ER 5

Pekaba sume? Selamat hari raya, taqobbalallahu minna waminkum (semoga Allah terima amalan aku & kalian - hari2 raya or happy amalkan ucap ucapan ni, sunnah nabi & sahabat nih.. lagi mulia ucap ucapan ni drp ziarah kubur pada hari raya.. silap2 ziarah kubur tu boleh tambah dosa lagi, Allahu'alam.)

Ok, selain drp dtg kelas, minggu ni aku sibuk buat research skit kt bibliotheca, cari bahan nak buat sample article utk apply columnist post kt www.malaysiakini.com Doakanlah yg terbaik... Tapi hari selasa malam rabu mmg aku dah peruntuk hari wajib utk aku lepak ER. So td dr kul 8.30pm - 2am aku lepak ER. Plan asal aku nak lepak ER outpatient je, sbb target nak cucuk IV cannula banyak2 & prosedur lain. Tp sbb aku ade bawak member dari jauh, so aku bawak die pegi ER surgery jgk. 

• Awal2 cam beser pegi usyar ER outpatient jap dulu, then pegi ER surgery, tp aku tak terus masuk OR la. Kitorg pegi kt plastic surgery unit dulu, kt tingkat 3 tu. 
• Ade sorg budak pompuan, umur dalam 10 tahun, bas die naik eksiden. So kulit kt muka dia mmg rosak teruk, siap ade abcess (nanah) lagi. Mase tu aku tgk tgn die ade plaster cast. Aku tak sembang byk sgt dgn parents die, aku igt die patah tgn ke ape. Parents die gtau dlm kul 10 jap lg anak dorg tu ade surgery, aku ingatkan utk muka dia & elective surgery. Pelik jgk aku, ade ke elective surgery malam2. Pastu aku mtk kt nurse nak inject IV cefotaxime, ok la cucuk kali ni. Pastu ade antibiotic lg 1, aku lupe nak tanye amende, tp cucuk kt bontot la, aku tau kene cucuk kt upper lateral quadran, tp aku tapenah buat depan doc lg, malas r aku amek risiko. Lepas sembang2, parents die pun belanje kitorg air, aku pegi turun ER outpatient jap.
• Masuk ICU situ, ade sorg nenek unconscious, anak2 die kate die tak bangun2 dari pagi lagi. Tp vital sign die tak teruk sgt, tachycardia & hypertension skit. so doc just bg oxygen je la.
• Ade pak cik seblah die, actually aku follow pak cik ni dari awal2 die sampai. Die eksiden, kaki patah & kepala bengkak. Aku rase ortho dep. transfer pak cik tu ke sini. Aku check MRI kepala die ade epidural hematoma kt right frontal & left occipital area. Doc buat endotracheal intubation & bg oxygen & pakai ambu bag skali sementara nak transfer pak cik tu ke ER surgery. 
• Then jumpe prof aku & resident unit aku dulu kt ER surgery. Malam ni tade kes utk abdominal surgery plak, so prof aku relax je la malam ni, dtg sembang2 je. 
• Pastu aku masuk emergency OR (operation room), jumpe plak budak pompuan tadi. Rupenye tangan budak pompuan tu rosak teruk, mmg 4th degree la. Aku sembang dgn surgeon situ, die kate mmg taleh buat ape dah tgn tu, tulang pun nampak, K-wire pun nampak, median, ulnar & radial nerve sume injured dah, nak reconstruct pun mmg tak bleh dah. So dorg decide nak amputate tangan kiri budak pompuan tu. Kesian plak aku tgk budak pompuan tu. Mak pak die ade tunjuk gambar die sablom eksiden, comel je tgk gambar die. Aku tgk mak die nangis2 kt luar tu, bukan nangis2 style arab beser, ni nangis senyap2. Surgeon tu consult prof. plastic surgery utk kes ni, sbb rare & complicated kot. Prof tu pun setuju nak amputate. 
• Dorg buang K-Wire tu, patahkan balik radius & ulnar budak tu. Then dorg dissect subcutaneous tissue budak tu kt area forearm tu. Pastu dorg potong muscle2 yg ade, potong vessels sume2 tu then putusla tangan budak, tp dorg biar subcutaneous tissue tu lebih. Dorg pun reconstruct balik pakai subcutaneous tissue yg lebih tu, lipat2 bodo je aku tgk. Time ni aku tak berkenan skit, sbb aku nampak ade bleeding lg, tp dorg terus stitch. Anesthetic machine tu siap alarm kot. Kalo setakat minor bleeding kt surface area tu aku tak kesah sgt, tp ni benda yg dorg nak tutup. Ntahla, aku nak nyampuk time tu aku budak2 je pon. Tp dorg stitch tu, dorg tak buat complete closure la sbb nak buat drainage kot2 ade infection. So kalo bleeding tu still persist tade hal sgt la, bleh nampak lagi. 
