Anger Management

I hate being angry.
It is really an unpleasant feeling.
Thankfully, i dont get angry very often...somehow over the years my knee-jerk angry spews have disappeared. Ask the friends that know me from way back in primary & secondary school and they'll tell you i'm known for my sharp tongue, impatience and temper (that's the bad stuff...). I guess we all grow up, learn a bit of tolerance, about giving in, and to not sweat the small stuff.

But still, shit happens.

Nowdays my anger is akin to a thunderclap : sudden, explosive, and scary (to me!)
The reason i dont like being angry is because of the thoughts that flood my mind following the offending situation/person. Its horrible. Things like wanting to push an old lady down a flight of stairs, or to slit someone's throat when they fall asleep, or wishing they fail exams, or wanting them to die alone & in disgrace. I cant believe such thoughts are actually coming from me. If anything, i am thankful i'm not one of the X-men or Heroes or own that book from Death Note. Otherwise in that impulsive fury someone will be hurt. Also, within the thunderclap, i can keep my mouth shut....which is probably a good thing, for that moment.

My reactions have evolved from 'confrontational' to become 'avoidant' and then passive-aggressive...which is NOT good. I fear becoming a ticking time-bomb. Of course i try to resolve the issue, after giving myself a few days to bring the temper down a notch and collect my thoughts. Alas, what am i to do if the other party refuses to respond or acknowledge? Surely that cant be a bad reflection on me, afterall it takes 2 to tango.

I guess it goes without saying that i'm having an unresolved conflict of sorts. Its draining. Nobody likes under-handed tactics & false accusations no matter what your age. Too bad for me needing a clear conscience. Its draining on me because i hate to leave things hanging, and i'm not one who can brush things off and say 'whatever'. Guilt? Only because u r my 'superior'. i didnt wrong you; instead you chose to make my pitfalls your problem.

The thunderclap is gone but the skies are still dark, waiting for a ray of sunshine.

Desperate Houswife?

If i find something i like doing, its just really really hard to go back or do something else.
I've had lots of fun doing O&G, and being in the A&E and clinics while i was in Banting. Now, i can't even make myself look at my campus, my dear PPUM, espiecially in the name of PAEDIATRICS. Urgh. I hate it.

Not surprisingly, my attention is diverted to other aspects of my life : friends, family, as well as my neglected bunny & daunting housework. I'm at present hopelessly disorganized; with >3 batches of laundry that needs to be done, bed linens in need of changing, floors & carpets begging to be cleaned & vacuumed...and THAT's just my room in grandma's house. In my hostel, i've got bags to unpack since moving out from Banting...the room, a months worth of collected dust...books & papers everywhere. Groceries? Zilch. I can't even concentrate long enough to decide where to begin.

Last weekend was my friend oNe's engagement. I got to her house just in time, despite her giving me wrong directions and making me do a 40km U-turn all the wal in Kuala Kangsar. I'dve killed her if it wasn't her engagement. Anyway the ceremony was cozy, the food was really good (really...really...good) and she looked like a princess, a blushing bride-to-be. I didn't really have a role, other than moral support & additional photographs. It really sucks that i wont be able to make it to her wedding...all in the name of Final MBBS.

Of course, upon my return to PJ my room was in shambles...part due to my piles of laundry, part due to the fact mum & sis stayed there for the weekend...you know how it is. So i've been staying home since then, my mind a blur, slowly cleaning up. At night, i watch tv with my grandma, and that's where the fun begins.

You see, i've been wanting to experiment in the kitchen for a long time. My culinary skills are very limited (NOT non-existent). Baking & desserts are easy, that's why i don't give myself the credit. You know what they say about cooking : learn to cook what you like to eat. When i ask for a recipe from MJ or my stepmum, they snicker as if saying "seriously, u wanna attempt that? its complicated". Fine, whatever. I'll get it from friends, or the internet.

Frankly, i think evryday dishes are difficult, main reason being i just buy them & didnt bother much in the kitchen before boarding school. The thing with Malay cooking, instructions are very vague with descriptions like 'secukup rasa' and 'naik bau' and 'pecah minyak'. They dont say 200g of this + 50ml of that & bake 40mins at 180. Its all 'secubit' and 'ukur dengan jari'.

So i try is the next best thing : anything i see on TV. Heck i've managed a pavlova & breakfast parfait from watching tv. From watching enough tv and eating enough food, i've concocted 2 recipes that i've yet to try:

1) Beef Stew : chunks of beef in a pot of water...a bit of salt...a sprig of rosemary...a few cloves, star anise & cinnamon...black peppercorns... lots of potato chunks to help reduce & thicken the broth. Boil & simmer a few hours...some tomatoes... i think that should do it. eat with bread...yumyum

2) Lamb Kebab in Pita : minced lamb...add 1 Tbs cili boh...some McCormick Allspice...some salt and olive oil... make into ball/sausage shape, skewer & grill. Then diced tomatoes, shredded lettuce, handful of pomegranate seeds & lemon juice... Next avocadoes, lime, cream, green capsicum & lime.. Toast pita... voila!

I actually enjoy all this housework, if i don't have anything else to do...which freaks me out, coz all my life growing up i saw myself 100% career woman, and now for some reason my contentment comes from being able to do my own housework.

Desperate Housewife? or Angelina Jolie?

Medical Mismanagement or Hopeless Communication?

Here's the original article on Malaysiakini, about a Dr whose father recently passed away in Hospital Taiping http://www.malaysiakini.com/letters/141502 .

In short he is saying there was mismanagement, poor conduct by the hospital staff & the doctors involved.

A 94-year-old Indian male with Acute Coronary Syndrome (ACS,minor heart attack) and possible chest (lung) infection who was progressively deteriorating in the ward, developed respiratory distress & hypotension (low BP). His son a Dr, believes he should've been in ICU/CCU, and that he should've been intubated and actively resuscitated whe he started to deteriorate. In fact, he (the son) started to do CPR and asked if he could intubate his father. The following day, the doctors asked if they could perform an autopsy to determine the cause of death.
It was a painful article to read, because it captured the father's final moments very vividly.

Responses to the article commented (more like complained) on everything : going to a Govt. hospital is a death sentence, Malaysian doctors & healthcare system is hopeless, too many medical schools resulting in mediocre doctors, the need for meritocracy in deucation, the country is going to the dogs...etc.

Let me be frank about something : the hospital & healthcare system is not a 5-star hotel with a menu where you choose the ward you should be in, or which specialist from what field should be treating you. This is not my response to the article per se, rather my feeling toward the more educated patinets out there, especially those who can afford the $$$$. Just because you have a chest pain does not mean you need a cardiologist. You may think your funny looking nails are due for a manicure, but don't be surprised if your GP sends you to a hematologist, a cardiologist or a hepatologist. Yes, a patient has a right to his choice of treatment, but treatment as counselled or recommended by doctors...not wikipedia

Sorry for the tangent. Here's an objective response to the article, by an Ida Bakar :
"I am writing in the hope to lessen your pain at the loss of your father. If your father had been admitted to a hospital in the UK, I doubt the outcome would be different.
1) it is highly unlikely that a 94-y.o. would be admitted to ICU
2)the diagnosis of ACS alone does warrant admission to CCU
3)presence of dentures can ensure the upper airway remains patent, detures are remained in situ during bag-mask resus
4)intubating your father will only prolong his agony; his heart and lungs have failed and his body was shutting down
5)the request for a post-mortem is not unsusual in a hospital death
It does appear here that the problem was one of communication. A Do-Not-Resuscitate decision was made. Perhaps a decision to keep him comfortable in the last hours of his life was made also. You mentioned the lack of monitors and drips, but the presence of a cannula may indicate that appropriate drugs were given"

Here's a snip of another comment, by a Tyrone, a doc with ICU experiencr :
"You father should have been given an opportunity to pass away with dignity and without suffering, hence no active resuscitation. A morphine infusion should have been started to alleviate any pain or discomfort; this is where the hospital staff should have acted promptly. You shouldn't have taken an active role in treatment because emotions would have clouded your medical judgement. Nonetheless, staff should have sttended to your concerns or explained to you why they did what they did".

OK. I'll be the first to say that in Govt hospitals, communication with patients leaves a lot to be desired. This is where we differ from UK, where patient counselling cn take up to an hour...if that were to happen here, we'll get a new letter in the newspapers saying that the waiting time in hospitals is too long. So patient education takes a back seat and usually delegated to nurses, monthly talks/briefings and to junior doctors. And in most instances, only the basic info of the disease, prescribed treatment is given...not much attention is given to alleviate concerns n giving patients peace of mind...

keyword here is PATIENTS....not relatives or mother-in-laws. And so far, for me as a student, this is where i come in : the bridge between the hard-core clinical stuff and the layman's perspective. Also, this is where private hospitals & clinics have the upper hand...there are no 'junior doctors' or specialized nurses, so the task of addressing the concerns falls solely on the consultant....which is also why some private docs give out their personal handphone number. This is actually why the general perception of 'doctors in private hospitals are better'. In terms of medical care, any Govt hospital wins hands-down. NEWSFLASH : if anything goes wrong in a private hosp, or a case seems complicated, they WILL refer to a Govt Hosp, any Hospital Besar. You will never see a govt. hosp, no matter how small, refer a case to a private hosp....unless it is because of a patient's request.

