Be fair to all your children

One day, a Chinese teenage girl presented with her mother to the PSYCH clinic as a new case that was assigned to me for full clerking.

I diagnosed her of Major Depressive Disorder, to rule out Borderline Personality Disorder.

The reason her mother brought her to this clinic was because she has been hurting herself by slashing her wrist a few times in the past.

She did not talk much during the clerking. She admitted that she felt very angry at her mother because her mother seemed to give more loving attention to her younger brother.

I asked the patient to go out and then I called her mother in to ask her whether this was true. The mother said, “Ala, adik dia kecik lagi maaa. Baru lapan tahun. Mesti lah saya akan bagi perhatian pada dia. Lelaki sorang woh”

Terus aku rasa macam meluat dengan mak dia ni. Hahah.

“Dia pun selalu marah-marah adik dia. Dia pun selalu dengki sama adik dia. Rajin gaduh. I pun pening lorrr.”

I gave the mother a nice, wake-up call. “Look at what your injustice has done to your daughter! And to her relationship with her younger brother.” but I  phrased  and elaborated the message in a nice way, of course. So that it would be easier for the mother to swallow the fact that her parenting skills left much to be desired.  

But at the end of the consultation, I allowed NO DOUBT in the mother’s mind that she should be more fair towards all her children.


I am so lucky that I was born in a family of all girls. I could not imagine how my parents would behave if they have one much-coveted son among all five thorny roses that are me and my sisters. (in my case, I have more thorns than petals, haha)

But knowing me (and my sisters), we are very used to not let any resentment fester and putrefy. It is not in us to just keep quiet when we don’t feel satisfied.

We will speak up and will tell our parents straight out, “Mak dengan ayah tak adil!”

So, if my parents were indeed not being fair, they would come to realize it, and thus they would try to adjust their actions and make it fairer. (We voice out –> they realize –>they adjust. Simple algorithm.)

But if it was only our perception that our parents were not fair, because we have voiced out what we thought, they would be able to explain their actions and sooth our resentment. (We voice out –> they explain –> we realize –> we adjust our expectation –> resentment settled)

See? Voicing out is important!

At the end of the day, because we siblings voice out what we feel, we get our justice. There is no misunderstanding. Our bond as siblings are very tight because we don’t allow unfair treatment by our parents to create prolonged resentment between us. We just performed a debate and argued back and forth in the living room and said it outright and got it done! (Those who are watching our, ehem, ‘family conference’ and not used to us would think we are a bit too much to handle. hahah).

When I was 16 year old, my mother asked me to do a task that was supposed to be completed by my 9 year old youngest sister. So I said, “Tapi tu kerja Wani. Kenapa pula angah yang kena buat?”

“Ala, dia kecik lagi. Tak payahlah berkira dengan adik. Kesian dia”

And you know what I said, “Mak, kalau nak kira umur, sampai bila-bila pun dia akan kecik daripada angah. Dah dia memang lahir lambat daripada angah. Kak ngah pun pernah kecik dulu, tapi kak ngah buat ja kerja kak ngah.” I thought my logic was indisputable. I was so proud of my spontaneous argument which really consisted of ‘kalau nak ikut umur, sampai bila-bila ke nak kena ikut umur?. Hahaha. (and like I said before, you don’t get to me via vague argument or by using emotion such as ‘kesian adik’. You deal with me using logic. This is my pattern of thoughts since I was a child. And I have no problem saying it straight. When you deal with Afiza, you better make sure your argument is sound.)

Just like that, my mother did not say anything else. My youngest sister still had to do her task. And I was satisfied. Justice win!

So you see, ours is a democratic household. Everyone gets to have their say.

Never have I ever felt that “Sebab Kak Long paling tua, so aku kena ikut cakap dia.”

Never have I ever felt that “Sebab aku lagi tua, tiga lagi adik-adik bawah kena ikut cakap aku”

In fact, if I ever try to ask them to do what I say simply on the merit of me being older, they would probably laugh me out of the room. Because really, allowing unfair treatment simply because one is younger or older than you is a laughable concept!

