MR ROMEO

Yesterday call was really busy.
But the best moment was managing this patient, i called him Mr Romeo. I will remember him forever for the rest of my carrier.


It was 8.30pm. I was just finished doing appendicectomy. Then I've received a call from ER doctor.

ER doctor: Bond...i got this patient la...he wanted to commit suicide..using a knife he stabbed him self over the abdomen..so far he stable la.

Dr BOND: ok la, admit him to male surgical ward..i see him in the ward...he is stable right????

ER doctor: ya ..he is stable..ok going to admit him to the ward now.

Soon he was admitted to the ward. He was surrounded with his family members. Patient look OK..appear calm. He is a tall young man, dark skinned and skinny.

Emmm...so surprise..why he want to commit suicide on second day of hari raya??
I was tired..i didn't bother to ask him or his family members.

from my clinical examination, there were two entry wounds over the abdomen (tummy)...look superficial...he was stable..blood pressure and heart rate was normal.

".the wound just superficial...i don't think it serious".
I just give him usual painkillers and antibiotics.

So far everything was ok till at 4am...then my nurse called me..

Dr BOND...Mr Romeo blood pressure was low...he vomited out blood. His pulse rate was raised.

Me: WHATT???

I was panicked and rushed to see him..
Ya his blood pressure was low...it could be internal bleeding..

NURSE! prepare him to OT now!! i really shouted like mad at 4am.

he underwent emergency laparotomy (opening up the abdomen)...it's started at 4.30 am and finished at 8.30 am. to my surprise the wounds were penetrated the whole layer of the abdomen.
and the knife actually make a hole in the stomach...that's why he vomited out blood. there was bleeding from the stomach wall.

He was damn lucky (or lucky me)...his knife only hit the stomach. If the knife hit the liver, spleen or heart there will torrential bleeding and he will die. he was stable on admission as the bleeding was slow and minimal which didn't show any early clinical deterioration.
i just repaired the hole and his stable thru out the surgery.

after the surgery completed, the whole family members came to see me..

Patient's sister: Dr BOND...how is my younger brother???
Dr BOND: so far his ok..the surgery went smooth..he is stable.
Patient's sister: Alhamdulillah..

Gosh!! Didn't Mr Romeo think of his loved one (mother, sisters) before committing suicide???

Then i asked this question..Why Mr Romeo want to kill himself????
Patient's sister: err....errr.....errr.


Question. Please choose single best answer.
Why Mr Romeo want to commit suicide?
A. his girlfriend left him, and find another man.
B. he is gay, his boyfriend left him, and find another man.
C. he is stress like Dr BOND because his bos didn't give cuti raya.
D. he is stress because he got no money to "pinang" his girlfriend.
E. none of above.

SECOND SYAWAL

For most people in the rest of the world and Malaysia..they still celebrating Hari Raya..
me too celebrating "Hari Raya".
Yesterday, 1 syawal was great..I enjoyed the nicest sleep ever..ya i slept most of the day.
the next day was totally different.
at 7 am, i received a call from my colleague. She is sick..had runny nose and headache and she can't work today. i have to replaced her and have to do oncall today..
"ok la ..no problemo...take a rest ok..i'll cover you.."
what a surprise.. I just break one of the ancient rule of oncall: never take your colleague call otherwise you will be curse.

Ancient oncall rule no 1: Please follow the oncall list as on the timetable.

"nevermind la" it's just an ancient rule....and i'm replacing my sick colleague..God will bless me.
rush to the hospital...i was surprised to see the ward was empty...
yaaa....can finish work soon..

then,,exactly at 8.00am, 1 of my patient became unstable. he passed out fresh melaena...ie black stool..when you are a doctor..you will be obsessed with examining stool..we like to see patients stool very much...yellow is healthy...liquid and greenish not so good....but when it is black..is EMERGENCY..
black stool is a sign of internal bleeding...this patient had bleeding from his stomach..
he was unstable..without delay we send him to operation theater for emergency scopes to control the bleeding.
my second boss doing the scope.

really bad luck..we can't control the bleeder ..hence we have to do emergency laparotomy ie opening his abdomen (tummy) and stop the bleeding after entering the stomach. the operation took about 2 hours. we succeeded ...and so far he is stable in the ICU.
After that...i received calls from districts and from ER..there were 3 ladies with abdominal pain (sakit perut).
all of the patients need admission for urgent investigations.
2 patients came with pain over the testis (sakit telor la doctor)..
i have to admit them for pain control.


Then, i was rushed to the OT again...This time i have to do emergency appendicectomy..
hah..this is "kacang" ..a simple operation..
to my surprised again this is the most difficult appendicectomy ever.
it took me about 3 hours instead of usual 45 mins.
preparing for op.
i was damn tired after the operation..then i received another call from the ER.

Dr Bond!!
Please come to ER now..there is a 5 year old boy..fall from the house.

OK...i come now..

He was unconscious...we have to do urgent CT brain..
the unfortunate boy

Thank God..The CT brain didn't showed any bleeding from the brain..otherwise i have to send this boy to OT for surgery.

By this time it was about 11 pm...I was really tired, smelly and hungry .

I fall asleep on a chair till i received another call at 4 am..



Question: Please choose single best answer.

Why Dr Bond is busy on second day of Syawal?
A. He break the ancient rule of oncall.
B. It is a test from God.
C. It is a punishment from God as he didn't do his work well.
D. because he didn't give me duit raya.
E. He deserved it! padan muka
F. whatever la, apa-apalah.
G. none of above.

