Saturday, September 29, 2012

Happiness, Found!


You are my sun

Nothing can hide my elated mood. Nothing can put away the smile on my face. Absolutely nothing can make me feel less of you, every single day.

Before this, I always have hesitations. Second thoughts. What-ifs. Buts. Negative in everything I do. Skeptical about our future. Now things have changed. After I have your hand that day, things are different now.

I am more positive. Felt everything is possible. Give my very best in everything. Felt like protecting you every moment. Love just about everything about you; your freckle on the right cheek, the naevus on the right nose. The way you hum your little tunes when you talk. Everything felt so right. Even our hand felt so apt together.

This is the power of love. And it strengthen the bond between us. So strong...

Wednesday, August 29, 2012

眼泪与累

最近一直被一些事打扰,做事也不起劲,凡事都欠东风。也许是筹备过程中遇上了不少坎坷路,也许是在适应新生活,况且身在远方的我无法控制局面,让不愉快的事发生了。偶尔在夜深人静的时候就会开始胡思乱想。

所有爱情,都要到开花结果的阶段吗? 一定要共度一生吗?一定要白头到老吗?会不会厮守一生吗?偶尔勉强带来很多不愉快的事,更糟的是,把两个人给疏远了。到头来,忘了要的是什么,渴望什么,追求什么,恨什么!

两个人要一生相守,不止在于你和我,还有很多新旧成员,有父母,兄弟,舅弟,公公婆婆,姨妈姑姐,还有他的狗。怎能只有我和你?如果往好的方面去想,家庭成员大了,凡事都有人关照;往坏的方面去想呢,就会觉得多人来烦,打扰私生活。

想到这里,一声叹气。眼泪也开始流下。了解不代表看开,爱情不是一切。有时吵架,心情低落,身心疲惫。一个字,累!

爱情不可以容纳后悔, 若有一丝的悔意,就会带来麻烦。

可是。。。

Sunday, August 19, 2012

There's No Monkey Business Here


Today my consultant taught me a very important lesson, especially for the young doctors like me. It struck me like a thunder. seriously.

My wards have been a dumping zone, nursing home, shelters for some and house for some permanent residents. One of them is a very old Chinese man, very unkempt, bed ridden for 3 months and came with multiple bed sores, dehydration and pneumonia. The relatives called an ambulance to pick up this man and since then, passed the responsibility to us to take care for the rest of their parent life. Since that day of admission, we never see any relatives, nor any number to contact. This old man remains gaga. Another man is young and fit man, unfortunately get involved with drug early in his life. He is unemployed, staying with a drug lord in Chow Kit and runs errants for him. In return, he gets his high. Recently, he had a row with the Boss, and he is left on the street. Left with no food or clothes, he had to fake his signs and request for admission. Lastly, there is another middle age man, active smoker and heroin chaser, had burned holes through his lung. He needs long term oxygen, yet reluctant to give up his cigarettes and old habits. A little bit of cough will straight away bring him to the hospital and the admission unit is always kindly enough to put him to our ward. He will be admitted at least 3 times a week, and scowled at us if we discharge him.

It has been a serious headache for me and my other colleagues. Our registrar is under constant pressure to reduce these unnecessary workloads.

On the contrary, my consultant is exhibiting la belle indifference towards this matter. He just nod when we shoved him with loads of our complaints. If the man do not want to go home, keep him for another day. We were puzzled at first, but today he shared with us a story.

He is used to be a very proactive, eager, hot head doctors once upon a time. He always upright the juctice, not allowing any wrong, no allowance for these hanky panky stuffs. One fine day, he received a call from his son's headmaster, asking permission to meet him in person. His son was in primary five in a nearby Chinese school. On a separate occasion, his wife received another phone call from their son's form teacher, asking to meet in another time. Puzzled with this events, they decided to turn up together to meet up the headmaster. The headmaster was shocked initially, seeing both of them turn up together. He explains that the reason for meeting them in different time is because they thought there were family issues between both parents, i.e a divorce. The headmasters proceed to inform them that their son, who was a top scholar, drastically deteriorates in terms of school performance lately. My consultant was taken aback, when the headmaster ask for how long they haven't check on their son's school work and academics. The son was so into the video games that makes him neglect his school. All these time spent up holding the rights, making sure the ward runs in order and all other stuffs had cause a toll on his family. Since then, he had taken a step back. Prioritized the important things in life and learned to put family first.

That little story suddenly give me an insight. Learn to prioritize.

Sunday, August 12, 2012

Chong Choon Cafe: 'THE' Famous Laksa Sarawak

My fiance has a very odd tummy. Whenever in Semenanjung, she can eat anything, from meat to soup, nothing goes amiss. When we were in Kuching, her tummy can't tolerate any type of food. She gets diarrhoea whenever she eats any local delicacies, while I am fine. Weird, ehh?

Despite the diarrhoea, we brace ourselves to the famous shop, the Chong Choon Cafe, which is on the right side on Abell Road. Sometimes it is hard to locate this shop as it has the nondescript and so-small-till-its-hard-to-read signboard. Just look for the car that double park on the street, you will find it.

