Semenggoh Nature Reserve

Seduku and child
Originally uploaded by zzz_junkie

Spent the afternoon at Semenggoh Nature Reserve. The area is reserved for Orang Utan rehabilitation and as part of the effort to protect this species the facility allows the public to view the primates during feeing time.

There are 26 primates in the surroundings (including three infants), and they are free to come and go as they like. Therefore, sightings during the feeding times are not guaranteed. However, we were very lucky. Seven primates came and awed the crowd. In the photo is Seduku and her yet-to-be named infant.

I admire the dedication of the rangers and staffs in protecting the primates. The place is well kept, and the orang utans appeared healthy and happy. I must say, the Sarawak Forestry have done an excellent job. And it is not just at this centre, I have been to Bukit Lambir and Miri National Park and the same amount of dedication and passion were shown by the staffs there. And tomorrow I will be in Bako, I expect to be further impressed.

p.s. photos of this trip will be uploaded as they come in to my flicker

http://www.flickr.com/photos/bakawali/sets/72157611009893596/

Gender reassignment

I have always been at ease with speaking English. In fact, I think in English too and thus always have to translate my thoughts to Malay when I converse. Please don't get me wrong, my Malay is not bad, I can speak and relay my thoughts in Malay effectively, it is just that the nature of my flow of thoughts, it works better in English.

But my English is not perfect. Now and then my friends would tease me for my improper grammar; I have a lot of friends who do speak almost perfect English *sigh*. However, at work, I am Mr Brown (remember 'Mind Your Language'?). Being doctors, one have no choice but to speak in English. There are so many medical terms and jargons that are not 'translatable'. I must say that many doctors attempt their best in speaking English but sometimes we really do have to get to basics.

It is especially annoying when a person cannot differentiate between male and female. He or she. His or her. Boy or girl. Sometimes it feels like a lucky draw..."and today the lucky word that will be used is 'HE'!!!!". And if it is just during a conversation is not as bad (though my ears were cringing at each mistake).

The worse thing is even in the written notes these mistakes were made. Mind you, I work in an IT hospital, each time you open a patient's record, flashed at the top the patient's name, registration number, age and SEX. And they still can make such mistakes. I had fits of laughter a few times I did medical reports for patients. Either the patients were transvestites and thus confusing my medical officers or the doctors were blind and deaf (lets not state the obvious :))

Therefore beware, you may come to the hospital a full fledged hot blooded male, but due to a value added service offered by the ministry of health, you may come out a lady/lady boy.

Grounded

A friend of mine used to say “it’s easy for you to do ‘amal jariah’, everyday you go to work part of it is amal jariah”. (Note: amal jariah is a malay term equivalent to charity). Anyway, I do not see it that way, to me, each of us has a role in the universe and if we do our job right that we are doing ‘amal jariah’ in our own way.

Anyway, what I love about being a doctor is the people I get to meet. I know previously I had bitched about irritating patients and families but that itself is an experience. I get to learn about a lot of things I normally would not be exposed to. I listen and get humbled by other peoples experiences. Some may be good and some may be bad. But in the end, I learn. “Yang baik dijadikan tauladan, yang buruk dijadikan sempadan”.

As a specialist, the opportunity to listen to a patient’s thoughts is quite limited. With the bigger responsibility of supervising and monitoring the daily on-goings in the wards and hospital I haven’t had the luxury of sitting down and chit-chatting with each patient. It is usually my medical officers who would alert me to any personal problems that the patient may have. Well, it was during my housemanship and MOship that I learnt the art of listening, I guess my time has passed.

However, today the rare opportunity presented itself. It was in the Operating theatre when I saw one of my ward patients waiting for a minor surgery in the waiting area. He is an elderly Malay man in his late 60s, white hair, an unkempt beard, and a pair of sad beady eyes. His pressure apparently went sky high as he entered the OT (it has that effect on many people, especially with its 16 degrees temperature). Anyway, he looked a bit distressed and so I decided to talk to him and ask how he is doing.

“ I am exhausted” he said. The polished English blew me away. He must be fairly educated, I thought.

I examined him quickly and then proceeded to talk to him. “That’s fairly normal Uncle. You have heart failure and thus you find it a bit difficult to breathe. The oxygen will help you”.

He said “Heart failure…hmmmm… that is how my wife died. She had heart failure, She left me 10 years ago”.

Me “I am so sorry uncle”

“That’s why I am here alone.” He paused for a while. Then he said “ I am so disappointed”.