I guess another point to learn from the story is, never underestimate the role of emotions, and how grief (or worse, impending bereavement) can affect somebody. Everyone has a hard time when witnessing death. Doctors may see it more often, hence dismiss it in another day at the job. But when it his home, when it stares you in the face, you WILL feel compelled to do something, ANYTHING, because afterall you were trained to 'rectify' any state/condition that is not functioning normally. This is why we have a lecture, Diagnosing Death....to know when to let go. Any person on the street can tell you if someone is alive or dead...it doesn't take a genius. But how do you tell when a person has death in line?

I guess that's enough for now. Back to school.

Arrividerci, Baby!

Wow...There's so much i wanna say, my head feels congested & i'm nauseated just trying to sort my thoughts out! But it's all good. Since finishing my Orthopaedics posting last Thursday and going home to Penang & back again, many things have happened (more like, a lot of normally-mundane things turned out to be awesome). I'm happy!!! See :) :) :)

give it a couple of days, it'll be gone once i'm back in my brain-dead medical school routine.

Just a concluding line for my ortho exam : i thought it was do-able; it would've been 'not bad' if i actually attended the first 4 weeks of class. I haven't submitted my case write-up though... Frankly it is not that i dont regret it; i just wanna keep the self-loathing quiet for now, ESPECIALLY because i am actually enjoying being alive instead of ruminating on how indecisive i am about being dead

now where was i? oh yea, PENANG. Seriously, i dont know why i dont go back more often. Its a whole different feeling, the minute i'm on the streets of Penang...regardless of taxi or mum's car, or my car. The scorching sun, the clear night skies, my quirky & moody little cats, the less-congested roads, my 'childhood' bed, the free-to-experiment kitchen...i tend to forget; it just hits every time i touch base. I'm wondering if i should work in Penang GH, right next to my 'ol high school SGGS. If i do then for one thing, at least my mum wouldn't be alone. The thing is, a part of me feels i should stay in UMMC...i've always had a strong sense of attachment to UM what goes beyond it being my alma matyr.

Anyway. in my flight back to KL, i happened to be sitting next to an Italian couple. Iattempted to make polite conversation but as it turns out, the husband doesnt speak English. At that moment, all i could think of was ''bon giorno", "ti amero", and "arrividerci", which loosely translates as 'hello', 'i love you', 'goodbye'....not exactly the words to say to a stranger u just met; unless of course you're in there for a one-night-stand, huhuhu. I spoke briefly with the wife, who told me they were in Penang for vacation...then they resumed their husband-wife conversation completely in Italian. I just sat there with my eyes closed, eavesdropping on a conversation to which i had no clue as wo what was going on....i was rather in awe coz i've never really heard conversations in italian before, aside from the brief opening scene in Angels & Demons.

So i spent the entire 45-minute flight lost in my own thoughts : i was ransacking my brain for all the Italian words i know. I came up with "aiuto", which means 'help'...i pressed on, then started singing my favourite Il Divo song, Ti Amero...."La notte schivole sormondo...que sia tormentera..." Heck, all i got from the song was 'one night', 'torment', 'lingering/continueing'.... In other words, not much prgress. Naturally, i proceed to what i can recall from the menu at Italian restaurants : tiramisu? quattro formage? de carni? spaghetti? lasagne? Even more useless for conversation...

I was beginning to get exahusted. I mean, if they were Spanish then i'd have better luck. I've always wanted to learn Spanish, and i did pick up a few phrases from my grandmother, and from songs & movies. See, TV does me a LOT of good. I havent had the opportunity to travel, but that is how i learn about the world & other cultures. of course, you'll need common sense to discern the 'hollywood fiction' factor from some of the stuff. plus, i love watching then discovery channel, natgeo, history channel, and sometimes discovery travel & the cooking channels. I guess what i'm trying to say is for some people out there who watch even more tv/series than i do and yet for some reason can still remain so close-minded and got no clue about other poeple's values, cultures, taboos, they have got to be the thickest numbskulls ever. Heads up peeps, this is what 'informal education' is all about.

and i digress yet again. now where was i...oh yeah, the italian food road block. fine. then i got an idea : i used to learn the piano, i was up to grade 5...we had to learn italian terms for music theory. Immediately i tried to recall : mezzo, moderato, allegro, adagio, lento, crescendo, allegretto, segno, maestoso, dolce, forte, presto, pianissimo, con brio, etc. Sure, it may not be enough for conversation but i was contented to at least know SOMETHING. By then we were about to land in KLIA. I was determined to at least say something in italian but i cant seem to work up the nerve for it...what if my understanding was flawed? what if my pronounciation is wrong, so wrong that they cant understand?

So we were getting our luggage, and the man said ;bon voyage. i said, wait first (the cabin doors were still closed). Just when the people ahead started walking out, both husband and wife said 'bye bye' to me...i turned to look at the husband (he was sitting next to me, afterall) and said, "arrividerci" and oh how their faces lit up! She said 'ah, brava!' and he smiled and repeated 'arrividervi'. I guess they were taken aback, coz they weren't expecting it. The were impressed, and i was pleased with myself. Walking toward the arrival hall, i was giggling to myself, and i was skipping with joy for actually finding the guts to say that one word. You see, earlier this year i studied Mandarin for a while and wasnt very good at it; and although i do know a few words & phrases here n there, i have yet to be able to muster the courage to speak with my chinese classmates/friends/patients...for the same reasons i mentioned earlier. I am too self-conscious for my own good, too egoistic to risk embarassment.

Then in the taxi, i had a chinese taxi driver whom i noticed had classical features/deformity of rheumatoid arthritis : boutonniere, swan-neck, z-shape, radial deviation of the wrist. I asked him about it, and he's had it for >20 years. Apparently it doesnt hurt when he drives. He gave me the same advice i've heard time n again : to master a language, u have to speak; it doesnt matter if they laugh at you.

So in summary; I had a great weekend. For now, arrividerci baby!

A Moment of Clarity

I was on Facebook for a few hours just now, waiting for my Farmville crops to be ready. I had run out of my usual online time-killing things to do, then i got a bright idea : inbox-messaging friends.

To be frank, i haven't socialized much in the past year or so. Most of the times i prefer to be by myself...i just had no mood for it. Even when friends try to ask me out, i reluctantly agree and end up cancelling in the last minute. Of course, friends/acquaintances in my immediate surrounding markedly shrank a long time ago when i left my initial MBBS 2005/2010 and joined with the juniors...even more so since they've graduated & started working in hospitals all over the country. So, in my everyday there is a steep drop even in casual encounters; hardly any more hi's or hello's from the 150-or so familiar faces walking down the corridor. Friends outside of med school hv always been tough to hangout with coz they're working or back at their home state.

As a result, i feel lonely a lot of the time. I don't blame them for it...well maybe i blame them about 30%...the rest of it is me not wanting to be around people, feel the need to be alone..and the part of me that doesn't understand why i do it; i just have to. Heck, most times i dont think i'd be any good for company, that i'd probably bore those who ask me out or come over, and i didnt wanna feel bad if i had 'dampened' the whole outing. So might as well stay in by myself & be bored by myself.

Anyway. Like i said i was waiting for my Farmville crops to mature & i was feeling rather joyful & i started messaging my friends, one after the other. With each message i typed, i felt a lil more uplifted. Somehow it felt like everything was clear now, and i had a certain calm embrace me. The feeling itself wasn't overwhelming...but when i realized the feeling, typing, 'talking' to my friends, I felt my old self. It was good. It felt wonderful. I felt like i had clarity, that i was being like my old chatty jovial self. Suddenly now, typing this, I begin to miss my friends...I miss chatting with them...I miss the feeling of security, knowing they will be there for me if i need someone to turn to.

It is in moments like these, that i 100% believe that i do indeed suffer from depression. In moments of clarity like these i can look back at my weariness, it-doesnt-matter feelings, incredibly boring & lethargic everyday then say for sure that the sloth-like existence cannot possibly be my own conscious doing...because they never feel right, and sometimes they don't even feel real. I never felt truly rested no matter how much i sleep, I never felt truly unburdened regardless how little i take on or even when i choose to do nothing. I know i am better than that, that i am capable of a lot more...but when i am in the slum, i never believe it, and think that i indeed subconsciously want to destroy myself. Even worse when people around me too start blaming it on me having a bad attitude, being lazy and irresponsible.

I felt that i had to write within this moment, before it slips away and i become my shadow again. All i want, just like evryone else, is to be happy and to be able to experience happiness. I want this clarity to just last longer, no need for forever. Just last long enough so i can get things done, and feel like I actually do exist, and that this a life, that i am not just an empty vessel floating through time.

