Isnin, 30 Ogos 2010

Patriotic thought

Today is our country's independent day. Merdeka! merdeka! merdeka! I thought I want to take leave yesterday because I want to sit down and feel the meaning of merdeka. "Nak menghayati rasa kemerdekaan". But I changed my mind and cancelled leave because I have students to teach. It is more important to me. At the same time I still can continue to be patriotic. Due to Hari Raya holidays, there will be not enough time for them to prepare before the final exam. Teaching is absolutely tiring. When I came back in the evening, I missed my tarawih prayer due to exhaustion. I went to sleep early. I hope whatever I taught my students yesterday will help them in their coming exam and identify their deficiencies. From my opinion, minimal improvement is still an improvement. Take it as a challenge.
Basically, what I want to say is all about yearly event that we celebrated, month of August, merdeka month. I am very proud to be born here. Even though, originally, my great grandfather and grandfather came from Sumatra, Indonesia. My Dad this year 2010 already 90 years of age and he was born here. Feeling of love for Malaysia was stressed on me by my Dad. He, those days generation definitely know what "Merdeka" really mean. He went through a lot and managed to see the changes in our country before and after independence. From my opinion, merdeka means that you are free in your thinking process, free to express your feeling and free to do anything at all that beneficial to you and to others, as long as you are not going away from the right principles based on our culture, religion and values. Last Saturday, on the way to Selayang, I didn't see many "jalur gemilang" waving in front or on top of the commercial buildings along the road. A few houses did have "jalur gemilang". This scenery is so much different from Dr.M era as a Prime Minister. During that time, even though we were asked to put "jalur gemilang", but we put it up anyway because we did feel proud to do so. Now, people don't respect our "jalur gemilang" anymore. I am not talking about other people but Malaysian themselves. They don't even bother to put up our flag in the month of August. Our leaders don't really put stress on it. People take it very likely. That the reason why Indonesian dare enough to do all sort of terrible things to our "jalur gemilang", the pride and the maruah of our country. All Malaysian do nothing about it. We just sit back and be patience. The Indonesian government couldn't care less. If they think that our relationship with them means so much to them, they should have done something about it. However, they did nothing. Our children should be reminded all the time on the importance of "merdeka day". They feel so complaisant with the life style that they have. Today, my hospital, organised by the O&G department celebrating the merdeka babies that delivered in our hospital. I guess, the parents should be the one, responsible to instill the feeling of love to this country so that they don't forget the root.

Rabu, 25 Ogos 2010

Current medical students - the way I see

I left my medical school for almost 24 years now. I still remember my lecturer taught me about pathogenesis of many diseases in reference to the normal physiology and function of specific organs. They taught me to be critical and analytical about every single problems. All the time we were reminded that not everything in medicine is definitely 100% correct. Some of the cases are straight forward and you can make the diagnosis or conclusion almost immediately. However, some of the problems tend to be a little bit complicated that require your ability to formulate and putting a serious thought into it based on your knowledge, experience and your readings to come up with the nearest possible answer. This is where the arguments and discussions are important. Obviously, at the end of the day, you will get the final diagnosis after specific test or gold standard test performed. The process of getting to the final diagnosis require a flexibility in thinking and the student must be able to reason it out to support their argument. That's the reason why in the medical school, first thing that you need to learn during your clinical years is taking a history from the patient followed by physical examination. Occasionally, you don't need to do any investigations to confirm the diagnosis. 95% you will be able to make a correct diagnosis after history taking and physical examination. All the student should develop the skill in getting relevant informations from patient and confirm it with physical examination to further strengthened the evidence. A doctor is just like the CSI officer who are trying to gather all the evidences and come up with the most possible diagnosis. It is an interesting process. Some of the diseases have overlapping clinical features and biochemical derangement, but you need to choose the most likely diagnosis. Of course, if we can do a specific test for the confirmation, finally we will get the right diagnosis. In order to go through these processes, we have to strengthened our basic knowledge on physiology, pathology, biochemistry and not to forget human anatomy. I always reminded my students on the basic things in medicine. We have to remember everything that we have learned in the early years of medical school. In order to recognise abnormalities, we have to know the normality first. Otherwise, we can't make any conclusion out of it. It is not an easy task. Students nowadays, are very poor in applying knowledge to patient. All of them are so call 4 flat students. They read a lot but unable to identify the relevancy of such informations to the patients. They have tunnel vision. Their arguments and discussion on certain diseases are very immature. Overlapping of symptoms and clinical signs are too much to handle. They easily get confused. Mind you, they are 4 flat students. Worse still if they don't have interest in the subject or in medicine. They do medicine for different purposes. Peer pressure or parents pressure. I take final year medical students from the public as well as private universities. They are equally bad but the public university do slightly better.....It is worrying situation. Probably, we need to look back at the presence curriculum or something have to be done. We have seen the prove from the quality of housemen that we have nowadays. The quality of our doctors are deteriorating, not only in skill but in knowledge, soft skill and attitudes. How much we specialists in the government hospitals can teach and guide them in 4 months posting if their basic medical knowledge is almost 0%. It is a tough job.......good luck to all of us ...

