In My Father's Footsteps

Learning that there is much more to medicine than diagnosis and treatment.

Wednesday, May 31, 2006

May End

Last day of May today, and it also mean the last day of my rotation in the geriatric ward. And you know what, I think I am going to miss it.. a little bit. I know I have griped about working there a lot but at the same time I recognise that this ward has it's purpose; just like every other discipline in my department.

I don't have the desire or inclination to be a geriatrician but those that are, are doing a wonderful job. In fact, the thing that struck me most when I first transfered into this hospital was the passion and dedication the specialists here have for their work and patients. These I seldom see in the other places that I have worked in.

Tomorrow, I join ID for good. ID is my own passion. I hope and pray that God will help me work with equal passion and dedication in this field that I have chosen as my life career. Amen.

Tuesday, May 30, 2006

Culture of Silence

I just came back from attending the monthly department meeting. This monthly meeting is usually a boring affair, mainly to discuss issues as ancient as the Jurassic Park (and as unresolved as well).

Today, it was slightly different. Today I spoke up (rather emphatically I'm afraid). I won't be writing about the issue here. It's not important. What's important is the fact that I personally know very few people who will speak up for what they believe in. Mainly because it will make them unpopular and it may even jeopardize their career should they voice their contra-opinion on issues that their superiors are advocating. I call that cowardice.

I believe in standing for what I believe is right. I believe in speaking up when injustice is done or imposed on others. I do not subscribe to the culture of silence....of keeping quiet, hoping the issue will just blow over; or just swallow your pride and go with the flow, even if it meant more work, more burden, more responsibilities, and therefore even more risks of error and the vicious cycle goes on and on. This has to stop somewhere.

So, today I spoke up. I don't feel proud about it. I am just defending my conviction. I may well have offended some people and I don't feel good about it. Yes, my career may be jeopardized, my 6 more months here not be all that pleasant and my popularity rating may have taken a drastic dip; but I have peace and my conscience is clear.

I doubt that by voicing my stand anything will change but at least I voiced what I believe is in the hearts and minds of the silent majority. I do not subscribe to the culture of silence. Never.
We're out of Salt Water!

I think it's totally laughable that while we are sending our SMART team to Yogjakarta to help the quake victims (and I think it's a noble cause); on the home front, my hospital (I am told) is running low on Normal Saline Infusion Solution! It seems that the contract with the supplier has expired. Now all my patients are on either Dextrose Saline or Paeds Solution, regardless whether they are diabetics or the fluid regimen is woefully inadequate (for instance, to correct drug induced hyponatreimia). :-(

Someone should be made accountable for this.

Monday, May 29, 2006

501!!!!

No, not the Levi's label (though I have always dreamed of owning a pair of Levi's....even the fake ones are expensive! Sheesh!).

Drum roll...

Today, I hit my target! Rather unexpected actually. The cardiac clinic just finished and I have reached my target of 500 patients! The one extra was a "What the heck! Just see one more -la" patient.

I feel a sense of great accomplishment and I am a little proud of myself. Heh heh! 6 months of slogging in the cardiac clinic is finally over! Praise the Lord! Inside me, I am just jubilating away! YooooooHoooooooooooooo!

Actually that's only half the work done, albeit the tougher half; now I have to sit down and 'clean up' the data, organise them and finally analyse them and then write about them. Anyhow, half the battle is won and I really, really, really feel good about it.

To reward myself, I shall not go to the gym. I am sipping some hot Milo now, it's pouring cats and dogs outside; I am going to wait till the rain stops, then I shall take a slow drive home and eat home cooked food (mum is in KL!).

Thank you Lord.

Last Day of School


Driving to work was a breeze this morning. It's every motorist's dream! It's the school holidays, which means traffic is cut by more than half (for the next 2 weeks anyway). My personal dream is that the authorities should relocate all schools out of the city and have special transport to ferry the students to and from the schools. But then again, the parents would not be too pleased right? :-)

Btw, I found the picture above on the net. Looks like bad English isn't just a local problem. I certainly wouldn't want to sit for an anal examination! Ugh!


Another Bad Sign

Another example of a badly produced question, confusing the students. I mean, do you even notice the arrows (I highlighted it); if you don't then both answers can be correct. Right?

