Saturday night always be the awaited night every week for everyone either they're single or double. Well, maybe all the single's not really looking for this night but let's be honest. Like it or not, saturday night is much better than every other weekday night, isn't it?
Last Saturday night I was on my on-call night shift. With hoping no patient would like to visit our ER in this lovely night I was hanging my wishful thinking. Which I should have never ever dare to think about that back then.
Jam 11 malam aku dapet telfon telling me a patient was waiting me on ER. I found a girl who was crying out loud lying on the bed while the nurse doing stitch on her injury. Kakinya luka tergores kaca. A minute later, masuk 2 pasien KLL. Salah satunya mabuk berat dengan luka robek di alis sama bibir. Setelah selesai beresin pasien2 ini, masuk lagi pasien baru dengan blood all over his face and shirt. Hebatnya walaupun darahnya udah muncrat2 dari kepalanya, si pasien masih bisa jalan tenang masuk IGD dan naik ke bed.
Karena kebanyakan pasien dan perawat yang terbatas, aku ikutan hecting (menjahit luka) pasien terakhir. Nggak berapa lama setelah itu ada ribut2 di depan IGD. Temen2 pasien yang mabok tadi pukul2an sama temen2 pasien yang kepalanya bocor ini. Satpam yg seharusnya doing his job dengan tenangnya sleep sound and safe unaware of the heat situation here. Untungnya mereka berhenti pukul2an dan salah satunya pulang ke rumah.
After awhile, temen yang pulang tadi balik ke RS bawa parang dan langsung ngebacok temen berantemnya tepat di depan pintu IGD. Like I have had not enough already. Kenapa juga harus di depan IGD? Kenapa juga harus pas shift jaga ku?!!
Setelah puas ngebacok kepala orang, si pembacok lega dan pulang meninggalkan pasien baru di IGD dengan 5 luka robek di kepala. Yang lebih keren lagi, satpam tetap tidur nyenyak tanpa terganggu ribut2 di IGD.
Jam 3 pagi aku masih harus berkutat dengan nald, catgut dan pasien mabok yang darahnya banjir di IGD. Dateng lagi pasien baru minta divisum abis dipukul. Yassalam, malam minggu gini kok banyak yang doyan pukul2an ya. Kenapa gak ngadain zikir akbar dilanjutkan sholat tahajud berjamaah aja sih -..-
Jam setengah 4 aku balik ke kamar langsung tepar. It's the worst scenario I've ever imagined. Setelah mulai melayang hampir tertidur hp ku bunyi.
"Dok, ada pasien LAGI di IGD"
F!
Selasa, 23 April 2013
virginity
Jumat, 19 April 2013
Lagi jaga sore di IGD, tiba - tiba dapet BBM dari dokter jaga nyuruh aku ke poli OBGYN segera. Padahal udah mau adzan magrib, dan poli juga udah tutup dari siang tadi. Nyampe poli udah ada dokter jaga, seorang ibu dan anak perempuannya. Ternyata ibu ini minta anaknya untuk di visum keperawanan.
Aku udah pernah visum keperawanan anak balita dan hymen (selaput dara)-nya masih utuh. Jadi visum kali ini beda sama sebelumnya. Pikiran pertama yang terlintas waktu ngeliat si pasien kemungkinan dia abis diperkosa makanya minta divisum. Karena penampilannya yang menggambarkan cewek rumahan, lugu, pemalu, dan alim.
Si ibu cerita "Anak saya ini punya pacar udah 11 bulan pacaran. Tiba-tiba diputusin sama pacarnya dan pacarnya pergi ke Medan. Beberapa minggu belakangan ini anak saya nangis terus. Saya tanya kenapa, dia cerita katanya pacarnya itu sudah punya pacar baru di Medan. Dan yang buat dia makin sedih, anak saya ini udah berhubungan suami-istri lah selama pacaran dulu"
Hmm.. kalimat pembukaannya cukup jelas menggambarkan maksud dan tujuan si ibu. Cukup jelas menghancurkan prediksi awalku.
"Udah nggak inget, pokoknya setiap ketemu pasti ngelakuin" jawab si anak waktu ditanya berapa kali udah ngelakuinnya. Another shocking fact hit me.
"kamu gak takut hamil? Udah pernah test pack? kapan terakhir menstruasi?"
