will the real SMART ASS, please stand up!!

Rushing through…

Had pretty tight schedule at emergency medicine. Had another ambulance run last saturday for 2 indian fellows… drunk fellows who skidded on their motorcycle and bang into one another.

Now, currently in opthalmology aka eye posting, but having the postponed viva tomorrow. Tomorrow also going to the asian medical student’s association health checks, meeting delegates from all over asia including taiwan, japan, china, bangladesh, pakistan… all of them preclinical. My group members are See Wie, Peng Peng and Nurul Suhaiza posted at Taman Seri Manja - we will be coordinating the other delegates and start writing appropriate referral letters prn (pro re nata).

Had to train hard daily now for inter-college team in ping pong, plus becoming the team manager together with my coursemate King Chong being the superb coach. Hopefully, with blessings, will have a medal in this sport in my final year in uni.

Will the real smart ass please stand up!! Recently heard a lot of stories, real stories about smart asses among the medical personnels, and being there myself to see a smart ass in action. I start wondering: Had I ever been a smart ass before? Or will I turn into one someday in the future?

• Death of a famous female athlete, because the smart ass dr does not believe the patient,
• Death of an uncle with abdominal distension, because the smart ass dr refuse to believe the nurses,
• Unattended fracture of the ankle, because the smart ass nurse refuse to believe the misalignment of the ankle as mentioned by the passer-by.
• Increase morbidity of patient because the smart ass medical students refuse to pass the chance to illicit the ‘interesting’ signs.

Pain & suffering & death more and more is caused by smart ass people nowadays. Have you had any encounter with any smart ass lately? I believe smart asses are everywhere in every field, and they come in various level of IQ, mostly high.

In conclusion, my birthday wish for this year: Hope that I will never ever be a smart ass, and also wishes everyone I care and around me to be ’smart ass’-free.

Gonna share a few touching lines from a birthday letter to me, from my senior, a 4th year senior when I was 1st year, Dr. Lim Kai Inn, currently at Hospital JB.

It is definite important to learn facts but we don’t need a smart ass to make you doctor. Learning fact is very much different from seeing a patient, a patient that has a life like you and me.

Look around and understand your life first.

Find the truth of life, before you put your hand onto the dying body and suffering soul!

Study your book and mean times study your life as well.

P/S surprised he brought up the ’smart ass’ word. As if we had telepathic link. the letter is longer, but I shall kept the more private sides of the letter to myself for the time being.

saving lives

Trails of pilocarpine:

Still pretty stranded in Accident & Emergency department, providing orientation help guidance to the freshies…

Pretty pissed off these few days when I asked some of the questions to my juniors aka freshies. Firstly, I asked them the typical old traditional conservative question "Why do you choose medic?"

Typical bullshit nonsense answer: "to save lives"

How many lives can they actually save? If death is inevitable, how could they help the patient? How can ‘mercy‘ be matched with the word ‘killing’ when both is words carries a totally different background of meaning? I faced a silent mode.

This is Andy the ambulance. I had the honor to follow an ambulance call at A&E recently. That night, it was raining rather heavily, and none of my group members would be sane enough to go to A&E, but I just felt like going despite that rainy weather at night. I was tagged along with a superb male nurse Ah Chai. The caller identified the emergency as ‘heart attack’ at the Pasar Malam at SS2, somewhere rather near UMMC. Reaching there, I saw the man still could walk, very very weakly, limping, i guess. Very very breathless and once he summoned all his energy to get into the stretcher into the ambulance, he just collapsed with GCS around 8/15 (meaning his consciousness dropped). And there I was delivering oxygen with the face mask & Ah Chai inserting a line into the patient’s vein with the ambulance swinging wildly from left to right, acceleration with deceleration. Superb skill from Ah Chai. And he also had time to ask & tutor me about the situation. Learnt a lot. The patient was resuscitated and he SURVIVED!!! We were all extremely relieved, especially me. Whenever I heard about "to save lives", I had an urge to request a few freshies to go for the ambulance call.

