if only.....

3 year is a long time in medicine. this is the time period that lapsed since this 51-year-old lady last came to see the surgeon, who had then advised her to remove a lump in her breast. she came back this week for the surgery & this is her chest xray taken pre-operatively.

the multiple coin-shaped opacities seen in both lungs are typically called cannonball lesions. they are most likely a result of the spread from breast cancer. despite surgery to remove the affected breast, she will still need to go for either chemotherapy or radiation (depending on the nature of the cancer), & even then, things don't look promising. she may not see the end of the year.

if only she had agreed to the surgery 3 years earlier....

but, it not too late for most of us. besides maintaining a healthy lifestyle & going for regular medical check-ups, frequent breast self-examination (read here) can detect early abnormalities. further info on breast cancer awareness can be obtained here.

multiple salary scheme

years ago when i bumped into an ex-classmate, a teacher, he was dating another teacher. double salary scheme, he sheepishly told me. they eventually married & have 2 kids who are now in varsity.

tonite, as i passed the lady security guard at the entrance to the ICU, i asked her, "budak baru?", referring to a new recruit by her side. there's always a constant turnover in the security service as people search for better paying jobs. the new girl, in her 20s, turned out to be her daughter, who took this job on a part-time basis while on holiday break from her college. in the midst of our conversation, yet another new recruit joined us & she is another daughter, also on college vacation to earn some pocket money. in this instance, they work 12-hour shifts, 6 days a week & are paid RM700 a month.

double or triple salary schemes - these are decent jobs during difficult times. if only people are prepared to rough it out & make an honest day's work of their lives, we would be faced with fewer menaces in the form of snatch thieves, mat rempits & sms scams.

a caring heart

went to the nursing home to see how my father was getting on. he's been there for 2 weeks & seemed to have settled in nicely. the skin sutures have been removed & he moves around on a wheelchair now. the helpers normally feed him his meals, but when we are there, my mum would do that. however, we were pleasantly surprised by the boy's caring gesture....

before we left, i asked him to offer a prayer for kung-kung & he did that without hesitation. & as if to prove that wasn't a flash in the pan, he even volunteered this as well...

i have to say i'm totally overwhelmed by this display of concern & responsibility. & you know what? i couldn't have done better myself.

Children, obey your parents in the Lord, for this is right. "Honor your father and mother"—which is the first commandment with a promise— "that it may go well with you and that you may enjoy long life on the earth." ephesians 6:1-3

public holiday on friday

it felt like an optical illusion - today being friday & a labour day holiday.

woke up late, had tim sum breakfast with daughter, then went to hospital to see a patient in ICU. by the time i finished, it was already 4pm.

for some reason, it felt like a saturday. because i was looking forward to watching football tonite & preparing for Lord's supper tomorrow.

am i the only one who felt this way?

a step at a time

parents constantly warned their kids not to run, climb, fight, jump, etc. to avoid injury to themselves. most times, the kids disobey & most times, they get away with it.

except for this 9-yr-old boy, who ran up the staircase 3 steps at a time. a mis-step & a trip later....

.....resulted in this deformed forearm....
(note: the GP had impressively improvised a wooden splint, which immobilised the fracture & therefore, reduced pain)

.......while the xray confirmed 2 broken bones.


so remember, kids, God made parents for a reason! take care!

saving for the future?

since i was not busy this morning, i opted to try for some ASW2020 units at the local bank. a long queue had already formed even before the bank opened at 9.15am.

why would a doctor in private practice join a queue like this, you ask. hey, in these difficult times, every little bit counts! i even filled in the forms & wrote out the cheque last nite. maybe that's the reason, despite the long queue, i still managed to be 5th in line to purchase.

actually, this is my 1st foray into ASW2020. last week, i topped up some ASM units & was pleasantly surprised there was NO queue. thus, i was taken aback at the small crowd this morning. is there something i do not know about ASM & ASW2020?

i hope the kids appreciate what i'm doing for them!!

the best things

this sign is placed by the road leading to whiteman/caversham park in perth. as this message is often repeated elsewhere, there must be some truth in those words, although there is no indication what these "best things" are. however, i think this version by robert louis stevenson is more definitive...

The best things are nearest:
breath in your nostrils,
light in your eyes,
flowers at your feet,
duties at your hand,
the path of God just before you.

even so, are we prepared to take on that journey?

**thanks, Yan, for the message**

78

when i get to be 78, bogged down with a broken hip & dementia, i would not want to be a burden to my family & kids. so, if i get placed into a nursing home for rehabilitation, i guess i should not really complain. perhaps living with like-minded people, pun intended, may actually speed up recovery. kids, take note.

anyway, this is about my father. because he is bedridden & unable to take care for himself, i'm left with no choice but to get him into a nursing home, where he will be looked after for the next 2-3 months, by which time the fracture would have healed & he should be able to mobilise with a walking frame.

sorry, father, but it's the only viable option.

just 4 words this easter

break...


mend.....



immersion.....


salvation.....

an easter to remember!

things sometimes happen at a furious pace. like this weekend, for example.