It just doesn’t make sense, people!

We siblings can get very sarcastic if we are expected to follow what one of us said without any justification, “Who died and appoint you as our leader? Pffft!? Awat pula aku nak kena ikut cakap hang?”

We don’t play by any other rules other than sound argument and plain fair justice. And to me, that is the best formula for creating a good bond between all your children and between yourselves and your children.

When my own friend told me that her own parents favour her elder brother than herself, I told her to speak up. She told me, “Hang lain, Afiza. Bila hang kompelin, mak ayah hang layan.Tapi mak ayah aku tak layan pun aku kompelin. Kalau aku kompelin depa bagi duit lebih kat abang aku beli rokok la, minyak motor la, mewahkan dia macam-macam…. bapa aku akan cakap, ‘suka hati ayah nak bagi kat siapa pun. Ni duit ayah’. Lagi sakit hati aku dengar. So baik tak payah cakap.”

I see. So this is how learned helplessness develops.

My mouth swung open when I heard her telling me what her father said. Her father had no reasoning whatsoever and so irrational. Can you imagine yourself in the position of her father? When someone complain against you that you are not being fair, you give stupid answers of ‘suka hati aku.’  which does not address the issue at all. It is so stupid, isn’t it? How can someone that stupidly moronic raise such an intelligent daughter like my friend, I have no idea!

By the way, even if it is his money to do whatever he wishes, he still should not give the answer of ‘suka hati aku’. The answer hurts his other children tremendously because it shows such lackadaisical disregard to their feelings. Like they don’t matter at all to the father. But even more relevant is the fact that  there is a specific hadeeth about the adab of giving gifts to your children. This is not a general hedeeth that is subject to various interpretation. This hadeeth is VERY SPECIFIC to just such a situation. You must abide by this!

The Prophet (peace be on him) said, ‘Do justice among your sons,’ and repeated it thrice. (Reported by Muslim, Ahmad, and Abu Daoud)

The story behind this hadith is that the wife of Bashir bin Sa’d al-Ansari requested her husband to give a gift of a garden or a slave to her son, al-Nu’man bin Bashir. She asked Bashir to go to the Prophet (peace be upon him) and request him to be a witness. Bashir went to him, saying, “The daughter of such and such—meaning his wife—has asked me to give a slave to her son.” “Does he have brothers?” the Prophet (peace be upon him) asked. “Yes,” he replied. “Did you give the same to each of them?” inquired the Prophet (peace be upon him). “No,” said Bashir. The Prophet (peace be upon him) then said, “This is not correct, and I can never bear witness to other than what is just.” (Reported by Ibn Hibban in his Sahih.)

Some other hadith in this regard are as follows: Do not ask me to be a witness to injustice. Your children have the right of receiving equal treatment, as you have the right that they should honor you. (Reported by Abu Daoud) “Fear Allah and treat your children with equal justice.” (Reported by al-Bukhari and Muslim.)

Let me repeat. Fear Allah, and treat your children with equal justice.

Which means, treating your children with equal justice is directly associated with having fear of Allah. Associated with takwa itself! That is pretty heavy, guys! Whenever you are treating your children unjustly, it means you have no fear of Allah. That’s pretty serious, folks! So boleh suka hati kau lagi ke?

Dan aku tak hairan kenapa benda ni ada kaitan dengan takwa. Benda ni berat sebab just look at the effect it has on your kids if you are not fair! Look at how it affects relationships between your children and how the pattern of jealousy and resentment will continue even when you are already gone from this world! Look at how they feel so tortured that they might end up having personality disorders or affective disorders.

And remember, you are not only destroying the self-esteem of the child you neglect to be fair to. But you are also destroying the decency of your favourite child by spoiling him/her into a rotten, self-absorbed, irresponsible person who thinks he/she can get whatever he/she wants unfairly. You are destroying all your children when you favour one over the rest! Even the favoured one is not spared the side effects of your unjust conduct because he/she will grow up into a weak, despicable, entitled human being!

