holiday-ing

Day 3 of holiday, i came back from kampung with my family for a cousin's wedding, and am currently in bangi...
tomorrow should be going to penang to see the chaps up yonder.

I'm the coolest person on earth (if I'm the only one there)

it's time for my 'newest insecurities' post..
If anyone ever bothers reading this crap, they'll notice some personal issues being broadcast out into the light...all intentional i assure you, however direct or poorly expressed they were, it was part of the blog that i thought should be there, to remind myself that i'm not here to show off or anything, and i dont really care if anyone reads this or not, and I'm confident enough to tell about myself that way and not feel like a self concious idiot, or some crazy dude people would shun. But I've always believed that we should live by a conscience through which we define ourselves, in every situation and changes we encounter, certain credos just above the tabula rasa from which we evolved into the adults we are. This just sounds deep but is actually getting crappier the more I try to explain.
insecurity no 1)
my 4th posting, but I'm still scared about my assessment in a few days..I guess it never gets easier, especially when the threat of consequences after a failure is real
2) I'm suddenly feeling pretty lost, like I dont really know myself anymore
3) I havent let go of some things I should have, and I feel that I have yet to accomplish anything in my life

positive consequences:
by acknowledging my weaknesses, I will try to get rid of them, and I now have a goal I can materialize and strive for

I might actually seriously study for the assessment if i get scared enough
the "need to accomplish" might make me do stuff other than work, read stuff, read manga, and stare at the computer screen for hours before dozing off
i dont know much about losing my "selfness" ...maybe it's just a transient feeling.maybe i should get a pet or a girlfriend or something, but I like my privacy, free time (albeit limited) and self-indulgement days right now

my latest pic

i was minding my own business, making insensible comments on facebook, when it became blurry...
and poof!


sebab komen dalam facebook, kene sumpah jadi gardenia?

Down's

Sometimes the best moments in your working day, where you learn the most, is at the end of it...well, at least that’s my reason for going back a bit late today although I was post call.

My friend doing newborn screening downstairs kept passing up babies with hypoglycaemia to the neonatal ward ( I changed wards about 2 ½ weeks ago). Being the kind to do so, he went up to check up on the babies he admitted, I was just about to go home when i saw him. Another friend was clerking a new case. While casually looking at the baby, the friend from downstairs suddenly commented – hey, doesnt that look like a Down’s baby? – no way, but hey there are single transverse palmar creases on both hands. We searched around a bit and found a bit more – low set ears, upward slanting of eyebrows, flat nasal bridge, sandal gap deformities bilaterally..

We called the MO who had also seen the baby for hypoglycaemia. Initially sceptic, he finally concurred with our findings. The more we looked, the more signs we saw.. the flat facial profile, incurved fifth finger etc. Fortunately the tone was normal, and no murmurs can be heard, yet. We decided to document our findings but not diagnose the baby yet.

Then we called our ward specialist, who had also seen the case and was ready to go home. Surprise, surprise, her opinion echoed ours and she ordered for chromosomal studies, an echo, and to counsel the parents on the possible diagnosis and prognosis. Unexpectedly, the baby had passed through 4 doctors of different levels, but everyone was more concerned on the hypoglycaemia, which was the most urgent matter anyway, but it was the one who initially admitted the baby who noticed first. It's pretty exciting when you find something your superiors missed, isn't it.

Since all was well, my friend from downstairs continued on his was to find his baby, only to come back since the one we were examining all this while was the baby he was looking for!

Even the best can miss a thing or two sometimes..hehe

*a few days back, the same specialist told us that if we did learn anything from our stay in the neonatal ward, she wants us to at least be able to diagnose a Down's Syndrome baby

where should I go?

InsyaAllah, my housemanship will end some day, and i'll keep my spirits up till then.
My senior, kak sal, is actually an mo in my kampung's hospital, it was pretty cool since i heard my relatives talk about this dr salina, then i found out about it a few months ago when i chatted with her on facebook.
Tomorrow i'll be going to pahang again with my siblings for aidiladha with our extended family (i have a few days off)
long term plans seem to bug me these past few weeks, starting my fourth posting made me think again about what i want to do when i finish my housemanship...
What would you guys think? So far i've gone through medical, o+g, and ortho..
I thought medical was not meant for me for a certain personal reason, but the past few weeks working in the general paediatrics wards, and a question by my specialist about what i wanted to do made me realise my curiousity of how things work, and joy in getting to the diagnosis might be suited for a ward like in the medical department. Also an mo i know (who i think initially hated me) also asked the same question, and when i asked him whether the dept itself would accept me, he said why not?, i guess i'm as eligible as the next houseman in the hospital at least.
So far paediatrics is great too, the workload (for housemen now, at least) is a lot lesser than our medical wards, the kids are cute, and i might have a certain affinity to them, and most of the discharges are all smiles and happy faces..of course, this is not always the case with the nicu and phdu...
O+g has a strict dept policy, not unlike peads, probably due to the medicolegal issues, but again, here, almost all cases are just normal happy people having a baby or two. The workload is a bit tough, but i might like that, just like the labour room, where the adrenaline rush makes you like it or hate it.and i'm not hating it. Again i'm not denying the general medicine department also has this rush.
I always thought I wanted to end up in a surgical area of expertise, as you can get to do something with your hands, and I like the OT environment since the first day I set foot on that tiled floor during my medical student years – again , I think it’s the adrenaline rush – the things that make you or break you. And probably coz it sounds cool... I bet a lot of you can say the same thing right?

I even asked around the Mos’ opinion if I could actually join orthopaedics. They gave the same answers, they find nothing that seems to stop me from asking the HOD to put my name there if I’m really interested. In the end I still didn’t ask the HOD..

There was a time when I got really interested in anaesthesia. At that time I spent a lot of time in the OT. I would talk with the anaesth MO or specialist, and got to see what their job was like, from getting the consent to managing the patients at the recovery bay. They even taught me how to intubate a few times, correcting my techniques, a specialist also encouraged me to join when i finish my housemanship, as they were short.

Another option is A & E. There are no calls, which means you can be at peak performance throughout your shifts, and the diagnosis there is really a challenge. Also, you will be the first to meet the acute presentations.I heard a lot of stuff about the A+E in Malaysia, but my friend is an MO there, and it’s the individual who makes all the difference.

In the meantime, I’ll just enjoy my Housemanship while it lasts, there are risks, the calls are as bad as you think it is, and you have to work 7 days a week. But who says being an MO solves everything? Your responsibilities are higher, you are expected to know more, your workload (currently) is actually more, and your calls are worse. Also, I wont have a good reason not to worry about my career as I’m not still stuck doing my housemanship. At least an MO’s working hours are less and you get weekends and public holidays off. I guess it’s just the job, being a doctor and all..

me assisting an amputation in my student years

It's a BOY!!

CONGRATULATIONS HAZIMI AND HANISAH
on the newest addition to your family,
Umar Al Fatih, welcome to this world



I should have posted this earlier
he's already about 1 month plus now, hehe

there are a lot of pictures of their baby in their facebook profile, go see for yourself if you know them

kids

I HAVE NO WORKING CAMERA WITH ME, AND MEDICOLEGAL & BIOETHICAL ISSUES WONT LET ME POST WARD PICS ANYWAY, SO THE FOLLOWING PICS ARE FROM 2006
WOULD HAVE BEEN NICE IF THERE WERE PICS OF UMAR AL FATIH THOUGH...SAM5 PLEASE UPLOAD SOME ONTO FACEBOOK!