Me: “Why uncle? Is anything wrong?”

“I have many children but all of them have to work. *sigh* You know, when you are ill, you hope there would always be someone beside you to cheer you up; to give you inspiration but now……”. He then kept quiet.

I was at loss of what to say. I just held his hand and told him that we are going to try and make him better. Deep down I know, physically he may be ok but deep inside he is a crushed man.

Well, it got me thinking. As a human being we need company. At the end of the day, having someone beside you in your time of need is the best feeling of all. It give a person the sense of security, that someone will be there to catch you when you fall.

And at this point of my life if I hope that all that I have done in the past and all that I will do in the future will not keep my family and friends away from me in my time of need.

Ah.... what deep thoughts have my brief 5 minutes conversation provoked. And this is what I like the most about my job, there are always subtle reminders surrounding us to keep us grounded and human. But only if we stop and listen!

Krabi - An Outdoor Person's Haven

Four days in Krabi is definitely not sufficient to try all that Krabi has to offer. It is a wonderful place with a variety of outdoor activities mixed around the traditional things Thailand has to offer.

We stayed at the quiet (and cheaper) Krabi town, a port for those hoping to go the the nearby islands of Phi-Phi and Lanta. Accommodation can range from RM30 to RM 160 depending on what is expected. This is in comparison much cheaper than Aonang Beach and Railey Beach.



Caption: Traffic light at Krabi Town. Statue of a prehistoric man stands above the intersection holding the lights. Krabi is also an archaeological site dated from several eras.



Caption: The quiet river of Krabi Town


Krabi Town was very quiet and clean. A lot of relatively cheap food joint, but beware the drinks cost a bomb, RM 2 for iced tea....hmmmm more expensive than KL. When I said relative it is relative to Aonang, but when compared to other parts of Thailand the place may be a bit dear. Minimum price for a plate or bowl of noodle is 35 baht or about RM3.50. But then, my bench mark for the prices were from my trips to Phuket, Samui, Songkhla, Hatyai and even Krabi 4 years back. Prices may have increased everywhere.

And my favourite thing about eating in Krabi is forty percent of the locals are Muslims. That means I can eat a lot of things - the sweet kuihs were really delicious and my favorite 'kerabu betik' (can't seem to re-call the Thai name). Merman liked the beef spicy soup(plus whatever weird organs) especially after he discovered part of the testis inside it. Euwwwww..... but it tasted damn good, the soup I mean.



On day two, we went kayaking in the mangrove swamp at Bhor Tor.The swamp lies in between limestone caves and passages providing a real excitement. We paddled through darkened passages and emerge into a beautiful secret lagoon on the other side. I felt as if I was on Fantasy Island (hehehehe... that statement really reveals my age). After that we had lunch by the riverside, all you can eat. It was part of the package we took (whole morning of kayaking, lunch and an afternoon dip in one of the rivers) and as usual being me, I ended up eating as much as I can the tempura shrimp and the tomyam soup well till my tummy felt like bursting.










That evening we went for a free massage(courtesy of our trip organiser).

Day Three was spent by the beach in Aonang. It is not the most beautiful beach I have seen but is is OK. The Farangs seem to be enjoying the bloody hot sun (I suffered heatstroke, mind you)sunbathing, swimming, playing weird games by the beach. And there were so many open air massage huts at the beach.

Apart from walking together by the beach (so romantic...hahaha) we also went shopping. Everything is so bloody expensive but only here we get to shop for souvenirs. There were very few souvenir shop in Krabi Town.

Caption: Aonang Beach with Railey in the background


Anyway, our initial plan was to go to Railey Beach which is only accesible via Longtail Boats from Aonang but it was too hot when we arrived. And by the time it was a bit shady, we only had 45 min to catch the 15 minute ride, spend 10 minutes admiring the beach and another 15 minutes to get back. So in the end, scrapped that idea and we just stayed and lounged around Aonang.

There were so many things that we wanted to do but we didn't. We missed going diving but it was ridiculously expensive to dive in Krabi. 3400 baht for 2 dives. Way too expensive. And we missed island hopping, but once you are into diving it is absurd to just go snorkelling and halfway cursing ourselves on why we didn't dive :(.

