Wednesday, August 16, 2017

Falling below expectation

In a way, looking back, I felt I was indifferent at best & negligent at worst.

The nurse called me last night about a late admission. This patient was supposed to have surgery this afternoon & I would usually see & assess on the morning of the surgery. Not knowing any detail of this patient, I refrained from giving any medical advice over the phone, lest it was inappropriate. Besides, once I start getting involved, I know the nurses will call me for every discomfort the patient may complain of throughout the night.

Therein lies my predicament. I am a doctor and yet I want a good nite of uninterrupted sleep, because I am not on call.

At my age, I dislike, & try to avoid, on-call duties, because I am on my worst behaviour without sleep.

Tuesday, August 08, 2017

Grumpy old men

I've always held the belief that as we get older & approach the sunset of our lives, we tend to be less uptight & bothered about trivial matters. But 2 recent encounters with my colleagues didn't attest to that.

The 1st, already in his mid-60s, was upset when we met in the doctors' lounge. I casually said he's come early to the lounge for breakfast. It was about 10am then. Apparently he took offence to that remark, that i implied he has no patients in his clinic. Hey, buddy, lighten up lah - it's a downturn that is affecting everyone - why do YOU think I am also in the lounge having breakfast?

The 2nd encounter just happened today, also at the lounge. This mid-50s chap remarked that I was being cynical & sarcastic when I mentioned that he was on a rampage with the food. He was already on his 2nd helping then. Hey, buddy, lighten up lah - the food is for everyone & there's more than enough to go round, even for 2nds.

So apparently I have offended 2 colleagues in as many weeks. Maybe I should look at myself. Maybe I am the grumpy one.

Sunday, August 06, 2017

The elective posting

It's time for the daughter to pick the hospital elective posting for next year.

Her 1st choice is a popular district hospital 160km away because there are more hands-on & practical experiences there. She will have to find new accommodation in the district & may be on the road often.

The 2nd is the city hospital only 12km away & 25 mins by train. On top of that, she already lives near the train station. For logistic reasons, being a foreign student, I much preferred she remained in the city.

As it turned out, she was allotted the city hospital. I was glad. And I forgot to mention that had she been posted to the district, she planned on getting a car & driving the 320 km round trip every week.

Phew!

Thursday, August 03, 2017

1st Christmas in the UK

this would be remembered for the wrong reasons.

i was on-call & the 1st case for the day was a 70+ year old lady for a DHS insertion, a procedure to fix a broken hip. the standard anaesthetic technique in that hospital was to give a general anaesthetic supplemented with a local anaesthetic (epidural).

the general anaesthetic went smoothly but i had some difficulty with the lumbar epidural, resulting in the accidental puncture of the dura. instead of abandoning the epidural & just have the general anaesthetic, i proceeded against better judgement to attempt again at a different (higher) level. after administrating the full 20mls of the local anaesthetic, true to form, the blood pressure crashed & the patient heart stopped. resuscitation was unsuccessful.

i can't tell you how angry i was with myself for such a novice mistake. maybe i was indifferent, maybe i was over-confident but i will never, ever forget how a lapse in concentration resulted in this unnecessary death. one good thing that came out of this was the unwavering support the consultants gave me, even at the inquiry for peri-operative morbidity and mortality.

i want to believe this made me a better doctor today & that death was not in vain.

Tuesday, August 01, 2017

Last day.

Having worked at the hospital for 25 years, from a shoplot practice to a new independent medical centre, and then to be part of a major healthcare chain, you'd think she'd be missed when she finally retires.

Truth be told, I can't remember the last time I have worked with a nurse so obnoxious, I just dread if we had to assist surgery in the same theatre.

I won't miss her. Seriously. Honestly.

Monday, July 31, 2017

Mini culture shock

In my 1st job in the UK, I was waiting for the hospital transport to get me to another hospital. As the van stopped in front of the lobby, a middle-aged gentleman in a full suit, coat, tie & all, disembarked from the vehicle. Trying to be friendly, I approached him.....

Me: Hi, is this the van to the WH hospital?

Him : Yes, indeed it is.

Me : By the way, I am Dr T & I am the new SHO. And you are Dr........?

Him : I am Ray & I am the hospital porter.

Lesson #1 : in the UK, most men in the service industry, from top down, wear full suits.

Lesson #2 : Introduction is commonly by 1st names.

Therein, began my memorable 4-year sojourn in a foreign country.

Saturday, July 29, 2017

Looks are deceptive

My friend's daughter is having her wedding reception dinner tonite. I am going to be late. I am thinking about the peer pressures of the modern day matching of life long mates.

I sensed that my friend was a bit disappointed. You see, the bride is a dentist and it would be expected by some quarters that she would pick someone with a similar honorific, e.g. Dr. Whether she wouldn't or couldn't doesn't matter, at least to me. I played table tennis with the guy last week and from that brief encounter, I was impressed with his soft spoken manners & politeness.

Doesn't matter if he's just plain looking or just an architect. He's in for the long haul. A successful marriage goes beyond looks & vocations. They both love God & that counts for everything.

And love is all they need.

Congrats, Ivan & Yen.

Friday, July 28, 2017

Am I losing him ?

I've always thought that I have fostered a blood-is-thicker-than-water bond with both my kids.

