migration to new zealand

when we vacationed in NZ last year, the whole family thought aloud in the same wavelength - fresh air, fresh milk, fresh lamb & lots of space. if you disregard the occasional tremor, it is a very liveable place. truth be told, we did toy around with the idea of migration.

but looks like 10 malaysians beat us to it....(read here)

apparently, in NZ, when you are caught for a drug-related offence, you are not executed like in some unciviilsed countries (see, another reason to move to a country where you actually live longer!) but granted permanent residence with free food & a place to stay, albeit behind bars. hmmm....think of the lamb shanks, fresh strawberries & local wine you'd be served!

actually, these drug mules give other bona fide travellers a bad name. don't be surprised if the immigration & custom officers give you a dirty look when you next visit.

ditto heathrow airport.

in the mean time, our NZ dreams remain just that.

dreams.

playing God......with a twist.

i posted earlier about how doctors are sometimes accused of playing God (read here).  here's one with a twist......


72-year-old Mr O was admitted a few days ago with chronic obstructive airway disease & acute renal failure. after he had gone for a CT scan & then connected to a ventilator to assist breathing in the ICU, his daughter then dropped a bomb - she wanted to take her father home.

WHAT?? we were stumped!

if a patient is incapacitated, we often respect the wishes of the family as to how they want treatment to proceed, within reason, of course. so while Mr O will benefit from a few rounds of haemodialysis & a few days on ventilator to tide him over this difficult period, there is still no certainty that he will be back to normal after that. he could remain in critical condition, or even get worse. perhaps it's the lack of a guaranteed outcome that the family chose to defer further treatment. both my colleague & i don't know for sure why the family took this course of action.

however, having to make many difficult decisions each day, it does lighten our burden just a bit when the patient or the family make their own decision & boldly adhere to it.

it's out of our hands now.

man with one kidney

i've had many patients who've undergone a nephrectomy (surgical removal of a diseased kidney), so it's not a big deal to meet yet another. but Mr K is special. and very unique in these modern times.

he has the courage to undergo the removal of a NORMAL kidney to donate to his younger brother who had 2 damaged kidneys from poorly-controlled diabetes & hypertension. the brother had previously required haemodialysis but since the transplant 15 years ago, has been leading a largely normal life, thanks to Mr K.

his family may have said he did it out of love.

youths of today may call this act "cool" or "awesome." (i often wonder if their vocabulary of adjectives is limited to just these words!)

i can only think of  one word. selfless.

we ourselves don't know if we are able to commit to this sort of sacrifice but we can always start small. like making regular blood donations. or, register with the Malaysian Society of Transplantation to pledge our organs. (download form here: http://www.mst.org.my/donorform.htm)

and, it's so appropriate that i met Mr K this easter week, his unselfish act reflected in Christ's ultimate sacrifice - His crucifixtion & resurrection.
this is what the apostle John wrote about love:

This is how we know what love is: Jesus Christ laid down his life for us. And we ought to lay down our lives for our brothers and sisters .1 John 3:16


Blessed easter！

poker-faced doctors？

is medicine like playing poker?

well, yes & no.

it's NOT like poker because you don't gamble with your patients' lives.

and yet, everyday you face problems that require both your own rational judgment & dependence on  a bit of luck  divine interevention. like sometimes, you have to decide if the problem is too big to handle & that the patient is better managed at another institution. in poker-speak, would you raise the stakes & take a chance that you have a better hand, or fold up & cut your losses?

proceed to treatment or refer to another hospital?

in my honest opinion, i think doctors make bad poker players.

internet banking?

internet banking is supposed to effect transactions in the blink of an eye, right?


when i tried out CIMB clicks, my account is debited & the money got transferred out as soon as i hit the enter button.


not so with RHB. i tried to pay my credit card bill today the same way. but after 12 hours, nothing has happened. i checked my savings account & no funds has been debited. so i called up the credit card centre to enquire if the bill has been paid. the lady said it'll take THREE DAYS to update the account!! to be fair to her, she did apologise although i doubt if she was responsible for this.

maybe that's why CIMB is the 2nd largest bank (by capitalisation, which probably also means 2nd richest) & RHB is not. but i'm only with RHB because their travelmoney credit card gives the best cash rebates (between 2 - 10%) for fuel.

something new, something old

penang has certainly moved on since i was last there 2 years ago....