We missed climbing the cliffs of Railey, a world renown area for rock-climbing. Out arms were aching from the previous day's kayaking and I don't think I can climb up even the easiest route. We missed exploring on our own the natural beauty Krabi district has to offer. Tried renting a Jeep but apparently that weekend all the Jeeps have been rented out. Wanted to see the Emerald waterfall, the numerous forest reserves but alas without a Jeep can't go off the beaten track. Well, renting a bike is cheaper (only 150 Bahts) but neither one of us can ride a bike; the last I rode a bike was in Form 6 - fifteen years ago! And plus the fact that the motorcycle accident rates in Thailand amongst tourist is so high.

But overall it was excellent. I had a good break and I had a wonderful time with my darling Merman. Next time we come we hope to bring an entourage so that we all have fun together. It is an exciting and beautiful place and I would love to come back soon.

Dreaming of tomorrow

I can't work today. My mind is really not in the hospital, perhaps it is because we do not have surgeries today nor clinics. It is a free day except for some teaching and the weekly grand rounds. Time was passing by SO SLOWLY!!!

Anyway, tomorrow is a holi-holi-holiday for me. Yippie. We are going to Krabi.A nice place which I have passed through in one of my trips to Phi Phi many years ago. We have no idea where we are staying and what we are going to do. It is really go with the flow kind of trip.

Roughly, it is down to three activities; kayaking, rock climbing (oooh my aching legs) and diving. We will decide when we reach there.

Right now I have to pack and also get my 4 kids in the car. Sending them off to the babysitter.

Hasil pukul empat pagi

Slept at four this morning making the above bouquet (aka sirih junjung). Marina's best friend's wedding today and she asked my darling sis to help out with these two items. The tropical garden theme is for the male side and the 2nd the girl's side.

What do I have to do with all this? Well, when my sis 'menyanggup' doing creative stuff she will call me up to back her (actually, I yang kena buat - she sort of by-proxy agrees...hmmmm). But then Ain (Marina's friend) is a nice girl and so I do not really mind.

But damn.... am I sleepy this morning!

Elevators and Escalators Breed Fatties

If we calculate how much time we wait for the elevator we will be surprise at how much precious time is wasted. I am sure it will amount to a reasonable period of a person's life (provided the person stays or work in a building with an elevator). I am sure it would be a necessity if you stay or work at the 14th floor of a 16 storey building.

But waiting for the elevator to go just one floor up really irritates me. If the person is disabled, infirm, old, or simply frail looking I would not mind. This is what we call necessity. And if there is no staircase in sight what can we do, up the escalator we have to go. But then there are people who are generally health young adults and who are simply LAZY. The bloody staircase is just beside the lift. Hello, move that bum of yours and go up the stairs. Exercise!

And if the reason is 'tak larat' then why can't at least they go down the stairs. You do not need much energy for that. Physics taught us that, at a height we have potential energy which is is porpotional to our mass or weight. That will be converted into kinetic energyw as we go down the stairs, so duh, the heavier you are the easier for you to go down.

The Ministry of Health over the years has been campaigning for people to exercise and what better place to start then at the workplace. Yeah, bicycling is a good exercise but it is not feasible in our towns (looking at the horrendous traffic and psychotic road users), one would end up dead if they try to cycle to work.

So MOH should start slow and easy. Encourage the fatties (all those kerani(s) and pegawai tadbir(s)) to start using the stairs, all in all in a day's work they may only use it 2 times.....twice up and twice down (when they come for work, go and come back from lunch and yes, 'punch out' time). This is calculated for those righteous ones who don't take morning break and the 3pm tea. If they do, that then it is much better, more energy spent. Because by the end of the day they would have gone up and down the stairs FOUR times.

And to ensure that this 'Cara Hidup Sihat' is promoted, there should be a Lift Holiday enforced in government offices at least once a week. Perhaps we should have at least one lift operating for the people who REALLY need them, and only those with passes from doctors can use them.

And I am sure by the end of two months of the campaign we would have more healthier and dedicated government staffs. Healthier as they would have by then have a better working heart and leaner body. Dedicated as they would only want to go up and down their offices once a day.... and thus they would spend more time doing their work and not having break now and then.

Well, isn't this a good idea?

p.s. I thought of this when I was climbing 4 flight of stairs. This is my attempt to exorcise the demons that has possessed my thighs making them look bigger than they actually are.

At Work...

At Work...
Originally uploaded by abdhakamabdah

Saw like his on one of my UM senior flickr. I wish I can take photos like this. I guess I must learn more about photography.

Nip and Tuck

Would you die if you have a few inches of cellulite?

