O Companion Most High

O Companion Most High

O Companion Most High,
As his head rested on his wife's thigh,
As his face perspired his exhaustion,
He softly whispered "With The Highest Companion"
And thus he left the world in grieving,
Void of his presence we've been missing.

O Companion Most High,
Your beloved once recited a narration,
"No prophet dies till he is shown,
His place in heaven with an option,
whether to live or to die"
So as he rested on his wife's thigh,
And as he chose "O Allah, The Highest Companion"
He made the world all over grieve,
Void of his presence we sorely miss.

O Companion Most High,
As Your beloved's precious final breath
Rise to heaven, mixed in the air,
He left us forever with The Greatest Miracle,
Messages of beauty without rival,
Of true words and faithful revelation,
To tide us over till the day of judgement,
When we too shall meet The Highest Companion.

O Companion Most High,
In my dream on the mighty throne You reside,
The mercy of Your love rise high,
The sword of Your justice drawing nigh,
I feel scared but I remember what You said,
I'd read it many times and it made me cry,
"O serene soul,
Return to Your Lord, well-pleased and pleasing,
And enter among my servants,
And enter My paradise," 
And in that dream, those words were uttered,
In my general direction as I entered,
Into the light of Your Grace and Mercy
Of untold happiness, zero misery, 
For the rest of my life, for eternity.

-Afiza Azmee-
 02/06/17

***

Okay, I haven’t written poetry for a longgg time. And that is because I also have not read poetry for a longggg time too. There is a connection between what I read and what I write. One inspires the other in a complicated two-way  direction I have always found very amusing.

So my effort above is a bit rusty. But you’ve got to push yourself and start somewhere, right? I can feel my literary skill becoming as dull as the rear of a knife. LOL. So I need to sharpen it because I was told that ‘belakang parang jika diasah lagikan tajam’ and so on and so forth. Haha.

But these days, I have been inspired to write poetry again. A few things happened to me these past few weeks that made me feel like I have to pause, take a breather and just read and write. These things that happened are listed as below:

1) I found Miss A again

I finally found and connected with Miss A again on facebook. Two weeks ago I found her. After all these years!! She was my good friend and my roommate in MRSM Langkawi. When I befriended her, she upgraded my reading from childish ‘picisan’ Sweet Valley/R.L Stine/Christopher Pike books to great classic literatures that improved my language very significantly. I owed her a lot! She was the reason I started writing poetry as a 16 year old. To be honest, I have always been more at ease with essays or short stories or novels than poetries. (You have to be patient in reading poetries because the meanings to the words are not immediately apparent upon reading. And to ACTUALLY compose them… that is a saga of headaches in itself and a practice of dealing with frustration.)  But because I wanted to compete with Miss A (haha! Silly teenager me!) so I took up poetry… and ah… I was never that good at it. Of course, she is better than me! Her literary prowess is as sharp as a point of a sword. Effortless she made it looked to me, who was completely clueless about poetry-writing at that time! Fortunately, she was pretty encouraging of my pitiful effort to compete with her.

So, meeting her again on facebook kind of inspired me to do this again! Miss A is currently in her first year of Master of Surgery. Miss A had found me first and she was the one who added me on Facebook. Needless to say, I was exhilarated when I saw her profile. She is married to a Turkish man (and that is why I haven’t been able to find her all  these years! She has been using her husband’s surname on facebook!) and her son is so cute and adorable! Miss A is one of those people who are good in BOTH the sciences and the arts. She will be a great competent surgeon with a soul of a poet, I believe.  She kind of reminds me of my elder sister; a statistician with a mathematical brain but a soul of a novelist. Maybe that’s why we clicked almost immediately.

You know, I have come to actually know that there might be some transcendent, metaphysical reason why some people are drawn to each other and click almost immediately even though initially, they don’t know each other all that much. I have experienced it only VERY FEW times… but I cannot deny the phenomena. Below is an authentic hadeeth that might explain the phenomena. But bear in mind, that there are many possible interpretive explanation to this hadeeth. Go and search them yourself. It is fun to learn things like this once in a while.

