Dec 29, 2009

Now everyone can lie?

Procedure trumps property – An AirAxia Experience.

Axia2.jpg image by dustyrhoads

Being a week abroad, I expected myself to start writing in about my adventures, but instead (probably a bit gloomy), I am penning my misadventure down.

I have always been a big fan of AirAxia, not because of the mediocre pricing, but instead of the proper planning of the charges. You pay for what you want. That itself is a brainy thing that some bigshot airlines were deprived of. Yeah, I know you know which airline I’m talking ‘bout.

Anyway, I was surprised, mostly utterly shocked when I was been taken a ride by the staff and cabin crew of AirAxia and I believe by the time this entry is out in my blog, my beloved handphone would have been already out of the horizon, long gone, in the Davy Jones’ locker, whatever.

Not only I suffered the agony of losing a priceless item, I had to struggle through yesterday on call without a proper line. I am sure every medical personnel know the detrimental consequences of being ‘uncontactable’.

Here’s what happened on Sunday December 27, 2009. I shall call it Black Sunday, because the same day, my sister lost something and a friend of mine had a car accident.

Sun rose beautifully on that day. The ever familiar morning breeze that had Claire and me frozen was absent in the LCCT Terminal.

We began to checked in our luggage and proceed early and immediately to Terminal 12, waiting tiredly for the plane to dock.

Claire reminded me to call my dad, to reconfirm the time of arrival.

We were bound to be on the flight from LCCT at 0830hours, reaching Penang at 0915hours.

Using my ever useful Sony Ericsson C902, I managed to spoke to my dad, confirming my arrival time. I slipped my phone into my right hand side pocket of my washed blue jeans.

My handphone not only comprised imperative information of my work and my personal data in codes, it was also of high sentimental value as it was a birthday gift from my dearest wife.

Soon after, my flight was ready for boarding. We strolled in together in a bee line and reached the designated seat which I had prepaid for. As I lifted our two hand luggages into the compartment above the seats, suddenly I felt my right hand side pocket EMPTY!!!

Immediately I told the airstewardess (If not mistaken, her name was Candy) at 0820hours “I lost my handphone. I probably had dropped it between Terminal 12 or the boarding pathway to the plane.”

The airstewardess immediately informed her colleagues, a much senior airstewardess and an airsteward.

I explained my situation to the airsteward and he couldn’t understand my Simple English. I almost fainted at that point, and I re-explained in plain Bahasa Melayu. And his reply was “Duduk dulu, Sir. Nanti saya beritahu kamu. Kena buat repot.”

*What report? By the time, I made any report, my handphone would be long lost*

I replied,”Give me just 5minutes, I can recover my phone. It is very important to me.Please.”

I kept looking at the watch. It was 0822hours. The senior airstewardess replied me,”Don’t worry, I already contacted the ground staff to look for your phone. Once they had got it, they will find a way to get to you.”

“Are you sure you’d contacted the ground staff.”

”YES, we had contacted the ground staff, please sit down, Sir.”

Putting my full confidence in the bright management of AirAxia, I sat down quietly in my seat, waiting for another 8 minutes before the lift off.

We reached Penang earlier than expected at 0910hours. It was probably a little something to be happy about. Except that it was overridden by the grief of my lost phone.

As I took down my hand luggages from the overhead compartment, I asked the group of airsteward and airstewardess about any news about my phone.

“Oh, Sir, you first need to make a report first in the Lost & Found Counter, and they will contact the KL ground staff, to start looking for your phone. It’s the PROCEDURE”

“What?!?!? You told me you contacted the ground staff 1 hour ago?!??”

