Mar 28, 2010

conceived after felatio?

In conjunction with the winning of the post of numero uno of EmCA by the great incidental actor, and now someone in the party who daringly challenge this possibility may have to eat and 'chew' her words, 'may'be denied those words or just continue to have 'fun' as if nothing was being said.

Here's something that is peculiar but true in the world of fertility.

Where millions of ladies worldwide fall into depression but not being able to conceive, this young lady probably destined to be infertile due to the congenital absence of vagina, through serendipity, she conceived after a felatio and a few stabs on her abs.

Read more below.
Oral conception. Impregnation via the proximal gastrointestinal tract in a patient with an aplastic distal vagina. Case report.

[Ed. note: There is no abstract, so we're including most of the original article below. It's a bit long, but trust us--it's worth the read!]

“Case report:
The patient was a 15-year-old girl employed in a local bar. She was admitted to hospital after a knife fight involving her, a former lover and a new boyfriend. Who stabbed whom was not quite clear but all three participants in the small war were admitted with knife injuries.

The girl had some minor lacerations of the left hand and a single stab-wound in the upper abdomen. Under general anaesthesia, laparotomy was performed through an upper midline abdominal incision to reveal two holes in the stomach. These two wounds had resulted from the single stab-wound through the abdominal wall. The two defects were repaired in two layers. The stomach was noted empty at the time of surgery and no gastric contents were seen in the abdomen. Nevertheless, the abdominal cavity was lavaged with normal saline before closure. The condition of the patient improved rapidly following routine postoperative care and she was discharged home after 10 days.

Precisely 278 days later the patient was admitted again to hospital with acute, intermittent abdominal pain. Abdominal examination revealed a term pregnancy with a cephalic fetal presentation. The uterus was contracting regularly and the fetal heart was heard. Inspection of the vulva showed no vagina, only a shallow skin dimple was present below the external urethral meatus and between the labia minora. An emergency lower segment caesarean section was performed under spinal anaesthesia and a live male infant weighing 2800 g was born…

…While closing the abdominal wall, curiosity could not be contained any longer and the patient was interviewed with the help of a sympathetic nursing sister. The whole story did not become completely clear during that day but, with some subsequent inquiries, the whole saga emerged.

The patient was well aware of the fact that she had no vagina and she had started oral experiments after disappointing attempts at conventional intercourse. Just before she was stabbed in the abdomen she had practised fellatio with her new boyfriend and was caught in the act by her former lover. The fight with knives ensued. She had never had a period and there was no trace of lochia after the caesarean section. She had been worried about the increase in her abdominal size but could not believe she was pregnant although it had crossed her mind more often as her girth increased and as people around her suggested that she was pregnant. She did recall several episodes of lower abdominal pain during the previous year. The young mother, her family, and the likely father adapted themselves rapidly to the new situation and some cattle changed hands to prove that there were no hard feelings.

A plausible explanation for this pregnancy is that spermatozoa gained access to the reproductive organs via the injured gastrointestinal tract. It is known that spermatozoa do not survive long in an environment with a low pH (Jeffcoate1975), but it is also known that saliva has a high pH and that a starved person does not produce acid under normal circumstances (Bernards & Bouman 1976). It is likely that the patient became pregnant with her first or nearly first ovulation otherwise one would expect that inspissated blood in the uterus and salpinges would have made fertilization difficult. The fact that the son resembled the father excludes an even more miraculous conception.”


Mar 26, 2010

Aim Sea Aye?

The bet is on.

Chua-Kong, OngKT-Lim or OngTK.

I am not a big fan of MceeA, not even their little fan.

But then again, I got my bets behind Chua-Kong winning this race.

Detrimental to the party-building, Chua probably has the right substance.

Probably, that’s the reason his progressive rise to lead was being ‘wickedly’ held back by the video set-up to spoil his image, not only as a family man, but also as a doctor.

But he didn’t hide. The matter of fact that he didn’t sport the ‘looks like me, sounds like me, fxk like me, but not necessary me” denial somehow let him being viewed differently from other leaders of the party.

Until now, no one in the party stands up and admits their bad taste of voyeurism which doubles as the wicked plot to topple Chua. Now, that is a scary thought. Who knows who will be his/her next victim?

Anyway, Chua’s repentance is his ace in the race, and the continuous rally to degrade him as amorous adulterer without undermining his capability to run the party will only push him further up.

No matter what, he got nothing to lose anyway. But the party has everything to lose if Chua is ‘the’ one that will bring up the party better than the other candidates.

The fear of not knowing, at times is worse off than fear of failing.

Kong will win by default because there is high chance that Liow will lose. As a matter of fact, he already lost when he overspent his time dreaming of being the shocker third faction to boot out Chua and subsequently discredit TK in his bid to be on the throne. And now, he exhausted his strategies and had to tail behind KT to boost his credibility, which is not much to begin with anyway.

Now, I don’t give a d*mn who is the winner as long as someone reliable and down-to-earth is being given the portfolio of Health Minister.

Mar 25, 2010

response and responsibility III: state of busyness

My active call the day before was over the cloud apparently. And instead of going back after my postnatal round, I stayed back for the Cardio update course which was a worthwhile thing to do. And finally rested for a while before the awesome futsal session with my colleagues.

I was getting around the hospital so much that I think I used up the cardio work out limit of the week.

Now, being busy can be a good thing apparently, it was associated with lower death rates, which is what being in this profession intended to do.