Layout of the cafe is pretty simple. There are 4 food stalls, but 99.9% of the customers orders the laksa. Laksa is a rice vermicelli in soury prawn curry broth serve with fresh bean sprout, Chicken slices, prawns and coriander. Honestly, I find it taste the best here compares to most other stalls that do the same dish. The prawns are of XL size. The noodle is tad bit soft, but the broth is tangy and fragrant. Can't describe more, you have to taste it!

However, the popiah and yam cake that we ordered is a straight no-no. The composition of the materials is substandard and the wrapping easily falls apart. The yam cake flaws in the lack of yam. Definitely not our taste. Not to order if you are not on prolonged starving.



Popiah and yam cake - yucks

   
Laksa Sarawak - The best of it's kind

After food, she had diarrhoea again. (Not due to this stall as the matter of fact, probably she has stomach upset earlier)

Saturday, August 11, 2012

Pu Tien: Chic but Not Cheap

After all the hype and a nagging fiancé that wants to eat at this eatery, we went there straight after touching down from Kuching. This is the first store locate in Malaysia, and found in 1 Utama (ground floor Promenade, or the old wing). The entrance to the store is rather obscure, but they have friendly staff to guide you. It's Saturday and it is packed to the brim. Menu is nice and clear and price are all written down. Service is fast. But the downside is, as with all Chinese restaurant, it is noisy and we can hardly have a decent conversation without having to resort to shouting.

Food: Presentation is good. Taste is excellent, however tends to be on the oily side. Portion is small too. If you are a big eater, better upgrade to big size or more dishes.

Prices: Steep. A simple vegetable can go up to 20 ringgit and a cup of Chinese tea costs a whopping 7.90

Service: Good staff. Very swift service. Food served within 10 minutes

Summary: does every penny well spent? I would beg to differ. However, the indulgence once in a while should bring no harm. It's a great place to start if you want to taste Heng Hua cookings.

A very hearty soup
Fried oyster with eggs

Slice bitter gourd with honey sauce- a must-try appetizer
Chinese tea serves in a cup
Chicken meat cooked in red sauce, very good!

Tuesday, August 7, 2012

Make It Count

In measuring a person's life, how old is old? How young is young? When is the ripe old age? When is dying young?

The irony is Death pays us a visit at any time. There is no fixed schedule. You may have plans in life but the ultimate plan is seldom revealed.

If I die young, I would wish that I lived. Every single day is a rich and meaningful day. Every day has a purpose. I wouldn't want to fret on the past, or worry about the future. I would enjoy my present moment.

I would thank my parent, and return their good deed of raising me. I would tell my loved one how much I loved her, and I would tell my kids to live their life without regrets. I would ring up my friends and ask them how they are. Alas! There are so much things to do when you live.

If you know Death comes anytime, appreciate your life now. Make it count. Make a present. Make it meaningful. Make it rich. Make it worthwhile. Make it the fullest you can be.

Thursday, July 12, 2012

Presint 2, Putrajaya

Since I moved down to Kuala Lumpur, I had chance to do the things that I always wanted to do. Photography is one of that 'thing' I consider as my passion. Initially I wanted to go to the wetlands, but having multiple turns and rounds, I still can't get to the opposite side of the road. The road in Putrajaya was made in such a way that a wrong turn will take you another 5 km to turn back, which is all the hassle. Drawn by the height of this bridge, I drove towards it instead.

From far, it looks like a yacht. From near, it looks awesome. This is one of the structural marvel that should be seen in real life. Many, including me, had make this bridge as their wedding photo shooting scene. Not unsurprising, as the lines drawn are very sharp and geometry wise it is in its harmony.Simply beautiful.

The complex network of wires and frames

Parallel lines

Sky curtain

The thick pillar

Twisting of the lines

Butterfly

Geometry is simply brilliant!

Tuesday, July 10, 2012

Last Moments of A Bachelor's Life


I guess a man always want to feel belonged. After having a stable career, he wants a family, a wife to journey the life, couple of children to share the joy, a house to live in and a group of good friends. He can't wait to start the family and get married. But I guess, human are always confused. He will have mixed feelings. On the verge of marriage, he will think of all the responsibility that is going to fall on his shoulders. Is this the right decision? I mean, what can a person lose when getting married? My married friend told me, you loose a lot. Gone were the days of partying till the wee hours in the morning, hanging out with friends, traveling alone to odd places,  talking simply about everything: who is the new 'chic' pharmacist, who is going to win the election or what is the best condom brand. Welcome to the real world. Now who is going to wake up to attend to the baby cry? Who is going to change his diaper, feed him milk? All the talks centered around the best formula milk, the most ergonomic stroller, and the nursery that abuse their kids.

It sounds like nightmare, isn't it? I feel scared sometimes.

My friend also told me, you will gain a lot. You'll have a life partner, to share the joy when you are up in the sky, and to comfort you when you're down on your knees. Behind every success man, there is always an even more capable woman to support him, to buffer him and most of all, to love him. There will never be a dull moment in your life. When the right time comes, and you are blessed with your first born, that joy is indescribable. It felt like your life is complete. If gives you a reason to come home after work, to quickly put aside your work and start your life. It puts a smile on your face that worth a million dollar. Though there are hard times, sleepless nights, seeing him grow up is the best thing you can hope for.