It's our (the boy's & mine) ritual to have breakfast on Saturdays when we have no commitments - he, to the school and extra-curricular activities, & I, to the hospital. Usually we'd have either the chicken briyani or tosai/canai.  Yes, we're that set in our ways. So when I asked him today if we are OK for breakfast at 9.30am tomorrow, he said it depends if he could wake up on time.

His response rankled me a bit; if he really enjoy having breakfast with me, he'd make every attempt to get up by that time, as I would. Besides, 9.30am is not that early by any measure.

I know when kids grow up, they often have their own circle of friends which they would want to hang out & chill out with, at the expense of the family

But I'd rather hope he'd choose dad over sleep. We'll see.....

Sunday, July 23, 2017

glutton for punishment


The hospital requires all doctors to undergo basic training for resuscitation to maintain its quality control status. Actually, it's already part & parcel of what we were trained to do, except that most of us have lost touch with the actual practice & may not have kept up with recent advances.
What's required is the attendance at the one-day in-house training & testing, again to satisfy the quality control status. All will naturally pass the tests, although some may need a 2nd attempt to pass. Basic stuff really. Once every two years routine.

However, what I did to fulfil the title of this post, is to take the advance course run by the Health Ministry. Not necessary to do this but I did it anyway. One full day of training and another half for the testing.

The price to pay : hefty course fees, unpaid leave on a Sat, 2 sleepless nites, and (to my colleagues and I) unnecessary self-inflicted stress.

The reward : a refresher on the theory & practice of giving life a second chance.

The course wins hands down.

Friday, July 21, 2017

Reminder to self

Made this decision in 1979 & never looked back since.

Through thick & thin, sleepless nites in the four seasons, forgoing social activities & staying beyond appointed working hours (what's that?), in life & in death, the Lord sustained me.

I have found my calling.

Wednesday, July 19, 2017

Learning for others

Many years ago, in the 80s, when I rode on the MRT in Singapore, I was so impressed by the almost seemless connectivity between North-South and East-West lines, that when I rode on the LRT in KL, the contrast couldn't be more glaring as I had to exit one station, walked to another in the vicinity, buy another ticket to ride on another line.

Years later, our transport minister finally realised his & his predecessors' folly at the disconnect of the whole system.

Too many crooks....err.....I mean cooks, spoil the soup, I guess, but we all end up slurping the unpalatable stuff.

New world hotel

I was staying at this downtown hotel & had a look at the snack tray. And guess what's in it?

Aphrodisiac and prophylactic.

Are we a progressive society or what?

Tuesday, July 18, 2017

Cholangiocarcinoma

This is a malignant growth of the ducts that connect the liver and gallbladder to the small bowel. These ducts deliver bile to aid digestion of fatty food. Diagnosis is often late & the downward course is often rapid.

My colleague's brother had it & he just passed away today. This condition struck a resonant chord with me because the very 1st patient I had as a medical student in the surgical ward (circa 1982) was this cheerful and obese middle-aged gentleman who was admitted for jaundice.

Mah Hung was his name & how I can still remember that, I don't know  ...... maybe it was because he was my 1st surgical patient & I saw him every weekday till he finally passed away.

But I will never forget his kind words to me during one of our meetings. He advised me to work hard to be a good doctor and hoped that I will be a specialist one day.

Dear Uncle Mah, you are long gone but your kind wish did come true. I was touched then, just as I am today. Thanks for being my patient & my  teacher, for who you were, what you had & what you went through. May your soul rest in peace.

Thursday, July 13, 2017

Extended invitation

Yesterday, the drug rep invited the 6 of us out for dinner. 3 of us couldn't make it, so the senior colleague, on his own accord,  invited a few nurses to take the place of the absent doctors.

In the end, 5 nurses turned up & 1 even brought her grown-up daughter. Even though the dinner came under company expenses, I felt it was highly inappropriate for my colleague to invite the nurses for what was clearly an invitation for doctors only. And to bring your daughter for a department function spoke volumes of the lack of etiquette & common sense.

I felt sorry for the rep. I wonder how she is going to explain to her boss about the extra (non-medical) heads for dinner, at RM85 net per pax?

Tuesday, July 11, 2017

Mt Kinabalu

This is the Big Event of my year so far. Last August, my walking buddy told me of a vacancy in his group going up to Mt K in April this year. Having been mulling about doing the climb for some years, I jumped at the opportunity to realise this dream.

We started training by climbing the local hill (vertical ascent 140m) & despite carrying backpacks of 7kgs, it was far short of the 8km trail & 3200m vertical ascent of the real thing. But it was better than not hike training.

There were 6 of us in this group. They had originally planned for 2015 but the earthquake put paid to that. So, after a 2-hour bus ride from Kota Kinabalu, we finally arrived at the park HQ in Ranau, which is already 1800m above sea level. We will spend a nite here & the adventure starts the next day.....

Should I start blogging again?

It's been 2 years since my last entry. This morning I had a brief chat (read: 2 sentences each) with an ex-classmate from 6th Form & she persuaded me to reconsider blogging. So here I am.

I think I was more diligent previously because there were stuff I wanted to share.

And  rave.....

.....and vent.

But I stopped because I felt it was time consuming, to fire up the laptop, to draft & rewrite the narrative, so that it sounded credible, with punctuation in the right places & tenses correctly emphasised.

But mostly because the smartphone was a gadget from Mars & I hadn't subscribed to a data plan yet. That all changed now, & I can literally blog anywhere, anytime.

