great white shark

i was amused with this letter posted on malaysiatoday where the writer lamented his & his friends' experiences in dealing with lawyers; so distressed was he & his friends that he resorted to equate lawyers' behaviour to that of a marine predator.

he wrote, "I would reckon lawyers are a desperate lot as they want to be seen living in luxurious houses, driving around in expensive cars and dining in expensive hotels. This has been a trend set by the senior lawyers and therefore any junior lawyer develops the same character devoid of any decency or conduct."

actually, you could replace "lawyers" in the above paragraph with doctors/accountants/politicians & that statement would still hold true. for example, it is well-known in local circles that a private hospital in ipoh has been derisively nicknamed Great White Shark.

it is no urban legend that some doctors would do anything, & i mean ANYTHING, to make that fast buck from their distraught patients. in fact, they are also not averse to making a quick buck at the expense of their colleagues, too. (hmm, why do i suddenly feel like the masked man in Breaking the Magicians Code??)

the writer concluded with this impassioned plea, "Please don't live your life by charging excessive and unconscionable fees from the already distressed clients whose only purpose of seeking your services is to secure some justice from courts."

it is a timely reminder for everyone in every profession who sometimes has their clients/customers at their mercy. it is not against the law to want to prosper, accumulate wealth & possess much. perhaps the fault lies with the instruments/ways we use to achieve that objective. perhaps, it's also timely to recall of the words of the prophet, directed appropriately to the Jews still in exile in Babylon:

"For I know the plans I have for you," declares the LORD, "plans to prosper you and not to harm you, plans to give you hope and a future. "
Jer 29:11

favour from the Lord

i'm on-call this weekend, & although i dread weekend calls, it's part of the job. left for the hospital at 9am today & had to skip church service (as well as holy communion).

at 10.30am, the boy phoned to say that he's just outside the OT & he's got a surprise for me...

how nice - lunch!



...& the main (& only course) happens to be freshly-baked shepherd's pie...


which didn't last very long....(burp!)

i don't often blog about my wife but today, she deserves praise...
He who finds a wife finds what is good and receives favour from the LORD. prov 18:22

even better is this....

Charm is deceptive, and beauty is fleeting;
but a woman who fears the LORD is to be praised. prov 31:30

who are the real killers?

DOCTORS:
(1) the number of physicians in the US is 700,000

(2) accidental deaths caused by physicians per year is 120,000

(3) accidental deaths per physician is 0.171

**statistics courtesy of US dept of health & human services**

GUNS-OWNERS:
(1) the number of gun owners in the US is 80,000,000
(yes, that's 80 million!!)

(2) the number of accidental gun deaths per year, all age groups, is 1,500

(3) the number of accidental deaths per gun owner is 0.000188

**statistics courtesy of FBI**

so, statistically, doctors are about 900 times more dangerous than gun owners!!

so REMEMBER : guns don't kill people, doctors do!

FACT : not everyone has a gun but almost everyone has at least one doctor....

ACTION : we must ban doctors before this gets completely out of hand!!!

however, out of concern for the public at large, i withheld statistics on LAWYERS for fear that the shock would cause people to panic & seek medical attention!!


**disclaimer** i received this email from a colleague but can't verify its authenicity**

check out more statistics on gun violence here and medical errors here.

you reap what you sow, except.....

Bernie Madoff has just been sentenced to 150 years in prison for his ponzi fraud.

former south korean president Roh Moo Hyun committed suicide last month on allegations (ie. not proven) of corruption.

japanese prime ministers Shinzo Abe & Yasuo Fukuda resigned in 2007 & 2008 respectively for poor performance.

& yet, we are still waiting for someone to take responsibility for bank negara's RM30b forex losses, & scandals involving Perwaja, MAS, PKFZ,....the list goes on....

it's so cliche...but malaysia boleh la!

kampung folks in the Big City

when we go to the Big City, we try out things that our "village" doesn't offer, like....

(1) teppanyaki...

which we enjoyed very much....


(2) ice-cream from new zealand & watching ice skating...

(3) super-sized bookstores &......


(4) new fast-food restaurants....


yes, we don't have all these back home but at the same time, we also don't miss paying toll, searching for parking, & getting caught in grid-lock traffic.

life goes on...

my father is back at the nursing home. the caring .....


