Friday, January 31, 2014

Year of the Horse for Ox (me!)

I was supposed to do my case report before I leave for good.

However, one can only concentrate for certain number of hours.

I am even worst. I cant seem to concentrate for one hour.

And so I ended up reading this:

HOROSCOPE!!

The saying: When ox comes into horse homeland, although they counteract with each other, but man's determination can conquer nature.

People born in 1949,1961,1973,1985,1997 are guilty of Jupiter in 2014 and the way to resolve
You would be guilty of Jupiter(Tai Sui) in 2014, which would infect your interpersonal relationships, but not too serious. The villains might make mischief behind or play tricks, which would make you sink into trouble unclearly. You could disregard as long as you could open and above board. Wealth would not be good. You'd better have a full understanding of the market before acting if you want to invest, otherwise you might incur losses. In health you would be interfered by magnetic field, you need to do more exercises. You'd better greet the arrival of 2014 with an optimistic attitude and a healthy body.

Zodiac Ox people Career Horoscope in 2014

You'd better prevent villains to make mischief, also prevent competitors to take reasonable measures to surpress. You'd better maintain a cautious attitude and magnanimous style for the potential pitfalls and crises in career. Only the heart is so candid, career naturally could be smooth. You would have a new career opportunity whether you are wage earner or businessman. You'd better strive to build good relationships and seize opportunities.

Zodiac Ox people Wealth Horoscope in 2014

Your wealth would be depressed with unexpected expenses. You'd better not lend money to others or be guarantor for others. You should be careful of contract or business documents to guard against fraud. You'd better know the background when cooperating with the others. Do not be overconfident. Wealth would always favor those who have maken preparation and worked very hard. If you could respond properly, you would have good wealth return.

Zodiac Ox people Love Horoscope in 2014

You would have more peaches in this year, then mostly are rotten peaches and you'd better handle carefully, otherwise troubles would come one after another. If you're married, you'd better control yourself and prevent from the third affair. If you're unmarried, you would feel the pressure. let it be. If you could face yourself and keep the reasonable and proper concept of selecting mate, grasp the chance initiatively, and enhance your external and internal conditions, then you could always get a good fate. You coulld feel free to seek help from friends and relatives. Marriage is an extremely important step in our life, you'd better not make wrong choice due to unstable mood.

Zodiac Ox people Health Horoscope in 2014

Your health would be poor, you'd better not make high-risk activities. You must be careful when driving, comply with traffic rules to spend the year in peace without any trouble and disaster. Elder Zodiac Ox people should prevent from falling down. You'd better seek medical attention immediately if you feel unwell.
Horoscope in 2014 of zodiac ox people born in 1985:The Na Yin of Zodiac Ox people born in Yi Chou Ox Year in 1985 is as "gold in sea", and is Bijie with "gold in sand" of Jia Wu Horse Year in 2014. Zodiac Ox people born in 1985 although harm Jupiter in 2014, but can get help from Bijie, brothers and friends can help you have a smooth ride out the storm, make more communication and cooperation with people, with external forces to solve the problem.
______________________________
I have never believe in horoscope or fortune teller but I believe in certain karma rules.
Like the more good things i do, the worst it turns out to myself.
Seriously one. 
MAY THE HORSE BE WITH YOU!

Thursday, January 30, 2014

Thank you

Such a well done video.

Like the story line, the music.

and the twist at the back. 

Well done!



It says reflect on yesterday, live for today, and hope for tomorrow

Hope everyone has a good year ahead

(the fireworks in Kuching is rather loud, with alarm disruption, but its CNY!)

Gong xi fa cai

:)

Tuesday, January 28, 2014

Done reasoning.

We all have done wrong things.
I have done alot of wrong things.
In fact it is still puzzling how karma havent touches me (oh well, think recently it does not only touched me but squashed me)
Sometimes we manage to find a reason. Reason that we can feel okay doing something wrong.
And we feel okay abt it.
Sometimes we cant seem to find an acceptable reason.
And we feel sad.
(sorry guys, down down down)

Monday, January 27, 2014

Sleep

Feel sleepy.

Made a cup of Nescafe 3 in 1, regular

Ah, feeling more sleepy.

Actual fact is that it doesnt matter how many hours you sleep, or how many cups of coffee you drink.

Sleep is a rest from physical tiredness,

But it doesnt help with mental tiredness,

I dont know what helps more - Holiday, Running Away, Smile, Befriender, Eat?