1st, my father had a fall & broke his hip. the operation to fix the fracture today was successful, thanks to Dr L & his orthopaedic-trained team. because i had to stay with him, i couldn't drive my daughter to KL to do the mensa test. my wife took up the challenge to handle the task, even though she hasn't driven to KL by herself before.

they came back just in time to attend our church 10th anniversary & installation ceremony of the new pastor.

and, tomorrow, as if perfectly-timed with Christ's resurrection, my daughter will publicly declare her faith by baptism through immersion.


hmm..where did i read that all heaven rejoice when a soul is saved? like i said, it's an easter to remember....

killer bottle

it seems these days, you don't need firearms or sharp weapons to kill. apparently, a water bottle can do the job just as well.

yesterday, a 12 year old student was an innocent bystander who was hit with such a bottle accidentally thrown by his school mate. being made of plastic, it is normally light, but filled with water, a 1lit bottle actually weighs 1kg, & can impart considerable impact when forcefully thrown. the result was this life-threatening blood clot in the brain, as shown on this CT scan...

the surgery to remove it was successful but unexpectedly complicated at the end with the presence of fluid in the lungs (deja vu ala A Kugan??) causing the lungs
to look white on a chest xray.....


this was vigourously treated & his lung dramatically improved today....

now that all is well, i wonder if the parents would make a police report on this unfortunate incident, & whether this report would achieve anything, other than for insurance claims. as a concerned parent myself i realise there's no way my kids, or anyone else for that matter, can be guaranteed safe while they go about their daily activities. accidents can & do happen. i can only repeat the prayer of David :

Keep me, O LORD, from the hands of the wicked; protect me from men of violence who plan to trip my feet. psalms 140:4

second chance

this is a true event which happened on 1 April.

41-year-old Mdm T underwent excision of a lump in the breast. just as surgery was to commence, she was in tears because 2 of her family members had cancer & she feared she could also suffer the same fate. during the procedure, the suspicious-looking lump was promptly sent for frozen section, in which the nature (or histology, in medic speak) of the tissue, whether cancerous or not, can be immediately determined.

if cancerous, the surgeon will proceed with a mastectomy, ie. complete removal of that breast, to be followed up with chemotherapy & an uncertain future.

if not, then Mdm T can look forward to another 41 fruitful years.

when told of the result after surgery, she cried again, this time with tears of joy.

on a day, when there were jokers aplenty, playing out pranks & making nuisance of themselves, life has graciously dealt Mdm T with an ace instead.

G'day, mate!

you know you're Down Under when you see this....
it was more an impulsive move rather than a well-thought out plan. when MAS offered some cheap flights in Oct last year (oil was about $100 per barrel), we couldn't believe that return tickets for Perth went for about RM1300 each, all in. having talked about vacationing in Australia for years but not doing anything about it, this was like an offer from Don Corleone.(the tickets have come down to under RM1k since)

after an uneventful flight, we touched down to a sweltering 35 degreesC, & this was supposed to be autumn already. my secondary school classs-mate CL picked us up at the airport & sent us to our apartment in Joondalup...
....a modern suburb about 25km north of Perth. after settling in, we went for a drive along the coast....

to the reknowned Hillary's Harbour, just in time to catch the sunset ....


...& for our 1st meal - a sea-food platter dinner....

a short visit to King's Park at nite was our last stop on the 1st day.

.

this is the city at nite as seen from the park & zooming in on the bright structure on the right, & hey, what do you know - they have their own version of the ferris wheel by Swan River....


the next morning, CL took us to a Car Rental & we decided on a Mitsubishi Lancer for $33 a day.....

now that we've got wheels, Perth is there for the taking. drove to Cottlesoe Beach where a local exhibition was on show.


some of the sculptures include giant polo mints....
extra long pencils....

...and an oversized scrabble set...


next post : swan river & the city

Down Under

the boy has never been on vacation with the family for more than 5 days - that was to bangkok last year. so, you can understand his excitement that he's going Down Under...for a whole week!

so excited he already marked it on his diary way back in january....

Obituary

"Today we mourn the passing of a beloved old friend, Common Sense, who has been with us for many years. No one knows for sure how old he was, since his birth records were long ago lost in bureaucratic red tape. He will be
remembered as having cultivated such valuable lessons as:

Knowing when to come in or out of the rain;
Why the early bird gets the worm;
Life isn't always fair;
And maybe it was my fault

Common Sense lived by simple, sound financial policies (don't spend more than you can earn) and reliable strategies (adults, not children, are in charge).

