Friday, October 16, 2009

Childhood Dreams And The Reality Of Adulthood II: The Prodigal Grows Up

Thought you had all the answers,
To rest your heart upon,
But something happens,
Don't see it coming now,
You can't stop yourself,
Now you're out there swimming...
In the deep.
In the deep.
- In The Deep, Bird York, 2006

Her last words to me were to take care of him, not to bully him but to look out for him.

My last words to her were unbelievingly bitter and insensitive, uttered with implosive hatred and stupid teenage anger.

The years in our walk of life rush by faster than we know and would allow them to.

We lose the people we love before we’re ready to, and usually at a time and age when we need them the most.

We sincerely want to repay the generosity and kindness we’ve received in life, and yet our struggles with daily survival get in the way.

Before we know it, something happens to the ones we love.

We are left helplessly lost, stuck and stranded in a place far and away.

Life keeps tumbling your heart in circles,
Till you let go,
Till you shed your pride,
And you climb to heaven,
And you throw yourself off,
Now you're out there spinning...
Now you're out there spinning...
In the deep.
In the deep.

It’s yet another sleepless night in the clinic, not because it was busy but because insomnia has trailed me here as well.

I counseled an asthmatic, drained a thigh abscess and reassured and anxious father, among others.

He called me up but I was not free.

The disappointment in his voice was palpable.

I promised to call back and I did so but reached his voice mail instead.

This cycle has been going on for quite a while now.

Our days of swimming and getting sunburn are gone now, the silly drives past funeral parlors at night also.

I won’t forget his tears when I left home to serve needy strangers across the South China Sea.

His phone call on my first day here were desperate pleas to come home.

I’ve saved strangers and relieved much pain here.

I could not mend his betrayed trust though.

What’s the point of saving strangers around you when your own loved ones are in pain and emotional distress?

In the silence,
All your secrets will raise their worried heads,
Well, you can pin yourself back together,
To who you thought you were.
Now you're out there living…
In the deep.
In the deep.

Have I made inroads in my medical career so far?

Yes, and quite certainly too.

Perhaps even to the envy of some senior colleagues.

Am I appreciative of the opportunities I have received in life?

Obviously and so much more reason to fight for social justice and greater equity for the poor and downtrodden.

Do I realize that I am greatly and wonderfully blessed?

Definitely and with great thanksgiving to the Almighty God.

Can I blame anyone anywhere for the mess that I feel I have created?

No, the prodigal has come of age but remains a prodigal still.

To my loved ones whom I left behind, I am truly sorry.

Now you're out there spinning...
Now you're out there swimming...
Now you're out there spinning...
In the deep.
In the deep.
In the deep.
In the deep...

Read more!

Monday, October 12, 2009

Childhood Dreams And The Reality of Adulthood

I haven't seen your face around
Since I was a kid
You're bringing back those memories
Of the things that we did
You're hangin round
And climbing trees
Pretending to fly
D'Yer wanna be a spaceman
And live in the sky

- D'Yer wanna be a spaceman, By Oasis, 1994.

I had a long chat with a colleague yesterday, someone I do not meet regularly or even call up occasionally.

We went through housemanship together where we endured the nags and outbursts so commonplace in obstetrics and gynaecology.

Our paths had hardly crossed since then.

Life is such that there will be those whom we meet everyday but find little in common, and then there are those whom we meet once in ages and still realize we have much that we share in thoughts and views.

“POTS, do you realize that the more we progress in our medical career, the less option we seem to have?” he said.

His statement reminded me of the 1994 hit song by the now-defunct rock band Oasis.

It was also a stark reminder of how far I and We and probably most of us have strayed from our original passion and childhood dreams.

At the height of my STPM exams, I kneeled and prayed and ask God for a shot in medical school.

The enthusiasm of doing missionary work in wretched nations torn by war and strife was burning within me then.

In the final years of medical school, I made grandiose plans to sit for the USMLE, PLAB or AMC exam, or all of them, hoping to make groundbreaking contributions in healthcare and medicine.

Now all I want to do is to make money and provide a comfortable life for my family.

You got how many bills to pay
And how many kids
And you forgot about
The things that we did
The town where we're living
Has made you a man
And all of your dreams
Are washed away in the sand

- D'Yer wanna be a spaceman, 2nd verse, Oasis, 1994.

I looked through some old photo albums of the family not too long ago.

At age 16, my dear father cycled from Batu Gajah to Sitiawan as part of his criteria of attaining the King Scout award.

Last year at age 60, he spent Christmas playing Solitaire on his desktop.

I am sure he has dreams and wishes somewhere deep within him but if he had any, he isn’t expressing them.

I wish he would, because I would do anything to see them come true.

My sister the high achiever can achieve anything she put her heart and mind into.

Somewhere between graduating summa cum laude from university, one rocky marriage and a few tyrant bosses, her dreams of revolutionizing the Malaysian healthcare system from within the system went up in flames.

Out of civil service and with two young children now, she’s content just being a responsible mother and peace-making wife.

Well it's alright
It's alright
Who are you and me to say
What's wrong and what's right
Do you still feel like me
We sit down here
And we shall see
We can talk
And find common ground
And we can just forget
About feeling down
We can just forget
About life in this town.

- D'Yer wanna be a spaceman, Chorus, Oasis, 1994.

My friend from secondary school days, Lee had this to message me the other day:
“Sometimes I feel like giving up on job, God, girl and all.”

It was a message one would never have expected from him, a person more fondly remembered to be the life of the party and a genius in his own rights.

These days, Lee sends me hollow, single-worded replies in SMSes.

I still think he’d one day be a successful paediatrician, but for now he is another dejected soul guessing over the life that could have been if he had left for Singapore after STPM.