& the clowning continues....

sports injury

my brother recently had surgery on his foot called repair of the archilles tendon, as a result of a badminton-induced injury. he had to put on a foot cast for 6 weeks after that.

my colleague is having severe backache (hopefully not a slipped disc), probably from playing too much badminton (at least 3 time s a week). he hasn't come to work for 3 days. my other colleague, a self-proclaimed worldly-wise sage, attributed these injuries to not warming up enough before competing on the court as well as age catching up. he could be right on both counts.
i myself have stopped playing badminton years ago (for fear of archilles tendon injury) as well as jogging (knee injury). so i just go for brisk walks & the occasional aerobics session at the park. i think there are just a few things in life you can't fight & win - like, income tax, bosses & Father Time. the sooner we realise that, the easier we accept our inadequacies.

speaking of Father Time, it seems my father's time is not up yet - he's just been discharged after 3 weeks in hospital & is now recuperating at the nursing home. thanks again for the prayers & words of encouragement.

farewell lunch

5 nurses recruited from India will be going home next month & it's customary to give them a lunch treat as a gesture of appreciation.

much like foreign maids, they come to fill a huge gap left by our locals who are seeking their fortunes elsewhere. but the similarities with the maids doesn't end there. most that come to malaysia couldn't make the cut in s'pore, hongkong or the middle east, so they generally fall short of the standard that i've come to expect from expatriates.

having worked in a foreign country myself, i can identify with them. they uproot themselves from their loved ones & go through all the hassle/inconveniences of living amidst people of different cultures, ideologies & whims. some adapt so well, they exend their 2-year contracts, while for others, the heat (not the weather) is too unbearable, so they cut short their stay & contract.

anyway, these 5 nurses had stayed on the full 2 years. it seems that having worked in malaysia is somewhat a status symbol in india & that can only enhance their worth to prospective employers & spouses!! to these 5, we hope you had enjoyed your stay here & that, unlike your indonesian sisters, we didn't treat you too badly. i'm sure you savoured our food but i bet you liked the your salaries even more. (heh heh)

bon voyage, ladies!

fatherly advice

my daughter made this card for me. simple as it may be, i appreciate it was created from the heart. in return, for some reason i now thought baffling, i gave her this piece of advice :

"when you grow up, don't marry someone like me, if possible.
instead, marry someone like your brother,
who loves God, loves people, & who will love you endlessly."

she just smiled & gave me a hug.

the decision

after discussing with my family & then with Dr L, we all agree that father will not have a quality of life we would all like him to have - he will be bedridden, unable to care for himself & for most times, not know what's going on around him. just a couple of steps short of being vegetative.

since, being the eldest, i was given charge to make all decisions regarding father, i sought counsel from the prophets & they spoke to me thus :

This is what the LORD Almighty says:
'Administer true justice;
show mercy and compassion to one another.'
zech 7:9

He has showed you, O man, what is good
And what does the LORD require of you?
To act justly and to love mercy
and to walk humbly with your God. micah 6:8

so i explained to the family that father will continue to have basic nursing care, including cleaning, feeding & his regular parkinson's medication. any other requirement will be assessed on its merits but there certainly will be no more invasive intervention, eg. resuscitation, ventilatory support.

as expected, they all agreed.

so, this is our decision : to act justly & to love mercy.

may God see us through.....

playing God

doctors are often accused of deciding which patients should have proper treatment for their medical problems while others are denied it, because of the lack of staff (usually doctors & nurses), hospital beds or medical equipment, esp if this decision was made without discussing the issues with the patient or the family.

this is often a dilemma in the ICU where adequate staffing is a perennial problem which subsequently affect the number of available beds.

today i played God but not based on the above reasons. my father has been on the ionotrope (heart-pumping medication, remember?) dopamine for 11 days & his blood pressure has been hovering around 110/60, which is lowish for him. after discussing with the attending physician Dr L, he concurred that my father should start having the dopamine gradually reduced & eventually stopped, irrespective of how the BP would react.

that was 5 hours ago & his BP has gone down to about 90/50. my sister arrived from KL this afternoon & my brother will be here tomorrow. maybe he's just waiting for my brother to turn up. after all, the last time we all got together was chinese new year 2008.

nevertheless, we all agreed he has suffered enough - 8 years with delibitating parkinson's disease, a broken hip & a serious chest infection.

yeah, the old man is running the home stretch. may he find Home soon....

education

as the debate on the use/importance of English in schools continues with no end in sight, many parents aren't taking any chances. hundreds thronged the Sunway Convention Centre last saturday waiting to pick up their kids while the latter sat for the Asean Scholarship selection test. it invites students to apply for entry into their Sec 1 & 3, & pre-U programs.

my daughter has an older school friend who applied last year & successfully entered Sec 3 this year. so she took it upon herself to follow the friend's footsteps - she applied online & prepared the required documents. my only role in the whole process was to send her to the post office to post the documents & fetched her back from the test centre. (she got a lift to Sunway from this same friend whose brother is applying for Sec 1). wife & i didn't give her our "overwhelming support", in the sense that, we weren't totally convinced she was ready to live out on her own in a foreign land. well, maybe for the pre-U....

