Another round of ramblings

The final post

2010-01-18T07:17:00.000-08:00

Time passes so fast. A year has passed by already. This blog is unable to serve it's purpose any longer due to several reasons which I shall not disclose. In addition to that, the poor internet connection here hit the final nail into the coffin. I'm moving off from spending too much time on the internet and shall be pursuing other things which I've been neglecting for far too long. Much more important and meaningful things in life. This virtual world has been my boon and a bane as well.

What I desire for Christmas & New Year...

2009-12-30T07:32:00.001-08:00

I can't stop salivating at this. The Ball Engineer Hydrocarbon Spacemaster. At a price tag of USD2699...it remains a wishful thinking hehehe

Pleasant memories

2009-12-27T08:39:00.000-08:00

Went out for dinner at this "kopi tiam" restaurant where the theme is retro. Each table has a "Happy Family" deck of cards and 5 bottle caps.

Which brings me back to the memories of my primary school days. The hottest games then were the "5 bottle caps game", the "turn the eraser over" game or the "turn the cards over" game. Simple games like these took hours of our attention. Of course the games also revealed who had more "cheating tendencies" hahaha...

The 5 bottle caps game goes like this. You put 5 of them up (the side with the "teeth" upwards) and then rotate them. They will then disperse. Your opponent will then choose which cap you need to target using another cap. You need to "shoot" one cap with another. You can use whatever method you like but assistance is restricted to your bodily parts only, usually using both hands. Many methods were used especially if the caps are not in direct line of vision with a third cap blocking the way. The most common way is using the other hand as a guide to swerve the cap over to the target cap. Another would be to shoot up the air hoping it will land on the other cap using the other hand as a "landing guide". You cannot however move your guiding hand. Most cheaters will move the guiding hand a little to "nudge" the cap to it's target. There are also several variations to the rule.

The other game I remember would be the "turn the eraser over" game. Each player would purchase some brand new erasers. Each will contribute one or 2 or even more erasers. They are then stacked up nicely. Then the starting player is chosen using the "bird, water, stone" method. The player would then warm up his inner palm by rubbing it repeatedly on the table. He then presses the stacked up erasers with his inner palm and lifts it up. Some or all of the erasers will stick to his inner palms and drops down later. Any erasers which turns over belongs to him. The next player will then try on the remaining erasers and so forth. There is a distinct method of turning over the erasers after lifting them up. The cheaters will usually discreetly "push" the erasers forward while trying to lift them up. This will cause the erasers to roll over instead. Believe me, those cheaters have refined the skill until it becomes an art. However arguments have occurred and the verdict was usually to repeat it. The game will go on until a player loses all his erasers or if he stops playing.

Proudly I think I was one of the top players in both games. I had won lots of the "bottle caps" game and also won lots of erasers. I was an honest player. Honest. The "cheaters" also won a lot, usually from unsuspecting newbies or new players. In retrospect, the "cheaters" were usually not very interested in their studies but are among the more creative and sociable people around. I'm not surprised if they are very successful in their careers today but probably not in the academic line.

I'm not sure what's the point of this post actually...but I suppose we can tell if our kids are destined to take up a traditional academic career or a more unconventional career pathway like entrepreneurship or business related line by just observing their tendencies while playing games. And I believe the "cheaters" will probably be more successful in the future as they are probably "risk takers", willing to take the risk of being found out for the glory of a huge victory hehe.

What's wrong with Malaysia?

2009-12-25T07:22:00.000-08:00

As 2009 is coming to an end, it's time for reflections again. With all the mega scandals in 2009 from the C4, to the PKFZ to the missing jet fighter engines that Hollywood might be interested, one cannot but wonder what lies in store for Malaysia

As for the common people on the street like me, more mundane stuffs dominate their daily lives. I've personally experienced some of them. I've some questions for which the answers might be pretty obvious. Answers which explain the path Malaysia has gone down to.

1) We have great government offices without signage sprawling in Putrajaya but no obvious public carparks. Cars are parked by the roadsides. I saw some police officers writing summons.

Question : Why do you have government offices when there are no carparks for them? And why summons them when you do not provide carparks in the first place? Is it not a place where public will go for government services?

2) We sell many Proton cars and even give RM5K discount as an incentive for old car owners to upgrade.

Question : Why do we encourage more cars on the road when the roads are perpetually jammed, full of potholes and confusing? Drivers get impatient and irritated - thus they make illegal U-turns, use emergency lanes or worse, get into accidents. And police summons them for that. Why there isn't any proper planning and proper roads? Why encourage sales of cars then?

3) To solve the traffic jams, we have public transport.

Question : How come there are long queues at the LRTs? We trade queuing at the jammed roads with the long queues at the public transport. How fantastic! I've been to places with higher density of population like HK and S'pore, their public transport is nothing short of efficient.

4) We have many police officers who can be deployed for disbanding public rallies, but why crimes are getting rampant?

Murders and aggressive crimes are highlighted almost daily in the newspapers. I've got colleagues whose bags where snatched in broad daylight, handphones pick-pocketed, cars whose windows were smashed. And my stolen shoes. What are the police doing about it?

5) Why inflation and cost of living has been spiralling upwards? Cost of property is beyond the reach of most people. Cost of food has been rising. And we introduce GST.

I mean these are the daily grind the public is facing and it looks like it's not getting any better anytime soon. Hopefully there will be some light in 2010. Sigh...

New Orleans

2009-12-12T16:12:00.000-08:00

I had the opportunity to visit New Orleans recently. The journey was horrible, with a total time of about 32 hours to reach there. However I was pleasantly surprised that my luggage had arrived there with no hiccups at all.

My first time to the US. The security and immigration was horrendous, to the point of being paranoid. The immigration officer (who looked like a Latino) asked me if the lady who was passing by the counter looked hot or not ! Anyway after the multiple security checks, there I was in New Orleans. Roads are wide, building are sparse (comparatively to KL or Hong Kong).

The city is by the edge of the Mississippi river and the weather was bearable. Not freezing cold. Apart from job related obligations, I went visiting the city, the wonderful Audobon aquarium of the Americas, the French market and tasted many local delicacies including the croc. Apparently New Orleans is famous for it's voodoo tours, Mardi Gras, swamp tours, crocodiles and the local food - gumbo, jambalaya, shrimps etc. The city itself had a very European feel. Many people speak Spanish and the French quarter is probably the highlight of the city.

We went for a spin at the swamps using the airboat and was given a history lesson. Apparently the US government wanted to prevent erosion of the swamps and introduced water lilies, when that got out of control, they introduced some big rats to eat it up, and when the rats got out of control they introduced hyenas, and when they started eating local wildlife, they started shooting them. Anyway didn't see any wild crocs as they were hibernating.

That's the fried croc meat. Anyway after about a week, I was more than ready to get home to the warm weather and spicy local food. New Orleans does not allure me very much. Malaysia is still my home.

Stupid Malaysians

2009-11-26T07:26:00.000-08:00

Some Malaysians are either too spoilt or too stupid to appreciate the things which are provided for them free of charge.

Some Malaysians refuse proven treatment for free, which will cost RM100K in private and rather go for dubious"alternative therapies".

On the other hands, foreigners, illegal or otherwise will grab any opportunity to obtain treatment in a medical facility. Perhaps by learning through some of their community's painful lessons of delaying proper medical treatment, these foreigners truly appreciate what is being provided for them in a medical facility even though they are poked many times left, right and center by inexperienced house officers. They thank the medical provider regardless of the outcome. I had one foreigner who can hardly speak a word of English or Malay, who is even willing to fork out RM60K for a particular treatment. And the patient had probably begged, borrowed or steal to obtain the funds for treatment.

In contrast, some Malaysians will outright reject proven treatments which costs a bomb to the government. Even if it is provided to them for free! How stupid can one get. They default frequently and behave as if they are primadonnas. The feeling I get is "we want to treat them more than they want to be treated". And their favorite past time is complaining, why they have to pay RM5 for consultation, why they have to wait so long, why this and why that. In contrast, we have poor foreigners who are willing to fork out RM50 for consultation and comes for follow up religiously. The Malaysians who are appreciative are the ones who have finished their money in private and realized that proper treatment is not cheap. We have seen a Malaysian screaming four letter words at the top of his voice just because he had to wait a little longer for consultation.