“No, Sir, you first need to make a report first in the Lost & Found Counter, and they will contact the KL ground staff, to start looking for your phone. It’s the PROCEDURE”

* Repeating the statement as if I didn’t know English is really classical. Would have record it down if I had my phone with me *

“No, you promised to call the ground staff 1 hour ago, can you call them now? If I had to file report, I don’t know how much longer it would take. You all could have let me go and recover my handphone when there is 10more minutes left before departure”

“No, Sir, you first need to make a report first in the Lost & Found Counter, and they will contact the KL ground staff, to start looking for your phone. It’s the PROCEDURE”

* OMG *

A security officer stated to me, “Calling later and letting you down before departure doesn’t make a difference. The phone may have been taken by someone in 10 seconds time.”

* This is also another classical Malaysian common sense. If it were the airstewardess’ handphone dropped in the Terminal 12, would they have called the ground staff immediately to help them search OR wait until their whole shift is over then go make a report, then only search begin? *

I left the plane, in search of beings with some basic common sense at the Lost and Found counter.

I spoke to a guy in the counter about my mishap in details.

“So can you call the ground staff in KL to look for it now?”

”No we can’t, Sir. But we will promise to call by today, but not now. Maybe evening”

“Today?!? Can I see the person-in-charge?”

“I am sorry, Sir. My in-charged person is not around. She is very busy, handling 3 flights. She will be available after 20minutes. Or will call you back later. I will need to photocopy your IC and boarding pass.”

I handed the necessary to him and he photocopied them. I gave him 3 numbers – housephone, my dad’s handphone and my wife’s handphone.

“Can I have your contact, just in case, you didn’t call me back?”

“Don’t worry, Sir. We will call you back.”

“I really need to have your number.”

He started to make some kind of funny faces, a good blend of grumpy and lost look, and went to the back room and came out with a number after few minutes.

I was utterly surprised a staff doesn’t even know their office number by heart. Probably, they lost their phones recently, too.

He scribbled down the contact and gave me.

The sun was up above high at 1200hours. The 3 numbers which I had given did not yield any calls from AirAxia.

I called back the number. I got to a lady, presumedly Malay.

“Oh, yes. Mr xxx. I know your condition. The cabin crew already searched the whole airplane and we couldn’t find your handphones.”

“No, I probably lost it in Terminal 12 last seat row or on the path to board airplane. NOT on the airplane.”

“Okay, Sir, IF YOU LOST your phone in the Terminal, you’ll need to make a police report in LCCT and they will hand you back if the handphone was recovered.”

“Err. Miss. How do you expect me to make a report in KL if I am already in Penang?”

* Not so bright *

“We had done everything we can. We can’t make the report on your behalf and I don’t have the phone number of the police station there. Goodbye, Sir”

Conversation ended abruptly.

After around 30minutes, I received a call from AirAxia.

“Hi, is this Mr. XXX. I am XXX, Operation manager from Penang. When I saw your name, I think I know you. I follow your blog regularly. Your latest blog titled xxx, right? I called up the police there in KL, but so far no handphones recovered. But you see, the police I called may be different from the Terminal’s police. I will call again and contact you back later, latest by this evening”

“Latest by this evening?”

“Yes, by this evening. You have a nice blog. Latest blog titled xxx, right?”

* Follow? Unlikely. My blog is superduper lame and unpopular. Really unlikely. *

“Ya. OK, I will wait for your call.”

Another conversation ended.

I quickly went online to my blog immediately and checked my “Feedjit” and I discovered few minutes ago, someone came to my blog after googling my full name.

I don’t know why but suddenly a catchphrase “Now everyone can lie” crossed my mind.

Till date, I have not received any calls from anyone pertaining to my handphone, except for concern from my colleagues about my lost.

Anyway, losing a phone is solely my own carelessness and believing whatever people tell me is another stupidity that I hope to correct before the next big crisis strikes.

Whether AirAxia’s overdependence on procedure and probably subquality staff’s training is to be partially be blamed for my unrecoverable beloved handphone will depend on their own judgement and reflection, mostly their own will to uphold their prestige and reputation for the future well-being of an airlines, reputable for awards which contains the word ‘Best’.

Personally, after recollection of the whole incident, I believe the best way to go about my calamity is to go down to Terminal 12 immediately and recover my phone. Even if I missed the flight and had to take a bus home, I would suffer a lesser loss.