The Prophet (pbuh) said: “The souls are (like) an army joined (in the world of spirits) whichever souls knew each other (in that world) are attracted towards each other (in this world) and whichever remained distant and indifferent (there) are disinterested to each other (in this world)” (Saheeh al-Bukhaari, Kitaab Ahaadeeth al-Anbiyaa’, Baab al-Arwaah junood mujannadah).

See? I think that hadeeth really explains some of the immediate connections that we occasionally have with certain people. And that hadeeth is AUTHENTIC, you know!

I usually don’t click with people immediately. I took a lot of time to warm up to people. But once I do, it is usually genuine (unless for the sake of politeness, I am somehow expected to fake it, but that is another story. haha) But Miss A was one of the few who I hit it off immediately…perhaps because we started our initial acquaintance talking about books. But then, I have also met people who talked to me about books but I still couldn’t connect with. (So, I think just talking about books with me doesn’t ensure immediate connection. Maybe something in our souls knew each other previously… just like what the hadeeth said. Similar souls recognize each other in this world and all that. I find this concept very interesting.) 

2) I feel burn out (for the second time in my life after housemanship)

I need to write again to recharge. We have lack of MOs in our department these days. So unfortunately, our annual leaves were temporarily frozen. And whenever I actually do have some free time, I have to study. So I stopped reading fictions as much as I used to. I used to read fiction everyday, you know. Continuously even! If people have chain-smoking habit, I have chain-reading habit. Hahah. I finished one book, after another, after another and another! Now, that habit has stopped. It was forcefully stopped too. So, you see, I don’t get as much inspiration to write when I don’t read. And that is to me, like experiencing anhedonia. Writer’s block is just not fun! So, even though today is Friday and it is weekend and I am supposed to study, I decided to take a breather, and take the  time to read something else no matter how guilty I feel about not studying.

3) Inspiring Seerah In The Month of Ramadan

Because this is the month of Ramadan, I have been reading and listening to seerah (because seerah are historical stories. And I love stories, you guys know that). I read again the story of my favourite superhero, Umar Al-Khattab R.A. And I read again about the many victorious wars that our Muslim forefathers had won in the month of Ramadan, making Ramadan literally the month of victory for us. And I also came across the story of the the Prophet Muhammad’s (pbuh) last moment in this world.

Screenshot 2017-06-02 10.45.08

And in my poetry, I coupled that story with one of my favourite verses from the Quran, surah Al-Fajr verses 27-30.  Personally, I find the Malay translation of this verse more beautiful than the English ones, but BOTH cannot beat the rhyme and rhythm in the original Arabic language. It came out so beautifully when you recited them in Arabic. The words in Arabic, because of their rhymes and rhythm, are therapeutic, I feel.

Try reciting them yourself. It gives you immediate optimism.

al-fajr-89-27-30-jiwa2-tenang

So I leave you guys with that real motivation booster.

And have a blessed Ramadhan, dear readers. I feel more recharged now just by channeling my creativity into composing the above poetry.

Until next time, insya Allah.

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
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
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.

51CC2jfysbL._SX323_BO1,204,203,200_

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?

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!

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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.

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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.

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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. 🙂

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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.

trait-theory

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.

joseph-eddison

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.

harmony

Intense Alhamdulillah

We say Alhamdulillah so frequently in our daily life that sometimes we don’t even realize what we should really be feeling while we are saying the word. We eat, we burp and we say Alhamdulillah. We sneeze, we say Alhamdulillah. We say Alhamdulillah when people asked us how we are doing.

But are we really feeling grateful to Allah while we are saying it? Or has it become part of our reflex response to everything mundane that we do?

The utterance of Alhamdulillah from someone who has gone without food for the past few days is different from us whose previous meal was only a few hours ago. The feeling of gratitude is immense and overwhelming when Allah finally gives you THAT VERY THING that you want so wretchedly badly that your heart constantly prays for it and at the back of your mind, you are always thinking about finally having it.

And you know that no one can make it happen except The Glorious Almighty.

I have mentioned before that I believe in the sunnahtullah of berusaha. But I also know that there is fate and qada and qadar. I have always known that ‘berusaha’ only qualifies you to be in the race. But whether or not you will win is something that can only be determined by God. Ultimately, God grants you what you work for. You don’t even get to paradise by your own effort. You get to Paradise by the grace and mercy of Allah.