Kali ini si ibu menjawab dengan tenangnya "Udah saya tanya itu dok. Kok bisa lah kau inang (panggilan sayang orang batak ke putri nya) nggak hamil tapi kau bilang setiap ketemu udah begituan. Trus dibilangnya dok, si laki-laki ini mengeluarkan "itu"-nya di perutnya"
Lemes..
Entah kenapa first impression aku tuh selalu salah total. Pasien yang awalnya aku kira good girl has already gone bad only in a minute. Aku yang awalnya bahkan gak berani bayangin si pasien bakal secara sukarela making love berulang kali. Eh, mereka bahkan ngerti caranya ngelakuin coitus interuptus :|
Daerah pelosok, jauh dari hingar bingar kehidupan kota, nggak menjamin penduduknya taat agama dan takut dosa. Aku udah sering denger sih dari temen-temen yang lain bilang banyak terima kasus visum keperawanan selama jaga IGD. Katanya sih free sex udah biasa disini, banyak yang minta divisum biar akhirnya dinikahin sama si laki-laki. Tapi mendengar sama mengalami langsung itu beda rasanya.
Si pasien ini masih 18 tahun. Segitu nggak berharganya kah keperawanan? Terserah lah kalo nggak peduli sama dosa. At least segitu nggak peduli nya sama diri sendiri sampe harta yang paling berharga itu gampang aja dikasih.
I don't know what went wrong with this people. While I'm strictly to stay virgin, they are easily giving it up in the name of fcuking love!! What a super irrational thought.
Hasil pemeriksaan sesuai dengan pengakuan korban. I don't wanna tell the detail here. I just wanna show how horrified I am to know the reality. Even in this unidentified place, virginity means nothing.
oh well, this poor girl.. Aku pengen bilang ke dia "kalo kamu aja gak bisa menghargai diri kamu sendiri gimana orang lain bisa ngeliat kamu berharga" tapi si Ibu keliatan ngebela anaknya abis2an. Katanya si anak terpaksa nurut setiap diminta ML sama pacarnya karena diancem bakal diputusin kalo gak mau.
Oh, give me a break. Entah si ibu yang kelewat naif percaya aja gitu apa yang dibilang anaknya atau dia sengaja percaya sebagai self defense. Dunno and dont care. All I can conclude about this case is while the moron meets the idiot they will make the most stupid excuse to having sex. Stupid!
Lagi jaga sore di IGD, tiba - tiba dapet BBM dari dokter jaga nyuruh aku ke poli OBGYN segera. Padahal udah mau adzan magrib, dan poli juga udah tutup dari siang tadi. Nyampe poli udah ada dokter jaga, seorang ibu dan anak perempuannya. Ternyata ibu ini minta anaknya untuk di visum keperawanan.
Aku udah pernah visum keperawanan anak balita dan hymen (selaput dara)-nya masih utuh. Jadi visum kali ini beda sama sebelumnya. Pikiran pertama yang terlintas waktu ngeliat si pasien kemungkinan dia abis diperkosa makanya minta divisum. Karena penampilannya yang menggambarkan cewek rumahan, lugu, pemalu, dan alim.
Si ibu cerita "Anak saya ini punya pacar udah 11 bulan pacaran. Tiba-tiba diputusin sama pacarnya dan pacarnya pergi ke Medan. Beberapa minggu belakangan ini anak saya nangis terus. Saya tanya kenapa, dia cerita katanya pacarnya itu sudah punya pacar baru di Medan. Dan yang buat dia makin sedih, anak saya ini udah berhubungan suami-istri lah selama pacaran dulu"
Hmm.. kalimat pembukaannya cukup jelas menggambarkan maksud dan tujuan si ibu. Cukup jelas menghancurkan prediksi awalku.
"Udah nggak inget, pokoknya setiap ketemu pasti ngelakuin" jawab si anak waktu ditanya berapa kali udah ngelakuinnya. Another shocking fact hit me.
"kamu gak takut hamil? Udah pernah test pack? kapan terakhir menstruasi?"
Kali ini si ibu menjawab dengan tenangnya "Udah saya tanya itu dok. Kok bisa lah kau inang (panggilan sayang orang batak ke putri nya) nggak hamil tapi kau bilang setiap ketemu udah begituan. Trus dibilangnya dok, si laki-laki ini mengeluarkan "itu"-nya di perutnya"
Lemes..
