Book Review: Go Set A Watchman

I know. I know.

It has been more than a month since I last posted in this dearest blog of mine. (hang on while I sweep the dust and cobwebs away  for you, LOL).

I feel the pain, trust me. One of the goals I set for myself is to write at least weekly because I personally think of writing as my brain exercise. The way I make hiking my favourite weekly physical exercise, I have made writing my weekly brain stimulation. When I don’t write, at the risk of sounding like I am having a nihilistic delusion, I can feel my brain shrinking. *drama queen sangat*

The only reason for my tardiness (because I do have one) is profound exhaustion due to my hectic schedule these days and because I have set other priorities to come first before blogging. I was swamped, to be honest. Inundated by work, housechores, studies and my stubborn determination to finish two literatures at the same time within the time period I have pre-determined for myself. (Go Set A Watchman by Harper Lee and Langit Petang by A. Samad Said. Of course when I said literatures, I didn’t mean the scientific journal kind. Hahah. I mean, the novel, fiction kind, of course!).

Usually, when I don’t blog weekly as I am apt to do, it must be because I am busy reading; either reading my academic books (my exam is in October, peeps) or reading my fiction/literature. On top of everything else, I was just recovering from URTI  and a severe allergic reaction that made my lips look like I had a botox injection gone wrong! (Oh, the horror of it all!) If anything is guaranteed to spoil your mood to write, it is general ill health.

So, today I am back to write a book review on Go Set A Watchman by Harper Lee. (I am so sorry. I know some of my readers are med students and some are fellow doctors who prefer that I write about medical life most of the time. But oh Gosh, my first and foremost passion will always be reading. Been doing it all my life. Addicted to it like one can be addicted to heroine. Hopelessly, helplessly powerless against the lure and magic of reading a good story. So occcasionally, that’s what I will write about. Please feel free to skip reading this post, adik-adik. You don’t have to read this really long book review.)

A Background Story of Go Set A Watchman

To those who don’t know Harper Lee, she was the famous, acclaimed writer and a Pulitzer Prize winner of my all-time favourite novel To Kill A Mocking Bird.  (Ring a bell, yet?)

Harper Lee

To Kill A Mocking Bird has been made a compulsory text in many English classes all over the world (but not in Malaysia, alas). When I first read the book in my teenage years, I had fallen head over heels in love with Atticus Finch, the lawyer who had defended the black man who was wrongly accused of raping a white woman. Atticus Finch was an upstanding, noble-hearted man who had defended, to the best of his ability, a wrongly accused black man and standing up against the racist society of Maycomb, Alabama, with the support of his family, consisting of his tomboyish daughter (6 year old Scout), charming son (9 year old Jem),  younger brother (a doctor), and his black maid (named Calpurnia). Atticus Finch was labeled as a nigger-lover (a derogatory term) by his neighbours, and was called as a traitor to the White people just because he wanted to ensure a fair trial for a black man. Throughout the court trial, Scout was bullied at school and was unfairly punished when she fought with other kids to defend his father’s good name. Atticus Finch was depicted as a wise, loving and patient father to his kids as he tried to shield his kids from the repercussions of his work as a defender of a black  person, but at the same time he educated his kids about what justice, fairness and kindness were all about. Atticus Finch taught his kids about courage and compassion. He told them that  courage is “when you’re licked before you begin but you begin anyway and you see it through no matter what”.

Atticus Finch (the film version) defending Tom Robinson (the black man)

In short, Atticus Finch is the moral center of the novel. The superego in To Kill A Mocking Bird…. that is Atticus Finch.

And if you belong to any book forum discussing To Kill A Mocking Bird, you will find many women readers all over the world had placed Atticus Finch as their benchmark of what a good man should aspire to be.

Sometimes, I even speculated that the reason Harper Lee never married was because in real life, she couldn’t find someone like Atticus Finch, the hero that she had created so many decades ago.

Harper Lee was said to be the ‘Jane Austen of Alabama’  and Jane Austen also never married. In fact, many great novelists I know didn’t get married. Harper Lee, Jane Austen (Pride and Prejudice, Persuasion, Emma and all her other great works and I have read them all), Anne Bronte (The Tenant of Wildfell Hall), Emily Bronte (Wuthering Heights), Emily Dickinson, Louisa May Alcot (Little Women)…. they never married.

Charlotte Bronte (author of Jane, Eyre, The Professor and Villete) finally got married at the age of 37, but she died only one year into her marriage. Only one year, folks! Makes one thinks that marriage is simply not compatible to the nature of a writer, huh? When they got married, they died SOON after. LOL.          

Another way to look at it is, what if being single gave some famous writers the freedom they needed to go on a writing binge without having to think of someone else? Maybe not having to face marital issues, make these women the great writers that they were. Maybe the solitude and peace that they got from spinsterhood inspired stories that are evergreen and stand the test of time?

“So, you are saying that the reason you are still unmarried is because you are like Jane Austen… like Anne Bronte?” my sister rolled her eyes.

“Pandai pun. You got the point.” I laughed.

“Perasan!” Hahhaha. Me and my sisters do goof around about writing a lot! Sometimes we do a lot of basket lifting (Read:angkat bakul, haha) about our writing abilities. Of course, I am NOWHERE in the league of Jane Austen. NEVER! But it doesn’t hurt to dream, right? *goofy grin*

But jokes aside, I believe that most writers are very idealistic. And the real world cannot meet that idealism. And they’d much rather enjoy their peace and solitude than being shackled and trapped with anything less than their ideals.

And in the minds of many readers, Atticus Finch is the ideal!

Harper Lee had published To Kill A Mocking Bird in 1960. Then, she didn’t publish any other novel for a very long time (almost for the rest of her life) until she FINALLY came up with Go Set A Watchman in 2015. She then died on the 19th of February 2016 at the age of 89, only one year after the publication of her second novel. So, for most of her life, she was an author of only ONE novel… but what an awesome novel it was! And only one year before her death did Go Set A Watchman get published, which was considered as a sequel to To Kill A Mocking Bird.

According to an article that I read, Go Set A Watchman was actually her first novel; her first draft which she sent in the 1960s. It was rejected by the editor. Instead, the editor had suggested that Harper Lee revise the plot to focus more on the childhood experience of Scout and Jem while Atticus Finch was handling the controversial trial… and so Harper Lee then followed the editors’ advice, and the rest is history; To Kill A Mocking Bird was born!

So, I advise that readers should read To Kill A Mocking Bird first. Otherwise, you might not enjoy Go Set A Watchman as much. You wouldn’t be able  to understand what makes Go Set A Watchman is as good as To Kill A Mocking Bird if you don’t get the context of how great Atticus Finch was in the first novel.

Because in Go Set A Watchman, Atticus Finch was no longer as idealistic as he used to be. One might even say that Atticus Finch had become a racists in Go Set A Watchman, albeit, with his own reason for being one. I felt like I was reading about a different Atticus Finch, at first. But at the end of the novel, I understood why Atticus Finch did what he did and said what he said.

When you read To Kill A Mocking Bird, you love Atticus Finch in the way a child loves her parent. An immature child has the purest of love towards her parent; ‘my father is so great, he can do no wrong in any situation’ kind of pure, undivided love.  But when the child grows up, goes on in life to see the world, she will start noticing that her parent is not as flawless as she once believed when she was just a kid, and so the now grown-up child has to readjust.

To me, Go Set A Watchman is THAT readjustment. Scout was readjusting her opinion of Atticus Finch and found that she could not agree with her father this time, that her father was not as perfect as per her childhood memory, but after much argumentation, screaming and tearing-up, she still loved him anyway. 

In my opinion, To Kill A Mocking Bird is Atticus story (even if it was told from the perspective of a 6 years old Scout), and Go Set A Watchman is Scout’s Story!

And I love them both!

A summary of the novel (copied from Goodreads):

Twenty-six-year-old Jean Louise Finch (“Scout”) returns home from New York City to visit her aging father, Atticus. Set against the backdrop of the civil rights tensions and political turmoil that were transforming the South, Jean Louise’s homecoming turns bittersweet when she learns disturbing truths about her close-knit family, the town and the people dearest to her. Memories from her childhood flood back, and her values and assumptions are thrown into doubt. Go Set a Watchman perfectly captures a young woman, and a world, in a painful yet necessary transition out of the illusions of the past–a journey that can be guided only by one’s conscience. Written in the mid-1950s, Go Set a Watchman imparts a fuller, richer understanding and appreciation of Harper Lee. Here is an unforgettable novel of wisdom, humanity, passion, humor and effortless precision–a profoundly affecting work of art that is both wonderfully evocative of another era and relevant to our own times. It not only confirms the enduring brilliance of To Kill a Mockingbird, but also serves as its essential companion, adding depth, context and new meaning to an American classic.

My literary analysis of this novel:

The setting of the novel is around the time when the blacks were fighting for non-segregation between whites and blacks in America. In this novel, the court had just ruled that in the case of Brown v. Board of Education of Topeka, it was unconstitutional to establish separate public schools for black and white students. In conjunction with this court decision, black students  now deserved to go to the same public schools as white students. This court decision together with the tension caused by the activities of NAACP (National Association for the Advancement of Colored People) had raised racial discord and controversies among the races in Maycomb Alabama.

By principle, Jean Louise Finch (nicknamed Scout) supported for non-segregation and equal rights between the races. When she returned home for a holiday in Maycomb, she was surprised when she learned that her neighbours and the Maycomb community did not share her sentiment. But she was even more devastated when she found out that even her own beloved father Atticus Finch and her own sweetheart, Henry, were against non-segregation. She felt betrayed when Atticus, who had taught her about justice in her childhood, had now turned out to be a ‘secretive racist’. She broke up with Henry because she found out that Henry did not have the same worldview as she does and that she “could never live with hypocrites”. Scout believed that the two men in her life did not possess the same integrity as she did in this issue and it hurt her tremendously.

Later, we found out that Atticus was not against non-segregation per se. He just thought that the Black was not ready for it. Examples of the blacks’ non-readiness to get equal rights were being placed casually throughout the book. There was one occasion narrated in the book when Henry mentioned that “the black people in the county now have money for cars but neglect to get licenses and insurance“.

In other words, the black people in the America AT THAT TIME, was not ready for the responsibility of a full citizenship. Atticus believed that citizenship should be earned. That if we allowed the backward blacks an equal vote, then they would run the country to the ground because they would not know how to manage the country. (and in that time setting, blacks were quite backward secondary to their segregation and lack of education; even Scout could not deny it when Atticus pushed the point).

