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"

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.

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

Less Than 12 Hours Away

Hello,

Hi, I'm dropping by to say that I'm very nervous
For tomorrow and the next 3 days.
It's not just me I'm sure...
Too nervous to even think about what I want to wear for tomorrow

I've been dropping this to my personal journal the past few days
But it still doesn't take away the nerve-wrecking anxious feeling pre-exam 
And I don't want to bother people in my IG and Twitter list

So let me just engrave this here,
That, even after 19 years post-SPM (high school exit exam),
Even after 9 years of post-medical school exit exam,
And 3 years post-MMed part 1,
Exam still induces SVT-like palpitation,
Especially the clinical exam.

Wish us luck!

One Step

Took this picture to remind me in the future of my first Reg call- the 6th call
The first on-call wasn't so bad, the second one I could only catch an hour of sleep
Feels like quite some time ago, the no-sleep on-call ^.^;

So the first step was taken,
Survived it, thank goodness. But my first MROC, weekend call to top it off, will come next week- am guessing another bout of palpitation will come sometime within 48 hours prior to that on call.... ^.^;
It sounds like I'm putting on a big drama, doesn't it?
But for a commitment-phobic like me, yeah, it feels like a big deal

A great teacher left us these words during our final year,
Toughen up during housemanship; even when you're tired or completely knocked down, just don't complain. Do your best, make sure to give it all you've got in these 2 years. Don't be calculative (exact words were 'jangan berkira sangat') with your colleagues, cover for them, have good teamwork!

That was sort of a mantra, and a frequent reminder when I was a house officer
Now even after that phase has passed, the whole message still stands, no matter which level you're at, you do need to toughen up, don't be calculative, have good teamwork... and this insyaAllah will ease your journey.
May Allah bless her caring soul...

Throwback: Face Down (2012)

Crossroads

Excuse me while I contemplate on life
At this age, I’m kind of ashamed that I still go through this kind of struggle
But,
Watch me grow
Walk with me
Watch me break through my struggles
In the hope of becoming a better person
One who can contribute to humanity, life, and my deen
InsyaAllah

Life is about making choices

From the smallest, trivial ones you have to make on a daily basis

To the important or life-changing decisions

I made my decision 

There’s no doubt that I want to progress and make that jump one day

I have made up my mind the moment I applied for Masters

I knew this day would come

But I’m still too scared to take that jump, to hold that title, to carry that responsibility

They said “with big role comes big responsibility”

Recently Sakurai Sho (of Arashi) said “with freedom comes a big responsibility”

I’m surprised at his statement, but I can understand from where he’s coming from;

You are given the freedom to make your own choices

You have to take accountability of the choices that you made

And you follow through

And you do your best to uphold that responsibility

Because in the end, it will come back to you

Some outcomes are measurable

But some aren’t so easy to measure

Your life satisfaction for example

Are you happy with the choices that you made?

I have made my choices

And I’m walking through these decisions,

Amidst my ongoing struggle to break through from my inferiority complex and my introvert personality

Yet, it still doesn’t hold back the fears that I’m having

I still feel incompetent

I still feel like I’m doing mistakes,

I still feel like other people are unsatisfied with me

Then I become more and more scared

I’m becoming angrier and angrier

I’m always in a bad mood these past few days

And I’m upset with myself most of the time

And finally I broke down

And I prayed,

Then it felt slightly better

The weight on my shoulder became just slightly bearable

And that palpitation calmed down a bit

And that anxiety simmered down a little bit

And I can breathe slightly better

At this juncture, there’s no more turning back

I should just hold my head high and face it forward

And hope to be more confident

And pray I make the best choices

The first step is usually the hardest one to take

And I’m sure I’ll be facing more and more hurdles as time goes by

So I might just as well bite it and give my best

And pray everything will come out alright

Tawakkal...

Ya Allah Ya Fattah… Iftah Alaiyah….


Please excuse me while I contemplate on life

[ Fight Song , 嵐 ]

새로운 시작은 늘 설레게 하지

모든 걸 이겨낼 것처럼---

내가 지쳐 쓰러질 때까진

어떤 이유도

어떤 변명도

지금 내겐 용기가 필요해---

It's always exciting to start over

Like you're gonna get through everything---

Let's start from now

Whatever the reason,

whatever the excuse

I need courage right now---

[ 시작 by Gaho (Itaewon Class OST)]

credits : https://lyricstranslate.com

 

//Trying to concentrate in Epilepsy Made Easy online course. Felt so long ago I joined a full-day course... The new norm, teachings are done online, social distancing is priority to break the infection....