nothing costs rm2.30 anymore at the islands glades food stalls. char kuay teow is now 2.80 WITHOUT eggs. a chicken egg costs an extra 50sen & a duck egg, rm1. no wonder people resort to manufacturing fake eggs!

in reflecting inflation on a larger scale, the straits quay development on reclaimed land near tanjung bungah, has terrace houses starting at rm1.2M!!

penangites will go far for good food. a thai food restaurant that has been in operation for 3 years is Bukit Genting Thai (on my GPS) near balik pulau. it's located on top a hill 290m above sea-level & you can get both a good view of the coastline as well as authentic Thai food at reasonable prices.we just had a snack & after that, my sisters-in-law were adamant they must have the famous balik pulau laksa another 10mins drive away. while in penang, be prepared to learn about the many famous food stalls - penang road chendol, craven A nasi kandar, air hitam assam laksa, etc. penang is not called a food haven for no reason!

however, some things don't change. i was at youth park this morning at 9.30am, hoping to have some quiet time for exercise. to my utter surprise, the car park was almost full & people are everywhere - families with young children, retirees, everyone - at a time i had expected people to be still having a late breakfast on a weekend or queueing up at the shopping mall.

but maybe i shouldn't be surprised. the youth park has been well maintained by the local council & it's a refreshing piece of green-lung right smack in the city, & it's always crowded in the evenings. looks like people throng the place on weekend mornings as well. as i walked up the hill, i noticed i'm panting more than i used to. i could previously walked up the 1st rest place without stopping but this time, i had to stop TWICE to catch my breath. truth be known, i haven't been exercising regularly of late.

all the more i should focus on after this weekend savoring the the food haven.

penang

penang is like an adoptive home for me.

i worked there for 4 years & i married a penangite. so when i am there, i feel quite at home. i still know my way around & where i can get great food. i also like the simple life there, except that the traffic drive me nuts sometimes.

and oh, the beach holds many a fond memory for me, too....heh heh!

yeah, i'm looking forward to going home this weekend. if only i had bought that house years ago when it didn't cost so much.....

taxes & death

who was it who said that the only things certain in life are taxes & death?

anyway, it's a load off my back now that i've submitted the receipts & statements as i fulfill my responsibility as a tax-paying citizen. but the issue that leaves a bitter after-taste is the way the guardians of our country's wealth seems to squander away needlessly on dubious projects & schemes.

it was announced yesterday that malaysian experts working overseas who return home to serve will be subject to a special flat tax rate of 15% (compared to a maximum of 26% we non-experts have to pay), except that it's only for 5 years. i doubt if our experts overseas are jumping for joy at this offer. only FIVE years & what happens after that? they will still have to put up with all the rubbish we all face on a daily basis.

nah, this is only a stop-gap measure & both the govt & experts know that. we all look for long-term solutions to our brain drain & other pressing matters, eg. education, healthcare, etc.

this requires strong political will to achieve & everyone knows this is still sadly lacking in the current batch of leaders.

looking for a good deal in sinking ship

like the proverbial rats scrambling out of a sinking ship, this scenario seems to be replayed in christchurch in the aftermath of the recent earthquake. varsity students are transferring out (read here) to australia & elsewhere. my friend in auckland who came back for a vacation said the property prices there has escalated steeply as the south islanders relocate to seemingly safer grounds in the north.


i'm not sure if it's foolish to invest in real estate in & around christchurch now, but i'm sure there are risk-takers out there who can smell a profitable deal from miles away. my point is that, while people are avoiding it like a plague, i would actually vacation in christchurch & the south island if there's a good flight deal now. i mean, look at it - the NZD is at a reasonable 2.35 exchange & i think there won't be as many tourists as in the previous years. except that, i can't find a flight cheap enough to convince me to take that small risk of a repeat tremor.


air asia is currently offering about rm1500 per pax in late november, & that's excluding baggage, insurance & meals.

nah....i think i'll wait....

but i'm definitely not planning for japan, not even with free flight tickets!