So here I am. Feel free to welcome me back.

Sunday, October 25, 2015

transfer

this is ironic.

the patient was seen at the general hospital but his family requested to be sent to the private hospital. after major surgery & 2 days stay in the ICU, they have again asked to be transferred back to the general hospital because of diminishing funds.

herein lies the problem. vacant ICU beds in the general hospitals are hard to come by because of the large number of critically ill patients. so the waiting game begins. it's been 3 days since & still no sign of an impending transfer. with every passing day, the patient shows no sign of early recovery, the family are distressed at the depleting finances, and the doctors and staff hope for news of a vacant bed.

it's the same old story year in & year out.

**this post was drafted in 2015 but the state of healthcare has remain largely unchanged**

Friday, October 23, 2015

going soft


 i must be going soft.

i've been watching reruns of grey's anatomy & and ally mcbeal & there were 2 episodes that got me all mushy.

grey's anatomy : the one where denny suddenly died shortly after he got his heart transplant. lizzie, the intern who fell for him like a ton of bricks, cried buckets. a cautionary tale for health workers not to get too emotionally involved with the patients under their care but denny was such a charmer, even i can understand why lizzie was besotted.  :P

ally mcbeal : billy has been acting strange, what with his blonde hair & entourage of robert palmer type leather-suited girls. as it turned out, he has an inoperable brain tumour. Married to another fellow lawyer, he did confess to his old flame Ally that he still loved her all of his days & with all of his heart. He then collapsed suddenly in court & died. And Ally too cried buckets.

*this post was drafted in 2015 but time has not lessened the impact of death on me*

Thursday, October 22, 2015

nothing ventured, nothing gained.


my colleague started private practice the same year as i did in 1997. 3 years later, we moved out & joined different private hospitals. another 3 years later, he moved out again & opened his practice in a shoplot & subsequently expanded to the adjacent lot as well.

his practiced flourished & he could employ 2 specialists to work for him. his 2-floor shoplot even had elevators installed.

everyone knew he was doing exceedingly well.

you'd thought he's reached the pinnacle of his career. behold, the coup de grace......

a Singapore group came over & offered to buy over his practice in a multi-million ringgit deal.

while most of us are contented practicing within the safe confines of a medical centre, my entrepreneurial & far-sighted colleague obviously took the path not taken & that has certainly made a difference.

congrats, my friend, you deserve the success for your courage & vision !!

Wednesday, October 21, 2015

lapse of concentration


i had a lapse of concentration yesterday.

i was doing an invasive procedure called central venous cannulation, essentially inserting a plastic tube (red arrows) into a vein lying within the chest, when i accidentally punctured the left lung.

this resulted in an abnormal collection of air (yellow arrows) called a pneumothorax in the space between the left lung and the diaphragm. it was potentially life-threatening and was managed by inserting another tube into the chest that provides an escape route for the air pocket into a bottle.

i just think it could have been avoided had i been more cautious. in a way, it was timely that it happened. i've been on a roll lately & this is just the wake-up call needed to remind me of the oath i took at the beginning of my career.....

first of all, do not harm.

Monday, July 13, 2015

locksmith on-call


my neighbour was caught out without keys to his front gate  at 11pm the other nite. he came over to ask if i have a saw which he planned to saw thru the padlock.

i don't have one & suggested he tried calling a locksmith who was willing to make house calls. the 3rd one that we contacted agreed to come & said upfront he was charging RM90.

he came over on his motorbike after 30mins & proceeded to tinker & pick the lock, eventually drilling & scraping at the key slot. i joke with my neighbour, an ENT specialist, that what the locksmith was doing is not too different from what he did at surgery - drilling & scraping.

the lock was picked after about 20mins, to my neighbour's relief. i don't think he relished the idea of spending the nite at my place.

& he whispered that he would have gladly paid even up to 2-3 times had the locksmith demanded that.

Tuesday, July 07, 2015

apology


what would it take to get an apology?

well, i myself don't offer one unless i feel i was at least partly to blame for the predicament. some people do so when the buck rests solely on their hands.


political leaders & industry captains have done likewise & stepped down from office for lesser shortcomings, eg. disagreement with policies, allegations of corruption & sex scandals, & the likes of Zaid & Soi Lek are to be commended. isn't it better to fail with honour than to win by cheating? or more poignantly, better to die standing than to live on the knees.

others may try to cling on & so subject themselves to the embarrassment of being shamefully dumped.

like you already are pelted with eggs on your face, don't get hit with the frying pan as well.

Wednesday, July 01, 2015

we are what we eat.


it's about a year ago when this news item was released.

i am writing this because a week before the fasting month started, i had to attend a meeting at the local health department. and sure enough, when the meeting concluded at 11am, we were invited to a jamuan teh, literally a tea treat, which you'd think would consist of some biscuits with a cup of tea - a quick bite just to tide over till lunch.


but then, not so in Malaysia & a jamuan would not be complete without the customary curry puffs, sweet kuih with even sweeter teh AND chicken curry with rice.

in fact, this is a worldwide curse & the EU will soon legislate obesity as a disability. which means, employers will have to provide fat people with health coverage & benefits (like someone who has fallen ill) & fat employees can seek legal redress if discriminated against.

"sorry, boss, i'm calling in sick today as i feel breathless just getting out of bed!"

sounds surreal, doesn't it?

