Sunday, April 26, 2009

Entertaining (and overindulging!) postcall

I love Sundays...the modern Sabbath, the day of rest. Of course, it's of extreme importance when one is postcall and today, it was nice indeed. Firstly, I was off earlier than usual and went home to wait for PS and CS. I was surprised with a pleasant T-shirt and bib number for paying for my non-appearance at the Bidor Half-Marathon. Thanx guys!

Now, being 3 very famished people, we decided to hit the town for a huge lunch. Unfortunately, the 2 runners were feeling a bit nauseated but it didn't stop us from eating at both Kong Hing AND Indulgence.

To me, Kong Hing and Indulgence are like the epitome of Ipoh. At one end, there's the typical middle-class Ah Bengs and Ah Lians and on the other end, there's the upper crust of society mingling at the Turf Club and owning houses with land as big as my hospital. Sandwiched in between are the rare minorities of yuppies = young working professionals who yo-yo in between these restaurants.

Now, no one should miss the famous popiah, noodles and pork satay at KH in old town. To top it up, you must have the caramel custard...absolutely delish for those with a sweet-tooth. As we missed the custard (the coffee shop next door was closed), we decided for dessert at Indulgence.

Guess we over-indulged lor....being overenthusiastic hosts, PS and I overestimated. Ordered tiramisu and the Ultimate (some sinful chocolatey cake) and spent almost 2 hours trying to finish it. Anyway, the ambience was superb and we were sitting next to some rich housewives flanked by their maids and cutesy kids. Eavesdropping have never been so fun!

Overindulgence aside (haha...get my pun?), we managed to drop CS off in one piece for his journey back home while I caught up with some precious zzzzzzz...

Thursday, April 23, 2009

Girl @ Work

This article marks the rare appearance of pictures of me from work and something featuring my little car...

What’s a good day for me on a working day?

  1. Assisting at least one interesting case
  2. Having my meals at regular hours (preferably a good meal too)
  3. Successful operations done by yours truly

So, on any account, I would say that I had a very good week so far. Firstly, I settled a lot of errands as home including letting my car has its treatment and health check-up at a friendly neighbourhood ‘car-spa’. I knew the uncle since young and was very happy when I didn’t have to go to the ‘official’ Perodua showroom with inflated prices.

Secondly, I was involved in the colorectal workshop, which is an annual event at RPB whereby a senior consultant surgeon from NUS in the land down south, will do a series of cases and endoscopic ultrasound of the anus and rectum.
The most fun time for me was when I got to assist something I have never seen before, which is a rectovaginal fistula repair using a labia majora flap. Oops, let me rephrase that in English…we repaired an abnormal track between the rectum and vagina by tying off the track and inserting a flap (some other living tissue from nearby that area) so that it will not occur again.

Sounds easy, but looked complicated enough for me. Of course I was very happy at the end of the day! Ah, I love my job :-) Helping people pass motion is part of a good day huh?

Thirdly, I had my meals at regular hours so far. Yay! No more gastritis pain and hunger pangs. Now that the hospital has only 3 working lifts, my work involves a lot of climbing up and running down at least 6 floors a few times a day…so good food is mandatory for survival. Somehow, echoes of the Queen E Hospital in KK kept on running in my mind as I walk past the broken down lifts. Shudders….

Today I saw a patient with bowel cancer in whom we cannot do a curative operation because of a severe aorta problem that IJN also couldn’t operate on. As she has two time bombs in her body, I had a very difficult task of explaining to the old lady on how there are limits to medical science and I admitted that we couldn’t do the curative as any one of the operation will risk her life and cause immediate death on table.

I was very apologetic and sad as I counseled her on ‘palliative’ care. As I go on, I realize that a good surgeon knows when to cut but it takes a courageous, good surgeon to know when NOT to cut. The decision to spare the patient from the risk of almost immediate death if we attempt operation was made by my seniors but as I was counseling the patient, I felt that I was learning very important life skills too.

So at the end of the day, the silver lining is that the patient accepted my explanation graciously and agreed for our future efforts in easing her suffering as she reach the end of the road soon. It reminded me that life and death is in God’s hands indeed….