I was introduced to the term 'Jonah' for being very eventful during on calls by Dr. Nara, my previous surgical MO, during my first posting as a house officer. He's now an aspiring surgeon.
Being inquisitive and all, I did ask him why the name 'Jonah'. His answer was "Jonah. Jonah lar. means you're busy lar." Apparently nobody bothers to find out the origin of this. I made an effort. Searched the web, asked a few more seniors - but there was any answer. Probably someone just made up the word 'Jonah' and over the years, juniors picked them up and used it.
Probably Jonah is just another MD who always has too much to do.

Anyway, my middle name was temporary being Jonah yesterday.

The height of moment came in after lunch hours. I got a call from Kev.

"Hey you gotta see this, MVA pregnant lady 33weeks. Got PV bleeding. Yellow zone, OK."
"OK, I come over.OK, Yellow zone. Patient stable"
"Yes, stable."

Rushing through my mind was the mother with uterine rupture post MVA that I had back then when I was a HO.

I settled a brief referral note in my gynae ward and called up my reliable HO down at PAC to bring the scan machine to the zone, making sure my assessment will proceed speedily once I reached.

I reached.


The unfortunate mother was lying there. Lucid. Awake. She detailed to me the whole incident.
She felt some chest tightness due to impact from the stearing wheel, but was not breathless.

Wall Waterfall

She felt her whole driver seat soaked with liquor, but no blood. Findings of my examination was of equal.

I took a deep breath of relief.

Her baby was still moving, and my ultrasound revealed the strong pumping heart of the baby. However, the major trauma bankrupted all the liquor around the little soul. I thought I saw a retroplacental clot, a small one.

Cardiotocograph of the baby revealed tachycardic at 180.

I called up my Paed colleague immediately, reminding her about the imminent delivery.
My surgical colleague came, assessed and cleared her chest injury as probably soft tissue injury. The chest radiograph was unremarkable by naked eye.

My anaest colleague was temporary at a lost whether to house the C-Section in the Maternity OT or the General OT. Something of a logistic management. But for me, just to be on the safe side, clearly General OT was the safest bet. Always expect the unexpected.

The op was done swiftly, intraabdominal examination by surgical team was optimistic for the patient.

I was too busy to find out about the 1.5kg baby until my Paed colleague passed the word to me about the gloomy condition of the baby in the middle of night when she was on standby for a Ventouse performed by another good HO, fully supervised.

Upon delivery, the condition of the baby wasn't that bright to begin with. The fontanelles was bulging and the eyes were slightly protruding. Intubated immediately and bagged.

My Paed colleague was very furious at the nurses in the OT for their lack of respect for humanity. As the maternity nurse was bagging continuously, she commanded for 'transport' to NICU. The OT nurse was 'busy' entering their swab and instrument counts in to the PC, ignoring her, probably believing strongly that this isn't under her job scope. She had to yell sarcastically to get that nurse to called up Labor Room for the transport.

I told her that this is just the tip of the iceberg that you're experiencing.

Their disrespect for humanity is a culture, rather than the exception.

There was another time when there was massive postpartum haemorrhage post C-Section and everybody was busy with even my specialist, Dr. J was called in. And as we need more instruments to secure the bleeders, the Assisting Nurse was nowhere found. She popped up later, telling everyone boldly she went for lunch. Well, gotta give her brownie points for honesty.

The baby was fighting for his life when I was postcall, struggling with multiple inotropes, but prognosis being poor was frankly conveyed to the father.

The fact that the delay would have much impact on the outcome isn't something that we should get ourselves acquainted with.

However, the fact that we should always do our best in the matter of life and death is probably what defines us as a human, not some ignorant beast.

Lens Piggy

Mar 23, 2010

1malaysia (Sabah not included?)

While the angry mob of patients in the peninsular are furiously mad about waiting time more than 30 minutes, the ill Sabahans are suffering silently during their 30minutes transportation time in the Queen- SMC-Likas-Lingzhi-BukitPadang medical merry-go-round, every few days.

I decided to echo my fellow product's letter for our health minister's attention.

"Dear Yang Berkhidmat Liow Tiong Lai,

Mr. Wong, an elderly man presented at Hospital Likas because of severe breathlessness and was found to have severe pneumonia on chest x-ray.

He was then admitted to the High Dependency Unit of Queen Elizabeth Hospital (QEH) 30 minutes away for treatment.

He improved after six days and was then transferred to the normal ward for further recuperation.

A bed was urgently needed one day later and the frail Mr. Wong was then shipped off to Hospital Bukit Padang for ‘rehabilitation’.

Alas, he did not improve but instead deteriorated.

As Hospital Bukit Padang was devoid of the necessary equipment and setup for managing emergencies and ill patients, Mr. Wong was then resent back to QEH for further management.

More tests were required and old Wong was then sent to Sabah Medical Center for a CT scan.

I’m not sure what happened to Mr. Wong thereafter.

Dear Minister,

I hope this short story did not catch you in an awkward moment as the infamous video did to your amorous predecessor.

I hate to interrupt you in the midst of your personal battle for self preservation in the increasingly irrelevant political party called MCA but the healthcare crisis in Sabah has just taken a turn for the worse.

The locals in Sabah refer to hospitals as ‘rumah sakit’ - translated literally to mean a ‘sick house’.

Increasingly, the Queen Elizabeth Hospital, the only tertiary referral center in Sabah is living up her grand title of being a sick house.

Partially shut down since September 2008, the ailing sick house of Sabah has turned critical recently, with worsening cracks and falling tiles and a real threat of frank collapse.

The older blocks nearby were declared unsafe and subsequently evacuated and shut down.