Lactobacillus acidophilus : a cautionary tale

that's the name of the good bacteria that's supposed to promote healthy bowels & is one of the "probiotics", a group of organisms used for medicinal purposes. this is commonly found in cultured drinks that's advertised extensively & is widely available in most supermarkets.

and kids just love them. i myself find it's just too sweet for good health but i digress.

today, we had a 4-year-old girl in hospital just from drinking that. no, the bacteria didn't cause her harm but the straw did. did you notice that the straws that come with these bottles of cultured milk are much stiffer, in order that they may pierce thru the foil-top? this poor girl was enjoying her drink when she tripped & fell, causing the straw (the blunt end) to pierce thru the inside of her mouth.

the puncture wound had to be surgically stitched up. & it will be the most expensive bottle of lactobacillus cultured drink anyone ever bought!

so, parents, warn your kids NEVER run, hop or skip, even with plastic utensils in their mouths!

here we go again.....

so, there're over 9000 top scorers with straight 10As for the 2010 SPM exam....(don't know about it? don't worry, the self-aggrandisation report will be splashed all over the media tomorrow)

so, that's many, many more than the 7000 plus top scorers the year before....

so, there'll be rush for scholarships....(& many students & their parents will be disappointed.)

so, i wonder how many will remain unemployed (or unemployable) after graduating?

same old, same old...

cheating time

for moment, i thought we were in different time zones.

when the patient was pushed out of OT, it was 4pm. i then went off to do some errands & when i checked on the patient again in the recovery bay later, i noted the nurse had timed the arrival at 4.15pm.

WHAT?

i asked her, how come it took 15 mins to move the patient a distance of only 10m. that's TEN METRES between the OT & recovery bay.

we looked at each other for a few tensed seconds before she broke silence : the clocks in the OT & recovery bay were set at different times. i checked & they were the same time.

after a few more uneasy seconds, she finally confessed, that the senior nurse had told to her to add 15mins. i've always known that something fishy invariably happens at 4pm. that's the starting time for claiming overtime. it happens all the time under our noses.

except that this time, i caught the sacrificial lamb culprit red-handed.

but don't we all cheat time ourselves? we cut queues to save time, we cut lanes & drive on the hard shoulder to reach our destinations earlier. we fix our appointments, then arrive late & make everyone else wait. how about we scratch out a later time when we put up our parking coupons?

in my mind now, the philosophical words of one of my ex-classmates* in secondary school ring true :

we are humans. we are basically dishonest!

*while i was still reading hardy boys & nancy drew, he was already on to john steinbeck.

bad

bad mouth + bad heart + bad attitude = doctor from hell.

is there one in your neighbourhood clinic or hospital?

new nurses, old habits

i prescribed syrup panadol to a child recovering from surgery, using the accepted acronym QID, or "quater in die", which in Latin means 4 times a day.

the 1st dose was given at 8pm, soon after returning to the ward from OT.

the next morning, i checked on the child & was surprised that the 2nd dose was given at 2am. reading thru the nite shift notes, it mentioned that the child was not in pain, was not having a fever & was sleeping at that time.

so i questioned the morning shift nurse as to why the child was woken up at 2am to be served the panadol. she replied, defending her nite shift colleague, that i had written the QID dosing, implying 4 times a day or at 6-hourly intervals.

so i questioned again, whether there was a difference between a prescription written "QID" compared to one written "6-hourly." this nurse, with her colleagues now overhearing our conversation, almost replied in unison :

NO!

i asked again : you mean, there's no difference between QID and 6-hourly dosing? and the response again, almost in one voice :

NO!

that's when i got a little hot under the collar.


ok, so i created this scenario: they went to clinic for backache at 8pm & the doctor prescribed a painkiller with a QID dosing. if they took the 1st dose at 8pm, would they wake up at 2am to take the 2nd dose IF they didn't have pain at that time? 

instead of the concerted response i had come to expect, now they gave me a blank stare. & to drive the message home, i cynically asked : if they won't wake up at nite to take their medicine, why would they want to subject a sick child recovering from surgery, who was pain-free, not having a fever & sleeping peacefully, to a rude awakening at 2am?

all i ask is a little brain common sense. life-saving medicine like powerful antibiotics are often prescribed strictly round the clock at clearly stated  intervals, eg. 6-hourly, & often given intravenously without awaking the patient from sleep. other less critical ones are prescribed to be taken during the day, eg. QID, in which case, they may be served at 8am, 12 noon, 4pm & finally 8pm.

2 things are clear now:

1) with the mushrooming of nursing colleges, don't expect the standard of teaching to improve;

2) i won't be very popular in the children's ward from now on.

playing God

because doctors often deal with life-and-death decisions, we have sometimes been unceremoniously accused of playing God, as if dictating who should live & who should not. i occasionally have to encounter these circumstances myself but i'd like to think that i always have the patient & the family's interest at heart, although it may not be taken in positive light.

but i leave playing God to ..... God.

last nite, we had this particular difficult case in surgery. the patient had a huge pancreatic cyst which required removal together with a portion of the pancreas. pancreatic surgery is fraught with landmines as it is, so after 4 labourious hours, it was finally excised.

