Sixth Month: Cooking Carnivale!

Working in primary healthcare service is challenging in times. It's been 3 months since I worked here in PKM Madapangga, Bima, and I'm still not getting used to so-called "the art of doing nothing". Yep, working in primary healthcare service is undoubtedly far less stressful than working in the general hospital. Daily, I have less than 10 patients. It's one-third of the patients I met during my work in the general hospital daily!

This over-relaxed daily routine quickly progress to boredom. Hence in the mood fighting the boredom and reducing the weight I've gained due to previous overeating (what else can I do when I'm bored?), I started to do my research on weight loss. So, there are four keys to healthy weight loss: eat clean, train regularly, sleep early, and drink a lot of water.

Working out, sleeping early, and drinking water are tolerable for me, but clean-eating is another story. From the result of my religious browsing, it is suggested that I cook two of the three meals I have in a day. Therefore, I can control the things that I stuck in my gut (it is called "conscious bite" by some people).  

Well, the problem was: I used to hate cooking! Even my mom had to drag me to the kitchen to help her cook back then. So who made me cook? Well, it's actually  not a "who", but a "what". It's Instagram! Thanks to all the pretty clean food pictures I saw, they successfully tempted me to bring my feet to the kitchen. 

So there goes my clean-food-cooking lesson. Some of my cooking failed, but some of them were successful. But there is one thing that matters most: I started to like cooking. It just feels good when you and your friends eat something that you make by yourself and you know you're nurturing yourselves with good things. Started as a time-killer, ended up to be a new hobby, clean eating and cooking showed some results: my weight went back to the previous number before I went to Bima PLUS all the immunity (I barely get sick lately!).

Even so, I still have my cheat-meal. It's very important that I enjoy my healthy-life journey. For a sweet tooth like me, cheat-meal means one thing: sugar! I still eat cakes and cookies as much as I want. Somehow it keeps me going and urges me to get back to my clean-eating for the next days. Well, we only live once so make the most of it: do what you love and eat what you like (once in a while)!

p.s: I'm not writing this to bluff myself, but to motivate young people to start healthy-living. I'm a beginner as well, but an expert was always a beginner once, right? 

Some of the clean food I made :)

Fifth Month: Learn to Make Lemonades

Hi there! 

Been a while since my last post, huh?

Actually I don't have any expectation that anyone would read my blog, but hey, some people do! Well the pressure is really on now! LOL

My internship now has passed the fifth month and I have moved to the community health center (Puskesmas/ PKM-red) rotation. It was located in Madapangga village, far away from Bima city, about 60 minutes by car. The village was located between hills and rice fields, reminds me of my dad's hometown. We live in our supervisor's home (which is humongous!) and we are provided with a motorcycle and an ambulance (both vehicles are as old as me) as our transportation means.

Well so much for intro! 

This week was frankly a very hard week for me. Me and the rest of the gang somehow were faced to a series of unfortunate events each and every day of the week. Starting from the broken stove, then comes the broken water pump, then our old ambulance called it quit and refused to be driven! To sum it up, our only hope, our  old old motorcycle, got flattened tire. Altogether with my premenstrual syndrome it was indeed a stressful week for me. But then I got a clear message today:

"As much as I want to complain about everything, life always shows me that I don't deserve to."

This afternoon I have to drag myself to buy groceries. Half tired and half grumbling, I pedaled my bike unwillingly to the market, 2 miles away from our house. On my way to the market, a guy passed my bike. He looks just like a normal guy, until my sight flashed through his legs. This guy only used one leg to pedal his bike. What about the other leg? It WAS there, but it was smaller then the other leg and it couldn't reach the bike's pedal, so it was rested on the pillar of the bike. He was cycling with one leg!

My heart was instantly shrunken. Wow, just in time I couldn't stop squawking about things, and BAM! this single-leg-biking guy hit me and shout to my mind "you have no clue about what you're complaining about!" I was so ashamed with the fact that I pray every morning that I can be content with what life gives me, but at the end of the day I refuse it. One of my friend said, "each moment in life is all we need". It is true. Whether we are in pain or in gain, just go through it in positive way because in both both ways, life is maturing us.

I'd like to end this post with a quote:

"If life gives you lemon, make lemonade out of it (or lemon tea, or cocktail, or anything! :p)"

Bulan Ketiga: Berjam-Jam untuk Lima Menit

Hi there!

Akhirnya seperempat masa internship sudah dilalui: bulan ketiga men! Hahaha.. Mau dibilang ga terasa ya terasa juga sih. Gue enjoy banget menjalani internship ini, cuma kadang-kadang rindu rumah udah pasti kan ya. Huhuhu..

Bulan ini gue lumayan banyak berpergian, hunting pantai-pantai bagus. So far gue udah ke pantai Kolo, pantai Rontu, dan pantai Wera. They're gorgeous, especially pantai Rontu! But that's not what I want to write about.

