Oxygen by Carol Cassella - Post Exam Read

Assalammualaikum.

My missions post-exam include KDramas binge-ing (Her Private Life, Hotel Del Luna which I finished, Chief Of Staff, etc), and finishing my unread novels.

I bought Oxygen in 2014 for RM5, perhaps during the BBW Fair in Mines that time (I write the date and the price of the books I bought) but I read it only halfway - can't seem to finish it.
I finished it this time and can't help but wonder why couldn't I finish it before.

Cassella is an Anaesthetist (or Anaesthesiologist, as they call it in the US) and hence her writing felt very close to me.
She accurately and brilliantly described her work routine, her worries and concerns in anaesthetising patients and her interactions with the OR staff.

The story started with it introducing the protagonist, Dr. Marie Heaton as a senior and renowned Anaesthetist in the hospital, and how the HOD is closer to becoming a businessman than an Anaesthetist. She then anaesthetised a little girl which ended up wrong, and the poor girl died on table.
It was a spine operation and the girl was lying prone; she portrayed the dismay the surgeon had when he had to stop his operation and turn the girl flat to be resuscitated, the adrenaline rush during the resuscitation as well as the agony she had to go through in breaking the bad news to the girl's mother - a single parent.

Then the real story unfolded.
The lawyers somehow got hold of the deceased patient's mother and started to instigate her to sue the hospital.
The hospital which initially backed Marie up then decided to split the defense and left Marie on her own to defend herself.
It talked about how close Marie is to her younger sister, Lori who is married and has kids on her own and is very satisfied with her life but also realistically struggles financially.

Her relationship with Joe, another anaesthetist colleague who is very smart, sturdy, reliable and charming - but perhaps not ready for a relationship was explored in great detail. In the end, it turned out that Joe actually keeps a dark secret unbeknownst to Marie. The secret that led to the death of the little girl with an undiagnosed cardiac disease.

I love how Cassella talks about the art of anaesthetising people, putting them to sleep, oblivious to their surroundings and waking up safe and perhaps cured.

I have also just finished another Mitch Albom's work - The First Phone Call From Heaven. This is one of his books that I find very hard to finish. It has so many characters that I got them jumbled up and confused. I will talk about this book later.

I still have a shelf full of unread books - one of the many reasons I stop myself from buying new books nowadays.

-Because life is a test-

-AkMaR-
http://nur-akmar.blogspot.com

Exam is Over

Assalammualaikum.

I had my exam 4 days ago; on 14th Dec 2019 at Monash Clinical School JB.
The exam started at 10am, and we were seated by 9.30am.
There were 30 of us, all from Johor / Melaka. Dr. Omar was the chief invigilator.
I am writing this in detail so that in a few year's time when I reread this post, I can relive the moment and perhaps, felt gleeful about it.

I studied really hard for the exam, took a 4-day leave prior to the exam.
I dreamt of physiological and pharmacological facts.
Words like pKa, potent, baroreceptors kept appearing in my dreams - for real.

I find the exam considerably okay - I could answer most of the questions. There were no "Wow, I've never heard of this" kind-of question.
But still, when people ask - I dare not sound as confident lest I do not pass this exam.
And I don't even admit to people that I studied hard, in case I do not pass.
And the markings system is really a disadvantage.
The negative markings mean I will get fewer marks than I expect to and it might not be sufficient to reach the passing mark.

There were 60 questions, to be answered within 90 minutes.
That means we can spend only 90 seconds per question.
Each question (stem) has 5 true or false statements.
That effectively means I have 300 true or false statements to answer.
As time passes, I noticed I took roughly 1-minute per question ie when I look up to see the clock, it was roughly 10.15am when I was at question no 15 and so on. That meant I finished answering the paper with 30 minutes left to check my answers.

I managed to check my answers only up to question no 52 if I remember correctly.
I only managed to check if I shaded the correct answer from then on - making sure I transferred the right answer onto my answer sheet.
And I erased many of my answers from the answer sheet the second time I read them. I chickened out.
I'd rather leave the answer blank than put a wrong answer and got my marks deducted.

One of the free-marks questions was "The intubating dose of Atracurium is 0.2mg/kg" - I was so glad reading this statement.
Atracurium is such a common drug in Anaesthesia that even our housemen are expected to know the correct dose at the back of their hands.

A flatlay Sharmine and I created during our study sesh in Amerin Hotel during the intensive course

OK, anyway the results will only be released in April next year.
Only then will I know whether I pass this entrance exam and if I am accepted into MMed Anes and if I am, which university will I be enrolled in.
Now is the time for me to be tawakkal.
Ingat, tawakkal itu di penghujung usaha manusia.
Tawakkal only comes after all the possible efforts.

For now, let's pray hard and also play hard. 😆😆

-Because life is a test-

-AkMaR-
http://nur-akmar.blogspot.com

MMed Anaes Entrance Exam

Assalammualaikum.
A short update today.

The exam is coming up in less than a week.
This is my entrance exam; ie the RM250 exam that will determine whether or not I get accepted into the MMed Anaes Masters Programme.

Last week we had an intensive course - one whole week in Hospital Permai.
The intensive course combined the entrance exam candidates as well as the first-year masters students - they will be having their exam in April next year.

I met many of my INTEC and IMU mates who are already in the Masters programme - sometimes I feel left behind but then, we should never compare other people's timeline with ours 💪

During the course, someone asked Dr Omar - what are the syllabus for the masters entrance exam, to which he replied - "There is no syllabus. Anything can come out - from primary to final year questions"
😫

And worse, the exam incorporates a negative marking system.
I have never had negative marking exams before.
Negative marking means your marks will be deducted for every wrong answer - that means if you don't know the answer, better leave the question blank!

As an example:

A highly ionised drug:
A. Is well absorbed from the intestine
B. Is excreted mainly in the kidney
C. pKa is close to physiological pH
D. Is reabsorbed into the renal tubule
E. is highly protein bound

The true answers are: A False | B True | C False | D False | False

So if I answered all correctly, I will get 5 marks.
But if I answered 3 corrects, but 2 wrongs - I get only 1 mark (3 minus 2).
And if I answered 2 corrects, but 3 wrongs - I get 0 mark (2 minus 3).
If I was certain of 3 answers, I should answer the 3 I know, and leave the other 2 unanswered, at least I get 3 marks.

Getit getit?

Anyway, that's it for today.



-Because life is a test-
-AkMaR-
http://nur-akmar.blogspot.com

Giving Up on Someone's Life

Assalammualaikum.

Some time ago, we had a female patient in her 40s, came in with respiratory distress into ED.
She was just discharged from the medical ward for some pneumonia and with advanced chronic kidney disease.
She was already advised for dialysis, but her husband and she were not happy with the diagnosis, they took an AOR discharge and defaulted follow up.
She came back in a bad shape; creatinine >4000 and urea >60 and a face and body full of uraemic rashes - wet and angry lesions.
She was intubated in ED, suffered a cardiac arrest and arrhythmia - CPR and defibrillated and brought into ICU.