It's funny how your dreams

Change as you're growing old
You don't wanna be no spaceman
You just want the gold
All the dream stealers
Are lying in wait
But if you wanna be a spaceman
It's still not too late

- D'Yer wanna be a spaceman, Final Verse, Oasis, 1994.

Someone very dear to me has all but given up her dreams of cruising the open seas and opening a kindergarten.

She spent a large period of her youth caring for an ill mother, and thereafter poured in a tremendous amount of effort rehabilitating patients incapacitate by stroke and Alzheimer’s disease.

Now stricken by endometriosis, she’s spending a great sum just trying to get pregnant.

Her self image has taken a blow, especially when she’s surrounded by baby-bloomers who seem to reproduce so very effortlessly.

Is this what life does to us as we grow up and age?

Maybe this all is all God’s plans – personal tragedies, familial diseases and financial struggles.

If it is, should I then abide by it or swim against the flow just as I have done my whole life?

Well it's alright
And It's alright
Who are you and me to say
What's wrong and what's right
Do you still feel like me
We sit down here
And we shall see
We can talk
And find common ground
And we can just forget
About feeling down
We can just forget
About life in this town.

- D'Yer wanna be a spaceman, Oasis, 1994.

Read more!

Wednesday, October 7, 2009

I’m not and neither are you.

I’m not a Muslim, Christian or Jew, just a sinner saved by grace.

I’m not Malay, Chinese or bumiputera, just a prodigal in search of my niche.

I’m not a learned doctor with gifted healing hands, just another mortal who bleeds and grieves.

I’m not depressed, deranged or even remotely disenchanted; I’m just posing questions unto the heavens.

I’m not anti-government or pro-opposition, just a lover of justice and hater of corruption.

I’m not a rumor monger or doomsday prophet, just a self-appointed whistle blower.

I’m not a slanderous rebel blogger with an open identity, just a restless soul drinking from my cup.

You’re not special in the strictest sense of the word, just a person born into a certain skin and creed.

You’re not the Holy Father or a bona fide martyr, just a hypocritical phony who’s misleading millions.

You’re not afflicted, handicapped or even imperfect, just an individual among many others carrying one’s cross.

You’re not immortal or the least invincible, just a fat-ass pseudo-surgeon who will die like the patients you transformed into vegetables.

You’re not the democratically elected leader of an apartheid nation, just a horny old man who denied any involvement with a voluptuous Mongolian model.

You’re not insignificant or fighting a lost cause, just a drop of goodness making its ripples.

You’re not better off or worse than your brother, just blessed in the bittersweet manner of the Lord our God.

You’re not lost on a one way street to nowhere, at least not any more than how I am currently.

Read more!

Tuesday, October 6, 2009

The Beginning of the End?

Just as I had expected, treatment of my recently diagnosed medical condition has turned me into a dull and stoned person if not already, prior to this.

I have been struggling to think and write but each time the blank page of Microsoft Word appears, my goes as blank as the white screen.

There is no motivation to pen my thoughts, no drive to make any shocking exposẻ and no irritation to the things that usually drive me up the wall.

Is this the beginning of the end of POTS?

Or is this the beginning of another beginning, one with a more subdued and mellow version of myself?

Was all my supposed righteous rebellion the result of misguided neurons instead of an inherent sense of right and wrong?

Am I now my true self, the personality I am suppose to possess all this while without the influence of a deranged physiology?

Will I be happy rediscovering a fresh identity or will I cling on to a deceased self that continues to linger around for a while? Read more!

Tuesday, September 15, 2009

Hari Malaysia Ke-46: Bangkitlah Anak Sabah!

Kepada anak watan Negeri Di Bawah Bayu,

Apabila jam melimpasi pukul 12 malam ini, negeri Sabah akan meraikan Hari Malaysia yang ke-46 sempena penyertaan Sabah dan Sarawak untuk menubuhkan negara persekutuan bernama Malaysia.

Persoalaan saya kepada anda sekalian, patutkah penduduk Sabah merayakan ulang tahun acara tesebut?

Seperti mana yang saya difahamkan, Sabah dan Sarawak tidak menyertai sebuah kerajaan yang sedia wujud.

Dalam ’20 Point Agreement’ yang disediakan menjelang September 16, 1963, Sabah bukanlah semata-mata sebuah daripada 14 negeri dalam Malaysia malah bersama-sama Sarawak, Singapura dan Semenanjung Malaya, Sabah merupakan sebahagian daripada empat tonggak yang membentuk negara Malaysia.

Oleh itu, Sabah telah dijanjikan kuasa autonomi dalam pelbagai aspek.

Antaranya termasuklah pentadbiran dalam isu-isu kewarganegaraan, imigresen, pendidikan, kewangan, sumber-sumber asas, kerajaan tempatan dan perkhidmatan awam.

Cuba fikirlah anak Sabah sekalian.

Adakah kerajaan persekutuan UMNO/Barisan Nasional memenuhi janji-janji yang terkandung dalam persetujuan 20 Point Agreement tersebut?

Adakah Sabah merdeka dan berkuasa muktmad dalam isu-isu kewarganegaraan?

Lihatkah sekeliling Sabah dan hayatilah dengan mata sendiri kesan-kesan Projek IC yang dilancarkan Mahathir Mohammad.

Tidaklah saudara marah dan terkilan melihat mereka yang berbangsa Filipina, Indonesia dan Pakistan menerima kewarganegaraan dan bersama-samanya hak-hak istimewa bumiputera Sabah?

Pelancong asing dari sepelosok dunia melawat Sabah dan terpikat dengan keindahan Gunung Kinabalu dan kepelbagaian flora dan fauna laut Pulan Sipadan.