The favoured and unfavoured children are both your victims!

So, yes. There is no reason to wonder why being fair to all your children is associated with takwa! Because the effect is huge, people!

YOUR CHILDREN HAVE  THE RIGHTS FOR JUSTICE. Hak! Bukan suka hati kau! Hak! Faham tak maksud hak tu apa?

Regardless of age!

Regardless of gender!

Kau ingat kau sorang jer ada hak sebagai mak bapak? Anak kau tak ada hak?

Aku rasa semua anak-anak kena memorize and keep this hadeeth in their minds. Setiap kali mak ayah tak adil, keluarkan hadis ni sebagai reference. (Hahah. Terus mak ayah sentap)

And I am the sort who argue based on facts, so I keep this hadeeth in mind as one of my secret weapon that I can pull out anytime the situation arise. (Just in case my parents need me to say it to them. Haha. But so far, I never had to say it to them. Either I end up understanding why they do what they do, or they end up adjusting what they are inclined to do so that it becomes fairer to everyone.)

Of course, there are times when I still feel I was unfairly punished, but it was not as a result of inequality among siblings. Usually memang aku buat silap, dan aku kena punish dan aku rasa macam punishment tu unnecessary. Tu ja. Tapi kalau lima orang buat silap, lima-lima orang kenalah. Mana boleh sorang kena, sorang tak kena. That never happened. If it did, I would be the first to question it.

The most important thing is, you have to create an environment that would allow your children to feel comfortable voicing out and telling you when you are not being fair. Otherwise, they would keep quiet and suffer inside. Some suffer so much to the point of depression or having chronic low self-esteem.

And kau yang rugi! Kau tak ada anak-anak yang boleh ingatkan kau yang kau tak adil. Sebab kau tak create that sort of environment. Dan kalau kau rasa hidup kau lagi senang sebab anak-anak kau semua tak berani nak persoalkan kau, kau memang agak bodoh. Anak-anak macam inilah yang bantu kau untuk jadi orang yang lebih bertakwa. I think my parents are blessed for having me (haha, allow me to perasan kejap). I am the most vocal of all. My epithet in the family is ‘kak ngah singa’, denoting my fierceness.

But I point out to them, “Singa bukan saja garang. Singa juga berani. I take being called singa as a compliment,” I have no problem confronting issues. I might not like having to do it, but when push comes to shove… I shall push, shove and smack down! Hahah.

You can learn from kids. They are very honest about how they feel without bothering with diplomatic crap. But their honesty will be tarnished if you never respond properly to their honesty. If you never reward them with justice when they point out the obvious, they will soon behave with learned helplessness. “Cakap kat mak ayah pun tak guna. Mak ayah memang lagi sayang abang sulong/anak lelaki.”

Learned helplessness is one of the worst thing that can happen to anyone. You just give up and suffer. You have zero initiative and just accept whatever injustice that come your way.

Is that what you want your kids to become? Is that your legacy to your children? Would they always remember you as the parent who destroy their self-worth for all time? Is that how you would like to be remembered?

So parents, you better buck up and do it right!

Having Fun With Literary Translation!

Me and my siblings have Whatsapp Group  just for the five of us sisters (without the parents).

Sometimes, we talk of silly things. Sometimes we gossip about the parents (in the most lovingly exasperating way… or… exasperatingly loving way, of course).

As siblings, we are quite close. When some of my friends told me that they were not very close with their brothers and sisters, I could not relate to that. I cannot relate to distant relationship between siblings. I cannot relate how when I took family history from my patients, some patients said that they haven’t been in contact with their siblings for years and therefore did not know what their siblings are currently up to.

In my mind, I went, what the hell kind of relationship did you have growing up?

Me and my siblings have a lot in common, growing up. Because our parents brought us up with the same formula and tradition (even though my elder sister and I still think that our younger siblings had an easier time of it. hahah).

