Mastodawn

SummerSimo Travel Troubles Notes and The Purring Page Jan 20

Chapter 1: The High-Contrast Crisis

The rain outside didn’t just fall; it “carried on like a pork chop,” hammering against the corrugated iron roof of the studio. Inside, the air smelled of burnt espresso and ozone. Liam, Dax, and Dev—the Three Best Friends—were locked in a battle against a deadline that felt like hard yakka on a Saturday arvo.

The Philosophy of the Studio

The trio didn’t just build websites; they built gateways. Their manifesto was simple: Writing for Web Accessibility wasn’t an afterthought—it was the foundation.

Liam (The Content King): He believed that for each web page, one must provide a short title that describes the page content and distinguishes it from other pages. He was currently obsessing over the “Space Teddy Inc.” homepage, ensuring the page name came before the organization name.
Dax (The Visual Architect): His monitors were filled with color wheels and luminance grids. He knew that foreground text needs to have sufficient contrast with background colors, a rule that applied to buttons and background gradients alike.
Dev (The Logic Master): Dev lived in the “code order.” He was currently ensuring that the order of elements in the code matched the logical order of the information presented. He often checked this by removing CSS styling to see if the content still made sense.

“If we don’t get this right,” Dev muttered, “we’re just pulling a swifty on every user who relies on a screen reader”.

The Arrival of Elias

When the thud came at the door, it wasn’t the sound of a visitor; it was the sound of a warning. Elias, a retiree known to the boys as a frequent tester of their designs, stood in the doorway. He was a man who lived with low vision, hand tremors, and mild short-term memory loss.

“I couldn’t get through the ‘Space Teddy’ checkout,” Elias panted, his voice shaking. “It was the Shadow of the Raven’s Wing. It’s back.”

Dax went pale. “The Shadow? That’s just a myth developers tell to scare juniors.”

“It’s no myth,” Elias said, leaning on a desk. “It’s a deliberate design to exclude. It’s when a site uses color alone to convey information, like marking required fields in red without an asterisk”. “But this was worse. It was a shroud.”

The Mystery of the Raven’s Wing

The Three Best Friends gathered around Liam’s main terminal. Elias pointed a weathered finger at a specific block of text that seemed to shimmer and fade.

The Raven’s Wing (Definition): A technique used by rogue developers to create “unnecessarily complex” content that bypasses the need for clear and concise sentences. It creates a “lack of headings,” making the document nearly impossible to edit or navigate for assistive technology.

“Look at the code,” Dev whispered. His fingers flew across the mechanical keyboard. “They haven’t just ignored the WCAG requirements. They’ve weaponized them. They’re using ambiguous link text like ‘click here’ to lead users into a loop”.

“And the images,” Dax added, his eyes narrowing. “There’s no meaningful text alternatives. For these informational images, they’ve used empty alt-text as if they were purely decorative”.

The First Clue: The “Superbear” Anomaly

As they dug deeper into the “Raven’s” source code, a name popped up that Liam recognized from a recent news article: Superbear.

“Wait,” Liam said, pulling up a local news site. “I just wrote about this. ‘Superbear saves the day… rescuing a young cat from a tree'”. He looked at the code Dev had unearthed. “The Raven is using the Superbear story as a mask. But look at how they’ve marked it up.”

Dev pointed to the screen:

They used a <h2> for the title “Superbear saves the day”.
They included a <time> tag for “7 Aug 2015”.
But hidden inside an <aside> was a list of “Related Articles” that didn’t exist in the real world.

“Fair dinkum,” Liam breathed. “These links… ‘Superbear stands for mayor’. That never happened. They’re using WAI-ARIA roles like role="search" to hide a data-mining script”.

The Friends’ Vow

The “Shadow of the Raven’s Wing” wasn’t just a technical glitch; it was a digital wall built to stop people like Lakshmi, the blind accountant, and Ian, the clerk with autism, from accessing the truth.

“We need to audit this entire city’s infrastructure,” Dax declared. “Starting with the contrast ratios of every government portal”.

“And I’ll start rewriting the instructions,” Liam said. “No more unnecessarily technical language. We need to describe input requirements, like date formats, so even someone as stressed as Elias can navigate ‘no worries'”.

