equality is overrated

2 days ago, I approached Dr. Thiyagar, HOD Paeds, the most respected man in the hospital, IMHO. Mostly because of his effective plan of management, early ward round starting 0630H and always the encouraging force for the MOs under him to learn up more and new things in Paed.

I heard a lot about him when he was not around in the hospy, sabbatical leave in Aus or so I heard.

"Pengarah had approved my attachment in Paeds, but I need to be on call in O&G"
"Oh, I was thinking about you doing tag calls to learn more about paed resus."
"Ya, I was thinking about the same thing, but..."
"So, how many calls you're doing there?"
"6"
"or then, you can't do much on call in Paed, you try to learn as much."

Personally I appreciated doing attachment in Paed, mainly NICU, but not being able to maximize my learning experience is just a sad thing that I did not want to voice out because I am thankful for what been given. It's probably not in my nature to be demanding. I probably silently make a note in my blog.

More often we're happier, not because we have more,
but because we demand less.

My colleague, Dr N, who just came back to work after long maternity holiday, reminded me of the times when the other colleague went for 2 months attachment and not required to do any call.

I do remember those times vividly.

During one of those on call, she was running around all wards, and even required to attend clinic as I was stuck in OT C-sectioning. She was so stressed up until she experienced some premature contraction, and in helping out, I cover her alone from 8pm onwards. Luckily she did not progress and subsequently she was indicated for 2 weeks of medical leave.

At that time, I had to cover her one of her on call - making my total calls per months = 9.
The higher level simply do not 'dare' to call the colleague on attachment back to cover N's 2 on calls. I was slightly unhappy to do the extra calls, but I justified it thinking other people will cover me when I go for attachment next time.

At present time:

Initially, I expressed my wish to do 2 weekends call, 2 Fridays (here, weekend is Fri and Sat. I know it's freaking weird, but gotta live with it), as it won't disturb my attachment during weekday. But I was given different math to work with.

Now, with minus me, there is still 10 medical officers in the department. Still, I have to do 6 calls out of 60 calls (1st and 2nd) per month. Easy math.

My time in Paed will be lessen due to my on call and post call drowsiness. I kept reminding myself

"It is not how much time you have but
how much you'd done with the time you have"

Sometimes, the inequality and mismanagement at microlevel will repeat itself.
Equality is always overrated.

The good thing about this inequality is self-righteous and self-indulgence gets into the equation, not race or skin color.

My dearest rarely came up with word of wisdom told me this:

It's OK if you fail in something (in this case, getting equality),
but just don't fail in your life.

I believe
Kamma always works mysteriously.
All efforts won't be wasted.
Every action has an equal reaction.

On forth, to the hybrid April.

P.S. I look forward to learn not just Paeds, but to learn more good values of Dr. Thiyagar.

record holder - 15, 16

congrats to my colleague, A, for breaking the record of having the highest number of C-Section in one day of on call 2 nights ago.

the 'lucky' number was 16.

that's about one C-Section every one and a half hour.

wondering whether does it got to do with the new roster that A put up in the pantry.
sometimes, kamma do works in a very mysterious way.

now, all wards is packed and loaded with undischargable post C-section patients.

whereelse, in Bukit Selambau, On 29 Mar, the EC finally announced a record breaking 15 candidates for the seat — the BN's Ganesan, PKR's Manikumar, and 13 independents.

probably some of the gullible independents thought about hitting the gold mine if they're elected and hopped. some people do take politics as a serious business.

prophecy

Grateful to Dr. J for helping me sort out some statistic headache.

Wow! I just completed the whole series of “Death Note” anime. Definitely more mind-blowing than the movie, but can be quite confusing if you didn’t keep your concentration straight.

After the eventful week that was.

I guess most of the people still pretty chatty about the new leadership of UMNO.

This party is the supremo uno in the BN coalition in this country and somehow, just like what America is to the world in every single way, except the maturity to see beyond race and skin color.

Everyone is being reminded to stay clear of talking anything bad about the new leadership, or else one will face some kind of judgments. Probably nothing much will happen till the 3 by-elections are over, just keep everything pretentious and all.

The recent water cannon incident near my place was the talk of the town.

From what I heard, as Brother Anwar stepped on the stage, not even a word came out from him, and he was ‘shot’ down instantaneously. I did not see this incident, so the validity of this news is doubtful.

However, some citizen were criticizing Pakatan Rakyat for spending unnecessary amount of money and effort for putting up all those flags, banners and all those speeches.