Tuesday, June 30, 2015

from dust to dust.....


my senior in med school passed away earlier this year (read here)

and just last week, a fellow alumnus a year my junior passed on, too. it's strange how things work. he was scheduled for tumour surgery when he suddenly collapsed in hospital the day before, probably from a major heart attack.

but he is in a better place now. i know this for sure because his last posting on his FB page was :

For to me, to live is Christ and to die is gain. (phil 1:21)

rest in peace, Dr L.


Monday, April 13, 2015

the worst


that's the superlative my colleague proclaimed a few days ago.

he was berating the way the nurses ill-prepared for his surgical case. i had to agree with him. it was messy & it slowed down the whole OT list.

i do miss those days when the nurses were more dedicated, competent, conscientious & thorough in their work.

when things run like clockwork with minimal self-inflicted disruptions.

when there was just one or two private nursing schools.

just in case you didn't notice, private healthcare isn't what it used to be. ringgit & sen, now more than ever, precedes service.

i am sure you have your own horror stories or even personal experiences to tell.

Sunday, April 12, 2015

camping out


finally, the boy is roughing it out......


tent - checked

sleeping bag - checked

bottles of drinking water - checked

note book - checked.

it's his scouts' camping trip. was it held out in the forest or forest reserve? outdoor camping site? on a field?

actually, none of the above.

it was held in the school compound. still, that hasn't dampened his enthusiasm for the outdoors, for roughing it out away from the comforts of home & for bonding with the fellow scouts.

however, he did call for help...to replenish drinking water for the 3-day camp out.

Tuesday, April 07, 2015

GST.....the final word.


seriously, none of us thinks the govt has thoroughly thought & worked out the breathe and depth of the GST.

how is it they were flip-flopping over the GST for pre-paid top-up cards?

is healthcare exempted or not? if not, why announce otherwise?

why the need now to consider to increase the number of medicines to be exempt or zero-rated?

be assured the saga will not end with this recent confusion.

how is it that they didn't learn from countries that implemented GST ages ago & avoided their mistakes?

i know for sure GST, as a consumption tax, is a fairer form of tax collection, but perhaps the timing is premature, or that it should have started at a lower level, say 2-3% first.

& there should be no exemption nor exception. tax everything but at an affordable & less painful bracket first.

while the government is whipping up confusion at every turn of the implementation process, the rakyat is suffering.

aren't you?

sigh!

Thursday, April 02, 2015

GST 2.0


i stared at this for some time.....


while many are fortunate to be able to seek attention at medical centres & specialists' hospitals, this booklet is stark reminder that, while we often take things for granted, like clean running water & electricity, there are those on the other side of the social divide who are not so privileged, having to make do with river water & kerosene lamps.

& then there are those whose healthcare needs can only be met in government-run facilities.

i had a middle-aged lady recently who was admitted to the ICU for a critical illness. after a week of intensive treatment, we managed to get her thru the most difficult period but by then, her family's fund was running low & they requested for her to be transferred to the ICU of the local public hospital.

believe you me, it's extremely difficult to get such a vacant ICU bed but by a twist of events, we managed to get a vacant bed the next day. she was promptly transferred but unfortunately, she passed on after 2 days.

it's impossible to say if she'd have a better chance at survival had she remained at our hospital but it did leave a hollow feeling in me.

with the expected RM22b to be collected this year from the recently imposed GST, hopefully we'll get .......

.......a better public transport system instead of a luxuriously-furbished jet plane for the private use of the elite few

.......basic necessities for the rural folk instead of a monthly million ringgit electricity bill for just one dwelling....

......and well-trained medical staff in well-equipped public hospitals instead of mushrooming private medical schools recruiting mediocre students.

Wednesday, April 01, 2015

GST


goods & services tax.

or, government say thanks.

or, a mean april fool's joke.

but i say...

"Render unto Caesar the things that are Caesar's, and unto God the things that are God's" matt 22:21

the govt is determined to get its pound of flesh. you can't change that now, even collectively, but you can determine who rules at the ballot box.

Monday, March 16, 2015

the pilot light & the hypocrite


we are having a demo machine in OT to be appraised for possible purchase.

the briefing on the operation of this machine was given by the vendor some days back & we're taking turns to use & get familiar with it.

i noticed this white light (arrow) on the right side of the machine...

i thought it was the pilot light, which is normally switched on when the main OT lights are switched off during certain procedures. we weren't doing any of those procedures, so i proceeded to switch it off.

the machine suddenly stopped & the screen went blank. as it turned out, what i thought was the pilot light was actually the power on-off button. good thing the vendor was present & she immediately pressed the button again & the machine came to life. phew!

i've often chastised my assistants that they shouldn't do things if they are not sure how or when they should be done & to ask 1st if unfamiliar with the procedures.

looks like i should heed that advice myself. after all, when you point one finger at someone, three other fingers are pointed back at you.

i bowed my head in shame.