One of the traditional task we were subjected to as daughters of Azmee was translating. All five of us were trained in English and Malay through article translations. Everyday, my father would assign us one article in English to be translated into Malay. Every day! That daily task was the bane of our existence! I had homeworks to do some more! I had Kelas Mengaji Quran to go to!

I really hated the translation task!

Sometimes, while waiting for my turn to recite the Quran in front of the ustazah, I would use the free waiting time to complete my article translation. So, I  had to bring the thick Cambridge Dictionary to surau.

Translation was tough work, guys. Because it was not enough for me to just get the meaning of the English phrases, I had to preserve the beauty of the sayings in its original language as well.

My father often complained that while I got the meaning correctly, my Malay translation did not capture the beauty of the sentences.

For example if I want to translate:

“I care nothing for the poverty of her purse, so long as her heart overflows with affluence.”

My 11 year old brain probably could only come up with “Saya tidak kisah dengan kemiskinan dompetnya, asalkan hatinya melimpah dengan kekayaan,”  (ugly isn’t it? The original English sentence sounds better, less awkward, definitely beautiful!)

My father would then read my translation and would probably frown and say, “While the direct translation itself is correct, you do not preserve the beauty of it at all. How about “Saya tidak hirau akan kesempitan hidupnya, asalkan hatinya kaya dengan kebaikan “ Tu lebih okey.

“Tapi ayah…kenapa nak translate jadi ‘kesempitan’ hidup pula? Ayat yang dia guna adalah ‘poverty of her purse’. Bukannya ‘poverty of her life’. Purse tu kan dompet. Tu pasal angah tulis dompet. At least, angah tak tulis ‘beg duit’. hahah. Sedap juga apa!” I would be trying to defend myself that way. (I could get really defensive when I am criticized, you know. I have that much insight about myself.)

“Lagipun ayah cuba tengok…‘overflows with affluence’ tu memang melimpah dengan kekayaan maksud dia. Kalau nak translate macam yang ayah kata ‘kaya dengan kebaikan’…mungkin ‘overflows’ boleh translate sebagai ‘kaya’ instead of ‘melimpah’. Tapi ‘affluence’ tu bukan kebaikan.” I would go on and on to defend what I had written. 

My father would then try to explain “Tapi itu yang penulis nak cuba cakap, sebenarnya. Tengok konteks juga. Dia nak cakap yang dia tak kisah perempuan tu miskin sebab hati dia baik. Faham tak?”

 I would insist, “Tapi…bila angah translate ‘hatinya melimpah dengan kekayaan’, secara tidak langsung memanglah angah cakap dia baik, kan? Sebab hati yang kaya adalah hati yang baik. So sama ja maksud macam yang ayah nak. Cuma perkataan lain saja.”  (Aku memang suka menjawab. Sabar sajalah parents aku. Hahah)

My father wanted me to translate according to context (rather than just direct translation) and at the same time I was expected to modify the direct translation to the normal Malaysian way of phrasing it. While doing all that, I was also required to make it beautiful.

So, in my translations, I had to find the balance between meaning, context and beauty.It was NOT easy…for an eleven year old brain. 

I could spend almost 10 minutes just perfecting one sentence alone. Just ONE sentence. Usually, the article that was assigned by my father for me to translate contained a heck of a lot more than just one sentence. It was that difficult. I was in agony! Especially when I knew a fussy perfectionist was going to mark what I had translated.

By the time I was 12 years old, my father declared that I was competent already and I was no longer required to do the blasted translations. I was sooo relieved. Of course one of the reasons I was no longer required to do those translations was because he wanted me to focus on my UPSR that year. (Yes…I could read his mind. If there was no UPSR to face, I might still be stuck at translations. This is also a tradition. We all couldn’t reach 12 years old fast enough! Better to deal with UPSR than daily translations.)

So whenever we siblings got together during raya or long holidays, we would reminisce on our hectic-torturous-but-fun childhood growing up with our parents. We were thinking of passing down the traditions to our own kids.

“Mesti depa pun rasa terseksa nanti.” We broke into laughter of evil glee.