His health began to deteriorate rapidly when well-intentioned but overbearing regulations were set in place. Reports of a 6-year-old boy charged with sexual harassment for kissing a classmate; teens suspended from school for using mouthwash after lunch; and a teacher fired for reprimanding an unruly student, only worsened his condition.

Common Sense lost ground when parents attacked teachers for doing the job that they themselves had failed to do in disciplining their unruly children.It declined even further when schools were required to get parental consent to administer sun lotion or an Elastoplast to a student; but could not inform parents when a student became pregnant and wanted to have an abortion.

Common Sense lost the will to live as the Ten Commandments became contraband; churches became businesses; and criminals received better treatment than their victims. Common Sense took a beating when you couldn't defend yourself from a burglar in your own home and the burglar could sue you for assault.

Common Sense finally gave up the will to live, after a woman failed to realize that a steaming cup of coffee was hot. She spilled a little in her lap, and was promptly awarded a huge settlement.

Common Sense was preceded in death by his parents, Truth and Trust; his wife, Discretion; his daughter, Responsibility; and his son, Reason. He is survived by his 4 stepbrothers; I Know My Rights, I Want It Now, Someone Else Is To Blame, and I'm A Victim.

Not many attended his funeral because so few realized he was gone. If you
still remember him, pass this on. If not, join the majority and do nothing."

**thanks, YO, for the email**

those were the days, my friend...

so, march 12 will be D-day for thousands of SPM candidates.

this is where the students are spoilt for choice - some have already started A-levels, while others wait for 6th form & matriculation places, & a small minority hope & pray a windfall called a scholarship.

i remember clearly the day i went to school with my friends to collect our results. nope, no top-scorers amongst & certainly none of that calling-parents-on-the-handphone rigmarole but hooray, we all passed! we had lepak-ed for over 3 months since the exam & we still had another 2 months before school re-started. yes, for us, life was simple - pass SPM (called MCE then), lepak some more & then join 6th form.

we ate ice-cream as we took a leisurely stroll through the istana gardens to town to catch a bus home...

on the way, we reminisced those care-free lower secondary days while ruminating over a concept still alien to us then - the co-ed classes of 6th form. hmm....girls!

& we laughed wickedly in anticipation.

evacuation drill?

Next time, if there is an evacuation drill in your office, think before you rush out...

In a large multinational company..............

A fire alarm rang at 4 PM in a large office when almost all employees were in office (approx 5000). As usual the entire office was evacuated within 3 mins & all employees gathered outside the office in the designated area waiting for further announcement.

The Security Officer in charge made the following announcement: "Dear employees - with sincere regret I have been asked to announce that for many of you it will be your last evacuation drill. Due to the recession the company is laying off almost 50% of its employees. So when this announcement finishes, I ask all of you to move back into the building and if your swipe card does not work then it means you have been laid
off, in which case you will not be allowed inside and all your belongings will be couriered to you by tomorrow.

The Company has used this innovative approach as we didn't want to fill up the email box with lay-off mails and good-bye mails in thousands & also to avoid any fight inside the office and the consequent security issue for all staff. Hope you have had a rewarding career with us and all the best ahead. Please move back in & try your luck".

**thanks, WW, for the email**

black sheep

a post-mortem examination is usually performed by a pathologist (also called coroner in UK or medical examiner in US) to determined the cause of death when it is not obvious, or in medico-legal or suspicious circumstances, eg. road traffic accidents or suicide.

or, like when someone dies in police custody.

we all know about the Kugan case & now that the 2nd pathologist's is available online, it should make us medics wonder how is it possible that the 1st report is so vastly different from the 2nd?

obviously, someone has gone against the oath. the hippocratic oath. the part that upheld one to abstain from whatever is deleterious and mischievous.

i know some of us overcharge, while others are less than meticulous in treatment, but to lie in a high-profile police case?

i've since removed this from my side-bar...

the head bone & the heart bone

lynnxuan's post got me thinking again about why i applied to do medicine in the 1st place.

this is that time of the year, after the SPM/STPM/matriculation exams, when career paths take shape. some students are focussed enough to know what they want to do, while for others, their ambitions are molded by well-meaning parents.

it really doesn't matter what the reasons are for doing medicine. it's noble to desire to want to heal & relieve suffering, yet it's not a crime to want to make lots of money.

many years ago, a dear friend gave me a cutting from a magazine, Newsweek i think, about a speech directed at a graduating medical class. the speaker was Alan Alda, most famously revered for his role as US army surgeon Hawkeye Pierce in the long-running TV series M*A*S*H. he highlighted several pertinent points:

You're entering a special place in our society. People will be awed by your expertise. You'll be placed in a position of privilege. You'll live well, people will defer to you. call you by your title - and it may be hard to remember that the word "doctor" is not actually your first name.Where does money come on your list? Will it be the sole standard against which you reckon your success? How much will it guide you in relating to your patients? Do patients in a clinic need less of your attention than private patients?

