Monday, November 29, 2010

Name, face, and status

Working in the ER besides pumping adrenaline, it's also refreshing sometimes. Watching all kinds of people coming to ER and all their personality, it's really interesting dealing with it. Like tonight, there was this man who came to the ER because his wife cut her wrist while she was washing the dishes. As he waited me to stitch her up, he saw my name written on the "on duty" board. He predicted that i'm a batak.. According to my name which is taken from the Bible. And my middle name is also interesting for him. While my last name didn't show on board because my name is long enough so there wasn't any more space, so he just guessed that my last name is my family name. A Batak family name, hahahaha... When he said that to me, i already explained to him that he was wrong. But he probably didn't believe me until he heard me talk to my fellow in javanese. Then he said that after hearing me speaking javanese, he believed that i'm a local, not a Batak. Aahahhaaa... Pretty stubborn man...

Problems also arise from my racial status. My face is clearly showing that i'm half chinese. But since i was born, no one talk in chinese so i can't talk chinese. I do took some lesson but i stooped half way, so i could understand some simple phrases but i couldn't talk back to them. A man coming to ER to translate a chinese family and he pointed to me that as a half chinese i should learn to speak the language. I just grinned back at him, because i do have the intention to learn chinese again, it's just the time that i don't have. This face has caused me some trouble because when they saw me, they thought i could speak chinese and they just talked in full speed while i couldn't understand what they're saying if they spoke that fast. *sigh* thank God i have my iphone to translate and help me communicating with the non English-speaking patients.

And my status as a pastor's daughter also cause some problems. If i didn't free the charge, they could badmouthing me and my family behind our back. Saying that we're greedy, not tolerant to the congregation's member. But if i gave them all free of charge, the hospital administration will ask my reason. I couldn't say that they were all my congregation's member as an excuse everytime coz it may be the hospital loss. But what can i do? For now, i have my own policy. Good friend of mine, without insurance, good people back at church, moderate income or lower, on their first visit, i'll free them off charge. But other than that, they have to pay. Fair enough?

Sunday, November 28, 2010

review: rizzoli & isles

another series that caught my eyes when i walked into the dvd stores. hahahaa.. actually, most series attractive for me, but my preferences are detectives, homicides, or medical stories, so.. this is another police-forensic series plus woman power. hahhaa.. my bf said that this series is my typical must-watch-list.

rizzoli : the female homicide detectives. yeah..it's another typical case of women working in men sector. she got underestimated but then turned out she proved that she's better than most men there. and the problem that came follow is, she got no one as her bf. typical problems. men scared of daring, intelligent, and strong women and at the top of her career. kinda annoying when the creator kept making her single while in the movie she's meeting with some guy that can compete with her. her another problems are a serial killer that always coming after her, her little brother that hoping to be like her, and her annoying mother that keep nagging her to get a bf. usual drama...

isles : pretty doctor and quite fashionable but contradictorily to her job as a forensic examiner. but turned out that she had pretty interesting personality. she couldn't stop speaking when she talked to someone, and then she had this urge to diagnose people the moment she met them. and unfortunately, that habit of her made some of her date ran away, hahaha.. i really laugh when i watched her diagnose her date "marfan's syndrome" and the guy had no clue about what she's talking about. hilarious..! the exciting point is when she found out that her birth father is not just some irish mob, but the famous and dangerous one. she began to question if she had that cold blood trail in her.

pretty exciting series, thanks to the interaction between rizzoli and isles that make it interesting. but as always, it ends with full of questions. i hope they will continue the series since i'm curious if rizzoli, both rizzoli, would make it or not.

sure life is an unfair world

one of our emergency nurse is being admitted due to pneumonia. she had fever for more than a week, cough crazily for about a week and she already had a blood count done, and the result came back normal. but she still had fever up until today. she got the night duty yesterday, and at the end of her shift, the doctor in charge suggested to her to get an X-ray, and the result is pretty shocking for me. she got pneumonia.

she's 25 years old, same age as me, still single and underweight (based on her appearance). she worked her ass off in the ER and she worked really hard. multiple overtime, crazy ambulance tasks, and God knows what else she has been dealing with in our ER. and now, she's sick. pneumonia...oh gosh..that's something you can catch from patients that came to ER. but that's scarier than just upper respiratory tract infection.

and it got me thinking. as a medical provider, we're at risk of catching something from our patients. unfortunately, here, we don't get the protection that we need. there are a lot of rules and conditions before our company paid our expenses. and hell with the universal precautions. here in indonesia, even though all the international-labelled hospital already tried to do the best they can to practice the universal precaution as standard procedure, unfortunately, there were holes and cheats here and there. no one here in indonesia that do the universal precaution 100 % as standard procedure. it's different from abroad where everyone is so strict about it. they are so afraid of spreading infections and stuff. and don't forget the patients.