Sometimes treating poor foreigners is so much more satisfying and rewarding. Serve Malaysians right if they have to pay through their nose for healthcare in the future.

A piece of paper

2009-11-19T04:28:00.000-08:00

The UPSR results are just out. 9.51% of students got all As.

Now, As are a dime a dozen. Even the Ministry of Education has decided there has to be a new category, A+. This is to satisfy the unending lust of parents and administrators to see more As. What's the value of an A anyway?

What's the value of a piece of paper? In the past, a scroll guaranteed certain things in life. Better opportunities for further education, a better job, a better status and a better chance of getting better remuneration. But what can it do now?

The last I read, there are over 50,000 unemployed graduates. Now everyone can be a graduate. It satisfies the students who can be called graduates now, it satisfies parents who want their kids to be called graduates, it satisfies their school and universities (better statistics = promotion for administrators, more students enrolling = more income) , it satisfies the Ministry of Education ( better statistics = promotion = higher salary + chance to be PM?? ) and our country can then boast to have a very high literacy rate. How deluded can we be ???!!!

We dished out As and scrolls to satisfy our own delusion. But what's the value of the scroll now? Can the scroll put food on your table? Can the scroll clothe you? Can the scroll protect you from the elements? Can the scroll repair a leaking pipe? Can the scroll repair your broken down car? It is just a piece of paper, nothing more than a piece of paper. Maybe useful as toilet paper.

I mean parents and students are spending tons of money for that piece of paper. This must be the biggest scam of all times. But never mind, we can boast we have that piece of paper with As, others don't. Hahahaha...

The hardly literate farmer in the furthest corner of the country can laugh the loudest now, at least he can put rice on the table. And you have to buy rice from him. And doesn't need to sell it to you either. What can your magical piece of paper do?

My new toy

2009-11-10T03:55:00.001-08:00

My latest indulgence. More pics to come ;)

TCM again

2009-11-01T05:07:00.001-08:00

I predicted a MBBS (TCM) would be offered in the future. This is spotted in a major daily newspaper today. Not enough with the overwhelming number of medical schools in the country, now we have a private university college offering TCM degree as well. Wow, I did not expect my prediction to come true so soon...

With so many students wanting to help other people to be healthy, we must be the healthiest nation on planet earth. Why not offer Masters and pHDs as well?

I just wonder how the ministry plans to regulate TCM degrees. Even now there is unending hoo-haa over recognition of medical degrees. Now there are TCM degrees thrown in. Who sits on the regulating board of the TCM? What criteria do you use for recognition of a TCM degree? Who qualifies to study TCM? How to you pass/fail a TCM candidate? Do you have theoretical exams or practical exams? Who qualifies to be the examiners? Gosh...there are so many unanswered questions.

Money, money, money...lets open the floodgates and let market forces decide. Healthcare? What's that? Is it a branch of business marketing?

Good things are meant to be shared

2009-11-01T01:41:00.000-07:00

What is life if it cannot be shared and enjoyed?

Went to this duty free island and returned with much lighter pockets ;) But what the heck...life is to be experienced, enjoyed and shared.

I was having difficulty choosing between a Moet & Chandon champagne, Remy Martin XO excellence or Martell VSOP. I thought Remy Martin sounded good...hahahaha

In my crash course on the finer things in life, I found out that XO means extra old and VSOP means very special old pale.

There were too many cognacs, champagne cognacs, champagne, wine, whisky etc for me to comphrehend in such short time. I was dumbfounded on which is what and what is good, so I just played by ear and ended up with these...The other option is to play by price.

Anyway, in an island where a can of beer is RM1.70 and mineral water is Rm2.10, who can resist?

Climbing hills and Yong Tau Foo

2009-10-25T01:37:00.000-07:00

Somehow after having tea at Cameron, I've decided to shed some kilos and perhaps regain my fitness by going to the now 'super famous' Broga Hills for a climb. Using my new toy, the E-trex Legend GPS, finding the place was easy. The GPS works like a charm.

Nestled between oil palm estates near Semenyih, this must be the most photographed place in blogosphere. Lines and lines of people literally queued up and down the tracks. Managed to scale up all the 4 peaks, took some wonderful photos and then slowly tracked down. Luckily the weather was kind.

Opposite the hill, at the mouth of the trail, there was a rabbit farm where you could enter (with a fee of course) and play with ponies, monkeys or rabbits. I guess some rabbit products were for sale also.

Then we literally breezed past Broga town and stopped by at a temple at the end of the town. Where there is a temple, there will be lots of Chinese people visiting. Hmm...

Later we tracked down to the old Ampang town in search of the famous Yong Tau Foo. Thank god for the GPS. There were 3 shops side by side and they were packed to the brim. Perhaps 30-40 table in each shop were completely full. Managed to secure a table in the less popular one among the three. The food was delicious to me. The business appears to be family run with many teenagers who looked like school kids taking orders and clearing the table. The cashier appears to be not more than 15 years old. It just makes me wonder, if they were already raking in tons of money, what's the motivation for them to get a paper degree? Paper degrees are more or less a dime a dozen nowadays. Even with a degree nowadays, one can hardly make ends meet what more compared to the Yong Tau Foo business which they could make tens of thousands per day!

Cakes and tea

2009-10-24T07:18:00.000-07:00

Having hot tea and strawberry cake up in the highlands looking down at the tea plantations with a great weather is fantastic. Blissful...

Not forgetting the ice-cream...

With such beautiful scenery, I tried taking multiple pictures in a panning motion with the intention of stitching them together later. Found out that there are 3 crucial things to consider to successfully create a wide panorama.

1) Use same exposures in each shot
2) Use very narrow depth of field
3) Never use wide angle as the lens aberration is too great to correct.

Now all I need is more practise...

Patient support groups

2009-10-18T09:10:00.000-07:00

Just have to put in my 2 cents regarding patient support groups. What do I think of patient support groups?

Well, the idea of patients supporting each other seemed a good one. The meet each other, share their experience and learn from each other. They have a shoulder to cry on and someone to turn to in times of need. That's simplistic.

They also share much more than that. They share with each other about their doctors, their treatments and their medications. We all know all patients do not get the same treatment. Whether in terms of the 'expertise' of their doctors (ie good or bad), the type of medications they receive or any other treatments. They compare. Is that good? Will the patients who receive 'lesser' care feel shortchanged? Definitely so. One will argue that this is good for the patients as then they can demand better care, equal to other peers in that group or in other nations. And this will improve healthcare standards as a whole. Ah...

We know not everybody gets equal treatment be it in terms of access, expertise, medications and so forth. Rationed healthcare is practised everywhere. Budget is limited. Somebody has to ration healthcare based on whatever criteria. Like it or not doctors also have the unenvious role of putting this to practise. Healthcare resources are not unlimited. Demand will always outstrip supply.

Then comes the pharmaceutical industry supporting these patient support groups. They subtly reinforce patients on what is the 'standard of care' often importing standards from more advanced countries knowing well that developing countries may not have the means, expertise nor budget to practise what developed countries are doing. And not necessarily what the pharmaceutical industry is promoting is always best for a nation as a whole. They are running a business after all with their headquarters in rich developed nations.

Patients start to feel shortchanged. Patient support group becomes a lobby group. Lobbying to get access to more expensive medications and treatments (thanks to the "support" of the pharmaceutical industry) regardless of the economic reality of the country. Lobby groups wield strong pressure on politicians, reminding them of the next elections and reminding the public that they may be in dire straits one day should they get sick. The public is also worried and pressure is mounting.

The pharmaceutical industry will now be smiling from ear to ear to the bank counting their revenue. They can now cut back on their promotion activities. Lobby groups/ patient support groups are doing the job for them and far more effectively. It doesn't matter to the pharmaceutical company with headquarters in a different continent if millions of people in the country are deprived of other basic necessities just to cater to the exorbitant costs of supporting a few hundred or even a few thousand patients in the lobby group.

And it all starts with "patient support groups". I strongly believe doctors should steer clear from heading these support groups as they will eventually turn into a lobby group through which the doctor would be pressured into promoting the pharmaceutical industry.