I've been working in the general ward of paediatrics for a few weeks now, but truth is, i've always been a little scared of working with kids. They look up to you, and will learn everything from you, actually the part i'm worried about is hurting them in the course of treating them.
I'm starting to hate poking kids with needles, but it's part of the job. And it wont help if I just run away from doing it, for me and the patients.

Anyway, I get the feeling I can understand them a bit better, since they are, like most people, creatures of habits and patterns which can be deciphered if closely observed, and in fact it is easier as they are more straightforward. Plus they’re cute, which most people, including me, have a weakness to. Like Superman and kryptonite weakness.

Still, it scares me...how should we act in front of them? I can act cool and all, and I've been practicing some really lame daddy jokes. quotes, and magic tricks (believe me, it's as lame as it can get) but that lasts about 5-10 minutes, although that’s pretty much ok given the average attention span of a toddler, but later on it gets weird, and their quizzed looks as they look at me probably mirrors my perplexion as how to respond to them, as they really really really are responsive to our littlest body languages, something some adults lose.
Anyway, yesterday was another mini-reunion with me, usen, sam5, ete, and jimi and family..we had a great time just hanging out and went with bear’s idea of eating at an arabian restaurant eventhough the mastermind himself couldn’t manage to come. (Too bad we’ve tried so many times for a reunion, but so far we could only have part of the gang to attend..in fact, I haven’t seen the female counterparts of the gang showing up everytime we met – aren’t farah, kham, suraya, also in hkl?)

Jimi’s son is so cute..I’ll repeat myself umar’s got his father’s nose and i agree with ete, he does look a bit chinese..not that it matters much..hehe.coincidentally, all present already went through the peads rotation, and the author himself is in the peads dept, so yeah, alhamdulillah, he’s one healthy baby boy.

Hmm I did a little typing and clicked that google button..and got this from the internet on how the Prophet Muhammad(pbuh) communicated with kids...the link’s here but click read more if you want a copy-paste version on my blog’s post – the article’s awesome, not just because I said so, but because it’s made into a scientific research paper, with a proper introduction, methods sections et cetera, and the contemporary references, and a reference section (which imo is the most important part, so others can see the source of the compiled information. Otherwise, it’s still something from the internet, where most information reliability are poor. Otherwise get a good book, with a more reliable source, or maybe a good reliable hadith book and search for the ones about kids

Actually this article is, like most scientific articles, a bit long, so I just read my favorite parts – eg the bold fonts, the hadiths, I didnt really read anything beyond the examples of children , and I kinda know the methods listed a bit..
I’d better get back to sorting out my overdue call claims, and really should get some sleep before tomorrow comes


Prophet Muhammad Pattern of Communication towards Children
By: Ali Zohery

Introduction:
According to a companion of the prophet, he had never come across a person who was more affectionate towards children than the prophet. Collections of Traditions contain chapters on his affection for children. They reveal his amazing sympathy with the child mind and method for their informal training in daily life, which persuaded the children to cooperate in a joyous enthusiasm for their training and education.
This research addresses “the theory of learning through interaction with the environment that involves reciprocal causation of behavior, personal factors, and environmental events.” The focus is on the children as they were treated by the prophet Muhammad.

Research Questions

How did the Prophet Muhammad communicate toward the children during his time?

What was the impact of the Prophet’s way on the following generations of children?

Methodology

Content analysis is the method of data collection for this research: “ Prophet Muhammad style of Communication toward children.” This methodology is an approach to qualitative and quantitative research that is used to identify specific characteristics in textual messages (Morris R., 1994). The textual messages in this research are the speeches and conversations that the prophet had regarding children. In addition, his orations or sermons that he delivered to address the mankind in general.
During the twenty-three years of the prophethood of Muhammad, there were many of the speeches, orations or sermons that Prophet Muhammad communicated through to deliver his message to people. The message of Islam was not only for the people of the Arabia, but also was intended to be universal.

Contents analysis looks at the characteristics of communication messages, their contents and the producers of these messages ( Rubin, R.B., Rubin, A.M. & Piele, L.J. 1996). The study is analyzing some of the speeches and events through which the prophet communicated messages related to children’s bringing and education.

The unit of analysis of this study is the Prophet Muhammad’s individual speeches. Codes such as dates, events, locations and circumstances. Using the content analysis, as a method to collect the data requires defining the categories involved in the research study. The definition of the categories will help to clarify the coding scheme and that will lead to the reliability of the research. (Hamza, M. J., May 1997)

The researcher is investigating the effects that the Communication Pattern of the prophet had on children. This will shed the light on the communication techniques and strategies that the prophet used to attract children to learn about Islam and to become good and productive individuals in the society.

Literature Review:

According to the prophet’s guidance, listed below are some of the ways of instilling strength and honor in children’s character:
Taking them to gatherings and letting them sit with grown-ups (row models).(blog author's not: role models?)
This will increase their understanding and wisdom, and make them try to imitate adults. The followers of the prophet used to bring their children with them when they went and sat with the Prophet. One of the stories that describe this was narrated by Mu’aawiyah ibn Qurrah from his father, who said: "The Prophet used to sit with a group of his Companions. One man had his little son with him; the prophet would bring the child from behind and make him sit in front of him…"

Teaching them good manners
Among the manners that should be taught are those described in the hadeeth narrated by Abu Hurayrah from the Prophet: "The young should greet the old, the passerby should greet one who is sitting, and the small group should greet the larger group." (Al-Bukhaari, 5736).
Giving them the praise and respect they deserve in front of others
This is made clear by the following hadeeth: Sahl ibn Sa’d said that the Prophet was brought a cup and he drank from it. There was a boy, the youngest of all the people, on his right and some elders on his left. He said, "O young boy, will you allow me to give this to these elders?" The boy said, "I will not give away my share of your blessings to anyone, O Messenger of Allaah," so he gave the cup to him. (Reported by al-Bukhaari, 2180)
Teaching them sports
Avoiding humiliating them, especially in front of others
Never belittling their ideas, and encouraging them to take part

Consulting them and asking for their opinions

Giving them responsibilities in accordance with their age and abilities

Teaching them to be brave as appropriate – including how to speak in public

Making sure their clothes are modest and protecting them from inappropriate clothing, hairstyles, movements and ways of walking

Avoiding extravagance, luxury, laziness and idleness

‘Umar said: "Get used to a rough life, for luxury does not last forever."
Avoiding wastes of time, because these go against strength, honor and seriousness
These are some of the ways and means which will increase strength and honor, and protect children.

Teach them the Qur’aan and the correct sayings of the prophet, and the good manners of Islam, such as honoring one’s parents, upholding ties of kinship, honesty, trustworthiness, etc. Make sure that they regularly pray in a group. Also teach them the Islamic etiquette of eating, drinking, speaking, etc. If they grow up with these good manners, they will be guided and will remain steadfast, by the permission of Allaah, and they will grow up in a good way that will benefit them and their nation. (From Fataawa al-Lajnah al-Daa’imah, 12/261-262)

Allaah has enjoined upon children to honor and respect their parents. He has made the parents’ rights very great and has connected duties towards to parents to duties towards Him and the obligation to worship Him alone. Allaah says (interpretation of the meaning): “Worship Allaah and join none with Him (in worship); and do good to parents…” [al-Nisaa’ 4:36] And Allaah has given the children rights over their parents, such as education and a good upbringing, spending on their needs, and treating them fairly.
One of the bad social phenomena that are to be found in some families is the lack of fair treatment towards the children. Some fathers and mothers deliberately give gifts to some of their children and not others. According to the correct view, this is unjust action, unless there is some justification for it, such as one child having a need that the others do not have, e.g., sickness; debt; a reward for memorizing the Qur’aan; not being able to find work; having a large family; full-time studies, etc. The parent should have the intention – when giving something to one of his children for a legitimate reason – that he will do the same of any of his other children should the need arise. The general evidence for this is the verse from Quran (interpretation of the meaning):

“Be just: that is nearer to piety; and fear Allaah.” [al-Maa’idah 5:8].

