Tuesday, September 23, 2014

Thoughtful

But most of us have needs and wants that made us worked all our lives for more.

Who will settle for whatever we are having as of now?

And as it is now.

It is

Two days to Pay Day October 2014.

Yeah!!

Monday, September 22, 2014

Stars



I read the book.

Unsangkarable? Ha ha Ha.

Good read la this one. So medical.


Saturday, September 20, 2014

Literature

When we were young and naive; they ask us to forget about money and all, concentrate on studying, like reading and writing on classical literature.

We just memorized the model answers and vomitted it all out during exams.

But now that we are all grown ups; we no longer have time for literature, but we have better appreciation of those literatures.

For example; this is one by Robert Frost - the road not taken.

I love it so much because we human are funny creatures who always; always

Invariably

regretting our choices.

Wednesday, September 17, 2014

UPSR exam and teachers

UPSR leakage created such a big hooha in our country.

Actually I have heard that every year has got all these leakages. And some of the teachers and parents are looking out for it.

But then hor, last time not so well spread.

Nowadays with the Whatsapp and Smartphone, it is very difficult liau la for anything to be secretive, really.

And the suggestions from the ministry to send the paper to overseas to print, I beg to differ la YAB.

I think the crux of the problem is that we are in this system whereby there is no moral regard for honesty from all levels of society.

Oh well, am I being too harsh on my own kind?

I gave my first bribe when I was Form 4, when I go againt the red light, with my motorcycle when I was 15.

And there are a lot of times I gave bribes or, agreed to it to have an easier way out.

I dont know about other people, but when it hit you, I dont have much problem choosing the wrong but easy way out.

For example, in the book "Ampun Tuanku" by Zaid Ibrahim, he mentioned that Sultan Kelantan at one point, (cant remember exact which Sultan) gave royal pardon to His son to get him out of legal problem, and it was the morally wrong thing to do that.

Perhaps it is easier for us to say so, but if it is my son, and I have that ability to get him out of trouble, I would not even think twice.

I think the concept of the battle against corruption to start with giver is difficult to achieve.

Humans, we are weak creatures.

But there should be harsh punishment.

And good enforcement.

And NO, escape.

Then, I wouldnt bribe anyone, because there isnt anyone offering to accept, how to bribe.

We have a funny system in this country, in which we think certain sin are smaller than others. For example to take a bribe for an offence that we think doesnt affect other people that much, we felt better.

Like Custom. I can understand. Money taxed or not taxed also Government don't rasa that much. So our Custom brothers might felt a bit okay to take it.

I dont know. I am not angel.

I am sure no one is. We are weaklings.

Doctors too. When we know it is Datuk or someone who is important, we tend to treat them better. Better meds. Better advice. Better attitude.

But deep inside me, I felt bad, just before I go to sleep.

All the best Malaysia.

Dont take it so harsh on the teachers. If I am parents also I will want leaked questions for my children. Not a single doubt.

I doubt you would be otherwise.

Tuesday, September 16, 2014

Brushing off

I am an MO that talks a lot in rounds with my HO but I know very little.

(Yes, I have insight)

But I only have one thing to teach them ; to trust your patient's complaints.

This is really what I didnt learn from school or books, but learn from my short years of working as a doctor.

Do not, rubbish your patient's complaints, seriously.

When I was in Cardiothoracic, we have quite a number of patients waiting inpatient in the ward. 

And you know, sometimes, uncles aunties like to complain, like..cough, backpain, headache....

so, when you see such well person walking around watching tv complaining headache, we tend to think that they are just being...complainitis.

9/10 times it will be all right...patients are just being patients...

But there will be 1 time when the complaint is a genuine serious signs of a serious illness.

I have a stroke patient in ward told me he has headache, and not responding to painkiller.

He developed weakness hours later

Of course I dont know whether the 2-3 hours time lag between headache and body weakness makes any difference, but deep inside me I know, I have branded him just complainitis at the initial complaint. 

Of course they say Judgement Day is between you and god.

But for some of us, the over thinker, it is 

daily.

before we sleep.

*This thought propped up because I have a houseman told me that the patient complained of leg numbness, whenever he went into the room, and no longer complain anything when the nurses went in to ask him if any problem. I felt maybe it is truela that this patient is exagerrating but we as doctors, taking a payroll, really, 

should address their complaints.

Just examine him a while, investigate appropriately, and if really turns out nothing, or turns out something despite your investigations, then, 

sleep also can sleep better, no?

Never, brushed off patient, especially in-ward patients.

I have a bone mets complaining backache, passed away with PE - just backache. and died hours later.
I have ACS in patients complaining of no appetite, with no chest pain no SOB no palpitation no sweating.

Patients and diseases come in forms and sizes, their presenting skills might be lacking, some not so good in telling you their pain or discomfort, do not take so much offences of them changing story once a while.

No one, I repeat,

No one, wants to be in Hospital.

Have a good day people. 