“I’ll handle the keyboard accessibility,” Dev added. “I’ll ensure every custom widget, from accordions to buttons, uses tabindex="0" to stay in the navigation order”.

They looked at each other. The task was heaps big, but they were the best in the business.

The Audit Checklist

Before they could head out into the “arvo” to confront the Raven, they had to prep their toolkit.

ToolPurposeContrast CheckerTo identify “insufficient” contrast that hides text.Screen ReaderTo hear the “info and relationships” hidden in the markup.Responsive DebuggerTo see how the “Raven’s” site adapts to a “narrow mobile phone”.Aussie GritTo ensure they don’t “pull a swifty” on their mission.

“She’ll be right,” Elias whispered, watching the Three Best Friends work. “As long as you keep the content clear and concise, the shadow can’t win”.

To Be Continued…

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The Theoretical Doctor Jan 5

2026 – The Beginning

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First of all, Happy New Year! I hope you have had a great start to this year and if you have any New Year’s Resolutions planned, I hope that you will be able to stick throughout the year.

I did not have any New Year’s Resolutions planned as I usually did the previous years. Mainly because I have just moved to a new place, settling in with things still pending in Kuching, trying to adapt to my working environment as well as picking up on new skills.

Thus, New Year’s Resolution? It’ll come as the year progresses.

My New Year’s Eve was spent at work and mainly in the ambulance with a dear friend as well as work colleague, however, that is a separate post for another time.

As usual, since I’ve started working as a doctor in 2023, I’ve always made it a point to work on New Year’s Day, a habit which I’ve adapted from my dad ever since he has started working at the age of 18.

However, New Year’s Day is a public holiday here in Sarawak. Thus, I was allocated as the oncall medical officer on the 1st of January as well as on the 2nd of January. Per oncall shift is from 8am on that day till 8am the following day (which means, mine ended at 8am on the 3rd of January).

My first case began with a case of wound breakdown over the right wrist, which the patient chose not to seek hospital treatment followed by another case of upper gastrointestinal bleed which was sent to hospital. This was then followed by another case of possible acute appendicitis which the patient and family decided to “discharge against medical advice” because they wanted to seek treatment in their hometown considering they were travelling and happened to be in the same area.

Upon returning home, I was called back for a case of breakthrough seizure likely secondary to under-dosage of medications. The patient had three episodes of seizure that day followed by a regular 1-2 monthly episodes. Hence, referred and sent to hospital.

Finally, I can return home. Time to get some rest since I would be working the next day. Shortly after, I was called back, a patient sustained laceration wound over the medial aspect of his antecubital fossa. Mechanism of injury? Unknown and he was in an extremely drunken state.

Otherwise, he was stable. Sadly, my medical assistant at that time could not be contacted to escort the patient to hospital and the family members did not have their own transportation.

If only, he was fully awake, I would have triaged him to green zone. However, transportation issues… Thankfully, the patient’s family has an uncle who was willing to send. The only thing was he needed some time to arrive due to the heavy rain and slippery roads.

I didn’t feel good leaving the patient behind although he was stable. Thus, I stayed till 4am until his uncle came and the patient himself had woken up.

After that, I went back home and straight away gotten ready for work since it’s a working day and I am still oncall.

The following day on the 2nd of January, went by smoothly during office hours with referrals here and there but it was manageable.

In the afternoon, another patient came in for symptomatic anaemia secondary to abnormal uterine bleeding with newly diagnosed cervical carcinoma. Her haemoglobin level was 5, who again, refused hospital referral claiming she visited the clinic for fever and not for her anaemic symptoms. After much convincing and discussion with my specialist, the patient still opted to “discharge against medical advice”.

Which makes me wonder… Why in the world?…

This was followed by dinner with my friend. I remembered thinking to myself that evening that maybe… just maybe… I would have a cold night. Enough of referrals.

However, at 11:30pm on the 2nd of January 2026, I received a call from my medical assistant that a patient presented to the clinic breathless with an SpO2 of 50% under room air, started on high flow mask and at best, it is only 90%.

Sounds like an impending intubation and CPR case.

I called up my friend immediately as I rushed to the car as she lives closer to the clinic. I needed all the help I could get for this patient. The roads were slippery and it was a rainy night. Yet, I sped. Thankfully, my friend had already arrived before me.

The patient?