We treated her for hospital-acquired pneumonia and an array of complications of kidney failure.
Strong antibiotics pumped into her with many other life-sustaining drugs to keep her heart pumping well.
Few days later, her blood parameters improved but her general condition didn't - she wasn't waking up and her breathing effort was minimal.
I met the husband and explained about the current condition and introduced him to tracheostomy - while exploring her social support.


Two days later we managed to extubate her and put her on NIV machine - a machine to help with breathing but without the tube in the patient's mouth.

However, she became weaker and weaker as the hours pass.
We had to re-intubate her after a few hours. She managed to speak to her husband on that day.
We told the husband she might deteriorate further.

A few days later, she still wasn't making a good recovery. She was still very fragile and perhaps demotivated.
She cries and appears gloomy.
She understands us, but she was so weak she can only lift her fingers and perhaps some nodding or shooking.
We implored again the husband's thoughts on tracheostomy, and he adamantly refused it.
He refused tracheostomy, he doesn't want to discuss it.
But he also refuses to withdrawal of care, he wants the wife to be kept ventilated but refuses both tracheostomy and CPR.

It was perhaps a good decision, if we perform a tracheostomy on her, the woman will now be very dependant on the husband.
Not only she needs a carer for her tracheostomy (I wrote about tracheostomy before here), but she also needs dialysis 3x a week.
The whole family needs to be really dedicated and invest time and effort and energy and emotion.
Perchance, this is the best choice for her.

But we were bitter with the husband's verdict.
We felt like the husband gave up.
He refuses active intervention, he wants to wait until the patient recovers, but that is a far cry from reality.
That is a hope that might never come true.
I remember my colleagues thinking "Men, they will bail out if they can. Who want to take care of a sick and dependent wife?"
We wondered will the decision be different if we have asked the mother instead?
Will a mother give up?

But deep down I know, or perhaps I hoped - this man just did not want his wife to suffer longer.
That he loves her, and enough means enough.
Perhaps it was just his way of expressing his decision that made us disturbed - he was almost rude, he questioned and blamed our decisions, he questioned all the interventions done to his wife during all her previous admissions (which we the ICU team can't really justify as we do not know the situation then).
And his wife was young! 40s!
Her daughter is still in primary school - and she is going to lose her mum.
It was very frustrating to let a young woman die. We know if there is no active intervention, she won't make it.

Why did she default all her treatments?

Why did she take an AOR discharge then?

Why did the husband and her waited until she was very severely ill before bringing her back to the hospital?

Why even bring her to the hospital if they trust traditional medicine more than the doctors?
All these questions kept playing in my mind - unanswered.

At last, we managed to extubate her but she was so weak she can't even cough out her own sputum herself.
The nurses did vigorous chest physio and suctioned her sputum frequently.
And after a day, we discharged her to the general ward.
And she succumbed to her illness.

I see this kind of patient very often.
Every time, it breaks my heart to make that kind of decision.


-Because life is a test-


-AkMaR-
http://nur-akmar.blogspot.com

OT Call: Sampai Dua Failed Spinal in A Day

Assalammualaikum.
-warning: Entry ni banyak jargons. Maybe susah for non-medical persons to understand-

Starting this year, we MOs are divided into pools ie OT pool and ICU pool.
Everyone will remain in the pool for the whole month and then we either rotate or stay in the pool, depending on our boss.
I was in OT pool in Sept, then Oct in ICU pool - which explains why I had so many thoughts on critically ill patients in mind.
I am now in OT pool until next January - that is 3 months yeayy.

2nd Nov was my first OT call after switching pool. Dah lama x buat spinal wey.
But thankfully I had L, a floating MO to tag with me for 24 hours.
He does most of the work, I was there mostly to supervise and decide some minor things.
And he had two failed spinals that day. No, this entry is not to bitch about him, it is just for me to read back in the future about some of my cases I experience during oncalls.

Caesar yg kena convert GA
First case yg failed spinal tu was for EMLSCS for an unstable lie in labour.
O&G post kt L - G2P1 unstable lie, os 2cm, contractions 1:10mins tapi last meal belum cukup.
Ada lagi sejam lebih before the fasting time (6 hours) complete untuk patient tu. For those who don't know, patient nak op akan kena puasa at least 6 jam.
Lagi lagi klo patient pregnant sebab nanti ada risiko tinggi untuk tersedak makanan, masuk paru2 and mati - senang cerita. Igt suka2 doktor nk suruh patient jangan makan?

That time I was doing appendix case, and ada lagi 2 appendix menanti..
And since surgical team dah ada dalam OR, and salah satu appendicitis tu in sepsis, TWC 26 - I called that one first.
So I rush the current surgeon untuk habiskan appendix tu cecepat.
Aleh2 dia bagi HO dia close the skin, I said "Okay tapi klo HO u lambat sgt, u hv to take over sbb I hv EMLSCS"
Obviously HO dia lambat la, tapi dapat la jgk stitch more than half of the wound.
Sekali patient ni pulak lambat banguuuun. 15 mins post reversal, the kid still hasnt emerge from anaesthesia - lalok lagi adik tu, x boleh extubate.
Last2 lambat jugak induce appendix yg sepsis tu.
I was already fidgety that time, kang tiba2 O&G post unstable lie tu as fetal distress, dah kena bukak second OT. Kan susah.

And I texted Farahin tnya - kenapa os baru 2cm and contractions 1:10 dah kira in labour?
And betul la apa Frhn ckp; os dah bukak, and dh ada contractions, in labour la tu.
I got confused between in labour and active phase of labour.
Seb baik tnya Frhn dlu, sbb klo tertanya O&G sini, maluuu.

Kena pulak appendix yg sepsis ni complicated, Masz x dpt nak release tip of appendix hence Mr I scrub in and korek keluar appendix nye.
At least mencepatkan lah, boleh la pggl caesar tu cecepat.

Pastu tengah2 L membagi spinal, tiba2 ada aspirate blood pulak.
In the middle of administering spinal drugs, usually we aspirate sikit nak tengok the CSF again. And we usually can see the "cloud" coming into the syringe - ie the CSF lah.
Tp yg L pnya ni, aspirate keluar blood la pulaaak. So ktorg betul2 kan, position balik etc, dpt balik CSF nye.
Tp by then dh mendak kot ubat spinal yg lain hence the block jadi patchy. Patient still sakit bila surgeon testing kt perut 😣

So terpaksa la call Boss John - discuss next step.
Boss kata GA je lah. Uhhhukss. Utk yg tak tahu, men-GA-kan perempuan mengandung adalah sesuatu yg seboleh2nye MO Anaest nak avoid.
Bahaya wey, banyak risiko nye. Paling menakutkan, klo hypoxic smpai mak tu brain damage. Kau nk jawab kt court?

Nasib baik tadi tggu utk last meal dia habis and siap ter lambat sejam lagi sbb buat appendix dlu.
Baby nurse terus call Paeds utk standby sbb mummy under GA kan.
And intubate la itu mummy - uneventful. Op pun uneventful.