Entah kenapa first impression aku tuh selalu salah total. Pasien yang awalnya aku kira good girl has already gone bad only in a minute. Aku yang awalnya bahkan gak berani bayangin si pasien bakal secara sukarela making love berulang kali. Eh, mereka bahkan ngerti caranya ngelakuin coitus interuptus :|
Daerah pelosok, jauh dari hingar bingar kehidupan kota, nggak menjamin penduduknya taat agama dan takut dosa. Aku udah sering denger sih dari temen-temen yang lain bilang banyak terima kasus visum keperawanan selama jaga IGD. Katanya sih free sex udah biasa disini, banyak yang minta divisum biar akhirnya dinikahin sama si laki-laki. Tapi mendengar sama mengalami langsung itu beda rasanya.
Si pasien ini masih 18 tahun. Segitu nggak berharganya kah keperawanan? Terserah lah kalo nggak peduli sama dosa. At least segitu nggak peduli nya sama diri sendiri sampe harta yang paling berharga itu gampang aja dikasih.
I don't know what went wrong with this people. While I'm strictly to stay virgin, they are easily giving it up in the name of fcuking love!! What a super irrational thought.
Hasil pemeriksaan sesuai dengan pengakuan korban. I don't wanna tell the detail here. I just wanna show how horrified I am to know the reality. Even in this unidentified place, virginity means nothing.
oh well, this poor girl.. Aku pengen bilang ke dia "kalo kamu aja gak bisa menghargai diri kamu sendiri gimana orang lain bisa ngeliat kamu berharga" tapi si Ibu keliatan ngebela anaknya abis2an. Katanya si anak terpaksa nurut setiap diminta ML sama pacarnya karena diancem bakal diputusin kalo gak mau.
Oh, give me a break. Entah si ibu yang kelewat naif percaya aja gitu apa yang dibilang anaknya atau dia sengaja percaya sebagai self defense. Dunno and dont care. All I can conclude about this case is while the moron meets the idiot they will make the most stupid excuse to having sex. Stupid!
Rabu, 13 Maret 2013
From hormone to mellow
Akhir - akhir ini sering ngerasa jadi cewek mellow yang gampang nangis karena cuma karena hal sepele, terutama 2 bulan belakangan ini. emang sih karena PMS, but this is the first time my life had been screwed by hormone.
Separah2 nya aku PMS, gak pernah tuh sampe nangis bombay kaya cewek yang gak disetujuin bapaknya nikah sama pacarnya di film india.
Dua bulan yang lalu, aku lagi di taksi travel perjalanan dari Medan balik ke Sidempuan. I was fully wishing to get a capable and the fastest driver since I've had to driven to Gunung tua when I got Sidempuan as soon as possible to catch my morning shift in emergency room. As though faith didn't took its side on me, I got the slowest driver so that he could never forced himself to precede the truck in front us. He was effortlessly drove 40 km/h for the heck fastest!!
I was about to burst out. Rasanya emosi, pengen gantiin si supir lambat ini. I felt something burnt inside of me and felt like punch this driver who was sitting next to me. Realize of not capable to did those things, I effortfully resist my anger. Tapi jadinya malah nangis. Nangis sejadi2nya kaya abis diputusin gitu. Untungnya kejadiannya malem, jadi si supir lambat ini gak ngeliat aku udah nangis bodoh aja sangking emosi sama dia. Right after that, I felt the abdominal cramp then I confirmed myself my period was coming right after that.
Bulan ini tepatnya minggu lalu, aku ditelfon mamaku minta dijemput di sekolahnya jam 12.15. Seharusnya aku ke kantor pajak buat ngurus NPWP, tapi karena mama minta jemput aku langsung nyetir ke sekolahnya. Nyampe sekolah jam 12 dan sekolahnya itu udah sepi, kosong, melompong. I called mama like 100 times yet she's out of reach. Lima belas menit kemudian mama nelfon aku katanya dia udah di rumah karena jam setengah 12 dia udah pulang dan gak ngeliat aku di depan sekolahnya ditambah lagi HP nya abis batere. Gak mungkin juga aku bentak2 mama, jadi aku langsung matiin HP. Di jalan balik ke rumah mataku udah basah. Kept remind myself to think logically that nothing's deserve to be cried to.