Sunday, March 15, 2015

makanan sampingan


those were the exact words the patient replied with when i asked her if she was having a late dinner. it's the local phrase for a supplementary meal.

admitted for a nose procedure the next day, she was eating fried mee with fried chicken when i dropped in on her at 9pm. having had dinner just 3 hrs before & now, another full portioned fried meal? i'd suppose that's common practice in this age of 24-hour fast-food restaurants & mamak shops.

still, she ought to exercise (pun intended) caution considering that she's only 22 years of age & already weighing 99kgs.

there must be some truth in a recent print report that Malaysia is the most obese nation in the region. furthermore, a case is being brought up at the European Court of Justice to consider obesity as a disablility. the implication for employers is that they may have to treat overweight employees better & even provide support, be it psychological or medical.

we may not be far behind this.

Friday, March 06, 2015

passing the torch


my senior in med school passed away recently while on a family vacation. he was in coma for a few days prior to that & it was an uncanny coincidence that on the day of his passing, his son was supposed to start year 1 in med school!!

i remember him well as a jovial fun-loving guy because we stayed in the same hostel for a year. we never met again after graduation 30 years ago & i only knew about his passing because his son & my daughter are classmates now.

it's almost like his demise was timed perfectly to coincide with his son's start in his medical career. i am certain, in this twist of fate, he will carry the torch his late dad proudly displayed all these years.

my friend TJ, may your soul rest in peace.

Saturday, February 28, 2015

tuition


the bane of most students & a major expenditure of most households.

because scoring straight As is the lifelong target from kindergarten to varsity.

OK la, i am just exaggerating.

but not by very much.

case in point : me.

i had taken BM tuition up to form 3 but not at form 5. which explains why i got a strong credit in form 3 but only a pass at SPM level. (yes, you've guessed correctly that i wasn't a straight As student.)

so, tuition is actually quite useful, if taken in the right attitude.

now that the boy is in form 1, we are thinking of trying to take the right attitude for his tuition. we came to the conclusion that he will only take BM tuition for now & he will be home tutored for the other subjects. i took it upon myself to teach him maths & science. however, today, he asked me a geography question.

so, what better way to study ...no, master geography than to take out the secret weapon.....

a map of the world....with latitudes, longitudes, international date line & the Marianna trench. that should keep him from mischief for a while!!

:-)

flown the nest.....again!

 
my daughter has gone back to varsity a week ago.....and yes, even after all these years of living away from us, i still miss her much.

very.

in the 3 months she was home, we managed a family vacation to hanoi & penang, played hosts to her friends on 3 different occasions & shared many happy memories eating out at her favourite food haunts.

                      **a most delectable pandan pancake with gula melaka & matcha green tea**

however, there are 2 stand-out events that particularly endeared her to me :

1) she taught me to appreciate the now concluded sitcom How I Met Your Mother. well, she didn't really taught me, but it's just that she has been watching it & when i watched with her, i sort of caught on. yes, it's legen.......(wait for it).......dary!

2) we enjoyed our walks/jogs around nearby the taman rekreasi. away from the prying eyes & ears of the rest of the family, we managed to share some of our dark secrets.....

"the long and winding road, that leads to your door, will never disappear" (beatles)

PS. i forgot to mention she left another mark behind, one we will not forget for a long, long time.....
                                                       **ouch!!**

Sunday, November 16, 2014

helping someone start a car


there are a few extra stuff i keep in my car.....

1) torchlight & umbrella;

2) spare cash;

3) spare bottle of plain water (for washer reservoir) AND battery water;

4) cloth gloves (for tyre change);

5) battery starter cables &;

6) a big stick (for self-defence);

i don't have a small fire extinguisher which would be useful as well.

i was at the petrol station today when i saw someone trying to start up a car with battery cables but for some reason, it didn't work. still, i was quite impressed that someone kept those cables handy. i have used my own cables twice & it successfully got the car started both times. so, i thought i'd find out why. apparently, one of the cable wasn't placed firmly on the battery terminal. a clue would be to see sparks fly when you attach the cables.

once that clip was readjusted, the car started at the 2nd attempt.

ah....my good deed for the day!

Monday, November 03, 2014

here today, gone today...


ahh....life is so fragile...

48 year-old man who has been smoking all his life had chest pain yesterday afternoon. he walked into A&E & was wheeled into the cathetherization lab to confirm the diagnosis of coronary artery disease.

even before the procedure has commenced, he became sweaty & progressively drowsy. within minutes, Code Blue was activated & after an hour of vigorous resuscitation, he has become another statistic of preventable death from heart disease....

.....leaving a trail of tears & wails from his young family.

then the finger-pointing started.....

...he had just tucked into lunch with the family....

.....he was OK when he walked into hospital......

.........what did the heart specialist do in the cath lab....?

................did he do something that killed him........?

when questions like these are thrown about, you know might not get paid this time....

ahh....just another day at the office!



Friday, October 24, 2014

another foot in the mouth....


it was quite easy enough preventing singapore-registered cars from filling with subsidised RON 95 petrol. anyone can spot such a vehicle from miles away - just ask our highway patrolmen with speed cameras.

but just how are you going to make high-income Malaysians pay the full price for fuel? making such an announcement even before the details are worked out is typical of our faux pas-strickened lawmakers.

for example, how are they going to decide the level of high income? how are the petrol station staff to decide who these people are? what happens if the drivers of the BMWs & Mercs are really the lowly-paid drivers? what if i asked the wife to fill up for me? will there be separate pumps for unsubsidised fuel?

i can imagine the distress the petrol station owners are going thru. installing whatever system to discriminate the car owners is going to cost money & these won't be cheap because some crony will be getting this contract &, if true to form, this will eventually die a natural death ala AES.

however, if this bird-brained idea actually worked out well, i should stick my own foot into my big mouth.

