It's time for a change. The keyword is CHANGE.
P.S. You're right. I'm not a big fan of the paperless technology, afterall.
27-year-old lady presented with persistent cough, sputum and fever for the preceding six months. Inspite of trials with antibiotics and anti-tuberculosis treatment for the preceeding four months, her symptoms did not improve.
A subsequent chest radiograph showed non-homogeneous collapse-consolidation of right upper lobe.
Videobronchoscopy revealed an inverted bag like structure in right upper lobe bronchus and rigid bronchoscopic removal with biopsy forceps confirmed the presence of a condom.
Detailed retrospective history also confirmed accidental inhalation of the condom during fellatio.[PMID Reference: 14870871]
The spat between Chief Minister and the ‘little Napoleon’ was never a surprise to those who are familiar with what was happening since the crimson tide swept and drowned the dark blue hill over this precious land.
Civil servants were largely overpaid legion in our Bolehland, except for a few who are tied down to their professional ethics to work hard and a lot of them who were gaining good pace in improving their own services. The one that I’m saluting lately would be the officers and great leaders behind the services that made preparation of MyKad and Passport a breeze and a 24-hours or less-than-a-week affair.
Traditionally, being in the civil servant is largely a comforting place to be. They run a higher risk of being suck into a black hole in space rather than being retrenched from the service or being fired, even if they are obviously in the wrong. Few years back, there is a Department solely for Promotion (Kenaikan Pangkat), meaning one either stay where they are, or go up. So, even if the quality of work is almost of equal to natural human excreta, one stay well employed with extra bucks to puff a few extra sticks.
Quality apart, their quantity of time spent on their work is often being divided between actual ‘serious’ paperwork and their twice a day ‘informal coffee break’ aptly named as morning tea and evening tea, exclusive of their formal 1 hour lunch break. Of course, I wouldn’t want to discuss about their nicotinic-nebulizing session at different frequency throughout the day in accordance to their level of addiction.
But largely, there is lot of improvement since Pak Lah and Najip cracked their whip. The agency for Promotion now also equipped with the power of Demotion. Whether or not this is a genuine move towards improvement or just another smokescreen to please the public is still questionable. Still, from my personal experience (and all the bitterness that came along with it), they are still a handful of sharp scissors in the civil service that helped me cut through the long stubborn red tape. And I hope they will always be around.
Civil servants in the State government seriously had a working dilemma in this two-party system. The life and death of civil service is under the Feds but their work is for the State.
Thus, who is the boss?
Let make it clearer. Federal government is like the owner of the business and in-charge of Human Resource Department, the major share holders. State government is like the Managing director. Save for this case, the Managing Director is not only answerable to the major share holders, but summed up their relationship as ardent enemies.
Not so clear, afterall.
Let make it clearest. The Federal Government is NOT the major share holders. The people, the rakyat, the Malaysians, the public is THE major share holders, the Feds just the temporary 4-years service Human Resource Department with its own autonomy, free from the control of Managing Director.
Hence, there is no dilemma after all. (and yes, I do get high on contradicting myself)
Civil servants should serve the public under the leadership of both the Feds and States.
Not any party.
Chief Minister is the representative of the majority of rakyat, therefore being insubordinate and downright rude to him is equally kept the people who voted him in equally pissed.
Condoning such misbehavior by the leaders from Federal Government totally defeats the aim of building up the correct work ethics in serving the rakyat.
People first? Performance Now?
P.S. A big thank you for my dearest family and all my friends for the birthday wishes... I never thought there will come a time for me not to hate spam... Thanks for spamming my facebook wall...
After a tired week, I was hoping this weekend would be a nice respite, but it was anything but. Nevertheless, to choose between being idle or productive, I chose to the latter, without any reproductive connotation.
I had some good slumber through out the night and evening, which was a luxury that I demand of in view of my busy days throughout the last few days, being an obligate caesarean sectionist by the day and pelvic ultrasonographer by night.
Honestly, I was panic a bit, in my own silence and all, when my dearest listed down some dreaded symptoms of this pregnancy – heatiness, abdominal itchiness, etc, etc and I stopped her when she mentioned ‘abdominal tightening’. Luckily, it was transient and I seriously hope it was all Braxton-Hicks, some regular sessions by the uterus to make sure when the real thing comes along, it can perform with great excellence.
I guessed I simply can’t take the baby’s room preparation at turtle speed anymore.
We went out, ordered the air-conditioner, and bought the fan and the new lights. Picking the right reliable model of air-conditioner together with the fairly-priced technician got few of our neurons well-toasted.
I was glad that my dad contacted someone to get the ceiling done as well. The old ceiling looked like it is going to crumble down at anytime.