The conversation between Scout and Atticus Finch below would make it clear that Atticus was no racist; he was just not as idealistic as Scout; more practical and more realistic,

Scout said, “….I heard a slogan and it stuck in my head. I heard “equal rights for all; special privileges for none”. And to me it didn’t mean anything but what it said….”

“Let’s look at it this way,” said her father. “You realize that our Negro population is backward, don’t you? You will concede that? You realize the full implications of the word ‘backward’, don’t you?”

“Yes, sir”

“You realize that the vast majority of them here in the South are unable to share fully in the responsibilities of citizenship, and why?”

“Yes, sir”

“But you want them to have all its privileges?”

I think the round above belongs to Atticus. Atticus drove his point here admirably well. Atticus was able to demonstrate that the blacks were unable and not ready to share the full responsibilities of citizenship, so was it then fair that they should have all the privileges that should come with responsibilities that they were not ready for? Here, Scout had stumbled and lost, I feel. 

If you read many book reviews and discussions in book forums, many people were frustrated that Atticus was made as a racist in this book. They lamented ‘where is the great Atticus that we so loved?’. But if I were to write an analysis of Atticus’ characteristics, the conversation above would be the evidence I would use to say that Atticus was not a racist. After all, he had defended a black man in a court trial in his younger days, remember?!

Atticus said that he just always thought like Thomas Jefferson (The Founding Father of America and its third President) and he elucidated his point by saying “Jefferson believed that full citizenship was a privilege to be earned by each man, that it was not something given lightly or to be taken lightly. A man couldn’t vote simply because he was a man, in Jefferson’s eyes. He had to be a responsible man. A vote was, to Jefferson, a precious privilege a man attained for himself in a live-and-let-live economy”.

So you see, things are not as black-and-white anymore. Atticus no longer seemed as racist as he appeared, at first. And Scout was made to look too idealistic, and less practical. And that’s what made this novel Go Set A Watchman so good! You are torn between supporting your ideals absolutely or planting your feet firmly in your flawed reality.

Another scene I love best is the scene between Scout and her ‘almost fiance’ named Henry (who she later broke up with). Scout had said that she was disappointed that Henry (who was also a lawyer working with Atticus) had not shared her worldview about equal rights and non-segregation.

Henry tried to justify his position by telling her that, sometimes there is a need to go with the flow, be like the rest, in order to best serve the community. (Scout thought that Henry was a coward when he said that).

Henry said “How can I be of any use to a town if it’s against me?….. Now, shall I throw all that (my education, reputation) down the drain…. when I could be helping them with what legal talent that I have? Which is worth more?”

This was the moment when Scout broke up with Henry. And personally,  I think she did the right thing. Henry had lost her respect from that moment forward and marriage will spell disaster for them both if they continued with the plan.

But I kind of understand why Henry said what he said to Scout.  Henry had come from ‘white thrash’; he began as a nobody (until Atticus took him under his wing) and he always had to be careful with what he said or what he did in the community. Whereas Scout had the reputation of a Finch surname that made the community viewed her with more indulgence. Henry told her that “There are some things that I can’t do that you can (because you are a Finch)”.

In a way, Scout was more privileged because she belonged to a reputable family in Maycomb. She could say any outrageous thing she wanted and she could deviate from the societal norms (within reasons) and the members of the community would simply chuckle and say “That’s just same old Scout,”

But if it was Henry saying or doing exactly as Scout said or did, the community would harshly say “That’s the thrash in him.” They would not view what he said or did in the same indulgent way as they did with Scout.

And this is something that Scout had taken for granted. She had her freedom simply because her life circumstances were much more privileged than the rest. So she sat on a high pedestal and could judge Henry as a coward. But what if Scout was also born as a ‘white thrash’? Would she have the means to be as outspoken and as courageous as she did? Maybe not. And that was what Henry was trying to point out to Scout.

Again, this is what I mean when I said there are so many nuances to Go Set A Watchman. More grey; not much black-and-white.

(When I read this part of the scene, it reminded me that this sort of double-standard occurred everywhere. Kalau specialist yang rude dan kurang ajar, they would say “Ala, that surgeon/specialist memang macam tu. Kitalah yang kena adapt”. But if it was a houseman who retaliate and being frank (not even rude, just frank), the houseman will be labeled ‘tak padan dengan houseman, dah kurang ajar, berani nak cakap banyak/tulis macam-macam.’ Hahha. And like Scout, I would not be able to respect Henry. I also would think that Henry was a coward. Hang takut apa orang nak cakap apa pun? Because if you keep on doing what you think is right, one day people will also finally said “ala, dia memang macam tu. Kitalah kena adapt.” Sementara kita nak dapat reputasi tu, memang tadah telingalah kena kutuk. But once you get to a certain level and you always have the reputation of doing what you feel is right, people will finally give you the same acknowledgement…“dia memang macam tu. kita yang kena adapt dengan dia.” But then, maybe I am more privileged and I didn’t realize it? This scene really made me think! It made me think a lot about my expectations of others around me. Maybe it is just not realistic for me to expect that people should be frank and forthright against any unjust authority that they don’t like. Maybe I should not base my respect and trust on whether or not someone is courageous enough to speak their minds. Well…. this scene certainly made me pause and think.)

Now, we come to another good scene that I absolutely adore. This is the scene between Scout and her Uncle Jack who was a retired doctor. This Uncle Jack sounded like a psychiatrist when he told Scout that the reason Scout was so angry at his father was because all these while, Scout had merged her personal conscience with that of Atticus. But now, over this black segregation issue, finally Scout had become her own person and able to separate her own conscience from her father’s conscience. (This scene sort of reminded me of Margaret Mahler’s Separation Individuation Theory, except that the theory was supposed to apply to an infant. Not to a 26 year old lady.)

Below are the quotes from Uncle Jack that I absolutely love because I think Harper Lee might have studied some psychiatry or dabbled in some psychology when she wrote this scene.

Uncle Jack said to Scout “…now you, Miss, born with your own conscience, somewhere along the line fastened it like a barnacle onto your father’s. As you grew up, when you were grown, totally unknown to yourself, you confused your father with God. You never saw him as a man with a man’s heart, and a man’s failings – I’ll grant you it may have been hard to see, he makes so few mistakes, but he makes them like all of us. You were an emotional cripple, leaning on him, getting the answers from him, assuming that your answers will always be his answer. When you happened along and saw him doing something that seemed to you to be the very antithesis of his conscience – your conscience – you literally could not stand it. It made you physically ill. Life became hell on earth for you. You had to kill yourself, or he had to kill you to get you functioning as a separate entity,”

Powerful, isn’t it? I love it!

There are many more psychiatry-esque quotes like the above towards the end of the novel and I drank them all like a desert traveler with an unquenchable thirst. I can see now why Harper Lee won the Pulitzer Prize. She was amazing!

I read To Kill A Mocking Bird when I was a teenager, with a teenager’s understanding and a teenager’s limitation. Even then, I had loved it. Loved Atticus. Loved Scout. Or maybe… love (as in, present tense).

I read Go Set A Watchman as a fullly grown adult, and I love Atticus and Scout even more. The only difference is that, my love for them are more realistic now.

I have mentioned before that the reason why I choose to specialise in psychiatry is because I love reading. Characters and characterization in novels that I read all my life give me the interest I have in psychiatry. Without a doubt, deep, meaningful novel like this is responsible for my career choice. My love of literature and my passion for beautiful words are the beacon that bids me to psychiatry. And I have been  following that beacon ever since.

So, now, whenever I am reading a novel, I will pretend that it is part of my psychiatry academic revision. After all, how else am I supposed to keep the beacon burning bright, if I stop reading, right?

Ku-Shan’s (mis)Adventure!

Is this how parents all over the world feel?

Do they often feel angry at their children but at the same time feel like laughing hysterically for the naughty things that their children do?

Do they worry about their children all the time but at the same time want their children to experience moments of freedom as much as possible?

Do they often feel embarrassed when their children cause a lot of trouble  to someone else, then feel guilty about having to punish their children for it?

*sigh*

I really don’t envy the work that is required to be a good parent. I couldn’t even handle it with my own cats!

***

I was worried sick when I lost one of my cats (I have three) named Ku-Shan, since Friday last week. Ku-Shan is the active, naughty, beautiful daughter of Ku-Ja (a Persian orange she-cat) and Putih (a mixed Siamese-Persian tom cat). I went frantic searching for Ku-Shan all over the place since she went missing on Friday. Before this, she always returned home just in time for her meals. She loved wandering all over the neighbourhood but she never went missing for more than 24 hours. Together with her parents, she would wait for me to come home every day to prepare her meals (a mixture of Fancy Feast wet food and Whiskas kibbles).

Putih (Ku-Shan’s Father)

Ku-Ja (Ku-Shan’s mother)

Ku-Shan, daughter of Putih and Ku-Ja. Mixed 3/4 Persian and 1/4 Siamese

Ku-Ja is a loving mother who likes licking and grooming Ku-shan

But on Saturday, more than 24 hours later from the time that she went missing, she still had not returned. I was oncall and there was nothing much I could do about it. I was worried about her at the back of my mind but I had to focus on my oncall anyway. That suppressed my worry a bit. I had a busy oncall, anyway, and I told myself that Ku-Shan would return soon. But, when I had some spare time in between my casualty cases, I looked for her again in the afternoon but to my grave disappointment, she was nowhere to be found.

On Sunday, she still had not returned. I was post-call, with bad sore throat that felt like it was on fire and a hoarseness of voice that made me sound like a transvestite deprived of his oestrogen… but I STILL sought for her around the house, calling out her name multiple times with my terrible voice. She was not around. (So this is how it feels when your heart is broken, now I know)

In my mind, I just KNEW that someone must have taken my beautiful Ku-shan for him/herself. My Ku-Shan is a beautiful cat of mixed breeding (3/4 Persian and 1/4 Siamese) with glorious, sexy big fluffy tail and healthy shiny grey coat that has brown highlights in strategic places.

And she has such a great personality (I am biased, I know. But she is not a passive, placid, lazy Persian like her chubby mom… because she has that cheeky Siamese gene in her. See? She inherits beauty from her mother, but personality from her father. I love that cat!)  Anyone would want her and I have always been quite paranoid about people stealing her from me! I used to keep all my cats caged and only let them out occasionally. I was afraid that they would be stolen. But I knew it is not natural for cats to lead that kind of passive life.