Baby je lalok. Mula2 keluar menangis pastu lalok pastu kena PPV. Last2 admit NICU under CPAP for TTN 😞

Indian yg Failed Spinal
Ini memang nk ketok L.
Bunyi mcm rasis, but no. Not rasis. Patient ni memang India mari, barely speak Malay or English hence everything was translated by the Indian employer.
Nak debride wound di kaki nya, so L bagi la spinal.
Spinal tu nampak mcm smooth je - I wasn't really paying attention sbb by then mcm dh trust L, and I started documenting BP HR sume.
Nak test level pun susah sebab the patient mmg tak faham ktorg ckp. So suruh surgeon proceed je drape.

Sekali waktu surgeon test pkai forceps, meringkuk2 patient tu sakit. Alahai kesian.
Tapi kaki sebelah dah berat, cuma yg op side je still sakit and x berat sangat. Tilt tilt table, tunggu 15 mins pun sakit lagi.
Wktu tu dah 2 lebih pagi, mata dah berat - kes x habis lagi.
Nk convert GA alaaaaahai.
Last2 supplement Ketamine. Yeay wonder drug mmg do wonders.
Terus patient lalok and tak sakit. Tnya sakit ke (secara body language) - dia kata tak, sambil mata dia dh membesar dan bercahaya kerana Ketamine. Heee~
Terasa berjaya sangat.

Tapi bila dah kena supplement2 Ketamine ni, tak boleh la nak tinggal kan L utk jaga OT sesorg.
Patient sakit je which is about every 20mins, kena tambah 10mg Ketamine and so on.
And akhirnya berjaya habis op, tanpa perlu convert GA.
Alhamdulillah.

Ok habis sudah ceritera oncall.
Till next time :)


-Because life is a test-

-AkMaR-
http://nur-akmar.blogspot.com

First Screening for Masters Programme

Assalammualaikum.

Alhamdulillah, I passed the first screening of the Masters programme for MMed Anaes.
The registration for the programme was in July this year.

The screening is just a formality to screen and filter out applicants who do not fulfill the requirements eg those that are not yet 3 years in service, or those with insufficient LNPT marks.
So as (almost) expected, it was smooth for me. Alhamdulillah.

eHLP - Permohonan Berjaya

I am not sure about last year, but this year the exam board created a blog / website for us applicants to register for the Entrance Exam.
The Entrance Exam fee is RM250. Initially, the closing date for the exam registration was 1st November but that doesn't make sense because the release of eHLP result of the first screening has not been announced. Thank God they postponed it to the 10th November 2019.

So today, I paid the RM250 and registered myself for the entrance exam which will be held in mid Dec this year.
Let's start studying again :)


-Because life is a test-

-AkMaR-
http://nur-akmar.blogspot.com

Treating The Critically Ill

Assalammualaikum.

ICU settings

As an Anaest MO, I work in both the Operating Theatre (OT) and the Intensive Care Unit (ICU).
Needless to say, the patients I treat in ICU are all very sick patients. Most of the time, they are intubated, to allow oxygen being delivered to them so that they can breathe better, and easier and thus, relieving their bodies of the fatigue.

Often, we managed to save them.
They recover, extubated and then discharged to the general (normal) ward.
Sometimes they don’t do well, and we need to know when to stop, and when to say “OK, this is it. This is our limit and there is no more we human beings can do”. It is challenging to determine that point. I am always scared that I gave up too early. What if I just need to try a bit more to save him?

Give up? Or try harder?

Often, the line separating surviving from succumbing is grey.
And adding to the complexity - is the life after survival.
One might survive the ordeal but left with disabilities that render him / her dependant on others.
One might get through a severe infection of the lungs but the heart became weak and can't even stand walking to the toilet without feeling breathless.

I would often think - would the patient rather die of the infection or live with permanent disabilities? How can we know? Will the children know?

Jangan menambahkan penderitaan seseorang / tak nak dia menderita lama

So what if we can save the patient, but we know the outcome will not be good? Should we still try all out and get the patient to live - but only having his heart beating but without his brain and muscles functioning well?

And then comes miracle. How sure can I be that no miracle will ever happen?

Families cling to the word miracle like a stranded hiker clinging on her fingernails.
They need it, they desperately hope for a miracle. And I am there, shattering all their hopes.

No, please don't hold your hopes high. You need to understand, your father is not doing well and his heart might give way anytime soon. Please be ready.

Yes, I believe in miracles. But that is specifically why they are called miracles.
They rarely happen. And if they happen, no matter what we did, it will still take place.

ICU is a very specialised and thus, limited place.
Not all patients can be admitted to ICU - we need to choose our patients carefully, those who can benefit the most from an ICU admission and we have our own admission criteria.
Some patients who unfortunately do not meet the admission criteria; will be ventilated in the general wards. And it breaks my heart seeing these patients being outside in the normal ward, and die eventually. I usually hope the families will bring them home, so that they can die at home, surrounded by their family members.
But our society don't really do that.
They'd prefer their parents to die in the hospital, and most of the time, they don't agree to the withdrawal of care. They will agree to at most, limitation-of-therapy.

Every critically ill patients have a story of their own.
They might be healthy and fit last week, but a severe infection of the lungs, or perhaps disseminated infection of bacteria into their spleen and livers, causes them to be incapacitated and fighting for their lives.
Sometimes, it is a motor vehicle accident - injuring their intraabdominal organs, their brain and/or their bones.
Critically ill patients can be any of us in the future.
Have you actually thought about it?
Would you prefer being alive but disabled permanently and relying on your family members or die trying?
Is life, or quality of life more important to you?


p/s: No I am not trying to say people that are already disabled to be better off dead. No no not at all.
It's just so hard to imagine living but not really living. You aren't even yourself anymore.


-Because life is a test-


-AkMaR-
http://nur-akmar.blogspot.com

Tweaked My Layout (Again)

Assalammualaikum.

Amalie Blog Template

Barely two weeks, and I have changed my blog layout again.
I dislike Carolina because it doesnt display all my posts in a page. It displays only the most recent post, and the rest are in grids.

Grids like these

I am also dissatisfied with the [Read More] fuction.
I don't like that function, it requires effort for readers to read my blog.
I'd rather read a blog which displays the whole post and I can read by scrolling down, and then able to read the next post.

For this Amalie template, I am still finding out how to remove this post footer.
It looked weird, the image in the background must have expired - hence it shows the triangle warning instead.

Getting rid of this footer soon

Still looking for ways to remove them and hope I will be satisfied with the outcome!

-Because life is a test-


-AkMaR-
http://nur-akmar.blogspot.com

Oyen

Assalammualaikum.

Oyen

This is Oyen.
She is not mine. I don't know whose is she.
I gave her that name this morning. She is currently pregnant - I don't know how far is she in her pregnancy.

I have never been a fan of cats. I don't like cats. I am almost scared of them.
I think I can't stand holding a moving living creature. It grosses me out. Maybe that is why I cringe waktu menyiang ikan - and I rarely do.
Aisyah, my sister is worse. She can literally cry when a cat comes near her, even when the cat is 6metres away.