Now, I am not scared anymore.



Sunday, June 24, 2012

The Painted Window


I was on a walking tour in Ho Chi Minh City. There was this very tall pair of stipples standing in the park of the town. Out of curiousity, I entered the church. I discovered this pair of painted glass on the side wall.

It tells a story. I do not know what the story is about, but I believe during war times, people seek refugee in this church. When the world is full of chaos out there, this place will bring them some peace and shelters. Many had carved words onto the walls, saying their prayers.

We live in a world of chaos, where brothers and sisters fights; the society fights; the government fights; and the nation fights! On the other hand, some had inner war, where there are conflicts of thoughts. All these will bring to unhappiness to us.

Hope you finds your inner peace tonight.

Saturday, June 23, 2012

夜深人静

又是失眠夜,翻来覆去都无法入眠。一个人躺在双人床,总觉得缺少了一些。

感觉无比强烈,一份思念,一份爱恋和一份渴望,全都交接在一起。如何入眠?

时间和距离逐渐拉近,心和心就此零距离。希望遥远的她能够感应。

Monday, June 18, 2012

The Days of The Blue Skies Are Gone

I had an exacerbation of asthma yesterday, not because I am a smoker, but all thanks to the recent haze. The friendly neighbour country began their yearly rituals of burning forest to make way for plantation. The results is the smoke that makes the road looks like in Genting highlands and the lungs congested. Despite many meeting and consensus made between our country and theirs, yet the old habit sticks. A month ago it was a beautiful sky in KL, but now its just haze.

I wonder all the effects of open burning and forest clearing on the wildlife such as the Sumatran tigers and rhinos? Are they being barbequed as well?

Hopefully someone please remind them again that we are suffocating here because of their doing.

Sunday, June 10, 2012

Saving Every Cents in a Pre-Wedding Photography

Just had my pre wedding photoshoot done earlier. It was a huge relief. No doubt, a very exciting experience for both of us. Thanks to the professionalism of our photographer, the photoshoot was a breeze. However, the bridal shop will find ways to incur more charges to us, in a way or another. My fiance and I managed to keep it within the budget.

We had many great shots, booth indoor and outdoor. When the photographer ask us to select the shots to be included in the photo album, to choose 50 out of 300, it was a difficult task. Moreover, the friendly staff will try to interfere with the selection process by giving unnecessary opinions. The ultimate aim is to include more photos and the extra pages can really mount up to the exorbitant amount. some times 50% more than the original amount.

Budget are tight when we plan for marriage and money are well spend into other aspects. So how to avoid falling into the trap?

  1. Choose the package wisely. I have friends that is getting married and they took up the packages that mount up the the sky high charges. Sometimes, the more expensive things doesn't mean it is better. Same wise, Cheap will mean nothing if it is not up to standards. Try to shop around, asking their prices. Ask opinions from others about the shop. Read online forums and blogs about the bridal shops. Do some background research then only sign up.
  2. Bring your own. Things that are consumable like the make up requirement are usually chargeable. Alternatively, you can bring your own and ask the make up artist to use yours. Things like the ampoule for make up sells 10x more expensive than outside (RM 35 compare to RM 3). So bring your own to save more but always consult the make up artist regarding what they need for the day.
  3. Always ask for hidden charges. There are some cunning bridal shop that incurs extra charges for items like gown or suits. Always ask them up front. There are shops that charges extra RM 100 per dress for their so called 'designer piece'. Sometimes they will charge extra for going outdoor. Bringing makeup artist along also cost more. So, be wise! Plan your shooting and think how you want it to be to avoid these charges.
  4. Say no to extra. When me and my fiance were choosing the photos, the photographer kept on pestering us that this shots is nice and that pose is perfect and so called un'delete'able. Then they start to arrange for more photo books and more shots than what we had agreed upon. The extra shots cost a staggering RM 1500 more. When we almost succumb to the trap, luckily my fiance were alert enough to stay on track. We manage to exclude all the shots that are not what we had wanted, even though it was a good one. We rate the photos from 1 to 10. Most of the below par were excluded in the first round and finally we have the most precious 50 shots that is nothing but the best shots. You need to see what you want and what is needed. That simple.
Above all, enjoy every moment of your pre wedding photo shooting, as we did ours.  

Monday, May 28, 2012

If I Am Not A Doctor

If I Am Not A Doctor


If I am not a doctor,
My life would be free,
As I neither care for a stranger's life,
Nor about his itchy hives,

I wouldn't get needle prick,
Nor get prolonged cough and TB,
Nor jaundiced because of Hepatitis B,
Spending months in recovery.

If I am not a doctor,
I would be home by five,
Have dinner with my wife,
Spend time with my child

Missed the moments they grow up,
Missed their graduations,
While I am busy in OT,
 Saving someone ailing heart.

If I am not a doctor,
I wouldn't have this heartache,
Of leaving everything behind,
And everything I loved.

Moving to another new places,
Meet strange people and new faces,
Only to find the city craze,
Nothing compares to my home,
My favorite place.