Thursday, October 23, 2014

another one bites the dust


anyone remember ericsson?

of course not, because no one remembers losers!

sony bought over the ailing swedish cellphone manufacturer some years back & that's that. now that microsoft has bought over nokia, the latter's name would soon suffer a similar demise. (read here)

but we malaysians have no fear of that happening here. with solid unfaltering government support, our distressed car-maker proton has more lives than a cat.

it almost became volksproton, though!

hidup proton!!

Monday, October 20, 2014

if your elderly parent is in hospital....


very often we have elderly patients coming for surgery & because they usually are afflicted with various medical problems, they take a myriad of medications for their ailments. sometimes they forget to bring these with them when they are admitted & their spouse/children cannot remember what these medications are.

so, i was pleasantly surprised when i saw this note attached to a patient's file.
not as detailed as i would have liked, eg. dose & frequency not stated, but it's good enough, esp when there are times i haven't the foggiest idea what some patients are suffering from & what medications they take.

and that would be like sailing into the high seas without a compass....

Thursday, October 09, 2014

the fat lady has sung......finally!

it must be the longest school exam saga in history.

the final paper, mathematics, is held this morning & at 9.15am, the students will finally be freed from their angst, no thanks to the bumbling people at the ministry.

it was exactly one month ago to the day when the UPSR exam began. what was meant to be a straightforward 3-day exam has degraded into a 30-day fiasco.

even before the dust has settled, the same fellas there decided to thread on thin ice & proclaim that forecast results would not be allowed as entry requirements for pre-U courses, undoing a practice that had been in place for decades, only to do a U-turn after a public uproar.

this, and the debacle concerning language for teaching maths & science, & local universities not participating in the ranking exercise, has just strengthened the view that the name of the ministry should be changed.

to the ministry of un-education.

Wednesday, October 08, 2014

careless or forgetful?


i went to pump petrol this morning. imagine my horror when i realised my credit card is not in its usual slot in my wallet.

i retraced my recent movements. the last time i used the card was yesterday evening at jusco. i remembered i had hurriedly kept the receipts & card into the wallet & may have dropped it in my haste to pay at the parking payment machine.

so it's gone now. alarms flashed in my mind. did someone pick it up? how much credit did that person rack up at my expense? full tank of petrol? new LED tv? business class air tickets?

arrgh.......!!

when i got home, i quickly ran thru my clothes & other personal effects & the shopping bag but it wasn't there. i called the card centre immediately to cancel the card. to my relief, no one had bought a tv or air tickets.

credit cards, like internet banking, can be a double-edged sword. use it wisely & it's a great modern convenience. foul it up & you get nightmares.

this is not the 1st time i had lost a credit card but i have been fortunate not to suffer any loss other than a few desperate moments.

i need to be more careful. we all do.

Thursday, September 11, 2014

exam leak...again!


i think it's more common than we are told about exam paper leaks. most probably occur at school level & are overlooked or deemed insignificant to be reported.

but when it is headline news on TV or print media, you know the leak is serious & extensive. it's unfortunate that my son is affected in this year's UPSR exams.

if this can happen at a primary school exit exam, is it not unreasonable that this security breach could also be happening at secondary school or even university exams?

i remembered it happened at the MCE (predecessor of today's SPM) BM paper in the mid-70s. the leak was discovered AFTER the students have sat for the paper & the replacement paper was arranged to be held after the last paper of that exam. i can imagine the frustration of the students at that time because a similar incident happened to me years later.

when i was sitting for 1st year exams in varsity, one of the lab exams was leaked & that paper had to be retaken the following day. i didn't sit for that paper but that's another story for another day.

coming back to this UPSR fiasco, it was honourable of the 2nd education minister to apologise to students & parents but no amount of apologies is going to alleviate their angst.....

except when they catch the culprit(s) & prosecute with a deterrent sentence......

and in a different country, the education minister would have tendered his resignation.

Tuesday, September 09, 2014

UPSR


it's that time of the year again.....


the exam season is upon us & along with it, comes its baggage of burning of midnite oil & of candles at both ends, sleep deprivation, last minute revision & extra tuition classes, amongst other labour-intensive tasks.

and the age-old tradition rears its ugly head....that the parents sit thru the exams as much as the students.

Monday, August 04, 2014

diving into shallow waters


just be careful when diving. or driving.

ok, just be careful in everything that you do.

this is the horrendous injury sustained when someone tried to dive into shallow waters.

 
this MRI scan shows a badly-fractured neck with extensive damage to the spinal cord. he can barely lift up his arms & cannot move or feel his legs at all. he required surgery to stabilise the neck (to prevent further damage) & the chances of recovery are slim.
 
what started out as a fun day at the beach has turned into a nightmare for this chap. let's learn from this & prioritise safety above all else.

Saturday, August 02, 2014

confession of a nurse


and no, it's not what you think it is....

nurse : doc, you know you have changed....

me: how so?

nurse : you used to be so fierce....

me : really?

nurse : yes, so fierce that i refused to join your department!

me : so, now how?

nurse : now you not fierce anymore. maybe you are getting old.

ha ha, how true! the older we get, we should mellow down & not hold on too steadfastly to the high ideals we have set for ourselves during younger days. some things don't change much, eg. work ethics, & sometimes the more you try to change (for the better), the more it feels like hitting a brick wall.

and, boy, have i had some terrible headaches from the impact.

so let's just let sleeping dogs lie.......and i may just live longer!