When I joined MMed programme for Internal Medicine, Year 4 seemed so far away... The registrars at that time were very impressive, detailed, and confident. I wondered if I would be able to get to that stage one day.

That was in mid-2017.

3 years have passed, it's 2020 now. A lot has happened; we're still in the midst of pandemic and living in a new norm.

At the end of our second last posting, in the feedback session, I realized I still haven't overcome one weakness of mine that has plagued me for as long as I remember. I knew at that time I said to myself, give me a little bit of time, I'll overcome it.

Then we had the exam in February, where the self-confidence just plummetted further realizing I still don't know much... I take it as a miracle that I passed the theory paper. Clinical exam however is postponed due to COVID-19.

Now we are progressing into the new semester, some of us suddenly upgraded to being (pseudo)-Registrars of the ward. That title alone gives me chills and puts a heavy burden on my shoulders. 

They say "with big roles, come big responsibilities."

And I realized it's mainly because I still haven't overcome my (ultimate) weakness: Self-Confidence.

which I don't have.... Self-doubt? I have that, a lot. But the confidence to carry this responsibility as a Registrar, and when we passed, Specialist... I wonder why does it still sound like a far distance goal, something that is out of my reach when it's near?

"The more you learn, the more you don't know"

Yes, we hear that a lot too... and I know this, experiencing it and I still feel like I still have a lot to learn... I still feel like I'm taking small steps and I'm still new to this field. And that scares me.

I guess it's because to have that confidence, you have to know your facts... and facts are something that I don't think I have enough. Yes, you can say all the more reason to learn in MMed... I am trying... But I still don't find it enough... 

And that thought is running through a never-ending loop in my mind, feeding further to the self-doubt that is already peaking inside me... it's like a repeated cycle, an obsessive thought that's running in the background.

I have some real issues here...

...

So maybe.... maybe this break that we unexpectedly received before the second part of the exam is the break that I need to sort out these issues. 

Time to reflect and find solutions. Time to build something.

Time to get used to be in this position and to take a step further...

I have a feeling that I'll be jotting down a lot more entries than expected this year, leaving more footprints, taking it one step at a time. So remember these, Wani :

Try to take a step forward on your own, utter "Ganbatte!"--

まずは自分で踏み出してみて

「頑張れ」そんな安いヤツでいい---

First, try to take a step forward on your own

"Do your best"　Such a simple phrase is fine---

[ Fight Song , 嵐 ]

credits: https://yarukizero.livejournal.com/40047.html

P/S- I love love LOVE the drama Itaewon Class! The development of the storyline & characters, the OSTs, the casts; everything!

Related post : Reflection : One Step - my first entry entering Masters

Haematology, a humbling posting

//Above is a snapshot of an abnormal blood smear magnified under the microscope

I'm doing Haematology posting. To be honest, I have always though that Haematology as a world of its own, a foreign sub-specialty even though we learnt the basic stuff in medical school. The first day of my first weekend round in Haemato, Dad sent me to the hospital and asked which posting I am in currently. When I said Haemato he went, “About blood only right? It should be easy, yes?”. I almost went berserk at that statement XD

Blood composed of a lot of constituents which include red cells, white cells, plasma, coagulation factors, platelets etc. Your white cells further have different types i.e. your granulocytes (neutrophils, basophils, eosinophils), monocytes, lymphocytes (B-lymphoctyes, T-lymphocytes, NK-cells). Each of these red and white cells as well as platelets come from a common precursor/immature cells called haemapoeitic stem cell that later differentiate into different cell lineage. Amazing yes?

