Tuesday, November 13, 2012

Budaya "Kosong-kosong" dan "Lebih Kurang Halal"

Ada seorang hamba-Allah bertanya mengenai budaya sebilangan rakyat malaysia yang bermaafan dengan berkata .."Kosong-kosong" / "lebih kurang halal".... Adalah hanya berkata kosong-kosong itu sudah cukup untuk menghilangkan semua dosa tanpa memberitahu kesalahannya??..

Sebagai contoh; Si Awang mencuri duit Si Dollah tanpa pengetahuannya si Dolah. Adakah dengan berkata "Kosong-kosong" atau "Lebih kurang Halal" hilang dosa si Awang??..

Jawapannya Tidak.. Si Awang perlu memberitahu yang dia telah menyeleweng duit si Dolah sebanyak ?$... Sekiranya si Dollah halalkan barulah dikira hilang dosanya...

Penjelasan Pertama:

Kita perlu ingat.. "Seburuk-buruk dosa ialah dosa kepada manusia" ... Kerana manusia bukan Maha pengampun dan manusia akan menuntutnya di Akhirat semasa hendak melintas Titi Siratulmustaqim..

Dengan kedua-dua pihak berkata "Kosong-kosong" atau "Lebih kurang Halal" tanpa penjelasan tidak menghalalkannya.. Cuba tanya diri sendiri.. Sekiranya ada sahabat anda mencuri 500, 1k, 5k, 50k tanpa pengetahuan anda, adakah anda menghalalkannya begitu sahaja sekiranya si pencuri berkata "lebih kurang halal"??....
Walaupun di pencuri itu saudara atau rakan karib kita... belum tentu mudah untuk kebanyakkan daripada kita menghalalkannya.

Penjelasan Kedua:

Sekiranya harta yang dicuri itu telah diniat oleh tuan punya untuk diserahkan ke pihak lain (masjid, anak yatim, saudara lain dan etc..) maka tuan punya akan memberitahu si pencuri itu "sekiranya nak kemaafan.. sila pergi jumpa di polan si polan kerana duit itu sepatutnya sampai kepadanya".. 

Sama-samalah kita renungkan… Wallahualam….

Tuesday, January 17, 2012


My title is elaborated in two stories.

Story No. 1
I’m not a big Soccer fan. I don’t even watch FIFA World Cup matches. Friends laughed when they discovered I didn’t even know about the FIFA game between Korea and Japan in 2002. However, watching Discovery, I saw something that made me think and I want to share it with you.

Apparently Italy has often had great soccer teams; they have won the cup four times. The first two were in 1934 and in 1938. They were supposed to be fantastic.

During the 1982 FIFA World Cup, the team was bombarded with general skepticism and negative reviews by the media. Italy barely qualified for the second round after three uninspiring draws against Poland, Peru and Cameroon. They were continually criticized by the media who circulated rumours and falsehoods. At some point, the team decided on a press black out. They refrained completely from talking to the press. By doing so, they managed to achieve things that were thought impossible. They were thus so strengthened they finally won the cup in that year.

Story No. 2

The Battle of Pearl Harbour was a surprise strike conducted by the Japanese Navy against the United States naval base located at Pearl Harbour in 1941. Soon after the attack, during a Japanese celebration of their success, the Japanese Admiral, Isoroku Yamamoto, allegedly said: “I fear all we have done is to awaken a sleeping giant.” His fears were realized when the giant (the US) dropped two atomic bombs on the cities of Hiroshima and Nagasaki in 1945.

My point is this, something said or actions that have not been well thought through can certainly “Awaken Sleeping Giants”.

In the future, we should always bear this in mind.

Tuesday, November 8, 2011

Blessing in Disguise II

I reported for duty as an Emergency Physician roughly 10 months ago. Being a physician carries many responsibilities. I’ve always tried to perform as best I can.

Part of my job includes giving countless lectures, writing reports, inventing products, attending workshops,, attending meetings, and assisting post graduate students. These do not even include my core clinical responsibilities.

I’ve always thought there aren’t enough hours in a day.  Quite often, I came back from work with “a few more things to finish up”.  At home, I’ll frequently stay in front of the computer and try to finish things.  I felt I was enjoying myself.