It may be an indication that you have more fat in your arteries and blood stream but I reckon you won't die of it. You'll die of a heart attack or a massive stroke but hell no, you won't die due to a few inches of cellulite.

But A recent death got me thinking. This lady (may her soul rest in peace) passed away after 10 months in a coma following plastic surgery that included liposuction. Hmmm... by definition that is death caused secondarily by cellulite. Quite sad, I assume she wanted to look good and hence the surgery. Everyone have their priorities and to some looking good is a priority. But then, at what expense?

I have no reason to condemn plastic surgeons, beauticians or even the lay people themselves regarding taking the short cut into looking good. But does it make them feel better about themselves? When I watch Nip and Tuck I realised that to some people plastic surgery is an addiction, a never ending story. It is the inside of the person that is ill, the person cannot see anything that is good in themselves and thus have to change their exterior in hopes that it would make them feel better. It is such a sad situation.

I don't know about other people but I love the imperfections in me. All of them have their stories. My crooked lips was due to a huge cut when I fell off my bike in Standard Two. My front teeth cut my lips into two and I had to have 4 stitches to repair it.My upper lip was swollen like a elephant's trunk for the following two weeks. My brother had a huge time teasing me and so did my aunt. Her friends kept telling me to go for plastic surgery to correct the deformity, they were very persistant and even tried to scare me saying that my first kiss would then not be perfect. They were right, my first kiss wasn't perfect.... it was indeed very 'sloshy' and wet..... but then it was never because of my lips. Today, they are still crooked but I love them, they make me unique.

And when I grow old I hope I would grow old gracefully. Wrinkles of laughter around my eyes, my lips and my forehead would remind me of a happy and wonderful life I have lived. And they would then complement my unique crooked lips.


p.s. not all plastic surgeons only do beauty enhancing surgeries. Many undertake good commendable work like soft tissue reconstruction for trauma, cleft lip and palate surgeries to enhance people quality of life.

Found this cute budgie resting on our car the other day. It must have escaped from one of the nearby houses. I was able to approach near and it seemed unafraid hence the close-up photo. My brother said that people clip their wings to prevent them from flying far if they manage to escape (horrible, horrible people).

Later that evening it was no longer there. My guess is one of the stray cats had a lovely dinner...burp... The last words budgie said was " I tot I saw a puddy cat...i did..." burp.....

Shitty Kerajaan's Tasks (SKT)

How truthful should I be when doing my medical officers annual appraisals?

I hoped that the answer would be as truthful as I can. My impression was that appraisals were done to inform people of their performance (or rather lack of it) so they will continue to improve in their work.

Anyway, this Government SKT (sasaran Kerja Tahunan - direct translation Annual Work Target??? that sounds wierd...) is actually a scam. It is useless and pointless. Those who are ass kissers usually do well..

Anyway, back to me. I have SEVEN appraisals to do. I started to be righteous and gave the MO what they deserved which majority is AVERAGE atau Sederhana. In this scoring system that would earn them 5-6 points in each section. In the end they will get a total of 62 points. Well, average points for average performance, I thought it was that simple.

But then, I was told the 2nd rule in this game. All MOs must get 85 points and above. WTF? Apparently the Health Ministry gave out a letter stating that unless a doctor gets 85 points and above for three consecutive years he will not be eligible to join any postgraduate studies. Shitheads!!!

85 points means I have to give an average of 9 points for each criteria. Crap crap crap.... 9-10 for Excellent work performance, 7-8 for Good work performance. Some of them do work hard and so I have no qualms in closing one eye and giving such a high score. But some (actually only ONE) do not at all deserve an 85. I shouldn't elaborate why but what I can say is I HATE GIVING 85 points to this person.

But then eventually... I succumbed to the pressures and gave what people expect me to give. Well, boss did ask me to be a bit lenient ( A BIT is an understatement.

So I did the next best thing. I told the person the marks he actually deserved and my excessive pity points. I told him he sucked in his work and my expectations of my MOs. And lastly I told him next year I will follow to the letter the scoring system.

I reckon since I have only been here for FOUR months only I do not have a right to judge them for the whole year. But next year watch out guys, I HAVE NO MERCY!!!

Egg-o-logy

Kuala Lumpur 26 September 2007

Ketua balai polis Brickfields hari ini mengesahkan bahawa pihak beliau telah menerima aduan dari Pemuda UMNO bahagian Seputeh mengenai Wakil Rakyat Seputeh Teresa Kok, mengatakan bahawa dia (Kok) telah menghina Polis Diraja Malaysia (PDRM) dan telur-telur seMalaysia.