Mereka ini cukup kagum dengan pembangunan yang pesat di sekitar Kota Kinabalu di mana hotel-hotel berbintang lima berbaris di seluruh kota raya.

Akan tetapi, berapa banyakkah anak Sabah yang berpeluang untuk menikmati pembangunan dan keistimewaan semula jadi negeri mereka sendiri?

Kos yang diperlukan untuk memanjat Gunung Kinabalu ataupun menyelam di Pulau Sipadan kini melonjat sehingga satu tahap yang di luar kemampuan kebanyakan penduduk Sabah.

Banggakah sekalian semua akan hakikat ini?

Kekayaan negeri Sabah kini dinikmati croni-croni UMNO/BN serta orang asing yang berada.

Pemuda-pemudi Sabah pula terus meringkuk dalam kemiskinan malah masih banyak yang tidak berpendidikan dan berkahwin dalam umur belasan tahun.

Anak muda juga tidak berkemahiran dan kalaupun ada, sukar mencari peluang pekerjaan.

Adakah ini sesuatu pencapaian yang patut diraikan esok?

Sekolah-sekolah sekitar Sabah masih seperti zaman batu.

Banyak lagi yang tidak tidak dilengkapi kerusi meja, elektrik, air mahupun papan tulis dan tenaga pengajar.

Akibatnya, generasi Sabah yang akan datang akan tetap seperti moyang mereka yang jahil tanpa mobilti social.

Di manakah autonomi pendidikan yang dijanjikan pada September 16, 1963?

Kebodohan rakyat Sabah memilih UMNO sebagai kerajaan negeri berkali-kali telah secara tidak langsung mengetepikan anak Sabah sendiri.

Perkhidmatan awam negeri Sabah kini dikuasai mereka yang berbangsa istimewa dari seberang Laut Cina Selatan.

Pejabat-pejabat kerajaan sekitar Sabah kebanyakannya di bawah pentadbiran orang-orang Semenanjung yang tidak mengenali Sabah serta keperluan rakyatnya.

Ke mana pergikah pemimpin-pemimpin UMNO/BN yang dipilih oleh para pengundi Sabah dalam pilihanraya demi pilihanraya?

Politikus ini sudah memperbodoh rakyat Sabah dan masing-masing meragut kesempatan untuk meningkatkan kekayaan dan harta sendiri!

Ke mana perginya sumber-sumber asas negeri Sabah yang berlambak-lambak sebelum ini?

Dari balak ke minyak dan ikan ke batu karang, kekayaan negeri Sabah telah dieksploitasi dengan melampau sekali.

Si bodoh seperti Bung Mokhtar dan Pandikar Amin tidak segan mempamerkan korupsi masing-masing manakala rakyat jelata tiada hospital umum untuk mendapatkan rawatan apabila sakit tenat.

Jadi, bangga lagikah pasal kesampaian tarikh Sept 16 esok?

Saya menyeru rakyat Sabah untuk tidak lagi menuduh pengundi hantu berbangsa Filipina.

Sememangnya, parti perkauman bergelar UMNO gemar menawarkan wang dan kad pengenalan untuk membeli undi-undi orang asing.

Namun, rakyat Sabah tidak lagi dapat menafikan peranan mereka dalam politik wang.

Sekiranya ‘Sabahan’ sekalian ingin terus terkongkong dalam korupsi parti buli bernama UMNO, silakan menyambut September 16 dengan bangga hati.

Silakan mengundi UMNO pada pilihan raya akan datang.
Read more!

Thursday, September 10, 2009

University Days: The Years I Slept Near A Surau

It was 5.30 am on a Sunday morning.

I was awake, not by effort or by consent but by chance.

It was the call of the azan coming from the college surau.

I had slept for less than three hours.

It was okay.

For five years I woke up intermittently up to the call to worship.

Mostly I went back to sleep.

Sometimes I could not.

Sometimes, it was the perfect way to be the early bird that catches the worm.

On Fridays, I would sometimes listen to the sermon coming from the mosque right next to University Malaya Medical Center.

There was little one else can do on a Friday afternoon.

The college rooms were stuffy and permeated with a stench of sweat-soaked socks.

Studying medical textbooks on a seething afternoon in such conditions were not possible for me.

It didn’t help too that the loudspeakers of the mosque faced my room directly.

Anyway, these were sermons delivered by UMNO-appointed imams.

I had grown accustomed to the hatred and anger in some sermons.

Among the usual Jew-bashing and anti-America overture, there were occasional reminders of how Malay and Islamic supremacy were supposedly under threat from the kafir population in Malaysia.

Anyway, I lived with five years of 200-decibel azan calls and Friday sermons teeming with xenophonic tones - just like so many non-Muslim students in public universities all over Malaysia.

It didn’t make me a lesser Christian.

Read more!

Wednesday, September 9, 2009

University Days: The Day I Was Declared Indecent

It was a day like any other, or so I thought.

We came back from swimming like we always did.

Our hair was still drenched and irritatingly grassy from the heavily chlorinated water of the UM swimming pool, except for Wong of course because he had no hair then.

We wasted no time and headed for the canteen.

My friends and I always had our forks and spoons in our swimming bags.

Mine was normally tucked comfortably between a worn swimming trunk and a used towel.

We made our way to the food counter in the canteen, preparing our student cards in order to collect food.

It was normally deep-fried catfish on Fridays.

The incredibly obese and bespectacled mak cik was seated as usual by the counter, halfheartedly and nonchalantly checking the students’ cards while giving a pleasant greeting.

I always appreciated her efforts to be nice and kind.

There was something different about today though.