Good night.

Of Weddings, Graduation and Upcoming Ramadhan

Last Saturday i attended the wedding of a former schoolmate of mine, Ezureen Ezani. Its the first of such weddings that i attended, though quite a number of my MRSM Taiping batchmates have entered a new phase in their lives. Some are engaged, most are newlyweds, others have welcomed their first child, and a tiny number of them are already pregnant with baby number 2.

Oh, how time flies. Apparently it has been 7 years since the lot of us left high school & SPM. Friends, former friends and even teachers have gone separate ways. Of course, being at Ezureen's wedding was like a small reunion of a handful of individuals; no longer clustered in 'gangs' or 'couples' or 'classmates' . I had fun! Oddly enough, there wasn't really any nostalgia. Everyone was here-and-now, celebrating our mutual friends' journey into marriage. I guess the lot of us had fun chatting & eating & laughing, we just HAD to have our own afterparty : Karaoke @ Wangsa Walk. Perfect Timing, coz Kemek (my karaoke buddy) & I havent been to karaoke for so long. Usually our karaoke trips are an all-girl outing, so this is the 1st time we have guys in the bunch. Frankly we were surprised to feel at ease, comfy enough to make fools of ourselves belting & screaming out of pitch for 2 hours.

Tired & happy, my day wasn't over : I had an Orthopaedic on-call shift that night, which also turned out to be fun and very informative.

The day before that (Friday) would have been a big day for me had i stayed on with my previous batch : Graduation, class of 2010. To be honest i anticipated a wave of depression to hit, just like it did they day they passed their final exams a few months back. Thankfully it didn't. The person i was really looking forward to see is my old roomate, Dahlia. She's a quiet girl, very hardworking and smart. Although i always say Dahlia is stiff, 'has no feelings' and hardly socializes (its the truth, she admits so herself!) but through the years we did become good friends. I was happy that she too really wanted to see me. I thought i was just going to meet her, say 'hi' amongst the crowd of graduates....i mean, i didnt want to interrupt her plans & celebrations...instead she asked to chill out in my hostel room & hv a quiet chat. Working life IS tough afterall, and after 2 months she has yet to receive her paycheck. I guess i just miss having her as a roomate & study partner.

Ramadan starts tomorrow. One month of fasting, before Raya celebrations. Regretfully this year i failed to 'pay my debt' if u know what i mean. Its a big deal to some people, and to others it means nothing. Me, its one of the things i usually make an effort to do in recent years. Perhaps if u'd notice, this is just another notch in the way things have been going on since late 2008....how i've completely let myself go; let go of discipline, of responsibilities, of decisions, and of everything i m 'supposed' to be. And now slowly & reluctantly i m resuming control of myself and my 'life'. I was never a failure, but now i'm halfway to becoming one....and i dont even know why. This posting (Orthopaedics) marks my worst/lowest point of academic participation thus far, possibly putting my future (exams/graduation from med school) in jeopardy. I dont even like myself for that, and it adds on every time i think about it. What does Ramadhan have to do with all this? Nothing, i guess. Its just another day of another month, except that i dont get to eat or drink during the day.

I gotta go to sleep now. Hope i make it to my 8.30 ward round tomorrow. Toodles!

Fill in the Blanks

Its been quite a while since i last wrote anything. The last few months for me felt rather uneventful, slow. Not that they really were, but it just felt that way. For some reason i've felt persistently bored, as if my emotional thermostat was stuck on 'blank'. Whatever feelings of enjoyment or sadness, anger or enthusiasm were short-lived and merely reactive. So naturally, i had no opinion on anything yet my thoughts were swarming left right and centre on god knows what...

I'm still not quite 'fine' yet, though i cant put a finger on it so really, questions like 'are u ok' or 'whats wrong' will be met by a stoned expression & a stiff, uncomfortable chuckle. It is 4.30am and i wanna kill time till i'm due for ward rounds so here goes.

1. My Grandma's 77th Birthday
Saturday 10th July. I dont know whose idea it was, but i have to say there were lotsa bumps on the execution of the party. i mean, i live in the same house as my grandma, but i only found out about the party when i picked my mum up (who came all the way from Penang mind you). Regardless, it was a huge turnout...5 or 6 cars worth of relatives, ud think it was a Raya openhouse! We ended up with 4 birthday cakes, some murtabak + pasembor and other 'snack' food but no 'real' food. Not to fret, Dima Marlina & her Domino's coupons saved the day! Heck, even Dominos sounded confused, coz i had to call and order twice that day...huhu. It was fun, really, seeing my grandma blow 30-something candles on the many cakes. She was happy, pleased, that's all that mattered. She said to me today, she never had such a big party, maybe she it was all the excitement or because of the shock that she's getting sick today (she's getting the flu).

2. OZ
OZ....The name on the street for the Oswald State Correctional Facility, Level 4. Haha. Its a tv series, by HBO waay back in 1997-2003...6 seasons altogether. I've watched it twice back in 2008 when i was doing my elective in the pusat serenti. And I've watched it again twice the last few weeks. Its a show about life in prison, and will probably be one of the most gripping, brutal, real and unique show u'll ever see. Man I love it. Super testosterone (haha). Gotta thank my dad for intoducing it to me. I haven't watched Prison Break, but to be frank, i'm skeptical coz i dont think something truly realistic & gory/intense would be able to be that mainstream. Anyway. I made my sis watch it and now she's hooked. Our fave characters : The O'Reily Brothers...i love Ryan & she loves Cyril...played by real-life brothers Dean Winters and Scott William Winters, respectively. And heck, their brother, Bradford Winters also came in as one of the writers for the show. But really, there are so many good characters that anyone who watches Oz will have a hard time picking favourites.

3. Schindler's List
When oNe came to stay with me a month ago, i was surprised to find this movie on her external hard drive. Its one of those movies i've heard of but have no idea what its about. I watched it, initially confused coz half of the dialogue was in German or Polish then in Hebrew or Yiddish but then somehow it didnt matter; the message was clear. Its a true story about the events during the Holocaust and how a man named Oskar Schindler managed to save the lives of almost 1200 jews from Poland. The movie haunted me; made me want to watch it again and again. It made me surf online to read a bit more on the Holocaust, Schindler himself, Amon Goeth, and whetever that was related. One particular night i scared myself shitless, reading on human vivisection (surgery/dissection on live victims without anaesthesia), human 'medical experiments', mass executions....all done by the Nazis to the jews & other prisoners...even the Japanese did the same thing during their occupation of China...they did that plus 2 other sick, grotesque practise : CANNIBALISM and 'comfort women' (kidnap village women & put them in brothels to 'serve comfort' for the soldiers). yeeesh. I didnt dare turn the light off that night.

4. Medical School
Not surprisingly, i'm getting the same feelings i had the last time : why does it matter? what the hell am i doing here? i'm not a doctor, i'm just a smart-ass in a white coat. Yeah, those feelings. Going to sleep & wishing i'd evaporate into thin air. I've finished my Medicine posting & my Psychiatry posting (i wish i had my head on right; i wouldve enjoyed it a lot more) and now i'm in Orthopaedics. Oh, we also had 3 weeks of OMHS (Organization & Management of Health Services) and my group was posted in Putrajaya. Boring as hell. Compared to the previous project trip to Maran in 3rd year for CRP (Community Residency Programme), i felt completely useless & out of the loop. All i did was interview the guy i was supposed to, wrote my report, & helped 1 editor with a teeny bit of editing. I'm just glad that's over, but it also means going back to the wards and unpredictable class schedules. hmmph. I just wanna be able to feel excited & interested...my reflex is to avoid it like a plague, or put if off until abso-freakin-lutely necessary, i.e. crossing the bridge when i get there. As if on cue, somehow on days that i have class suddenly i cant wake up, completely knocked-out in a 16-hour coma. Frankly right now, i'm contented if i complete/submit my assignments, do my on-calls & vaguely know about the posting. I couldnt care less about making the 80% attendance mark or to be as good as evrybody else. One day, this will change. I cant live with myself like this.

I guess that's it for now. Till next time, ciao!

Breaking The Glass Ceiling

Today the Final MBBS Exam results for batch 2005/2010 came out . The end of their 5-year struggle. My former roomate texted me, sharing her good news. I logged on to facebook and saw the many congratulatory wishes & thank yous to God, parents, friends and everything else. Talk of celebration and 'rebellion' to studying are everywhere. As of today, they have finally obtained the right to be addressed as Doctor.

It could've been me.
I was once one of them.
But it was I who decided to pull myself out; to deal with other demons or i would probably be a corpse today.

I am happy for them, i really am. But i would be lying if i said the happiness isn't enshrouded by intense jealousy. I just really wish i was one of them. I wish i would be standing with them on stage at graduation.