If there is one thing that bothers you, you wont be able to sleep.

but if that thing bothers you till you cant sleep but feels sleepy or oblige to sleep,

that, my fellow readers - is sadness.

and as The Passenger put it so succintly;



Only know you've been high when you feel low

-

The good thing about sadness, it will invariably

ends, somewhere, somehow.

Sunday, January 26, 2014

Time

Ah, almost there.




A new start!


I read a good quote somewhere today:
Some cause happiness wherever they go; others whenever they go.
- Oscar Wilde

World Most Beautiful Sound

There was this article in Thestar yesterday  about the world most beautiful sound.

Locality - Kuching, Sarawak!

I am not sure how beautiful was the sound, as usual, I was talking all the time, as usual.

But, it was a very beautiful place, very beautiful waterfall.

Not very difficult jungle trekking for probably 1-2 hours, I cant really remember the duration.

I did blogged about this place.

Kubah National Park

Memorable hiking. :)

Thursday, January 23, 2014

Reply

I read all the the comments on my piece as Another Malaysian Doctor, and also the reply from one Soraya Salim to my opinion.

1. I did not say that building hospital would not help. But we need more than just that. 

It is very simple logic to accept that more hospitals = less waiting time, but I think I would have failed myself if I sent across a message that I objected building hospitals.

2. The first Msian doctor's piece is personal and emotional. - judging from the title itself 

Patients coming to Sungai Buloh Hospital, beware!

Not personal and, not emotional title?

3. The reply from Soraya Salim is totally personal. And even more emotional. 

I agree with her on the data she put across regarding admissions/bed and so on, sounds concrete and yes we do need more hospitals. Please refer to point 1.

Her relative waiting for 3 years for heart surgery will definitely benefit from training up more cardiac surgeons, cardiac anaesthesiologists, upgrading cardiac OTs, rather than having more hospitals. 

Her parents who waited for whole day for Outpatient consultations would benefit from improved primary care rather than more hospitals. Postal service of medication by Pharmacy like what we have in Sarawak would help. Not more hospitals.  

------------------------

Actually, the reason why I wrote my opinion to TMI is because of this sentence:

Meanwhile, Malaysians who have no other option, except government hospitals, will continue to suffer.

Because there is a Mak Cik back in Penang never went to school, use an EX5 to commute Penang GH, and got her treatment right for her medical problems since her son was at secondary school not even know what is Penicillin.

When he was 13 year old, the Mak Cik had a ruptured ectopic which the doctors picked up, operated on, and followed up with a BTL and following that had a TAHBSO done years later.

When he was 20s, the Mak Cik had very bad multi joints pain and stiffness later diagnosed as severe Rheumatoid Arthritis, but she presented so so late to the doctors in Penang GH, but managed to get her treatment well on par with UK standards where her son read medicine and not in Penang with her.

When and most recently she had Bells Palsy which her son thought is Stroke, but unable to fly back from across the South Chinese Sea where he worked as a doctor, but the A&E doctors in Penang GH managed to do the CT Brain, follow up closely by Neurologist with proper treatment and investigations.

And all these without the doctors knowing that her son is actually a medical officer.

And when A Malaysian Doctor say Malaysians who go to Government Hospitals will continue to suffer,  

I am supposed to keeping quiet?

Now this is personal. And not going to be published in TMI. 

We should not be talking personal things in public and ask for public intervention. Keep academic discourse, academic. 



Wednesday, January 22, 2014

Another Malaysian Doctor

I read the recent article by "A Malaysian Doctor" regarding Sungai Buloh Hospital and the comments from readers with interest.

The author has put forward his/her concerns regarding the deplorable state of government health service as a doctor in the system. However, I personally think the article is somehow too personal and emotional.

Now I fully agree that there is so much more we must do to improve the service. There are indeed many weaknesses in our system; overcrowding ward, fatigue doctors, lack of forward thinking policies and others as correctly pointed out.

It would take us days to finish discussing these and other weaknesses. But there are a few questions that I always find it difficult to answer when we talk about healthcare system. 

Number one; Is our state of healthcare beyond help? Well, the picture painted by the esteemed author is suggesting that we are in very deep trouble - patients awaiting admission for days, standard of care received is depending on patient's luck and sick patients turned away due to overcrowding. 

I believe that there is some truth in that but I dont think that it is as bad, at least not in where I serve. I think as a medical staff, we should be mindful in our comments about fellow colleagues and refrain from suggesting praying for caring doctors or what not.

Number two: Are the weaknesses due to not spending enough money on healthcare? United States spend the most per GDP in the world but the healthcare there is far from perfect. Nearer to home, does Singapore has an exemplary healthcare system that we would want to adopt? 