Our Prophet (PBUH) points out this truth as follows:

The Prophet (pbuh) said: “No one of you will enter Paradise by his deeds alone.” They asked, “Not even you, O Messenger of Allah?” He said, “Not even me, unless Allah covers me with His Grace and Mercy” (Bukhari, Riqaq, 18; Muslim, Munafiq, 71-73).

Our deeds and our worship would not even repay Allah for the gift of a pair of eyes, let alone for the usage of the rest of our senses and our many blessings in life.

Alhamdulillah, my dear readers. I passed my Part A MRCPsych exam.

Alhamdulillah. One step forward to becoming a specialist in the field that I love.

Alhamdulillah for this happiness.

And my Alhamdulillah this time feels way more overwhelming than what I feel after my usual meal. (Haha. Not that I think a meal is not just as important as passing an exam. I mean, if survival is the main aim, food is so much more important than whether or not we pass ANY exam, right?)

This particular Alhamdulillah is intense stuff. Serious stuff, folks! After more than 2 months of excruciating wait, FINALLY Allah allows me a beautiful rest. Alhamdulillah.

And this success feels even sweeter because my good friend and colleague, Dr. T, passed too. We were overjoyed when we found out that we passed from our friend, a Master student in UKM who had checked our results even earlier than us. At that time, Dr. T was busy oncall so she did not have the opportunity to check her result straightaway. As for myself, I was driving back to Alor Star, bringing my staff nurses and PPKs home from our fun kayak trip in Baling. Me and Dr. T knew the result would come out around 8.30 pm on the 17th of February (it is morning, UK time) but we just didn’t have the opportunity to get to it straightaway.

When our friend congratulated both of us (in our own Whatsapp Group created only for the three of us) I was afraid that she had somehow misled me. I needed to see it for myself. Haha. So, I told my staff that I needed more time with my phone even though all of them were already in the car and eager to resume our journey home after the short break in Gurun.

When I finally see it… MY NAME! on the list of those who have passed (or rather, my father’s name, since that is my surname, Haha) I wanted to jump with joy. So, unofficially, my staff nurses and my PPKs who were in the car with me were the first people in my department to know about my passing the exam (other than Dr. T and our  mutual good friend who had congratulated us). I told my staff nurses and my PPKs not to tell anyone in the department first, because I have very specific people I want to have the honour of being OFFICIALLY informed first.

Such as my family.

I whatsapp my parents straightaway because I couldn’t wait until I got home to do it properly. Haha.

And my siblings were like “Okay, esok Angah kena belanja makan!” Hahah. My younger sister, Alida, has been saying “Kak Ngah memang suka buat drama. Hari dia balik exam, muka monyok macam apa. Cakap konon susahlah. Exaggerate la tu. Sebenarnya dia saja kata susah, supaya kalau dia pass, dia boleh cakap kata dia terer.” I laughed out loud. (That’s NOT TRUE, guys! To me, it was the hardest exam of my life. Only about 50% of our candidates actually passed. Out of 661 candidates all over the world, only 346 passed Part A. I have told my siblings, if I pass, it must be because I was somehow triggered to choose the BEST answer. Because correct answers were in the options, but BEST answer is the one they want. It was confusing as hell!)

I had officially informed my dearest best friend too, Dr. F, who has just passed her Master exam Part 1 last December and we are planning to celebrate our mutual happiness once she is back from KL.

The next day (well, this morning), I sent a text to my ex-HOD, Dato’ R, to tell him that Dr. T and I have passed our Part A. I think he deserved to know first because he was the one who had granted us our one month unrecorded leave to allow us to focus on our exam. (I end up using my own annual leaves due to some really annoying administrative stuff. But his intention to grant us such generous unrecorded leaves was clear from the start and Dr. T and I really appreciate his gesture from the bottom of our hearts. In some centers, they won’t even let you get straight study time even if you are using your own annual leaves. So, I am very grateful to Dato’ R.)

And then,you, my dear readers! Officially, after my family, my best friend and my ex-HOD, you guys are the ones I officially inform regarding my beautiful blessing. My happiness is too big for me to hug it all to myself. I am JUST over the moon.

