Apr 30, 2009

Nagol vs Einuo

in conjunction with world book day, I got myself a good bargain. A rather good book on face reading by Joey Yap at discounted price. I guess we shouldn't judge the book by its cover, or rather judge a person by his or her look, but then again, first impression really is after all very important. perhaps tomorrow, I can enjoy that labor day reading this book, and probably be able to sum up someone at the first glance.

Yesterday, I was put on call, replacing someone, summing up highest number of call per month, but surprisingly I enjoyed it mainly because my mind was relieved of 2 things deadlined today - income tax report and abstract submission and registration for OGSM coming june.

Other thing would be the enjoyable and educational night round with Dr. Kuna, my HOD.

Along the team being on call last night was a russian-grad house officer, by the name Dr.Nagol (obviously, not the real name). Nagol attire totally took Dr. Kuna and me by surprise. Nagol wore the blue scrub shirt, a trackbottom and black socks & shoes. Not only it looked rather unprofessional, it wasn't that fashionable as well.

K: Low, do others wear similar way?
Me: This is the first time I saw this combination of clothings
N: Sori, my black slacks got wet after wash up.
K: Why not clad fully in scrubs, then? Half here half there.
N: Sori, no next time.

The first day I encountered this HO was a few weeks ago. Nagol looked like a slob to me, mainly because Nagol wasn't cleanly shaved, and Nagol's hair was standing up like a vagabond. Let's just say the hair part - it was more of a health problem resulting in cosmetic complication.

"HARLO!! HAH!! HA!! OKAY!! "
Loud voices behind the screen. This was my 2nd encounter with him.
Nagol was midway clerking a patient when he had to answer to a call. There Nagol was, seated beside the patient while loudly talking through the phone.
This seemed rather rude.

But over the weeks, I observed and perhaps discovered something surprising about Nagol. Even though, Nagol looked like a slob, Nagol talked like a slob, but Nagol wasn't a slob. He worked up to the capacity. Not calculative. Got down to business. No MIA so far. (MIA = missing in action). Nagol's clerking is informative and slightly above average, I must say. By far, Nagol functioned pretty well.

I guess, Nagol needed a little more convincing thoughts on tidying up to mark up professionalism, from someone close to Nagol.

In a way, Nagol is far better than the local-trained Dr. Einuo, another HO who was totally different. Einuo would look tidy, hair well combed, looking fresh and talk cock very professionally but specialized in MIA. With a lenient posting Einuo is having right now, MO often had to put up red carpet to ask Einuo to complete the on call duties. Even that posting's HOD put Einuo within the 'radar' for early detection of MIA.

Nagol vs Einuo?
Which kind of doctor would you rather have?

Perhaps above is a stupid question to ask, because most of the time, one would already chosen Einuo based on the first impression, only to find out later Einuo is just another joker with a good sense of fashion. Nevertheless being a physical slob, Nagol poses a fair amount of infectious risks.
*****
grateful today to: Dr Haliza for such a good, short and precise CME talk. simply inspirational, I guess.

Apr 29, 2009

TV sets for Penang St Nicholas home

Penangites - MUST READ THIS

got this from susan's



YES! We’re talking about the television set(s) that you have at home. If you wish to discard or give away your tv set, St. Nicholas’ Home, Penang dormitory is more than happy to be on the receiving end. All they are asking for are two (2) TV sets that are still in working condition. [Good hearing condition].

What does ‘working condition’ mean? = still sound emitting, but not necessarily with clear vision, as they just need some mode of contact with the outside world, whereby they can listen to daily news, entertainment and songs, anything… to accompany them through day and night, ups and downs…

Wouldn’t it be nice if you can be the one to bring in music to their ears and sounds to their hearing?

Please pass this email around to your friends and families. If you wish to donate your tv set, please contact Joyce Yeoh or Grace Ong, or deliver the tv to us, the TV Collector @ Resource Development, St. Nicholas’ Home, Penang, 4, Jalan Bagan Jermal, Penang. You may also wish to contact us at 04-229 0800 for more assistance.

Remember, the blind may be out of sight, but they shouldn’t be out of mind. Let’s help bring some joy into their lives.

May God bless you.

THANK YOU FOR YOUR SUPPORT!

Apr 27, 2009

hospital mates

another patient's perspective, now from the gynae side.

[180px-HospitalSungaiPetani.jpg]
5 days at the hospital ward was full of memories. I'm fortunate that Allah swt send me some kind people to help me. My hospital mates were helpful and friendly, and as they could walk about after their own D&C, they had helped me when I couldn't help myself even to a cup of water (being stuck on the bed with tubes). We kept each other's spirits up and cracked jokes to pass the time. The stories we shared were enough to write a book, hehehe. Rosiza, Hanisah, Kak Aini, Saadiah, and Siti. Pregnant with diabetes, miscarriages, bleed during pregnancy, nausea during pregnancy, etc. Ah, it's tough being a woman. When they left on the 4th day, I was quite depressed as the new set of roommates were not so friendly.

somehow, hospital mates are just as valuable, helpful and important as the doctors or any medical personnel.

napster nabbed

Monday April 27, 2009

Saravanan upset by ‘napping’ A & E doctors

http://richardoshen.com/wp-content/uploads/2008/02/nap.jpg

KUALA LUMPUR: Deputy Federal Territories Minister Datuk M. Saravanan caught two doctors at the Kuala Lumpur Hospital (HKL) emergency department doing their own thing instead of attending to patients waiting for treatment.

Saravanan made the discovery at about 10.30am yesterday when he went to the hospital to visit a university student who was knocked down by a car driven by his driver.

“I waited for a while for the girl to be treated and, realising that none of the patients were being called in by the doctors, I opened the door to the treatment room.

KPI? KPI? KPI? ISO? ISO? I-asshole? Here's the thing: probably the patients haven't waited 30mins yet... KPI says must shortened the waiting time to 30mins.

“I was shocked to find one doctor reading a newspaper and the other doing his own stuff.

“This should not be the way doctors work. The patient should come first. Furthermore, it is the emergency unit, which is supposed to be fast in dispensing treatment,” an irked Saravanan told Bernama.

He said he reprimanded the doctors and demanded to see a superior who, he said, appeared after 30 minutes.

“After that, those waiting were promptly treated. This should not be the way government hospitals work,” he said.

how come things changed 360 degrees when there's authority around? is this how medicine is practised?
In Petaling Jaya, LEE YUK PENG reports that initial findings showed that the two doctors were housemen who had just completed their shift.

housemen overwork, underpaid, hyperbullied... yet have the leisure to read newspaper, instead of going to bed? are we actually having shortage of doctors?
Health Minister Datuk Seri Liow Tiong Lai said he would ask HKL for a report.

“I will investigate if such a thing happened. Let me check first,” he said. “If the doctors are on duty and they do not treat patients, then it is negligence on their part,’’ said Liow when contacted.

I guess DS Liow should go make surprise check, instead of Datuk M. Saravanan...
Meanwhile, HKL director Datuk Dr Zaininah Mohd Zain said the hospital would be the first to take action should there be any element of irresponsibility.

She said HKL’s investigation showed that there were only eight patients and 20 relatives waiting for treatment and that none of the patients were in pain as stated by Saravanan.

HKL doctors, she said, were hard-working but added that they were human, too. Reading a newspaper in the doctor’s room should not be interpreted as a sign of irresponsibility, she told Bernama.

reading newspaper while 8 'not in pain' patients waiting = responsible?
Dr Zaininah said the emergency department managed 550 cases a day and was served by six medical officers in eight-hour shifts with one specialist, one consultant and one (supervising) senior consultant.

anyway, let's wait for the report. probably some lame media cook up, but then again, just take a stroll to emergency dept, sometimes there are surprises.

Apr 26, 2009

happy birthday, aedan!!

grateful to: Fairy Cakehouse, SP for such wonderful cappuccino sponge cakes

bday1 by you.

bday1.5 by you.

bday2 by you.

bday3 by you.

bday4 by you.
* translation (hokkien) : buy more toys, go out more, mummy buy more cappucino cakes *

bday5 by you.





