Apakah agaknya baginda akan berkata pada doktor muda?


Why do you believe what you believe in ethical issues? Blindfold or rational?


How should housemanship be?


Keluar dari zon selamat!


Kami berminat untuk menerbitkan apa sahaja artikel, grafik, kartun, cerpen yang berkaitan dengan perubatan. Kami alu-alukan sumbangan anda!

Monday, 30 January 2012

Getting your money back from KWSP.

Getting your money back from KWSP.
Peace For Everyone...
I am now working the in the primary side of our health system and in the past year I have learnt some things that I never would have known working in hospital especially about allowances and claims(financial gain and stability are some of the reason of why we do our job right..)

Before that I would like to congratulate all the Medical Officers reading this for the overdue review and increment of our On Call Allowances,hopefully there are part of it for Infaq,InsyaAllah.
I would also like to offer condolence for the House Officers as your RM750 Critical Allowance were abolished and from what I heard most of you guys still have not receive the RM600 promised for the shift system,hopefully the sum will be paid fully later(though if it’s considered an allowance,most probably you would not be getting it,be prepared)

I assume that most of us already know that once we are HOs ,part of our salary are automatically put aside into KWSP(about RM400++) ,and once we’ve agreed to sign our pension scheme we are entitled to get back the sum collected by KWSP.

Here I would like to tell you guys the steps of getting your money back as soon as possible.
First and foremost,you are entitled to get it only if you have signed the Skim Berpencen(you are now a government servant till you’re 60)..

After a short while(in my case,nearly 2 years),the documents you signed will be sent to SPA,Human Resources in Putrajaya from your respective JKN via your Pusat Tanggung Jawab.You will receive a notification from your JKN for this.

Meanwhile you can easily check the progress of the process “Semakan Taraf Berpencen” here and clicking Semakan Status Urusan Perkhidmatan (sometimes the portal are offline,so be sure to pray hard before logging in..)

After some processing there(a few months),the guys in Putrajaya will write a 1 page letter to your current management notifying that the process was a success,which will arrive at an amazing speed of one month++.You will hopefully be notified of this(I went to check myself at the office)

Once they received this notification,your salary will be updated promptly( around 2 months),and you will receive the pay without any KWSP cut(you can comfirm this by checking the E-Penyata Gaji site which annoyingly can only be opened with Firefox and Internet Explorer)

Then you can go to your nearest KWSP office(just a mere 145kms for me) and check your balance,approximately 45% of the total sum is yours. They would then give you some forms to be filled,some of them must be signed by your current employer/superior(most of us won’t be able to do this in a day),and remember that all copied documents must be presented with the original and verified by a grade A officer.

If all goes well,you’ll receive the full amount in your account soon(it’s still a mystery even for me)..

P/s:These are the steps I’ve taken...your PTJs(Pusat TanggungJawab) may differ and hopefully are more efficient...mine is considered OK...and if you’ve been moving around it may take longer...

Thursday, 26 January 2012

Housemanship - My Two Cents

I was an IB sudent studying in Kolej Mara Banting when I first heard about the three types of medical teaching philosophy that are in existence.

Those are namely:
3) Problem Based Learning (PBL)

Each of them stem from different school of thoughts, different opinions on how best to study medicine.

I am the product of PBL who at times wished to go traditional. And I have heard of the traditional med students who wished for integrated or PBL.

Yup, the field always seems greener on the other side, folks.

But the point of my bringing up the whole issue is to demonstrate that our teaching is not static. There will always be someone who thinks that we could have learned better when we were students if only they had implemented this or this or that. So they come up with ideas, all for the sake of making it better. The ideas will be examined, analyzed, shredded to pieces by discerning eyes. Once the ideas are found to be able to stand the test of logic, reasons and rationale, then plans will be made to carefully and gradually implement the ideas.

The key to on-going civilization is ideas! Innovations!

Being static is not an option.

Do you have any idea on how to make housemanship a better learning experience to prepare us to the real battlefield of diseases once we attained the rank MO-ship?

Previously, it was taught that putting a lot more hours into housemanship will increase your exposure to diseases and management, and thus would prepare you into becoming a good MO. Thus, the on-call system (sometimes EOD), the exhaustion, the denied physiological state of drowsiness and sleepiness, the GUILT of being made to believe that you won’t be a good enough MO if you don’t do on-calls.


I have other ideas. I am not saying that my idea is the best and it SHOULD be implemented. I am just using this medium in Blogger Ubat Muda as a sounding board to test what sorts of training would make a good MO. And I would like to hear ideas from others too. I am sure a lot of us have some ideas of what would make housemanship a better training program.