All health systems in the world has weaknesses, and this is because healthcare is made to run on a limited resources, be it big or small budget, with an ever increasing patients and ever increasing costs. 
Number three and my main point in writing this piece; Who we should blame for this overcrowding in hospital?

I agree that the rising cost of living would increase the number of patients seeking care in the public hospitals, which is already highly subsidies by the taxpayers. 

It is not unreasonable to blame our politicians for the rising cost of living. We have the right to demand for better management of our country, just like our patients have the right to demand for good service from us. It is a trust and responsibility tasked.

But we must bear in mind that rising cost of living is not the only reason that are increasing burden of care in public hospitals. 

The demographics of an ageing and growing population, the increasingly unhealthy lifestyles predisposing to certain diseases, the exponential population geo-shift due to urban immigration, the influx of both legals and illegals immigrants bringing with them communicable diseases and poor sanitation and hygiene, all would have much more impact on the raising burden on public sectors, more than just purely rising cost of living.

I am sure everyone agrees that there are indeed so much to be done by those in power. We have all the rights to ask for a better tomorrow. Perhaps those in power should look into prevention of preventable diseases, adherence to healthy life styles, proper hygiene facilities and improving health education and reducing abuse of healthcare system.

Building more hospitals or reducing cost of living would not help as much.

I think rather than pointing fingers and praying for patients to have beds and less fatigue consultant to oncall, let us put our biggest efforts together and work hard to improve ourselves first, as caring doctors and stick to "Kami Sedia Membantu"

Sunday, January 19, 2014

Weekend almost over.

In one year we have 52 weekends.

I have this procrastination gene in me that I always leave everything to be done until the weekend.

And then when the weekend comes...

I felt lazy, and the urge to enjoy the weekend.

and thus pushing what I am supposed to do to the weekdays.

and the cycle continues.

and nothing get done.

Not good not good.



Perhaps should cut down on blogging too.

Saturday, January 18, 2014

Sweat like....

So ngam, oncall passive kena activated.

Got someone in hospital, that has a super emphysema.

which is to describe air beneath the skin

and this fella has like all over up to the face and all.

Anyways

boss ask to put a subcutaneous drain in, biggest size.

shitss..

boss said aiya, like put a chest tube, but u dun go korek into the chest cavity, just put it above the muscle, beneath the fat...

the problem...after i cut and try to do is.....

our chest not much fat leh...

not sure it would work or not, to suck all the air beneath the skin...

and so kesian the patient

like do liposuction like dat...

Just cut and push the fat aside...

kesian the ahpek

Coz subcutaneous is quite painful one leh, kesian the ahpek, once the ubat bius wear off, he will scream!

Maybe not ngam do surgery.

if everytime do procedure also sweat like this...how leh!!!

#everydaydo(learn)somethingnew

Friday, January 17, 2014

Another one.

Oh no, another entry of an emo rants by the ever emotional ACS again.

Sorry, dont read la pan.

I went to GH to trace the results and to arrange for a cool frozen section procedure (but distance from OT to lab is 17 km)

then I met the relatives of a young patient.

25 year old, with thymoma. We opened up abt 3-4 months ago, and found the very vascularise mass to be encapsulating the heart, no way we can excise that.

Discharge him, back home.

He was depressed.

I met him once with his very caring sister in shopping mall once, 2 months ago I think.

Sister says he is depressed, not doing much, so brought him to mall and movie.

Oh well,

I saw his mother and sister.

He passed away on Monday.

Tragic and fragile isnt it?

Passing away at such a tender age.

So many deaths I came across recently.

Am I getting old, or the people I know getting older?

We will all die i know.

The tragic thing is that we dont know when, and how.

Death it self, the end of everything, is not that tragic.

It ends everything.

#emochuimeh!

Tuesday, January 14, 2014

Kang Kung

Just because of a rather unwise comment that the kangkung price is coming down, PM Najib got fried by the social media.

So overdose with #kangkung over the twitter.

Nothing more news worthy kah?

Its a rainy rainy public holiday today.

A gloomy public holiday.

Anyhow,

Salam Malidur Rasul.

Enjoy the off day people.

Monday, January 13, 2014

Problems

So many things to settle.
Tired.

Sunday, January 12, 2014

Bipolar

Someone asked me the other day what is bipolar mental disorder.

Now I dont know the real definition or the exact diagnosis of it, from what I think it is, the something like mood swings.

Of course it is at more pathological way and magnitude than that of our usual mood swings.