Apr 25, 2009

ALERT: Swine flu A/H1N1

The World Health Organisation (WHO) on Saturday declared the swine flu outbreaks in Mexico and the United States "a public health emergency of international concern".

File:Sow with piglet.jpg

Asia on alert

Malaysia on alert

Here's the CDC full guidelines.

Otherwise prevention is just like how you prevent a flu:
basically go far and wide whenever you hear a sneeze. Close your mouth with hanky when sneezing. regular handwash and avoid American and Mexican, for the time being.

The virus appears to infect by human-to-human transmission. Investigations of infected patients indicate no direct contact with swine, such as at a farm or agricultural fair. In contrast, for example, disease transmission in the last severe human outbreak of influenza, the bird flu that peaked in 2006, was determined to be entirely or almost entirely from direct contact between humans and birds.

anyway, just be careful when taking pork.

Apr 24, 2009

best position in 1st stage of labor

RCOG statement

15/04/2009 - 00:01

A recent Cochrane review found that women who assume upright positions during the first stage of labour - such as walking, sitting, standing or kneeling as opposed to lying down - experience a shorter first stage of labour. The review also found that women who laboured in upright positions were less likely to seek pain relief through epidural analgesia.

The Royal College of Obstetricians and Gynaecologists (RCOG) encourages women to mobilise and remain upright as much as possible during the first stage of labour. It is likely that being upright helps that baby's head to descend and turn into the right position. The pressure of the baby’s head on the cervix may also help to strengthen contractions.

In the past, traditional epidural methods meant that it was impossible for women to walk around. However, most hospitals now offer a mobile epidural, which allows women to walk around and remain upright. A mobile epidural contains a different mixture of medication, providing pain relief while limiting loss of sensation in the legs. It is consequently possible for most women to choose pain relief and to remain mobile during the first stage of labour.

Fetal monitoring need not interfere with mobility. Intermittent monitoring of the baby is recommended for low-risk women, while high-risk women may require continuous monitoring. Fetal monitoring equipment can be attached by a lead that allows for freedom of movement. All women having a vaginal birth are encouraged to ambulate during the first stage of labour, provided that they feel capable of doing so. The RCOG recommends that women be encouraged to assume whatever position is most comfortable to them.

Reference

Lawrence A, et al. Maternal positions and mobility during first stage of labor. Cochrane Database of Systematic Reviews. Issue 2, 2009.

Apr 23, 2009

by-election: to be or not to be?


Godfather and the pussy (no, this ain't WCH.)

i'm always a big fan of Wong Chin Huat's political analysis.

one of his fine articles reviewed how government is similar, or rather different from Mafia, by the defining process of election.
It is clear that in political theory, there is only a thin line between a government and a mafia or triad. While a government collects "taxes", a mafia or triad collects "protection fees". Sometimes, the mafia or triad is the government and carries out most governmental functions. For example, Kapitan Yap Ah Loy was both in 19th-century Kuala Lumpur.

So, what is the real thin line between a government and a mafia or triad? That mafias or triads do not know how to employ a public relations company for legitimacy branding?

No. It is elections. It is the principle of "no taxation without representation", which ignited the American Revolution.

No mafia or triad will allow their subjects to elect their Godfather or Patriarch. You only have a duty to pay protection fees, but no right to elect your protector.

In a civilised world, a state must not be like a mafia or triad. That's why electoral processes and elected governments must not be subverted.

However, looking at the explosive amount of taxpayers' money 'well-spent', mainly by the police force to keep the election area peaceful and free from chaos, I guess, instead of calling an election off, the expenditure must be thoroughly audited by an independent party and more innovative or cost-saving steps can be taken to reduce the cost of each by-election.

What do we do with the tents after the by election?

How much is the rent? Is it always that high cost? or somebody had been pocketing the extra?
Is there anything that we can re-use?

Subsidizing transport and cost of living for the police force coming in from KL to the by-election areas, like Bukit Selambau, does raised a big question about what the local police force or those from the neighboring states been doing.

High cost for by-election should not be published only with big numbers, but rather with transparent breakdown of the expenditure and the cost-reducing measures.

The electorate commission and police should provide the details, as should the mainstreams be knocking consistently to get to the answer, not go reporting about some new nude photos of politician.

The poor, the unemployed and the Malaysians from the slums need to know why there remain hungry, cold and deprived when large amount of money were spent for election rather to keep their basic necessities sufficient.

Neither should them be rejecting election for all the wrong reasons.

After all, without election, government is just no different from the Mafia.

peer pressure

peer pressure by Avi_Abrams.

my dearest aedan almost reaching two. few days away.

already able to count from one to ten.

although physically still a small little chilli padi, he's a rather smart little rascal.

too smart sometimes just tip him over to be notorious.

perhaps, it is a bad habit of me and my dearest, every times he did something smart, we would applause like crazy, and this egged him on to count or name something or some animal.

boastfully, he would count loudly every times we're not at home, working.

and two other neighbourhood parents of whom had children few months older than little Aedan was taught the similar counting.

peer pressure, starting up so young, is rather unhealthy, i guess.

nevertheless, competition doesn't it makes a better man?

Apr 22, 2009

journey of a lifetime

sometimes it's nice to read and discover... silently understanding the mindset of patients...

" Tanggal 12 ogos 2007…setahun yg lalu aku menghadapi saat yg paling getir dlm hidupku..hari itu, aku ada appointment utk check-up pregnancy di Hospital Sultan Abdul Halim. Seawal kandunganku 3bln aku telah disahkan mengalami tekanan darah yg agak tinggi. So, aku perlu membuat check-up BP hampir setiap hari di klinik. Apabila didapati BP aku sentiasa tinggi, kes aku dirujuk kepakar O&G di Hospital berkenaan. Maknanya kes aku ni perlu di awasi oleh doctor pakar. Aku tak boleh bersalin di private hospital kerana diorang tak nak tanggung risiko jika ada sebarang masalah nanti.

Berbalik kepada ceritaku tadi…seperti biasa aku dah sampai di Hospital berkenaan seawal jam 7.45pg slps aku punch card keja pg itu. Aku ditemani hubby aku time tu. Biasalah hospital kerajaan…temanya kena tunggu berejam baru diservis…procedure biasa aku perlu timbang berat badan, check ujian air kencing dan check BP dan juga HB. Slps 2 jam menunggu baru dpt berjumpa dgn doctor biasa (belum diiktiraf doctor pakar). Bila doctor scan, doctor kata ada problem dgn kandunganku. Dia kata dia tak pasti sgt, kena rujuk dgn doctor pakar jugak… dia suruh aku tunggu lagi. Slps sejam baru terdengar namaku dipanggil utk berjumpa dgn doktor pakar. Aku dan hubby dibawa masuk kebilik khas untuk scan. Doktor pakar tu tak cakap apa2 pun pd kami. Lps scan doktor pakar tu cuma cakap sepatah je…dia kata “pn perlu admit wad hari nie juga”. Aku pun heran…kenapa?…nak bertanya pun x sempat sbb dia dh tinggalkan kami…dlm hati aku berkata…”doktor pakar mmg x byk cakap ke”…lps tu, aku dipanggil berjumpa dgn doktor yg mula2 aku jumpa td. Baru dia terangkan pada aku bahawa air ketubanku dh semakin kurang, so baby dlm keadaan bahaya jika aku x bersalin secepat mungkin. Aku akan diindius supaya bersalin esok..Ya Allah…aku belum bersedia lg la…tarikh aku dijangka brsalin sepatutnya 31 Ogos 2007..mcm mana nie?…setelah berbincang dengan hubby, kami decide nk admit wad pukul 2.30ptg.

Jam 12.15pm aku ngan hubby terus pegi makan kt restoren D’Sayang.. aku makan nasi goreng kampong dgn air fresh oren…2 gelas aku minum…maklumlah lps nie aku kena pantang…lama gak tu…nnti kempunan pulak…then, kami p kedai keta…siap tukar semua tayar keta lg…sempat lagi tu…pastu balik umah aku siapkan barang2 yg perlu. Actually, aku dh siapkan barang2 tu. Lepas solat…about pukul 2.30ptg aku dan hubby ke hospital semula….