Perhaps this is my pride talking. Looking at the bigger picture, i will become a doctor as well...only 1 year later. I hadn't failed. Things happen. Unforseen events. It can't be helped, and there is no blame to be put. Regardless, i can't help what i feel. Perhaps i could grieve and put these feelings to rest.

Things have not been working so smoothly the past few weeks...ever since the fire in our home in Penang. Though it wasn't major, but one can feel the stress eminating from mother & daughters. Everyone's busy, everyone's slammed with job/academic commitments. The tension is unavoidable. One has to bear it as long as it takes to make the house back to what it was.

It has been difficult for me to concentrate on what i'm doing. Restless boredom. The lability of my emotions draws me into seclusion...avoiding contact yet yearning it all the same.

Anyway. What does it take to break the glass ceiling? The unseen & unreal barriers to materializing ones dream. The exaggerated gravity of situations. The fear of failure. The irrational loathing towards certain departments. The inherent compulsion to procrastination.

Looks like i have a long way to go.

Sex Education

The first time i heard about Sex Education was in Form 2, where it was the topic for our class debate and i was in the opposition team. It was meant to be for our English class, among fellow classmates; but since we had that class in front of the school co-op (it was more spacious, so we could arrange chairs & tables to get a better 'feel' of debate) i got rebuttals from Form 4 and Form 5 students...SCHOOL DEBATERS mind you (who were apparently frustrated because they just lost a debate) leaving me flustered, confused & tongue tied so our teacher finally stepped in. rather unfair for a first-timer, dont you think? either way i don't think it affected my assessment so much.

Anyway. Why Sex Ed? Is it really necesary? To be honest i dont really care if they implement it or not. However, since i generally dislike sex out of wedlock & promiscuous behaviour, and unfortunately some go about it like we live in caves (i.e. no choice, no contraception, no restrictions, no-knowledge-just-urges, no rules) i think it becomes necessary to educate and break the apparent naivete.

OK. To Sex Ed or Not To Sex Ed. From newspapers & blog comments i see most people debate on that. I'm more interested as to what they MEAN by sex-ed, and the fact that if improperly implemented there could be potential misuse by perverted teachers. So to be frank, i think the best people to teach sex education are doctors, nurses, trained teachers (include some open-minded ustaz/ustazahs/religious leaders if any)...basically anyone who is trained and capable of talking about sex academically, objectively, and clinically.

Sex ed is NOT teaching people how to have sex (i.e. cuddle & kiss for how long then do this and do that here or there). Sex ed is about sexual behaviour, consequences/products of sex, and prevention.

So, here is my suggected scope for sex education.

1) Primary Sex Education : probably for high school students
-normal human sexual development (from in utero, puberty, sexual maturity and regression)
-sexual anatomy (male and female)
-views on sex and its role/practise by different cultures & religions (preferably worldwide...include current malaysian law)
-sexually transmitted disease
-pregnancy, abstinence & contraception (i'm talking hard core contraception including implants, tubal ligations and vasectomies...not just condoms & pills)

2) Secondary Sex Education : matriculation/A-level/university, maybe?
-the differences between gender and sex (gender roles, gender identity, sexual identity, transexualism)
-sexual preferences (homo/bi/heterosexuality)
-sexual harrassment & the law
-family & relationships (responsibility, maturity, infidelity, polygamy)
-psychology (body image, self-awareness & empowerment)

3) Tertiery Sex Education : optional, for sexually active individuals (hopefully married)
-the Kama Sutra & enhancing sexual pleasures
-non-conventional practices (S&M, swinging, necrophilia, pedophilia, bestiality, incest, rape, etc)
-overcoming common sexual problems (performance anxieties, erectile dysfunction, painful intercourse, etc)

what do you think?

Discouraged

Last week my article was published on the blogsite Unscientific Malaysia. Here's the link http://unmalaysia.wordpress.com/2010/03/11/my-2-cents-on-fatine-2/comment-page-1/#comments You can find the original article in my blog archive, January 2010

I submitted that blog post to the administrators because the discussions on UnMsia's Facebook page at the time was going a lot into gay/LGBT issues and thought it would be a good idea to share. So imagine my surprise when they responded and decided to publish it. I mean, i am nobody...just another girl with a blog.

When the article came out, i was practically jumping up and down with excitement. I went to check it out for myself & nearly had a heart attack : there was a comment by Marina Mahathir. There it was, one of the earliest comments. I was stunned. Marina Mahathir commented on something I wrote, not the other way around!!! Once the initial shock wore off, i was elated and proceeded to forward the link to my friends, my mother, my sister... At that moment i felt like a kid showing-off her artwork, and was so happy for the support from friends.

That was then.

Obviously i followed my article closely. Now there are many more comments, and a significant proportion of them negative, with non-helpful criticism. Some responded emotionally, convinced i have no idea what i'm talking about, or that i am so far away from actually understanding the issue. The comments on the Facebook page are a lot harsher, some telling me to "shut the fuck up" http://www.facebook.com/notes/unscientific-malaysia/my-2-cents-on-fatine/355903123510 .

Even my comments attempting to clear misunderstandings or misconception regarding statements within the article were met with 'dislikes'. Basically all the bad comments were just one step short of name-calling or branding me a 'disgrace'. They refuse to accept my clarifications of the article, that it wasnt meant to be a scientific/research article thus was written based on observation, brief reading, and knowledge at hand. They dont see the fact that i am not writing as an activist, a sympathiser, an opposer, or as an individual with 'experience' (i.e, a transexual or a family member or someone living with a transexual)...heck they even questioned when i say i'm on the fence.

Seriously. If i had wrote the article as a Professor of Gender Studies or Sociology and had made those errors in my article, then yes, feel free to crucify me, i'd deserve it. Don't punish a 10-year old for not being able to do PMR level quadratics.

The 'up' side to my article was that there were transexual women who read it, and they did not condemn me except for my haphazard teminology. I appreciate them sharing their stories, and they were not like the stereotypes i wrote about. The problem with trying to reach out to the marginalized or 'frowned upon' population is that they get so defensive; i faced similar criticism when i interviewed drug addicts at the Pusat Serenti. They disregard the fact that i had CHOSEN be there & learn about them; instead some condemn me for being skeptical about trusting drug addicts. Instead of showing me why & how they can be trusted, this guy just confronted & lectured me on MY 'sincerity' and motives. Same with these transexual sympathisers (like i said, the trans women were actually receptive) chose to laugh at my 'ignorance', express their appalled-ness over my lack of 'initiative' and 'understanding'.

You know what's sad? my mum & sis haven't even seen my article. never mind reading or commenting, they haven't even looked at it.

Why is my title 'Discouraged'? Well, i've told u about UnMsia's Facebook page. I debate there a lot, and unfortunately i always find myself having to speak about Islam because of the blatant condemnation & apparent misinterpretation by the anti-Islam and left-wing liberatarians. all i do is put out facts that i know. and instead of taking the facts, they question my understanding, my interpretation, my motives, my knowlegde and accuse me of pick-n-choose Islamic teachings as well as manipulating Islam to prove my point. Mind you, i dont even quote the Quran or Hadith and i make it a point never to do so unless talking to other Muslims.

Debating there was my outlet when stressed : it channels my aggression to something more useful; helps take the edge off. Instead of creating drama or picking fights with friends/family, i 'fight' about topics, issues, and causes. Just as what happened with my article, i now spend more time clarifying & justifying the points i put out; with no help from fellow members or friends.

My once source of stress release has turned into my source of stress. I guess it is time stop & move on to something else.

Exhaustion by Expectation...AAARGH!!!

I am currently in the 3rd week of my medical posting...or at least i am supposed to be. I practically slept through the whole of last week; i could barely keep myself awake. This week i'm plagued by insomnia, waking up at 3am and unable to fall back asleep. I am very much interested with my studies, but just overwhelmed because there is too much to do. Its draining just thinking about it & planning my next course of action and frankly, i have little energy to do anything. Forget eating or socializing; i'm too tensed most of the time anyway.

Let me give you a tour of the expected life of a final year medical student in University Malaya.

My current posting : Internal Medicine.
We are rotated among the 8-10 sub-specialty wards each week (cardiology, neurology, geriatric, hematology, etc.) for the 8-week posting. Depending on the ward, each student will have about 7 patients to cover; meaning to fully clerk the history, full examination, trace lab results & X-rays, study the case notes, and follow-up until discharge. By exam standards, full clerking + examination + diagnosis + plan investigations should be done in <1 hour (experienced doctors can do it within 10-30mins depending on the illness...that's y the GPs shoo you away after 2 minutes). Simple math will tell you it will take minimum 8 hours in the ward including breaks & moving between patients, just to cover the patients...without even checking reference textbooks about the disease. 8 HOURS OF BASIC EXPECTED PREPARATION FOR JUST 1 HOUR OF CLASS (TEACHING WARD ROUND). We have 2-3 teaching ward rounds a week. And some of our lecturers expect us to be in the ward 7.30am-5.00pm to join with the consultant/medical officer ward rounds or help with blood taking and other things like that. Then we have on-call duties once a week so we have to stay at the ward or emergency department at least until midnight & follow the doctors.

