Off-Day Thoughts: Jonah or Anti-Jonah?

I've come to the conclusion that there's no such thing.

It's too complicated. The admission rates do not depend on the MO, HO, or SN on duty; rather, it has many extraneous factors too. You can predict that it will be a week with many admissions for AEBA and MVAs, for example when it has rained heavily; or for drowning and burns, during holidays and large national celebrations.

But there is no telling which healthcare personnel really contributes to a sleepless on-call, no matter what. Even if an MO has been having an unfortunate streak with admissions, eventually that he/she will get a break- and vice-versa. This entirely dissipates the J/Anti-J theory.

Of course, it's just more fun to look up the MOs on duty and try to anticipate the admissions.
It's part of being a doctor in the government, to me- it could even become the starting point of a great discussion and subsequent bond with your colleagues and superiors. But never put too much stock into what others tell you as a 'bad case of J-ness'. Unlike asthma in young children, and apart from the abovementioned environmental factors, there is no solid predictive index for admission rates!

But hey, if that trend really persists with someone you know- or even YOU- at least you know there will be extra EXP & pahala! Ka-CHING!

The Importance of Being Patient and Venting

I knew from the get-go that this is not an easy or relaxing job and there are difficult, difficult days.
As I've said before, I have great colleagues and superiors in this department so I'm really fine. But you have moments, and in these pockets of moments my level of 'fineness' unravels almost entirely.


1) The moment after you take a short nap after 7 hours of non-stop admissions & procedures; you wake up and internally whine, 'No, I cannot continue'. You come to the counter and see that there are 3 more cases waiting to be clerked, two of which aren't even BHT-ready yet, and you sink into one of those chairs behind the counter, put your head in your hands and close your eyes- never mind that there are patients and relatives who just arrived in front and can clearly see you.

I am glad no one has made me viral yet in those two minutes. I am glad they understand that I'm only human.

So I cajole myself into thinking, 'This too shall pass' and 'think of the pahala of seeing and trying to help these sick children and their parents' and 'it's okay, just two more cases' and get up, walk to the patients and attempt to sound friendly even though I feel like Death.

No matter what people say, there are moments where you have to motivate yourself by repeating cliched motivational things that may sound very egoistic.


2) You get a call from the lab/x-ray department/emergency department where they inherently tell you 'It's not my job, it's yours' in less obvious words.

This happens. People get tired and cranky and forget that other people get tired and cranky too. And not belonging to a certain place, it's easy to feel unattached and angry at others by assuming they're not doing their job as good as you are.

It's human. I'm human. I apologize, but telling me to come over and rectify something that is clearly not my job while I'm busy on the basis of 'YOU ordered this' is very irresponsible, especially when you use snarky tones. Perhaps if you were nicer I wouldn't be so angry.

If you are unable to hold the patient down for an x-ray because you're "not a relative", how come I am a candidate for holding the patient down? I am not the patient's relative; I am the patient's caregiver, just like you. And asking me to come during peak hours in a ward that is (ostensibly, to you) overflowing is really mean.

I was *this* close to shouting over the phone. Instead, I barely settled for huffed silences while you talked, and managed a very short 'We'll see later.'
Then I whined extraordinarily to the staff nurse who passed the call to me, who understood my cringing. And my colleagues, who shook their heads emphatically.


3) Patients imply that your team is not doing a good enough job.

Okay la I serve you right now, it's my job to be cordial.
And as a professional I cannot scold you; merely, advise strictly.

Deep breaths.

But when you talk about taxpayers money, hello, I pay taxes too. Please lah don't bring up the "taxpayers argument" with me, it's so cliche. And if you do, don't get surprised to see that angrily astounded face I might let slip. Especially if you're supposed to be educated.

Because the cost of treating you or your relatives is not at all nearly worth what you're "paying me".


I am amazed at my senior staff's ability to mask their anger. This is something we all need to practice as we practice medicine, make no mistake. You WILL get angry, but you WILL have to mask it- greatly!


Enough venting for this period. Now I need some sleep.

Slip Gaji/Payslip

Here you go. This is how your payslip would look like without any increments yet, including the amount deducted for KWSP.

That is not a small amount.

The Elaun Sara Hidup, if I'm not mistaken, can be more or less depending on where you work. Actually, just bear in mind this may vary depending on where you work.


Work hard.
And budget your spending wisely!

Off-Day Thoughts: The Doctor

When you enter medical school, you must have been asked the Golden Question:

"Why do you want to become a doctor?"

This question will be repeated, time and again, and will not cease even after you have attained the seemingly prestigious title of "Dr." in front of your name- which, by the way, I've never used outside the context of work.

Remember your initial reason? It may involve a tragedy in the past, or other emotional incidents. I am sorry for your loss.

But I- honestly- don't remember a good reason as to why I wanted to become a doctor. 