Oyen started coming to my house around a month ago - or perhaps I started realising her these past few weeks.
Cats have been sleeping on my porch intermittently for now. But Oyen caught my eyes because she is pregnant hence she stands out from the other cats.
I started looking out for her lately. Maybe the maternal instinct kicked in, since she is pregnant.
Akmal started it first. He considered buying catfoods during our routine grocery shopping - the price was the only thing that stopped him. Why are cat foods so expensive?!
He then gave our leftover Texas Chicken to Oyen.
Since then I started giving some of our leftovers.
Then Akmal bought a pack of cheap catfood!

Her favourite spot - in front of my sliding door

This morning I saw her again.
She was lying in front of my door. I almost stepped on her as I was going out of the house to hang my laundry.
I was actually looking for her on my porch, not realising she was really beneath my feet.

Whosever she is, I think the owner is not taking care of her much.
She looks like she yearns human touch - if that makes sense. She keeps gesek-ing herself to my shoe rack, and my grille.
She gives the single mother vibe. Like she is now on her own, pregnant, surviving for her baby and must look for a place to give birth.
My colleagues said she is testing to see if I am trustworthy - if she can actually give birth here.
OhGod. That sounds like a commitment.

Cats used to sleep on my dustpan. I think it's because the plastic dustpan is warmer than my tiled porch.
But Akmal removed the dustpan, he put it upside down now. So cats don't really have a place to sleep on now.
And I feel bad for pregnant Oyen.
So I made her this.

Box bed - for Oyen

I put some cat food in it, she ate the cat food but did not sleep in the box.
She continued sleeping in front of my glass sliding door. Perhaps she needs more time to trust that box bed.
I hope no other cat will sleep there.
And I am prepared for Oyen to give birth to little kittens there, as long as they don't shit anywhere on my porch.

'til then.


-Because life is a test-

-AkMaR-
http://nur-akmar.blogspot.com

Sanggup ke Jaga Tracheostomy?

Assalammualaikum.

I am an Anaest MO. That means I work in both the operating theatre (OT) as well as the Intensive Care Unit (ICU).
Undeniably, the patients in ICU are very critically ill patients - they require intensive care and resuscitation and monitoring to keep them alive, of course dengan izinNya.

Some of these patients sadly, after surviving the most critical part of their illnesses, they don't recover to their previous state.
They might suffer a stroke along the way, or the prolonged acidosis in them have affected a good portion of their brain function permanently, or just in general, became very weak and thus will take a long time to recover. These are the state ICU doctors call "Poor/Slow GCS recovery".
It just mean that their mental state and muscle power takes very long to recover.
And most, if not all of these patients are intubated.

Intubation is a way of delivering oxygen and ventilation to someone through a tube down his/her throat and straight into the lungs. And we can't keep the tube in the throat for long. There are a lot of problems tagging along with a prolonged endotracheal intubation.

An intubated patient. [Source]

So we will usually counsel the family for tracheostomy. Tracheostomy is basically an operation in which the surgeon makes a hole in the front part of the throat/trachea, below the vocal cord and passes a tracheostomy tube through it. The tube is the same size as the endotracheal tube, but it is shorter.
It bypasses the whole chunk of throat muscles - the muscles which a patient needs to control in order to breathe properly, the muscles which a very weak patient might not be able to control.

Tracheostomy Illustration . 

Tracheostomy. [Source]

Living with a tracheostomy is not exactly easy.
It affects not just the patient, but also the family members. More so if the reason the tracheostomy was performed was "Poor GCS recovery"
That means the patient will be almost vegetative, relying on the family members to care for him/her.

Normal people produce phlegm all the time - we then either spit them out or swallow them subconsciously.
But tracheostomi-ed patients can't do that. Coupled with the lack of ability to filter inspired air, patients will produce a lot of sputum especially in the earlier months. Thus family members MUST MUST MUST be able to perform suction of the airway - imagine putting in a smaller tube into the tracheostomy tube and suck all the mucus out. And it definitely is not for the faint-hearted. The patient will cough and gag and the secretions are not going to be clean and white. They are basically phlegm, spit, whatever you want to call it. They are not nice. They are gross.

So frequent suctions need to be done. And the suction is not just once early in the morning, and then once more in the evening when everyone's back from work. The patient's airway will be blocked by then. There need to be a dedicated carer to care for a trachy patient - to perform suction every few hours, more if the secretions are copious. See the commitment we need from family members? See why doctors don't perform a tracheostomy on just anyone?

I have had a few cases where the tracheostomy patient dies at home, some was even almost deliberately killed by their family members. One mother allegedly covers the vegetative son's face with a pillow to end his life. But hey, he wasn't breathing through his mouth nor nose! The son's lifeline was that tracheostomy tube, mom! Please don't ask me what happens to the son and the mother, I don't know. But I know things like these happen. Imagine what kind of frustration must the mother must have felt to try and end her son's life. Perhaps she thinks her son is not even living anymore, just laying there vegetative. Perhaps she thinks it might be better and easier for the son that way.

Tracheostomy is also not an easily reversible decision. There is no turning back.
In intubated patients, when the family and doctors agree, we can withdraw our treatments when we see there is no more that we can do. We can remove the tubes and let nature takes its course.
It is harder to do that once a tracheostomy tube is there. It is hard to withdraw treatment from tracheostomy, as we dont really remove the trachy tube from the body to withdraw treatment.

It always breaks my heart when I need to counsel family members for tracheostomy. Most of these patients are elderly, and the family I counsel are the children.
I need to really knock into them the reality of tracheostomy. Knock knock knock - these are what you signing yourselves for if u agree for tracheostomy. You mother or father will still be lying there, weak and very dependant on you. Tracheostomy is not going to fix it. Tracheostomy is ONLY to deliver the air into them so that they can breathe easier.
It doesn't fix their brains, it doesn't make their hearts stronger, nor will it cure the infection your mother / father might still be having.
And you now have to discuss with your family members - who CAN and who WILL take care of this parent?

Brutal question huh?
If they can't agree on a carer between them, then doctors can't perform the tracheostomy.
Then they might feel they are not trying the best for their parents - they will feel the guilt of not going all out for their parents.
But is tracheostomy really the best though in these patients?
If they DO agree for tracheostomy, but then later are unable to care for their parents, that will be an even greater sin.
The sin of menzalimi mak ayah sendiri. The sin when they let their mother father die drowning in their secretions, because there are no one to care for the parents. The sin of hoping and thinking "Baik lagi mak ayah mati".

But if they can't agree for tracheostomy - it might make them feel like they are giving up on their parents.
Tough, tough question.

Maybe this is the reason why many medical practitioners in the west are tyring to advocate an advanced directive - although it will be very hard to implement and has many loopholes in it.

A quesiotn for you:
Would you want tracheostomy done onto you in the future?


-Because life is a test-

[p/s: The terms in this post is simplified to suit the non-medical readers]

-AkMaR-
http://nur-akmar.blogspot.com

New Layout Again

Assalammualaikum.
I think I get bored easily.
I spent so much time browsing through free templates and tweaking them and then decided against them.

I hope this "Carolina" template will last me long.
But I hate the slider. How can I remove the slider on top?
I've Googled and tried almost all methods, non worked.

Ok, let's sleep.
I am in ICU now, oncall.
Pray hard not to get any referral tonight!