• Then ade 1 kes extensor kt jari putus, tak sure extensor ape, tp extensor la. Doc sambung je yg putus tu, tp dorg just pakai local anesthetic je. Bising plak patient tu.
• Ade kes multiple fracture kt 2nd, 3rd, 4th metatarsal, masuk K-Wire. Pening & susah sebenarnye nak masukkan K-Wire ni, pakai driller, kejap masuk, tetibe tarik keluar balik, pastu masuk balik, keluar balik sampaila dorg puas hati. Kadang2 tgh drill masuk, terdrill glove surgeon yg pegang tangan patient tu plak. Payah jd tukang kayu nih, hehe. 
• Mase lepas ER outpatient td tu, ade doc offer aku suh buat injection utk arterial blood gaseous. Kalo nak buat inject IV aku ok. Nak main artery2 ni aku tak bleh lg. Doc tu pun 2-3 kali cucuk baru dapat, payah kot nak cucuk bajet kene kt artery.
• Kes2 lain cam beserla, eksiden, kepala pecah, berdarah, mata lebam kene pukul, arab bawak geng bising2 kt ER.. Plus hari ni tambah skit, ade sorg patient tu die tuduh doktor pukul die, pastu die suruh call polis. Amendela patient tu.
• Ade nurse sorg tu tak give up lg ngorat aku dari hari tu, haha. Die ajak duduk sembang2, aku tolak, sbb aku datang nak belajar. Nak abes2 tu baru aku balas die kenyit2 mata & lambai2 kt die, hehe. Pengajaran hari ni, aku tahu kadang2 aku ni hot jugak sebenarnye, hehe. 
• Kepada adik2 junior 1st year yg baru sampai & yg lain2 jugak, pape yg aku citer psl ER & medic dalam blog nih, tak sume kes2 tu korg boleh jumpe bile dah belajar surgery nanti, ni "real" cases. Time round surgery tu, korg belajar elective cases yg korg boleh buat clinical exam pape pun kt patient tu. Kalo salu lepak ER, salulah jumpe kes2 emergency camni, inshaAllah. Semoga bertambah minat korg kt medic.
• Last sekali aku nak promote website ni, www.cyberclinics.org .. ni hasil usaha member aku dari cairo, satu website utk org awam kt Malaysia tanye pape masalah kesihatan, tapi dalam bahasa melayu, besernye dalam english kan, so ni 1st try la dalam bahasa melayu. Aku salah sorg panel yg buat2 layak kt situ, hehe. Free2 usyarla, banyak soalan2 pelik, sampai aku pun kene jumpe prof nak jawab. Ok, tq bace. Cau

Mohd Peng.

Legitimate Racism In The Name Of Democracy

The best way to overcome the distraction is to stay focus on my pursuit. So im doing some researches about the egalitarianism or the equality or the so called the democracy.

"Democracy is the worst form of government, except for all those other forms that have been tried from time to time." - Winston Churchill

Democracy is no more than a system of government, but in western democracies it has acquired a sacred status and it is taboo to question it. Yet there is no moral basis for this cult of democracy, for this sacralisation.

It was not a democratic way for President Bush to send troops to Iraq & Afghanistan. It was rather a revenge for his father's personal failure in the former Desert Storm operation. Yet, this is the president of a nation who claimed themselves as a democratic nation. So democracy has no right or wrong, it depends on the people's vote. If the majority of the people said killing muslim is right, so democratically, killing muslim is right. The point here is, if you're a minority, democracy is not your world.