When my mother had to do her cataract operation and I went to stay at my parents’s house to help with her recovery, I had no choice but to give my cats some freedom to roam freely in the neighbourhood. I stayed at my parents’ for 3 months (one and a half month of recovery period for each eye… thus, 3 months altogether) and I could not possibly justify leaving them in their cages for the whole of that three months. That would be the animal equivalent of emotional abuse, right?

For the whole of that three months, I only went to my own house once a day to give my cats their wet food. I also left 2 bowls full of kibbles to tide them over until I could come again the next day to feed them. And each day, they never failed to wait upon me at my porch even though I didn’t cage them and allow them their complete freedom for that three months. 

But that Friday… only Ku-Ja and Putih waited for me…but no Ku-Shan! It was so ironic because that Friday I was coming back to stay at my own house after 3 months of staying at my parents’ house! And I was looking forward to greet all three of my cats to tell them that I would finally be around now. Instead, I was greeted by a wave of worries that my Ku-Shan was missing and was probably lost to me forever and ever.

I prepared myself mentally to accept that I may never get her back. Friday, Saturday, Sunday…. no sign of her. I mean, I am a pretty optimistic person, but even I knew when to lose hope. I just hoped that she might be stolen into a better household than mine, with a good owner that would love her.

Then…I woke up on Monday… checking my phone as usual, and I was rendered shock by what I saw on my Whatsapp.

I was stunned. I couldn’t decide whether to feel relieved that my Ku-Shan has been stuck inside of my neighbour’s house all these while… or horrified for the damage she had done to my neighbour’s house. I ended up falling back into bed and rolled myself all over my bed in mortified agony, trying to contain the embarrassment I felt towards my neighbour for the sort of trouble Ku-Shan had caused. We are talking THREE freaking whole days of Ku-Shan being stuck inside the house… who knows what sort of crazy shit (literally!) she has done to the house.

I took a deep breath before I made myself reply to my neighbour’s message.

I called my parents to let them know what Ku-Shan has done. My mother called Kak Ain to apologize to her and to offer a cleaning service by our Indonesian domestic help. My father personally called Kak Ain’s husband who is a dato’ (Kak Ain is the second wife) to apologize to him as my father knew him personally.

Dato and Kak Ain were very nice about it. They declined the offer for a cleaning service and said that they have cleaned the house last night (when I was deep in sleep while post-call and having a fever).

But wait! Later,  I found out more about what Ku-Shan had done and it was even worse than what I could have ever imagined!

When I read that part of the whatsapp message, I didn’t know whether to laugh or to cry. I ended up doing neither. Instead I sat down on my bed, thinking about the amount of money I have in my bank account! How the heck am I supposed to pay for the handbag and the backpack?

Oh God! Ku-Shan…. why do you have to pee on a handbag of the daughter of the house? Okay, I know it is not reasonable to expect Kushan not to pee or excrete her waste for three days… I mean, we cannot expect any animal to defeat their biological urges. But why couldn’t she just pee on the floor? Why did she have to purposefully do the worst thing that ever could be done on an expensive handbag? Typical women are crazy about their handbags! (unlike me, I spend my money on experiences, travel and books. But most women I know spend really good money on handbags and shoes. An anak dato’s handbag may cost me my whole monthly salary or even more!)

Of course, I offered to pay! But mentally, I was calculating how much money I have put aside for my exam and how much I can spare to pay for the damage done by my satanic cat! Ugh!

In my head, I dreaded having to borrow my parents’ money for this! I have NEVER asked my parents for money ever since I went to Australia for my medical studies. I always told my younger sisters about how Kak Long and myself are the most independent among us siblings. (I was afraid my younger sisters would make fun of me about this for the rest of my life, as a payback for always lecturing them in the past. Hahha. I will never again be holier-than-thou when I talk to my siblings about money management next time) All these while, whatever my parents gave me, was freely offered. It’s been more than a decade since I needed their money for anything. (Like when they offered to pay for my exam but I said no. They then insisted to pay for my flight ticket and my hotel in Singapore, so I accepted their offer. But I could have paid for those things myself.) The bottom line is, I have been surviving on my own money ever since I was 20 years old. And now, because of what Ku-Shan did, I will have to break my clean track record and my principle on this!

Breaking my principle would be so painful! It would be like tearing my heart apart! (Yeah, I can be melodramatic when I am in the mood. Hahah)

Kak Ain, being so nice and neighbourly, of course had said that there was no need for me to pay for the handbag and the backpack. I admit, I was relieved when she said that. But I felt so terribly guilty. I went to work on Monday with a terrible sore throat, a hoarseness of my voice and a heaviness in my chest. That heaviness is, of course, the weight of my guilt.

I decided to punish all my cats! All of them are grounded! I am going to put them in their respective cage for one week! Maybe more!

But when I heard them meowing non-stop, wanting to be let out of the cage and taste again the freedom they have been used to for  the past 3 months, my heart softened a little.

But still…. I don’t know how to strike a balance between giving them their freedom to roam freely but at the same time making sure  things like this won’t happen again.

I am the sort of person who is once bitten, a thousand times shy. I learned so well from mistakes so that I would never feel the same pain again. That is just the sort of person I am. What had happened is horrifying and I was only lucky that my neighbour was so nice about it. The next neighbour may not be as patient! So, I MUST not take any chances. The next time I let them out of the cage, it would only be inside my own own house! 

But how about their freedom? Is it fair to them? Is it morally required for us to think about what animals might feel? Are animals entitled to their freedom?  I really don’t know. I can’t decide.

This is not totally Ku-Shan’s fault. Even as I was telling Kak Ain ” Sorry sangat. Ku Shan ni jahat sungguh. Nanti saya kurung dia!”… in my heart, I knew she is not a bad cat! I only said that to Kak Ain to convey my remorse and my regret on Ku-Shan’s behalf.

In actuality, Ku-Shan is very disciplined, but also an active and curious cat who likes to run around and unfortunately, her curiosity often gets her in trouble. She is fully toilet-trained! She pees and excretes her poo only in a proper litter box. I don’t use regular sands for her litter, instead I bought the premium crystal litter for all of my cats. None of them would pee or excrete their poo anywhere in the neighbourhood even when they were allowed to roam freely in the past 3 months. They don’t just pee/excrete in any sands or any grounds. They are used to the crystal litter that I’ve trained them with. Below are the pictures of the usual brand of crystal litter that I usually used for my cats. The texture of this litter is very unique and my cats were specifically trained to do their business only in this sort of litter… so  that they won’t dirty my neighbours’ house and grounds when I set them free. My cats are very disciplined!

The usual brand of crystal cat litter I use

The texture of the crystal cat litter

What was Ku-Shan supposed to do when she was stuck and unable to get out? I mean, she must be suffering in the three days when she had nothing to eat and drink! She must be feeling really scared too for that three days! Poor Ku-Shan. But at the same time, poor Kak Ain and her family! When Ku-Shan finally returned home, after hugging her to my chest, and feeding her an enormous amount of food, I straightaway caged her and not pay any attention to her howling and meowing of wanting to be let out of the cage. But deep inside, I felt so terrible about it.

I felt like a mother who wanted to scold their kids for bad things that have happened but at the same time didn’t know how the kids could have done any better in that situation!

I really don’t know what to do. Can I afford to let them out again? My instinct said I can. But my fear of things going awry makes me hesitate.

I leave you, my dear readers, with my facebook status regarding what had happened. A lot of my friends and even my own mother (Yes, my mother has a facebook account! haha) commented on my status. Their comments were so amusing! Apparently, many of them have had experiences of their cats being naughty towards their neighbours. Some of them even said that their cats have ‘menjatuhkan maruah keluarga’ hahah (probably by impregnating other female cats in the neighbourhood). At least, I was smiling while reading their comments, even though my heart was in agony for leaving my cats caged. *sigh*

Medblogsphere And Confidentiality

The truth is there is an epidemic explosion of doctors who blog, showing to the public that physicians are not robotic and cold. That their heart beat just as passionately as the rest of humanity. That the logistics of their work is not just about doing the best for their patients (unfortunately), but they also must deal with excruciating paperwork, sound or unsound hospital policy, budget cuts, (nice or annoying) superior’s instructions despite what they think is best for their patients, and the list goes on.

I am not at the stage where I have to worry about making hospital or departmental policies, but when the policies are made, they do affect the quality of my work. (what investigations I can order for case work up, whether I can admit my patients into the ward or not, what meds I can prescribe)

What you said you wanted to do when you said you wanted to become a doctor (to help people, to make a difference, to save lives), you said all that without reading all the fine prints that came with the contract of being a doctor. Life is not so flowery when you cast away your rose-tinted glasses, alas.

If you are a frequent blog reader and are familiar with blogger doctors all over the world, you will notice that there are SO MANY doctors who blog but at the same time there are just not enough ethical guidelines regarding what you can write and cannot write in your blog. This is still a grey area that must be carefully manoeuvred… but nothing an experienced blogger can’t handle.

I began this blog when I was a medical student in 2009. So many years ago! Even then, I had already researched about what I could write, what I shouldn’t write at all and how to manoeuvre and manipulate the matter so that even if I write something that is borderline forbidden, I can still get away with it. I might get in some trouble, but nothing anyone can really pin down to make a case. I know my way around med blogging. So whenever people express concern about doctors writing about their cases in the blog, I just take note of their concerns but still continue to do my thing. Because I know my way around medblogsphere. I would never do something risky without a potential exit plan. (but I humbly admit that sometimes exit plan can have loopholes… but nothing that a good lawyer cannot rectify).

I know how to write about cases so that no one can identify my patient, not even my own colleagues. And not even the patient will know it.

I have written about Mrs. H once. But her name doesn’t start with H.

I said that Mrs. H went to KL after her divorce. But that wasn’t where she went. 

I said she had a son with a previous marriage. But how many previous marriages did she have? Or she might actually have a daughter.  Or she might actually have more than one children. See?

I said that Mrs. H has to sell sandwiches to support herself. But in reality, she might have never sold a single sandwich in her whole life, but perhaps she sold something else…. or even had another job altogether, say, a cleaner. 

If the Mrs. H (whose name doesn’t start with H) were to read my post, she wouldn’t even be able to recognize herself. Because as a doctor, I am only concerned about the main lesson/point in her life story that I can share with my readers. But in other aspects of her story,  I am like a writer who is given free reign to manipulate all her personal information, from how she looks (whether she is beautiful, whether she wears a hijab or not, whether she has any scars or personal defects) and her personal information (her age, her race, her job, her other illnesses, who her husband is, how many children she has) and her general characterization.

It’s like writing a short story or even a novel.