Bermulalah episode gerun dlm hidupku. Aku nie mcm bahan experiment pulak disana. Aku perlu jalani check-up mcm pg td sekali lagi. Tensyennye.. dh semuanye settle, aku ditempatkan di wad kenanga. Dlm bilik tu ada lagi 3 org patient. Best jugak wad nie…bersih, kemas dan teratur…lebih kurang pukul 7.45mlm waktu melawat dh abis dan hubby terpaksa pulang kelumut meninggalkan aku sorang diri di hospital tu…sedihnyeeeee….hubby aku navy, sbb tu dia kena balik keje jugak. Tak pelah…aku faham…bukan kehendak dia untuk tidak berada disisiku tapi dia terpaksa….

Malam tu aku tak dapat tido mengenangkan apa yg berlaku hari ini dan fikirkan apa yg akan berlaku esok…takutnye Allah saja yg tahu…huh…..

Seawal jam 6.00pg aku diindius…kemudian aku dibuat pemeriksaan CTG…cukup siksa kurasakan…bacaan pada CTG menunjukkan jantung baby ku semakin lemah. Kelam kabut kulihat nurse menyiapkan aku utk dioperate. Tiba2 doktor yg indius aku td dtg memberitahuku bahwa aku perlu dibedah segera kerana jantung baby ku semakin lemah, dia bertanyakan tentang suamiku untuk sign borang ape tah tapi nampaknye aku kena sign sendiri…barulah ku faham kenapa nurse2 tu kelam kabut siapkan aku td…then, aku dibawa masuk ke dewan bedah…Masya Allah…takutnyeeee…tapi hatiku sempat berdoa supaya Allah selamatkan baby ku walaupun aku tidak dpt diselamatkan…saat itu tiba2 hatiku sayu…jika ditakdirkan umur ku x pjg saat itu, aku x sempat mohon maaf pada semua orang yang kusayang terutamanya suamiku serta ibu dan ayah…

Tepat jam 10.02 pg aku telahpun berada didalam bilik bedah…aku Nampak segala peralatan2 yg disusun kemas utk pembedahan…then aku dibius dibhgn tulang belakangku…hingga skrg masih lagi terasa kesan ubat bius tu….dlm hatiku x putus2 berdoa supaya baby ku selamat…aku hanya memandang jam did lm bilik tu. About 10.18pg aku terdgr doctor dan juga nurse riuh sebaik shj baby ku ditarik keluar…”kecilnya dia” satu suara berkata…beberapa saat kemudian aku terdengar suara baby ku menangis…Alhamdulillah….bila terpandang babyku, aku menangis…bagaikan tak percaya..zuriatku dh lahir…. Syukur sgt…emmm…baby girl spt yg aku mahukan….

Babyku ditahan kewad disebabkan beratnya hanya 1.71kg. then, stlh siap segalanya aku dibawa kebilik khas patient slps operation. Bila kesan ubat bius sudah semakin hilang barulah terasa sakitnya diperut bagaikan dihiris hidup2…seluruh tubuhku menggeletar…sakitnyaaaa….Allah saja tahu kesakitanku saat itu…

Hampir pukul 1tgh aku dibawa kembali ke wad. Nurse memberitahuku suamiku telah diberitahu tentang kelahiran baby kami…aku pasti dia dlm perjalanan pulang. Pd jam 2.30 ptg aku memberitahu keluargaku bahawa aku telah selamat bersalin…waktu melawat jam 4.30ptg barulah aku bertemu semula dgn suamiku…sebaik shj dia Nampak aku terbaring lemah dikatil dia telah kucup aku didahi dan mengucapkan terima kaseh krn melahirkan baby yg sgt comel utknya…kulihat dia menangis dan dia memohon maaf kerana tdk dpt bersamaku disaat2 aku melahirkan baby kami…ibu dan adikku juga berada disisiku saat itu…bahagianya rasa…Alhamdulillah..segalanya telah selamat…"

Aliskiren - new kid on the block

grateful to medtutor for an insightful summary and update of National Heart Association Scientific Meeting 2009 (NHAM) held from 17th to 19th April 2009 at the Hilton Hotel, Jalan Sentral, Kuala Lumpur.
  1. Sleep apnea or hypopnea can be a cause of resistant hypertension. It can also be a risk factor for atrial fibrillation.

    http://www.clinicalpharmacology.com/apps/images/photo_us/071/tekt485a.jpg

  2. A new antihypertensive agent is now available. It is a drug called Aliskiren. This is a direct renin inhibitor which, by blocking renin, reduces plasma renin activity and angiotensin levels. Unlike the ACE inhibitors and Angiotensin receptor blockers, this drug does not increase plasma renin activity because it does not stimulate the feedback loop towards Renin in the Renin-Angiotensin-Aldosterone cycle. It has been used in a dose of 150mg and 300mg per day. It reduces systolic and diastolic BP in all age groups and there are no dose adjustments necessary in hepatic and renal impairment. Also it does not have any important drug interactions.

  3. If we know a patient’s plasma renin activity, we can use that in choosing an antihypertensive.
    1. low renin - Thiazide diuretics, loop diuretics and spironolactone are the choice in
    2. average renin - Alpha blockers
    3. high renin - Aliskiren, beta blockers

  4. The updated UK NICE guidelines on management of hypertension were also mentioned. These state that, for uncomplicated hypertension:
    1. initial choice:
    below 55 y/o - ACE inhibitors or ARB .
    above 55 y/o / black - Diuretics or calcium channel blockers
    3. The second step 2-drug combination of ACE inhibitors/ ARB with CCB / Diuretics.
    4. The third step 3-drug combination of ACE inhibitors/ARB plus CCB plus Diuretics.
    5. The fourth step is to +++ the dose of diuretics or + alpha blockers or beta blockers.

  5. The “Fab Four” drugs in the management of stable angina are:
    1. Aspirin/Clopidogrel,
    2. Statins
    3. Ramipril/Perindopril
    4. Beta blockers.

  6. There is now evidence from the BEAUTIFUL trial that a persistent heart rate above 70 beats per minute increases the risk for cardiovascular events. There is a new drug called Ivabradine that acts on the f-current (f current for funny current) in the SA node and reduces the heart rate. Trials with this drug have shown that it reduces myocardial infarctions in those with angina.
more updates.

Apr 21, 2009

guard dog


http://www.josiger.com/uploaded_images/guardPalace-798907.jpg
toy soldier r' us

few days ago, i read this article and was amused.
He pointed out that keeping a dog at home is better than recruiting a security guard as dogs would not sleep when they are “on duty” and would not disappear for two hours just to buy a packet of cigarette.
amused, but totally agreed to it.

spot on.

growing up in a rather moderate family background, rarely do I required the service of security guard. Our house can be left open and nothing much would be happening.

it was when I started working, only then, I had several encounter with security guard.

First day of being to work, all anxious and green. I was denied of entry to the hospital compound, as I do not have the parking sticker, the name tag or any hospy ID. I explained in length with the help of my small stacks of appointment letters and all the relevant documents. Only then, the guard let me in with a smile. But of course, I had to park my car far far far far away in the public car park after going around 2-3 times looking for a parking spot.

In the old hospital, guard were seen wandering around the whole hospital, being partly observing any chaos and partly being the informal information fellow. Only 2 spots were heavily guarded - the neonatal ICU and the postnatal ward. Reason being, the breaking and everlasting news of the baby abduction in the hospy.

The guards, then were completely apathetic. Anyone can go into the wards.
I had encountered insurance agents going around selling, and also self-claimed reporter talking to an underage girl patient.
No such thing as visiting hours.
The hospy is like 7-11. Open 24 hours,
All you need to do is - sweet talk.
I chose my choice of hospital based completely on the proximity of that hospital to my house.

And this hospy was my 3rd choice.

