Life and Lies of Egan Goh

Your Friendly Neighbourhood

2012-02-01T23:35:00.001+08:00

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

2012-02-01T23:10:00.000+08:00

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.

Be Thankful!

2012-01-09T12:09:00.001+08:00

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.

Have Passion!

2011-12-31T10:04:00.003+08:00

This is the first and the last post for 2011.

In life, we encountered many difficult situation. Many deadlines. Jobs that seems endless. Bosses that keep giving pressure. Ends doesn't seems to meet each other. This is my life now. We tried to do all at once but 24 hours a day doesn't just seems enough.

But one thing that keeps me going on and on, it is the passion for this job. The hard work you do for the job you love will pay you in the end. Passion bring on the fire, the motivation to move you on. You will do it tirelessly. Don't be afraid to try something new. If we try, we will either succeed or learn new experience. If we choose to stay put, nothing is done.

I have seen many of my junior doctors who chose this profession other than the passion itself. They bring sad faces to work. Poor attitude. Lack of professionalism. At the end of the day, they bring regrets and sufferings home. The cycle repeats itself. If there is no passion, soon they will burnt out. Better to reconsider other options than stuck in a job that will dread you for life!

Life is short. It is meant to be enjoyed to the fullest, ain't it?

Happy new year, folks.

Growing Up!

2010-06-19T18:59:00.002+08:00

Finally, I can say I had reached a stage of equilibrium. Stage of maturity. Full grown.

Now, as I wrote this blog, I am being promoted as officer in a small town's hospital. As a matter of fact, I am being in charge of the casualty. With it, its safe to say that my job has come to a stable pace. I enjoyed more privilege than before. There are staffs that I have to take care and work together. People will look up to you for decision making. Your decision finally will affect the patient's life. I am not afraid. I believe I have enough of 'juice' to run the casualty. It's the skills that I need to honed up.

Before this, if I have any doubt, there is always someone senior to guide me through. But now, I am fully in charge of my own decision and the decision of others under my care. This is the process of growing up, and growing out of my shell.

I am enjoying my life, now, at least. Every moment of it.

Love is...

2010-04-30T19:15:00.001+08:00

Love is putting someone above yourself, sacrificing yourself for the one you love.

Love is stopping by for grandma cross the busy road

Love is cooking a hearty meal and put food on table

Love is thinking of people in need, and cry for not able to help them

Love is caring and guiding your enemy, despite how they mistreat you

Love is waking up in the middle of the night and making coffee for two

Love is caring yourself well, don't let your loved one worry

Love is holding the hand of Ill one, and say the couraging words

Love is never overlooked small happiness in life

Love is nothingness

- Posted using BlogPress from my iPhone

My Babies

2010-01-15T21:06:00.001+08:00

Work is so boring, if not because of all these kiddo, I wouldn’t enjoy much of my work of late…

First is the monitor of the ward. Hehe. Sleeping soundly. But when he is awake, he can make the havoc out of the ward, Poor thing, still oxygen dependent.

This little gem always gives you a wide smile. All he wants is you to carry him around. He is the most cheerful from the lot. And witty too.

Whoa! She gave me shock the first time I saw her, and still do. If you happen to walk into the ward in midnight and she is wide awake, might give you a scare or two.

Mr Sweet is always so adorable… The crewcut is due to branula setting. Otherwise, he is a vey quiet boy, feed the fastest and sleep most of the time. The eyes are big, but I am doubtful that he can sees.

Time Waits For No One

2009-12-06T19:04:00.001+08:00

Year 2009 just zoomed by. I was taken by surprise. Without a sign, Spring turns summer, then autumn and now its winter. December in just a flicker of candlelight. Looking back to my resolution made in 2008, I was shocked that I achieve few, if not none.

For one, I did reunite with old friends. We had good time going up Mount Kinabalu. We had nice foods. We chat till dawn. The old company is still close together. I really appreciate these old dogs. They coloured my life.

Regrettable, my weighty issue still not settled. Maybe I did nothing about it. Guess this is gonna be my 2010 resolution.

While I didn’t joined or affiliate with any organization, this is due to the fact that I was not ready, I can’t meet up with people’s expectation while not having adequate skills and knowledge. I always love to help people.

Another wish that was fulfilled, that is I got my first dSLR. Its a Nikon D40. It might not be the very best one, but it served the purpose well. I am still learning on how to use it, though. Right now, it churns out pretty good pictures. I just love it.

My hope for year 2010:

Enjoy my work and doing what I know best. I am going to finish housemanship soon. Hopefully I can get to do what I want then.
Health, not only me, but my father, mother, and everyone.
Love. I wish that I can bring the relationship to another level
Travel. The next destination is China/Taiwan. And if possible the States.
Weight loss

Tragedy

2009-11-07T18:07:00.001+08:00

“You made me.

Yet you left me.

This is where I am. In this cold room. All the time. Why? Because you made me.”

This is what a child felt. Two years old. And five months in the ward. Not a single soul came to claim him. Nobody visited him. No family members fed him. Day in and day out, he was kept in the ward. Waiting for placement in special welfare home.

According to the officer, paperwork takes 3 months to half a year. Placement is subject to availability. So we wait…

It started when the child was brought to us by a referral from district hospital. A child from aborigines in Pahang came down with odd symptoms. He kept on have repeating bouts of cough post feeding, fever and was unwell. On top of that, the child lacks facial expression. At two years old, he is still unable to vocalize, nor responds to his parents. There is a problem with his swallowing mechanism. The secretions pools everytime. He can’t swallow. He can’t cough. The is paralysis to his facial muscles due to defect in the cranial nerves. He gets bouts of aspiration leading to pneumonia. Feeding tube were made.

The parents is of the lower socio-economy group. Apart from this child, they need to take care of more kids. They need to work. They need to feed a family of 10. Staying in hospital is out of question. Taking care of a special need child is totally impossible. Bringing the child for follow up is a no-no. There is only one road. Disowning him.

Fate is a strange thing. Some are lucky, some don’t. I guess this is survival of the fittest.

In One Breath

2009-10-04T23:32:00.000+08:00

Hundreds of steps under my feet, but I have to just go on. I can’t stop and will not stop, until I reached my destination. There may be missing steps, and potholes along the way. Sometimes, the railings were missing, but it can’t stop me. I am determined this time, and I will reach to the top!

There Is Always Hope

2009-10-02T23:24:00.001+08:00

When you come to a crossroad, no signs leading to your destination, and you are lost. The road you took seems new and unfamiliar. Don’t despair. There is always hope. Just hold on. Eventually you will reach your destination.

At the dead of the night, you can’t see where you go, and you lost your way. You can’t figure out the path. Don’t be afraid. The daylight is just around the corner. At the break of the dawn, everything will be crystal clear.

This journey is full of challenges, and the reward is waiting for those who is persistent and determined. Just hope, and always hope for the best.

Wish you success, my dearest.

July: The Haunting

2009-09-20T20:31:00.002+08:00

In Chinese culture, July (in Lunar Calendar) marks an important date. It is the date people speaks in hushed tone. It is the period of the month where we avoids going to travel and out-station. It is the month where undertakers' business is blooming. It is also known as the 'Hungry Ghost' month.

In my personal experience, I had seen more mortality case than usual. My days during on call usually blessed with less case and I am yet to see many mortalities during this rotation.

The first case happened during the first day of July. The sky was drizzling lazily. Yet what we were dealing in the resuscitation room is all but cold. There were a deadly accidents involving 2 cars and few motorcycles. Two victims is already dead. Another two were intubated when I was called upon from my fever zone. There was this guy, young guy in early 20's. He had gas trapped between the layers of his lung. My service was needed to insert a chest tube. After the procedur, patient started going down hill. Blood pressure dropped followed with respiratory arrest. Shortly, cardiac arrest ensues. Resuscitation was done. About an hour later, we had no choice but to pronouce his death. As for one of the intubated patient, she did not make it after the emergency operation to evacuate the blood clot in the cranium. So a total mortality of 4 cases.

A week had passed. During my shift in the resus room, There were one ambulance call, despatched to pick up a patient who involved in accident. 'Ting, Ting Ting'. The bell rang three times, The the patient was pushed in in troly, face covered with blood, and the medical asistant was bagging the patient. We sprang to life. Seeing this patient, she was not spontaneously breathing. Pulse was also absent from palpation and the cardiac monitor. Everyone was playing their role. I started the CPR. She was intubated and given fluids and blood, but she didn't make it. Another soul was taken.

Then, three days ago, another patient fallen for heart attack before my shift started.

Just be careful, people. Its is July now.

Unmasked!

2009-09-17T20:40:00.001+08:00

It is funny to watch people in panic nowadays. In the height of H1N1, you can see the reaction of human beings. There are few things that caught my attention, though.

First, does the people know what’s the purpose of wearing a mask? It is to prevent the spread of disease to other people, not really prevent from contracting the disease. Unless you are speaking of N95 or N100 respirator. One day, I saw a couple waiting beside me for the traffic light, Both of them wore mask even when they were in car! You gotta look at their face, they were so proud wearing mask in the car! How on earth… Maybe that makes them a Mask Rider.

Then came along people that wear mask, just enough to cover the mouth only. The nostrils were staring at me. When they start talking, they just pull their mask even lower, to show me their mouth. I would say: “Hey there! Wait a second. Put back your mask!” They indeed wore mask, but only to cover the neck only. These are the ‘Neck Masker’.

Maybe it is a market hype, or latest fashion trends. Some patient wear a weird mask, or shall I say, a fancy mask? I have seen one that was black in colour, come with side gills and a pretty red linings. It might look trendy, and fashionable in a way, but I can’t say it confers protections against the miniscule virus particles. The side gill is indeed holes that is perforated, that permeates the passage of air in and out, way too large for a filter actions.

Mask is indeed an important object in term of self protection. Wear it correctly, it become a protection. Wear it wrongly, it might become a nuisance. Your choice.

G.I. Hoe: Rise of the VIPER

2009-08-20T14:40:00.001+08:00

Lately, there are too much of workplace politics, to my likings. I am not a political person per se, but things do come to your face when you least expect it.

First, My MO forms two battalions, one called themselves as the ‘Shift Workers Union Team’. The SWUT army consist of those who work in shifts, not confined to the usual 8 to 5 and those who need to do night shifts. Its members is about 10 persons. The other side is also known as the ‘Office Hour Liaison’ (OHL). OHL has smaller number of people. In fact they have only 3 members to speak of. However, don’t judge the OHL by sheer number, as all the member are high ranking officers. The battle line between the SWUT and OHL is clearly drawn. OHL accused the SWUT for working less hours and not allowing them to take their day off. SWUT blame the OHL for not doing any oncall at all despite the number of MO is minimal. If you think the SWUT and OHL is like cats and dogs from the start, you are wrong.

Going back to history, They were not like this. They were loving each other, complementing others work. They OHL wouldn’t mind helping out night duty. The SWUT wouldn’t mind the extra calls and all those weekend shifts. It was due to a OHL chief that is able to find harmony between the 2 teams. The peace was not forever. With time, the chief promoted to other post and came the new leader of OHL. Within the week of taking the throne, she had made new rules and changes that favours OHL. She blame SWUT for not working enough. She pushed the SWUTs to work extra. Many SWUTs that can’t take the new ruling resigned. There are also some SWUTs that stay on and put up a good fight with this OHL.

Out of nowhere, came a swarm of General Infantry (G.I.), sent by the Higher OrdEr (G.I. Hoe). These are G.I. Hoe. When all else fails, they don’t. They can work 24/7. When the Order call, they can work without food or rest. They know no fear. They have the tolerance of getting 60 rounds of automatic machineguns per second to their head without breakdown (I mean the scolding).

So the new chief of OHL saw an opportunity, and she snapped it! The swarming of G.I Hoe is seen as the solution for the uprising battle between the SWUT and OHL. Then she fully utilized the G.I.’s and put them is many calls and rotations that they don’t belong to, for example in the fever screening zone. Everyday, she do rounds in resus and green zone and shunt away all G.I. to this fever screening zone despite no patient in the fever zone! With these, she can shut some of the SWUT’s mouth and the OHL especially her do not need to be on call at night at all. What a brilliant solution! Pity the G.I. Hoe, working day and night in the fever zone. They are supposed to learn something in the resus and green, but all they get is only seeing the fever cases…

One day, the VIPER (Very Important Person in Emergency Room) will rise, and the chief shall fall. I am longing for the day to come…

Birthday Blues

2009-08-07T11:43:00.001+08:00

Dear Mom,

It is your birthday today. I did not bring you any present. I am sorry. I just want to wish you happy birthday. Deep down in my heart, I wish you enjoy every moments you lived now. Your life journeys marked heavily on your face. Each line is a passing of a past that turns into nothing but memory. Each dots speaks for itself for a legend that you make.

There are few things that I regretted in this life. I am sorry for not spending more time with you. Its all the work, stress, love, and sidelines that keep us apart. I know you are lonely. The vast amount of time that you spent on the couch crunching away the stupid Taiwan Hokkien TV series is to filled the emptiness of this house, more of the emptiness of your heart. The nonsense that you joined, to give back life to the ex drug addicts, says it all. I know. I can see it in your eyes.

I am sorry that I behave like a jerk. I raised my voice to you. I turn a deaf ear to you. I shut myself from you. I lied to you. I am trying to shake loose this connection. All because one day, I am ready to fly. I will be going away, sooner or later. You stories ends here, but my life starts from here. There is endless possibilities out there. I will be back, as the new me.

Don’t cry, mama. Your agenda is not my agenda; your life is not my life; to you is good but to me, maybe it’s bad. Alas! we are two different people. I read from a book once: you know your child only as much as when both of you are connected via the umbilical cord. After the cord is cut, the child is a person by himself. You don’t know what he thinks, why he behave like this. You have to admit, the child is a totally new person, and you will not understand him/her fully.

I don’t want to break your heart, mama. Sorry for all the things that I did, things that I ought to do but I didn’t. Sorry for the big gap in between us. Sorry for the words that I said but didn’t mean it, and the words that I should have said but didn’t. I still love you the same. Till then.

With love,

Son

The Pan(dem)ic Flu

2009-08-02T23:27:00.002+08:00

At the time of this writings, the author is suffering one of the worst post call syndrome in his whole career.

I am recovering from one of my worse call ever. Since the escalation of H1N1 cases on top of new mortality reported on daily basis, my emergency department had faced its hardest time. On the usual daily basis, I am seeing about 100 cases per night shift. Yesterday alone, there is a whooping jump to 380 cases! The card stretched 3 times than our table can accommodate and the waiting time is up to 4 hours. If you take a walk outside my clinic, you might think you had walked into Puduraya or Bazaar Ramadhan. There are seas of people, with all seats occupied and the ‘standing’ seat also taken. People lying on the floor, on the trolley, on wheelchair, in toilet and into the open road outside. During the past 20 years of its service, this is the worst ever ever faced by Emergency department. We had declared a state of ‘disaster’, and channeled doctors, nurses and paramedics from all over hospital to come to aid.

