back to the desk.

I am finally back to the ED desk today…after a strenuous journey from KLIA to HKG and to K city. I woke up at 4 and finally reached K city airport at 6:30pm. I sent the rest of the family home and rushed to the ED in time for my shift. (it is payback time...)

A very short but interesting journey for me and I am more sure about my direction in the future.

Waiting...

It was supposed to be a struggling banking day with 3 bank run and a presentation to menara Maybank....haggling with the KL traffic, but thank god we are sitting here waiting for the afternoon show of Ah Beng... the morning run concluded before noon(KL run was waived by Grace ....)....we had a sip of chendol klang., then proceeded to Setia Mall....there was this night family dinner at 7....Grace ....and we are 30 min to a good laugh....

Back.....

After one day of strenuous travelling....we are finally back to the Boleh land...
I got up at 4 did the final check, wake the rest at 5, and push out by 5 forty. The traffic was light and we got to the carpark in 30 min.  The carpark was not crowded (if so, the management would ask for keys...so that they could move the car accordingly. The morning airpory was crowded and we had quite a queue at the security check and immigration.
The flights was smooth and satisfactory, 9 inch in flight entertainment system with fried beehoon(kwongfu chao style) and siu mai. We had a small tour in the hkg airport and an expensive lunch in a chiew zhao restaurant.
The flight was darn pack.....and we hit klia on time.
The immigration check took less than 5 min with the autogate....smoothest ever. We picked up the car and drove home......
I was totally worn off with less than 15 hrs of sleep over 3 days....weather was hot but I hit dreamland by 10. ...
After a good night sleep...restoration and we would be doing our bank run today....

last preparation....

I had finally survived the final shift of the 7 straight…well, yesterday was the worst one as I had to attend the govt clinic at the lion land. I managed to check in at 8am and secure a connecting seat for everyone of us (2-4-2) and that was a lot of seat to choose from. However I was able to check in the KHH to HKG route and the HKG to KUL flight could only be checked in at 1pm.

I took a slow drive to the govt clinic and was lucky that I could stay put in the clinic and no road call. I did not go home straight and instead travel back to the hospital and waited for the connecting flight check-in.

I was not that lucky on the check-in as I found that I had only less than 10 seats to choose from.

I reached home at 2pm after I changed some HKD in the local bank. I hit bed at 3pm and after 2 hrs of sleep and dinner, I headed back for my final shift. With the LORD mercy, I had a good sleep during the shift.

Well, survive and kicking and I am going off… 

T minus....

After 4 tiring day shift, I have 3 night shifts to go before….

T-36hrs to online check-in and selecting seat

T-72 hrs to flight

T-80hrs to Homeland…

I am a little disturbed about the count down and confuse of what to pack. If I could, I would pack everything, but I could only take what I want…

I had shown “Up in the Air” to Yun and Xian last night (minus the affair part …) and they had a good laugh on the check-in and boarding part. I am a fan of George Clooney; back from those day of ED-> John Ross, night shift ED physician ( I had the same job….)

Well, frankly said, I am not a frequent flyer like my brother who had flown probably hundred thousand of miles. I am always nervous about flying; not about the flight but due to the arrival. Picking up and travelling to our destination. I don’t like uncertainty and surprise, but sarcastically, I had job that is full of surprise and uncertainty.

I am going to bank to change some HK note (for eating the yummy dim sum at the airport) and layout all my gadgets that I am bringing back. Those gizmos would really come in handy when needed….

I do not have to worry about luggage as we had 80kgs of allowance.