When I told people about this hospy, everyone would tell me: Oh, that hospy that baby stolen.

I don't even know about this breaking milestone.

Moving to the new hospital.

Everything upgraded, except for some people's mentality.

No guard house, initially.

Just built one recently. Even with that around, clinic hours were still rudely disrupted by announcement of this and that car blocking this and that entrance, or parking in ambulance or specialists' carpark.

Still lots of people 'hanging' around in the hospital, not really doing anything but finding opportunities.

The quarters within the hospital compound was an easy target for burglar. multiple times.
Motorcycles of nurses or their next of kin stolen. multiple times.

Car of doctors were not spared. My surgical colleague's father in law's car surprising disappearance is a very alarming and heart breaking affair.

Nice car of doctors, scratched 360 degrees, almost graffiti work. multiple times.
My houseman, Dr Randy, moved out the next day to a safer neighbourhood.

Some foreign workers can be seen fishing in the big longkang within the hospital compound.
Some may be just plain 'fishing'. Who knows.

Now, the guard simply puts up disclaimer, urging us to be responsible for our own property.

Perhaps the occupants of the hospital's quarters should rebut that they should be responsible to their own duty.

Dutywise, some guards just put a sign "Went to toilet or prayers.", and never did come back till the next morning.

Some guards lulled themselves to sleep with a small radio by their table.

Some guards simply knitted the whole winter sweatshirt by one single shift session.

Some guards ran away when there was troubles or problems.

I guess in our country, guards are just another easy job.

No need much of experience.

No need much of qualification.

No much of work either.

Of course, I am plainly talking about the security guards of the hospy.

Anyway, nowadays, guards are humans, too.

With family to feed, lust to fulfill and possible some mental illness to be suffering with, guards can rape, kill or steal and they're at the best position and having the best opportunity to do it.

watch dog cartoons, watch dog cartoon, watch dog picture, watch dog pictures, watch dog image, watch dog images, watch dog illustration, watch dog illustrations

Apr 20, 2009

perverted search

all the major twisted perverts in Malaysia, especially Klang Valley, rather than hump themselves dry with pictures of models, super models or sexy singers, will instead go around the WIDE web to search for
New pictures of Nude Eli Wong
Hard-T
Lee Kok Liang Sr
Lee Kok Liang Jr
As a mainstream media, publishing such article to further on continue the "Eli-Wong-nude-this-nude-that" wave, rather to let it slowly cool down, is not just despicable, it is downright appalling.

And NO, inserting the following paragraph
Eli (Wong) is a strong person and she can see herself through this. She has been carrying out her duties since her return and attended the monthly morning meeting (on Monday) and faced everyone.
doesn't really help to show you're singing praises for her courage. Instead, it is just another hidden show of hypocrisy.

And this article doesn't scare any people into submitting those photos, either.

You got enough political gimmicks to sell, no need to further fuel Eli's darkest past.

Apr 19, 2009

WTF of the month: a simple Malaysian man



similar rantings here.

my side.

Q: How come PNSB paid RM110,000 for your presidential suite in Honolulu?

A: I am not sure. It was all organised by them. And I didn’t ask. I didn’t even get to enjoy the suite or the facilities. I just used it for sleeping. I returned from the programme at midnight and by 8am I am up.

Pilo: with RM110,000, can provide proper safe beds for thousands of homeless people around Malaysia.

Q: You say you are a simple man but people would disagree because you fly first class and stay at expensive presidential suites?

A: You must remember when I was the (PNSB) chairman. I have my entitlement. If I were to reduce my entitlement to what an officer gets then what is the officer going to reduce to? I am the chairman. There is the deputy chairman, board of directors, government officers going along. If I fly business class (not first class), then what happens to my state secretary? He will complain. If I am travelling alone it is easier. But I am travelling with a group of people and if I downgrade myself - it’s a problem for the others. But I never ask (for the pricey presidential suites or first class flights). Whatever they provide, I go along with. I just tell them to give me a full itinerary on these trips. I want a full programme with investors and companies.

Pilo: last time, if not mistaken, YB Sdr Lim Guan Eng, Penang's CM fly economy class. Does this mean, his secretary sitting on the floor when flying?

Q: Why did PNSB give you a Patek Philip watch worth RM159,000?

A: I told them they shouldn’t have done that and I turned it down immediately. It was too expensive a gift. I was quite surprised. I never asked for anything that’s why I returned the watch. I told them you better sell the watch back and get the money back.

Pilo: err... haha. why don't i get any Patek Phillip. Batek Filip, I also don't mind.

Q: Are you suing the state government?

A: I am looking into it.

Pilo: looking nia.. not sue lar.. later korek korek korek... kena sue balik lagi susah.


The whole fairy tale here.

Apr 15, 2009

sukuk (not an english word)

Glad she's staying!! here's probably the reason.

The first series of this Islamic bond, called Sukuk Simpanan Rakyat (SSR) 01/2009, is part of the Government’s RM60bil stimulus package announced on March 10, where up to RM5bil in saving bonds will be issued this year for people aged 21 and above, and with a maturity period of three years.

This programme is designed for Malaysian citizens as an alternative savings vehicle providing double the current fixed deposit rates, with option for account holders to withdraw their money any time.

and this...

“This is a good way to make our money grow as it is safer and more secure compared with other kinds of investments,” she said when met at a bank yesterday.

The pensioner who bought the maximum amount available for an individual at RM50,000 said the interest return at 5% was the main attraction for her.

“The interest rate for FD (fixed deposit) is only 2.5% for a year.

“I’ll encourage my friends and family to buy the bonds too as now it seems to be the best way to make money grow, especially for pensioners like me,” she said.

there's 2 schools of thought.

1. "hey, the government is giving us money. that's double the interest of the fixed deposit!!"
2. "bond, means I am giving the government loan. I don't think i want to borrow the government. it maybe in black and white, but if the government goes hollow and bankrupt due to some reason, i think i will get back less than 2.5%"

my school of thought.
- if got extra money to spare, no harm in investing. but then again, don't believe the bloody shit everyone is spinning, believing it is oh-so-stable and oh-so-certain.

remember, nothing is certain, except for tax and death.

bloggers' warning alarm

after the famous RPK arrest.

http://www.pamdemocrat.org/newspaper/Commentary/BLOG%20-%20Alarm%20Bell%20ringing.jpg
another alarm is ringing.

steak... I mean, stakes are being Raised (no pun intended).

and it is creating ripples...

and ripples...

internet does not work in a legal vacuum... but then again...

after releasing a whole lot of ISA detainees,
a brand new 'image' is not easy to upkeep, right?

here's a poem by annoyed, which I find rather amusing.

1 Utama is only a drive away

1 Malaysia is a concept? A vision? A place?

DPM and the rest are not even clear of
what more people like you and me?

maybe PM just say only, 1 Malaysia
as there is only 1 Malaysia on earth
this may be what he meant

just like people may be confusing
between Rias and Rice
betwen Yatim and Orphan
Malaysia’s Rias is not Rice
neither, Rias is not an orphan

which one you prefer?
1 Utama or 1 Malaysia
Rice or Rias
I prefer none of them

I want Malaysian Malaysia


Apr 14, 2009

tis little piggy pergi aquarium

I guessed Penangites are truly blessed.

The island simply got everything.

We got hills,
we got sea,
we got the rivers,
we got almost everything (except those withheld by the Fed Garbermen)

here's the thing, 2 weeks ago, in conjunction with Aedan's 3rd birthday by lunar year. It's actually by simple math 2 years old, but somehow lunar year, the basic principle is to +1 to the real thing. I never seems to understand why.

I used to ask my mom, being the inquisitive child.

" Like dat, like dat lar. No need to ask."

When I asked when I was in primary school.

"Like dat, like dat lor. No point asking."

When I asked when I gone to secondary school.

"Like dat, like dat lar. You ask for what?"

after a while, I asked other people. No one seems to know either.

my conclusion: Like dat, like dat lor. +1 mah +1 lor.

