Nov 23, 2011

Value has a value only if its value is valued

30 seconds speech by Bryan Dyson: Former CEO of Coca-cola
Imagine life as a game in which you are juggling some five balls in air. They are Work, Family, Health, Friends and Spirit and you're keeping all of these in the air.

You will soon understand that Work is a rubber ball. If you drop it, it will bounce back. But the other four Balls - Family, Health, Friends and Spirit - are made of glass. If you drop one of these; they will be irrevocably scuffed, marked, nicked, damaged or even shattered. They will never be the same. You must understand that and strive for it.

Work efficiently during office hours and leave on time. Give the required time to your family, friends and have proper rest.

Value has a value only if its value is valued
I was again and again and again enlightened by this short speech.

Nov 22, 2011

genevieve's body parts

"In three words I can sum up everything I've learned about life: it goes on."
Robert Frost

genevieve's development milestone has been rather weird so far. at 15months, she able to walk independently, yet her speech just barely able to go over 'papa', 'mama' and 'nennen' (milk).

funnier thing was few months back, no matter how much I tried to teach her to greet me 'papa', she wouldn't say it and just echoed back with 'mama'.

But now, it is completely different. Whenever asked to greet 'mama', she would first sheepishly Align Centersmile and cry out loud 'papa'.

then she started to learn about various parts of the body.

when asked about...
the eyes, she would cover her right eye with her hand
the nose, she would blow out air from the nose as hard as possible
the mouth, her index finger would point to the angle of her mouth
the hair, she would rub her hair
the ear, she would grab her ear
the hand, she would shake her whole arm
the leg, she would be wobble her leg in the sitting position
just recently, she learnt about beard when I had a few weeks of look with a goatee and beard.
whenever asked about beard, she would rub her chin

recently, as we went through the whole ritual of going through the body parts with genevieve, she was busy strolling in circles.

as we asked about the leg, she pinched the baby fat over the upper third of her right thigh with her right hand and trying to shake her right leg in the standing position.

in her annoying state of not being able to fully demonstrate, life goes on.

she appeared truly comical and we all burst into laughters.

Nov 20, 2011

Bolehland’s Bunch of No-Nos

Najib has no balls
Muhyiddin has no brains
Hishammuddin has no integrity.
Rais Yatim has no sense
Zahid has no defence
Nazri has no consistency.
Palanivel has no merit
Yen Yen has no explanation
Peter Chin has no energy.
Shafie Apdal has no clout
Noh Omar has no answers
Mohamed Yakcop has no transparency.
Shahrizat has no “beef”
Kong Cho Ha has no backbone
Liow Tiong Lai has no sincerity.
Ismail Sabri has no price controls
Ahmad Shabery has no medals
Idris Jala has no sagacity.
Ongkili has no innovation
Douglas Uggah has no enthusiasm
Shaziman has no accountability.
Tsu Koon has no leadership
Dompok has no support
Subramaniam has no empathy.
Rosmah has no self-control
Ezam has no real issues
Khairy has no decency.
MIC has no voice
MCA has no choice
Gerakan has no stability.
Judiciary has no honour
Police has no independence
AG has no impartiality.
MACC has no results
MCMC has no logic
EC has no credibility.
Parliament has no vibrancy
Speaker has no fairness
Civil service has no quality.
Himpun has no relevance
Jais has no evidence
Perkasa has no respectability.
Utusan Malaysia has no ethics
Umno’s papers have no limits
MSM have no objectivity.
Umno has no shame
It has made no changes
It has no morals and honesty.
BN has no future
A coalition of no principles
The government has no dignity.
Bolehland will have no money
The country will have no hope
A pariah nation – Asia’s tragedy!
Say “NO!” to Umno
Say “NO!” to BN
Say “NO MORE!”

Martin Jalleh, 31 Oct 2011

Nov 15, 2011

gloomy truth bout Bolehland's medicine

After reading the following article, being inside the inner circle, I felt a compelling urge to share it out with everyone, since not everyone have access to Malaysiakini. The content of the article, everything, if not mostly, is the honest cold truth about our current medical landscape, which had turned from the graceful underwater coral beauty of Sipadan to the barren dry wasteland and disease-infested dumpsite of Kuala Lumpur. The writer seeked to warn everyone about the storm coming, I believe we are already in the middle of it. Some are already being beaten up, tattered and shattered by the storm.