After some weeks, I started to feel a pain in my right jaw (temporal mandibular joint aka TMJ).  Being a typical doctor, I treated myself.  In a few days, the pain was so severe it woke me up in the middle of the night.  I noted some cracking sound when I moved my jaw.  Some people commented that my TMJ looked swollen and my jaw was starting to deviate on opening.

After 10 days I decided to see a respected maxillofacial surgeon (who is also a medical degree holder). I thought he was going to tell me that I had a tooth abscess or something related to my teeth. Within 3 minutes of history taking he said “you are in stress”.  I initially laughed and denied his diagnosis.  I personally couldn’t accept that I could suffer from stress.  I was happy and enjoying my work.  Sure I felt tired, had difficulty sleeping and woke up tired most of the time... but Hey !!! I was not stressed !!. 

He advised me on how to relieve the pain (to take care of the stress) and I went back to work. I think deeply in his heart he knew I would ignored his advice and will come back to see him.  Sure enough, 1 week later I came back with worsening pain.  This time I almost had my jaw tied with a wire to prevent me from grinding my teeth.  I admitted that I have done some literature review and it certainly all pointed to his diagnosis.... ”TMJ Disorder Secondary to Stress.”

I had to wear a silicon mouth guard, eat blended food for 2 weeks and pray that I won’t get my jaw tied.  I stopped doing any paper work at home.  Soon my pain resolved.

From that day onward I have tried my best not to do any office work at home.  No more typing reports, doing lectures and other such chores.  Except for clinical consultation, I basically open my computer for fun.

I read books and search the website on how to manage time at work.  I don’t want to let go of some of the jobs that I love.  Surprisingly, after a short period of time, I became more organized.  

Now, not only am I able to do things that I did before, I have started writing a case report, Emergency Department clinical guidelines, and editing residents’ thesis and much more including giving numerous lectures.

Without my TMJ disorder, I would have continued doing what I thought were the right things to do.  Indirectly my quality time with my family was affected.  

I’m glad GOD gave me the disorder; It has made me search for a way to make the most of the things life offers.  I’m still adjusting, still learning... but at least I know I’m moving toward better time management skills...

TMJ Disorder... a real Blessing in Disguise.

Sunday, October 2, 2011

Team player Vs Culprit...

Now days we occasionally hear healthcare provider will say.. “be a team player... we are on the same team”... I personally, have heard this statements numerous time.

When someone did something wrong, I’ve heard people said... “You must work as a Team”.

When someone said something wrong,.... “We must work as a Team”

Honestly, I’ve been called “Not a Team Player” before. I was accused this when I shouted at a medical officer seing my patient in Emergency Department.

Am I really not a team player??. Sometimes I wonder and start to think back... What do we mean by the word “Team”.

“Team” in a simple words mean : Group of people working together for a specific goal.

On the other hand “Culprit” means: “The cause of a problem” or “person who is responsible for a crime.”

In healthcare, a Team should be a group of people that fight for a common goal... PATIENT’S CARE.

So, when someone shouted because the care provided to his patient was inadequate ... he is a team player not a culprit.

Went someone raise an important issue regarding patients care ... he is a team player. Opposing that is the Culprit.

Finally, as for me:

When a lay person did something great to the patient... He is a Team Player

When a Consultant/physician/surgeon/medical officer/etc did something lousy... He is a Culprit. Stop calling him a Team player.

Wednesday, April 13, 2011

Excellent Emergency Physician

I’m sure most of us have heard this

An average surgeon knows how to cut,
A good surgeon knows when to cut and
A better surgeon knows when not to cut

I’ll like to adapt this to Emergency Physicians (EP)

An average EP knows how to detect emergency condition
A good EP knows when and how to treat
An excellent EP anticipate complication

Thursday, November 11, 2010

Blessing in disguise….

One morning, I just completed my night call and on my way to our CME room. We were having our weekly departmental CME and naturally the emergency physician would chair the session. I called one of the senior resident who worked with me that night and asked him to attend.

