graffiti war, NOT only at theatres

Disclaimers: Though all the words are meaningless fictional teasers meant for entertainment, not for otherwise, but the graffiti is real (made by white board marker buatan malaysia. Malaysia Boleh!!)

xmas down south

everyone loves Christmas (no offense, Muslims), even though you don’t know what the heck it is for (no offense, non-christians, most of you all really don’t).

The reason probably why xmas is so popular perhaps would be it is the only other season besides Chinese New Year that someone would have the privilege to wear red, or perhaps it is a time where somehow it seems like everyone is having a birthday. Everybody receiving gifts for everybody is always an unforgettable nice moment, unless of course, you find that

the process of thinking what to buy,

the process of going through shopping complexes to buy something,

or the process of forking out a great amount of money to buy so many gifts

is a truly agony too harsh to bear.

Anyway, xmas is xmas,

it is a season of green, white and red,

a season of xmas trees and santa clauses,

a season of snow,

a season of xmas carols,

a season of going places for holiday,

a season for wild shouting and countdown,

a season to count your blessings, etc…

my xmas was spent at orchard road, singapore. It was really a wild countdown and everyone was flocking around like there were gangfights all over orchard road. Everyone were there. The rich, the poor, the old, the children, the babies, the elated ones, the depressed ones, you name it, you got it.

this is my second time at singapore. my last time in singapore (>10years back) was also during xmas time, and was also at orchard road. At that time, the lightings were cool and great but the people were less wild. I remembered how my dad kept saying how wonderful to celebrate xmas at the orchard road, over and over and over and over again…. over and over again. Couldn’t recall how great it was back then, but the most significant thought about that trip was it was my first time on a plane, from Penang to Changi, Singapore.

This year, everything was wild and dangerous. Not snowing at the tropical country does not deter the ah bengs at singapore of mass importing the "snow in the can" and making the whole orchard road a war zone. It is actually looks like hairfoam in the aerosol can, going at the price of S$10 for 5 cans. People just blasted away the snow at one another like hong kong movies. One guy actually held the two cans as if he was holding 2 guns and as he shoots he SPINNED around. knuckle head. i suspect he was on pills on that night. Anyway, not just the youngsters were at it, even the middle aged (40-60years old) also bought several cans and shot around at everyone randomly enjoying the moment, perhaps de-stressing themselves from their everyday’s work. nice to see their participation. Foreigners got blasted like mad, and one actually turned into a walking snowman.

All this aerosol is from china, and they may be just some damn cheap stuff which is hazardous to health. i wonder whether any health or environmental officials care to check them out. no report about them so far. I googled about it.

Got lots of photos with some else’s camera, so will be uploaded later, much much later. wouldn’t risk bringing my palm camera into such a risky place.

The best thing about xmas this year was I celebrated it with someone special, and staying over at her sister’s place.

being a unpaid student, i made something special for her.

white xmas in a can. (CFC-free) - copyrights not reserved -

taking the train to Singapore

Xmas eve travelling - chinatown complex

Xmas night at my faculty - the most best that i had seen in 5 years. Cheers!!

bore and boar, part 2

reply aka comment from tauke:

So, let’s say the dozen of students who had been deeply encouraged by their enriching palliative experience in Taiwan deserved to ignore the lecturer, we still have more than 80% of the class. They chose to ignore this one simply because it is not coming out for the exam, and maybe most medical students care more about diagnosing rather than the totality of management itself, which palliative care is a part of.

I agree that I am being self-righteous when I label my coursemates as kiasu. But sincerely, the reason for my previous post is my utter disappointment with the shallowness of the future doctors who cannot even give one hour to listen a palliative care lecturer who came all the way to UMMC, probably with no pay, who is just interested to enlighten our darkened minds something about caring for the terminally ill.

So what if we can diagnose a 6th nerve palsy due to a cerebral abscess secondary to AIDS, if we know nothing about the palliative options of this AIDS patient?

Amongst those who stayed behind for the lecture, some were playing Bingo, some were reading their medical handbook, some were chit-chatting, some were sleeping, some have no idea what they are doing in medical school. Very few actually cared.