Looking back, it was childhood experience like this that bonded us. Because our parents were very strict, we bonded over the many ways we had broken the rules (and hide the evidence)


One day, I was going through quotes after quotes that I could include in my essay. (I write essays of my thoughts as a hobby, though I never published them here).

I had this beautiful quote that I had wanted to translate into Malay for a long time.

It was a quote by Francois de la Rochefoucauld:

“absence diminishes mediocre passions and increases great ones, as the wind extinguishes candles and fans fires”

Today, I tried translating it into Malay on my own:

“Ketiadaan seseorang menghapuskan terus cinta yang lemah, dan menghebatkan lagi cinta yang kuat, sebagaimana angin memadamkan lilin dan memarakkan api.”

(really…langsung tak sedap. The original English words are so much better. Why do beautiful phrases in English just sound so off…when translated.)

Slowly, the old childhood frustration resurfaced, as it always did whenever I couldn’t get my translation right.

But of course I could not allow myself to be frustrated alone. I posted the quote in the Siblings Whatsapp Group and challenged anyone to beat my own (not so beautiful) translation.

Me: Siapa boleh translate dalam BM bagi sedap, aku  akan acknowledge dia bijak sampai bila-bila. (ingat senang aku nak mengaku depa bijak. Hahah)

Izati: Acknowledgement ja ka? Bagilah hadiah. (yes….my mercenary, money hungry younger sister)

Me: Aku belanja. Coffee at Blackwood.

Kak Long: Aku nak join the contest.

Alida: Aku tunggu husband aku balik…dia cikgu BM.

Wani: aku akan fikir dan try jawab lepas habis kuliah. (my youngest sister was in class and whatsapping? Naughty, naughty girl!)

Me: Nih, cuba lawan apa yang aku dah translate: “Ketiadaan seeorang menghapuskan terus cinta yang lemah, dan menghebatkan lagi cinta yang kuat, sebagaimana angin memadamkan lilin dan memarakkan api.”

Kak Long: I think your translation is already nice. 

Izati: “Kehilangan seseorang memadamkan cinta yang pudar dan menyemarakkan cinta yang jitu sebagaimana ….(sambung balik ayat hang)”

Me: Jitu? Cinta yang jitu??? Hahahha.

Kak Long: Cinta yang jitu tak sedap. Cinta yang teguh laaa.

Me: Yes, I like ‘teguh’.

Izati: Okey…second try. “Kehilangan seseorang menghapuskan cinta yang pudar dan menyemarakkan cinta yang menyala, ibarat angin yang bisa memadamkan lilin dan menyemarakkan api.”

Me: Berapa kali hang nak guna perkataan ‘menyemarak’ dalam ayat yang sama? And one more thing…’absence’ bukan ‘kehilangan’. ‘Absence’ tu lebih kepada ‘not around’. Macam long distance relationship. Out of sight, out of mind, gittew!

Alida: Yes. ‘Kehilangan’ tu macam tak ada langsung dah. ‘Absence’ tu tak dak kejap ja.

Izati: Absence = ‘hilang for awhile’ pun boleh juga! Ayat kak ngah yang ‘ketiadaan’ tu lagi x sedap. At least, ‘kehilangan’ lagi sedap.

Me: Okey. Instead of ‘ketiadaan’ atau ‘kehilangan’….kita ganti dengan ‘berjauhan’. Berjauhan menghapuskan terus cinta yang lemah dan menghebatkan lagi cinta yang teguh, sebagaimana angin mematikan lilin dan memarakkan api.” Sedap kan?!

Izati: Maksud ‘absence’ bukan berjauhan! (Adik aku yang ni banyak cekadak sikit)

Me: Aarrrghhhh! Mana boleh direct translation. Konteks, meaning, beauty semua nak kena jaga. Berjauhan lagi sedap!

(see how we siblings can argue over words)

Suddenly, my youngest sister (Wani) came up with something out of this world (mungkin dia dah habis kuliah. haha)

Wani: “Kala berjauhan menjadikan cinta layu, ia juga memekarkan cinta menjadi teguh; sebegitulah angin yang memadamkan sumbu lilin, ia boleh merebakkan api.

