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The Theoretical Doctor @[email protected] · 2026-01-15 · 01:00 UTC

My New Year’s Eve – 2025

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31st December 2025. I was NOT oncall.

It was a Wednesday and it was a normal working day. Hence, at 7:45am, I left to work as usual and was there by 8am. It was the New Year’s Eve. I thought that maybe, just maybe, there would be less patients in the clinic.

The day started off smoothly. Surprisingly, there were many patients who came for their follow up followed by additional patients (the defaulters and walk-ins) but it was manageable. We went about our day, seeing each patient and when lunch time came, we went for our lunch break.

At 2pm, we went about our work, seeing patients as usual and I was taking my time with each patient. The patient load in the afternoon shift was lower compared to the morning shift and both my colleagues were done with their patient load.

Suddenly, a staff nurse barged into my room saying that there is a massive accident that just occurred nearby, 2 patients were already brought in and 2 more were on their way. They called in all available doctors (which were only the three of us) to help out.

I told my colleagues to head out and help out first while I rushed through the consultation of my final patient. After that, I rushed to the tiny Emergency Room of the clinic. My colleague who was oncall on that day was already attending to a child. I went over to the other patient, an old lady and did my primary survey and fast scan.

She was desaturating badly under room air and needed oxygen support. She had an open skull fracture, multiple abrasion and laceration wounds over her face, upper and lower limbs as well as rib fractures and on top of that, her left leg appears shortened and she has a closed fracture over her right lower limb.

I didn’t think that we should proceed with an x-ray at our clinic even if we had the facility at that time, the best would be to send them straight away to the hospital because she could deteriorate further any time. Thankfully, her GCS (Glasgow Coma Scale) was full.

I was focused on my patient, stabilising while referring her to the specialists of various specialities as well as the emergency physician that when I finally got ready to transfer her out that I noticed the child that my other colleague was attending to. The child’s right arm was crushed and the distal limb of his right arm was pale and his right lung was obvious till mid-chest.

Just how in the world is he still awake? The poor child was crying out in pain…

Judging by the state of his and my patient’s injuries, it was definitely high impact.

The story was, the whole family were travelling back from Miri to Kuching. Both the parents were sitting in front and the father was driving whilst the two children and their grandmother were sitting at the back.

The father claimed that he was not speeding but as he was about to make a u-turn at a junction, he claimed to have hit the curb and the car turned many times into the other lane before finally stopping and the grandmother and one of the child were thrown out of the car.

It sounded like a very high impact collision. Thankfully, the parents and the other child were well and unscathed.

We had to transfer both patients in two separate ambulances to the Red Zone of the Emergency Department at Hospital Bintulu as one ambulance could only transport one patient at a time.

Upon arriving, I met my colleague and friend at the Red Zone of the hospital. After we have handed over to the medical officers and specialist in the Emergency Department, we headed back together. However, upon reaching back, there was another patient who came in who was extremely tachypnoiec.

Oh, here we go again… Another Red Zone referral…

We stabilised the patient and referred her to hospital again. The clock was already showing 10pm when we left. The journey to the hospital takes about 45 minutes to an hour for each journey and the both of us have yet to have our dinner. This time, I choose to accompany her for the referral, mainly for emotional support and also in hopes of stopping by McDonald’s to get a takeout.

Yes, we did stop by McDonalds after sending the patient safely to the hospital and yes, we used the ambulance and went through drive-through.

By the time we left, it was already 11pm. The journey takes around 45 minutes to an hour and it was raining heavily. At this point, I was wondering if we would end up celebrating New Year’s in the ambulance.

Me and my friend ate in the ambulance on the way back while we joked and exchange oncall stories. Thankfully, we reached a little before midnight. The day was completely unexpected, not to mention tiring but it was nice to have spent it with a friend.

It’s still the beginning of 2026, so if I’m not too late, Happy New Year!

If you are travelling anytime soon or in the future, do drive safely, stay within speed limits especially if it is raining. Remember to get your car and tyres checked before any long distance journey and NEVER drive under the influence.

Stay safe always!

