Sunday, December 10, 2017
If you have seen the movie, you'll be convinced you can't escape death. The movie makers & movie-goers alike must also believe it because there were another 4 sequels after that.
I have seen three of my late colleagues in the obituary page - one from a stroke, another from a delibitating disease & the 3rd from a ravaging cancer. Then I look at myself in context & wonder whether mine will be cut short like in the movie.
If my number had been up, it would have happened years ago.
When I was about 12, I tried to mimic a pole vaulter at the home garden. Strung a rope across & used a stick to jump over. Fell awkwardly facedown & felt excruciating pain over the whole abdomen. On hindsight, I could have ruptured the liver or spleen.
When I was 14, I opened the fridge at home during a thunderstorm & felt a sharp slap-like pain at the back of my calf. Was that a teeny-weeny electrocution?
When I was 27, before I could afford a car, I rode the motorbike to do part-time locum at a clinic along Jalan Jelutong, Penang. Many times, I had to stop in the middle of the road while waiting to turn right. If you live in Penang, you will know it's a very busy road & I had to depend on the goodwill of vehicles passing behind me to keep a safe distance.
When I was 29, while driving down from Penang to KL, I drifted off to the left of the main trunk road (before the NSE was opened) & as a reflex, turned the steering wheel excessively to the right & the car jumped up the kerb & veered sharply to the opposite lane. I lived to tell the tale because there was no oncoming traffic.
My personal belief, and I stress personal, is that my time is not yet up because in the grand scheme of things, there must be a role I still need to play, the reason for my very existence, as is for everyone else who is still alive.
It is my wish that all of us do whatever we can, while we still can, for the betterment of mankind.
Saturday, December 09, 2017
nurses played a major role in my life.
my mother was one and that may have inspired me to follow a certain career pathway, but there were student nurses in the hospitals that I trained at or worked in that changed my outlook in adult life.
I thought I had found the girl of my dreams before I left for varsity. We went steady for over 3 years despite the long distance relationship & during term time, we kept in contact through public phones & letters.
It all changed when I started going to the wards during the clinical years. There was this student nurse PB in the surgical ward that drove me crazy. Her friendly & bubbly personality gave me crazy ideas. Like if I didn't see her in the morning, I would make it a point to
my preoccupation with her drove me to break off with the erstwhile girlfriend, who was distraught beyond words. what do you expect, one day it was lovey-dovey...the next, it's adieu. well, not really because our parents knew each other well, so it wasn't really a clean break.
Coming back to PB, the chemistry was definitely there but it somehow just wasn't enough to clinch the deal. The one memorable moment I spent with her wasn't alone with her but at her home with her parents during Chinese New Year. Her mum was truly charming & I was sure PB inherited that attribute from mum. We remained friends to this day.
After that, I got to know CP, a classmate of PB. Like PB, she stayed at the nurses' hostel, so it was easy to meet. CP is from Penang, so we continued where we left off after I graduated & did housemanship in Penang. Just when I thought I will clinch it this time, she married someone else - the son of the landlady she was renting from. I attended her wedding but was a tad disappointed she
Then came AE...a student nurse at the Penang Hospital. Woo hoo......she really got me eating off her fingers. Bubbly, charming & intelligent....graduated top of the class even. Even met her parents when I spent a weekend at her home. This one was definitely a "done deal" but guess what?
I got cold feet & chickened out. Eventually, she married my colleague - personally & frankly, I think she was better off with him.
Which begs the question : was I really ever ready to commit in the 1st place? Probably not because there was a string of short term relationships after that which never really took off....no lasting chemistry...no sparks.....
But three years later, the stars ignited & planets lined in place. The one I thought will never happen ....the outside bet...the dark horse....actually did. After a 2-year courtship, we married.
Oh yes, she also a nurse.
(did I not allude to this at the beginning?)
Monday, November 06, 2017
I didn't feel I had prepared well for it & I remember I had a particularly torrid time with the Biology papers. The results certainly reflected that sentiment.
How I ended up doing Medicine is a rags to riches story.