Perrrrgghhhh!! I was speechless. Even though I think the meaning was not quite accurate, but she came up with it beautifully.


So at the end of the day, for the quote “absence diminishes mediocre passions and increases great ones, as the wind extinguishes candles and fans fires”….

I  shortlisted these three translations to choose from:

1)Berjauhan menghapuskan cinta yang lemah dan menghidupkan cinta yang teguh, sebagaimana angin mematikan lilin TETAPI memarakkan api. (This one is my translation. I think my style of translation is: ‘meaning and context over beauty’. I would compromise beauty for the sake of meaning and context.)

(you would notice that I used ‘tetapi’ memarakkan api. Even though, direct translation of ‘and fans fires’ adalah “DAN memarakkan api’. I just think that in the Malay language, ‘tetapi’ is more appropriate than ‘dan’.)

2)Berjauhan menghapuskan cinta yang lemah dan mengukuhkan cinta yang teguh, bak angin yang memadamkan sebatang lilin tetapi menyemarakkan api. (This is Alida’s translation. Like mine, her style is ‘meaning over beauty’. But she replaced my ‘menghidupkan cinta’ with ‘mengukuhkan cinta’, and used ‘bak’ instead of ‘sebagaimana’, used ‘memadamkan lilin’ instead of ‘mematikan lilin’ and added the word ‘sebatang’ to the lilin. Hahah.  Like me, she also used ‘tetapi’ instead of ‘dan’.)

(Don’t tell her, but I think her translation is better than mine. But then, she is a TESL teacher. Kira okeylah juga aku punya translation considering that I have left languages since medical school)

3)Kala berjauhan menjadikan cinta layu, ia juga memekarkan cinta menjadi teguh; sebegitulah angin yang memadamkan sumbu lilin, ia boleh merebakkan api.

(This is Wani’s translation. Her style, as you can see, emphasizes more on beauty than the actual meaning. Considering that she is the youngest among us, her translation ability is not too bad).

So readers, if you think translation is easy work, think again! Think of me when I was eleven years old! I wanted to cry!

Nowadays, as we have grown into our language, translating becomes relatively easy compared to before. But it is still a challenge if you are translating metaphorical, literary sentences instead of say…a newspaper article.

I have yet to make up my mind which one I would end up using for my essay. But my sisters have been a lot of help.

And we had fun.

So there you go. Arguing about language and usage of words are one of our top five favourite pastimes. This is how we have fun. Having fun the Azmee sisters style!


I leave you with another quote I would love to be able to beautifully translate into Malay. (I am still trying). This is the quote by Kahlil Gibran:

And ever has it been known that love knows not its own depth until the hour of separation. 

-Kahlil Gibran –

The quote is stunningly beautiful in its simplicity. It really is a simple quote. “Kita tak tahu betapa dalamnya perasaan sayang sampailah nak kena berpisah”. That’s the basic direct translation meaning, kan?

But try to translate it while capturing the essence of its beauty as well. What words would you like to add? What would you omit? Which would you replace? What interpretative privilege would you use as a translator in order  to translate this sentence into beautiful but simple Malay?

You may contribute your translations in the comment section if you wish. I will be very interested to read it.

Until next time. Ciao!

So This Is How It Feels

I was informed by my specialist that a patient who I saw one month ago had committed suicide at home. He killed himself by hanging.

I was shocked.

“Afiza yang last jumpa dia. Bulan lepas. Tapi sebelum tu ada banyak doktor lain lagi yang jumpa dia. Nasib baik Afiza ada tulis yang ‘patient denied suicidal ideation’.”

I felt terrible almost immediately. I have never lost a patient to suicide before. No patient on my regular follow up has ever committed suicide before.

Medical Officers don’t always see the same patient each time the patient comes for follow-ups. Patients are seen by any medical officers according to which medical officers are available, unless the patient specifically requests to see a specific medical officer. I have a few patients who will only see me but most of the time I see general patients who are not on follow-up with any specific doctor.