Sunday, April 22, 2012

Crawl...Walk...Fall...Walk Again


A baby learn to walk is no easy feat. It will start with a small steps, small and uneasy steps. The gait is waddling, the toes are in-curling. There will be numerous falls and bumps. Numerous bruises on forehead, scratches over limbs and endless cries. Given enough time and practice, small steps become big steps, uneasy become steady, then there is no more falling down, Walking become the second nature.

Isn't it the same with life? House officers learn from experience, numerous failures, many ups and downs, to become a safe doctor, and a better person?

New ruling created by the day to help these 'underpriviledged' group of people. First come the rule of house officers not allowed to follow in ambulance. Then came the shift work system to cut back the working time to 60 hours. Now there are hospitals that won't allow them to clerk case and examine patients! Looking at all these rules, it follows after certain events.

First, there were an incident of a house officer in Melaka Hospital involved in road traffic accidents while transporting patients. While we cannot predict the future, shit does happens to anyone. I witnessed a case of a staff nurse sustained a fracture of the radius bone while transporting a pregnant mother to general hospital for delivery because the new ambulance driver hit on a wild boar and the ambulance go turtle. Do we bar the nurses from sending patient? Certainly not! While I cannot say the ambulance is the safest ride home, even a fully registered doctors like us cannot prevent any untoward things to occur.

Then, house officers complaining of long working hours in the hospital. Hospital basically become the second home. There is no social life, love life or party life next to working. Then came the shift work implementations. Initially was full of glitches, but thing smoothed out in the end. The draw back is the oncall claims was with held. Then complaints starts again become there is not enough money to cover the car installment and side expenses, so another 600 bucks given on top of the shift work. What they didn't realized that without the adequate exposure, there is simply a disaster in the making. Not only more officers will be extended for the lack of skills and knowledge, they will be less equipped when sent to places that has no senior people to back up. The situation is similar in most of the government hospitals.

Are we doing them any good? Ask yourself, in years to come, will you want to go to any government doctors when you fall sick? If the answer is no, then please review the system again. For me, to be a great person, one have to fall many times, then when he stand up one day, he will be standing up tall. The scar is to mark how resilient you are, and prove to the world that you are not a weak doctor! 

Wednesday, April 4, 2012

Rising of The Phoenix

I don't like to write about advice. In fact, I am poor at teaching people, guiding them. There are a handful of juniors under me that seems to have not benefited anything at all after they left from my department. I just like story-telling, narrating of the whole event, from the beginning to the end. 

I was sitting by the beach, eagerly waiting for the sunrise. It was a long time that I didn't find my 'inner peace'. Despite they said I am fortunate to live in this town that has beautiful beaches, scenic mountains, and a peaceful river carved the beauty of this small town, but I didn't see it. The sound of the waves hitting on the white sands attracts tourist from far far away, but I didn't hear it. The coolness of the rushing waterfall on the skin that washes away all the troubles, but I didn't feel it. These few years I had been severely disconnected to the environment.

Watching a sunrise is a good chance to think about our life. Every sunrise is like a hurdle in life. It gets dramatic in the early part, and became very hot and difficult to manage during its peak and when the sun settle to the west, so does the problems. With time, things will work their ways. When a new day starts, the cycle repeats again. There is not a day without sunrise, nor a day without sunset. Similarly, there is no life without problems, nor solutions to every problems.

I am making comparing this to my education. When I first step into the primary school, I were so elated. When the happiness wears off, left with hard facts of life. Homework, co-curricular activities and exams... Then came the UPSR examination. The hard work put into preparing the exam till I faced head on with the exam. Finally, I passed the examination and moved on to secondary school and the vicious cycle repeats itself, again. Fast forward till now. I had just crept out of my comfort zone as I have been accepted into Masters degree program in internal medicine. And its all rise and shine again. Time to wake up!

Sunday, April 1, 2012

KongMing Lantern







Saw this KongMing lantern today. If you never see one, it is a sight to behold. A seems to be very simple mechanism brilliantly brings a lantern up in the sky. What is more surprising is the design was made way back in the ancient Chinese, by non other than the brilliant Sir ZhuGe KongMing.

Its basically a tightly sealed lantern, exposing the bottom end. The fuel of the lantern will create a hot air inside the lantern, expanding it, and bring it airborne. Used in ancient war time to pass messages, now Chinese use it for prayers, writing the wishes on the lantern and hopefully it brings the message to the heavenly place.

Simple, but brilliant.

路上行人欲断魂

破晓
神明

妖魔

幽灵

狱火

诚心
扫墓


 世界上真的有天堂、地狱吗?
人死了,又会到另一个世界吗?还是一切归于乌有?
难于理解


Sunday, March 25, 2012

草草了事


要简简单单,还是隆重?
要花花绿绿,还是朴素?
要不懈重本,还是节俭?
选择,实在让人头疼。

他们说,不在于结果,只在于过程中的点点滴滴,
而我却在苦中作乐。

马马虎虎,草草了事;
仔细挑剔,隆重复杂。
一切随缘,快乐就好。

Thursday, March 22, 2012

The Dog-faced and The Dog-breathed

Someone to hold your hand
Last night, another kid try to take his life.

He is the dog-faced. We (the semi-alert on-call doctors) are the dog-breathed.