Or maybe someone can give me a much better sound advice in the event of such mishap.

I am willing to give a small reward and deeply grateful to anyone who can recover my phone for me.

Dec 23, 2009

Beware, father-to-be!!

Pregnancy itself lets the ladies brag themselves to heaven that they are one facing the real deal all by themselves. They're not wrong in bragging. The whole deal of being gravid definitely took them in for a rollercoaster ride filled with danger and not to mention, the agony of pain, one way or another.
Mr. Fantastic


As for the husband or the male partner (if one not married) takes the toll mainly from all the psychological stress due to emotional rantings or the never-ending effort of getting palatable dishes to fulfill the exceptional choice of food during pregnancy. I am making a general statement after talking to several fathers-to-be, definitely without any special reference to myself.

However, something that is for real. Of my knowledge, the male partner can also suffer from

1. Couvade syndrome - excessive vomiting when wife's in first trimester (first few months of pregnancy) - well, at least I had known two of my colleagues had it...
.. Studies have shown that the male partner cohabitating with a pregnant female will experience hormonal shifts in his prolactin, cortisol, estradiol and testosterone typically starting at the end of the first trimester and continuing through several weeks post-partum. Suggested explanations of how and why this occurs include an interaction of factors (some of which are little-researched) such as pheromones, circadian rhythms, simple stress, and mitogenetics. It has been suggested that spouse sleep disturbances may affect the neurohormonal. One possible mechanism is the increased basal estrogen levels from peripheral conversion of testosterone by adipose tissue. To date no biologic target has been identified as a cause of this pain syndrome levels...

Milk Drop
2. Male postpartum depression - depression after wife's delivery.
... We don’t know the exact prevalence of male postpartum depression; studies have used different methods and diagnostic criteria. Dr. Paul G. Ramchandani, a psychiatrist at the University of Oxford in England who did a study based on 26,000 parents, reported in The Lancet in 2005 that 4 percent of fathers had clinically significant depressive symptoms within eight weeks of the birth of their children. But one thing is clear: It isn’t something most people, including physicians, have ever heard of....

.... By far the strongest predictor of paternal postpartum depression is having a depressed partner. In one study, fathers whose partners were also depressed were at nearly two and a half times the normal risk for depression. That was a critical finding, for clinicians tend to assume that men can easily step up to the plate and help fill in for a depressed mother. In fact, they too may be stressed and vulnerable to depression....

Cutting the edge

Dec 19, 2009

sex in the clinic

I think my title should be clearer. It should read ‘identifying sex in the clinic’.

If you fella open this entry for the wrong reasons, may god bless you.

The awesome thing about O&G is like you’re playing a bit of everything.

We can operate like a surgeon, dispense like a physician, give advice on women’s health like a public health officer and lastly do scan like a radiologist. I know you’re wondering what’s with my obsession with role-playing.

Probably one may put it that we’re ‘Jack of All Trades’ and I think you know what follows.

But I believe (wholeheartedly, if not, more), that we’re not master of none, but rather we’re master of jack of all trades, and some of the senior consultant or professors that I knew have truly escalated themselves to being master of all trades, like Prof Abrahams.

Going through the 4 months posting in O&G, a house officer not necessary able to equip himself with the adequate scan skills especially if that person has no vision. No vision that one day, without an interest and a reasonable basis to be retained in the hospital, or due to unforeseen administrative decision, he or she will be sent to a district clinic to run the mother and child clinic. It is there when he will be conducting scan for a big crowd of pregnant (and sometimes grumpy) mothers. At that point, they will probably proceed without sufficient scan skills and simply main hentam, till they were being given the privilege and proper training in the obstetric scan course, or they have a really nice, caring, dedicated, honorable family medicine specialist to teach them without any remuneration.