Sunday, April 19, 2009

Reporting not so live from heart of Golden Triangle (in KL, i mean)

KayEl, Malaysia - At the heart of the golden triangle, there was a school called St. Mary’s Secondary School. It’s an all girl’s school which may have gone ‘extinct’ due to habitat destruction. You can see remains of it on Jalan Tengah.

Anyway, a group of St.Marian loyalists decided to gather up for a night of mayhem and misadventure at the foothills of the school, namely the Jalan Pinang area. These girls were seen exiting a serviced apartment, heading for dinner at D____ at Ascot.

Their tracks were easily followed as D___ is a prominent landmark around KLCC area and well-known for their other-worldly cakes (esp brownies)

Once there, the group gathered around for a photo-taking session, only to realize the hard way, that props and décor in a restaurant can be as fake as Pam Anderson’s boobs. The moment the chirpy gals leaned on the partition, it fell and created a commotion. What a glorious moment in culinary history!

Aside from a few red faces, there were no harm done as high spirits again descended upon the fun-loving group of long-term buddies-for-life. After gobbling up a delicious variety of food that D____ offered, the group decided to reign havoc upon 789.

Look at their sombre faces as they discussed about important issues like world peace and the latest movies unleashed by the forces of Hollywood.

Duck meat and drummets aside, it was still respectably early when the gals finished their extravagant meal. Thus the mastermind suggested a nearby club for logistics reason. After all, t's not easy to transport 11 rowdy gals in the middle of the night.

Although this chic place has a chic ambience, it's really hot, hot hot! Like what grandpa used to say, one man’s meat is another man’s poison. To most Asian chicks, a night out with the girlfriends means aircond, lovely music and plenty of dance floor space. To a lot of expatriates, a cool nite out means alcohol and heat. Upon finding out that 789 was too hot for their liking, the group retreated back to their comfy and cool suite at CR and spent the entire night yakking away.
At press time, there were no casualties noted, except for a few liver cells.

So to my longest friends ever, here's gambate and wishing you guys good health, happy life and joy in all that you do. St. Marians rock!

P.S: Don't forget to invite me to the next crazy do! I'll just make sure that i m not postcall...

Friday, April 17, 2009

Exploring buffet again

I wonder if it’s the start of the dry season again. Today we faced an uncharacteristic dry day in the metropolis and the heat scorched me...I was feeling faint although I went out only for a short while in the afternoon. The tip of the day is : stay indoors, drink lots of water and try not to get a heatstroke!

Back to my food story in Ipoh….

We had a buffet dinner for the medical officers and surgeons in the surgical department and all the relevant hungry people turned up. For me, it’s my first time in the brand-new Tower Regency hotel, a spanking tall tower looming just behind the houseman quarters. We used to bemoaned it as a much-maligned eyesore as the project was abandoned for 2-3 years..…now it’s a proud new hotel and tower.

The décor was quite tasteful and the blue lighting is different from the usual brownish, reddish atmosphere in most high-end restaurant. However, the international buffet is kind of small in variety and limited to a lot of local food. Spotted : One surgeon deeply in love with cencaluk (which I believe is the saltiest condiment in the world and I could barely tolerate it myself)

As for me, I don’t really eat much (serious) and this is the most I can do. One plate and it’s not even full... I’m quite an atypical Malaysian when it comes to food. Small stomach but easily hungry. Cannot and would not repent of it. Gluttony is a sin!

We all received a small door gift courtesy of B. Braun and I'm the proud owner of a huge mug, very conducive for my tea and floral drinks. Anyhow, the bluish lighting casted a peculiar hue to my pictures isn't it?

Well, the night ended early as it was raining heavily and my friends wanted to go home to study. I guess my favourite part of the buffet was the mushroom soup but otherwise, the food is pretty forgettable although the ambience is cool, especially for a small town. Definitely a place to bring your date in Ipoh, what more if you are on a diet and too excited to eat.

Wednesday, April 15, 2009

Lousy picture and foodies galore

I'm very particular about the quality of pictures I post on my blog. I know I am not a Nat Geo photographer or someone pro, but I love photography and editing. Just that I cannot resist putting this cute photo in its unadulterated, unedited form.

