Wednesday, October 25, 2006

a rude awakening & the parting of the red sea

no one likes to be woken up at 3am. esp if you have just gone to bed at 2am. i was put in that unenviable dilemma recently. well, actually it wasn't a dilemma - i was on-call & i had to answer the phone.

the emergency dept (ED) medical officer (MO) was desparate. he has a middle-aged man who had surgery for cancer of the thyroid followed through with radiation therapy to the neck. he was recently discharged from hospital but has come back because of breathing difficulty. the MO attempted to intubate (medic-speak for inserting a tube into the mouth & passing it down the windpipe to maintain an airway & to assist respiration) but he couldn't identify any of the structures in the throat to facilitate the procedure. ah, this is not good - i'm half awake, a difficult problem has cropped up & this could be life-threatening.

by the time i got to the ED, sleep has worn off & the adrenaline was in control. the MO heaved a huge sigh of relief - 2 heads are better than 1, right? the gentleman was obviously in distress - he was panting like he's just done a sprint & his lips had a sickly bluish shade, indicating he's not getting enough oxygen into his lungs. & i seriously thought he was a goner. i mean, he's got cancer that has breached the original boundaries & now, obstructing his respiration. & i'm getting flashbacks of darth vader breathing down my own neck.

ok, i definitely won't be thinking of curing his cancer, i thought, but i'm going to try to pull him through the night, at least. so here goes........

endotracheal tube - checked!
laryngoscope - checked!
oxygen - checked!suction - checked!
tissue paper (for mopping my forehead) - checked!
intestinal fortitude - err, checked, i think....

using the laryngoscope to look into the throat, i can confirm what the good MO saw - it's a war zone in there. i cannot recognise the usual anatomical landmarks other than a deformed epiglottis, which resembles a flap overhanging the opening into the windpipe, through which i must insert the tube. except that there was no opening where one should be!! zero. zilch. the devastation of the spreading cancer & the rages of subsequent radiotherapy had altered the landscape altogether.

on to plan B, & this comes with experience. seriously. (young ED MOs, before you hit the panic button & yell for the ENT consultant - & face his wrath - at such unearthly hours, you might want to consider this.) i inserted the tube just behind the epiglottis because theoretically, this is where the opening should be. as i gently prodded at the fleshy tissues with the tip of the tube, they gradually gave way to reveal the hidden orifice. suddenly i felt like moses at the parting of the red sea.

with the tube well-secured in the windpipe, oxygen breathed life into the patient, who was then transferred to the ICU for assisted mechanical ventilation. 2 days later, a tracheostomy (an artificial orifice surgically created through windpipe) was performed & he was able to breathe on his own without further mechanical assistance. after another course of radiotherapy, he was well enough to go home. i had earlier thought he was a goner, but he lived another day to dote on his grandchildren. & i love a happy ending.

"many are the plans in a man's heart, but it is the Lord's purpose that prevails." proverbs 19:21

Thursday, October 19, 2006

cuti-cuti malaysia, take #1.

it's been ages since i got on a plane. but each time it accelerates for take-off, my heart jumps into the throat, & i feel a knot in the neck. every time. without fail.

that's still how it was when i went with the family last weekend to langkawi. i don't think anyone noticed that i was squirming in my seat, partly because it wasn't a full load & partly that it was only a brief flight (45mins from KL). during those few moments aboard, i made a few mental conclusions :
1) even though everyone can fly now, many are turned off by the haze,
2) or prefer to stay at home during the fasting month;
3) those stewardess in red tops & matching skirts look neat & yet stunning, and
4) stunningly sporty if they put on those crimson baseball caps as well
(all hail, Tony F, ceo & fashion guru), &
5) nobody asks for food/drinks on-board when they have to pay for it.

the best way to explore the island is probably to rent a vehicle & there are no less than 12 vendors lying in wait to mean, attract travellers at the arrival hall. on their brochures, a wira 1.5A goes for rm120 a day but in off-peak season (fasting month, no school or public holidays) i got one for RM45 without bargaining. & the air-con worked, too! as the fuel tank was nearly empty, the 1st stop was the petrol station. the nearest was petronas at telaga harbour park, a scenic man-made bay where a handful of yachts were docked. above the convenience store is the petronas smart, a science-themed play area similar to petrosains at klcc, except that it's smaller & does not charge for entry. anyway, the kids loved exploring the various exhibits & the brief body-snatching experience. i heard the harbour is managed by a certain datuk azahar of solo-circumnavigation fame.