Yes i know i cant judge democracy wholly from that single mistake. I do admit the benefits of democracy even my religion, Islam is one of the earliest faith that promoted the idea of egalitarianism & anti-misogyny. So what is the problem of the democracy then?

Firstly, i disagree with some of the democrats in my country, what they are doing is too political, they're just politicking & they are legitimating racism in the name of democracy. It's more than political, it's a lie when they project our government as not democratic & at the same time, these are the people who claim our government as racist. Fyi, the Malay race & the bumiputra (the origins of Malaysia) are the poorest races, in IKS industry, in corporate & private sector, in inter-racial household income, in economic wholly, in education & so forth. So our government had created an economic model based on the racial differences in order to overcome the racial differences. It's not the Malay Supremacy, it's equalizing the inter-racial gaps. But you cant expect the 50 years old age government could be free from bribery, corruption & etc. So there's a need of oppositions and the economic model is still doesnt reach the target of 30% Malay & Bumputra equity & if you go to the city areas in Malaysia, there are mostly Malaysian's Chinese that run the businesses.

So by enforcing the democracy & the equality in all aspects in this condition, i believe that there'll be more racial hatred than now, it's an ethnic cleansing of Malay & Bumiputra races, thus it's RACIST! The Chinese race will be richer & richer & this is what i call as legitimating racism in the name of democracy. But personally, i do agree with egalitarianism or equality, but not now, maybe in five more years i guess? Pape pun, orang melayu kena bangun.

Secondly, the coalition of DAP, PAS & PKR as the Pakatan Rakyat party is not absolute & limited to some common interests only like justice, rule of law, anti-corruption, integrity, non-racial politics & etc. This coalition is formed before 2008 & the basis of alliance is predominantly to enable a viable majority, not an ideological concurrence as PAS are still with their aim of an islamic nation whilst the DAP are against it. The structure of the coalition is so unstable because these different ideologies are united by one-manship man, Anwar Ibrahim. So what will happen when Anwar's dead?

Recently there's an issue about non-muslim rights in Masjid. It's not wrong for non-muslim to enter the Masjid & give talk, yes i admit that. But the problem here is why the Muslim in Malaysia cant unite, keep blaming each other, contempting each other, just because of this very non-muslim who might even be doing that as a political purpose, intentionally, perhaps just to provoke the Umno & break up the Muslim more & more, WHY? Cant they have a nice discussion instead of contempting each other? WHY? Because they are blurred with posts & now they're confused what is right, what is wrong. Instead of returning to God, they just conclude that as long as it is from Umno, it's never gonna be right & this is racist!

The best thing to do is free yourself when learning something about Islam & talking about any political ranting, so you will not misuse Islam for the political purpose. It's not secularism, but just not to misuse it.

We cant find an absolute democratic nation in this world because in any nation, there are people who fight for posts & these people will just do whatever it takes even in the so called democratic nation, US. So this means, cheating is not a wrong thing to do as long as you dont get caught in democracy.

What i want to say here is, democracy is not always the best choice. Thank you for reading, have a nice day.
Mohd Peng.

Ishaemia-Reperfusion Syndrome

Aku baru start study surgery balik. Mase study bab shock, aku terbace bab ischemia-reperfusion syndrome dalam buku bailey & love's. Aku rase ramai budak2 medic esply Alex tahun 4 (skang tahun 5) yang tatau pasal ni sbb aku tak jumpe dalam slide lecture. Bagi aku benda ni sangat penting!

Sape2 yg ade buku surgery bailey & love's bolehla bukak m/s 13 part bawah sekali. Or boleh click link ni -> hamba wiki

Secara ringkasnye patient tu systemic hypoperfused, so cellular & organ damage progresses sbb direct effect of tissue hypoxia & activation of inflammation. Patient ni maybe ade hypovolaemic shock contohnya. So kita mesti nak correct volume & hypoxia tu. Kita pun bagila saline & oxygen. Tengok2 condition jd worse & patient tu maybe mati sbb cardiac arrest.

Sebenarnye ape yg berlaku tu la ischaemia-reperfusion syndrome or wikipedia kate reperfusion injury.

