“All My Patients Were Neighbours”
Humans of Medicine #27
When the call initially went out, I knew deep down what I had to do as a Medical Officer (MO) and a Malaysian. I had been working as a MO in Johor in the Orthopaedics department for the past 6 months but I knew that there were other places in need. I had to leave my comfort zone and respond to the call of need from Sabah and before I knew it, I was saying goodbye to my parents and off I was to combat the pandemic ravaging the island. I was nervous and afraid of what I was about to face, it certainly didn’t help that the information coming out of Sabah was few and far between. Even when the media reported the covid-19 situation in Sabah, the details were sparse. I was going into this blind, with my medical knowledge the only shield protecting me. Despite the daunting task ahead, I knew deep down that this was what I wanted to do, to make a difference wherever and whenever I could, after all these were the reasons I pursued a career in Medicine.
As this was during the height of the pandemic, there were no commercial flights between Sabah and Johor. Due to this, the Ministry of Health was using planes from the Army to transport health workers to and from Sabah to West Malaysia. I subsequently boarded a Royal Air Force plane with a few other doctors in tow and was immediately flown to the frontlines in Sabah. In retrospect, that was the shortest boarding time I have ever experienced.
As soon as I touched down, I was sent to a district hospital in a nice little town around 30 minutes from Kota Kinabalu. My job as the MO at the district hospital was to cover the Accident & Emergency (A&E) and treat all incoming Covid-19 positive patients. Thankfully at Tuaran most of the covid-19 positive covid-19 patients who arrived at the A&E had few symptoms and those that did present with symptoms were still generally quite well.
There is no cure for Covid-19, and the only treatment we can provide is to alleviate patients’ symptoms. This was the case whether I was in Johor or Sabah - the protocols for treatments were identical. The only difference was the influx of patients, and the lack of available beds in the hospital, especially in the Intensive Care Unit (ICU). When the ICU was filled to the brim, patients who required it were then sent to Queen Elizabeth’s hospital in Kota Kinabalu.
In Malaysia, the general protocol for patients with Covid-19 is to be admitted into hospitals. However, in Sabah due to delays in getting Covid-19 test results back, patients were only admitted eight to nine days after they took the test. This meant that in a small town like Tuaran, these patients were going about their normal routines while transmitting Covid-19 unknowingly.
It reached a point where we had 40 daily patient admissions into the A&E for Covid-19, and around 4-5 patients were transferred daily to the Queen Elizabeth hospital in KK due to their deteriorating conditions. Every time a patient required care that only the Queen Elizabeth hospital could provide, I had to call the Infectious Disease Consultant in KK and explain the situation. The consultant would then determine whether my patient would be given a bed at the hospital or not. The situation in Tuaran was becoming so dire, and patients kept piling in. The majority of my patients admitted into the ICU were neighbours.
I remembered seeing a 60-year-old uncle, fit and healthy despite his advanced age with good vitals being admitted into the hospital after testing positive for covid-19. He boasted about his exemplary physical condition and his ability to perform sit-ups and push-ups and even performed a few in front of us to show he wasn’t bluffing. Ironically, on day two of his admission, his vitals and condition deteriorated rapidly. He found it much harder to breathe and was given oxygen levels to maintain his oxygen saturation levels. The same old man who was performing pushups and situps the day before was now bedbound and unable to walk unaided. The speed in which his physical health deteriorated was alarming and it acted as a warning to all those there that the virus was not something trivial but deadly and harmful. Needless to say, he was rushed off to the hospital. Fortunately, after two weeks of treatment he was discharged and had fully recovered. I was left appalled, witnessing how dangerous contracting Covid-19 could be for everyone regardless of how fit they may be.
Looking back at my time in Tuaran, Sabah, I can say that though it was a very stressful and tiring period to be in, I enjoyed my time there. Unlike in Johor, there is a willingness amongst patients in Sabah to listen to their doctors and to take their advice. Furthermore, patients were very polite and willing to have a conversation with me wherever I went, be it in the hospital or out in public. I was treated with much more respect than I had experienced whilst working elsewhere and that led to a much more positive experience for me.
Whilst working in Johor as a MO, my patients were my ultimate critic, more so than my attending. For they held the power to enhance or reduce my reputation amongst the consultant doctors. I say this because their complaints or praise of me had an enormous say. The consequence of this was that I ultimately had to meet all of the medical demands of my patients. For example, with the dissemination of medical knowledge throughout the internet, patients would request for procedures or medications that I would have deemed unnecessary. Regardless of my medical advice, most would insist on receiving what they had demanded for and more often than not, I bowed to their demands. For if I did not, they would complain to my attending and my reputation as a result, would plummet.
On the contrary, my patients in Tuaran were substantially more understanding, most did not demand certain treatments or medications. They asked for my professional opinion and more importantly, they listened to these opinions and accepted them. Not only that, but they were much friendlier too, they would make sure you felt comfortable in conversation with them, as if you two had been friends for years rather than strangers who had just met. Now some who read this may think that the patients in Tuaran were more willing to listen to my advice because of the notion and stigma that those in Eastern Malaysia tend to be less educated than those in Western Malaysia. I don’t believe this was the case at all, they treated me with more respect and friendliness not because of their lack of education, but because this was their culture, this was their way.
About the author
Written by freelancer Justin Soon.
Consent has been obtained from the interviewee for the purpose of this publication. The author has rewritten the article with permission from the interviewee.
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