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The Theoretical Doctor @[email protected] · 2026-01-13 · 01:00 UTC

Lazy Days As A Medical Officer

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Do lazy days make you feel rested or unproductive?

While I’m at work, I’d be looking forward to returning home or towards my off day. In contrary, while I’m at home or on my off day, I’d be thinking about returning to work.

Do you feel the same way?

Previously, as a House Officer, I’m used to the “one off day per week”. Whereas, as a Medical Officer, weekends and public holidays are granted off days, except if you’re well… oncall and that depends on your current department as well as some departments require you to put in a half day shift during weekends or public holidays.

I’d say for me, considering I live alone and I don’t even own a car here in Sarawak, I’m pretty much lazy and unproductive to the point I get restless sometimes.

That’s counter productive as rest days are meant to make you feel… rested, right?

Thus, on my off days, since I’m an early riser, I try not to disturb my circadian rhythm by getting up at the same time as usual every morning, partly because I forgot to off the alarm or somehow, my body clock just wakes me up every time.

To feel so-called “productive”, I’d do some studying with my morning coffee till I well, lose my focus, then I start wondering about lunch and start cooking, handwash my clothes because I’m too lazy to walk downstairs with a bag of clothes and finally doze off for my afternoon nap.

I’d then wake up in the evening to have dinner and pack my essentials and bag for work the following day before finally, retiring to bed early.

I really need to be more productive during my off days.

Even me writing this just sounds too depressing.

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The Theoretical Doctor @[email protected] · 2026-01-12 · 01:00 UTC

Reflection: 2 Months As A Floating Medical Officer

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At the time of writing this article, I’m on leave which I took from the 1st of October till 15th of October, which my Head of Department (HOD) was more than kind enough to allow.

I needed the break, perhaps it was an adjustment disorder on my side but I was struggling. Physically, I caught up, I showed up and I was there but mentally, I felt left behind and lost and on most days, I was low.

Perhaps, it was out of tiredness as I have just recently off-tagged and in combination with my low mood, I felt demotivated and in general, felt that I have lost my love for medicine. I decided then that clinical life in the hospital was not for me. True, we were lacking doctors in various departments and hospitals in general across Malaysia. However, during that time, even if there enough manpower, I don’t think I would still want to continue.

I tried looking on the bright side, tiny things as well as the positive aspects of things to help me to get through the day.

Firstly, I’m thankful to be in a subspeciality department instead of the bigger and more hectic departments, I think I would have broken down within the first week itself. Secondly, I was in the department with the sweetest and kindest bosses who were more than happy to teach or lend a helping hand when needed. We are small in number, yes. But it felt like being part of a family.

I was happy, the environment was good, kind and non-toxic. However, mentally, I knew that this is not my place.

This further saddens me as I have always looked forward to being part of this lovely department. Yet, I knew, it’s just a matter of time before I slip and broke down. My body knew that I wouldn’t last long here nor do I foresee myself handling the complex and complicated cases here. If my interest is not here, how would I even make it through to specialise?

Amidst the business and my mind and body trying to keep up with the steep learning curve place before me, I was unable to view my options or to consider other departments.

I was just done in general and sadly, I wouldn’t be able to fulfil my quote in my medical school yearbook, I feel myself losing my will every single day nor do I find the strength within myself to serve.

Sadly,“sometimes what we like is not necessarily what is suited for us”, a fellow colleague told me and that hit me hard. I had no interest in other departments either or practicing in general at that point. All I could think of at that point was to quit and to hand in my resignation letter. After all, I have successfully completed my 2 years of internship / housemanship training. I can still locum if I wanted to. But of course, I didn’t enjoy it either. All I was ever passionate of was to teach. Thus, I considered changing my field and entering university as a lecturer did not sound appealing either as I did not like research at all.

Thus, after much contemplation, I approached my Head of Department (HOD) to validate my 30-day-resignation letter. My HOD is another kind soul who enquired to know what prompted me to come to such a decision. She signed my papers but advised me to consider changing departments instead of quitting.