Ill and frail patients were shipped off in a frenzy like unwanted cargo to nearby centers like Hospital Bukit Padang the mental institution, Hospital Likas, and the makeshift hospital of Lingzhi Museum in Kepayan and of course, UMNO’s favourite Sabah Medical Center (SMC).

Mr. Minister of Health,

The formation of the Queen- SMC-Likas-Lingzhi-BukitPadang medical maze has brought total chaos to healthcare services in Sabah.

The docile and unassuming Sabahan patients are constantly playing a wicked game of musical chairs, being transported around from one hospital to another according to their changing healthcare needs.

There is not one single center that can address a patient as a whole.

A lady in labor will be told that she can’t do so in QEH, while a fitting patient are whisked away from Likas to QEH.

A child with a broken limb may go to SMC but the surgery can only be done in Likas.

Elderly Mr. Wong is merely one of many such victims.

Continuity of care is virtually impossible when patients are moved about every few days.

Valuable investigations and data are lost in the process of multiple transfers resulting in costly, repeated tests.

Patients have even died due to the lack of emergency equipment and the deficient setup at the peripheral wards.

You will not hear all these because your little pharaohs in the state health department have done a great job concealing negligence, mismanagement and sheer stupidity.

Medical personnel are suffering in silence too.

Doctors from house officers to specialists are rushing around the five medical centers daily, wasting precious time, fuel and energy in the process of doing so.

Medical officers have been doing eight to fifteen on-calls every month as a result of the increased locations housing the sick.

That is fifteen days away from home and family every month, mind you.

Just in case you forgot we too have young, growing kids to care for.

Absent parents do not make for good family dynamics, won’t you agree?

We are risking our lives each working day wondering if the abandoned tower block will one day collapse upon us and send us to our Maker.

Our comrades serving in Sabah Medical Center are not having it any better.

In spite of the Barisan Nasional’s grandiose publicity buzz over the RM 245 million purchase of Sabah Medical Center, the medical personnel and patients have remained mere squatters in the premises.

The medical staffs are receiving summonses so very too often as a result of limited parking space.

Those of us in surgical disciplines are working till 9 pm on Mondays to Fridays so as to optimize the operating time of our three miserable rented surgical theatres.

In the SMC wards, 4-5 patients are cramped into rooms meant for two as the hospital was built to house a capacity of 150 beds only.

Mr. Minister,

My colleagues and I cordially invite you to come and see the ground situation for yourself without a grand entourage of administrative boot-lickers.

Patients who require hospital admission have to be turned away due to the insufficiency of places.

The inpatients meanwhile are packed like sardines in the current wards, with hardly a metre of space between beds.

The situation is comparable to a Vietnamese refugee camp.

Hospital-acquired infections are the norm rather the exception.

When a patient with tuberculosis coughs his lungs out, everyone in the ward will be inhaling the highly infectious Mycobacterium.

After 50 years of independence, our ill patients who require close observation are still sharing monitors and other equipment between themselves.

Is this the standard of care that Barisan Nasional is according to Najib’s self-proclaimed fixed deposit?

Whatever happened to all the oil money that Sabah has generated for Tanah Melayu over the last 50 years?

So you see, Mr Health Minister, we don’t need more jobless house officers, more empty promises and more tasty slogans like 1Malaysia.

We need 1Hospital and 1HealthMinister who is attuned to the sufferings of the rakyat under his care.

Do and be all that even though Sabah will most likely hand Barisan Nasional another landslide victory come next general election.

With warmest regards,

Product of the System."

Mar 22, 2010

abdominal swelling


Overheard this interesting conversation in Mandarin by my dearest with my almost 3years old Aedan, driving back to SP from Penang.

Dearest and Aedan was seated behind, while I was driving.

Aedan: Mummy, why are you not wearing seatbelt?
Mummy: Mummy belly big mar...
Aedan: Oooo...
Mummy: So mummy fat can't wear seatbelt lor...
Aedan: But, mummy, daddy also fat, he can wear seatbelt. You see, he's wearing seatbelt.
Mummy/Me: (=,='')

Reminds me of the several 'F' we learnt in our medical school about differentials for abdominal swelling. Fluid, Flatus, Filthy Tumor, Fetus and Fat.

I guess it is time to adhere to some weight loss regime.

Mar 19, 2010

virginity - new commodity

As out feeble-minded society got attached with the outrageous idea of pantyless valentine, globally something much more sinister is is happening.

Probably it is the smart version of flesh trade, making millions out of serving one, rather than the conventional pay-per-hour services.

One of the legitimate ad reads as follows:

I have never had a sexual relationship and am still a virgin.

I am offering my virginity by tender to the highest bidder as long as all personal safety aspects are observed.

This is my decision made with full awareness of the circumstances and possible consequences.

I am fit, healthy and have no medical conditions of any nature.

I am a keen athlete and have a trim physique.

And the final bid fetched up to NZ$46,000.

Other offers here, here, here, here and here. Here, too.

It got me thinking.

Let just say, those ladies got themselves great hymenoplasty, wouldn't the bounty be boundless.

Anyway, I ain't pimping here, but this is just another sneak peek at what dark sinister future our next generations will be heading to.

And where the hell is the strong condemnation by our global sensible society?

I really couldn't imagine the day these practices will reach our Malaysian shore.

Mar 16, 2010

when it rains, it POURS...

Few weeks back, since few days before the CNY, the weather in the Peninsular was murder.
Killer Hot.

Even at night, I was sweating like a dog, although I don't actually have a long tongue to stick out to cool down myself.