***

I am very blessed for having such a supportive people around me. My family is my pillar of strength. My parents never stop praying for me. They take academic performance seriously and they always push us to continue our studies. When I achieve anything, the first person I want to inform it to will always be my mother. Then, my father and the rest of my siblings.

They give me what I need to put in a good fight and a good effort. As much as I appreciate wishes of good luck and emotional support, I don’t really need it that much (especially the copy-pasted good luck spamming via Whatsapp that people tend to do these days). I mean, by fitrah, Allah gifted me with the ability to self-motivate. Alhamdulillah.

I appreciate practical assistance and practical help rather than just meaningless wishes of ‘good luck, Afiza. Mesti hang boleh buat.’ Hahah. I mean, that is of course very nice of them to say that. But at the end of the day, I can say that to myself too, right?

I appreciate practical assistance to help me with my effort. I don’t need you to teach me or to study with me or to supervise me. Because I can do that for myself. I can study myself and to be honest, I study best by myself. (I am not trying to sound arrogant here. I just know myself and my style of studying after years and years of non-stop exams. INTPs in general don’t want anything that curb their freedom to do what they think is best and supervision is one of the thing they don’t really like. They are more likely to disagree with their supervisors and would resent having to follow what their supervisors say. Hahha)

Give me the tool that I need, and I will appreciate you so much more than if you just give me words of encouragement. For example, my parents support my effort by sponsoring my flight ticket and my hotel room. Money is practical stuff. (Hahah! Take note that I pay my own exam fees. I could have paid my own ticket and my own hotel room, but my parents insisted to pay for my flight and my hotel. So what is a daughter to do but to accept? Haha)

Doa is also practical stuff. My mother especially never stops praying for me. It so happened that my parents’s annual umrah is always in November. My parents just got back from Makkah one week before I was due for my exam and they told me that they prayed the hardest for me. So when I was sitting for my exam, I was accompanied by a fresh doa out of Makkah!! I believe that doa is powerful stuff.

I appreciate past years papers or notes too. Those are really practical stuff I can actually make use of!

The reason I appreciate Dato R so much is because he too had given me the practical assistance that I really, really, really REALLY NEED to help me with my effort. In order to put up a good effort, I need TIME! Time and space to focus and do my thing! And he gave it to me. I don’t think I have ever properly thanked him for it. (Because even though I am a psychiatry MO, I am just not so good at expressing my own feelings, especially face-to-face. Tender feelings such as fondness and gratitude… I stumble whenever I want to say things like that. I am just VERY good at expressing disdain and contempt at those who annoy me. That’s a bad, bad trait, I know. I am nicer now, though. Ehem, I think.)

I am not saying that when you guys are wishing me good luck and all the best, I don’t appreciate it AT ALL. I do appreciate them, especially personal messages of good wishes that are not copy-pasted over and over again in the Whatsapp Group. Very nice of you to take the time to think of me and type up your personal wish properly to let me know that you want me to succeed. I am just saying that I appreciate practical assistance THE MOST. (because Alhamdulillah, I have enough motivation and encouragement for myself within my own self)

My friend told me that I am a hard-to-impress person. Mengayat, memujuk, memang tak jalan… habis air liur pun tak hairan! Hahah. It’s true. Because words will never be enough to impress me. I know very well how words can be said without meaning it. Maybe because I read and write so much (almost all my life, minus the first five years of my childhood when I was not yet able to read) that I have become an expert in how words can be manipulated, twisted, bent over, rhymed together, and punned… so that I can clinically and objectively appreciate your ability to use your words to be nice or romantic or diplomatic, but that will never be enough for me. Subjectively, intuitively…. I will never be won over by words ALONE.

I need pure, sincere intention as well. And that can only be determined by your actions. To me, Dato R has shown his INTENTIONAL support for me to succeed in my exam by his ACTION of allowing me a one-month leave to focus on my study, just like what he had given to all other master MOs in the past. He WANTED us to succeed. He had proven his intention by his action. (Even definisi iman adalah percaya dalam hati, ucap dengan kata-kata dan amalkan dengan perbuatan. Ucap saja tak cukup, kan? Aku pun boleh ucap apa saja!)

And I am so GLAD that me and Dr. T have been able to show him that we used that one-month time properly. That we did not abuse his trust. What he gave us, we were able to make use of. Alhamdulillah.