-Because life is a test-

-AkMaR-
http://nur-akmar.blogspot.com

An Apple A Day Keeps The Doctor Away

Haksss..
This cracks me.

I posted it to my family WhatsApp group with the caption "My Future"

And my brothers replied:

Chye: Oh no, *throws Apple away
Wasil: #boycottapple and #boycottappleproduct

Lulz.
Just a short one today.

Gotta study and then, prepare dinner!
And I hate the "Shift" button on this keyboard. It's so user-unfriendly.


-Because life is a test-

-AkMaR-
http://nur-akmar.blogspot.com

ASUS ZenBook UX33FN

Assalammualaikum.
So I talked about how my 2-year-old Macbook Air failed me and how much it will cost to repair it.

And I really needed a laptop to help me with my study, and so with mama's help - I bought a new laptop!
Yes, I really wish I could by the new Macbook Air 2019, but it will cost close to RM7,500 including the extended warranty.
After careful and almost, but apparently not extensive readings on the internet, there are many ultrabooks that trumped Macbook Air which included Dell XPS 13, Huawei Matebook 13 and ASUS ZenBook 13.
Huawei Mate 13 cost a bomb, and somehow Surface Laptop 2 did not appear during my research.

Hence I narrowed my readings down to Dell XPS 13 vs ASUS ZenBook 13 (Surface excluded, as I didn't know abt it 😑 ).
I went to Low Yat to see the price, and ASUS ZenBook is the cheaper one.
So I bought my very own ASUS ZenBook 13 for almost RM4k. Thank you Ma and Hubs!

Let's do a bit of review abt this laptop, after abt 2-3 weeks using it.

Let's start with the good things first.

The Advantages
1. The Long-lasting Battery
Last week I left the charger in Mama's hse in KL during my visit there.
With the battery at only 53%, I was afraid it will die after using - so I barely use it. Only used it about 2 hours every day and I set the battery usage to minimal. I switch it off every time after using it instead of just letting it sleep.

It managed to last me 5 days when the charger Aisyah posted to me finally arrived via PosLaju.

2. The small and compact body but 13" screen
Like the new Macbook Air, this ASUS ZenBook didn't have the extra space bordering the screen, it is almost full-screen, like mobile phones nowadays. So the screen is still 13" like my old MacBook Air but the body became smaller, since it doesn't need extra space.
And it is very light, barely 1.5kg.

I have not brought it to work but I am pretty sure it will not weigh my bag down like my previous MacBook Air.

3. The USB ports!
Not just one, but there are TWO USB ports on this machine.
One USB 2.0 and another is USB 3.0.
Hence I can easily connect my mouse AND printer at the same time, without worrying about charging the laptop.

The major disadvantage of MacBook Air 2019 in my opinion is the lack of USB ports. It has 2 Thunderbolt ports - one of which is also the charging port.


The Disadvantages
I am sad, there are still more of these compared to the advantages but perhaps I just need to adjust myself to Windows.

1, 2, 3. iCloud
This might be the biggest trouble I am facing now.
I use iCloud heavily ever since my switch to Apple 9 years ago.
I even paid for the monthly cloud storage. So when I had to switch back to Windows, I had trouble syncing all my iCloud documents into this ZenBook. Although there is an iCloud Drive software for Windows, it isn't as automatic as it is in MacBooks.
The document parts are all solved now, I managed to sync it to my C: drive.

However it can't sync my photos from iPhone as efficient as my MacBook can - simply because they are using different platforms.

I used to be able to take a photo on my iPhone and with internet connection, the picture will be on my MacBook within seconds.
If I do not have Internet connection, I can just AirDrop the picture from my iPhone to the MacBook - which takes seconds as well.
Now, I MUST have an Internet connection to be able to have the picture on my ZenBook, since iPhone can't Bluetooth files to computers and there is no AirDrop in between these two devices. The iCloud Photos are not syncing really well, I am not sure why so I had to go to iCloud.com, and manually download the picture into my laptop.

With this change of platform, it also mean I can't use Notes anymore.

No, this is not my Notes. This is from the net 😂

I take notes on the Notes app on my iPhone, and then I can edit it on my MacBook - because they sync.
Now I can't view them easily anymore because there is no Note software for Windows.

Maybe I need to start using Evernote now.
Alternatively, I can do this.


4. Compact Keyboard
The keyboard is really compact, I always mistype words.
The "Shift" button is especially challenging because it is as small as all the other letters buttons.
"Shift" buttons on keyboards are usually as big as the "Enter" buttons on laptops - if u know what I mean.
So now, everytime I need to type a capital letter, I have to stop and see the "Shift" button to correctly press it.

It's the right side of the keyboard that I found difficult adjusting to.

5. Speaker Pecah-Pecah
I am not sure what to call it in English but at certain volume, the sound starts to disperse haphazardly.
Imagine sound waves coming out at certain speed from the speakers and colliding with each other and the music produced is scattered - if that makes sense.
When I read the reviews, there was no mention about this. In fact, most of the reviews stated that the speakers are really good.
I wonder if MacBook speaker is exceptional, hence I got so used to it that I feel this quality is sub par.

SUMMARY
I WILL adjust to this Windows ZenBook.
I aim to use it for years from now.

But as of now, I still have the intention to go back to MacBook. Perhaps after I complete my Masters training and become a Specialist and earn more
🤩

Some of the reviews I read: (in most of them, Dell wins. But ASUS is cheaper, but still more expensive than non-Ultrabooks)
1. ASUS ZenBook 13 vs Dell XPS 13
2. ASUS ZenBook 13 vs MacBook Air 2019
3. Dell XPS 13 vs MacBook Air 2019

-Because life is a test-

-AkMaR-
http://nur-akmar.blogspot.com

The Evolution of My Social Media Addiction

Assalammualaikum!
Let's talk about the social media addiction that really is plaguing our modern society so much so that families and friends aren't really connected anymore even when they are in the same room!
What better way to describe the addiction than my own addiction!

2005 - 2009
I can't exactly remember when was my first mobile phone but it was around 2005 / 2006.
That was during my Form 4 or 5 in high school.
The first phones were of course the solid Nokia phones.

At that time, I was addicted to SMS-es.
I SMS a lot of friends.
I always had my phone with me, sometimes even to toilet.
I reply SMS-es very fast, I can type without even looking at the screen - that's the beauty of having a proper keyboard.

At that time, Hotlink was the cheapest package. Only RM0.02 for each SMS.
I spent about RM30 per month for my phone prepaid. I barely call anyone. I only misscall my mum or dad, as a sign for them to call me back.

My mum and aunties were always scolding me for "melekat je kt handphone tu"
I had to be called for meals, and I will bring my phone to the dining table.
Thinking back, it was a very ridiculous behaviour.
I was there in the room with my family, but not there with them.

2009 - 2011
Then I entered IMU in 2009.
I reduced the SMS time significantly. But I was hooked with Facebook.
Pre-IMU, I used Friendster and MySpace. Yaw, sape igt lg Friendster and MySpace?
But in IMU, people started using Fb and I joined the bandwagon.
I replied comments very quickly, and I open Facebook everytime I am on my laptop. I remembered feeling so amazed with the ability of Facebook to connect so many people together. Many of my school and college friends were on Facebook and one friend leads to another and another and another. I can't stop commenting on their pictures and chatting with them.
Thankfully I can only do that on my laptop so it sort of limits my addiction time.
There were not much SMS-es around.

