Thursday, June 29, 2006

girls in unison

choral speaking.

what in God's green earth is that? when i was in primary school, which incidentally was roughly when brazil took permanent possession of the jules rimet cup, the group activities (now called the politically- correct term "co-curricular activities") i was exposed to games like badminton & rounders, or the more sedate stamp-collecting & gardening. is it any wonder that i have no lasting memory 0f what i did outside of reciting the alphabets & baa baa black sheep, & playing one-leg during recess?? oh wait, i did remember that i was teacher's pet but i digress.

but the kids have it good now. just these few days, i read of cheer-leading competitions amongst schools at state & national levels. i think having young girls prancing around in mini-skirts & tights, & flexing their nubile bodies to the sound of rock-and-roll would have given dear matronly Mrs Thumboo an apoplexy. but i am glad we have moved with the times & the powers-that-be have accepted & encouraged such healthy sports as much as tug-of-war or rock-climbing.

when i 1st heard my then 10yr old daughter in practice for the state-level choral speaking competition some years back, i was pleasantly amazed that pre-teens could be coaxed & coached to speak articulately in unison, & still maintain a musical ring to it. ah, the wonders of young, intelligent & impressionable minds!! her school went on to represent the state at national level & it was indeed a proud & memorable experience for her & her friends to do honour for the school. perhaps, as 1st timers, expectations ran high as they had anticipated a top 3 finish but their naive aspirations came to grieve (literally!!) in the face of fierce competition. they cried & were momentarily inconsolable when the results were announced.

this year is the 3rd one running that they have gone on to the national finals. the team came in 5th out of 15 schools. the girls must have matured (or did they just got used to not being in the top 3??) because they had a blast of a time despite the disappointment. no tears, no wailings, just good fun! i'm personally relieved that they realised winning would be nice but is not everything. i hope they remember that when the UPSR results are released.

Thursday, June 22, 2006

wolf in sheep's clothing

my mother-in-law has coronary artery disease (CAD). one of the 3 main blood vessels supplying oxygen to the heart muscle is 80% blocked but she has never complained of chest pain, a cardinal feature of the disease. instead, she has had a nagging tummy ache for some months which her family doctor attributed to consuming traditional chinese medicine for her persistent joint pains. a course of anti-ulcer pills provided symptomatic relief.

my heart specialist friend, whom i shall call B8, checked her up & put her on a exercise treadmill test. the results suggested that CAD was likely. a subsequent coronary angiogram, where dye is injected into each of the main arteries & real-time images are caught on xray films, revealed the offending blocked vessel. next up was a balloon angioplasty, where a fine catheter whose tip has an inflatable balloon was inserted to break up the obstructing plaque & subsequently to dilate the narrowed vessel. it was only after several nerve-wrecking attempts lasting over 2 agonising hours (&, may i add, 3 costly catheters later) that a sweaty B8 finally emerged to proclaimed that the procedure was a venerable success. and for good measure, he even inserted a stent, an expandable metallic wire-mesh, at the site of the previous blockage to maintain patency to the vessel, giving it a new lease of life, so to speak.

as any cardiologist will tell you, CAD can mimic anything from a tummy ache, to a backache, shoulder tip pain & numbness of the arm, just to name a few. a chameleon of sorts, it often baffles & deceives the clinician as to its true, potential deadly nature. who knows how many people have succumbed to this a vicious wolf in sheep's clothing, thinking it's just a minor ailment.

it is my personal observation that we are getting CAD at a progressively younger age. how often have i seen patients in their early 40s going under the surgeons' knife for coronary artery bypass surgery, often a last resort when angioplasty has failed to relieve the blocked vessels?? too many for close comfort!! blame it on the constant brainwashing from fast food comercials, or stress from 21st century living, or that we just don't care about the abuses we subject our bodies to.

still, my mother-in-law is one fortunate woman. she has been innocently living with a ticking time-bomb & she goes on with life thinking all she has is a vague abdominal colic. i'm glad & she's glad that i have a colleague who shows conscience & compassion, & has the skill & temperament to match. whoever said doctors are mercenaries hasn't met B8. i like to think that i'm doing my part for healthy living & avoiding a coronary- eat with temperance, exercise frequently, yadda yadda yadda. but just to be on the safe side, i have B8 on my speed-dial.