USAF Thunderbirds

2009-10-04T08:45:00.001-07:00

Nothing inspires awe like birds in the sky. I had the opportunity to snap some pictures of the United States Air Force Thunderbirds F-16Cs when they dropped by in KL for a show . Maybe it was an opportunity for them to send us a subtle message as well : Don't mess around with the USAF

Anyway it's a thoroughly enjoyable display.

Reflection blues

2009-09-22T06:54:00.000-07:00

Sometimes I just wonder what the heck am I doing everyday? Hours passes, days passes, years passes...Doing something repeatedly daily is not what I had envisioned. Especially if it's the same old thing. I can't seem to find the motivation these days. If I had just made a different decision many years ago...

I think "fate" plays a understated role in our lives. Hey, we cannot choose how we were born, we cannot choose what we learned during our upbringing. We cannot choose which kindergarten or school we went to. It was all "pre-destined". Yes, we can be arrogant to say we control our fate but to a large extent, I think this is pure "motivational talk" bullshit. We cannot change many things in our lives.

For example, if you were brought up in a mafia's family, you'd be a mafia boss one day. If you were brought up in a farmer's family, you'd be a farmer one day. If you were brought up in a political family eg the Kennedy, chances are you'd be a politician. Look at the generations of miners or fishermen for example. The upbringing, exposure, the environment, the opportunities, are pre-destined for you.

Yes, it's possible to "turn" your fate. But it's easier said then done. We were all fed by Hollywood dramas and "one in a million chance" success stories to cheer up the reality in our lives.

I gotta get out more often.

A great break..

2009-09-12T03:39:00.000-07:00

Tranquility in Koh Samui...you'll never know how stressed up you are until you see this.

Where do you draw the line?

2009-09-12T02:36:00.001-07:00

Me : I want one plate. How much?
Char Kuey Teow seller : RM3.50. But you need to pay an additional RM1 for the use of the plate and chopsticks.

I'm joking la...this is just a fiction of my imagination. Or is it?

I've decided to purchase a house. Went to the company lawyer's office to sign the S&P. First time ma...a bit blur blur.

The lawyer outlined her fees. Certification of photocopied documents RM50, stationary/stamp postage/photocopy/telephone bill RM50, travelling expenses RM20...bla bla bla, all must pay upfront. Although I was the one who drove to the lawyer's office and paid parking as well. Maybe she needed to drive up and down to settle my stuffs, I don't know.

Anyway I'm not here to bash up the lawyers. It appears common nowadays to "split" the fee as a means to jack up the cost. You book a hotel room, they provide internet connection and TV, but to use the internet or view certain channels, you need to pay. Patients get admitted to private hospitals, uses the toilet - gets billed for the toilet roll.

The excuse the various people use is "It actually saves money for the people who do not use these services". I say this is utter bullshit. For example in a hotel, even if nobody is using the internet line, I'm sure it is used (shared) by the management themselves. They would not lose a single cent even if every guest uses the internet but they stand to make lots of $$ if they charge. It is not that they are helping people to save but rather an opportunity to make more $$.

I won't be surprised if lawyers will start charging for internet line usage, computer rental usage, air-con bill, usage of table and chairs, food and drinks bill and even for toilet rolls.

Doctors also are beginning to learn this trick. I guess in the future for an operation eg total colectomy + jejunostomy, one can charge for laparatomy, ascending colectomy, transverse colectomy, descending colectomy, peritoneal washout, stump closure, jejunostomy and skin suturing. So it's actually 8 procedures. Can charge 8 times. But lawyers, rest assured, in the medical field "fee splitting" is unethical and not permitted...for now.

Anyway it's a dog eat dog world. Whatever goes around comes around.

How come?

2009-08-31T06:09:00.000-07:00

It's been 7 months I've been driving up and down, left and right in the city. Never met any JPJ roadblocks till yesterday. Wait, yes - there was one police roadblock during the famous protest not too long ago.

Yesterday and today (yes, on merdeka day) I came across 2 roadblocks by the JPJ/traffic police looking at the car's roadtax. Not during the day, not on highways. Both of the "operasi" were at night at the small neighbourhood roads near residential areas and eating stalls where there isn't any commercial vehicles at all. They waved my car through after flashing their torchlight at my road tax, on both days.

Why are the JPJ people interested to do checks near residential areas and at night? And on public holidays when traffic is minimal? Surely the chances of spotting expired road taxes is extremely low given the dismal amount of traffic.

Ah...but it's 3 weeks before a major national holiday...."Ang pau" and "green pau" comes to mind. Everyone can do with a little extra income. Am I being cynical?

Deeper and deeper...

2009-08-24T07:41:00.000-07:00

Hobbies are enjoyable but when it comes to the cost, some are higher than others. And when you delve deeper, more and more stuffs are necessary. Some of which never crossed my mind earlier.

I remember the simple cheapo point and shoot film camera I had. No need special care. Use until rosak or berkarat. And berkarat indeed they do on the metal parts. Then came the more expensive digital camera, need to keep inside cupboard. Then came the digital SLR, and I used a polystyrene fishbox with "thirsty hippo" inside to keep fungus at bay.

Now I've got a drybox with a dehumidifier and hygrometer/ temperature monitor. Googled around and found out that the "ideal" relative humidity for lenses and cameras is between 35-45%. I think in our tropical climate, humidity is above 90% most of the time which is ideal for mould and fungal growth. So a drybox is a must if I wanna protect my investment. Hopefully this will keep the dreaded fungus away for a long long time.

And what my significant other wanted to put in my drybox? Handbags!...Ummm camera lenses and handbags don't like each other.

Good ol' MC

2009-08-17T07:22:00.000-07:00

After the shock and getting down with the flu recently, I had the chance to sleep soundly and to switch off my handphone. Despite that calls still came gggrrrr, but since I was imprisoned at home, well what the heck..

But I needed that break. The flu somehow knew I needed it and gave a little nudge towards the right direction hehe. Come what may, nothing is gonna stop me from taking a real holiday soon. Tickets checked, passport checked, currency checked...

I cannot help reading the numerous complaints with regards to the goverment's response to this pandemic. It's always government's fault. I'm no boot-licker but hey, gimme a break. Just look around you. It is the public's attitude and civic consciousness or the lack of it. How many times you see the "Char Kuey Teow" seller sneezing into your hot fried char kuey teow? How many times you see dirty dishes on the sidewalk frequented by rats and dogs? When was the last time you see a clean public toilet ? How can the government enforces just about everything? People have to start behaving responsibly for themselves. I remember the trip to Vienna early this year, nobody checks if you have bought a ticket to board the train. It's just a civic responsibility to sustain the service. Like wise, Malaysians should learn civic responsibility.

And the MSM reported that the government may invoke the Disease Prevention Act of fine and jail if somebody with the flu flouts the quarantine. I mean get real lah...if 2 million Malaysians are inflicted with flu and flouting the quarantine, do you have jails large enough for all of them? Or enough prosecutors and judges to hear all the cases? It's a pandemic!

This wearing of a mask for the sake of wearing is also bullshit. Just for show that "something is being done". A mask is not going to prevent anything unless our attitude change as well. It's just giving a false sense of security. Some of the school children aren't even wearing it properly - you can see them being worn upside down, inside out, below the nostrils etc..you name it.

And the fallacy of a pill for every ill. This is the drug company's windfall and the industry is pushing it that way. And imagine the chaos and anarchy if a really virulent pandemic is on the way and the response is "We've got no treatment for it".

Some members of the public are also hitting the government over the "higher than norm" death rates. Hey come on, if the denominator is under-reported, the rates aren't gonna be correct. And nobody is capable of monitoring the denominator any longer.

Now a nice Ba Kut Teh would be a great end to my MC. Hehe. Can't remember the last time I took one.

How to ?

2009-08-12T10:22:00.000-07:00

How do you console a friend whose kid got very ill due to the dreaded H1N1 flu? And how do you console the friend who was suspected to have inadvertently passed the bug to the kid?

I really cannot imagine to be in either of their shoes.

Should the friend who was suspected to have passed the bug to the kid get tested? If it's positive, probably this friend will feel extremely guilty for life. How to face the kid's parents later? Or is it better to leave it be - unconfirmed, since this friend has already recovered? I really don't know. In any case, it wouldn't reverse whatever that has happened.