Just take my word for it - zero to hero.
Sunday, November 05, 2017
The exam starts tomorrow. It used to be called MCE when the language of instruction was still in English. It's a faint memory for me but I remember the 1st and last papers well.
Wednesday, October 11, 2017
I didn't stay long in the last class. After a couple of good monthly test results, I got promoted to J class, was made class monitor by midyear, & went on to stay in EC till 6th Form.
That was the name the BM teacher called me in Form One. She didn't know my name then & I was the only one in class with glasses.
There were 10 classes of Form One that year, Form I A to F, then J to M. I was in Form 1M, the last class.
That was an anomaly that year. The premier secondary school for boys was EC. Every smart kid wants to get in but admission is by location; you get in if you live in the area. I lived far from that & ended up in the not-so-glamorous neighbourhood school, SAB. As we were gathering to register on the 1st day of school at SAB, after much delay & confusion, we were told to report at EC the next day.
Because we were not the original EC batch, we were temporarily allocated to J-M classes and because they couldn't trace my Secondary School entrance test results, I was arbitrarily banished to the bunch-of-losers last class.
Yes, that's me, Specs, starting secondary school right at the bottom of the pit. But there's one consolation, though - from thereon, there's only only one way to go.
Tuesday, October 10, 2017
Some one took the trouble to create such a day. I wouldn't have known about it had not someone posted on FB.
Not sure how to celebrate it, if at all. For me, all I want is for the patient to leave the operating room alive and healed.
That alone is reward enough.
Sunday, October 08, 2017
it was a pretty good week...
the real Unifi guys finally turned up.....I meant not the earlier pretenders who came & checked up the place and yadda.....yadda......yadda......can only do internal wiring....Telekom need to pull the external wires from the router box....RM500 excluding the modem....
a whole month after registering for it, the earlier installers really gave me the run-around.....and finally, Unifi finally sent these fellas who did everything in one go, for just extra RM200.
oh yes, there are more than a few installers out to make a quick buck.
and finally, got the daughter's accommodation sorted out for the next (and last) 2 years of her course. every year at this time, since she has been in varsity, we agonized whether she could secure a place to stay near the varsity and we are glad this predicament is a thing of the past.
hope your week has been good, too.
Sunday, September 24, 2017
My colleague's son is having his wedding dinner at an upmarket hotel.
For the 1st time ever, in addition to the menu, this was placed on the table...
Personally, I didn't think it was a good idea. It's as if the diners don't already have enough of surfing at home, at work or while waiting at the traffic lights. But then it's the sign of the times. Even if the free wifi is not provided, most will already have their own data plans anyway, but with this added service, it will certainly encourage more people to surf in between & during dishes.
So, if you don't mind, just hold the yam seng while I reply to my WhatsApp message.
Saturday, September 23, 2017
Bonus Commandment Story.
** #8 is my personal favourite**
Friday, September 22, 2017
that, in latin, means 1st, do no harm.
i've not always adhered to that principle - blame it on immaturity, anger, or just plain callousness. i recalled an incident very early in my training when the senior consultant of the department ( aka The Boss) hauled me into his office to give me a mouthful.
on that morning, i had a dispute with a consultant of another department over the management of a child. in anger, i walked out on the child, to whom i had just given some sedation. that consultant rightly complained to my Boss about what i just did (the argument & subsequent abandonment of the child) & that was just 1 of many reprimands for wrongdoing in my career. yeah, i was a serial offender - bad, bad doctor!
however, i learned valuable lessons that day....
1st, my patient becomes my responsibility, no matter what i had for breakfast, how miserable i felt or who i fought with. his well-being is my priority.