The specific evidence is the saying of the prophet narrated from al-Nu’maan ibn Basheer, who said that his father brought him to the Messenger of Allaah and said: “I have given this son of mine a slave that I had.” The Messenger of Allaah said: “Have you given something similar to all of your children?” He said, “No.” So the Messenger of Allaah said: “Then take (the slave) back.” (Narrated by al-Bukhaari; see al-Fath, 5/211). According to another report, the Messenger of Allaah said: “Fear Allaah and be fair to your children.” He said: so he came back and took his gift back. (al-Fath, 5/211). According to another report, “Do not ask me to bear witness to this, for I will not bear witness to injustice.” (Saheeh Muslim, 3/1243).

Undoubtedly some children are better than others; this is well known. But the father has no right to show favouritism because of that. On the contrary, he has to treat them all fairly because the Prophet said: “Fear Allaah and treat your children equally.” So it is not permissible for him to prefer one child over another because he is better or honors his parents more. He has to treat them all equally and be sincere towards all of them, so that they will all be steadfast in honoring their parents and in obeying Allaah and His Messenger. He should not favor some over others in gift-giving, or bequeath wealth to some of them and not others. All of them should be equal in inheritance and in gift-giving, according to what is prescribed in the Islamic law concerning inheritance and gift-giving. If they are wise and tolerant, and they say, Give our brother such-and-such, and they clearly do not mind, and they say, We don’t mind if you give him a car or whatever… and this is clearly done freely and not because they are too shy or are afraid of him, then that is OK.
The point is that they must be treated fairly. But if they are wise, whether they are male or female, if they have no objection to one of them being given something for special reasons, then that is OK and they have the right to do that.
(Majmoo’ Fataawaa wa Maqaalaat Mutanawwi’ah li Samaahat al-Shaykh al-‘Allaamah ‘Abd al-‘Azeez ibn ‘Abd-Allaah ibn Baaz, vol. 9, p. 234)

Examples of children were brought up around the Prophet:

1. Fatima ( the daughter of the prophet)
Aishah. (the wife of the Prophet) said when the Prophet use to see his daughter (Fatima) approaching, he would welcome her, stand up and kiss her, take her by the hand and sit her down in the place where he was sitting." She would do the same when the Prophet came to her. She would stand up and welcome him with joy and kiss him.
Fatimah's fine manners and gentle speech were part of her lovely and endearing personality. She was especially kind to poor and indigent folk and would often give all the food she had to those in need even if she herself remained hungry. She inherited from her father a persuasive eloquence that was rooted in wisdom. When she spoke, people would often be moved to tears. She had the ability and the sincerity to stir the emotions, move people to tears and fill their hearts with praise and gratitude to God for His grace. (Internet, Alim on line)


2. Jafar ibn Abi Talib
Jafar ibn Abi Talib was a brother of Ali ibn Abi Talib, both were cousins of the prophet. Because of the mistreatment that the Muslims received from Quraish, Jafar asked the prophet if he and some other Muslims could emigrate to Abasynia. Its king was famous for being fair and just. Under the leadership of young Jafar the Muslims group arrived to Abasynia and the king granted them his protection. Quraysh did not let them stay without attempt to bring them back to Makka. Both groups, Quraish representatives and the Muslims were in front of the king to decide about the finial status of the Muslims. Jafar advanced and made a speech that was moving and eloquent and which is still one of the most compelling descriptions of Islam. the appeal of the noble Prophet and the condition of Makkan society at the time. He said: "O King, we were a people in a state of ignorance and immorality, worshipping idols and eating the flesh of dead animals, committing all sorts of abomination and shameful deeds. breaking the ties of kinship, treating guests badly and the strong among us exploited the weak. "We remained in this state until Allah sent us a Prophet, one of our own people whose lineage, truthfulness, trustworthiness and integrity were well-known to us. "He called us to worship Allah alone and to renounce the stones and the idols which we and our ancestors used to worship besides Allah.
"He commanded us to speak the truth, to honor our promises, to be kind to our relations, to be helpful to our neighbors, to cease all forbidden acts, to abstain from bloodshed. to avoid obscenities and false witness, not to appropriate an orphan's property nor slander chaste women. "He ordered us to worship Allah alone and not to associate anything with him, to uphold prayer (Salat), to give (help to poor) Zakat and fast in the month of Ramadan. "We believed in him and what he brought to us from Allah and we follow him in what he has asked us to do and we keep away from what he forbade us from doing.
"Thereupon, O King, our people attacked us, visited the severest punishment on us to make us renounce our religion and take us back to the old immorality and the worship of idols. "They oppressed us, made life intolerable for us and obstructed us from observing our religion. So we left for your country, choosing you before anyone else, desiring your protection and hoping to live in Justice and in peace among your midst."
The Negus was impressed and was eager to hear more. He asked Jafar: "Do you have with you something of what your Prophet brought concerning God?" "Yes," replied Jafar.
"Then read it to me," requested the Negus. Jafar, in his rich, melodious voice recited for him the first portion of Surah Maryam which deals with the story of Jesus and his mother Mary. On hearing the words of the Quran, the Negus was moved to tears. To the Muslims, he said: "The message of your Prophet and that of Jesus came from the same source..." To Amr and his companion, he said:" Go. For, by God, I will never surrender them to you." (internet, the companions of the prophet)

3. Abdullah ibn Abbas
Abdullah was the son of Abbas, an uncle of the noble Prophet. He was born just three years before the Hijrah. When the Prophet died, Abdullah was thus only thirteen years old.
When he was born, his mother took him to the blessed Prophet who put some of his saliva on the babe's tongue even before he began to suckle. This was the beginning of the close and intimate tie between Abdullah ibn Abbas and the Prophet that was to be part of a life-long love and devotion. When Abdullah reached the age of discretion, he attached himself to the service of the Prophet. He would run to fetch water for him when he wanted to make ablution (wudu). During prayer (Salat), he would stand behind the Prophet in prayer and when the Prophet went on journeys or expeditions, he would follow next in line to him. Abdullah thus became like the shadow of the Prophet, constantly in his company.
In all these situations he was attentive and alert to whatever the Prophet did and said. His heart was enthusiastic and his young mind was pure and uncluttered, committing the Prophet's words to memory with the capacity and accuracy of a recording instrument. In this way and through his constant researches later, as we shall see, Abdullah became one of the most learned companions of the Prophet, preserving on behalf of later generations of Muslims, the priceless words of the Messenger of God. It is said that he committed to memory about one thousand, six hundred and sixty sayings of the Prophet which are recorded and authenticated in the collections of al-Bukhari and Muslim.
The Prophet would often draw Abdullah as a child close to him, pat him on the shoulder and pray: "O Lord, make him acquire a deep understanding of the religion of Islam and instruct him in the meaning and interpretation of things."

There were many occasions thereafter when the blessed Prophet would repeat this dua or prayer for his cousin and before long Abdullah ibn Abbas realized that his life was to be devoted to the pursuit of learning and knowledge.