I remembered seeing this patient on the 23rd of December 2025. At that time, his lungs already had crepitations with reduced air entry over the right side and yet he chose to “discharge against medical advice”. I remembered telling him that he would collapse if he didn’t go and true enough, here he was… sitting up, gasping for air.

His vitals? Blood pressure was sky high, lungs filled with crepitations but no pedal oedema, lines were set, no ECG done but we didn’t have time to waste…

I called up the Emergency Physician in the nearest hospital (which is an hour away), presented shortly and informed that we had to proceed with intubation because he was too tachypnoeic.

We prepared for intubation, informed the family members as well as explained the risk of CPR and death. The family understood and agreed.

Intubation… This was a difficult intubation for the guy was a very large guy with hardly any neck visible.

But before we could start, his GCS dropped and so did his heart rate, I started CPR while my friend attempted to crash intubate. We attempted to crash intubate and both times, it failed… I called up the Emergency Physician again and told her that we were 30 minutes into the CPR, she told me to call off after the current cycle.

My first death at a new workplace and on the third day of the year at 0027H, 3rd of January 2026.

Then, I proceeded to complete my notes for the family members to bring to the police station to lodge a police report and broke the news to the family. I was calm and so were the patients’ family. After that, I called up the Emergency Physician to thank her and then, I broke down.

I broke down because had he gone on the 23rd itself, he wouldn’t have to gone through this.. He lives alone and his so-called family members aren’t even his biological family members but neighbours and friends… I broke down because I also felt defeated… We tried our best with such limited resources and manpower…

Yet, I couldn’t save him…

If you have YET to come up with a New Year’s Resolution… At least consider this, adhere to your regular check-ups if you have any… Stay compliant to your medications, diet restrictions or any fluid restrictions if you do have…

And if something is off or not right, please RUSH to the nearest clinic or better, the hospital… Because there is only so much that we can do with such limited resources in a community clinic.

Otherwise, I wish that you have a Blessed 2026 filled with love, beautiful memories and wonderful opportunities.

Remember to have fun and do enjoy it but please do so, responsibly.

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The Theoretical Doctor Aug 21, 2025

Tagline: “Hourly Toilet Break”

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If humans had taglines, what would yours be?

Those who have worked with me know that I have such thing called “The Hourly Toilet Break”.

Firstly, because I consume lots of fluids and secondly, that is how I ensure I do get the break once in a while on a busy day or maybe, the day is quite slow and I am just, bored.

Of course when the day is rather busy and hectic, time just flies and that I do not even realise the time passing by. By the time I actually do complete my task and take the opportunity to just rest for a while, 2-3 hours have gone by.

How Did The Hourly Toilet Break Started?

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I didn’t actually planned for such thing at work. Obviously.

At home, I do frequently go for my toilet breaks as I’m forever consuming green teas or black coffees or water. All of which contributes to the filling of my bladder, in addition to the fluids being diuretics.

It wasn’t until I started my tagging in my sixth rotation, the Emergency & Trauma Department that I reinforced this so-called “hourly toilet break”.

The tagging hours in the Emergency & Trauma Department is long, just as in other postings whereby we had to work from 7am til 10pm everyday with an off day each week for 10 days straight.

Thus, it helped me in ensuring that I either get to sit and recollect myself during hectic days or to make the hours pass during slow days.

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The Theoretical Doctor Jul 10, 2025

The Most Enjoyable and Tiring Day In Medical 3

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I can’t remember which day it was but it was probably during the weekend or a public holiday as I remembered that I was allocated on call who was in charge of this ward.

I was allocated to “General” on that day and was I was alone at that time. I remembered sitting at the other end of the ward at around 11am when one of my colleagues who was allocated to be covering the “Neuro” patients went to have lunch.

The medical officer on call at that time, a rather “happy-go-lucky” and rather jovial person struts into the respiratory cubicle and asked if there were any house officers available?

To which I responded, we’re right here and he came over. He asked for the person who was in charge of the front cubicles which happened to be my colleague who went for lunch. I asked what’s wrong, is there anything I can help with?

He casually replied, nothing much, just walked in and saw a patient’s pulse oximeter reading 70% under room air. Then he laughed.

Me and my friend who happened to be there at that time were shocked and rushed to the patient. True enough, the pulse oximeter reading was 70%, well, 68%. Oddly enough, the patient seemed rather comfortable and not tachypnoeic. In fact, he was surprised as we crowded around his bed, looking concerned.