A young Malay lass with no tudung was standing by mak cik, her arms folded across her chest in an authoritative position.

I have come to learn of this lady as a newly appointed hostel warden.

She aged no more than 24 years.

In other words, she was much younger than some of us final year students then.

She was a failed government scholar pursuing a trainee lecturer course with UM.

From afar, I could see her reprimanding some students, both Muslims and non-Muslims alike.

Some headed back to their rooms without food.

I wondered why.

We found out soon enough.

By the time our turns came to collect food, the six of us experienced Islamic hypocrisy of the highest degree.

We were chided for wearing sandals and short pants.

One of us was told off for wearing a sleeveless shirt.

We were told that our dressing was indecent and unacceptable for a Muslim nation.

Our behavior and noncompliance to the new college dressing rules was deemed unbecoming.

Our manner of dressing was allegedly promoting immoral activities within the college and posed a challenge to the Islamic faith.

We were threatened with expulsion and disciplinary action.

After a brief but lasting tongue lashing, we were sent to our rooms for a change of attire.

By then, my friends and I were already more than pissed, our appetite gone for a good reason.

We ended up eating in section 17, treating ourselves to a truly porky meal and the pleasures that came with it.

For the rest of the year, students were held and disciplined for trivial reasons like pants that hang more than two inches above the knees and sandals that do not cover enough of the feet.

All students who wanted to eat after were required to be in a ‘decent’ attire befitting of an Islamic country, even if one was soaked with sweat or feeling mighty hot after evening sports.

Meanwhile, the male wardens and their student friends continued smoking and puffing and littering cigarette buds around the hostel.

The free-hair lady warden too continued exerting her ruthless reign over students much older than her.

It was just another day in the premier university of negarakuku.
Read more!

Tuesday, September 8, 2009

University Days: The Day I Discovered Malaysia Has No Hope

It was initially just another Wednesday evening in 6th College, University Malaya.

I went for a swim with my friends and came back for another college dinner – fried hypothyroid chicken with sour, half-cooked vegetables.

We had a chat after our meal and made our way back to our rooms.

Along the corridor were anti-semitic posters put up by some Muslim students.

On them were the usual messages of how the Zionists were murdering innocent Palestine children and how the umat could help by boycotting Jewish products ranging from Kit Kat to Coca Cola, if these were even Jewish to begin with.

The posters did not carry any stamp to indicate approval from the university authorities.

A friend of mine wasn’t having his best days of life.

He took one brief look at the poster and tore it off the wall.

It was to be a mistake he would never forget.

Neither would I.

Later that night about 10 pm after the evening prayers, I had a visitation.

There were loud bangs on the door with shouts of 'buka pintu'.

The visitors were not Marfanoid aliens and greenish Martians or horrifying beasts with tentacles but no less terrifying anyhow.

At the doorway were a group of about seven Muslim students clad in long, flowing robes and white skull caps with six-inch beards for completion.

Apparently someone had thought that I was the one behind the removal of the anti-semitic poster.

I was led behind the hostel, where it was dark and secluded.

Thus began an orgy of racial supremacy and religious dominance.

The seven of them surrounded me and started hurling verbal abuses without prior clarification whether I was indeed the culprit.

They said I was ungrateful and unpatriotic and anti-Islam.

I was shoved back and forth and held by my collar.

One of them puffed a mouthful of kretek into my face.

Another challenged me to go back to China and India.

Somewhere between ‘pukimak’ and ‘babi Cina’, the hostel warden intervened and I was finally allowed to talk.

In the presence of the warden, the Islamists were as timid as a mouse and as gentle as a lamb.

I clarified to the warden that I was not the one they were looking for and had nothing to do with the act of removing any anti-Jewish posters.

They then turned their efforts into hunting for my friend and repeated the whole cycle of verbal harassment and threats of violence.

My friend and I were allowed to retreat to our rooms only at about 3 am.

That was the day I knew Malaysia had no hope.

Read more!

Wednesday, September 2, 2009

I Choose Ethics

Not too long ago, I was doing locum in a clinic in Kampung Air, Kota Kinabalu.

The deal was from 8 am till 5 pm, so RM 40 X 9 hours = RM 360.

It’s not much for a day’s work but it’s definitely more than the wage for a cashier in a KFC restaurant.

The day started like any other general practice.

Common things were common and in fact in abundance – upper respiratory tract infections, food poisoning, skin rashes, STDs and more STDs.

However, the situation became fishy when patients started turning up with medications that were not in their medical records.

A schoolgirl with recent food poisoning came back with severe bloating and constipation, her hands clutching some residual Lomotil and doxycyline.

Her clinic notes by another doctor showed that she was supposed to receive only oral rehydration salts and charcoal tablets.

A young man with common cold whom I had just discharged with symptomatic treatment came back into the room furious, asking why he was given the antibiotics.

He was dispensed Flagyl, an antibiotic usually reserved for anaerobic and protozoal infections.

An elderly Filipino lady with a fungal skin rash was outraged because she was charged an exorbitant sum for a treatment that didn’t work.

In her clinic notes one week earlier, the previous locum doctor had prescribed antifungal cream only.

However, she was sent home with the antiviral acyclovir five times daily and a potent steroid cream.

It wasn’t long before I discovered the culprit behind all this nonsense.

The clinic receptionist – she was not even a nurse proper, was dispensing poisons as she liked.

In her warped and twisted little mind, the locum doctors were less experienced as she was and the doctors’ treatment plans were not bringing sufficient profits to the clinic.

Much to my horror, I soon discovered she was handing out allopurinol for simple arthralgia and double antibiotics for a mother with possible dengue hemorrhagic fever.

