1 in a Million

‘How come the patient is not being wheeled out yet?’ my senior colleague Dr Aida asked, conversationally.

‘Mm Hmm?’ I was wondering the same thing. We already stitched the kid up and left the theatre 10 minutes ago to write the operative notes. The operation was brief, and the problematic tooth was taken out somewhat easily. So why is the boy not out yet? His mother was waiting anxiously at the spacious holding bay.

We stormed back inside OT2 and found the atmosphere solemn in there. Surrounding the still unconscious chubby 11 years-old boy, is the team of anesthetists and our boss, Dr Dass. And our own dental staff and nurses quietly observed the resuscitation effort from the corner of the OT. What the heck is going on?

I didn’t ask, because it seems like nobody would want to answer. I used my eyes and ears to understand what had happened during the 10 minutes when I was outside. Chubby boy’s vital sign is unstable and Dr Syd is monitoring him very closely. Quietly. His face was focused, contorted with a tinge of worry. So unlike him.

Dr Syd entered the OT earlier and his voice boomed a cheerful ‘Good Morning!’ He had been a great help to the Dental people by being the jolly and friendly anesthetist. He took Dr Dass’ camera and played around with it. He joked with the staff like college buddies. Not only he brought noise to the OT, Dr Syd also brought a lot of positive energy with his cheerful demeanor. But not now.

Dr Dass… The boss I respect. His eyes were fixed on the monitor, his expression grim. To me, he’s the fearless doctor who is so knowledgeable and competent. Throw him any topic, he can elaborate enough to write a quality essay. Any topic. Being a confidently cocky fellow he is, he constantly neutralize his ability by saying ‘I don’t take all the credits. God is the all powerful one.’ This moment, his confident smile is wiped away. Suddenly my boss looked a bit older.

Dr Dass explained to Dr Aida, who is equally quizzical as I am.
‘During reversal, kid was given Atropine. His heart went into ventricular fibrillation. We put him on 100J defib. He regained sinus now…..’

I imagined in my head.
Dr Syd noted the VF pattern of Chubby’s heart.

The defibrillator was quickly pushed to Chubby’s side, chest bared.
100 J Charging!
Clear!!

POOMP!

O my gosh…. God, help this kid to be alright. Pray for Your mercy to take him out of this agony. The human body can be so fragile. How long did his heart stop pumping? He could be stable now, but … the idea of brain damage is unthinkable. And there’s a mother outside anxious and having no idea what is happening in here. My mind is a train of thoughts.

It’s a rare case, 1 in a many thousands of healthy children. Unless… this child is not healthy, he has an undetected illness? Anaphylactic against Atropine?? I knew Dr Syd had everything under control, with his calm speedy management, but no one is celebrating just yet.

‘Dr, saya teringat arwah ayah saya.’
I didn’t notice trainee Hidayah was standing beside me. Behind her spectacles, it was unmistakable tears glistening in her eyes. This young Malay girl is different from other trainees I met. Hidayah has a side of maturity. Her dad passes away 2 years ago. She is still fasting everyday if she is able, in remembrance of him.

‘Dr. Actually every time I enter the Operating Theatre, I am struggling within. I remember my father on the table, I was there. They tried to save him using the defib machine too…’
Here’s a girl who is not hiding her tears. Damn the racial barriers. I reached out and hugged her. Not a word.

‘Dr, my heart really goes out to this boy.’

We continue to watch the boy and look at the vital signs monitor, although I couldn’t make the most out of it. Many of those labels do not make sense to me.
Soon, people started to disperse from the OT. Dr Aida and Dr Syd went out to explain the situation to Chubby’s mother.

It left Dr Dass, Hidayah and myself in there.

During the last OT a week ago, Dr Dass asked me ‘Do you fear God?’
‘Absolutely…’

Dr Dass explained the situation to me again, like what I heard he explained to Dr Aida.
He added ‘Statistics means nothing. Things can be as rare as 1 in a million. But that ONE can happen to you.’

Boss paused for a while, eyes fixed on Chubby.
‘You know, I was about to leave after we finished the surgery just now. I already went out, but somehow I cannot explain, I just came back inside.’

At that moment of time, I know inside the Operating Theatre, 3 Malaysian of different races and religions are praying silently to God, that God help this boy. (We’ll put him on a diet programme later.) There is such unity in diversity, when humanitarian can humble us all.
Chubby is later wheeled out of the OT into the ICU, just to borrow their ventilator and monitors for 24 hours. Reminded me of a friend who had to be in ICU to borrow their ventilator a few months ago. The other 2 cases lined up for today is cancelled.

Chubby is going to be alright, the brain damage is minimal or none.

‘You!’ Dr Syd poking his buccal fat ‘almost gave me a heart attack.’

Part II

There was some ruckus outside, beyond the doors of Paediatric.

In a mixture of languages and incoherent sentences
‘WHAT THE HELL! @$%^# YOU YOU YOU *&^%%# MALAYSIA.
YOU WANT ME TO DIE and some Chinese mumbo-jumbo?!’