Initially, I had the most noble of intentions- perhaps reasons interviewers are very familiar with. But over the course of years, and with countless introspection, I realized that my reasons, like many others in our culture especially, are pretty darn simple:

Preconditioned to think that it was A Great Occupation, and The Most Noble of Professions, as an overachiever in primary and high school people just told me stuff like, "Hey, if anyone can be a doctor, it would have to be you." This, and my parents and family's perpetual nudge in that direction ever since I can remember, led me (willingly) to a rather turbulent path that ended with my assignment as your friendly neighbourhood Spider-Man er, Humble Officer. 

Currently one of the most ridiculed positions nationally, and arguably the most criticized.

Gone are the days when being a doctor entitles you to special treatment. Your position does not command the respect it did, and neither does it make you better equipped to deal with others. Doctors nowadays do not perform as well as those 'back in the day', we are too reliant on technology and too lazy and entitled. Et cetera, et cetera, et cetera.

At least, that's what a lot of people say.

But is it true, really?

Nope.

We still get special treatment- such as our insane starting salary, for this country's standards at least. And despite the increase in waiting time, we still have guaranteed jobs (hopefully that will continue to be true for all our juniors)! We take this fact for granted a lot. My advise to recent graduates, enjoy your prolonged holidays and do not be too antsy to start, if you can afford the privilege of waiting.

Your position still commands respect, if not with everyone then with a lot of people still. All those years in my medical school, at least, does equip me better to communicate with my patients and colleagues and superiors. And come on, with the help of technology we SHOULD be able to perform better than our predecessors in The Land before Time (meant with the utmost respect). What matters most is how we utilize the technology!

But laziness and entitlement? True as well. Too true, in fact.

How many posts have you seen about doctors, written by doctors, emphasizing on how being a doctor is extremely dreadful and that we should be appreciated? Not limited to doctors themselves; sometimes medical students write them and viral them, too. And as much as I am for freedom of expression, there is only so much viral posts I can see before I get agitated.

Yes, we play with blood, fecal matter, and other body fluids, but so do nurses and MAs.

We have ungodly working hours, well so do most other people trying to earn a decent living, some of whom have 9 to 5 jobs but have multiple jobs to support their families.

We don't have time for our family members. The same goes to anyone who works every day, 9 to 5, even with weekends off- there simply ISN'T enough time with your family as long as you're in your working years, unless you're one of those lucky people working from home or somewhat.

And every job is stressful. Many jobs involve human interactions, and there are less pleasant humans in any possible setting involving human interactions.

My point is, there is no need to repeatedly tell everyone how miserable your job is, because it doesn't command their respect all the more when you repeatedly whine about it. Every job can be miserable.

Again, I say that with the utmost respect.

This is not an easy job. At the start, no job is an easy one. But I can tell you why our job is harder than most: It's the fact that people's lives are directly entrusted upon us. Their demise would be entirely upon us. And no matter how many people are involved in their care, the doctor-in-charge is the one who will take most of the blame, as compared to the nurses, or MAs, or any other healthcare provider. There is no way around it.

And this is something everyone expecting to go into the profession should bear in mind.

Human lives cannot even begin to be equated to money or paperwork.

Yes, you may be able to tolerate long working hours. And yes, you may be able to handle insults and degrading remarks hurled towards you. You may be able to stand holding in your urine for over 12 hours, or function on an empty stomach for over that duration, and not sleep for 36 hours straight while still maintaining a pleasant expression and managing to remember your cases. You could even take the blood of, and successfully dispatch, over 20 patients within the span of 2 hours.

But can you do all that and trust yourself with the lives of others?

Can you defend yourself, your own integrity, when you are questioned on why a patient died while under your care?

Can you do this in a room filled with strangers, some of whom are trying to pin the blame on you?

[Ugh, I started a post talking about how this job is worse than others. Sorry.]

Now I, for one, am not one of those people who will discourage other people from becoming a doctor, nor am I one of those people who think our country has 'enough' doctors. But I can tell you what I feel from personal experience, and that is the fact that this isn't the most horrible job out there, nor is it the most rewarding career for someone who is academically brilliant. I think we are easily deceived by the fact that this job immediately gives you a title in front of your name- something that doesn't come with most jobs in the world. 

We have deluded ourselves into thinking that this is the best job for our overachievers; only for the best of people. When in fact, this is a job that can be done with above-average intelligence (yes, you need to be slightly more intelligent) but most importantly by anyone hard-working and resilient enough to endure abnormal amounts of stress; anyone with the passion to care about others more than their own immediate needs.

Being a doctor is not as prestigious as it used to be, but with the changes in current demands you can bet that it's becoming harder. Your faults can be easily found and spread by various social media, making them more permanent. Doctors in the past got away with many mistakes- whether or not they divulge them is another thing entirely. Contrary to what some may say, doctors in the past DO make mistakes, too. They're just not able to go viral.

But with technology, it's also easier for us to seek help, and for others to know our side of the story. It's easier to disseminate information and to keep in touch with the latest and greatest. We are not bound to our hospital walls- we can go beyond it, and combat the misperceptions with a few taps of our fingers. Several people have been doing this to great success at the national level.

People are becoming more and more tech savvy, and believe it or not, more often than not, they DO see reason. It's just, empty cans are the loudest.