It's an albino snail! There's so much of pollution on planet earth that snails are mutating, even right here in Limestone City. Seriously, I found this snail crossing my path on my way home from dinner with PS one fine night. It was moving (albeit slowly) and the path was very dark...thus the blurry image. I waited for the reappearance but so far, I have no met Mr Depigmented again.

There is a new place called Olivenz cafe and I landed in this place at Ipoh Garden East on one very rainy evening (now, its been raining every evening in every major towns in Malaysia but who's counting right? I've lost count!) The chicken chop is ok lar.

We regularly eat Japanese food...since I have been so deprived of it in TI, I was so ecstatic to be indulging in my favourite cuisine. Although its mostly Sushi King (yeah, you purist go cringe and sulk in the corner), it's better than nothing. Of course, I prefer Sushi East and Ala II but the food there is slightly more costly. Aiming to try Kizuna one day though. Of course, nothing beats the variety and cost of Jap food in KL (now thats one thing I always miss about KL..Jap food!)

And then, we have the occassional sinful, greed-fest. We have surgical breakfast every friday and recently, one of the house officers bought big apple doughnuts. I went into hyperglycemic 'shock' and almost puked. Guess 2 doughnuts are enuf to tip me over the edge when it comes to sweet stuff and tidbits. Cannot tolerate sweet stuff at all...weird girl huh?

Then one really sweet girl (another house officer leaving the department) baked a lot of chocolate cupcakes on the same day as aforesaid sweetness-overdose party. No wonder i OD on desserts huh? Eating so much of fast sugar on an empty stomach. Recipe for dumping syndrome man!

Sunday, April 12, 2009

Snippets from Suturing workshop with my house officers

This article began to formulate in my mind when I read about some stories on the deteriorating quality of house officers and doctors, especially in civil service, in recent years. When I glanced through MMC report on disciplinary actions against doctors, I realized that as the number of doctors increases in Malaysia, the number of bad apples and black sheep has increased in tandem. It’s a natural law of statistics.

At the same time, I have hope that some of the under-performing doctors will improve and change with time, effort, training and good guidance. It’s very important for us not to be demotivating and derisional, just that it’s natural for some of the senior doctors (especially perfectionist like yours truly) to feel very impatient when faced when people who learns slower (PWLS)

I face a substantial amount of PWLS daily. They could be house officers, staff nurses and even patients. Truthfully, I feel like giving up at times because some of them has skulls as thick as Hitler’s Eagle Nest bunkers.

Yet recently, the house officers in Ipoh seem to give me some hope that they are improving. Maybe it’s because my bosses are very patient and we give massive amount of teaching to them. In fact, I like to think that the surgical house officers face the highest amount of criticism and occasional scolding because surgical-related illnesses are life-threatening. Knowledge, skills and attitude need to be cultivated. I’m really encouraged by how the senior consultants seem to spend time in teaching the juniors in this department. This is a good culture and I wish one day that more surgeons will rise up from the ranks of current batch of house officers.

Some of the house officers, especially those from foreign universities, seem to be at a disadvantage when they first start work. It’s true that local grads have a headstart because they are shadowing house officers and managing patients under supervision even at final year of undergrad studies. Some of the foreign grads are not even allowed to set lines or take blood from patients as they were ‘foreigners’ I sympathize with them as their clinical skills start from almost zero. At the same time, for those who are willing to learn and have a good attitude, their learning curves are very steep and I am proud of some of them. Some of these foreign grads, the non-PWLS are now gaining trust and confidence as they catch up with some of their compatriots.

There are plenty of horror stories regarding how house officers are faring in public hospitals these days. My advice is that there are good doctors and there are bad doctors out there. The sanctity and nobility of the profession might be tarnished slightly by a few, but on the whole, there are still very brilliant, kind and nurturing doctors out there. If we highlight the role models and give them further encouragement, we might offer a glimmer of hope and these exemplary doctors will serve as examples for most of the junior doctors.

Doctors who are inspiring, high-achieving, brilliant and kind should be motivated to progress further in their career. They should not be discouraged by being thrown to the smallest, furthest districts or in departments they do not want. Sometimes, the amount of outwitting and maneuvers we see in the world of medicine is astounding. It rivals even Survivor or the Apprentice. Some of the people with the biggest cables but not necessary the best doctors for the job will get the best ‘postings’ in the hospitals they want.