I was also obsessed with Yahoo Messenger and MSN Messenger.
The 3 platforms that I must open when my laptop is open were Facebook, YM and MSN.

2011 - 2014
I went to Manchester in 2011.
After a few months, I bought a Sony Xperia Ray - a contract phone with O2, the telecommunication company in the UK.
Don't be surprised, I bought the exact same phone with Akmal and we were only friends at that time 😅.
Xperia Ray was the cheapest in the market at that time, one that is available as a contract with O2.

That was my first smart phone.
It was so cool to be able to browse Facebook and emails through a phone.
But I still has not started using Whatsapp.
So then, I was addicted to mobile Facebook.

Somewhere in 2012 only I started using Whatsapp.
Then back in Malaysia, my mother bought her first smartphone and I asked Wasil to install Whatsapp for her so that I can chat with Mama easily.

My first Whatsapp group was between Mama, me and Wasil created on 17 Dec 2012 😱
The second group was between my housemates in Sharoe Green Lane, Preston. I created it on 25 Jan 2013.

So at that time, my social media addiction was Facebook and a little bit of WhatsApp with Akmal.
I don't really have a lot of Whatsapp groups yet.
Thankfully my addiction wasn't as bad when I was in high school.

9Gag was another major distraction at that time.
I can browse 9Gag for almost an hour, and laughing at most of their posts.
I told Akmal about it and he was actually surprised. He felt 9Gag is more of a man thing, not a lady website.

All the while, I was also engrossed with blogging.
Most of my blog entries were in 2010 and 2011.

2014 - 2019
I came back to Malaysia in 2014 after graduation.
I created my Instagram profile in the same year. My first Instagram post was on 2nd March 2014; it was a picture of me and Erni Dayana's son during my holiday trip back to Malaysia. Yo Neni, kau patut sangat berbangga.

But I did not have many Instagram friends / followers so I wasn't really active there.
Then I started my housemanship in late 2014.

That was when I started to have various WhatsApp groups!
I was added into Ortho HO group, then Ortho HO + MO group then Ortho HO + MO + Sp group, and Ortho Ward 7F group and the daily Oncall Ortho group and not to forget, the Orthoban group! (Orthoban was a group we created consisting of only us 8 first posters in the group - sort of the really junior babies HO ortho group where we lash and critic and talk bad about our seniors or MOs or specialists hikss)

After Ortho, there were also many groups in the subsequent postings.
Some postings we had groups for newbies, some not.
Most of the postings will need a group for HO only and for HO+MOs and some +Sp as well.

So from these groups, we had lots and lots of conversations.
We talk about the really important stuff, as well as gossips. Sometimes very hot gossips.

So I became fixated to Whatsapp groups.
I always read and many times, reply promptly in those groups.
Akmal will sometimes be angry at me for ignoring him and only focusing on my WhatsApp group (we were already married by then).
From his critics, I tried to reduce my WhatsApp time.
I learned to differentiate between urgent matters and non-urgent ones.
The ones that I need to reply now, and the ones that I can wait and reply later.

Somewhere along the line I started to be more active in Instagram.
And then Instagram story came around.

Now, apart from Facebook, I have Instagram to browse - which increased my screen time.

So I will take my phone out and scroll Facebook or Instagram while waiting for the lift, while in the lift, or while waiting for Akmal, or while walking to the laboratory from the ward.
Basically I scroll them all the time that I was not talking to a human being, or when I was with another person but do not know what to talk about.
It consumed my time a lot!

2019
This year, a whole new addiction appeared.
It is still in Facebook but it is now in the form of videos.

One video can lead to another interesting video and another interesting video.
The next video will automatically play and it made it harder for me to stop watching because I had to make an effort to not watch where else if I simply stare at my phone, videos will keep on playing.

And due to this nasty profiling technology, the videos that were played were all very tailored to me ie I get funny videos, baby videos, heart-warming good samaritans videos and so forth.
I can lie down and watch videos only for more than an hour!
Thats saying something!

Another addiction is Netflix.
I already have unlimited 100Mbps unlimited Unifi installed at home and with a Smart TV, I can watch Netflix anytime.
There is no advertisement within the episode and Netflox smartly play the next episode within 10 seconds.
Once the next episode starts, it really requires a great deal of effort and determination to hit the "Back" button and do other things.

And Netflix is also intelligently designed in such a way that they string related movies and dramas together and come up with a list of dramas and movies you probably like.
So far I have watched Doctors, Chief of Staff, Sky Castle, Designated Survivor, Arthdal Chronicles and many more that I couldn't even remember.
All these dramas are at least 16 hours long!

Social Disconnection
The trend is actually worrying - I am talking about my own addiction and perhaps this is happening to a significant percentage of people in the world.

We were at first addicted to SMS-es - we start to ignore those next to us, to communicate with those not with us.

We then got addicted to WhatsApp - where we can communicate with MANY MANY people at once, in real-time but in the expense of those next to us.

Then we also get addicted to Facebook and Instagrams - where we see updates from many of our family, friends, acquaintances, celebrities, politicians, influencers, online shops and reduced the quality time spent with real people nearest to us.

Now, we are addicted to videos and Netflix. Those are not even people. We aren't even communicating with people anymore.
We are being fed with such animated entertainment, that we are jeopardising the real communication with the real people in the real world.

I did not even touch the subject of video games. So many people are addicted to games be it on the phones, computers or dedicated devices like the Playstation or Wii. Akmal is also addicted to Hearthstone that many times he was unable to focus to me.

I wonder what will the next addiction and distraction be.
It is always a trial and a battle to fight these addictions, especially my latest videos diversion.
And in this crucial time of nearing my exam, the more I need to discipline myself.

With that, let's get back to study!



-Because life is a test-

-AkMaR-
http://nur-akmar.blogspot.com

Freaking RM2000

Assalammualaikum.

I sent my Macbook Air 2017 to an Apple Service Centre about two weeks ago.
5 days lter, I received my quotation.
RM 2,240 for my screen replacement!
And an additional of RM100 for service charge.

The words on my mind: "Crazy! Crazy! Crazy!"
The Macbook isn't even 2 years yet. I found my original receipt. I bought it in Oct 2017, for RM 4,999.
The one-year warranty ended.
The girl at the service centre rubbed salt on my wound - "Tu la kak, kalau dulu akak amik Apple Care tu, warrranty cover sampai 3 tahun"

Felt like slapping her - I didn't expect a Macbook Air to last only 2 years.
I asked how could this happen? She said maybe because I always carry it in my bagpack and thus the inside shakes eventhough I have never dropped it.
But hey, if I do not need to always carry it, I might as well just buy a desktop!

So now I don't have a laptop.
I collected the Macbook Air from the store. Plan to send it to any laptop repairer, perhaps I could get a cheaper price from non-Appple technician which means I gotta go recce around The Mines or Lowyat. Any idea?
If the cost is too crazy, I might just sell this off and get a new one.