Selasa, 24 Ogos 2010

My children that I adore so much

Over the years, I wish to have one big family like my parents. There are nine of us, 4 boys and 5 girls. But when it comes to me, I only managed to get 2 of my own, double joy, a twin girls that colour my life. I had two abortions after the twins. I pray to God all the time, to give me two sons to replace my two abortions that I had. I was waiting for so long for the moment of truth. God answered my prayer. Instead of giving me 2, HE gave me 3 sons. Even though God gave me the over grown sons, I love them like my own. Of course, all my sons have their biological parents but I love and care for them like my own. I will make sure that they become successful in their life. Share my wisdom and be there for them when I am needed. They are lovely children. I am truly blessed. I don't really care what people say about having over grown sons. What important to me is, my happiness and their success. I have plenty of love to be given away. Rather than waste it, make as well give it to someone that you love and care, my children. Not to forget my nieces and nephews that I love and care too. Let me introduce you to my children. The beauty about them is, there are not the same including my twin girls. Just imagine, I have to deal with five characters and five taste of things. It was fun. All five of them are already grown up. Eldest among all is Along (Dee) followed by Aniep, Aiman and the twins. If you see them, you can imagine how close they are. They shared a lot of things together. They care about each other. They behave like they are "true" siblings. That's what I wanted anyway. Probably, many people won't understand and won't know how deep their relationship is.Only me and them know. If you see them, you will see how close they are. As far as I am concern, they are my children. As I mentioned before, when I decided to do good to people, I will never look back. I am throwing a stone remember, into the ocean and not throwing a boomerang. I will tell you about them .....sometimes...

Isnin, 23 Ogos 2010

When you do good to others - don't look back

I have many friends, closest to me and far away from me. Not to forget, my family members who always be there for me in every situation and circumstances without prejudice. I learned a lot from them. They have different characters and different ways in expressing their feelings and views. Of course, I have my own ways. The way I see, the way I acted and my views on certain things are very much influenced by the way I was brought up by my beloved mum and dad. It is also derived from my own experience as well as from my readings. Definitely, genetic configuration also play an important part in my life. However I am blessed because I think I have more of my Dad rather than my Mum. My siblings admitted it too. My mum is a very fierce lady and sharp but of course she has a lot of positive values that she taught my siblings and me during our childhood days especially how to respect people older than you as well as your brothers and sisters. No matter how terrible your brothers and sisters treating you, no matter how serious the argument is, or so much different views we had on certain matters, at the end we are still one family and should love each other. Your family will come first before anything else. I absolutely agreed with my mum on that matter. My dad used to say to me that when you want to help or do good to people, do it sincerely. You shouldn't do it for names or recognition. If you already did it, you don't have to mention about it all the time, again and again on how good you are. As a doctor, a profession that my Dad taught when I was in primary school when he mentioned it to me, is the best profession for me, for sure I have done a lot of good things to my patients, for my friends and many more. Not to forget my students. Well, I definitely don't want to hurt or causing any trouble to anyone. I love to help anyone in needs. When I do good things to people I will never look back or mention about it because if you start to talk about it, it is no longer relevant as I see it. Doing good to others, the way I see it is like throwing a stone into an ocean and not like throwing a boomerang. Why I say that because if you throw a stone into the ocean, no matter how hard you try to discover it, you will not be able to find it. The stone is too small in comparison to the big ocean. Whatever the good things you do, in the eyes of God, it is just a small thing compared to the wealth and good health that HE, almighty gave us. Furthermore, don't do good the way you throw a boomerang where you are expecting something in return. If you do good things to people the way you throw a boomerang, make as well don't do it. No one is forcing you anyway.....the way I see it..

Jumaat, 20 Ogos 2010

Merdeka! merdeka!! merdeka!!!