Alhamdulillah for everything!

My Mother’s Epiphany

My patient came to me recently, with a tinge of happiness in her voice, as she said, “I did as you said, doctor. I am finally free. I am so happy now.”

I swallowed. “What did you do?” I waited with bated breath. 

“I’ve left my husband. I gave him 3 years but he never changed. I am done with that useless man”

“Are you doing this for you? Are you doing this because this is really the right thing to do, FOR YOU? Or did you leave the man because you simply wanted to follow what I said when you asked me what I would do if I were you?”

“I have always known you were right. I just didn’t have the courage to do what I have to do. Your words gave me the right push to make that move.”

She is an educated lady of nearly 60 years of age and thus our whole conversation was in English. She is one of my favourite patients. 

I do have favourite patients, you know. I can’t help it. I treat all my patients the same – that is, I give them what they need. But with some patients,  consultations with them feel more stimulating than usual because they themselves are psychological minded and they ‘get’ what you are trying to say. These people usually have the capacity for self-reflection, self-examination, introspection and personal insight. When you ask them a question (which is meant to get them to think for the answers themselves, even though you already knew the answer) they give a delightfully honest answer that helps you to help them. I like these kind of patients.

This particular patient, let’s call her Mrs H, is a well-off lady. She has her own pension and has invested in a few lands as an asset. She has her own house in KL prior to coming to Alor Star. She plays the piano as a hobby, and she already has a grown-up son from her previous marriage. Unfortunately, when she first came to me in 2013, she had just recently remarried to a 70 year old Kedahan man, for whom she had left her KL hometown. She was stressed by that marriage. She felt cheated, used and taken advantage of by her new husband and his family. She was in the clinic crying her eyes out because she felt like she had made a huge mistake.

Even though at that time, I wanted to tell her that “yup, you probably did make a huge mistake” but I refrain myself (of course). You see, therapists in general TRY not to impose their own opinion on their patients. It is okay if you cannot help having judgmental thoughts, but you should not APPEAR to be judgmental. You MUST preserve the illusion that you are always on the side of the patient. The patient should always feel safe to confide in you about anything… and they would only feel that way if you give off the vibe of being understanding and non-judgmental. But human beings, as a species, are active thinking beings! Judgment and thinking are what make us so special. I would be LYING if I say I don’t judge what my patients do. Part of the evaluation process HAS to be judgmental. If you don’t judge, you can’t diagnose. If you can’t diagnose, you can’t treat.

If you go back to the psychoanalytic era when Freud and his followers reigned supreme… they could make snap judgment about others without any evidence whatsoever and they called it psychoanalysis. Hahha. Those were the DARK AGES of psychiatry, in my opinion.

So to be clear, I am a judging, thinking being. (Believe me, ALL OF US are. I am just more upfront and honest about it). But I just don’t have to tell my patients about what sort of judgment I come up with, that’s all. Instead, I store that judgment in my head and use it to treat the patient. I use my judgment to help them.

Some patients have zero insight about their marital problems.

“Saya tunggu dia nak berubah. Saya okay ja. At least, mak mertua saya baik. Suami saya pun kadang-kadang baik.”

“Apa contoh kebaikan yang puan dapat dengan dia? Tadi puan kata, dia tak cukup duit, kahwin sampai tiga. Siap perabih duit puan nak tanggung isteri ketiga.  Kereta dia pun puan bayar. Kalau puan rasa dia baik,  puan report kat saya benda-benda yang tak baik saja saya dengar selama ni. Apa kata puan habaq apa yang dia baik pula hari ni?” Nice, soft tone was used to mask the biting sarcasm. (So, dear readers, please reverse and read again my dialogue in a softer inquiring tone. Haha)

Some patients have good insight about their marital problems.

“Doktor, saya memang tak tahan dah dengan suami saya. Saya memang nak bercerai. Ni lawyer suruh mai psikiatri, sebagai bukti yang saya trauma dengan perangai suami saya. Senang ada surat doktor kalau pi mahkamah nanti. So saya mai lah.” This patient is direct, honest, and knows exactly what she wants. I like these sort of patients too. But…

“Baguslah puan dah ambil keputusan yang tegas dalam hal ni. Cuma saya tak bolehlah nak buat-buat puan ada kemurungan kalau puan tak murung.” I am also direct and honest. I like direct and honest patients because I reciprocate and mirror their own style, which is really my default style, anyway.