He is an 18 years-old. He had met his hurdle in life, and I am sure this might not be his first. There is always a mixed feelings when examination results were released. Yesterday was SPM results announcement. He is unhappy with his results. And he took a total of 50+ tablets, containing a mixture of paracetamol, loratadine, cinnarizine, and maxolon. The mother found him 4 hours later, in severe abdominal pain, but luckily he is not intoxicated.

I could remember how elated my feelings were when I get hold on to the results slip. It wasn't because my results were that good, just seeing that what I had worked for bring fruits and what I prayed for were answered. It is a relief that is beyond words. It is a feeling of putting down a stone from the inside your heart. But soon after that, another stone will starts to grow and the cycle repeats again...

There are many ways we can choose to handle the critical situation. He might had flung his examinations, but there is always a way to go about it. He can ask for help. He can talk to his friends or parents or his teachers. He can share it out. He can get self-help, or learn to forget. Is there something wrong with our society's support system that makes it difficult for young adults like him to get help?

I try to talk to him, to peel into his self defense. Unsuccessful. He choose to keep it a secret. Or he is too shy and regretted to what he did. All his vitals were stable and blood parameter were luckily normal. IV's were pumped in to rehydrate him. He survived, at least for another day.

If we try to see our problem from different perspective, or just stand back and looking at the problems again, the matter might just shrunk and disappeared after all. There is always a way to every situation and there is always something good behind things that seems so bad. For example, you fall sick, very very badly and recovered from it, you will develop immunity and become stronger.

For me, the best way to overcome a problem is with a song. Singing put away all your stress. It is as good as any tranquilizer. And there is just the perfect song for all troubles. "Let It Be" by The Beatles. My all-time favorites.



Sunday, March 18, 2012

The Voice of a Nanyang Chinese

Malaysians
Often, i came across teachers who made headlines by provoking the students in class,
usually involves racial issues. "Kamu orang Cina balik ke negara China!" means you
Chinese go back to your home country, China. This is really regrettable, especially when
nation unity involving multi-racial and diverse cultural background is at stake.

Truely, majority of Chinese were immigrants during the rise of industrial age during late
19th and early 20th century, to fulfill the job vacancy such as miners, traders and manual
labours. Those jobs were regarded as unfavorable by the indigenous then. The influx of
Chinese and Indian were fueled by the ambition of our previous colonial rulers to gain
their foothold, making profits and the race to conquer South East Asia. Many of our
grandparents were from China, or their parents originated there. Many travelled south in
search of better future and hoping that one day will bring the hard-earned cash to feed the
hungry ones in China.

This trend took a major turn during the World War II, when the rising if the Communist
party, taking over the whole China. The motherland become a place of desolate. Many
Nanyang Chinese had forgone the idea of going back, had choose Malaya and Singapore
as their new settlement. They married and lay roots here since then.

What about those Chinese who migrates early (around 1500 a.d) during the time of the
rise of Malacca as the entreport? They had long been part of the society and blended in.
This is what you see in the Baba and Nyonya culture, distinctively in Malacca. Are they
considered as the indigenous people?

My story is about how my rgrandparents came about. My paternal side grandfather
originated from China, came to Malaysia as manual worker, to built houses. My
grandmother borne in Malaysia. Her father came from China, settled here early. My
maternal side is complicated. My grandfather is a mixture of Thai and Chinese. My
maternal grandmother is borne in Malaysia. Siamese people roamed the northern part
of Malaysia, blended in to the local people. It was used to be Thailand territory, until the
Britons made a deal with the King of Thailand, and the 4 northern states became part of
the Malaya. So can he (my maternal grandfather) be considered as the indigenous people,
or the most important question, can I be considered as indigenous?

It doesn't matter anymore. The newer generation already regards Malaysia as their home
land. They never get to know what happens in China or India that much now, all they care
is about the land they set foot on. Like me, I had never been to China yet, and my root is
deep in Malaysia. If you ask me to go back to China, I will be like an Indonesian coming to
Malaysia. This puzzle piece don't fit anymore.

This is what 1Malaysia means to me.

Friday, March 16, 2012

The White Doves

Many white 'doves', which are quails, actually...

Proposal... checked
Tell the parents... checked
Choosing the pre-wedding photographer... checked
Choosing the white dress... checked
Date and time... checked
Venue... checked
Registration... pending
Wedding band... unable to decide

Chinese style wedding is a very taxing, time-consuming, pocket-emptying exercise. I think that is why Chinese practice monogamy... You simply declare bankruptcy after the event, which last less than 24 hours, by the way. Afterwards you will get explosive migraines looking at the aftermath.

The most important thing (highlight) is not the wedding itself, but is to decide on the venue, and checked with their schedule. Booking must be done real early, if not a year ahead, or you will get some crap dates which everyone will not come because it clashed with the lunar calendar. Speaking of the lunar calendar, it is one of the oddest thing, to start with. There are certain dates that looks just fine, but looking at the lunar calendar, the only thing you are allowed to do is to be buried or move into new house. Chinese have been believing in this things, since ancient times. Seldom people dare to break the believe, nor choose the date that doesn't favors both parties (i.e July in lunar month).

