Summer Elective : A week living with the dying.

Assalamualaikum wbt.

(idk why I started to feel awkward to start my post with this. Maybe because I don't think anyone will read the stuff I wrote here. Oh well.. )


Anyway.
Last week (from the 23rd July - 27th July) I did my summer elective at one of the best hospice in Ireland. Emm I'm not sure if the word 'best' is appropriate to describe a hospice though. So a hospice is basically a hospital that caters to end-of life care.

I started the week feeling so pumped up with adrenaline, I have prepared myself to witness the thing I feared most in medical field - watching your patient die!

So I walked into Marymount Hospice in Curraheen with that mindset - I want to be stronger emotionally. I want to be prepared. I want to learn how not to get affected by loss(es). The reason I choose palliative care for my elective is mostly what I said above .. and a tiny bit of  I-havent-had-this-kind-of-exposure-in-fourth-year and also a little bit of this-one-week-elective-gonna-fly-without-much-learning-to-do.

I started the week with MDT (multi disciplinary team) meeting , there I met my supervisor (Dr Marie Murphy), the Reg and SHO (Ciara and Dierdre) , the staff nurse ( I call her V) , the pastor (Daniel) and the community staff nurse (Mary) and the ward manager (Ger) . They were soooo nice and welcoming. I feel great.. but halfway through the meeting, my sleepiness from jetlag started to kick in. I cant believe I dozed off for a few secs, i hope no one notice that!

So the week went by with MDT, ward rounds, coffe breaks, more ward rounds, taking history and do examination on stable patients, listening to doc's prognosis on some of them was hard, but that's part and parcel of the job. 

I started to feel like : this is such a bad place to work in. Some of the patients I see during ward rounds are feeling low -almost all the time. Prolly because they are lonely and thinking of the ones they will leave soon. 

I asked my supervisor one fine morning "The patients are feeling low, you can't cure their disease / illness. Why palliative care though? What drives you to continue?"

So Dr Marie Murphy gave me the best answer anyone could, she ask me back. What's the principles of providing healthcare? 

And I was stunned. All I know is "DO NO HARM" lol. 

She added "..Do no harm, do good to patient, respect their autonomy, and respect the use of your resources"

So she explained on how we must care for the patient as an individual, striving to ease their pain, giving them chances to live in comfort and pain-free, improving their quality of life for no matter how many days/weeks they have left. 

Those things.. matters to the patient..maybe more than just having the chance to live an extended period of time but constantly in pain, unable to eat, and feeling weak all the time.  What's the good in that?

and she corrected me : "and you know what, not all of our patient here died in this facility. Some of them gets better than how they presented at first. We treated their symptoms and we are happy, as much as they are happy to go back home and spend their time with their family. That .. to me, is a good motivation"

This place might not be as big as Cork Uni Hospital, with hundreds of beds. But I like the ambience here, I love the lessons I learn - as a doctor, you do not treat your patient's symptoms like crossing off  things from your list. Treating an individual is more than that. To make them feel human again. To make their life worth living. 

As I walk down the stairs for one last time, I thought to myself. If I can't treat hundreds of patients each day, having one that genuinely feel good after our encounter is all I need as motivation and drive to continue. 

This job is never a fulfilling one if what you seek is popularity and good money. I hope I can keep my intention pure in providing what's best for my patient, using my resources as ethically as I can and respecting them as human beings .. and not just another case to settle before I go back and hit the bed.

And I think.. it is okay to have soft and mushy heart that breaks 

every time I experience loss(es), witnessing death 

and other bad news that I have to deliver to my patient 

as I see their expressions become gloomier. 

It is okay to feel bad, to shed tears. 

It is part of our human emotions.

Let's not lose the empathy every single one of us should have.

With that in mind - I hope I can grow to become a good doctor. 

One that can give my best in any given situation. InshaAllah. 

"Rabbanaa laa tuzigh quloobanaa ba’da ith hadaytanaa 

wahab lanaa min ladunka rahmatan innaka antal-wahhaab"

“Our Lord, let not our hearts deviate (from the truth) after You have guided us

and grant us mercy from Yourself . Indeed, You are the Bestower.”

On my last day, I saw this on the reception desk. I can't help but to capture it. :) 

Going back in time.

As I flew against the timezone
I can't help but to travel back in time
back to when it all started.

Those days I hold dearly in my heart..
..they are so beautiful, right?

And because they were so beautiful
To me.. (perhaps to both of us)
that makes them precious.
Too precious I'd say.

Part of the clan I do crazy stuff with..