I still want a Macbook as already get very accustomed and comfortable with Macs.
The features are comprehensive and easy to use. There are a lot of things I can do with Macs, but will otherwise need a separate software in a Windows computer.
For example editing a PDF file. I can easily edit a PDF file using "Preview" in Mac.
You will need another software (I don't know what) to edit a PDF file in a Windows laptop.

I am kind of in love with the new Macbook Air 2019.
It has a Touch ID feature. And it is a lot lighter and smaller than my Macbook Air albeit the screen sizes are the same (13").
There is a lot of "excess" space in my 2017 Air where as they designed the 2019 to be "full screen", like most of the phones now.

The two main drawbacks to me are
1) Definitely the PRICE!
It cost RM5,349 for the Macbook Air alone! Without the 3 year Apple Care extended warranty.
If I want to pay in a 12-mth installments, I must buy the Apple Care which I think is close to RM2k.

2) It does not have a USB port.
Yes, to make the macbook the lighter and thinner, they sacrificed the USB ports - that is the port that most if not all pendrives and hard drives and printers and mice and keyboards connect to. They only have two USB-C ports - which is the type of port newer Android phones have.
Out of the two, one is for charging so there is only ONE vacant port left.

They are advertised as USB-C however the Canadian Stores advertised them as "Thunderbolt 3 port"
- Yes I checked the Canadian website in case it is cheaper to buy over there since my family's gonna visit Canada this year.
Upon further reading, Thunderbolt 3 is almost similar to USB-C apart from the speed they can provide ie a USB-C cable can connect to a Thunderbolt 3 port and vice versa however Thunderbolt 3 equipments will have a much faster speed when connected to a Thunderbolt 3 port.

To use conventional pendrives and printers and mice, we are advised to buy the adapters.
This is almost as stupid as removing the audio jack ports from the iPhone.

My exam is coming soon and I feel handicapped without my Macbook. But even to repair is expensive.
I am now occasionally using Akmal's laptop but he is also studying for his exam and need his laptop too.
I have a Samsung tab but then, a Macbook is always more comfortable to use.

Haiz.


-Because life is a test-

-AkMaR-
http://nur-akmar.blogspot.com

No, (Govt) Doctors are Not Rich

Assalammualaikum.
Well, we are not rich but we are comfortable.

My starting basic pay as a medical graduate was RM2777, and after adding all the other allowances, my take home pay was about RM3.5 - RM3.7k depending on how much was deducted for EPF.
That is definitely more than my other peers who started working as a non-doctor. It was even higher than my siblings' take home pay when they first graduated few years after me.

Almost 5 years down the road, my take home pay is a tad more than RM5k (sorry, salaries are such sensitive issues it's hard for me to disclose it in public here).
And my increment over these early years was more than some of my non-doctor peers, and even my siblings in the private sector.

But I get only RM500 bonus per year (when PH first ruled, I wasn't eligible for any bonus as the country was supposedly near the brink of bankruptcy) while some other people working in the oil and gas industry received one, two- or sometimes 6-months pay as their bonus. My sister Aisyah received her bonus of an undisclosable amount (even I don't know how much), and she can afford to treat our and my in-law families to a dinner celebrating my birthday in a fine-dining restaurant (it definitely was more than RM500 in total).

And yes, even though my increment was almost exponential these first few years, they will plateau over time.
After 10 years, I will earn less than those of my age in private sector. The trend is obvious. The more experienced you are, if you are hard working and smart, you will get paid more in the private sector. My brother is now being sought after by multiple companies for his barely 4 years experience and if all goes well, he might earn twice as much or even more as I will in 10 years time.
That is why also, many specialists are leaving the government hospitals to join private sectors.

But what government offers, which the privates can't is stability.
I know I will get my pay by the end of the month.
I will get all my allowances.
I can get my parents and hopefully children medical bills to be reduced so much, which still enjoying the first-class treatments should they ever need it.

Anyway back to my topic of doctors being not rich.
Yes, we are not rich but we are comfortable.
I can afford Sakae Sushi or hotel buffet every now and then.
I can afford a Macbook and an iPhone.
I can afford some TudungPeople shawls once in a while.
I have more than enough food in my fridge, a comfortable bed to lie on with many many comforter sets that my husband rolls his eyes every time I want to buy more beautiful comforter sets on sale.

But I am not rich because I still need to weigh and decide if I want to buy a pair of branded shoes or a handbag, or if I want to install a water heater in my bathroom because I can't afford all of them at the same time.
I have a course in KL some time this month and yes I received a complementary hotel room but if I want Akmal to come with me, I either pay for a separate hotel room, or I can use that money to buy the Tudung People tudungs that are on Merdeka Sale now, or again, install water heater in my shower. It's either one.

I gotta change my car battery anytime soon and it cost RM500, but I also want to install and air-cond for my brother's room in mum's house.
It's always a fight of luxury vs necessity and of course, necessity always have to win.
But even my necessities are luxuries to some people and I really really need to realise that and be thankful.

And now, my already-out-of-warranty macbook is giving my trouble.
The screen is flickering and it's impossible to do work on it.
I am now typing this on Akmal's computer.
I wonder how much it will cost me to get this repaired. Heck it wasn't even 3 years yet! Perhaps just passed the 2 years mark.
How can how can the macbook disappoint me like this?!

So many things to buy but also so many things to pay.
Being an adult is so difficult.
But then again, I lead this kind of life because I am still child-less.
Maybe I will learn to let my "wantings" go and work my way around my "needings" once I am with child.

-Because life is a test-

-AkMaR-
http://nur-akmar.blogspot.com

Applying For Masters Programme

Assalammualaikum.

Hadiah Latihan Persekutuan (HLP)
For those who don't know, HLP is the name of the program by MOH for staff to apply for further studies be it doctors applying for masters, pharmacists or nutritionists applying for masters, radiographers applying for a degree or perhaps masters and so on.

Every year, the HLP offer will open at around July for a month.
And this is my first year of applying.

Last year and the years before, one of the many conditions set includes the average for the 3-consecutive-years mark of SKT must be 85% or more. That means if u start working in 2014 ie first SKT is in 2014, hence to apply for Masters in 2017, you will need the average of your 2014, 2015 and 2016 marks to be 85% or more.
If you get 89% for 2014, but somehow got 74% for your 2015 and then 89% for 2016, your average for past 3-consecutive-years will not be >85% and you will not be eligible. That was what happened to me last year 😞

This year, they changed the ruling.
You need an average of 3 years' marks within the past 5 years to be more than 85%.
That means the rule above still apply but in case you start work in 2014, and you have SKT of 2014, 2015, 2016, 2017 and 2018 - you only need any of these 3 years average to be more than 85%. So it doesn't matter if you scored really badly in 2015, as long as you excel in other years. They removed the "consecutive" condition. And it doesn't matter if you are not yet 5 years in service.

The Entrance Exam
For each programme, the entrance requirement will be different. Radiology (Hubs, Akmal is applying for Radiology) for example, the applicants will need to go for an exam as well as an interview.
For Anaesthesiology (me me me!), on the other hand, there will only be ONE SUPER-DIFFICULT entrance exam which will be somewhere in December this year.