Maybe this is to satisfy the parents that their children is growing up faster.

Maybe this explain why people nowadays when growing up, they tend to be more 'western', so they can be younger, can break away from the '+1' rule.

Just, maybe. maybe.

As the saying goes, the best things in life is indeed free. The visit to the awesome aquarium was great. I believe Aedan watched and learned a lots of new things and made friends with some new animals.

aqua1 by you.
talking parrot & big koi

aqua2 by you.
feeding the koi & watching the iguana shit

aqua3 by you.
up close with iguana & the rich "kam chien" kuai (turtle)

entrance is free.
parking RM 1.
koi feeds RM 1.
time with my family - priceless.
for everything else. no mastercard needed.

Apr 13, 2009

'i' asshole vs ISO



ISO, KPI, PTK all are mimics of the standards set by other countries which uses a systematic way to improve and keep track of their work, and to justify the control and constant development and delivery of process.

We all criticized China for being the king of ciplak, yet here, we ourselves are the ciplak.
Worst still, we are not even good at ciplak-ing.
At least, ciplak from China or other country looks like the real ones.
Ours are just pathetically recognizable ciplak - literally original ciplak.

ISO, KPI, PTK is just another ciplak like most shows in Malaysia which lacks originality, mainly exhibited by the buffets of entertainment ciplak game shows or celebrity get together served in our local TV channels. Celebrity Karaoke, by far is most appalling show. Ever. Personally, as far as I know or exposed to, the only original thing Malaysian can be proud of is the work of Yasmin Ahmad.

ISO sounds the same as I-asshole.
Therefore, you also have to be an asshole.

From ISO to KPI, it sparks another argument of whether the KPI should be made public.

Why are we being particular about the branches and the leaves, when there is something obviously pathetically and annoyingly wrong with the root and trunk.

IMHO, KPI is total bullshit, if it is set by people who thinks about the whole protocols and all but does not practice medicine.

KPI talks about reducing waiting time
reducing waiting = reducing consultation time = insufficient medical check up = error in medicine = morbidity and mortality

ISO talks about locking every darn linen room. And in the event of emergencies, needed to change to sterile attire to go and standby for baby via Caesar, someone goes missing with the key to the linen room and everything got delayed.

KPI talks about fully documentation of flow of decision to C-Section in computer.
To get patient into the OT requires more than 10 clicks and at least interface.
Luckily, aiming to save the baby and the patients, KPI is ignored.
by the time baby delivered,
by IT, the mother is virtually still in Labor room.

So is this failed KPI?

You know what we really need.

We desperately need a KPI to regulate the KPI.

ISO is just the assessment for that transient period of time where everyone work up to standard, and then celebrate and rot later.

* KPI - key performance index. ISO - international organization for standardization, PTK - penilaian tahap kecekapan.

Apr 12, 2009

Chinese government in Malaysia

hope. i hope the water supply returns today.
hearsay. large water pipe burst in Sg lalang. now, everyone in SP is holding on to their tangki's water.
mine had outlived its function. what's taking them so bloody long to fix.
my colleague's place already without water for 3days.


from MI:

Tan Sri Muhyiddin Yassin is confused, perplexed, puzzled.

He cannot understand why Malaysian Chinese voters continue to treat the Barisan Nasional with disdain. He cannot fathom why after tossing millions of ringgit to improve Chinese language schools, the BN lost by-elections in Bukit Gantang and Bukit Selambau.

Malaysia’s deputy prime minister wonders whether the Chinese have begun to think of themselves as kingmakers in the new political landscape.

“The Chinese even though are a minority group feel that they have the deciding power because the Malays are split into three groups… In such a situation, they can decide the outcome of an election and this can be seen from the general election and the by-elections.

“They think they have the power to decide. It is not only the Chinese but the Indian community as well,’’ he told Mingguan Malaysia today.

Tun Dr Mahathir Mohamad says that Chinese voted for Pakatan Rakyat because they were swayed by efforts by the Opposition to frame the Perak constitutional crisis as an attempt by a Malay government to usurp power of a Chinese government............

  1. please do not toss our own money (taxed by government) back to us at the discounted amount
  2. kingmakers? who are the people making the king do things for them?
  3. minority? since when?
  4. government - voted by the Malaysians for Malaysians. Is there a Chinese government before?
it's been more than a year since the last GE.
some people are still as lost as ever.

looks like we're just going to lepak till the next GE,
where real business will resume action.

as for now, we just need to keep an eye on people who will probably go around last minute plundering, stealthily.

life in the slow lane



I guess when i laugh LOUDLY... i kinda does annoy people, plus making their life 'technically' longer...

Apr 11, 2009

hospy ghost

http://livingedgeblog.files.wordpress.com/2009/01/ghost-chair-1sq.jpg

post call today. yesterday was an entertaining call.

as i was assisting in the scope for ectopic pregnancy, there was this buzz going around the staffs of OT, about the ghost in OT, particularly in the MO oncall's room.

scared the hell out the MO on call yesterday, which is my buddy.

even my house officer who quietly sat down cannulating the uterus felt the chills.

from what i gather, 2 student nurses saw a white female figure climbed up from a bed. which bed, i couldn't reveal further.

not surprisingly, hospital is an area where people passed away, and where kamma took them, the ghost world is just another world of existence.

not just yesterday, whenever I took the elevator alone at night in the hospital, it did felt like there are 'others' around in the elevator. But I wish them well, and hope with metta, it would reduce their suffering.

I guess the OT ghost is there maybe for a reason.
Perhaps, there are things she had to complete,
there are mistakes she wanted to rectify,
or simply she just wanted the true clarification on her death or something else...
(ok, this begins to sound like the movie, but it could be true, right?)

perhaps the SNs should begin to look carefully for any specimen or body parts that supposed to be sent for HPE, but was left behind unattended, and not given back to their family members.

any stories from other hospitals?

Apr 10, 2009

new portfolio

up coming...

http://www.bc.edu/offices/omc/meta-elements/jpg/portfolio_lg.jpg

chinese affairs portfolio
indian affairs portfolio
iban affairs portfolio
kadazan affairs portfolio
dusun affairs portfolio
dayak affairs portfolio
chindian affairs portfolio
mamak affairs portfolio
babanyonya affairs portfolio
any-other-mix affairs portfolio
indonesian affairs portfolio
pakistani affairs portfolio
other-foreigners portfolio
kelantan-footballers portfolio

moving towards a non-racist governance, why on earth do they decline the post, instead of objecting to the whole idea, altogether.

maybe this is yet another stimulus package to reduce unemployment rate among the non-elected politicians in 308 tsunami.

luckily, at the bottom management and professional groups, i can still make this statement, without breaking rule 21(1) of the General Orders.

anyway,

for every beauty, there is an eye somewhere to see it,
for every truth, there is an ear somewhere to hear it,
for every love, there is a heart somewhere to receive it.

Ivan Panin



scandal in Bed

found this interesting pic.

perhaps something really sometimes happens
by chance,
by faith,
by destiny
or simply by choice.

happy easter

grateful to: a gravida 8 para 7 mother for showing me that insanity during labor can occur disregarding the parity.
Eggshell Flowerpots
just thought it would be cool, to share this idea of eggshell flower pot by Martha.


Apr 9, 2009

fiction 2/7 ago

1: hey, don't be shock tomorrow
jk: what to be shock?
1: u're not in the gang
jk: y not?
1: u're evil, n u can't work, at least, I can work
jk: so what u 1 (no pun intended) me to do? shake xxx?
1: just dun cause trouble
jk: are u threatening me?
1: no. i'm warning u. btw, just ordered boxes of C3
jk: ok. i will tell ppl i will focus on something else
1: whatever excuse, not my problem.
jk: so M&M got some into the gang
1: not ur business, either.
jk: ok ok ok. bye. (thinking: u just wait, u old man)

never fair, never right

grateful to: bongkerz for all the most wonderful jokes...

Whenever you think you're being mistreated,
whenever you believe you deserve more,
whenever you felt neglected,
think of the following joke,
it will definitely lighten (no pun intended) up your day.