Let’s discuss it.


I was quite incredulous when I read the opinion of a houseman who thought that we should bring back the on-call system because he felt that housemen need the hours.


Let’ s say he was right.

Let’s say we do need the on-call hours.

But to do what?

To do more Brannulas?

To do blood taking?

To be informed by staff nurse that Pak Cik Ali has some temperature so that we can then order T. PCM and tepid sponging and then start taking Blood Culture?

To be informed by staff nurse that the patient in the acute cubicle has low BP – so that we can then run some fluid fast and then do hourly BP and then KIV start some inotropes if indicated after informing MO?

Granted we also clerk some new cases that come into the ward, but most of the time we just carry out the plans already ordered by our MO who was on-call in casualty.

Well, of course setting brannulas is important for patient who is on IV antibiotics. Of course blood taking is important when the patient is suspected of dengue and you need to monitor her/his FBC.

But when they said that we need the extra hours to be a better MO…are we supposed to devote those extra hours to be doing the above in the wards? Or to go to casualty and clerk new cases, and come up with a diagnosis and then decide on investigation as well as appropriate management plan for this patient?

Doing brannulas/ blood taking/ and order simple things like ‘run fluid fast’ or ‘T. PCM stat’ during oncall would not make us a better MO. It would not even make us a better houseman because we would already be doing those during office hours anyway! If you are already an excellent blood sucker, sucking more blood during on-calls would not make you more excellent than you already are. Like wise, if you are already an excellent brannula setter, setting them for an extra 100 times won’t make you any better. So what is the necessity of rendering our housemen exhausted and lethargic by hiding behind the reason that ‘they need the hours to become a good MO.’ The hours that they put in – that you say they need – should be devoted for doing something that will make them become a good MO, right?

Be smart!

If they need the hours, put them in casualty! Make them come up with diagnosis and appropriate investigation and make them come up with proper management plan from casualty! Make them use their brain because that’s what they will be doing once they become an MO.

If you want them to be tired, AT LEAST, make them tired for the right reason.

However it’s true that we need housemen in the wards too. It’s true that Brannulas still need to be set. It’s true that someone still need to take routine blood investigation from a dengue patient. It’s true that someone should be around if patient collapse.

But you see, my point is, the houseman can do all that without you hiding behind the reason that they need the hours to be a good MO. Why do we have to make them so tired going on-call for doing something that is YES! NECESSARY! – but won’t make them a good MO. Let them feel fresh to learn the most during office hours. If they are too tired from having worked for more than 24 hours on the previous day, do you think they will be able to absorb as much the next day, during office hours, when they need to maximize the use of their brain.

Don’t just work hard. Work smart!


Imagine this scenario.

Imagine a teacher who teaches add maths to a class of 25 students.

The teacher knows that at the end of two years, she needs to make sure that the 25 students will all be ready to answer the add maths questions in SPM. At least ready enough to pass.

So she reasons that in order for the students to pass Add Maths, the students need to do basic things ; multiplication, division, factorization, quadratic equation, differentiation, integration. They spend hours memorizing formulas that they know they will need to use when solving mathematical problems.

The Teacher spent the whole two years asking the students to practice all the concepts that they need to master in order to be able to pass SPM at the end of two years.

The exam day arrives at last.

The students are shocked! They are shocked when they find out that the questions come in the form of long paragraphs that they need to ponder and decipher and APPLY the concepts that they have learned. They are confused because the question is not as straightforward as ‘Do differentiation’ Or ‘factorize this equation’.

And at last only two students out of 25 pass Add Maths that year.

The teacher is very angry. “I teach you for two years! We even have Kelas Tambahan for you to keep doing quadratic equation and differentiation and integration bla bla.”

“But the questions in the paper were DIFFERENT than the one we are used to.” One student answered back.

"Ah alasan! How come these two students Ahmad and Ali pass? It’s because they have the initiative to study beyond what is taught in the classroom.”

Ahmad and Ali smile. They have a secret to their success. They both went to a tuition centre for ONLY two hours per week. In that two hours, they were taught how to apply the concepts that they learned. They were given past year questions and they were given questions in the form of long paragraphs just like what came out in the SPM.

Silently they want to say, “Oh teacher, we don’t need to spend all those extra hours in the classroom doing repetitive stuff on basic concepts. If only you had just spent 2 hours per week doing the real thing that we need to face during SPM, we would all have passed.”


We need to be able to set brannulas

We need to be able to do blood taking.

We need to be able to do procedures.