That is just the ward work. Mind you, its not like we are getting paid...and neither are we actually treating the patient...just aggressively observing.

Then in every posting, we are expected to observe procedures like X-rays, CT scans, endoscopy, biopsies, blablabla...at our own time. Regardless if we have seen such procedures before (perhaps in different postings), failure to obtain the the attending doctor's signature to complete/fill out log books would reflect poor attitude and less marks. On top of that, we have tutorials on various topics once or twice a week, each taking about 1-2 hours. Because the lecturers themselves are specialists/consultants, they are very busy thus last-minute schedule changes are not uncommon. Then in some postings we also have to attend to the clinics, to learn about follow-up, clinic vs ward setting, learn how to decide which patients need to be admitted, so on and so forth. And because UMMC is very sub-specialized, different clinics are on different days!!! Then there are additional stints with the Departments of Pathology and Radiology every other week....sometimes requiring searching for additional patients or writing up reports. Then we also have 1-2 hours of general lectures and 2 hours of Clinical Pathology Conference (CPC) once a week. Attendance for EVERYTHING is compulsory, anyone with <80% per posting will be subjeced to inquiry by the Dean's Office and barred from our final exam. Oh, and did i mention that we have end-of-posting exams every 8 weeks?

Overwhelmed yet? Noticed that i haven't even mentioned READING or STUDYING.....let alone RELAXING. Ideally, they expect students to read up on the disease/conditions of their allocated patients in the wards as well as their treatment options, read up in tutorial topics beforehand, revise the contents of the general lectures, and prepare for the CPC which are very complicated cases like you see on House. I personally think one has to either be manic or hyperthyroid or hyperactive or addicted to coffee/red bull/crystal meth to be able to cope. That's why i am contented with my C-mark at every major exam.

Hospital staff (doctors, nurses, dentists alike) always say this about UM grads : UM grads are excellent, they are very skilled with clinical work and have a lot of knowlegde, but have bad attitudes. Well, that's because in the process of our training/grooming/education we have learnt to say FUCK YOU!!! We'll go around doing out own business, as long as the patient is safe/stable, the filing & documentation is up-to-date, we really don't give 2 shits about anything else.

Ain't we a fun bunch. Now...has anyone got some crystal meth for me?

Buttering Myself Up

I've been in somewhat of a bad mood for the past several days. Although i remain motivated, my temperament has been foul; thanks to no small part to the hypocrites i call family. If u had read my previous post with regard to sex out of wedlock, you can obviously see how strongly i feel about it. I have to be honest and say my stand has been conditioned by upbringing, religious education, and to no small part influenced by the incidents that lead to the wreckage of my only family institution : the inability of 1 man to control his sexual desire + 1 immoral woman who had no qualms about having sex with just anyone.

Do i not feel ashamed writing that down? why should i, when the offenders themselves have never truly been apologetic. Not my problem. Yet apparently the collateral 'victims' to the ordeal don't feel as strongly as i do. So i guess its everyone for themselves, they way it should have been from the start. No good deed goes unpunished. For trying to stick to what i believe in and truly spend time with my relatives, I get unadulterated version of the unspoken resentment and end up being the soundboard & the reliable one when it comes to...well, anything.

So. Let's butter me up to make me feel better.
Definitely better than beating myself up, right?

I come from a very educated family. On my mum's side, you have the ultimate definition of academic : my grandma, Prof Emeritus Puan Sri Dato Dr Fatimah Hamid Don. Yep, my grandma has a PhD. Google her and you'll get her journal contributions, newspaper articles & the sorts. As if that wasn't great enough, she is the founder and held high positions in several of the women NGOs in Malaysia. Then you have my late grandfather, Tan Sri Dato Ishak Pateh Akhir. Google him and you'll see his face as chairman of SPA & MIDA...he was a high-rank government officer. My mum, Dr Fawziah Ishak, Obs & Gynae specialist. She's well-known in Penang, esp in the mainland. On my father's side, my maktok Jumabee (MJ) was a teacher for over 40 years. I think she started teaching when she was 14...mostly math & art in primary school. My grandfather Daud was also a teacher, a high school art teacher (oil painting, pottery) ...its pathetic how i did not inherit ANY art skill. Although my MJ & tokwan aren't as high-powered as my other 2 grandparents, i am still very proud of them...many in their generation are illiterate, many never went to school, let alone have careers. My dad Mohd Rafi started as an engineer/technician and has long ventured in to business and the world of economics/venture capitalist/investments that i dont understand one bit.

That's them.

What about me? I always say i'm average but my friends always disagree. I guess academically i've been blessed. 5A UPSR + offered Sekolah Tun Fatimah, 8A PMR + offered MRSM Taiping, 9A SPM + offered PASUM, 4.0 PASUM + offered UM Medicine. According to my dad's calculations, among the ~200,000 that took SPM my year, ~2000 got straight 9A1..... since i only had 8A1+1A2.....that puts me at around the top 2-5% among my fellow batchmates. Now, I'm in my final year of Medical school where everyone is crazy brilliant, i haven't really felt smart in a long time. In medical school, i'm in the bunch who gets just enough to pass (so far).

So nevermind academics, i've always tried do to other things. Like my ventures into drama/theatre/performing coz i really enjoy doing so. Regardless of the feedback i get, i just cringe seeing myself on stage. Unsuccessful there. Art, i won't even bother. I've never been good in sports, probably because i've always been on the heavy side thus i get winded quicker than others. Nevertheless, i really did enjoy my 3 years in Goshin-ryu Karate and i still wish to continue till i get my black belt, if & when i have the time. I don't read much until recently (political blogs), I'm the worst when it comes to technology & gadgets, and in person i am pretty 'blur', not very eloquent and in my opinion, not really that interesting.

But i am intelligent.

It is only recently that i realized that. In searching of my forte, something that i can rely on and feel confident about, finally i could connect the dots. I am smart, as 'evidenced' by my academic track record. So what am i good at? what is my forte : STUDYING!

So what am I doing about that...refer my earlier post about turning 24. I am currently :
1) taking Mandarin classes
2) reading political/social/religious blogs & giving my opinions
3) reading Mahathir's book : The Malay Dilemma
4) studying a compilation of hadith : Tajzibu Athraf
5) studying the tafsir Al-Quran in english
and of course, i cannot leave out my medical textbooks & notes...but i have to admit, i get distracted with the aforementioned.

Perhaps i am being overzealous...i have 2 more books to read once i'm done : The Other Malaysia by Farish Noor, Kisah 25 Nabi & Rasul, tafsir Al-Quran in BM...novels & Chicken Soups. I can't help it, i'm excited but reading is taxing. Writing in this blog also helps keep me interested. Frankly i was surprised to see >50 hits on my blog in within a week, coz i really thought i had maybe 5 friends who actually read what i write.

That's enough buttering. Now i'm craving butter-fried prawns..Ooohhh...

Premarital Sex & Caning of Women

I am just fuming. This topic has got me all riled up in a bunch. Oh, I don't know, maybe because it most likely concerns my generation, people in my age group? The many comments i've read about this topic is actually the fan to my fire.

Its not my intention to mimick Dr. Mahathir's blog style, but i need my thoughts in order

1. I am against pre-marital sex. I do think it showcases loose morals and irresponsible behaviour on both sides.

2.It is not something intrinsic of the East...it is not advocated in any religion i know. Blame the media or whatnot; it is only practised by a certain bunch of 'liberal' Americans (ie, the MTV or any form of protesting bunch which happen to get most of the airtime) and European countries, where ignorant young people compare the age of losing their virginity.... thanks to that UK has the highest incidence of teenage pregnancy. Is that really something to be proud of? Is that really 'modern' & 'progressive'? Sounds like young African tribal brides to me.

3. Most of the idiots i know who 'terlanjur' (i hate this term coz who on earth can 'accidentaly' have sex? its a lot of effort man!) usually i hear they cry after their 1st time coz of shame, 'regret', because 'it just happened' (yeah right...)...then ignore their conscience do it again & again because 'it doesnt matter anymore now that virginity is lost' and 'alang-alang'...and of course, who can deny the pleasures of sex? Now, their initial reaction of self-realization n regret MAY be described as the feeling of 'insaf'...judging by the events that followed, is it really?

4. Having said about 'insaf', lets talk about the caning of women issue. Look, i am not a die-hard fan of caning, neither am I a religious extremist, but what the hell is the big deal? Why on earth are you arguing on basis of women's rights and what nots....Men have been caned for ages and when its time for women to get cained u claim injustice... You want gender equality, you gotta take it as a whole...not 'selectively' when it suits you, you bigot. You get same jobs as the men, same opportunity as the men, same punishment as the men.