Part of the troop I learn more about myself and my direction in life..

More than just friends, more than just 'sisters'..
idk maybe, pain in my ass? yeah.. sounds like it :p  

I hope I will always remember those days when we were together. :)

(Oh! and all the memories engraved in my heart but got no picture to attach.. haha.. you guys are awesome too) 

Ellipsis (...)

Have you ever been in a situation, where you are helplessly waiting for the next thing in life to happen but you just can't help to guess the possible outcome?

I think that's where I am now.

Almost everyday, I woke up feeling ... empty. I will look for my phone, and like any other day, there's no new texts. No missed calls. No one.. is looking for me. So I put it under my pillow again while I give out a heavy sigh.

I thought I could live alone, having no close friends means... I can be friend with anyone and everyone, right?  I thought it was a gift, to be able to turn on my 'friendly mode' and just talk to anyone in any given situation, in any given room.

I was wrong.

It slowly creeps in.. the thought that whatever I have is actually a curse.

I was too friendly with everyone,
so I forgot to actually make friends.
You know, those who actually stays and cares.

I was too busy trying to get involved with everyone's affairs.
Huh.. what was I thinking.
Did anyone actually knew what's going on in my life?

Not even my family knew what's troubling me.

All these years, I genuinely believe that the outside world will be just like what I saw on screen.
I grew up watching alot of tv shows, documentaries and movies.
They all ended up with a great ending, where everyone will get their fair share of happiness.
No one will be lonely. No one will end up feeling sad.
Except for the villains, they always get punished at the end right?

I was so naive, tricked into believing a lie, misled by the fantasies I myself created.

The Ellipsis.
The dots after a sentence.
A pause.
It's where a sentence trails off.

I'm not a villain.
I'm always kind to everyone.
If I didn't, I knew I actually tried to.

Then, why do I feel like I'm being punished in these indefinite dots in my life?
I feel like I was hang out to dry.

Slowly, every bits of happiness and joy,
every single good memories I kept in my heart,
every little energy and passion,
everything is slowly disappearing.

But watching the news of kids being tortured to death,
Babies murdered by the real evil force out there,
It makes me believe that I don't have any rights to feel beaten.
I should pick myslef up.
I should dust off my scraped knees.

This ellipsis won't lasts long.
That's not how it works.
My whole story is not complete yet.
I'm not even done with this sad chapter.

This is the part where I take pause to build myself up and continue to write my story.
I have faith that I'm not meant to stay in my room all day , listening to sappy old songs.
I am destined for something great. Something bigger.

If my passion in something is disappearing, then I'll find a new passion, a new goal.
If the good memories are forgotten one by one, then I'll head out and make new memories.
If I'm not happy now, I can always try other things that will somehow leads me to my happy ending.

The key is to not give up.
The key is to not let out those heavy sigh.

I'll open up a new chapter.
I'll write with confidence with my fountain pen.
The one where I'm stronger.
One where I am not afraid of being alone.
The path to greatness, and going extra miles are not crowded.

My story might not be similar to those you came across out there.
Mine is..slightly longer.
Not just one with more adventures, conflicts and drama,
but also more exciting events, more surprising characters will come along
and the ending will be spectacular!

I will not give up easily.

This ellipsis won't lasts long.
Have faith in yourself, Tim.
Have faith in Allah :)

Ya Allah
I seek your refuge from incapacity, laziness, 
cowardice and miserliness.
Grant my soul taqwaa, and purify it, 
You are the One to purify it,
You are its Guardian and its Lord. 

Ameen. 

A little thing called......

I was flipping through some random novel I found on my bedside when I was reminded of a funny thing that happened this year.

I think I should just put it here, so when I'm older, I'll be able to read this again and just laugh (like what I did now! ) Disclaimer : This is just a funny lesson , I think I should immortalize it in my blog. :p

_____

Hari Ahad lepas, aku jumpa balik dengan kawan-kawan sekolah menengah.  Let's just name them as F, T and N. Saban tahun, aktiviti wajib mestilah makan, lepak dan borak tentang semua perkara yang telah menjadi highlight hidup dalam setahun yang lepas.

Selalunya.. hampir semua berkisar relationship.

Tak tahu kenapa! Mungkin sebab sejak mula berkawan di sekolah menengah, memang itu topik yang seronok untuk diceritakan sebab masing-masing boleh berlawan kisah siapa paling sedih (atau lucu)

Jadi aku buka cerita tentang hidup seorang Fatimah yang masuk usia 25, dan entah keberanian jenis apa yang merasuk tubuh untuk tahun ini... aku buat semua perkara gila yang tak pernah aku lakukan sebelum ini! 