It is safe to say 99% of the case came to hospital for sole reason: to ascertain whether they contracted H1N1.

People are in panic. They fear of H1N1. They want to be sure that what they are having is not this strain. I can’t blame them. The propaganda for this disease is very extensive. I will take time to explain to them and make some facts right. I hope it would help the people who read this article. Yes, it’s you.

While it is true that the Director General (DG) of Health said we should not be less vigilance on this disease, there is a general rule of the thumb that one should adhere before coming to hospital:

Please COME to hospital/health facilities if you failed self treatment after 3 days. AH1N1 is a new strain of Influenza virus. Means there is no herd immunity. Means it can and will spread like wild fire. But flu is always self-limiting, that is to say it will resolve within few days of onset. We take a rule of 3 days. So to say, if you are having underlying risk factors such as obesity, pregnancy, underlying heart of lung disease, or any condition that renders your immunity less than ordinary people, you are welcomed to see us earlier.
Take adequate water and rest. Yes, it is important but often overlooked steps. Take vitamin C. Take 2 large bottles (3L) of water unless you are told not to. Don’t take too much of carbonated isotonic drink if you are having vomiting as the gas will make you bloat and nauseous.
Bring your medications to follow up. It will definitely help us a lot if you can remember what medication you took, but most of the people will describe to me “the white pill” “small yellow tablets”. This is like describing Adam Lambert by telling me he wear a blue jeans.
The Throat Swab. I know this is a very controversial issue. Majority of the referral cases from private healthcare to us request us for a throat swab for confirmatory test. This is also a confusing issue. At the early part of the disease, the government requires all patient that came from affected area to be screened from AH1N1 by doing the throat swabs. With time, the disease burden increases to a level that National Lab unable to cope with the amount of throat swabs analysis with the escalating amount of patient. New circulars are out by the minute to limit the screening to high risk patients i.e. pregnant mother, heart disease patient or with other co-morbids. In outbreak cases, for example in a closed compound like a school facility, only a random sample of 10 throat swabs will be taken. So you understand why we as the staff of Emergency department do not take anymore throat swabs; this responsibility is passed to Medical Department specialist and medical officer to decide which cases are severe enough for a confirmatory test. In shorts the throat swabs is a limited test now and NOT done for mild flu cases.
Help us to help you. This is my personal opinion. We are seeing at least a 400% to 500% increase in patient a day. My clinic usual closed with 100 patients during a night shift; but in this hard times, the numbers jumped to 400 patients at night time only. The number of doctors are very limited at night, and we are recruiting ‘cold’ department Medical Officers to aid in seeing patients but still average waiting time increase to 4 hours. It does help a lot if the patients behave less hostiles towards the doctors. It is a testing times. No one like it either. Tolerance is the key.
Please adhere to home quarantine order. I have few cases in hand that came to us. She was supposed to be in home quarantine as the school closed for a week. Out of her sympathy, she went to visit a sick friend and got fever instead. At this time, the cinema, shopping complexes is full of youngsters that feel that home quarantine is nothing but a scam. Home quarantine is meant for reducing the disease spreading rate. As a general rule, any viral fever should settles within 7 days and by separating the affected and unaffecting, we are hoping to limit its spread till it dies down. There is always a reason for things to be done.

This is both a testing time for us, the healthcare provider and the people out there. H1N1 is hard to control. But we still have to do something. The number of cases is increasing and the mortality increase. However, the rate of mortality remains fairly low. There is no reason to panic. Mostly recovers from H1N1 as a self limiting viral flu. At the same time, we should take precautions as listed in ministry of health guidelines, cheerful and above all: constant vigilance.

Same Mistakes

2009-07-25T11:23:00.001+08:00

Unable to sleep yesterday. Was pondering over things that happens lately. Not sure I had done my best. Worse still, did I do something wrong?

At times, you did your best, but things just don’t go your way. Then, all of a sudden, someone kind enough would point to you, saying “hey, You made a mistake. Buckle up!”. I don’t hate them, but thanked them. They make me learned my mistake. After all, we are human.

I did save life. That is what I mean to be, but the mistakes always come and knock your door, disturb your inner peace, making ripples in what supposed to be a calm lake. There are things that you are so sure the minute before, turn out to be opposite. The outcome that you anticipated, turn out to be no more than a waste of time. The effort, the sweat, and the name, all go down to drain!

I can’t help but realized, Is this what they mean by the difference of working life and student life? What makes the difference? Is it responsibility? Is it remorse? I don’t know. Honestly.

What I know is I will fight on! Come what may. I welcome every challenge.

Small Tip on Preventing A(H1N1) Flu!

2009-06-28T10:17:00.001+08:00

The uprising of the A(H1N1) flu to become pandemic flu is indeed a worrying thing. The number of people affected is increasing exponentially with new cases detected every hour. On top of that, the virus is capable of local transmission is not going to do any good to curb this problem. Amidst the commotions, there are panicky people who makes the situation worst by spreading some untrue fact regarding the disease. I am going to straighten some facts here.

Eating raw or rare meat can spread the illness

I heard this statement over a well-known radio station. While it is true that the origin of H1N1 is from pork, but it is an influenza virus, which means it need to spread through airborne and nasal droplets. It is in no way at all a chunk of meat able to spread the disease. It needs the respiratory system to produce the aerosolized viral particle to spread.

Avoid crowded public place

This is a very important steps to curb the spread of disease. As you frequent the crowded place, the chances of getting the illness will be higher. But one place that people often forget is the Hospital itself. While it is true that when you are ill, you go to hospital, but a trend that I observed lately that the non urgent case also in the waiting room of my clinic. The hospital should be classified as the highest risk of all public place as the confirmed case or suspected case of H1N1 case will go through our screening centre. Yet parents also bring the little ones with cases like scabies or impetigo at the depth of the night to seek for help, all this which can be done in the daylight in out-patient department. The worst case of all that I had seen was a man who is perfectly well, came to me 2 days ago, says that his subordinate had been in contact with a possible case of H1N1. Apparently the subordinate had attended a lecture given by an American. I asked whether the American had got any fever symptoms. He said no. So I discharged him within 30 seconds.

Wearing a Mask while You Travel

I saw a few photos cutout from local daily, saw a couple from Germany went down from Batu Caves with a mask on each. While the virus has escalade to Level 6 which is a pandemic, there are still people that ignores the WHO advice regarding travelling. All the mask do is to prevent you from spreading the illness from other people and a little bit of protection from the outside to inside. This is absurd. I have seen cases from Pulau Tioman, Caucasian on their way travelling in Malaysia, and bring along the disease. People, listen up! Stop unnecessary travelling and the disease will be better curbed.

The Homeless Nest

2009-06-25T20:33:00.001+08:00

One fine evening, I took my camera out for a shooting. And I found this empty nest. I vaguely remember there were a robin with 2 chicks some 3 weeks ago. Guess they grown up already and left the nest for a better life.

Back to real life, my sister is leaving the hometown for good, for the future. What she left to is an empty nest. Grandpa used to be dependent of her. When she is gone, this old man will be lonely. Yet, true to the sayings, old man are stubborn. I just simply can’t him to stay with us (me and mother) for he has things that he can’t leave behind. But most of all, he is afraid of change. Any trip to unfamiliar place will pose a treat to the stability.

Soon, there will be the ‘Empty Nest Syndrome”…

Reflection: Surgery

2009-06-23T12:37:00.001+08:00

It had been a tough 4 months in Surgical internship. I had made it! I had made it to the end. With all the bad remarks regarding the department staff, the rotation itself and all the no-nonsense attitude in the posting, I am surprised myself for being able to go through it.

First, the department head gave a lot of pressure to us. He is treating us all like an army recruit. “You may do this with written permission; You are not authorized to do that; You must submit your form by 0800 on every 2nd of the month and bla..bla..” Working hours was from 7 am till 8 pm. Gosh! I had so little time for myself, my girlfriend and my family. All devoted to the ward and the sick bay. His style can be described in one word…unpredictable.

Next, the ward staff are bunch of back-stabbing monster. They will do anything to sell you out for the sake of their own good in front of the Big Boss. I had it once. The Sister of the ward once file an invalid complaint against us, saying that the House officer were not doing their job for discharging patient. It never occur before because discharge is our level 1 priority when doing the ward work. I was in rage when the boss came to tell us that we need to have schedule for the HO to do discharge. All for the sake of Sisters…

Yet I find a lot of fun in doing surgical stuff. All those logics in managing patient, decision-making and the thrill of hands-on is so nice. I like the feeling of holding the scalpel, carving the lines, and remove, repair, and remodeling the disease parts. It feels so real, so myself.

Now, the time is gone… I am already into my next rotation. Emergency department. Now it is a better time for me.

A Selfless Act

2009-06-02T21:12:00.002+08:00

This case happened during my on call...

It was midnight. Rainy nights. And he is just another typical boy. Young and bright boy, and just finished school, waiting to go to college. Let's just called him Ali. Ali was riding his bike down the street. He just finished work and was rushing to go home. The watch on his wrist shows 25 minutes past eleven. The street was quite deserted, only few cars cruising down the road. Like him, they are going home too.

Out of no where, this cyclist dart across the road. Spinal reflex kicks into his action. His right hand jam into the brake, and his left hand quickly steer to the left to avoid the imminent crash. Alas, the wet road does no help. In no time a all, his bike skidded and he was dragged along. It just won't stop. With a loud 'crack', he hit head on into the road divider. The last thing he ever saw is the flash of street lights. Then he went into unconscious state.

I attended him in casualty department. His Glassgow Coma Score was merely 6/15. CT scan done, There were extensive skull bone fracture with massive intracranial bleed. A ring to the neurosurgeon on call realized my worst fear, his condition is beyond the help of modern science.

This piece of news was broken to the Ali parents. Naturally, they were in the state of devastation. I wasn't expecting anything less than this. Having raised this child, seeing him rocking the cradle, to his first word to his first graduation, there is more than just memory. There were life, joy and there were pain. There is no grieve worst than a white-haired sending away the black-haired, as the chinese saying goes.

"I wish to give away the organs of my child to the needful person." The mother said to me.

"What?" I replied. This was not what I would expect in a typical parent in such situation.

"I don't want him to die like this. I want him to be remembered as someone brave. And I want his spirit to live on in people that need it the most." The mother added.

I was taken back of her decision. It seldom happen in this country, what more in this small hospital. Her generosity to donate organ is genuine and pure from the heart.

A couple of phone calls and paper work later, the organ harvest team arrived from Kuala Lumpur by plane with all sorts of equipments. Finally, he was lay to rest at 1 am the next day. Physically, he is no longer here but his spirits and organs lives on in the other people.

Bravo to such a selfless act. Only wish that there were more people that wiling to take such steps to help the people in need. Anyway, death is just a path that everyone has to walk down alone. Why we need to carry all the organs that will eventually rot or cremated along while it can help people like those haemodialysis dependent or external cardiac machine and give them another ray of hope? Time to think, people...

My Love

2009-05-23T21:25:00.002+08:00

If you ask me, I never regret taking this road, although it may be a hard sometimes, lonely sometimes. The transition between a lone ranger to this state now needs a lot of change. I don't know, but I feel the person I used to know six months ago is no longer the same anymore.

It always amaze me, how your hand fit in mine. My hand feels cold and clammy, its yours that warm me. It felt just nice.

Oh my love

The Brain Drainer

2009-05-08T09:51:00.003+08:00

It is always glad to know that you are on the safe side. After passing my assessment, finished with my presentations, all I have now is 30 days of smooth sailing journey ahead (I hoped!) to reach the next rotation. Apart from the long duration in the ward, Surgical rotation is never a bad posting to stay on. The work load is not too many, the patients are easier to handle and not too many medicolegal stuff to start with.

We get to do neurosurgery rotation as a minor posting here. It was fun handling the 'higher function' of human. Day in and day out, we deal with 'brain drain' craniectomy/craniotomy - for those patients that has blood clots in their skull. I have 2 patients: one is a 14 year old boy from Felda Selancar (somewhere in Muadzam Shah) while riding a motor bike, ram into the back of a school bus, and rendered him unconscious. He was not wearing helmet for one, and at this age, he is definitely with no licence. On arival to my hospital, CT brain of his shows a massive extradural blood clots, and was open up. After fourteen days post operation, his conscious level still not improved. Repeat CT brain hold the key to this mystery. During the accident, there were brief episodes of hypoxia. Now the essential centre of the brain has infacted, which may includes the conscious centre. He might be in a vegetative states, if he survived.

Then, there is another boy, a young and vibrant 17 years old Malay boy from a village in Kemaman, riding bikes to refill petrol in nearby petrol kiosk. Again, he is not wearing helmet, and was hit from sideway by another motorcyclist from sideway. After the accident, his conscious level dropped, significant to warrant a CT brain, and further admission to Intensive care unit. I assisted the evacuation of blood clots. Currently, he is still recuperating in ICU post operation. At least he is recovering well.

The similarity in this 2 patients is both of them are young adults that has bright future ahead. Yet, both failed to adhere to simple measures such as wearing a safety helmet. One might recover, the other might be in coma forever.

Neurosurgery is one of the highest mortality department. You don't open up a patient, he dies, You open up, either he dies on table, dies post op or dies later. Either way, outcome is not so bright in my settings. That's why I dont quite into neurosurgery.

A Quiet Afternoon with Myself

2009-04-18T14:17:00.002+08:00

For a long time, I have not seen daylight. Working schedule that makes me goes to work at 6 am and back at 8 pm makes me an indoor person. After a long on call, I am back with myself in this quiet afternoon with no one but myself.

Life is soon to be back at the square one. The one and the only is leaving soon to out station for duty. Nothing that I can do to hold her back. Its the government's order. Without realizing, my life has been so much dependent on her. Everything seems to be evolving around the both of us. 'We' has replaced the 'I'. I always look forward for more time to spend with her. Albeit, time is short.

Now, there is no better place than here, inside me. Inside my heart. Dwelling with the memories. Swimming in the sea of futures. How I wish all this happens earlier! How I wish time is longer!

I just want to be with me now.

Flowing Gently

2009-04-04T23:37:00.003+08:00

It's ever so soft, caressing every rock and sand;
yet it is strong, carving ways as it goes.
It gives life to whatever we are now.
Let's save water

The Dead End

2009-04-04T23:15:00.005+08:00

Do you ever wonder, the road in front is not the path that you ever want to walk ever more?

It is exceptionally lonely now, when you are alone walking down this wrong path. Can I ever turn back? I am not sure how. I am being pushed my the rush of people to the destination that I do not know where. Could it be that the destination is still the same, but it is me that changed?

Maybe its a dead end of the road. Or it is the cliff that I need to embrace myself to jump in. Then I can discover the new horizon

A Letter

2009-03-25T21:06:00.005+08:00

Dear friend,

I know it is hard what you have been through. You are a tough man. You can make it through.

The joy of sharing a cuppa coffee, the good time of holding hands walking down the park, and the thought of someone is there for you when you are down may be gone. And you said the efforts for all these years may go into the drain. You feel sad, angry, and felt cheated, but it is still not the end of the world.