If this is the kind of attitude my future consultants have in the hospital, then I fear for the terminally ill patients of their time.

my reply:

shallowness is always there.
people are born shallow.
some actually grew to become more shallow unfortunately, fallen victim to their instinct to survive.

in the spirit of malaysia boleh,
palliative is part of management, who cares.
rehab is part of management, who cares.
lifestyle is part of management, who cares.
alternative medicine is part of management, who cares.

all ppl interested is in the advanced pharmacotherapy or surgical technique
at least, that is what our examiner would be interested to know, so they think.

i had the most disturbing experience in my recent rehab class about orthosis and prosthesis, one of my coursemates actually asked me to sit in front, so that i could answer any question from the rehab dr, dr rameezan. "y u can’t answer meh?" "no lar, i am not interested, not as interested as you do, i can’t be bothered" i gasped, nearly anoxic.

albeit, rehab dr, palliative team, primary care dr, is often being perceived as less important.

but in real fact, lots lots and i shall repeat again, lots have actually forgotten that the best part of medical management that really does matter which is preventive medicine, as the old saying goes "prevention is better than cure".

if the prevention is good,
we would have less cancer patient in palliative,
less MVA survivors in rehab,
etc etc etc…

but since we still in the "malaysia boleh*" state, hopefully we should still harp onto "to cure sometimes, to relieve often, to comfort always", hoping this will be better in the future, where doctors will be doctors, not "veterinarian"

transformation of heart largely is by self-effort and self-realization, living up to one’s principle and conscience despite pressure from peers and others.

kiasuism is always a relative thing.
self righteousness is always a relative thing.

prof philip poi once told me, "sometimes you all are just too relax, and not being kiasu enough"

* malaysia boleh ada orang merokok di tangga hospital dan tempat larangan merokok seperti universiti
malaysia boleh ada rekod terbaik dalam bilangan kemalangan jalan raya
malaysia boleh ada orang lepas sakit jantung masih hisap rokok bagaikan ubat
malaysia boleh banyak banyak lagi

lastly, in medicine, no one should be ignored, the most important person in the management is not the specialist nor the consultant, often forgotten, it is the PATIENT.

Dr. Liew "we must empower the patient and also give power to the patient"

kisah di avicenna

disaster:

few days ago, i nearly got mugged. i came back to college to get some stuff at around 9:30am and i was in the room, leaving my door closed but not tightly closed. A malay guy opened my door and saw me. He responded "Roslan adakah?" I know he is lying, but he was bigger than me. Wrestling him down may cost me a fracture or some other traumatic soft tissue injury. I was alone in the whole block. Therefore, I just keep cool, holding a mug (not seen by him) and pretended to ask further in the most casual manner, just to complete my inspection (the next time i meet with him, I could recognize him easily). He backed out of my room.

me: siapa roslan?

villain: dia pelajar tahun 2, medic.

me: oh, tak kenal lar

villain: dia pemain hoki

me: tak ada lar, tak ada pelajar tahun kedua main hoki. you dari mana?

villain: i dari API (akademi pengajian islam). tak apa, i cari sendiri. terima kasih (and he cabut)

I reported this matter to the office. And the makcik at the office told me prior to this, there was already a case of stolen wallet and handphone in the lower floor. Why aren’t all the occupants being forewarned?

I told the makciks at the office to paste a notice. They said "ok". But that "ok" seems to be a malaysian "ok", meaning the notice will probably be out after a rough estimation of another 5 to 10 cases of theft at the college.

The makciks also asked me to write a report, a formal one.

Ingat saya sangat senang ke? formal lagi?

Wouldn’t it be easier if i report it to police? at least the police will type the report for me.

nearly being mugged is not a disaster, spending 5 minutes with that 2 makciks is.

a better word for disaster is malapetaka. you can feel it.

- words from Dr. Kwan

blessings:

• the water cooler near my room is ALIVE AGAIN!!!
• i’m nominated as one of the contender in Mr.Personality at our MPIS nite. (some sort of prom night). I know I won’t win. I am just being there to pad up the number of nominees. But still, I am happy that my eventual defeat will make that winner feel better about himself, and I wish him well.
• Xmas night was a great success last night. great decorations, great activities. great job, guys!

bore and boar

here’s what this mamat wrote:

Apakah hebatnya jika
kupanjangkan umur kamu
tanpa kubantu kamu
bersedia untuk meninggal?

Almost the whole class gave an applause of satisfaction when the rheumatology lecturer ended his lecture which was full of good jokes and exam tips. When he left the lecture hall, half the class began to leave just as the next lecturer was coming in.

The next lecturer was Dr.Ednin Hamzah from Hospis Malaysia, who came to lecture us about palliative care.

It was a good lecture. Probably had it been given in Singapore, Hong Kong, or London, it would be a memorable lecture for a medical student. But unfortunately, almost all of my fellow colleagues are too shallow or indifferent to give a damn about the business of helping people die peacefully.