after checking in the hotel & a quick, late lunch, we drove towards kuah town, passing by tanjung rhu & stopping at a hot spring appropriately named air hangat village. it was here that we learned the origin of kuah. according to history, a couple from 2 rich families on the island were forbidden from marrying by their parents. the families fought each other, leading to bitter quarrels & public brawls - faces were slapped, fists were hurled, clothes torn & hair pulled (this was before the existence of MCA Youth). also pots of gravy were thrown & jugs of hot water broken. the spot where gravy was spilled came to be called kuah, & where the hot water jugs landed, a hot spring sprouted & villagers called it air hangat.

the jetty at kuah has changed tremendously since the last time i was there over 2 decades ago. gone are the wood & plank & in its place, a spanking new concrete building, which housed duty-free shops, & watched over by a very large inanimate eagle.

after a bit of shopping, we settled for a (what else?) sea-food dinner. the fish & prawns were fresh & prices reasonable. not cheap, but reasonable.

the next day, we headed for one of ex-PM's pet project - the cable car. in a bid to promote local tourism, the rates are slashed down to RM15 & RM5 for adults & children, respectively, if you can produce the mykad. otherwise it's RM25 & RM15, respectively. now, this is definitely different from the cable car at genting or even sentosa in s'pore because it's one heck of a steep climb up gunung macincang, which i estimate at about 60 degrees (but actually 42 degrees, according to the cuti2 m'sia website) .

at the upper viewing station (there are 2 viewing stations) 710m above sea-level, there should be a panaromic view of the andaman sea, the surrounding islands & kuah town, except that it was a little misty (not hazy) that day.

even the suspension viewing bridge, accessible via steps carved out on the side of the hill, which looked impressive during the accent,

was barely visible by the time we reached the peak.

now, don't you wonder where Tun M got the idea for the (cancelled) scenic bridge??

after another round of shopping at kuah, we again had seafood dinner at pantai cenang, a "touristy" area lined with restaurants ( at "touristy" prices, i presume) & craft shops, very much like batu ferringhi in penang. oh yes, we stopped by the underwater world
located nearby, but was turned off by the (prohibitive?) admission prices - rm28 & rm18 for adult & child, respectively!! mind you, this is already reduced from the rm38/rm28 meant for foreign tourists. we definitely didn't fly no-frills just to splurge on such steep admission prices!!

we were back home the next day. it had been a thoroughly enjoyable break for us but i concluded that it would have been better had we extended our stay by just one more day, to be spent going on a round island boat trip plus a spot of snorkling thrown in. the 1st time i snorkled decades ago, it was at pulau payar, just south of langkawi & the memory of diving into crystal-clear water amidst fishes, corals & sea-urchins has not been lost on me.

of course, nobody leaves langkawi without stocking up on cheap, duty-free chocolates. lots of it!! yummy!

Thursday, October 12, 2006

prof & mrs thumboo

edwin thumboo is emeritus professor at national university of singapore's english dept (& i'm sure he does not approve that i do not use CAPITAL LETTERS for proper nouns & at the start of new sentences!). his list of academic achievements is nothing short of astounding, as you can read here.

i have never met the good professor but i do know mrs thumboo, who happened to be my class teacher when i was in primary 2 & 6, & with whom i had lost contact, until 2 years back. i chanced upon a review on the professor's work in the online edition of s'pore's NST & contacted the writer, who graciously provided me prof thumboo's office tel no. & , oh so cliche, the rest is history.

i soon met up with mrs thumboo in s'pore & as we reminisced upon the good old days, i enquired if she remembered a poem prof thumboo wrote about me that was published in one of the english books used for primary 2 those days. i gathered that i was accorded that honour because, at that time, i resembled their son julian (who surprise, surprise is also a medic). that book is no more in publication so i asked mrs thumboo if a draft of that poem still existed, perhaps amongst some old newspapers in her storeroom. that was 2 yrs ago.

lo & behold, when mrs thumboo came to town a few days back, she brought with her 2 volumes of "child's delights", the professor's collection of childrens' poems, personally signed, & gave them to me.

what touched me even more is that, God bless her good heart, she even remembered gifts for my 2 kids - jane austen's emma (very appropriate) for the daughter & a dinosaur toy/book for the son. i joked with her that in 50 years, when the 2 volumes become rare collectors' items, they would be worth a million bucks.

of course i jest. i would never, ever part with those classics................ for less than 10million apiece.

class photo, 1966. on mrs thumboo's right was the class monitor, to be me.

