Monday, August 30, 2010

Cerita Elective Posting - Ajal Maut Tak Kenal Masa

Salam ramadhan buat anda, semoga Iman anda semakin bertambah di kala bulan suci yang menghampiri akhirnya ini. Alhamdulillah, saya diberikan peluang untuk berkongsi satu cerita dengan sahabat2 pembaca sekalian, satu kisah berdasarkan pengalaman saya sendiri, melakukan elective posting selama 4 hari di unit Medical (a.k.a. Internal Medicine) di Hospital Sultan Abdul Halim, Sg. Petani. Banyak pengalaman menarik yang saya perolehi di sana, tapi di sini saya nak kongsi satu cerita jer. 80% of the story will be delivered in English since it is easier.

The story is about a patient named Puan Salmah (bukan nama sebenar) aged 50’s. She was presented to the hospital with septic arthritis (jankitan kuman dalam sendi) of the knee joint which leads to septicaemia (kuman aktif merebak dalam darah).

On the first day of my posting, the patient was just transferred to the ward from the ICU, but later in the afternoon, the doctors noticed signs of developing respiratory failure, as a result, finally the doctors decided to do an intubation, the intubation was successful after the third attempt by a senior MO from Gen. Anesthetic (GA) department, after two attempts from a HO and junior MO failed. From there, I realized how difficult it is to intubate a living human being compared to a model (patung). The patient was then sent back to the ICU since she needed assisted ventilation. I took the chance to accompany the doctor and nurses to send the patient to the ICU.

Yesterday, which is my third day of posting, the patient is back in the ward, and responding well to the doctors. Today, during the morning ward round with the specialist, the patient looked lethargic with shortness of breath, but still responding to the doctors.

But later, after the round has finished, while the doctors are working with case files and I was reading some of the files, suddenly a nurse called the senior MO who was in charge at that moment. Later on, I noticed that the curtain around the patient was pulled and the head nurse was assisting the doctors. Usually, when the head nurse personally help the doctors, it most likely something serious, so I decided to join the doctors behind the curtain.

I was shocked to know that the patient has developed septic shock (extreme drop of blood pressure), the doctors and nurses were extremely busy doing everything they can do to resuscitate the patient. It was the first time for me to see clinically an emergency management of a patient in shock, with multiple IV lines and multiple sympathomimetics administrations with maximum dosage and speed.

Earlier the patient is still responding to external stimuli like pain and voices, but later, with the blood pressure remaining low, the patient become unconscious, so the doctors decided to intubate her, a senior doctor from GA/ICU was called to do the procedure. Despite everything that the doctors did, the patient suddenly went into cardiac arrest (if I were not mistaken) so CPR was performed. I was asked by the senior MO to help the team, we took turns in doing the chest compression while another doctor did the bagging (assisted ventilation with ambu-bag).

Doing CPR on a real patient is definitely a tough job, it’s tiring, so it’s better to have few doctors, preferably with strong hands. My hand was shaking after the CPR, not just because the fatigued muscles, but also due to the thought that I was helping these doctors to keep this patient alive as long as we could. The thought of doing CPR while hoping the patient will come back to life and looking at her motionless face and body, that’s not something that could be described simply by words. The CPR was done for nearly half an hour since at her age, she’s still considered as young.

Then, the final moment came, the senior MO told us to stop doing the CPR, she said there’s no more hope, and we did everything we could. She also told the nurse to call the patient’s sons (around late 20’s to late 30’s) who were waiting outside the cubicle while telling one of the HO to continue the bagging process. When the sons came in, she told them to whisper syahadah to their mother’s ears. I was touched, because she’s a non-muslim, but she calmly reminded the gentlemen to help their mother perform her last syahadah. Even when the sons stopped for a while (maybe due to sadness), she still reminded them so they don’t stop whispering syahadah to the patient.

Akhirnya, saya bersama seorang HO, pergi bertemu anak2 pesakit berkenaan, dan kami menyampaikan takziah daripada semua doctor dan jururawat yang terlibat. Saya juga sempat mengingatkan mereka agar mengambil peluang sepuluh malam terakhir bulan Ramadhan ini, untuk berdoa sebanyak mungkin buat arwah ibu mereka, moga2 memperoleh keberkatan Lailatul Qadr. Lega bila melihat mereka menerima dan redha dgn kematian tersebut sebagai satu takdir daripada Allah S.W.T.

Pengalaman melihat seorang pesakit meninggal dunia di depan mata, mengajar saya, betapa kematian itu tak mengenal masa dan usia. Manakala, pengalaman membantu doktor2 cuba menyelamatkan nyawa pesakit berkenaan, mengajar erti betapa besarnya tanggungjawab yang akan dipikul di masa akan datang. Bukanlah suatu pengalaman yang seronok, tapi bagi saya, ianya satu pengalaman yang cukup bermakna. Juga, pengalaman melihat wajah anak2 yang kesedihan dan kepiluan di saat kematian ibu mereka,tak mampu bayangkan diri saya untuk menghadapi saat itu suatu hari nanti. Moga Allah S.W.T mengurniakan kesihatan yang baik buat ibu saya dan ibu2 anda, dan semoga Allah S.W.T. mengurniakan ‘husnul khatimah’ buat ibu bapa saya yang tercinta dan juga ibu bapa anda. Akhir sekali, moga Allah S.W.T. menjadikan saya dan rakan2 saya, doktor muslim yang cemerlang, yang mampu merawat jasad dan roh pesakit2 kami.

Semoga kisah yang dikongsikan dapat memberi serba sedikit manfaat buat anda yang membaca, sememangnya kematian itu merupakan suatu peringatan yang amat besar. Ayuh beramal sebanyak mungkin di sepertiga terakhir Ramadhan ini, moga-moga dapat bertemu Lailatul Qadr, dan moga kita keluar daripada madrasah Ramadhan ini dgn keampunan Allah dan suci dari dosa, kalau mati pun boleh masuk syurga insyaAllah.

Wallahu’alam, wallahu musta’an.

4 Extra Sharings (Comments):

islahmujahidin said...

menarik cerita...

cuma nak tanya sikit
x bahaya ke CPR kat patient yg ada infection ?

Neo Rantissi said...

thanks dude.

ermm, the patient was in cardiac arrest, rasanya x jadi isu dah masa tu ada infection ker apa, u just want the heart to beat again. anyway, i don't see the risk between CPR and infection, care to explain? rasanya mcm prof x penah sebut masa ajar CPR dulu.

ibu said...

a good one, dah dgr dah cerita lah still enjoy reading it. meaning to say,was touched by ur well written experience. alhmdulillah n thanks a lot for ur doa. btw teringat lak sakit lutut kanan ibu ni mcmana nk tau kalau2 termasuk spt sceptic arthritis mcm the late patient tu..?(na'udzubillah..)

*mad blk lusa insya Allah

Neo Rantissi said...

Dear beloved ibu, it's such a pleasure to read such comment from you, hopefully it'll inspire me to write more meaningful things here, skrg tgh xder mood sgt nk menulis, hehe.

Ibu, regarding your knee, hopefully you've arranged an appointment with a doctor. Untuk septic arthritis, look out for few important signs; swollen knee joint, very painful, red and hot around the swelling, and fever, tp insyaAllah it's not septic for your case sbb ibu sakit lutut tu lama gak, dia kalau septic ni usually start suddenly, bukan slowly. Apa2 pun, I always pray that Allah S.W.T keep you safe and healthy, syafakillah ya ummi~

rindu gak nak jumpa adik sy yang sorang tu, huhu~