Monday, June 19, 2006

a father's day blog

fathers' day came & went.

i was never particularly close to my father & still am not. i can't really figure out why. my father is a quiet, unassuming person & seldom shares his thoughts. my earliest recollection of our relationship is one of a stern & strict discipline. he used the rotan as & when it was needed to impose some form of control over my inherent delinquent nature, or so i thought. hard as i tried to recall, i don't think i had terribly bad behaviour.

but he was definitely a family man. as often as he could, he would take mum, my kid brother & i out on evening drives by the sea....actually, the straits of johore but to my young mind, anything that was not on land was sea. we would sit by the grass verge & try to count the number of stars in the sky. i only learnt much later that there are as many stars as there are grains of sand on the beach - infinite. again, how naive & gullible our young minds were!

two things my father impressed upon me, was the importance of doing well in studies and to have a masterly command of the english language, both of which i'm not sure if i have fulfilled but which, i hope to impressed upon my kids. ironic, isn't it - i couldn't do it but hope someone else could!!?? it was mum who taught that it was important to be a good person as well. was that why i was closer to mum? one reason could be that she played the roles of father, mother & companion when my father had to work in another state for 6 of my formative years & the other was that it was mum who supported me thru varsity. but i knew my father was, & still is, very proud of me when i graduated. i still remember he was close to tears when i left for UK to do post-grad, appealing that i came back soon. "soon" was 4 years long.

just before i came home, he had to undergo major surgery & i extended my deep, heart-felt appreciation to a fellow colleague who took care of him while i was away. he pulled thru after a few near-death escapes, only to develope parkinson's disease (a neurological disorder resulting from a lack of a brain chemical, causing tremors & slurred speech) years later. his symptoms are now controlled with medication but, by & large, there is no definitive cure currently.

fathers' day has never been celebrated in my family with the same significance as birthdays or chinese new year. so, a phone call home did the trick but he knows, come rain or shine, my brother and i will be home for his birthday, feting him to lunch at his favourite restaurant. perhaps it was the sight & aroma of the black-pepper crabs & deep-fried prawns with oats that litted up his face with glee but i suspect it has as much to do with the timely gathering of his family - his clan - on his special day. perhaps, that's all that matters as he enters life's twilight.

children are truly a blessing, & i have been richly bestowed twice over. my elder girl is 12 this year & she made me a card from the printshop software. the boy is 4 & he conjured up, with some help from his kindergarten teachers, these cards in which he drew what he perceived to be me - big head, small tuft of hair & small eyes with glasses. how we see each other reflects our mental maturity, socio-cultural influences & personal experiences. perhaps the sweetest, most beautiful images are seen thru the innocent eyes of a child.

Saturday, June 17, 2006

defer the trip home

i'm happy but not to the extent of being ecstatic. i was watching the england-trinidad & tobago match last nite and exchanging text messages with a football-mad colleague. we were both criticising the way the english forwards (who?? what forwards??) were misfiring and the midfield, though having most of the play, were not dictating the game. the back 4 were the saving grace & without their rock-solid display of grit, the game might not have been scoreless at that stage. my friend even suggested that sven start booking their flights home. however, crouch & gerrard's late double strike probably postponed the inevitable - consignment to the heap of underperforming discards. hold on to those tickets, sven.

i'm not a true-blue england fan. but after having spent some of the my best years living amongst the queen's subjects, surviving on a diet of shepherd's pie, fish & chips, low-cal coke & scandal-exposing tabloids, i have to admit to feeling some affinity to the football team. after all, i was brought up on a staple of star soccer (that's what the highlight program of the old division 1 was called in the days of black & white tv) & shoot! magazine, & at one stage of my juvenile life, posters of alan ball & charlie george were paid homage with religious fervour. yeah, i was an arsenal fan even before thierry henry was born.

i commiserate with the english team, in that they do not have in their current rank a (fit) marksman that will strike fear in their opponents. someone in the mould of alan shearer, ian wright or gary lineker would lend invaluable support to rooney, set the field alight & get the bookies all excited again. is it time for theo walcott to get a game? ah well, if they do get thru to the last 8 or 4, good for them but that's as far as they deserved to progress. otherwise, it's back to the drawing board for steve mcclaren.

like i said, i'm happy but not ecstatic.

