the unique tragedy

I just saw a videothat is part of a video series about death entitled For Those Left Behind, by ustaz Omar Suleiman from the Yaqeen Institute (https://yaqeeninstitute.org/watch/series). This particular episode (https://yaqeeninstitute.org/omar-suleiman/ep-11-losing-a-child-for-those-left-behind) talks specifically about parents losing a child.

Briefly, few points from the video:

1. Losing a child is a unique tragedy. For parents, having to grieve for a dead child is one of the heaviest and greatest trial in life. 

2. All children are pure, and they will definitely enter Jannah. They will also wait for their parents at the gates of Paradise. This is true whether they are children of believers or non -believers, whether they died after having lived for awhile, or miscarried as fetuses.

That is why, it was mentioned in the video, that we do not have to worry for the children that have died, for they are pure, and they are definite dwellers of the Paradise. It is us, the adults that are left behind that need to live on with the pain. And if we were to do it right, the way Allah intend us too, we will meet our dead children in Paradise as well.

3. The prophet himself, Muhammad (pbuh) lost 6 of his 7 children! And still, he himself cried, despite knowing about Allah's promise of what happens to these children in the hereafter, despite him already being able to see and smell Paradise with Allah's will. 

It is okay therefore, to be sad, to cry, to grieve. It is okay to acknowledge this great pain, as long as we accept the loss humbly and be thankful always to the Almighty for it. Allah has promised us the rewards - protection from the hellfire, and chance of seeing the children again in Paradise. We just need to make sure we continue to strive for it, insyaAllah.

 Subhanallah!

kenapa anak saya takut doktor? (based on real-life events)

Scenario 1:
I meet an old frend/relative with his/her cute kid. Kid starts coming to me arms outstretched to salam or mintak dukung. I stretch my arms too, ready to receive the incoming bundle of cuteness and affection.
Kid's mom/dad: "Adik, acik ni doktor tau. Adik takut doktor kan?"
Kid: *patah balik* tak jadi kawan
Me: Dengki la. Kau memang nak anak kau benci aku ke apa?
What really bugs me: *Dahle le kau panggil aku acik!*

Scenario 2 (this happens ALL the time, but I especially hate it when it happens when I am just about to examine a kid):
Kid's mom/dad: "Haa, cucuk dia doktor, cucuk dia ni. Dia nakal sangat!"
Kid: *looks at me with those big eyes, lips tremble, mouth opens and .. *CRYYYY (as loudly as a kid can cry)
There are multiple reactions to this one ..
Me: *Acute deafness*
or ..
Me: Olololo ..tak cucuk la.. *dan ayat2 pujuk seerti dengannya*
or ..
Me: Dengki la uols. Kan dah nangis. (mood still good, laugh with parents)
or ..
Me : Donkey la korang  #@**!!^&;^%$#! (mood out, temper in, what I really wanna say, but dont say la of course, dalam hati only)

why i still haven't quit my job

i find work to be increasingly stressful and tiring recently. it isn't anything more than the ordinary of course, working as a doctor in a government hospital, it's all part of the job. but there are times when you feel really tired, both physically and mentally, to a point that, for me, i start to think about the possibility of quitting. this also isn't surprising or new, you can talk to any doctor, almost all if not everyone of us have thought of quitting more than once in our medical career. the worst for me was probably when i was doing my masters program. the pressure to perform well, pass your exams, finish your thesis, all while still providing service to the patients in the hospital and being oncall, at the same time trying to balance your personal needs and the needs of your family, was more than enough for you to think of quitting at a daily basis! it's definitely not as bad now, but from time to time, the feeling does creep up again.
so i decided to take a day off today just to unwind and "recharge" myself. i went to the bank, did a bit of groceries and some shopping and then went back home, cooked a bit and then started reading a new book-iban journey by golda mowe. by the way, i went to the bookstore just now only to buy a pen and a whatchamacallit the whiteout-liquid-paper-correction thingy, but of course i cant help from browsing the book section too, so i ended up paying about rm100 for 3 books, 3 pens and whatchamacallit the whiteout-liquid-paper-correction thingy,  . sigh. i really should have bought the pen at the grocery store.
anyway, suddenly there was a whatsapp message from the sister in my palliative care team, sharing with me a message she received from a patient of ours today. just yesterday, the patient came to the hospital for her cardiology clinic follow-up and went looking for me in the ward. she wanted to show me the tablet she got from the children's wish society (cws). she was referred to our team about one and a half year ago, because she has a congenital heart condition that is now worsening and is limiting her daily activities and eventually her lifespan too. she is a very shy and quiet girl and it took me quite an effort to get her to warm up to us, and some coaxing to get her to tell me if there was anything that she wished to have. in the end she wrote me a 2-lined letter stating that she would like a tablet.