The pandemic has reached our shores far and wide. Every person will probably get it sooner or later, symptomatic or otherwise. Scenario like this will become the norm. Finger pointing and the blame game may cause untold sorrows and may even break marriages and friendships. Especially in fatal cases.

I sincerely pray and hope for the recovery of the kid.

Heathcare cost 2

2009-07-30T23:41:00.000-07:00

From our esteemed Health Minister. Here.

This is how healthcare costs will rise. How can you ask for a "will not cause death" warranty for a vaccine? Many important drugs, present and in the past have caused death before, either directly or indirectly. For example many antibiotics are associated with fatal idiosyncratic reactions. How can one guarantee a vaccine is 100% safe???

If I'm the supplier, my response would be "I cannot guarantee 100% safety for any drug/vaccine. Take it or leave it. Your choice."

I think statements like these are uncalled for. In medicine, it as ALWAYS benefits vs risks. Many new drugs or vaccine although have passed phase 1, 2 and 3 clinical trials will still need post marketing surveillance. Many new side effects are found during the post marketing surveillance. Unless you want a trial to run for decades /centuries to ensure long term safety before marketing. Then again which company will develop a drug/vaccine which needs decades of clinical trial? It doesn't make economic sense. Even if they would, the costs would be exorbitant and ultimately passed down to consumers.

What next? Will he be saying "I want a 100% warranty this treatment will not cause death or else I'll sue". Anybody wants to treat him?

I'm a bit worried with this Health Minister.

Then our DG said this.
I have no qualms doing any test/every test for any/every patient. If the patient is paying for it, no problem. But who is paying for it? Can the country cope with all the demands? Financially and physically? Does it make economic sense to screen everyone with mild, self limiting symptoms? I say since the DG says so, just take the swab-lah for everybody. I just wonder, what if the many overly worried public lie about their symptoms, if any, just to get tested? After all it's "free"!

Just don't ask me when the specimen collection kit is depleted or if your result is still not ready after a month. Ask the DG.

Another example on how to raise healthcare costs. Clinical judgement goes down the drain.

I'm also a bit worried with this DG.

Another day...another year

2009-07-30T09:22:00.000-07:00

Time flies. Another year has passed. As I remember correctly, I might have passed this day at work a couple of times already.

Anyway got home fast. My other half and me went out together and ate something nice for a change. It was a really nice dinner. Near the restaurant was a nice shopping complex and an international squash tournament was held there in a nice glass court erected just for the tournament. Our national players and some international players were playing.

And I looked with a little envy...the young athletic, agile and fit players retrieving those shots so effortlessly. And I felt a little sad. I might have passed my peak...sigh. I remember those years when I could do so effortlessly as well. Anyway it was an enjoyable sight. Far better than tennis or football.

How I miss those competitive games...the sweat, the exhilarance of better endurance and tactics and the friendship that comes with it. Something money cannot buy. Now the only thing I do most of the time is exercising my fingers signing on a piece of paper while listening to complaints.

Don't ask me

2009-07-28T08:50:00.000-07:00

Not been in the best of mood these few days.

Don't you freaking hate it when people ask you ;

1) "why my investigation results take so long?"
2) "I sent my blood already, how come the results are not here?"
3) "why my records are not here?", followed by
4) "why can't you get my stuff from xxx hospital over to here?", followed by
5) "why you ask so many questions, can't you look at my records?"
6) "why this hospital hasn't received my what and what"
7) "I already gave this to so and so"
8) "Can I do this there and ask them to send over here?"
9) "Why must I repeat this again?"
10) "How come..."

First of all, I don't personally receive anything you sent. Proof of sending is never proof of receipt. I don't bloody know why it's missing. I don't bloody know why it was not sent. Whatever stuffs you may give so and so should end up somewhere. If not, I don't bloody know where it is. I'm not begging you to repeat any damn thing. If you b***dy trust the system, don't look for me if it's missing. Why it's missing? Well, I'm as baffled as you. Don't ask me, ask someone else. I'm not your safe deposit box. I don't keep your stuffs at home. You want to send something? Do it yourself. I'm not Fed-Ex. Do I look like a courier service?

I don't control the system. I'm not the courier boy, I'm not the safe deposit box, I'm not the office boy, I'm not the typist, I'm not the IT administrator, I'm not the record office. Go look for them and ask.

There...I feel a bit better now.

"The 11 commandments"

2009-07-20T04:07:00.000-07:00

Wonder how to get promoted? Wonder how to make it to the top? How to survive and thrive?

This is the government service guide which you cannot buy off the bookshelves, nor learn from your classroom. This is accumulated from years of observation, experience and a little bit of common sense. And mainly accumulated from people who had excelled in it and lived to tell the tale.

Note : This is not for entrepreneurs, nor people seeking excellence. But for people who simply want to get the best out of government service. Ok, let's go.

1) Don't be a smart alec. Stay low. After all bosses don't like smart alecs. Makes them look stupid. If your boss says jump, ask how high?

2) Never criticize. Keep acquainted with phrases like "Wow, this is great!" or "I'm sure this will take the world by storm!" or "You're so smart!". If you use it often enough, you become a valuable "team player".

3) Don't be too efficient. The more work you do, the more you'll get.

4) Never aim to get top marks for anything. After all if you're at 100% this year, the only way you can go from there is down! Better start off with 10% and double it every year. Then you'll have 100 % improvement for the next 4-5 years. Very useful for that SKT thingy. You might even get the best improved employee award!

5) Always do your paperwork. It's all in the numbers. That's all anybody sees.

6) Read your general orders like a bible. Do you know you're entitled for tea time?

7) Do your work slowly and keep asking stupid questions. It makes you look conscientious and hardworking. And of course it makes your boss appears supremely clever.

8) Always grab any opportunity to leave office. Be it for courses or "volunteer work" or even some stupid programmes. None of this is real work. But it appears legitimate and will even earn you extra brownie points.

9) Always buy some cheapo stuffs for the guards, clerks and generally anybody who can make your life more pleasant. Buy a RM1 nasi lemak for the security guard and rest assured you will have unopposed entry at all times. Sometimes even free entry to carparks. For eternity.

10) Get pregnant yearly and breastfeed continuously. You are assured of maximal maternity and medical leave. None can be questioned.

11) And lastly don't forget, buy that punch card machine off some junkyard. It's priceless. Coupled with a handphone, you could be working and holidaying in Hawaii.

More shall be revealed in time to come...

Dance of joy

2009-07-18T07:56:00.000-07:00

I never knew this festival existed in Malaysia for the past 33 years. Bon Odori. A friend asked me to come along and all of us went armed with our digital SLRs like hunters out for a kill :) It was an interesting sight with many stalls set up selling Japanese food followed by performance of drums and dances. Plenty of people attended until there was no place to sit and hardly any room to take photos.

And the number of cameras (and photographers with more than 1 camera) exceeded the number of participants by many many fold. It was astounding. I guess many came to shoot the kimono clad girls. The were many Japanese wannabes hanging around too. It was a pretty interesting sight.

Anyway, managed to purchase a Japanese alcohol free beer! It tastes sweet and nice, unlike the usual beer. Got some Japanese green tea in bottles too. I bought the tea because they came in very unique bottles. What a sucker I am ;)

Anyway some of the photos here. I'm sure there will be hundreds of blog postings about the same thing.

Cost of healthcare

2009-07-17T08:08:00.000-07:00

Had an interesting scenario today at work. Maybe this exemplifies how healthcare costs have spiraled up these days...

A patient had suspected acute appendicitis. I think the diagnosis is a clinical one. A more experienced colleague thinks the patient should get an ultrasound. An even more experienced colleague thinks a CT scan should be done.

I was trained in a "jungle". The first colleague worked in various towns/cities before. The most experienced colleague works in a big city hospital where "cost is no objection" (and where perhaps legal repercussion is the highest).

The manner and place we were trained and the available facilities determined our approach. The fact is if there are more "sophisticated" and expensive tools available to us, we will use it. Why not if it might save us from a lawsuit? It will give the impression that "the best tools at our disposal has been offered. If something goes wrong..well the best has been offered". Will this translate to better patient care? I doubt it...

I think better patient care comes from better human touch rather than the use of more expensive tools per se. And that is kinda more difficult to achieve.

A dilemma

2009-07-12T06:47:00.000-07:00

I always wonder, is it ethical to let patients wait for their appointment even if though it is urgent?