Pemuda UMNO itu diwakili oleh Timbalan Ketua Bahagian Alawi Dahalin telah menuduh Theresa menghina telur apabila beliau mengatakan makanan yang disediakan kepadanya sepanjang penahanannya di Kem Kamunting sebagai 'hanya layak untuk makanan anjing'.

Pihak polis mengambil serius terhadap tuduhan ini dan akan menjalankan siasatan sepenuhnya. Setakat ini, pihak polis telah dilihat menahan reman ibu-ibu ayam, bapa-bapa ayam dan anak-anak ayam yang berkeliaran di Lorong Haji Taib untuk membantu siasatan.



Dari siasatan yang dijalankan, didapati telur-telur ayam bergred rendah telah dihantar ke pasaraya-pasaraya TESCO, Giant dan Carrefour manakala yang bergred tinggi telah dihantar ke Kem Kamunting untuk santapan seorang kerabat diraja yang sedang bermastautin selama 2 tahun di kem tersebut.

"Kami akan pastikan bahawa bekalan telur Gred tinggi di Kem Kamunting mencukupi untuk tempoh dua tahun untuk menghindarkan lagi penuduhan yang tidak berasas ini"

Laporan dari BERNAMA

Maxis oh maxis

I used to love being a Maxis phone user. When I started using Maxis in 1999 the customer care service was excellent. I used to call the 123 hotline if I had any problems with my number and the service was very prompt.

Well, they say things have to change and with Maxis Hotline it turned for the worse.

I sort of 'lost' my phone today. And being paranoid, i suspended my line. IT took me 4 phone calls to get through for my 1st encounter with the Hotline.

An hour after that, my medical officer came and returned my my phone. She saw it lying on my desk and fearing that someone may steal it (though I can't imagine anyone who wants to steal that less than RM100 Nokia phone) she took it for safe keeping.

That's when my nightmare began.

Using my love's phone (he has a hotlink number) I dialed 123. A lovely automated voice answered. Apparently, one cannot access the 123 hotline from a prepaid number and thus the voice instructed me to dial 1300820120

I complied and within two rings the phone was answered by a customer care consultant. I thought well, this is great! I am impressed! Very fast! The nice man heard my problems and nicely told me that the hotline is 'only for pre-paid customers' as he is from the Pre-Paid Department. So he advised me to call 1800821123.

Thinking, "yeah soon my woes would be over" I quickly dialled the said number. The Voive again answered "Thank you for calling Maxis.... if you wish me to talk in Bahasa Malaysia please press One....". Being a supporter of the Bahasa Kebangsaan I chose Option One. I was listening very hard for the subsequent options and after a while I got utterly confused. I kept coming to the end of the menu and there was no usual option of "talking to a customer care consultant". I thought that perhaps my Malay must really suck as i couldn't even decipher words that means "customer care consultant" in Malay and thus keep missing the option. Damn.

So I decided to switch to English.... and again the same thing. Double damn! I finally figured out that the Maxis Hotline must have a switchboard that automatically directs a prepaid number to the prepaid menu.

I was scratching my head. This was a huge problem. I am oncall tomorrow and I need my phone to be in working order. What to do? What to do? What to do?

I need to talk to a REAL person! Ah... try again lah the 1300 xxx xxx number, at least they have a LIVE REAL person. I again had to explain the bad luck that befell me and how i just couldn't get through their Maxis post paid counterpart. i must have sounded pathetic as he offered to call the other department and get them to call me back.

Ahhhhh...finally. And after missing two episodes of Teen Titans (dratts...) I managed to get my phone working again.Phew....

I MUST SAY, MAXIS CUSTOMER CARE HOTLINE SYSTEM SUCKS!!! The only consolation is they have pleasant and helpful customer care consultants. This is NOT the way to go Maxis!

Possessed

"Krrriiiingggggg" the sound shattered the silence in the bedroom. It was deafening. But my reflexes was slow, I was so tired. I stretched my legs and arms and dream that someone would just make the clock silent. Ah.....

Out of the sudden, my love jumped out of bed like a man possessed. He grabbed the clock, smashed it to the floor, and when back to bed without missing a beat.

He's sleepwalking again!

Ampang Wannabe : the shit continues

The writers and directors of Ampang Medikal just do not know their limits. They aim high but do not have the knowledge or even expertise to execute their objectives.


Episode 4 clearly exposes their weakness with blatant disregard for finesse.