Nyampe rumah mama bukain pagar trus aku langsung ngomong "mama bilang jam 12.15. Nenny dari jam 12 udah di sana, gara2 mama gak jadi nenny buat NPWP" trus langsung lari ke kamar nangis sesengukan. Sumpah ya, sinetron juga gak bakal selebay ini kali. trus mama ngetok2 kamarku bilangin dia salah bilang maksudnya pulang jam 12 kurang 15. Tapi aku udah terlanjur nangis kaya ditinggal kawin. Beberapa menit setelah itu I've got my period as I predicted before.
Bener2 hormon ngerusak mood and my way of thinking.
Nah, tadi pagi aku bbm-an sama mama, curhat gara2 papa yang pelit. Aku minta duit bensin ke papa trus papa pake acara nyindir aku udah dokter kok masih minta subsidi dari ortu. Emang sih duitnya dikasih tapi ego ini udah terlanjur terluka (halah..). Trus aku ngadu ke mama "biar mama tau aja, papa blom ada loh ma ngasih duit makan nenny bulan ini. Nenny makan setiap hari pake nughet yang dibeli pas belanja bulanan kemaren". Tau gitu mamaku langsung heboh mau transfer duit ke aku, trus suruh ibu yang bantuin di rumah Sidempuan buatin lauk buat aku makan di Gunung Tua. Again and again, aku langsung nangis gak jelas gitu donk. Padahal udah selesai nih period ku.
I don't know how to handle what this hormone did to me. I cant even control myself to not crying out loud. Oh, I guess it's time to find my next-to-be husband as the impingement for my hormone disaster.
Separah2 nya aku PMS, gak pernah tuh sampe nangis bombay kaya cewek yang gak disetujuin bapaknya nikah sama pacarnya di film india.
Dua bulan yang lalu, aku lagi di taksi travel perjalanan dari Medan balik ke Sidempuan. I was fully wishing to get a capable and the fastest driver since I've had to driven to Gunung tua when I got Sidempuan as soon as possible to catch my morning shift in emergency room. As though faith didn't took its side on me, I got the slowest driver so that he could never forced himself to precede the truck in front us. He was effortlessly drove 40 km/h for the heck fastest!!
I was about to burst out. Rasanya emosi, pengen gantiin si supir lambat ini. I felt something burnt inside of me and felt like punch this driver who was sitting next to me. Realize of not capable to did those things, I effortfully resist my anger. Tapi jadinya malah nangis. Nangis sejadi2nya kaya abis diputusin gitu. Untungnya kejadiannya malem, jadi si supir lambat ini gak ngeliat aku udah nangis bodoh aja sangking emosi sama dia. Right after that, I felt the abdominal cramp then I confirmed myself my period was coming right after that.
Bulan ini tepatnya minggu lalu, aku ditelfon mamaku minta dijemput di sekolahnya jam 12.15. Seharusnya aku ke kantor pajak buat ngurus NPWP, tapi karena mama minta jemput aku langsung nyetir ke sekolahnya. Nyampe sekolah jam 12 dan sekolahnya itu udah sepi, kosong, melompong. I called mama like 100 times yet she's out of reach. Lima belas menit kemudian mama nelfon aku katanya dia udah di rumah karena jam setengah 12 dia udah pulang dan gak ngeliat aku di depan sekolahnya ditambah lagi HP nya abis batere. Gak mungkin juga aku bentak2 mama, jadi aku langsung matiin HP. Di jalan balik ke rumah mataku udah basah. Kept remind myself to think logically that nothing's deserve to be cried to.
Nyampe rumah mama bukain pagar trus aku langsung ngomong "mama bilang jam 12.15. Nenny dari jam 12 udah di sana, gara2 mama gak jadi nenny buat NPWP" trus langsung lari ke kamar nangis sesengukan. Sumpah ya, sinetron juga gak bakal selebay ini kali. trus mama ngetok2 kamarku bilangin dia salah bilang maksudnya pulang jam 12 kurang 15. Tapi aku udah terlanjur nangis kaya ditinggal kawin. Beberapa menit setelah itu I've got my period as I predicted before.
Bener2 hormon ngerusak mood and my way of thinking.