But one thing that basic obstetric scan course may not cover is how to scan for sex. I mean, the politically-correct word to be used is ‘gender’. Most of us learn how to scan for singleton or twin, location of placenta, presentation, fetal heart, amniotic fluid index and the growth parameters such as CRL, BPD, AC, FL, HC and etc, because those are the essentials that will ultimately interfere in the management of this pregnant lady to safeguard the best delivery scenario for the mother and the baby.

Now after saying that, I think most of the mothers couldn’t care less about those parameters that we’re saying. Their main concerns can be summarized into two.

One, “Is my baby healthy/normal?”

Often the misleading “Yes” can be interpreted as baby’s totally healthy without any disease by the general public. A screening of parameters and amniotic fluid index, may only tell us that baby is generally well, but only detailed anomaly of some organs or minor physical anomaly ie the existence of extra digits can only be excluded by a ‘detail scan’ which must be done by an experienced person or the fetomaternal consultants. Even if the detail scan is a clean sheet, it can confidently promise a physically-normal baby but, the baby may also still be abnormal, ie having endocrine disease, psychologically-twisted or perhaps just born evil. The usual term would be ‘prognosis is guarded’. Guarded by who? No, I don’t have the answer for this one.

Second, “Boy or Girl?”

Now the importance being put on this question differs from one person to another.

Once I had this interesting interaction with this elderly mother.
She: I know you can see whether boy or girl?

Me: How?

She: you see something with the legs.

Me: Oh… ok…

She: So what is that something with the legs?

Me: Oh it is that something between the legs.

She: What?

Me: Err. The genitals, between the legs, of course.

She: Oh.

Technically, being a boy or a girl doesn’t really matters in the aspect of the health.

Is boy stronger than girl? Or otherwise?

Therefore inadequacy or when luck is not on your side, inability to inform the anxious couple from the ultrasound seems to cause disappointment in the couple and frustration in the doctors. This frustration may sometimes lead to destructive statement like, “Oh, jika perempuan, tak mau ke? (Oh, if a girl, you don’t want her?”. Maybe in China, with a one child policy, the ultrasound ability to know the sex early may have a remarkable impact, in which a female fetus may not even make it to see the sunlight.

In actual fact, knowing ‘sex’ may have several benefits as well, in our setting.

1. Social reasons. Somehow one way or another, telling the mother the sex of the baby does open up lots of conversation and trivial talk. Usually I would only give them a ‘maybe’ as in “maybe a girl or maybe a boy, you know this scan is black and white, can’t really tell for sure”. And once, I had a lady just after delivery smiled and told me “Scan u betul lar. Memang lelaki (Your scan is correct, really a boy)”
I overheard what my specialist Dr R once said to a pregnant mother.
She: So, Dr. R, is it a boy or girl?
R: Scan shows probably a boy
She: really?
R: Well, it looks like boy, it sounds like a boy, but still may not be a boy. (Lingamgate)

2. Economy reasons. The expectant parents can start buying clothings and stuff like blue for the boy, or red/pink for the girl. Some parents want to buy definite stuff and don’t really go for neutral colours like green, yellow or purple.

3. Family planning reason. Simple actually, no matter how modern our world is, there are still parents who would continue the waiting game, or rather the producing game until they have both – a boy and a girl. There after 4 girls, and getting to know for sure (or 99%) that their 5th child is a boy, they can probably contemplate on permanent contraception like tubal ligation, which can be done simultaneously in case the mother end up with emergency C-Section.

What are the signs we really see to determine sex?

For the boys, we’ll see the ‘sausage with eggs’,

The image “http://i.ehow.com/images/a04/vr/dd/tell-sex-baby-ultrasound-200X200.jpg” cannot be displayed, because it contains errors.

while for the girls, we’ll see ‘burger’,

It's a girl!  Twin B - 18 Week Ultrasound

which is the ultrasound signs of the genitalia.

No wonder, the young generations (even some old ones) are fonder in taking them in, savoring and enjoying like food.

OK. Bad joke. Apology.

Dec 9, 2009

Fertility pool?

fail owned pwned pictures

I think the daughter got her genes (mostly) from the father.