Babies with mild cough were given the potent antitussives pholcodeine and dextromethorphan.

It’s not often I blow my top but on this occasion, my patience reached its limits.

I gave a stern warning that if she continued changing my medications and endangering patients at her whim and fancy, I will walk out and leave the clinic without a locum doctor.

She continued in her unrepentant ways and I walked out – less than two hours into the locum.

Between money and ethics, I choose ethics.

Better to live with less money than to suffer the knowing that one’s next meal was bought at the expense of patients’ health.

In Islamic terms, one’s earnings are haram.

The last I heard, the clinic is still continuing its wayward practices.

The clinic owner has since been charged for illegal possession and distribution of psychotropic medications but that did not discourage the doctor and his staff from a tradition of deception.

While the Ministry of Health is obsessed about the size of clinic doors and the measurements of its examination rooms, clinics like this continue to flourish from ripping off one’s hard-earned money, causing unmeasured harm and morbidity in the process.

P/S: This is not a tall tale of holier-than-thou self-righteousness. To all fellow locum doctors out there, let us all preserve whatever is left of the integrity in the medical profession. Let’s boycott damn clinics like the one I mentioned. It’s the least we could do for the society.

Read more!

Saturday, August 22, 2009

Ukrainian CPR, Russian Life Support and The Boris Yeltsin Classification of Heart Failure V: A Final and Total Closure.

I’d like to pick up from where I left four months ago.

I have been working closely with many Russian and Ukrainian graduates over the last four months.

If I had been negatively and unfairly biased against any of my house officers at any time, may lightning strike me dead this very moment.

My conscience is clear in that I have treated each of my house officer with equality and justice.

A senior clinician has requested my help in submitting a report on the competency of Russian and Ukrainian graduates to Ismail Merican, Director-General of the Ministry of Health, Malaysia.

Seemingly, news of incompetent house officers have caught the attention of Ismail Merican and he is seriously considering derecognition of degrees from the institutions concerned.

I did not write that report.

I was too caught up in my personal affairs to write an official report on a topic so wide with so many confounding factors.

Nevertheless, my final stand after four months of quiet contemplation remains the same:
• The Russian and Ukrainian universities are providing substandard medical education to Malaysian students

• The MIC and its unscrupulous agents have effectively destroyed the future of thousands of young Malaysians aspiring to be doctors by cheating them into Ukrainian degree mills like CSMU

• The majority of graduates from Russian and Ukrainian institutions are indeed lacking in skills and knowledge. The competent and truly qualified graduates will unfortunately suffer the stigma resulting from their underachieving peers.

• Attitude goes a long way and will ultimately determine one’s competency as a clinician.

Speaking of attitude, it really doesn’t help when one hears from such a stupid and arrogant doctor:

“I am a Russian grad. All I can say say is that I am competent.I wanna do surgery but my MO always asks me questions that do not reflect practise like what class of antibiotic is this and this? Who cares? Just give the god damn antibiotic - the patient needs it. And then asking me about ABG interpretation. Hey - just give some oxygen, why the fuss on ABG? When I transfused a patient with 13.0 level of HB - my MO went mad. I’m like huh? The normal level is 15 - so i topped him up.

In short - I think we can learn more if these MOs let us do more and stop asking irrelevant questions. They wont even let me insert a central line-so how am i gonna learn??? Instead of teaching me - they ask me about anatomy.

I am so sick of this -why must Russian grads be treated so bad?”

Anonymous, July 22 2009, 5.29 pm.

At the same time, I also do not condone emotionally-charged comments such as this written by a very frustrated longtime friend of mine:

“Obviously if you don't know what class an antibiotic is, how to intepret an ABG, your anatomy or what the big fuss is all about transfusing a patient with Hb=13, you simply don't deserve to practise medicine. You are worse than a Form 5 student. Medicine is not a profession that you can do whatever you like with the patients, thinking that if you can operate on a patient you are a great doctor. If you still don't see my point, you are just too stupid to be a doctor.

Mind you, anonymous...I will say it again (and I don't regret it), you are just too stupid to be a doctor. Just go flush your face in the toilet bowl. If you guys don't know simple things like your anatomy after going through 5 years in medical school, there's essentially nothing more you guys can learn even if you were given the opportunity to learn.”

AK, August 2 2009, 11.57 PM

This will be the last article I’ll be writing on Russian and Ukrainian graduates.

This very eventful topic of will come to final and total closure hereafter.

You may now direct your curses and threats to the nearest brick wall.

Thank you.

Read more!

Monday, April 20, 2009

Bangkitlah Melayu!

Pada 15 April 2009, akhbar Utusan Malaysia dalam halaman utama telah menyeru rakyat Malaysia yang berbangsa Melayu untuk ‘bangkit dan bersatu dalam berhadapan dengan tuntutan kaum lain yang kini dilihat semakin keterlaluan’.

Sahabat sekalian yang berbangsa Melayu,

Bangkitlah daripada tidur lena anda selama 50 tahun kemerdekaan negara kita daripada jajahan British.

Nescaya selepas setengah abad bawah kepemimpinan UMNO, bangsa Melayu yang bijaksana mampu mengesan budaya penipuan dan omong-omong kosong kerajaan Barisan Nasional.

Sehingga bila negara Malaysia kita perlu berbau perkauman dalam semua aspek kehidupan kita sebagai rakyat biasa?

Rata-rata kita sebagai anak Malaysia sama ada Melayu, Cina, India atau Kadazandusunmurut adalah penyayang keamanan tanpa sebarang kepentingan politik.

Tanpa mengira warna kulit mahupun kepercayaan agama, kebanyakan kita sebagai rakyat biasa hanya berhasrat untuk membina keluarga masing-masing supaya anak-anak kita menjadi individu yang berakhlak dan berguna di dunia ini kelak.