So management utk kes camni dalam buku ni sebut by reducing the extent & duration of tissue hypoperfusion je. Dalam wiki - aortic cross-clamping, therapeutic hypothermia & yang aku berminat nak tau dgn mendalam, hyrogen sulfide, H2S.

Ok, tu je utk hari ni. Good luck 10 malam terakhir ramadhan ni, sama-sama rebut pahala insyaAllah dan good luck kpd sape2 yg ade exam.

Mohd Peng

Where Did I Go Wrong?

Awak pernah dengar tak, orang laki pun ada maruah?




Saw the world turning in my sheets and once again I cannot sleep.
Walk out the door and up the street; look at the stars beneath my feet.
Remember rights that I did wrong, so here I go.
Hello, hello. There is no place I cannot go.
My mind is muddy but my heart is heavy. Does it show?
I lose the track that loses me, so here I go.
And so I sent some men to fight, and one came back at dead of night.
Said he'd seen my enemy. Said he looked just like me,
So I set out to cut myself and here I go.
I'm not calling for a second chance,
I'm screaming at the top of my voice.
Give me reason but don't give me choice.
'Cause I'll just make the same mistake again.
And maybe someday we will meet, and maybe talk and not just speak.
Don't buy the promises 'cause, there are no promises I keep.
And my reflection troubles me, so here I go.
I'm not calling for a second chance,
I'm screaming at the top of my voice.
Give me reason but don't give me choice.
'Cause I'll just make the same mistake,
I'm not calling for a second chance,
I'm screaming at the top of my voice.
Give me reason but don't give me choice.
'Cause I'll just make the same mistake again.
Saw the world turning in my sheets and once again I cannot sleep.
Walk out the door and up the street; look at the stars.
Look at the stars fall down.
And wonder where did I go wrong.

* Good luck test awak. Terima kasih buat saya macam ni. Abes test nanti, silalah bagitau saya yang awak tanak saya lagi dah. At least saya tak tergantung macam ni. Jangan seksa saya sangat, saya pun manusia.

A Rule of Middle Finger

Kadang-kadang hati kena keras. Kita buat baik orang pijak kita. Kita boleh buat pape, boleh terus baik, tapi aku nak macam ni.

Kamu pulak nak yang mana?

Yang ini?

Atau yang ini?

Kasar eh? Yang ni lembu sikit, ok?

Yang lembut pun tanak. Yang ni camane?

Dahla, buat je la pape yang kamu nak, fuck off!

Mohd Peng

ER 4

Malam ni pegi ER dgn we. Anip yb dtg lambat skit.

• Hari ni aku sedih skit sbb operation room kt ER traumatic tu tade surgery. Awal2 sampai ade la 1, tp tak ramai org plak. So aku tak tgk surgery ari ni.
  
• Hari ni ade kes antihistamine chlorpheniramine overdose, nitroglycerin overdose, atrial fibrillation, gunshot wound kt right lung, kes2 trauma org kene pukul sampai lebam 2 biji mata, eksiden & lain2. Kitorg dpt gak la belajar resuscitation skit2.
  
• Hari ni aku jumpe member arab 4 org, student nk masuk 5th year 2 org('ala' & sape ntah sorg lg) & nak masuk 4th year 2 org (ahmad & mahmud)... Dalam ICU kt ER outpatient mahmud ajak aku buat resuscitation utk sorg mamat arab, eksiden. Aku tanye doc kt situ, bape lame kene buat resuscitation tu, doc kate sampai dapat mech. ventilator. Kitorg buat insufflation je sbnanye, pakai ambu bag tu sampaila doc transfer patient tu ke ICU traumatic unit.
  