A good writer KNOWS that plots do not vary much. You read a few variations of each genre once, then you have read them all. (that’s why we have genres. Boy meets girl and falls in love – that is romance. The plots won’t vary that much. Good guy defeating the crazy villain – that is mystery/thriller. A vampire collaborating with a demon to create a high-tech powerful device to conquer the world- that is paranormal sci-fi.  Most plots, depending on their genres, are always the same. Over and over again. Any reader KNOWS that).

So a good writer knows that a good book MUST have great characterizations to counter the overly-used plots, so that the readers would love the characters themselves, even though the plot is same old, same old. A good writer would invest a lot of time to create a good characterization if he/she is smart.

So let’s go back to Mrs. H.

Mrs. H, if she ever comes across my blog, would NEVER be able to say in absolute certainty that “That’s me! That’s me the doctor had written about!”. 

But she might recognize the main plot of her story “a woman who was tricked into marrying an elderly man whose family wanted a free maid and financial provider for their aging father”. But how many people in this world have been in the same ‘story’ as she? Legions! She would most likely end up saying, “Wow, looks like I am not the only one in this world who suffers through the same thing. There are other patients like me.”

In the VERY unlikely event that she were to sue me, she would end up paying my legal fees when I win the case!

This is just an example of what I meant by knowing your way around medblogsphere. You have to manipulate the characterization of your case. We are only interested in the main lesson and take home messages from a certain case. Readers don’t care about the details of the patient’s character. So, use that to your advantage. Purposefully disguise your character without compromising the actual point/lessons of the case. Then, you should be reasonably safe.

Another important aspect of knowing your way around medblogsphere is to know how to use disclaimers! This is so important! Once you put a disclaimer, you are also reasonably safe. I have an existing general disclaimer for the whole blog from the day I started working in MOH (you can scroll  down and find the disclaimer at the bottom of your right hand side) and also for each specific post that I think requires an additional disclaimer.

Below is an example of my own disclaimer which has been standing for the past seven years.

“Afiza Azmee is an individual, and My Life Poetries That May Not Rhyme is a personal blog. The opinions expressed here are the author’s product of her thinking process. And they do not represent the thoughts or opinions of anyone related to the author and especially NOT the author’s employers (the ministry of health).

The information in this blog is provided ‘as is’ with no warranties and confers no rights. Please use your discretion before taking any decisions based on the information in this blog. Author will not compensate you in any way whatsoever if you ever happen to suffer a loss/ inconvenience/ damage because of/while making use of information in this blog.

Author reserves her rights to a change of opinion in the future. She is, after all, an open-minded person.

All images in this blog, unless stated otherwise, are courtesy of Google Images. Thank you, Google.

Author welcomes your comments, your disagreements, your views about any of her posts in this blog. But she reserves her rights to delete those that contained profanities, vulgarities, unrelated topics, and annoying anonymity.”

I subscribed to Psychiatric Times which is a very reputable online magazine for psychiatrists in the US. The doctors there write about their cases all the time. One example is given in this link below. The title of the post is ‘A coin flip’. To read the case, you can click H.E.R.E  

http://www.psychiatrictimes.com/residents-corner/coin-flip

The famous Kevin M.D blog also writes about cases frequently. The blog has even more tips about how to write on clinical cases, which PROVES that writing about your case is not absolutely forbidden. You just must know how to do it right. If you want to read the tips, you may click the link H.E.R.E

http://www.kevinmd.com/blog/2011/09/doctors-write-clinical-cases-online.html

When I was a HO, I had written about one particular case, disguising the character and the patient as I have always done since I was in medical school. A doctor wrote in the comment section that “I shouldn’t be writing about cases. Not even for educational purposes due to confidentiality issues.” I knew she was an MO in the same hospital as I and at that time my blog was viralled because of something I had written against a particular department in my hospital when I was a HO. She meant to reprimand me in her comment but I knew what I was doing. Like I said, I learned ethics thoroughly. I may not always be professional in what I said, wrote or did as an MO, but there is ALWAYS poetic justice behind every action I took. Someone must have crossed my boundaries and my principles, causing me to snap and when that happened, I wouldn’t answer about what I am capable of doing. So I replied by saying “Based on what I have written in this post, why don’t you track her down, find out who she is and locate her, and then get her to sue me for breaking confidentiality. I’ll wait.”

She never replied to that comment. Perhaps, because she never bothered to track the patient. Or perhaps because even if she wanted to track the patient, the patient would be untraceable.

We CAN write about cases. If cases can’t be discussed even for educational purposes, how would lecturers teach medical students? 

Sometimes a patient talks to you specifically about her situation, without knowing that you will be discussing the case with your specialists or even with your other colleagues later in the day… is that okay?

For example, most of us have not told our patients, “Kes awak nanti, kami akan discuss dalam meeting pagi-pagi. Dalam meeting tu ada student nurses, student MAs, student doctors etc etc.”

Remember, these students are not even our own staff… they are students who do not actually see the cases themselves but come to know about all those cases when they are discussed in meetings/audits/mortality reviews.

So, ARE cases allowed to be discussed for educational purposes? Yes! And also… No! Depending on the situation and how the case was discussed or written.

So the MO who had written the comment of how ‘cases are not allowed to be discussed even for educational purposes’, was just plain wrong.

You cannot give such a blanket statement over this matter. This issue is rich in nuances and must be treated and analyzed in a case-by-case basis. Otherwise, we will be contradicting our principles with our own actions when such a blanket statement is given.

Regarding cases discussed in blogs, there was never a clear black-and-white guidelines about it other than making sure that identifying information are not included and discriminating information are edited! That is the only important rule! The rest are carefully manoeuvred, again, on a case-by-case basis. For example, if the case is high profiled and well-known, just changing the identifying details may not even be enough… so, you must improvise even more.

Again, I suggest to read Kevin M.D blog post from the link I provided above, regarding how to go about editing identifying information.

***

I have heard of stories of how some master students who suffer from depression were so betrayed by their supervisors when their conditions were revealed to other lecturers and then their whole batch found out about it! And things like these happened in the academic setting of our own medical university!

Confidentiality ke laut!

How about housemen? When I was a HO, I found out from another HO that there was this particular HO who was under psychiatric follow up! Apparently, somehow, words got around. But how?

Maybe confidentiality is only preserved for hotshot specialists or only applies for HODs or ‘orang ternama and berpangkat’. But, perhaps not for the HOs? Once a HO (or a university trainee) is diagnosed of some mental disorder, somehow it is okay if their cases are discussed around?

If you are in Australia, the trainee could sue her supervisor! But in Malaysia, you don’t do that unless you want to fail your master program. Hahha.

For aspiring medbloggers out there, don’t worry if you want to start a blog to record the journey of your career as a doctor or simply to vent about your daily grievances in general. This has been going on for years in the West and Malaysians are catching up so admirably in this aspect of medical culture. Internet and social media are such an integral part of our everyday lives and it does not show any signs of fading. Older generations who are not internet-savvy have either retired or retiring. In fact, even older physicians who were not born as Gen-Ys (non-millennials older doctors) do have a blog. By the time internet-savvy doctor-bloggers become specialists and HODs, blogging doctors would be mushrooming all over the place.

This phenomenon cannot be stopped. It can only be regulated.

You just have to know the ropes and the absolute do’s and dont’s. The rest are in the realm of the grey areas. Just employ your creativity to disguise the details of your cases and make sure your disclaimer is well-written.

Good luck!

National Service

I have been following the news about the North Korea-Malaysia strained diplomatic relations quite closely these days. Part of me wonder, if we are to go to war (the likelihood of it is quite small for now) how prepared are we to fight?

During war, not only the army are involved, capable men (and women maybe) will also get recruited, right? That’s the basis of many countries making it compulsory for all their citizens of a certain age  to do a stint of national service.

We should all do National Service like the one in Singapore. According to Wikipedia, National Service in Singapore, (commonly known as NS), is a statutory requirement for all male Singaporean citizens and second-generation permanent residents to undergo a period of compulsory service in the uniformed services. Depending on physical and medical fitness, they serve a two-year period as National Servicemen Full-time (NSFs), either in the Singapore Armed Forces (SAF), Singapore Police Force (SPF), or the Singapore Civil Defence Force (SCDF)

I think, in Turkey, compulsory military service applies to ALL male citizens from twenty to forty-one years of age. Those who are engaged in higher education or vocational training programs prior to their military drafting are allowed to delay service until they have completed the programs or reach a certain age.

After SPM (2002) I voluntarily joined PKSN (Program Khidmat Sosial Negara) while awaiting my SPM results. PKSN 02/03 was the last batch of PKSN ever before it was then replaced with PLKN (Program Latihan Khidmat Negara). PKSN was a non-compulsory program in each state in Malaysia and anyone who was interested could simply fill up the registration form and joined the program for free.

So because it was to be the last PKSN ever, we felt like we were a special batch. Hahaha. 😛

I was the only one of SBP/MRSM school who attended the program in the Kedah state. The rest were made up of students sekolah-sekolah biasa (tak jumpa lah budak Asma, budak Bahiyah, budak2 sekolah cluster or sekolah berprestasi tinggi…banyak budak2 dari sekolah daerah terpencil dan sekolah kampung. To them, this was the only activity available to fill up their time while awaiting for their SPM results. Unlike some of us who get to go on holidays overseas, these kids really looked forward to this program because this was about the only highlight of their post-SPM celebration)

The facilitator was surprised when I introduced myself at the start of the program and told them that I was from MRSM Langkawi.

They said “Jarang budak2 sekolah mrsm join program macam ni”. 

So, I told them “Saya memang minat.” I have always loved adventurous activities ever since I was a small kid. (I was a girlscout since I was in Asma primary school. And then I got involved in Girl Guide when I was in Asma secondary school. But unfortunately Girl Guide in Asma did not organize much outdoor activities to keep my restless soul satisfied and occupied…  so feeling bored to tears, I quitted Girl Guide and joined Police Cadet instead. When I got into MRSM Langkawi, I joined Fire & Rescue Cadet / Kadet Bomba. Until now, I still go on hiking trips at least fortnightly.)

I spent my time in PKSN with camping, hiking, jungle tracking and joining program anak angkat in small villages. With the program anak angkat, we had to live the way the poor people in that kampung live and helped them out with their paddy planting/ street vending / rubber tapping/ fishing etc etc. (But the bapa angkat I was assigned to was a Tok Imam in the village who owned a lot of paddy fields, and quite well off in his own rights. There was nothing much for me to do. So, I ended up not having to help out at all. Hahah. I was the only one in PKSN who did not really have to live poorly like the rest of them. But I actually envied them their experience.)