What fair? Right? Just?
What the heck are you talking about?
The truth about fair and just in this country is just like Samyvellu’s left testicle.
Never RIGHT.
Never FAIR
politics in malaysia. real bollocks.

fear nothing but fear itself

The image “http://static.guim.co.uk/sys-images/Guardian/Pix/pictures/2008/06/15/fear460.jpg” cannot be displayed, because it contains errors.

Obgy greatest fear is PPH
postpartum h'rage

Paed greatest fear is PPH'N'
persistent pulmonary hypertension of newborn

Some'1' greatest fear is PPH'M'
persistent personal haunting of mongolian

It was a tragic moment. And definitely a difficult bad news to break.

A newborn with PPHN. My first encounter with a newborn with PPHN, diagnosed by pre and post ductal saturation and also saline agitation test with USS.

she was quiet. she blinked her eye slowly as the sedation began to shadow into her consciousness.

her umbilical lines were jammed up with 3-ways, stacking up one another like Lego pieces.

she desaturated 3x today. and reversion to ambubagging was immediate.

looks like as I am blogging right now, my paed colleague on call, will have to helplessly camp beside her. watching and listening closely to the alarm.

it's a waiting game from now on.

hopefully the viagra and high flow O2 will follow through with good news.

and to that PPK of NICU who turned off the ventilator momentarily to switch to high flow machine, without prior telling any doctors...

if she wasn't sedated, she would probably give up 2 middle fingers and 2 middle toes for being such a nincompoop

losers and winners

relieved. at least, we don't have a monkey in the drawer.









losers:
  • Datuk Seri Syed Hamid Albar (Home),
  • Datuk Seri Azalina Othman (Tourism),
  • Tan Sri Amirsham A Aziz (Minister in the PM's Department),
  • Datuk Seri Ong Ka Chuan (Housing and Local Government)
  • Tan Sri Muhammad Muhammad Taib (Rural and Regional Development)

winners:

NEW CABINET LINE-UP:

Prime Minister and Finance Minister 1: Datuk Seri Najib Tun Razak

Deputy PM and Education Minister: Tan Sri Muhyiddin Yassin

Ministers in Prime Minister’s Department
Unity and Performance Management: Tan Sri Dr Koh Tsu Koon
Law and Parliament: Datuk Seri Mohamed Nazri Aziz
Religious Affairs: Brig. Gen. (Rtd) Datuk Jamil Khir Baharum
Economic Planning Unit: Tan Sri Nor Mohamed Yakcop

Deputies: Datuk Liew Vui Keong, Senator Datuk Dr Mashitah Ibrahim, Datuk SK Devamany, Ahmad Maslan, Senator T. Murugiah

Finance
Datuk Seri Najib Tun Razak
Finance Minister II: Datuk Ahmad Husni Hanadzlah
Deputies: Datuk Chor Chee Heung, Datuk Dr Awang Adek Hussein

Education
Tan Sri Muhyiddin Yassin
Deputies: Datuk Wee Ka Siong, Datuk Puad Zarkashi

Transport
Datuk Seri Ong Tee Keat
Deputies: Datuk Abdul Rahim Bakri, Datuk Robert Lau

Home
Datuk Seri Hishammuddin Hussein
Deputies: Datuk Wira Abu Seman Yusop, Jelaing Mersat

Information, Culture, Arts and Communications
Datuk Seri Dr Rais Yatim
Deputies: Datuk Joseph Salang Gandum, Senator Heng Sai Kee

Energy, Green Tech & Water
Datuk Peter Chin Fah Kui
Deputy: Noriah Kasnon

Plantation Industries and Commodoties
Tan Sri Bernard Dompok
Deputy: Datuk Hamzah Zainuddin

Rural and Regional Development
Datuk Seri Shafie Apdal
Deputies: Datuk Hassan Malek, Datuk Joseph Entulu

Higher Education
Datuk Seri Khaled Nordin
Deputies: Dr Hou Kok Chung, Saifuddin Abdullah

International Trade and Industry
Datuk Mustapa Mohamed
Deputies: Datuk Muhkriz Mahathir, Datuk Jacob Dungau

Science, Tech and Innovation
Datuk Dr Maximus Ongkili
Deputy: Fadillah Yusof

Natural Resources and Environment
Datuk Douglas Uggah Embas
Deputy: Tan Sri Joseph Kurup

Tourism
Datuk Seri Dr Ng Yen Yen
Deputy: Datuk Seri Sulaiman Abdul Rahman Abdul Taib

Agriculture and Agro-based Industries
Datuk Noh Omar
Deputies: Johari Baharum, Rohani Abdul Karim

Defence
Datuk Seri Dr Ahmad Zahid Hamidi
Deputy: Datuk Dr Abdul Latif

Works
Datuk Shaziman Abu Mansor
Deputy: Datuk Yong Khoon Seng

Health
Datuk Seri Liow Tiong Lai
Deputy: Datuk Rosnah Rashid Shilin

Youth and Sports
Datuk Ahmad Shabery Cheek
Deputies: Datuk Razali Ibrahim, Wee Jeck Seng

Human Resources
Datuk Dr S. Subramaniam
Deputy: Datuk Maznah Mazlan

Domestic Trade and Consumer Affairs
Datuk Seri Ismail Sabri
Deputy: Datuk Tan Lian Hoe

Housing and Local Government
Datuk Kong Cho Ha
Deputy: Lajim Ukin

Women, Family and Community Development
Datuk Seri Shahrizat Abdul Jalil
Deputy: Datin Paduka Chew Mei Fun

Foreign Affairs
Datuk Anifah Aman
Deputies: Datuk Lee Chee Leong, Senator A. Kohilan Pillai

Federal Territories
Datuk Raja Nong Chik Zainal Abidin
Deputy: Datuk M. Saravanan

Apr 8, 2009

diam-diam biri-biri (silence of the lamb)

grateful to Dr. S for teaching me UVC/UAC insertion.


Azilah who started his testimony on Jan 15 stated that he had no motive to kill or destroy the woman and instead he only met Altantuya to advise her politely not to harass Abdul Razak or create a ruckus outside the latter's home.

Azilah also told the court that he was ordered by a superior, DSP Musa Safri to help Abdul Razak and thus he would not have done something stupid like killing and what more when he was a policeman.

While defending himself Sirul Azhar broke down a few times and related to the court that he has been made the 'sacrificial lamb' in the murder.

As the whole malaysia go silent, anxiously awaiting the new cabinet line-up, 2 police officers were being sentenced death for doing the extreme. they may have been the scapegoat or 'sacrificial lamb', no one put a rifle to their head when they decided to stuff the explosives into the mouth of the victim. nevertheless, they are too young to go around fooling with C4.

is this the end, or is it just the end of the beginning?


chronicles of k: revenge 1 & 2

fully written by Bro. LSF. sometimes, I think it's a blessing given my current working environment.

http://laurasworld.files.wordpress.com/2007/06/shanghai-1930s.jpg
shanghai 1930...

one day, a new district hospital director came to k, he said,

"boss, my hospital is now short of medical officers, currently i only have three MOs left. one is on leave, another one is giving birth, one just left for good. all of a sudden, the number dropped from 6 to 3. and of the three, 2 are very new, they just completed housemanship one month ago."

he kept on

" we have 300-400 out patients daily, 5 wards with a total 80-120 in patients, operation theater and a busy casualty as there's no private clinic operating after 5pm in town."

" i need you to come for about a month. all expenses will be covered."

k used to help covering in other district hospitals, so he said ok.

k told his boss about the relief, and he had to ask his colleague to cover his own clinic when he was off for the relief. he had to put his thalasssmia and HIV and shcool health programme on hold.

in that hospital, he had to do on call, in charge of ward, out patient clinic, and OT. and he had to cover the hospital director ass too.

whenever the director was on call, he'd just simply admit/discharge patients, and he wouldn't refer to tertiary centre no matter how bad was the patients' situation. so whenever the patients that he had admitted deteriorating in ward, k had to go and eat his shit.