I mean if there are 20 urgent new clinic cases for a doctor per day and the doctor can only see 5 new cases a day, then there will be patients who will only be seen months later assuming there are 5 working days per week and everyday is a clinic day with 20 new cases per day. Do the maths- it's a geometrical increase everyday with no end in sight.

Would you prefer a proper consultation with an appointment 3 months down the line or an immediate consultation of "Hi ma'am, what's the problem, take this med and goodbye".

It is not unheard of on appointments 8 months down the line. However administrators will NEVER side with the doctor if a complaint is made over the long appointment time. And frequently these administrators will "order" the patient to be seen stat. After all, complaints from patients will be more detrimental to promotion prospects of the administrators rather than complaints from their own doctors. Because the adminitrator's SKT do not take into account of the doctors' opinion of the administrator's performance.

So what's the solution? Force doctors to work faster? Waiting time can be measured. Quality of consultation cannot, and in any case is the doctor's fault. On paper it will look good, no waiting time. Administrators doing fantastic job. Go figure...

At the end of the day, I pacify myself to think this not about ethics but demand and supply. You want to buy 20 apples but I only have 5 to sell. What to do?

'Plug n Play"

2009-07-12T05:55:00.000-07:00

Just when we thought we are going forward, we are actually going backwards.

If the BM subtitles in our movies are not bad enough, now we are aiming to expand science and technical terminologies. Here.

Let me give you an example which we were laughing our heads off in office. "Plug and Play devices" = "Alat cucuk dan main". "Install hardware" = "Masuk perkakasan keras". Accurate translation but hilarious at best. Unless we want to be a laughing stock of the world...

I remember during med school days, there we bilingual questions during anatomy exams although ALL the books were in English. "Internal jugular vein" = "Vena jugular dalaman". " Common peroneal nerve" = "Saraf peroneal sesama". Nevertheless to say I never read the BM translation any further. No idea what the heck it meant.

To add salt to injury, we have an MP who said "People in the Philippines are proficient in English, but many have landed up only as maids". Here. Wow, this is an intellectual at it's best. I'm concerned the way we are going, we won't be able to even export maids!!Maybe we should just ask the MP to translate all our science and technical books.

He further said "The Philippines, took pride in their peoples’ ability to speak English but had only succeeded in exporting many maids, whereas Japan has produced many international award-winning scientists who could not even utter a word of English". So he thinks that Malaysia will produce many award winning scientists like Japan if we all revert to Bahasa Malaysia. Wow he needs psychiatric treatment. This is called "delusion". If he doesn't understand the English term, the best translation I can think of is "menipu diri sendiri". Or maybe use a favourite translation method - get rid of the last two letters, delusion=delusi, illusion = ilusi. Is it still Bahasa Malaysia ? Or we just plagiarized the English version so that we can proudly say "Made in Malaysia". Deluded.

I've got absolutely no reservations assisting any persons who cannot understand English terms but to regress to a Taliban like state is unthinkable.

So do I have a dirty mind? Maybe I do....hahahahahaahaha...

Missing something..

2009-06-28T10:04:00.001-07:00

It's been a couple of months since I've left the fabulous city which I've lived for many years. How I miss the wonderful sunset at the beaches, the best I think I've ever seen in Malaysia. Whenever I'm bored or there is a need to get acquainted with the great outdoors, there is always the wonderful beach and sunset. All I need to do is to grab my camera and then perhaps a cup of steamed corn from the many sellers nearby and sit to watch the sunset. A mere 10 minutes away from my apartment. Parking is never a problem. Right next to the beach. And it's free. Watching children playing at the beach or looking at tourists having a walk by the beach is so relaxing. Chatting up the kids is so easy. The people are pretty friendly.

In the current city I'm staying, don't even bother looking for sunset by the beach. Even looking up friends is not easy. At least 45 minutes away plus RM4 toll charges. And frequently everyone has their own things to attend to. Most of the time is probably work related. Any extra time they will probably need to allocate for their chores/family. There is really no time for real friendship.

The daily grind of waking up 6.30am, doing rounds, rushing to clinics, writing reports, doing some presentations, settling some ward problems and then going back after sundown sucks big time. Any extra time even weekends, will be obligated to attend some stupid drug talk which tells you that drug A works better than drug B by 5%, CMEs and so forth (becoz boss asked or for the sake of the stupid PTK thing). If I had to choose my profession again, I would stay far far away from the medical profession. I just don't see the point.

I guess most of us earn a living as to be financially free so that we can spend quality time with our friends and family and do the things we enjoy, and not to worry about our next mortgage payment. But in order to achieve financial freedom, we are sacrificing all those things dear to us. And at the end, we may never achieve real financial freedom anyway. We will never be satisfied with how much $$ we have. We stand to lose both ways.

If we can already spend quality time with family and friends and do all the things we enjoy why on earth we need to go into that rat race? It's ironic...Maybe it's for that Porsche car.

So there goes again the daily grind tomorrow...sigh.

Retards

2009-06-19T08:43:00.000-07:00

After a couple of weeks at my new office, I decided to call the IT department to set up an intranet email account for me as it was the practice that all internal communications are relayed through internal email, just like any MNC out there. After a few weeks of bliss, somehow I wasn't able to access to my email anymore in the same manner I used before. I wasn't bothered then. Anyway who reads boring internal emails.

A couple of weeks went by however, I felt that I had missed out many important internal emails which could be of interest to me. So I called the IT department again to assist me in correcting any settings in my email set up. Well, it worked after that. So far so good I thought.

In the evening when I tried accessing it again, dang...stuck, some error came up. Called the IT department again and after some remote assistance, voila it worked again. Unfortunately I wasn't able to see what was being done as I am calling the IT department far from my computer, as the only phone was a distance away. And I was put on hold while they worked at my computer. Anyway I was glad it was solved, or so I thought. However I was getting a little pissed off as a simple task like this can be so daunting to the IT experts here.

The next morning, I tried accessing my email again. And whaddaya know, some error came up again. So I politely called the IT again, for the 4th time. And again I was put on hold while they did something to the computer. And so it worked again. I was kinda pissed off this time. I sent a polite albeit a little sacarstic email to the IT department asking them to look into the problem so that it will not recur again.

Then this guy, the boss of the IT department replied my email in an extremely crude and rude manner. I didn't really expect such a rude reply. To cut the story short, he blamed me for not learning about the IT system and asked me not to blame the IT system as it was my fault I wasn't able to access my email. What the f**k ##$??!!! All I asked was for him to look into my email account set up if there was any problem. Something the IT staff themselves have set up for me 3 times previously and failed to work later. Something is seriously wrong with this fella. He was extremely defensive, not to mention rude.

Thinking he was a smart alec, he asked me how was I able to email him if my email account wasn't working? Obviously he didn't read my email to him properly, in which I told him that the email account was just set up the 4th time (and working) but I wanted him to look into the matter so that it will not happen the 5th time. Some bl**dy moron. I wrote to him in plain simple Bahasa Malaysia which any Standard 1 kid will understand.

I wrote him a nice sacarstic email which I struggled to be as polite as possible. Using his logic, I mention why doesn't he just blame the patients for not being able to treat themselves when they are sick?

I just don't f**king get it with these people. IT support my foot. They can support my ass. That also I'm not too sure they can. He can f**ck off for all I care. And why should I be learning IT from an IT department which failed to solved my problem in the first place ? I'm just waiting for the day when he gets ill and then I'll tell him why didn't he learn how to treat himself...

I'm amazed that such people are given the extremely important task of overlooking the IT system in a fully computerized hospital. Maybe he spends his time snooping at patient's electronic records for any sodomy cases or downloading porn. Who knows? Only in Boleh-land...

Free healthcare

2009-06-13T03:18:00.000-07:00

This & this is why i think virtually free public health care is not sustainable. If the patient/their family has to pay, they would seriously consider the costs vs benefits of "doing everything possible". Defensive medicine (or maybe monetary medicine) is driving medical practise towards this direction. And some relatives I've met, have "pressured" doctors to do "doing everything possible", even if it is futile, just because it's free.

Hotel California

2009-06-11T07:31:00.000-07:00

You have a chronic ailment. Nobody wants the burden of taking care of you at home. Ah, but there is a hotel...