2nd, to err is human, to forgive is divine. my Boss censured me in the privacy of his office, thereby sparing me the humiliation of a public flogging. that, IMHO, constituted a pardon in itself, & till this day, i appreciated that magnanimous gesture. therefore, it was with much sadness when i read last year that he had passed away from cancer.
so, it's ok to be human - to resent, to antagonise, to show displeasure. were we not from the fallen beings of eden? paul has this valuable counsel:
"in your anger do not sin. do not let the sun go down while you are still angry, and do not give the devil a foothold." ephesians 4 : 26,27
** this post is a saved draft from 2007. I don't remember why I didn't post it then, but here it is...a reminder to myself that it's OK to start badly but must finish strong **
Tuesday, September 19, 2017
Whatever, there will still be an additional (but unnecessary) of RM124 plus GST to the patient's bill.
Monday, September 18, 2017
As if having an allergy is not enough, how about having an allergy to the medication used to treat the initial allergy??
40 year old woman admitted for nose surgery. In the OT, just before commencement, she developed an allergic reaction to the anti-vomiting injection. We treated the severe coughing and breathlessness with alternative medications, for fear of triggering another allergic reaction should the standard anti-allergic injection be used. The surgery was subsequently postponed for safety sake.
The allergic reaction subsided the next day & surgery proceeded with no further untoward incident, with administration of alternative anti-vomiting injection.
We really have no idea what we are allergic to until we develop it. Some are mild, e.g. to prawns, while other maybe severe or even life-threatening, e.g. to peanuts. As doctors, we were taught how to treat it, but it is safest to avoid the offending food or medication, if we are aware of it. Patients should communicate these previous incidents to their doctors, too.
Saturday, September 16, 2017
Wednesday, September 13, 2017
I met up with an ex-colleague over the weekend after a lapse of 26 ( yes, TWENTY SIX !!) years. And we both concurred that we didn't change much physically, as we immediately recognised each other.
Tuesday, September 12, 2017
T was my Best Bud in secondary school. We clicked because of our interest in chess and football. I then came to know his family very well.
Thursday, September 07, 2017
My Primary One class teacher, Pn RB, passed away last year. I've only fond memories of her. You see, I was the proverbial teacher's pet & it helped that my parents were friends with her.
This 60+ gentleman has been with the hospital since it started in 1990. He's an operating theatre assistant, preparing the room & helping the surgeons during surgeries. Very likeable chap & adept at his work.
Preparing the OT is like a pre-flight check. Would you board a plane scheduled to take-off at 2pm when the crew only starts checking at 2pm? Which means the flight can't possibly take off at 2pm. As if there aren't enough delays already!!
Wednesday, September 06, 2017
I was at the stadium to watch the Malaysia v Hong Kong AFC qualifying game, as I wanted to savour again the "live" experience of a competitive football match.
What a difference it was from watching in the comfort of home!! I never realised there was a section where local fans called ultras congregate and sing patriotic songs to the beat of drums...
...and no, I didn't hear them sing anything offensive to their opponents.
Speaking of patriotism, I am convinced sports is one unifying activity (food being the other) that transcends age, gender, race and religion. In unison, the crowd cheered when we scored the equalising goal & in one voice, boo-ed vociferously at the referee when he unfairly awarded an injury time penalty to the visitors. But just was served when HK missed the penalty. woo hoo!! unfortunately the stadium was less than a quarter filled, so the intense atmosphere was sadly missed.
Because it was windless, the air was a tad stale & reeking of cigarette smoke. I also missed the action replay like on television. I got distracted momentarily & completely missed the 1st goal.
Despite the unique experience at the stadium, I doubt if I would be back any time soon....
.....unless Barcelona or Real Madrid comes to town.
Tuesday, September 05, 2017
Monday, September 04, 2017
so also with the Malaysian F1 racing for the last time this month. this after the initial novelty of 1999 has worn off, plus the more attractive night race further south (alcohol on freeflow, city centre location, and entertainment by One Direction, Seal, Chainsmokers & Duran2), it's not surprising that something has to give.
with Proton, Bandar Malaysia, Forest City & Iskandar, amongst others, sold to foreign interests, the signs aren't good.
let's hope the F1nale is only restricted to motorsports racing.
Saturday, September 02, 2017
My orthopaedic colleague in another hospital is ranting.
Every time he sends patients to the Xray department, either
1) the queue is long,
2) the report takes ages to be issued
and worst of all....