This year, 2010 is a busy year. As a doctor, we were warned by the Selangor State Director of Health on the outbreak of dengue in Selangor. We, in the paediatric are well prepared for the circumstances of many admissions to the ward. But the most exciting about 2010 is fasting month falls in the month of August, our merdeka month. Month for you to be more patriotic in your thinking and act. We love our country very much the way we love ourselves. All of us should, if we call ourselves a Malaysian. This year, we are going to celebrate our 53rd merdeka year. During this period of time, our leaders keep on changing depending on the election result. Whatever it is, all of our leaders, their aim is almost the same, trying their very hard to bring up Malaysia to the eye of the world. It is just the methods and approaches that they used are different. They want to maintain the stability and improve the economy of the country. Different leaders have different styles and vision as well as mission. Under this current leader, we are talking about One Malaysia or Satu Malaysia where the motto is "rakyat diutamakan, pencapaian didahulukan. I read in the newspaper about this concept. I don't really get it till now. My view is, I think all of our previous leaders have the same mission. It is just that, it was not written on paper. Any development they make, is for people of this country. Us. We, as the citizen of our beloved country, Malaysia enjoy all the good things that our leaders have done. Of course, if we want to do anything, we will do something that is achievable. Don't waste our time trying to achieve something impossible to achieve at this current time because after spending so much of money, time, effort and resources, at the end of the day, all the these will go into the drain. A lot of money will be wasted which are people's money.
I want to share my view about language. 53 years merdeka, it is not a short period of time. There are many changes were made to improve our education level in this country. We read in the newspaper, several changes need to be done to achieve the best educational status of the people. I don't know whether we are progressing well or regressing. Lets talk about Malay language, our national language. During my primary and secondary school, all the students, Malay, Chinese and Indian could speak malay very well. I have many friends from other races in school as well as in my village. We were so close with each other. No worries. Now, when it's come to my children, they have no opportunity to have friends from different races except 1 or 2 that they met in the boarding school. Even when they entered university, they don't really know how to make friend with their colleagues from different races. I really pity them. Some of them can't even speak Malay well despite being accepted to the university. Well,I am saying not all of them. When we talk about national language, we expected all of these students should be able to speak well in bahasa. My daughter said to me one day "Ibu, I really got fed up with my group because they speak Chinese among them selves during the discussion just because they are the majorities in my group. How about us, me and my Indian friend. Why can't they speak the language that everyone can understand". To some people, probably this is a small matter but to me it is an issue. This is happening everywhere I guess. What has gone wrong?. Well, we are free to speak whatever language we want but when it's come to the group discussion, we should know what bahasa we should be using so that everyone can understand. Insensitivity like this basically developed from the primary and secondary school. Here, we are talking about one Malaysia. Together, we are one. I thought, with the development of good school curriculum, this scenario won't happen. Bahasa Melayu is the national language and it should be the duty of all Malaysian, if you call yourself Malaysian, to learn. I meant all of us. English is the second language, so learn it by hard.
Let me tell you a story. Recently, there was a Chinese boy, 8 years old admitted to my ward. He was suspected to have leukemia. He was such a lovely boy. He understand Malay and English well but can't say the words. We were having problem with the mother because we wanted to explain to her about the child's condition and the plan for him, we could not do it because she said "tak pandai Melayu dan tak pandai olang putih". I asked her"sikit-sikit boleh tak atau kita cakap dengan suami". She said,"suami kerja". Then, I looked around to find my houseman. I have two Chinese HO. So, I call the first one to explain to the mother the situation of the child. To my surprise, she can't speak mandarin or any other Chinese languages. I call the second HO. Initially, I didn't want to call him because I didn't trust him at all to convey the message to the mother. I was worried that he would gave a wrong information. However, I had no choice. True enough, after the explanation done by my second HO, the mother requested to go home with the child. I talked to the mother again in Malay and persuaded her to stay for the sake of the child. I called my medical student, the last resort, a Chinese to talk to the mother to make her understand the situation, but to my disappointment, he also couldn't speak Chinese. "shame on you" I scolded my student. The mother is a young mother. I reckon she must has gone to school because she was reading a Chinese newspaper and magazine. 53 years of independent and yet we still have this scenario. What had went wrong? Whose fault is this? Which direction are we heading for? We are no here no there. By right, anyone who are born here should know at least 2 languages. One, their mother tongue language and the other one is our national language which is Bahasa Melayu. Is it so difficult to speak bahasa? If yes, why the Nepalist or the Bangladeshies or even the Chinese foreigners can speak bahasa only in a few months they are here in our country, but not us, who are born, eat, work and stay here for the rest of our life. I wonder.......??!!