“Come on lar, brother. PR puts up a ‘teh kor’ also can win liao lar.”

* teh-kor = underwear.

I was wondering whose underwear will PR field?

Bukit Gantang and Bukit Selambau will see a bigger majority.

Batang Ai’s still a worthy fight.

I guess the R-A-H-M-A-N prophecy will come true after all.

I can’t say I am glad, can’t say I ain’t happy.

R-A-H-M-A-N, afterall, ends with the letter N.

NRP

grateful to: all the Paed' s facilitator esp Dr. Anu + Sisters for making this the most productive workshop I ever been to. Like I said, I never been to much of workshop, anyway.

the silent (?lonely) teachers


after every talk, there will small evaluation to decide whether you really listen or dozed off like how you attend most of the course/workshop organized by you-know-which ministry. if you fail the evaluation, you fail to get the certificate.

practical training - scenarios after scenarios after scenarios after scenarios...

new chapter

grateful to: the camera salesman who gave me the biggest joke last night. "No discount lar, brother, now all camera price had gone up, way up." "Hahaha" and I left.

congrats to Sia & Cat for their 001 cutesy baby!!

Patrul Rinpoche:

Do not take lightly small misdeeds
Believing they can do no harm
Even a tiny spark of fire
Can set alight a mountain of hay

Do not take lightly small good deeds
Believing they can hardly help
For drops of water one by one
In time can fill a giant pot

gone bonkerz

2 nights ago, an sms from my colleague Dr. T startled me. it was good news.

Just in case, I doubled checked. I NAILED IT!

Although just a simple first part of it, but I guess in the journey of delivering the results every drops of effort and sacrifice will not be forgotten.

I might be the one trembling in fear or crashing my brain out prior to the big event (getting myself almost brain dead), but it was all along my wife who gave me lots of time and space. In the process, it did rob little Aedan and my family back in Penang bits and bits of well-deserved quality time.

last 100m dash to the finish line

Not forgetting my HOD for granting me unrecorded study leave and my senior colleague Dr. A for piecing the separate pieces of study leave to slightly longer stretch, enabling me to have a better reading days, instead of going all exhausted after on calls.

And also to other colleagues for covering me in my absence and all the well-wisher of whom knew I was going to this small little battle.

With a calm mind, I am glad I nailed it.

As I promised, I will soon have a new hairstyle and my wife will have a new set of perfume (inspired by Dr. Yew), and my family is going for a nice family trip soon.

Now onwards, to a new chapter.

1st splash

grateful to: Dr. C for informing the well-worth Splash membership for 2 near my working place. Now I can go for a nice swim regularly with my loved ones, after the registration completed. Already 1 week, they still haven't contacted me.

I think I should buy a boat instead of an aeroplane...
He may get the wrong idea about aeroplane floating on the water...

desperately curious

what is this condition?

russian resistance

leningrad: the great russian resistance

I met this hardworking medical student when I was a relatively young house officer back in the old general hospital where everything is plain lousy but by standard, providing minimum sufficient medical service to the public.

She would follow the ward rounds. After rounds, follow us to do scut job. Ask about almost everything under the sun in the charts. Tap a few clinical practical experiences under my colleague’s supervision.

I was amazed at how much she spent in the hospital and her initiative to learn.

I later found out that she was in her first clinical year, and she is studying in Russia and she is doing attachment during her holiday.

I don’t see much of my colleagues doing attachment when we are in holiday, and I guess by far, at that point, I really think highly of Russian medical students. It was later that I found out she is probably the small minority.

My fellow friend POTS wrote a very interesting sarcastic entry on the house officers from Russia. Ever since then, he was entertaining a huge mob of Russian-educated Malaysian students and I did notice there is a bit of spillover to my new domain due to my small comment on his entry.

I guess by POTS’s excellent and perhaps precise sarcasm on the quality of Russian grads, it is only sensible for the students there, the agents who brought them there, the parents who chose the Uni there for their kids and also perhaps relevant government-related units to feel threatened or perhaps annoyed.

Of course, the most reasonable rebut would be there are bad apples everywhere, please do not generalize or make early assumption.

But here’s the thing, POTS opinion is purely observational. It is exactly like observing the nature. If the majority of soil of the land is loose, it will cause a landslide sooner or later. POTS is not putting a few pebbles thrown down the cliff by some baboons into the equation of the forecast of a landslide.