But we don’t need to do them for two years (siap sampai tak tidur and on-call lagi!!) to be good at those. In fact, that would NOT help us to become a good MO

What we need to do:

-interpret ABG – come up with possible Differentials.
-interpret CXR - come up with possible differentials
-interpret ECG – come up with possible differentials.
-interpret CT Brain – come up with possible differentials
-interpret MRI – come up with possible differentials.
-Decide on which antibiotics to use after patient is not responsive to one.
-Come up with management plan for all those differentials.

It doesn’t matter how many times we do on-calls….if we don’t spend the extra hours doing the right thing, we will never be a good MO. Might as well we don’t do the extra hours and come to work fresh and smiling and more receptive to learn by ourselves.


This is only my humble opinion on the current housemanship training. We should spend extra time thinking the way our MOs think!

Not everyone is like Ahmad and Ali who has the initiative to seek outside resources. Besides, by rights, the teacher should have recognized from the very beginning what sort of training is beneficial and what sort is not so necessary. By rights, regardless of anyone having extra initiative, the teaching should be successful simply looking at the amount of hours the students already put in to study. Work smart, remember?

I am not entirely convinced of my ability to become an MO even after 1 year of housemanship now. I am very scared to be all alone out there.

And I am discussing this issue not for the readers to agree with my opinion. If anyone disagree with what I have written, please say so and give us a solution. I would like to hear them. Maybe…we can make a few suggestions to the ministry.

What does everyone else think?
Let's discuss this.

Sunday, 22 January 2012

Anatomy of A Medical Student


Pelajar perubatan boleh dikatakan macam mini Doraemon. Dalam poket whitecoat ada macam-macam jenis barang. Kalau tak bawak, nanti pensyarah tegur dalam nada sinis. "Mana alat-alatan anda?" Lepas tu semua tersengih-sengih macam kerang busuk.

Pembaris - nak ukur jugular venous pressure
Tendon hammer - nak uji refleks
Calculator - Sebenarnya pelajar tak perlu sangat (dan dah ada dalam telefon masing-masing)
Steteskop - tahu kan fungsinya. :)
Tongue depressor (macam kayu aiskrim) - nak tengok anak tekak dengan lebih jelas
Kapas dan stik oren - nak uji deria
Jam - WAJIB! nak kira nadi dan pernafasan
Measuring tape - penting untuk periksa ibu mengandung, pesakit hydrocephalus, ukur bengkak kaki dll
Penlight - banyak fungsi

Lagi? Buku rujukan! penting jugak nak terus cari apa-apa yang tak difahami. Kalau simpan nanti dah balik penat, dah basi.

Dunia dah semakin canggih
Tapi ikut juga keaadaan. Sekarang teknologi dah canggih, orang bawak internet ja dalam poket. Doktor tanya, search, google. Dah banyak ebook, application canggih yang boleh dimuat turun dalam telefon/ipod/ipad/tablet masing-masing. Hah canggih kan pelajar perubatan. Doktor pun tak marah dah sekarang kalau pelajar belek-belek telefon waktu kelas. Silap-silap, ada doktor yang suruh pelajar cari di internet.

Kata orang pakai telefon bimbit mahal kerana nak bergaya, sudah tak valid lagi dah. :)

Berbalik kepada 'alatan', sebenarnya tak semua kena bawak. Ada yang boleh ambil di hospital mengikut keperluan.

Contoh lain yang tak ada di sini :

- sarung tangan - untuk sentuh pesakit atau jika nak tolong buat prosedur apa-apa
- tuning fork  - untuk uji pendengaran atau deria pesakit terhadap gegaran.
- face mask - untuk perlindungan diri dan pesakit
-opthalmoscope - satu set termasuk untuk telinga harga lebih kurang RM700. Tak semua pelajar sanggup beli. 

Dan paling penting, bawak otak dan fikiran. Jangan tertinggal di bilik pulak.
Ada soalan? Kemukakan dalam komen.

Monday, 16 January 2012

Stand up for yourselves

Working at a KKM hospital is satisfaction 5% and heartache 95%. It’s not because we got no satisfaction treating the patients, but from up top to down bottom, rotten apples are everywhere. In government service, everything is about seniority. Everything is about hierarchy. Everything goes by what the boss says.

This system of hierarchy actually serves to protect the main KKM clients – the patients. A specialist with 15 years of experience certainly would give much more accurate and decisive treatment than a one-month old houseman. But the system also opens up another door – bullying. Bullying has been a culture of KKM doctors since forever. The main reason for this bullying – for YOU to learn. Whether it’s really the best teaching method, nobody can say.