Some patients know what to do already, but they couldn’t commit to any action because they are afraid of the unknown.

“Saya tak mau orang mengata. Saya tak mau jadi janda kali kedua.”

Mrs. H belong in this category – fear of the unknown made her stay on until one day she couldn’t take it anymore. And neither could I.

So, it took her 4 years (2013-2016) to ask me “What would you do, if you were in my place?”

I was very upfront about it. “It is not my place to tell you what to do. After all, it is YOUR marriage and you are the one who have to live your life. Not me. But since you asked me about what I would do if I were you….well, I would leave him. But then, you have to understand that we make decisions based on specific context and our own natural inclination, and our own personality. My personality and my personal inclination is such that I can never love someone I cannot trust; and I can never trust someone I cannot respect; and I can never respect someone who cannot fulfil his responsibilities. I am very strict about these things. If I have a husband such as yours, I would have left him a long time ago. Of course, some women have such a huge capacity for love that she can continue to love just anyone regardless of whether or not she can trust and respect  that person… so if she’s okay with that, who am I to insist otherwise?” I paused, allowing her to digest what I really meant.  “At the end of the day, we live with the decisions we have made. I don’t mind to continue seeing you, because trust me, medication cannot cure you. Your husband is the perpetuating factor to your depression.”

She is an intelligent woman, dear readers. She knew that I also had had enough. She knew that my “some women have such a huge capacity for love” is an euphemism for “misplaced loyalty”.

I have mentioned before that it is not enough that we do what we like. We have to learn to like the right thing. For example, I have to learn to like literature. Haha. And I end up liking it.

Love and loyalty is also like that. Learn to love and be loyal to the right person. The person you can respect and trust.

So when one day she finally said, “I am finally free, doctor,” it truly made my day. It took her four years of suffering before she would commit to a decision. And that was only because she had asked me personally about what I would do, and I was impatient enough to actually give it to her. Who knows what would happen had she asked the question sooner.

Some psychiatrists would probably say that I am unduly influencing my patients.

Well, to be honest, we all influence patients in variable ways and extent.

I don’t like to stick to only one blanket way of dealing with patients. I would use different approaches for different kinds of patients.

As a doctor (and especially in psychiatry), we learn that there are a few models of doctor-patient interaction, namely:

The Paternalistic model: It is assumed that the doctor knows best and the patient is expected to follow the doctor’s decision. Usually this approach is desirable in emergency situations. However, this approach may result in clash of values.

The Informative model: The doctor is seen as a dispenser of information. The choice is left wholly up to the patient. May be useful in one-off consultations, but may not work well if strictly followed on long-term professional relationship.

The Interpretive Model: Here, the doctor will be treating the patient for a long time and might know his/her patient well and understand the circumstances of their micro- environment. Here, shared decision-making is established.

Deliberative Model: The doctor here may act as a friend or counselor to the patient, where information dispensing is coupled with advice on a course of action. This is commonly used to enable lifestyle modification and to address maladaptive coping.

Some doctors like to use only one approach regardless of what type of patients they are dealing with. Maybe they like that particular style and think it is the best interaction style with every patient. For example, some prefer the informative model because they think it is the most neutral and would suit most people. Maybe they don’t know the patient enough and therefore doesn’t want to feel responsible should something bad happens as a result of the patient following their advice.

I don’t know. To me, in each specific case, whatever model of doctor-patient interaction that we use, it actually reflects on our own conviction or our own insecurities about that particular case.

We learn from experience and we would know what approach to use for each of our own patient. Paternalistic style won’t work well with manic patients, for example. It would only make them more irritable towards you and you would then lose the patient.

I would use the informative model for someone who is educated, and like to make her own decision, especially if I don’t know this patient all that well (other than that she is educated and has good judgment skills). I would NEVER use this informative model for someone with low education level. I wouldn’t want to take a chance of her making the wrong choice as a result of her disadvantaged background. This model requires that the person on the receiving end can make sound judgment based on the information that doctors have given. This is not the case in patients with low education attainment.  

