Feeling happy with going to ACOMET hospital

I signed contract with ACOMET hospital in Kabul, and here in BDK I am just waiting for 23rd of April. Today I was thinking why I was happy as I am leaving Badakhshan, am I interested in ACOMET too much? Maybe, but I had the same feeling when I was leaving Samangan, I was very happy I was leaving Dehi district hospital. Here I just stopped with my feeling for a moment, and thought maybe after 5-6 months I would be happy leaving ACOMET, but why is that so? I am thinking I am a jumper, no….no…..no. I don’t want to be a jumper. I will try to stay with my next post for at least 1 year, if I am a live and if God wanted. In ACOMET two things are disturbing me, but there are two things that give me hope. Low salary and tight regulations (no private job, no holiday for first 6 months…etc) make me feel uncomfortable, but what I hope to learn, and the chance to share my knowledge with junior doctors makes me optimistic. If failed in my hopes, then maybe I would have the same feeling at that time, that I have now.

How did people understand about my resign?

It is three days passing from my resign from Badakhshan, and it rapidly became public. Everyone comes and asks me why I resigned; even some of my colleagues in Kabul called me and asked me why I was leaving. My answer is very simple; I am joining a professional job. Some of colleagues in turn show that they are unhappy about my leave, and some encourage me to work in a place where I would promote more. But for me it was very interesting that how did these people understand I have resigned, and why they are so interested. It gave me a sense of proud that I have been so important person but I did not know!!!???, but letter on I was thinking maybe people didn’t like me to be here, so they are happy that I am leaving, but the way they are interacting gives the opposite thought.

Lessons from Badakhshan

• A, As manager you need to have a mixture of autocratic and democratic style, but a pure autocratic or pure democratic is of no use
  B, You will not recognize a person with working a day or too, no matter how friendly or harsh he/she is. You need time
  C, As manager don’t ever argue with very low level staff in public. Go through lines of management, or if needed talk with them in private.
  D, Start your day with clear plans; note them on a piece of paper, no matter how ordinary they are, because at the end of day you need to have a tool to evaluate yourself and your day.

The simple head of team........

Yesterday a high ranked team of donor agencies visited our hospital. I had received a notice that the team will be coming in a day or two. I did some preparations in terms of managerial issues, as I wanted to be ready for any question or information they would ask for. So finally they arrived and I was called that they are in the hospital waiting. Some of the team were expatriates and some were Afghan nationals. After initial introduction, we had a tour of hospital. I was leading the team, and explaining about different departments. At the middle of the tour, I saw someone quit simple, entered the room, headed his way to the middle of team and after a brief greeting asked questions and started leading everything. I did not know him, I thought that he may one of the lower ranked people, accompanying the team, and I was not feeling ok answering all of his questions. I was thinking to stop him, but I didn’t do so. As we finished one of the departments, all team members stepped back, opened the way and he was asked “This way sir!” After that I found that he was not the ordinary person, he was head of that high ranked team. I was happy I had not stopped him and after that I was feeling easy answering all his questions and comments.

Our Wishes...

There are things in your life that you cannot express them………….you may say to yourself, but you may not find anyone to hear……………you may have hopes, that you could not achieve…………they may die in your heart, but you cannot bring them to the words……….you may think you would build your future on your thoughts and wishes, but latter on you would find them with broken wings unable to fly…………you may think either you will not live or you won’t do any wish……….but then again it turns to be a none achievable hope. But why our wishes remain just wishes and cannot be a part of our real life. That is because we fly our wishes in the sky, we take them so high that hides from the reality, we fly with our hope high, but finally we have to come to the real life which is down to the ground. You feel you have fallen and failed, and so you are depressed.

Horrible day

Some days, when you wake up, you just don’t feel good. You think you are starting a terrible day. Whoever sees you, can understand your thoughts and feelings by reading your forehead. Maybe you have run to the same condition or you may remember one of your friend saying “hay man, what is the problem, you look depressed?” and you just reply “well, I am not feeling well today”. For most of people it is just today, the next days they are ok………..but what would happen if you are NOT OK for days………..horrible!!!

What is more important to a patient; medicine or good behavior?