Rabu, 18 Ogos 2010

Making the right choice

I love to share with my children and others what I have read in the book. Previously, I have no time to read other books than medical books. Now, I have a little bit of extra time, I want to improve my knowledge on the moral, social and emotional aspect of life. I want to improve myself in many areas that I feel a lot of deficiencies. I want to be a better person than what I am now. I want to do good to people who need my help because I know that the greatest good you can do for others is not to share your riches but to reveal to him or her his/her own. When we treat people with respect, indirectly we help them to gain confidence and reveal their inner potential. Everyone has the potential to become great or someone successful provided they believe in themselves and look at things in a positive manner. I remembered one quote by Lao-tzu saying "Knowing others is intelligent. Knowing yourself is true wisdom. Mastering others is strength and mastering yourself is true power". I really like this quote because I do believe that we have to know ourself first. Of course, knowing people around you is a bonus because it will help you to develop your inner power and determine your purpose. However, some of us rely too much on other people to make decision for us. Before he'she venture into something or making the most important decision in his/her life, rather than asking themselves what exactly they want, they will ask other people first, not really for opinion but asking others to make decision for them. Remember, mastering yourself is true power. Power doesn't have to show off. What its mean by power here is self confident, self-assuring, self-starting, self-stopping, self-warming and self-justifying. You will know when you have it. Most of us will be thinking "what people will say if I do this". We are trying very hard to please others rather than trying to please ourselves first. We should know what best for us. We are suppose to learn from people around us and decide what is the best for our future and not allowing the external forces to influence our decision. That was my advice to my niece Syimah sometimes ago when she was in great dilemma whether to do her master in US or to do master on the job. She asked many people for advice. Of course, she got many version of advices and opinions until at the end of the day she was still blur. Even worse when some of the remarks that she received from various people make her feel sad and miserable. She was still unable to choose which one to follow. Pressure all around and every corners of her. When she told me her problems and frustration, she was crying. At that time I knew that I have to do something about it. I gave my version of advice of course. Well, I am a very simple lady. I told her, it was up to her whether she want to follow my advice or vise versa. Thank God, being a smart girl, she made the right decision to continue working here and declined the offer to go abroad to further her study. She does her master locally as part time student. Now, she is in the second year and she is doing very well. It is tough but if she believe in herself, she will get what she wanted, insyaallah. I wasn't sure whether I told her or not that intelligent is just like a river. The deeper it is, the less noise it make. Just do whatever you think is right. Do you know 18/40/60 rule. I read about this rule somewhere, I can't remember. What it mean is "when you are 18, you are worry about what people thinking of you; when you are 40, you don't give a darn what anybody think of you; when you are 60, you realise that nobody's been thinking about you at all. So, don't waste your time trying to please others. Everything you do should be an expression of your purpose or destiny.

Isnin, 16 Ogos 2010

Antibodies - where did you come from?

Yesterday Sunday afternoon, when I having my nap, my daughter called me and woke me up because I received a phone call from hospital. I asked her "who is it". My daughter answered " Don't know. Man voice. I think Uncle Zainudin". I walked to the phone thinking Zainudin was on the line. Well, my daughter know that Zainudin is the only man in my department. If she heard a man voice, she will think that voice belongs to Zainudin. I picked up the phone and to my surprise, it was Dr. Amir, my paediatric cardiologist. He was on-call that day. He wanted to consult me regarding a new admission to the ward. Basically, he didn't know what else to do for one of our patient that was admitted with symptoms and signs of haemolysis. The child Hb was low 4gm/dl and the haemolytic process still present. He wanted to transfuse blood for the child but during cross-matching, the lab staff found the child's blood contained plenty of antibodies. It was very difficult to find a matching blood. The presence of antibodies in the child's blood him as well as me because the child had no history of getting any blood transfusion before to explain the situation. Of course we cannot leave the child without treatment. He need blood indeed. Otherwise, if the Hb drop further, the child will develop heart failure and die. It is a critical situation. I advised him to do a few things and no matter how to try to get the blood for the baby. Worse come to worse, we need to give 'O' negative blood as the last option. Dr.Amir sounded satisfied with my advice will do as told. Sometimes as consultant, I need to be ever ready when my advice is needed. After I put down the phone, I was still thinking about the patient. How does he gets antibodies in his blood. I tried to formulate something rational but still blur. Anyway, today morning, I went to the ward to see the child, to find out how he was doing. He was a lovely chubby boy, 9 months old. Very friendly but pale. He was not in cardiac failure. There was tinge of jaundice of his conjunctiva. I also saw a few bottles of dark-coloured urine sample on the table. My doctor managed to get the most suitable blood for the child last night, informed my HO. And another pack of blood was in reserve if we need to transfuse some more. Looking at the child, I knew that he still need another blood transfusion. I ordered them to proceed with the second blood transfusion in view of the child still pale and haemolising. All my doctors were around me, listening to the questions that I asked the mother. I was trying to find out the possible cause of the haemolysis and presence of antibodies in the child's blood. The only positive relevant finding that I managed to get was about the mother who had blood transfusion for the treatment of dengue haemorrhagic fever in one of the private hospital in Kajang. One year after that, she conceived this child. So, I really don't know whether the mother developed antibodies toward the blood transfusion that she had before, and these antibodies were transfered to the baby during pregnancy via the placenta. I really am not very sure. Furthermore, I was not told the type of antibodies in the child's blood. Not only the antibodies puzzled us but the haemolysis that has occurred in the child. We still cannot find the cause of it. Several investigations done did not help to determine the cause of haemolysis in this child. My postulation is that, it could be still due to G6PD deficiency, which is very common in our population to cause haemolysis even though in this child the result of the G6PD screening test at birth was negative. I don't know and till now, I have no definitive answer to it.