• Mahmud tu cam beserla, aku ingatkan die resident, tp time die nak buat iv cannula tu tetibe nurse ajar, so die student. Aku pun mintak nak buat gak iv cannula, die pun gtau nurse kt situ. Tapi syg skali sbb time tu dah dekat pukul 1, tak byk patient plak. Aku ingatkan kene tunggu doc suruh baru boleh buat IV cannula or pape basic procedure tu, rupenye ckp kt nurse je. Nurse tu semangat gak la nak ajar aku, haha.. sampai mcm nak paksa patient plak. Tape, esok luse aku dtg target nak buat iv cannula. Mahmud buat iv cannula ok, tp bile die nak amek blood sample utk patient lain, kantoi plak. Patient tua, bape kali cucuk ntah, tak dpt2 blood. Last2 nurse td dtg tak sampai 30 saat je buat, haha. Tp ni mmg beser la awal2 kan.. Pastu anak laki patient tu cam tanye2 apsal Mahmud buat tak jadi, nurse & mahmud tu cover baik je la.. hehe, standard.
  
• Ok first case antihistamine chlorpheniramine overdose, pompuan. Doc buat ECG & ECG die normal, doc auscultate, pun ok. So patient ni just kasik gastric lavage & maybe IV saline.
• 2nd case nitroglycerin overdose, pompuan muda, nangis2. Die ade deep shallow breathing, lebih dari 20 bpm. Doc buat ABG, resp. alkalosis. ECG die aku rase normal jgk. Tp tak follow up plak ape treatment die.
  
• 3rd case sorg nenek ade atrial fibrillation, just tgk doc buat ECG. Aku tgk kejap je, awe tgk lame, sbb ade patient emergency, die eksiden & ngadu abdominal pain. Besernye mmg org tekan2 kt sternum or in between eyebrow tu.. Aku nampak doc tu buat camtu. Tapi doc tu picit kuat2 nipple mak cik tu sambil sebut2 name die... hehe, skill baru ni. Then doc transfer patient tu ke ER traumatic sbb dorg suspect ade intra abdominal injury kot.
  
• 4th case - budak laki dalam belasan tahun, gunshot kt right lung, perforated wound. Tataula budak kecik tu buat ape sampai kene tembak, tp nasib baik la tak kene kt jantung or kepala, panjang lg umur die. Die kene tembak dekat depan skit dari mid-axillary line, dalam 4/5th intercostal/costal area, lubang dalam 2 x 3 cm. Doc2 resident berkerumun kt budak tu, sbb jarang kot kes2 cani. Dorg kasik 4/5 pack IV saline, kt tangan, central (neck) & kt malleolus. Sementara tunggu senior doc, dorg just cover perforated wound tu & stop bleeding mcm dressing beser. Pastu ade doc yg pegi amek ultrasound punye machine tu bawak masuk ward tu, pasang2 je blackout plak ward tu, haha.. ok2 tak baek gelak. Then dorg bawak patient tu pegi kt imaging room, senang citer. Pastu aku, awe & anip yb tak follow, kitorg pegi kt ER outpatient plak, lepak2 ngan student arab 4 org tu buat insufflation & etc.
  
• Tapi aku wonder la, ape ek treatment utk gunshot wound camtu? erm.. Concern kita selain drp bleeding, maybe ade pneumothorax. Pastu ribs yg patah & peluru tu kt dalam paru2 tu camane plak nak handle. Ntahla, aku pun tatau & tak ingat dah belajar ke belum bab ni. Korg ade jawapan? dialu2kan. Camanela kalo aku dpt patient camtu nanti.
  
• Minggu depan maybe aku tak dpt pegi ER, sambung lepas raya plak, sbb nak prepare utk show raya kt Cairo. Doakan show berjaya, insyaAllah, amen. Tq.
  
• Ok, tu je utk hari ni. Selamat berpuasa, ramadhan kareem.

Mohd Peng.

ER 3

Lambat skit tulis psl ER kali ni sbb aku tak bape sehat skit. Perut buat hal, aku dah telan byk ORS.. Yela, kalau boleh tanakla skip puasa. Malam tadi pegi dgn Pit Daz dari kul 9 pm lebih - pukul 1am tepat, hehe. 

Prof yg ajak aku pegi ER awal2 dulu ade dtg, Prof Islam name die.. Resident unit surgery aku dulu (hepatobiliary) pun ade dtg, Dr Islam dgn ape ntah lg sorg tu.   