3) the report is unreliable, inaccurate or inconclusive.
So, imagine you are the patient. You arrive at the clinic at 9am, see the doctor at 10am, go to the Xray department at 10.30am to see a long queue before you, get the Xray/scan done at 1pm, & wait for the report which is issued only at 4pm, and go back to the clinic only for the doctor to tell you that the diagnosis remains uncertain.
And you may need another scan.
You spent the whole day & loads of cash only to return to square 1.
You are upset, the doctor is upset and the cycle repeats itself.
No wonder my colleague is ranting.
Monday, August 28, 2017
Sunday, August 27, 2017
Satay without peanut sauce;
English breakfast without bacon;
Nasi lemak without sambal;
Cendol without gula melaka;
ABC without red beans...
Saturday, August 26, 2017
My father used to work with the British army in Singapore. We were quite financially well off. Staying in the clan's home, we had 2 rooms & we were the 1st family with a TV. We eventually moved out to our own home.
When the Brits withdrew, he was laid off. We tightened our belts during this difficult period. He then worked for a while with a timber company in Temerloh (Pahang) & then Paka (Trengganu), which means he was away from home a lot. When the company closed down, he came back & became a driving instructor. I still mention with much pride that I was taught by him.
He's always been thrifty in his spending. In fact, when we go to the supermarket, he'll just wait outside because he said he has nothing to buy while we filled our trolley with groceries.
I still retained that DNA. Which is why I was ecstatic when I found this ......
After all, I AM my father's son. I think I'll wear this to church tomorrow.
Friday, August 25, 2017
my daughter says she wants to do internal medicine. either that, or cancer research.
i feel it's good to have an ambition. at least, there's something to look forward, and work towards, to. an objective to focus & channel one's energy & time.
but the wise man has this to say....
Many are the plans in a person’s heart, but it is the Lord’s purpose that prevails. (prov 19:21)
i should know. after all i wanted to be a bus conductor, and then an aviation engineer.
see how i turned out.
Thursday, August 24, 2017
Wednesday, August 23, 2017
I love this class USSB. Upper Six Science B.
Marvelous Chemistry, Biology, and General Paper teachers, and special mention to the late Mr GV Pillai, Physics teacher. I did apply to be an engineer, you know, but I digress.
And my beloved classmates who were comrade-in-arms in work & play.
I'd like to think you've all impacted my life as much as I have yours.
Tuesday, August 22, 2017
Monday, August 21, 2017
It's often proclaimed that wherever we are, whatever we do, it's for a reason. Like if we had not gone there, then ...... or, If we hadn't done that, then...........
If you are religious, you'd feel it's even like a divine decree.
Last Wednesday, I was at such a place and time. My scheduled case didn't not take place & at 4pm, I was just walking pass the surgical ward, getting ready to change & go off.
I got an urgent call from that ward that one of the patients I had anaesthesied earlier that morning was having a convulsion & was not conscious.
I was by the bedside before you could say Code Blue. With the help of the nurses, we proceeded to do CPR. Although the heart momentarily stopped beating, we managed to restart it because prompt action was instituted early, which is the essence of CPR anyway.
The stay in ICU was quite stormy, and we weren't sure if the patient has suffered brain damage because he remained unconscious for 2 days after that. But on the 3rd day, as we scheduled him for CT scan of the brain, he suddenly opened his eyes & started to respond to instructions.
All I could say was Hallelujah. It felt like a religious decree that I was at that place at that time.
The patient was discharged very much alive from hospital today.
Wednesday, August 16, 2017
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
Sunday, August 06, 2017
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.
Thursday, August 03, 2017
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
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
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
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
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
Friday, July 21, 2017
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
Tuesday, July 18, 2017
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
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
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.....
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.
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
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.
Friday, October 23, 2015
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
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
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
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
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
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
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
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
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
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.
Thursday, April 02, 2015
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
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
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 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
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
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
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!!
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.
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.....
PS. i forgot to mention she left another mark behind, one we will not forget for a long, long time.....
Sunday, November 16, 2014
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
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
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.