It is nature, just like, it is also observational that even graduates from the top local Unis are performing poorly and some are even pure menace even to themselves. No doubt.

Every department has a fair share of Russian grads.

The most memorable one that my department had did improve after lots and lots and lots of hardwork and perseverance. Initially, her knowledge (or grave lack of it) can be equal to a third year medical student. By simple assessment, one will find she is no difference from a fresh year 1 medical student. My humble specialists (even the most benign one) got totally shock. One even wrote a complaint letter to the Pengarah, 5 pages long. She gradually improved after more than one month of tagging and with kindness of the head, based on her working performance, attitude and her knowledge of recognizing the intra abdominal fat as omentum, she left the department without extension.

Needless to say, I also heard news about other house officers tagging till months in other department and was not given extension. Basically can’t wait to chase them away to other department. This is a conversation that my colleague overhead.

HOD 1: Hey, how do you actually let this Dr. X leave the department? (smirked)

HOD 2: Hahaha, now Dr. X is all yours (long smile)

Basically I do not have knowledge of how much red tape or paper work in other countries, but the Consultants in the hospital are loaded with clinical duties as well as receiving loads and loads and loads of paperwork plus multiple unnecessary meetings that somehow totally unnecessary and mostly were held simply for accreditation and not to improve the healthcare in any big way.

Therefore, critizing the Malaysia’s Consultant for not taking their time to teach the new house officers to take blood pressure for patients is perhaps masquerading as a joke. But in reality, is truly a comment out of lack of judgement, experience, common sense and lack of respect for you and the Consultants.

IMHO, like the old age word of wisdom, prevention is always truly better than cure. I propose MMC to let the Russian grads to have their final year training in our local university just to filter out the bad apples, plus to prove that the Russian Uni are the simply better than Malaysians’. By then, with the standard exams, one will see whether the general observation is truly statistically significant.

It will be harmful to the public once they donned the white coats and roamed the streets. Houseman training is not meant to develop perfect house officers, but rather to train one to be a sensible and functional medical officer. Therefore, house officers should not be judge by their efficient in doing ground work as house officers but also to have good clinical judgement and management of medical officer.

Back to memorable house officer, I guess if given more time to really build up her foundation she would have graduated well to function safely as a doctor, but sadly, she’s stuck in the system. Can’t go forward, can’t go back.

I think the major message that me (and perhaps POTS) trying to raise is an awareness for Malaysian to avoid going to Russian Uni to study medicine, but if you’re already there, do make extra, double, triple and quadruple effort to learn things in medicine, NOT just to pass.

One might pass the exam, but one may fail as a doctor.

One must realize the benchmark of providing a safe health care is pretty different from the benchmark of the exam.

If you really screwed up and brought up to the court,

that’s the end of your career and the total waste of your parents (or government’s) money.

By that time, you can’t go forward, can’t go back.

Likewise, everything is observational.

It is not who you are, or where you come from that matters, it is what you do.

There are 4 classes of people in this world.

Those who don’t know, but knows they don’t know.

Those who doesn’t know, but think they know.

Those who know, but think they don’t know

And those who know, and know they know.

Do not fall into the danger of becoming the 2^nd class of people.

If you’re the 1^st class of people, your perspiration will see you through.

No point getting depressed on the fact that you’re studying in Russian.

Probably, in the future; observation will see that the Russian grads will perform better than the local grads.

After all, we’re all products of the ‘good’ system.

P.S. if I'm still stalking that medical student.

retro CNY 2009

Found: 7, 8

today must be a good day.

finally, today, little aedan got his seven and eight... CHEERS!!

Few nights ago, he seem to be holding a decent short conversation with his grandpa and grandma too through the phone...

Haiz... growing up so fast... Wondering whether watching the Little Einstein's series of DVD been boosting his cerebral capacity... but after Barney, everyone in the house except little Aedan are pretty bored by it...

Lights out 830pm tonight.

Wondering what should I do?

dark saturday

grateful to: bro km for sharing george carlin's real good shit.

Yeah, Sat 8.30pm, I am switch off my non-essential lights for 1 hour. I am still scratching my head what to do for that 1 hour with Aedan and my dearest.

Not only for earth hour. But also to mourn for what bout to happen in this Saturday, as foretell by the media.

Anyway, here's a good perspective on saving nature. Human are created because God did not know how to create plastic.

da big questions

day 1 NRP: brain all toasted, but so far, this is the best workshop I'd been to. Not that I been to many (another story for another day).

