why is there bullying in school?

i've alway thought that kids will be kids & that bullying is a phase they go through while growing up. a black eye is like having a vaccination - you get it & you move on. but it didn't occur to me to figure out WHY the need to exert violence to get what you want.

until i read today's star. (read here)

claiming to have been falsely accused of embezzlement, this brainless moron guy is challenging the CM of penang to a fist-fight to settle the issue - in the holy month, at that! seriously, how would a brawl resolve the issue?

and because kids eagerly imitate their parents' behaviour, good AND bad, this is my theory of the origins of bullying in school.

**image from the Star**

2 moons?

apparently tonite is special. the earth & mars will come so close that mars can be seen almost as big next to the moon, even though there's a distance of over 34 million miles in between. & this won't happen again till the year 2287.

the email that has been circulating proclaiming this event is actually a HOAX. read here.

the "bright star" seen near the moon is actually jupiter & it'll only appear as a bright spot.

i took this picture myself & it's just convinced me of one thing........

.......i need that dSLR!!

cello

the boy & the girl are both like chalk & cheese. she is focussed in her studies, hardworking & determined. a science student through & through.

he, on the other hard, is playful, likes to explore gadgets & work with his hands. very likely an artsy or technical sort of student.

& unlike his sister, he plays the piano because he actually enjoys it. so that's why we decide to give him exposure to a second musical instrument when the opportunity came round. my colleague has a cello teacher who comes over to teach cello to his 2 kids. he asked me if i was keen for the boy to take it up as well. since the teacher allowed a couple of trial lessons, we agreed.

we are happy that he has been looking forward to the lessons. hopefully the enthusiasm persists...

the tooth, the whole tooth....

one of the boy's front tooth fell off this morning. he asked me to check his gums, then calmly washed the tooth & put it in a container where he kept all the previous dropped teeth.

i asked him if he was going to keep it under his pillow tonite & maybe the tooth fairy will reward him. he gave me a puzzled look & asked, "the tooth fairy doesn't exist, right?"

that's when i had to come clean with him & admitted to the truth, the whole truth & nothing but the truth about the tooth fairy & how the tooth under the pillow is replaced by cash in the morning. while at it, i also debunked the myth about santa.

in church later, while the offering bag was being passed around, i asked him if he had brought any money as offering. he blew me off when he replied, "no, but i brought something else. myself !"

he's just a kid but he's definitely growing up nicely.

PS. he's never kept a tooth beneath the pillow, he's never brought any money from his coin-box for offering & i don't think he understands the significance of offering himself to the Lord.

can 2 wrongs make a right??

this piece of research just came off the press...

doctors at imperial college london have discovered that if you live with an unhealthy diet, in this case a QuarterPounder with milkshake, you can actually reduce the cardiovascular risks by taking a statin tablet (which reduces cholesterol), even to the extent of providing these tablets to go with the meals, & further justifying this by stating that it doesn't costs much more to supply these tablets!! read here.

they even defended this proposal by quoting other examples of dangerous lifestyles, like wearing seatbelts while driving & using filters in cigarettes, to minimise the associated risks.

this is like saying, drinks manufacturers should include diabetic tablets with their 6-pack sodas, or cigarette firms include chemotherapy pills in their packs.

does this sound like logical reasoning?

what this study doesn't highlight is that statins have their own side effects on the liver, muscles & kidneys. so now, instead of just destroying your heart by wolfing down fast food, you're also threatening your liver and kidneys with a chemical drug.

i think the simple (??) solution is just to abstain from fast-food/sodas/cigarettes, etc etc., or more conventionally to take in moderation & eventually to stop altogether.

because, in this scenario, 2 wrongs certainly don't make a right!!

trees

how often do you stand or walk under a coconut tree? not often, considering there can't be many coconut trees in town.

and how often have you actually witnessed a falling coconut? even less, i'd think.


so it's utterly unfortunate to have a coconut fall on your head, like this 60-yr-old lady in ICU now. she's recuperating from surgery for a big bleed into her brain but her recovery will not be complete for she will not fully gain control over some parts of her body.


trees are useful - they provide shade, bear fruits & make up part of a green lung in cities. heck, you can't have a tree house without a tree & where would tarzan be without one?


but the downside is that they sometimes topple on you, your car or house. & you really don't want to take shelter from one in a thunderstorm.


so watch out for the coconuts.

or durians.

talk about the wrong place & the wrong time.

attitude

this cannister is part of an elaborate anaesthetic machine used to provide anaesthesia for surgery. it contains soda lime granules which absorb carbon dioxide from the patient's breath & then return that breath back to the patient minus the carbon dioxide. a recycling of gases, if you will.

soda lime contains a colour indicator which tells the user when it is already saturated with carbon dioxide (in this case, from WHITE to PURPLE) & therefore needs to be changed. so when it turns purple, the whole cannister is emptied & fresh white-coloured ones refilled. something akin to changing your domestic water filter when it turns brown.

another manufacturer makes RED-coloured soda lime which turns WHITE when saturated with carbon dioxide. it really doesn't matter which manufacturer you source the soda lime from, as long as you are aware of the colour change.

so what happens when you decide to change from one manufacturer to another? surely, you'd completely exhaust your existing stock before using the new supply, or else the colour change will be confusing, and dangerously so.

this is what happens when people get careless & therefore set the stage for a medical catastrophe.....