Next thing is to 'tackle' the parents. They said a match made in heaven, I refused to believe it! How can two person on this Earth can come together just like that, a live happily ever after? The habits, cultures, do's and dont's, fixed-false believes cannot just go away. Expectations may not met with reality; spending that doesn't match the earnings. There is a lot of arguments, discussion, despair, tears and finally change and tolerance. Then there comes the true love, that is everlasting, time-tested.

To live together with another person is really a challenging feat. You have to get over her lip-smacking habits, her smell, her messy hair, which is hard at first, but in the end, it is the things you can't live without.

Wishing all my friends who are doing the same at this moment, to enjoy every second of it, and smooth sails ahead.

Saturday, March 10, 2012

Suffering of a Soul

What is this?

Ask yourself, if you met a beggar coming to you, will you spare some sympathy or some loose coins? Or you just turn away and ignore his agony, whatever his suffering is all his wrong-doing and bad luck, nothing of your concern. Or you will kick him squarely on his butt, chasing him out of your sight and solve the problems once and for all? What about this is a stray dogs?

I saw a viral video on Facebook about how people tortured their pets, and this feeling came to me. Human has both good and evil side, just like the face of a coin. It is up to our control that which sides prevails. The choice is ours, to choose the dark path or walk the path of light. Seeing the animal cries in pain simply heart-breaking, needless to say it is much more worse for the accomplice.

The situation took a twist in the hospital settings. Often, we gets patients from the prison. They come in bright and colourful clothes, and for a peculiar reasons, their clothes stinks, sour and hard. Some are not well, but truth be told, they are less of a person when they are being admitted. They came in chains, and with a bodyguard. But doctors (generally) thinks they are nuisance, self inflicted illness, or worse still, want to be admitted because wanted to take a 'prison break' and occupy a softy hospital bed instead of a hard cells. Their IV's are difficult to established. Their complaints, no less than a handful, and their stay usually prolonged.

Yet, they are human too. They have names, they have stories, and they have their family who waits for their release one day and pray for their well-being, just like us. Whatever done in the past is NOYB. We can't segregates them just because they are convicts. They are our guest, too. Treatments and care should be given same, if not more for these people. Just offer your service with a sincere heart.

The picture above is the hangman's rope. One day when our life come to end, wouldn't it be nice to know that someone cared for you, too?


NOYB = none of your business!

Sunday, March 4, 2012

Lost, and Found Again

Gelora Beach, which means 'Waves' in Malay

Recently, I watched a movie of Shrek. He made a promise with Rumpelstiltskin, in exchange for a day of being an ogre, he gave up one day. And that one day was the day he was born. So he loss everything that he had, including his lovely wife Fiona and three cute ogress. And he was deeply regretted that only when he loss everything, then he only noticed what was gone. Aren't we the same in real life?

I took a walk to the beach one day, only to be amazed by the beauty of the sky and water. It was there all the time, but I never took notice. One day if I left this place, I will surely missed the waves, and the gentle breeze, an awful lot.

Sunday, February 26, 2012

The MMA Pahang Second Annual Scientific Meeting: Handout

Reminder: Handout materials are strictly the property of their author. For personal viewing only. Not for redistribution or commercial use.


Just click on the hyperlink to download the files:

Handouts




Wednesday, February 22, 2012

Negative Psychology

Human... A very difficult subject to study. Half the time, I do not know what I am dealing with.

Having busy myself to prepare the upcoming scientific meeting in my area, makes me realized one thing. You need a lot of negative psychology to deal with people. The program was heavily sponsored, safe to say, participants pay only a quarter of the actual amount. Yet, the respond for the participation had been underwhelmed, with only a handful of early adopters, the rest were 'dragged' into the program. I spent 1 whole evening calling every possible places, all the nearby health clinics and hospital, even rang up the health centres in nearby university, just to plea for participants. However, the past conferences that I attended to, which we have to fork out between RM 400 to RM 800 each, it was a full house, and I was actually being rejected for admission to one of the conference held in Penang! Probably, when people pay, they will actually feels the pinch and think it is a very important thing instead!

Same with patients that I see day in and out. The healthcare cost is pretty much covered by taxpayers' money when one admitted to the ward or visits the clinics. However, a person I knew was diagnosed with lung malignancy. He refused treatment in general hospital for the sake that it is free and free means it is no good or second class. He rather fork out hard earned money to get chemotherapy in Singapore instead. Currently, he is in Beijing getting some novel 'cold' therapy for his cancer. Same as generic versus labeled medicine. I have a colleague who encountered this type of patient that we labelled as 'fussy'(not uncommon, certainly seen in daily practice). She was seen by other doctors for her diabetes and hypertension. First line medications were given to her and explanations made. However, she wasn't satisfied because she received the generic medications and made a big fuss to complaint if we do not change her medications to the box type that has fancy colours. Probably its a good idea that the generic pharmaceutical company made their medication in better packaging and interesting colours instead!

Human... When can I finish learning this subject? Probably never.