A tinge of self-righteousness here, but I think our fellow students are too KIASU as to even waste time on something that would not be tested in our exit examination. For them, what matter are the 11 criteria of SLE, the different causes for cyanosis, the steps to examine for 5th nerve palsy, and all that academic stuff that make them shine like a gold medallist. Palliative care? Don’t waste my time, please, I can almost hear them say.

In the hospital, I see many frustrated patients and parents. They are not getting well, long hospital stay, because our doctors do not know when to stop treating, and start palliating. We do not know how to explain our actions, just thinking that they are too stupid to understand the basis our clinical practice guidelines.

Unfortunately, the smart ones who will one day be consultants in my great hospital are the ones who left the palliative care lecture. Because the smart ones also happen to be the most kiasu.

Sorry, my dear coursemates, but that’s what I think some of you are - Kiasu and shallow!

my comment (plus and minus):

people could not stay for class is because all they wanted is to pass… no, i’ll revised that.. is to ace their final exam, or at least pass it with ease.

all this while, they are following their instinct, not their conscience,
or perhaps they believe that to follow their conscience IS to succumb to their instinct.

palliative class is a bore, at least, this class is, frankly (i do not practise hypocritism, nor am i implicating that tauke is practising it). you can’t just strike a person with an idea, a vision or an ultimate dream by a simple lecture, and words that doesn’t carry much weight.

weightage comes from experience,

weightage comes from practicality of matter,

weightage comes from realizing that someone dearest or yourself is living or perhaps dying the palliative way….

"only after the last meat had been hunted down, last fish had been caught off, the last drop of clean water and air had been taken in, only then one will realize that money can not be eaten"

i had been exposed to the established palliative care during my elective last year at tzu chi hospital, hua lien, taiwan.

the experience is one of its kind, and nothing can replace how much it made me realize the importance of palliative.

how one touches another person’s heart required great effort, endless perhaps, but one can never never ever ever ever give up, and sadly to say, labelling people negatively would never help. It would be just like critizing smokers as annoying and moron.

y makes things so difficult.

John: No, if you wanted it back, you got to ask me yourself. You got to act with your mind and conscience, not blindly following your instinct. That is the difference between you and him [pointing to the oinking boar that was caught after falling greedily into John's trap]

Charlie did asked him 3 times after a period of struggle, and J

watching one of the episodes in "Lost", there was this inspiring scene. All of people in this series are survivors of a plane crash in an exotic island. There was this guy, Charlie who was totally wasted, stoned and addicted to a pack of drug, which falls into the hand of another person, John Locke.

Charlie: give me back my drug.

John: I’ll give you back if you asked me 3 times.

Charlie: If you ain’t giving me back, you might as well throw it, wh

ohn disappointingly gave Charlie back the drug. But Charlie, at that point, threw that drug into the burning fire, that light up the cave they are living in, (added by moi) and at the same time, lighting up his brand new life without drug.

it is similarly, in the spirit of challenging one’s capability of controlling our instinct that make us different from animal. We see to it that we are not the animals who are surviving the medical school (this seems to be a famous phrase -"surviving medical school"), we must be the doctors who earn every wisdom from medical school by our own effort and by our own commitment.

what the world need is for someone, or perhaps a group of somebody starting doing things practically and we’ll see how the rippling effect goes.

it’s time we walk the talk, or else, this will be just another blog entry in somewhere that deem to be repeated in the future as just another blog entry in somewhere else.

bore

(bôr, br)
tr.v. bored, bor·ing, bores To make weary by being dull, repetitive, or tedious: The movie bored us.
n. One that is wearingly dull, repetitive, or tedious.

boar

n 1: Old World wild swine having a narrow body and prominent tusks from which most domestic swine come; introduced in United States 2: an uncastrated male hog

bringing god into the picture

TV Smith: As I was photographing some migratory birds in Bangi today, a grim layer of clouds descended. Bludgeoned blue retreated as swirling white sparred with turbulent black. An awesome scene unfolded before my eyes. God was drawing Malaysia. Before the island of Borneo became properly etched, He tossed his easel impulsively. It spilled rain, life and death onto the land below. The monsoon is here.

speaking of god… yesterday, i had the most furious day of my life. well, ok, not the most, i had worse times before.

here’s how it all happen… My posting group will be having anaest class every monday, 1:30pm. It is close to universal truth about the arrangement of this schedule. Yesterday, 2 of them told me they did not know about this class and asked why I did not remind them about the class in the morning(they urgently need to hire a nanny to remind them, since they are still behaving like a big baby. Can’t imagine them being a doctor, reminders from patients perhaps?!?!). The schedule of class was stated so since the beginning of time (at the first or second day of posting, meaning 4 weeks ago).