I say it a chapter in life that everyone must go through. Its like a book. Growing is a chapter. Falling in love is a chapter. Having children, career are chapters itself. We can't predict every chapter in the book has a happy ending. There are ups and downs in the stories that make it an exciting one. In the end, it is the whole story that matters. We are writing a book, not just dwell in a chapters.

You said the wound still hurts. It hurts when it matters. I say give it time. Let time heals. In the end, you will thank her for making who you are now. At least you are loved. It is never a waste. It makes you grow. Looking back, now you are full of experience than before.

As a friend, when I say I will be there for you when you are down is a total BS. But my ear will be. Always be. You must be strong. This storm must be weathered. Given enough time, you can walk out of this dips in life.

Twenty Nine Days

2009-03-20T22:50:00.005+08:00

It not right to feel for the patient you are treating. It is almost wrong when you are emotional connected to a patient that you are treating. They says it affect your judgment and the clinical acumens. Despite all the teaching saying so, I still made the mistake.

Dasuki was a very unfortunate boy. At the age of twenty, almost all of his fellow at the peak of their life. Everyone venturing into working, busy with marriage, but this poor boy was bed bound. Not only he had to depend on his father for the simplest chores as to personal sanitation, he had become the increasing financial burden of the family for his medical need and disabilities.

After a freak accident one day where he lost control of his motorbike and skidded, his life changed. The motorbike hit a sand dune and he was thrown forward and landed head on. On arrival to hospital, doctors pronounced that he had a spinal segment T8 and T9 fracture, which translated into paraplegia for the rest of his life. He lost feeling of both lower limbs. Anything below umbilicus feels numb. Both legs were heavy and felt disconnected o the torso. Passing urine and bowel habit became automatic event, and he has no control whatsoever towards it.

Studying the family dynamic, he is the youngest of eleven siblings. As if to add salt to the wound, his mother is a stroke-surviving patient with hemiplegia as well. Father earn a meager pay by doing plantation work in small scale. He has a sister he used to mention quite a lot. This sister is closest to him, bathing him, feeding him at regular interval. But what to do, his sister has to get on with life. She need to work. She need to take care of her family. After her marriage six months ago, she had moved away from Kuantan to Johor Bharu following the husband.

He came to us with prolonged bed bound, 12 months after the accident. Instead of a young and vibrant boy, we saw a nutritionally-deprived boy, dirty and unkempt. The bed sore already formed over huge area over sacral, the heel and even elbow. A sigmoid colostomy had been made to accommodates faeces passed through anterior abdominal wall. This could prevent soiling of faeces and the sores.

At the last 11 days of his life, we have to open him up, to find the bowel is a mess with adhesion and perforation. Everything necessary had been done. After the operation, he was going down hill. On the other hand, we are giving stronger antibiotic and nutrional support for him.

The day before he is intubated, I was talking to him. There were very few visitior for Dasuki. The father seldom came as to take care the other needy one at home. We talked about many things. All I want is to set a long term goal for him, to make him ambulate by wheel chair. At least he is less dependent if he can whelled to the toilet or to reach for things. He said that he missed his sister, and asked me to called up the sister. He wanted to see her badly. On top of that, he says living has no meaning for him anymore. I just kept quiet as did not respond.

The defence finally breached on the last 3 days. His lung and heart had gave up on this battle. We intubated him and put him on inotropes. Blood pressure on few instances were unrecordable. Most of the time, it was lowish. We rang up the father, told him that his son was not doing well. Soon after that, the relatives, family members came.

The last word he said to me was I am tired.

On his last day, his sister came to see him. After twenty nine days of long winding battle, he finally passed away, fulfilled his last wish. Rest in peace, Dasuki.

How to Avoid The Fear of Change

2009-02-09T20:53:00.007+08:00

Have you seen lately that more and more people start to fret about the posting they are going into? Some said they are going to the worst posting, some says they are going through hell. All mean the same. We don't enjoy our posting, or the rotation is not meant for human.

Most of us prefer to dwell in the latter one. Blaming other people is always easier than working out our self conflict. Yes, we work extra long hours, sometimes up to 36 hour non-stop. We seldom get adequate rest, most of us came to work with 'panda' eyes. Most of all, we get all the work, plus the scoldings as well. Isn't that what we have expected? Is that what we have signed up for? Why regret now?

People loves to tell stories, and most of the time, the stories aren't what it is. Sad to day, we chose to believe the stories. People might tell us, how bad it is to go into this posting, how bad the superior is, how hard it is to work extra hours, all sorts of things. These are stories anyway. Stories that will bring us down and demotivate us. We cannot predict what will happen in future, nor we can change the past. Its now that's most important. We lived out each seconds like its the last. We work like one at a time. There is no problem that cannot be solved. We choose to write our own stories, not dwell in theirs.

Be a non-conformist. Do not live by others' shadow. You are the best, and no one else. Just be who you are, not dictated by the stories.

Reflections: Obstetric and Gynaecology

2009-02-08T11:19:00.004+08:00

The end is near. I can see the light at the end of the tunnel now, but what lurks ahead might be total darkness to me. The once happy go lucky, couldn't-care-less person I used to be now underwent changes. Every words I said, everything I did now carries weight, and I have to be responsible to it.
Four months of delivering babies, supposed to be the happiest moment in life. Why I didn't feel the joy? Was I not passionate with my job? I think not. Come to think about it, I think it was due to the medicolegal stuffs that daunt every doctors. How could you be happy if you wake up everyday waiting for phone calls that one day will bring you down, tear your reputation, take away your hard-earned pay and ruined your medical profession. With these thoughts, how could you be happy?
Speaking of hardship, I am already anticipated long work hours ahead, scowling from boss, friends that's take advantage. Its already a norm. What I need is excitement, excitement that brings fire and passion in this job, to get me through.
On the light side, I've someone to share with me the ups and down through the hardship. I've count my blessings. Thanks to the one, that make my life better and more complete. For now, I just want to go home.

Solar Eclipse

2009-01-27T22:42:00.006+08:00

On 26th January 2009, we citizens of Malaysia evidenced the event of partial eclipse. It began at about 4.30pm and last to about 6. Without a good lens, its pretty difficult to capture the image of the sun. However, the UV filters of my cam (or I believe so) able to create the reflection, which inverts the eclipse and produce the double image. The reflections is in the yellow bracket.

Kids: Gift from Heaven

2009-01-20T22:05:00.006+08:00

Innocent. Which correctly describes the nature of the kids. They would not lie. They cannot lie. They express their feelings through their eyes. The eyes would tell a thousand words.

Playful. It's their nature. They learn through play and they play to learn. From play, they learn to share, they learn to fight for themselves. Most of all, they learn the skills for survival.

Some live a happy lives, some, carry the heavy weight on their shoulder. They mind are like sponge. They see, they absorb and they change.

Strangely enough, simple things like balloons will make their day. Their soul is as clean as a piece of white sheet. Only time will make a mark on this clean sheet.

On Call Blues

2009-01-07T19:03:00.002+08:00

Today, I am on call again. On a straight EOD calls for three days in a row! Since I go on call for quite sometime, I had seen many types of people lingering around me:

Some, albeit rare, are the hardworking type, working beyond the time limit set, working beyond their boundaries, never feel tired and always ahead of other colleague. They help you to take blood for the patient, arange for caesarian section, buy you dinner, talk to you and tidy up the mess. So far I have seen only 1 out of 25 housemen.

Some always watch the clock, punch card ready since 4.30 pm, eager as ever to go home. As the clock strikes 5, they will transform from little filthy mice into a handsome stalion. With a magical "pop", they will vanished into thin air, like never existed. Any new cases that pops in at 5.00:29 will be considered cases for the on call people. Haha. What do they care about other people?

Some people feels like chips more (T). Now you see it, now you don't! They are mentally and spiritually be with you during your on call, but not physically. When you need them the most, they will say:" Hey ya, I need to go and pray, can you sort of cover me for a while?" Then they are gone. After prayer, they will text you again, saying that they will go and take a bath, and then go for dinner, and then spa, and then meet the uncle's best man durinmg high school... then only they will be back on call.

No matter what type of people you are, please respect you job. When you are dealing with live, they deserved nothing second best. Do the right thing and do it right.

Goodbye to You 2008, Welcome 2009!

2008-12-27T19:16:00.005+08:00

Year 2008 is coming to an end. Time for a reflection for this eventful year.

No doubt it has been an eventful year for me. In Chinese, 2008 is supposed to be an auspicious number, thus an auspicious year perhaps. Maybe. Maybe not. For the starter, this year marked my grand entrance to the earning years. So far 6 months into working, starting to know more about working world, human relationship, team work and no less, the despair, frustration, lethargy and anger. It's so complicated. Spending money is so much fun, but the hardship of earning money makes me think twice before going on another shopping spree.

It also marks the end of my academic year. Or does it. They say in medical field, learning is an on-going process, so they say. After leaving school, I hardly pick up any academic book to read. I should continuously learning, to better myself. The only problem is I haven't decide on the specialty I want to further myself. I haven't decide what I want, but I will give everything a try first.

Then came my relationship. I did not expect it, nor do I work towards it, but it just came head on. They called it my 'yuan' or love luck has arrived. I have to agree. Love at the first sight, so be it. As long as both of us found what we found, appreciate each other, and care for the counterpart more than self, it should keep the steam of love brimming.

In 2009, I wish that I could achieve five things:

Loose weight, make myself looks better and feels even better. This has been my resolution since 6 years old, but I will always work harder to achieve it.
Buy a Digital SLR (is this a wish list or a new year resolution?)
Saving cash, then invest some (the actual amount shall not be disclosed for obvious reason)
Participate in social service, to give a helping hand to the public. I always like the field of palliative care, which I think I could use my knowledge.
Reunite with old mates, throw a good reunion party which everyone can remember upon.

At the end of 2009, I will reflect at the resolution again.

The Unforgettable Journey to Niah

2008-12-19T21:22:00.002+08:00

If you happen to live in Malaysia, you will be blessed with many beautiful places to visit. You will definitely be amazed by the breath-taking scenery, the people and the places. I was skeptical, before this. I never imagine the place I grown up to be such a nice traveler's hotspot until now.

I went to Niah cave last week.

Remembering those days, when I was a little boy, one of the chapter in the History book described the greatness of the Niah cave. They said, it can accommodates 40 737 planes inside. You have to see it to believe it.

The Great cave of Niah (so they called it) was 10.9 hectare wide. It accommodates many other small caves. It once was the home for pre-Historic man in Borneo and their proof of living were marked on the wall of Painting Cave.

What I remembered the most from this trip to Niah was the beauty of the cave. It was rainy season. It caused the lake on the mountain to be filled with water and the water flowed through crevices, creating waterfalls inside the cave. The water snakes into the underground river. The sound and the sight of it is the experience of a life time.

I would highly recommend anyone to visit Niah Cave.

收拾心情

2008-12-18T20:49:00.003+08:00

最近发生太多不如意的事了。

刚认识的女友，却得了病需要动手术。需要开刀的时候，身为男友的我，却不在她身旁，真是遗憾。但是手术很成功，她安然无恙。心中的大石也就可以放下了。

有人说，一段感情，若没有经过风吹雨打，就经不起时间的考验，我不信！为什么不可以让一切平淡，只有快乐，没有烦恼？难道没有挫折，就不会成长？没有跌倒，就学不会爬起来吗？

工作上也到了一段瓶颈，每天重复做一样的工，面对同样让人气愤的上司下属，每天都要面对工作上的政治。唯有等待下班时跟女友约会，家人用餐，让自己松弛心情。要等待加薪，还有好远；要等待换岗，都要多两个月。

自己开始遗忘最初的理想和梦想了。这些都是属于学生年代的东西，现在面对的是事实。嗨... 难得充实的利用六天的假期，现在还是收拾心情，明天又开工啰！

Silence of the Rain

2008-12-08T09:06:00.002+08:00

I was on called yesterday.

Kuantan had been raining cats and dogs for the past three days. There was almost no daylight. I was lying in my bunker. Next to me, a couple is embracing into sweet dream. I hate myself for intruding. So I turn my body the other way, away from them, awaiting the sleep that was hard to come.

The wind is howling outside. Storm was picking up after subsiding for the nth time. The rain hits the window pane, like a bullets in the battlefield. The door in the next room was blown by the strong wind. The sound can be eerie, but my mind is extraordinarily tranquil that time...

I was walking down the rainy road in midnight. The path connecting my room and the main building was uncovered. Storm was blowing cold wind down my neck, sending chills to the spine. The rain was hitting on my face. Questions after questions that I never asked myself before pops up.

Have I found my other part?
Is she the one?
Am I the one?
Have I done too much?
Or too little?
How she feels about me?
Can I really take this responsibility?

I can't stand the rain anymore.

The Breaking of The Self Defence

2008-12-03T20:50:00.002+08:00

Before this, I was a strong person. My ego was high. My self esteem is unchallengeable. I am being at the top of myself. Being 25, you feel like you can do anything. You don't need anyone. You are the best of what you are. Until recently, my defenses has eroded. My ego has gone to the drain. I was stripped. I wasn't the 'me' that I looked into the mirror everyday. This has become the new 'me'. I almost don't recognize myself anymore.

I guess being in love means a lot of breaking your ego, challenging the new heights, and being in the place that you never thought you could ventured into. I had been in my comfort zone for too long. This comfort zone had provided me everything I want. I was loved. I was warm. I never need to live in fear. But I had decided to break the circle, jump out my comfort zone. I was prepared to get hurt, again. I am ready for the coldness. I am prepared to go across the hurdle in life.

I am venturing into the new height in my life.

Revelation

2008-11-29T01:28:00.002+08:00

I am at it again. Me, being just me, like to write crap at midnight.

How to gain more out of your first date:

1. You gotta have chic music in your car.
Your ride is everything that reflects you. Even if you doesn't have a face of Brad Pitt, as long as your car has the right sort of ambiance, she will definitely give you a nod. It's gotta be soft, kind of atmosphere that brings people to talk. If music way too loud, she will think that you are a punk, and is a definite no no.

2. Never, Ever go for a movie on the first date.
For all you know, you are stuck at your seat for the next 2 hours. You can't talk to her, you can't look at her straight. You feel like your time is a total waste.

3. Strictly no Chinese food on the first date
Chinese restaurant is the most noisy place on earth, next to a paediatric ward. It wouldn't sound so romantic if you shout this out: "You are beautiful" compare to you whisper it out by her ear in a posh restaurant.

Nah, these are guides for dummies like me. You might loath it, but who am I to care?