& right there & then, a small vessel started bleeding profusely. this was immediately dealt with, but not after 250ml of blood had been lost within minutes. (note: the excision of the cyst had resulted in a litre blood loss earlier)

this was when one of the doctors exclaimed : thank God,  it bled now & not later!

if the bleeding had occured later when the patient was in the ward, the outcome would have been catastrophic. the rapid blood loss would have cause immediate deterioration in the patient's condition & there might not be time to re-explore the abdomen in OT. most likely, it'll be a one-way trip to the morgue.

seriously, when we doctors have our heads firmly screwed unto the shoulders, we realise we are just pawns on the medical chessboard. God alone decides which piece will be moved.

i just pray there aren't too many checkmates on my watch.

what i like about funerals

i attended a wake back in the hometown over the weekend. it was the passing of a church member. far from being a sombre occasion, everyone seemed to be in good spirits, including the family of the deceased.

met up with quite a few people from the days i 1st attended church & it felt like a reunion of sorts - the ex-student pastor who is now in management within the church body, the ex-door-to-door book salesman who is now a medical rep & the youths of yore who now have families of their own.

that's what i like about funerals & i don't mean any disrespect to the deceased nor the grieving family. i often catch up with a whole bunch of people that i will not be able to under other circumstances. in a way, i relish reliving my past life .

do you still remember your 1st love? of course, this doesn't apply if you married that person but many do not go through life that way. i didn't.

the wake happened to be for the beloved mother of my 1st love. as the projector flashed the life & times of the late mrs K, & as each family member paid tribute to the matriarch, i too recalled those care-free days of my youth & the start of my christian life in which she left a big impression. as it turned out, she remains a wonderful mother, grandmother AND mother-in-law in a world where two out of three is the norm.

it was indeed a remarkable trip down memory lane. almost like the green, green grass of home.

a root of many kinds of evil?

the hospital organised an in-house badminton competition. a few of my colleagues who were taking part asked me to join as well - just for fun, they said.

i was reluctant for 2 main reasons. 1st, my joints creaked when they are stretched. and 2nd, nobody plays just for fun when cash prizes are involved.
besides, i was on-call that weekend. 

the day after the tournament ended, i found out that a few people had cried foul over the draw. well, actually it was over the re-draw. many questioned why the re-draw was necessary & why it wasn't done publicly. as it turned out, the re-draw had largely favoured a particular participant with a bye. the one who was given the bye in the original draw even withdrew from the competition in protest because of this lack of transparency.

in the end, justice was served & the favoured participant didn't win. i've always felt that when money is involved, all gloves would come off. nothing would be just for fun anymore.

the person organising this competition is a colleague, so i took a dig at him - told him the MACC are looking for him & i advised him to request for an interrogation room without windows or one on the ground floor.

we both then burst out laughing.

am i overdoing it?

the boy & i felt like having burgers for lunch but not the full meal, because we had a late breakfast. so i decided i'll order a mcvalue meal and another burger alacarte.

he wanted a big mac & i, a spicy chicken mcdeluxe.

that's when i noticed the difference.

a mcvalue meal with either burger costs rm7.95 each, while for alacarte, a big mac costs rm6.70 & spicy chicken mcdeluxe, rm7.55.

if i ordered a big mac mcvalue meal & a spicy chicken mcdeluxe, it would cost rm7.95 + rm7.55 = rm15.50 plus tax. if i ordered a spicy chicken mcdeluxe mcvalue meal & a big mac, it would cost rm7.95 + rm6.70 = rm14.65 plus tax, or about 85sen cheaper for the same items.

so, if you had to order a combination meal like i did, would you be also doing mental calculations to save a bit?

or, am i just overdoing it?

btw, our local mcD allows free refill of soft drinks; however, i don't know if this unwritten & unspoken offer applies nationwide. if your skin is thick enough, try asking. nothing ventured, nothing gained. heh heh!

a boy will always be a boy

it's almost 2 weeks since he broke his forearm. the other day, we went to the park for a walk but when we reached the children's playground, he let his juvenile instincts loose....

in the last picture, he got his just reward for agreeing to walk with me - keropok lekur to take-away. i shan't upload pictures of him kicking the ball at home, on tiled floor, lest you think i'm a bad parent.  :P

looking & smelling nice

this chatty 50+ lady came for surgery the other day. even though she was in OT attire, i could see that she has groomed herself in preparation for the procedure. she had put on lipstick & face powder, her hair combed & tied neatly AND i could detect a definite whiff of perfume.