Pantai-pantai yang gue sebutkan di atas itu letaknya jauh dari kota (tempat gue kerja sekarang). Sekitar 2 jam perjalanan dengan mobil (I know, kalo di Jakarta emang ga berasa, tapi di daerah sepi macam Bima ini, 2 jam itu jauhhhh banget!). Jalanan yang dilalui juga jauh dari mulus dan lurus. Intinya penuh perjuangan deh. Buat orang-orang yang ga biasa, perjalanan ini bisa jadi tantangan tersendiri, karena harus mendaki gunung lewati lembah, dan bisa end up mual-muntah karena motion sickness. Gue yang jarang mabok darat aja mual di perjalanan ke pantai-pantai itu.

Nah, dalam kemualan dan kebetean gue karena ga nyampe-nyampe itulah tiba-tiba gue teringat pasien-pasien di rumah sakit. Mereka datang dari tempat-tempat yang jauh ini, bahkan lebih jauh, hanya untuk berobat ke rumah sakit tempat gue kerja di kota. Apa rasanya ya lo lagi sakit, harus ditambah mual dan bete karena perjalanan jauh, cuma untuk ditengok selama 5 menit oleh dokter?

Gue jadi tersentil sendiri. Ga jarang gue melakukan anamnesis dan PF seadanya ke pasien. Apalagi kalau pasiennya udah urutan 20 ke atas, udah mulai keder dan ga fokus. Ditambah perawat yang mulai memburu-buru kalau jam sudah mendekati waktu tutup poli, semua jadi serba kilat. Ga ada lagi cerita mau kasih tata laksana holistik dan komprehensif. Big fat guilty feeling strikes my heart.

Saat gue cerita ke temen gue soal guilty feeling ini, temen gue yang lagi dinas di IGD juga menimpali: "Apalagi gue, Ni. Rasanya ga enak banget kalo ternyata pasiennya dateng ke IGD malem-malem dari jauh dan ternyata ga harus dirawat inap. Jadi harus pulang malam itu juga."

Ternyata ga sampai di situ aja ceritanya. Dua minggu terakhir ini, alat Rontgen di rumah sakit rusak dan reagen di laboratorium pun habis. Alhasil, pasien Jamkesmas maupun Askes harus tetap mengeluarkan uang untuk pemeriksaan radiologi dan laboratorium di luar rumah sakit. Apa yang lo rasakan saat lo menangani pasien anak DBD (demam berdarah dengue) yang seharusnya dicek trombositnya tiap hari, tapi orang tuanya ga mampu bayar pemeriksaan laboratorium yang harusnya gratis? Gue yakin ga cuma gue yang mengalami hal ini. Teman-teman yang sudah atau sedang menjalani internship pasti pernah mengalami situasi yang sama.

Since then I commit to take more time to listen and talk to my patients. Apapun yang bisa gue usahakan untuk mereka, walaupun hanya hal-hal kecil seperti ngajarin cara bikin F-75 atau bahkan cara membersihkan telinga yang benar. Capek dan jenuh itu manusiawi sekali, tapi seenggaknya lo udah berusaha maksimal! Remember, it's not always about curing your patients, it's about giving your 100% for your patients.

This is a reminder for me and all of my colleagues out there. Good luck friends! :)

A Note To Myself

People have the tendency to be unsatisfactory;

Striving for a higher position at work, 

Dreaming of a fancier car,

Complaining for a bigger room, 

Craving for a slimmer body,

Seeking for a perfect partner, 

Expecting more in a relationship.

Know why? You use other's standard of happiness.

One thing you should learn: don't compare yourself with other's situation, you never know what's going on behind the scene.

That higher position may come along with more contenders to defeat, 

That fancier car may come along with pricey maintenance cost,

That bigger room may come along with deeper silence,

That slimmer body may not come with a good lab result,

That perfect partner may come with psychiatric issues, 

And the relationship that you expect to go further may go oppositely.

Life doesn't always go the way you want it to be. Just be grateful for what you are and what you have now. This, you have to digest.

Bingka Dolu

Ola!

Our second week in Bima surely went fast. This week we got our first chance to visit the patient's wards since we have the ward rotation first. Each of us followed up one patient, from the day the patient got in the ward till they went home.

This week, we were in the internal medicine ward. The first time we got into the ward, we were shocked. The ward was far from decent. There wasn't any air conditioner nor electric fan, so the air was so frowsty. The beds were old with mattresses as thin as a paper, no wonder the patients had difficulties sleeping.

Apparently hand gloves are luxury things in RSUD Bima. The nurses usually wash the used gloves and dry them under the sun so they could be used again. I wonder if some of the washed gloves were previously used to do rectal examination or catheter insertion.