Monday, September 15, 2014

Wtf

How can he be so pretty?!?!
This is extreme la.
Although we men are visual creatures; the thoughts of him as him before this her look...is ...weeerekkkk.
Anyway; did something very mulia this morning. So a bit scared of the bad karma I will get from this good deed (ya I still strongly believe in ang's reverse karma)
I have been working since back from oncall on something I owe my ex boss for very long time ago. Need to do poster abstract and submit see whether can make it or not.
Go. Go. Go. A. C. S.
Ok people; Have a wonderful day.
Ya the song is quite nice but not the original one. The Stacey Kent one. (Go youtube yourself la)

Sunday, September 14, 2014

Penang Free School

I went to PFS to see how's the school nowadays.
This is actually a very beautiful building. I mean with some touch up; it does have some similarities with the buildings we have in Edinburgh.
My 5 years (1998-2002) in this school is very mixed; very lost and yet very profoundly successful in eyes of many.
Ah profound; I remember the word profound is to describe dirty knowledge. Oops; I regressed. I do this a lot of times recently. Okok...back to PFS.
I started the schooling in this school with very poor command of English. I graduated from the this school with probably; with some language proficiency but still; can't differentiate between past present and future tenses. With very poor vocab. I think I can only name 2-3 vegetables. Lol.
(my English teacher will be proud and surely in complete disbelief that one day this angchoonseong is writing to pass time having had to wait for 6 months in between or twice a year for me to write more than 2 sentences in English)
I have a few unforgettable moments in this school. I found most of my friends here.
I found confidence here. I did well in almost every exams. I also did well cheating. Lol.
I found fitness here. I used to jog many rounds around the huge field (700-800m) to catch some glimpses of the Form Six girls playing volleyball in the court. Forgive me; or us; as we in PFS is rather desperate.
It is always very melancholic when I walked around this school. I have to admit; after all this years I haven't masters the super deep English school song but I did owe it to this school that I am who I am.
Free School; a school for scholars, sportsman and gentleman.
And buaya. Ngap. Ngap. Ngap. Yang jinak.

Friday, September 12, 2014

Monday, September 08, 2014

Happy Mooncake Festival

Although it never makes much difference to some people like me;

As my family don't celebrate,

Too kedekut to buy overpriced mooncakes,

Eaten all the small kids nearby and no young kids within close extended family

and most importantly

No public holiday granted for this day.

So, it is just another day.

but for those who celebrate; have a good reunion with the loved ones

:)

Wrote this sadistic entry due to thought block on what to blog. This entry spurred from a msg from my respected friend leader of SUPP.

Saturday, September 06, 2014

Politician

Time and again we have to be reminded of what is politics all about.

And the sad thing is that we tend to forget very fast.

I watched the news regarding our Internal Security Minister speech in the UMNO Bukit Bendera's divisional meeting today.

No, not the one about arrogant Chinese.

This one is on the "dont be kurang ajar"

Scary I tell you.

Then about the Chinese people getting arrogant is also very interesting.

That one actually took a very good turn - Mr Minister explained, like all other politicians, that his speech was taken out of context and that he is looking for the reporter.

Shyte, if I am the reporter, I sweat liau.

I have to say that on one hand, I dont believe the reporter dare to maliciously take his comment out of context - as The Sun is, afterall, a main stream media.

I look at Mr Minister's face also I takut la, let alone misquoted him at such a scale.

Oh well, I think a video recording of the speech would clear the sky once and for all.

But what I am buying is that, we should take his comment with a pinch of salt.

Because he is addressing the UMNO divisional meeting, and he has to play the music according to the crowd.

And here lies in, our biggest problem in Malaysia - 57 years of nationhood;

We are just like him, outside 1malaysia, inside still by our skin colour.

Politicians sell us what we want to buy.

And really, we are still buying the, skin colour way, sadly.


And there are alot of political issue to be blogged out, but I choose to comment on this one, because I deeply believe that we will need another 57 years with new batch of Malaysians to feedback to the politicians that

NO, after 114 years of nationhood,

we do not buy, what we use to buy, and we hope you can sell us another product.

Happy Independence Month Malaysian.

- ACS

ME

Friday, September 05, 2014

Bacteria

I remembered a colleague, fellow house officer who is so excellent in medical knowledge.

Really, he just out-know (is there such a word?) in terms of medical knowledge.

I have always think that all of us are born equal.

We choose to focus our learning and time on certain things but not others.

We cant be good in everything we do.

We only have one bullet in life, we choose where we want to shoot that bullet at.

Anyway, regarding him (whose name shall remain anonymous, hehe), I remembered there is once he talked to me about bacteria.

Out of very random conversation really.

And I am so amazed he can tell me so casually, on so many points regarding what we need to know about bacteria.

It is really amazing.

We can easily ask question to other people and wait for the answer, and if there is none, we answer them. But that does not really test what we know, because we are asking from our pool of knowledge, and surrounding understanding of the particular subject.

Anyhow, why I became so melancholic about this thing, is because I tried to teach my houseman about bacteria:

of course from my understanding, the very shallow, and inadequate knowledge:

which can very briefly, as below:

(I got it from passmedicine last time, which I still remembers till now, so it might be useful for you too)

Bacteria can be divided into Cocci and Rods / Bacilli (from the shape)

And both cocci and rods has got Gram stain - positive and negative.