5. From what i know Shariah caning is different than the usual caning we see : the graphic images of the buttock skin torn from the many lashes revealing the angry bleeding red flesh underneath. Shariah caning is not like that. For one thing, you have clothes on. Second, it is not meant to cause permanent injury. Third, they dont use big scary rotans. Fourth, they dont ask a huge masked burly man to smack the life outta you

6. If someone is a Muslim, it is only logic to assume that they KNOW the do's & don'ts...so please dont act surprised when authorities say what you do is wrong especially when you are guilty / caught in the act (making out, consuming alcohol, lying through your teeth)...and especially, dont even bother covering it up or say it is unjust. With that, i'd like to express my respect to Kartika, because she did not petition against her punishment; she accepted that she has done wrong and deserves her sentence. It shows she is not ignorant, and that she is a woman who has self-respect.

7. Having said that, i think it is pointless for these 'raids' by Jabatan Agama Islam.... There are a lot more pressing issues to be dealth with, like ajaran sesat, high corruption, public education, reforming the eduation of Islam for the benefit of younger generations. Moral/akhlak issues are between a person and his/her immediate environment....their family, friends, teachers. It all starts from waaay back when

8. I am an advocate of educating & councelling. As i've said, premarital sex or casual sex or extramarital sex is all a reflection of loose morals...which begs the question of their upbringing. Parents should really educate their kids about the true value of sex...it is incredibly sad to see people being punished for their natural God-given urges. Or are the parents themselves behaving like reckless teenagers in heat, with their own porn stash and extra-marital affairs?

I guess that's sufficient for my 'lepas geram'. Let's all work & pray for a better future.

Polygamy?

This point of view just came to me yesterday for some reason.

Perhaps one could view the allowance of polygamy in Islam through the lens of early feminism. It could be a way of saying :

" Yeah if u still wanna go & f*ck around even though you're married then go ahead; but you're gonna have to marry that woman too. You gotta treat her well, provide for her & care for her as you do your wife. There aint no such thing as free bonus 'ride' for you, honey!
And if you STILL wanna go ahead and pursue that subsequent marriage, you can only do so with blessing from your wife. If she is kind or unconditionally patient then fine, you're safe. Otherwise you'll find yourself facing divorce, annulment or other forms of dissolution and by that you have already incurred the wrath & heartache of God for executing His least favoured of righteous acts."

Just a thought.

Doctor, doctor

As I awaken at 2am from my slumber, realizing I haven't done the presentation slides of my ICU patient, I sat on my desk and turned on my laptop. I then proceed to Facebook and Farmville, harvested my crops, commented on walls, and read a few posts. So ingrained is my routine of delaying unpleasantness, i now function my best once the world has gone to sleep. Not to mention i have grown disturbingly comfortable and skilled at churning out just-enough-for-passing-grade academic assigntments in a matter of hours. Perhaps it is now evident that i am no workaholic.

Anyway. I've been wanting to lay my opinions on the recycled issue concerning doctors : that there aren't enough doctors in Malaysia.
http://www.bharian.com.my/Current_News/BH/Wednesday/Mutakhir/20100127125427/Article/
Pure hogwash. The statement was probably true a few years back, but now with more than 20 medical schoold in Malaysia, plus the many more studying overseas, pretty soon Malaysia will be flooded with doctors. Even now, there are too many students-per-teacher, and in the working world, too many House Officers per ward.

What we need are better doctors, or perhaps more doctors with better mindsets. Ask the question, why does it seem we never have enough doctors?

Number 1, its the massive amounts of patients. Not just the usual Monday crowd (MC-seekers.) Its not that Malaysians are a sickly bunch, but most Malaysians are not medically-literate and come in too late, usually from very preventable complications. It is obvious that they have no idea what is going on with them especially when they come thinking 'angin' is the root of all evil. Headache= angin, abdominal pain = angin, chest tightness = angin, shooting nerve pain down the leg = angin. But, one good thing with these patients is that they are more likely to stick to one doctor, although by no means are they more compliant to medication and therapeutic advice.

Number 2, the certain bunch of demanding patients. Not every headache is a brain tumour, and most headaches dont need a demand for a CT scan. Dont believe everything you see on Spektra or House or Grey's. Doctors in private hospitals would probably entertain such requests, because they dont have a long waiting list plus the extra money in their pocket, justified as "for the patient's own ease of mind". Wouldn't it be better if these resources are used for the people who actually need it? In government hospitals, the doctors would tell you to go fly kite...then doctors get the bad press. These bunch of patients are the ones who go 'doctor hopping', which is not good. One visit to a doctor who didnt 'cure' them, they find another doctor a few days later who can give 'better medicine'. This is potentially dangerous because without existing records, there is no continuity of care.

Here's an example of unrealistic expectations of a patient :
http://www.themalaysianinsider.com/index.php/opinion/sazlin-daud/47633-doctor-doctorcant-you-see-im-waiting-waiting

But of course, doctors are not without faults. More often than not they are too focused on what they need to do for/to the patient that they forgot that they have not explained much to the patient what is going on. I've read somewhere that doctors overestimate the time they spend with patients by 900%. Now as a student, that is where i come in. Whenever i speak to my patients, young or old, i try my best to talk to them as friends. Hopefully if they are receptive, then they feel more at ease and open to ask me stuff, and I will gladly explain what i know about their condition.

For example, my Gynaecology patient was admitted for heavy periods, but she was also desperate to conceive and she asked me to help her understand the various methods of assisted conception. Then there was this man at the ENT clinic whose wife was having her ear examined & cleaned because an insect flew in it. We were both looking at the monitor (along with many other nurses & medical students) and i just asked him what happened. Then i just pointed to the screen and told him that the white thing was the eardrum, and that was where the insect was attached too. The a big ooooOOhhh came from him, learning a bit of trivia, almost with a hint of amazement for seeing an actual eardrum for the first time. Also like my uncle, curiously listening to his son's heartbeat with my stethoscope. Then there was this man back in Klang who had a heart valve condition (if i'm not mistaken) and having students flock around him day-in and day-out to have a listen at his heart. His daughter was there when it was my turn, and I told them that because of his condition his heart sound was different from the norm, and as students we had to learn to differentiate. I also demonstrate how it was different, and if i remember correctly i even offered my stethoscope.

PATIENT EDUCATION. Get them interested with their own health and illness. No time to counsel? Provide useful reference or websites. In short, i completely disagree with extending compulsory government service. I also believe that as long we provide f.o.c healthcare, peeple will not wise-up and take responsibility of their health, because they do not understand the cost of the medications & equipment used. I am of the opinion that the resources should be focused on patient education and more community outreach programmes. Don't even get me started on medical tourism. Look inwards and improve the health of Malaysian citizens first before offering 7-star treatment to foreign patrons. To paraphrase a Malay proverb : dont go breastfeed baby monkey in jungle while your own baby dying of hunger.

Time to get back to calculating my patient's potential death risk.... (does anybody know how to work the APACHE score??)

You Got Mail

My grandmother sent me an SMS earlier today saying a package just arrived for me from Australia. I've got a package!!! No, not a-dick-in-a-box a la Justin Timberlake, (neither do i wish to receive one...its just creepy) but rather a small parcel I've been expecting; a gift from my oldest friend in every way, Sufia.

And behold! As if right on cue (with reference to my previous post) it is a small Quran with english translation. Somehow i knew that that was the thing she wanted to give me...after all a few months back i did ask if she knew where i could get 1 for myself; and i wanted it to be in english, and prefereably not Shakespearean english, but she had given hers away to someone. Put it this way : if I was going to get a Quran from someone, it would either be from Sufia or MJ (Maktok Jumabee, my paternal grandmother).

A few months back, i received a package from the UK. This time it was academic; I had asked Ili Liyana for a copy of the BNF (British National Formulary) which is like a 'dictionary for drugs'...they get it f.o.c there while here in Malaysia the price is around RM100!!

Then a few weeks before that, i received the most adorable home-made (or at least self-modified) card from another of my favourite-test people on earth : Azlaili!!! All the way from Savannah, Georgia...partying in the USA. A card for no special occasion, just an old-fashioned token of friendship to say 'hey' and 'be happy' and 'all the best for everything'. Opening that little envelope made my day.

Isn't it fun to open mail, cards, and personal letters? Perhaps i'll take this moment to lament on the fact that most of the time nowadays the postal service is used for bills, formal application forms/notifications, advetisements and catalogues. At least this is the case for my mother back in Penang....and my grandmother in PJ (except that she looks forward to her subscription of National Geographic / TIME / Readers Digest among other things). I remember the days, about 15 years ago (damn! damn!) back in school, it was so much fun slipping Hari Raya or Chinese New Year or Deepavali or Christmas cards into my classmates' desk or bags. Or receiving birthday cards and presents....something tangible that i can hold.