The whole episode centered on a 10 year old child with leukaemia who supposedly was dying. And as her last wish she wanted to donate her organs to help others. Noble issues to highlight but execution was….. as my hubby said ‘reeks of rotten mango with a tinge of belacan’.


My first bone to pick was the choice of actress to portray the sick dying child. She did not doesn't even look as if she had underwent chemotherapy at all; and her hair was long and shiny; her cheeks pink and rosy and her skim smooth and radiant.She looked more like a normal HEALTHY bubbly girl. Hey producers, there is such things as special effects and make-up artiste.


Second, don’t the producers know that one of the excluding criteria of organ donation is active cancer?


Third, well this issue is an ongoing issue with this series. The show do not know the local medical environment and uses American terms in their dialogue. For example, Dr Wong was overheard saying “ saya perlu mengambil darah untuk ujian CBC’. CBC stands for complete blood count but in Malaysia we use the term FBC or Full Blood Count. It may be a small thing but it is clearly a lack of research on the writers part (As we know, they just plagiarize the whole thing from Grey’s Anatomy, thus the American term. I am sure they are too stingy to pay the local medical experts such as myself to run through the scripts and scenes)


Fourth, after the girl died, the camera was focusing on the child and her parents. Have some sense not to show the chest moving up and down with each silent breath she took. Oh us ever so stupid viewers might think that "It's a miracle, she's alive".


Lastly, again a recurrent issue. The set-up; I wonder, why in a critically ill patient, there was no vital signs monitoring, no sphygmomanometer, no cardiac monitoring, nothing. And the chest leads to monitor the heart activity again ended beneath the sheets. It must be a very state of the art hospital bed as all the wires appeared to be connected to the bed ;)


And that’s Episode Four for you. Crappy and unrealistic!

Spearfishing and diving

Recently, I read a post on the malaysianunderwater forum on an incident of spearfishing (click here) during one of the trips joined by some of its new members. I chuckled and smile. At least, the fella had enough sense to write it up.

Anyway, the idea of a forum was a good one. I met a few good friends through there and I also met numerous 'characters'. The most fun I had is listening to people who call themselves 'otai' or legends bragging about their diving quests.

Note: I think the word legend should never be mentioned unless the person is dead like Jacques Cousteau.

Back to the issue of spearfishing, hahaha... I must say it thrives within the community itself. Most comments relaying feelings of horror and aghast were genuine but some I feel were mocking the situation. I met a few people during one of the MUW famous 'teh-tarik' sessions and they were the ones very into the so-called sport. Shockingly (or perhaps not so shocking), according to them they usually go with others who were doing their fun-dives.

The trip organisers offer the sport as an itinerary to attract participants (plus I am sure they are the ones hard up to go for a hunt). However, it is so irresponsible when they also open the trip to other unwary divers just to get the numbers so that they can have have a cheaper trip. My personal opinion is that people spearfishing and diving should not be in the same boat or vicinity.

People may say I am just talking theoretically. Well, I have in person, seen a spear-gun bought by such person as he was happily showing his new toy to his fellow divers.

Hmmm... and people wonder why I never join such huge trips. I am not crazy!

Note: I respect that spearfishing is a sport and as any sport it is governed by rules to ensure the safety of the person, surrounding people and the environment. The problem with the sport in this country is that many disrespect the local laws and blatantly break break the rules

My new addiction

I must admit although Ampang Medikal is a disgrace I am hooked into watching it. My Thursday's night is never the same again. I will never see a Malaysian hospital in the same light again and to think I work in one everyday.

May god have mercy for my soul.

Anyway, the damned show is utterly confusing. Before I move on, let us get the cast right. This information is taken from the press release in the Star.

There are FOUR house-officers : Dr Siti Alesyha (aka Meridith Grey), Dr Melissa (query if she's a crossover between Meredith and - I guess we will find out later), Dr Wong Sui Chen (aka Izzie) and Dr Rajesh (??? George or Karev)

And there are the specialists, Dr Jeffrey the paediatrician; Dr Maznah the cardiologist ; Dr Idris the surgeon and Dr Amir Shah Stephen the neurologist. I reckon the producers are confused too and used cardiologist/ cardiothoracic surgeon and neurologist versus neurosurgeon interchangably.

The storylines are weak so I have decided to dedicate my Thursday evenings to rectify JUST the technical blunders.