And I have not studied enough, yet.
Urgh I really should start studying.
Very very few people get in on their first attempt, but Hui Fong did it!
Yeah, that girl did it. I am not sure how had she studied for the exam, but knowing her, she must have slept, ate and vomit books and notes.

And we have to pay for that exam!
And next year onwards, they will start conducting exam through Medex (I might talk about it in a different post in the future) and it will cost RM800!
Crazy.
They are making the exam equivalent to a Royal College exam.

Anyway, it looks like I have to start burying myself in books like I did mine during medical school years.
To adiks2, yes. There is no short-cut.
You just gotta study hard and smart.

Oh, some might ask. What's in it if I get into and graduated from this Masters programme?
Well, Masters graduates are basically Specialists!
So once I am a specialist, 1) Higher pay 2)Bigger responsibility 3)Becomes a bigger boss 4)Can be malignant 😈😆


-Because life is a test-




-AkMaR-
http://nur-akmar.blogspot.com

Of Dr Zakir Naik and Malaysiakini

Assalammualaikum.
I rarely talk about political issues nowadays. But I just need a place to pin them down for now.
Lately, there have been many racial conflicts within the people of Malaysia.
And I hate them. I think these issues are brought up by certain irresponsible parties to purposely create the tension and fear among Malaysians and hence in return, these people will feel they have someone fighting for them and thus, supporting these people.

Other than the teachings of khat/calligraphy, the usage of Jawi writings, the talks about the abolishment of vernacular schools as well as the UEC exam, Dr Zakir Naik has lately become the talks of the town.

I was familiarised with Dr Zakir Naik since my A-Level years, circa 2008-2009.
We had a Friendly Comparative Religion (FCR) talk in INTEC and Mr Shah Kirit was the Muslim representative in the debate.
From then on, I was introduced to Brother MY who then introduced me to the FCR community and I went to the part 1 training course.
And I was absolutely enchanted. I was amazed by these people who have Quranic verses at the tips of their fingers and can easily quote them. Dr Zakir Naik was also heavily quoted, and he was dubbed the "Master of Comparative Religion"

Around the same period of time, my mother was also heavily involved in Malaysian Chinese Muslim Assc (MACMA) and we had a few encounters with Mr Shah Kirit as well. From there, I found out that Mr Shah Kirit is the disciple of Dr Zakir Naik. He underwent intense training in India. There were talks that there were 5 Malaysian men sent to study with Dr ZN but only 2 or 3 made it and Shah Kirit was one of them.
So yeah I was introduced to Dr ZN from my academic as well as family involvements.

I used to listen to his talks and read books on comparative religion. Then I went to the UK.
Then it came to a halt. I lost contact with these things.
But I still believe in him. Occasionally I read some horrible news about Dr Zakir Naik, but I didn't pay much attention to it.
In fact, I wasn't really interested in finding out. At that time, I thought it was either 1) People are really trying to bring him down or 2) He really was a big-time deceiver. The second option was more depressing hence I hoped the former was true. But I did nothing to find out.
News about him comes and goes.
Then he came to Malaysia, something about he is trying to run from unfair treatment in India or something.

Then, past few weeks he became the talks of Malaysian.
Malaysiakini has deceivingly quoted his sentences out of context and made him sound very politically incorrect and racist, and provocative. When I first saw the news by Malaysiakini, I immediately felt I must stand by his side.
I lost trust in Malaysiakini many years back after I started working.

When I was in the UK, Malaysiakini used to be my homepage. Yes, Malaysiakini INSTEAD OF Google or Yahoo was my homepage.
I didn't wanna miss things happening in Malaysia, as I was thousands of miles away.
But over time I find Malaysiakini very disturbing and offensive. They blow issues out of proportion and sometimes even their headlines are very misleading. Especially political and racial ones. Hence I stopped reading them entirely - out of my own judgment.

Then this happened.
https://www.malaysiakini.com/news/487902

See la, see the headline.
Outrageously provocative. Equivalent to Utusan Malaysia's "Apa Lagi Cina Mahu?"
This headline obviously tried to spark anger among the Chinese in Malaysia.
And as expected, BOOM.
Even Syed Saddiq the minister wanted to chase Dr ZN out, despite the PM, Dr M adamantly states he will not deport Dr ZN out of Malaysia.

Thank God for the advanced technology.
There is a full recording of Dr ZN's talk that night and no, he didn't mean to tell Malaysians to chase Chinese out before thinking of deporting him. But the damage is done. Jumpy people jumped, people already started cursing, the boat has sailed.
And so Dr ZN publicly apologised for the hurtings some people felt.
And walaah, some people took it as him admitting to his mistakes of chasing the Chinese out of Malaysia.
See how some people twist and turn words to make it politically advantageous to them?

Thank God also, our Muftis stand by him.
Muftis of Pahang, Perlis, WPKL, Pulau Pinang, Hadi Awang of PAS and many other renowned ulama' of Malaysia stood by him.

And so will I.
Oh, I just found out that Dr Zakir Naik is a medical doctor 😁😁

-Because life is a test-


Imam as-Syafi'i pernah berkata: Nanti di akhir zaman banyak Ulama yang membingungkan Ummat, sehingga Ummat bingung memilih mana Ulama Warosatul Anbiya dan mana Ulama Suu yang menyesatkan.

Lantas murid Imam as-Syafi'i bertanya "Ulama seperti apa yg kami harus ikuti di akhir zaman wahai guru?"

Beliau menjawab: "Ikutilah ulama yang dibenci kaum kafir, kaum munafiq, dan kaum fasik. Dan jauhilah ulama yg disenangi kaum kafir, kaum munafiq, dan kaum fasik."

وسئل الإمام الشافعي رحمه الله تعالى: كيف تعرف أهل الحق في زمن الفتن؟! فقال: اتبع سهام العدو فهي ترشدك إليهم

Imam as-Syafi'i pernah ditanya oleh muridnya tentang bagaimana caranya kita mengetahui pengikut kebenaran di akhir zaman yang penuh fitnah?

Jawab beliau: "Perhatikanlah panah-panah musuh (ditujukan kepada siapa) maka ia akan menunjukmu siapa pengikut kebenaran."

Jadi pilihlah dan ikutlah ulama dengan ciri berikut agar selamat di zaman penuh fitnah ini:

➖ Ulama yang paling dibenci dan tidak disukai orang kafir
➖ Ulama yang paling tidak disukai orang munafik
➖ Ulama yang keras terhadap orang kafir yang mengganggu
➖ Ulama yang lemah lembut terhadap orang Islam
➖ Ulama yang tidak peduli dengan caci maki orang kafir sepanjang menyuarakan kebenaran
➖ Ulama yang jika kita memandangnya dan mendengar nasihatnya semakin membuat hati kita semangat untuk lebih rajin beribadah

Semoga kita diselamatkan dari fitnah dunia dan fitnah dajjal yang seperti semakin dekat kemunculannya..
-AkMaR-
http://nur-akmar.blogspot.com