Tiada sebarang kaum yang tengah berkomplot untuk menindas mana-mana komuniti yang lain.

Pendek kata, ahli-ahli politik Barisan Nasional yang diketuai UMNO telah mengeksploitasikan paranoia golongan Melayu untuk kepentingan diri dan kroni masing-masing.

Sampai bilakah warga Melayu rela dijerat dalam ugutan palsu ciptaan politikus hipokrit Barisan Nasional?

Daripada tanah air yang berpotensi dan kaya dengan sumber semula jadi dan bekalan tenaga manusia berbilang kaum yang berkaliber, negara Malaysia kini semakin tercemar dan tandus.

Negara Malaysia tercemar bukan hanya alam persekitaran fizikalnya malah dari segi kemasyarakatan di mana jenayah ganas semakin berleluasa dan gejala sosial semakin di luar kawalan.

Ibu pertiwi kita ketandusan bukan sahaja dari segi penyalahgunaan wang rakyat dan pembaziran sumber bumi tetapi juga dalam bentuk ‘brain drain’.

Sejak Mei 13 1969, Malaysia dianggarkan telah kehilangan sebanyak dua juta tenaga professional dan intelektual daripada semua kaum kepada negara asing di seberang Selat Tebrau.

Anak-anak Malaysia yang telah berhijrah ini tidak sama sekali patut dituduh sebagai penderhaka negara yang tiada semangat kenegaraan dan jati diri.

Sebagai pengerusi Pemuda UMNO pada tahun 1987, Perdana Menteri Najib Razak telah menyeru ahli-ahli UMNO untuk membasahkan keris dengan darah Cina.

Budaya mengugut dan melancarkan keganasan atas masyarakat minoriti Malaysia ini kian menjadi tradisi UMNO.

Pada tahun 2004-2005, perwakilan di perhimpunan agung tahunan UMNO telah berikrar untuk menonjolkan kewiraan Melayu jati dan bermandi darah menentang masyarakat bukan Melayu.

Kempen menabur perasaan benci dan curiga terhadap masyrakat bukan Melayu semakin hangat semenjak pilihan raya Mac 2008. Parti UMNO kerap kali menyebarkan desas-desus yang tidak berasas dengan tujuan UMNO akan sekali lagi menerima sokongan pengundi Melayu.

Warga Melayu Muslim yang ikhlas dan berpegang teguh kepada ajaran agama perlu bersatu, bangkit dan menolak ketagihan keganasan yang semakin menular dalam parti yang memperlihatkan dirinya sebagai penyelamat ugama, bangsa dan negara.

Sebab mengapakah masyarakat Melayu Malaysia terus bergantung pada Dasar Ekonomi Baru (DEB) apabila bangsa Melayu secara semula jadi adalah bangsa yang gagah dan berbakat yang lebih daripada mampu untuk berjuang di persada antarabangsa?

Sejak 1970, DEB bukan sahaja gagal membanteras kemiskinan di negara kita tanpa mengira kaum malah telah meluaskan lagi jurang pendapatan dalam setiap komuniti masing-masing.

Melayu yang kaya dan berkepentingan politik dalam UMNO semakin berada dengan kontrak and tender lumayan manakala Melayu yang miskin semakin terdesak dalam kehidupan harian.

Cina yang berharta dengan talian MCA semakin meluas monopoli mereka sementara Cina yang berkeperluan terus dinafikan peluang walaupun hanya untuk menjadi empunya tanah kecil yang didiami bertahun-tahun di kampung-kampung baru tersusun.

Masyarakat bumiputera Sabah yang papa sejak turun temurun terus tertinggal dalam alaf baru tanpa akses kepada perkhidmatan kesihatan manakala ahli politik yang bernama Pairin dan Ongkili berjuang sesama diri untuk diberikan kuasa dan kedudukan yang lebih.

Sememangnya, DEB bukan sahaja gagal menjadi pemangkin mobiliti golongan miskin malah menjadi batu penghalang kepada pencapaian dan keupayaan Melayu sejagat.

Tanpa pertandingan terbuka yang sihat dan adil, anak-anak Melayu dari segenap lapisan masyarakat sama ada pelajar sekolah mahupun professor universiti semakin leka sebagai jaguh kampung tanpa sebarang motivasi dan tekanan untuk mencabar wilayah selain Tanah Melayu.

Seruan untuk membubarkan DEB daripada pelbagai pihak bukanlah untuk merencatkan pembangunan masyarakat Melayu sebaliknya menyediakan komuniti ini untuk menghadapi dunia pasca moden yang tiada sempadan.

Pembaziran aset nasional oleh perompak Barisan Nasional atas nama Dasar Ekonomi Baru ini tidak boleh berlanjutan lagi.

Ibu pertiwi kita bukanlah lombong minyak yang tidak terhad.

Sedarkah Melayu sekalian identiti Melayu bumiputera semakin dicabuli oleh opportunis yang hanya bergelar Melayu semata-mata kerana mereka mengidamkan hak-hak istimewa bumiputera?

Kaum India-Muslim mamak seperti menteri besar palsu Perak, Mohd Zambry Abdul Kadeer dan bekas Perdana Menteri Dr. Mahathir Mohamad bukan saja berlambak-lambak di dalam parti UMNO malah menerajui kedudukan yang berkuasa di peringkat negara.

Dalam keghairahan untuk terus berkuasa dan memperkaya diri dan kroni, UMNO tidak ragu-ragu menggadaikan identiti Melayu sejati.

