unexpected experience...

It was a Saturday morning, Ving had gone to a conference up north and I was enjoying my time with the two kiddo. After sending Yun to school, Xian had suggested a swimming trip as he would be facing his swimming test few weeks later. I complied with Xian’s request and headed to the nearest swimming pool but found out that it was closed for service. We decided to go to another swimming pool  nearby and we had noticed an accident at a T junction during the drive. A lady was laying at the middle of the junction and a few bystander were standing around. Normally I won’t stopped as most of the time, there would be a lot of bystander willing to help but this was different as the victim was laying without movement. I told Xian that we would stop and offered some help. I parked the car along the roadside and told Xian to grab an umbrella to shed the patient as it is still hot during daytime.

The scenario was a bloody one as the lady suffered from an open jaw fracture and skull base fracture. After securing the airway and c-spine(that was what I could do, as I did not bring my bag and was driving Ving’s car instead of mine) and packing the wound, I called out the ED at A-hospital(my employer) as it is the nearest facility with neurosurgery capability. The nurse whom I knew told me that their computer was downed and I told them that they are the only hope for the patient and we would be coming over.

The ambulance arrived 10+ mins later and the patient went into arrest. I commenced CPR and have no choice to accompany the patient to A hospital as only one EMT-B would not be enough to manage the patient during the ride. Xian had come along and taken a seat at the front seat passenger seat of the ambulance. I managed to insert the LMA into the patient and continued the CPR session until our arrival in ED 10+ mins later.

The pass-over was a crap as the attending ED physician did not bother for a pass-over. I brief the triage nurse and walked out from the ED. The morale is low at that department as most of the ED physicians there are asking around for job lately. 

Xian had acted bravely during the scenario but freaked out during the ambulance ride. The local drivers have no driving ethic as no one is giving way for the ambulance; the ambulance had to drive like snake crawl during the journey. 

Well, the ambulance was kindly enough to give us a drive back to the scene to pick up our car. It was a perilous and educational journey for us. Xian had finally taken a look at what I am doing and I had a good workout…it was 2+ years since I did a long duration of CPR(we had a auto-CPR machine since then).   

It is my 1st time to involved in CPR on board an ambulance...not a pleasant one but yet a memorable one...

For Xian , it was another trilling experience on a speeding vehicle ( the first one was the TUK TUK ride in Sri Lanka months ago...)

As for the victim, sadly she did not make it even though ROSC was noted after she arrived at the hospital....

serve....

I had a small chat with Han during the insertion of double lumen catheter few days ago. One of my classmate had gone back to Malaysia to practice recently. He is cardiothoracic surgeon by training and is currently posted to Penang… he is satisfied with the 10+K RM salary and I envy him. 

There had been many occasions I had been asked if I wanted to go home to practice and I told them that I wanted to serve the public instead of the affordable. Indeed, the only way to serve the public in Malaysia is to work with the govt. It would be a chop waist cutting of salary for me….and if I open a clinic or work with a private hospital, I could not do what I am doing now….

The only regret I have is that I could not be my parents attending physician whenever they need me.

It is always a trading game, just like MPQ, one would need to determine the priority and go for it and never look back.
6 more year before Xian hit college and hopefully it would be a turning point for me...

Kukaracha...

It is Annual Nuke Disaster Exercise day again. As usual, Lem is the decon team leader and I acted as the ED in charge…Well, the case was a nuclear power plant worker with traumatic head injury and vomiting. He had exposed to unknown substance and vomited 2 hrs post trauma. Lucid interval was noted

The key to the exercise was DD of intracranial lesion vs Acute radiation syndrome...

I had read up at 6am, refreshing my knowledge, and downloaded the latest REMM mobile app...
 The outcome was great…..the Q&A was flawless and one of my staff had told me that no question could electrified me and I answered, “yeah... just like cockroach..”
indeed it feels good when you are invincible during such Q&A. Yun is getting the hang of it and frequent shared her experiences about her recent exams, but i knew she could do better...

the reward...

 Our last stop was a tour in Hatyai. Hatyai was a place that I had known for over 30+ years but never set my foot on. My neighbor, auntie and many whom I known had gone there, it is a shopping paradise for many. The 1D1N tour pushed out in the night and reached Hatyai in the morning. After a day tour, they would hop back to the bus headed home. No stay in hotel and they often come back loaded with stock.

The bombing might have shadowed some foreigner but yet Hatyai is still flourished with its tourism. The streets around Lee Garden Plaza are very similar to the Petaling Street. There are varieties of shops around the area. We had put up at the Tune Hotel which is very closed to the main shopping area. I did not spend a fortune but my suitcase was still filled up (with Pocky (banana, strawberry ....)).

 Despite of the tense atmosphere, I told myself, I would bring my family here next year….