A houseman does not outrank the nurses. The nurses rule the ward, they know how the works are being done all this time while the houseman keep changing every few months. They determine whether we had done things correctly or not, whether this form and that form are filled in correctly, whether our work is complete or incomplete, whether we can have meals or breaks during our shifts. I certainly don’t remember myself outranking the PPK because last I heard, I was told to “Jangan kacau saya boleh tak? Kalau doktor nak urgent, pegi hantar ABG ke lab sendiri lah! Saya banyak kerja ni!”

A houseman is at the bottom of the food chain. It’s so easy to bully a houseman with the reason “so that you can learn”. Me, I cannot tolerate bullies. I don’t stand up to every bullies in my workplace, but when I do, I make life messier for them.

When I was in medical posting, there was a discharged patient who is ex-IVDU with Hepatitis C positive, supposedly in radiology for a CT-scan, but was sent to our stable ward without any notice whatsoever for a venofix. The reason being; they couldn’t fix it down there. At that time there were only 2 houseman taking care of 30 patients. Medical being medical, with so many transfer-ins, discharges, bloods, referrals, charting, procedures, summaries etc, we just do as asked without asking questions, sometimes without knowing the cases. So my colleague at that time saw this patient and tried to insert branula for him. She was really in a rush as she has loads of other referrals to settle.

She attempted few times, but couldn’t get any because the patient’s venous architecture is no good. Frustrated and rushed, she made another try, and poked her own finger! She was crying after she got the needleprick injury. She was so stressed up. But she hasn’t known the case yet. Only after few minutes she got that needleprick, she discovered that the patient is ex-IVDU and Hepatitis C positive! And then she was even more panicked than ever.

I did feel pity for her and feel angry at the radiology MO who sent the patient up for us to fix in a branula. So I sent a memo back to the radiology MO saying that we couldn’t fix a branula and in the process of trying, a houseman got a needleprick injury, so please do your own job without pushing the work to us busy housemans. And I went straight to see one of the hospital administrator in director’s office to talk about this incident. I brought up the issue “Why should radiology push a patient to medical for venofix?”. Yes, radiology pushing venofixes to houseman is not a new thing. I was called down to radiology several times for venofixing. But I was so pissed off that day because one of us houseman got needleprick for helping out radiology.

And the said MO got a good yelling. But one of the radiology consultants wasn’t happy that I stood up. He wasn’t happy that I spoke to the administrator and wasn’t happy on how I wrote the memo. So he came to my ward and gave me a big yelling. You houseman with attitude, when I was a houseman blabla, needleprick injury no big deal, I will tell your consultant to extend you in medical etc etc etc.

I was happy I stood up for that. I heard that there was no more unnecessary bullying like that happening again across departments (radiology bullying medical houseman). The medical consultant actually backed me up and praised my courage for standing up like that. And I was NOT extended in medical. But I got a very big stare every time I walk down radiology department, arranging for ultrasound, CT and MRI for my patients. Damn, I made lots of enemies already…

You can see how miserable most KKM staffs across the board, one blaming another, save your ass first before someone else’s. That’s because they do not speak up. So they can just complain at the back. And this includes specialists that complain too many houseman and taking the frustration to the poor housemans. Houseman cannot do anything about our numbers, they also can’t do anything about it but they don’t want to speak with higher ups in fear of retribution, so they take out on the houseman.

So, if you don’t like how you are being treated, firstly, DO NOT EVER ACT LIKE THEM. Seriously. Secondly, speak up, but choose your battles well. You cannot want to win every time.

Remember, the bad things in the world happen because good people don’t speak up.

Wednesday, 11 January 2012

Its Just An Acute Appendicitis


Today I would like to talk about appendicitis. This is merely general information to all of you(non doctors) out there and I hope by the end of this topic, it educates patients to be more alert and seek treatment as soon as possible.

What is appendicitis? What are the symptoms and why do I choose this topic among all others? Of course, this is an emergency surgical case that if we took even a second of delay, it has higher chance to progress and contribute to higher mortality and morbidity. Appendix is a blunt end hollow organ filled with lymphatic tissue. Well, it plays a role in our immunity, especially in children.

It is located in right lower abdominal region(its most common place). The symptoms are simple - sudden onset of pain, pricking-like, increasing in severity, aggravated by food intake, fever(on and off), nausea and vomitting (these are the most common symptoms I usually see among my patients).

Well, as a surgeon, we see the patient as a whole. Besides appendix, there are several organs located exactly at the same location where appendix is situated. We have Meckel's diverticulum, cecum, ureter, ovaro-fallopian tube(for women) etc.