Dari Selangor ke Sabah, warga Indonesia, Filipina dan Pakistan dikurniakan kad pengenalan Malaysia dan seterusnya mengisytiharkan diri masing-masing sebagai bumiputera Melayu pada hal mereka hanya berminat untuk menerima ‘hak-hak istimewa’ yang terkandung dalam Dasar Ekonomi Baru.

Saudara-saudari yang berbangsa Melayu,

Bangkitlah engkau untuk menentang mereka yang mencuri dan memperbodoh identiti Melayu dan bukan mereka yang berganding bahu untuk membangunkan ibu pertiwi kita.

Bangkitlah anda semua untuk mengusir mereka yang menyamar sebagai penyelamat umat Islam tetapi mengamalkan budaya dan aksi keganasan yang bertentangan dengan agama Islam.

Bangkitlah bersama-sama mereka yang meskipun kafir dan bukan bumiputera Melayu tetapi sayang akan negara Malaysia kita dan menggembleng tenaga untuk mewujudkan suatu negara Malaysia yang benar-benar adil, makmur dan saksama.

Seperti mana Tok Guru Nik Aziz Nik Mat berkata, “Kita semua adalah anak Adam”.


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Wednesday, April 15, 2009

Ukrainian CPR, Russian Life Support and the Boris Yeltsin Classification of Heart Failure IV: Pak Abu Dies

Pak Abu passed on today.

Take a guess why.

It’s all in the ABCs of basic resuscitation.

Someone did not ask for senior assistance when Pak Abu went into distress.

Someone forgot to clear the bloody secretions.

Someone did cardiopulmonary resuscitation on her own without addressing the ‘P’ of CPR.

Pak Abu survived open heart surgery.

Pak Abu pulled through a major abdominal surgery.

Pak Abu cheated death twice, the second time just barely.

Pak Abu worked hard his entire life to send his eldest son to study medicine in Monash, Australia.

His son will now graduate without a father by his side on graduation day.

Pak Abu was a great man in his own right but not great enough to survive that someone from CSMU.

That someone could have called for help but she didn’t.

Perhaps that is why there would be a funeral for Pak Abu tomorrow.

Rest in peace, Pak Abu.

See you at the crossroads.

To my dear readers from the Russian and Ukrainian medical schools, this short article would have served its purpose if you are outraged after reading it. May your anger and rage be translated into a greater determination for self improvement as opposed to running down the critics and skeptics around you. I am speaking to myself as I write so.

God bless. Read more!

Sunday, March 29, 2009

Education For The Illiterate And Enlightenment For The Uncivilised

A short rebuttal before my planned hiatus.

Wow, I never thought that my two truthful encounters with the Russia graduates would ignite such fiery responses and emotionally-charged hate mails.

It appears that the literacy rate among Malaysians is not as impressive as we thought, huh?

Now, way back in 2005, I wrote a lenghty article to the mainstream media and Malaysiakini lambasting the Malaysian Medical Council for abruptly derecognizing CSMU and consequently leaving the students (and parents) in limbo.

My salient points back then were plain and clear – our local medical graduates are not superior to the CSMU students and in fact clearly lacking in many aspects.

Therefore, those who only started reading this blog in the last one week would do well to search through the archive of articles in Malaysiakini for the year 2005 before accusing me of attaching a negative stigma on graduates from CSMU and Russia.

Four years have passed since the CSMU controversy in 2005 and now we are having the graduates put through the baptism of fire i.e housemanship.

The current batch of house officers is in their third month of housemanship.

They outnumber the local graduates in a ratio of 3:1. There are probably around 35 house officers from Ukraine and Russian universities. I am not sure of the exact figure because I am obviously not in charge of administration.

Have I met all of them? Obviously not.

Nevertheless, the chatter among the clinicians is similar – most of these medical graduates are lacking in competency and fall short of their minimal expectations.

Do note my persistent usage of the term ‘most’ and not ‘all’.

Also note my first post stating very clearly that the students / graduates themselves are not to be faulted.

Regardless, if I were a CSMU or Russian student / graduate, I will look at these criticisms not as insults but as a challenge to disprove the critics.

Thus far, the only one who responded in such a manner is him.

Essentially, I am speaking for myself to hear.

With all the doubts over the competency of local graduates, the onus is on the local graduates to prove themselves worthy of the degree conferred upon them, and this is not limited to a medical qualification.

In their unchecked anger and uncontrolled emotions, the illiterate and uncivilized have hurled very colorful verbal abuses upon me without realizing that these are acts that only serve to embarrass oneself.

I shall not stoop to your level and participate in your exercise in vanity.

Instead I shall rest tonight knowing that this blog has truly served its purpose – to expose that which is presumably wrong and await the ripple effect to other sites like the much acclaimed Malaysian Medical Resources.

May I be excused now if you don’t mind - my avocadoes are waiting for me in the blender.

Till we meet again.

You can continue cursing me now.


P/S: Dear Ken Lui, I have removed your name from the alleged impostor. The posting remains for the purpose of discussion. My humble apologies.
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Friday, March 27, 2009

Ukrainian CPR, Russian Life Support and the Boris Yeltsin Classification of Heart Failure III: The Insiders’ Revelation

For perhaps the first time since I started this ‘little corner’ of mine, I’m posting two articles that are not written by myself.

Medical students “Newly Circumcised” and “Moscow Medical Academy Student” would like to share their personal experience studying abroad.

May you lend the two of them a listening ear. I’m reposting their comment in a verbatim state.

Insider I: Newly Circumcised

With all these heated up debate bout CSMU, I guess its time someone from CSMU stands out n clarify things for real.

Firstly i want to prove to all the readers out there (esp CSMU students); I'm not an imposter who plans to destroy CSMU's image.