For example,

1. a patient presented with Upper Gastro intestinal bleed, (a medical emergency), the director just admitted the patient to the ward by prescribing a H2 antagonist. (well, that hospital actually has PPI), without a PerRectal, or FBC! the next morning when k was doing ward round, he found out that the patient was as white as shit, and he referred stat, and you know the response he got from the tertiary for LATE referral..

2. a pregnant lady with BLEEDing low lying placenta at 34 weeks, with contraction. the director, admitted to ward for BED REST, no scan, no referral. luckily the nurse in ward was good enough, they've seen mothers bled to death before, they informed k, k went and do a LATE referral.

3. an open wound fracture, he kept in ward for one day.

4. acute apendicitis, admitted to rest in ward.

5. malaria, he treated as NSTEMI, just because the LDH raised a bit.

6. he was on resus call, and blue alert was alarmed, a baby came out flat... he didn't come to stanby or resus, he was having fun with contractors in golf club, the next day he asked, "oh so how's the baby?"

7. hypertension, with pulse rate 45/mins. he gave beta blocker.

8. his own driver, BP 180/110. he discharge home. the driver came to k one hour later, vomitted in front of k, BP recorded 220/120.

9........



ok, 16 days was over, one of his MOs was back from leave. he told k " now you can go"

k asked him to issue a formal letter to state the dates he spent in the hospital, so that k could bring back to k's office to keep as a record ( if not, k would have use his own leave for that 16 days as the office may just take that 16 days as if k didn't come to work ) , secondly, with that letter, k could then make some claim for the relief ( which is also not much, imagine RM125/24 hours, which is merely RM5/hour or USD$1.40/hour. )

and the director turned his face and said," oh no no no.... i won't pay you...., you should be gladful that i offerred you a chance to serve the people...."

k said, " but you told me differently...."

director," you know what, i told state director already, and if you dare to do complaint, i'll ask him to transfer you to work directly under me in my hospital. and you won't want this to happen right? you know you'll be working directly under me, which is NOT a good news for you, hahaha...."

?@#$%^&??????

k was speechless.

that night, k went for a drink with his friends.

after a few glasses of tiger, they went high...

some were good in maths, they calculated, if RM125/day times 16 days, it would have been RM2000....plus transportation claims....
if you spent that 16 days doing locum in private, say just RM35/hour...you'll get....

a few more glasses of tiger, they went even higher...

suddenly they talked about revenge....

some were good in law, they said, "let's file a lawsuit letter agaist him....

some were good in politics, they said, "i know liow i know liow, let's call him and transfer this guy out....

some were loan sharks, they said, " let's do him a "Shang Hai 1930s" style......

some were animals, they said, " he bites you, we bite him.....

some were fishermen, they said, " we used to bomb fish, but we have never bomb anything on land... maybe his D-Max is a good try...

some were hunters, they said, " hunting is good, you'll never know what you'll get...

some thought k had saved their balls (k only assisted visiting surgeons in repairing thier hernias), they said," let's cut his balls....

some were buddists, they said," this is karma...maybe you owed him last life... if not, he'll have to return it back to you next life....

some were from kota marudu, they said " ai ya... quit government lah, do GP.....







part 2:

he gave 3 letters to k,

1st (b4 relief), stated that he'd cover ALL expenses, letter sounds like begging. " like we are really short, you are really needed.....blablabla)

2nd(upon completing relief), said only will cover lodging

3rd (after completing relief), said won't cover a single thing. "u fxxx off" that kind of letter.

and when you went to talk to him, he threatened you... you talked to the top level, the answer was the same

holy shit, k thinks the ppl at the top level are contracts($)-related brothers, no point arguing... they can't kill each other as their own hands are not clean with contractors $.

it reminds k of a movie, when someone tried to call a lawyer to sue another lawyer, he got trapped and sued by his own lawyer as the two lawyers were friends with common interest.

there's no justice "PAO" in our current system.

oh there's a phrase to describe this, "birds of a feather Fxxx together", i don't know, last time i used this phrase in secondary school, the teacher said one word was not right but she didn't tell me answer... err... maybe it's "Bastxxxs of a feather Fxxx together"...well, i can't think of anything better....

you don't have to study law to know law, you study politics.

again it's not the money that we are talking about... RM2k, anyone could earn that back. the system, the service, the attitute, is hugely disappointed.

p/s last night, the great master created another joke (well, it's not a joke, it involved 3 human lifes--- thank god they are poor and uneducated and they don't know lawyers), he admitted a TWINs @ term with PROM without seeing the patient. when asked about what kind of twins? how many week POG? what's the complaint? the reasons for admission? how's the ctg? have you referred specialist for opinion? the reason of admission?..... his answer is ," oh i admitted the patient BUT i didn't see the patient... the nurses will assess the patient...."
when he was asked to go back to reassess the patient, he as expected, DIDNOT go.
the other MO had to go in the middle of the night...

he has the licence to kill.

k is thinking of a nickname for him.... you know, you can't call him 'boss' anymore...

Apr 7, 2009

rakyat vs nasional: 2 to 1

grateful to: Dr.T and A for good practical points in Paed.



another victory for the rakyat.

i guess releasing prisoners whom doesn't need to be imprison in the first place doesn't make a difference.

i guess setting up bus, airplanes, bicycle, keys, chicken, fish, umbrella and whatever into the equation doesn't really split the votes or make the rakyat any more confusing.

it only made the city much more merrier.
much more stimulating to the microeconomy.
not to mention, generating heaps and heaps of rubbish in the area of Bukit Selambau.

but, I am pretty surprise as I drive through the voting site around 7pm, I saw a young chap wrapping two shirts, one on forehead, another on the neck with a dagger in his mouth, trying to take out PKR's flag and cleaning up in the midst of rainfall. I guess it is really nice for Pakatan's thoughtful swift action to clean up their own mess, instead of going out partying after their winning.

anyway, i guess the prophecy may be true after all.
(No, not the teh-kor part, but the ... ends with the... part)

lastly, the jokes is on the rakyat's need for Viagra for firmly having grip on the 2 Bukits but
not able to get the Batang up.

but it is also the rakyat that will have the last laugh.
orgasm can be pretty mental sometimes.

without the people, there is no nation.

Apr 6, 2009

MSCED

1/28/09: Shattered pacifier
aedan's worst nightmare for the time being...

MSCED is to make something cool every day, a pledge Brock Davis made to the world. I guess, we should make this creative pledge and really go forth and open up our world of imagination.


trauma-tize

here's a joke that my dearest found it extremely hilarious. for me, i think it's just so-so.

http://k43.pbase.com/o6/25/285225/1/70382112.ZYcl5ooo.Isabeegie.jpg

In her hometown, there was this nephew and niece of hers that always went berserk every time they got something good to play and pretty prone to domestic injury. And so her auntie would tell them:

"Hey you fellas, you must stop running like that, if you injured your head, we'll change your head with the dog's head. Do you want that?"
"No, grandma, I don't want a dog's head."

And now, we're trying this same trick for Aedan. Hope it works for him. He's been having lots of trauma-associated lump & bump lately. Haiz

Apr 5, 2009

adedas, nikke & setarbak medicine

Birthday greetings to Potato, and thanx to all my pals for a great time in Bed. (pls note the capital letter 'B').

http://www.passdt.com/wp-content/uploads/herbal-medicine.jpg

Practice of medicine is pretty similar to Buddhism.

No, I am not going to bored everyone with that same lame but true story equating Dukkha, suffering to illness and the Eight Noble Path as medication and Lord Buddha, the great enlightened teacher to a doctor.

Basically, Buddhism is pretty much divided into several traditions – Vajrana, Theravada and Mahayana. But a true Buddhist, will practice following the gist of the teaching, disregarding the tradition. As all the traditions are simply the shades of the true practice.

Similarly, I do not find rejecting traditional medicine or ‘complementary’ medicine as something benevolent in the practice of medicine.

If we seek the most established joint for a cup of coffee, some other branded stuff, I think traditional medicine existed beyond the time.

