a (dangerous?) precedent

there's been a few odd incidences here & there but this is the one that got me all riled up....

it was already arranged months ago to have leaders' training session last friday & all CG leaders are required invited to attend. then, earlier in the week, the pastor emailed to all leaders involved to enquire if the session could be brought forward to thursday instead, because it clashed with a charity dinner (on fri) which the church contributed but isn't even directly involved with.

in reply to the email, i wrote : has there been a precedent when a church-sanctioned training was displaced by a charity event?

only J responded, emphasising on setting our priorities right with God.

Paul wrote to the Hebrews:

Have confidence in your leaders and submit to their authority, because they keep watch over you as those who must give an account. Do this so that their work will be a joy, not a burden, for that would be of no benefit to you. (13:17)

i've had several disagreements with the pastor before but just let him be because of Paul's admonishment to the church, but now, i'm not so sure. i just feel that one shouldn't rush in where angels fear to thread.

it's times like this that i think i may have Pharisaic ancestry.

Mr & Mrs K - part 2 (or is this the finale?)

i had just spoken to Mr K's oncologist today & he said something that struck me numb. well, sort of.

he said one of the most tragic experiences in life anyone can face is to find out that you have stage 4 cancer, which is essentially incurable, and you never had any symptoms to even suggest that anything was wrong - no pain, no numbness, no discomfort, nothing.

you go for a routine medical check-up & BANG! the huge tumour is staring at you from the xray.

i had the question at the tip of my tongue - how long has Mr K got - but i refrained from asking. because it's all irrelevant now. it's too late but Mr K should make peace 1st with himself & with his God, & then with the world.

after the hair-drop, vomitting, weight loss & feeling like it's the end of the world from the effects of chemotherapy, at least reconciliation will preserve some degree of dignity on the final stretch.

be strong, Mr & Mrs K!

Mr & Mrs K

this is about Mr & Mrs K from the previous post.

i was quite certain Mrs K was going to do Mr K in, but as it turned out, Mr K's brain surgery was a success & he recovered without much fuss. the biospy taken from his brain showed that it was a small-cell carcinioma & in this case, most likely to have spread from his lung. he has been referred to the cancer specialist & will receive chemotherapy next week.

i met up with the couple again today. he looked cheerful while she was lovingly feeding him dinner. i asked him about what the other doctors have said to him & noticed the wife putting her finger to her lips, implying that he doesn't know his real condition is & what's in store for him.

it's just reinforced what i had thought all along - she's the one making decisions for him.

so, can you forgive me for thinking that she'll do him in ??

a hurried decision

Mr K, 45 years, a chronic smoker now presenting with a brain tumour. a CT scan of the chest revealed another tumour in the right lung, even bigger than the one in the brain, & it has even shown signs of spreading out already.
this new finding has taken us all aback. after presenting the pros & cons of brain surgery to the family, expecting them to think over carefully, they made the decision to operate within the hour. apparently Mr K is undecided but Mrs K has made the decision for him.

without any surgery, he may succumb to either tumour in 3 - 6 mths, even with chemo and/or radiotherapy.

with brain surgery, he may last slightly longer, probably up to a year. but that is only if it is vastly successful & recovery from it is uneventful.

but i'm not optimistic. i think they should deliberate over the weekend & come to a consensus. as it is, i can see some of his family members are keen on surgery, while others aren't. & this decision is made while tears still flow & the duress is obvious.

i feel this is a hurried decision. and, i sure don't have a good feeling about the outcome.

ugly head

when we talk about a drug problem, what usually comes to mind are images of intravenous users in back alleys, air passengers stuffing contraband into hidden compartments & every known orifice, or patrons high on "ice" in a club.
we all know the problem permeates much wider & deeper than that.

i still remember vividly when i was on-call one evening while training at a teaching hospital. we were considered junior doctors then & were searching high & low for the lecturer-on-call to help us handle a particularly difficult case. despite repeated calls on the phone, pagers (there were no handphones then) & PA system, he was nowhere to be found.

then someone finally located him, on the toilet floor, groaning & frothing at the mouth. found nearby was a used syringe. empty.

to cut the story short, he had been injecting himself with painkillers & this time, he overdosed. he was immediately admitted to the ICU & subsequently recovered. my boss, to his credit, kept things under wraps - told the offender to take medical leave & on completion of his expatriate contract, to return home. the hospital was not informed the real story behind this episode.

later, after i had left the hospital, i was told one of my junior colleagues did the same thing. he was then asked to leave post-grad training.

at another hospital where i worked in UK, i  found out 9 years later that one of my peers had been doing the same thing when we were in the same department. he had been depressed because he couldn't pass his post-grad exams. in the end, he also left training & ended up a GP.