During the lecture, I noticed that he didn’t show up. So I sent him a text message…

“Sometime I wonder kenapa kau tak suka dtg CME. Dtg la. Belajar aje.” (Sometimes I wonder why you don’t like to attend our CME. Please come for the sake of learning).

For those who don’t understand Malay, it is consider a slap on the face if a student got this kind of message from a teacher/consultant.

I made a big mistake. Actually I did not notice that I mistakenly sent this message to my senior consultant.

He replied:”Tq for reminding…sya d Putrajaya” (Thanks for reminding, I’m in Putrajaya).

This text message when from a very junior emergency physician to a respectable senior consultant. The content should be considered as something rude.
The way he replied my message showed his maturity and why he is the “respectable senior consultant”.

I regretted I sent him the message, but I’m glad it happens. Without that incident I would have not learn a valuable lesson from him… To be humble.

It is a real blessing in disguise…

Tuesday, October 19, 2010

Dear Doctors – Are we guaranteed enough to be saved in our own grave??

We, Muslims believed that everything that we did during our lifetime will be questioned back, the moment we have been put in our own grave. All these while, it involves good deeds and of course the negative sides of our own mistakes that we have done.

In fact, we will receive punishment in our grave prior to the “judgement day” in which life in the hereafter.

Do bear in mind that all the things that we did will either help us or punish us. I don’t think I need to explain more regarding the duty on how to perform prayers, fasting, paying zakah as well as performing haj. These can be referred directly to our pillars and all Muslims will say that they knew about it.

Moving on to the next agenda on the matter of our duty as doctors? Well, let’s talk about what we did all these while. Believe it or not, we will definitely be asked in our grave and yet, Islam has always being the way of life as it practices equal judgement. Hence, I would like to highlight once again about what we do in our lifetime will be asked in later life.

The medications that we gave to our patients, various investigations that have been carried out and others will be taken into account. Thus, this is for sure that we will be asked either it has been justified or not.

So, let’s ask ourselves, “Have we caused harm to our patients?, Do we really care and allow our patient with peritonitis to just lay down on bed at 2am and plan to do laparotomy at 8am?, Can we say that all emergencies CT with contrast need a renal profile and let them wait?. Did we fight for our patient's right or simply keep our mouth shut letting things be?

Can we answer all these questions comfortably in our grave? Perhaps, almost all of us will say a big NO. All of us must have done something during our career timeline thus that will lead us to answer it as such. I would say that nobody’s perfect in this world and we all did mistakes. But then, mistakes can be very subjective based on different views of people. It can always be intentionally or unintentionally.
In this blog entry, let us focus on the “Big Intentional Mistakes”. Big Intentional mistakes may be seen and overlooked by some of us as it is small and perhaps some may be saying that it is not a mistake at all.

An example of this big intentional mistake will be a surgeon who is preaching everyone during lectures, seminars, and conferences regarding an urgent exploratory laparotomy in an unstable intra-peritoneal bleed. Surprisingly, in his own department, it has not been done. Patients will undergo CT Abdomen to rule out other things. When they have been asked whether this “other things” can change the management or not, they will keep their mouth shut. As a matter of fact, even a surgeon in training will answer in his examination that an urgent laparotomy is needed in an unstable intra-peritoneal bleeding. But then, in real life, he would waste valuable time ordering repeating ultrasound and CT abdomen prior to the procedure. This kind of person has no insight in answering and supporting his statement yet this is the person among some people who might have hard time in their grave answering all these questions.

But, do think twice. We are “The Doctors”, the one with high ethical value. We have been taught and trained well. I personally can’t remember the exact number of various ethics’ lectures that I’ve attended. But then, think again…. I’m not talking about coming late to work. I’m talking about the simple life saving procedure and simple way to ease patient’s burden.

So, here are some questions to be pondered about:

Why each time during examination, you answer exploratory laparotomy, but in practice you delay the definitive treatment with investigations…?
Patient with meningeal signs: Why for patient A you will do CT with contrast urgently but for patient B you let him wait for hours wanting to see the renal profile first?
So, What is our answer?. Are we guaranteed enough to be saved in our grave?

Perhaps, let us start correcting these “Big intentional mistakes” and then start focusing on the small ones.