patients here clueless about what they could do to us. they forgot that we're also human, that we can be sick too. that we can be infected from anything that they had the moment they came into our ER. the moment we treated them. the moment they withhold important informations from us. patients abroad very meticulous about their complaints. they listed their complaints and problems. any previous history they told us all. they understood that anything could affect our judgements if they withheld some informations.

but here? we, as doctors and nurses, are required to be semi mind-reader and fortune teller. we need to have the ability to scan the diagnosis out of the patients just by watching them from head to toe as they might not reveal everything. and we have to play some tricks in order to get all the right informations from them. and the most dangerous part is, here, we have more HIV cases every year. it's getting nearer to our home. but since it's taboo to reveal that you have HIV, some patients just withhold that important information from us just because they're embarrassed about it. which is sucks.

me, myself, am a sloppy person. i got bruises and scratches and cuts here and there. i bumped into things more than anyone else. i got cut from nearly everything. i'm at chance of having micro cuts that i might forget, that i might not know i'm having it, that i might not feel when i got it. which means i'm at risk of fluid exchange if i didn't wear gloves or goggles or anything else written in the universal precaution' procedure. which means, damn...i might get infected if i still being reckless. *sigh*

it's hard to become a health provider. we offered our help to help others. we're at risk everyday. we seldom get the gratitude from those that we've helped. we often get complaints from simple mistakes that any human could do. and we get minimum protection from our company. sure life is an unfair world.

learn from mistakes

#1 miss A: she came to ER 5 minutes before my shift ended. she complained of abdominal discomfort, she felt nauseous and kept vomiting even though she's already had treatment the day before. since i wanted to go home soon, i checked her real quick and suggested that she should be admitted. since she showed no specific signs of any specific conditions, i admitted her as dyspepsia case and being treated by an internist. the internist came in the afternoon and examined her, also found nothing specific and ordered USG for the next day. turned out she had perforated appendicitis! gosh... and then, the problem didn't stop there. after she's being discharged, she came back again because there's pus from her operation site. and her case became worse. she needed the second surgery and stuff... hufff... really... pretty complicated from an unspecific case.

#2 mr.S: he also came at injury time. i already exhausted. and the moment he came to ER, i already knew that this won't be easy. multiple trauma case. and i needed to act quick. so i consulted to a neurosurgeon that still in the hospital at that moment. unfortunately, since he needed a lot of examination, and he got multiple lacerations plus he's delirious, it was hard to stitch him up. it took me more than an hour to stitch him up. and then, i couldn't pass him to the morning shift because she had another trauma case also. pretty hectic morning. so, in my exhausting state, i consulted him to various doctors. and then, as we evaluated again what has been done and what hasn't been, it turned out that we haven't done the USG. the nurse told me that they could do the USG in the ICU, so after stitched him up, the nurse took him straight to ICU as he still had to wait the radiologist to get the ultrasound. again...turned out he had hepatic rupture... :( and he had to stay lonnggggg in the ICU until the family decided to take him to another hospital which was cheaper.

#3 mr.A :this is probably the worst case so far. he came to ER for getting x-rays after falling down a day before. since there were problems with his company insurance, and he couldn't afford to pay it first, so he decided to go home and won't back to hospital even though i had called him to get back to the hospital because he probably needed more examinations and probably an abnormal results and he needed to be admitted. he refused. and i don't know till today if his result really came back abnormal. so...this is a slap in my face to be more careful. and listen to my gut.

Friday, November 26, 2010

my new world

yep.. now i'm in adults world, which is sucks. got a new job, pretty fast though, remembering what i put in my resume is not quite impressing. i don't know why but i got accepted, which..thank God for that. i was applying to mitra waru at first, but then the medic manager saw my address in the resume, she offered me to get transfered to mitra satelit. at that time, my only concern is getting a job so even though they said that it's though in mitra satelit, i didn't listen to them and just agreed to the idea.

turned out that working in mitra is incredibly insane. people are demanding. pretty exciting at first, but also frustating. there's a morning report, two night duties in a row every week, an on call, referring patients, and hotel clinic. lots of job huh? but it's interesting. the not interesting part is the payment. pretty minimum for a doctor, but as a newby, i don't expect much anyway. but i'm hoping that my salary will increase as time goes by.

and then there's a degree here. ward doctors, icu doctors and emergency room doctors. the ward is the lowest degree and the emergency is the highest. you have to pass the ward first and then graduated to icu before finally being in the emergency room. being on duty at emergency is fascinating but also scary. i'd like to be in the emergency room, but sometime i don't like to be alone there. having a partner to back you up, that's what i need sometimes. somehow, i'm still not confident enough facing all the patients coming at the emergency ward. but until now, i'm still trying to be one.

so..here i am, in my new world. just trying to fit in and hopefully i will be the REAL doctor soon. (not that i'm not..but sometimes i feel that i'm not one)

welcome!

yak2...welcome to my new blog... well, i actually planning to move all my posting from my previous blog but i failed couple times, so this time, i won't move my previous posting and just started the new one since i can blog here from my phone.

so..once again, welcome!