During the process of differentiation and maturation, at any step the process could go wrong and thus causing your haematological cancer (leukaemia, lymphoma, multiple myeloma), and there could also be structural defects or enzymatic / constituent defects for example in red blood cells (thalassaemia, sickle cell anaemia, iron defienciency anaemia, G6PD (enzyme defiency which cause your red cells to breakdown when exposed to certain agents), haemolytic anaemia where your red cells breakdown for different reasons e.g. infection, malignancy, immune mediated where your immune system attack the red cells), or deficiency in any of the other blood products (e.g. coagulation Factor VIII or IX deficiency in haemophilia or thrombocytopenia which is low platelet which can be due to different reasons) or too much production for example in polycythaemia rubra vera where red cells production is excessive. Not only that, your bone marrow i.e. the factory that produces blood can also have problems i.e. not producing enough blood like in aplastic anaemia, myelofibrosis or abnormal production e.g. myelodysplastic syndrome. I can go on and on and on and the list will just continue.

For us, once you recognize a problem or an issue, the next step is how to manage it.

Back in medical school, our Dean Prof Hatta, taught us a prayer that I still recite until now - "O Allah the Most Merciful, the Most Benevolent, please let us be the tool of your Mercy in serving the humanity regardless of race, creed and religion"

I currently have a few patients under my care who are around my age- One gentleman with a very rare refractory extranasal, extranodal NK-T cell lymphoma whose disease is far ahead of us and kept coming faster than the next cycle of chemotherapy and he would be in pain, because the cancer “grows” on his muscles and bones. If you want to look at it from the point of “fighting cancer”, we’re definitely at the loosing end. Patient and family however is still looking for a miraculous cure.

Another gentleman with progressive lymphoma, now affecting his central nervous system which made me learn about Omaya Shunt and intraventricular chemotherapy. His condition is complicated with many infections after infections which affect his chemotherapy schedule. He asked “why did I get (all) these (infections), Dr?” My reply, because he's immunocompromised, meaning his immune system is low hence he could easily catch any sort of infection. But beneath that question is, "Why me?"

Haematology for me is a very humbling posting- from dealing and learning from these patients, to learning from my consultants and specialists; amazed at the level of passion and care they have for their patients, and it made me realized again and again that the more I learn, the more I don't know...

"Which then of the bounties (favours, gifts) of your Lord will you deny?" 
[ar-Rahman 55:13]

Panda Run! I mean, Panda Rolls

 So yesterday I had my first fun run; after days being "badgered" by a colleague to do so (and she succeeded in pulling not only me, but another friend as well) I repeatedly said to them I can't run (which was true) and we would only walk. And since we're all on the same page, that was really the agreement.

Until I kinda.... walked slightly faster than them (>.<)
To be honest, I kinda surprised myself- at the little stamina that I had to sustain short run and fast-pace walk, and at how much I enjoyed it. Maybe those hours at the gym helped. Maybe my sister's advice on "try to go as fast as you can without compromising your breathing pattern". Maybe putting on upbeat songs while walking/jogging/running helped.

//Us, before starting

//And we finished!

//See how cute the finisher medal is!

So after run, we makan la kan? XD

Anyway, now entering 2nd year, we have a bit more time over the weekends if not doing on-calls. Supposedly that time is filled with studying, yeah I know... but one thing lead to another, we have yet to restart the engine of the study group. Past 2 semesters, we used the time after work to sit down and discuss questions, but now even after office hours we're still seeing referrals so there need for a dedicated time over the weekends for group discussion.

But 3rd sem is approaching the end fast and we're still yet to start the engine... Being into rotations with minimal people is also not helping. Ilham and I were having hard time adjusting to it; it's slightly better now but we're still agitated receiving referrals.

And I've added an extra activity into my already busy schedule- trying to keep up with 150 mins per week of physical activities. I guess there was a reason why I got into Endocrine as my first rotation this sem- giving advises like "cut down your sugar" and "you have to exercise at least 150 minutes per week, activities that make your heart rate goes up and you to sweat" are only believable when you're doing it yourself. At least now I can look into my patients' eyes and say these mantra without feeling guilt.

Working out for me also means venting out all those frustration and pent-up anger etc. You kinda literally feels lighter and satisfied after a good session, thanks to the endorpins and dopamine released. I think I have a better sleep and better energy at work too.

And those days I go to the gym, those are my happy-pill days because I got to spend time with my cousins! 