连夜雨

2008-11-24T19:56:00.003+08:00

雨季的来临，带来一阵阵的连夜雨，
今夜，冷风吹来，雨声绵绵，
一滴一滴的雨点，打在窗口，
心里不知有多凉快。

不知心一直在想什么，
也不知心里要的是什么，
多年以来，执着些什么，
梦想是什么，理想又是什么！

直到她的出现，
让这一切都变了。

每天渴望她的来电，
每天想着她的背影，
每天都在盼着明天，
能够与她会面相见。

是否，
缘分已经到来，
时机已经成熟，

可是，
下一步如何走，
会有什么变数？

我不知道
我没有答案
还是让连夜雨把思念传寄与她

笔

The Depth of Death

2008-11-24T18:21:00.004+08:00

Death has been a topic which people discussed with a hush voice. It is a word that you shouldn't use during festive season as people will scowl at you. Yet I had written a handful of blogs regarding death.

The fundamental rule: Everyone must go through death at least once. Some people had escaped death, coming back to tell tales about near dying experience. Which brings to the fundamental rule No 2: You can delay death, to the extend of prolonging death, but you can't totally avoid death. Patient with brain death can be hooked on the ventilator machine. The can breath. They have heart beat. But once without the mechanical support, he or she is very vulnerable.

I don't like death. It brings tears to people, it breaks the heart. But I faced with death, day in and out. No matter what you do, you just can't avoid death. If you face death like a journey that one must endure, then death may come with less pain.

One good friend of my parents were diagnosed with advance breast cancer about a year ago, competed surgery and chemotherapy. About 2 weeks back, she had a fall one day at home and was brought to the a private hospital. CT scan of brain were done, showing multiple metastasis to the brain. Nothing curative were able to be done at that moment. Family members were desperate, seeking for second opinion, asking for miracle to happen. Everyone seems to know the diagnosis except the patient herself. She was kept from the truth, fearing that the truth will burden her already troubled mind. They brought her to hospital, asking doctors to do further active management for her.

I believe this is not the first case. Most of us face death with fear, only few have courage to stand up. More often than not, we often omit how the patient feel with regards to her own body. If you are the patient, lying on the death bed, will you don't want to know what is wrong with you? Will you like the truth to be buried with you to the grave? Most of the time, the patient is not blind, death or dump to be not able to guess what is wrong with her own body. Yet, she has no right towards her own body when it comes to death? What if the patient wish to meet certain people, to forgive some relatives and to repay some old dept before she dies, wouldn't she feel regretted for not able to do so? If she wish to donate her organs to benefit many, we would have selfishly denies her to do so. Death is not as simple as close your eyes. There are many legal matters involved. For example, bank accounts, saving bonds and funds that needs to be transfered to some one else. These things, although small, will be a big hassle for those who live on.

Please, do not deny the patient from the truth. It hurts me every time I faced with this situation. When you come to make decision for other people, always put yourself in other people's shoe. Do you want to be treated that way? If the answer is no, please don't do it on other people. You have absolutely no rights over other people.

Making Heaven Out of Hell

2008-11-22T09:42:00.005+08:00

Lately, I had been having conflicts with my new department. Being accused for the things that I didn't do, senior officer talking bad behind us, colleague that is very calculative and no team work spirits and many more. All these had been burdening me quite a lot lately, to the extend of almost feeling depressed.

Yesterday, I had a revelation...

I was walking down the alleyway towards the cafeteria. Suddenly a thought stuck me... I was making my own living hell. Why not make a heaven out of it?

Now, I am working in one of the wards. My senior officer in the ward is what a common people would call 'bitch'. She was the kind of people that likes to gossip. She has a couple of horrible gossips partner, that not only tell nothing but lies, but also love to wreak havoc. What makes the matter worse is she is also likes to report to the big boss regarding small matters, and exaggerates things. Her mood swing is as fast as the F1 racing machines.

Lately, I had been called to an inquiry, no less thanks to her. She had been telling lies behind the big boss. Glad the things I did was acceptable under standard medical practice, I was spared from getting a punishment.

How can I clear up this mess?

First, make truce with her, my senior officer. I said to myself, why would my mood be affected by someone that is so less important to me? She can curse, talk bad, laugh about me, but she can't control the way I feel. Follow her order, my day will be fine. Against her, she makes the hell out of me. So you tell me, which way I should go?

Being nice to people doesn't always equals to people being nice to you. There are people who takes advantage on other people. I notice of late, there are colleague that fits into the criteria above.

She came late to work. She doesn't want to clerk cases. She does not want to present to a consultant during rounds. She does not like to wake up during night call. In the end, who needs to cover her? Me. Who needs to clerk case? Me. Who needs to present cases? Me. All me, and me and just me. Naturally, I was up in smoke. How is it justified that who of us get paid but only one get to work?

And again, why should I be not happy for some other people's problem? If she doesn't like to learn, it is her problem. If she doesn't want to work, it is her problem. The more I work, the more I gain, in terms of knowledge, experience and improves on my patient relationship. At least, I know the hard-earned money I get at the end of the month are worthy.

Working is fun, only if you can make heaven out of the living hell.

The Unexpected Death

2008-11-07T19:30:00.003+08:00

I think, almost every mother bearing a child came to my clinic would expect to bring back a child when they were discharged. No one, absolutely no one expects the others.

Today, I faced with a difficult situation.

8.27AM, an expecting mother came to my clinic because she is feeling pain at the lower abdomen and the contraction was getting stronger. After a quick examination by my fellow friend, she was already in the advance stage of labour. So we pushed her to labour room.

I was the most senior house officer at that time. My friend was a tagging house officer since she just joined the department. After a while, the medical student rushed out for my assistance. She looked scare. So without wasting any time, I rushed to the labour room.

The atmosphere was cold. Nobody speaks. Everyone looked at the newly delivered flesh laying motionless on the green sheet. His body, swollen up twice his size. His face plethoric and the skin peeled of like plastic cover, exposing the red flesh. The umbilical cord was snapped into half. It was an awful sight.

The mother looked at me, half expecting the outcome of the labour. "How was my baby, Doctor Goh?"

"Did you go and check you baby well being lately?" I asked.

"I felt the quickening lessen throughout this week, but there was contractions. People said contraction was due to the baby moving..." She said.

Then came the hardest moment in my career, breaking bad news.

"Madam, I am sorry to say that you newborn is a stillbirth. He must have died quite sometime in your uterus. I am really sorry..."

Then she cried. I did not try to console her. This was grief which she must go through, so Elizabeth Kubler Ross said.

I offered her the opportunity to see the child. She could not bear the sight of a dead child. Must have been a great loss to her, her family and her love life. And I had to break the news to the husband as well, which he accepted quite well.

I am not good with death counseling. There is still a long way to go.

My Teacher, Then My Patient, Then My Teacher Again

2008-10-20T21:29:00.005+08:00

Nothing touched me so much compared to this.

One fine day, my brother rang me up, told me that a patient had handed a note to him mistakenly, (as we share same surname). It was a small piece or parchment, apparent scribbled in a hurry. Each and every words were misaligned. After reading the note, there was a warmness spreading from the heart. Thus my tiredness bubbles. At least I know there is love in this world.

Read on for the content of the note:

Sometimes, a word of gratitude is more valuable than expensive gifts. His gratitude lights up the healing heart of mine.

Working is fun, all along.

A Different Perspective

2008-10-06T08:49:00.003+08:00

Staying grounded for too long for me, is not good.

Sometimes, I need to fly. Above the ground more than 30,000 feet. Then you will understand what is perspective. I like the clouds beneath my feet. The sky, bluest of the blue, melt with the horizon. The lush green of the forest, dotted with buildings, and the river snakes around to reach the open sea. The sea, seems to be permanently marked by the ripples, and the ship frozen over the blue sea.

That is the way with life. Problems seems magnified when we look at it heads on. When we stand at a different perspective, sometimes the solutions seems to be the there in front of our eyes.

I just love flying.

Reflections: Medical Posting

2008-10-03T22:06:00.005+08:00

Four months had passed, just in a blink of eye.

I had completed my first rotation in Medicine posting. It seems like yesterday, a fresh grad, half trembling, half confused, make his steps into this biggest hospital in the biggest state of Peninsular. Countless of sleepless night, exhaustions beyond words, pressure from superiors, ragging from peers, finally, yes finally I reached the end of the steps.

I learned a lot. Stuffs that I don't learn throughout schooling years. Stuff like interpersonal relationship, teamwork, overtime, and overwork. Not that I am not expecting all this to come, but the culture shock it gave to me. If I wasn't strong enough, I would have been a total failure. I would not be considered bragging when I said I am excelling in Medical posting. Most of the supervisors gave me an approving nod. (some even going to the stage to extend me so to help them out with work) I think to summarize it all, hardworking and honesty are the values that everyone values.

Next, I am going into Obstetric and Gynaecology. Hope I still have the passion to go on. I just love this job.

A Tale of Resurection

2008-10-03T21:40:00.003+08:00

Today miracle happen to me.

After more than 30 resuscitations, today I am able to revive a patient, after he went into asystole.

He is a 70 year-old Malay, came in with congestive heart failure, very poor ejection fraction, and came in with fluid overload. He had pitting oedema up to knee, shortness of breath and congested lungs.

Initially, he was well. After going to toilet, his son rushed to me, when I was taking blood for another patient. He had fainted in the toilet. He fell squarely behind the toilet door, obstructing the only way out. Fifteen minutes passed of struggling to moved him away from the door. When I able to get to him, he was already unresponsive. No pulse. My adrenaline gets into action.

Immediately he was pushed into the acute bed. Cardiac monitoring put on. Flat line, no pulse. Barely any effective breathing activity. CPR started. After about 3 minutes, he regain pulse, with an extremely bradycardic pulse that is. Medication to increase blood pressure started. Blood pressure maintained. He was intubated and ventilated.

It is not all lost hope when the patient went into asystole (or not heart beat). But the chances that we are dealing is pretty slim. For an average Joe with no medical complication, the chances or revival is about 15%. However, the percentage dropped to almost 0 if the patient is having multiple medical illness. On top of that, the patient after being revived, requires intubation, ventilation, Intensive Care Unit admission and nontheless complications to multiple organs. That is why we always take into consideration patient's wishes for resuscitation and family views with regards of this matter. Sometimes, it is not prolonging the life, but prolonging death.

Think about it.

2008-09-24T21:03:00.003+08:00

Life isn't smooth sailing, as always.

I had a bad day, today.

My patient died under my hand. She came with septicaemia. Down with DIVC. Needed a central line. However got oedematous peripheral limbs because of overload. Lower limbs were inflamed. Trial of Short line through internal jugular would only stress her limits as her INR was 5. My boss said:" Proceed, I trust you."

So Short line tried, but got stucked at 5 cm. Then I got it removed at once. Bleeding was mad. Haemostasis secured only after 15 minutes of compression. 15 mins later, she went into asystole. Resuscitated for 1 hour. Unable to bring her back. Thinking back, was it my mistake? Probably. But her premorbid status was not well, either. She would need the High dependency ward back-up the very least, or intensive care unit. But none were available.

Sigh!

Working in such a tight resource, is really stretching the limits. You have datelines, you have urgent things, you have sidelines, all coming to your face at the same time.

Time to ease out a little bit. Life goes on.

Insider Vs Outsider

2008-09-11T21:36:00.003+08:00

"Chinese are the immigrant, squatters"

I can't believe I am still hearing such a low mentality statements being made.

Despite being independent for more than half a decade, the fundamental mentality is still stopping at British colonial times. As a Malaysian Chinese, we had rooted here for such a long time that we have little or no memory that we originates from China. I am born as a 'Malaysian'.I do not have a place in China for me. My mainland is here, Malaysia.

Despite all the moves to recognize every entity as 'Malaysian', there are people who still can't get over the overwhelming feeling of their own race being the greater one. Understandable. When we are equal, lost are the special privileges, unfairness, and foul play. Having a divided race entity is important in this context.

We may be independent at the outside, but inside, there is still a long way to go.

The Doctor With Fxxxed Up Teeth

2008-09-11T21:14:00.002+08:00

How do you feel, if a doctor walks up to you, when you are sick, lying down on the bed. She oped her mouth: "What brings you here to the hospital?" You almost fainted with the stench of an unmanaged teeth.

This reminds me of a colleague of mine. Whenever he is post-call, he never care to brush teeth. He will carry on with the next day job. While this may be good as responsibility towards his job is high, it doesn't help in term of his personal image as a doctor. When he speaks, I stood 3 feet away.

Halitosis, or commonly known as bad breath, is a under-addressed issue. It doesn't affect only doctors, but people from all walks of life that doesn't find it necessary to brush their teeth. It is as bad as having a body odour.

Being in this field, talking sometimes play a therapeutic role. Having a bad breath does not help the situation at all. Not to mention the yellowish stained teeth and what it can do to the doctor's image. So a reminder to myself and my friends: Take good care of your oral hygiene.

Hospital Is My Second Home Programme

2008-08-24T19:03:00.002+08:00

Most of us would try as hard as possible not to step into the hospital, to have nothing related to it. Hospital is synonym to sick, death, dirty, and all sorts of infections. Admission to hospital is suffering.

Yet, some will find all ways to get admitted to the hospital. I have seen quite some diagnosis such as " Poor oral intake and patient requested admission". Those 'patient requested admission population' are generally from the low socioeconomy status group, prisoners, intravenous drug users, and those with very poor family support group.

The first one, Ah Tat is his name. Every time we discharged him, he will return to our door steps on the third day without fail. Every time with the same complaint. He was not able to control fluid intake, subsequently taxed the ailing heart, ended up with heart failure symptoms. Despite giving the best medications, he did not want to take because he believed taking too much medications will do him more harm. So if I am on call and he is admitted, I do not need to clerk him, simply give him some advice and a nice bed. That's all.

The second case, 77 years old elderly, initially having acute renal failure, requiring dialysis. But the children strongly believe dialysis will do more harm than good. By going against doctors advice, the patient was going downhill. Currently, her kidneys is damaged beyond repair. But her will to live is strong. She had multiple episode of severe ulcers bleed, the next day I come, she is still alive. The daughter refused to take back the mother because apparently no brothers and sisters will take the responsibility to take care of the mother in the care towards the end and there were no maid at home. The best option is to let the staff nurse to take the responsibility of the children to take care of the mother. So until now, we still can't discharge her.

The third case, a 30+ guy, actively injecting drugs, despite went in and out institution, still unable to stop this habit. He would come in every other week for worsening abdominal distention. His liver was already cirrosed, because of viral hepatitis. When he was in the second home, he wreaked havocs. The staff nurses loathed him because he stole their ketchup. However, he has passed away unfortunately due to severe liver failure.

Hospital is not only the place for the sick. It is also the place for the unwanted, the lonely, the leftover, the unemployed, and those who wanted free food with some hospitality. My hospital door is always open (because there is no door!). Welcome to our second home.

Length Doesn't Matter, or Really?

2008-08-20T19:31:00.002+08:00

I was doing my respiratory rotation when he admitted to the ward. Pretty advanced cancer of the oesophagus spreading to the lungs. He was breathless all the time. Chest tube was attempted by me and the initial drain was like a water hose spurting out the putrid greenish fluids. Afterwards, his breathlessness was gone.

Two weeks later, I learned from my friend that he passed away. Cause by failed ventilatory support system. Sad, nevertheless. But I learn something from this gentleman.