Nah, tadi pagi aku bbm-an sama mama, curhat gara2 papa yang pelit. Aku minta duit bensin ke papa trus papa pake acara nyindir aku udah dokter kok masih minta subsidi dari ortu. Emang sih duitnya dikasih tapi ego ini udah terlanjur terluka (halah..). Trus aku ngadu ke mama "biar mama tau aja, papa blom ada loh ma ngasih duit makan nenny bulan ini. Nenny makan setiap hari pake nughet yang dibeli pas belanja bulanan kemaren". Tau gitu mamaku langsung heboh mau transfer duit ke aku, trus suruh ibu yang bantuin di rumah Sidempuan buatin lauk buat aku makan di Gunung Tua. Again and again, aku langsung nangis gak jelas gitu donk. Padahal udah selesai nih period ku.
I don't know how to handle what this hormone did to me. I cant even control myself to not crying out loud. Oh, I guess it's time to find my next-to-be husband as the impingement for my hormone disaster.
Mama, the most patient woman on earth <3 font="">
Kamis, 28 Februari 2013
The power of 'marga'
Nothing bonding is as tight as Bataknesse's. I was driving on the way heading off to Padang Sidempuan by myself. In the middle of the way my car was stopped by some policeman for a 'sudden operation'. Maybe because of me as a girl, they stopped me. A policeman greeted me and asking for my license. A lil bit worried penetrated me while I have to face the policeman in the street. I had a very bad relationship with them. Somehow, every time their checking for my car completeness, there would be always something was missing and I must paid for the fine!
I gave him my license and STNK. He's checking my name on it and being pleasure by my surname. Coincidentally we have the same surname which is giving me the advantage. So, here's the conversation we had just now.
He : selamat pagi bu. Bisa lihat Surat2 nya?
Me : (giving him my license and STNK)
He : wah, boru harahap ternyata. Sama lah saya juga harahap. Harahap dari mana? (He asked my hometown)
Me : dari Sosopan
He : saya juga dari sana ( then he unbutton his jumper and show his badge name. There I saw we have a similarity in surname). Dari mana mau kemana ini?
Me : dari gunung tua mau ke sidempuan pak.
He : yasudah, hati2 ya nyetir nya
See? I don't even know this policeman. Just because we have the same Surname everything worked fine. It's not that I have lack of completeness car utility. It's just that they usually easily saw my fear when they're stopping my car then looking for any little mistake which is impossible to get fine!
Last year I was driving my car from Medan to Gunung Tua. It took me 10 hours to get there. In the middle of the way, exactly in Batu Bara the policeman stopped my car. Because I'm a girl, he's effortfully looking for any tiny mistake I have. He ordered me to open my baggage and showed him my car safety utility such as : kotak P3K, segitiga pengaman sama racun api. That was the first time i heard 'racun api'. The moment he asked about that I did realize that I would never been let go by him until paid the fine. Because I was fully aware that I didn't have that damn 'racun api'.
I told my father about that then he yelled at me. He told me that racun api, etc couldn't be the reason to get fine since my car is a personal transportation instead of the public one.
I'm fully aware that that fcuking policeman will never stop looking for my mistake until I gave them some money or we have the same Surname like I had happened just now ;)
I gave him my license and STNK. He's checking my name on it and being pleasure by my surname. Coincidentally we have the same surname which is giving me the advantage. So, here's the conversation we had just now.
He : selamat pagi bu. Bisa lihat Surat2 nya?
Me : (giving him my license and STNK)
He : wah, boru harahap ternyata. Sama lah saya juga harahap. Harahap dari mana? (He asked my hometown)
Me : dari Sosopan
He : saya juga dari sana ( then he unbutton his jumper and show his badge name. There I saw we have a similarity in surname). Dari mana mau kemana ini?
Me : dari gunung tua mau ke sidempuan pak.
He : yasudah, hati2 ya nyetir nya
See? I don't even know this policeman. Just because we have the same Surname everything worked fine. It's not that I have lack of completeness car utility. It's just that they usually easily saw my fear when they're stopping my car then looking for any little mistake which is impossible to get fine!
Last year I was driving my car from Medan to Gunung Tua. It took me 10 hours to get there. In the middle of the way, exactly in Batu Bara the policeman stopped my car. Because I'm a girl, he's effortfully looking for any tiny mistake I have. He ordered me to open my baggage and showed him my car safety utility such as : kotak P3K, segitiga pengaman sama racun api. That was the first time i heard 'racun api'. The moment he asked about that I did realize that I would never been let go by him until paid the fine. Because I was fully aware that I didn't have that damn 'racun api'.
I told my father about that then he yelled at me. He told me that racun api, etc couldn't be the reason to get fine since my car is a personal transportation instead of the public one.