We did more social service activities than military activities in PKSN. The roughest part of PKSN was only the jungle tracking… and I happened to enjoy those, anyway.

In PKSN, I got to know people whose concerns were not academic performance, but other important things such as patriotism, helping others in need and selflessness. It was quite refreshing, actually. They didn’t talk about books, they didn’t worry about their SPM results. They didn’t talk about their answers to some confusing SPM questions that they had recently sat for. These people were a totally new breed to my usual friends who were academic-oriented.

But they are a gem in their own ways. They were good in practical, survival stuff, you know. They have patience in times of difficulties. They were creative about doing performances to entertain the orang kampung. Their social skills with the elders were crazy good. They were so… at ease….with the orang kampung.  With the orang kampung, they talked of stuff I had not the slightest idea of involving ‘kerja-kerja kampung’ I was not at all familiar with. At that age, I was still an awkward teenager who only wanted to talk about the latest fiction I had read. I didn’t know how to relate to others who didn’t share my interest. I was very self-absorbed. But by observing how they interacted with one another and how they found pleasure in simple things, I learned a thing or two about contentment and finding enjoyment in everyday occurrences.

After one month of fun, community service, and BTN-like talks and programs, it was time to say good bye to all my new friends and acquaintances. I never met them again. I was not even sure whether they continued their tertiary studies. But I think, they were street smart people, anyway. Institutionalised education might be too restricting for people like them.

The year after, they abolished PKSN and started PLKN…. and they made it compulsory for the listed names.

I don’t know how military-based PLKN is.

I heard that only certain types of students were chosen to join. Brilliant students from good schools can always request for exemption.

Maybe brilliant students don’t care enough about anything else other than academic performance.

Not much difference than the cohorts in PKSN, then.

It looks like only students from kampung school will ever be interested to serve the nation.

If Malaysia ever HAVE to go to war, how prepared are we?

We should make National Service compulsory for ALL students… postpone your studies, and do your national service. If anything is to be learned from the North Korea-Malaysia diplomatic tension recently, it is that we should never be complacent about our country’s sovereignty and peace. At any time in the future, our country’s safety and freedom could be threatened.

Burying our heads in the sand and refusing to wake up and smell the coffee might prove to be one of our greatest mistake as a nation.

Just my humble two cents.

Peace!

A fiction

Since I was in my primary school, I’d loved writing short stories. I was nowhere as skilled and as competent as my elder sister in writing stories. But I did it anyway because I enjoyed it.

So today, I find myself wanting to do it again…to write a fiction, just to recapture again the innocence of my childhood pleasure in losing myself while composing something from inside my head, merely for the heck of it. The title of my short story is: Risiko.

Enjoy!

***

Risiko

Dr. Assad Fajaruddin memicit-micit kepalanya yang mula berdenyut sakit. Gagang telefon yang tadinya terlekap ditelinganya dijauhkan sedikit. Gema suara bingit Dr. Syed meleterinya mahu dikongsi bersama jururawat yang bersama-sama oncall dengannya pada hari itu.

Staff Nurse Fatin yang kecil molek itu tersenyum simpul, faham apa yang Dr. Assad rasakan di saat ini. Inilah habuannya apabila oncall dengan doktor pakar seperti Dr. Syed. Staff Nurse Fatin sudah lama menadah telinga mendengar doktor-doktor lain bercerita tentang Dr. Syed. Malah dia sendiri, pernah merasai kepahitannya. Tetapi  ah, sabar itukan separuh daripada iman. 

Assad menggigit bibir bawahnya menahan geram yang menggunung. Masih dia ingat kata-kata rakan baiknya sebentar tadi, Dr. Taufik. Taufik telah memberi amaran kepadanya tentang betapa ‘legend’nya Dr. Syed ini. Taufik sering berkongsi rasa tidak puas hatinya terhadap Dr. Syed kepada Assad sebelum ini. Assad layan dan dengar. Hari ini, dia pula yang kena.

“Good luck ya, oncall dengan Dr. Syed. Aku doa kau  tak ada kes dan aman tenteram oncall kau. Seksa weh… oncall dengan dia. Seriously macam siot gila!” Taufik berkata pagi tadi. 

Waktu tu, Assad hanya ketawa kecil.

Tapi kini, tiada humor di wajahnya. Hatinya hanya bergema dengan bisikan yang menyatakan bahawa kata-kata Taufik memang sangat tepat. Memang macam siot gila, getus hati Assad.

Assad cuba untuk mengawal intonasi suaranya yang dirasakan sudah mula mahu melonjak ke oktaf yang tertinggi. Dia cuba beristighfar…. tapi rasa marah itu membuak-buak.

Suara Dr. Syed tidak habis-habis meleterinya menerbitkan suatu rasa muak dan mual, hingga mahu muntah. Sungguh Assad menyampah! 

“Dr. Syed, pesakit ini agresif. Saya bukan saja-saja nak admit pesakit ni ke wad. Tapi memang ada risiko kalau tak admit. Skor BPRS dia sampai 18. Sampai sekarang pun, polis masih tak buka dia punya gari sebab dia agresif! Dia sangat paranoid pada ahli keluarganya. Mak ayah dah tua, tak boleh kawal pesakit di rumah. Kalau saya bagi dia balik, tak ada sorang pun  ahli keluarga yang berani jamin akan bawa dia follow up semula esok. Kita sendiri tak boleh buat home visit sebab esok adalah hujung minggu. Jumaat dan Sabtu…. dua hari itu…how are we going to continue our treatment of the patient dan support dia punya family dalam masa dua hari ni?” Assad menarik nafas laju dan panjang, setelah membalas leteran Dr. Syed dengan jawapan bertubi-tubi.

Staff Nurse Fatin terangguk-angguk di sisi, gaya memberi semangat untuk Assad meneruskan hujah bagi meyakinkan Dr. Syed untuk memasukkan pesakit ini ke wad psikiatri. 

Tapi Dr. Syed masih berdegil. “Assad, saya tau dia agresif. Tapi bukan semua patient agresif kita admit.”

Assad yang dah bengang mula mahu memotong. Dah lama dia berhujah dan mengulas tetapi Dr. Syed masih memberi jawapan yang sama. Dia sudah sakit hati dan bila-bila masa dia boleh meletup.

“Memang bukan semua patient agresif kita admit ke wad. Tapi ada yang kita admit juga kan… sebab ada risk of harming others! Kita masukkan pesakit yang ada risiko la, Dr. Syed. Macam selalu!” Assad ternaik juga suara akhirnya. Sudah lima belas minit dia bercakap dengan Dr. Syed. Kata putus masih belum dapat. Dia sudah penat.

Jam sudah menunjukkan pukul 12 tengah malam. Yang menambahkan lagi bebanan perasaannya, ada satu lagi kes yang belum dia lihat dan sudah pun dirujukkan kepadanya sebentar tadi oleh doktor kecemasan. Kes itu pastinya akan makan masa berjam-jam lamanya kerana itu juga adalah kes baru. 

Assad mendengar Dr. Syed mendengus di corong talian. “Dia dah tak sihat setahun, Assad. Selama ni boleh jer family dia kawal dia. Baru hari ni bawa datang ke kecemasan. Kenapa dah setahun sakit, baru hari ni tiba-tiba keluarga tak boleh manage pula?”

Assad menggenggam tangan, cuba menahan rasa geram yang makin mencengkam. Berapa kali aku nak ulang benda yang sama ni? Apakah Dr. Syed tak faham apa yang aku dah terang tadi? Iys, hampir kesemua pesakit psikiatri yang dibawa ke kecemasan selalunya tidak sihat memang dah lama. Paling tidak pun, tiga atau empat bulan dah tak sihat baru keluarga bawa ke kecemasan. Kalau ikut hujah Dr. Syed ni, tidak ada seorang pun yang layak masuk wad psikiatri selama ni. Baru hari tu saja, ada seorang pesakit yang dah lima tahun tidak sihat sebelum akhirnya dia di bawa ke kecemasan, tapi dia tetap dimasukkan ke wad kerana ada risiko!

Reasoning apa macam ni? Assad mula menggerutu dalam hati.

Yang menentukan samada pesakit dimasukkan ke wad atau tidak adalah betapa tingginya risiko untuk pesakit mencederakan diri sendiri atau orang lain. Bukannya berapa lama dia dah sakit sebelum datang ke kecemasan!  Kalau macam tu, tiada sorang pun pesakit  yang datang ke kecemasan yang layak masuk wad!

Kalau dah pakar, jangan bagi judgment dan reasoning yang lemah macam ni. Menjelekkan, tahu tak?! Assad sambung mengomel dalam hati. 

“Jadi, Dr. Syed tak nak admit lah ni?” Assad menekan.

Dr. Syed terdiam.

“Dr Syed?” Assad menekan lagi.

“Bukan tak mau admit. Tapi pesakit sebenarnya dah  tak sihat setahun dah kan. Kalau ikut pengalaman saya, tak perlu admit pun.” Suara Dr. Syed yang turut melonjak naik itu memanaskan lagi hati Assad ketika ini.

Mata Assad mula mencerlang. Tak habis-habis kau bagi kat aku reason generic yang sama. Aku bagi situasi yang context-specific. Kau bagi reasoning yang langsung tak tepat dan jitu dan mengabaikan konteks yang aku bagi. Assad geram.

Aku dah cakap yang dia agresif; yang dia paranoid; yang dia nak bunuh keluarga dia hinggakan pisau-pisau tajam semua disembunyikan oleh ahli keluarga; yang dia mengugut keluarganya; dan esok adalah weekend di mana kita tidak dapat melakukan lawatan ke rumah jika ahli keluarga tidak dapat membawa pesakit untuk pemeriksaan semula. Punya banyak reason aku bagi, kau asyik dok ulang ayat yang sama yang kononnya pesakit sudah lama tidak sihat.

Samada kau pekak atau kau langsung tak memahami perkataan! Bengang Assad berganda-ganda.

“Kalau Dr. Syed tak nak admit, tak apa. Tapi saya rasa ada risiko lah.” Assad tegas dengan penilaiannya. Dia takkan berganjak.

Dia mahu kata putus. Tak guna mendengar Dr. Syed berleter jika akhirnya kata putus masih tak dapat. Kalau kau tak nak admit, kau tak payah berletar panjang-panjang. Kau cakap jer tak nak admit; aku akan tulis yang kau tak bagi aku admit. Tapi aku takkan buat-buat, berpura-pura  seolah-olah aku puas hati dengan keputusan kau. Takkan! getus hati Assad.