THE poem. this is probably as close as i can get to seeing my name in print. the prof also wrote about his kids julian & claire in the collection.

ps. prof thumboo, if you are reading this, please feel free to correct my grammar, punctuation, sentence construction etc., as you see fit.

Thursday, October 05, 2006

the gospel of st luke according to bruce kuhn

ruce who?

i've read the rave reviews. i've heard from hearsay, that it's the ultimate one-man show. a compelling, unadulterated, & in-your-face recitation of luke, not the jedi but the doctor who wrote the gospel. i figure it would do the show no justice just reading or hearing about it, so i took it upon myself to pull a church friend along & we got tickets last saturday, near the end of its current run at the bangsar actors' studio.

after having been at the cavernous petronas auditorium before, i was pleasantly surprised at the cosy ambience at the bangsar stage - just 6 rows of seats, which i thought made a mockery of the disparity in prices. other than lowest-priced seats located at the sides of the stage, those that face the front should really cost the same, because they are all quite close to the stage. ah, just my 2 sen's worth....

bruce kuhn is obviously an experienced actor, having done les miserables & tolstoy previously & has been re-telling luke for 20yrs. anyone who can hold court for 90mins without props, fanciful stage clothes, back-up singers or musicians takes some beating & deserves a 2nd look. the lightings though, when appropriately directed, helped emphasise some decisive scenes eg. the appearance of the angel Gabriel & the crucifixion. i revere professionalism & admire spontaneity but an artiste exhibiting a photographic memory with matching facial expression & body language truly fascinates me. acting out the whole gospel of luke, literally word for word, & king james version at that?? the virtuoso's display in bringing the bible to life is no more a prediction. it's a fact & i'm a witness to it. simply put, i'm blown over.

in uncertain times like this when religious conflicts abound, i'm a little taken aback, & simultaneously glad, that this show was allowed to be widely publicised & staged, without the pre-condition "for non-muslims only" tagged to it. i hear that bibles were handed out freely in the the american series & the accompanying flyers detailed where one could join the local christian fellowship.

regular church-goers would no doubt be impressed with this masterful performance of biblical proportions but i suspect it could be a life-defining event for some yet to believe in the virgin birth, or more crucially, the resurrection of the saviour. who knows, bruce kuhn the actor may yet save some souls !!

all hail, bruce almighty!

PS. i wonder if billy graham started out this way....???

Monday, October 02, 2006


anyone of us guys who have loved & lost would have been consoled with these immortal words : if you truly love her, you should set her free & if she comes back to you, then she is meant to be yours (although we are rarely advised what we ought to to do if she doesn't come back!). or as connie francis sang it more simply : que sera sera.

i too am a great believer in fate. or destiny, as some would call it. nothing happens by chance. everything has been pre-destined & is part of a master plan. nope, this is not a sunday school message. it's about how things are just meant to be.

a few days ago, i was in the operating theatre doing this major excision & reconstruction job on this unfortunate man's head & neck, scheduled to last the best part of 12 hrs. all OT personnel were prepared for a long day & night ahead. during the course of surgery, it was discovered that the tumour wasn't as extensive as the CT scans had suggested. the procedure was completed in 9 hrs - what a stroke of good luck, i thought. i was about to call home to tell the kids that papa will be on time for dinner after all, when the patient started coughing out blood - blood coming out of any orifice is never a good thing - & his neck was getting swollen. he wasn't a pretty sight, i can tell you, but he definitely needed exploration into the neck wound. & sure enough, there was a little recalcitrant spurter (medic-speak for arterial bleed) that was eventually ligated.

the chap survived the ordeal. so did the doctors & staff. but it was a close shave. in the end, both procedures took up 12 hrs in total. just as we predicted from the beginning. just as it was pre-destined.

see what i mean? if you're meant to put in 12 hrs of work, you put in 12hrs. there's no running away from it. is this fate or what?

and this is the sunday school message : and we know that in all things God works for the good of those who love him, who have been called according to his purpose. (Rom 8:28)