Contoh pertama - aku minta penjelasan dari kawan zaman sekolah tentang hal lama. Kalau orang lain, mesti dah tutup kambus habis, siap timbunkan daun kering untuk hilangkan tanda kewujudan hal yang mahu ditanam dalam-dalam.

Tapi seorang Tim (yang entah keberaniannya datang dari mana) tiba-tiba sahaja whatsapp dan minta penjelasan.  Bila fikirkan balik, Ya Allah kesian kat kawan tu. Dia elok-elok dah bahagia dengan kehidupan dia, tiba-tiba seorang kawan lama yang entah dia masih ingat atau tak.. tiba-tiba contact balik, untuk tanya pasal hal remeh. HAL BUDAK-BUDAK. 

I think I make myself looks even more weird. 

Still, aku happy bila dapat jawapan sebenar. Yang aku sebenarnya bukan dijadikan target untuk dimainkan. Bukan kijang lembik yang terpilih sebab kelihatan macam easy prey. Benda ni nampak kecil di mata orang lain. Isu yang kalau aku tanya pada orang lain, semua akan capai kata putus yang sama "tak payahlah fikir panjang-panjang".Tapi aku tak tahu macam-mana otak aku boleh ada kapsiti untuk simpan semua memori. Maklumat penting yang lain, taknak pulak disimpannya.

Bila dah ada closure untuk kisah lama, barulah aku rasa macam... this is just a simple thing! Kenapa tak tanya dari duluuuuuu... aduh terbazir space dalam hati sebab benci dan marah pada orang yang tak perlu dibenci atau dimarahi.

___

Contoh kedua - apabila aku tanya directly kepada kawan lelaki aku, tentang posisi aku dlm hidup dia. Ini sebenarnya, bila aku ingat semula pun, rasa macam astaghfirullah.. hantu mana masuk dlm badan malam tu ! Tiba-tiba rasa macam nak clarify, so I just ask him right away. And that.. is sooo not me. 

Growing up, aku dah biasa hidup dlm zon kelabu. Aku rasa aku memang tak boleh berkawan rapat dengan lelaki. Sejenis mudah tergelincir.. kau faham tak? 

Jadi, aku selesa dalam zon selamat. Tiada yang kacau aku, hidup aku tenang dan bahagia. Walaupun dikelilingi kaum sejenis dan kadang-kadang teringin juga nak rasa hidup berteman macam orang lain, tapi aku diamkan aje perasaan itu, sebab aku pun tahu priorities dlm hidup. And.. hakikatnya memang takde orang nak ngorat kita pun.  

Jadi bila dah besar sikit, dah mula pandai bergaul dengan member kat universiti, bekerja sama-sama di hospital.. some lines are meant to be crossed. Dan seorang perempuan yang tak reti nak asingkan rasa dalam hati...tergaul rata semua perasaan yang ada.

Maka, kesianlah nasib si kawan lelaki yang tiba-tiba kena lecture.

Hanya sebab aku yang confused dgn perasaan sendiri.

Akhirnya, sepatah kata pun tak lagi bertukar antara kami.

Ini dikira putus sahabat ke?

Tak kisahlah.

Yang penting, I saved myself from a possible disappointment dan frust menonggeng. 

I know myself well enough. 

It's either I like someone for a good few hours/days..

..or I fell hard for  yearssssss and yearsssss to come.

and we dont want that to happen again, kan?

Letih la one-sided.

 ____

Jadi, 

a little thing called courage

is all you need 

to make yourself more clear 

of your own feelings

or how others feel towards you.

Perhaps someday,

this little thing called courage

can help you to navigate your way 

to find the path towards another little thing.. called love. <3 div="">

Sementara tu, carilah bahagia dengan bersahabat dengan alam. 

To forgive and forget.

Reconcile with your past.

Let them go.

Let go of your past mistakes.

Stop blaming yourself.

Forgive yourself.

..and try to forget..

for the n-th time.

Please, Tim?

Of robes, mortarboard and scrolls.

I woke up that morning without a smile.
I sit up, feeling unmotivated to leave my bed.
I draw the curtains  and the sky greets me with its brightest shade of blue.
I smile a bit.. but it quickly fades away.

"What a beautiful day to graduate, right?"