Sabtu, 14 Ogos 2010

Learn from my grandsons Harith and Ryann (son of my niece and nephew

I have 7 grandchildren from my nieces and nephew. What I am going to tell you is about 2 of my grandsons that closest to me. I adore and admire them a lot. When I miss them, I will go to my brother's home to see both of them. They live together with their grandparents, my brother and my sister in-law who refuse to let them stay on their own. They just like twins brother. They fight and they hug. They also jealous with each other in many ways. But when it comes to food, they eat together. They shared breasts too. They can enjoy breast milk from both of their mama. These 2 boys are very lucky to have 2 mama, who love them very much, an ayah and a papa.Their age different is only 3 weeks. Talking about love, these two boys have all the love and attention that they need from all of us after their parents. One thing about them is, they love themselves. They admire themselves very much. A lot. Lets talk about Harith. Harith is a son of my niece Kak Ti. Kak Ti, is a lovely lady. She was so sweet when she was a child. Even now, she is still sweet. Always relax and easy but sometimes quite firm. Same with Harith. Happy go lucky. Acuna metata. No worries. Harith is a handsome boy. I think, when he grow up, he will break many girls heart. He loves to play with tractors and lorries. Heavy stuffs. But what I really want to tell you is, he is so self obsess. He loves to look at himself in the mirror. Make faces and laugh at it. He knew that all of us pay a lot of attention to him. He will try to draw your attention by doing many things such as run here, run there, throw things and never sit still. "Penuh kesanjungan", that the words we used to refer him to. He really admire himself a lot. He is still unable to talk in sentences but he knows how to express himself. One day, he was crying of something that I couldn't remember why. While crying, he was looking at the mirror and making faces and interestingly looking at himself but still continued crying. I really amaze. Start from young, he already learn to love himself and appreciate what God has given him and use it to the fullest. He is very playful like his mama. Everyone blaming me for him for not able to speak properly. because I talked to him using a language that me and him understand or both of us didn't understand either. No meaningful words such as achapacapa and many others. Well mind you, he seems to understand. Harith love to make people laugh. Different with Ryann, my other grandson. He belongs to my nephew Dek Aleem. Dek Aleem and his wife Kay Yun, that's what we call her, are a loving couple. Dek Aleem is a duplication of his father, my brother. He is a handsome man too. I am not lying. You will believe me when you see him. Therefore, his son, Ryann is a cute little boy. I really like and love both of them, Harith and Ryann very much. Nice to see them growing and develop into a toddlers. Interesting to look at them. Ryan is a smart boy. Proper in conduct even though he is only 2 years of age. If he wants something, he will ask politely for it. He is a clever boy. He is a clever boy. He also admire himself very much too, same like Harith. He love to post when you want to take his picture. He will give you the best post that he can make with a smile to kill, that kind of smile, you know what I mean. He is so cute. These two kids basically believe in themselves. They don't care what others think of them. They just do whatever are right at that point of time. The way they see it and try to do anything to get what they want. They will try all sort of things and give us the very best of things that they are good at. They keep on trying especially when its come to fix the toys. They never given up. I guess, we should follow them as well. You have to believe in yourself when no one else does. That's will make you a winner. We have to learn to get in touch with the thought within ourselves, and everything we do must have a purpose. To be on purpose, it means you are doing what you love to do, doing what you are good at and accomplishing what's important to you. Therefore, everything you do should be an expression of your purpose. Self respect is the fruit of discipline. A person who lives without discipline, will die without honour. Learn from my grandsons, Harith and Ryann. You will never regret. Believe me...