the surgery was went well & when i saw her in her room the next day, i asked her why she had put on the make-up & perfume. she replied that in case something went wrong & she didn't wake up from the surgery, at least she would look & smell nice to the end.

with her undeniably good looks, can you blame her?

fruits & nuts

i like fruits & nuts in chocolates, morning cereals, breakfast bars & salads.

so when i saw this fruit-and-nut flavoured potato chips in the local store, i was immediately attracted, esp since it came with a buy-1-free-1 offer.

however, i must admit this fruit-&-nut flavour is one of an acquired taste, esp after years of getting used to the traditional barbeque, sour cream & tomato types. the rest of the family also didn't quite like the taste. maybe that's why it was on offer - because there were few takers. i can imagine it will go the way of vanilla-flavoured coke or lemon-flavoured pepsi, both of which were widely promoted many years ago but never quite took off in sales.

perhaps, some things should be left well alone but then, nothing ventured nothing gained, right?

in the meantime, i'm stuck with 2 cannisters of stuff that tastes neither like traditional chips nor breakfast cereals. we have a house rule - anyone who buys food that the rest of the family doesn't like, will have to finish it off himself/herself.

anyone game for blueberry & hazelnuts?

deep sh*t

two 2nd-year students from a local private medical university spent some time in the OT this week. since their intention was to learn, i usually ask some general questions relating to the cases that were scheduled in OT. the questions mostly center on basic sciences like anatomy & physiology.


what i find most disturbing about these 2 fully-sponsored students, was that i couldn't get beyond one or two questions before they stumbled or were stumped.


they don't know what factors determine normal blood pressure.


or, the group of drugs used to treat hypertension.


and they don't know the blood supply to the liver.


in an oral examination, these are standard questions that start off the session. if students can't answer these, there's not much else to go on because these are important topics that all medical students & thereafter, housemen & medical officers are expected to know. if they don't know these, it just reveals a big gap in their knowledge of the basic sciences. mind you, these are topics taught in the 1st year & yet these 2nd-year students can't recall any of these. it's obvious they wasted their time here because they didn't learn anything new.


what happens, if by some stroke of "good fortune", they pass their final exams ∓ are let loose to become house officers & then medical officers? they could be treating us.

and we could be in deep sh*t.

P.S. i recently ranted about the housemen glut here.

football injury

the boy injured himself playing football. when i examined him, it was obvious his right wrist was not the normal shape. our worst fears were confirmed when xrays showed that he had fractured 2 bones. he braved thru the pain & only cried after he found out he had to go for surgery. i thought that was rather valiant.

the advantage of working in a hospital is that you get things sorted out in double-quick time. it took just an hour from A&E to xray to OT. the procedure involved inserting 2 wires to stabilise the fractures, followed by an arm cast, which he has to keep on for a month.

he can still go to school, but he can't have music lessons till the cast is removed in a month & no more football or other contact sports for a further 2 months. his friends provide much moral support by visiting him in hospital & at home, bringing gifts to soften the blow (pun definitely intended!)....

of course, in line with tradition, they get to autograph his cast...

 

and by God's grace, he is a left-hander.

the (secret) personal touch

you know how it is when you've tasted something nice, then ask the person who prepared the food how it's done - you'll be told the ingredients & the method of preparation, & when you do it yourself, it doesn't taste quite so heavenly?


presumably, there may be a important ingredient or crucial technique which was never revealed in the 1st place? after all, not many people are willing to share their prized dish with others, or else, it won't enjoyed its uniqueness.


so when i read that the secret ingredients of coca-cola has finally been revealed (read here), i sniggered to myself because i doubt the authenicity of the secret. besides, the technique of preparation wasn't revealed, so it may be many, many more years before anyone else can come up with an identical brew. i mean, have you tasted tesco's cola??


similarly, whatever spices people think they can guessed from the colonel's recipe, no one can quite fry chicken like KFC. if we could, KFC would have closed down long ago.

it all boils down to the personal touch.

a tale of 2 teenagers

i read with sadness that a 17-year-old student took her life by falling off the 2nd floor of her school building (read here), apparently from a failed relationship. i suppose it could also be a myriad of other possibilities - poor exam results, unable to cope with school, pressure from parents, or just depression - all compelling reasons that can drive teeagers to despair.