Wednesday, June 14, 2006

4 pizzas & a pepsi

i saw the movie 4 weddings & a funeral over 10years ago when i was studying in the uk. it was funny in the british sort of way, what with hugh grant & rowan atkinson mumbling & fumbling their way thru. i guess i could associate with grant's character ( as i also did in notting hill & bridget jone's diary) esp the way he beat around the bush & got his words all tangled up when trying to get a date with andie mcdowell's character. anyway, despite a sombre moment at a funeral, there was a happy ending - the 4th wedding.

i just had 4 slices of 3 varieties of large-sized pizza from pizza hut. that's equivalent to half a large pizza. of course it's not to the pizza chain's advantage to reveal the calorie content on the packaging, but i can guess those 4 slices would send a calorie-meter way past the red zone, screaming "heart attack! heart attack!". i could have sworn 2 of the varieties had extra cheese cleverly disguised as toppings. downed that with a 12oz non-diet pepsi, & you have my cardiologist colleague shaking his head in disapproval & probably secretly pencilling a date for me in his appointment book. as if in an act of defiance, i decided i'd TRY to work off the extra pounds later in the evening, doing 30 mins of rigourous aerobics. (yeah, you heard me right - me, a guy doing aerobics but please don't tell my mum). but in reality, this is a futile attempt to postpone the inevitable (read: heart attack! heart attack!) bcos the maths just don't add up. the pizzas & pepsi easily add up to 1200 calories while even a breathless, heart-pounding & muscle-aching session at aerobics would hardly subtract 600 calories. so to express this mathematically :

4 pizzas + 1 pepsi - 30mins aerobics = 1 coronary stent

if i keep up with this diet, i should not take out a mortgage beyond 5yrs & should put my cardiologist number on speed dial, but thank goodness this is a one-off; an aberration to my normal routine. like the movie, this is a happy ending. and i lived to eat another day.

Tuesday, June 13, 2006

funny thing. i set up this blog yesterday mostly on impulse. i mean, i had toyed with this idea for sometime, but when prompted by blogger that it was a simple task (can any internet-inspired computer-driven task be simple for a novice like me?) i took on the challenge, like i said, on impulse & now that it is up & running, i'm thrilled to bits. however, when asked for a title for the blog, i mulled & hesitated before deciding on "1st, do no harm". then when i tried to search for my own blog online, i discovered, to my horror, that there are 100s of listings under that title. so embarassed that i may be derided a copy-cat or one lacking in originality, i decided on a modification & hence, "1st & last, do no harm" was re-born.

scrounging around for some photos to post & lining up some stories to regale, so hang on there.

1st blog

this is my 1st ever blog.

the hippocrate's oath, which by & large governs the practice of medical doctors, provides several guiding principles for which the latter are admonished to adhere. For example, to revere his (refers just as much to her) Teacher (not in the same context as in da vinci code) as much as his parents, to give no deadly medicine to anyone if asked, and not divulge all that he sees or hears in the life of men, just to name 3.

really, i can't remember, for the life of me, all that hippocrate had wanted me to be. but what i do know, deep in my heart, is that above anything & everything else, i must do no harm to those who seek my expertise in the art of healing.

but while we are frequently inspired by great & mighty acts of heroism and ingenuity in medicine, which may have contributed to the high esteem accorded to doctors & which may also have resulted in the scrambling for medical places in the varsities, i hope to share with you instances, circumstances & experiences that reveal doctors are as human as the next person. we laugh & cry, revel & suffer. & we have made errors of judgement with unfortunate outcomes.

join me, won't you?