Reaching your goal

Today is the fifth day of fasting in the holy Ramadhan. Time fly and leave you behind without you realizing it. That's the reason why I always reminded my children that if you want to do something, go ahead and do it. Don't try to wait for the perfect time because there will be no perfect time. I remembered the motivational book that I have read many months ago. There are 2 groups of people in the world. First, people who are included in the group of "ready, aim and fire" principle and the second group is using other principle which is"ready, fire and aim". There are many people in the first group where they are spending their whole life getting ready and getting perfect. They are waiting for the perfect time to act but all of us know that there will be no perfect time. So, this group of people will become a looser at the end of the day because they will miss the opportunities in front of them. In another word, they miss the boat. I taught my children to use the second principle in order to be successful in whatever they are doing, be it in their study or in their work. That phrase really taught me a lot of things. What we need to do is, get ready and decide what you want to achieve. Make reasonable plan but please don't take too long. Identify your target carefully and fire or go for it. After that then you see whether your bullet or your action hit the target or not. If you miss it, don't worry. What you need to do is, identify your mistakes or deficiency, determine how far it is from your goal and make some adjustments to get closer to your aim and fire or try again. Keep on firing or trying. Sooner or later, with God will, you will reach whatever you wanted, by making plenty of changes and adjustments rather than persistently waiting and trying to be perfect. If you try to be perfect like in the other group of people, you will end up aiming your target forever, scared to make mistake. At the end you will loose. No man ever became great or good except through many mistakes. Failure is an important part of the learning process. The reasons we know so much because we learned from our previous mistakes. However, don't make a habit trying to make mistake first before you can learn. Well of course, this is so true if you want to learn from your mistakes. Some people, the looser, make so many mistakes and never learned from their mistakes. They blame others for their failures and never blamed them self. Even though they are given so many chances, they don't take that chances seriously and at the end, they end up with nothing. One more thing, we also can learn from mistakes done by others. Blaming other people is a waste of time and a sterile act. Learn from the people around you. These experiences will guide you to achieve your purpose or destination. I have 4 children. When I talked to them about how to reach their targets and be successful person, of course, all of them will give me different reactions. My twins, the naughty most among them will be saying "oh no! not again" especially my Indian-like twin. The Chinese-like one will just smile and agreed completely to what the sister commented. She will listen no doubt but yet to follow. The eldest, Along, will listen and pay attention and try to make sense out of it. Angah, second son, smile and think of something else. Day dreaming. Always out of focus. Syimah, my dearest niece, always make fun to what I have said but I know, she agree and try to learn from it. She is such a happy young girl. Always has no confidence of her credibility and talent. But one thing about them, they are very good children, polite and well behave. As a mother, my children inspire me a lot. I learn from them too. They have very different characters and ways in thinking process. But whatever it is, I have done and taught them what I am supposed to do, now it is all up to them. They will have to make a decision whether they want "happiness and success" or they want "suffering and failure". One more thing that I always reminded them was "children, you have to respect and love yourself first before you can respect and love someone else". I guess, this is true, the way I see it. You have to set certain criteria on people or friends you want to be with. You have to put values on yourself high enough, the way my beloved niece, Syimah said one day. I love her very very much and absolutely agreed with her wisdom. I also love my other nieces and nephews as well. Nanti kecil hati pulak dia orang. She said "I know I am not pretty (I know she is pretty and adorable in her own ways), I know I am not so clever like my sister (she is clever, yes she is). but I do have certain standards that I want for anyone to be my friends or special boyfriend. I don't care what people say and I don't want to grab or take just anyone, just to please people or just for the sake of having a boyfriend. I won't do such a thing". I really like her. I definitely and completely agree with her. You have to love yourself. You deserve a better person, to be your friends. Don't put yourself too low. By doing this, it does not meant that you look down on people or you are too choosy. It is not true. It is just that you value yourself. Successful man used to say, "if you choose 5 loosers to be your friends, you will become an average of 5 of them. But if you choose 5 successful and clever men to be your friends, you will become an average of these 5 people". You just imagine that people that you are mixing with will have influences and determine the way you think, the way you act and the most important of all, determine your future. Everything that you experience today is the result of the choices that you have made in the past. I absolutely agree with it. I always reminded all of my children as well as Syimah, just like my own child, to have certain principle that they can follow, to be successful in life. Follow the closest example, our beloved prophet Muhammad SAW. Our religion taught us a lot how to survive and be successful in this world. If you follow that principle, you will never go wrong. Insyaallah....may God bless you, my children. The photo of my children including my niece, Syimah. They are so adorable, aren't they?. They are my inspirations, of course not to forget my beloved and dearest husband who was not in the photo (workerholic) but always in my mind, who is always there for me in all situations and circumstances as well as give me the support that I need.

Isnin, 9 Ogos 2010

Do I care or ada aku kesah!!

I have a terrible reputation to leave on. I am labeled as a nasty HOD who loves to extend houseman when they come to do their posting to my department. Even, the news spread to the other hospitals. They said that I am the most fierce person in town.. tigerest. Worse than a real tiger. Yes, I was born in the year of a tiger and I have extended 7 HO so far. Mind you, I was accused to be racist as well. Ada aku kesah?!! As far as HO is concerned, I have done my duty. I teach and guide them to be safe and competent doctors. If they cannot perform and unsafe, I will extend them for sure. The decision to extend HO is not an easy decision to make. Many procedures to be followed including take them for a viva session. It is done based on cumulative decision by all the specialists. Not my decision alone. Majority of our HOs nowadays. based on the one that I have. have poor knowledge including basic pathology, physiology and worst, anatomy. Poor in problems solving, no analytical thinking and have tunnel vision. Don't mention about bad attitude, so many of them. Psychiatric illness also have....They are crazy, in turn make you crazy too. Poor coping mechanisms. They just like robot, in fact worse than robot. Robot will do whatever you ask them to do because you programmed them that way but my HOs, most of them, no matter how many times you teach them, they still never learned and do the same mistake again and again until you yourself will develop epilepsy (sawan) trying to make them understand. You asked questions, you have to answer back otherwise, I have to continue doing my round forever. So difficult stimulate them. I am tired, really tired. Sometimes, we have to teach them from the basic. I wonder, if they can't learn in 5 years in medical school, do you think my specialists and I can do it in 4 months. By right, my duty as clinician is to teach them in the application of their medical knowledge to the clinical situations and patients. Who to be blamed? The parents who forced their children to take up medicine even though the child didn't want to, or the medical schools that rise like mushrooms with insufficient lecturers to teach the students in order to meet the demand to increase the quantity and ignoring the quality of the students produced. Is it something to do with the students selection? People have the perception that to be a doctor you must get very good result in the exam because the IPTA or IPTS will only take the cream among the cream. Well dear friends, it is only true for local universities but it doesn't really applicable to the "foreign universities". Not only the cream, the base of the cake also can become a doctor. Don't ask me how. I guess the issue is too sensitive . However, these cream also failed to be good doctor. Indirectly saying, to be a doctor, you must be good in all areas and aspects, not only in academic. For example, an 18A1 student also can become a prostitute, mind you. I feel parents and teachers must put other values in the all the best academic performers such as soft skill, stress coping ability, critical and analytical thinking processes, social, religious and cultural values and many others so that they can survive in this demanding world. Otherwise, our psychiatrist will be very busy treating and counseling these doctors like what happening now. Therefore, I will continue to extend them if they deserve to be extended. No mercy because I do this for the sake of our generation...... and for them as well. You have to be cruel to be good.