but i don't think i will be able to understand why another teenager would want to put on school uniforms, strap himself with explosives, be a suicide bomber & killing 31 in the aftermath (read here) . what can possibly drive someone so young to murder? where did he accumulate so much hatred, or was he just brainwashed to carry out this task by his  military masters?

seriously, i look back & i miss those school-days when we enjoyed going to school (for the camaraderie, not the studies!), attending club activities, playing football & watching movies on weekends & generally making a nuisance of ourselves.

that was an age of innocence that seemed so distant now.

no more needle-phobia?

it seems that the doctors have got it wrong all along!

everytime i take blood samples or give injections, i invariably tell patients to look away & think of something pleasant. a recent study (read here and here) has shown that patients actually feel LESS pain if they look at their own hand or arm, but NOT at the needle.

this just goes to show that although medical science has advanced by leaps & bounds, we still do not have a complete knowledge of pain or its treatment.

so, what will you do when you are next faced with this situation? still look away?

i think i would!

advertising

doctors in malaysia are prohibited from advertising their services in the mass media, in compliance with the Medicines (Advertisement & Sale) Act, 1956. however, private hospitals have some leeway, in that they may place entries in the Yellow Pages, informing the public their location & of services available but not publishing names of their doctors. presumably this is to maintain some degree of  professionalism & prevent doctors from soliciting.

so, i was rather surprised to see these two adverts placed side-by-side in the papers when i was in s'pore last weekend....

they were just 2 of the numerous adverts placed that day. even the names of the doctors & their fees were included along with contact numbers. apparently, the S'pore Health Ministry lifted restrictions on advertisement in 2003 to compete for international clients who may have previously favoured malaysia or thailand. (read here)

should we follow suit & expose the public to a wider range of medical services & let them choose whom they wish to consult? i don't know. so far, the word-of-mouth method of recommendation seems to have worked out well. on the other hand, if advertising were allowed, there is also a possibility that some unscrupulous ones may try to outdo others with outrageous claims like being the best in KL, PJ & some say, seremban.

unlike the hilarious phua chu kang, this would be a tragedy, wouldn't it?

1Malaysia

when i was in primary school, i had friends from all racial background. we never needed any fanciful slogans to spur us on to foster a close friendship. how times have changed. but i was pleasantly surprised to discover this phone charm tied to my daughter's mobile.

EVA are the initials of her name & that of her indian & malay friends. V is now in boarding school while A is still in the same kebangsaan school. whenever the school vacation comes around, they will meet at least once to catch up. i've seen some of the photos they've taken together - they went for meals, tried out clothes at the mall & took cute fanciful pictures at instant photo booths.

that's how i remembered my school days & that's how students (& life as we know it) should continue to be.

unfortunately, those ketuanan bigots politics got in the way.

a new start

i'm always dismayed when a business fails. it could be due to bad management, poor business model or just lousy location.

when i dropped by the local supermarket this morning, i was greeted by this...

....shutters slammed shut & this is supposed to be peak shopping season. a sign in the front confirmed my fears..

yeah, relocating is a nice way of saying that the business has failed at that premise. i'm not actually surprised since the mall has seen 3 changes of management & the previous supermarket & anchor tenant have both folded up as well. it's the bad feng shui, people say. how else can you explain that jusco, directly just across the road, with its slightly more expensive prices, has not only been in business at that location for over 15 years but has expanded & renovated as well?

i suppose, with the new year, there is hope for better times & for prosperity. blessed new year to one & all!

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

money changer

music lessons aren't cheap & neither are concert tickets. that's probably why music teachers can charge a premium & there will still be a queue for their services.

the boy started learning cello a few months back & he seems to enjoy himself with the lessons & his new-found talent (i use this term this loosely). as each session lasts only 30 mins, i usually send him & then wait for him to finish. then i pay the teacher, as & when he has the lesson. 

i just started to joke with him.

me: you know, your teacher is like a money changer

him: how come?

me : every time i give her some money, she changes a smaller note for me.

parting is such sweet sorrow.

staff nurse N has resigned from her job to go back to her hometown in another state, where her 2 little children are being looked after by her parents, & a little closer to where hubby is working.


when she asked to have a photo taken with me today, i was a little taken aback. we didn't have a smooth working relationship. i've known her from the time she started as a fresh-faced graduate & although she struggled the initial few months, she picked up with time & experience. even then, i think i still gave her a hard time because i didn't think she was focussed on the job. i reckoned she would at best be mediocre.