However, at that time and at that current state of mind, I was fixed on my decision. Hence, the following week on a Monday, I submitted my 30-Days-Notice of Resignation, only to have it retracted the following day. Although I have handed in my 30-Days-Notice, a part of me felt a tinge of regret and sadness. Somehow, some part of me did not want to leave but I could not see any way out of this virtual box that I appear to be caged in.

My colleague and my parents played an important role in my decision to retract my resignation. Instead, despite my limited amount of leaves left for the rest of the year, I chose to take some time of work. Perhaps it was due to tiredness that contributed to my rash and impulsive decision.

On the 1st of October 2025, I took the first flight out and then throughout my leaves, I locummed at several General Practitioners. Remember when I said that I did not like locum either? This time, I decided to give it a second try and to keep an open mind.

The first GP I locummed at was a rather chill one with only 3 cases being seen throughout the whole day. The subsequent GPs were hectic and had multiple procedures, literally from the beginning of my shift till the end. In all of those times, I was the only doctor in the clinic. In my previous experiences, I have locummed at clinics which had 2-3 resident doctors.

Honestly, I don’t know how I managed to pull it off. Despite the hecticness and the patient load, I found myself looking forward to return and I enjoyed talking, listening and consulting the patients. It was fun. Slowly, I found myself enjoying and falling back in love with medicine and practicing medicine and thinking on how I could improve myself to serve better.

Then, I realised, perhaps venturing into family medicine might not be such a bad thing. True, there is abundant of family medicine doctors now and lack of doctors practicing in the hospital but that doesn’t mean that they are still not needed. Sadly, as much as I want to force myself to carry on and stay practicing in the hospital, I knew that it is not meant for me in the long haul or for me to last for even a year.

The opportunity to specialise is there but how can I continue if I can’t even see myself as one, or even have the inspiration?

Suddenly, the plan and my pathway seems clearer and I’m more than ecstatic to embark on my next journey. It was definitely the rest that I needed. To think and to reflect. If I were to stick to this journey, how can I do so for the long haul and at the same time, enjoy it?

I hope that in months or years to come, the decision to stay is the right choice. Perhaps, I still need time to discover my interest in this vast field. At times, I wish that it can be simple and that I would know what or which department I’m fitted to or destined to specialise in.

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The Theoretical Doctor @[email protected] · 2026-01-08 · 01:00 UTC

My First Tagging On-Call Shift As A Floating Medical Officer

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My first tagging oncall shift was on a Sunday with a fellow medical officer I knew when I was a House Officer in General Surgery. Back then, he was having his attachment in General Surgery.

Just like a House Officer, we had to undergo a period of “tagging“.

In the Department of Plastics and Reconstructive Surgery at Sarawak General Hospital, I had to undergo a tagging period of one month, every other day (EOD). This is because, I am a newborn medical officer with no previous experience in General Surgery (as a Medical Officer).

This is an advantage as I would be able to learn as much as I could within a span of 1 month. However, it was also a disadvantage as I’m afraid, I would be burnt out mentally and physically considering the on-calls were on every other day (EOD).

“I can do it. If others could, I could too.” , I repeated this mantra to myself but the learning curve is going to be an extremely steep one.

During my first tagging oncall, thankfully, it was with a fellow senior colleague who I was rather comfortable with.

We started with our morning ward rounds followed by passover and peri-rounds. After we were done, we went back to the ward to settle our pending job-lists followed by lunch.

As a tagging on-call medical officer, the first call would be to me for referrals. After which, I would discuss with my senior and proceed to see the referred patient together. After reviewing our newly electively admitted patients, pre-op rounds with surgeon and demarcating the op site and pre-op meeting, we went back home in the evening and returned at night together for our night reviews which we updated in the Department’s WhatsApp Group on the progress of certain patients. Incidentally, a patient whom we were awaiting for op was called into the operating theatre and the operation ended at 2am. Finally, we returned home for the night.

I was nervous of course as I usually get anxious easily. However, I took my shower and headed to bed.

My phone was kept beside me in case I were to receive calls or referrals. At 6am, I returned to the ward and started our morning reviews as well as prepared for our morning rounds.