The voices inside my head started to whisper it's darkest thoughts.
It echoes and it repeats after itself, indefinitely.
Even as I was taking my shower (and crying under the running water) ,
as I choose my best attire to go out to show that I am doing just fine,
as I put on my make up to cover the dark circles and swollen face,
as I practice my smile in case it looks forced.
and saying 'congratulations' to the mirror with no genuine feelings in it.

I took a picture to commemorate the day I mustered up courage to watch them graduate. 

After I perform my Dhuha prayer, my eyes started to get a little bit teary.
I know this day will come.
I thought thousands of times over whether to show up and pretended like it was nothing
or not to show up at all.

But I decided , at least I have to show my face and say "congratulations" and "all the best" to them.
I might not see any of them anymore.. I should do it, so I won't have any regrets later.
I owe big thanks to Syifa and Sofieya for making me go to see it..
..and take me to town to lift my spirits later.

If I didn't turn up at all,
my poor Kak Rina won't be having the chance of capturing our usrah together in a photo.
and Shah wouldn't have anyone by her side.
and at least, I should show that I actually showed up to my usrahmates.
..for this is a closure. I guess, for a long dreadful chapter with them as final years.

I was picked up by Kak Rina at 12 pm.
I put on my sunnies. to cover my eyes in case it started to become teary in front of them.

As I walk towards the quadrangle filled with people,
Kak Rina said she saw Effah.
But my eyes were looking for Syifa and Sofieya first.
I saw them sitting next to idk-who.
We chatted for a bit before I started greeting others and take picture with them.

I was okay until one clueless friend asked to take a picture of us two..
and she decided to make me hold her scroll while she holds her flowers.

I scoffed.
I literally looked at the scroll in my hand and I can't believe she actually makes me hold it for her.
I wanted to scream at her face, and throw her hard-earned degree on the green field,
and stomp on it like it was nothing but a piece of paper.

But I didn't.
Alhamdulillah.

The scene just keeps on playing in my head while I stand next to her with that scroll in my hands.
I hope it was not captured in the picture how I hated her for making me do it.

I saw Shah in a distance.
I said hello to her.

Her eyes quickly becomes teary and so did mine.
We hugged each other for a very long time..
and for the first time, I actually feel like I made the right decision to come.

We cried as we hugged each other,
and she said thanks for coming.
I genuinely wished her congratulations
and wiped away her tears.

It was the warmest moment ever in my entire year.

I saw my usrahmates in a distance.
I know they are expecting me to go there.
So I walked over to them with Kak Rina.
We took a few shots together.
I don't feel like taking any photos that day.
But I did anyway.

None of them are in my phone.

As the cameraman give cues to take pictures,
and I plaster my fake smile,
Another voice in my head started to whisper,  "Can't you just be happy for them?"
I let out a sigh and say - "Don't you think that's too much to ask from me?"

I owe a lot of explanation to the people around me.
But I think,  giving explanation would not change anything.

I will still lock myself in my room when I feel like doing so.
I will still stay up and binge on whatever instant food, dramas or movies.
I will still text S randomly and walk to her place whenever I feel like I need to talk to someone.
I will still choose to ignore those texts from anyone about anything because I don't feel like replying them.
I will still pluck up that dandelions I saw by the roadside and wished for a  knight to come and save me as I blow it.
I will still pray to Allah over and over again to give me strength to forgive and forget my mistakes.

As long as I can keep my sanity.
As long as I can still love myself..
.. a little bit more than self-hate.

I owe no one any explanations.
I owe no one any apologies.

Because if I did explain, or ask for their forgiveness,
I have to hear that one sentence that I hate - "We understand." 

Honestly no one would.
No one could.

Only Allah knows how hard I try to keep myself sane while trying my best not to hurt other people.
I didn't want things to end this way, I hope I can make our chapter ends in a better note.


Someday, when I feel a little bit better, maybe I will text you guys and ask how you were doing,
how's life and what it felt like to work in a hospital. I will throw in some jokes, and make you laugh at it.... like good old times.  Someday, I will genuinely give my whole attention and listen to your stories without having any intention to walk away.


But for now, watching you guys in your black robes from a distance is all I can do.
As you throw your mortarboard, and show your scrolls to your family and friends,
all I can do is to wish you a plain, monotonous 'congrats'
then turn around and let out a sigh.

I hope there is a better way for me to do it -
but this is the best that I could do.

A little throwback of my favourite picture. InshaAllah your turn will come, sayang.

Black

It came uninvited.
It crept in , unannounced.

I said "Should I just.. let you in?"
The black dog stares back at me.

It was a complete silence..
..before I let it in -
gnawing on whatever's left on my bones.