I asked him if he was having any difficulty breathing which he was not. Thus, our first instinct was probably the machine was faulty and proceeded to check with another vital signs machine.

This time, it was 65%.

I proceeded to take full set of bloods while my medical officer was writing his review and my friend attempted to call my colleague.

I ran his arterial blood gas and it showed Type 1 Respiratory Failure. Considering he did not have a baseline during this admission, we do not know if this was near his baseline or a sudden deterioration.

We called the Peri ICU team and referred the patient for non-invasive ventilatory support (NIV). Imagine, not knowing why this long stay patient was ever here in the first place to summarising the reason for admission down to his current progress. It turns out, he was due to be stepped down to a district hospital for continuation of antibiotics.

Well now, he can’t.

We transferred hum to the acute cubicle for closer monitoring while awaiting the Peri ICU team.

While awaiting, my medical officer decided to check on a patient who was handover to him for afternoon reviews.

This lady was in her 60’s and was admitted for left pleural abscess, meaning there’s pus in her lungs and for this patient, the whole left lung was completely filled. Clinically, she seemed well, speaking in full sentences and laughing to her family members as well in the morning.

In fact. I was even taking her bloods that morning only to have it splashed all over me after attempting to fill the blood culture and sensitivity bottle.

I recalled walking past her as I made my way to the front of the ward and she seemed alright. However, the moment me and my medical officer oncall stood in front of her. She desaturated an started being tachypnoeic.

Well, here’s another one.

There goes the next referral to the Peri ICU team for intubation and also Urology for emergency suprapubic catheter insertion as we attempted to insert a urinary catheter multiple times but failed.

Now, all these events happened very fast but at the same time, time flew by fast. The second patient was intubated and we inserted a femoral venous catheter. My medical officer then wanted to excuse himself to settle the pending discharges in his other ward. However, the first patient wasn’t saturating well under NIV and needed to be intubated.

There goes another intubation as well as another femoral venous catheter insertion. Finally, after all the chaos, things began to finally settle down.

I proceeded to trace my coming mornings, considering that I was the only one in charge of “General” that day and nobody would be helping me. Finally, I proceeded to begin my oncall reviews. This was around 8pm by that time.

After completing my in all reviews with intermittent disturbance in between. I proceeded to aid my friend in preparation of her coming mornings.

It was close to 11pm, I was just clearing my stuffs and getting ready to go when a nurse informed me that a patient seemed rather tachypnoeic.

Annoyed and tired, I attended STAT to find a patient sitting at the side of the bed with his BiPAP machine unlatched and hanging at the side of the bed. The patient beside him then told me, he removed it himself an hour ago.

Boy… Why am I not surprised?

This is another impending intubation.

At this rate, I might as well not leave anymore.

The day was busy enough. I sometimes wonder why is it that we feel guilty to even desire to return home on time? To walk out with the family members watching us finally ecstatic to return home for the day while their family members are stuck in the hospital?

Back to that patient, I didn’t left him gasping on his own of course, I fixed back the BiPAP machine, took an arterial blood gas and alerted my night colleague and medical officer oncall to which they attended STAT.

Thankfully, the following day, I was allocated as night shift. Thus, despite returning home late, I was able to sleep in and recuperate a little before returning back to work that night.

It was a busy day but considerably a rather fun one considering that I happened to work with a rather jovial medical officer oncall and my colleague stayed back to accompany me despite her shift being till 6pm.

Working with certain people definitely helps alleviate some of the pressure of the day.

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The Theoretical Doctor Apr 13, 2025

My Evening Routine In The Medical Posting | Housemanship Diaries

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On most days in the Medical Posting, at least in the hospital that I’m practicing in, we are allocated to work the “Short Day” or “SD” shifts.

“Short Days” last till 6pm. Occasionally, we would have to work the “Long Day” shift or “LD” which lasts till 10pm or “on-night” which is the night shift.

On days where I’m allocated to work the short day shift, I try to leave work by 6pm. Most of the time, it is feasible while on some days, it is not so.

However, my evening routine is pretty much the same upon returning home irregardless of the time I leave work.

1. Preparing My Dinner

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I love to cook. However, considering I live alone, the meals that I prepare are usually many for one person. Thus, I would keep the extra, rendering me an extra meal prepped for a day or two.