it's obvious this isn't a 2-bit scholarship test that we are all too familiar with. it's a whole day session which tests on English (includes writing an impromptu essay), Maths & General Ability. if the student get past this, then there's still the final interview to contend with.

from the parents' perpective, the final objective is presumably to do pre-U & then at least gain entry into the Univ of Singapore (ranked #30 in the world in 2008, & for comparison, outranked ALL aussie varsities except Australian National Univ at #16, & Univ of Malaya is #230, read here)

the issue of patriotism doesn't arise at all here. this is our kids & the govt has messed about the education system far too often & for too long (& let's not get started on the quota system) NOT to give them an alternative.

seriously, is there a parent who is satisfied with the way public schools are currently managed & who wouldn't provide the kids the opportunity to do better?

not me. (or, is it not I?)


(test over)

thanks.

thanks to all who have sent messages of encouragement & interceded in prayer on behalf of my father. he is still in ICU & recovery has been slow. he does not need any respiratory assistance now but is still dependent on inotropic (literally, heart pumping) support.

every cloud has a silver lining, they say. of the many things i learned from this difficult period, the one that stood out is my son's care & concern for his grandpa. he wants to visit everyday & has lots of questions to ask at the bedside. at the end of each visit, he will offer a prayer for him, & for the other patients, doctors & nurses.

i ask for nothing more.

Like arrows in the hands of a warrior
are sons born in one's youth.
Blessed is the man
whose quiver is full of them. psalm 127:4,5

a setback

just when we thought my father's recovery from hip surgery was going smoothly, within a week our optimism grounded to a screeching halt.

1st, the hip screw which had held the hip fracture in place.....

loosened quite a bit....


he could have tried to stand up & put pressure on the hip before it recovered fully. because of this, it's back to square 1 & another 6 weeks of non-weight bearing, ie. not allowed to stand on the affected leg.

the carers at the nursing home then resorted to feeding him in bed for fear of aggravating the hip. last week, he apparently choked on his food. although he recovered, some food may have lodged in his right lung resulting in an infection....
(Friday)

(Sunday)

so currently he is in ICU on multiple medication & respiratory support. it's a strange feeling. after treating so many patients in ICU, i'm dealing now with someone i've known all my life. will it be easier? will my clinical decisions be biased because of this relationship? & will i make a decision which i wouldn't normally do for someone else?

i may have taken the easy way out. i asked my colleague, whose clinical acumen i have the highest respect for, to manage the treatment & reassured him i will not interfere with his decisions.

my brother in Christ, JL, sent me this verse when he heard the news:

Do not be anxious about anything, but in everything, by prayer and petition, with thanksgiving, present your requests to God. And the peace of God, which transcends all understanding, will guard your hearts and your minds in Christ Jesus. phil 4:6,7

amen.

spelling bee

just heard from the news that a 13-yr-old indian-american has won this year's US spelling bee competition. (read here)

the winning word? Laodicean.

which according to websters dictionary, refers to one indifferent to religion, caring little or nothing about the matter, like the Christians of that church, mentioned in the Book of Revelation.

To the angel of the church in Laodicea write:
These are the words of the Amen, the faithful and true witness, the ruler of God's creation. I know your deeds, that you are neither cold nor hot. I wish you were either one or the other! So, because you are lukewarm—neither hot nor cold—I am about to spit you out of my mouth. (rev 3: 14 -16)

which, please reprimand me if i'm wrong, also aptly describes the general state of christian believers these days. myself included.

a spoonful of birthday cake

we celebrated the boy's birthday during our CG recently. amidst playing with his friends...


anticipation of the cake....


a Ben 10 one at that....


& posing with his friends.......


i think this spoonful meant the most.....


happy birthday, boy!

tourism India-style

this promotion says it all.....

Spell It Right

my daughter's school participated at the state-level competition today & i lent support by being there. this was sponsored by RHB bank & New Straits Times as part of their corporate social responsibility. RHB provided the financial backing, to the tune of RM 2m for the whole competition i was told, while NST organised the event & provided personnel & logistic support.

personally, i did not think that the overall standard of english the students exhibited was good - it was mediocre at best. even the quiz master wavered in the pronunciation of certain words!

as each student was given a different word to spell, a fairer assessment of the students' ability would be to give the same word to each group & allow them to write it down instead. after all, i did overhear some mothers mention,"how come my daughter got the difficult words one?"

anyway, all was not in vain as i learned a few words myself, eg. menhir, elegy & gossamer, none of which, by the way, was spelt correctly.