Friday, February 17, 2012

Sakit Jantung Is Not Heart Ache

Malaysia is a multiracial and diverse culture nation. So the language evolve considerably between ethnic. Explanation for medical jargon can be a very confusing business. For once I cannot understand what my specialist explanation to his patient while doing his round. Below are the examples:



English: Sir, you had a heart attack. Coronary angiogram showed 3 vessels block and you need coronary bypass operation done early.
Malay: Pakcik, kamu kena serangan jantung. Angiogram menunjukkan 3 salur darah sumbat. Pakcik perlu buat operation untuk bypass pada masa yang terdekat.
Chinese: Pakcik, lu punya paip dalam jantung ada sikit masalah. 3 paip sudah sumbat. Lu kena kasi operate itu jantung kasi buat itu bypass cepat-cepat.
Indian: Ane itu jam hati manyak mati. 3 itu jalan darah sudah block. Manyak susah. Kena bukak itu jantung kasi baiki itu jalan.
Aborigine: Pakcik jantung ada masalah. Kena potong, tau?



English: The risk for angiogram is contrast related renal impairment, risk of stroke and myocardial infarction
Malay: Risiko untuk buat angiogram termasuk masalah buah pinggang, strok, dan serangan jantung.
Chinese: Itu angiogram boleh buat lu punya pinggang losak, otak jam dan itu jantung losak juga
Indian: Itu jam u buat angiogram, boleh bikin itu buah pinggang ada masalah, itu otak boleh strok, dan itu jantung boleh block.
Aborigine: Pakcik jantung ada masalah. Kena angiogram, tau?



English: Sir, your heart function is worsening, please mind your fluid intake and take your medication regularly.
Malay: Pakcik, jantung pakcik sudah lemah, kena jaga-jaga minuman dan ingat makan ubat.
Chinese: Lu punya jantung sudah lemah. Itu air kena control betul-betul, ubat kena makan betul-betul
Indian: aiyo, itu hati manyak lemah. Itu air jangan kasi minum manyak-manyak. Itu ubat makan ikut itu jam. Jangan lupa-lupa
Aborigine: pakcik, jantung ada masalah. Kena makan ubat. Air ikut ini (hand pointing to the mineral water bottle)



There is more to learn in this life than medicine itself. Don't you agree?

Monday, February 13, 2012

Happy Valentine

  

Sorry sweetheart, 
I may not be the BEST person in your life, 
but I will be the ONLY person you need in this life.

Happy Valentine's.

Friday, February 10, 2012

Thirty and Wasted

This is a true story. 

This is a story of a boy. He is 30 years old, and paralyzed. A freak accident 6 years ago took away not only his limbs and his freedom, but also his dreams and his life. A boy that has plenty of future, ended up lying on bed more than 20 hours a day.

We pass urine without even break a sweat. He needs to self catheterized. "Or else I will have retained urine." He said. Passing motion is a automatic response. Moving around means a lot of work transferring himself to wheelchair and back, involving many helps and energy-consuming. He and caretakers resorted to the simple way out, that is not moving at all. He has a loving wife, staying beside him, answering to whatever his needs are and tend all his errands. Whenever he is admitted, she will stay beside him, like a shadow.

But he is not always a good boy, to start with. He has issues. He can't get over the fact that his life has changed. He did drugs. And he had complications from it. The heart fails as we witnessed that he has worsening oedema all over his body. He is breathless at rest. He is tired all the time. And he makes his wife suffers. The newly gained weight caused him more disability. As a result, there were multiple pressure sores over the buttock and the prominence of the hips. And it sure smells bad too.

With good medications and nursing care, we bring him out of the disaster.  His failure symptoms resolving. His infections under control. Proper rehabilitation goes a long way to restore his function and self esteem. Last I saw him, there is a shine in his eyes that were absent previously. The smile that he and his wife gave us tells us a lot.


This is not only Malaysian dilemma, I believe it is rampant all over the world. Illicit drug is a very serious problem, both in term of healthcare burden and social aspects. Most of the drugsters are of the young and so call productive group. The country lose out the brilliant assets when these people getting high in some dark alleys. They are prone for blood-borne illness, as well as creating sense of insecurities in the neighbourhood. Many ended up in correctional facilities or prison, some even to the hang rope. 

I don't despise these people. I felt sorry for them. I will try to help them, if it is within my ability. I don't deny that many treat them as a nuisance, a self-inflicted illness, 'high risk' for infection transmission case, and difficult vascular access case. But I sincerely hope it will change. It start from within your. Please...

Sunday, February 5, 2012

MM Kills the Doctors


No. It is not Marilyn Monroe. And it is certainly not your M&M sweets (although some might argue that the high sugar content will cause harm). No, I am not talking about multiple myeloma either.

Its maternal mortality.

Just mention this term among your colleague, it will certainly bring chills to their spine. Some had nightmares of going through the painstaking process of being interrogated. Months of sleepless nights, loss of appetites, anhedonia, and suffers in term of performance at work. Some even loss their money and worse case scenario, losing jobs. 

I want to share a personal experience of my recent encounter with MM:

Mdm Z was a 24 years old expecting mother. She enjoys good health previously. She had a loving husband, and a caring family. This was her first pregnancy, and she had lots of hope for it. The first trimester of pregnancy passed through like a breeze.

