Monday, April 14, 2014


Just finished doing a last minute powerpoint presentation for coming morning.

I like doing powerpoints, I like talking, I like presentations.

I like sharing what I know, although it is very limited in magnitude, to be honest.


In so many powerpoints I have done before,

there was once, that whenever I thought of the presentation, I will smile.

It was a time when I got the day of presentation wrong.

Funny people do funny things.

Weird people do weird things as well.

:(                      TTM again.

ok sleep. Good nite people.

Saturday, April 12, 2014


Unfortunately, I am a damn damn weird person.

An old song that came to mind.


Saturday, April 05, 2014

Oh Patients

I have read a lot of comments, regarding the state of our country's healthcare.

Many stinging criticisms has been put forward by many, on a lot of issues related to healthcare; the overcrowding hospital wards, long waiting time in accident and emergency, incompetence, unprofessional and insensitive medical staffs and so on.

I must admit that there are a lot of weaknesses in our system.

Much have been said about the doctors. Doctors' quality, medical errors, attitude problems and so on.  

As a doctor myself, I have to say that we are a big part of the system and of course we should be rightfully blamed when the system fails.

Honestly, it is getting increasingly difficult to do a good job as a doctor.

Not about the time of work. 

Not about the seemingly low pay in comparison with what other professionals are getting 
comparing to the time and effort spent.

Not about the stress at work actually.

To me, it is more about the patient factor.

I once met Mrs A, 55 year old lady, who takes up 2 jobs as helper in hawker stall. 

I spent so long talking to her way past the lunch hour, and that of my clinic nurse, to get her to change her diabetic insulin jabs, only to get her telling me, with full conviction in her eyes, that she has some friends taking herbal medications from China and they are all cured of diabetes.

"Western medications are good, but herbal medications has no side effects,"reasoned Mrs A.

There was then a Mr B, a 60 year old retired civil servant, who refuses a medication called Perindopril after I said that we need to check the bloods after two weeks in case the medication causes the kidney function to worsen.

"Why are you starting me on such medication that can hurt my kidneys? Where you graduated from? I want to see your specialist."

Those words are hurtful, Mr B.

Then there was also a Mr C, who is so unhappy after waiting for hours in the clinic. "I paid taxes you know," said Mr C.

I am not from the Inland Revenue Mr C, and I don't care a slightest bit, whether you have paid your taxes or you are getting a BR1M.

I always find patient's attitude, beliefs and character towards our "Government Service", very mystifying.

To the extent that I think solving this might save more lives that finding a new vaccines, getting more specialists or building more hospitals.

People can wait for same duration to pay an expensive fee, to see a private doctor but cant seem to do the same for in a free, government clinic.

They thanked their private practitioner who referred them to public hospital with a fee, but gets very agitated in public hospital's clinic when the nurses over the counter give an appointment to see specialists later.

"It is cancer you know! How can you see in TWO weeks!" 

"I want to talk to your specialist now!"

No wonder it is always very difficult to keep specialists in government settings.

It is not about the pay. It is not about the burden of the workload.

It is the patients' general attitudes towards a free (oh well there is a fee); cheaper service.

There are so many who smoke a few pack of cigarettes a day, eat nasi kandar at midnight, but expect to have a life without disease and refuses medications.

"My friends all okay and no problem. Doctor, you got check properly or not?"

"My uncle smokes 2 packs a day, he is still up and well at age of 79, Doctor, I know what I am doing".

Sometimes it is very difficult; 

And i always think to myself, so then what kind of patients would make my job a bit happier and easier?

Is it the highly educated ones, who thoroughly googling their diseases' pathophysiology and the gold standard management; and demanded the best medications that even I myself not authorised to give my own mother. 

We have never given away substandard medications, just not the most expensive ones.

Or is it the not so well educated ones, who are not bother to know their diseases and only keen to seek opinion from the bomoh and listen to their friends in the kampung, changing doses of medications on their own according to their "feelings".

The answer is I dont know. 

Patients are always patients, with their unique expectations and beliefs. Some of these beliefs and expectations are really making doctors' life difficult.

Having said all that; there are always some patients who makes us smile. 

Those who appreciate, thankful, and listen to what you have said and compliant the medications and advices. It is an absolute beauty and satisfaction to see they get better, at least the numbers, as they might not felt the differences between blood pressure of 170/90mmHg or 120/70mmHg.

But sometimes we cant do a good enough job for certain patients, because of the number of patients in our settings. There are times when we want to monitor them more closely, but if doing that would mean operating the clinic way past 2 pm. I do sometimes felt a bit worried for some of these patients. 

There are simply too many patients who we cant get it out of the hospital systems to the local polyclinic because apparently the waiting time there is too long for them.

There is one thing for sure, and there is one thing that I think we all should spend some money on.

Patient's Education.

Patients have to be responsible for their own health. 

It is actually to me, the most difficult part in being a good doctor; to educate your patients about their diseases. 

We must strive to educate the public. We have rethink our strategies to educate, to strengthen our public health efforts. It might seem impossible to have the makciks and pakciks in kampung to be able to adhere to the diabetic diet, but we must try harder

Preventative, health talks might seem less glamour and less effective than the minimally invasive coronary artery bypass surgery, but it will save more lives than the latter.

Friday, April 04, 2014

Tree of life.

Went to buy porridge in a stall that will greet you:
wait for at least 30 mins.
saw this old house next to it.
i think with some marketing, this can be marketed as a tourist attraction.