Next week, I will be painting the room, and it’s going to be ‘pink’. My obvious rejection of this motion was denied. My wifey and son, Aedan ganged up on me.
Hope the room will be ready for the homecoming of my lovely little princess Genevieve.
On his own ability as a young candidate, Koay said: “Dr Teng says I am young and I can wait (to become a state assemblyman). Yes, I can wait but can the people?”
Koay admitted that the campaigning was “tough going at the moment due to the small number of volunteers though we hope to recruit more soon”.
I have a penchant for good jokes, especially those seriously-made jokes which repackaged themselves as something of a serious nature.
Recently my colleague received a referral from a certain unit with an ill patient hooked up on oxygen, as the lung function was pretty much not doing her much justice in the area of gas exchange, due to a fair amount of pulmonary haemorrhage aka bleeding in the lungs, clearly shown in the chest signs and radiograph. Her stare with the bloodshot Dracula eyes with florid conjunctiva haemorrhage were hardly a sign of terror, but simply the horrible sad, gloomy subsets of the aftermath of the probable over-the-top anticoagulation disorder coupled with her underlying connective tissue disease.
From her oral cavity, she did managed to retch out some blood, staining her saliva, or was it the other way round? And subsequently an intelligent move of prompt referral was made to the esteemed surgical team. Fortunately for her, the per-rectal finger check did not yield any signs of sinister bleed within the gastrointestinal tract.
There was nothing coming out of her genital tract, but probably a modern day risk management accounted for the referral to the gynae squad, to rule out any bleeding from the genitals. Who knows, perhaps a fair amount of blood might be collected within the potential space of the vagina and decided to stay there without dropping out, right? Thus, this had subjected the obviously misled and misguided lady to more unnecessary examination which should have adequate bed rest and rest and rest till the coagulation antithesis kicks in to bring this unfortunate soul over this crimson crisis.
Looking at this trend, probably prompt referrals should be made to the neurosurgical, gastro, ENT, renal, and every other teams which had always been dedicated on standby with high regards for any bleeding, major or minor, involving their respective pet organs.
This is what the Director of UCEM’s Inquisitorial Disciplinary Committee had to say:
I'd screened through most of my anaesthetic colleagues, i believe none of them were a SOPOS.
“We have suspected the existence of such a society for quite some time now. The identities of the society’s members are frequently shrouded in secrecy and are difficult to ascertain. However, UCEM investigators have developed a powerful tool for profiling suspects. Validation studies have repeatedly shown it to have excellent performance characteristics.”
“The profile consists of a scoring system using the following items:
- even though the anesthetic tech has checked the anesthetic machine three times, the individual always insists on rechecking it his/herself (and, in the process, usually disrupts some key component that the tech then needs to correct while the individual isn’t watching).
- the individual is left dumbfounded by the notion that there could be more than one way of doing something.
- the individual draws up each of the following drugs in triplicate (in case two of each fall on the floor at the same time): adrenaline (in at least 4 different dilutions), atropine, ephedrine, intralipid, metaraminol, midazolam, propofol, sugammadex, suxamethonium and thiopentone.
- the individual regularly attends Sudoku-aholics Anonymous meetings.
- the individual believes that a serum potassium of 3.3 mmol/L is a strict contra-indication for any kind of surgery — regardless of the indication or patient’s condition.
- compared to blood stains, coffee stains are at least 12,387 times more likely to be found on the individual’s scrubs.
- no operation can proceed unless the individual has confirmed that at least 10 units of blood are cross-matched and available in the operating theatre.
- the individual refers to the drape separating him/herself from the surgeon as ‘the blood-brain barrier’.
- no operation can proceed unless the patient has at least two 14 gauge intravenous cannulae in situ.
- no operation can proceed until the individual has found a spare socket for ipod and speakers. (hat tip to @pieterpeach)
- no operation can proceed until the duty anaesthetist has confirmed that the individual will be relieved for a morning tea break, a lunch break, an afternoon tea break and that come hometime (about 3:30 pm) they will be immediately relieved for urgent convalesence after their full day’s work.
- when asked to state the main role of the anaesthetist, the individual responds emphatically: “to stop the surgeon killing the patient” (rather than correctly reciting the Anaesthetist’s Hymn — see below).”
“For each of these items 1 point is accumulated. A score of 3 or more has a positive-predictive value of 103.4% for the identification of the individual as a bona fide member of the Society for the Prevention of Surgery.”
“We believe that the use of this tool will allow utopian medical practitioners to identify Society members early, thus allowing any obstacles that may arise to be anticipated and, hopefully, overcome.”