so, i know a senior, a colleague & a junior who had abused drugs. well, surprise, surprise, the ugly head has reared again.

now, a male nurse i used to work with had been found to falsify entries in a drug record book, including creating fictitious patients to obtain the pain-killers. doesn't matter if it's for personal use or worse, for resale; he will be punished, subject to an internal inquiry. his HOD is obviously not as gracious as my ex-boss, which is why the misdeed is the talk of the local medical fraternity.

and unless he can pull cable or divine intervention intercedes, his career as a nurse is as good as over. which is a real pity because he has shown such good promise as a capable & competent paramedic.

teacher's day

i have to confess i don't have any recollection of a teacher's day celebration, such that yesterday passed by without much ado for me. but that does not take away the impact teachers had on my life.

i am still in contact with Pn Rahmah (primary 1 teacher), Mrs Thumboo (primary 2 & 6, read here) & Mrs Chan (biology, 5th & 6th form). but the one who convinced me on a career path was Mr GV Pillai (physics, 5th & 6th form). he was such a masterful teacher, appropriately so as he was the only one with a M.Sc in school, he made physics so simple that a whole bunch of us in class decided we want to be engineers.

so what happened?

that's when i met the other Teacher:


As Jesus started on his way, a man ran up to him and fell on his knees before him. “Good teacher,” he asked, “what must I do to inherit eternal life?” Jesus looked at him and loved him. “One thing you lack,” he said. “Go, sell everything you have and give to the poor, and you will have treasure in heaven. Then come, follow me.”  Mark 10: 17, 21

so, did i interpret this encounter correctly? did i sell off my engineering ambition to take an alternate path to public service? perhaps the circle will be complete only when i backtrack return to serve the poor.

friday, may 13

because the boy's birthday falls on exam week, we decided to celebrate it on friday, after CG. his sunday school buddies were invited & to him, that's all that matters.

in fact, because he has only one much older sibling & few cousins, none of whom live nearby, his friends mean a lot to him. as parents, we try to provide him opportunities to fellowship & give him a sense of belonging outside of family ties.

and for one day a year, he is the centre of attention. who doesn't relish that?

& he gets the applause appropriate to the occasion....

for a child, all innocent & impressionable, what can bring more happiness to the birthday event than to have fun & share a meal with his peers.

i never knew the trauma of may 13, 1969. i only read about it. but we are all grateful that on this particular friday, we celebrate another year added to the boy's life & pray that we in malaysia continue to live in relative peace & harmony.

even as some irresponsible bloggers & press media try to fan the flames of racial & religious discontent.

month of May

May is supposed to be a merry month, presumably as it heralds the coming of summer.

not so for my kids, both of whom were born in May. they can't truly celebrate their birthdays with a lavish meal on an outing because both are right smack in their mid-term exams.

perhaps that's just a small price to pay.

after all, this May could have been much worse off if you take the context of Osama or George Yeo. suddenly studying on your birthday doesn't seemed that difficult.

my elder girl agreed.

informer

the income tax dept is very keen to reward informers who snitch on tax evaders (read here). i have my personal experience with an informer this morning.

except that she was "a nurse" who called me up at 6.30am to tell me about a new patient who was admitted at 12 midnite. despite his multiple medical problems, she could not provide more details, like the duration he's had the problems & the medication he's currently taking.

and no, she also hasn't traced the patient's old notes which held a wealth of information the health status. as such, i could not give any instructions over the phone.

so, as far as i'm concerned, she wasn't a nurse (hence, the open & close inverted commas in the initial description of her job), she was just an informer.

she just passed a message, a task a ward clerk would have performed admirably with less salary.

the wedding - an english lesson

you couldn't have missed it - it was the wedding of the year, maybe of the decade or the century. it was televised on both free-to-air and satellite TV & the media screamed its headlines.

so here's our english lesson....

what's the difference between complete and finished?

when you marry the right one, you are COMPLETE.

when you marry the wrong one, you are FINISHED.

AND when the "right one" catches you with the "wrong one," you are COMPLETELY FINISHED!!

so, i wonder what the outcome will be when you refuse to vow obedience.....　

don't be

don't be fat.

ok, if you can't help being tubby, at least don't smoke.

ok, ok, if you weigh 108kg & smoke 3 packets of ciggies a day, at least stay away from doctors.

unfortunately, if you're obese & you smoke like a chimney, you're most likely to develop diabetes, hypertension and/or high cholesterol, & then you CAN'T avoid doctors.

and, if you have to undergo difficult abdominal surgery, your recovery is very likely to follow a stormy course.

Mr G is such a person. he had to spend one day in ICU hooked up to a ventilaor after surgery, because he couldn't breathe, when most people would have just breezed through.

he's only 45. i dread to think what he'd be like in 10 years if he didn't change his life style!

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!