as i looked back at her time with the department, i'm trying to figure out why she isn't confident & couldn't excel in her job. it wasn't obvious to me till now. it can't be easy to fully concentrate & be focussed on the job when the hubby is working miles apart & the kids are even further away. living all alone can't be good for a marriage. now that she will at least be reunited with her parents & kids in the hometown, i hope she will be happier & henceforth be a better nurse. actually, i know she can be one.

if she wanted to.

quality control

the quality control people are at the hospital to assess, what else, the quality of the service provided by the hospital. for these 3 days, they'll scrutinse everything - from correctly filling of forms, signing of important documents, safe dispensing of medication & proper provision of healthcare by all levels of staffing. even the kitchen & waste disposal won't be spared the surveillance.

the ward is extremely efficient today. extremely. the staff are looking busy at their stations or with patients, no one is having coffee in the pantry, the floor is squeaky clean & the corridors are cleared of clutter (i wonder where they managed to store them).

this is too good to be true!

maybe it's because i overheard the sister barked this morning : i don't care how you do it but for these three days, you better do everything the proper way!!

i should relish this while the survey is ongoing because by friday, i fear it'll be just another day at the office.

love bites can kill!

we all know what love bites are, right? but do you know that these can be dangerous? and girls, i don't mean the situation when your fathers find out about them.

it was reported that a maori woman in new zealand suffered a minor stroke as a result of some vigorous kissing. read here & here.

so, there's a cautionary tale for dating couples & a chance for medical students to impress their examiners & get bonus marks by mentioning neck-kissing as a rare cause of a stroke.

MRT: here we go again

the mass rapid transit transport system is estimated to cost RM36b. (read here)  lobbying has begun as to where the lines should run & stations be located. naturally, the shopping malls & commercial owners want the stations nearby their premises while home residents want them as far as possible, both for obvious reasons.

i don't live in the klang valley but the few times that i've used the LRT/Star trains, i find the whole exercise inconvenient, to say the least. when i needed to switch lines, i have to exit one station & walk to another station some distance away & then purchase another ticket. but i can actually understand why that happened - because the different lines were constructed at different times & by different parties.

now that there is a Urban Transport masterplan in place, hopefully when the whole thing is up & running (estimated to complete in 2016), there is some semblance of a much needed smooth (dare i say seamless?) travelling experience. hopefully they don't need to send some more people for study trips to europe/america to learn how to design/construct/manage a MRT. they only need to look south.

call me a pessimist but going by past events, i suspect terms like "unexpected delays" & "cost over-runs" to be bandied around in time to come.

however, i would like to be proven wrong.

underwear

no, i'm not referring to the scanty lacey types women put on that drive men crazy.

i meant the cotton or polyester types that little boys of school-going age should wear. if they don't put one on, one day in their haste to zip or unzip their pants, a bit of the foreskin may get caught & ouch! it's not a pleasant experience for the boy, his teachers or parents.

just tonite we had such a boy - 7-years old & his "little brother" was caught as he was unzipping his pants to pee. this is worse than getting caught zipping up because he HASN'T peed yet & the pain has made him fearful of peeing. by the time he reached hospital, the discomfort of his distended bladder is causing him more distress than the pain from the zipper. poor kid!

anyway, the zipper was released under general anaethesia & a circumcision was subsequently done to reduce the risk of future "accidents." both his parents have been advised to encourage the boy to put on underwear from now on.

and as far as i know, little girls are spared this little embarrassment.

horse has bolted

it's right there on page 3. (read here)


another reminder of how our education system has gone awry. & the recent changes on History as a compulsory-pass exam subject & going ahead with the move to make the elective languages of Arabic, Chinese, Tamil, Iban and Kadazandusun compulsory for all Year One pupils this year when there aren't enough language teachers are not going to inspire confidence amongst parents & educators. & we haven't even begun on language of instruction, university places, scholarships, etc. etc.


no wonder concerned parties are sceptical over the government's Talent Corp program (read here). how can you expect  people to return home when the house is in disarray? anyway, if policies don't change, & so far there's no indication they would, expect more exodus & brain drain. it's like trying to shut the stable door after the horse has bolted.

but then, maybe they don't care as long as semuanya ok.

needle phobia

this patient really got me riled up!!