Top three highlights for Episode Three:

No 3. Melissa and Dr Amir (the neurologist cum neurosurgeon) confronted Nasha who had just delivered..."daripada pemeriksaan yang kami lakukan terhadap bayi encik kami dapati tanda-tanda yang konsisten dengan pengambilan dadah semsa mengandung"... and then Amir said" bayi encik perlu menjalani pembedahan cardiopulmonary bypass bagi meletakkan jantung dan paru-paru artificial untuk perjalanan darah". No other explanation, nothing!

I was totally perplexed by this scene. Dr Amir is a neurosurgeon NOT an obstetrician NOR a paediatrician OR EVEN a cardiothoracic surgeon. Then the other matter, withdrawal syndrome in an infant is mainly supportive treatment i.e. support the child till the drugs are out of his system... not surgery. Hmmmm.......


No 2. Mr Fernandez was intubated but there is no ventilators nor any vital sign monitors in the room. The tube just ends under the pillow.....arrghhhh. And to think this was said in the Star when asked about the medical setup.

".......... Azhar’s involvement in Ampang Medikal has sparked a new venture in his life: he recently set up a production house offering quality mock hospital equipment after realising there is a dire need for it in the local film industry.

“It is not easy to get permission to shoot in hospitals (Ampang Medikal managed to shoot some scenes in Assunta Hospital in Petaling Jaya but could do so only on weekends) and I realised that there is a need for such facilities,” the canny actor explains.

The production house – called, appropriately enough, Emergency Room – in Plaza Damas in Sri Hartamas, KL, even has a realistic-looking emergency room!...."

Duh, realistic, oh puhlease!


No 1. The patient Mr Fernandez is wheeled into the 'ER'. Dr Wong puts a BP cuff on his arm( yeah, they got this right) and then applied the stethoscope to the chest while reading the BP. She yells out to Dr Rajesh "tekanan darah tidak stabil, start CPR". The fella started CPR and then immediately Dr Wong shocked him, not once but twice. And hooray, Mr Fernandez was revived!

Comment: Dang! Who is their bloody technical advisor? First of all, you DO NOT put the stets on the chest when you are reading the pressure. Second, start CPR when the sign is low BP? CPR is only commenced when there is no pulse; there is 101 things to do for a low BP. And again, you do not shock a patient with low BP!!! I am appalled! Who ever is their technical advisor should be shot (or in this case, shocked) to death.

So there it is. That's my top three blunders for this week. Stay tuned for next week's highlights!

Parking Woes

Sometimes the Government wonders why are medical specialists are leaving the service. Many speculate it is mainly because of money. That may be true in some cases but there are many who left that wereare disatissfied j with the way they are treated by the government, by the administrators.

Last week, was a reminder of how little is the value of a medical specialist in a government hospital. A day prior to the long Merdeka holidays a memo was sent to the HOD of all departments in my hospital stating that only TWO parking lots will be allocated for the Department. And then on 2nd September, when all of us came back to work we were shocked, our previously alotted parking lots had been taken away. There are at least THREE specialists in each department.

And just imagine, we are talking about government officers (Pegawai Kerajaan Kumpulan A - i.e. Professionals) who had been working in the government for at least 8-9 years. And these people had to spend another 4 years doing their Masters to improve themselves to become SPECIALISTS.

Come on, what other perks can we expect. Our basic pay is a pittance, it is only plumped up by the specialist allowance; working hours are unpredicatable; and even our overtime stands at only RM 3.33 to RM6 per hour (RM50/day to RM 90/day). Our MOs get better pay!!!!

It some hospital, we do not even get a room or a desk. Might as well not study hard and become a pegawai tadbir and then sit at YOUR desk all day long doing not nothing but just something. And you may even get a parking spot if you are nice to the CC.

So a parking lot is a big deal. At least you do not have to scramble for a lot in the mornings and if you have to go out to the bank, you know it will be waiting for you when you get back. It is just a little bit of respect and dignity that we are asking for.

So administrators, before you go pointing fingers and accusing doctors of being money minded just think, what have you done to make our life bearable!

Ampang Wannabe

Malaysian are always good at stealing. They are good in making pirate CDs, DVDs, fake Loius Vuitton hand bags, Levis Jeans just to name a few. The quality is as good at the original. But then, their abilities do not extend to the silver screen. The latest rip-off performed by the Malaysian 'film director' or 'drama-producer' (note the inverted commas- it is intentional) is Ampang Medikal.