Besides all the other stupid questions that me and my fellow had asked, I asked a serious question: "what is the name of the course that they are taking in UM?" 30% don’t even know the name of the course, 90% don’t know about the curriculum, 70% knows only about the basic sciences they are taking in the first year, namely anatomy, biochemistry, physiology… And they already had at least 2 introductory lectures about the NIC (new integrated curriculum) and they don’t even know that basic sciences is just 1 of the strands in NIC, together with PPD (personal & professional development) and DPHS (doctor, patient, health & society). I had doubt whether all my beloved coursemates (including juniors) knew about this. To some of them, Basic Science 90%, PPD 5%, DPHS 5% as in our exam papers.

I had a lecturer who seems to strive for excellence for his patients and always critises the inefficacy of malaysian systems. But on one occasion, he really disappointed me very very very very very very very very very very very very very very very very very very very very very very very very very very very very very very very very very very very very very very very very very very very very very very very very very very very very much. There I was waiting for the elevator to go to 12th floor, 2 elderly ill looking patients in wheelchair waiting together with a few nurses. Suddenly the door to the lift opened, and as the 2 wheelchairs were heading towards the lift, out of nowhere, suddenly that ‘respected’ lecturer rushed into the lift talking some Greek with another dweeb lecturer, ignoring the 2 patients. Even the nurses paused to give way to the patients. I guess the freshies could not ’save lives’ at this moment, nevertheless the least they could do is BE CARING, BE SENSIBLE. Caring is not a word, it is an action.

Surely I wanted to yell to that 2 lecturers "I know what’s their (patients’) problems, but what YOURS!??!?". But I didn’t. Let me pass my final MBBS exam first, anything could happen in our ‘malaysian’ setting, right?

- It is the little things that we do that matter the most -

parents: who are they?

Trails of pilocarpine:

at last, back into UM again.. errrhmm… again… Orientation started, being swarmed by freshies, busy like hell in A&E, no guidance yet as Dr in charge still at holiday…

First day at A&E, and I’m on call, stayed till 2am, first time in my life, learnt to do gastric lavage, tasted the charcoal with my finger tip… did an arterial sampling from the femoral artery… participated actively assisting an intubation…

Who are the people that we identified as parents? The one who carries us so burdensomely over the 9 months? The one who wraps us up in the most precious way when we come to this world? The one who bears the duties as our protector, our healer, our educator all the time? The one we hang onto dearly during our childhood? The one we are ashamed of being with at our activities or outing during our teenage hours? The one who we sees as the big nagging machine as young adults? The one who is delirious, childish needs us around to give them diapers & help of ambulation when we are adults?

Last night, an uncle comes in to resuscitation. He was suffering and had multiple problems - his sons knew it… and they were complaining about it, rather than keeping the good spirit of taking good care of that uncle.

One nurse commented "1 bapa boleh jaga 10 anak, 10 anak tak boleh jaga 1 bapa".

First few years of life = last few years of life

1. we’re fragile, easily susceptible to disease & injury
2. we’d incontinence, too - faecal & urinary, at least before 1 1/2 years old.
3. we’re started off with innocent babbling & crying loudly during nighttime.
4. we had strange behaviour at times… correction… most of the times…
5. we needed more care & support from our loved ones more than anyone else.

The only difference is when we are small, we are on our way to accept life, (parents are always with us) and when we are old, we are on our way to accept death.

Who are we to judge our parents?

special thanx: the nurse at A&E

war of the worlds

‘War’ things so far…

1. Went to watch "War Of The Worlds" last night with my dad, sis, and her friend at MPV, Prangin. As mentioned before it was more than 10 years since my dad last watched anything in a cinema. He done a big mistake of not listening to my sister - "Wear thicker clothes, it’ll be cold". Indeed it was cold, and my dear dad end up being very very hungry post-’war’. He actually asked me whether he had to switch off handphone during the movie, and I asked him a very stupid question "do you watch with your handphone on last time?". He laughed "Where got handphone last time?".