So please do not feel irritated when the doctor ask you as well other questions, because they need to exclude other diseases as well. Who knows, it could be urinary tract infection with appendicitis, or urinary tract infection alone or even appendicitis alone..sounds complicated isn't it?

After all clinical examinations are conducted and diagnosis established, we go in!

For me, I have already done 10-20 appendicectomy,  yet still have a kind of feeling while doing appendicectomy. It's just like playing cards....yeah right! Because we never know what we will encounter while going in until we see the last part of abdominal layer..sound interesting right? It could be easier or harder than before.

The palpitation begins just before the incision is made and I guess it will end only after the operation is completed. We never know how is the condition of the appendix,  is it perforated, suppurated? Will it be hard to find? Will there be lots of adhesion, that the appendix cant even be visualized and mobilized?!!

But even the 'simple' appendicectomy can be converted to laparatomy if the appendix is severely damaged or involves the caecum. This is how cruel appendicitis can be to someone.

Well guys, this is neither a medical lecture nor CME, so take it easy. It is just a general information which I'd like to share with you guys. From its clinical presentation to the surgeon's feeling while opening up in search for the appendix. :)

Have a good day. :)

EDITOR: Dr Aizat is currently serving as a junior medical officer in Surgical Department, in one of Malaysia's government hospital.

Saturday, 7 January 2012



Satu kelebihan yang diperolehi setelah menjadi pegawai perubatan, adalah membuat locum secara sah di sisi undang-undang. Selain menambahkan pendapatan (penting bagai doktor-doktor yang bakal berkahwin), ianya juga menambahkan ilmu pengetahuan kita. Seperti kata seorang doktor senior, “Kita sebenarnya banyak belajar bila buat locum.”

Kalau orang politik menggunakan slogan ‘dekatilah rakyat’, maka ‘dekatilah pesakit’ dengan membuat locum. Ada perkara yang kita tidak akan belajar dan rasai dengan hanya bekerja di wad dan hospital.


Doktor GP klinik swasta  sepenuh masa selalu diperlekehkan oleh doktor hospital sebagai pakar URTI(upper respiratory tract infection) dan malah kawan saya berseloroh doktor buat locum klinik sebagai URTI-ist. Namun ketika locum, berwaspadalah kerana kadang-kadang boleh menerima pesakit berpenyakit seperti ectopic pregnancy, Dengue hemorrhagic fever dan sebagainya.

Ada juga penyakit kebiasaan tetapi tidak dilihat di wad seperti atopic eczema, allergic dermatitis, scabies, tinea corporis dan banyak lagi penyakit kulit yang lain. Kita perlu membezakan dan merawat dengan efektif. Saya bersyukur pengalaman bekerja di Jabatan Dermatologi banyak membantu.


Sewaktu locum jugalah kita belajar untuk mendengar luahan hati pesakit. Datang dengan mengadu sakit kepala, akhirnya pesakit meluahkan perasaan yang terbuku di hati dengan tangisan. Semua akibat tekanan hidup zaman sekarang. Tekanan seorang pengurus wanita terhadap persaingan di tempat kerja, tekanan seorang isteri yang tidak dapat melahirkan anak.

Ada seorang guru perempuan 50an yang merasakan terhina. Setelah perompak mencuri komputer riba milik sekolah di rumah, beliau diasak-asak oleh pihak sekolah untuk membayar ganti harta sekolah malah berulang kali menerima surat amaran tindakan tatatertib daripada kementerian. Beliau kata sudah berdekad berdedikasi bekerja sebagai seorang guru, beliau tidak pernah mengambil cuti sakit, sudah 3 kali menerima anugerah guru cemerlang. Tetapi merasakan sumbangan seumur hidup beliau begitu tidak dihargai sehinggakan dilayan seperti seorang pencuri. “Duit itu saya boleh cari, tapi ini bukan soal duit doktor.”

“Maaflah doktor saya cerita semua ni.”

Apabila dibawa isu ini kepada rakan kaunselor, mereka mengajar sedikit sebanyak cara membimbing pesakit sedemikian.


Di hospital kita merawat pesakit mengandung dan membantu melahirkan anak. Di klinik locum, kita mengkhabarkan berita gembira bahawa mereka atau isteri mereka mengandung. Ada yang terlompat-lompat gembira, ada yang rasa lega dek tekanan daripada keluarga.

Ada yang selepas tahu mereka mengandung bertanya, “Ada apa-apa tak yang doktor boleh buat?” Tergamam diri apabila diminta menggugurkan kandungan. Lidah kelu tidak tahu apa yang ingin dijawap.