I thought to myself. The heat of the day and night was probably a good thing, creating an universal sauna for me so that I can peel off a fair amount of excess adipose from my CNY's binge eating.

It's really hot up here in the North. I read those temperature recorded by our Meteorological Department published in The Star Paper lately. Perlis had the highest temperature recorded. Basically, if you're hot in KL/Johor, here we're just kind off 20% warmer than you.

Sauna up north is better.

Nevertheless, the heat was kinda troubling, to the extend that I can't focus on doing much, although there was a mountain of things for me to settle.

Gladly, few days back, the weather stabilized and I was seriously glad that the blazing summer was over.

I could remember vividly the first day when the heat went away.

It was cloudy all day through, from breakfast till evening tea and finally it rained heavily after dinner.

It was a happy moment for everyone, consciously and subconsciously.

But not all good news are really blessings. If you're familiar with the story about the Farmer who lost his horse, you'll know perfectly well what I mean.

Yesterday, as I was replacing one of my colleague's call, I received the news of the OT in my hospy attaining menarche.

And it was not something new in the hospy, as 2 years back, my hospy's NICU already had their first menses.

I guessed many parts of my hospy are simply maturing in a good way.

When I mentioned about menses, I was simply echoing the heated, most talked about parliamentary debate in 2007, when two Barisan Nasional Members of Parliament (MP) — Datuk Bung Mokhtar Radin (Kinabatangan) and Datuk Mohd Said Yusof (Jasin) — used menses as a way of discrediting DAP MP Fong PK's legitimate question about Parliament's leaky roof.

I wasn't there when it happened, but gathering from others, it was a pretty dramatic affair.
If there was a video on it, I am sure it would be the video of the year, and make it to our Malaysia Book of Record.

According to one fella, the rainwater accumulated heavily and suddenly the ceiling broke, then followed by a 'waterfall', flooding the OT.

Another fella related to me that the main emergency OT still can be used, but there was this major puddle of water in the scrubbing area which one had to tread through carefully.

Double Time

Now, probably, this is where the kungfu of being able to walk on water really comes in handy.

And finally, the two million dollar facility of Maternity OT had to be reopened for business, after collecting dust for 2 years, sitting silently between the two most active facilities of the hospy - NICU and Labor Room.

I was surprised after counting at Day 2 post leakage, the news didn't get into the pages of local media. Either the Papers are too bored with this kind of leakage news, or the Garvmen is spending quite a handsome sum of moolahs to shut them up.

The second alternative seems to be less likely mainly due to few reasons. One of the reasons being Garvmen had not much of money left for the health sides, after parting heavily with a big part of it trying to build a decent amount of the dangerous blood-sucking 1fmalaysia clinic which serves more as political propaganda vehicle rather than a safe healthcare facility.

I had doubt that without a solid financial backup, will our hospy survived this damn... i mean, damp crisis.

Even if there's solution round the corner, for how long do we have to wade through the problems?

As for now, life goes on.

Cool Baby

We can't simply sit around like a cry baby. Maybe we just need to have a much better branded OT shoes.


No point being angry or unrealistically frustrated as well.

Anyway, like I said, it is all part of growing up and maturing, having the first unexpected pour and all the psychological and physical consequences that ensue.

Mar 13, 2010

tis little piggy tells a story

little Aedan tried to tell his first story: the little Red Riding Hood in Mandarin.

a little camera-shy, initially.

after NG for few days, he finally completed telling his first story last night.

Mar 12, 2010

Another nice weekend

I was thinking about doing this and that for my weekend, but then again, I think at times, too much of planning ain't that good, either.

Life Is A Choose Your Own Adventure

Mar 10, 2010

Chinese to take over

there's this interesting article from malaysianinsider titled "Chinese will take over in the next elections, warns Perkasa"

KUALA LUMPUR, March 8 — Malay nationalist group Perkasa warns that the Chinese community will use the next general election to take over the country.

Perkasa feels that the last general election weakened the Malays and empowered the Chinese community.

Dr Zubir Harun, director of Perkasa’ economic bureau, who was at the Malay Consultative Council’s (MPM) round-table discussion, said during his presentation that a divided Malay community will empower the other races.

According to delegates at the discussion and documents received by The Malaysian Insider, Perkasa wants the New Economic Policy (NEP) to be the “spirit” of the New Economic Model (NEM).

“Perkasa believes that disunity among the Malays has weakened Umno, causing the non-Malays to be more vocal in their demands. They say that the Chinese are also blackmailing the government to give in to their demands by threatening to vote for Pakatan Rakyat,” said one of the delegates.

Zubir also said that Perkasa is worried that the New Economic Model will have a Chinese agenda.

“The Chinese people feel that the next general election is the best opportunity for them to gain power in this country.

“This is why Chinese NGOs, such as Ziong Dong and Associated Chinese Chambers of Commerce, are using this chance to make demands of the government. If their demands are not met, then they will vote Pakatan Rakyat who are willing to give everything to the Chinese,” he elaborated in his presentation.

Zubir added that the Malays have “sacrificed” for the country by allowing “the immigrants” to live in Malaysia.

“It must be reminded that the Malay people have sacrificed tremendously since independence with a quid pro quo policy... the Malay race have compromised by allowing foreigners into the country. The Malays endured hundreds of years of colonization and the result is the migration of foreigners into the country. We were forced to accept this policy,” he said.

Zubir also slammed non-Malays and liberal Malays for wanting to rewrite the country’s Constitution and social contract.

Perkasa believes that the NEP is still relevant because it will help the Malay community to counter a market which is dominated by the Chinese.