All of us were very excited, as Yun said,” she had never been so anxious of going back to Malaysia…”

Of Kangkung and ETC

I am a Kangkung liker -> the dish "Ma Lai Feng Kuang"( Malay Taste) was a cheap and tasty dish. It was like RM5 per plate during my school days. The rest of my family dislike it -> claiming that it is "cool" and not good for the health. I had grown some of it in my farm and found that it was very easy -> spread the seed and wait for harvest.. there was this chinese emperor who once asked his minister that -> no rice to eat, why don't they eat meat....so, "upper class" people don't know how the life under; when you earn many thousand, price hike is not a problem, you save less, but when you barely make a living there would be nothing to save and maybe go into red...
I am not oppose to any price hike, the increment of price could in a way stimulate the economy ->boss earn more, pay more salary to staff and in the end everyone is happy...but it would take a pain in the ass period to hit the harmony..
The ETC is however a privatization of Highway Toll Collection system here. The system is definitely a crap and we could do nothing....
This 2 topics have similarity - both was bombarded by the peoples badly... 

last straw....

I had been a non-30minutes ACLS provider in the past. The practice of at least 30 minutes of CPR before certifying had been an

a non-written understanding among providers well before my days of internship. Well, as my grew in seniority and becoming an Attending, I had always stick to the rules and had not met any problem, but I had kicked over a iron plate 1+ weeks….

A busy Sunday night and I was attending a small wave of OPD grade patients when a bunch of family rushed in a young male. Prior to the arrival, the local rescue ambulance had responded to the scene and failed to secure the patient as the family had ferried the patient over with their own transport during the wait. The patient was a case of alleged self poisoning with chemical use to poison fish. I initially thought the victim had ingested some poison vine. I was wrong when the family came in with the patient. They had brought in a packet of light brownish color powder and one of the them told me it is potassium cyanide.

My initial thought was darn -> I had no cyanide antidote kit and there is no automated photo taking booth in our hospital. (I still recalled the episode of Macguyver saving the life of Pete with fluid(Na thiosulfate) from automated photo taking machine… Macguyver’s swiss army knife had inspired me and I have 4 swiss army knife(3 victorinox

and 1 wegner)). I had proceeded with resuscitation and the patient had ROSC (return of spontaneous circulation) noted after 10 minutes. A referral was planned to my ex-employer but unfortunately our ambulance had been out for ambulance call. I had asked one of the family about the cause of suicide and the family had told me that it was family issue. The wife came later and I overheard her conversation over the phone

The ROSC did not last long and the patient had gone into arrest again. After 50 mins of effort, I gathered the family and told them that nothing much could be done and I would give a trial of 10 more minutes. With the help of CPR machine, prolonged CPR had not been a stress for us and for case that is still hope I would push to the limit, but yet 1+ hrs is my limit. The wife had knelt in front of me begging and I told her that I would do my best…

At 1+ hrs. I decided to quit and walk out to tell the family that I had certified. Well, the family members had gone into a hysterical state and I continued to see the pool of patients which piled up over the past 1 hours.

While I saw the other patients, the family had kept bugging me for the next 10+ minutes; one had come out telling me that he felt pulse, the other had come to me saying that the patient is still breathing(Ventilator effort of coz..)…

Finally I talked to the folks and told them that I felt that it would be harming the patient’s “big body”(means cadaver in Chinese) if I continue to do chest compression. A bunch of family had begged again and the final straw which crushed my heart was the daughter of the victim, who knelt down before me and asked me to save her father…

Well, I called my team back to the resus room and start the CPR again for another 10+ minutes…

It was truly a heart breaking moment for me….the daughter was at Yun age…and I just can’t bare to turn down her begging….I had crossed the red line after all these years…

Well, case of the months for me….

looking back and moving forward....

It was a tremendous ending for me…I had the luxury of having a 4 days leaves. The camping trip was an awesome one as the weather was not that cool as forecast by the weather bureau. Great BBQ dinner and a good night sleep in the sleep bag.

After the long leaves, it is da pay back time and I had to work on the 1^st day of the year….

Our ED shift had changed to 8-8 and I enjoyed a late push off, despite of the absence of night OPD, I had a good call.

New year new start and our task on the list is the “returning”…D-24 days…

Every journey home is a challenge to me, especially the driving part, adapting the left/right drive is a challenge; I had explored many places, driven more than 1000km in total since 4 years ago.

I had a list of food tour which included the Sate Kajang Hj Samuri, Bah Kut Teh, Hock Kien Mee and Mamak store….