The Prophet moreover prayed that he be granted not just knowledge and understanding but wisdom. Abdullah related the following incident about himself: "Once the Prophet, peace be upon him, was on the point of performing ablution (wudu). I hurried to get water ready for him. He was pleased with what I was doing. As he was about to begin prayer (Salat), he indicated that I should stand at his side. However, I stood behind him. When the prayer (Salat) was finished, he turned to me and said: 'What prevented you from being at my side, O Abdullah?' 'You are too illustrious and too great in my eyes for me to stand side by side with you,' I replied. Raising his hands to the heavens, the Prophet then prayed: 'O Lord, grant him wisdom." The Prophet's prayer undoubtedly was granted for the young Abdullah was to prove time and again that he possessed a wisdom beyond his years. But it was a wisdom that came only with devotion and the dogged pursuit of knowledge both during the Prophet's lifetime and after his death.
During the lifetime of the Prophet, Abdullah would not miss any of his assemblies and he would commit to memory whatever he said. After the Prophet passed away, he would take care to go to as many companions as possible especially those who knew the Prophet longer and learn from them what the Prophet had taught them. Whenever he heard that someone knew a hadith of the Prophet which he did not know he would go quickly to him and record it. He would subject whatever he heard to close scrutiny and check it against other reports. He would go to as many as thirty companions to verify a single matter.
Abdullah described what he once did on hearing that a companion of the Prophet knew a hadith unknown to him: "I went to him during the time of the afternoon siesta and spread my cloak in front of his door. The wind blew dust on me (as I sat waiting for him). If I wished I could have sought his permission to enter and he would certainly have given me permission. But I preferred to wait on him so that he could be completely refreshed. Coming out of his house and seeing me in that condition he said: 'O cousin of the Prophet! What's the matter with you? If you had sent for me I would have come to you.' 'I am the one who should come to you, for knowledge is sought, it does not just come,' I said. I asked him about the saying of the prophet (hadith) and learnt from him."
In this way, the dedicated Abdullah would ask, and ask, and go on asking. And he would sift and scrutinize the information he had collected with his keen and meticulous mind.
It was not only in the collection of hadith that Abdullah specialized. He devoted himself to acquiring knowledge in a wide variety of fields. He had a special admiration for persons like Zayd ibn Thabit, the recorder of the revelation, the leading judge and jurist consult in Madinah, an expert in the laws of inheritance and in reading the Quran. When Zayd intended to go on a trip, the young Abdullah would stand humbly at his side and taking hold of the reins of his mount would adopt the attitude of a humble servant in the presence of his master. Zayd would say to him: "Don't, O cousin of the Prophet."
"Thus we were commanded to treat the learned ones among us," Abdullah would say. "And Zayd would say to him in turn: "Let me see your hand." Abdullah would stretch out his hand. Zayd, taking it, would kiss it and say: "Thus we were commanded to treat the family (ahl al-bayt) members of the household of the Prophet."
As Abdullah's knowledge grew, he grew in stature. Masruq ibn al Ajda said of him: "Whenever I saw Ibn Abbas, I would say: He is the most handsome of men. When he spoke, I would say: He is the most eloquent of men. And when he held a conversation, I would say: He is the most knowledgeable of men." ( internet, Compoinians of the Prophet)

4. Abdullah ibn Umar:
From an early age, Abdullah ibn Umar thus demonstrated his keenness to be associated with the Prophet in all his undertakings. He had accepted Islam before he was ten years old and had made the Hijrah with his father and his sister, Hafsah, who was later to become a wife of the Prophet. Before Uhud he was also turned away from the Battle of Badr and it was not until the Battle of the Ditch the he and Usamah, both now fifteen years old and others of their age were allowed to join the ranks of the men not only for the digging of the trench but for the battle when it came.
From the time of his hijrah till the time of his death more than seventy years later, Abdullah ibn Umar distinguished himself in the service of Islam and was regarded among Muslims as "the Good One, son of the Good One", according to Abu Musa al-Ashari. H e was known for his knowledge, his humility, his generosity, his piety, his truthfulness, his incorruptibility and his constancy in acts of worshiping Allah (ibadah).
From his great and illustrious father, Umar, he learnt a great deal and both he and his father had the benefit of learning from the greatest teacher of all, Muhammad the Messenger of God. Abdullah would observe and scrutinize closely every saying and act ion of the Prophet in various situations and he would practice what he observed closely and with devotion. For example, if Abdullah saw the Prophet performing Salat in a particular place, he would later pray in the same place. If he saw the Prophet making a supplication while standing, he would also make a supplication (dua) while standing. If he saw him making a dua while sitting, he would do the same. On a journey if he saw the Prophet descend from his camel at a particular place and pray two rakats, and he had
occasion to pass on the same route, he would stop at the same place and pray two rakats. In a particular place in Makkah, he once observed the Prophet's camel making two complete turns before he dismounted and prayed two rakats. It might be that the camel did that involuntarily but Abdullah ibn Umar when he happened to be in the same place at another time, made his camel complete two turns before making it kneel and dismounting. He then prayed two rakats in precisely the same manner as he had seen the Prophet do.
Aishah, (the wife of the Prophet) noticed this devotion of Abdullah to the Prophet and remarked: "There was no one who followed the footsteps of the Prophet, in the places where he alighted as did Ibn Umar." (internet, Compinions of the Prophet)

Theoretical framework:

How Do Children Learn?

In Islam there are several kinds of methods to educate children, some of which are: Observational learning (modeling and imitation); learning from advice; learning by way of orientation, which includes knowledge acquired from recreational and leisurely activities and parables; learning by doing and repetition; and learning through reward and punishment. ((Khouj, Education in Islam, 1987)

A. Bandura and Observational Learning
Some psychological theories emphasize that humans learn by observing and imitating others. Theorists such as Bandura, Twain, and skinner have discussed observational learning in their works. Bandura (1961) theorized that children learn morality from imitating and observing the behavior of others. In general, role models can be either good or bad examples of human behavior, depending on the particular orientation of the role model. In this way, role models in Islam must exhibit good behavior, which comes from an integrated and balanced personality. (Khouj, Education in Islam, 1987)

Observational learning, also called social learning theory, occurs when an observer's behavior changes after viewing the behavior of a model. In this study, the two elements of the theory are Prophet Muhammad as the model and the followers of the prophet as the observers. An observer's behavior can be affected by the positive or negative consequences--called vicarious reinforcement or vicarious punishment-- of a model's behavior. In this case, only positive consequences were the results of the observation process between the followers and the Prophet. The social learning theory of Bandura emphasizes the importance of observing and modeling the behaviors, attitudes, and emotional reactions of others. Bandura (1977) states: "Learning would be exceedingly laborious, not to mention hazardous, if people had to rely solely on the effects of their own actions to inform them what to do. Fortunately, most human behavior is learned observationally through modeling: from observing others one forms an idea of how new behaviors are performed, and on later occasions this coded information serves as a guide for action.". Social learning theory explains human behavior in terms of continuous reciprocal interaction between cognitive, behavioral, an environmental influences. The component processes underlying observational learning are: (1) Attention, including modeled events and observer characteristics, (2) Retention, including symbolic coding, cognitive organization, symbolic rehearsal, motor rehearsal), (3) Motor Reproduction, including physical capabilities, self-observation of reproduction, accuracy of feedback, and (4) Motivation, including external, vicarious and self reinforcement.
Because it encompasses attention, memory and motivation, social learning theory spans both cognitive and behavioral frameworks. Bandura's theory improves upon the strictly behavioral interpretation of modeling provided by Miller & Dollard (1941).
Social learning theory has been applied extensively to the understanding of aggression (Bandura, 1973) and psychological disorders, particularly in the context of behavior modification (Bandura, 1969). It is also the theoretical foundation for the technique of behavior modeling, which is widely used, in training programs. In recent years, Bandura has focused his work on the concept of self-efficacy in a variety of contexts (e.g., Bandura, 1993).