To be honest, I hope this article goes viral and to be read by every citizen of Malaysia. I know that is not going to happen for several reasons, mainly because some are still being marginalized from proper education, some are still reluctant to learn up English and fall back in comfort in their own mother tongue, and mostly just don't care.

Kindly read it and share it out to everyone.
'Storm is coming' for our medical profession
There has been a recent rash of angry letters and articles in the press, detailing the incompetence and lackadaisical attitude of many of the new generation of junior doctors, known as interns or house officers.

Most writers are contemptuous about the majority of the 7,000 new doctors entering the ranks of the medical profession every year.

Some letters, on the other hand, are written by house officers or their families, complaining of long working hours and harsh treatment by specialists.

It is obvious that feelings are running high. Traditionally, most Malaysian doctors do not write in much to the press. Doctors rank among the most conservative citizens in the country.

Even when the profession was faced with the torture of 106 prisoners of conscience in Operation Lalang in 1987, most doctors remained silent.

But in recent months, like other urban, educated and Internet-savvy Malaysians, many doctors have been changing tack.

Senior doctors took a concerted stand in July against the tear gas and water cannon used in a police assault on Bersih 2.0 protesters sheltering in the grounds of Tung Shin Hospital.

NONEFollowing the arbitrary arrest and imprisonment of Dr Michael Jeyakumar Devaraj (left), one of the Emergency Ordinance Six (EO6), a large group ofPerak doctorsworking in public hospitals looked squarely into the camera, and called for Dr Jeyakumar to be freed.

The Malaysian Medical Association (MMA), the professional body representing over half of all registered doctors, also criticised the detention without trial.

This mutiny by middle-class Malaysians augmented the efforts of Parti Sosialis Malaysia (PSM), PAS, PKR and DAP, as well as civil society groups like Suaram, Aliran, the Bar Council and religious groups, in pressing the Home Ministry to release the detainees.

Vocal debate over ‘substandard’ interns

Some concerned doctors are now warning of future disaster in our health care, caused by substandard new interns.

“The storm is coming... Commercialisation of medical education will soon affect all of us. The glut of doctors is getting worse and many of them are being under-trained,” wrote Dr Pagalavan Letchumanan, a consultant rheumatologist and prolific blogger on crucial issues in health care.

Prominent doctors argue that profit-seeking degree factories in Russia, Ukraine, Romania, Egypt and Indonesia, as well as local medical schools with low teaching standards and inadequate lecturers, have condemned thousands of house officers to a hollow career they are not qualified for, and ill equipped to cope with.

The number of medical schools in Malaysia is 35, a staggering number for a population of 28 million. This is twice the corresponding ratio for the United Kingdom, with 33 medical schools for a population of some 62 million.

Of these 35 local institutions, 18 in the public and private sectors have already passed out house officers. Another 17 medical colleges will produce graduates between 2012 and 2017. Understaffing in local institutions is endemic.

The government claims the new doctors are needed to improve the ratio of doctors to patients from the current 1:1000 to 1:400, a level typical of developed nations, by 2020.

The Health Ministry has reneged on last December’s promise of a moratorium on new medical courses.

Several senior government doctors, requesting anonymity, blame political patronage by ministry officials, in this lucrative business of producing doctors, for the huge excess of house officers.

Greed, they claim, has been the prime mover behind the proliferation of officially recognised, but substandard, medical degrees from deficient medical schools, both inside and outside the country.

But many of these same senior doctors in the public service fail to report the poor performance of some of their new interns to the Malaysian Medical Council (MMC), the licensing body.

Some supervisors dread the paperwork involved in blocking the inept doctors from being registered. Others are simply reluctant to rock the boat.

These established doctors clearly lack the mettle of more vocal colleagues, like the current MMA president, Dr Mary Cardosa, who spoke up for Tung Shin patients, and for Dr Jeyakumar.

‘Pampered and reluctant’

Several specialists tasked with training the new doctors say many of these interns are pampered, reluctant members of the profession, cosseted by unrealistic, well-to-do parents.

Firsthand accounts by these specialists indicate the average quality of interns has plummeted, even though there has been a surge in quantity.