You can have different mates every couple of days, sometimes more often. You are served food and drinks 5 times a day. Your toilet needs are taken care of by simply pressing a bell. Medication is served to you daily. If you cannot swallow, your meds will be crushed and fed to you. You'll get free clothings and free laundry service. If you can't walk, you'll get crutches or a wheelchair with a porter thrown in. You can even bring family members to stay with you over the weekend. Everyday, medical staff will come to check on you. Tight security is provided to you, no worries of being robbed. You can even get counseling services should you have "issues" to let out. Dang...even your room is cleaned everyday.

You can complain if the food is not to your liking. You can complain if nobody comes to turn you or exercises your limbs a few times daily. You can complain if if have to buy your own pampers or additional food. You can complain if nobody picks up after you. You can complain if nobody bathes you or make sure you are clean. You can complain if it is too noisy or too cold or whatever. You can complain if nobody attends to you immediately when you press the bell. You can even complain if there is no entertainment or if there is no motivation provided.

Heck, even your family can complain if you die.

Best of all, it's practically free !!! And you can stay as long as you wish. If not, you can also complain !

Welcome to Hospital California. Who the heck wants to check out !!!

Baffling

2009-06-07T09:00:00.000-07:00

I just don't get it. How petty some things can get.

I can understand if a building collapses or if a person got robbed. Then it warrants some serious discussion at the top level.

Small issues should be sorted out by the persons involved. Or even ignored. It doesn't warrant a top level management discussion. I mean, it's like asking the Prime Minister what kind of taxi the company executives should hire to go to work? Or whether they should stand to pee or sit to pee because the office toilet is made a little high. Or whether the door should be painted blue or white?

I feel a little astounded that small issues can turn into big issues. Every small thing said is given undue attention. It is baffling to me. The environment can be very tense and unproductive if everything said by everyone is given undue attention. Just let some things pass and forget it! Not all things will influence the outcome in any way.

Ok, some might argue that small problems must be solved first to avoid big problems. But not all small things will turn into big things if we don't let them. They will turn into big things only if we let them. Sometimes if we ignore them, in all likelihood some small problems will disappear. Not all small things need to be discussed by the board of directors! If not, there will be no end. And the remedy to some things is just to ignore it. Just like that niggling backache.

Sigh, I just feel pettiness is being encouraged by the undue attention we give it. And it's awful if it is the norm of your workplace...

House shopping

2009-06-01T07:49:00.000-07:00

Last week was a very hectic week for me. Decided to hunt for my own place to call home. Set out with a friend on a mountain bike. Up and down we went, along the highways, along the alleys, through tunnels and across roads. Checked out an area near to the most inflated properties in Klang valley. Supposed to be an area where inflation hasn't creeped in too bad yet..or so I thought. Initially I thought it might be a good buy for investment as well.

After checking out the general area, looking at condos from outside, I spent the next 2 days contacting real estate agents and the various managements to look at the units inside the various condos. Yup, they were completely new and bare. This is not the problem. The problem is with the really poor finishings. For the price range I would expect some decent furnishings. They do not even supply proper PVC pipes for the kitchen sink. The paper thin piping practically disintegrated on movement. And 3 condos we saw uses the same type of piping, obviously from the same supplier.

Then there was this management agent who tried to push something we didn't want. He probably hiked up the price 40% for an obviously "nobody wants" unit facing the busiest/noisiest highway in Klang valley and said he'll give us 10% discount and throw in a free carpark. And he was rather rude ticking me off for asking if water and electricity has been connected. He replied "How can CF be issued if no water or electricity?" Damn bloody cocky. If his unit was the last unit on planet earth I would not buy from him. Act as if we owe him a living. I'll be damn.

The launch price of a particular unit was <200K for a 1100Sf unit and he is quoting RM350K AFTER discount for a developer's untenanted unit. With that attitude and poor finishings described above, forget it man! A new condo unit near the area with also 1100sf is going for almost 400K. With nothing at all, completely bare except the disintegrating kitchen sink.

Another condo was going for a more reasonable price. Keys handed over 1 year ago with a launch price of RM140K for a 800sf unit but a similar developer's unit now is going for 200K. But with the disintegrating kitchen piping as well. A 1000sf unit would be 280K.

Oh yes and there is a maintenance fee of 25 cents per square feet monthly.

Sigh, I think I'll save my money for somewhere outside Klang valley. Talk about economy crumbling...developers and agents still try to keep up a facade of "highly sought after" and artificially pushing prices up . Perhaps they rather leave it empty, as most units I saw were empty, than to push the prices down. Hope they don't run out of cash flow haha.

Big boy's toys

2009-05-24T02:42:00.003-07:00

Aah...excited to get this thing off the road or perhaps on the road...the DUKE highway. Still debating whether to get a helmet and some elbow/knee guards. Midlife crisis...reliving my school days..

Cloudy

2009-05-24T01:39:00.000-07:00

Unlike the magnificent clouds at dusk at my previous apartment, nowadays I see gloomy clouds descend upon the medical profession. Why?

Lately I've seen numerous advertisement in the newspapers by many new private universities/colleges offering medical courses in addition to the 16 institutions ( maybe more, don't really know nor care) offering it now.

Newcastle University Medicine Malaysia (2+3), AMIST (Asian Medical Institute of Science and Technology), MSU (Management & Science university) and UCI (Unity College International) are among the newcomers jumping into the bandwagon. Why not? It is lucrative wat...In future, any college with a couple of shoplots can also start offering...

I often wonder what happens to the thousands of students studying medicine in or outside the country? Are they returning, have they made a U turn, or left as soon as possible? Instead of addressing core issues, the government's response is, lets produce more! Let's flood the market with as many doctors as possible..dish out degrees, dish out postgrad degrees even, to satisfy the students and public alike. Who cares about their quality? That's their problem...It's even better if our degrees are not recognized elsewhere..then our doctors have nowhere else to go! Everyone can also bash doctors if they are not up to mark...

I'm just looking out for the day we have MBBS (TCM Malaysia)

Next...

2009-05-18T05:13:00.000-07:00

Moving on to my 2nd book...beautifully written, bringing my mind far away from my daily routine. Making me wonder...

Idle minds

2009-05-11T07:28:00.000-07:00

Got this book for a good laugh...something which I missed terribly.

Set in KL, with familiar places like Bangsar and Jalan Alor, with characters like pimp Fellatio Lim Boon Seng and Education Minister Datuk Yusof Shamuddin and Minister of Defense Datuk Razali Ahmad, this book makes a hilarious laugh...no prize for guessing who these fictional Ministers' names rhyme with in our present goverment...

A comical and light story. Good for a Sunday read. Tthe author has even a blog at idlemindskl.blogspot.com. However when I checked out the site, it just had a picture. Maybe the author is busy writing another book with regards to the comical political situation in Perak now....

A splashing good time

2009-05-02T08:22:00.000-07:00

Had a fun time at the waterfalls. A little dangerous but satisfying and refreshing. The water was clean and very cold. I could even see small fishes swimming around. There were several waterfalls along the trail. Trekked up the hills till the very last waterfall. Fantastic falls.

"Napping" doctors

2009-04-27T05:00:00.000-07:00

I get really hot whenever reading posts like this. Typical behaviour of VIPs whenever they go to hospitals.

Why is this VIP allowed to go into the treatment room when he is not even a patient nor a close relative? How come he can simply be allowed to walk into a treatment room??!! What if a female patient was being examined in the treatment room?

Quote “I waited for a while for the girl to be treated and, realising that none of the patients were being called in by the doctors, I opened the door to the treatment room"

Why doesn't he go to any government offices and nap the many officers who goes for "makan pagi", "minum pagi", "makan tengahari", "minum petang", "tak tau pergi mana.." etc

Is it wrong for doctors to get a break for say 15 minutes to read a newspaper? Are doctors robots? Are any patients collapsing outside? Does any government officer work 8 hours NON STOP? Does he btw??!!

Often housemans as junior doctors will refer to protocols or guidelines whenever faced with uncertainties...what does he mean by "doing his own stuff"? The HO could be referring to a protocol...has he checked what the HO was actually doing?

Further in the report "In Petaling Jaya, LEE YUK PENG reports that initial findings showed that the two doctors were housemen who had just completed their shift".