The Malaysian Insider reported today that the government has decided to incorporate the proposed New Economic Model (NEM) into the 10th Malaysia Plan (10MP) in June, as fine-tuning and tweaks will go beyond its initial end-March launch.

It was learnt the delay came after feedback from various quarters prompted the government to rework its ideas and proposals that will turn Malaysia into a high-income nation based on innovation and creativity.

Among those with reservations about the NEM are the MPM which yesterday demanded it be based on the 1970s-era New Economic Policy (NEP) and should comply with Article 153 of the Federal Constitution that protect Malay and Bumiputera’s special position.

I decided to pimp out the article, just in case, it was censored later. You never do know how pathetic the Gahmen will do nowadays.

Well, if indeed Zubir is our Bolehland's Nostradamus, I guessed it is time I choose which part of the country that I would want to take over. Greenlane? Bukit Jambul? Ayer Itam? Batu Feringghi?

Nah, maybe I'll just get a tree house...

As for NEP, i think it is still relevant. Its relevance correlates well with the great economic divides, even within the same 'sacrificed' race. Its relevance raised the self-esteem issues in some Malays who believed that without these crutches, they can be just a good as other races. Without any cynism, I believe they can.

Spectrumtastic Toes

Success transcends through any barriers of races, religions and skin colors.

No one would want the credit of their success to go to NEP instead of their self-diligence and self-effort. Without the abolition of NEP, everyone will always cast a doubt upon the real struggle to success.

But calling other Malaysians more 'immigrant' than others, I guessed he should be utterly condemned and jailed under the ISA. The grand evidence that he's currently a happy old man walking freely in the streets once again proven that ISA and the idea of 1malaysia are actually a couple of phoney 'empty vessels' that kept making unnecessary vulgar noise pollution in our media landscape.

Now, back to the real question about several paragraphs of musing:

Will Chinese take over in the next election?


Yes, we will.

Well, half right maybe.

A simple math looking at our current racial breakdown will surely deemed the Chinese take-over as a myth only written in the Grand Holy book of Perkasa.

But Chinese will take over, sooner or later, but not in a bad way.

If you really follow the global trend closely, after English glorious dominance in 2 centuries ago, and America's superpower reign in the last century, it is the prophecy of unknown sources that China will own this century.

Napolean Bonaparte once said, "When China awakes, it will shake the world"

China had overtaken Germany as the top exporter. China had loads of bonds of Treasury of USA. China is getting lots of resources and raw materials from African countries by giving them back some infrastructures. China has great plans ahead.

No, please do not be mistaken that I worship the grand motherland of China, despite what some pathetic out-of-touch right wingers will believe, Malaysian Chinese will never be the same as China's Chinese. Never.

Our root and skin color maybe the same, but our identity is totally different.

It is different, and it always will be.

Here's the thing.

More and more Malays will be learning Chinese along with our national language in years to come - which is a good thing, I believe.

With an extra language at hand, the majority of Malaysians will be more marketable. Breaking into the China's market will inevitably help our country grew faster and stronger.

Secondly, by understanding the culture and language, inevitably, it will break down big communicative and cultural barriers, leading to greater unity.

Wow, such an ambitious dream, such a vision, premonition and bla bla...

In actual fact, this idea is actually semi-stolen from our small Southern neighbour. Singapore's think-tanks recognizing the current global trend, are sweeping the country with encouragement for their people take up more of Mandarin than their everyday's English, while it is the opposite for the Chinese-speaking Malaysians across the Causeway, who learns to be more proficient in English.

Most of the bright Malay nurses that I knew of already been sending their children to SRJK, without losing their own heritage and culture.

Maybe it's women's sixth sense, maybe it's motherly instincts. One thing for sure, they knew exactly deep down in their hearts that their choice is for the best for their children.

Yes, Chinese will take over - but not in a bad way.

Lars-Julien Meyer - Angelo Crystallis

Let us all build a better Malaysia the right way.

Mar 7, 2010


George Bernard Shaw once said:
The power of accurate observation is frequently called cynicism by those who don't have it.
But as a Malaysian, there's no need to have accurate observation, cynicism just comes along as an everyday's item.

Besides being humored lately by the government purchase of derailed locomotive and submarines which unable to submerge, I was pretty amused by some house officers.

One mistakenly mentioned wide-spaced nipple as wide nipple.

The other was telling me about the fingers-compensation theory, when I asked him to try to remove the product of conception near the os digitally for a patient with incomplete abortion. As far as I know, I think fingers-correlation theory was more widely accepted than his theory and he (& probably his partner) should not delude themselves with the other theory.

Well, but the real joke which crosses the border of pathetically funny is this:

If you cross the North Korean border illegally
You get 12 years hard labour.

If you cross the Iranian border illegally
You will be jailed indefinitely.

If you cross the Afghan border illegally
You will be shot.

If you cross the Chinese border illegally
You will never be heard from again.

If you are Indonesian and cross the Malaysian border illegally you will get......

MyPR (Permanent Residence status/Pemastautin Tetap)
A driving licence maybe a taxi driver's licence
Voting rights
Job reservation
Eventual Bumiputra status
Subsidised rent or loans to buy a house
Free education
Free healthcare
Total acceptance as "one of us"

plus this

A man came home from work and his children ran to him and called out ‘Ayah! Ayah!’.

His neighbor got very upset and said to him, “Can you please tell your children not to call you ‘Ayah’?”

The man asked, “Why?”

The neighbor retorted, “Because my children call me ’Ayah’ too. They might get confused and mistake you to be their father.”