With Mrs. H, I have known her for 4 years. She is educated, and yes, I could stick with the informative model if I chose. But I know her case inside and out. I know her micro-environment. So, I think I am still within my professional boundaries if I use the Interpretive Model and Deliberative Model with her, especially when she had specifically asked me about what I would do if I were in her place. (To be honest, interpretive model is my preference, most of the time. Followed very closely by deliberative model. If I just want to be informative, I could just ask the patient to read a lot and google, right? Pfft. A doctor is more than that.)

She asked me a question. I gave her the answer.

Whether or not she would follow my advice, was totally out of my hands.

***

When I was in my early 20s, my mother imparted to me a piece of her wisdom when she said, “Older women and older men are not the same. Older men benefit more when they remarry after having lost their wives. But older women would lose a great deal if they remarry after having lost a husband. If anything happens to your father, I will never remarry.” She declared, confidently.

She came up with that epiphany after listening to the woes of her friend who was in the situation of suffering after remarrying at a very mature age of 50. It was not unlike the situation that Mrs. H herself was in when she remarried at the age of 60 in 2013.

At that time, I thought my mother was being loyal when she said she would never remarry. But actually, she was just being smart. She was right. There is very little benefit in remarrying when you are already old.

All the benefits are on the elderly man’s side – they get a free maid and a free nurse, all combined in one person. In fact, sometimes they even get a free financial provider if the women they marry are richer than them. 

Mrs H could have enjoyed her own money and her own freedom had she remained single at that age of 60. She has the company of her friends from surau and the care of her own son.  She could have been far more well off than she currently is if she did not remarry a man who was older than she was (and therefore, couldn’t even work or provide for her financially because he was too elderly). Had she remained single, she wouldn’t be expected to do any housework or housechores if she didn’t want to. She didn’t have to cook or clean or look after another person when she herself was at the age of 60. Her son wouldn’t come to resent her because she had to obey her new husband and hurt the feelings of her only son. She wouldn’t have to play the role of a breadwinner to an elderly husband when she herself was not that young.   

But…unfortunately… she had remarried.

Her pension, which should have been enough for herself, was no longer adequate. So she had to work, selling sandwiches, because her husband was no longer fit to work. Her husband’s children expected HER to care for THEIR father just because their father had married her.

This is the problem with our society!

The elderly man who had lost his wife wants to marry again. And their children also prefer their elderly father to marry again…so that they won’t have to be the ones who have to care for their own father and their father doesn’t have to live with them, disturbing the dynamic in their own household.

BUT, they don’t provide their father the money that is required for their father to be a husband again. So the new wife suffers! The household money would not be enough. In the case of Mrs H, the husband’s children often scolded her when she asked them for money. Such nerve! Such audacity!

Don’t get me wrong. I am not giving a blanket statement that elderly people shouldn’t get married. I am questioning the fact that some responsibilities might not be met with such marriage. (so, if you can fulfil your responsibilities, go ahead and marry even if you are already at 100 year old of age)

My own grandfather had remarried at the age of 72 to a 40 year old woman. That means, my  new step-grandmother is younger than my own father!  My grandfather remarried NOT because my father refused to care for him, but it was because my grandfather preferred to marry. I remembered feeling so perplexed that my grandfather at the age of 72 STILL wanted to marry another woman. It was all done within 6 months after my grandmother died. It just boggled my mind at that time. I didn’t say anything to my grandpa about what I felt. To be honest, I was really disappointed because I had expected that my grandfather would live with us.

I did NOT expect that he would remarry! My grandpa should have looked forward to playing with his great-grandchildren instead of playing house with another woman. I felt quite personal about the whole thing.(well, but to be fair, my sister was not yet pregnant at that time and there was no great grandchildren around to play with, yet.)

But since my grandfather just wanted to marry no matter what, my father had asked around for anyone who wanted to marry his 72 year old father. We NEVER thought it would ever come to anything. I mean, WHO would marry such an elderly man, right?  But miracles happened. Can you believe it?  A 40 year old woman agreed to the marriage. I was flummoxed by the development. My grandfather remarried when I came back from Australia at the end of my 2nd year in med school. (At least, he waited for me to come home before he tied the knot). I was by his side when he pronounced the akad. I had accepted (reluctantly) that it was his decision to marry and maintain his own household.