• ER outpatient cam tak best plak semalam. So dtg tunjuk muke jap then terus pegi ER traumatic. 
• Semalam ade 4 surgery yg kitorg tgk. Utk yg tak amek medic, sebenarnye kes banyak sgt tau, tapi dorg kene beratur kt ward  menunggu. Kt ward menunggu tu ade doc2 yg uruskan pape yg boleh kt situ. Kalo dah emergency sgt baru masuk spontan punye surgery.. ni la specialty medic yg aku paling suke, emergency surgery.. Kalau nak sambung pakar pun aku sambung dalam bidang ni. Aku tak suke tgk org mati tak aman ni & specialty ni mencabar, tu pasal aku minat. Pape pun tu kuasa Allah kan.
• Ok, ade kes acute appendicitis, flexor carpi ulnaris rupture, extensor pollicis rupture & multiple fracture of mandible.
• Prof aku buat surgery utk acute appendicitis. Aku paling suke Prof ni sbb bile tgk die aku teringat kt M. Shadow, vocalist Avenged Sevenfold, haha. Prof buat incision kt lower right quadrant tu, then dorg keluarkan appendix & caecum. Mase tu aku tk caecum tu pelik, tak smooth, cam ulcer plak. Doc gtau tu early phase of appendicular mass, so boleh remove appendix. Kalo dah jd bulk @ appendicular mass, taleh remove terus, kene tunggu dulu bape hari sampai mass tu loose balik. Ade minor bleeding kt caecum tu, inflammation kan. So prof buat haemostasis suture, macam ligation gak, tp die suture terus mane2 vessels yg bleed. Pit Daz mmg mantap, aku pelik gak, apsal die prof duk suture je caecum tu, pit daz kate sbb nak stop bleeding, hehe. Then bile dah settle bleeding dorg proceed utk excise appendix. Dorg ligate kt neck appendix tu & clamp distal portion. Dorg tak buat double ligation. Then dorg potong area in between tu, so terputus la appendix & then kitorg blah. 
• Second case flexor carpi ulnaris rupture. Doc kate kes ni cosmetic jgk sbnanye. Surgeon yg buat operation tu aku rase plastic surgeon. Die sambung balik flexor carpi ulnaris tu je la. Tapi care anak murid die suture balik incision tu mmg nice & cantik. Maybe ni la specialty plastic surgeon. Nurse sorg tu nk jgk buat pandai, sbb die nampak ade 2 org org Malaysia kt OR tu kot, hehe. Tp suture die cam beser je la, byk sgt bleeding. 
• Pastu ade kes sorg budak kecik, die main pisau ke ape aku tatau la. Tapi extensor of the thumb die putus & tulang kt situ fracture. Mase x-ray dorg tak gtau ade fracture, so doc tu igt nak kene sambung extensor tu je la. So dorg masukkan jarum kt fracture tu, macam masukkan K-Wire jgk. Then dorg sambung balik muscle tu & then dorg remove balik jarum tu. Aku rase budak2 kecik kte taleh bagi internal fixation senang2, dorg kan tgh membesar, nanti terbantut plak ibu jari budak tu. 
• Then last case kitorg usyar semalam kes multiple fracture of mandible. Surgeon yg buat surgery tu baru tahun dua kuliah dentistry, hehe. Jgn pelik. Die ade degree medic, die maxillofacial surgeon. Tp maybe die nak subspecialist dalam orthodentistry jgk kot. Kitorg sembang dgn assistant surgeon, die orthodentist asal dari kuliah dentistry. Die kate die penah apply nak buat specialist kt HUKM Malaysia. Tp Malaysia banyak songeh mintak pengalaman 3 tahun keje. 3 tahun keje as MO, bukan internship. So die sambung je kt sini lg senang. Aku rase tersentuh bile die macam expect gaji kt Malaysia tinggi dari Egypt. Mmg la betol. Tp doc Malaysia tak pernah puas dgn gaji kt Gomen, so dorg blah gi private or migrate ke negara lain yg lg mahal cam Singapore. Kite tak pernah bersyukur kan. Bagi aku medic ni bukan pasal duit sgt, die passion ko nak rawat org lain. Benda ni yg aku kagum dgn doc2 & prof2 kt Mesir, dorg bleh je migrate kt negara lain yg lagi mahal salary, tapi dorg stay sbb sayangkan ilmu & negara snirik. Tapi aku senirik nak sambung specialist kt US/UK + keje kt sane jap kalo ade rezeki nanti, hehe.. Bukan sbb duit, tp sbb nak bawak diri & merantau lagi.