BTN | bit too nasty?

Bro. Wong CH lined out exactly how BTN is deeply flawed.
Flawed beyond the big verbal battle between the Tun and Datuk Seri.
In his own words -
The BTN saga exposes the two attributes of the Barisan Nasional's authoritarianism — racism and the one-party state.
He also gave thumbs up for the PR states, especially Selangor for having the balls to actually bar BTN, coming up with an alternative programme. He lined out how the ideal programme should be like.
Their alternative programmes should have three features. Firstly, the participation should be made voluntary, except for civil servants and bonded scholarship holders. Secondly, the programmes must be framed in a democratic framework to introduce not only Pakatan Rakyat (PR)'s position, but also the BN's position and the positions of various civil society groups. Administrative neutrality should be the guiding principle in the training for bureaucrats. Thirdly, in line with the plural content, lecturers, panellists and trainers should come from all political persuasions.
Bro WongCH called in BTD - biro tata demokrasi.

Apart from being amused by the drama of the verbal wars between the two UMNO leaders (can i still call Dr. M a leader?), I do not think there is any need for any fine-tuning/ revamp/ upgrade/what-ever for BTN.

I don't really know about BTN that others had attended, but I believed the one that I went through, personally, it was more of a summer camp than a brain-washing/propaganda program.

I can still remember my BTN participants' leader first sentence in his parting speech, beside the usual greeting and prayer.

He said,"I thought it would be a brainwashing camp, but I think the camp turns out alright."

With a preset mind that this is a brainwashing camp, most of our minds already were closed up tightly for any indoctrination.

Secondly, the lecturers, panellists and trainers constantly reminded us about their neutral stand. However, from their 'neutrality', sometimes, it was obvious that they are pro-rakyat more than pro-nasional, giving us ample time to condemn the wrongs of present national administration while ridiculing some obviously nonsense part of the module. It was like being a member of BN, and running its campaign, and during the election day, the big 'X' on the ballot paper differs.

Lecturers and trainers are afterall human, and rakyat who wanted nothing more than to live in a peaceful well-balanced country free from bitterness of racism.

BTN is flawed, at times, in a good way.

_______________________________________________

Grateful to: my dearest for the wonderful golden fried rice for my on call yesterday, and my great team of house officers which never seems to go to sleep even there's no work in the middle of the night.

P.S. Datuk Seri Nasli always seems to be exceptionally vocal when it comes to something that gotta do with 'racist'. Remember his first well-celebrated video on 'racist, racist, racist'? Could it be some kind of medical disorder?

Dec 6, 2009

spawn & respawn

I sat quietly today, as an audience to a much veteran crowd, discussing about how our population is dwindling and all those-2012-end-of-the world talk, and how rare to see pregnant ladies nowadays. Skeptical. The statistics stated otherwise - at least in SP.

And an auntie went on saying...

Last time hor... one family hor... so many children...
Now hor... only 3 also consider many liao...
Last time hor... one house got many people...
Now hor... one fella hor... got many house...

I kept my silence. After all, their amount of bridge-crossing does trump my experience of road-walking.

But then, suddenly a thought crossed my mind.
Yes, I always have all those funny amusing (sometimes fairly idiotic) thoughts, which come to me like an epileptic fit.



There was this house officer who was always missing in duty, and taking so-called indicated 'emergency leave', that even twisted my HOD's arm. An EL my HOD just couldn't refuse. His 'emergencies' mostly involved certain relative - mainly his grandfathers, who was believed to be dead more than 5 times. Twice in my department, once in another, and twice again in the next.

In a small hospy like mine, the MOs do sit down and go through certain vital stats like how extended some family of HO can be and all the mysterious (and probably cool) re-spawns of that certain family member.

grateful to: Dr. M for letting me actually toast the ectopic in a fully-hands-on supervised lap salpingectomy.

P.S. since i started twinning in facebook. no one seems to come to blog anymore =( huhu.