Here's a good NRP joke (fresh from the oven), courtesy of Dr. F.

Dr. P reminded me to remember the 4 vital questions to ask during the delivery.

Dr. F replied:

1. whose's child?
2. are the parents rich?
3. are the parents lawyers?
4. are the parents warganegara?

I guess I couldn't have agreed more with Dr. F

traces of conspiracy

Grateful to: Mr H for meeting up after so many years and giving me an intro on property investment.

Months ago, I went for hiking at Bukit Semarak and I saw something peculiar. There were shredded paper along the hiking pathway. To me, it looks like pollution. But on closer look, it seems like they're papers or letters from government's department. I wonder what is it that was destroyed and so carelessly left in this famous hiking place.

if you'd read enough, you should have heard
what they say about Eastern Mata Hari
and our country's defence.

towering capability

you know times are bad when 2 professionals started to stack up cucumber and other vege during their lunchtime and sharing a single bowl of Pizza Hut's salad...

that tower of salad

the mastermind

wow... i don't think I can finish it.

response and responsibility

real teamwork is simply too overrated

I wrote this blog entry in an extremely solemn mood, in total disappointment with how another mother and baby were mistreated in the first world operation theater surrounded by 3^rd world mentality medical personnels.

1030pm. I was called upon that the mother planned for emergency C-Section had the sudden urge to push. I rushed to that mother and I saw the mother pushing madly with the baby’s head crowning on the perineum. The maternity staff nurse and me attended to the delivery. The baby popped up, covered with thick meconium stained liquor. As we called for help to call the Paed MO. No one answered. Everyone left us alone, as if, this is purely our O&G work, not theirs. Someone just passed me a few sterile scissors and left.

In summary, simple plain - calculative.

In reality,

“who care a damn if the baby die of meconium aspiration syndrome or the mother die of bleeding due to PPH, the O&G team should handle it, or they will be held responsible to it. She’s our patient only if she’s going for C-Section”

That, of course, was not said out loud. But that pretty much sums up their body language. Basically goes missing faster than the Great Houdini. I was thinking probably or perhaps the Great Houdini is their disciple.

I brought the baby to the warmer. She was moving vigorously, and crying well. Cord stained with meconium (oh god!). Unable to do much of direct suction, just proceed with oral nasal suction (moderate meconium stained – oh god!), warm and stimulate and rush to NICU for better observation and Pediatrics MO evaluation.

As the maternity staff nurse busy contacting Labor Room for the transport box for baby to NICU, I evaluated the mother and asked for help to take vital signs, give Pitocin and hand me a suture to stitch the oozing perineal tear. No one is around. Even if there is someone there, she pretended that she did not hear what I said, expecting her colleagues to come to help me. I can’t even assess the perineum properly. It was truly bad lighting at the observation bay and no one willing to bring in any extra lights. I took of my sterile gloves and timed the mother pulse – not tachycardic (thank god!)

It was hopeless to do anything for the mother in the OT. I called the Labor room for a trolley, applied a pad for temporary direct pressure on the perineum. The perineal tear was sutured well in the Labor Room, under good lighting.

I met the Sister (Head of Staff Nurses in a specific ward or department) on call incidentally and I told her about the appalling incident.

“It’s always happening. What can we do?”

Her reply truly irked me.

To them:

The patient is someone else.

The patient is someone else’s wife.

The baby is someone else’s baby.

I do my job. You do yours.

The patient is just another case. A job. A burden.

Dr. J (fr Unit Kualiti) once said,

“Life is always like that. Only when they lie in their death bed, only then, they realize people would have done more for them, if only they had done more for others when they can.”

I would not want my younger generation (yep, I’m old liao) to inherit such an horrendous tradition, but scolding them or explaining to them is like talking to pigs.

You know what they say about pigs.

Don’t fight with them.

They just wants you to get to their level – all dirty and smelly, without response or responsibility.

keeping abreast of things

yeah!! manage to cross majority of stuff off my 'To Do List'.

Some time ago, I stumbled upon these in front of the auditorium.

This is my choice - the best lactational breast.
Don't ask me why.
Didn't stick around long enough to find out 'bout the winning breast.

officially disaster-trained

Grateful to : Tuan Pengarah. a long walk made me see new beautiful floras and decos around the hospy.

arrgh... i ain't taking the long walk thru this...