.....twice!!

this lackadaisical attitude happens everywhere though :

in school, when wrongs facts are taught;
in construction, when wrong angles are calculated;
on the roads, when overtaking on double-lines;
& even at home, leaving the gas stove burning with a curious child on the loose.

i seriously think a lot more things didn't get a lot more worse because of divine intervention.

btw, it's friday 13th today but do have a good and SAFE weekend!

insider tip

surgery on the body below the waist can be done under general or regional anaesthesia.

for general anaesthesia, the patient is rendered completely unconscious & largely pain-free till the surgery is complete.

for regional anaesthesia, only the part of the body below the waist is anaesthesised. the patient remain awake but lower body is immobile & pain-free. operations suitable for this technique include C-section, haemorrhoids & lower limb surgery. (read here)

if you are young & healthy, there's not much to choose between the 2 techniques but as the co-existing medical problems like hypertension or diabetes occur with advancing age, it may be (but not necessarily always) safer to have the surgery done under regional anaesthesia. this is largely due to the fact that regional anaesthesia interferes with body function (eg. heart, respiration) to a lesser degree compared to general anaesthesia.

take C-section as an example. everything else being equal, it is inherently safer for the mother to have a regional (in this case, spinal) anaesthesia because it removes the risk of having gastric contents enter the lungs, which is a possible & dangerous outcome if the mother was rendered unconscious by general anaesthesia. besides, being awake at the time of delivery provides the mother with the precious opportunity to hear the baby's cries & be bonded by physical contact.

but here's the deal - very few private doctors will tell their patients that it costs less, up to RM500 & sometimes beyond, to have a spinal instead of general anaesthesia. this is because fewer medication & equipment are required for the former.

so now you know.

PS. however i must put it on record that regional anaesthesia may NOT be appropriate in all operations below the waist. you need to discuss this with your doctor before making a decision.

running on empty

the current average life expectancy in malaysia is 74. (71 for men & 76 for women) (read here)

so any day lived in health beyond that can be considered a bonus. some call this having a long life; as an avid fan of Air Crash Investigation on Nat Geo channel, i cynically call it Running On Empty.

this 86 year-old woman was brought back to Casualty by her family, just 3 days after she had been discharged. she has heart disease, a previous stroke, was bedridden & had just recovered from pneumonia, having spent 3 weeks in hospital, 1 week of which in ICU.

in Casualty, she was gasping & was barely conscious. i explained to the family that she was very ill & recovery would be very unlikely, given her current & past medical problems. however, the family was firm that i should do the necessary for the her.

i wished they had never said that.

because unfortunately, "do the necessary" here means putting in a breathing tube into her windpipe, attempting many times to insert a cannula into a vein but succeeding only once because she had dainty blood vessels. in the end, we had to proceed with CPR because her heart had stopped. in the process, we used over 20 ampoules of medicine & broke a couple of ribs from the vigourous compression on her frail chest.

all in vain.

i wished they had never given the instruction "do the necessary" because i knew she was already running on empty but i was duty-bound to provide a service i had been trained to do.

i wished they had said 3 other words instead, like maybe "make her comfortable" or "make it painless". masterly inactivity would have provided a more dignified end to a long life.

may her soul rest in peace.

and 3 more were added...

we had a baptism yesterday. actually, there are 3 souls saved but the event was different.

i've witnessed baptism by submersion in a baptism pool in church & at sea, but because both were either inaccessible or impractical, we had it at a brother's house with a swimming pool. yet another sign of the changing times.

but, surely it doesn't matter where it's done, whether in River Jordan with John the Baptist, or in the desert with Philip, as long as the heart is transformed. yesterday, there was much rejoicing in heaven as it was on earth

i'm certain the Father is well pleased.

excellent service at Watsons

i usually get over-the-counter medication & vitamin supplement from Guardian, but occasionally i go to Watsons because they have a discount section where items with short expiry dates are sold at between 30 - 70% less.

today i purchased a bottle of chewable vitamins whose expiry date is 20 Sept, at 70% discount. while making payment, the guy at the counter reminded me of the expiry date & even advised that i keep the bottle away from sunlight &, after opening, to store in the fridge, to prolong its shelf life.

how informative, customer-friendly & RARE is this?? it made my day & just goes to show that it doesn't take much to make a customer happy.

if we were in a restaurant or hotel, i would have given him a tip!