Then the man told his neighbour, are you not ashamed to say that your children do not know who is their 'Ayah'? So you are saying that by using the word 'Ayah' , your children will call me ayah too without knowing who is their father.

The neighbour said "Yes", and only he should be allowed to use the word 'Ayah'.

The man said, "Then there is something wrong in what you are teaching your children. They are not sure and do not know who their 'Ayah' is.

Mar 6, 2010


New Born Baby

Few decades ago, a few exceptional obstetricians or rather the journalists coined the term 'too posh to push' pushing (no pun intended) Caesarean section rate up a notch.

Something that I can't really understand, seriously.

Superstars or great actresses who gladly went under the knife under their persistent request was giving the excuses that they don't want nasty thing to happen below. But the thing is, they are not esteemed performers involving their body parts below between the navel and mid thigh.

Maybe they are just polite beings, posh and polite, not being capable to summon enough earth-shaking power to bear down a child through the 10 centimeters perineal exit.

Similar things happen in my hospy's labor room.

No, there are no great actresses coming along.

Once in a blue moon, inevitably, one will find a lady with her second pregnancy coming into labor room with strong contraction pain. I do not really know how bad was the pain (lucky me?). One thing for sure - it serious hell.

As the baby was crowning, she refused to bear down, refused to deliver and closed up her legs and told everyone in the labor room that she didn't want to 'beranak' (deliver the baby).

Of course, she did not go around the labor wards telling everyone, but her high-pitched yelling is enough to shaken the whole labor room perhaps at the Richter scale of 7 and above.

Response from the nurses: Laughter.

I responded with laughter, too. A bit of natural response. A bit of peer pressure. A bit of annoyance.

This laughter wasn't the usual laughter where it ends with a sense of relieve and satisfaction plus happiness. Instead, it ends with a bitter feeling that she will probably end up going under the knife.

The laughter had no effect on the lady. She didn't give a damn.
Everyone tried our best to counsel her to follow through in delivering. She didn't give a damn, either.

A quick browse through her antenatal book revealed previous uneventful vaginal delivery.

Finally, this child had to come out from a different route from his/her elder brother.

I used to have no inkling of idea of what absurdity that I was facing, that sometimes in the midst of laughing I felt like crying in sympathy for this patient.

Now, perhaps, I realized that this patient may be simply tokophobic and maybe I can do something for her the next time round. Perhaps. Perhaps. Perhaps.

Here's an enlightening confession by a tokophobes who struggle to fight her fear.

Jessie Hewitson

Jessie Hewitson, who has an extreme fear of giving birth, is now pregnant herself.

I'm lying in hospital, shaking with fear. There are no familiar faces, only doctors and midwives hovering above me, their mouths moving silently. The contractions keep coming, and I'm horribly confused. How can I be in labour when I would never have allowed myself to get pregnant?

Welcome to my subconscious, which regularly reminds me of my terror of childbirth. The nightmares started in my teens, when I decided I could never cope with giving birth; the pain would be intolerable. Since then, the merest glimpse of a heavily pregnant woman has filled me with searing panic – my hands shake, my heart races.

I had grown used to the idea that I would not have children. But when friend after friend started a family, seeing them with their babies led to a brief suspension of terror, and six months ago I got pregnant. At first, it didn't seem too worrying – after all, I had the best part of a year to go – but the anxiety has grown and grown.

The extreme fear of childbirth, tokophobia, was first identified in 2000 by Dr Kristina Hofberg, and is surprisingly common, affecting one in six women. Hofberg separates sufferers into two categories: primary tokophobes, who fear childbirth before pregnancy, and secondary ones, whose fear is ignited by a traumatic birth. Speaking as a primary, the fact that a secondary category exists says it all.

What separates tokophobia from the usual anxieties of mothers-to-be is the depth of fear. Some tokophobes think they will die; others imagine something unbearable happening. The most common trait is a fear of vaginal birth, with no corresponding dread of caesarean sections (although some women find both prospects equally terrifying). For many, the idea of a baby growing inside them is deeply unsettling. They often seek out stories to back up their fear of labour, and my recent internet history includes a shameful number of awful-but-compelling parenting sites.

Alison Ellerbrook took a similar path when she was pregnant with her daughter, Isobel. "I read everything I could on childbirth, but it only made my imagination run wild," she says. "By the third trimester, I was frequently tearful and shaking. I had panic attacks and terrible nightmares about labour. I would tell my husband, 'I can't do this.' At my NCT [National Childbirth Trust] class, people would say they were nervous too, but it wasn't the same. I was scared I was going to die."

Unfortunately for Alison, her labour turned out to be long and complicated. "I started to feel like my body wasn't my own," she says. "Towards the end I had 13 people at the bottom of the bed. I felt like a piece of meat – there was no dignity – and I was in complete shock."

She suffered flashbacks, and was later diagnosed with postnatal depression and post-traumatic stress disorder. It has taken her two years to recover. She would love a second child, but thinks it unlikely; she uses two forms of contraception – not unusual for a tokophobe – and will not countenance pregnancy again unless, at the very least, she is guaranteed a caesarean section.

Psychotherapist Graham Price, who has treated many patients with the condition, says there are some specific triggers. Victims of sexual abuse are more likely to suffer from it, as are women who are prone to anxiety. The fear can germinate after being told a particularly gruesome birth story at an inappropriately young age, or witnessing a graphic birth scene. The actor Helen Mirren is convinced that an educational video shown at school put her off labour for life. "I swear it traumatised me to this day," she said in an interview in 2007. "I haven't had children and now I can't look at anything to do with childbirth. It absolutely disgusts me."