When my specialist told me the name of the patient, I just could not recall who he was and how he looked like. It made me feel even worse. He died and I could not even remember who he was.

I asked my staff to trace his OPD card.

Sure enough, that was the first and the last time I had ever seen the patient. I gave his next  appointment in one month time.

God, maybe I should have given him an earlier appointment date. (Regret number 1)

I looked at what I had written in the card, hoping it might help me to remember. But all I saw in my mind was a blank picture. (Regret Number 2)

I looked at what I had written in the card and I felt sick that all I had written were only five lines of documentation: (Regret Number 3)

-Symptoms improving

-Mood is much better

-Appetite still low

-Sleep requiring Stillnox

-Denied suicidal ideation

There are not many times that I feel like kicking myself. But this is one of those times. Ya Allah… Afiza, couldn’t you have written in greater details? My only saving grace is the fact that I had actually documented that the patient had no suicidal ideation, which only meant that I had asked about it.

But did I ask earnestly enough? Did I see his face when he denied having suicidal ideation? Or was I busy writing, rushing to call out another patient on a busy clinic day? Maybe if I was not in a rush, he might feel encouraged to say something that would  clue me in on his suicidal ideas. Maybe if I had watched his face carefully as he was denying the suicidal thoughts, I might have seen something.

A flicker of sadness in his eyes… maybe.

A sad, wry, self-deprecating smile… perhaps.

A finality to his demeanour…

Just something! Something that would prompt me to explore more, dig deeper.

The problem is, I couldn’t remember a damn thing! And that might be a good thing. If I feel THIS devastated for losing a patient I could not even remember, maybe I would feel a thousand times worse if I could actually remember the whole interaction. By not remembering, God spares me the regret I would feel if indeed I had done a sub-par job. 

On a busy clinic day, I might have spent 15 minutes talking to a patient. But I might only scribble a few lines of simplified documentation because I am in a rush to see the next patient. Or I might only see the patient for a few minutes and thus the documentation was brief. So the length of my documentation does not always reflect how much time I have spent exploring his issues.

The problem is I cannot recall anything, including how much time I have spent with him and whether or not I spent any minutes exploring his issues properly.

I went home on that day with a feeling of something deuced uncomfortable in my chest. Not exactly like sadness. But more like a heaviness…. that I associated with a feeling of regret.

If I feel this bad for losing a patient I have seen only once, I cannot imagine how shattering it would feel to lose a patient who is on your regular follow up. You couldn’t help feeling that you are responsible somehow. That you have missed something. Was it something you said? Was it something he said that you did not pick up? Was it just fate and happenstance? Or are you just a crappy doctor?

I packed my things and stayed with my parents that night. I need my mom’s comfort food. I need to see her face. I need to hear the sound of her voice telling me things that I already know. That I couldn’t have predicted these things. That  things happen. That there might never be anything different I could do that would change the outcome. That many psychiatrist have had patients who had committed suicide.

That I am not to blame.

Now, I know….this is how it feels. 

So I followed Julie Andrews famous advice in The Sound of Music: When the dog bites, when the bee stings and I am feeling sad. I simply remember my favourite things….and then I don’t feel so bad. (Don’t you just love how Julie Andrews and the kids look so adorable and happy in that song?)

So I did my favourite things.

I started writing in my blog,

And then, I lie on my bed at my parents’ house, reading my novel and start losing myself in the story. Getting drunk in someone else’s journey.

Thank God, for favourite things! It soothes the blow of this crappy feeling!

In Which My Sister Thinks That I Am Too Cranky To Be In Psychiatry!

“Hang ni garang gila. Macam singa. Entah-entah patient-patient lepas balik jumpa hang, lagi depa stressed.” Said my younger sister in one of our nowadays-rare-altercation. Yes, sisters show they love each other by insulting each other and having frequent verbal fights. That’s why women always win in verbal arguments. We practiced well, growing up. We don’t resort to physical fights like the boys. 

I laughed.