Sekali lagi dia teringat kata-kata Taufik yang sering meluahkan perasaan kepadanya mengenai Dr. Syed. “Dr. Syed tu anxious. Dia tak berani nak buat keputusan. Berleter panjang-panjang sampai nak dekat setengah jam. Lepas tu tak ada kata putus. Haru betullah pakar macam ni!” Taufik menggerutu, geram.

Assad mengeluh, kesal. Taufik, kau dah bagi amaran kat aku. Sekarang baru aku rasa. Damn it!  Hatinya menyumpah sorang-sorang. Bila diingatkan semula, bukan setakat Taufik yang memberi amaran kepadanya tentang perangai ‘anxious-tiada-kata-putus-suka-tolak-kes’ Dr. Syed. Malah begitu ramai lagi. Tapi tidak pernah Assad kena handle situasi seteruk ini.

Kakak, ibu dan adik pesakit di hadapannya memandang wajah kelat Assad dan mendengar setiap butir kata-kata yang keluar dari celah bibir Assad. Walaupun mereka tidak dapat mendengar apa yang Dr. Syed cakap di talian, tetapi, mereka dapat meneka yang Assad sedang berperang dan berjuang untuk mereka. Assad malu kerana mereka mendengar dia sedang bertekak dengan bossnya.

“Macam ni lah, kalau you nak admit juga, you admitlah. Tapi kalau esok saya tengok dia okey jer, saya takkan sign borang 6. Sebab borang 6 tu untuk extend admission sampai sebulan. Kalau esok dia okey, saya takkan sign borang 6.”

Menyirap darah Assad.

Kau cabar aku… tak nak sign borang 6? Damn it!

Tidak pernah selama dia bekerja sebagai pegawai perubatan di jabatan ini dia mendengar seorang pakar yang setuju untuk admit pesakit ke wad, dan kemudian dengan ayat seterusnya menyatakan yang dia tidak akan sign borang 6.

Kalau kau tak yakin yang pesakit ini patut masuk ke wad, sampai kau nak buat statement berbaur ugutan tak nak sign borang 6, kau patut turun sekarang ke kecemasan, kau tengok sendiri pesakit ni! Bukannya buat keputusan bodoh seperti ‘allow admission, but I might not sign borang 6.’ Itu hanyalah sikap seorang pakar pengcecut  dan tak berani nak ‘commit to a decision’ tapi pada masa yang sama pemalas nak turun padang tengok sendiri keadaan pesakit. Hati Assad membara panas.

Kalau kau dah perangai macam ni, kau tak payah jadi pakar okey! Kau patut ambil tanggungjawab kau, commit to a decision and don’t blame others the next day! Sekali lagi jiwa Assad meronta-ronta mahu melepaskan apa yang dia rasa terus ke corong telefon, biar Dr. Syed tahu betapa marahnya dia sekarang ni.

“Okey. Kalau Dr. Syed tak mau sign borang 6 esok, tak payahlah Dr. Syed sign. Discharge lah dia,” Assad membalas cabaran Dr. Syed.

Dr. Syed terdiam sekejap kemudian menjawab. “Tak adalah… memanglah kalau kita admit patient, selalunya kita tunggu sampai weekdays juga lah nak discharge. Tak adalah kita discharge over the weekend.” 

Dah tu? Kalau kau dah tahu memang macam tu kita dok buat selama ni, kenapa kau nak bring up pasal borang 6? Saja nak bagi aku sakit hati? Hey, tak payah nak berleter lah pasal fungsi borang 6 tengah-tengah malam ni. Aku tau lah borang 6 tu untuk apa. Hiys!  Assad mencemuh lagi dan lagi.

“Jadi, kita admit ke tak ni?” Assad menekan. Dia tidak kira, Kalau Dr. Syed tak bagi dia masukkan pesakit ini ke wad, dia akan call boss besar sendiri.

Kau ingat aku macam Carla yang baru setahun jagung jadi MO sampai kau boleh berleter panjang-panjang dan aku akan dengar saja tanpa boleh berfikir dan buat judgment sendiri? Hey, kau silap orang, okey! Carla yang setahun jagung menjadi MO pun pandai menilai, mana pakar yang cekap, mana yang cemerkap!

“Ha, admit jerlah.” Dr. Syed akhirnya mengalah. Tetapi nada tidak puas hati Dr. Syed bagaikan api yang di simbah dengan petrol dalam hati Assad. 

Gagang telefon diletakkan. Sedikit kuat ia terhempas. 

Assad memandang staff nurse Fatin dengan mata dan wajah yang letih. Letih yang amat sangat!

“Benda boleh selesai consult lima minit… jadi 20 minit.” komen Staff Nurse Fatin.

Assad tersenyum sinis. “Hari tu, Carla kena setengah jam! Rania pula hari tu hampir 45 minit dengar bebelan jer… dah lah tu, tak ada kata putus pula lepas tu. Ni first time saya pula kena sedahsyat ni. Ni pun kira okey lah 20 minit jer! Dan akhirnya dapat juga admit. So, puas jugalah hati saya. Kalau sampai 20 minit consult and then tak dapat admit, saya pula yang mengamuk sampai Fatin kena cucuk Haloperidol kat saya pula nanti.” Assad berseloroh, cuba memujuk hati sendiri dengan berjenaka hambar. Staff Nurse Fatin hanya ketawa kecil. 

“Kalau tak dapat admit tadi, saya dah call ketua jabatan.” ujar Assad, kali ini lebih serius.

Staff Nurse Fatin menggeleng-gelengkan kepala dan kemudiannya menyelesaikan semua urusan surat-menyurat yang diperlukan untuk memasukkan pesakit ke wad psikiatri lelaki.

“Terima kasih, doktor Assad. Sebab masukkan adik saya ke wad.” Kakak pesakit bersungguh-sungguh berterima kasih. Assad dapat lihat sepasang mata wanita itu sedikit berkaca.

Assad menarik nafas, menahan rasa terharu.“Sama-sama.” Hilang penatnya hanya kerana ucapan terima kasih yang ikhlas daripada ahli keluarga pesakit yang begitu mengharap padanya.

Assad menyandarkan tubuhnya ke belakang kerusi, mahu membuang lelah atau melelapkan mata barang seminit dua. 

“Doktor, ada satu kes lagi ni. Tak boleh rehat lama-lama.” Staff Nurse Fatin mengingatkan.

Assad kembali menegakkan badannya dan mengangguk, tahu yang dia tidak boleh berehat lama, membiarkan satu lagi kes tergantung menunggu perhatiannya. Oncall masih perlu diteruskan walaupun jiwa dan emosinya masih terdera dengan kisah kes tadi. 

“Kali ni, saya akan buat keputusan sendiri. Dan takkan consult Dr. Syed lagi. Buang masa!” Assad mendengus. “Okey, panggil next patient masuk!”

***

Pada hari Ahad itu, Assad segera pergi ke wad psikiatri lelaki. Dia mahu melihat sendiri keadaan pesakit yang dia masukkan ke wad sewaktu dia oncall hari Khamis itu. Adakah sudah bertambah sihat atau masih agresif seperti hari tu?

“Dr. Assad…. you tau tak, patient yang you admit hari tu… dia mengamuk sampai pecah cardiac table semalam. Teruk sungguh” Carla bercerita.

Assad tersentak. Terangkat keningnya.

Dia tahu pesakit itu agresif dan patut masuk ke wad. Tetapi dia tidak fikir pesakit itu boleh sebegitu ganas sehingga ranap cardiac table wad psikiatri ini. Dalam hati, Assad memanjatkan rasa syukur kerana dia bertegas mahu pesakit dimasukkan ke wad walaupun terpaksa bertegang urat leher dengan boss sendiri.

This is why I become a doctor. For my patient. Not for my boss. Do what is right and you will be rewarded. If not here, then in the hereafter, insyaAllah.  Hati Assad berbisik.

Taufik yang berada di sebelah Assad memberikan ‘thumbs-up sign’ kepadanya. “Puas hati juga gaduh. Kau tahu kau betul. Dah clear tanda Allah bagi… untuk tolong kau justify kenapa kau admit pesakit ni. Pesakit lain yang senang admit pun tak adalah ganas macam ni. So, don’t worry. Obviously, Dr. Syed was wrong.” Taufik menepuk bahu Assad.

“Kalau nak ikutkan, buat apa aku nak penat-penat gaduh dengan orang atasan. Apa yang aku dapat? Buat apa nak susah-susah kalau bukan mengingatkan yang kerja ni amanah dan insyaAllah kita akan dapat balasan yang baik. Kalau hari tu weekdays, aku boleh justify lagi nak bagi pesakit balik rumah. At least, aku boleh back up dengan lawatan ke rumah pesakit esok hari. Tapi in this case, esok tu cuti….dua hari pula tu….dengan pesakit agresif macam tu…aku tak boleh nak justify diri aku kalau aku  tak fight untuk admit pesakit. Kalau jadi apa-apa, I can’t live with myself.”

Carla mengangguk.

Taufik pula menyampuk. “Memang tak logik la Dr. Syed ni. Judgment out! Punya banyak you bagi reason nak admit… dan reason you semua context-specific. Dia dok ulang reason yang umum yang sebenarnya bukan justifikasi yang cukup untuk tidak masukkan pesakit ke wad. Punya banyak pesakit yang kita admit selama ni yang datang ke kecemasan lepas dah lama sakit. In fact, hampir semua pesakit yang datang ke kecemasan dah berbulan-bulan dah sakit… adakah semuanya tak admit? Admit juga kan! Maksudnya admission bergantung kepada risiko harm to self and harm to others…tak ada kaitan kalau dia dah sakit setahun ke, sepuluh tahun ke…. be objective la…yang nak ulang ayat yang sama tak habis-habis tu, dah apahal??!”

“Aku rasa aku boleh tahan lagi kalau dia berleter jer. Aku just tak suka kena cabar. Kena ugut. Konon tak nak sign Borang 6. Tak pernah aku dengar pakar lain cakap benda macam tu. Aku tahu dia tak nak admit pesakit. Tetapi pada masa yang sama, sebab aku insist pesakit ada risk, dia tak berani juga nak discharge. So dia tak boleh nak buat decision. He was upset and he took it out on me. Kau ingat, aku ni baik sangat ke macam si Carla ni, nak tahan sabar bila kena treat macam tu?” Assad bercerita apa yang menyebabkan dia benar-benar nak naik hantu pada malam itu. Pantang Assad Fajaruddin diancam dan diugut! Pantang dia jadi pengecut! Lagi dicabar, lagi disambut. 