Thursday, July 31, 2014

farewell


Gave a farewell dinner last week to one of the nurses who has left the department.

it's the usual occasion for best wishes to be exchanged, promises to keep in touch to be made and group photos taken.

so, i was most surprised when my colleagues & i each received a gift from the nurse concerned....
 
maybe we said, taught or did something or encouraged her in ways we didn't even realise. i remembered her from her student nursing days & have seen her pass thru the rite of passage from a blurry-eyed student to a confident staff nurse. even attended her wedding.
 
she will be missed much.
reminds me about the way our country is managed. there must be ongoing brain drain in every industry & the biggest beneficiary is the Little Red Dot down south.
 
but i digress.

Monday, July 28, 2014

fully booked


i expect cinema halls, concert shows, plane flights & hotels to be fully booked.


but also restaurants at the mall?

don't take me the wrong way but i'm glad that the fasting month has finally come to an end, & i doubt i am the only one who feels this way.

think : providers of emergency/critical services.

Sunday, July 27, 2014

philipian


apparently, last week i had a patient from 1st century Greece.

 
Philippi was an ancient Macedonian city (of Alexander the Great fame, remember?) & one where the apostle Paul had helped set up church.
 
 
however, i wouldn't have gotten all excited if our education system had taught our "lost generations" proper geography - that the inhabitants of the Philippines are called Filipinos.
 
i just shook my head & shared a good laugh with some friends.

Wednesday, July 23, 2014

act of God


apparently i slept thru a thunderstorm (what?) last nite.

because this is what i saw going to work this morning....

a tree in the visitors' car park has toppled over.....

......causing a dent on the roof.

so, who should pay for the damage?

the hospital because it collects parking fees?

car insurance comprehensive insurance?

the hospital has made its stand that cars are parked at owners' own risk & car insurance policies generally do not cover  "acts of God."

guess the car was at the wrong place at the wrong time.

just like MH17?

Saturday, July 19, 2014

deep sh*t


staff turn-over is a common event in many companies - people move for various reasons & these may be "pull" or "push" factors.

even in hospitals.

but when staff in their peak years move on to greener partures & the heads of department replace them by re-hiring retired staff with a poor previous working record, it doesn't speak well of employment process.

quantity instead of quality?

filling up the numbers?

or fixing sink holes with duct tape?

yup, we are in deep sh*t!!


Thursday, July 17, 2014

age of decadence?


i am a regular guy.

i buy regular stuff (read: mostly when on offer) & i drive regular cars (read: B-class Japanese).

which is why i cannot fathom why people in not-yet-1st-world malaysia would pay this much for a meal....yes, just ONE meal!

not exactly exquisite continental cuisine but just a buffet dinner at a local hotel....so i imagine there must a quite a number of irregular guys out there!

Wednesday, July 16, 2014

30


i am 30 today......as a doctor.

on this day in 1984, i reported for duty as houseman in the paediatrics department. although medicine wasn't my 1st choice of career for most of school life, i had a change of heart when applying for varsity courses. although i initially struggled thru the initial stages of the course, it did take some time before i got used to it.

the rest is history & today, my classmates & i, of the class of 79/84, we celebrate our own special milestone.

 
*those days, i had a lot more hair & a lot less waist*

Thursday, July 03, 2014

saman 2.0

the earlier court hearing was postponed because the court room had to make way for an "emergency hearing."



so my turn for the re-scheduled hearing will be held this afternoon. of course, it disrupts my schedule, in addition to causing some degree of anxiety & distress.

which makes me realise that each one of us will affect someone else's life, in the decisions we make everyday, whether good or bad. i have to attend this court hearing because of someone's lack of rational thinking, lapse in judgement or selfish ambition.

oh well....have to go now....off to the lions' den....

Monday, May 19, 2014

saman


that's a scary word. it means "summons," & we're all to familiar with it, be it from the police,  road transport or internal revenue. usually it implies that some form of payment is outstanding & due.

it's also used when we receive wedding invitations. this may be from a friendly party but the outcome is nevertheless identical - a payment is in order.

i just received one last week.....


this is to attend court as a prosecution witness. someone from the hospital had used my name to pilfer stuff. so, in addition to getting the guilty party charged for wrongdoing, it's also to clear my name.

i just hope to defence counsel don't tear me to pieces 1st!!

Sunday, May 18, 2014

into the terrible teens...


my dear boy is 12 today....


tradition dictates that he will now enter a phase of life called the terrible teens. apparently, although still wet behind the ears, they think they know enough to stamp their identity & rebel if they can find a cause to do so. & that has resulted in untold angst amongst parents.

i wasn't a terrible teen when i was younger, yet i was no angel by any means. yes, i told a few lies & experimented with cigarettes & got distracted by girls. my earliest recollection of a birthday celebration was when i was 19.

and there wasn't a birthday cake either....

if i had my way, i'd make sure he'd as least not fare worse off than i did...


but i know he has a mind of his own. i just have to make sure he gets proper guidance before the rebellion starts...blessed birthday, dear boy!

Train up a child in the way he should go,and when he is old he will not depart from it. (prov 22:6)

Friday, May 09, 2014

20


as a 2 year-old, enjoying a macadamia ice cream......

and she's 20 today.....