& as a delayed birthday treat, my daughter had an over-rated, over-priced cup of....

why cigarettes are bad.

mr H, a 61-year-old ex-rubber tapper used to work from sunrise till late afternoon tapping, collecting & selling latex in his smallholding business. he looked after his family well, so well that he has 2 - wives & respective families, that is. although no stranger to hard labour, his only vice seemed to be smoking 2 packs a day of them bad boys for the last 40 years. well, this has come back to haunt him. it's called chronic obstructive airway disease, or COAD for short.

13 years ago, he was admitted to hospital for breathing difficulty & the chest xray revealed...

...an infection in the right lung. the infective process compounded by damage due to years of smoking resulted in mr H suffering from recurrent chest ailments. each time he recovered with a course of antibiotics, bronchodilators & steroids but this recent attack 3 weeks back must have been the last straw.

although the chest xray actually looked better than previous ones, he didn't improve with the usual medications, & needed to be put on a ventilator...

- he was persistently out of breath, as if he had just completed long-distance running.

efforts to take him off the ventilator proved futile, so the next step was to create a little hole in his windpipe (tracheostomy)...

which helps him breathe easier & facilitate nursing care as well. with this, he took a whole week to improve & even then, it was with a little help from this BIPAP device...

...a compact piece of equipment that bridges the recovery process between total dependence on a ventilator & being able to breath without aid.

today, he's breathing on his own with the tracheostomy tube still in place. he will be transferred to a hospital-based nursing home where the tube will eventually be removed.

3 weeks in ICU with a barrage of tests, procedures & medication, i hope the bill doesn't trigger another attack....

a conspiracy theory?

we shared about the H1N1 flu at prayer meeting tonite. my worldly-wise colleague B8 proposed his conspiracy theory - that although there is a real epidemic going on, it's been played up beyond its true severity by......get this....the manufacturers of N95 masks & pharmaceutical companies that produce tamiflu & flu vaccines.

it's possible, isn't it? remember when SARS raged in 2003 & how bottles of vitamin C & N95 masks were rapidly bought off the shelves in pharmacies?

it may or may not be true but have a look at the stock price of 3M, one of the manufacturers of N95 masks....

**source**

..which is showing an uptrend starting May (& also note the rise in 2003 at the peak of SARS). the stock of Roche, the producer of tamiflu, however, behaves differently....


**source**

err...it's still at a 5-year low!! ok, never mind, but good try, B8!!

anyway, before you rush off to buy those N95 masks...

..costing RM100 per box of 20, check out this myth-busting report.

remember guys, back to basics & take care!

they're here....!!

now that the 1st cases of H1N1 flu has been reported, it's only a matter of time before more cases flood in. the ministry of health has already sent out circulars to advise the private hospitals how suspected cases are to be handled.

we started out with closing all entry/exit points except 2 - the main entrance & the emergency department, where staff were stationed to screen visitors & patients &......

several temporary counters were set up to advise those with doubts or queries.

personally, i feel that this is just a token effort. short of measuring everyone's temperature, like how they do it at airports, which itself is a logistic nightmare, a lot of people with a slight temperature are going to get pass. besides, those in the early stages of the flu may not have a fever but may be infectious.

so what should we do?

totally avoiding unknown infected persons is impossible, unless you lock yourself in till the storm blows over. i would stay away from enclosed spaces as much as possible, like elevators, cinemas & airplanes, but having to go to hospital at least 6 days a week would negate all that.

the jury on the effectiveness of immunisation with the H1N1 flu vaccine is still out as rapid mutation of the virus may make that particular vaccine useless. virus resistance to medication like tamiflu has rendered this treatment option doubtful at best.

so where does this leave us then?

i guess it's back to basics then, & that is to maintain a healthy lifestyle - eat balanced meals, drink plenty of fluids, exercise regularly & have enough rest.

and pray for divine intervention.

This I declare about the Lord:
He alone is my refuge, my place of safety;
he is my God, and I trust him.
For he will rescue you from every trap
and protect you from deadly disease.
psalms 91:2,3

angels & demons

bought the book last year at a warehouse sale & it's been collecting dust on the shelf since. now that the movie has just been released, in Rome no less, i literally spent the last few days glued to the book.

it has a mind-blowing plot with a vile twist, & i'm surprised there wasn't more opposition to the book/movie from the catholic church.

even after reading the book, i think i'll need to see the movie TWICE to fully grasp the essence of plot.

like i said, mind-blowing!

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?