Khamis, 5 Ogos 2010

We are not the same

I did my ward round as usual. During the morning round, I will take the opportunity to teach my doctors and the medical students. Teaching is something that I enjoy and love to do. The young doctors, students and my staffs are giving me energy to carry on with my daily work. Toward the evening, normally I still feel that I am full of energy but most of my doctors already looking like dried flowers. They can't even smile. Most of them were getting ready to go home. I used to offer my students extra teaching in the evening especially when the final exam just around the corner, but none of them are interested. I smiled at them and said "very well, up to you children. I am willing to stay back if you want me to". You see, time has changed. During my student days, we have to find senior students or any lecturers with a kind heart to give us extra teaching. Now, teacher offer but no takers. So sad. Never mind. Let me tell you about one of my patient that I saw that morning during my round. I went closer to the bed and introduced myself to the mother. Her baby boy was sleeping. He was only 4 months old and was admitted for bad pneumonia. He was on cardiac monitor and on nasal oxygen supplementation. The mother appeared very anxious. I examined the baby and told her the progress. She asked me" doctor, kenapa anak saya jadi macam ni? Macam mana dia boleh dapat jangkitan paru-paru?". I knew the mother was so worried. I explained to her slowly on the possibilities the mechanism how the infection could have occurred. And then she replied"doctor, anak saya tak pernah dapat sakit teruk macam ni. Termasuk anak saya yang sulung. Dia sihat. Ini adalah kali pertama. Saya jaga anak saya dengan baik, doctor". I looked at her and smile. I told her not to feel guilty on what had happened to her son. It was not her fault. Germs were everywhere and the lungs are exposed to the environment. They can easily get infected by bacteria. I reassured her that her baby will get better with the treatment that we have started. I also told her that her first and second baby is different even though they come from the same parents. I also told her that in life, before you can experience a second time event, you must go through the first time experience. It is normal. I told her about my twins. My beloved twin girls. They are 18 years now. Both of them are completely different individual even though they grew in my womb at the same time. Phenotypically, they are different. One look like Indian with curly hair and the other one look like Chinese with straight hair. The foods that they like also different. The curly hair loves western foods but the other one loves spicy traditional foods. One has allergic disease as well as asthma but none in the other one. They grow up in the same environment, same exposure. same school, same food that they eat and of course, the same teaching and love. However, they are different in many ways. Their thinking process and behavior are completely different. In term of knowledge, also not the same. Basically, in another word, none of us are the same. We have to acknowledge the differences among our children as well as the people around. us. No matter how hard you try to make them to have the same character, you will fail. But you can make the difference smaller in scale. My twin girls that I truly love and admire. You can see the different. They inspire me.

Rabu, 4 Ogos 2010

Purpose of life - my view

As a doctor and as a human being, I always amaze with people around me. The way they walk, their look, their behavior and their response to the environment. There are billion of people in the whole world and none of us are the same. We are different in many ways. Just simply look at the thumb print. Never the same and many more that I don't have to tell. The all mighty God has created us for a purpose. To achieve the purpose, we must follow certain principles. For muslim like me, I have to use the principles already outlined in the holy Quran. Whatever we do, we cannot run away from our believe in Allah. However, Allah has given all of us the most valuable organ ie the brain. You have to decide which principles you want to choose, based on your knowledge, experience and creativity of thinking process to achieve your purpose or destination. We have all the freedom to choose, freedom to love and freedom to do anything at all as long as we discipline ourselves and follow the principles that we already set up. We must have self respect because it is the fruit of discipline and sense of dignity. Who lives without discipline dies without honour. All of us want to be a winner. We have to believe in ourselves in order to make us a winner. Easy said than done. I know many of us so scared to make mistakes. Many of us want to be as perfect as possible. If you make mistakes, you will get into trouble and you will not be able to reach your destination or purpose. But mind you, no one is perfect and there will be no perfect time to do things. Don't be scared to make mistakes because failure is an important part of the learning process. There will always be a learning curve. No one ever became great or successful except through many mistakes that they have done. But of course this is only true if we learn from our mistake and try not to repeat it again and again. There are people continue to make mistake again and again and never learned from it. There are also people spending their whole life getting ready and getting perfect. They waited for the perfect time to act. But we know that there will be no perfect time. You have to grab any opportunities that pass by and try to make the best out of it. Occasionally we need to make some adjustments along the way to suit our purpose. " ...aims is completely different from "". Which one you want to follow. It is all up to you. However, please remember that everything that we experience today is the result of the choices that we made in the past. In another word, everything you do is the reflection or the expression of your purpose. We only have control on three things in our life ie the thought that we think, the images that we visualized and the action we take. Try not to blame others because it is a waste of time. All these make us so much different from each other. Some of us will reach our purpose earlier, some will take a longer time and some will never reach their purpose or destination till God take away their life. Therefore, always bear in our mind that the price of being success is to keep it alive in our mind. Try not to be a failure.......