Principles:
1. The highest level of observational learning is achieved by first organizing and rehearsing the modeled behavior symbolically and then enacting it overtly. Coding modeled behavior into words (statements of the Prophet Muhammad) labels or images results in better retention than simply observing.
2. Individuals are more likely to adopt a modeled behavior if it results in outcomes they value.
3. Individuals are more likely to adopt a modeled behavior if the model is similar to the observer and has admired status and the behavior has functional value.

There are several guiding principles behind observational learning, or social learning theory:
1. The observer will imitate the model's behavior if the model possesses characteristics-- things such as talent, intelligence, power, good looks, or popularity--that the observer finds attractive or desirable. That was the case between the children and the Prophet Muhammad.
2. The observer will react to the way the model is treated and mimic the model's behavior. When the model's behavior is rewarded, the observer is more likely to reproduce the rewarded behavior. When the model is punished, an example of vicarious punishment, the observer is less likely to reproduce the same behavior.
3. A distinction exists between an observer's "acquiring" a behavior and "performing" a behavior. Through observation, the observer can acquire the behavior without performing it. The observer may then later, in situations where there is an incentive to do so, display the behavior. The Muslims children were trying to imitate the prophet in his behaviors.
4. Learning by observation involves four separate processes: attention, retention, production and motivation.
• Attention: Observers cannot learn unless they pay attention to what's happening around them. This process is influenced by characteristics of the model, such as how much one likes or identifies with the model, and by characteristics of the observer, such as the observer's expectations or level of emotional arousal. Every word or action of the Prophet was recorded because of the extreme attention of the followers.
• Retention: Observers must not only recognize the observed behavior but also remember it at some later time. This process depends on the observer's ability to code or structure the information in an easily remembered form or to mentally or physically rehearse the model's actions. The Holy Qur’an and the statements of the prophet were retained and remembered. There are now 1.2 billion Muslims on the earth.
• Production: Observers must be physically and/intellectually capable of producing the act. In many cases, the observer possesses the necessary responses. However, sometimes, reproducing the model's actions may involve skills the observer has not yet acquired. Because of the effort of the followers of the prophet, the message of Islam spread around the world.
• Motivation: In general, observers will perform the act only if they have some motivation or reason to do so. The presence of reinforcement or punishment, either to the model or directly to the observer, becomes most important in this process.
5. Attention and retention account for acquisition or learning of a model's behavior; production and motivation control the performance.
6. Human development reflects the complex interaction of the person, the person's behavior, and the environment. The relationship between these elements is called reciprocal determinism. (www.funderstanding.com)

B. Vygotsky and Social Cognition
The social cognition learning model asserts that culture is the prime determinant of individual development. Humans are the only species to have created culture, and every human child develops in the context of a culture. Therefore, a child's learning development is affected in ways large and small by the culture--including the culture of family environment--in which he or she is enmeshed.
1. Culture makes two sorts of contributions to a child's intellectual development. First, through culture children acquire much of the content of their thinking, that is, their knowledge. Second, the surrounding culture provides a child with the processes or means of their thinking, what Vygotskians call the tools of intellectual adaptation. In short, according to the social cognition learning model, culture teaches children both what to think and how to think.
2. Cognitive development results from a dialectical process whereby a child learns through problem-solving experiences shared with someone else, usually a parent or teacher but sometimes a sibling or peer.
3. Initially, the person interacting with child assumes most of the responsibility for guiding the problem solving, but gradually this responsibility transfers to the child.
4. Language is a primary form of interaction through which adults transmit to the child the rich body of knowledge that exists in the culture.
5. As learning progresses, the child's own language comes to serve as her/his primary tool of intellectual adaptation. Eventually, children can use internal language to direct their own behavior.
6. Internalization refers to the process of learning--and thereby internalizing--a rich body of knowledge and tools of thought that first exist outside the child. This happens primarily through language.
7. A difference exists between what child can do on her/his own and what the child can do with help. Vygotskians call this difference the zone of proximal development.
8. Since much of what a child learns comes form the culture around her/his and much of the child's problem solving is mediated through an adult's help, it is wrong to focus on a child in isolation. Such focus does not reveal the processes by which children acquire new skills.
9. Interactions with surrounding culture and social agents, such as parents and more competent peers, contribute significantly to a child's intellectual development.

How Vygotsky Impacts Learning:
Curriculum--Since children learn much through interaction, curricula should be designed to emphasize interaction between learners and learning tasks.
Instruction--With appropriate adult help, children can often perform tasks that they are incapable of completing on their own. With this in mind, scaffolding--where the adult continually adjusts the level of his or her help in response to the child's level of performance--is an effective form of teaching. Scaffolding not only produces immediate results, but also instills the skills necessary for independent problem solving in the future.
Assessment--Assessment methods must take into account the zone of proximal development. What children can do on their own is their level of actual development and what they can do with help is their level of potential development. Two children might have the same level of actual development, but given the appropriate help from an adult, one might be able to solve many more problems than the other. Assessment methods must target both the level of actual development and the level of potential development. (see references related to Vygotsky Theory of Learning)

Definitions of major terms and concepts

1. Ali: Muhammad’s cousin, one of his first followers and the 4th Muslim caliph. Married to Muhammad’s daughter, Fatima.
2. Hadith: the statements of the Prophet Muhammad.
3. Hajj: The Pilgrimage to Mecca. Hajj or Hajji, one who has completed the pilgrimage.
4. Hijrah: Muhammad’s flight from Mecca (AD 622), from which Muslim dates are calculated.
5. Islam: The faith revealed by the Prophet Muhammad
6. Kabah: The house of God at Mecca, toward which the Muslims from around the world face during their prayers.
7. Khadijah: First wife of the Prophet Muhammad, the founder of Islam.
8. Medina: The city that prophet Muhammad emigrated to from Mecca.
9. Mecca: The most holy city of Islam, Mecca is the birthplace of the prophet Muhammad.
10. Negus: King of Abyssinia (Ethuopia)
11. Sunnah: Deeds, actions, way of life and the statements of the Prophet.
12. Quraish: The tribe of Prophet Muhammad
Summary
Prophet Muhammad communication style toward children during his time produced educated and knowledgeable Muslims who spread the religion of Islam, not only within the Arabia but also outside to the north, south, east, west and southwest of the Arabia. His pattern of communication toward the children made them to love him, to learn his teachings and later to be great teachers themselves. They spread the teachings of the prophet to the following generations to come.