//Ok, this was when we went out for dinner, but these 2 girls are part of my support system for a long time :)

Now that I steadily scheduled exercise into my routine, the question is, how to fit in studying into the equation? Questioning myself this means that I'm entering a panic mode. Exam is only 3 semester down the road. (>,<)

Sticky Note 1-2018 : Madrasah Ramadhan (1)

//Sticky Note:

I am still somewhat green in this field, still learning the ropes and steps but sometimes when you’re working in this field, in general medicine especially, you’re sort of "immune" when you’re dealing with dying patients / death. Automatically there’s this invisible, protective barrier surrounding you, devoid of any emotions so that you can manage your next patient without having the recurrent thoughts of that particular patient looping in your mind.

I still remember the first time I encountered a patient that we (the team) issued “DNR” (read: not for active resuscitation, for best supportive care) in my second posting as a House Officer, I was shaken and I almost cried (read here). At the time, I kept asking myself if I did the right thing.
Nowadays, issuing DNR when indicated (i.e. when we postulate that the prognosis is poor) is something that is not as hard as before.

But my first referral in Resus during on-call last Monday, I lingered around longer than expected, trying to make sure the patient and family knows what was happening, what was bound to happen and how we planned to deal with it. A young gentleman with terminal metastatic cancer and we know that nothing much we can offer except for comfort care; to counsel him while he was still awake and aware, something struck my core.

He’s not much older than me, and he’s probably at the end of his life. I wonder how it feels to be in his shoes; not being able to do much and depending on others to care for him, with shortness of breathand his bloods showing multiple organ impairments… when I was counselling his sister, I myself almost tear up.

Another recent young death, Mr Ali Banat, also resonated in similar way- a young gentleman who passed away recently due to cancer, being able to contribute up to his last breath. These people were given chance by Allah, to prepare before they breathe their last breath.

But what about us?
Have we atone enough?
Have we seek for forgiveness from The Creator and other mankind whom we’ve wronged previously?
Have we settled all our debts?
Have we save enough merits for the hereafter?

“Ya Allah, iftah ‘alayya”

Sky Blue

...Congratulations

幸せになってくれなきゃ困るぜ (Baby)

素晴らしい未来へ　愛を叫べ

...Congratulations

You've just gotta become happy, (Baby)

Shout this love to a wonderful future

愛を叫べ (Ai wo Sakebe), Arashi

(because One Love for wedding theme is overrated IMO... haha!)

I scrolled my journal and to my horror, there were only TWO entries for this year? O.o 

The lack of posts means either I'm under much stress that I couldn't even be bothered to write anything (because essentially writing is how I vent out previously), or I found better ways to de-stress. 

Or, I do no more traveling for whatever reasons. =( My last trip was to Korea last May and I foresee that there will probably be no more traveling next... 1 year. Or more. 

Anyway, it may be the combinations of all three factors mentioned above.

However, since today is a special day, I'll jot something here to bookmark the day.

//Arashians' gathering on Ija's wedding
.Picture courtesy of Annys and Zura.

Sometimes weddings are the only time and place to catch up with your friends, especially now when everyone's working different jobs and places and have different priorities etc. I haven't met these girls in ages!

//Zeti also matched our blue-coloured unoffical theme XD

First of all, CONGRATULATIONS to Ija and husband. May your life filled with barakah and happy memories, insyaAllah.

It's a bit difficult to explain how Ija and I knew each other, but it's also the (only) same answer I have if people asked how I knew the girls in the first picture- Arashi. And like the F4's, it started from Arashi Forum (which is no longer exist I must say)- so that dated back in.... 2009 - 2010... ? (because korek2 LJ, earliest mention of Ija was her birthday shoutout back in 2010).
Anyway, from fandom to lepak-ing buddies to coffee-mate after work and occassional trips / sleepovers domestically and overseas (Japan and Singapore je pon), I think Ija is one of the few who actually had witnessed my bimbo-moments, especially during driving -.-;
I guess now she doesn't have to see that anymore XD

After I've transferred to KL and started working in Putrajaya, I commuted by train and later we found the easiest way to catch up was at dinner and coffee after work, since she's also traveling via train. And since then, our regular catch-up / shopping / coffee session has became one of my ways of de-stressing (aka ranting) and keeping my sanity in check.

From the bottom of my heart, thank you for spending your time listening to my work-rant and about life in general, Ija =) The frequency to catch up probably won't be as many as before but I do hope that this friendship will last.

//F4 (missing Aimee) and Ijaji

//We need to fix a date for another of F4 meet up!