So, to quote a famous franchise: With great power comes great responsibility.

Remember that as you go forth in life.

Do not let your years of studies and that title in front of your name go to waste.

And keep praying to do the right thing!

Cuti Rehat

Known as CR, this is a luxury/right (depending on whom you speak to) given to all government workers. For us humble officers, this accounts for either 8 or 9 days per posting, INCLUDING MCs and ELs (Emergency Leaves). So try not to MC or EL too hard 'kay.

CR has to be informed in advance and, depending on where you are, can only be taken during certain periods and only for certain maximum durations. According to a briefing by my hospital, if you have remaining CRs in a posting, they can only be carried forward and taken after your MOship has started and cannot be used during your other postings during housemanship.

For example, you are such a hardworker you only took 1 day of CR in your first posting, before moving onto your second one. Your second posting turns out to be difficult, and you are thinking of taking more than 8 days' leave throughout the entirety of the posting. However, this is not possible without some actions being taken by the hospital- the remaining 7 days from your previous CR allocation cannot be used on top of the 8 days allocated for your second posting; or your third, or your fourth, and so on. However, the balance of unused CR from your previous postings during HOship can be used during your MOship, after you are fully registered. So make sure you finish housemanship and get fully registered, mmkay?

For any more doubts or clarification, kindly seek out the admin staff in your hospital, particularly the ones in charge of HOs. They should be able to help you more!

Anyway, I'm not here to talk about these technical things, which will be explained to you during PTM and your respective hospital orientations. I'm here to talk about CRs and why they are essential. So I would definitely be the party that says CRs are a right- a basic human right. Hehe.

I've listed several reasons why you SHOULD use your CRs and not try to accumulate them to a time in the future which may or may not arrive. This is because I've known of people who try to save up all of their CR so they can use it in that transition period from HO to MO.  It's doable, to be sure, but not for everyone. In fact, it's not for most people. But here I've listed down the reasons fr you to not feel guilty and use your CR:


1. De-stress
No need to kid anyone: This line of work is especially stressful, and that's saying something because ALL jobs come with their own sets of stress factors. You need the time off of your job; time for you to unwind and leave behind the stress for a bit. Not only will you be doing yourself a favour, but also, potentially, your colleagues and patients.

And for the ladies out there, you know how the stress can affect your more womanly cycles. It's not pleasant.


2. Change of perspective
It's all too easy to be caught up in the hospital walls. To forget that there IS life and boundless opportunities outside of your hospital. Your CR will hopefully be longer than your off-days, and give you the needed time to get away from your department, hospital grounds, and even the district of your hospital. Go do that thing that made you happy before, even if it doesn't seem like it's going to work! Get outta that place and see something new! Meet new people who are NOT healthcare personnel! A breath of fresh air is more than needed after some time, to jolt yourself back. It's highly recommended, particularly when your working environment may be a little toxic for your emotions.


3. Recharge
Drained and apathetic- the usual feelings you get during work. This tends to accumulate, particularly if you have been repeatedly experiencing negative experiences for days in a row. I believe that we also have our emotional gauges, and sometimes our positive, more happy gauges get low after multiple beatings. A day or two off may allow for these gauges to refill, but some postings do not offer you the privilege of too many off days, or simply expose you to a lot of negativity. Perhaps you're not the type to recharge too quickly.

So take your CRs to recharge. But do not think of it as the only solution. Perhaps a change of perspective is needed (See #2); think of your work in a different way, of your possibly intimidating superiors in a different light. Somehow, you need to make your work more bearable. How you do it, ultimately, is up to you, but some days off should help you to revisit your options.


4. Make others happy
When you are less stressed, and your happy meters are higher, this positivity is bound to show in your work. You are then more likely to make your colleagues and patients happy, too! And giving others happiness is an easy blessing in and of itself, not to mention the fact that you're taking active part in trying to help mankind. Tell me, how can that not be a reward?


5. Rezeki
Your leave is also your reward, blessing or rezeki. If you find it approved, that is rezeki! Far be it for me to push away my reward, or as we say it tolak rezeki. Seize it and use it wisely.


And for something unexpected: During my rather lengthy CR, I missed my work.
I enjoyed my CR days, don't get me wrong. I was loathe to come back to work when the time came to it. However, I did not expect a part of me to always wonder how my patients are doing. How my colleagues are coping (my poor groupmates, one lady short!). Did my patients improve? How many were discharged? What cases are they seeing without me?

And this was what I needed:

6. You cannot miss something until you've left it
This is a feeling you should experience, even temporarily. It makes me appreciate my job even more. And hell, the first time splurging on things with my own hard-earned money feels AMAZING. So yes, it won't be too far-fetched to say I miss working more than I expected myself to.

And of course, it's always good to reserve some days and not use all of your CR days in one go. You never know when an emergency happens, God forbid, that you may need to use your EL for. Remember, MCs and ELs count towards those 8 days per posting- that's about 2 days per month, should your posting go as planned.

I hope these feelings will remain in my future postings. Until then, good luck planning out your days off and keep on dreaming big!