During her second trimester, she had fever for a week. To cut short the stories, she was found to have infective endocarditis of the native valve. She was told of the problem and treatment commenced. As she was pregnant, many drugs were contraindicated, so the choice of antibiotics were limited. After about a week, she developed heart failure, probably because the infections cause valvular insufficiency. However, as of many Malaysian, they have predominating mindsets that alternative medicines works, and refused the trial-proven therapy. So the family brought a Shaman at midnight to her cubicle (without our prior consent), chanting spells for 2 hours, spraying water all over (nevertheless, causing massive rain inside ward and disturbed the other patients). You know what, the fetus died the next day!

Couple of days later, she delivered. Treatment was continued (and many 'I told you so, yet you don't want to listen'). Finally she was discharged well after weeks of antibiotics and planned for operative management in near future. Just a week after discharge,  patient condition deteriorated at home yet family refused to bring her to hospital. When we rang up to follow up her condition, that's when we knew she had met her maker.

Who's at fault?

Sooner or later, there will be inquiries regarding this maternal mortality case. We have to attend countless of meeting, fired with many questions and waste many time in between.

MM also created a culture of defensive medicine where managing team will priorities the non-emergent case over others to save themselves from this MM inquiries hassle. What do you think?

Wednesday, February 1, 2012

Your Friendly Neighbourhood

I was going through my copy of 2010 ACLS guidelines. Something strikes me...

This is only happening to the Chinese patients. I never see it occur else where.

Whenever a person falls very ill (or collapse), we as a natural instinct will start our resuscitation effort. Secure airway, Bag-valve mask, Initiating chest compression. Orders will fired across the poor chap. Adrenaline, IV access, Oxygen...


Then a head will poke inside the curtain. "How is the condition of this patient?" He ask. Seriously, I am not joking! He is the familiar face around the hospital when you work long enough. And he is not even related to the patient or the relatives!

I will usually ignore him.

Resuscitative effort carried on, Nurses getting grumpy, junior doctors getting fatigue, and I am also exhausted. Finally I terminate the resuscitation. Break the bad news. Family cries. Some howling, Some fainted. But he will snake around to me and ask, "What is the time of death?"

The man is an undertaker. Its his business to care for the afterlife, and its a good business, where every 'customer' average from RM 3000 onwards. Beneath what we see, there are few companies doing this and  these people are fighting with each other to get more customer. There are eyes and ears in the hospital looking for potentials, and last time I heard, they are the attendants and the nurses. Tips can go up as high as RM 200 (more than an on call pay for a doctor).

What I hope is that they respect the person that we are resuscitating, as well as the family. The privacy of the patient should not be breached. One should never be a busy body around the resuscitation. You may be the obstacle for the process. On top of that, they are harassing the family members with the 'packages' and the promotions of the day. Often, critical periods like this are usually the last moment a family can spent with their loved ones and prepared mentally for the worst.

Its a good business, but please do it with some sense of responsibility.








From Bad to Worse

Medicine is a highly regarded field. The stakes are high. The demand is always overwhelming. When they tell you there is surplus of doctors, they are actually talking BS, at least in Malaysian context. This created a demand for youngsters to go into medical field. Many parent send their children to medical schools, be it local or abroad, self sponsored or scholar shipped. Many graduated. Some are knowledgeable and willing to endure the workloads. Handful are not very intelligent, but able to carry out the job. Yet a small portion are neither having the marble nor the right attitude for the task awaits.

Sometimes, I encountered a few special cases that worth mention:

The Troll

This type of people are born with a very thick skull bone. They cannot follow orders. If I give them plans of management, they will not give me results. If there are 10 plans, probably 1 or 2 were carried out. Sometimes poor time management are to be blamed.

The Escapism

These people usually less equipped. When given the task beyond their capability, they are at lost. They would not know what to do. The solution is to run away from the trouble. There are also a mixture of laziness in these people. They refused to learn up new knowledge and skills, despite how much I try to guide them.

The Fierce

Conflict of ideas are common when you are dealing with matters. Some when confronted, will over react and snapped back immediately. They take every comment as a negative thing. Some forgets their position as a junior staff. Some just forget how to respect other people. Some don't have manners.

The Fart-and-go

At times, I met some junior doctors that always looking at their watch whenever they do round with me. When given a job to do, they do it half-heartedly. The case summaries needed to be summarize again. The referral letter most of the time are plain useless. In the end, the ministry decided that these people are not up to the task of doing these things and the medical officers have to take over.


Despite all this, now they are cutting down the working hours for junior officers to 60 hours. I sincerely hope these doctors can absorb the needed knowledge or skills. It is also my duty to guide the young doctors so to make them a better person. Well, I will always teach whoever that wanted to learn.

Monday, January 9, 2012

Be Thankful!



Be thankful...

That you are still breathing, as some people never wake up from their sleep.

That both of your parents are still in good health, as time is short.

That your partner still loving you, as love is not an eternal thing.

That your friend still cares for you, as friendship can fade with time.

That you still have a job, even your boss is mad.

That you have a roof over your head, even though it is a simple house.

That you have a means of transport, as some people has to walk miles instead.

That you have food on the plate, as many children died of famish everyday.