I came to work a bit late (than usual) today.
couldn't get a parking space, even there were ample places allocated for us. Most of the space were occupied by either tom, dick or hairy (yes, hairy).

I parked my car by the roadside, but was flagged by the security guard who was normally sitting in their own booth, shaking their .... legs.

He told, "sorry, boss, can't park here. Pengarah's order. Want to clear the road to mortuary"

Syikess...

For mortuary? Either there will be angry mob accompanying the deceased or the deceased is Mr. Big Foot.

And so, no choice, park my car... far far far far far away.

Had a long walk this morning.

Later, I found out it was for disaster training. Clearly, O&G side not involved.

Mock bus turnover near Cinta Sayang.

One insider told me after my midday sport session, the reason for the disaster training is

1. This new hospital never had one before
2. Accreditation season soon
3. Bukit Selambau by-election

Syiikeess...

We're actually expecting violence during the by-election.

Hopefully, no pregnant women get hurt, NO, hopefully zero violence during the election.

By votes, no one knows who will be the big winner, but surely the biggest loser is predictable.

Winning a by election is like winning a lottery, or maybe, better.

To cash in, just hop.

As for the disaster training, when the real unexpected disaster comes along some fine day....

this training will be just another cup of teh tarik, a complete mockery of our own denial or exhibitionism, and total waste of time, money and manpower, only in a slight manner, preparing anyone for the real thing.

foot prolapse: that eerie waving hands

grateful to: both my HOD and Dr. M for letting me join NRP (neonatal resuscitation program), even if it is after my clinic. I'd been conducting delivery, attended to problematic babies first hand (and even intubated 1 baby) for almost 2 yrs without knowing the right procedure/protocol/technique. Luckily, nothing bad happen (touchwood).

2 nights ago, I was on call with Tim.

My call with Tim had always been sensational. super jonahism.

I had my first C-Section of the day early 8am.

Then, it was cool and I made myself busy working on my little study, hopefully to submit to OGSM on time.

There was 4 ERPOCs, completed late at night due to the non-urgent nature of the op. Leaving OT 0130H, I kept my fingers crossed tightly, hoping for a good doze off soon.

PC. Shutdown.

Clean up.

Lights off.

Entering NREM sleep cycle....

and minutes after entering REM sleep cycle, the phone rang.

- Oh. Shit... -

"Hi, Got 1 Caesar. 35 weekers Twin breech breech with foot prolapse. Foot out a lot."

Heart pounding faster.

"Ok, i'll be in OT soon. You come in, too. 2 heads better than 1."

"Ok"

"Any word of wisdom from Dr. M (specialist)"

"She just said for caesar"

- That's lots of confidence in me, probably she's on the way -

Patient on the table, inducing spinal anaesthesia.

I reviewed her red book. She was having uncontrolled BP, supposed to come 2 days before. She didn't turn up. She was leaking since the night before, but choose to come that night.

There goes the accountability of a pregnant mother to herself and her babies, or is it lack of communication from the prior doctor.

This is not her first pregnancy. My best bet is on the former.

Crash C-Section commenced, fearing further descend of the presenting part.

As I cut opened the uterus. There it was.

Facing me. The baby face and hands. The hands waving at me.

Eerie hands - means buttock may have been deep down.

(Palpitation) (Severe palpitation)

Adrenaline rush.

My right hands goes in, trying to scoop the buttock of the first twin out.

- No, way... Too deep... Ishk... T minus 2 mins before I call for Dr. M or extend the section -

Instinctively I scooped the head of the first twin and delivered cephalic.
Basically the baby sort of front-sommersaulted out with my manouvre.

- Phew... Definitely more difficult than delivery for tranverse lie -

Relieved.

2nd twin delivered uneventful.

Last check, both twin doing well.

I hope never again in my life to see another eerie hand.

It's really eerie.

Beware: KKM is judging

Capaian Disekat

Capaian anda ke laman web jimbocyberdoc.wordpress.com/ telah disekat dan direkodkan
kerana mengandungi unsur-unsur Tasteless & Offensive
yang melanggar polisi capaian internet, Bahagian Teknologi Maklumat dan Komunikasi Kementerian Kesihatan Malaysia.

Does jimbo knows about it?

race

no, not this kind of race
gynaecology specialist is gynaecologist, biology specialist is biologist,
physic specialist is physicist, race specialist is....

Before, I was colour blind. Now, I am blinded by colours.