   The movie was enjoyable, overall because it was good quality time spent together with my dad. There were several times when my dad really talk to the movie, just like the opening reminder, and inevitably I had to ‘consult’ aka "ssshh, dad"… Have to also "consult" my sister as she was also making stupid comment about all the clothes flying around after the tripod laser blast being underwear…

2. Heard about the tragic incident at London. The war between terrorist & mankind continues… Lastest stats 50 deaths and 700 injured…. - grief -
3. Went to War Museum, Batu Maung this afternoon. It was an outdoor museum, with tunnel, cannon, artillery area, torture chamber, wells, observation chamber… RM 10 was worth it definite

Let’s face it. Like it or lump it. The world is at war. War against terrorism, an invisible war by itself, which the only pain we felt in our heart currently is just plainly sympathy… not feeling the REAL pain.. Even if we imagine our KLCC(or KOMTAR) being striked by 2 aeroplanes, or our PUTRA LRT was bombed at Station University, we wouldn’t have felt a single 1% they are feeling.

This war is borderless, and (touch wood) what I had mentioned above may come true. Let us just take a brief moment of silence to think about it.

How do we face this war? Or should we wait till the real terror strikes us first…

Penang rediscovery

from "The Star"

Thursday July 7, 2005 North Why surnames dominate

highlighted "Weld Quay" another underrated tourist attraction in Penang..

updates so far:

1. Pangkor with family cancelled: bcos my sister’s leave application was rejected. change of plan to watching "War of the Worlds" tonight at MPV Prangin Mall, because my dear dad commented "I din go watch movie for more than 10 years liao" plus coincidentally heard about this movie from this mamat
2. Planning to visit the War Museum at Penang… another unknown penang attraction..
3. Having all the trips cancelled indeed was making my holidays really a holiday… where I can sit back and relax… and continue rediscovering the sparkle of Penang…

hidden sparkle of pearl

Can you hear wolf cried to the blue corn moon?

or ask the grinning bobcat why she grinned?

Can u sing with all the voices of the mountain?

Can u paint with all the colours of the wind?

This was the view from one of the hills at Ayer Putih(white water), Balik Pulau. Being the ‘X-generation’, my life was being too preoccupied by Ayer Itam (black water as opposed to Ayer Putih) and all the other busier faces of Penang island that I had totally neglected this part of the pearl of orient.

I still remember vividly how my coursemates and I was awed by the shadows of the clouds fallen nicely on top the hill in front of our hostel in Hua Lien, Taiwan. I thought I would never ever again have this amazing sight on local soil. I was wrong and there it was, this amazing view smiling naively at me.

To all penangites, more precise, to all penang islanders… it is time we get to know penang, the WHOLE of the pearl….

not just the clubs n cafe at pulau tikus…

not just the sidewalks of gurney drive…

not just the beaches of batu ferringghi…

not just the penang laksa of ayer itam market…

not just the durians and rambutans of balik pulau…

not just the char koay teow of lorong selamat…

P.S. next time, one wanted to hike up… do ask me to tag along, ya?

X Generation?

Updates so far:

1. Finishing up my development blocks - spraying rather punkish blue, red, green, with some numbers on them 1 to 12.
2. Sunday: morning - went to park for senamrobik with my dad, then rushed to go for dana with Bhante Javana
3. Following the dana, went to hiking with Bhante & brothers sisters of dhamma to few high places - Dhammadipa Vihara of Ayer Putih, Balik Pulau and the retreat land further up from the Kek Lok Si temple.
4. Thailand trip - "cancelled due to insufficient participant" sms by kee seng
5. Pangkor trip - sister can’t find a package, dad rather go to cameron highlands…. well, back to the drawing board

The young generation, or more explicitly, the X- or Y- generation, as one of our lecturer called it, is a metropolitan lovers. The X- or Y- generation is defined by him as the generation where our parents were not born or dread through the era of wars, battles and occupation. Therefore our parents living in comfort, or rather relative comfort, will pour more and more ‘necessities’ for us to enjoy lying cuddled up in the lap of luxury. And the developments, the cities and the technologies in our metropolitan life presents as a challenge to the people who are too blind to see.