I'm fully aware that that fcuking policeman will never stop looking for my mistake until I gave them some money or we have the same Surname like I had happened just now ;)
Selasa, 26 Februari 2013
Real case. Eventually..
Jaga malam kemaren dapet 3 pasien. Dua diantaranya emergency yang butuh penanganan dan berpikir cepet. Mungkin karena udah terbiasa dapet pasien gak penting kaya salah satu pasien tadi malem yang dateng karena keluhan insomnia (intinya sih dia minta obat tidur), jadi otakku bener2 lambat untuk berpikir cepet nanganin pasien emergency.
Pasien pertama laki2, 8 th, diagnosa flame burn grade 2b derajat 34%. First thought crossed my mind was fluid resuscitation. Since pasien luka bakar sangat besar kemungkinan nya dehidrasi kan, aku minta perawat masukin RL aja dulu sambil mikir what's next? Berapa banyak cairan yang harus dikasih? How to deal with the injury in addition i'd got a pediatric patient here. Surprisingly the patient didn't cry. He just absentmindedly looking at what he had done. All i could think about to decrease the pain and keep thinking what's next. Somehow, everything I'd studied in school and coass obviously gone by the wind without a trace behind back.
The situation urged me to open book and admitted me as a total failure of doctor :| i was worried about the amount of fluid resuscitation, the complication and so on. There i found the initial fluid therapy to be given is 4 ml/kgBW multiple to the degree of the burn. For the first 8 hours, you should've been giving a half of total fluid that had calculated before. For the injury I was about recommending burnazide or mebo zalf to decrease the pain and relieving reason. Yet, since the drugstore of the hospital has nothing of them, I just could give him a wet lint along as hoping it'd be enough for him till tomorrow, until the family enabled to bought at the outside drugstore.
Alat, obat, dan otak yang terbatas bener2 buat nasib si adik ini jadi sial maksimal. Jadi pasien ku ini awalnya mau ngidupin lampu minyak. Somehow, minyaknya tumpah dan bakar semua kaki, bokong dan tangan kiri nya. As his doctor, i felt so useless and disappointed. Luckily the hospital has a 24 hour-pediatrician. So she took over handling the patient in ward.
Pasien selanjutnya wanita primigravida yang sedang inpartu dan sudah pecah ketuban sejak seminggu yang lalu. Karena tinggal di pelosok yang jauh dari peradaban, pasien baru bisa nyampe rumah sakit sekarang. My first action? Sent her to delivery room. There i tried to identified if the fetus still alive by doppler. DJJ (denyut jantung janin) terdengar sekitar 150an. Stupid me of not having a watch so i couldn't count the DJJ. Another misfortune patient of having me as her doctor :(
Then went another disaster, pasien gak bisa bahasa Indonesia dan bahasa Batak. Taunya cuma bahasa Nias which no one here known but his husband. Jadi untuk nanya2 pasien harus nyuruh suaminya yang translate. Pfft. Setelah ditensi pasien ternyata hipertensi emergensi 200/130 mmHg. Aku masukin nifedipine digerus sublingual. Then, blank...
Huaaahhhh... What a super pathetic doctor I am!!! I cursed myself to the most stupid and lazy and useless doctor ever. The most right thing I did last night was calling the 24 hour-obstetrician ASAP :|
Sp.OG nya langsung nyuruh aku pasang kateter untuk cek proteinuria karena krisis hipertensi nya. Damn stupid me, how could PEB (Preeklampsia Berat) didn't crossed my mind?! Trus dia suruh aku cor RL karena pasien mulai ngantuk dan ditakutkan syok. Haaahhh... Menilai kesadaran pun aku gak kepikiran :/
Infus udah di cor, urine udah aku ambil trus aku bakar. Dan bener aja proteinuria +4, Kejang (-). Sp.OG nya langsung nyuruh aku persiapan operasi SC cito untuk terminasi kehamilan dan pemberian MgSO4 bolus 15 cc. Trus 30 cc Mg SO4 dimasukkan ke 500 cc RL di drips 14 tetes per menit. Believe me, waktu koass aku sangat hapal semua prosedur di atas. Sampe kalo aku lagi tidur trus tiba2 dibangunin ditanya penatalaksanaan PEB, aku bisa jawab di luar kepala tanpa harus mikir. Dan sekarang? Semuanya hilang like I just heard them for the damn first time.