“Awat? Hang ingat semua psychiatrist kat dunia ni lemah lembut ke? Pfft…jauh panggang dari api!Ada yang langsung tak dengar patient nak cakap apa. Ada yang suka block apa yang patient cakap, main potong ja. Aku pula, kalau aku nak marah patient pun, aku kena dengar dulu apa dia nak kata. Sebab aku nak kena guna apa yang dia kata untuk generate my own rebuttal. Tu kalau aku nak marah balik la. Tapi kalau mood aku sabar hari tu, aku mendengar dengan tujuan untuk respond balik. So hang tak payah risau. Patient aku okey ja.”

To me, having proper interaction with patients is akin to being in a debate. Everyone must have their own turn to speak up. Systematic. Otherwise, siapa nak dengar, siapa nak jawab? And while listening to what the patient is saying, our mind must constantly analyze on what she is saying. Active listening! And when we reply to her later, we have to show her that we have listened and we have analyzed what she had said by using proper interviewing techniques. (Listen, analyze, respond/rebut. Just like in a debate)

We take our cues from patients. We used what patients say to respond to them. We reflect. We summarize. We paraphrase. We clarify. We confront. All these techniques are needed to discipline our mind to listen or at least to appear to be listening. Kalau kita tak dengar betul-betul, then apa kita nak cakap as a response kan?  Macam mana nak reflect? Macam mana nak paraphrase? Macam mana nak summarize…kalau kita tak dengar betul-betul. Macam mana nak bagi suggestion?Macam mana nak tanya follow-up question kalau kita tak dengar?Kalau kita just go through the motion without really analyzing what the patient is really saying,(passive listening) kita cuma boleh respond ala kadar sajalah. Tak jitu dan tak tepat. (Dan pesakit boleh sense benda ni. Diorang boleh sense bila kita distracted dan tak dengar betul-betul. Sebab kita punya respond tu macam tak betul-betul address what they have just talked about.)

And of course bila ada pesakit atau PAP yang tak reasonable, aku nak kena dengar juga apa depa cakap supaya aku boleh balas balik and show to them that they are being unreasonable. Lepas tu aku nak kena dokumen apa depa cakap dan kenapa aku reject apa yang depa nak. So really, there is a lot of benefits that come from being a good listener.

Above any other interviewing techniques, I think developing the ability to listen and to listen well is the most important of all. Because if you can’t do this, then the rest of the other techniques don’t matter anymore. You won’t be able to use them effectively if you don’t listen. 

So I told my sister, “Don’t worry, all my patients get what they deserve with me – incuding my garang-ness. I have listened to them. I have analyzed what they said. I gave them my replies according to what I believe they need. Whether or not they end up being more stressed….well, only God knows.”

“Look at you. They must be stressed,” My sister reiterated.

“I think you should worry more about your students. Hang pun garang juga. Kalau ada anak murid hang mai kat aku for school refusal, I know their fear is warranted.”

“Eh, budak-budak suka kat Teacher Alida, okay,” (Yeah, she is so ‘perasan’. I don’t know which part of my parents’ gene she inherits.)

“Ceh! No big deal. Patients pun suka kat aku juga!” (Yeah….forgive my conceit and my own ‘perasan-ness’. I couldn’t possibly let her win. Hahah)Aku ni…. garang dengan hangpa ja. Dengan hangpa, tak kuasa aku nak control-control.” I added.

Because no matter how annoying I am, my sisters have no choice but to love me anyway. So with them, I have the freedom to unleash all that pent-up emotions in all its terrifying glory. Blood is thicker than water and all that. Hahah. And just like they tolerate my annoying habits, I also have had to tolerate their annoying habits, okay? All of us at least have the comfort of behaving exactly as we are, without bothering to cover up our less than attractive attributes, because we know at the end of the day our siblings have no choice but to keep their affection for us intact. 

Of course I will vomit first before I ever admit that love has anything to do with it. Siblings argue. That’s what we do. Don’t destroy that beautiful relationship by mentioning anything as ordinary and mundane as love.