An excellent batchmate of mine currently serving the people over the Borneo side wrote a compelling frank note about his own life experience, the growing up process and how much the country, no, the government love the people of the country. Some of the people, that is. Everything was plain and simple during early childhood until it get complicated and all the injustice of the country began to get on his nerve. In summary, STPM is just another word for discrimination.

I guess I shared the share sentiment. Most of us do.

I guess polarisation of citizens of Malaysia by race is without doubt not something new, not something that will change in the near future, not something that anyone can do a thing about. Even if you're doing something about it, it is simply fat and slim chance that it will bring in any changes.

This polarisation is like a shit. The shit stinks. The shit awful to the eyes, ear, nose and (if you're being forced upon it) tongue, yet, it will be there.

Writing about it. Bitching about it. Shouting about it. Fighting about it. Ain't gonna change a f*king thing.

Subconsciously, everyone is a racist. Some obviously more racist than other, but still deep down, as a Malaysian, you're either a racist or a hypocrite.

Choose your own poison.

I was put in charge of the house officers who came along for training for 4 months. A leader had to be chosen and the leader will pass the baton to the next once he/she finishes this posting.

Nothing fancy about this leader – more work, no pay rise, no extra leave, no extra allowance. The only perks – one can control/predict the on call dates

I chose an efficient chinese HO at first.

Then, a malay HO was chosen as he was the suitable for the job.

For the following candidate, my heart was contemplating, just to be fair; I should choose a macha or tanggachi for the job.

IMHO, my contemplation, although for a split moment of time, was that subconscious racist part of my Malaysian mentality.

Tun does make sense sometimes, as he was commenting about people going hoo haa about Obama elected as the US supremo uno, and people started to comment on the possibility of non-Malay PM in future in view of our current sociopolitical turmoil.

Tun is right. If our mentality is right, the best Malaysian should be the PM, the race doesn’t really matter.

My simple split second thoughts on race may seem like a thoughtful consideration for all races, but in reality, it is simply another pathetic menace and hindrance to the implementation of meritocracy in our country.

And this thought is probably the silent subconscious mind in most of the Malaysian.

We need to select the best person for the job, and to accomplish that job will benefit everyone.

Our system bugged by quota and semi-meritocracy only will drag the country further down to gutter of poverty. At the end, everyone will suffer.

Even the leaders, at time will subscribe to the similar mentality. One example would be - if the CM is a Chinese, the DCM must be Malay and Indian.

Our mentality had not progressed together with physical and material development in this country.

It is like a regular thing in hospital to hear announcement about car’s license plate numbers, of which the cars are blocking the ambulance path, the entrance path, or even the mortuary.

There are also self-written notice advising people not to pee on the floor of the toilet and to flush adequately.

There are also footprints on top of the sitting toilet bowl.

There is this Chinese proverb '3 people walking, everyone is everyone's teacher.'

In every race, they have their own strength and weakness. And everyone is everyone’s teacher. There is no need to quote those good people of any specific race.

There are good and bad people in every race.

No matter black cat or white cat, the one who can catch the mice is a good cat.

By meritocracy, it will enable the good people to stay and build the country the right way, benefiting everyone in the long run.

At the end, I chose someone who I felt best to shoulder that responsibility, inspite of their colour, their race or their gender. The next candidate was not a macha or tanggachi.

At the end, this entry is just like any other entry about racial polarisation.

I write about it. I bitch about it. I shout about it. I fight about it.

It probably ain't gonna change a farking thing.

Before, I was colour blind. Now, I am blinded by colours.

Aren't we just part of the large majority blinded by colours?

completed function

grateful to : Tim, for keeping the call cool so far...

I entered OT today and I saw this OT list.

yours to discover

grateful to: astronomer amanda bauer, for such a wonderful blog on astronomy. i wonder whether she's related to Jack Bauer (24).

When I'm in high school, I was a keen astronomy follower, together with Wei Pin, Kah Chong and the rest of the gang. My school has an attic for star gazing session and organize Space Camp every year. Space Camp is just another fancy word for fellowship bungalow stay up in Brothers' Bungalow in Penang Hill with injected astronomical teaching and star gazing session. Not that we go to space or anything like it. We just have more space for ourselves in the camp.

Since those days, I had not been following anything related to astronomy until my mystic colleague discussed with me regarding some extraterrestrial issues, such as Nibiru and 2049 made me think - how much I miss astronomy.