Ok, ok, I confess I am a little miffed over it. Kiasu parents are allowed that. :-P

Anyhow, I am very proud of my girl. Here's her full tally:

Maths : 100/100
English : 99/100
B.Melayu : 93/100
Science : 90/100
Moral : 83/100 (gotta work on this one...)

Well done sweetie! And enjoy our school break! :-)

Faulty Signs (Science)

My daughter got back her Science paper last week. She scored 90/100. I believe she could have scored better had the teacher taken the trouble to produce better quality pictures.

The teacher probably thought that her students have telepathic powers (ala Jean Grey) that would enable 7 year old kids to decipher what all the arrows in that ink smudge above point to!

A formal complaint lodged with the teacher had her saying that she had pasted a larger similar picture (I am not sure whether by saying it's similar meant it was equally bad?) on the black board and she had in fact, instructed the students to refer to the black board when answering that question. I wonder how big was that picture and how many students (there are 40 of them) could see it clearly (my kid said she couldn't and she wasn't even myopic).

Well, as I was saying, if only she has done a better job in the beginning...

Friday, May 26, 2006

A Very Long Month

I think the month of May is the longest so far. I wonder when is it going to end!!! It seems like I have been in the geriatric ward for ages! :-P

The patients are generally wonderful and pleasant. It's just that I don't think I am cut out to be a geriatrician (which makes me really respect those who can be one!).

5 more days and counting.....

Picture For Thesis

It's amazing what you can find on the internet these days. I typed 'viagra' and 'beer' into Google image search and see what popped out! I wonder if I could use it for my thesis cover? Hmm....


Btw, the tagline was "Guys, NEVER mix Viagra with Beer!". Real funny.

Parent's Day

My church is celebrating Parent's Day this weekend (I declined an invite to the Langkawi Island for a weekend meeting for this....a tinge of regret but I think it's the right move). I am not sure what's the program will be like but there will definitely be 'makan' (food!!!). If anything, my church is big in a few things..FOOD and FELLOWSHIP! :-)

In fact, that's what attracted us to the church in the beginning, the overwhelming sense of love and concern for each other. It's hard to find this in most churches these days.

A kind reader has sent me a song which will be sung by the Sunday School kids in her church. I think it's appropriate to post it here. It's a love song to the Father. Btw, she thinks I am a great dad! Blush blush! So pai-seh la...

Daddy You're My Hero

Father You're the best, my delight
Father You're so sweet
Sweeter than honey on the rocks
Father You're the light in the night
Father You're my strength
and my forever friend

Ch:
Abba Father You're my hero
You're there when I need you
You sent the greatest gift
of love into my life

Daddy You're the best and you're mine
Daddy You're so sweet
Sweeter than anyone I've met
Daddy You're my song in the night
Daddy You're my strength
And my forever friend

Ch:
Daddy Daddy you're my hero
You're there when I need you
You are the greatest gift
I received in my life.......

Song writer: KB Chan

Thursday, May 25, 2006

Dog-tired

It's been a long day. An entire day was spent in the cardiac clinic (preceded by a 'tsunami' round in the ward; because there was no one else to do the specialist round) filled with very impatient and angry patients. Sometimes I wonder why are they are called 'patients' when patience is hardly evident in them!

At 5.10 pm, I left the cardiac clinic, having recruited another 21 patients into my thesis study. I could have recruited more if not because I had to do the round this morning (usually I need not on cardiac clinic days) and the fact that I 'accidentally' saw 2 other patients whom I have already recruited earlier and that ONE particular patient who took up 45 minutes of clinic time telling me how high his sex drive was and that his poor wife could not cope with his needs and that he has to satisfy his itch some where else and that he is planning to marry a second wife soon (he haven't told wifey number one yet!). Tsk! Tsk! Tsk!

I think I could write a book on the stories I heard while recruiting patients. I shall call it 'Desperate Hubbies'.

Locum's over (yeah, need the money for the weekend. The hospital again did not pay my on-call claim!) and I just want to shower, and crash. TGIF tomorrow!!

Good nite! :-)

I've Been Spammed!

Some lower life forms have been spamming my blog anonymously. It hasn't done much damage yet, except to flood my mailbox (all comments are cc-ed to my email). Sorry guys, I think I will have to change my settings not to allow anonymous comments. I have to do this to prevent my mail box from being overwhelmed.

Btw, X-Men III was awesome (and yes, I did see some celebrities but didn't rub shoulders with them).