Does he have the right to reprimand the doctors without asking for a proper investigation first? I hope he will have to eat his own words...Can the HOs concerned sue him for defamation if it is true they were NOT ON DUTY as reported? Hey they could be waiting for someone to pick them up for all we know.

And lastly why doesn't he reprimand the public who frequently misuse the A&E for minor cough and cold?

I just dislike immensely these judgemental VIPs who probably never sought treatment in a government hospital before. Or even if they do, demand to be seen by consultants and getting preferential treatment.

This fella probably is more interested in getting some brownie points and bask in the sun showing off his deluded "authority" towards doctors... If it wasn't his driver knocking down the girl, I'll bet he wouldn't care two hoots whatever happens in the hospital...

Interesting pen

2009-04-25T19:00:00.002-07:00

Got this from another conference...

2 in 1, on the same end. Just twist out the highlighter over the pen. Something creative...

Exams and exams

2009-04-24T08:49:00.001-07:00

I was just wondering if taking exams are inevitable nowadays. What is the original purpose of exams? I suppose initially it is used to gauge a person's grasp of learning so that extra assistance could be given to the ones who fare poorly. Maybe somewhere along the line, exams are then used to distinguish between "good" and "bad" students. So that the "good" ones can be given further opportunities to excel.

Then where is the line where exams have outlived their purpose? Or is there a line? Exams are now more a less a tool to "prove one's ability". For a purpose...scholarships? jobs? promotions?

I think up to a certain stage exams are useful for the above because there is no better way of "fairly" distributing out something limited. But after a certain stage it's really pointless. Come to think of it, exams are really useless to distinguish the potential of a person. After all exams are just as good as the examiners only. If you don't need or don't want to prove yourself to others why take an exam? The only reason I can think of is "that certificate" will bring "recognition"by others and the accompanying privileges. It's the certificate which says you're qualified...or is it? Exams techniques can be learnt and mastered. One can study for exams and then forget everything. So does exam results really show the "quality" of the person? I think not.

So are we taking exams merely so that we are "recognized" by others? If so it's really sad. We're not studying for the sake of passion but to be recognized by others. That's the reality of life. The reality of life is, "paper qualifications" are seen by public as proof of knowledge whether it is truely so or not. And that's the only way to attain certain things in life. It doesn't matter if you have been studying for decades out of passion but if you don't have a paper which is signed by another person...well...it's a tough ride.

Looking at history, a person once said the earth was round but didn't have any papers nor recognition by his peers who said it was flat and all was left of him was a memory...dang...can't even remember his name now although he was right in the end!

The sad thing called exams. So my conclusion is taking exams are never for knowledge but rather to get something you want from others.

TLC

2009-04-20T04:00:00.000-07:00

No, this is not Tender, Loving Care. But Truly Loving Company...hahaha. Seriously. Check out the company's name and address below. And all dividends go to charity apparently. And no, this is not advertisement. Bought this soap out of curiosity (and it's cheap...)

Anyone familiar with this brand of soap? Hope it feels as nice as it smells...

Monkeys galore

2009-04-18T10:58:00.000-07:00

Had a good outing today. Took a long drive to a coastal town and found monkeys to shoot. It is amazing thing that the baby monkey is completely golden in color compared to it's older siblings. One can be forgiven to think that they are 2 different species. Despite the difference color, the mother is fiercely protective of it's golden young.

Nature is always amazing!

The weather was also excellent and I managed to capture this dusk shot at a river not too far away.

Memories

2009-04-15T09:00:00.001-07:00

Looking back at not too long ago, while in a district, modern amenities were scarce. However people were happier, more contented, cohesive and cooperative for common survival. They were more creative and less dependent on assistance. They learn to improvise and make do with whatever that was available.

This was my sleeping place at work during the night. Similar "niche" were used by other members of the team at night. Nobody really complained. We made do with whatever that was available. In fact it was an "adventure" to see who can be more creative.

And this was my regular eating joint. Looks a bit sad but it doesn't appear to be so then. It kept me alive and kicking :)

Fast forward to the future, despite the many super modern amenities available in bigger, more sophisticated cities, people appear to be unhappier. Expectations are higher, common survival is not an issue, one's own survival is more important. Fault finding and finger pointing is common. Creativity is not necessary, one just needs to complain and expect improvements to happen.

So does happiness correspond to the degree of material wealth we have or the modern amenities available to us? My observation does not support his hypothesis.

Nostalgic times...

Needing something different

2009-04-12T08:10:00.000-07:00

People always ask " Is it difficult to do medicine ?" I don't find doing medicine that particularly difficult. In fact in can get monotonous. As more and more "guidelines" come into play, doctors actually has very little room to "use his discretion". I mean how difficult it is to look for certain features and "just follow protocol"?

In fact sometimes I find medicine kinda boring now. There is no more thrill, no need to use brain matter too often. The protocol will take care of it. Procedures - the more you do it, the better you are at it. That's it! Its purely a technical skill much like a carpenter's. What's more difficult in medicine is to handle the interpersonal/interdepartmental interactions.

What takes a doctor's time nowadays is to just follow the latest development and trials in other places and perhaps taking part in some trials. Then again trials is about following protocols. How boring! You just need to be hardworking and keep up to date... I mean there is really not much room for creativity in medicine. In fact if you're too creative, you might get into trouble. Just follow "what most people will do" will save your skin in this age of legal repercussion ie just follow the "standard of care". This differs from other professions where you WANT to be different...medicine is where you do not want to be different.

In this way, medicine is quite constricting. Definitely not for people who are bored easily. I mean all doctors talk most of the time is "My patient has..this and that.." When you listen to this day in and day out for at least 5 days a week... Am I burning out or perhaps in the wrong field?

I need to do something different. Like having this banana beer...

Medical camps

2009-04-06T06:51:00.000-07:00

Something to get off my chest.

Have you ever hear of "medical camps"? I loathe to hear this term nowadays. This is an overused, overhyped nonsense by people with other agendas. Which really degrades the medical profession to the core making it like a cheap pasar malam.

Many NGOs and religious organization nowadays often have this "medical camps" programme and "catches" doctors to go and "volunteer" for the camps.

First of all : Do they think doctors are free labour ka?

Secondly : The "medical camps" I attended so far, the medical part of it was NEVER the real agenda. The real agenda is to promote that organization, so that somebody can get a name, so that they have an "aktiviti tahunan" to put into their yearbook, take photos and chit-chat. The members go to these camps with fashionable clothes, bringing cameras, kids, chips, sodas, mats whatever you name it- like a picnic!

These "medical camps" are a disgrace as so far as real medical care is concern. I as a physician was utterly embarrassed to be associated with such events. Not only it is a wish wash sort of thing, there was never any real concern for medical care. Panadols were distributed like candies with people coming asking for painkillers, vitamins, antibiotics etc like a UNHCR free food handout programme. No privacy nor adequate time was allocated for real medical consultation, advice and examination. There weren't even adequate equipment for examination. Even if serious medical conditions were uncovered there were no real plan to get these people to follow up in a hospital on a regular basis. Most of the time, it's just writing a referral or a one off transport to the nearest health centre. I mean if these people can go to a hospital by themselves on a regular basis, we wouldn't be going in to see them!

One may argue the aim is to screen for diseases not to treat them on the spot. So what?...

For example if one found a person to be severely hypertensive, that person needs to get medication and follow up regularly. If a person has cataracts, that person needs to go for an eye examination and treatment AND follow up review (it's not like changing car tyres for crying out loud!). IT IS NO POINT SCREENING FOR SOMETHING WHEN NOTHING REAL CAN BE DONE LATER. It is a wasting everybody's time except the organizers. I might as well go fishing in the river instead...

Another argument is that, the aim is not to treat but to relieve symptoms, relieve pain etc. Yes, if the person has chronic pain are you going to give him a sack of panadol to last him a year till you return next year? Assuming panadol does not have side effects...

Ah and the famous...bla bla bla..to comfort always. So you are gonna spend 30 seconds per patient saying emphatically "I understand your pain you are going through..." and feeling good about it?

It would be more acceptable to me if these "medical camps" were labelled as " basic health education programme" or something like that. Give some slippers, toothbrush, proper stove to boil water etc...will be much more beneficial. Even giving deworming pills and lice treatment is not really helpful, they will get reinfected in no time!!!