Where will your family come on your list? How many days and nights, weeks and months, will you separate yourself from them, buried in your work, before you realize that you've removed yourself from an important part of your life?

I congratulate you, and please let me thank you for taking on the enormous responsibility that you have — and for having the strength to have made it to this day. I don't know how you've managed to learn it all. But there is one more thing you can learn about the body that only a non-doctor would tell you — and I hope you'll always remember this:

The head bone is connected to the heart bone - and don't let them come apart.

here is the full text of a most inspiring message every prospective & new medical graduate should read, deliberate upon & keep in mind, as they embark on their brave journey.

bon voyage, doctors!

20 years

we've had our share of friendship blues, lovers tiffs & running battles as man & spouse.

be that as it may, 20 blissful years & 2 lovely kids later, i'm still married to the same person.

i think that's how God would want it.

He who finds a wife finds what is good
and receives favour from the LORD. prov 18:22

a good deal?

my insurance agent is like a friend. having known him for over 12 years, he still keeps me informed of what he thought to be good deals. like oil palm land for sale. or a property whose owner was deep in debts. the latest on offer is a BMW 325 sports - less than 2 years & only 7000km on the clock at a "giveaway" price of RM200k (RM305k when new). ha ha!

but like the land & property before this, the deal is dead right after he mentioned "BMW". in these difficult times, when terms like insolvency, slow-down & rescue package are everyday conversation pieces, i guess it's prudent to be frugal.

the pastor once expounded: why buy things you don't need with money you don't have, just to impress people you don't even like. yes, why indeed?

thanks, but my current car has gone over 7 years & 100k km with us & we're ok with this.

timeless

we've heard it all before.....

love is blind.....

love is patient.....

love is kind......

the greatest is love......

but here's another dimension of love....

thanks, Jems, for this insight.

the lovers, the dreamers & me

have you, like me, always thought that pot of gold at the end of the rainbow was a story you only told to kids? well, wonder no more, because someone actually photographed the end of a rainbow in california (read here) & there's certainly no glitter in sight.

i learned of the significance of rainbows at different times of my life....

when i was young, i was told never to point your finger at one, or it'll get chopped off (how, i don't know as i've never put that myth to the test)......

in primary school, i had to remember all 7 colours of the rainbow in its order....

in bible school, it was the sign that there will never be another Great Flood, the tsunami notwithstanding....

and then, Kermit the frog sang of the Rainbow Connection...

Whenever the rainbow appears in the clouds, I will see it and remember the everlasting covenant between God and all living creatures of every kind on the earth. Gen 9:16

abandon ship?

we've been pondering a move out of our current Care Group. having been with them for over 4 years & witnessing its steady growth, credit for this positive transformation, from just 3-4 families to the present 8-9, is due in no small part to the shepherding skills of B8. in fact, i paid him a glowing tribute when the CG leaders met with our new pastor just last sunday. i was the only one who did so.

still, i thought it was time to move on. i have to admit our spiritual needs are well met in this CG with 1 exception - my daughter's. the adults study the lessons while one of the wives taught the kids. however, there are currently no other teenager attending this group & i felt it's important she interacted with her peers in a bible study setting. 

this is just an intent for now, having sounded out to B8 as well as the leader of the CG we planned to move to. we shall pray & see how we can do the Lord's bidding.

(true) love @ 1st sight

despite these difficult times of global melt-down, recession, extreme weather changes & political upheavals, i find this message particularly soothing. so, to all mothers whose unrivalled love & devotion to their children is never in doubt, this one is for you....

appropriately, Mitch Albom wrote this in For One More Day:

"And I realised when you look at your mother, you are looking at the purest love you will ever know."

corporal punishment

my son grew up with his group of friends in church who were all born within months of each other in 2002. 3, including the boy, are in the same class in primary 1 while the 4th is enrolled at another school.

he is particularly close to this girl - he used to chat in class & spend recess time with her. i'd even go on to say they'd be inseparable if the teachers didn't intervene. just today, the teacher smacked her with a ruler & she cried her heart out, a response i suspect to be a result of not ever been punished by her parents. now, she doesn't want to go to school for fear of another beating.

so i asked the boy, what if he gets punished by the teacher. i'll try not to be naughty in class, he replied.

what if the girl gets transferred out to another school & he loses his best friend, i tested him. this is what he has to say: it's ok because i still have to go to school.

i'd say he's got things under control, but it's still early days yet.

The rod and reproof give wisdom,
But a child who gets his own way brings shame to his mother.

prov 29:15, NASB

**image : NST, 29.6.2000**