The constellation above is the most simple constellation everyone will easily spot in the Malaysian sky at some part of the year. And it is this same constellation that pioneered my interest into astronomy.

This constellation is Orion or the hunter (I was told).

The three blue stars in a straight row are the hunter's belt.
The orange star is the arrow tip of a stretched bow.
As for the red star.... go figure.

I also remember the Big Dog (Canis Major) constellation beside Orion, which consist of the brightest star in the sky - Sirius.

Anyway, I hope to re collect my astronomy interest from this year onwards, in conjunction with

I simply love astronomy not because of the star, not because of the constellation, not because of the comet, not because of the moon or the planet, but simply because

it's an exploration of possibility
it's a wild wild wide world out there
and we're just another speck of dust in the universe

tap project

grateful to: clement for this awareness

before we move on to Earth Hour.

I guess we should know that next week is World Water Week, March 22-28, 2009.

And the water that we take for granted. The tap water we left flowing

Every day, 4,200 children die of water-related diseases. Nearly 900 million people worldwide lack access to safe drinking water.

Someone really wise once mentioned that the great inventor in medical field is not the antibiotic's Fleming, but rather the inventor of the flushing toilet.

Dirty water or the lack of water is almost equal to death.

In 2007, the Tap Project was born in New York City based on a simple concept: restaurants would ask their patrons to donate $1 or more for the tap water they usually enjoy for free, and all funds raised would support UNICEF’s efforts to bring clean and accessible water to millions of children around the world.

Growing from just 300 New York City restaurants in 2007 to over 2,300 across the country in 2008, the Tap Project has quickly grown into a national movement. Restaurants, corporations, volunteers, advertising agencies, community groups, local governments and everyday diners participated to save millions of children’s lives.

If you have that extra bucks, donate it. For every dollar raised, a child will have clean drinking water for 40 days.

If you don't have it, simply cherish the water that you have and stop wasting water.

This year, the UN World Water Day theme is "Shared Water–Shared Opportunities." Special focus will be placed on transboundary waters. This year on World Water Day, we call attention to the waters that cross borders and link us together. Whether we live upstream or downstream, we are all in the same boat.

common sense 1

sometimes, there's more than one.

there I was suturing up in C-Section, the phone in MOT (maternity OT) rang, and the SN of MOT asked me someone in the O&G clinic asking me whether or not I am busy.

FGS(for goodness sake), I am performing a C-Section.

The question on whether or not I am busy while i'm operating - is that

A. a question?
B. a joke?
C. a sarcastic remark?
D. another average Malaysian's common sense?

Lost: 7,8

Grateful to: all the SNs in OT for running around trying to find the perfect connectors for the hysteroscope, yet couldn't found one.

Little Aedan is becoming more and more cheeky. I don't know whether that part of the gene is from me.

At least I know he is not as quite as I was when I was small. Today, he got a bump on his head. He couldn't get the things he wanted and he ran around like amok and knocked his head onto the wall. Too late for anyone to stop him. It's time for him to understand the consistency of the wall - hard.

I know I surely wouldn't run amok when I was a little kid, because I was too fat to be running.

He's been learning a lots of vocab from that AAA ciplak Baby Einstein series from JB. He is currently even learning about the animal I don't even know of. One example is caribou. The nearest word I knew to caribou is probably Karembau.

And the most hopeless thing to do is for him to count 7 and 8. always and forever missing.

