Presint 2, Putrajaya

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

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

The complex network of wires and frames

Parallel lines

Sky curtain

The thick pillar

Twisting of the lines

Butterfly

Geometry is simply brilliant!

Saving Every Cents in a Pre-Wedding Photography

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

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

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

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

Above all, enjoy every moment of your pre wedding photo shooting, as we did ours.  

The Voice of a Nanyang Chinese

Malaysians

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

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

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

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

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

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

This is what 1Malaysia means to me.

Negative Psychology

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

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

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

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

Sakit Jantung Is Not Heart Ache

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



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



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



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



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

Thirty and Wasted

This is a true story. 

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

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

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

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

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

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

MM Kills the Doctors

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

Its maternal mortality.

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

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

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

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

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

Who's at fault?

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

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