If we hunger for some good food, a good cuppa, we wanted to buy something good, some branded stuff or wish to attain something guaranteed of quality, we'll go for the established joint, the established shop or kopitiam.

It is the big reason why establishment is very important in most of the advertising logo or name. Just look around, how people used ‘Est’ or ‘Since’.

Fighting against establishment, the new or upcoming ones will not survive the market slaughter by the well-established ones.

In the spirit of ‘Can’t fight them, join them’, you’ll see lots of Adedas, Nikke, Louie Vuitton or Fuma in the market, trying to steal the cheese that was meant for the established ones.

IMHO, traditional medicine came a long way, before conventional medicine came along. In actual fact, traditional medicine is the father of conventional medicine.

Most of our medications were either derivatives or substrate of some leaf, some roots, some flower or some tree bark.

Who are we kidding by rejecting traditional medicine?

Traditional medicine is much more established than western medicine.

However, traditional medicine are losing ground, mainly it doesn’t work fast enough, and it doesn’t work always (you think western medicine always work? Think again), its functions can’t be explained scientifically and more because of all those phonies out there, especially in Malaysia were using self-claimed, self professed ‘established’ traditional skills to kill time and kill their patients, instead of heal.

Traditional medicine should be practiced with the foundation of conventional medicine. That is a hallmark of a safe traditional medicine practitioner, as in how it is practiced in Taiwan.

The traditional practitioner cannot just keep their certificate high while having a baseline low knowledge on the general medication. It will only kill not heal.

Just imagine, someone

who prescribe steroidal herbs for someone already immunosuppressed,

who prescribe circulation enhancing herbs for someone bound for major operations

who prescribe any thing believing it will make the placenta praevia travel up to the fundus.

Therefore, in Malaysia, there is no place for ciplak traditional medicine practice, more so, not a place for the half-baked academician to endorse any Tom, Dick or Harry legally fit to put their moronic brains into sorting out the health problems of the simple-minded people.

Mind you. Even the recognized house officers from recognized medical school are having bloody difficult times in sorting out Daflon from Dafilon, omentum from subcutaneous fat and arteries from veins. Main reason why unnecessary amputation have to be done.

Brings me to another expose I heard from my friend, a bubbly chap who clearly laid out the how our dear country is producing more and more killers in the form of (yet again) half-baked nurses. Worst still, in the process, digging a big hole in the government’s pocket.

Vowing to put upgrade and supply enough nurses to Malaysian healthcare, the government are pouring, yes, pouring as in flooding money in a bid to produce lots and lots and lots of nurses.

Therefore PTPTN decided to increase their loan from RM8K to more than RM40K, or more or less.


This made majority of private colleges looking at it as good business opportunity.

Business school, offer Nursing.

IT school, offer Nursing.

Architecture school, offer Nursing.

Racing school, offer Nursing.

The best part is coaxing those fresh high school grads, who have too much money with their parents, and too little brain cells working, by telling them how highly paid nurses are in those Arabian countries, hiding the fact that they need to rot first for few years in Malaysian settings before they got enough experience to be hired somewhere else. Sometimes, they need more than experience, they need luck and also cables. To have good cables, one will need to sacrifice more.

But by the time, they enrolled themselves into the program, the private colleges already sees each of them as a gold mine, happily tapping into them every semester for gold. No money, get government loan. By the time they graduated, they are being fooled with all those serious and prestigious ceremony, and they go all frenzy and snobby till the day they realize it is time to slog it out to pay back the government.

Many don’t even pay the government loan without any repercussion, especially those being sent to European countries. Not that they are too poor to pay, they just couldn’t bother to pay. More of like, if you start paying, people will actually look down at you, laugh at you or alienate you. To them defaulting loan payment is like peer pressure kind of thing. Maybe I am just pulling your leg. Maybe I am not.

Anyway, going back to the main point.


Do not reject traditional medicine, just because all the time, you’d encounter the fake and phony.

Do reject the fake, phony and ‘certified’ medicine, no matter they are traditional or conventional medicine.

Primum non nocere.

Apr 2, 2009

pilihanraya = pilihan kaya-raya

Pilihan raya = Yang dipilih menjadi kaya raya.

The tri-election as they called it.

Is pretty obscene, come to think of it.

2 Bukit in Semenanjung and 1 Batang in Borneo.

Recently a short drive to work got me thinking. I am really blessed to be staying in such a rich country. Even in the times of economic crisis, the rich people (or the government using the money of the poor people) are pouring money into producing so much of banner, poster and etc which will be deemed useless after the election, when the similar amount of money can actually help a poor child get a decent school material (small kid did not go to school because unable to buy uniform & stationery), clothes the homeless (kesian all those homeless ah peks at the kaki lima), provide water supply to the underdeveloped area (family of five, with the youngest 7years old admitted with typhoid as all drank from the well after the rain) or provide proper transport from rural area for the pregnant ladies to get to antenatal check-up.

Obviously the whole town will be heated up as more and more political leaders (is that what we still call them nowadays?) came here to shake hands, smile smile, laugh laugh and talk talk. In the same time, boost the micro economy by staying in the luxurious hotel, chowing great buffets and perhaps play some golf in between all the shake shake, smile smile, laugh laugh and talk talk.

Instead of covering BS news like caning of hands leading to death due to central nervous system, the media should expose how much money are wasted for all the electorate campaign (the real amount, please. Not quoting the BS report) and how much suffering the people of the area are enduring due to poverty and unemployment secondary to economic crisis.

Like I said previously, PR even flying an undies will win hands, legs and whatever down. It is better for PR to go down for real and start helping the people.

Pilihan raya = Yang dipilih menjadi kaya raya.

Perhaps the equation above best explained why there was so many record-breaking candidates pay up their deposit to stand as Independents. And I am sure the EC ran out of logo for the Independents.

There is this candidate with an aeroplane logo, and another with a bicycle logo.

Aeroplane vs Bicycle. Huh?!??! Really tough choice.

Even the staff in the hospital, in the sentiment of election, created their own poster, just for the fun of it.

I don’t think using the Tiger logo is a wise decision, for him as a Muslim. Think about what tiger is associated with – Tiger Beer, Tiger show, Tiger-to-C4-and-blow-her.

Seeing that self made poster made me reminisce my first year in Uni when my batchmates played a big prank on me. My ‘election poster’ was posted around the hostel and even in the female toilet. My other batchmates took down the poster for me. I couldn’t remember what I was thinking at that time. Sort of shocked. Sort of lost. Sort of curious. Sort of restless. Sort of blank. Sort of feeling I’m being misunderstood.

Nevertheless, it was one of those unforgettable moments in my life.

volvulus or volvolus?

It is just sad to be VOLVO-LESS.

http://www.heritage-motors.co.uk/userimages/volvo2.jpg

But it is worst to have volvulus.

caecal volvulus

Apr 1, 2009

cane-brain disease | serembam virus

newly discovered virus. DNA (dumb nonsensical ass) double-stranded virus.

http://static.howstuffworks.com/gif/light-virus-1.jpg

currently actively spreading in the city of Serembam.

claimed first victim - 9 years old student.

believed to be actively spread along the hands and the brain.

where trauma or inflammation on the any parts with high viral load (hands or brain) will result in the inflammatory response in other parts of the body, especially the central nervous system.

incubation period still under observation.

believed to have spread to the media people reporting the death of the 9 years old as just another case of student abuse.

believed the primary lesion in the media people is the brain, in contrast to the hands of the 9 years old.

therefore, it is also believed virus primary site of attack will greatly determine the prognosis of the disease.

unable to determine whether the spread of the disease is by air droplets or affinity by sheer stupidity.

therefore, all the citizen of seremban or nearby places are advised to keep your hands in a safe place, preferably at below -5 degree Celcius or at least hope that the virus primarily attacks the brain.

prevention and control of this virus is still under low budget research.
Sponsor are welcomed.
Kindly click on the upper left side of this website under 'Stalker's Pocket money'

Signing off

Berkhidmat untuk negara.