Seorang rakan doktor  kata, “Jawablah begini: Janganlah gugurkan kandungan ni kak, kerana mana tahu, antara anak-anak akak, anak inilah yang sanggup menjaga akak bila dah tua nanti.”


Ada kalanya kita tidak tahu apa penyakitnya dan ini pastinya merisaukan seorang doktor. Iaitu memberitahu pesakit bahawa kita tidak tahu apa penyakitnya. Terlalu ego sehingga kita rawat secara simptomatik, tanpa memberitahu apa penyakitnya. Mungkin lebih baik jika kita rujuk pada doktor lain atau ke hospital.

Ada ketikanya kita terjumpa penyakit yang jarang dijumpai di klinik locum seperti lupus erythematosus, scalp psoriasis, acute generalized exanthematous pustulosis dan sebagainya. Selepas dirujuk ke hospital, ambillah kisah tentang pesakit dengan menelefon mereka kemudian hari, untuk mengambil tahu tentang keadaan mereka terkini. Ini juga dapat mengukuhkan pengalaman memberi diagnosis sesuatu penyakit.


Saya kerap bersembang bersama staf klinik. Selain membina hubungan yang baik bersama staf, ianya juga peluang untuk kita pelajari tentang selok-belok membuka klinik, terutamanya apabila bertanya dengan staf senior.

Antara faktor yang menyebabkan pesakit kembali ke klinik yang sama adalah hubungan yang baik bersama doktor. Doktor haruslah sudi mendengar masalah pesakit dan melayan mereka dengan baik. Sehinggakan ada pesakit yang datang ke klinik bertanya hari apa Dr. ZZZ bekerja, dan datang pada kemudian hari.

Bila saya tanya ada tidak pesakit yang datang cari saya, rupanya ada juga. Rasa lebih bersemangat untuk bekerja. Patutlah ada pesakit yang tanya nama saya. Ingatkan nak saman.


Selesai solat di bilik rehat doktor di klinik locum, terlintas hati untuk mendoakan sembuh penyakit pesakit-pesakit. Harap kita semua amalkan sedemikian.

Wednesday, 4 January 2012

"Kualiti Hidup Saya Terjejas"

Ada segelintir masyarakat yang mengganggap bahawa kesihatan pergigian bukanlah isu utama dalam kehidupan mereka. Mereka merasakan kualiti hidup bergantung kepada sejauh mana organ dalam tubuh mereka boleh menjalankan fungsi dengan baik. Contohnya, keupayaan jantung mengalirkan darah ke seluruh tubuh dengan baik serta keupayaan organ-organ utama yang lain seperti ginjal dan hati dalam menjalankan fungsi masing-masing.
Tahukah anda bahawa bilangan gigi yang normal adalah 20 batang untuk kanak-kanak dan 28 ke 32 batang untuk dewasa? Tahukah anda juga bahawa gigi adalah tulang yang paling kuat pada tubuh manusia? Tahukah anda bahawa gigi geraham atas mempunyai 3 akar manakala gigi geraham bawah mempunyai 2 akar? Tahukah anda bahawa setiap satu morfologi(bentuk,saiz) gigi adalah berbeza-beza? Tahukah anda bahawa setiap gigi mempunyai setiap fungsi yang berbeza dalam memastikan makanan dibawa dengan selamat ke dalam usus perut? Tahukah anda bahawa gigi mempunyai 3 lapisan utama yang mempunyai karakter mikroskopik yang berbeza-beza sesuai dengan fungsinya yang berbeza?
Dan tahukah anda bahawa Allah menciptakan gigi dengan sebegitu banyak ciri-ciri istimewa bukan dengan tujuan yang sia-sia? Namun betapa ramai masyarakat kita hari ini memandang enteng tentang penjagaan gigi seolah-olah gigi yang begitu kompleks penciptaannya itu tidak memberi sebarang makna kepada kualiti kehidupan mereka.
Benarkah begitu?

Jika anda benar-benar menghargai dan mensyukuri gigi sebagai salah satu nikmat daripada Allah, kenapa anda tidak berusaha untuk memastikan gigi anda dijaga dengan baik?

Justeru, saya akan kongsikan kisah seorang pesakit saya yang akhirnya mengetuk dahi mereka sendiri kerana alpa dalam penjagaan gigi. Sebelum itu, ingin saya ingatkan bahawa saya tidak menuding satu jari kanan kepada mereka untuk mengatakan mereka memang patut menyesal. Tidak juga 5 jari kanan untuk mengatakan mereka patut menanggung kesannya, apatah lagi 5 jari kiri untuk mengatakan mereka yang bertanggungjawab sepenuhnya di atas kealpaan mereka itu.