We only have one neighbouring department, which means the chaos would only come from the Oral Surgery Clinic. The shouting voice of a man was so loud and clear that I believe he was standing just right there behind the door. Punctuating the angry ranting of this man, I heard the distinct voice of another man hush-hushing him.

What the heck is going on. This is a hospital, for goodness sake. The man was cursing non-stop and loudly. He spoke mostly in Cantonese, which is a relief as not much people would understand and be verbally offended by him.

The curious Paediatric staffs , myself included, went to the door to find out what happened. They opened the door slowly, cautiously, as if a tiger would jump in anytime soon, and peered out on top of one another’s shoulders.

Then words came in ‘He’s psychotic….’

There were 2 men. One tall shabby man in his late 40s, loop-sided eyes and angry face shouting murderous threats. And another shorter man in his 70s holding Mr Psycho’s arm as if to restrain him.

‘I’M GOING TO SUE YOU *** OFF. RACIST ! bla bla. TAKE THIS *** THING OFF. Blab la!! ’ (sorry, he really said it. I didn’t make this up)

Basically all the angry words did not really make much sense, but obviously, he was upset.
Sometimes the uncle in his 70s would shout ‘SHHH DIAM DIAM!’ Shut-up.

I shook my head, I don’t want to watch this and I returned back to work, while the rest continue to watch for a few minutes.

Pity the old man. Bearing the shame of the youngster and taking care of him. Having understood the man’s psychotic problem, people in the clinic dropped the judgment and let him be. His night medications finished some time ago. Somewhere within our hearts, we sympathize him and the old man. Must be his dad.

Wait! An old man with a psychotic son?
That psychotic son? Mr Biker? Whom I helped translating couple of weeks ago??
No wonder his loop-sided eyes looked awfully familiar.

O gosh…
Mr Biker was a gentleman when I first saw him and spoke to him. He was able to provide me with details, he can recall phone numbers, and he was safe. Today he was violent, completely a different man.

And oh, that dad… I spoke to him on the phone. While some people can afford tens of thousands Ringgit for an operation, this old man have to dig out what is left of his old savings and pay for his son’s operation. And that amount actually still fall short half of the quoted amount.

Today Mr Biker (I’d like to respect him as Mr Biker, instead of calling him Mr Psycho) came for review after the operation done last week. He was pissed about the intermaxillary fixation (IMF), wires fastened around his upper and lower jaws to stabilize his bite. IMF is a necessary procedure especially in jaw fracture cases, and we keep them in the mouth for a recommended 4 weeks.
Only after one week on IMF, Mr Biker wants the wires out. And he screams about it. It’s ironic how could one scream and make so much of noise with the teeth tied together. Thing is…. There goes daddy’s personal savings.

I snapped from my thoughts, and continued writing the treatment records I was working on. Get well soon, Mr. Biker.

Strawberry Flavour

Adorable kids come from great parents.

I had seen so many Tarzans (screaming on the dental chair) and Mr Don’t WantS and Miss DifficultS that I forgot the other extreme of heart warming kids.

Hou is a 6 year old kid with less than 1 cm of hair, that when you pat his head, you touch his scalp. He came with a young, smart and stylish female lecturer, who is his mother. These mother and kid combo is the kind I rarely forget. Assertive but polite mother.

I sent Hou to a check-up and instructed them to come back to my clinic when they are done.

So they did, this time Hou had in his hand a box of glico ROCKY biscuit sticks.

Mommy : Hou, you wanted to give doctor something?

Me : Really? No need la.

Hou was hiding behind mommy, avoiding eye contact with me and still holding the box of biscuit in his tiny grip.

Mommy : How come you are so shy now? Just now you keep saying wanting to buy the wafer for doctor?

Sounds like a sincere effort, so I stood in front of Hou and allowed the shy kid to give me the box. I took the biscuit and remembered, hey, he’s just a kid.
Last time when dad bought me something and told me to share even though I don’t really want to, dad would say ‘Don’t worry, they would not really take any of yours.’

Awkwardly and quickly, I smiled and put the box back in Hou’s hand.
‘Thank you, but keep for yourself la.’
I sat at the writing desk and continued to settle his other paper work.

Here comes smart mommy again.
Mommy : Hou, give to doctor la. How come you’re so shy now?
(to me) Just now he kept saying that he wanted to buy wafer for doctor.

It went to and fro, to and fro.
Hou was so shy that I began to feel embarrassed too! O my gosh.

Mommy : Go go… Go and give the wafer to doctor.
She nudged him and from the corner of my eye, I noticed that the shy but generous kid was walking towards my table, where I was writing. His little hand slid the box on my table, and quickly retracted his hand. Like a kid secretly put a flower on the desk of his favourite teacher.

The equally shy doctor turned around and pat Hou’s hair/scalp.
‘Thank you, Hou.’

This time he looked me in the eyes and gave me a toothy grin.

It was Strawberry flavour. Sweet kid.

Told you So

(unwritten)

About a mother who won’t listen