As Prof Lucy, my respected paediatric tutor, once commented to us that it is so common to have a maid to do everything that the children fail to do even the simplest of task at home. Imagine a child with lots of maid at home, going to summer camp, and when given a simple task of washing his own plate, is taken aback "I never done that before, I am not sure I can do it". It may seems like a joke or a comedy, but this is the hard, cold fact of life.

Listening to her, it reminded me of how ignorant I was back then, too. In my primary school, I had never ever taken a public bus before. Main transport is usually car, car, car and car. Then, when I stepped into Form 2, my co-curricular activities necessitates me to have longer period of hours at school and this is the time when I learn to take a public bus. My sifu: my classmate Wei Kong, an old friend who I had lost contact with. My biggest or rather disturbing shame at that time was I don’t even know how does the ‘bell’ looks like, looking all around the bus like a fool, when it was an obvious button in front me of me. I had a rather good time laughing at myself after this incident, and since then, I decided to be more adventurous - trying new things… correction… trying new healthy legal things…

Now, look around at the comfort you are having now, are you sure they are helping you, or they had been so far creating more disability in you?

I had a friend who took bus home regularly, but did not bother to remember the way home. Sleeping throughout the ride probably. When she first had licence for her motorbike, she took an easy ride to school but could not recall how to get back home. And guess what she did?

She followed the bus that she took everyday.

P.S. I may not be cool but travelling in the bus around penang is a sure must as one of my future family activity.

Pali glossary

Pali is ‘d’ original language for Buddhism as this is the language used by Lord Buddha in preaching His wise teachings. In contrast to Sankrit, it is a language without words, only pronounciation, originally used for the upper caste to communicate to the lower caste, and between the lower caste. Words were given and created in roman alphabets so that everyone can understand them globally. Comprehend? Chiao..

bhante [bhante]: Venerable sir; often used when addressing a Buddhist monk.
dana [daana]: Giving, liberality; offering, alms. Specifically, giving of any of the four requisites to the monastic order. More generally, the inclination to give, without expecting any form of repayment from the recipient.

holidays begins

Yes… COWABUNGA!!! as ninja turtle would have said it. 1 week of pure holiday. Finished off paediatric posting with a short case with Prof Lee with nutritional assessment. Rather difficult as I was given the direct instruction "You wake him up, I fail you!!". Still, the baby cried spontaneously and I had to pacify the baby for few seconds and he calmed down. No so much of a nightmare to me as Prof Lee was a cool examiner, despite the rather indifferent images that my fellow coursemates are trying to paint about him.

travelling plan so far…

1 go thailand with my coursemates - penangites & kedahans

2 go pangkor with my family

Despite rather uncomfortable ride from KL to Penang, I had a fruitful day today. In the morning, after being invited by Sister Koon Wei, I went to the Island Glade Buddhist Society to do Dana to a Bhante. Plan to do it again tomorrow together with the hill climbing expedition with Bhante. Sister Koon Wei going back to Kedah today with her family.

Went back home and assisted by my dear dad, started on making the cubes for my development assessment for my future paediatrics short cases. Sawing, measuring, painting… phew… so tired… got lots of carpentry pointers from my expert dad…

Then, my noisy sis came back home, and sinisterly we discussed about making sushi.. and actually started making sushi today… booked the whole kitchen… cooking orders went wild all over the place "you cut this" " you cook this" "not too much water" "wrap harder" "more mayonnaise" Neighbours may start to think we are going to kill each other shouting so loudly…. But i was fun, though. Even my father who originally doesnt really agree to this sushi making ordeal, started to enjoy the sushi, because he did request one additional thing into the sushi - the tau hu….

That’s all for now… COWABUNGA!!! to all my coursemates…