You can learn a lot from the patient if only you see. Whenever during visiting hours, the bedside is full with concerning friends and relatives, you know either he has a good social support or second possibility is that he has a lot of money and the will is not made yet. If you see a bouquet of flower on the desk, there is someone care enough to give the well wishes for the patient.

This patient of mine was a teacher. A secondary school teacher. What is peculiar about him was if you speaks malay with him, he will answer in english. Maybe that was his style. He will question every management plan we had for him, like why is this medication on, why is this procedures carried out.

With his death, his teaching life came to abrupt full stop. But many had learned from him, and become a useful person to the society. He may not teach anymore but his teaching still passed on. On the day of his death, there were a crowd more than 50 that came for him, the largest I've seen so far. The wife came up to me with teary eyes, thanked me for taking care of the husband. It stirs my inside, and I loss my speech. I just return her a sincere smile.

You may say he live a short life. Nevertheless, it was a meaningful and purposeful life, I say. Does the length really matter, huh?

The Final Step Between Learning and Earning Years

2008-08-16T20:45:00.005+08:00

Last week I finally attended my graduation. Five years of hardship turning into something rewarding. Walking up on stage, getting the scroll, snap-snap, meeting friends and talking dreams. Now I am a degree holder, haha!

Somewhere before the convocation, we some couple of old friends met up to chit chat. When I thought I worked so very hard, on call almost 10 times per month, there is someone else worse than me. My friend in Sungai Petani had to do calls up to 15x a month! That is equal to doing every other day calls. Phew! Some had significant loss of weight. Others are doing easy calls like 5 to 6 times a month with not much patient to care of. But some did not live to the good name of the University. I heard he left the hospital during his call to meet up with his partner and the whole hospital was looking for him. Irresponsible.

People come with many faces, and many behaviours. What separates us is our attitude. If we have positive attitude, then we will survive well. On the other hand, if we give the impression to other people that we are lazy, then working will be like living in hell. When you manage patient, you can't be lazy. That is what my Prof Emeritus Dr Adeeb favorite quote. Lets give it a deep thought, my friends.

2008-08-06T08:29:00.000+08:00

The graduation bell is ringing this Saturday. Now I am on leave from the hectic work of medicine to enjoy some peace. Will keep posted with photos later.

This Old Man, He Play One, He Play Nick Nack...

2008-08-04T21:46:00.002+08:00

I came to know an old man. A lonely old man.

He loves to wait by the telephone for her daughter to call, but they seldom do.

He loves to watch movies on big screens, yet no one has time to accompany him.

He loves to cook nice dishes, sometimes the taste can go awfully wrong, and no one there to eat the food.

He loves to travel, yet no one would look after the house for him.

He loves to talk, yet walls is the only listener for most days.

He loves to try his luck on the scratch ticket, yet no one share the joy of winning with him.

He loves to sleep during noon time, because time is easier to go by to fill up the absence.

He loves to learn English, asking his grandson grammars and pronunciation, because that is the communication link between both of them.

He loves his family, and do not know how much love the family gave returned to him.

He is

My grandpa

Goh, can you do me a favor...

2008-07-26T17:23:00.002+08:00

Into working life for about two months now. Start to see things clearer. And I start to know people.

There are a type of people, who is genuinely being a friend with you, helping you out, guide you and cover your back. They treat you as a team, working together towards a common goal.

On the other hand, there are also people who likes to take advantage on other people, thinking that everyone else is stupid and they are the only clever one on earth. Every time a challenging task is assigned to them, they will start to find every one else:" Can you do me this favor?" "Can you help me with this?" "I am really rushing home. Can you manage this case for me?" All sorts of excuses, to evade from work. These people haven't grown out of their cocoon world, still living in the student years, where there is no need for responsibility. In the student years, you can leave the ward anytime you want, throw aside the branula for the houseman if you can't set it and have plenty of holidays. Not anymore since I ventured into housemanship time.

Everyone is getting the same pay. Why would one answer so many favours while the other one just wait and see? Between giving fishes and teaches a person to fish, I would rather go for the latter. As the time comes, our service will be needed to do the daunting task in the middle of the night without any guidance. Only pure skill will help us through. I don't mind sharing the skills, which I did most of the time. But I hate people taking advantage by asking favor everytime the same problem arise.

And the third type of people are those who only work within their working boundaries. They did their job perfectly well, no question asked. But when it comes to do a little bit more, they will be calculative. Team spirit is never existence. These people are hard to work with as well. In the end, the one that works alone will be suffering more.

Which types are you belongs to?

The Meaning of Life

2008-07-18T19:08:00.004+08:00

Life...

Life is between this breath and the next. Are you aware of the breath you are taking now? Are you consciously believe that you are alive now?

Many don't. Many take for granted for this life. Some even wasting their life now.

Without knowing it, the next breath that we take will be more effortful, more difficult. Every breath we take brings us closer to death. whatever said, it is not the destination that matters. The journey through this life is the things that bring colours to our life.

I work along with death. I see him many times a day. In the morning, during ward rounds, when I am having lunch, and especially in the middle of the night when everyone is fast asleep. I particularly remembered one event, seeing Mr. Death in the resuscitation room. He brought along a boy, in his early twenties, left a lifeless body with many fractures and scars. At one glance, most probably high velocity motor vehicle accident that cause his demise. Another glance, maybe he is someone that I mentioned before, someone who wasted their life by racing illegally. Cause of death - polytrauma and spleen ruptured leading to hypovolaemic shock.

Today, 364 days to my 27 birthday. War of the the middle earth has ceased. The race to the end has already begun.

When The Pager Rings...

2008-07-06T21:01:00.006+08:00

I couldn't help but agree to my Professor who said this to us one day...

" When I was a student, I longed to have that pager when I work as Doctor. When I first had a hold on the pager, how I wished I wouldn't have it."

On my second day of on-call, I was doing 3rd/4th caller, which means I care for 2 passive wards as well as the whole hospital where medical patient is located. That covers from rhesus room in emergency department till the first class in 8th floor.

The first ring from the pager when I was doing my morning rounds. It was a call from first class ward.

"Hello, Dr. This is ward 8A. We have a patient from medical side. She is currently complaining of..."

"No, no, no, This is 8.30 am. You should call the the peripheral doctor in charge." I said.

"Is that so? OK then."

The second one was about 2.30pm. It was from 2197, rhesus room.

"Dr Goh, please come down to rhesus room now for a arterial blood gas sampling."

I was doing my acute rounds in female ward when the third and fourth pager blares.

"Dr Goh, there is a patient complaining of cough. Can you come over to see him?" This one from first class ward.

"How bad is the cough? I am doing acute rounds now. How bad is the patient?"

"Not very bad. SpO2 is stable"

"Then prescribe her with syrup diphenhydramine 15 mls stat and tds."

The other one from second class ward.

"Dr, there is a patient requires a headblock (needle inserted for drip infusion or intravenous medication). Can you come down please?"

"I am still doing my acute bed rounds. Could that patient waits?"

"Yes."

"Ok then, I will come down when I finish the acute rounds."

When I finish the acute rounds it was already 8.30 pm. So I went to insert the headblock to the patient. It was a male patient.

The fifth pager rings when it was about 12.30 am. Again, it was from the rhesus room asking me to do ABG sampling.

Finally, I get a chance to sleep at 2 am.

Beep! Beep! (2.30 am)

"Hello, HO medical on call speaking. How can I help you?"

"This is from the second class ward. There is a patient complaining of cough and wants to see a doctor."

"What? Only cough? At 2.30 am?"

"Yes Doctor."

It was the same patient that I inserted the headblock just now. When I finished my duty that night, it was already 3 am. Morning is just 2 steps away.

The Difficult People

2008-07-05T21:33:00.003+08:00

Somewhere in life, you had and ought to deal with extremely difficult people. I had one encounter last 3 weeks...

(Not to name this person as my future will be in jeopardy)

This person is my superior. He/she decides when do I starts working, when do I get my holiday and when do I get to upgrade to the next level. Glad enough he.she does not decide whether I get paid or not. So I was on tagging for the first 2 weeks. Towards the end of tagging, we will be reassessed whether we were deemed suitable or not for on-call.

At day 12 of tagging, I was extremely tired. Constant lack of sleep does not do any good to this barely functioning body. So I met up with this superior to discuss whether I can off tag slightly earlier than schedule. I believed I am competent enough to do the crap job.

No

There came his/her reply. Straight on the face. The reason being I haven't completed my procedures. Fair enough. Luckily that night she was having calls. So I got change to 'show' that I am able to do my procedures well. On the day 14, I went to find this superior again and finally green light was given for me to off tag.

Not so lucky for my friend that started her medical posting 5 days later than me. She is still on tag until today. That is like day 18 of tagging. Heard that she had problem with this superior.

How to deal with the difficult people?

This is my style:

Always says yes. Even though they were wrong, or against your principle. There is not much harm to follow them as compare to having them picking on us.
Always follows their order. They maybe having a set of their ways in doing things that may not be of our liking, but they are our superior. They give orders, we follows.
Always turn to a deaf ear for bad remarks. It is always nice to have a good ear and a bad ear so you could 'switch off' those hurtful words. Never, ever answer back on those bad remarks or being emotionally because that could leave a lasting scar on the relationship.
Always look forward to the good things ahead e.g. paychecks, future improvements and important things to do. If we think this is our life and it never progress, then we are wrong. I always look forward to the time I myself become a superior, and always believe that the time of being houseman is only temporary, a stepping stone to become a specialist. Only then we will ignore all this tiny mini ripples in life.

If I am wrong, please do correct me. I am only learning on how to start my life.

The Fragility of Life

2008-06-26T20:35:00.006+08:00

Life is so fragile...

I remembered setting a CVP line for an old man who was just admitted for cardiac failure. He was still talking to the children, like nothing ever happen. The next moment, I was doing resuscitation on him, while his life gently fade away and left behind a lifeless and cold body.

It has been my life, or rather my job to save life. Yet sometimes, sometimes life and death is not in my hand. I can do as much as to help. The fragility of life is something I must learn, and adapt well.

(This week I had seen at least 10 deaths)

A New Beginning

2008-06-09T23:17:00.002+08:00

A new dawn, tomorrow, it will be. A brand new start. A new page, a new chapter, a new leaf... So many words, yet it means only a thing, I am happy being posted back to Kuantan Hospital to serve my housemanship.

This few weeks I had been undergoing kursus induksi and kem biro tata negara. Tired. Yet happy to catch up with the friends. It was the last chance to gather them together for about 3 weeks to attend a course. Kind of missed them now.

Happy, yet anxious for whatever that may come tomorrow. I had never ventured this far before. Working life was a new thing to me. Whatever the outcome maybe, come what may. I will, I shall and I believe I can face it and deal with it.

All I need now is some sleep. Then some strength, then some luck, then...

Five Days, Five States, One Thousand Kilometers and Massive Dose of Fun: Part 3 - There and Back Again

2008-05-08T22:13:00.005+08:00

Previous post:

After the 2 days 1 night stay in Langkawi, the group went back to Penang island by boat and depart to Ipoh on the next day. Ipoh mari!

Day 4:

Seng Fai insisted to drive. So he take the wheels from Penang up to Ipoh. It was noon then when we reached. Hot as ever. Jam as ever. Lunch settled in a famous kopitiam shop in oldtown Ipoh. I guess that's the origin of the famous Oldtown Kopitiam. The fullness of dim sum in the morning carried over till noon. So we had a kaya toast, peanut butter toast and some kuih. The coffee was particularly nice for me, but gave others tachycardia because of the high level of caffeine.

The oldtown 'oldtown Kopitiam' in Ipoh

The next goal in Ipoh was to look for the famous caves. There are a few to start with, but the famous ones are Kek Lok Cave, Sam Po Cave, and the one with Guan Yin Cave. The first cave we visited was the Kek Lok Cave. It was a huge cave with Buddha statues inside and the exit of the cave overlook a nice lotus pond. The atmosphere outside and inside the cave is totally different. Inside the cave, you feel the darkness and the dampness and the water dribbling down from the ceiling. It was eerie inside. Outside, it seems like a whole new world, you can leave behind those worries and stresses. Time had already frozen in this wonderful place. The lotus was blooming. Soft breeze brushes your face. We sat for a long time in this shangri-la.

Kek Lok Cave - from the inside

The lotus pond

Julian is in ecstasy

The next cave we ventured into was the Sam Poh Caves. Similarly, there is a buddhist temple build into the cave and the exit also goes out into another isolated world. Somehow, they had built a monastery in this place, which looks grand besides the mountain. We had little time spent here as they were closing the cave for religious ceremony.

The monastery in Sam Poh Cave

We did not stay overnight in Ipoh as it was a labour day then. Hotel rate would be at its peak. So we decided to drive back to KL on the same day. Ming Huei already booked us for dinner at her father's shop in Sunway. After diner, we went to stay overnight in Seng Fai's house.

Day 5:

On the last day of the trip, We planned to go to Sungai Gabai waterfall. This time, Peggy and Ka Man joined us. So a party of 7 person went to this waterfall. We went the wrong way and the long way by going to Semenyih first. However, I never regretted taking that road because we enjoyed a scenery beyond words. There was a lake, or a water reservoir and the road snaked around the lake. The view in the morning was most refreshing. Along the way, we met an aborigine settlement. It was a long drive down to this waterfall. As a conclusion, this is a way more beautiful waterfall compared to Telaga Tujuh in Langkawi. We had to climb a stair for about 10 minutes to reach the top. There were natural water slide. We waded in the shallow pool and had picnic there. It was the last stop of our trip. I had so much fun. Hope in future we have opportunity to gather again for another adventure.

Waterfall in Sungai Gabai

One of the stopping place for photos along the 10 minutes climb

Five Days, Five States, One Thousand Kilometres, and Massive Dose of Fun: Part 2 - Langkawi

2008-05-07T21:15:00.007+08:00

Tanjung Rhu, a must visit place in Langkawi

I could believe this is somewhere oversea if not for the hot temperature

I could live here, you know

After being sentenced to death for the adultery that she didn't commit, Mahsuri lay a curse before her last breath. "I will be the witness, for 7 generations, Langkawi will be the land of drought and waste (padang jarak padang terkukur)." Legend says her blood spurted out was white in colour. The rice planted there after was 'burned'. Langkawi was backward as people deserted this land.

Day 2:

There goes the legend of the beautiful lady and her tragic death. We reached the island about noon time. It was hot like an oven. Since we can't transport our car over here, the next natural things to do is to rent a car. 6 people, 5 seater, what to do? 2 cars or 1 car? After a lengthy discussion, we opted for 1 car, as petrol and going places was the main concern. We do not have a guide either. We rented a 7 seater MPV Innova for a price of RM 130. That was further discounted to RM 110 for it is non peak day. Haha. Whereas if we get 2 cars, it will cost RM 50 each. With a car, we were able to move around. We rented a motel in town, which was RM 100 for deluxe room with air-conditioning and also RM 10 discount.