Since, it was a Monday, it was morning ward rounds, handover and peri rounds as usual. However, since I was still tagging, I was expected to stay till 5pm or to join the ongoing surgeries.

Thus, my first postcall was spent in the operating theatre assisting till 6pm. However, despite the ongoing operation, I excused myself to return home and rest.

The following day will be another one, thankfully, not oncall but within office hours.

Thankfully, it was a good call with a fellow senior that I was comfortable with in terms of approaching in regards to my doubts which was undoubtedly, many.

I can only hope that I would be able to survive this whole month of tagging.

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The Theoretical Doctor @[email protected] · 2026-01-06 · 01:00 UTC

My First Day Of Locum And As A Medical Officer

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A locum or locum tenens, is a person who temporarily fulfils the duties of another; the term is especially used for physicians or clergy.
– Wikipedia.

The first time I ever tasted or ventured into locum or a so-called “part-time doctor” was on the 3rd of August 2025.

At that time, I was back in my hometown and on a 3-weeks-break post housemanship / internship at a small private clinic, yet to officially begin as a Medical Officer.

While I was in medical school, I would occasionally hear this term “locum” from my fellow seniors or batch mates, lecturers, parents or even friends of my parents. However, in order to locum, one would need to be fully registered with the Malaysian Medical Council (MMC) and possess a valid Annual Practicing Certificate (APC). In short, I had to graduate medical school, finish my internship or housemanship first, then only am I able to dive into this.

Thus, upon acquiring my full MMC and APC licence, I was looking forward to locum. Looking forward to it as well as nervous to dive into this. Thankfully, I had just completed my final rotation in the Emergency and Trauma Department.

In the Emergency and Trauma Department, there are various zones in which the patients would be triaged into in terms of presenting complaints, severity and their vital signs. The least critical in severity would be triaged into Green zone. The Green zone is similar to a clinic setting, thus, it gave me some idea on the type of cases I would be expecting.

My first locum was just 3 hours long, from 7pm till 10pm. I figured that since I am just starting at that time, it would be better to start with minimal hours in order to get used to it and also.. if I would enjoy it.

The clinic was quaint and small but equipped with basic necessities and a scan machine. The only thing that it did not have, was an x-ray facility. The moment I sat down, the patients kept coming back-to-back. As soon as I was done with one, another came.

For a first-timer, I felt it was equivalent to the Green Zone in General Hospital whereby the cases were always there but the patient load was manageable.

However, I was extremely scared.

Mainly afraid that I might accidentally jeopardise the patient’s safety in terms of mismanagement. Thankfully, by 9:30 pm, the clinic assistant stopped accepting new patients and prepared to close the clinic.

For a first experience, it was a good one despite it being rather terrifying for me.

But, we all have to start somewhere and build our confidence, don’t we?

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Inside the Red Head's Head @[email protected] · 2024-05-24 · 10:51 UTC

Daily writing prompt Who would you like to talk to soon? View all responses

Ever since the Covid lock downs hit I’ve been pretty isolated from the world. I keep in touch with folks, but outside of family it’s been tough. Because of that, I don’t talk to very many people as much as I should. So the broad answer to today’s question is pretty much everyone.

More specifically, I would like to talk to the kids. Any time, any place, any reason. Both of my step kids live three hours away now. I miss shooting the shit with them. I’m always looking forward to the next talk.

I need to talk to my dad more often. I am such a terrible son. There are so many times where I’ve thought about just giving him a call and I haven’t. There’s no excuse. I’m just awful. I am going to call him this morning before we leave for the vacation. I promise.

I’d like to talk to my mom. We lost her two years ago. She was dealing with dementia for a lot longer than that. I just miss her.

I’m in the cellar right now, eating breakfast and typing this literary masterpiece*. My wife is upstairs. I will be going upstairs within the next 5-10 minutes or so. I am really looking forward to talking to her. It’s been over 40 minutes since we’ve spoken. Eternity.

*Sarcasm, of course. I mean… duh, right?

https://robertjames1971.blog/2024/05/24/lets-talk/

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