Program Pembangunan Keluarga organised by PUSPANITA HSDG

Last Saturday on the 30th October, HSDG PUSPANITA organised by my dearest friend Dr.Saraiza a wonderful informative programme for children and adult especially for parents on issues of parenting. How to become a responsible parents and how the children can be successful in their life. It was an excellent programme with lectures and activities. However, I was quite disappointed because the turn up was very poor. By right, the parents supposed to come together with their children but only very few came. No fathers. There were supposedly 100 participants registered but only less than 50 came. We invited 2 good and excellent speakers who almost always come up on Astro Awani. During the session and the lectures, from my observation, probably only less than 30% of them was paying attention and really listening. Most of the children didn't really bother. Sometimes they make fun of what was being said. Majority of these children belongs to the families who are staying in the hospital quarters. They came on their own. I really enjoyed the lectures given by the two speakers but at the same time I continued my observation, make my own analysis of the children's behavior. Some of the children I know their mothers and some I don't. Some how I know how are they being brought up. I can clearly see who are clever and who are not. I know I might be wrong but I do have strong feeling about it. Anyway, many people especially those from the quarters are not interested to get involve in educational programme like this. They prefer entertainment program rather than educational programme. We cannot force people to learn and improve themselves. They should have their own initiative to improve and learn from someone experiences by participating in a very good programme like this because if we want to read from books, it will just not going to work to some of us. All of us should remember that our minds are like parachute. They only function when open. Therefore, we must have an open mind to learn more and more because knowledge is so important for survival. We have to make the best use of time, we need to live each moment as if it is vitally important especially in gaining knowledge. In this situation, people bring knowledge to you but you don't want it. It is really a waste of an effort. I guess I have to accept that not all of us think and behave the same way. How are you going to live or the future that your creating is your own choice......hopefully it will be the right choice.......

4 just nice but 21 is messy

Almost everyday my specialists will tell me about how terrible the HOs nowadays. Previously we have only 10 HOs at one time to torture us but currently we have sudden influx of them. 50% of them are first poster, freshly from medical school. I have 2 general paediatric wards and one NICU, such a small unit. I am scared that soon the number of HOs will out number the patients. I keep telling our hospital director that we can't really teach the HOs properly because we don't have enough patients for them to learn. They are suppose to do minimum 8 calls by regulation but they only did 4 or five calls the most per month. Each HOs will be in-charge of the most 4 patients. Well, with that number of patients that they have to look after, they still can't even remember or know what's going on with the patients. The antibiotics the patient is on and the number of days that the patient already in the ward. Worst still, they don't even examine the patient to know the patient's progress. Don't ask about disease, forget about it because the normal values also they don't know. There are so many protocols and informations available in the ward for their day to day work but they hardly used it. Basically, they know nothing. Very poor basic medical knowledge, bad attitude, no pro-activeness, lazy and some of them worst, beyond economic repair. We do have the numbers but where is the quality. We really have a tough time teaching them. You ask questions, never get any answer. Silent or you have to answer yourself. Fine, probably, we need to teach them and show them the way. Yes, we did that with difficulties. We have to teach even the basic medical knowledge such as how to differentiate between stridor and wheezing, petechiae and purpura, pallor and jaundice, crepitations and rhonchi and many others. Showed them how to take good relevant clinical history and to do proper physical examination in which all these should have been taught in the medical school. By right, my job is to teach and guide them in applying their knowledge to the real patients. But the situation is so different because there is no knowledge or skill to apply. Whether we like it or not we still have to teach them otherwise the patients will be in danger. We can't be there to hold their hand forever. After 2 months, probably 1 or 2 will improve but the rest remained the same. DG advice us to treat them nicely and give them TLC. Yes, we did that as well but nothing happen. If we increase a bit of our voice, because one or twice or sometimes you lost your patience, the eyes start to turn red and some of them will just cry out loud. Every day during the rounds, my specialists and I keep on repeating again and again but it doesn't seem to get into their grey matter. I really don't know who to blame. The HOs themselves or the universities or the new medical curriculum? For how long that we specialists have to go through this?. Looking after 4 patients they said too busy and tiring. 4 calls is too many until they don't have a social life. Give them more, the parents will come and threaten you that they will make a police report for torturing their children. Teaching was taken as torturing. Nothing seems right. I continue to encourage my specialists and medical officers not to give up on the HOs. Keep reminding them that it is our duty and responsibilities to train and teach them but I don't know for how long. I am so scared to think about the future generation of doctors that will treat me when I get old or treating my grandchildren when they are sick. I wonder how they pass their exam in the first place. No doubt, as a lecturer or teacher, we want all our students to pass the exam but we shouldn't compromise on the quality. Recently, I was one of the examiner in the final medical professional exam of one of the university. During the examination, the external examiner from oversea whispered to me commenting on the students performance during the exam. He was shaking his head. My colleagues failed few of the students during the exam but to our surprise, all of them pass their exam. This is just because their continuous assessments are good and the final exam only carries 20% mark. It is not that I don't want them to pass their exam but we should have some standards for our future doctors. I wonder why in the first place we need to carry out the final exam if we already know that the students are already pass their exam prior to sitting it. Are we doing it just for the sake of fulfilling the requirement by the board. May God bless our children.

Geared toward professional medical exam

5 more days before Hari Raya aidilfitri celebration. During fasting month, KKM and people used to refer it to "Kementerian Kuat Makan", not many meetings being conducted. Therefore, I have more free time so called, to teach the medical students especially from the CUCMS. I hope it is the correct short form. I have difficulty in remembering that. Well, it doesn't really matter. I have the last group for this semester before they sit for their professional exam this October. They have been with me before but not specifically the 6 of them in my group. Sharmila, Nadhila (always mistaken with Dhalila), Reen, Shamson (so difficult to pronounce his name and I called him Simpson instead), Zaimi and Khairuddin whom I called Kay. I can see the girls were more proactive, energetic and geared for the exam but not the men. I am not sure whether it is due to fasting month or something else. I hope someone will kick their butts to be more focus and prepare for the coming exam. I guess, girls are doing better than men. I am saying this not because I am a woman or I am sexist, but majority of them from my observation either from CUCMS or UPM, girls are better. Sharmila, she is a funny girl, but very brave and trying her very best to achieve the standard that we wanted. Same as Nadhila. Nadhila still unsure and worry to say or voice out her views. Reen is a quiet girl. I know she knows about many things but too difficult to find the right words to express her opinion. The boys are followers. Zaimi, I think he is thinking in Malay and translated it to English during his presentation. No doubt English is our second language, in medicine, you have no choice. We have to speak English. My English too is not so good but I speak with my family members in English so that I will get better and better. I was from a malay medium school before in so remote kampung school. Used to get so depressed when I couldn't find the right words to say. But, with great determination, perseverance and believing in own self, I managed to improve my English. Now, I can deliver lectures in the international congresses without problem. When my children were still in the primary and secondary school, I used to create an English week at home where everyone have to speak English. If they did speak Malay, their pocket money was cut off. It was so funny because during the so call English week, the house was so quite. Very minimal conversation could be heard. They were using sign languages. Later, when they became more confidence, with the encouragement from the aunties and uncles, alhamdulillah, their English are not so bad after all. So nothing is impossible as long as you asked for it and go for it. It just need a little bit of commitment in whatever you do. Take every matters seriously and you will succeed.

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.

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 ...

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...

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..