References:
1. Holly Qur’an
2. Akbar, M. U. (1991). The orations of Muhammad the Prophet of Islam. New Delhi: Kitab Bhavan.
3. Al – Hawfi, A. M. (1996). Portrait of Human Perfection: A description of the appearance and character of the Prophet Muhammad. London, Dar Al Taqwa Ltd
4. Bandura, A. (1993). Perceived self-efficacy in cognitive development and functioning. Educational Psychologist, 28(2), 117-148.
5. Bandura, A. (1986). Social Foundations of Thought and Action. Engelwood Cliffs, NJ: Prentice-Hall.
6. Bandura, A. (1973). Aggression: A Social Learning Analysis. Englewood CLiffs, NJ: Prentice-Hall.
7. Bandura, A. (1971). Social Learning Theory. New York: General Learning Press.
8. Bandura, A. (1969). Principles of Behavior Modification. New York: Holt, Rinehart & Winston.
9. Bandura, A. & Walters, R. (1963). Social Learning and Personality Development. New York: Holt, Rinehart & Winston.
10. Besant, A. (1932). The Life And Teachings Of Muhammad, Madras, P. 4.
11. Doolittle P.E. (1997). "Vygotsky's zone of proximal development as a theoretical foundation for cooperation learning", Journal on Excellence in College Teaching, 8 (1), 83-103.
12. Encyclopedia Britannica: (Vol. 12)
13. Faizi, S. F. H. (1997). Sermons of the prophet. New Delhi, Kitab Bhavan
Gandhi Mahatma, (Young India)
14. Gaury, G. (1991). Rulers of Mecca. NY: Dorset Press
15. Gibbon, E. And Ockley, S. (1870). History Of The Saracen Empires, London, P. 54)
16. Glubb, J. B. (1991). The life and Times of Muhammad. Chelsea, MI: Scarborough House.
17. Hamza M. J.( May 1997). Press Coverage of the New World Information Order in the U.S. and Tanzania, 1976-1985: A Comparative Study. ( A Ph.D. Dissertation Submitted to the Faculty of the Graduate School of Arts and Sciences)
18. Hart, M.H. (1978). The 100: A Ranking Of The Most Influential Persons In History, New York, P. 33
19. Haykal, M. H. (1976). The life of Muhammad. USA: American Trust Publications.
20. http://www.islam.org The Great Revolutionary Prophet,
21. http://www.usc.edu/dept/MSA The Science of Hadith,
22. http://salafipublications.com Shaikh Saleh ibn Abdul-Azeez Aal-Sheikh, Seeking Knowledge and One's Intentions,
23. http://salafipublications.com Saeed bin Wahf al-Qahtani, Guidelines For Acquiring Knowledge,
24. http://www.usc.edu/dept/MSA Islam, Knowledge, and Science
25. http://www.usc.edu/dept/MSA Adhering to the Sunnah of the Prophet
26. http://www.funderstanding.com
27. Kayyali & Zohairi, Encyclopaedia of Politics, p.327 ) ( in Arabic)
28. Khouj, Education in Islam, 1987
29. Lamartine, (1854). Histoire De La Turquie, Paris, Vol. Ii, Pp 276-277)
30. Lane-Poole, S. (1994). The speeches & table-talk of the Prophet Muhammad. New Delhi: Kitab Bhavan.
31. Lings, M. (1983). Muhammad his life based on the earliest sources. Rochester, VT: Inner Traditions International, Ltd.
32. Naidu, S. (1918). Ideals Of Islam, Vide Speeches & Writings, Madras, P. 169
33. Nicholl, Trish An introduction to some of the basic concepts of Vygotskyean theory (culturally-mediated identity).
34. Peters, F E. (1994). Muhammad and the origins of Islam. Albany, NY: State University of New York Press.
35. Rauf. M. A. (1996). The life and the teaching of the prophet Muhammad. Alexandria, VA: Al-saadawi publications.
36. Rubin, R. B., Rubin, A. M., & Piele, L. J. (1996). Communication research: Strategies and Sources(4th ed.)
37. Shah, S. I. A. ( 1996). Muhammed the Prophet. Reno, NV: Tractus Books.
38. Sharma, D.C. (1935). The Prophets Of The East, Calcutta, Pp. 12
39. Shaw, G. B. (1936). The Genuine Islam, Singapore, Vol. 1, No. 8
40. Siddiqui, A. H. (1991). Life of Muhammad. Chicago, IL: Library of Islam.
41. Smith, B. Muhammad And Muhammadanism, London, 1874, P. 92.
42. Vygotsky, L.S. (1962). Thought and language. Cambridge, MA: MIT Press. (Original work published 1934)
43. Vygotsky, L.S. (1978). Mind in Society: The development of higher psychological processes. Cambridge, MA: Harvard University Press.
44. Wertsch, James and Cole, Michael "The role of culture in Vygotskyean-informed psychology".

45. Zahur-ul-Haque, Muhammad the Greatest Leader, pp. 51-53

Выхожу один я на дорогу

Выхожу один я на дорогу
Стихи: Михаил Юрьевич Лермонтов
Музыка: Елизавета Сергеевна Шашина

Выхожу один я на дорогу;
Сквозь туман кремнистый путь блестит;
Ночь тиха. Пустыня внемлет богу,
И звезда с звездою говорит.

В небесах торжественно и чудно!
Спит земля в сиянье голубом...
Что же мне так больно и так трудно?
Жду ль чего? Жалею ли о чем?

Уж не жду от жизни ничего я,
И не жаль мне прошлого ничуть;
Я ищу свободы и покоя!
Я б хотел забыться и заснуть!

Но не тем холодным сном могилы...
Я б желал навеки так заснуть,
Чтоб в груди дремали жизни силы,
Чтоб, дыша, вздымалась тихо грудь;

Чтоб всю ночь, весь день мой слух лелея,
Про любовь мне сладкий голос пел,
Надо мной чтоб, вечно зеленея,
Темный дуб склонялся и шумел.

mne nravitsa golos u shtokolova, a stikhi lermontova, tak skuchna, i krasivi

Alone, I go out onto the road (1841)
Poetry: Mikhail Lermontov
Music: Elizaveta Shashina

Alone, I go out onto the road;
The rocky way gleams through the fog;
The night is quiet. Nature listens to God,
And one star talks to another.

How solemn and wondrous is the sky!
The earth sleeps in a blue glow...
So why am I troubled? What weighs upon me?
What am I awaiting? Do I have regrets?

No, I expect nothing now from life,
And have no regrets at all;
I seek only freedom and repose!
To forget myself and sleep!

But not the cold sleep of the grave...
I'd like to sleep forever,
But for life to slumber on
In my softly heaving breast;

For love's sweet voice to sing
All day, all night, caressing my ear,
For the dark, ever green oak
To bend down to me and rustle.


too bad i'm an internet freebies leecher

Я Вас любил (ya vas lyubil)

Я
Вас любил, любовь еще быть может
В душе моей угасла не совсем
Но пусть она вас больше не тревожит
Я не хочу печалить Вас ничем

Я Вас любил безмолвно, безнадежно
То робостью, то ревностью томим
Я Вас любил так искренно, так нежно
Как дай Вам бог любимым быть другим.