so i referred her to the cws team who then got her the tablet she wished for just about a month ago. and so she came to the ward yesterday to show it to me, and then asked to take a photo together. and so we did, i chatted with her a bit and that was it.
who knew, after that she sent a message to the sister, sharing the photo that was taken, and inviting us to visit her at home for raya. but what blew me away was that she also said that she misses me and that she loves me like her own mother!

so what am i supposed to do, (other than cried like a baby) after reading that?

well i cant quit my job yet, that's for sure!

why i am a 25 year old doctor. or at least look like one. at least to the eyes of my darling patient.

this was a conversation on whatsapp between a patient of mine and a staff nurse on my palliative team. the patient's nickname is "baby" and she is 10 years old with  congenital heart disease. initially when she was referred to us, she was so shy and i had a real hard time getting her to talk to me. her condition was slowly deteriorating, and her mom revealed to me that baby was becoming very moody and was often angry towards her mom and her older sisters. in order to get her to talk to me and gain her trust, i asked baby to come up with any questions that she may have for me. they can be about anything. i promised that i will answer all her questions or will at least try and find the answers for her. when i saw her 2 days later, she had written 6 questions for me, 3 of which were actually about her mood swings and whether they were related to her heart disease. i was happy that i managed to get straight to what had concerned her mother and  me, and i addressed the questions and explained to her the best way i could. according to her mom when we followed up on her recently, baby's mood has been much better at home now, and i'd like to think that our little q&a session helped her with that, even if a bit. 
as for the other 3 questions, well surprisingly, they were all about me.
she asked what my full name is, whether i am married, and my age. when i told her my age, she didnt believe me, stating that i look younger, and i laughed (happily, of course! i know i know.. she's only 10, what does she know about how 40 year-olds are supposed to look like, but hey.. i'm taking it in. or rather-sucking it in. get it? haha). anyway, that was more than a month ago, and at the time it was only she, her mom and myself during that meeting because she was too shy to even let my nurse in. but the nurse continued to visit her everyday while she was in ward, and later even visited her at home after she was discharged, and they have been keeping touch via whatsapp. when i had to go on leave for 2 weeks after my recent miscarriage, we had to postpone her clinic appointment with me, and that's why she asked if i was well too during the whatsapp chat. it's so amazing that even though she herself is unwell (she doesnt even go to to school anymore because she tires easily) she still thinks about my health. here's to you, your health and your happiness, darling baby. God bless you, not just for being so naive and kind for saying i look 25 ;), but for being the sweet strong thoughtful you, as a reminder for the rest of us to love life and always be thankful. 

There's an obese kid in the room...cant u see??

Oncall again. Another resuscitation. Despite all we did, another child dead.

 This is the one thing about my job that I hate the most. But most times, I am able to deal with it, and tell myself that we had tried our best. I know as well that my colleagues and I have to often remind ourselves and each other, that no matter how bad we want to, we cant save everyone. I usually am most aggrieved when the child that died had been a relatively "well" child, no known illness, pretty much a normal kid. But in this case, although the family claims their child had been "normal & healthy" prior to getting this bout of infection few days ago, I really have to disagree.

One look at the patient you can tell that he has a serious medical condition. It was so obvious. But probably the family never saw it as a medical problem. I'm sure most of the people who knew him and had seen him (or other children like him) didn’t think so either.

The patient was 5 years old. He weighed more than 40kg.

He was morbidly obese! So much so that we couldn’t see his neck, and when he collapsed, the doctors in the ward knew right away that they would have difficulty intubating him but fortunately they manage to get the anaesth in to help.

But all was not well. His heart stopped 3 more times after that, and we couldn’t revive him anymore after the 3rd round. He died less than 12 hours after he was admitted.

It was so sad to see the doctors huffing & puffing doing CPR on a 5-year old kid! They should have been able to do the chest compressions using only one hand! But because of his big size, they still had to climb on the bed and do the compressions with both hands. And because his weight was waaay off the chart for his weight, his meds were given based on the ideal weight for his height, which was not as accurate as compared to giving meds to a kid with proper normal weight.