I dont know if all of us have, but I do have my swings.

Typically I woke up a bit down. 

And the mood came up more the moment I meet people.

Ha ha ha. Probably then I can talk to people, it cures my downness.

Oh well, but sometimes I have my ups, energetic and very fast thinking, at that moment I will quickly go to my keyboard and start to write some good pieces of things I am thinking.

I will be able to read a lot of things and understand some theories (which have nothing to do with medicine)

Hehehe, anyway, CNY is around the corner. 

The CNY songs started to invade the malls.

Gong Xi Fa Cai countdown!



In case you are overseas and miss all the tune. (1 hour of CNY songs, take that!)

Saturday, January 11, 2014

New Year Resolution

Sorry to be a bit late for this.

This year is simple.

New Year Resolution:

One only.

To get rid of the big belly.

#saynotoMcD

Wednesday, January 08, 2014

I lost one of my favourite patient over the weekend.

And I think another one is going soon.

Very sad thinking of the things they have said to me, the kindness they have shown to the people around them before.

Sometimes I think if I pass, what would be the people around me feel?

Anyhow not to talk too much into the above question, as it implies deep sadness.

Anyhow about my favourite patient, I met and talked to the family members. The currently sick one has got tremendously lovely family. The daughter that had been staying in ward with him is a very nice lady, very understanding and generous with smile, even at the time when there is tears in her eyes.

I guess it is true that until the needle hits you, you will never feel the real pain.

Similarly, we can only offer acknowledgement and nods to the family of the passing, but we would not know their actual pain.

Someone said that I am someone who empathize. But too much, sadly.

I am not suitable to be in the rat race or the money-only marketing.

Sorry I went off topic again, but hmm...

I feel for someone who did not get the best deal.

Perhaps my job is the better between what I wanted to do when I started to think about quiting the current job.

I actually do not think that I can sell something that make myself richer and another person at a loss.

#emo

Sunday, January 05, 2014

Health

The only way that we can keep everyone healthy is not to create more doctors, or to build more hospitals.

Or to come out with better medications.

Or invent new diagnostic equipments.

But is simply;

Educate people about good health.

Education > Medication > Operation.

Saturday, January 04, 2014

Heaty?


Saw a copy of The Heat lying on the table behind the cashier in the canteen.

The boss said apparently cant refund the unsold copy coz now the paper is banned.

Curious to know how heaty was it, I bought for the original price ( the boss damn happy la )

Although I know that not this particular edition which spurred the authority to revoke its permit, I think a paper's heatyness should be able to be judged by a common edition previously.

Is it that The Heat is so heaty that pihak berkuasa felt that it will confuse, threaten and make us becoming 2-3Malaysia, instead of 1malaysia?

#Governmentknowsbestforever

Wednesday, January 01, 2014

Students

I followed our country's political scenario with interest but only on desktop closely.

And I am concerned with our politicians' comments and tweets regarding our youths going to the street to protest the price hikes recently. However, I was particularly taken aback and actually disappointed with one of our youth leader's comment regarding students going to the street.

I categorically do not agree with the notion that youths, and specifically students should not involve with the politics.

Many had argued against that notion with reasons of human rights that students too have their protected right to be involved in peaceful assembly.

Some even quoted examples of student's activism in the West to push for reform and for the good of the nation. Others quoted the early days of our leaders today were also student activists. The likes of Dr Mahathir and Anwar Ibrahim started to lead activism since student life.

The counter argument and I cannot agree more that students should prioritize their studies and not over zealously involved in politics.

However, to me personally, involvement in any planned and organized street demonstration for a cause that they believe in is perfectly fine.

Now my opinion stemmed from my own experience. I was a student then, and graduated 3 years ago and currently working.

My humble opinion is that the short 5 years of  tertiary student's life is the only time that nothing is holding back the minds to pursue the cause and principles that they believe in.

Students in general is still less affected by the date of the next month's house mortgage installment, or whether their preferred baby products that are on special discounts in the supermarket. These are times that they are not worried about their in-laws opinion on the motorcycle that he or she is riding around or bothered by the cholesterol levels of their parents.

Once he or she is out of the universities or colleges and entering working life, there is so much at stake and tendency to look after your own business, rather than holding and acting on matters your believe will contribute to the society, so to speak.

What I experience is that once money comes into the picture, the once ambitious and thoughts that I could try to correct the social inequality - sadly, relinquished.

And so, politics became the activity exclusively to those who have large disposable income, and less of a concern, to those whose income matches expenditure, in perfect balance.