Through 4 years of work, I have found medicine to be of three parts: Knowledge, skills and good behavior. If you have knowledge but not the necessary skill to use it, and good behavior to take the care of your patient, you lose at the beginning. If you have knowledge and skill but not the good behavior, you may treat the disease but not the patient………patient never will be thankful………but if you have good behavior, but not enough knowledge and skill, though you won’t be able to treat the disease, but still you can establish a strong rapport with your patient.
People when get sick, cannot have good judgment about doctors’ knowledge and skills, but they get highly sensitive to your behavior…………. your smile, the way you look, talk, touch and react may not attract anyone when you are in a local market or on the street, but when you are in hospital or your private office, every movement of yours is judged by patients and visitors………..that is why doctors are mostly respected in their own property, because everyone wants to seek special attention of the doctor.

How is the life in private clinic?

It is quite simple…
You are just waiting for someone to enter your office. In office the best music ever you will hear is voice of foot coming toward you… And when you have someone in your office, most of your attention will be in the pocket of patient. You are just waiting how much fee is the patient paying. So for some doctors everything ends when patient pays the fee, and then they don’t care what happens to the patient.

Am I the same kind of doctor? I don’t know… I hope I won’t be, but still I like the music of foot coming toward my office. Still I like to get fee from my patients. However my heart doesn’t want to get fee, as most of people here are very poor… but there is something inside me which wants money…Sometimes I resist, and at times I go with its idea. Sometimes I am thinking that doctors are like shopkeepers, they sell what they have, and they have the right to get something back. But then I argue with myself. Doctors are respected much more than shopkeepers, that is because they have unique position in the community. They get two things for their service; money and respect, while shopkeepers only get money. So even if they are not given money, still they receive things that are more precious, and those are prayers and respect.

REFAMPIN for ABDOMINAL PAIN

Some weeks ago I had a trip to Kishm, a beautiful district to the north of Faizabad. On the way, in a valley called Sabzi Bahar, something like 50 KM away from Faizabad, we stopped to take the breakfast in a local restaurant. This was a small, basic and a real rural restaurant, but with delicious food……… Kabab, and Dashi were outstanding……. As we filled our stomach…..and got some energy to see around, we started arguing with each other about infection in the restaurant……after all we were doctors!!!!!!! We had to think about the infection!!!!!!………but the idea came to our mind after we had everything in our belly. Who knows how many parasites and bacteria were dancing in our body……….To our surprise, where we sat and ate our breakfast, on the back of us on the wall there was a big poster about medical ethics!!!!!!Who knows why they posted in the restaurant instead of a health clinic or hospital………..Maybe they knew that we were coming for breakfast…..and they also knew that we were the key health personnel in Badakhshan……….and maybe that was a kind of protest to change our behavior when we faced with patients…………So we had enough agenda to talk in the restaurant with each other; food, infection, medical ethics…………..we did not come to any conclusion in our short post meal meeting!!! We paid the bail and went to one of few shops near the restaurant to buy some fruits to increase our body immunity against all the infection we had eaten!!!(Actually we did that to please our belly by sending something more!!!). This was a small shop, but had everything, maybe it was a super market for the local people. You could find a small sample for everything……fruit, grocery, shoes, clothes and even medicine…….Yes, there was a small bag full of tablets!!!!!!!!!!!!!!! We asked the shopkeeper to show us the contents of the bag……..He had medicine for every kind of disease…….. “if you have headache take this tablet……. and this is for malaria……. this one is for typhoid fever and these red tablet are very effective for diarrhea and abdominal pain……..” yes he was the real Family Medicine Specialist Doctor……. “my co-worker???!!!” That big red tablet, effective for abdominal pain and diarrhea was REFAMPIN!!!!!!!!!!!! Yes he was giving Refampin as a usual drug. We asked that how he found that the tablet were effective……..and he replied he has used on people!!!!!(Retrospective research!!!) We asked him if he knew anything about TB, Anti TB and drug resistance to TB, the reply was brief idea… but nothing about drug resistance……we tried to explain the dangers of giving medicine, side effects and drug resistance and that he may be legally followed……but nothing could convince him……….it was his market……….finally we give up the argument, got up in our vehicle and had enough agenda to talk and to shorten our long boring trip……….

Medicine is driving me crazy!!!!!!!!