Nowadays, with the advent of handphones, SMS, emails and social networking sites, all wishes are conveyed via Facebook wall, or hp inbox, or Friendster page. The most personal thing you'll get is a phone call, and I appreciate them dearly (especially due to its sheer scarcity). Quoting Azlaili, Facebook dilutes friendship. Technology is not without its perks, but i believe it is limited to the sake of connectivity and networking. Nothing can substitute face-to-face encounters. The best substitue to that are letters (not emails!!) and phone calls, because there is always that 'personal touch' and effort. I call often and I love to meet up, but I'm guilty of not writing...I hardly give presents coz I never know what to buy!

Perhaps I'll start sending out letters/cards like my friends, paying it forward. Reciprocity. That is the key to make anything work. Maybe it will even be therapeutic for me, and hopefully bring some joy in their lives. First, i'll have to imrpove my penmanship and buy nice cards coz it will be horrible for me to attempt 'decorating' them.

That's all. Till next time, good night.

24 = Jack Bauer?

Hahaha, I wish! Well its 2010, and I turn 24 in May. Does that mean i can also turn into super-cool multipotential CTU Federal Agent Jack Bauer, from the TV series 24? Unfortunately, no.
With a heavy heart I must admit that i am now in my mid-twenties... no longer a teen/adolescent...not even a young adult anymore.

Perhaps after 2 weeks of writing on heavy stuff (refer my previous posts) both on my blog & on my Facebook, i finally came to the realization (yet again) that :
1) i am not governing this country
2) i am not a politician
3) the decision-makers of Malaysia aren't listening to me speficially, thus what i have to say makes no difference whatsoever
4) last but not least, the most important of all........... I am still a medical student, undergrad, i am nobody...YET

And with that, i revert to lighter issues such as how much i adore the movie Sherlock Holmes, or my newfound admiration for the writings of Farish A. Noor, the chocolate fondue party i hosted in my hostel room, my awesome weekend with my favourite friend oNe, reflecting on my long overdue workout session....and perhaps most urgently (yet least impotant to me) my assignments & reports and their sneaky deadlines.

Nevermind that, what I do want to write about is this : I turn 24 this year, so what do i want to achieve? Here's a bunch of things i wanna do before i turn 30. In no particular order:
1) learn Mandarin
2) learn guitar
3) study the Al-Quran
4) lose weight!!!!
5) be able to cook basic meals
6) pave my way for medical-related community outreach programmes, or Drs without borders
7) decide & proceed with my post-grad specialty of choice
8) road trip around Malaysia (the Peninsular at least!)
9) back-packing / travel to Europe or US
10 ) revisit & relive my love of performing arts

10 things. Even if i dont manage to check all of them, i'll be happy. Also, i made it a point to write down only the things that are within my control; not things like get married & hv 2 kids & hv RM******* in my account & migrate to Maldives. I think my dreams are somewhat attainable, dont you think?

I guess that's all for tonight. I'd better get cracking on my case reports & prepare for the viva tomorrow. Wish me luck!!

Why, Malaysia, WHY!!!

Perhaps it is time for another blog post. Today i've been reading a lot about Malaysia's current 'hot' debate about The Herald, a Christian/Catholic publication wanting to use 'Allah' as a substitute word for God in their newspaper and Malay-language bibles. The Malaysian Courts have approved the use of 'Allah'; the reverend is smiling in victory and the government is planning to appeal the decision. The rakyat? Extremely divided; some furious, some preaching to others about how good it is, others say it really doesn't matter. To me, there are two parts to this :
1) Is it legal? YES, i agree with the courts. No need to overcrowd the jails.
2) Is it right? Is this morally correct? NO.

Mostof the arguments (that i've read) against the decision can be divided into 3 :
1) This act is tampering with the sanctity of Islam - I agree with this, and will elaborate later
2) This is an act of the Christians in an attempt to confuse/distort and destroy Islam - bullshit
3) This is a political strategy by UMNO to win the votes of the Malay majority once the court's verdict is overturned, thus they appear triumphant as defenders of Islam - i dont give 2 shits about politics

The people who support the decision give these reasons :
1) God has no objections to what He is called, because He is there for all mankind
2) The word 'Allah' itself predates Islam, and is still currently being used by those of other religions especially in the Arab countries
3) Other religions such has Sikhism also mentions Allah in their teachings, so 'Allah' is not exclusive to Islam

" What's in a name? That which we call a rose; by any other name would smell as sweet " - Romeo and Juliet, by William Shakespeare.

EVERYTHING is in a name. Although the quote rings true but to me, it only works in a private, smaller-scale. The minute you were born, before you even get to develop your own individuality, you've been given a name. Nicknames come and go, they change over time, but your name stays with you till the end. It becomes a part of you, and at a mere mention the people around you know who you are and have a mental picture of what you're like. You wouldn't call you kid 'girl' or 'boy' for the rest of their life; the name is a show of love. Say MAHATHIR and the world knows who i'm talking about. Say Prime Minister of Malaysia, and it could be one of many. Similarly, you say God, peeple relate it to who you pray to, 1 or many, trancending religion. You say ALLAH, anywhere in the world and they know you are referring to Allah in association with Islam. Common sense.

To Muslims, Allah is not just a word. It is an entity, the diety to ehom we pray to, who we come from, who we return to, The One and Only God. In Malaysia, most of the Christian subgroubs believe in The Holy Trinity; whereby God exists as or is a combination of 3 forms/entities, The Father, The Son, and The Holy Ghost/Spirit. In Nomine Patri, et Fili et Spiritus Sancti. The Father is God; Jesus Christ is The Son (of God) and is God's presence on earth, it is only through Jesus can they find God and salvation; The Holy Spirit is somewhere between the two...i dont know much, i aint Christian nor am I a theology major. Catholicism adds another prayer for the Holy Mother Mary.

In Netherlands back in 2007, Bishop Tiny Muskens wanted people to start referring to God as Allah. A survey in Netherland's biggest-selling newspaper De Telegraaf found 92% of the over 4000 people in the poll disagreed with the bishop, who also drew ridicule. One man wrote "sure. Let's call God Allah. Let's call a church a mosque and pray 5 times a say. Ramadan sounds like fun". Read the full article at http://www.msnbc.msn.com/id/20279326/.

Naturally, the Christian community would respond :
http://www.christianpost.com/article/20070823/is-calling-the-christian-god-allah-wrong/index.html
In this article, they concluded that it is fundamentally WRONG to say Allah and God are the same, because of what i mentioned earlier (the different concept of God in both Islam and Christianity).

So I really don't see why Reverend Lawrence Andrew insists on using 'Allah'. Yes it WILL be confusing, but not to fully-practicing Muslims. What about new converts a.k.a muallafs? What about children? He insists that there is no suitable word to use for translation, that Tuhan or Lord is inadequate, that it does not convey what they wish to deliver. Let me ask you another question. You translate the bible to Tamil and Mandarin as well, but do you attempt to equate God to Krishna/Vishnu/Shiva/Murugan/Saraswathy or Buddha/Confucius? is it really a language barrier? Does it mean that much to you to use 'Allah', which is just a word to you, as a tool while on the other hand Allah is the centre and the holiest of our religious teachings? Does it really mean that much to you as it does to us?

The arguement that the word 'Allah' predates Islam, yes i agree. Yes, it is still being used in Arab countries by people of other religions to mean God...I say, SO WHAT? It is their culture, it doesnt bother them. Are we to absorb every single piece of foreign culture that remotely brushes against ours? Also, a simple Wikipedia search would tell you that in the Arab countries, when Christians use 'Allah', they use at as Allah al-'ab or Allah al-ibn to denote God the Father and God the Son, respectively. They have their own Arabic 'Bismillah' to say "In the name of the Father, Son and Holy Ghost", their translation to In Nomine Patri, et Filli et Spiritus Sancti; whereas the Muslim 'Bismillah' translates as In the name of Allah, The Most Gracious and Most Merciful.

Is this just another political ploy? God I hope not (pun intended). If it is then it's just too much. It is a very delicate issue; everything is when it comes to any religion. Is it really the age-old conspiracy theory about Christians or Jews trying to destroy Islam? if you ask me, you'll find a conspiracy theory anywhere about anything if you look hard enough.

I guess that's it. I've said enough. At the end of they day, when you walk into a Christian house you're not gonna find an embroided 'Allah' on the wall, it's still a crucifix hanging up there.
Give it up.

My 2₵ on Fatine

OK so this may be a little late, but apparently even until now I can't let the topic slide.

I read an article somewhere on the internet where this supposedly conservative MP was backing Fatine up, urging her to return to Malaysia. He said something about Fatine being khunsa; of course many comments that followed the article protested greatly. Was Fatine/Fadzil really a khunsa? What IS a khunsa?

Back in school, especially when we were being thought about 'sembahyang jemaah', the definition of khunsa that was fed to our young minds was of a person with both male and female genitalia. A khunsa may be imam to women but not to men, and a khunsa may not marry unless to another khunsa (correct me if i'm wrong about the marriying part).