Isnin, 2 Ogos 2010

My beloved patient

For the last few months, I have been busy. The wards were full with patients. It was a Dengue season. There were so many dengue cases. Thank god, so far we have been doing very well and no mortality among our paediatric patients. However, we did get other cases as well which was related to infections such as lung infections, meningitis, URTI, and others. I want to share a story about one of my patient's parents. Of course, my job is to make my patient well without residual morbidity if possible. Deliver the best treatment that I can give based on the current development in medicine. My priority is the child whom I treated. On top of treating my patients, I will tell the parents of the child about the disease of their child and the treatment. My specialists will give the family of the child health education as well on the disease itself. I guess health education is far more important because it play an important role in prevention of a disease. Like many people say "prevention is better than cure". I absolutely agree with this phrase. Last week, middle of the night, 3 months old child was admitted to my ward presented with fever for 4 days and irritability. The child was seen by my senior MO who was on-call and a diagnosis of meningitis was made. She started the child on the treatment of meningitis. The next morning was Tuesday. As usual Tuesday is the day that I will do my grand round and teaching round with my doctors and medical students. I went to the child's bed. Both parents were there. I introduced myself to the parents and asked my HO to present the case to me. The presentation was good and clear. However. I noticed that the child was sleeping in a strange posture. I asked my HO whether lumbar puncture (ambil air tulang belakang - in malay word) was done or not. My HO said that the parents refused to give consent for the procedure and only that morning they agreeable after one of the consultant talked to them. I touched the child and turn her to supine position. To my supprise, I noted that the child's face was asymmetrical, deviated to the left. She was unable to close the right eye. She also had unequal pupils. One sided of the body was stiff. I think I don't have to tell the detail of the examination because many of you will not understand. I suspected that the child had more neurological problems. I asked my doctor to defer the lumbar puncture but instead to get an urgent CT brain. Our plan of management and suspicion was very well explained to the parents. Both parents are educated people and graduates. They appeared understood with the problem. My doctor managed to get an urgent CT brain that morning itself. However to my surprise, the CT result was reported as normal. I was in the meeting when I got the message. I was not happy because the clinical presentation did not correlate well with the CT findings. After the meeting. I looked at the CT brain myself and I felt the CT was not normal. The next day, we managed to get another radiologist to report the CT and true enough, it was not normal. I asked my consultant to explain to the parents the findings of the CT brain and told them the management that we were going to give to the child. The parents were not happy. They felt the child was being posses by spirit and wanted "AOR" at own risk discharge. My doctors were not happy. Once again my specialist explained to the parents. They insisted to go for the traditional treatment. As a doctor, our concern is the child. We tried to convinced them to stay in the ward so that we could continued the antibiotic. They agreeable to stay after so many discussion and explanation. We practically begging them to stay. Sometimes I asked myself, why do I have to do this and take the trouble to persuade them to stay. If I let them go, I will have one empty bed. Easy life for my doctors and nurses. I will be very happy if I have less patients to see. If the parents clever enough, they should be able to think rationally, for the sake of their child. Despite being educated and well informed, they just couldn't care less about the child. The whole family members think that the child was under the control of an evil spirit. They agreed to stay but refused any treatment from us. No blood taking and no setting lines. Scolded my nurses for no apparent reasons. The next morning, I talked again to the grandmother but failed to convince them to stay. Therefore, I allowed them to go home. No matter how you try, the baby still theirs. You as a doctor, can only do up to a certain limit. The rest, we leave it to the family and God. I can assure you that there are many more parents like this everyday that we have to deal with. Sometimes we given up on them. We pity the child. Occasionally some of them do come back to us in a bad state after taking "AOR" discharge. At that time you feel that you want to kill the parents...???..!!! frustrated.
Please, don't be like this parents. Think about your child's health. If you don't understand what's going on, ask again and again. We have to progress and not regress in our way of life.