I'm so grateful by having an emergency case just not as usual. Every patient who admitted to ER is a learning for me and reminder to study more as well. And another moral of the story: where on earth you can find doctor who's not have a watch?! So, nenok!!! Get your stupid watch back and change the battery AND quit being a lazy!!!
Pasien pertama laki2, 8 th, diagnosa flame burn grade 2b derajat 34%. First thought crossed my mind was fluid resuscitation. Since pasien luka bakar sangat besar kemungkinan nya dehidrasi kan, aku minta perawat masukin RL aja dulu sambil mikir what's next? Berapa banyak cairan yang harus dikasih? How to deal with the injury in addition i'd got a pediatric patient here. Surprisingly the patient didn't cry. He just absentmindedly looking at what he had done. All i could think about to decrease the pain and keep thinking what's next. Somehow, everything I'd studied in school and coass obviously gone by the wind without a trace behind back.
The situation urged me to open book and admitted me as a total failure of doctor :| i was worried about the amount of fluid resuscitation, the complication and so on. There i found the initial fluid therapy to be given is 4 ml/kgBW multiple to the degree of the burn. For the first 8 hours, you should've been giving a half of total fluid that had calculated before. For the injury I was about recommending burnazide or mebo zalf to decrease the pain and relieving reason. Yet, since the drugstore of the hospital has nothing of them, I just could give him a wet lint along as hoping it'd be enough for him till tomorrow, until the family enabled to bought at the outside drugstore.
Alat, obat, dan otak yang terbatas bener2 buat nasib si adik ini jadi sial maksimal. Jadi pasien ku ini awalnya mau ngidupin lampu minyak. Somehow, minyaknya tumpah dan bakar semua kaki, bokong dan tangan kiri nya. As his doctor, i felt so useless and disappointed. Luckily the hospital has a 24 hour-pediatrician. So she took over handling the patient in ward.
Pasien selanjutnya wanita primigravida yang sedang inpartu dan sudah pecah ketuban sejak seminggu yang lalu. Karena tinggal di pelosok yang jauh dari peradaban, pasien baru bisa nyampe rumah sakit sekarang. My first action? Sent her to delivery room. There i tried to identified if the fetus still alive by doppler. DJJ (denyut jantung janin) terdengar sekitar 150an. Stupid me of not having a watch so i couldn't count the DJJ. Another misfortune patient of having me as her doctor :(
Then went another disaster, pasien gak bisa bahasa Indonesia dan bahasa Batak. Taunya cuma bahasa Nias which no one here known but his husband. Jadi untuk nanya2 pasien harus nyuruh suaminya yang translate. Pfft. Setelah ditensi pasien ternyata hipertensi emergensi 200/130 mmHg. Aku masukin nifedipine digerus sublingual. Then, blank...
Huaaahhhh... What a super pathetic doctor I am!!! I cursed myself to the most stupid and lazy and useless doctor ever. The most right thing I did last night was calling the 24 hour-obstetrician ASAP :|
Sp.OG nya langsung nyuruh aku pasang kateter untuk cek proteinuria karena krisis hipertensi nya. Damn stupid me, how could PEB (Preeklampsia Berat) didn't crossed my mind?! Trus dia suruh aku cor RL karena pasien mulai ngantuk dan ditakutkan syok. Haaahhh... Menilai kesadaran pun aku gak kepikiran :/
Infus udah di cor, urine udah aku ambil trus aku bakar. Dan bener aja proteinuria +4, Kejang (-). Sp.OG nya langsung nyuruh aku persiapan operasi SC cito untuk terminasi kehamilan dan pemberian MgSO4 bolus 15 cc. Trus 30 cc Mg SO4 dimasukkan ke 500 cc RL di drips 14 tetes per menit. Believe me, waktu koass aku sangat hapal semua prosedur di atas. Sampe kalo aku lagi tidur trus tiba2 dibangunin ditanya penatalaksanaan PEB, aku bisa jawab di luar kepala tanpa harus mikir. Dan sekarang? Semuanya hilang like I just heard them for the damn first time.
I'm so grateful by having an emergency case just not as usual. Every patient who admitted to ER is a learning for me and reminder to study more as well. And another moral of the story: where on earth you can find doctor who's not have a watch?! So, nenok!!! Get your stupid watch back and change the battery AND quit being a lazy!!!
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