X-men III was about 1 million times better than MI-III (maybe it's because I like Hugh Jackman a lot better than old Tom). I definitely recommend all to watch it!

However, as in all sequels, the 1st part was the best followed by the 2nd and so on. Sigh!

Wednesday, May 24, 2006

It’s not just about money, Dr Chua

I've been told by my friends that my blog is too wordy. They suggested that I should add more pics. I do agree that a picture speaks a thousand words but sometimes there aren't any pictures to convey what I would like to speak. Here is one of them. Sorry guys. I just had to say my piece. Feel free to skip it but if u have the time, I appreciate a read or two. :-P

Our Health Minister recently announced that specialists willing to return from overseas will be placed on the salary scale of Grade U48, “RM4,000 jump for docs” (The Star, May 22).

Not too long ago (before the Sarawak Election clouded out everything else, including the devastation of the coral reef in Sipadan), doctors working overseas were called all kinds of names for not returning to serve in their own country. They were labeled ungrateful, unpatriotic and mercenaries among other things.

Now it seems the Health Ministry is dangling out a different kind of carrot. “Come back now and we will instantly promote you to Grade U48 (starting scale for Specialists in the civil service); no need to start from scratch anymore.” The starting salary will be RM 7,000 instead of the RM 3,000 odd if they started from scratch (meaning a Medical Officer’s pay).

In addition to this, the minister also warned that in the next few years, it will become more and more difficult for Malaysian doctors to work in Britain as it has to give preference to citizens in the EU. Malaysian doctors would be lumped with others from all over the world.

While the announcement was much welcomed, I wonder how many will actually go for the carrot. I also wonder why it took so long for the Ministry to finally agree to give recognition to these returning specialists when it has been a perpetual grouse for as long as I can remember.

How many will want to come back if by coming back you have to start at MO level, with all your foreign (and well recognized all over the world) qualifications and years of experience ignored? Who will give up a well-paying job overseas to return home to a measly RM 3,000 per month? Being patriotic has nothing to do with it.

I am glad that the Health Ministry is finally doing some thing in the right direction. Still, at the end of the day, I really doubt many will take up the offer. The crux of the matter is, it’s not just about the money.

This July marks the 10th year of my service as a doctor. Though there has been great joy serving in this noble occupation, I have more than my fair share of hardships too. Some of them are listed below:

1. As a House Officer (HO) in the Kuala Lumpur General Hospital (KLGH), I was made to work 7 days a week. If I wanted off on a Sunday, I had to apply for leave. Sundays were considered half day work in the medical department there. Half day here meant you finish your work at 3 or 4 pm!
2. The maximum number of calls I have done in a month as a HO was 18 days! That meant there were days I had to work back to back with no break in between.
3. To add salt to the wound, I was not allowed to claim call allowances more than 8 days per month as I was told by the hospital that they ‘did not have the budget’.
4. My working hours in the medical department was from 5.30 am till 9 pm if I was not on call. And if I were, I had to work from 5.30 am till 9 pm the next day!
5. I have slept on any number of the following: transfer trolley, sofas, patient’s bed, floor, chair and coffee table, simply because hospitals were built with no thought of a resting place for doctors (they still built hospitals this way)
6. I have been denied taking leave even when I got married, because there are ‘not enough doctors around’.
7. My starting pay was RM1690 and the call claim then was RM 20 per 24 hours (which worked out to be 83 sen per hour; by comparison, a 7-eleven worker those days earned RM 3 per hour). 8. Car loans were not extended to HO then (a year after I started work, it was rectified to allow HOs to take car loans from the government).
9. Once we, HOs, were all hauled up on Sunday to carry hospital beds/cupboards/other heavy furniture up and down a lorry because they were opening a new ward somewhere.
10. Food meant for on call HOs were usually eaten up by inconsiderate specialists and MOs who were not even on call. By the time we had time to ear, all that was left was usually white rice and nothing else.
11. As a Medical Officer (MO) in a district hospital, I was moved from one department to another, just to fill up vacancies. My plea for some training in Paediatrics was denied. To this day, I have no training in paediatrics. Instead I was moved from surgery to A&E, back to surgery, to just about any unit that has a lack of doctors. That ended when I wrote a formal letter (and cc to the State Health Department) for placement in Anaesthesia (which I subsequently did for almost 3 years)
12. The most calls I did in a month as an MO was 15 days!
13. I was denied the privilege to write insurance claims for patients as all the claims were monopolized by the Hospital Director then. FYI, an insurance claim can earn us RM 40 per claim.
14. My application to do Masters was rejected twice with no reasons given. When finally succeeded in getting in, they threatened to withdraw the seat because they found out that I was planning to leave the civil service. I finally left the service in 2000.
15. I was asked to pay rent for the house I was occupying in the hospital vicinity as well as paying for water and electricity as well.
16. Getting a house (meant for doctors) in that hospital was near impossible as the Hospital Director then favoured his office staff by allotting all the available houses to his cronies. I finally got mine after a formal letter was written, one and a half years after I moved there.
17. As a MO in Seremban Hospital, I did an entire year of MO calls and never received a sen. All because they ‘did not receive a memo from the ministry authorizing the payment’; all because I was not a government servant then! (I have no such problems in the hospital I work in now). I estimated that they owed me RM 9,000!
18. My working hours then was from 8 am to anytime between 6-8 pm daily.
19. Weekend round was a horror as an MO. My round started at 8 am and usually ended at 8 pm!
20. We had no proper on call rooms to sleep in. The available rooms have faulty locks. Our things get stolen all the time. We didn’t have lockers.
21. MOs were not allocated parking lots. So we had to come real early to get a parking lot of risk driving round and round forever or worse, be slapped with a parking ticket by the ever vigilant policemen when we park along the yellow line.
22. My call claims were never paid on time. Sometimes it would be months before we see any payment.
23. When I transferred here for the MMed program, things were not that much better. Doctors here are also not allocated parking space, they are all assigned to lecturers and professors who sometimes come to work at 11 am! Parking lots are also assigned to clerks and the like. The criteria for allotment were never explained to us.