“Assad…. maksud nama kau kan singa! Memang takkanlah kau boleh sejinak Carla. Sabar itu jauh sekali.” Taufik menjuih bibir. Dia masih ingat lagi Assad memberitahu kepadanya bahawa namanya dipilih oleh bapanya. Assad Fajaruddin bermaksud ‘singa yang pertama atau the first lion, memandangkan Assad adalah anak sulung. 

“I bukan jinak laaa…. I kena buli laa…. sebab I baru. Tak berani lawan.” Carla memuncungkan mulutnya.

“Aku nak pi complain kat ketua jabatan. Dah setahun aku sabar. That was the last straw that broke the camel’s back. And I couldn’t take it anymore.”

“Apa yang ketua jabatan boleh buat, weh? Nothing. Boleh slow talk jer lah… kau rasa ada perubahan? Memang takkan punya!  Ada specialist Ortho kat hospital time aku buat houseman dulu, punya banyak orang complain pasal dia… masih lagi dia dok bermaharajalela. Specialist O&G kat hospital adik aku dulu pun sama! Bila orang complain kat facebook, kata tak guna saluran betul. Tapi sepanjang kita dok guna saluran betul ni, tak ada pula nampak perubahan pun! Ayat politik jer lebih! Saluran betul, konon! Kadang-kadang kena ada juga orang macam kau ni! Baru orang buka mata!”

“Tak apa… aku cuba pula saluran betul kali ni. Tak jalan juga… Aku akan burst out balik. Macam selalu. Hahha”

“Typical Assad. A leopard can never change its spots!” Taufik berseloroh. 

“Perhaps, I can hide my spots with cosmetics of some sort!” Assad membalas.

“And the cosmetics will come off the next time you are doused with a stream of provocation,” Carla membuat konklusi.

Terhambur ketawa mereka bertiga. 

Assad, Carla, dan Taufik berjalan bergandingan keluar daripada wad psikiatri lelaki dan menuju terus ke klinik.

Assad berfikir sendiri: Yesterday in history. Today is another day. And If I have to do it again, I would not change a thing! Not a word! Not even a single syllable!

-The End-

Disclaimer:

The story, all names, characters, and incidents portrayed in this creative writing are fictitious. No identification with actual persons (living or deceased), places, buildings, and products is intended or should be inferred.

Ultimately, my responsibility is for my patient!

My facebook status today!

My life would have been a lot easier if I can be someone docile with no principles and no backbone to fight for what I believe as right.

Unfortunately, my father raised me to be outspoken and to fight when I believe I am right. (so my life is full of the drama of me being a rebellious anti-authority) I am taught to fight for the underdog and to crush the bullies in the society.  I am always going to be the one who cheers for the losing team against the favourite team. I am always going to be pro-housemen, in general. I like it when the underdogs win. I like it when the underdogs DARE to fight for the sake of truth and justice. Truth and justice are like my life’s theme, around which I build my personal saga on.

And 90% of the time, I always win whenever I fight for something. Another sunnahtullah that I believe in is that Allah will help you when your intention is sincere and you are doing it for the right cause!

I might be a rude, loudmouthed virago in the society. But when you are looking for a sidekick to fight with you for the sake of justice, I am the one you want by your side! I will get things done, insyaAllah. And I won’t stop until I get it! My patients are lucky if they get me as their doctor… I will fight for them if they are ever in a situation of injustice. I can face my superiors and debate with them until I get them to agree to give what my patients need. If my patients need something that my superiors won’t allow me to give, I will find another way to get it for them if I believe  they deserve it.

My job is my ibadah. And I take it seriously. I may not look deeply religious. I may not be able to quote Quranic verses out of thin air or effortlessly talk about hadeeth narration on top of my head. But I understand the core principles of my religion. And I stick to it. I can even be pretty rigid about it. Like an autistic kid who would throw massive tantrum at the  existence of the slightest deviation to his normal routine. When it comes to things involving my principles, I am very strict. Principles are not to be stuck with just when it is easy to do so. The purpose of having principles is to help and guide you make the right choice in the situation when it is so hard to choose. If you are going to balk and cower down at the slightest pressure by any authority, then what’s the use of having principles?

My job is my amanah. When I am oncall, my patients depend on me to argue their case on their behalves. If I think they need admission, I am willing to argue and fight until I get them admitted. If I think community treatment is the one that is best for them, I can spend one hour just cajoling and persuading the relatives to bring the patient home after acute treatment has been given. On the one hand, I will have to persuade my boss to allow me to admit my patients when I think they require admission. On the other, I will have to persuade the patient’s relatives to bring the patient home when I think the patient’s best treatment should be in the community. Ultimately, I do all that for patients. Not for myself.

My patient is my amanah. I don’t work for bosses! I don’t work for my hospital director. I don’t give a damn about KPI! I don’t give a damn about kissing my superiors’ ass. If they punish me in any way, shape or form (public reprimand, giving low marks for my annual appraisal etc etc), I STILL don’t care. I don’t need a high SKT marks for MRCPsych program. So, I don’t need to kowtow to anyone in the work place. And that’s my power. Because you can’t blackmail or threaten someone who don’t give a damn!

If I am nice to you or polite to you, I do that out of common courtesy and because I genuinely like and respect you. I have no ulterior motives to be nice to you, otherwise. Because I don’t need you that much to pretend differently. If you have pissed me off, I won’t even bother to hide my disdain. I am transparent, that way.

I have designed my life so precisely according to my cardinal trait and my central trait. I have also designed my life so precisely according to my most enduring overvalued idea. My overvalued idea is “Power tends to corrupt! And absolute power corrupts absolutely!” So my life is lived in such a way that I don’t have to need anyone for anything and I pray (so hard!) that I will never be forced to sacrifice my way of life as it is. This is liberation! I pray that no power can ever threaten to corrupt me.

Another facebook status of mine!

I respect good reasoning! I respect excellent clinical judgment. I respect genuine intention of someone wanting the best for their patients regardless of what the KPI or the hospital policy says. I respect someone who can bravely do what is right even if tomorrow they will have to face the displeasure of someone above them, judging their clinical decision. Having a responsible, honourable boss like that will gain my utmost respect.

I abhor cowardice. I hate indecisiveness. I despise incompetence. And I don’t care what position you have in the society or in the government! If you are my superior and you are indecisive and unnecessarily anxious, I will find it VERY HARD to respect you. I may not go out of my way to challenge you for every single annoying thing that you do that affect me. But once you get in the way between me and my belief system (which include doing the right and honourable thing for my patients), I am going to fight you.

So, don’t get in my way! Because I am not moving! When it matters to me enough, I can be either an unstoppable force or an immovable object.

Physics  101, anyone?

The best thing is: When you TRIED to get in my way, and then I fought you until I got what I wanted. And AT LAST, I was proven right for fighting for what I wanted.

That, dear readers, is the sweetest feeling in the world. Such a sweet, euphoric feeling! My own version of cocaine. Yup, to be proven right is my cocaine! (Hahha. I am so immature when it comes to wanting to be right and wanting to win)

Thank you, Allah! For always giving me the signs that it is worth it to fight for the right thing.

I leave you with a repeat of my facebook status with the extension of the comment section. Just a little private joke to those who know the story. 🙂

For A Happy Life, Make Life Decisions Based On Your Cardinal Trait

I was asked for tips regarding how to pass MRCPsych Part A at one shot.

The truth is, I don’t really have any tips. I can only tell them what I did (mainly doing a lot of questions and covering 80% of Stahl’s Psychopharmacology). But how would I know whether any of the things I did were REALLY what made me pass? I have mentioned before that I passed by the mercy and grace of Allah. Even after the exam, I wasn’t able to tell for sure whether I was able to make it.

So my tips would really be worthless. Because some people didn’t do what I did, and they still passed. And some people did more than I did and they still did not pass. So, you can ask me and I will tell you what I did but don’t blame me if it doesn’t work. Hahah.

To me the most important thing is to KNOW YOURSELF. You have to know your weakness and your strength, your style of studying and revising, whether you can deal with last minutes cramming or you are the steady and constant type, whether you are good at memorizing without having to understand or whether you must understand before you can memorize, whether you can study in noise or whether you need peace and solitude, whether you can deal with distractions or whether you need to shut yourself off somewhere to focus.

Once you know all that, you can start planning to study in your own way and style. Never let anyone tell you or influence you to do what they think is best. No one KNOWS you better than you know yourself.

I know I don’t like distractions, even minor ones, when I am deeply enmeshed and engrossed in certain stuff. When I am focused in certain things, I can shut myself off in my house for days and weeks and not contact anyone and just do my thing. Any attempt to contact me would be rebuffed and rejected.

When I was preparing for my exam study, some specialists suggested to me that I shouldn’t have to sacrifice my annual leaves for study time. Instead, I should just come to work as usual  (punch in and punch out to record my attendance) and just be around the clinic without having to do any clinical work. They said that they would allow me the time to study in the clinic, but I must ‘be around the clinic’ instead of at home. Even if I am not doing any clinical work, I must be around, they said. 

I thought that was ridiculous of the admin, by the way! Why should I come at all if you don’t expect me to work? If you only want me to come to work to be around while I am studying, why can’t you allow me to study at home? How come other master students can take unrecorded leaves without having to be around at all? That’s just unfair to me and Dr. T! Until now, whenever I think about how many years I have covered for everyone’s unrecorded leaves… but when it comes to my turn, you guys create so many administrative issues to deny me the SAME privilege that others have enjoyed before me… when I think about that, I become angry all over again. Me and Dr. T got over our anger eventually but damn, it was hard! Hahha. I still feel angry on and off. Which goes to show that I don’t get over things involving fairness and justice easily. I will always remember stuff like that. I might not show my dissatisfaction anymore, but I will always remember it. That’s just how I am. 

I decided that, “Fine, I didn’t need the unrecorded leaves that you so begrudged!” I could use my annual leaves because I had so much of them (I don’t have children for which I have to use my annual leaves to care for them if they fall sick. I don’t even need my annual leaves for balik kampung because my kampung is right here in Alor Star and I can always  see my parents during the weekends. I have so much accumulated leaves from previous years  that I can afford to use up some of my annual leaves to study) Since they were going to create so many obstacles for me to have my study time, then I could afford to sacrifice my annual leaves. But I refused to do something as stupid as just coming to the clinic to punch in and punch out and being around without having to do any clinical work. What’s the point when I KNEW I could do better in my own domain. I study BETTER in the solitary of my own house. I might want to study until 3.00 a.m and not want to have to wake up early just to come to the clinic to punch in and ‘be around’. Or I might want to sleep early and wake up to study from 4.00 a.m non-stop until 9.00 a.m. I might want to wear comfortable clothes while I am studying and I can’t do that if I have to ‘be around’. When you asked me to ‘just be around in the clinic’, you took away MY FREEDOM to arrange my schedule any way I wished at the most critical moment when I needed it the most.