Depending on my mood as well, should I be working the morning shift the following morning and I’m just too exhausted after work and there is no food, I would go for my regular comfort food, instant noodles.

My version of instant noodles involves sautéing chopped onions, curry leaves, mushrooms and diced chilli before adding the water and mixing the instant sachet powders into the broth. I usually add additional curry powder as I like the broth of my instant noodles to be extra soupy and not dry. Once it has come to a boil, I would crack two eggs into the gravy and boil it for a minute or two before adding “half” of the instant noodles and finally topping with some leafy vegetables.

Yes, that’s right, I only consume half. My instant noodles are extra soupy and has less noodles.

Partly because I love adding rolled oats into my broth, thus the whole meal would be too heavy for me if I were to eat all the noodles.

What do I do with the other half of the uncooked noodles?

I keep it and usually comes in handy if I were to cook stir fried noodles.

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Then, there are evenings where I’m filled with energy and the following day happened to be an allocated off day or my night shift, allowing me to cook something different.

Nevertheless, irregardless of my dish of choice for the evening, I would always prepare a set of chopped tofu and mushrooms which I would marinade with some oil, salt, crushed black peppers, diced chilli, slides garlic, curry leaves and some curry powder or chilli powder prior to air frying it.

Thus, by the end of 10 minutes, my dinner would usually be ready.

2. Resetting My Room

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I don’t go through a major spring cleaning in the evenings, just simple tiny actions to reset my room back to an “acceptable” state.

This includes folding my clothes and keeping them back in my cupboard and their designated places, taking out the trash and vacuuming.

Considering I wash my hair every morning prior going to work, there would be strands of hairs on the floor after drying my hair and dusts and tiny debris begins to gather. Thus, I would vacuum almost every evening.

Since I live in a studio apartment, this action is merely a 5 minute job.

3. Preparation For The Next Day

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“Your morning begins the night before.”

I’ve forgotten where I’ve heard this but it’s what I’ve been practicing since I was a kid. Usually the night before, I would know of the set of clothes that I would be wearing the following day.

Next, I would prepare my jars of cold coffee. I usually save up spaghetti glass bottles or jam bottles to keep my tea or coffees or sometimes to be even used as drinking glasses.

I usually carry two 1.5L of flasks to work, one of it contains green tea and the other, my special prepped coffee.

After all of that is done, next would be…

4. Unwinding for the Day

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This begins with me pampering myself with a hot long bath to wash myself of the stench and tiredness of the day, followed by donning myself in a soft, flowy night dress and going about my self-care nighttime routine.

Only after that would I have dinner as I usually fall into a state of food coma after eating.

This is then followed by me clearing the dishes for the last time and finally, heading to bed, which on some days, would be as early as 8pm. However, on average, it is usually around 9-10pm.

This is my evening routine in my Fifth Posting, the Department of Medical, as a House Officer thus far.

I often get questioned by my fellow colleagues as to why I would even consider cooking considering that there are a lot of steps or effort that goes into the process.

However, I do not find it tiring at all as it is my version of de-stressing.

Nothing calms my mind more than listening to music or putting a good show on Netflix while going about my dinner preparations with my phone in “Do Not Disturb” or “Sleep” mode.

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Inside the Red Head's Head May 17, 2024

Daily writing prompt What sacrifices have you made in life? View all responses

I feel like I answered this question recently, but could it have been a different question? Is it just a coincidence? I don’t know, and I’m too lazy to do any research on the topic at 7:07am on a Friday.

Sacrifice is a really heavy word. A sacrifice is what a soldier does when they give their life for their country. It is what you do when you give your child’s life to the fire god at the local temple. You know, serious stuff. What have I done that measures up to things like that?

I sacrificed eating sugar to the gods of weight loss. How’s that for making bariatric surgery more dramatic? Did it work? No? Oh well. It is the first thing that pops into my tiny little brain when I think of the word sacrifice. It’s not what I’d call noble or anything.

I don’t really mean to be a smart ass here. I am looking forward to reading through other people’s responses to this because many of you really are noble and deserve respect for what you’ve lived through. Don’t hold my being a doofus against me, please and thank you.

https://robertjames1971.blog/2024/05/17/sacrifice/

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