Lunch was at a small place in the Kuah town as someone insisted to have Chinese food. Not very nice food, though. Then we visited the famous Mahsuri tomb. Along the way, we stop by a nice watching place. The label of the place is pathetically small but the scenery is first class. The sky was not doing any good. Soon, it rains cats and dogs. The scheduled 1 hour became 2. Glad, after the downpour, the sky turn sunny again. The next stop, 7 wells waterfall. Actually, the waterfall was not as good as it sounds. It was like watching a baby pee on top of the falls. The water stream is very small. Downhill, we bought tickets to go up the famous cable car in Langkawi. Weather was clear then but the cable car operator refused us to go up the cable car! After one hour, it was still the same. There was no point arguing with them. So there is an excuse for us to go to Langkawi again next time.

I believe I can fly... On the watching place

Now you see what I mean. You call this waterfall? I called this 'pee' fall

Geopark, where the cable car is

Beautiful girls on rocks, but all taken

This make a good roast for dinner

Oh my rabbit stew, nice and sweet.

After the cable car thingy, we went across the island to the black sand beach. Nothing special. It is a long stretch of beach with a very little playable place and dirty sands. But Tanjung Rhu is way different. You need to drivetill the end of the road, and you will come across a nice beach. Perfect place for sunset watching and seaside walking. The beach is serene and picturesque. Alas, too much cloud. So we packed up early for dinner.

This could be a winning shot if only the clouds were gone. Anyway, we were aiming for sunset

Beach girlsThe beauty of the beach marred by these guys

Night time is good time to let loose. Someone again suggested we make cheap tequila pop since alcohol is cheap on this island. You can get a Carlsberg with 20 cents extra compare to a 100 Plus. We guys got very drunk that night. I never had liquor in my life and that night i lost my alcohol 'virginity' to it. Funny things is that none of us said we were drunk when we can't even walk straight to toilet. That is how an alcoholic always do, right?

Day 3:

The next day, we went to the underwater world, but decided not to go in for the entrance fees was too high. We went to the duty free shop next door, instead. The last stop in Langkawi was Dataran Lang, where a huge eagle overlooking the sea port. Nothing new to me as this is the same eagle 10 years ago.

We boarded the 2 pm boat back to Penang and stayed a night over there. At night, we had dinner in a hawker centre near Sunway Carnival and coffee afterwards. You guess what's on the menu. Its wanton mee! After the goodbyes, we were prepared to go for our next stop, Ipoh.

Day 4:

Breakfast was with Shui Wei's parent as they insisted. We had overloaded ourselves with Dim Sum, which was very nice indeed. After 2 days of getting in touch with the Penangites, I found out that they develop a very sensitive sense of taste. They can tell you this fried kuey teow lack of the wok Qi eventhough we can't spot any difference.

Its time to zoom-zoom again, this time to Ipoh.

To be continued: Part 3 - Ipoh and back to KL again

Five Days, Five States, One Thousand Kilometres, and Massive Dose of Fun: Part 1 - KL, Penang

2008-05-07T09:11:00.012+08:00

Old Clock Tower near the jetty, Penang

Holiday is always the time to go around the places you wanted to visit. I had chance to travel up north to Penang and Langkawi during this summer holiday with couple of my friends. Initially, there were 7 people, but the company shrink into 5 people due to some unavoidable reasons. Anyway, we set out on a fine morning to our destination - Langkawi.

Day 1:

To meet up with the company, I had drove from Kuantan to Kuala Lumpur the day before. Before daybreak, I drove to Seng Fai's House in Pandan Indah. A total of 4 person including me, Seng Fai, Ming Huei and Kok Chong started our journey from here. It was Monday Morning and the famous "KL Jam" just started. We spent half an hour from his house to get to Jalan Loke Yew. There, we had our breakfast in 亨记 Restaurant. The shop is famous for its wanton mee (云吞面). That morning, I had some bread before departure, so I ordered a small sized mee just to taste. The waiter looked at me and ask me again: "You want double mee or big mee?" "Just a small one will do." I said. Later, when the food was served, I ended up with biggest plate! What to do? I spread out mine to Kok Chong and Seng Fai, who already ordered a double mee. Kok Chong gave me a killer look that morning.

Our host and guide, Shui Wei with her F1 driving skills in Penang

We reached Penang about 1 pm. Luckily, our accomodation was arranged by Shui Wei. She spared out 2 rooms for us in her house in Bukit Mertajam. It was lunch time then, and the traffic congestion was at its peak. So we decided to call up Prai friends to meet up and have fun together. Lunch was at Chun Siong's father shop, which is also famous for the wanton mee. So we had the second helpings of wanton mee for the day and that was not the last. After gathering up Ling Shie and Chun Siong, we decided to cross over to Penang Island.

The first stop, Kek Lok Si (极乐寺). It is a well known Buddhist temple with a huge figurine of Guan Yin that stood up for few storeys high. Personally, I had been there about 10 years ago. Renovation was under progres to build a huge shade. There is a saying that nowadays all Penangite worships Guan Yin (since Guan Eng been installed and the CM of Penang). Other attraction of this place is a tortoise pond and the temples around.

The most priced figurine of Guan Yin - under renovation

Me and Kok Chong posing under the shadow of the Pagoda, also under renovation

After that, we went down to Farlim to look for Apple (not the type that grows on a tree, but a person). and we had a nice bowl of Laksa with 清補涼. The laksa served in Penang is garnished with slices of fish, lots of big onion, mint leaves and pineapples. Spicy and mouth-watering. Some will add the prawn paste just to sweetened the soup but I preferred not to. Meanwhile waiting for the Penang bridge jam to pass over, we went to Batu Feringgi. The sky was cloudy then and thunderstorm was building up. Without warning, the rain falls and we ran for shelter in Gurney Plaza. The rain won't stop until about 8 pm. Then we left the shopping complex to cross over to Butterworth.

We had our dinner in Da Wei which is a hawker centre with some of the very nice local delicacies you can find in Penang. We ordered Lo Bak, fried egg with oyster, fried kuey teow, curry mee, and popiah. The price were reasonable. Funny thing is that most of the company ordered iced Ambla with sour plum, a highly recommended drink in Penang.

It was a long first day, and we need a rest for a long day ahead, as we are crossing Penang to Langkawi.
Day 2:

At the break of dawn, drove from Bukit Mertajam to Butterworth and took my ride for her first time to cross the straits of Penang by using ferry. Then we took the boat transfer from Penang to Langkawi. Most of the boat company charges the same rate at RM 55 per single ride and you can get a little bit of discount (RM 5 only) if you purchase the return ticket immediately. Tips: Do specify your return time properly for there is a chance that you might not be able to catch a boat ride back to Penang if the boat is full. The boat ticket only valid for 24 hours.

To be continued in Part 2: Langkawi

This is Where I Called Home

2008-04-21T19:41:00.005+08:00

Let me introduce myself to you guys. My name is Muthu. I am eight. Eldest of the five siblings. All are boys, the youngest is 1 year old. I never attended to any formal school until now. My parents never send me to one. I am staying in a hut as you can see with a blown off roof after the last thunderstorm and a door that barely close. There were no windows.

I introduce my mom first as she is the person that I see the most everyday. My father seldom at home. He loves alcohol more than our family. My mother is currently expecting another baby. Heard that it is a girl this time. I seldom see my dad. He is never at home. I don't know what he is. Only thing I know when he is back is mother will get hit and we all siblings we got beaten up for no reason at all. Since he has this new found girlfriend, he came home less and less. I knew my mother cried a lot for him.

Since I am not attending any school, I had plenty of time. I like playing around with friends. Though they always have some shiny new toys I could only hoped for. So I found a way to make money. I asked from people. Sometimes, on 'luckier' day, I could earn myself a can of coke. 'Bad' days can be really terrible. Anyway, I don't enjoy reading. I can't read anyway. Although I hate it, I have to take care of my younger siblings for my mother sake.

Life is tough. I never want all this responsibility of grown man. I wanted to play, I wanted to go to school like the other boys, to see the world. Above all, I wanted a home that is warm, a father that provides, mother that heal all the wounds, and everyone around table to enjoy a nice dinner. Not this and definitely not what I had now! I am so longed for a change in my life and fate.

To see this broken family really breaks my heart. They were a defunct family living off the main road from Kuantan to Gambang. They were the poorest of the poor among the area. The house they lived is no living condition. Torn down roof, no rooms, poor sanitation, with food and faeces lying around. Anyway, it is a shelter provided by some kind people. They were like a roadkill from the economic highway.

Father does not has a permanent job and mother is a housewife. Most of the income were spent on the drinking behaviour. Moreover, the father is abusive at times and his beating never spared the younger child as well. Education for the young one never seems important. The health condition were terrible. Almost all of them having head lice manifestation with the second youngest child having scabies infection as well. I have no doubt that the other siblings will have the same infection. All of them seems malnourished and looks small for their age. The mother, though pregnant, never attended the routine maternity clinic check-up for the young one inside.

People around had been trying to help them, with monetary support from governmental agency, non-governmental organisation and people with a heart of a Buddha. People donated food and clothing to fulfil only the basic necessities but they were far from enough. They need better homes, and most important, education to promise a brighter future for the younger generations. With the help of people who cares, this family will be relocated to the foster home to ensure proper living condition and schooling for the child. There is still hope if everyone only lend their helping hand.

The Money-Making Pet

2008-04-21T09:54:00.011+08:00

This is not a zoo. This, in fact is my house. And this is no ordinary monkey. His name is 'Beruk'. He is owned by Pak Mat Beruk (in local tongue we pronounce as 'Pok Mat Berok'). His job? He plucks coconut for Pak Mat. How they pluck the coconut is fun to see. First, he will climb up the coconut tree. Then he will liaise with Pak Mat on which coconut to pluck (you don't want a young green coconut to be plucked as the flesh is still relatively thin and no value). Pak Mat will shoosh here, praise there and they will get job done. After that, he will be rewarded with food.

This is a thriving local industry in my home town. Coconut fetch a very good price in the market and it is in all time demand. The coconut-plucking monkey enjoy his job, and I am going too, in the month to come when I start my job.

Combo of Pak Mat and his beruk equals to nicely skinned coconuts

Bak Kut Teh: Smelly Pork No More

2008-04-15T22:40:00.006+08:00

Do you know that bak kut teh originates from Malaysia? Have you ever wondered how it come by? According to local people, it started as the manual workers that works in seaports of Klang long time ago was looking for a way to curb the stench of cooking the pork raw. They needs something filling for their job nature as well and the bak kut teh served with rice is just the answer for a hungry man's call. So they found the way by adding certain chinese herbs to the stew will bring out the aroma and curb the smell. Now it had evolved from worker's meal to all time favourite of Malaysian.

Nowadays you can easily find bak kut teh everywhere in Malaysia, but with their own variations. Usually, it is served in claypots to preserve the heat. Almost all part of the pork whichever is edible will be thrown into the stew. The soup is between clear to dark colour depends on the chef. Usually, there will be garnish such as lettuce, and you char kuay. There will be strong smell of herbs usually. It will go along very well with chinese tea. Usually, in bak kut teh shops, you will see pots of water boiling beside the main table. This is for the customer to refill the tea themselves.

Yesterday I had a chance to taste the well known bak kut teh in Klang itself. It was one of the well known shop near the port Klang. We called for both soupy and dry bak kut teh. The dry type according to the owner, is a new taste. For the soupy one, the taste was just okay, too mild to my liking. And the selection of the meat was mostly the fat one. As for the dry bak kut teh, after the meat was boiled, it was fried with dark soy sauce and chilis. So it tasted a little bit seet and hot. Anyway, not bad overall. The price was fair, about RM 12 per person.

If you happen to have a chance to enjoy this dish, please do so. It will surely leave a lasting impression of a special taste in Malaysia.

Oh I Love You So Much, My Love Durian

2008-04-15T15:59:00.007+08:00

So they say, durian is the king of all fruits. Some like it, some loath it. It can be anything from the
best thing in the world to the piece of thing that smells like a rotten fish.

It is spring time again. The durian trees is blossoming. There is a nice fragrant in the air. Between sakura and durian flower, I like the latter more. All because it turn into little durian fruit later. I say, durian is a weird fruit. It is covered in spikes all over the skin. yet the flesh is sliky smooth and glistening yellow in colour. In three months time, some these flower will turn into fruit and ripe.

It is best to enjoy a durian when it is fresh, best about 12 hours after it fall. If we eat the fruit right after it fall, it will smell like grass and the fruit will be slightly hard. This year, the trees flowers a lot, compared to last year. Hope it all turn into lots of durian.

Celine Dion 'Taking Chances' World Tour Live in KL Attended

2008-04-15T14:45:00.013+08:00

I had an amazing weekend. It was all because of Celine Dion. She had performed her best for us, Malaysians in her 'Taking Chances' World Tour in Stadium Merdeka.

The weather was not helping very much initially. It was heavy downpour since 3 pm in KL. However, the weather changed to clear sky at about 5 pm. Me and my mom went there early, so there wasn't so much of traffic and parking was easy. This is the first time she attends any concerts and I thought of bringing her to experient how a live music would feels like. We parked in front of the Victoria Institute. However, the person in charged of parking came and collect RM 10 from us! Who are they actually? The car was parked on the pedestrian's walkway . I never knew the walkway was theirs. Anyway, we just paid.

At 5.30 pm, there was already people lining up to get into the stadium. Celine was singing that time! She dressed in green top and red pants and she sang 'Taking Chances'. After 2 songs, there were no more singing. We waited for at least one hour and the crowd is building up very fast. 10 minutes before seven we were able to be seated in the stadium. As you can see from the photos, there were a very weird structure situated between the RM 400++ seats and it was in the middle. Thus everyone avoided sitting in the middle part of the stadium that faces the centre stage. The stage was quite plain, with 3 big screens and no fancy stuffs, so the enjoyment is purely from the performance of Celine. Meantime, the waiting process was very long and boring as well because there were no slideshow or whatsoever being put up on the big screens. There were only some crappy music box-like songs being played. Wished the organizer could improve on this next time. There were quite a holdup because the VIPs were late. So the show begins at about 9 pm, which was 1 hour later from schedule.

All I can say is Celine Dion is absolutely a superstar. She never failed to entertain us with her strong and powerful vocal and at times, she was witty as well. She is a true singer. It was an one and a half hour intense show. She sang most of her hits such as 'I drove all night', ''Because you love me', 'It's all coming back to me', 'Pour Que Tu M'aimes Encore', 'I'm alive', 'River deep mountain high' and songs from her latest album such as 'Taking chances', 'Alone', 'Eyes on me', 'My love' and many more. She ends with 'My heart will go on'. Amazing. As for the clothing, she had been conservative. She wore a silver shining dress, and leather pants throughout the show and only changed to a white gown for the last song. She had been sweating like mad, though.

Even the King also attended her performance. Among the VVIPs were Siti Nurhaliza and Tun Mahathir's son. After the concerts, I managed to grab a poster of her, haha. She will bound for Manchester, UK for her next stop. This will be a memorable time for me and my mother. Thanks to you, Celine. Happy belated 40th birthday, Celine.