So-called the Malaysian medical drama of the year is Ampang Medikal. The hype was huge but when I saw the teasers I laughed. And last week I had the unfortunate opportunity to view the 2nd episode. I know I am not the first Malaysian doctor to comment on the series as it is so appalling.

The screen-writers, the director and producer never did any background work on the medical profession in Malaysia. They totally copied Grey's Anatomy from the concept, the story lines, the characters.... total plagiarism! Just look at the photo-shoot of the cast. Doesn't that look exactly like Grey's Anatomy? Who the hell run around in blue scrubs in Malaysia? Blue scrubs are meant for use only in ICU and the operating theatre. Any doctor (in Malaysia) knows that if you frolic around in the wards in your scrubs you definitely will get a shelling from the Sister or Matron.

And the background set-up of the story, these newly passed out doctors whom in Malaysia we call House officers (never ever called residents, duh producers get your terminology right) are placed placed in a private hospital to do their 'internship'. The interns are placed directly under the specialist and run around like dungus not knowing what to do. Questions, question,questions?

1. Where are the medical officers?
2. Since when in Malaysia can house-officers do their internship in private hospital? And since when interns can choose what rotation they want to do (Dr Siti moved to KL to do her internship under Dr Maznah a renown cardiologist...) Fact: here house-officers have to do compulsory five four-month rotations of Medical, Surgery, O&G, Paediatric and Orthopedics before they can get their full registration as a doctor!
   
3. Since when does a specialist present during ward rounds to the interns, what does the intern do??? No one writes anything during rounds...uh...then how does anyone know what was ordered and what is the management of the patient. No wonder Dr Siti is so stupid, she doesn't even know her patient has stage 4 lung cancer and what that means.
4. How come interns are not allowed to access patients' medical records? The way I see it, in this show they looked more like medical students, having to resort to seducing the nurse to view the medical records.

Anyway, listening to the medical jargon and how these doctors came to a diagnosis was hilarious. In once scene, Dr Idris were presenting the case of Mr Wong to his interns...."Mr Wong mengalami kesukaran bernafas, batuk berlanjutan......blah, blah, blah.... jangkitan jaundice dimata..blah, blah, blah". Jangkitan jaundice di mata? Holly crap apa menda tuh?

FYI dear producers. Jaundice is a symptom that presents with yellow staining of the skin and sclerae (the whites of the eyes) by abnormally high blood levels of the bile pigment. It is not an infection of the eyes. So 'memalukan'!

Another scene, a patient post coronary by-pass presented with shortness of breath. The cardiac monitoring showed only tachycardia (means elevated heart rate of more than 100 beats per minute) but Dr Siti deduced that patient had myocardial ischemia, and out of the sudden she also deduced that he had cardiac tamponade. Ah go figure, from a bimbo suddenly she's a genius, NOT!

Conclusion: Ampang Medikal is a rip-off hoping to ride on the popularity of Grey's Anatomy. It is an insult to the medical profession in Malaysia and it is an insult to the intelligence of the Malaysian public.

Lalang

Politicians lie that is what they do. And they do it without blinking an eye. I have accepted this a part of the cycle of life especially in Malaysia. However, having a so-called leader making contradicting statements and actions is utterly ridiculous.

I was told that this is the ‘style’ of this leader i.e. announcing something in the press and the next day do something totally opposite to what he had just announced. Style? My foot, it just shows what a weakling, a wuss the person is. When you say something commit to it. It is such an embarrassment to the country who acts like a ‘lallang’.

The latest of his antics was the last weeks’ fuel price decrease. I am happy that the prices have gone down but Mr Leader was playing games with the nation the whole of last week. On last Thursday, the headlines read “No new fuel price announcements for now, says Abdullah”.

And then the following day, “ PM announces reduced fuel prices”

Uh, duh? What bullshit, do you mean he suddenly got a revelation in the middle of the night that he should drop fuel prices? If that is the way he leads this country just to his whim and fancy then oh…boy are we in trouble. Or perhaps this is already pre-planned, I am sure it is definitely related to the Permatang Pauh by-elections, “Surprise people…. Fuel prices are now down…Vote for BN”.

Whatever you want to do it is your bloody right as the ‘esteemed’ leader but please don’t say one thing and do another immediately after. Someone has to teach our esteemed leader the words ‘No comments’ when asked issues he does not want to answer or reveal at that point in time.

At the end of the day you are what you are, a liar would always be a liar. It doesn't matter whether you are a garbage collector or the Prime Minister of Malaysia.