My father increased the monthly allowance that he gave to my grandfather so that my grandfather could provide for his wife. A small house was bought where they could live together, so that my grandfather didn’t have to pay the rent. My step-grandmother is a full time housewife and DOES NOT have to work to support my elderly grandfather. My parents were in charge of all my grandfather’s appointments with doctors and did not simply leave the care of my grandfather to his new wife.

Mrs. H was not as lucky as my step grandmother. Mrs. H was the financial provider, the carer and the maid, all in one. (It’s like being a mother to a big toddler, ain’t it?)And on top of that, her 20 year old son who is still a student resented her marriage and did not get along with her new husband. If I were the son, I would resent the whole situation too. Here’s an elderly man taking advantage of his mother! If his mother disobeyed this elderly man, the religious line “I am your husband. You must obey me,” would be flung around. Isn’t it ironic when a dayus husband insisted to be obeyed? It’s a trick designed to make the wife feels guilty, in order to deflect his own inadequacies. His mother was better off not marrying that man. When she married him, her life deteriorated right before her son’s eyes. It violates all sorts of social-exchange theory I have learned. In this marriage, the risk-benefits assessment skews in GREAT favour for the elderly man and a HUGE disadvantage for Mrs.H. 

I couldn’t bear it if I were the son. I would probably perform some serious rebellion and would say “You have to choose between your son or your husband.”. (Hahah. I am a dramatic diva like that.)

But here lies the problem. Talak is NOT in the woman’s hands.

That’s why when an elderly man remarries, his children don’t feel that they have lost their father as much. In fact, they would feel like they have gained a free carer for their father. A man holds all the executive decision making. So, his children won’t feel that they have lost their father so completely. If they want, they could influence their father to make any decision that would favour them against their step-mother and the father would say, “Okay, I have made my decision. My children were right. I am your husband, so you must follow me.”

But when an elderly woman remarries, the children would feel the lost acutely. Now THEIR MOTHER who they have known their whole lives is the new wife of a complete stranger. The happiness of their mother lies in the hand of someone they are not sure they can trust. And this stranger holds the power on their mother. Even if the children could influence their mother for a specific decision, what can the mother do if her new husband disagrees? Even if eventually their mother wants to be free from the marriage, talak was not even in her hands.

So a mother remarrying would be taken as a loss for her children, because like Mrs H, now her whole life and energy revolves around the new husband… as a breadwinner, a maid, a nurse! What’s left of herself for her children?

The bottom line is: The elderly man’s life becomes easy when he remarries. The elderly woman’s life becomes harder when she remarries.

And therefore my mother was right to decide never to remarry should anything happens to my father. (I wouldn’t allow it, anyway. I would be very forthright about it too.)

Of course, there is context to everything. Just like there is an exception to every rule. For example, the elderly woman could have married a richer guy, right? Haha. But then putting my self in the shoes of the richer  guy, I might as well marry a young woman instead of an elderly one (haha, just trying to think like a man). So MOST OF THE TIME, an elderly woman ends up with a poor elderly man whose children might or might not provide financial support for their father to enable him to provide for the new wife. 

So in general, my mother hit the nail on the head when she declared her epiphany.

Imagine if your elderly mother remarries? Can you bear the thought? I am not talking about young mothers, but elderly mothers! What benefit do they get from such marriage? Would you advise your elderly mother to remarry? Am I (and my mother and sisters) the only one who think like this, I wonder?

So that day, after Mrs. H finished telling me that she was now a free woman, and she was going back to KL, I smiled at her and said, “I wish you all the happiness in the world. Don’t hesitate to come back should you need anything else. If you need to talk to me about anything, just call the clinic. You know, I will always take a call from you.”

Since then, she had called me twice.

We kept in touch.

***

Disclaimer: Some details are hidden, altered or disguised to preserve Mrs. H’s privacy. But the gist of the case remains the same. This is not only the story of Mrs. H, but also the tales of many other women, even when they marry as a young woman. When they marry as an elderly woman, it gets even worse. Take care of your elderly mother. Never make her feel like she has to marry again for companionship. In most cases, it’s just not worth it.