I am certain that my experience is by no means unique. I am sure everyone in the medical profession has their own horror stories to tell.
I could go on and on of course but what I am trying to say is, “Honorable Health Minister, unless things improve for the doctors working here in Malaysia, dangling bunch of money to lure these specialists back from overseas just isn’t going to cut it.”

Anyway, RM 4000 isn’t worth the trouble, at least not in my books.
Japanese Tea Garden At the Colmar

Near the Colmar, there is a Japanese Tea Garden. The Colmar Resort provides shuttle buses to the garden as well as to all the other attractions. But my advise is, if you have a car and don't mind driving, it's better to just drive yourself there. Waiting for the shuttle can be very tiresome.




My boy seemed a bit lost here

A Japanese Garden will not be complete without the obligatory koi pond


Colmar - the story behind it

Some of my friends have written to me and asked me where is this Colmar Tropicale that I wrote about 2 days ago. A very kind reader (and fellow doctor) have given me an interesting link. Please go to http://www.colmar-alsace.com/ to read all about Colmar. Thanks BoodDoc for the link.
Bizarre Day

Today started strangely. I was up a little later than usual (expected when I am post call) but I still managed to get ready by 6.50 am. And then it happened, the left nose piece of my spectacles fell off. Now, I am practically blind as a bat without my glasses and I went "Oh dear...how to find that tiny piece of plastic?".

I went down on my knees and squinted my high-myopia eyes and lo and behold! There it was! Right at my right foot! And then I went "I will need a miracle to find the even smaller screw" and so I squinted my eyes even more and there it was, next to my other foot! What luck (or miracle!)! Since I didn't have one of those microscopic screw drivers, I had to improvise with a knife. Took me a good 10 minutes to screw that thing in.

The drive to the hospital was ok, considering that I started later than usual. I can't get over the fact that Malaysian drivers would cut queue even at toll booths! I mean, what's the rush?

Ward round was equally bizarre. On top of the usual irritating relatives, one patient decided to stop being responsive! We attended to him immediately. He came in a week ago due to severe urinary tract infection with kidney failure due to urinary retention (prostate problem la). We could not wake him, his BP was unrecordable, his pulse was racing, his bedside sugar was 6 mmol/L (normal). We did manage to stabilise his vitals later. The weird thing was that he had very good strong pulses in the periphery and yet we could not register a blood pressure reading, either manually or using the automated monitor! His ECG, except for tachycardia, was totally normal. Bizarre indeed.