• Ok balik pd kes tadi. Patient tu request tanak pakai skru utk internal fixation of her mandible sbb die nak maintain function mandible. So surgeon tu sume pakai wire ape ntah. Sablom start surgery tu, dorg gulung wire tu jd cam bentuk sotong dua kaki, dorg buat banyak2 sotong tu. Aku tatau ape name fixation jenis camtu. 
• Time tu aku tgk la anaesthetist tu inject diprivan dalam 2.5 syringe 10 ml. Aku rase maybe 25 ml diluted. Then die buat jaw thrust. Asalnye aku rase dorg nak buat endotracheal intubation kot.. tp since surgery tu involve mandible, susahla kot. So dorg buat nasopharryngeal intubation, masuk kt hidung. Lepas dah sedate, surgeon pun start buat keje. Dorg masukkan amende ntah kt mulut patient tu, cam hold mulut patient tu then terus start masukkan wire sotong td tu, dorg cucuk tembus gusi patient tu terus then ikat. Gusi kt area yg fracture tu la. Aku & Pit tak tgk abes, aku penat da time tu, tak bape sehat kan. Then kitorg balik. 
• Hari ni aku terbace artikel Dr Asri psl doa untuk bukan muslim. Tersentuh aku. Kita selama ni duk benci sgt kt Cina.. Kadang2 kita kene fikir jgk, dorg pun manusia, walaupun bukan islam.
• "Dalam sebuah negara yang berbilang agama, adakah kesejahteraan dan keamanan akan tercapai jika salah satu masyarakatnya porak peranda? Jika masyarakat bukan Islam hidup dalam keadaan tidak aman dan bergolak sesama mereka, apakah negara akan aman?" - Dr Asri. 
• Tapi bila org politikkan agama, tu mmg sial la. PAS pun tak bolehla 24/7 politik duniawi, tambah dorg perjuangkan islam, dorg kene stick & tegas dgn Quran & Hadis, tak bolehla 24/7 tahalluf siasi. Sbb tu Ali bin Abi Talib penah cakap, "Perkataan yang benar, tetapi bertujuan batil" (Al-Khatib al-Baghdadi, Tarikh Baghdad, 304/10, Beirut: Dar al-Kutub al-'Ilmiyyah) 
• Walaupun aku sekarang ni cenderung kpd optimist dgn perubahan Kerajaan Barisan Nasional @ sokong Kerajaan BN berubah, tapi Islam is always my top concern. Kita tak boleh kekal defensive macam fahaman kaum tua. Islam ni utk disebarkan, kita kene sebar kt non-muslim. Kalau cina kafir takut kt Islam, kita tak boleh amal escapism, kita kene face it, itu realiti. Adakah dgn kekal dgn fahaman & budaya defensive, maka islam akan tersebar? Kita nak org hormat islam tapi kita tak hormat dorg? Kita tak tunaikan tuntutan islam sendiri kt kita dalam adab kita dgn org kafir? Macam tu nak sebar islam?
• Jadi ni antara dilema paling besar umat islam kt Malaysia sekarang ni. Nak doa kesejahteraan bukan islam pun jadi isu. Amende la org bukan islam duk fikir pasal islam agaknye kalo kite kekal terus camtu.. Dahla kita tak ikut betul2 adab muslim dgn bukan muslim macam dalam quran, pastu kita blame plak dorg. Tak kesah la yg jd isu tu Lim Guan Eng ke, Soi Lek ke, tapi prinsip tetap prinsip. Allah dah ajar kita camane nak beradab dgn dorg (al-Mumtahanah ayat 7-8), kita kene ikut. Tak boleh terus kekal escapism. 
• Tapi tu la, kalau nak proaktif skit bab2 ni kene cop wahabi. Skit2 wahabi. Apa la nasib... Semoga Allah mudahkan dakwah islam kt Malaysia, insyaAllah. Allahu'alam.

Mohd Peng