Price says that "severe tokophobes will go to extreme lengths to avoid pregnancy: they eschew long-term relationships or secretly take contraception while pretending to be trying for a family." Some who are desperate for children get pregnant, but then terminate their pregnancies in utter panic. Others try to induce miscarriage by over-exercising, punching themselves in the abdomen or drinking and smoking. Tokophobes lose partners and husbands over the issue, and often feel judged by the people around them.

Camilla Smart, a 33-year-old DJ, has been considering having children with her long-term female partner, but isn't sure she could cope with being the birth mother. "I became aware of my fear during GCSE biology classes," she says, "when I was incredibly squeamish about the issue. Since then, it's got worse: I can't imagine having something growing inside me, and I don't think I could ever go through with a pregnancy. It doesn't seem natural for me, and I feel completely dissociated from pregnancy. It would feel like a ticking time bomb." The anxiety does not stop there. Smart fears that if her partner carries the child, she will spend nine months in terror on her behalf.

Close to the heart of every tokophobe is the right to have an elective caesarean. Any woman who considers this risks being slapped with the "too posh to push" label, but a study published in the British Journal of Obstetrics and Gynaecology in 2008 found that almost half of women who request a caesarean do so not because they are vain and shallow – but because they are scared.

Maureen Treadwell of the Birth Trauma Association says that a caesarean is often a good option for someone with tokophobia, but many are not guaranteed one. "They are told by doctors and midwives to wait and see how they feel, which only compounds their panic, leaving some to seek a termination," she says. "Such a lack of understanding of the issue seems incredibly cruel."

Of course, the majority of women don't have a traumatic birth, as Barbara Kott, a former president of the NCT and an antenatal teacher with 30 years experience, points out. "Mostly people are surprised at how much better labour is than they were expecting," she says. "Part of the problem is the frightening stories women are told when they are pregnant. For some reason, people tend to focus more on the negative stories – often involving pregnancy situations that are extremely rare – rather than the positive ones, which make up the majority. Another reason people can be anxious is because of the way childbirth is presented on TV. It's always a drama, with people being rushed into hospital bleeding heavily, and it's actually just not like that. Most births proceed in a completely straightforward manner, and for most women it is a very positive experience. I try and counteract the fear factor by making sure everyone understands how well women's bodies are designed to give birth."

Price has found that several of his patients, who have been on the brink of terminations, have been able to deliver naturally after spending time in psychotherapy working out what caused the phobia. One patient was a 25-year-old primary tokophobe who had told her husband she was infertile, while secretly taking contraception. When the contraception failed, she was shocked and planned a termination, without her husband's knowledge.

"A friend persuaded her to see me," says Price, "and we started to tackle her fear. She was very distressed at first, and convinced that my only purpose was to persuade her to go through with the pregnancy, but by learning to accept her fear and look at whether it was justified, it started to subside. In the end she decided to have the child, told her husband, and coped with a natural birth. I saw her afterwards and she said she was fearful, but it was manageable. In fact, last time I spoke to her she was planning on having another child. For people with less severe tokophobia, it is possible for the fear to disappear altogether."

Just re-reading this piece prompts a wave of panic, but I am, for the moment at least, generally able to think myself out of the most distressing thoughts. I'm also busily trying to manage the experience that lies ahead. I've hired a doula – a non-medical midwife – to be by my side on the big day(s), and I'm reading up on hypno-birthing techniques, which friends have recommended for keeping calm.

I still dearly want a caesarean though, and before we even started trying for a family, I asked my GP whether this would be possible. Back then, she said it should not be a problem; now she seems a lot less certain. I'm therefore preparing for a natural birth, trying to focus on the sensible words of NCT experts, and reminding myself that it doesn't have to be so awful – on the contrary. But I am secretly hoping for a breech birth: my passport to a surgical delivery.

Some names have been changed.

Mar 5, 2010

1fmalaysia clinic

* delayed entry

Day 3 of the Chinese New Year – the Year of the Tiger.

A ferocious year as described by the Chinese astrology expert, which certainly make most Chinese or those who chose to believe it to think twice before diving in on dangerous sports or activities.

I was told of this hypothesis about vulnerability of those who were born under the year of Monkey, as evident by my cousin sister’s femur fracture as the target board victim from a speeding buffoon on a bike and my 2nd uncle’s ulnar fracture from a freaky slippery floor accident while he was on a bike.

Anyway, our southern neighbor Singapore was more than thrill to open the wide door of their formal gambling den in the spirit of the Tiger to prey on its visitor. Ironically, their government runs a vigorous campaign to fight compulsive gambling, yet they decided to open a casino with an open excuse of not wanting to trail behind in revenue in this aspect. Perhaps they just wanted a slice of cake from our Genting fatcake.

Perhaps. Perhaps. Perhaps not.

A night before, my mother-in-law stayed up whole night, rallying between her bed and the toilet sink. She was having epigastric discomfort which elevated to pain with accompanying sweating and possibly sympathetic symptoms followed by repeated vomiting. Initially she emptied her delightful chicken dinner and followed by yellowish gastric juices. She was under the radar for the whole night until in the morning when I found her rather weak and held her fist close to her upper abdomen. She had a long previous history of gastritis but was not committed enough for the gastro scope yet.

My dearest’s aunt who came back from Australia suggested a consultation from the 1Malaysia clinic nearby which she was taken aback when I told her the person in white w

ho had put a stet over her chest few days ago before she was given some medication for her cold and cough was neither a licensed doctor nor a trainee doctor, but a medical assistant.