The centre stage from where I seat

The RM 200++ seating, not yet packed because it was still early

My mom and her first time in concert

The line behind me at bout 6 pm.

That is how far I was from the entrance. There was a weirdo wearing rain coat (in yellow) despite no rain.

The Power of Believe

2008-04-09T09:07:00.004+08:00

I had been helping out in a secondary school lately. There is this young boy, who is delinquent, create a lot of problem to the teachers and the friends. It seems like law does not applies to him. Law were mean to be broken anyway. In fact, her mother is a teacher in the same school. There is some sort of high expectation from him to perform well in academic and behaves well. Alas! It turn out that he failed several subjects in the school test. The mother had lost hope with him. His teacher thought he is just another naughty student that refused to study. His friends think that he is a bad company to mix around. Even he himself does not believe in himself that he is capable. This creates a self-fulfilling prophecy, as he try to fulfil the low expectations in his surroundings.

Then, came along the school counsellor. She found out he is an intelligent boy. She never lost hope in him. She told the mother to tell him one day that he is actually a good person and the counsellor believe that he will succeed one day. After listening to such a simple word by her, his life changed totally. It takes one person, only one, to have hope and believe in him that he can do it. From that day on, he changed to become an obedient student, never missed a class, and does not create trouble for the school anymore. His academic performance improves. Now, he even became favourite student of his class.

Sometimes, we unwittingly condemned a person without thinking twice. Without knowing it, we might actually strip off the person's hope in themselves by giving negative remarks. It is easy to notice a person's mistakes but it is very hard to appreciate a person's good. Next time, before we passing out a comment to a person, think twice, thrice or more. Our words might done a damage beyond repair to a person's life, or save a person from the brink of destruction. Choose carefully.

Road Trip to Peninsular Malaysia

2008-04-04T14:27:00.004+08:00

I am planning for a road trip around peninsular Malaysia soon with couple of my buddies. Starting point will be Kuala Lumpur. We will travel north, using the trunk road, through Ipoh and Taiping, up to Penang, then transect from West to East using the Grik way. From there, we shall go south, cruising along the beach side road. and stop by Kuantan. From Kuantan, we will travel further south till Johor Bharu, finally picking up from there through Melaka and Negeri Sembilan. Finally back in Kuala Lumpur.

This is to reminiscence the old memories of these places. When I was a little boy, my mom used to take us around Malaysia during school breaks. Along the way, we shall meet the friends that had been scattered around after the last parting. Most important of all, I think, is to enjoy the journey along the way, things that we had missed when we rushed things through. Isn't it always that way? The process of doing something is always most fun. However, when we had finished the thing, it is sort of anticlimax already. Just like my medical school life.

Hope that this road trip will bring back some sweet memories to me and my lil car don't give me trouble.

Live à Kuala Lumpur: Celine Dion World Tour

2008-04-03T11:46:00.006+08:00

Haha! I have been waiting for this with anticipation. I am going to CELINE DION TAKING CHANCES WORLD TOUR 2008! OMG. Wait a second. What? Postponed? Now it is on 13th of April. Glad it is not cancelled or something. Bought this ticket on the day it was released. This is the first time I attend an English concert. Last time attended Emil Chou concert. Even the second lowest price was RM 111 after 10% discount (Original price was RM 123). Not that I want to complaint for the pricing of the ticket, it is simply ridiculous to price the starting price of the ticket from RM 158 and way up to RM 1000 for the grand seats. Maybe she wasn't mean to perform for youngsters like me, though. More over, the venue. Oh~! So cheap! Stadium Merdeka is just a torn down place to watch such a wonderful superstar performing.

One funny thing I encountered during buying concert ticket. I had made my purchase and waiting for the salesperson to print the ticket. There was this couple, in their forties, wanted to buy ticket. During that time, the cheapest fare is still plenty and the seating is facing the main stage. However, this couple straight away enquire about the RM 288 ticket, which is seated sideways. Experience tell me that whichever type of cheap seating, there is no significant difference between the enjoyment level as we STILL cannot see the star and can only see the big screen. On top of that, you enjoy a good neck strain for looking sideway for 3 hours. Next time don't ever buy sideway tickets (from my personal experience). The last time I attended Emil's concert in Bukit Jalil Indoor Stadium, I need a full good body massage the next day after sitting sideway for 4 hours.

See what I mean? The cheapest face centre stage but the more expensive sit sideway.

The first time I fall in love with Celine's songs was during 16 years old. The very first CD album I bought in my whole life is 'A New Day Has Come'. I think it was the album début that captured me. Subsequently, I ended up with her other albums as well such as 'Lets Talk About Love', 'One Heart', 'The Collector Series', 'Miracles', and the latest addition 'Taking Chances'. However, NOTHING compares to listening to her LIVE! Here I come, Celine.

Investment is the First Step, But How?

2008-04-01T20:10:00.005+08:00

Since I am back in Kuantan, I suddenly feels there is nothing to do. There is always excess time. There is no more early awakening to cover bed, ward rounds, or do revision. No more (and not yet!) Instead, I woke up to the chirping of the birds and sweetness of the morning mist. There is hardly any motor vehicle that pass through the road in front of my house. Only one word to describe: Peace.

This gave me a lot of space to think. Where do I want to go from here? I have been reading books about investments and given a thought about financial stuffs. I thought I am a person that want to drive a good car. This maybe due to my family background that think that a car is nothing but a depreciating piece of metal, unlike a property or even gold, which will increase in value with time. So we never own a good driving car. However, I always think that I should drive a car that can ferry the passengers safely and feels well made. The car should be up to my status as a professional. So I have had conflicts with them about this matter. My mother wants me to drive a Proton Saga as a fresh man, the most is a Toyota Vios, nothing more. On the other hand, I would prefer something of a higher hierarchy such as a Corolla Altis or a Honda Civic. I even test drove a Civic that day to get the 'feel' of a nice car (however got disappointed by the car and the salesman).

Then, I come across this book that teaches a whole new idea about getting into debts. If we loan from the bank, say RM 100,000.00 to buy a new car, with the interest of 2.38% per annum for 5 years, we are actually paying an extra of whooping RM 11900 for nothing (that's about 11% of the total value!). The monthly instalment will be RM 1865. If we save this amount of money and put it into investment , by the end of 5 years, we will gain more than the amount we paid for instalment. Meantime, drive something cheap before driving your dream car. This idea seems feasible. I will seriously give a thought to it. In fact, starting a life with huge debt is no good as it limits the amount of cash flow into investment that would be dependent of the time factor. The earlier we start investing, the better it is.

I am still at the crossroad of how to invest. Can someone help me?

Filial Piety

2008-03-30T21:59:00.007+08:00

Today is a special day. At least in Chinese people point of view. It is cheng beng (清明节). Last week, I was hoping that I could make it this year to this occasion, and I made it.

I didn't do it last year as I was in Kuching doing my electives this year around. Basically, it is a tradition of the young one revisit the graves of the remembered ones. They will bring along their offerings to be given to the remembered. Nowadays, it is ridiculous! They had commercialize the offering, making Mercedes Benz with driver, TV sets, hand phone, massage chair, even maids and latest addition is LV branded bags! The event which was solemnly done now becoming an extravaganza celebration. Instead of firecrackers, now they even put up a firework display in front of the graveyard. Cheng Beng had become like a new year... With modernisation, hope that the core value of this day will not change, that is to relinquish the loved one and practice filial piety (孝).

It is a norm for our family to visit 2 graveyard on this day. One is my late great grand mother, which originates from Guang Dong province. The other grave is for my Paternal Grandfather and grandmother. Walking down the same hill brings back do many memories of the last moment before they were cremated. It was my late grandmother that went ahead of my late grandmother due to colon cancer. Grandpa said a very touching word to her before she passed away. "Do wait for me when you got there". Grandpa suffered very bad diabetes, complicated with pancreatitis and systemic infection. I did had chance to visit him 2 days before passed away. He was in Intensive Care Unit. It was during one of my third year semester break. I never regretted that I spent quality time with him. I did a lot of dressing for his ulcers. As far as I can remember, we always have communication problem. He speaks nothing but pure Teo Chew dialect and I did not master this local dialect. We communicate in mandarin, not knowing how we understand each other. But as always, message always got through! Life goes on after he left for about 3 years.

It is most sad to see those young soul that lies beneath the grave of my late grandpa and grandma. One of them barely lived to see his twenties. How the parents handle it is really beyond my knowledge. In Chinese saying, the pain of the 'white head' seeing the death of the 'black heads' is one of the most unbearable one. Life is unpredictable. You wouldn't know when Mr Death come knocking on your door. Before you knew it, it is already too late. Appreciate what you have now, and look at the people around you. Repay them whenever you got a chance. Never wait.

Tale of The Great Teacher

2008-03-28T16:31:00.005+08:00

A good teacher will test what you know, but best teacher will let you know what you don't know.

Throughout this five years, I came to know a very great teacher that not only teaches, but make us learn what is more than the textbook. His name is Dr. Mohd Shahrir Mohamed Said.

Dr Shahrir is a rheumatologist, dealing mostly with rheumatological disorder such as rheumatoid arthritis and all sorts of autoimmune disorders. My first encounter with him was during my second year, but it was just a glimpse as I was the student representative coming from Kuala Lumpur campus to HUKM to meet my voters (junior nurses). He was then a deputy headmaster of Kolej Tun Dr Ismail. During that meeting, we were doing campaigning for the up coming university election. It was then the bond with him already started.

After being elected as the student council spanning from end of my second year till my third year, I became more and more in contact with Dr Shahrir. He was, during that time, a Deputy Headmaster still despite having no real headmaster. It was then due to his political involvement during his student years that leads to the holdback of his promotion. We have quite a number of meeting between the college and the university level, and most of the planning were done with the presence of him.

Then, I rested for a semester before he came back to me during my third year, end of semester break. During that time, he sincerely asked me to join the college comittee as the secretary. Initially, I wasn't too keen as I do not require anymore involvement in these kind of position to gain a place in college. Simply put, I already exceed the requirement to be eligible to stay in the college. Another thing was, I thought I wanted to concentrate more in my study. However, my friend Guang Hong agreed to join earlier and need me as well to help the college comittee, so I gave it a try. Then we met more and more often.

There were many projects to be carried out throughout the year and I am part of the planning comittee. We get to meet often to discuss for plannings, budgets and administrative stuffs. I never regretted working with him as he is a dedicated person, and a seriously dedicated one. He never failed to provide us with useful feedback and be with us througout the projects. But life is never a smooth sailing one. Then, there was a lot of blackmailing going on. Even some go to the extend to spread words about him to the higher level, causing him a lot of hardship. Me and my friends were his places to complain, and we had quite a number of late night 'mamak stalls' meeting to listen to his problems. Not that we can solve anything but letting him ventilate makes him feels better. In fact, we often voice our complaints as well to him regarding problems that we had encountered throughout our medical studies. He will provide us solution and try to help us as much as he could.

During his time as the headmaster, I think he is a very caring person. He knew the students by name and knew their behaviours as well. He kept a good list of students phone number. If any of the student faced any difficulty, even late at night, he will not hesitate to help them. One thing about him is he love gossips, especially which student is pairing with who and who is breaking up with who. Whoever that failed during any posting will be seen by him personally to make sure the student is not facing any hardship in life which he can help to solve. However, there were students that works against him behind his back. As he is pro-university lecturer (as well as pro-government), those pro-student activist had worked against him. This more or less gave him the heartache.

Into our final year, he offered himself automatically to gave us extra classes! He will stay back during after office hour or even sacrificed weekend for the sake of student. Otherwise, most of the lecturer would not be bothered to do it. He wanted to see every student under his hand passed and do him proud. We have extra classes to present long cases, practice short cases and we even go as far to KL General Hospital to practice with him. He arranged a lot of case presentations, to boost up our knowledge. A teacher is never complete if he is not a good motivator. He will give us morale support to go throught the tough times.

Every year, there will be at least a 10 percent of student that has to repeat their professional exams. He personally feels that it is not necessary that we follow this trend. Every student deserved a pass, if we achieved above the passing mark. Sad to say, this year's mortality is reaching 15 percent, and most of them were more than average students. However, some had made him really proud by making into the distinction list as well as being awarded as honours student.

Yesterday we had a final meeting in his place. He was very sad for our departure as we were the closest batch with him. At times, I can see the shiny glimpse in his eyes. He was holding back his tears, I knew. Then he gave me this msg:

"My heart broke a thousand pices when you all left my house. Tears easily flow down my chubby cheeks. I will always luv you guys and will miss you truly. Please keep in touch... Pity this wandering soul."

After this farewell, will there be another Dr Shahrir in my life? I doubted it. But as far as I can say, part of my success today as a medical doctor belongs to you, Dr Shahrir. Thank you very much. We will do you proud, I promised.

Dr Shahrir (Left) with my friend Ong Guang Hong (right)

Vice Chancellor visiting our college during my time as the secretary

Farewell Dinner in Mines Resort. From Left: Tan Kar Choon, Me, Neeta Kesu Belani, Dr Shahrir, Dr Wong Chee Yeng and Teo Li Sar

The Last Banquet, Seperation and Farewell

2008-03-27T09:44:00.003+08:00

There are many types of tears. We cry when we are sad, we cry when we are overjoyed, we cry when we feel embarrassed. Yesterday, I shed the tears because me and my dearest friend is going their own way. 天下无不散之筵席。I do not know of any simile for this Chinese proverb but direct translation means every banquet must come to an end and everyone going their way.

Life is a sea, we are the one charting and sailing through. Along the way, we met friends that would help us through stormy weather, even help us when our boat capsized. Some are pirates, trying to rob you, make you weep, and lost is the vast sea. There is one friend of mine that had been with me night and day, help me sail through the choppy sea. Her name is Apple. If there is anyone that I would missed after this, it would be her. She made me cry yesterday.

She is a person who speaks directly, straight on the face. Never bother or feel over controlled by the authority. She has a loving heart, never fail to care for those who lacked behind. She is also down to earth, seldom show off. To me, she is the type that you can rest your shoulder on, sharing your thought and problem. We have close friends since second year, even more from then onwards. There had been crisis before, because of my closeness to her, caused a lot of unnecessary suspicion and talking behind our back. Although she is married, I always treated her as the very good friend of mine, nothing more.

Just wanna share the lyric of 'I'll Stand By You' from Pretenders

Oh, why you look so sad?

Tears are in your eyes

Come on and come to me now

Dont be ashamed to cry

Let me see you through

cause Ive seen the dark side too

When the night falls on you

You dont know what to do

Nothing you confess

Could make me love you less

Ill stand by you

Ill stand by you

Wont let nobody hurt you

Ill stand by you

So if youre mad, get mad

Dont hold it all inside

Come on and talk to me now

Hey, what you got to hide?

I get angry too

Well Im a lot like you

When youre standing at the crossroads

And dont know which path to choose

Let me come along

cause even if youre wrong

I just can't fight this overwhelming feeling of sadness. The uncertainty of when to meet again is strong. We will live our life, and head our own way for sure. Till then.