Романс "Я вас любил" нап стихи А. С, Пушкина

ya vas lubil;

lyubov isho, b'yt mozhet;

v dushe mayei ugasla ne sovsem;

no pust ona vas bol'she ne trevozhet;

ya ni khachu pechalit' vas nichem;;;

Ya vas lyubil;

to molnost'yu, to revnost'yu tomim;

ya vas lyubil, tak iskrenno, tak nezhno;

kak dai vam Bog lyubimoy byt' drugim

Pushkin wrote this for someone's wife..you'd be surprised how often this happens, and i'm surprised at how beautiful this poem really is


my favourite rendition of this poem here

a tormented soul's silent anguish bleeds silently, trading lost dignity with false pride, lost pride with shameless acts, finding comfort with indifference, knowing solace a utopia for even dreams, pitiful, yet does it deserve pity.drowning in sorrow, yet not wishing to be saved.let me be..let me bleed..

though a weak human that i am, i seek not redemption

o err'd have I, moronic my deeds were
to be human, to be me

25 years

22 september 1984

it's been a beautiful life
although i made a lot of mistakes, sometimes repeatedly
the ups and downs..

goodbye ramadhan..

the masjid in front of htar which i went for terawih..one of the perks of having a car


ramadhan came and went by...
to see this blessed month next year..is enough of a reason for me to keep on living..
hope to see you again dear friend

other than that selamat hari raya aidilfitri everyone maaf zahir batin

a friend told me to keep on writing, even though it's been months..thank you for the support..


a lot happened this past few months for me..it was the most eventful, and yet, nothing happened
the memories were beautiful, but the ending, although not as well for me, hopefully is for the best and i hope the choices made will be the happiest for others.as for me i feel like i made some stupid mistakes, but this is one of those times when mistakes can never be repaired, or forgiven...i'll live with this regret...this clown still have a show to put,and an audience to entertain..i'll paint that big red smile over my face..and live on..

to shafiq and mazidah

congrats bro

my third posting

i am now in orthopaedics..so currently i'm in my third posting after having done with medical and o+g ..it's been approximately 10 months since someone called me doctor in Klang hospital
my entries seem to be getting darker tones and scarcer than ever, but believe me i am the same man, though i couldnt help but bear a grudge for having to extend another 2 months of my already two-year-long housemanship training while i was in my 1st posting in the medical department.
truth be told i do enjoy my work, other than what i said just now, i like being a HO, even the 2 long months of extension was beneficial in a way (I had more time to do more procedures than normally a houseman in Klang Hospital would.)

I found myself more relaxed doing stuff, and some people seem to think it’s a big deal i finished those 2 previous postings, but i wouldnt say I’m ready for ortho just yet...every dept is different and it’s helpful to know what exactly you are doing no matter how many times you’ve done something similar in another department.

Orthopaedics is a great relief in comparison, finishing at 5 is only 2 hours earlier, but after coming home only after 7 every weekday, it’s so refreshing.

I’m actually doing tagging calls, which means i have to stay until 10pm (in the other departments its up to 11pm, but who’s complaining right), but the feeling of going back early is just too great, I’d still go back 1st, rest,eat and pray and then return to look for something to learn.

The calls are also something i’m looking forward to..4 to 5 calls per month- approximately half of what i’ve been doing in my previous postings (approx. 7-9 calls per month in medical, 11-12 calls per month in o+g which usually means a train of eods throughout the month)

The ratio of patients per HO is also so little in comparison i could’nt help but smile whenever i think of it.

It doesn’t mean starting as a HO in ortho would make you less of a HO though,IMO. I know a few guys who were really smart coming from ortho, who could do their jobs in their new depts just as efficiently.

Life is changing...the guys who got married are mostly expecting. I finally bought a means of transport and will soon move out of this old skool hostel.I’m starting to contact my old buddies especially those near me. Facebook is a great tool for this (besides fster). We’ve been laughing off electronically (no, not as if in the transformers voice, though it'd be cool if i could) as we look at some of the more comical moments in our student lives in zam’s photo album.

The kids in volgo are coming back again, and some fresh blood will enter the service of the Ministry of Health...mmm..fresh blood..

an entry to wrap up 5 months and get some crap outta my head

5 months.
if i was truly faithful to this blog.it would have been filled with entries, love/hate stories of my life's work, how it changed me, touching goodbyes to my overdue stay in medical, the new department i came into, my newfound struggles there, my recent assessment, hopefully my expected leave from the o+G department, the new phone, the new car im planning to buy, my latest exploits, the upcoming wedding of my friends, my ex-roommate's birthday, my gourmet adventures with my current roommate, my exciting, fun and definitely enriching experiences in the labour room the past month, and how much i miss my university life, and how thankful i am they taught me to be a doctor, especially dr alexander zharkin and the other professors who taught me exactly what i needed to be an accoucher (to this i defer from a friend of mine's comment to me in private that what he learnt did not help him much- it helped me TREMENDOUSLY, in fact, what they taught me was more than what i learnt here).of course, here is where i learned to BE a doctor. take responsibility (however little it is now,thankfully) and train to become a good one, or at least a functional one who knows what he's doing.
my struggles in the medical department taught me the hard way that here i need to learn the local medical jargon, learn how to present them correctly, how to work with the system, and the current local protocols and management.and it works. and also to keep studying. even the consultants take time to read bak once in a while...it'd be egoistic for me not to study just to prove my university taught me well enough.which i did for a short period, for which i hated myself for taking in too deeply coincidentally hearing what some arrogant colleagues of mine thought of the supposedly inferior doctors the government sent to learn in some foreign country or other.
i'm actually smart enough to keep it to myself, brewing it in and occassionally annoying (hopefully not) my roommate- those comments which made some actually nice people into annoying jerks whenever i thought about those few dumb words they talked that day. i mean, it's okay to have pride in your university, but downgrading others just to show you're better? any high school kid can pull that off, and anyone with any common sense can see through that ruse.
the only thing we can do about it though, is to show them what we've got.just give those 'inferior'
docs a few months, and, in my case, i'll be just like any doctor you can point to. sitting with me in that conference room. believe it. (yeah i kinda still hold a grudge- it's a good motivational tool, see)
as for you guys still in my alma mater. have faith and study well.be motivated in learning, which i know most are.try to do the practicals here when you are in the clinical years. we are not high school kids who suddenly become doctors in hospitals. i know my six years were not wasted. i only had to learn the common local terms, investigations, and protocols (which are actually really simple compared to our textbooks)

oh and the original thing i was thinking about:

8 hours a day, no calls, 10 beds 2 housemen, intense cases and lotsa cute babies - LABOUR ROOM ROCKS!

Troublesome patients, troublesome job

“We are not witch-hunting, this is only a learning experience, please dont take it badly...will the houseman and mo responsible for the patient please stand up”

You’ll hear this a lot from our HOD of Medicine during our Friday mortality meetings and whenever there is an issue, or a mistake made...
Make no mistake, I believe the HOD is a good man, and he means what he says, and believes it to be true.and it is..It usually really is a learning experience, and not once did any mistake got out of that meeting unless it couldn’t be helped. Our medical department really does protect their doctors.
The only problem is, no matter how you cushion it, or cover it with sugar, spice and everything nice, it’s still putting blame on someone, and I doubt anyone who gets up likes it.
Fortunately I haven’t had that rather uncomfortable experience – yet.

An interesting thing that happened in our recent meeting was when he produced some actual complaints from ex patients or a powerful relative..
One such criticized the referral letter done by a HO. It was badly done, as the HO had just started, didn’t really ask, and the MO didn’t notice.
Another one was an email sent straight to the MOH, and incredibly stated the name of the HO the patient was complaining about. It was about the unethical ill-mannered way a HO handled the patients in the dengue wards. The houseman wasn’t there, was already scheduled to leave the department the next day, was already a 3rd or 4th poster, and later denied ever taking care of the patient more than blood taking once, without even an exchange of words. But that particular HO could only deny that point, as the HO was known to be brash, and at times ignited the ire of not just the patients.
At that particular moment, the HOD couldn’t even get himself to read the letter, so he asked someone else to read it. The moment the email was about to mention the HO’s name, probably all the HO and maybe some of the Mos held their breath or skipped a heartbeat, including me...everyone had a skeleton in their closet they’d never want to recall.

At one point in my work, I developed that tendency to get mad at every patient complaining of pain/sob all the time....even to the point of patronizing them for disturbing my and the nurses’ work. A patient I once admonished expired during the weekend about two months ago...nothing medicolegal or complaints happened...but it was a painful lesson in a way. Now the worst I could do is be indifferent, but the old temper can still be ignited if rubbed the wrong way, so I became careful. Now I almost don’t sleep during my calls, and I keep going back late, double checking to see if everything’s well. Thankfully my experience the past few months helped me a lot in deciding on management issues.