Since I was around and the 1fMalaysia clinic was just few blocks away, I decided to bring my mother-in-law (MIL) in her 60s there, mainly to get a good medication for her highly likely gastritis attack and to rule out other possibly lethal condition, such as the most common heart attack and pancreatitis.

The clinic was very impressive. Bling bling. Full

y air-conditioned, glass front and all new furni

ture with a PPK or female attendant seated there.

The PPK popped the question to my MIL


“Ade ape makcik?” (What do you have, auntie?)

“Sakit perut.Gastric” (Stomachache. Gastric)

I kept quiet, resisting the urge to play the role of the patronizing son-in-law.

She got the number ‘2’.

Waited for 5minutes and we’re up.

There were only 2 more patients after us.

No wonder the short queue was thrilling most of the people who wrote in to local press to jack this 1fmalaysia clinic.

The short waiting minutes did not deprive my roving eyes. I noted the organization chart with names of few doctors who are nominally in charge of this clinic but physically not in the clinic.

I accompanied my MIL into the consultation room. The g

uy MA was seated comfortably there behind the posh desk with the laptop screen over his left showing of football formation with the title ‘Crystal Palace Formation Tactic’.

Another nurse was seated opposite him in another desk busy with some paperworks of her own, appeared working independently from one another.

As soon as my MIL seated down after a slow stride to chair, the MA posed the question in haste while his hands were busy scribbling on to the medical note.

“Auntie macam mana?”

“Sakit perut.”

”Auntie, tahun baru, makan banyak?”


He immediately cut to the chase, put the stethoscope on my MIL’s right and left iliac fossa.

“Auntie, angin… banyak angin.”

“Sakit di sini.” My MIL was pointing to epigastic area. The MA couldn’t care less, wasn’t even looking, scribbling down name of medications.

original medical note of 1fmalaysia clinic

“Auntie, angin.”

“Ini menantu saya, loktor.”

The MA suddenly sat right up and appeared more attentive.

“Oh doktor dari mana?”

“Saya dari xx. Sini boleh buat ECG? Ada ranitidine?”

“Tak, sini klinik kecil saje. Kita hanya rawat symptomatic je.”

He turned to the big cabinet behind him with multiple compartments with multiple over the counter medication, and passed to me some Gelusil (antacid) pills.

“OK, tak pe. Thank you.”

By that piece of ‘thank you’, I thanked 1fmalaysia clinic for giving me a valuable lesson in realizing my stupidity in wasting time with such a fraud medical set up.

I travelled further down 2 kms to the emergency department of a district hospital which is bustling with people and was clearly understaffed. I sympathized with the nurses there who worked continuously like lab rats, but they kind enough to spare few minutes to do an ECG for my MIL. As for the rest, I clerked, set branula, prescribed, got the medication from the pharmacy and took blood to rule out pancreatitis. Improvement was evident a few minutes after I pushed some good old Ranitidine into my MIL’s vein, and she was all bright and shiny on regular Ranitidine tabs. As for my future plan, I would need to seek out any acquaintances of mine down south for an appointment in Surgical Outpatient in JB.

Now I would like to make several notably point about 1fmalaysia clinic.

Firstly, without a doubt, the clinic had given false reassurance and by all and any standard, is more of a killer than a healer.

The MA was there as a leader of the medical team, yet he was in a rush to get back to his ‘Crystal Palace’ team. He didn’t even care to ask some other questions, just to rule out heart attack which could present with epigastric pain. Of course, he could have argued my MIL recovered in the best case scenario, but who knows, how many had silently passed away at home and took the fast lane to mortuary.

No one can blame him, actually. Someone put him there, in spite of his inability to screen for warning signs, and unfortunately, his confident diagnosis of ‘angin’ gave a false reassurance which may lethally delayed proper treatment.

Traditionally, we're taught never to see the patient as a disease or a system of collection of various organs, but see the patient as a whole, the way of holistic medicine. But 1fmalaysia clinic serves efficiently as the health center for 'symptomatic' treatment, now the advance healthcare in Malaysia is moving 'forward' from seeing patient as a whole to seeing just symptoms.

My MIL asked me a question that I couldn’t answer. “Why was he putting his stethoscope at my lower abs when my pain is in the epigastric?”

I sighed in silent.

If my MIL wasn’t in her sixties, I would be calling it a sexual molestation.

And this would go on and on and on and on, till someone would come in for a check and balance for this idiocy.

Secondly, this is clearly public fund embezzlement. When all this real money can be used to upgrade the nearby district clinic, it was instead being used to pay for this air-conditioned joint serving a mediocre function.

Instead of lightening the workload of the hospy nearby, deployment of these 3 medical personnel in this 1fmalaysia clinic is a poor wastage of human resource.

The only benefit is serve the public is you just need to pay RM 1 for the RM20 over-the-counter medications for minor ailments.

Thirdly, the wave of political decisions for this ‘third world’ set up which swept swiftly across the country despite of strong professional bodies’ objections just proved that, either our country’s medical elders were too weak, too pussy, too apathetic or too corrupted to care, or our political leader is in a haste to set up a legacy, destined to gamble with the public funds and many innocent lives of the rakyat.

Nevertheless, I would like to end with a positive note.

All the accumulations and collections of medical misappropriation along with all the future cropped-up sodomy allegations will definitely be gold mines for my fellow friends practicing the art of Law.

Note to self: Prime Aedan to be a lawyer when he grows up.

P.S. please don't make any speculation as what the f between the 1 and malaysia stands for.