So; remember Gram positive cocci = two famous names + not so famous one =

Staphylococci, Streptococci, and the not so famous one - Enterococci ( thats all the three gram pos cocci I know)

And then Gram negative cocci = 2 famous one + not so famous one =

Neisseria Meningitis , neisseria gonorrhoe and the one i can remember best although not famous - pizza name, Moraxella

And so habis la the gram pos and neg cocci

Next is Rods (bacilli ) Gram positive - ABCDL

A - actinomyces
B - Bacilus antracis (antrax)
C - Clostridium
D - Diptheria
L - Listeria

And the rest of the world - just tembak as Gram negative rods

( Surely there is alot else to know, but once you started working, all you need to know, is to give broadspectrum and pray patient respond and houseman trace the culture)

Haha. Happy weekends guys

Thursday, September 04, 2014

Polo Ground


One day when I m able to work in Penang GH, will be bringing my boots to work, because after work, going to jog for 5km before playing helmet football with the Polo's.

Then, SPP would be within grasp.

HOHOHOHO

(until then....hehehe)

Just had a MacDonald GCB for dinner. So full.

ACS - Ang Cannot Sleep

I remembered when I was studying in KMB last time, I used to listen to music while doing the super duper gila babi hard mathematics.

After a few days, when I do the test, I cant remember a single thing.

Then I concluded that studying while listening to music is a form of self deceiving, because studying is so dull, that you want something more interesting to go with it.

But little did you know that actually that something more interesting to go with studying is taking much of your concentration and subconsciously, you learnt nothing.

As usual, I will say that is another Ang's theory, and it is the absolute truth and nothing but the truth, oh well, I used to command such confidence about myself.

They say we grow, and then we realise actually this world is actually much more complicated than what we know, and we are far from the centre of the world.

With that, here is the song I was listening when studying, and I realised, I learnt nothing and wasted the long hours.

Better sleep I guess.

But then again, cant sleep. Argh!



(I always need lyrics on the video because I have difficulty identify English words in song form)

Wednesday, September 03, 2014

Government Doctors

There are pros and cons to be working in the public sector as doctors.

Let us always think of the bright side and thus, talking about the pros first.

before that let me assure you that I did not give a pre thinking before typing this post, meaning to say this entire article is produced impromptu and thus forgive me if there are lots of flights of ideas and jumbled thoughts across.

The major advantage as a practicing doctor in government service, to me is the chance to educate junior doctors.

Medicine is such a field that our decisions or practices are turun temurun rather than learning by the books. Until today I still havent look it up in the books regarding the many many practices that was told to me and I have done them for years. For example; why we need to take the calcium level without cuffs, why fluid restriction for heart failure is 800ml or 1L/day, why Fondaparinux is given for 3 days, 5 days and not 2 days or 4 days?

Indeed I enjoy my rounds with juniors as when I impart what I know, I then realise what I know. It is difficult to gauge otherwise.

However, that is provided that there is no overcrowding of patients, that lead to just finish the job as there are so many many many jobs awaiting.

Unfortunately, that is always the case.

Second advantage of working in government is my this sentence;

Uncle, I am trying to help you. Whether you listen or not, whether you follow my advice or not, my pay is still the same. I do not get extra money for telling you again and again, nor I get my pay cut if I dont advise you.

The above is actually my favourite sentence. Many patients I met, think that we doctors in government dont know much therefore we still stuck in government. I never doubted the private doctors, in fact I will accept the diagnosis of private practitioner with extra weightage because they are usually the senior doctors with golden years of practices in medicine, seen much more than the entire medical library.

But there is so much resistance in the patient's acceptability. And may I be racist - especially the Chinese and Indians. Sorry Malaysian.

Third advantage of working in government is to be a real doctors without considering cost, to some extent.

I hate the part when I called private centre to ask for price for my patients who cant weight in the emergency red zone. For example when they have a heart attack and they are aware of Primary PCI and they wanted to have it done ASAP in private.

I felt, so, not, doctor, of us.

Of course, the counter argument is that we are not god, and the private doctors and hospitals also have mouth to feed.

I dont know, many a times, not once or twice, it is tempting to leave this profession and get a life I have always wanted; office desk job 9am-5pm, with regular meals break, and weekend to either enjoy some hobby or work extra for assignments.

But nowadays, it is getting harder and harder to work in government doctors.

Paperwork, paperwork and paperwork.

Bureaucracy, bureaucracy

Punch card during normal days if not done properly, we received explanation letters.
Did not punch out after a 36 hours oncall sometimes, we have to go through some steps to get our RM200 for that call.
Applying leave to rest, we need to make sure it is not clinic days, not busy days, no other colleagues have emergency or sickness, or else everyone plus the patients will suffer from waiting time in clinic or in ward.
Did not wear tie to work, we get our names mentioned.
Complained to newspapers, we are seen as rebellious (like this post)

We are not paid handsomely as some might think, and everyone in my pangkat are paid the same despite different job scope.

We cant be that charitable all our lives.

But really, my dear readers, everyone has a breaking point.