I woke up early on the final day and I viewed the life ceremony of the returning of fellow Malaysian from Armsterdam. The kawad kaki was darn lousy, if I were the sergeant major, I would have their axx....

The returning journey was a stressful one for me after the break..

Although I had asked, requested, begged to change the flight returning from Thailand, the organizing party did not comply my pledge. The returning flight would arrive at 10:30pm…and it is 4+ hrs drive from CKS tom my house…although I had tried my best by providing the flight no. I preferred but yet my pleading was not heard.

The flight was eventually delayed for 30mins and I was lucky to get into my car at 11:20pm…The drive was uneventful and I reached home by 3:45am….

By 8am, I was back to my ED desk….

It was a journey which brought some surprise for the local staff; after many years of struggling and servicing the local people, the local staff had the opportunity for the 1^st time to spread gospel during their visit to a family….Indeed the mission is not only a personal feeling to sacrifices and acted but yet, it is the mission of the great one, known as “mission dei” (I learnt it during my last subject…indeed this was a practical session for me..).

There would be another tour in December and this time all of us are going….

Lead by the light

The stay in Satun and Langu were a great experience for me…

The local staffs were friendly people and dedicated to their job, they were experience at reception of foreign short term mission, they had a few mission visits per month and they would bring them around while executing their daily routine. Even though they are new to this medical relief mission (only 1 last year) but yet their passion to their job had eased our tour.

On D3, we had two clinics and one of them was held in the local govt health clinic. The office in charge had given a lunch which consisted of fish, prawn and crab (which would cost you a arm and a leg if you go to some sea food shop which you are not familiar). The cooking style was simple but the materials were very fresh.

After 2 days of bread and packet drink as breakfast, I was bored and I had walked over to the store opposite, even though the local had told me that the food they serve was very sweet.

After I tried out their teh kurang manis and bought a pack of onde-onde , I decided to eat breakfast at store instead of buying it 1 night before.

We left Langu the on D4 and proceeded down south and back to Satun.

The last 3 clinics we run were smooth and the last clinic was held in a small town where 90% of the patients speak Malay. The 1^st patient was a teacher who has surprised me with her good command of English. The local peoples were friendly as those Malay I had served during my medical officer day…

It was a life risking journey though, as we had utilized small truck as our transportation tool. We had also travel to a swamp area crossing a wooden bridge that look unstable ( the returning path was more perilous as it was raining heavily).

God had blessed us and every one of us had gained something during this journey….
The final debriefing with the local staff was a touching one and although we were warned about not to promise anything, but I told them that I would be back again next year....

am I doing the right thing ?

We were sent to Langu (means Laut in Malay) the next days as there was this HK mission of 16 coming to Satun.

Our 1^st clinic started in a secluded small village in Langu…

I met few local peoples that could speak Malay; they had surprised me as they speak Malay Baku instead of the Malay pattani.

The local missionary in charge is a Taiwanese lady. She had brought us to the local beach and we had some snack at the small pasar malam. We had our dinner at a local restaurant around the beach side and retreated to the local office for rest.

As usual, we were dropped by the local 7-11 where we could buy our dinner.

I had started to question my strategic of seeing patient ? did I really help them ? I got my answer later when I reached home… the local people had started to ask when is the fatty doctor coming back?

Not to worry when you work for the great one...

I did not sleep well as “trafficking” the medication was actually illegal. Well, I woke up at 4:10am and starting the final checking and packing. Leaving the hotel by 5am and dropping the car at the carpark. I was ferried over to the airport by the car park operator as usual.

I met my team members later at the airport. The check-in was smooth and I took a nap on board.

The plan arrived at Bangkok airport on time…I missed my lunch as I was too worried about the “load”…The short intro clip about the departing x-ray scan was quite disturbing.(this is the only country that I knew that wanted an xray scan of luggage before departing airport ).

However with the grace of god, the custom officer did not ask us to open the box of medication and we had slipped through the scan without any obstacle…I praise the great one and almost kneed down when we walk out from the airport.

The atmosphere around the airport is tense; heavy armed arm forces securing the perimeter….

We were picked up by the director of the foundation and we headed to Satun.

After a brief introduction by the local staff; we were told that we would be sleeping in the office instead of posting to the other missionary’s house.

The 2 nurses took the room and I slept at the conference room.

We were lead to the local TESCO and had dinner there. I had a plate of fried Kwaitiao -> Singapore fried beehon flavor… food was nice but very small plate; although the rock which hung on my heart was thrown to limbo but yet I was worried about the clinic tomorrow, the small plate of Kwaitiao was enough. 

The medication had entered with blessing but yet I was still worried about the amount - > is it enough for the 6 clinics we planned ?

We picked up some bread and packet drinks before we left TESCO.

I hit dreamland just after 10….