Me: One...
A: one... two... theeeeeeeee....
Me: Four...
A: fourfivezix...
Me: Seven...
A: Nine, TEN!!!! YEAH!! (and he clapped wildly)
Me: No, Seven!! (Serious face)
A: Nine, TEN!!! YEah!!! (again the wild clapping)
Me: Aedan, what about seven?
A: Nine, TEN!!! YEah!!! (again the wild clapping)
Me: Aedan, you say seven, eight... we go kai kai...
A: Selen... Nine, TEN!!! YEah!!! (again the wild clapping)
Me: Where's eight?
A: Kai Kai... Kai Kai... Kai Kai... Kai Kai... Kai Kai... Kai Kai... Kai Kai... Kai Kai... Kai Kai... Kai Kai... Kai Kai... Kai Kai... Kai Kai... Kai Kai... Kai Kai... Kai Kai... Kai Kai... Kai Kai... Kai Kai... Kai Kai... Kai Kai... Kai Kai... Kai Kai... Kai Kai... Kai Kai... Kai Kai... Kai Kai... Kai Kai... Kai Kai... Kai Kai... Kai Kai... Kai Kai... Kai Kai... Kai Kai... Kai Kai... Kai Kai... Kai Kai... Kai Kai... Kai Kai... Kai Kai... Kai Kai... Kai Kai... Kai Kai... Kai Kai... Kai Kai... Kai Kai... Kai Kai... Kai Kai... Kai Kai... Kai Kai... Kai Kai... Kai Kai... Kai Kai... Kai Kai... Kai Kai... Kai Kai... Kai Kai... Kai Kai... Kai Kai... Kai Kai... Kai Kai... Kai Kai... Kai Kai... Kai Kai... Kai Kai... Kai Kai... Kai Kai... Kai Kai... Kai Kai... Kai Kai... Kai Kai... Kai Kai... Kai Kai... Kai Kai... Kai Kai... Kai Kai... Kai Kai... Kai Kai... Kai Kai... Kai Kai... Kai Kai... Kai Kai... Kai Kai... Kai Kai... Kai Kai... Kai Kai... Kai Kai... Kai Kai... Kai Kai... Kai Kai... Kai Kai... Kai Kai... Kai Kai... Kai Kai... Kai Kai... Kai Kai... Kai Kai... Kai Kai... Kai Kai... Kai Kai... Kai Kai... Kai Kai... Kai Kai... Kai Kai... Kai Kai... Kai Kai... Kai Kai... Kai Kai... Kai Kai... Kai Kai... Kai Kai... Kai Kai... Kai Kai... Kai Kai... Kai Kai... Kai Kai... Kai Kai... Kai Kai... Kai Kai... Kai Kai... Kai Kai... Kai Kai... Kai Kai...

I guess you know where this conversation ends.

7, 8 goes kai kai everytime counting started.

at your 'cervix'

grateful to: Bayer's Yee Ling for the little guide on all the latest contraceptives of the world.

It was a busy day. Diving down to help out my colleagues who are really busy and practically (probably) seeing her world turned upside down or other way round.

I was called to help out as the 2nd call colleague stuck with C-Section.

I was told there was this massive PPH secondary to ? cervical tear happening in the ward and sending to OT for EUA and proceed. EUA is just another fancy term meaning examination under anaesthesia, meaning we try to knock out the pain maximally in order we could position this lady for a better view of the problem.

This was the same lady that gone through ventouse earlier this morning by my junior colleague supervised by me. I was really stumped because there was not much bleeding after the ventouse and there was definitely only small first degree tear.

My junior colleague told me it was probably a cervical tear and she had bled 750cc so far, by pad and gauze calculation. Gauze nowadays are getting thinner and thinner (probably thanks to CSSD earning kopi duit from taking those ciplak stuff in), I guess she may have overcalculated. But still the bleeding was real.

I cleaned and did a simple digital vaginal examination.

Hmm. It looked like the cervix, bled like the cervix, torn like a cervix, but it definitely doesn't feel like cervix. It was somehow less fibrous and less firm. Anyway, post partum cervix may have felt that way. But still not that bulky.

With simple strength, I try to pull out that piece in the vagina. It got torn off.

Bright light in OT.

This is definitely no cervix.

It's the placenta and I proceed to grab another big chunk of 500mg of it out.

Ta daaa...

Bleeding stopped.

Reexplored by ERPOC and did some simple suturing of minor vaginal wall tear.

Re-re-re-re-re-re-re-re-re-re-reviewed the post delivery notes: placenta and membrane complete.

Most probably diagnosis: Succenturiate lobe. In layman term, it's another satellite lobe from the main lobe. Not an everyday diagnosis of PPH.

tip of the iceberg

The Malaysian Medical Council has acted against 13 doctors — including striking the names of two of them off the medical register — for various offences last year.

Among them are:
1. Dr Nusyirwan Mohd Syukur - using UKM instead of the real uni (fraud)
2. Dr Zuabidah Zabidin - allowing an unqualified person to attend, treat and prescribe scheduled poisons to patients without her or any other registered practitioner's supervision. (dangerous)

This news came as a warning and also a timely regulatory, but with lack of knowledge, lack of practical training, lack of commitment from the medical school, and finally with increasing patients load, patients' demands, red tape in public practice and politic play in medical practice, this is as what Winston Churchill once said, " This is not the end, or the beginning, this is the end of the beginning."

Time will tell whether we'll see beyond the tip of iceberg.