It was a good chance to catch up with Ai and Jules too; a tad short for Ai but Jules and I had coffee before going home and talked some more; yeah, that's the separation anxiety peeking up XP

//Also, thanks for the surprise! Ape la pulak pengantin bagi surprise present ni? XD

One Step

またひとつ夜が明けて　誰の胸にも眩しい光が　差し込めば
過ぎた日を思うより　新しい何か見つけたくて　歩いた

持ち合わせの言葉じゃ　育てた気持ち伝えること　出来ずに
不器用と言われても　自分に嘘をつけないから　顔上げた

涙を隠して　笑顔見せた
今も聞こえてくる　あの日のままの思いが

雨が上がり　また歩き出す　昨日と少し　違う気持ちで
Hey　全てに意味があるさ

Another dawn has come　When the bright light shines into someone's heart
Rather than thinking of the days long past, they'll want to find something new and walk forward

The words you have on hand weren't enough to describe the emotions that'd been growing inside
But though you might be told you're awkward, because you can't lie to yourself, you raised your head

Hiding my tears, I showed a smile
I can still hear the feelings from those days talking to me

The rain stops and we start walking again, feeling slightly different than yesterday
Hey　Everything has a meaning

One Step [The Digitalian, 2014], 嵐 Arashi

//The right watch was a birthday present my sister gave when I was in my first year of housemanship.

The watch on the left was a farewell gift from my previous department, which marked my new journey

One week plus
I'm still adapting. Changing places, new environment, new routine, new challenges... I'm never really good at quickly adapting, hence this may also take some time.
I still have palpitations going to work in the morning...
I still have worries when I go back home.
I still feel anxious knowing next few days would be my first day, my first weekend round, will be my first oncall and my first weekend call...
I still... have reservation towards everything and everyone at this point of time.

No matter if I've tried to prepare myself mentally for months, knowing it and actually facing it in reality are two different things.
This is yet another first step I'm taking
When you think that you've passed through one hurdle, another one seems higher and bigger.
When I was 16, I thought moving to Terengganu and changed school, left with no choice to take one particular subject I was trying to avoid was hard... It took me 6 months to adapt.
When I was 18, 1 month in Matriculation, living alone, making new friends despite the fact that I was introvert was hard... hence it was huge relief when I was accepted into pre-university foundation programme in Perth; the transition wasn't as difficult as it was in Matrics...
When I was 23 and had to repeat from Year 2 uni, I thought that was my biggest hurdle... it was, at that time that is. I didn't know there were more to come... towards end of our study years, our batch had some problems and it drove us past frustration but all was well afterwards and we finally were able to start work by August-September 2011

And there it was, at 27, working 300+ km away from home, I changed... became more reclusive, suddenly much less talking apart from at work to a point my housemates were worried about me. I was in a defence mechanism, which was actually part of my adaptation process. It was almost similar to when I was 16, when we moved to Terengganu. And it took me 6 months to finally being able to say "I'm comfortable working this job."

At 29/30, you think I've been accustomed to a new place, especially when it's closer to home... but nooooooo.... again, it took me more than 6 months to finally like my job, the new place and new environment.

So what makes me think that at this age, 33, it would be any different? Especially when it comes with heavier responsibilities with added title of a student?

I still have this penetrating cycle of thoughts that questioned my decision to take this path; of 'why did I choose a harder road?' 'why burden myself when there's an easier choice?' 'now you know why a lot of people quit this programme, right?' 'can you do it?' 'won't you quit already?' 'why did you have to go out of your comfort zone'.
Honestly, they are suffocating. And they make me nauseated, anxious and almost regret my decision.
Until I realize that's exactly what happened back when I first started working, comparing myself with my other friends whose had weekends and public holiday to rest and spend time with their families and I envy them... Hence I need to break that cycle of thoughts and find other ways of adapting.

I'm lucky that I still have my parents close with me and home to go back to as a place of solace. I'm fortunate my friends are around when I need them. Things may and will get harder from now on but I need to remind myself that لَا يُكَلِّفُ ٱللَّهُ نَفْسًا إِلَّا وُسْعَهَا (Quran, 2:286)
InsyaAllah...

//These 2 were with me when we set off as houseman, and they came to distract me from work a few days ago