Nora Zain - Agen Wanita 001 (1965)

My mom introduced this movie when I was very very small..
Since then i was inspired to be a spy like her and james bond. To safe the world from the evil people....
I don't know what went wrong and i eventually become a doctor.
ha ha ha.


Filem Melayu pertama bertemakan penyiasatan ala James Bond..Diarahkan oleh Lo Wei dan diterbitkan oleh Shaw Brothers.Antara lokasi penggambaran adalah di Hong Kong.

Filem ini turut dibuat dalam versi Cina yang kemudiannya diberi judul "Angel With The Iron Fists".Antara bintang Hong Kong yang turut berlakon ialah Lily Ho & Tang Ching.

Starring: Saadiah,Aziz Jaafar, Nordin Arshad, Fanny Fan, Tina Chin Fei
Director: Lo Wei

SELAMAT HARI RAYA

JBM ingin ucapkan Selamat Hari Raya kepada semua pembaca blog (walaupun seorang je pembaca setia) , kawan-kawan dan kaum keluarga.
Sambutlah kedatangan Syawal dengan tanda kesyukuran kerana anda beruntung dapat menyambut raya bersama keluarga.

What a Small World.

About a year ago, there was 1 lady (Puan R) came with her husband to my surgical clinic. She complained of swelling over the neck for 20 years, but recently the swelling got bigger. She also had difficulty in swallowing and mild shortness of breath.
My clinical examination revealed an enlarged hard thyroid gland. I did an urgent ultrasound and a biopsy.
Unfortunately, the biopsy was reported as thyroid cancer: the anaplastic type. This is the most aggressive type of thyroid cancer. Usually patient will die in a few months after the diagnosis made.
My boss asked me to do a CT scan of her neck and chest. To make it worse, the CT scan showed the cancer already spread to her lung.
I explained the situation to both of them (patient and her husband).
They seem understood the fact that the cancer already spread and it's can't be removed surgically. "She is terminal" i said.
We did discuss this case with the consultant oncologist (cancer expert) , kota kinabalu...and he suggested for radiotherapy to control the tumour.
In fact..this is the only treatment left that we can offer.
Both of them agree to have the treatment and we have to send the patient to Kota Kinabalu.
So far everything went smooth, appointment taken,,,MAS flight already booked (with 1 doctor escort) and the doctor in KK expecting the patient to come soon.
The patient fly over to KK...unfortunately when she arrived at the Queen Elizabeth Hospital, Kota Kinabalu she complained of difficulty in breathing. She was ventilated and repeat chest xray showed the cancer got bigger.
She died the next day.
The husband (in denial phase) got angry. He blame us (the sandakan doctor) for his wife death. He said we were slow in sending his wife to KK for treatment. And even worse..we received a death threat from the husband. The husband want to "cungkil" my eyes..
The news spread to whole Sabah and it does create tension among us.
Me and the other doctor who escorted her was really terrified. We didn't go out after 6 pm. We just stay in the house after working.

Now almost more than a year had passed we didn't hear any news from her husband. Our both eyes still safe and intact.


Five days ago I had a dinner (breaking fast) with my brother. He introduced me his girlfriend (Miss M). She is a very nice lady, i think reaching 30's.

We eat, chat ...gossips..then suddenly my heart beat start pounding..

Miss M is a Puan R younger sister.......

LETS PARTY!!!!

my boss is away for 6 weeks!!! He is on his way to London, visiting his family.
like people says::

when the cats away, the mice will play


let's party..

Semen Analysis

Am I normal?

A couple met me in the surgical clinic a few weeks ago. They already got married for 5 years but didn't have any children. His wife already met O and G doctor (pakar sakit puan)..and she is okay.
So the problem could be the husband.
Eventually the husband did a check up...and one of it is the Semen Analysis.
A semen analysis is medical test that evaluates certain characteristics of a male's semen (air mani) and the sperm contained in the semen. Its a common test if a couple have problem in infertility (means no child la).

How is the test done ????
First he need to go to the hospital...
Then we will great him and explained how the test done..
We will give him 2 things: 1) a container/bottle to collect the semen 2) a magazine.
After that...he needs to go to a special room or toilet...where he needs to unzip and start masturbating. (while flipping thru the magazine)
after that he must give the "sample" ASAP..ideally within 30mins and we will check the quality of the semen and the sperm.
(he can do all this at home or office...but he must send the sample within 30min...and it must keep warm, ideally kept in his wife breast/bra).
after getting the sample ...we will check the volume, color, pH of the semen and the most important is the patients sperm count...

back to the patient..he already did the semen analysis....from the report its look acceptable..
i showed the report to my boss...here goes the conversation between me and my boss..

me: hello boss..i got 1 patient to discuss..this is a man with no child..he already did his semen analysis and it's okay...look normal...

the boss: alright..let me see the report..

me: here..

the boss: SH_T!!!!!....the sprem count is low...only 1 million..

me: hah????

i left the room puzzled...what 1 million is low????

Question..
What is the normal sperm count in 1ml of a semen?
A. 1 million (obviously this is not the answer).
B. 1 to 5 million.
C. 5 to 10 million.
D. 10 to 15 million.
E. 15 to 20 million.
F. more than 20 million (or equivalent to malaysia population).
G. 1 billion (you must be joking).

Winner will get a special prize from me...a very nice magazine...he he he ..