Flies are also a big problem in the hospital, let me correct, in town. In the ward, hundreds of flies buzzed around the patients while we were examining them. Flies also hanged around the patients' food and the wards' toilets. Even the most sterile place such as operating theater has flies in it. They were literally everywhere. But I guess this is a common view in Bima, because nobody in the hospital seems to care enough to spray some insecticide. 

Realizing the fact that RSUD Bima is the biggest hospital in town, I think the hospital is below the standard. Maybe it's because I am used to be in RSCM, where everything seem to be so clean, hygienic, and neat. But again, RSUD Bima is the only place where all these Bimanese could have healthcare service, and from their perspective it is the best they could get. Isn't it pathetic?

After visiting the ward, we went to the polyclinic. We were divided into 5 departments: general medicine, internal medicine, surgery, pediatric, and obgyn. We shifted each departments every 3 weeks. I got the general medicine rotation first. There were 2 general practitioner and 3 nurses in the department. 

Since the first time I went to this department, I could feel the vibrant ambiance of it. The nurses were very kind and helpful. They helped me translating the patient's complaints since most of them can't speak Bahasa Indonesia clearly. When the service is almost over, the doctors and nurses gathered around and share some snacks. During the whole week, there's not a day that we skip the snack time. There's always someone who brings snacks and fruits to feed our gastronomical need. Moreover, chit-chatting while snacking with the nurses  feels so heartwarming and somehow makes me feel like I'm home.

One day, one of the nurses brought a cake called Bingka Dolu or mud cake in English. It's a very sweet and delicate cake, made of flour, egg, coconut milk, and brown sugar. The cake is baked on cast pan so the cake is perfectly round in shape. The outer part which stick to the pan is usually a bit overcooked, creating a bitter-tasted crust. The first time I tried this cake, I fell for it. 

As I come to think about it, this cake is just like the hospital I'm working in. My first impression to the hospital is as bitter as the crust of Bingka Dolu, it is indecent and it doesn't look inviting at all. But after the first bite when I "tasted" the warmth of the people in the hospital, which is as sweet as Bingka Dolu, I fell for it. The bitterness and sweetness in the hospital is just as perfect as Bingka Dolu. Just like my new addiction to Bingka Dolu, I think I can work happily in this hospital everyday.

Bingka Dolu, Bimanese Traditional Cake

Kalembo Ade!

Greetings from Bima, West Nusa Tenggara!

This is my first post in this blog. I made it intentionally to keep my internship experience here and to share it to my colleagues, friends, and family.

As an introduction, I was sent to Bima with 14 other colleagues to do the internship program for one year as a requirement to get my license as a GP. First time hearing the news, the first thing I do was googling the map of West Nusa Tenggara to spot the city. For those who are as clueless as me, Bima is located in the eastern side of West Nusa Tenggara, adjacent to Flores and East Nusa Tenggara. It was the second largest city in West Nusa Tenggara, right after Mataram, the capital city of the Province.

 A few weeks before our departure to Bima, I browsed the city's profile to get a certain picture of the city we're going to live in for the next one year. All I've heard was that the Bimanese are intractable and short-tempered people. Hassles and tussles were common events in Bima. Those infos alone already shrunk my heart. What kind of city am I actually thrown into?

With this question in mind, I arrived in Bima on November 20th, 2012. It was the first time for me to be in Bima. From the window of the plane, I saw the dry and arid land of Bima. When I stepped my feet on the land, the sunlight directly hit my head. It was so hot that I sweated as hell. The Bimanese said that the weather that day was nothing for it was a rainy season! I surely don't want to imagine how steamy it will be in the dry season.

After almost a week living in Bima, I found that the Bimanese are not as "scary" as I imagined they would be. The Yes, they are short-tempered, but they are kind, hospitable, and helpful. They speak Bimanese language, which is totally different with Bahasa Indonesia. The problem comes when I have to meet my patients. Most of the elder patients only speak Bimanese language, so it's kind of difficult to do the anamnesis alone. Thankfully my supervisor and the nurses help a lot in doing the translation.

One of the Bimanese sentence I've learned and has become my favorite sentence so far is "Kalembo Ade". This sentence means "be patient, forbearing, and lenient". This sentence is conveyed from a doctor to his/her patient, a seller to his/her buyer, and in many other occasions. Somehow I think it is a very nice way to show empathy and care to others who are having difficulties. 

Difficulties just like the ones I'm having in my first week here. Adapting to the new working place, meeting new people, learning new streets, moving into my new home, and bearing my homesickness all at once were honestly very tiring. So I keep this sentence in my heart and tell myself "Kalembo Ade". A little adjustment here and there to my new life here, and I know I will be fine. To my family and friends whom I left in Jakarta, I would also like to say to you "Kalembo Ade". Wish me luck here. See you when I see you!

Intership GP team Assigned to Bima and Dompu, West Nusa Tenggara