon.

The jab itself wasn't painful, but I experienced slightly worse minor side effects (compared to the first dose) afterward- feeling feverish, headache, arthralgia, and myalgia akin to viral-like symptoms that warranted regular paracetamol... they lasted for about 48 hours and after that, you'll be okay.

The SNs were so gentle that you felt nothing and it was over in an instant

Completed 2nd dose. Let's all do out part, protect yourself, protect others :)

I Believe In...

She looks at the screen
She's had conversations with different people from a different group of people- her friends, her colleagues, her superiors, her seniors, her family... and every time, with a heavy heart she whispered, "but I want to go and achieve my dreams first- the small ones and perhaps if time permits, the bigger ones, before I commit myself to whatever commitment down in the future"

She's aware and realized that after months of juggling and struggling with one task after the other and handling new responsibilities, she's discovered a new side of her that she didn't even know existed. And that has sort of opened another window of opportunities in her career pathway that she can think about in the future.

"Only that...."

"Only that I want to go and do what I've been wanting to do.... things that I have put on hold for the past 4 years since I entered into this programme," she said out loud.

It's the basis and foundation of why she chose and ended up in this career pathway.
It's the essence that she wanted to embody into her existence in the world.
It's a legacy she wanted to leave her name with.

She doesn't know how long that will take.
And she's not sure if she would even like it enough to keep on doing it.
Perhaps she'll find that with time it's not as relevant as how she thought it would be.
Perhaps with time, she no longer has any energy and enthusiasm for it.

But before she decides on that, she wants to at least dive into it, freely doing it at her own pace, and just go crazy with it until she decides to stop or slow down.

"That's the main reason I read medicine, work in health care line and progress into this programme anyway. The whole purpose of this whole thing since I was 15-16 years old is to achieve these goals. Let me have a taste of it, to see if it's as sweet as I thought it will be...

... then we can talk on what's next.

Because what's next for me, is doing it- achieving my long-term goals"

Because perhaps she'll fall in love with it, so much so that she doesn't want to do anything else.

#IBelieveInAchievingMyDreams

Pin: 1st dose

 

Ad-hoc list today.
1st dose.
Just to document this here.

#SnowFlower

Dear me,

To be honest, I thought 2020 was hard

It's only been a month and 10 days into 2021, and I don't know how many times I've already broken down in tears under the pressure, felt like I just wanted to end it and in the end, I hate the person I've become nowadays- the short-tempered, sarcastic & emotional labile walking human being. I'm not the nicest person walking around, and even I don't like myself.

You may call it self-destructive thoughts I'm having, but that's the reality.

I probably am not as resilient and as strong as I thought I would be.

So we may need to have a little bit of change in our game plan, yeah.

Give me some time.
I want to see how much I can bend under this pressure. 

"The whole world is full of white flowers

Make our atmosphere deeper

Under a stopped street lamp

May the flowers fall on your bright smile"

Snow Flower by BTS V (feat. Peakboy)

2021 : Unplug

I haven’t been able to write in my blog for a while.

Believe it or not, a lot has happened in the last 17 days.

2020 for me closed with one of the most memorable events- "This is 嵐 Live"; real-time fangirling over the online Arashi concert, crying over the last hours and minutes, being amazed at their performances, and feeling a lot of gratitude for these 5 guys whom I’ve known since 2008 and has taught me a lot about life principles, work ethics and friendships.

Kicked off 2021 with a good workout with Les Mills Bodypump and continued with RPM but had to run to the hospital halfway through to help with the Covid team. I thought I wanted to do things at "my pace" this year, but that prolly turn out to be a bit difficult.

And work continues till now, with new instruction and rearrangement every so often and troubleshooting while working out solutions are almost like second nature.

Almost at the cost (or perhaps already is) my daily ward work and thesis progress. Which worries me the most at the back of my mind.
And it almost, if not already affect me physically and mentally.

On another note, again this pandemic has unmasked and unveiled the uglier shade and truth behind a person's angelic face and persona- which is maybe a good thing so we can identify them and be more careful when dealing with them.

Unplug. Looking at things from a different perspective. 

Hence I have decided to unplug from most soc-med platforms, unplug from things that don't matter and decide to listen more, turn worries and anxiety into gratitude, take a different approach by trying to see things from different perspectives, and work on problem-solving & coaching rather than being a trouble maker and a complainer.

They are not easy tasks... but let's see how the coming days unfold and how they can help me grow.

Like rainfall over the flowers in spring, I'm waiting for spring day to come.