Now, after almost 5 years in Medical School, learning a brief stint of Embryology (the study of human development, from development of sperms/ovum to zygote, a mass of cells and eventually a fully-formed human being; and everything that can go wrong) as well as Paediatrics (especially with regard to genetic anomalies and congenital/birth defects) I can tell you that such condition does nit exist. No person has 2 external genitalia. However, what does happen is that a baby is born with Ambiguous Genitalia. To simplify, the clitoris may be large and looks like a penis, or the penis is small and that the scrotum is not formed properly and ends up looking like the labia. That, is just the genitals.

Usually it happens secondary to some form of hormonal irregularities, or abnormalities that occur during the reproductive development of the fetus. Some may physically appear like a normal female, but genetically they are XY and may have testes when further invastigated. Some may be XX, but due to an overactive adrenal gland they may look like men, with deep voices and a full beard, a penis-like clitoris, etc. Nowadays in the West, they call this group of people Intersex. I dont want to elaborate on the various different conditions, because i'm not planning to write a medcal textbook. Just google 'Intersex' and you'll get more than enough. or, read Jefferey Euginides' Pulitzer Prize-winning book, Middlesex. Available in Borders.

Anyway. Let me get to my point. For the transsexuals you see everywhere, like Fatine (I assume), most of them have none of the conditions I've mentioned above because otherwise they would definitely be treated either since birth or extremely-delayed puberty. These people believe they were born in the wrong body, assigned to the wrong gender. My question to you is : Are these people Intersex? can they be considered as Khunsa?

Before you answer, I want you to ponder for a moment. Do you believe in the soul? Do you believe in the mind? Do you ackhowledgne fields like Psychology and Psychiatry? If you answered YES, then you believe that the mind and the soul has its share of illness and troubles. Schizophrenic patients believe (among other things) that the government is tracking their every move. So severe is their belief that most of them (who hv not received treatment) live in fear, afraid to leave the house, never trusting people because anyone can be a government spy. These are their delusions; false and abnormal situations/events that they believe to be real. Now think about the transexual who looks at his own male body and think it is wrong, that they dont belong in this physique. He convinced that he is a woman, depite everything that points otherwise ; his family, his physique, his chromosomes, his hormones. In the West, this condition is known as Gender Dysphoric Disorder, and it is a psychiatric condition. After much extensive councelling, and if the psychological dilemma/trauma is still not lifted, only then Gender Reassignment is prescribed, starting with hormones and eventually surgery. No going back.

What happens in Malaysia is this : if you have the congenital abnormalities mentioned earlier, then gender 'altering' surgery is done; (female-male)the clitoris is shrunk n they'll be on hormones for life. Its not called gender reassignment. Gender reassignment per se such as for the trans community is illegal here. Psychiatric help, i'm not too sure but generally speaking there are waay too few psychiatrists around which is why not all hospitals have a psychiatry Department. So these trans individuals, what do they do? they take hormone pills which are most likely smuggled from Indonesia. they start dressing like women, talking like women, mixing around with women. Once the physical effects of the estrogen takes place, they start being marginalized because people aren't sure if they're men or women. Alpha-males, the "macho men' (whom I despise, for the record) will most definitely make them the butt of their jokes, or sodomize them as a show of 'power', because these people have 'castrated' themselves, by giving up their masculinity. From what i've read, these trans community have a hard time getting jobs due to discrimination (but i see them so ofther in Body Shop, trying to make me put on make-up) so they end up in the sex industry (think, Lorong Haji Taib).

Ok. Now that I've asked you to ponder on the definition on khunsa, intersex and gender dysphoria, i have another point to raise : if these people truly desire to become and live as a woman, meaning their sole concern is their gender itself, how come all of them behave as only 1 type of women, the so-called 'modern' 'chic' 'westernized' 'liberated' type? How come none of them live moderately, even conservatively/traditionally? If any of you watched the movie Transamerica, starring Felicity Huffman as a transsexual (her Oscar-nominated role), she lived her life quietly, goes to church, makes peace with her family, etc. In Malaysia, these bunch go clubbing, drink alcohol, engage in casual sex. Wanna know how to spot a transexual? look for the one with the fake eyelashes, ridiculous heels and the plunging neckline. Its as if once they decided they are women, they are no longer Malay nor Islam. So it begs the question : what IS their primary motivation? What is their problem? Is it that once you embrace an unconventional decision, you have to embrace the other non-conventional norms of your society?

whew, that's a long one. So these are my thoughts on the issue. Do share yours. Take care.

Money Matters?

The incoherent thoughts of this particular girl is put into words once again. This time, after a typical one-sided conversation with my grandmother about family and property.

The way i see it, there are two types of people : the Business-minded, and the Charity-minded. At least in my immediate society, it is always the former that gets the praises & credits. Why? They are creative, full of initiative, opportunistic, and usually successful. It was only in recent years that i've grown to loathe these group of people. Nowadays, i am more inclined towards charity. I am not a saint, and i'm not blowing my trumpet. Its a fact.

I never really understood why people want so much; why most of them say that they 'have to work very hard'. One may argue that i come from a wealthy family, that i have never known financial hardship. Let me make one thing very clear : my FAMILY is wealthy, not me. I dont have a scholarship, so i survive on the monthly allowances my parents give. My car was a gift from my mum because she viewed it a necessity. To me, it was a bonus. I was getting along fine hopping trains & buses.

The business minded. They buy & rent out properties...they set up shop somewhere & start selling things...and they do this in addition to their (usually) adequately-paying full-time job. My question is, WHY? I dont understand the need of taking on additional responsibilities, especially when one is living comfortably as it is. On campus, i see students joining direct-selling groups (which i believe 100% are scams) or renting our their cars. Why? Most likely explanation is that they've spent their allowance on rebonding, or the RM100 present they bought for their girlfriend/boyfriend, bought a new digital camera or topping up the balance when trading in their mobile phones for a newer model. WHY? Apparently all these have become standard 'necessities'. I see fresh, fresh graduates fussing over car payments. Its all for luxury. Just car pool, or take the train. Best example : squatter houses with the ASTRO dish.Keep your money for God's sake. Why do you want to start out in debt? In the end, they complain of having too much 'commitment', 'responsibilities' and can't manage, completely burned out. May i be blunt and say that people own these things because they can afford it; they dont need extra jobs to make it happen. The reason I have all these things is because my parents can afford these things because of their surplus in income, not for the sake of providing them for me. I have these things because i can afford it; you, dont.

My own father was telling me the other day,that he has no money, because what he has now is solely his resource to support him & his wife throughout retirement. We were in his car (mind you, a now 10-year-old S-class Mercedes Benz) mentally doing the math of how much he really needs on a monthly basis. Guess what, it amounted to RM 10,000 a month which i think is completely excessive. I've met patients with 6 kids living with salaries of less than RM1000 a month, and they are FINE. There he is living in a luxury penthouse, smoking Cuban cigars every night, driving an S-class, buying designer shoes & handbags for his wife, spending RM85000 on a watch for himself, buying >RM1000 Mont Blancs as 'stationery', with 6 laptops lying around the house among his blackberry and cutting-edge digital cameras...and you wanna tell me you dont have money? F**K OFF. The only reason you 'dont hv money' is because you want to live like Beckham. Move to a smaller apartment, get a practical car and quit spending on unnecessary things and you'll already have enough to live 100 years.

Back to topic. Its greed. Pure and simple. It may not start out that way, but all business-minded people will reach that state.

I admit, i myself want a cushy lifestyle and i'm happy as long as I have money in reserve to spend when i need, for whatever reason. Anything more than that, i have completely no use for...and i can bet there are a lot of others our there who could use some extra cash. When i was in primary school, talking to a classmate of mine...i just learned that her father was a labourer, 'pekerja buruh'. I felt bad, because i had RM2 in my pocket, and i dont know how much she had. Bear in mind, i was probably 11 at the time, with very little tact but a naive, well-meaning heart. I assumed that she must surely be poor, and i felt sad for her, almost guilty, so i tried to slip a 50sen coin into her pencilcase. She, of course, protested. It has only occured to me now how condecending my actions were, but neither of us felt that way; she knew i just wanted to help.

Personally, i just want enough to support my livelihood. I wish more people would stop trying to chase for wealth. Even now, as a student, i can save RM50-RM100 a month if i dont self-indulge. What more when i work? How much do i really need for myself? I could keep all that money and either give it to charity homes, or i could set them aside as a fund for my own doctors-without-borders project. Free medical treatment or medical education to the rural areas. Adopt a child, a teenager, sponsor their education. Feel too icky about strangers? Then i'm sure you have poorer relatives, or friends, or children of friends. It really doesnt take much. Dont have money? Give your time, lend an ear. You dont have to go so far out to seek strangers. Answer me : when was the last time u had a chat with YOUR grandmother? Or did something for someone just for the sake of it and not because they asked you to? Who is the person working next to you, what is their story? Catch up with an old friend over a cup of coffee.

Charity. It really doesnt take much. Does a person really need three houses as an investment?

I guess that's all. As i've mentioned earlier, i apologize for my incoherence. Till next time, ciao!