Because I knew myself and my need for peace and solitude, I told them that “I prefer to not be around even if I have to sacrifice my annual leaves for it.” I need my solitude. My time alone. My space. And I will do whatever I can to get it! If it means I have to use my annual leaves, well be it! But I will always remember that other master students did not HAVE to use their annual leaves and simply took unrecorded leaves without having to ‘be around’. No one made a fuss when THEY took unrecorded leaves.

You see, that’s my cardinal trait. I want justice to be upheld. Things must be fair and balanced. In books that I read, the theme of justice and fairness reigned supreme. Most books that I read involved a struggle for justice and a journey to find truth (Books like ‘To Kill A Mocking Bird’, ‘The Tenant of Wildfell Hall’, ‘A Time To Kill’, ‘Twelve Years A Slave’, and many, many more. Especially books written by John Grisham which I devoured in my teenage years. Those books shaped my worldview and my principles in life.).

Another one of my cardinal trait is: being free. Freedom is important to me. I need it so much that I am willing to sacrifice anything I can afford to get it.

So whatever choice I make, at the forefront of my mind, I will always ask my self “Will I still retain my freedom if I make this choice? Should injustice happens to me, will I get the freedom to fight back without suffering unmanageable consequences?”

So some of you without any psychiatric background may still wonder what is this cardinal trait Afiza is talking about. Well here’s a little background story:  Gordon Allport was an American psychologist who was considered as one of the first founding figures of personality psychology. He was also one of the first modern trait theorist of personality. He looked at thousands of personality traits and then organized these traits into three hierarchies; Cardinal Traits, Central Traits and Secondary Traits.

Well… cardinal trait is this characteristic that you have that dominate and shape your behaviour and collectively known as your master control; your ruling passions. It tops the hierarchy of your traits.

Some people don’t have cardinal traits (only central traits and secondary traits) and therefore might find it difficult to understand those who do have them. But to those who have cardinal traits (and there are not few of us who do. I have known some.) they make all their life-altering decisions based on their cardinal traits.

Including me.

Some people with cardinal traits sometimes can make the mistake of choosing a certain life option that opposes their cardinal traits (because at first, they thought they could handle it) and they usually live to regret the decision they have made. It is not easy to constantly and consistently live in a manner opposing your cardinal trait. One day, something got to give.

So, if you have a cardinal trait, you should respect it. Otherwise, you shouldn’t have one (even though whether or not you have cardinal traits is beyond your control). Admittedly, it’s easier for those who don’t have cardinal traits because they won’t be bound by it. But for those of us who do, never make the mistake of tricking yourself into thinking you can be someone you are not.

I believe that we should not always remain the same and unchanged…. because we are not perfect. We should always improve ourselves… but only according to our own cardinal trait.

For example, I don’t want to remain as just an MO even though it is comfortable enough for me. I have to change! I know that. Remaining the same and stagnant does not do justice to what Allah have created you to potentially become. I should improve myself and study to become a specialist. I knew that. But now, I have two options to go about doing it: master program or MRCPsych program.

I knew from the very beginning that MRCPsych program was the one to choose because it celebrates my cardinal trait (even though at that time I did not have any idea about trait theories just yet. I just knew that master program will never be for me)

When people asked me why I didn’t choose to do master and had chosen MRCPsych program instead, I told them a lot of things such as:

1)It is internationally recognized. My undergrad medical degree from Newcastle University is internationally recognized and I want the same for my post-grad qualifications too. (Should I need to move elsewhere outside Malaysia, I would have more choices regarding where I can practice).

2)If I pass this exam, I know that I am at par with the World Standard. Not merely the local standard. (The local standard might also be at par with the World standard but getting the world to recognize that is another matter entirely).

3)I like the lack of hassles and the flexibility.

4)I don’t want to owe the government a large sum of money should I fail to complete the Master program.

I told them a lot of things regarding why I chose MRCPsych  but only one thing matters the most to me: MRCPsych appeals to my personality and my cardinal trait.

As I mentioned before, my first Cardinal Trait is justice. I want justice to be served and fairness to be upheld. Not just for myself but for everyone.

I have heard so many horror stories about the master program. Some of the situations were so ridiculously unfair that if I were put in that situation, I would have the tendency to answer back and argue with my superiors. And if they then make my life difficult due to my inability to suppress my dissatisfaction at them, I would have no choice but to bear with how they treat me for my, ehem, insubordination. Or maybe I will have to suppress my tendency to fight back (and thus I cannot celebrate my cardinal trait of fighting for justice and fairness). At the same time, I could not just quit because I would then be owing the government a lot of money. So, there goes my freedom too… another one of my cardinal trait that I have to suppress if I choose the master program.

So repeating the questions that I always ask whenever I have to make a decision (“Will I still retain my freedom if I make this choice? Should injustice happens to me, will I get the freedom to fight back without suffering unmanageable consequences?”), would a master program ever appeal to me?

Nope! Not in a million years!

Now, compare the situation when I am taking MRCPsych program. I don’t owe money to anyone. I use my own. There are no lecturers or supervisors to annoy me (until I have to do  attachments later on…. but by then, insya Allah, I would have passed the major exams already). Should I, for any reason, decided to quit, I can do so without suffering any unmanageable financial setbacks due to the owed debts.

Of course, I do have superiors in my own hospital that occasionally annoy me (like all superiors anywhere else do. Let’s just admit that all of us cannot be in the same page with all our superiors all the time. It’s the facts of a working life. Colleagues and superiors annoy one another. That’s just how it is). But most of the time, I know I can answer back. Even if they can make my life difficult (most of my specialists are generally nice. None of them are malignant. But I am speaking theoretically and hypothetically), I know I have the freedom to walk away anytime I like after giving them a piece of my mind. I can simply quit and work with my father. No one will have any absolute power over me… ONLY relative power because of their position as my superior. But at the end of the day, I can keep the image of me as a free human being, unafraid of anyone.

How can I do that if I take the master program? How can I retain the mental image of me as a free person, able to say what I want to say and do what I want to do without being afraid of anyone… how can I retain the ideal image of a free self… when fighting back would make my life miserable and at the same I can’t just walk away because I will then have to settle a huge debt to the government?

Our religion taught us to FEAR debt. Because debts can take away your freedom. Debts can force you to remain in an oppressive situation because you have NO OTHER CHOICE. (in other words, no freedom). Our religion doesn’t want us to be in debt because it curbs us from doing what we feel as right… because we are too afraid to speak up. And therefore we were taught to pray the doa that I always say at the end of my prayers; the doa that would help us avoid being in unmanageable debts:

اللَّهُمَّ إِنِّي أَعُوذُ بِكَ مِنَ الْهَمِّ وَالْحَزَنِ وَأَعُوذُ بِكَ مِنَ الْعَجْزِ وَالْكَسَلِ وَأَعُوذُ بِكَ مِنَ الْبُخْلِ وَالْجُبْنِ وَأَعُوذُ بِكَ مِنَ غَلَبَةِ الدَّيْنِ وَقَهْرِ الرِّجَالِ

“O Allah I seek refuge in You from worry and grief, I seek refuge in You from hopelessness and laziness, I seek refuge in You from miserliness and cowardice and I seek refuge in You from overwhelming debt and from the force of men”.

I love this doa so much. One of my favourites of all time! Seeking refuge from hopelessness and laziness… that’s awesome! Hopelessness is one of the symptoms of depression and this doa reminds us to protect ourselves against it. I also love the part where you are seeking refuge from cowardice! One of the things I never want to be is a coward. And finally…. you are seeking refuge from ‘overwhelming debt and force of men.’ Have you ever wondered why overwhelming debt and force of men are being grouped together in this doa? Because they are related! Once you are in debts, you are weak enough to be forced upon! In the past, your inability to pay debts could turn you into a slave!

So this is why I am in love with the doa, which is included in one of the Al-Mathurat verses! This doa encompasses everything I want for myself! From the very moment I learned of this doa and its meaning when I was in medical school, I was struck by how much this doa suits me to perfection!

I work because I like working. I don’t want to have to work for money alone just for the sake of making ends meet and settling debts. That would be a miserable life. I want to work for myself to serve my society because that’s what a good Muslim does. Even if I am ever lucky enough to marry a rich king (haha, not that I believe I am at par with Neelofa who is now gossiped to be in a relationship with one of the royals out there), I will still want to work because being able to contribute to the society is our basic need. It fulfils our needs for esteem and self-actualization (Abraham Maslow theory of hierarchy of needs). It resolves our middle adulthood conflict of generativity vs stagnation (Erik Erikson Theory of Psychosocial Stages). It fulfils our need to create and nurture things that will outlast ourselves.  In fact, being able to function is one of the main criteria being evaluated in psychiatric assessment.

Productivity is what makes us a happy human being, folks.

Feeling useful is a need. Even if you are born rich or a princess, you will still need an outlet to be useful. So these rich people would then devote themselves to charity organizations or to become presidents of NGOs etc etc. When they accomplish something altruistically for the sake of the society, their reward is the inward joy that they feel in their ability to contribute for the betterment of humanity. That’s why… eventually, no matter how wealthy and privileged you are, a life of hedonism and enjoyment would not satisfy you anymore and you will want to find meaning to your life by being useful to the society. Everyone needs something to do! According to Joseph Addison, ‘something to do’  is one of the three grand essentials to happiness.

So, work for yourself! Love your work. If you can’t love your work, it might be because your work is oppressing some integral part of either your cardinal traits or your central traits. Try to find another job that is more in tune with your cardinal traits or central traits. But if you need your job and cannot afford to follow your natural inclination (and therefore you have to be practical rather than ideal), have some form of outlets in hobbies or favourite pastimes that would spice up your life.

I will NEVER choose to do anything that goes against my Cardinal Trait, if I can help it. Once you put yourself in a situation that is repugnant to your core principle, you might as well just be prepared to deal with discontent for as long as the situation persists.

So I leave you now with my happiness maxim: “For A Happy Life, Make Your Life Decisions Based On Your Cardinal Trait”

Trust me! I always stick to this maxim and the doa above! And Alhamdulillah, I am content all the time and happy most of the time.