Saturday, May 03, 2014

a sign of maturity


when i was a houseman many years ago, i could not make clinical decisions without consulting a senior colleague, eg. medical officer or consultant. as junior doctors, we were not expected to take such heavy responsibilities concerning the lives of patients.

as i gained more experience & read a lot more, i became more confident in the decision-making process by making correct calls & judgments. and when i made a wrong move, i knew how to do damage control and/or take corrective measures.

i call that a sign of maturity.

my daughter took a step towards that today....

she turned down a scholarship offer......but as concerned parents, we cheered her on....


because we have reassured her, unconditionally, that we will see her through her chosen field of study.

Wednesday, April 30, 2014

crossroads


i was once at a career crossroad.....

having already decided to do engineering during my secondary school days, as maths & physics were (& still are) my fave subjects, i made a sharp turn & took up medicine instead.

it was a major change, biology being my weakest science subject.

it was easy to explain the change to anyone who asked.....i received a higher calling & i have not looked back since.

this week, it was my daughter's turn at the crossroad......

having enrolled earlier this year into a pre-med course in auckland, she has been offered direct entry into another course ......


however, this is a different dilemma compared to mine.....it's a step down in terms of career prestige but it's offered by the top-ranked university in asia with a full scholarship thrown in......

ahh.....decisions.....decisions.....although i elaborated to her the pros & cons of each offer, i restrained from expressing my preference. after all, it's her career, her life & her consequences.

in times like this, i directed her to some choice advice.....

Thus says the Lord:
Stand at the crossroads, and look,
    and ask for the ancient paths,
where the good way lies; and walk in it,
    and find rest for your souls. (Jer 6:16, NRSV)

i myself am curious whether she'll waver from the current path...like what i did years ago.

Thursday, April 17, 2014

this is your pilot speaking......good night!


this is a true story narrative.....

my colleague went on an evening MAS flight from KLIA last week. it was after boarding that the passengers were told that there would be a delay because of a "technical problem." they had to remain seated for over 2 hours without air-con or beverage. my colleague decided to complain because of the discomfort of the warm & humid, not to mention cramped, environment. i suppose if you're already flying, the constraints of economy class could be easily overlooked. after all, you paid for those seats but you certainly didn't expect to be seated & yet not moving for over 2 hours.

with no further announcement forthcoming, people started to get restless. after an extremely long silence, this came over the PA system:

this is your pilot speaking......good night.....i'm going home.

as it turned out, pilots have a strict work-hour schedule & there has to be a change of flight crew after certain number of working hours, presumably to prevent effects of fatigue.

in the end, they had to change planes (presumably the "technical problem" was a major one) & the flight finally took off after more than a 4-hour delay.

with the current controversy over MH370, i think pilots should be more sensitive & refrain from saying "good night" in their flight announcements. i am just surprised a pandemonium didn't erupt.

Tuesday, April 15, 2014

what changed the world?


i can totally relate to this article. the world now is not the same one we used to know when we were kids. progress stamps its mark but along with change comes its ugly baggage as well. how often do we wish we could go back to the good old times?

i would. that's why i look forward to reunions.

we just had one.

this is our class of 79/84.

Tuesday, April 08, 2014

authorised car service....or another scam?


dropped off my car last week at the authorised workshop for the 50K km service. the service advisor told me the parts that needed to be changed, eg. engine oil, filter, which i had expected.

half an hour later, i got a call from the foreman servicing my car & he said the wipers, air-con filter & battery needed replacement. apparently, the wipers had uneven edges, the air-con filter is clogged up & the battery is weak.

i said OK but told the guy that the battery was changed middle of last year & it's still within the warranty period, ie. 12months & 20K km. he said he'd check & call me back. it was the service advisor who called me & said the battery was weak because i hardly use the car, hence it's not fully charged.

i told her it doesn't matter how much i used the car, as long as it's within the warranty period & if the battery is "weak", then it should be changed without any cost to me. then she started bla ...bla....bla.... that she'll get the foreman to fully charge my battery & that should be OK after that. but i stood my ground, questioning why the foreman asked to change battery in the 1st place when all it needed was a full charge.

anyway, i told her in an agitated tone to do what needed to be done & i'll come collect the car later that evening. my mind was screaming,"Scam! Scam!"

 i sort of held my breath when i went to the workshop later. as expected, the woman service advisor whom i had earlier dealt with avoided me & it was another guy who who attended to me. he explained that, although not standard practice, the battery was changed out of goodwill. i thanked him & wondering if it was standard practice to change parts that do not need changing.

back home, i deleted the email i had earlier drafted, addressed to car's corporate HQ in KL.

Monday, March 17, 2014

we prayed and we prayed.


we prayed.

we waited.

and it rained......finally, over the weekend.


then we continued to pray.


and we wait.

will this prayer be answered soon?

Monday, March 10, 2014

one born every minute


email scams are so common, yet people fall for it all the time. the ones i often get are strangers from african countries who seemed to have pin-pointed me as a beneficiary of grand sums of money left by unknown benefactors.

but a windfall from singapore airlines may sound more believeable.....

esp if the reward is in SGD & not USD.....

the postal address is correctly stated but the email domain remains highly suspicious.....
 

so i just deleted it.

i don't want to be another statistic.