PS. those in the pharmaceutical industry can confrim that those pills are effective up to 6 months after their stated expiry date.

of doctors & teachers

it's a well-known fact that doctors in private practice earn more than their counterparts in government hospitals. much more.

hence, the mass exodus into private service once the 3-year compulsory "national service" is fulfilled. of late, the govt has instituted many measures to stem this outflow, like improving the pay structure, introducing additional clinical allowances (which are largely tax-exempt), expanding post-graduate opportunities & hastening promotions. the coup de grace has got to be the establishment of private wings in certain hospitals, eg. UMMC, HUKM, where specialists are allowed to practise (& charge at private rates) after their regular office hours.

naturally, those who are bent on private practice will leave anyway but the recent measures has succeeded in convincing the fence-sitters to reconsider. i mean, specialists who are 3 years post-grad can expect to take home RM10k -12k a month. that's not too bad for a 30-plus-yr-old.

similarly, teachers supplement their income by giving tuition, which is really big business these days. i know of tuition centres that have classrooms of 80 students where the teachers use microphones & powerpoint. on top of their regular classes in school, they also do administrative work, conduct co-curricular activities & attend in-service courses. no wonder the constant complaints of being overworked!!

from august 1, the graduate teachers can engage in politics. (read here) wait a minute! i thought they said they were overburdened?? presumably some weren't. so, headmasters can soon expect absenteeism not only amongst the students, but the teachers as well. after all, politicking does take up time & effort.

personally, i don't think the standard of education will drop much after this, not because it's (reputed to be) already at rock bottom level, but rather i believe the really good & dedicated teachers will stay true to their cause & remain in the classrooms.

the other volvo

we all know about volvo cars - the swedish brand reknown for its (previously) boxy exterior & impeccable safety features. volvo is latin for "i roll", implying a circular movement or the rotation of wheels.

volvulus is a surgical condition in which a loop of bowel twists upon itself, causing a life-threatening obstruction. this usually present with acute abdominal pain with distension & constipation. a 55-year-old had just that this week. she looked like she has a twin pregnancy, such was the degree of abdominal distension, & she was obviously in distress over it.

the pre-op xray was confirmatory of the diagnosis - the Xs delineates the twisted & distended loop of bowel.

on opening the abdomen, the offending loop virtually popped out of the incision. the bowel distension was a result of trapped gas.

a small puncture (left) was deliberately made to release the gas. 

the bowel subsequently deflated, like a leaking balloon. the loop of bowel was carefully untwisted & the operation concluded. the patient recovered completely.

it could have been worse had there been an obstruction of blood supply to the affected bowel, causing gangrene, rupture & sepsis. a delay of one day would have resulted in a totally devastating outcome.

no one knows for sure why volvulus occurs & it's certainly nothing we can do to prevent it. it just happens & it's important to realise that persisitent abdominal pain requires immediate medical attention.

given the choice, i'd rather have volvo the car.

superdad

went to see the movie with the boy last weekend. instead of just killing a couple of hours, i'm beginning to realise that these so-called kiddie (animated) movies, as much fun as they are, actually inculcate good moral values within its plot & encouraging us to be & do better. the message i got from this movie is that, no matter how mean or despicable one is & can be, there's always a glimmer of hope that, under unusual circumstances, some good can actually come out of that person.

looking back to some movies i've watched with the kids, these are some lessons i think that could be taught & learned:

Kung Fu Panda : don't make fun of fat, clumsy people - they may yet be the hero you are looking for!

Shrek Forever After : even though you know you are married to your one True Love, you really don't appreciate her till you lose her.

& my favourite cartoon movie....

UP : the epitome of true love, sprouting out of shyness between 2 kids, blooming throughout adulthood & culminating in realising their dream, even after one has passed on.

yeah, i know - i get all mushy inside with True Love movies (i like Grease & Notting Hill, too!), but after watching Despicable Me, even if i'm not that despicable, i think i want to be a SuperDad.

PS. Bee Movie & Wall-E both not only left no impression, they also left me clueless!!

what the World Cup Final means to me.

it means the guys from English College (renamed Maktab Sultan Abu Bakar but we never got used to it) in JB are getting together.

i missed out on the football match which was held on friday. at the last reunion, we had it on a saturday but this time the field was to be used for a prior event. however, that didn't lessen the delight i enjoyed in the company of the guys.

we drank & sang.......

we ate...

& then we ate some more.....

i think guys in general just love hanging out together....

the FIFA World Cup Final is just an excuse.