My point is that transparency and accountability is very important in our daily lives. If we lack integrity, moral and good attitude, even the best education will not get us anywhere. Eventually, whatever wrongdoings we do, whatever mistakes we try to cover up, will get back to us and bite us in the back.

In closing, I do agree with POTS (from regarding the state of house officers from the countries up north when I first started working with them. I almost died of heart attack (!) when one of my house officers gave wrong blood to a patient that I was resuscitating, back in Teluk Intan days. However, I find that as I am exposed to a few more from the same university, I realized that some of them are quite good. I stopped being so judgmental and cynical now, and do put in more effort to help them improved. It's quite liberating when we are freed from no expectations at all. If I find that I cannot help them at all, I just end up doing everything by myself. Although it's tiring, it's safer for my patients in the long run, I guess.....

Saturday, April 4, 2009

Trivial 101

Now there are times when I do get a bit truthful about myself and decided to talk about something less grand and more down to earth. You know, no more world peace stuff, nitty gritty Freudian philosophies, Grecian proses, etc but just something personal. Today, I would like to talk about random things I like.

Firstly, I love to talk. There is something everyone with the XX chromosome have in common. Most of the time, I try to talk sense, or even talk sense into people. However, there are certain times of the year where I could tolerate idle chatter, like during Chinese New Year, other traditional festivals and in some parties with people I barely know. As years go by, I begin to understand that listening is an understated skill and therefore, I am trying to listen more!

Secondly, born and bred in one of the warmest country in the world means that I adore the cold weather. The sad fact is that I have cold feet (and hands) in cooler temperatures and thus I have to keep the distal parts of my body covered. Otherwise, autumn and winter are my favourite seasons. After all, I am born in winter....

Thirdly, I adore soft toys. Yeah, i have outgrown and outlasted many of my eighties toys but that doesn't mean the girl in me would not love a soft, cuddly toy provided its dust-free and clean. Of course, being allergic to house dust mites means that I have to be careful around you-know-what.

Fourthly, I love dogs, especially puppies and occassionally some kittens too. And watching Marley and Me didn't deter my dream of owning my pet one day :-) Even the incorrigible Marley absolutely doted on his family and there is just so much of unconditional love in doggies. Now what's the number to that nearby pet shop again?

Finally, I have this unexpected gravitation towards American serial dramas. Somehow, I drown myself in the vapid world of Upper East Side or imagine myself chatting to some McDreamy/McSteamy in Seattle Grace Hospital or fancy some battle of wits with Dr Gregory House. Perhaps it's some form of escapism?

The irony of it all

I think it’s really funny when more than 10 people decided to contest for one constituency in the recent by-election. One local newspaper even compared the situation with the Formula One grid…placing all the candidates in a row. I guess this bewildering scenario can only happen in Bolehland isn’t it? Not only we have the extremely dubious distinction of being one of the 4 tax ‘havens’ in the world, now we have the most contestants contesting in 1 by-election. So, what’s going to happen next? Promoting Malaysia as the ultimate retirement destination for 3rd world despots and infamous extremists?

Oh, talking about Formula One, I wonder why is it that we loudly celebrated Earth Hour last Saturday and then suddenly, we are welcoming the Formula One hoopla to Sepang this weekend. Watching race-cars go in circles around the track and race-drivers going circles around the most buxomy models is almost a slap to Mother Nature’s face. I am hard-pressed to find something that is ecologically-friendly in the world of motor-racing. Perhaps I am not ‘intelligent’ enough to find the rationale behind burning massive amount of fossil fuel or changing more tyres? Maybe some fans would kindly educate my ignorant mind?

I guess I can do my part by changing some of my habits to help the Nature…switching off all electrical products when its in idle, reducing the use of paper & plastic bags, using eco-friendly transportation (ok fine, I will use my car less and do more walking I hope!) and reducing the use of water and electricity whenever I can. After watching the recent Nat Geo documentary on 6 degrees and how global warming can affect the entire earth, I know that we must stop plain preaching and start walking the talk.

In short : REDUCE, REUSE & RECYCLE. So, how about you?

P.S: Do try to identify the green campaign symbols's quite fun to check out the eco movement websites while you are at it.