One surgeon said he received a telephone call late one night from the angry father of an intern. The father complained bitterly that the surgeon had ticked off his daughter for a mistake, earlier that day.

hospital heart surgery patientsThe surgeon asked to postpone the conversation until the next morning, explaining he was on his way to the operating theatre, but the father kept up his barrage of verbal abuse.

A specialist in Sabah recounted an episode of a house officer going absent without leave for several days. When challenged, the young doctor claimed he had been admitted to a private hospital for a “heart attack”. A check with the private hospital confirmed it had never heard of him.

“Some house officers just don’t know the basics,” one exasperated consultant told Malaysiakini. “I was trying to teach two house officers, both of whom had been working for a year.

“I was soon reduced to asking the most basic questions. Even then, they couldn’t tell me the normal range for the heart rate. One guessed ‘60 to 80'.

“Even Wikipedia has the correct answer. They couldn’t tell me what a normal blood pressure was either.”

Another specialist added, “Some of these house officers did not make the grade to enter reputable universities for a good reason. Their parents shouldn’t have forced them to become doctors, they’re simply not interested.”

There are, undeniably, a number of bright, dedicated potential doctors in the ranks of the new house officers. But the lack of motivation among many of the interns is plain to see.

One government specialist tried an age-old trick to elicit some empathy for a patient who had been treated badly by an obdurate house officer, by asking him: “How would you feel if this were your own mother, lying here in this bed?”

The specialist was taken aback by the young doctor’s reply.

“My mother wouldn’t be in this bed. She’d be in Singapore if she fell sick.”

KERUAH USIT is a human rights activist - ‘anak Sarawak, bangsa Malaysia’. This weekly column is an effort to provide a voice for marginalised Malaysians. Keruah Usit can be contacted at

Nov 14, 2011

unforgettable intro

Got a phone call from someone...
Hi, Are you Dr.Pilo? I'm calling from ABC. I think we need to admit this patient to your ward.

Yes, I'm Dr. Pilo. Oh, I'm sorry, I had specifically discussed this patient with my Specialist-On Call and we do not see this admission to be a warranted one. May I know who I am speaking to?

Dr.Pilo, I am Dr X, Medical Officer from Y Department, 2nd year Master Student in Y of Uni of Z, I am telling you're the primary team and this patient have to be admitted to your ward.

(Gosh, wow, a Master Student... ) Like I said, I can't allow that to happen. My specialist do not see this admission as warranted.

No, you see this patient came here with this problem... bla bla bla.. bla bla bla... it's a gynae problem... bla bla bla... (Wow. a speech. Awesome)
... the rest of the discussion was a boring one and finally it was up-levelled to the specialist level.

Kinda bowled me over when some people believes in the prestige of being a trainee or Master student, including their status being higher or more solid than others...

As for me, for now, I appreciate the grace and solidarity that invisibility has to offer.

Nov 12, 2011

the patients at the back

it's been amazing, knowing many survivors of gynaecological cancers.

most of them will be admitted and be placed at the 2nd half of the ward, therefore, aptly being addressed as 'the patients at the back'. Their place at the back doesn't mean less attention given to them, but instead the other half of the ward is the more slow-paced, peaceful area with a simple fun, loving group of people.

but in few months time, slowly, i had grown used to calling them by their first names.

to see them go through the emotional rollercoaster of fear, anxiety, sad, depressed, grumpy, irritable, hope, joy and relief.

when a whole row of patients can share the some laughter over a few simple jokes, i knew i done more than treating them.

when a patient can share their fear and joy, i can see there is really more to life.
much much more.

their survival over their own emotional turbulence trumps their survival over the disease.

the following video had done a marvelous job in capturing that exact emotional rollercoaster in something that we take for granted everyday.

The Princess from Disposable Film Festival on Vimeo.

A film by Adonis Pulatus – amazing emotional, real-life roller-coaster of time-lapse photography

Nov 9, 2011

random short chat

halfway through the department's weekly presentation, my colleague noted the fetal scan parameters was a bit funny.

"Hey, Pilo, comparing the 2 scans, you see after the few days, the AC (abdominal circumference) of the baby became smaller. You saw that or not?"

"Yes. Probably the baby farted."