(snigger!)

reunion

the last time we met was in 2007 (read here) & we agreed to meet henceforth every 4 years at the FIFA world cup Final weekend.

this is the THE weekend & the motley crew has arrived in KL with some late-comers, like myself, joining in tomorrow.

we were near 50s then but now, we are all over 50. balding with beer bellies & probably over the hill physically but definitely still young at heart.

how much have we REALLY changed since?

i await in eager anticipation.

sin of the father

my other colleague is stressed out.

in addition to clinic work & operating on patients, he has to catch a flight to kota kinabalu tonite. his daughter has been accepted into universiti malaysia sabah & he will accompany her to KK as orientation week starts on monday. so, he alternated between his clinic & the OT, trying to cover as much ground within the day.

as he talked about his flight plans, he related that he was supposed to be sent to sabah during his compulsory service but he managed to wrangle out of it. he then joked that his daughter now has to pay for his sin as he broke into a hearty laugh.

only that he didn't realise that he has unwittingly quoted part of the 2nd commandment:

"You shall not make for yourself an idol in the form of anything in heaven above or on the earth beneath or in the waters below.  You shall not bow down to them or worship them; for I, the LORD your God, am a jealous God, punishing the children for the sin of the fathers to the third and fourth generation of those who hate me, but showing love to a thousand {generations} of those who love me and keep my commandments. " exodus 20:4 - 6 NIV

i didn't have the heart to tell him the punishment may be passed down the next 2 generations.

but he must be relieved that ragging is now banned.

life saver?

i saw this at a shopping mall in s'pore recently.

an AED is an automated external defibrillator. (read here) it's a crucial piece of equipment used in Cardio-Pulmonary Resuscitation, & in addition to being readily available at all medical facilities, the American Heart Association recommends that public places like office complexes, shopping malls & sports arenas be equipped with these devices.

although any man-on-the-street can perform CPR, the AED should only be used by those trained in CPR (read here) which explains the warning label & the key in the glass casing.

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
although this mall is to be applauded for installing AEDs for emergency use, the success of this operation is dependent on many interconnected processes, eg.
 
1) the public must be aware of its location;
 
2) it must be regularly serviced/maintained to preserve its function;
 
3) there must be a mass training in CPR for the public before the use of AEDs can be effective;
 
4) there must be an rapid-respond emergency team available within minutes of such an an emergency;
 
if all these procedures were in place, you'd wonder if the tragedy at a recent marathon could have been prevented. read Zewt's take here.
 
it's all academic now, but don't bet on such an incident NOT repeating in the near future.

PS. the AED in this post is located at the basement level of Wisma Atria & i'm told there are many like this positioned in offices/malls along orchard road. iPhone users in s'pore can download the free app "AED nearby" to locate the nearest device.

duracell

remember the advert where the toy powered by duracell battery continues to operate & outlasts toys using other brands of battery?

i have a colleague who seems to be powered by alkaline batteries. he'll run his clinic in the morning & work right through mid-afternoon before starting his operating list, which means his day will only be over in the late evening. this is his routine.

of late, he's been operating on non-emergency cases on weekends as well. which means, he's in hospital everyday of the week!


where does he get the energy for such a gruelling schedule, you ask? i don't know. maybe age is on his side. but what i do know is that he is made of flesh & blood, not mechanical parts. at this rate, someday something will give way & new batteries is not going to help.

i just hope he realises this before it's too late for him.

hospital visit with a mission

my neighbour runs a roaring business. as they did not attain higher education, they took it upon themselves to ensure that their 3 boys studied in the best schools & are given the opportunity & support to enter the best universities. so all 3 are enrolled in private schools. the eldest just finished A-levels & has a firm offer from UCLA Berkeley for chemical engineering, which he will accept.

the 2nd boy will be doing A-levels next year & is still keeping his options open. unlike his elder brother who is fixated on doing chemistry, his mother is trying to persuade him to do medicine. she asked me if i could show him around the hospital, just to give him a feel of what to expect, even though he has no burning desire to take up medicine.

so, i took the boy around the other day. 1st, i asked my friend Dr L if he could demonstrate some communication etiquette with his patients in the clinic. the boy got more than he bargained for because Dr L also allowed him to watch a gastroscopy & colonoscopy done on 2 different patients.

then, in the afternoon, i took him into the OT & let him witness a couple of surgical procedures. at the same time, showed him some the of advanced equipment & ran through some of the precautions taken for patients undergoing anaesthesia.

i'd say it was an eye opener for him. should he eventually decide to do it, i can expect a big treat from his generous mother. unfortunately, there was a drawback. over lunch with a few of my colleagues, all of them were adamant that they won't encourage their kids to imitate their career choice, giving reasons like over-saturation of doctors & lack of specialist training opportunites.

even though the boy is matured enough to decide for himself, never underestimate the potency & influence of maternal persuasion!!

i'll let you know if i get that dinner invitation.