Btw how come there are no "free legal camps?" Or free "architectural camps?" or free" engineering camps"? Or free "motocycle repair camps?" Or free "electrical wiring camps?" Or free "teaching English camps"? Why? coz doctors "must be compassionate, so must give free" ka?

It is so embarassing for me as a physician to go for these so called "medical camps" looking at all the bullshit "medical consultation" to the poorly educated folks.

Ok. That's all for today folks.

Another con job

2009-04-03T07:15:00.001-07:00

I found this brochure sticking out from my car in the hospital carpark. Among the many claims of cure from cancer to stroke, surely the claim that this medicine from China cures "nyanyuk" beats 'em all. (Nyanyuk = forgetfulness usually associated with dementia/ageing). This must be the fountain of youth we've all been waiting for.

In the brochure, coronary artery stenting was illustrated together with a ventilated patient. It did not expressly say that the medicine can unblock the arteries nor cure respiratory failure but I'm sure one can guess the implied message. And this was circulated in a hospital carpark!

Some pictures from Praha and Wein

2009-04-03T01:51:00.001-07:00

A stained glass catching the sun rays inside St Vitus Cathedral in Prague CastleOutside the St Vitus Cathedral in Prague castle
Prague castle from afar
Attending a classical concert in Wein
A statue of Johann Strauss in a park
A Strauss souvenir I bought - looked similar huh
And the schnitzel
Stephensdom Cathedral and Schonbrun Palace in Wein

A different view

2009-04-02T10:08:00.000-07:00

I just got back from visiting two beautiful cities recently, Wien and Praha - Vienna and Prague. Still have not got rid of the jet leg which I'm very susceptible. I felt very fortunate to have been able see and experience another part of the world which I had not known before.

We took a 10 hours+ flight to Vienna, stayed there for 3 days (including for the conference hehe...), then took a 4 hour train ride to Prague and stayed in arguably the best backpacker's hostel I've been so far. The rooms were clean, the sheets were comfortable and the toilet/shower spotless. We walked and walked to see the various sights despite cheap efficient local metro trains/trams. One thing that is remarkable in Vienna is that nobody checks or asks whether you have ticket or not. I'll bet that even if we hadn't bought any tickets we will not be found out. However I think it is quite shameful to avoid paying (esp when one can afford it) when the system puts so much trust to it's citizens. However things are a little different in Prague. We did meet 2 metro inspectors who asked for our tickets (presumably to get some "duit kopi" fines from bewildered confused tourists who might not be familiar with the ticketing system- hey nothing was written in English!). Despite on a budget we also tried some local delicacies, the schitzels and goulash. And beers. We had a hard time looking for plain bottled water - most bottled water in Prague are of the "carbonated" type and it tastes horrible. Feels like your teeth will dissolve while drinking the "gassy" water.

And often whenever I come back from a visit to another country, I feel more relaxed, seeing things in a more "philosophical" perspective. Feeling a little grateful for the life in our own country despite the many "roadblocks" along the way. Although some might beg to differ I think we should "fight" for a better country for ourselves rather than giving up hope and leave for another country. Yes, many people have left this country feeling that there is no future for them (and I don't blame them), but then again this is going to be a self perpetuating philosophy. How can there be a better future when there is no one left to "fight" for it?

Anyway, that's for another day. For now, I'm gonna sleep. The above 2 pictures are from Prague. More pictures to follow later :)

Higher, faster, further...

2009-03-22T09:08:00.000-07:00

Higher, faster, further...why competition in sports is so addictive?

I find sports competition extremely motivating, engaging and delightful. The adrenaline rush, the urge to outwit, outrun and outlast your opponent. That last touch, that last breath, that last step can decide your fate. To win or lose.

The motivation is that, the more you train, the more you practise, the harder you try, the outcome will be definitely better. And victory will be rewarding, your triumph over your opponent.

Unfortunately the same cannot be said about being a doctor. Your effort does not commensurate with the returns. The more effort you put in does not equate better returns. Promotions for example does not take into consideration how many patients you see, how satisfied your patient is, nor the outcome of your treatment. Promotions may rather depend on who you are and who you know. Having said that, you cannot measure patient satisfaction nor treatment outcome per se as an overall assessent of a doctor's performance. For example if you give MCs to all your patients, invariable all of them would be happy. Conversely if you deny them what they ask for invariable they wouldn't be happy. Outcome of treatment is also difficult. If you see ICU patients, invariably a large proportion will die, however if you just see cough and cold, all of them will live!

Perhaps outcome of your treatment depends a bit more on how much you know, how much experience you've got but at the end of the day, you do not decide the fate of the patient. A higher calling decides that. We have too little knowledge about life. You may be the "best" doctor in the world, you may spend every minute of your life beside your patients, inevitably you will still lose patients. Conversely even you are a "lousy" one, inevitably you'll save some patients and might be promoted as well. They say self satisfaction is ultimate goal, not "worldly" rewards like monetary gains and peer recognition. But then self satisfaction is based on what? Knowing that you've done your best? It's easier to say than to swallow. Doing your best is not synonymous with gratitude nor recognition. Do I sound jaded or what?

So if you ask me I'd prefer to put more effort into running faster, jumping higher and going further as it is more satisfying. If I had practised more often, I might have been one inch faster and one inch closer to vistory. And then the rewards that come with being triumphant. Self satisfaction too for being the best. So see you at the courts! I shall be there more often :)

The idle mind

2009-03-18T07:41:00.000-07:00

Recently I had a rather interesting topic which was talked about during work. Epigenetics.

It happened to be related to a drug we were using. The talk drifted to Lamarck's theory of acquired characteristics vs Darwinian's theory of natural selection ie survival of the fittest. On which is more dominant in evolution. More on epigenetics here

Basically epigenetics is related to an acquired characteristic which can be passed on to the next generation. Compared this to genetics which is an inherited trait which is passed on the next generation too. My colleague drifted to this example of evolution of giraffes which can also be found here

So which do you think is more dominant for evolution? If you believe in evolution lah.

From Hanoi

2009-03-16T08:19:00.000-07:00

Having to live with a pathetic internet connection is not good. But life is such, you get something, you lose something.

On the positive side of things, since I moved over here, I had the opportunity to visit Hanoi. It was a nice change of environment from work, work and work. Life is much simpler in Hanoi. But the traffic and motorcycles beat KL's anytime. Pedestrian crossing? Well, just close your eyes and walk. The motorist will find a way to avoid you...if you dare. We managed to watch the famous "water puppet show" and had some Vietnamese noodles.

And for my safety I decided to purchase a nice silk (I hope) handbag, a beaded handbag and a small jewellery box for my significant other as a consolation for not being able to tag along. Or else I might hear no end of it...As for myself hehe, I couldn't help buying a stone figurine which was intricately carved. I love art collectibles especially carvings and figurines. This was tagged for USD50 but I managed to get it for USD30 before the whole gang of our group came and spoilt my bargaining leverage. My way of bargaining? Look a a bit disinterested and down the price by 40-50%. However I still think I paid way too much. But hey, it's art...the value is determined by the purchaser and how much you are willing to fork out for it.

Moving on to another place, another life

2009-03-12T11:18:00.000-07:00

It has since been more than a month since I left my previous state which I have called home for more than 7 years. New place, new city and looking forward for a different adventure. So far it hasn't been too great. Waking up at 6am, reaching home at 7pm. Social life = zero. My URL aptly describes my social life : staying way past midnite, and it's not in the pubs or any happening places.

Just got a new internet connection today. I cannot believe it! In the biggest city in M'sia, there isn't a broadband available in my place. I tried Wimax, streamyx, celcom, maxis but no avail. Either the service is not available or broadband internet not available. One of my last resort is Izzi, which is what I'm using now. I can hardly describe it as broadband. My initial impression, it is worst than dialup. But what to do? Maybe past midnight it'll past dialup standards. Yeah, Malaysia boleh...in this day and age. Can't even get a decent internet connection which is a necessity nowadays.

Well, that's all for now. If I stay up any longer it'll be morning. Hopefully the connection improves over the next few days...and I can upload some photos.

Here is my small modem from Izzi which has a rather stable connection but damn slow...not worth the price of subscription if you ask me. But I've got no choice :(