Tetapi jari-jari yang ada di kedua belah tangan saya ini ingin sekali saya tuding ke arah semua doktor pergigian yang mempunyai tauliah tetapi gagal menyampaikan maklumat tentang kesihatan pergigian, juga kepada badan-badan kerajaan atau bukan kerajaan termasuk swasta yang menyulitkan lagi proses rawatan kepada mereka, serta sesiapa sahaja yang terasa patut menyalahkan diri mereka sendiri, khasnya untuk mereka yang mempunyai ilmu tetapi tidak mahu beramal dengan ilmu mereka.

Semoga kisah ini menjadi salah satu wadah untuk saya menyampaikan maklumat tentang kepentingan penjagaan kesihatan pergigian kepada masyarakat. Semoga anda dapat melihat kaitan antara gigi dengan kualiti kehidupan yang baik.

Seorang pesakit saya bermusafir dari Indonesia ke dua buah hospital yang tidak dapat merawat kesan trauma yang dihadapinya 2 minggu yang lalu. Beliau akhirnya ke hospital tempat saya bekerja untuk mendapatkan rawatan. Rahang bawahnya patah, bersilang dan gigi di rahang bawahnya bertindih akibat daripada kemalangan. Tisu sudah bersatu. Rawatan yang ada hanyalah mematahkan kembali rahang bawah dan mencamtumkan kembali yang bersilang kepada asal. Rawatan berjaya walaupun sepatutnya pesakit terus mendapatkan rawatan dalam tempoh kurang seminggu selepas trauma sebelum tisu bercantum.

Dari jauh saya melihat satu susuk tubuh yang dibaluti dengan pakaian yang indah. Dari atas ke bawah tertutup kemas selaku dirinya merupakan seorang muslimah. Beliau dipanggil masuk apabila gilirannya sudah tiba.

Saya memandang wajahnya yang bersih dan berseri-seri itu. Seperti biasa selepas memastikan pesakit tiada sebarang masalah kesihatan yang berkaitan, saya bertanya apakah masalahnya.

“Mak Cik akan pergi haji sebulan lagi.”

“Ya kah? Alhamdulillah.” Saya memberi respon.

“Tetapi Mak Cik risau tak ada gigi. Atas depan tak ada. Bawah tak ada. Tepi-tepi ni pun tak ada.” Sambungnya sambil jari telunjuk dialihkan ke kawasan yang dimaksudkan.

Mungkinkah Mak Cik ini berasa sukar untuk makan? Mungkin segan untuk bercakap? Atau segan untuk memberi seulas senyuman? Atau sisa makanan sering tersekat di kawasan yang tiada gigi? Boleh jadi juga gigitan sudah tidak seragam kerana ketiadaan beberapa batang gigi?
Atau ada gigi yang goyang akibat tekanan yang tinggi kepada gigi yang masih ada ketika mengunyah? Atau?

Beliau menyambung. Wajahnya yang tadi tampak tenang kini melahirkan kedutan di kiri dan kanan.

“Mak Cik tak dapat nak mengaji!”

Tersentap saya mendengarnya. Sambungnya lagi,
“Doktor, susah Mak Cik nak sebut huruf-huruf tertentu. Bunyi lain, maksud jadi lain. Memang Mak Cik tak menjaga gigi. Tapi Mak Cik tak sedar bila tak ada gigi rupa-rupanya bukan sahaja susah nak makan dan nak bercakap pun segan. Tetapi bila dah nak pergi haji baru Mak Cik rasa sukar hendak mengaji.”

Kualiti hidup anda ditentukan dengan bagaimana anda melihat erti kehidupan itu sendiri. Jika anda merasakan hidup anda bererti apabila anda boleh membaca al-quran dengan baik, maka ingin saya tekankan bahawa gigi anda yang tiada memang mengganggu kelancaran sebutan huruf-huruf tertentu.

Memang gigi palsu dan tanaman gigi (dental implant) boleh memberi penyelesaian, namun tiada yang sebaik gigi original dan rawatan itu sendiri ada pro dan kontranya. Tidak semua pesakit sesuai untuk rawatan yang dinyatakan. Tambahan lagi, rawatan itu bukanlah penyelesaian kepada masalah yang dihadapi.
Jadi anda bersetuju dengan saya bahawa gigi memberi impak kepada kualiti kehidupan anda? Mungkin saat ini sempena sambutan tahun baru 2012 kita patut mengambil sedikit masa untuk merenung bagaimana kita ingin menjadikan kehidupan kita lebih bererti. Apa sebenarnya yang memberi erti kepada hidup kita?
Jika kita ingin menjadikan kehidupan kita adalah sepenuhnya beribadah kepada Allah sepertimana yang dinyatakan dalam surah Adz-Dzaariyaat ayat 56, saya ingin tegaskan 2 perkara.