24-yr-old guy who underwent surgery last month under general anaesthesia. now, he's so scared of pain that the removal of stitches on his face will need to be done under general anaesthesia AGAIN! he won't even allow a catheter, no matter how small i tried to reason with him, to be inserted into his hand. after 10 minutes of negotiation & bargaining, he still refused & we decided to give him the "gas" to put him to sleep, a technique usually reserved for children.

in the end, the removal took less than 5 mins - a procedure that is usually done in the ward without any anaesthetic.

so, what's so unusual about this, you ask?? ok, get this.....

he is a 4th year medical student & in TWO YEARS, if he passes his exams, he could be serving the public, which means people like you and i. think about it - if he's terrified of needles himself, how is he going to administer an injection to his patients?

let's not even think whether he could stand the sight of vomit.

or blood.

why does God allow suffering?

i ask this question not because the speed demon crashed on the expressway & suffers severe head injury. neither because the guy ate like there's no tomorrow & now suffers a heart attack.

i ask because of a 11-year-old girl who is completely paralysed from an inoperable tumour in her spinal cord. she is totally ventilator-dependant in ICU & needs to be fed & cleaned. when she's awake, you can see the emotions she goes thru - the occasional smile & grin but mostly solemn & grim. she will most likely not recover, a few doctors have concurred.

my initial reaction was that it wasn't fair for an innocent child to go through such suffering with no cure in sight.

i am searching for answers myself.

but then, there are many things we do not understand until such time that God chooses to reveal to us (deut 29:29). it's certainly not because she or her parents had done anything wrong because Jesus Himself said those who died innocently were not more guilty than others who lived (luke 13:1-5).

i then realised that it all boils down to one fact: all have sinned and fallen short of the glory of God (rom 3:23) & the wages of sin is death (6:23).
& the stern warning to me is this :

"But unless you repent, you too will all perish."

but that doesn't stop me from feeling sorry for the girl & her family. somehow i must try to share the Good News even if it's obvious that they are staunch believers of other faiths.

NZ #7 : hobbiton & rotorua

it was a really, really long drive from whitianga down to rotorua. although only about 250km (like from seremban to JB) in distance, the route through hills & valleys on a damp day made the journey longer than it really was. but we did make a stop at mata-mata, just an hour north-west of rotorua, for this...

the shires are under reconstruction for the new movie to be filmed later this year. this is private land & when the owner was asked to leased it to the film company, he was offered to stay anywhere in the world, all expenses paid, till filming was complete. what made this land special is that it has this lake...


**notice the houses are larger on the left & built smaller towards the right.this is to give the effect of dwarf-like hobbits in a large house & humans in a cramped hobbit's home**



.....and a century-old oak tree next to it. remember party tree & party field at the beginning of the 1st episode?

some places were still out-of-bounds as they were being prepared for the new film, so we could only picture frodo's home from a distance.

rotorua is a definite must-see if you only have a few days in the north island. the best authentic cultural performances are said to be here, held on traditional (sacred) maori land. the show started with the MC demonstating how our "hangi" dinner was being cooked...

followed by warriors paddling their "waka" down the river....

then a welcome by the women....

followed by the traditional haka performance - the local battle-cry before combat, seen more often nowadays when the NZ rugby team All-Blacks prepares for competition.

but one attraction that will thrill the kids is the skyline cable car up to Mt Ngongotaha...

then take the luge downhill.....

and back up again by cable car.

yeah, we each went on 3 rides of different levels of slope.

St Faith's Church, by the edge of Lake Rotorua, is the 1st permanent church built in the Rotorua area.

what's unique here is the image of Christ sandblasted on a glass window with the actual lake rotorua as backdrop, giving the impression of God walking on the water!!

ok, rotorua is famous for its geothermal activities as it stands in the crater of an ancient volcano, giving rise to geysers, thermal springs & boiling mud pools. the odour of sulphur can be revolting to sensitive noses.

geysers

boiling mudpools

one more stop before departing rotorua is the Huka Falls jetboat ride. the driver definitely knew how to skillfully manipulate the boat as it twists & turns on the river, as well as approaching the waterfalls itself. needless to say, the kids loved it!

there's no doubt in my mind that Rotorua is the one-stop tourist attraction of the North Island. no wonder Rolf Harris had this hit song many years ago, which went like this: 
Hurry hurry hurry home love
Hurry home to Rotorua
To the mountains and the valleys
Hurry home to me
I know I know
You had to go
Please hurry back home love
I miss you so.

no doubt, too, that many people will return one day, including us. this concluded our 12-day vacation.


waiting at the bus-stop in downtown Auckland for the express bus to the airport