Even so, I tolerated the childishness and informed them that class is starting at 1:30pm when I arrrived at OT at that time. I waited patiently together with 2 other groupmates, with the lecturer from anaesthesiology department in the OT. They came at 2:20pm. (To calculate how late they are: 2:20pm - 1:30pm = 50 minutes). The lecturer was a benign one.

Makcik A & B : We don’t know about the class.

Me: I was stated since the start of posting, others(my two groupmates with me) know about it.

Makcik A: No lar, you didn’t tell me this morning. (signs that she urgently need a nanny)

Me: Ok, but I called and sms-ed you at 1:30pm, why so late?

Makcik A: I sembahyang lar….

Me: (silent mode)
(feeling: obviously furious "everyone knows you don’t need 50 minutes to sembahyang")

N.B. not a single word of "sorry" to the people who had been patiently waited for them.

I am buddhist, and I believe in Gods, plenty of them in heaven, not believing in particular creator God. But she is an avid believer of her own one and only God. But I found it most annoying and disgraceful for someone to bring god into the picture. One of the groupmates that were present with me at 1:30pm had skipped lunch (I don’t know why, as we had no class that day from 11:00 am onwards) and gone for prayers just to make it to the anaest class. He is not a dilligent guy, but he never ever bring God into his own mistakes or errors.

The same thing also happened during my O&G on-call days (few months ago), where Makcik A wanted to have extra 30 minutes of break more than others, because she had to "sembahyang". Of course, I courteously rejected her suggestion.

I bear no grudges to Makcik A as a whole, as I always know that she is good girl generally, and this attitude of bringing god into the picture is somehow over the line, way OVEEERRRRR….

Someone should talk to her. I believe there will be someone who’s reading this, and that someone will tell her. (To someone: Thanks)

slimming down

Warning: Kids, please do not try this at home. May bring hazardous effect to general health and cosmesis.

From adorable hugables to Smeagol. Just for laugh.

Disclaimer: No animal(s) were subjected into unnecessary cruelty in the making of the photo above.

an informal guide to nick 1 million from national trust

The Star (Friday December 16, 2005)

PSD refers 44 medical graduates abroad to A-G

KUALA LUMPUR: The Public Service Department (PSD) has referred to the Attorney-General’s Office the case of 44 government-sponsored medical graduates who failed to return after completing their studies overseas.

Parliamentary secretary in the Prime Minister’s Department Datuk Mohd Johari Baharum said the graduates did not apply to defer their return to Malaysia, which violated the terms of their agreement with the PSD.

“The Government agreed to allow graduates to stay back for between one and four years but with permission from the PSD and under certain circumstances,” he said in reply to a question by Tay Puay Chuan at the Dewan Negara yesterday.

He said among the circumstances were if the graduates were pursuing studies at a higher level or waiting for their spouses to complete their studies or training.

On their return, he added, the graduates would be required to register with the Public Service Commission and the Malaysian Medical Council to facilitate their appointment in the civil service.

A total of 264 medical graduates have failed to return after completing their studies.

They were among the graduates whose applications to stay back were rejected.

Mohd Johari said government-sponsored students who failed to return must pay back the costs incurred, which included study fees, allowances and flight tickets.

Previously, in 2003, such graduates would have been fined RM160,000, but now they have to pay all the costs, which in the case of those who studied in Ireland amount to almost RM1mil per student. – Bernama

conclusion: no wonder, our country is short of doctors… and also short of funding for lots of our health services… over these years, if the calculation is correct, we had lost RM 264 million. The names of those "doctors" should be published in local newspapers for "stealing" 1 million from all the down-to-earth black, brown, yellow-assed tax-payers in our country.

PSD took 2 years to come up with the idea of raising the fine from RM 160, 000 to RM 1 million denotes:

• lack of efficiency in PSD, never could really walk the talk
• there will be slim chance for the complete collection of fines, and if it does happen (a miracle!), it will probably be in the year 2030 (thanks to prediction by Madame Zouk, gypsy at 3rd alley down Old Klang Road).
• as for now, there will be a continuous outflow of money to sponsor medical candidates abroad.

To all christians, or christmasians (non-christian who actually loves Xmas more than christians)…

Season of joy, season of giving, home is where the heart is,

Be at home, and have yourself a merry, merry little Xmas…

pilo-ism: there’s a million ways to skin a cat, there’s also a million ways to skin the tax payers money, and the best way is to get a loan and turn it into a ’scholarship’.