From Zygote to Fetus

2008-03-26T08:40:00.002+08:00

I guess this is really the end. The time for me in this small but lovely room is almost up. Two more days before I need to shift out. There is a lot of memories, mostly sweet one in this place.

This place had witnessed the turn of time. It had bring together a group of people from different background and places to be united as friends. Some even united as a family. I never made so many friends from so many places until I entered university. Five years is just in the blink of eye. Now is the time to leave, and I started to missed everyone.

Yesterday I met a friend of mine who have to resit the exam. I admired him. He is able to stand up after falling down. His will is strong and spirit is high. It is still not the end for him. I am wishing him and all those who is resitting exam a smooth sail ahead and good luck.

Is Free Always Good? Yes!

2008-03-25T07:48:00.009+08:00

The linux distro was giving me problem these few days. I was in the transition period to change from running 3 hard drives to only 1 hard drives as this simplifies the boot process. The linux distro I used was Kubuntu 7.10. However, after I installed it, I find it a hassle to use as not very user-friendly as compared to my good ol' Ubuntu. At first, the installation went on smoothly towards the end as it was fairly straight foward. After automatic update (which is about 200+ megabytes), the whole system fails to start! The problem was when I update the system, the secondary drive was present because I was transferring the data back to new disc. The secondary drive also contains the old linux distro. These created a confusion for the update manager when it is trying to change my current boot loader. Afterwards, the system just refused to boot into Kubuntu.

Then, I took the opportunity to reinstall the Ubuntu instead. However, there was a problem with the CD burner, resulting in at least 5 discs binned. Finally, I got a disc which is non faulty and got the system up and running (where I am writing this blog). Now it is automatic updating itself. Hope the system works fine afterwards.

This is a trend that I observed is a lot of my friends still using non genuine Microsoft Windows. There are very few who wants to change and use a free distribution instead. I was among the 'sceptical' before. The first experience I had with linux was 3-4 years ago. This I had to thank my brother for introducing it. I remembered it was Mandrake linux (now Mandriva). It was not as user-friendly as it is now. The setup was complicated with lots of error. I can't even get a working OpenOffice. Maybe it was my hardware problems. In the end it gave me a big headache.

Now it is a different situation altogether. There are so many linux distro around and the installation process is a breeze. You can choose from Ubuntu (which I am using now), Sabayon, FreeBSD, Mandriva, SuSe Linux, Gentoo, and many more. It was the traumatic experience with Windows that brought me to use linux. I am already too fed up with computer viruses that always hogs the machines, stealing datas, and making me reinstall the software. With linux, virus is not the main concern as they generally do not run executable files from other platform. They have their own codes to run. Generally, there are many free software (you read me, it is FREE) with just clicks away. For those ardent fans for Windows or cannot live without Windows apps, there is always emulators such as Wine to run Windows software. What I feel most important is the conscience that I am using something legal and do not need to send cash to Mr Gates.

I found a link to a nice website that generally summarized the benefits and the drawback of using linux.

Hope these websites sparks a little love for linux.

Old School New Dreams

2008-03-22T22:16:00.004+08:00

Today, I was sorting through some old books. I found an old yearbook from my secondary school. Haha! It brings back all the memories of the past.

Flipping through the pages, I found a page that was dedicated for me. It contains the interview of myself and a picture of me, because I was awarded Eastman Excellence Award, an honour for a well rounded student in academic as well as co-curriculum activity. Until now, I never thought I deserved the award. If being an all-rounder is the qualification, then I only fulfill the academic and society criteria. I was never good in sports. This was the first runner up secondary school in Kuantan, counting from the back. There is seldom any competition around us. Maybe the focus of the student were different then. everyone wish to come out to run their parents' business, or be a better mechanic than their fathers. Study was never the first priority. So I easily obtained the first place in the class. In fact, I had been obtaining the first place in class since my first year of secondary school.

Come to think about it, I never remember how I studied during my secondary school years. But it was all those activities that I participated that etched a lasting memory. I remembered once that we had a leadership camp in botanical park in Kuantan. That was the time I got close with my Malay friends, working as a team. We had lots of funs then. Then there were outing of Chinese Language Association to Balok Beach. Although the programs were crappy, yet we had lots of sweet time together. I remembered the most was the time we had a camp in Balok beach for uniform bodies. It is usual to have 'night owl' game where every team were dispatch to explore the designated locations. It start at midnight and ended 5 a.m. in the morning. We had to explore into forest, some abandoned house and the seaside to look for clues and the first team that came back will be a winner. However, I think I had lost that time.

Although I came from a not-so well known school that has nothing to be proud about, I am able to explore my potential to the fullest. Sometimes it is the school that shape a person; but most of the time it is a person that shape a school. Most of the students want to attend an established school to get better result. If you can first change yourself, you can achieve what you want despite of your background.

School Sports day. My teacher Miss Cheong and friends

These is how we play!

This was a booth we designed for canteen day. They said it looks like Chinese funeral due to the black and white theme.

My friends, enjoying the 'ais kacang' that my chess club prepared

Under the Moonlight

2008-03-21T23:43:00.003+08:00

Outside my 4 pane window, there is a full moon on top of the coconut tree. The willow is moving ever so slowly with the night breeze. Not a single dog is barking. The night is peaceful and sweet. I had not enjoyed the serenity of the night for the last five years since I further my study in Kuala Lumpur. Last time, I never appreciate the night like what I do now. Peace had been a luxury when you live in KL. Traffic jams, people rushing, talking right in front of your face spraying their saliva, trying to get a piece of you, make fool of you and overtake you; I have had enough with all these craps. Maybe when you lost something, then you will appreciate the thing that you gain. I love peaceful nights.

I enjoy rainy nights more. The sound of the rain drops falling on the leaves, hitting on the window pane are simply the best orchestra of Mother Nature. Before the new house is build, I used to live in a wooden bungalow. There were 4 rooms. Mine was near the road with 2 side windows. There were no air conditioning, only a small wall fan. Whenever it rain, I will fall asleep very fast. It is during the rainy nights that I thought of my late grandma more often. Sometimes I thought I saw her reflections in my room. Sometimes, I can hear her voices talking to me. I couldn't recall much of the past memory of her. But I knew she made a good pants that lasted me 6 years throughout my secondary school time. There are things that I didn't have time to tell her. She left in a hurry. Mr Death had eyed on her.

It is the time for Cheng Beng again. I had not fulfill my responsibility as a grandson quite a while due to time factor. Wish I could make it this year around.

Seperation Anxiety

2008-03-19T08:06:00.005+08:00

March 19, 2008, 743 AM
Broken Clouds, 24 degree Celsius

Finally, I have reached this day. Many had anticipated and waited eagerly for this day. Not long ago, I was among them. I had never thought the end would come so unexpected, un'enigmatic', so anticlimax! It is just like a movie come to a sudden end. It feels like a piece of my heart had moved out of me, because there is sudden emptiness and loneliness that is gripping me. I had early awakening today because the feeling of loneliness was just overwhelming. Coffee seems tasteless. Maybe I am not a person that is used to do nothing. Nothingness means laziness to me.

There are boxes lying around. I had already packed my belongings. Books, pens, photo albums, clothings were put in boxes. They were just lying lazily around. Memories were tied up properly. Five years through this gruesome learning curve, there were more than just plain knowledge that I gained. I learned to 'see' friends. There are friends that I can pour out secrets, while there are not-so-few of those 'Hi & Bye' friends. Some plainly what to get a piece of me, I know. True friends are hard to look for, because they come to you with time.

I used to have cheap tears. They were easy to produce. Now my heart is made of steel, or rather casted in steel. It is the environment that shaped me. You don't expect a doctor that shed their tears when patient told about their agony, do you? It is such an irony, that I am expected to care for the patients, yet not to feel for them. This is what they called 'empathy', not sympathy. At times, I don't feel like 'me' anymore.

Many people had help me stand up when I fall down. I still remember when I am in my first and second year, I embrace myself to be a student council. It was a hardship, dividing between the time of study and the long meetings and many projects to plan and accomplish. I was glad, that I found 2 true friends, Julian and Guang Hong, that gave me and still giving me moral support and be my loyal fans. Without them, I would not have reached here. There were fine teachers like Dr Shahrir, my ex-college master that help me be myself today. I don't know how to repay them.

I am leaving tomorrow. Maybe this is my last goodbye to this college, this university and my friends that had make my life more beautiful and more meaningful. I will definitely missed everyone and everything.

Aftermath: Battle of the Books

2008-03-18T06:38:00.003+08:00

Yesterday was the longest day of my life.

Because on yesterday, I crossed the hurdle between academic life to working life.

The war broken out on the helm of Mount La vie et la mort. It was winter time then. Armed with nothing but hand gun and small medikit, thirty six of young infantries were sent out to the helm to fight. Goal is simple, to survive and come back alive. I was one of the survivor to this battle. There were wolves and vulture waiting for their moments to strike. No sign of human life as far as my eyes can see. At 0925 sharp, the commander stationed us into different battalion, and I was with battalion 7. I didn't realized that was the last time I saw my friends. I have a paramedic in battalion 7. So we scaled the mountain and for sure it was bitter cold. The fog is thick and visibility was poor. My hands are chilled and numb. My thought were only one: to live.

In the small curves ahead, there was a cave, just a small cave enough to fit few peoples. Me and my partner went in to check it out. Suddenly, there was a beast charging at us from this cave. He was tall, dark and hairy and his name is Malades mentaux. His claws were sharp as razor and his eyes were red as fireball. His special moves was attaque de panique. There were no escape. I almost thought this is the end of my 25 years of life. Somewhere deep in my heart was asking me to fight. To stand on my ground. Armed with only 6 bullets and 60 seconds to survive, I fought bravely. Shortly, I ran out of bullet. I have nothing left. We fought and fought for a long time. I didn't realize we had reach the cliff. Behind me was the deep cliff that I can see no bottom and I was surrounded by him. Malades thought he had the upper hand of me. He was laughing out loud. Without thinking twice, he charged at me at full speed. At the nick of time, I evaded him and he fall down the cliff so that was the end of the legend of Malades mentaux.

This battle had taken toll on me. There were wounds of the claws and bites thanks to Malades. Walking downhill, we met the commander. He told me that some of my friends did not make it to the end. I was heartbroken. Deep in my heart, I wish all of my friends reached the shore one day. Now all I need is just a rest to heal this wound. Time can heal everything.

Just wanna share a movie excerpt that I listen to before I go for this battle:

ARAGORN
             Hold your ground - hold your ground! Sons
            of Gondor - of Rohan . . . my brothers!

            I see in your eyes the same fear that would
            take the heart of me. The day may come when
            the courage of Men fails; when we forsake
            our friends and break all bonds of
            fellowship; but it is not this day - an
            hour of wolves and shattered shields, when
            the Age of Man comes crashing down - but it
            is not this day!!! This day we fight! By
            all that you hold dear on this good earth -
            I bid you stand!            
      Men of the West!

(From: THE LORD OF THE RINGS: THE RETURN OF THE KING)

Tips? All but a Foolish Trick!

2008-03-12T13:41:00.001+08:00

I don't know why I am doing this. Just half way through my exam. It's the 3rd day, to be exact. I am blogging away. Hehe. Exam, exam, exam. I truly believe last minute effort would not work. Plus tomorrow is a multiple choice questions, which can sometimes depends on luck factors. So why study at the nigh hour?
There has been lots of tips circulating around lately. Before exam, during classes, outside toilet, over dinner table. Experience had tell me that not to depend on them solely as that can bring destruction. This had been true for the first day and second day exam paper. Some joker must have been spreading news that Trichuris trichiuria (a worm infestation) is definitely a spot question for paediatric during this exam. In the end, Malaria infection is being asked! Surprise, surprise. Everyone that depend on the tips is cursing away when the exam was over. Today, we were having patient management problem on psychiatry. Again, tips regarding some freako alcoholic is sure coming out. Naturally, everyone is reading Delirium tremens, Alcoholic Anonymous, Intoxication of alcohol right before being summoned into the exam hall. I reckoned that the one that provide the tips must have seen the front page of the exam question only because it turn out to be a young man involved in motor vehicle accident became delirious and in the end, found to be SCHIZOPHRENIC! Everyone is shouting: " Where the heck is the alcohol!" Haha. Isn't it fun to have exam?
I guess the real useful tips for exam is not to be overanxious before or during exam, because that really impair the judgment and performance during the exam. I always take exam as 'another tutorial or practice'. There you go, when you are calm and cool, your mind works better because there is less thought block. Always recite a prayer, charm or something you like before entering the exam hall. Try to forget everything before the exam starts. That's right. Unlearn the things that you know. Only then, you can perform your best.
Hope it turns out alright for me this time. Pray for me folks.

The Last Battle of Books

2008-02-22T20:06:00.006+08:00

If you come across a person that said doing medicine is easy, he is either lying without blinking in front of your face, or he is really lousy student, not even striving for the best.

I am preparing for the last exam of the final year... the professional exam. At this point of time, all my friends are doing their revision. The atmosphere is so tense up. If you go to ward some time in the day, you will encounter more student than the patients. Most patient will 'mummified' themselves just to prevent student from examining them. While everyone is doing revision, I am writing this post out of boredom of studying. Just to illustrate how much books we have to cover in the coming 2 weeks time. I am not showing off.

The first stack above my book rack. Mostly not to be read again.

The main bulk to be covered in 3 weeks time

Notes, notes and notes that I made

Even the books found its way to the floor!

The only thing that I look forward after the exam is this.

Lonely Valentine

2008-02-13T21:24:00.001+08:00

Valentine again. It has been another normal day for me for the past 5 years. Since my last breakup, there had been no valentine for me. Every valentine day for the past 5 years was celebrated only with my close friend. I had been trying to disguise those lonely feelings in the past. Now, its getting more and more distressing, trying to hide my feelings, trying to pretend that I don't need love.

The first relationship turn sour after we both were separated to pursue our own dreams. They say long distance relationship would not last, I believe it now. Four years, it had been till the end. Sometimes you need to believe in fate. How it started? We were young and ambitious. Maybe we were immature that time. It started as I hold her hand, thus triggered a chemical chain reaction. There were many sweet memories of being loved, sad times of feeling down, dumb moments of doing stupid things; all for the name of love. How it end was kind of blur to me. There were distances that cannot be patched by communication alone. There were barriers, lots of them. Both side parents were against this relationship. Thus, our relationship did not stand the test of time. I did not shed a tear on the night that we officially break up, just the feelings of extreme loneliness closing in my life.

Therefore, I became a coward when comes to love. I am afraid. Afraid to go down the same path again. Afraid of being hurt again. Even with the one that I like, I wasn't able to express myself. I was afraid that I will make a fool of myself. Now, the same feeling of extreme loneliness five years ago is getting stronger by day. Maybe it is towards the end of schooling life, starting of a new, unfamiliar world of working. Maybe I am desperate. Maybe it is because the friends around me mostly had paired up. Maybe it is the inner feelings that is struggling.

Hope that the valentine in years to come will not be the same again.