Even more bizarre was an sms that came all the way from Indonesia. It was from Joe, one of my HIV+ patient who had to resign and leave the country when he tested positive on routine check up. First it was just the "apa khabar doc" message which was followed by the real intent in the next sms: "Doc, is it alright for me to have sex if I use a condom?". Apparently he has recently fallen in love with a chinese guy there (yes, you read right) and he (the chinese guy) has been pestering him for sex.

Since international text messages are expensive, I tried to squeeze my reply into one sms (50 sen) using all the abbrrevations I know. Basically I asked him to 'inform his partner and then they decide whether to go ahead". I think that's the best reply I can think up at the time.

And then, just now, I received a call from a nurse I knew when I was working in a district hospital. She called to say 'Hi'. How bizarre indeed. I have great respect for her, having raised her only son alone (her hubby left her for a newer model); now she is nearing retirement and her son is due to graduate from the National University of Singapore in Engineering. I have left that hospital 6 years ago!

The day isn't even half done yet....I wonder what more is in store! :-)

Oops!

So 'pai seh la' (embarrassing). I got the date wrong! The preview movie is tonight! Thank God I noticed it before I made the trip to 1 Utama! But in a way, it was good as I could get some rest yesterday after the grueling call and I also managed to watch Desperate Housewives! Heh heh!

Will be going with my friend tonight. :-)

Tuesday, May 23, 2006


X-Men III

Yes! I am going for the primier tonight at 1-Utama. My friend (I shall not reveal my source) managed to get tickets for the show and has asked me along! :-)

Actually, I am post call today and I had one of the worst call ever...been up most of the night attending to this or that patient. I slept a little just now over lunch and feel a lot better. I am not about to let a bit of sleepiness prevent me from attending such a glamourous event. Heh heh!

Tell you all about it tomorrow...if I am awake enough to get to work!

PS: All I want for Christmas is a pair of Wolverine Claws! :-P

Monday, May 22, 2006

Rabbit Farm at the Colmar

Think 'rabbit farm' and I believe most of us will think of hypersexed long eared little furry mammals that do nothing but eat and multiply and yes, pass out really stinking rabbit poo. But, sometimes we forget that kids find them really fascinating, as did mine. I think the show 'Wallace & Gromit' did a lot to endear these furry pests to the hearts of kids!

Lining up for the grub

My girl discovered that 'rabbits have teeth'!

My boy discovered that the little furry thing is actually alive!

There is a deer farm nearby too


'Neigh' you say?

Colmar Tropicale - a pictorial guide

Entrance of the Colmar Tropicale, fronted by the draw bridge and clock tower Pine tree outside the window of our apartment
Each building at the Colmar was unique. Each has a lovely garden at the ground level. This one belonged to the building we stayed in.



'Fuchsia', the building where our apartment was located is at the right.
Lovely quiet walkway
'Azalea', another building next to ours

The walkway leads to the front of the Colmar
The 'Draw Bridge'. The road leads to a double storey underground carpark. The entire Colmar complex was built above the carpark
One of the 2 white swans swimming in the 'moat' under the bridge
There're another pair of black swans on the other side of the moat

I went around the entire complex, keeping to the back lanes. Not a soul in sight!


The entire place was planted with many types of flowers

The swimming pool (the water is heated). There is a big gym next to it and sauna for males and females. Nice clean place
The Viewing Tower located at the far end of the resort. The 3 storey building was easily assessible via stairs and, for the lazier ones, elevators!

Colourful roof tops taken from the Viewing Tower
The Clock Tower at the other end
More roof tops!

Spiralling stairs in the Viewing Tower
'French Street'. The yellow canopy covered the outdoor restaurant of the 'La Blasson'. I had my meals here. Food was so so only, 5 out of 10! Bland bland bland! You can also see the Wishing Well located in the middle of the street. There are many shops selling anything from baked goodies, poultry delicacies, pasta and pizzas and aromatherapy massage.


' Fuchsia', where we stayed in. The buildings were named after flowers (I think!)
Inside the 'Fuschia'

Small canopies on the street sheltering street vendors. At this one you can make a wax cast of your hand/palm/fist, whatever, at a price. The children can also enjoy 'sand art' here
Come on weekends as there are plenty of activities going on like the live dance show, street clowns and magicians
For a price, you can even get your caricature done here
Night view of the Souvenir and Plaster of Paris Cast Shop
The Clock Tower by night
Fountain at the entrance of Colmar
The French Street at night