Pertama, kebersihan adalah sebahagian daripada iman. Islam mengajar kita untuk sentiasa memastikan kebersihan, maka tidak hairanlah mengapa Rasulullah sendiri membersihkan gigi setiap kali sebelum solat! Gigi yang bersih memberi jaminan bahawa anda menjaga kebersihan. Justeru semakin banyak bilangan gigi yang berlubang menunjukkan betapa anda bukanlah seorang yang pembersih. Adakah itu wajar untuk memanifestasikan tahap keimanan anda?

Kedua, kekhusyukan dalam beribadah menentukan sejauh mana bernilainya amalan kita di sisi Allah. Perbuatan yang tidak khusyuk mungkin melahirkan kesan yang tidak dikehendaki. Buktinya betapa ramai masyarakat yang bersolat tetapi masih melakukan maksiat. Saya melihat ramai pesakit saya merasakan kesakitan pada gigi sukar untuk dikawal. Ia sakit dan mengganggu aktiviti seharian mereka.

Sebagai seorang Muslim, adakah kita berasa mudah untuk khusyuk dalam solat jika gigi sedang sakit? Mungkin kita akan mempercepatkan solat? Malah kekadang ada yang langsung tidak solat. Apatah lagi ibadah sampingan yang lain. Memanglah kita tidak minta untuk sakit. Tetapi sakit gigi bukanlah suatu proses yang berlaku dalam tempoh sehari atau seminggu.
Tahun masihi 2012 adalah tahun baru yang diraikan oleh seluruh warga dunia. Setiap tubuh pasti mengharapkan tahun baru menjanjikan kehidupan yang lebih bererti untuk mereka. Saya ingin menyarankan anda untuk menjadikan tahun 2012 sebagai tahun permulaan anda untuk menjaga kesihatan gigi.

Beberapa pesakit datang mendapatkan pemeriksaan gigi,

“Are you coming for check up and scaling?” Saya bertanya kepada seorang pesakit yang berusia pertengahan 20 an. Dia adalah perokok.

“Yes, Dr. I want new teeth for new year!”

Saya gembira mendengarnya walaupun saya mengalami sedikit kesukaran ketika melakukan penskaleran(cucian) gigi kerana beliau adalah seorang perokok. Perokok sering mempunyai gigi yang lebih kotor berbanding bukan perokok.

Pesakit yang berusia awal 50-an ini menghidap kanser hidung dan tekak, Nasopharyngeal Carcinoma, NPC. Kalau giginya bagus pasti tiada apa yang perlu beliau risaukan tentang hakikat bahawa 11 batang giginya perlu dicabut untuk mencegah komplikasi akibat rawatan radioterapi kelak!

Nasihat saya, berjumpalah dengan doktor pergigian dan dapatkan pemeriksaan gigi segera. Keyakinan anda untuk berada di tengah-tengah masyarakat juga dipengaruhi oleh keadaan gigi anda. Dan orang juga mungkin menilai anda dengan melihat bagaimana keadaan gigi anda.

‘Ada hitam di tengah-tengah gigi.’
‘Nafas berbau.’

Sekarang anda bersetuju dengan saya bahawa gigi mempengaruhi kualiti kehidupan anda? Jika ya, dapatkan pemeriksaan segera!

Nota kaki:
  1. Daripada Ibn Umar r.a. berkata: Rasulullah s.a.w. bersabda : “Jadikan bersugi itu satu amalan, kerana ianya (bersugi) menyihatkan mulut dan merupakan kesukaan kepada Maha Pencipta.” (Hadis Riwayat Al-Bukhari)
  2. Jika tidak menyusahkan ke atas umatku, aku ingin menyuruh mereka melambatkan solat Isyak dan bersugi (menggosok) gigi setiap kali mereka hendak melakukan solat. (Hadis riwayat Muslim)
  3. Sesungguhnya Allah SWT menciptakan jin dan manusia tidak ada tujuan lain melainkan hanya untuk beribadah kepada Nya sahaja dan hanya beribadah itu sahajalah jalan yang dapat menyelamatkan jin dan manusia di dunia dan di akhirat nanti. (Az Azzariyat : 56)
  4. Sesungguhnya solat ku, ibadah ku, hidup dan mati ku adalah untuk Allah Rabb sekalian alam. (Hadis Riwayat Muslim)

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