Again problem of shortage of medicine…..it is driving me crazy. Every time I am explaining why we are having of this shortage…..but I don’t know if these people don’t understand my language, or I am having problem in conveying my message. At every meeting I am criticized for inadequate medical supply, and I need to explain again and again that we cannot provide 100% free medical service. I have told the story of medical supply from the place it is given, to the point it is prescribed to the patients, the policy and limits, so precisely that every time at the end I think no one will question me again. But when they change their seat at the same meeting the question is again asked. Two, three days ago, in provincial health committee coordination meeting, shortage of drug was again targeted and once more I had to tell the whole story………Unfortunately one of the highest officials of UN in BDK rose the possibility of haif wo mail of medicine in PH………It made me crazy……..and since the meeting was very official, I just answered officially………….while I needed to give him a tough answer……And today in hospital management meeting, again shortage of medicine become the headline of agenda………and it was raised by the person who herself knows the root of problem……..it made me so angry that I could not control myself and answered with a harsh voice and tone…….when I finished talking I looked that everyone was quiet, and understood how much harshly I have answered. When the meeting finished I apologized the lady whom had raised the question, and for talking harshly……….. now it was her turn to talk the same way I did………….

So, finally we finished residency life…

Now everyone is scattered everywhere…
I am in Badakhshan, Matin and Rahim are in Ghour, Hazim is in Samangan, and so on…
So what is all this life? We come together, become like family, than separate. Are we having western type of life? I don’t know. But what we all know is that this is just a life that our fathers were speaking about. I can remember my father telling his stories about his friends… “So! When I and … were in your age, we where the closest friends… we went to army together, and came back to our families 2 years latter together, but then we separated, we never met each other again… and finally yesterday I heard that he has passed away.” I am thinking, am I going to say the story to my son? I don’t know…
I can still remember the last day of medical school, that at depth of happiness, we were all sad. Why? Because friends were getting separated, and we did. I never met some of my friends after that.
But I hope that we will all meet again.

Psychiatric Disorders???

Today I was reading an article about GAD (Generalized Anxiety Disorder). According to criteria for diagnoses, most of patients should be feeling bad about things running around them, they should be thinking that they are in failure……………. And then I started thinking about famous writers and authors. What these people have written about the world and life, shows their frustration regarding what was going with them and around them……… I have read many autobiographies, most of them has negative ideas about life, I have read poems talking how life in this world is difficult and in some cases nonsense. Reading Depression, Bipolar disorder, anxiety…etc and thinking about these famous people, I don’t know if these people were sick……or what they have written is just the reality…….. In many books it is said that pain full feeling gives great inspirations, and the great poems start with it……..what does it mean? I don’t know…….maybe it means when you are in a bout of depression or anxiety you can say or write something great!!!!!!! So if we treat all these depressions, and stop all pain full feelings what will happen to world of literature? I don’t know………. I am not a writer…..nor am poet…….I am not in a position to think about the world of literature, but I am a doctor……..I would be still treating psychiatric disorders.

Who am I? 13.12.87……………….03.03.09

To be honest I don’t know………that is because I have changed through the 30 years of my life…..at the very first as long as I remember I was a child…..with funny dreams………and when I got older and went to school I changed and the same did my thoughts…………and as I entered high school I was a big man……….with great ambition. In University, I was not the same as before………I found myself to be a scholar with interesting objectives………..When I was engaged……..my romantic life started……with lovely ideas…………by marriage and after having the first child I found myself in a new page of life………... and here I am in another face and shape………….
You know how did found all these……….I found that in my diary…….I have recorded my thoughts and ideas in my diaries………many notebooks……..many scratch papers…….As I am going through the history of my life by reading my diaries I see how much have I changed………..but there is one objective which is mushtrak in all pages of my life…………and that is to be a good and real Muslim………..to help the Muslim community to find its lost place in the world and to be a great person…………….Yes Islam is in every cells of my body…….and that is what give me joy and happiness. How much I have reached to these goals? I don’t know……..I am acting like a good Muslim………..But Allah Almighty knows how real actor am I………But regarding the Muslim community………….I have done almost nothing!!!!!!!!!!!!! Sometimes it makes me to think that this is the main objective I am given by Allah Almighty, and so is every Muslim in this world………and I am going back to him…….what I can I say him about it????????????????I don’t have any answer, no good reason……maybe I am lost in my personal life too much………..I am thinking about my own and my family……..but what about the community around me? This is what I have to re-think………and maybe CHANGE ONCE AGAIN.