In another point of view, some patients are troublesome in itself. Those ‘manja’litis patients, or those afraid of needles, or those who even have the nerve to refuse and even get angry at the doctor trying to get a line (which is sometimes hard,depending on the HO’s experience and the patient’s condition). These are the guys whose drug charts would state brenula required instead of the usual initials signifying some iv treatment had been administered. And the MO the next day would have a headache and if on a bad day, would scold the houseman.
Sometimes it’s the relatives that are the problems..the ones nurses complain that they think they’re so important they deserve every minute of the nurses’ attention. Quite frequently these are relatives who are doctors , and they would quite often question the decisions the doctor in charge makes, especially if they know he’s a houseman, and a first poster like me, although they know it’s unethical and they shouldn’t interfere in the relative’s treatment
Usually it’s with these patients I let go of my reins completely. I become really indifferent, I’ll nod at every suggestion, but never really follow them, because that’s what they really want, for me to follow instead of decide. Usually in this case I’ll let the MO decide even the simplest decision, as apparently, that’s what these relatives really want. Of course if they want to do the blood taking, I let them. Less work for me, and less chances of needle prick or another unsatisfied or patient in pain for me.
Not that I couldn’t manage. I have every confidence that I can, to a certain degree, manage simple cases on my own. To disagree with them would only incite anger in me, and just further misunderstanding. To follow their opinions blindly would be stupid. I let the MO discuss and handle the situation.
Of course what would you do if it was your parent in the ward, right?
I try to keep that in mind in every case I handle. But humans can forget.

Clinicians versus radiologists

This is purely from my experience, after 4 and a half months of being at the bottom of the pyramid of the professional caste of medicine.
The clinician and the radiologist – both possible future options for housemans and med students. First of all im really thankful i’m in medicine...there are so many possible choices for my career in the future...i feel like the little zergling worm that gets to become anything from a giant flying alien crustacean to a living disgusting zergling factory/fortress to a superunit in starcraft..
Anyway these two species rarely meet in this diversely intercorrelating small environment called a hospital..but both are crucial, like so many other aspects, in the treatment process of the patient..the central subject of our work.
So how do they interact? That’s where we house officers come in...our role as messengers have been embedded deeply into the programme called housemanship I’m supposedly “enjoying” right now. I dont mind having to go down every now and then, read up on the way (especially when it’s not my case- sometimes), and try my best to convince the ever-so-busy radiologist that this is an urgent and necessary intervention. But in some things,as with everything in this world, they are always at odds with their idea of what is urgent and what is not.
One “urgent” request i never could get urgently was the “urgent ct neck,thorax,abdomen and pelvis for staging”. I know, both parties have reasons why it is’nt/is urgent.
The clinician/specialist/mo wouldn’t want this ct study too late, as the earlier the cancer is treated, the higher chances of the 5year survivability rate..letting the patient go home first, take the scan a few weeks later, then deciding what kind of treatment is simply unacceptable in their minds..i tried to talk the out of it, but who listens to the houseman right? Some common replies from my pleas of not wasting my time in (in my opinion) a futile attempt to get the radiologist to do it on the same day of diagnosing the cancer was “of course it’s urgent. Are you nuts?” or something like that, or something along the lines of “why wouldn’t they accept it..it’s stated right here (shows the previous scan and/or u/sound) that they were the ones who suggested it”
After those brief conversations, the houseman/peon takes out his pen, dishes out the forms,carbon paper, etc, gets the specialist countersign, and prepares himself for the impending encounter with the radiologist downstairs..(on a good day, that certain HO even believes in his heart that this will work,and those helpful tips he got from the specialist/mo would prove fruitful)
He gets to the scan room, clears his throat, and does his best to impress on the radiologist the urgency of doing this.
Deep down, he knows why the radiologist would’nt want to agree..here’s a list:-
• There is no urgent or life-saving procedure no matter what the outcome of the scan (unless it’s a primary cancer- which is usually a coincidental finding or after routine screening, and without clinical symptoms already)
• Urgent for them means the patient’s life is in danger and severe permanent outcomes would happen if they didn’t do the examination helping in the decision for the course of treatment
• They would have to put aside extra time to check almost all the systems from the neck to the pelvis- precious time needed to finish their scheduled scans and reports before the clock turns 5.this might sound a bit selfish, but they do have a lot of work, and like everyone else in the hospital, they manage their time the same way – they prioritise.
So what’s my point?unfortunately i can’t recall another “mission impossible” task of urgent special examinations...but this one is clear, and the point is I hated whenever this examination comes up, because it would mean me wasting my time going down and up, sometimes multiple times, trying to get something they’ll never agree upon –maybe they would, when-um- stretchers learn to fly or something..
Dont get me wrong, i’d take a ct brain urgent TRO ICB or US KUB urgent TRO obstructive uropathy or any other necessary tests that requires urgent intervention any time and help save that poor patient’s prognosis. Especially when u get all the facts/reasons right, and everyone agrees it’s urgent.
The bottom line- why wouldn’t they just tell me to get a really-really early appointment, we’ll decide the date (usually within 1-2 weeks) and readmit the patients like how the nephro team does, and decide the treatment..as what usually happens anyway (actually, they get a TCA ward first, and THEN the MO would decide to admit the patient to start chemo, or to refer to ghkl or any other oncological department in Malaysia) instead of telling me to fight over something the other party would never see. Come on guys..agree to disagree..and cut the chase..at the end of the day i’d still learn something anyway...but with way less time and effort wasted
And here is the rest of it.

A day in my life

this was one common boring Monday
1. Reviewed 12 patients
2. Discharged 7a 7 8 8a 9 12
3. Followed MO reviewing my rounds
4. Traced all results
5. Requested for urgent ct scan
6. Went to mortality meeting
7. Went for Friday prayers
8. Helped put brenula
9. Helped someone clerk
10. Helped someone remove CVP
11. Accompanied patient for us urgent
12. Cxr reporting
13. Us urgent for patient which had cxr reporting
For the patients not leaving:
1. One had hypokaliemia and anemia for FBP to find out why (probably because he has diverticular disease too)
2. Another is supposed to be refferred to HKL for further treatment
3. Another needs 10 more cycles of PD before discharge
4. Another developed temperature just after my review...but probably it’s URTI and we’ll discharge him tomorrow
5. One just had ultrasound TRO AV fistula of the femoral vein and artery- which he didnt have..but still needs to be reviewed by the nephro specialist before discharge
6. Another still has signs of fluid overload – his EF is 23%, the swelling was noted in gp long before...i dont know when we’ll be able to discharge this guy..probably when we’re satisfied with th eresults (it IS improving) and then we’ll refer to IJN again (he defaulted follow-up)

Things i found out
The patient at the back with chronic liver disease & massive ascites is transferred to acute d/t loss of cinsciuosness (E¬1M1V2)
The ex ivdu patient at the back with extensive tattoos and symptoms of gangrene 2o to emboli or DM foot ulcer is now in subacute
Half the Dengue patients are finally going back today
Anil might be extended
Kuhan will go to pediatrics
Why voltaren(diclofenac) could be dangerous (adv reaction- toxic epidermic necrolysis)
I’m still not sure what to do next
I’m pathologically addicted to mangas
I cant login to my ym messenger
And here is the rest of it.