He had an infection yes, but his heart was actually already hypertrophied, and that's most probably why he succumbed quite fast. His heart was already in trouble no thanks to his obesity, and all the infection did was tip it off the edge.

Like I said, I know that many people do not see obesity in children as a serious medical problem, just like it is in adult  (and even that is only recently recognized and accepted by the public), because when I do see an obese child and pass the comment to the parents, the reaction I usually get from the parents (who would have brought the child in for another complaint usually eg. Fever/cough/runny nose/etc) would range from -- "Eh tak baiklah doktor ni cakap anak saya gemuk" or "ha-ah la doktor, tapi dia ok, main semuanya ok, takde apa2".

So in this case, although I am still aggrieved that we couldn’t save him, I cant help but feel that the adults are still to be blamed for letting him get as fat as he is. People need to recognize that obesity is a SERIOUS problem in children as well as adults, and that chubby fat kids do not equal cuteness, and do not especially portray healthiness (observe that many people will say "wahhh…sihatnye anak awak ni" instead of "wahh..obes-nye anak awak ni"). I understand that we dont want to hurt their feelings, we wanna be sensitive, which is fine, dont say it to the parents' face in public, or dont say it in front of the kid, but dont mask or hide the problem by implying that it's ok to be fat, the kid is still really cute. (in my defence, when I do make the comment above, that a kid looks obese, it is honestly out of concern for the kid, not passing judgement to the parents..but ok, I get it, people are sensitive... I should be more sensitive too..).

And when I say people, I do mean EVERYONE of us, including doctors and medical staff, because I know for a fact that there are doctors who prescribe vitamin supplements, and other supplements like omega-3-fish oil and colostrum to kids with cough and cold, in addition to the usual meds. It's one thing if it's for a skinny kid or even a normal kid with perhaps poor appetite, but if it’s a real chubby obese kid sitting in front of you in the clinic, you should findout why he/she is so, and then try and get them to lose the weight instead of supplying them with more multivitamins, colostrum and fish oil! (if it's simple obesity of course.. Other diagnoses need to be ruled out as a cause for the obesity ie metabolic syndrome etc whereby you would then need to refer them to the experts, but reducing weight still plays a huge part in the treatment).

Anyway, I'm definitely not an expert, but I do believe that we need to be able to identify that there is a problem first before we can actually try and solve it.

Kids, eat healthy, play more!
Parents, get ur kids to eat healthy and play more!!

KONY 2012 - save the children

oohh.. and there goes the head.

scenario:a teenage boy was playing with his 2 yr-old cousin, and by playing, he meant throwing her high up in the air ("oh look, ur flying!). catch. up in the air again. catch. the girl squeals. up in the air again..higher now..
and... tang!..slosh!.. there goes her head!
ok.. i'm exaggerating.. her head didnt fly off.. but she did sustain a deep laceration wound to her head, after being hit by the blades of a whirring ceiling fan that was just inches from her head!
so with blood covering half her face and she screaming in pain, she was rushed to the hospital by the whole family.
examination showed that she also had a depressed skull fracture, and was bleeding into the layers covering her brain.

obviously this isnt the 1st case of a child sustaining head injury from the blades of a ceiling fan. we see quite a number of this preventable injury at the emergency dept. and they get them through different ways too.. from jumping up and down on the bed, from jumping down from an upper bunk of a bunk bed, from being thrown in the air by an adult... and then .. tang!..slosh.. there goes the head.

interestingly the other day when i was seeing the 2 yr-old girl, there were different comments made from the staff as they hover around:
staff 1: uih.. that's why-lah, cannot throw the kids in the house, gotta do it outside the house, out in the open area. no ceiling fans there!
staff 2: what was the speed of the fan.. laju sangat kot?!
staff 3: must be the ceiling of their house is too low.. that's why can hit the fan!
staff 4: no-lah..not safe to use ceiling fans.. we should all just use air-cond only!


so i had to tell them: umm..no.. the one important lesson to be learnt here is.. NOT to throw a kid up in the air..like anywhere, eVer (Yup, i even strained on my V there!)
we live in hot malaysia..and not everyone can afford air-conditioning, and so it's totally okay to have a ceiling fan running at top speed i think, as long as you dont throw a kid up to its rotating blades!
even if you were doing it outside, or you dont have a ceiling fan, and your ceiling's real high.. what if you throw a kid up in the air, and u slip and/or couldnt catch the kid back?
maybe..there goes the head, and/or neck, and/or arms, and/or legs .. you get the picture.