Dec 5, 2009

tips for the driving mother

The lucky survivor(s) commented:

I was in a rollover car accident when I was nearly eight months pregnant with my second son. The car skidded on some ice, rolled down a hill and flipped over, landing on its roof.

The car was totaled - axles snapped, roof caved in, broken glass everywhere.

I had my seat belt on, worn properly and was uninjured. The baby was born two months later without incident. He’s a sophomore in college now - an intelligent, friendly kid who is also a talented musician.

I knew we were lucky, but now I realize just how lucky we were.

But one wonder what is the real thing that a pregnant lady should do to prevent oneself from car accidents which was rather rampant in our country, especially during the festive season.

Personally, the worst case that I had experienced with, was when I was the green house officer back in the old hospy. The mother was the one on the driving wheel, and the next moment, she was admitted with some abdominal pain, but definitely still lucid. Our best bet was then, on severe preterm labour, but then again, the ultrasound lined out one hell of a horror tale. The whole baby and some parts of the placenta was already outside of the uterus, with the fetal heart still beating.Without further delay, we knifed the abdomen, and fortunately, the mother went into the stats as another 'near miss'.

Although not a professional site, but I guess the advices given was quite valid and sound-minded.

A summary of what the pregnant lady should do:

1. drive responsibly. (no drink and/before drive, no handphones, no sms, no speeding, no orthodox life-threatening stunts)


http://www.caradvice.com.au/wp-content/uploads/2007/05/womendriver.jpg

the wrong way.

2. wear the seatbelt PROPERLY. (3 point belt is the best, one across the shoulder, the other on the lap, NOT across the abdomen)

http://images.teamsugar.com/files/upl0/10/109609/12_2008/seatbelt.jpg

Stock Photo titled: Pregnant Woman Driving Car Using Seat Belt, USE OF THIS IMAGE WITHOUT PERMISSION IS PROHIBITED

CORRECT: baby-friendly.


Pregnant woman putting on seatbelt in car

WRONG: Feticidal.

3. best coupled with the airbag

The image “http://www.dodge.com/shared/2007/nitro/safety_security/air_bag_protection/images/lb_airbags.jpg” cannot be displayed, because it contains errors.

4. as far possible from the steering wheel (Some vehicles have a button to adjust the height of the brake and gas pedal so shorter people don’t have to sit so close to the steering wheel. And there are after-market pedal extenders.)

http://www.pedalextenders.net/gas%20extender%20for%20hang%20card.jpg


Dec 2, 2009

derailed thoughts

There is this bold house officer who asked me multiple requests yesterday, and ‘why other department can, but this department can’t’. I was stumped, obviously, awed by her boldness, but then again, I believed soon, her bold move was actually frank moronic stupidity masquerading as courage, which I think no high level of medical education will tell you that beforehand, until one really said it upfront and found shit up to thigh level or deep shit. To be in a department of the hospital of which house officers enjoyed pm off after on call plus weekend off without any deficits on their call claim, yet bold enough to ask for more, I think this is a classical case of ‘bagi betis, minta paha’. On second thought, it was more of ‘bagi paha, minta punggung’.

By now, I think many house officers around the country, will probably reading this and scheming up to assassinate me, or hypothesizing how my frustration going to stress-KO me out cold.

Aircraft Rocket

"It's slightly warm, but no anger is going to get over my head"

Fine. This wasn’t meant to be an entry about house officers initially, anyway. I just feel like bitching about monstrosity of house officers who treat patients inhumanely yet asked to be treated as a human. I think we should all take a moment of silence to grief on that. By ‘we’, I meant everyone, not just the medical people, because at the end of the day, you’re going to be lying there, dead because of some mismanagement of certain defective house officers, thanks to Ministry of Education (or is it Higher Education) for recognizing their obviously defective medical school, and Ministry of Health who pant obediently like a lapdog happily accepting them to screw up everybody’s life.

Now, I had forgotten what I initially wanted to blog about.

And no, I wasn’t d.a.m.n. p.i.s.s.e.d. about this.