1) Last week we had Amazing Race Simferopol where all the stupid participants sang "Negaraku" in terrible falsetto voices all evening.

2) MSC president- Mayurran. MCA president- Baba.

3) See Choo is doing hair cuts at weekends at the 1st hostel 4th floor common hall.

4) All the hostel are located at - Rechnaya Street beside the Park Gagarina with the stupid Prom night poster now on 4th Hostel wall.

5) 5th hostel "kiosk" selling Samosa at 2.60 grivs.

CSMU students reading this will know I'm not an imposter.

I'm a "REAL" CSMU student.

Now lets begin with the main issue - why Ukrainian grads lack clinical knowledge?

The answers to this enigmatic question are-poor non-practical teaching systems n lazy, idoitic students.

Here's the details.

For clinical year students the schedule is 1 or 2 lectures a day with 1 class. Needless to say, the lectures r conducted by old Russian uncles or hags in Russian language, e.g Infectious Disease lecture which obviously are boring n totally USELESS.

Now, about the classes. In Malaysia classes r conducted as ward rounds where the clinical instructor n med students discuss, examine n perform clinical procedures together. In CSMU, the students go to hospitals too but everything else is TOTALLY different!!!
After reaching the hospitals, students will go to designated classrooms - so called " uchebnaya komnata". Then, the lecturer will come in, discuss about the tasks, make a break, continue discussion n the students will be free.

We don really get to examine patients because the patients are reluctant, n because the lecturers are lazy!

Why the patients are reluctant?

Because we're foreigners, we come from less civilized country, we're "DIRTIER".

Thus, in average for 1 cycle, students will only see 1 or 2 patients.

I really mean "SEE", most students just go to the patient, converse in broken Russian, make some short notes n that's all.

No clinical inspection, no careful analysis of lab results.

Even if there is, the clinical examination is "CINCAI".

Before the end of cycle, students will do case reports (case histories) which are actually "Copy n Paste" work of other reports. Worse still, we can "Make-up" any fake symptoms, lab results to fit the diagnosis. Cool ha?

What's way COOL is, sometimes we just take other peoples case reports, change the name of the patient n hand it to the lecturer.

U guys must be curious right-how come the lectures didn't notice it?

Of course they wouldn't know, because all the case reports ends up as "Free Toilet Papers" for the lecturers. Unless, they read while they're in the loo, how do u expect students to be competent when the system is so corrupted n vain?

2nd problem-the students themselves. Most students here are "EXTREMISTS".

Here's why.

Some are Extreme Religionists, all they do is sembahyang, attend Bhajans,go church services,Dharma classes. They would even skip classes to attend religious activities.

Some are Business Freaks. Instead of studying they waste time selling stuffs or services. Some sell Char Siew Pau, some Rojak, some Chicken Rice. Some work as "Flight Agents", Avon direct sales, manicure experts, barber n artists.

Then there is the Clubbing Maniacs. These bunch go to night clubs, dance, smoke, get drunk, fight with some Russian strangers. The hardcore ones take drugs e.g Marijuana n visit brothels. Yes. Some CSMU students r STD infected!!!

Another group - Rich Bastards. These people r the pampared, spoilt brats of rich Dato or Tan Sri. They'll play their PSP(Playsation Pocket) during lectures n classes. Download or watch movies, play PS or Nintendo wii at their rooms. There is virtually no academic conscience in them.

Luckily, there is-Kiasu Nerds. These students know of their incompetency - the result of the system. And are trying their best to improve themselves. They study Malaysian protocol books, watch n practice clinical examination methods e.g from Macleod or Talleys. But what they're doing is of limited value since real clinical skills come from hands-on experience not some video, or healthy friends to act as ill patients. Well,at least they put in effort to improve themselves.

Unfortunately though, they r the minority. They're being "Oppressed"! Students from other categories ridicule them, alienate them, some even criticize them; labelling them as nerds,geeks,No Life.

These people are good students STPM pointers 3.7-3.9. Some of them were neglected a course of their choice even with good results. Instead they were given courses like Aquaculture, Enviromental Science, Forestry which were not one of the 8 choices selected in the IPTA form.

I, myself, am a victim to the goverments so-called "Meritocracy" even with 3A1B n band 5 for my STP. Worse is our parents are tricked by the agents into sending us to study in Ukraine. They created wonderful yet obviously implausible lies like - it is the best uni in Ukraine, it is world recognized-u can work anywhere in the world with the degree. Feel sad for all the nerds, including myself.

If there really is a time machine, i would never, never, came to study here.

Well,I can only blame bad Karma.

About the students who come here on government funds.

Yes. It's true. They're Bumiputras on MARA or Yayasan scholarships.

How much? About USD 500 per month about 2500 grivens.That's quite a sum.

How do they spend these tax-payers money?


Go to Euro-trips n buy whatever they like. I've witnessed them buying Prada shoes from France trip; MAN-U jersey,Nike boots from England trip. Some smoke, take drugs n frequent high class restaurants.

Some just use the extra to get married.

Yes. This is true. MARRIAGE. Imagine.

A pair of med-students with no income marrying.

Guess who's paying for the Kenduri n Euro-trip honeymoon costs?

After some sex the wife gets pregnant, gives birth in CSMU. The child is left at the nursery while parents attend lectures etc.

Guess who's paying for the nursery n baby stuffs?

As a conclusion, I sincerely hope the MMC will implement a qualifying exam for all students alike. Those who fail should be given a workshop or training period. I don't care even if i have to pay. Because i don't want to "kill" my future patients. And i request senior officers not to "stereotype" all CSMU graduates.

Not all are stupid like the Surya. If given proper guidance we can at least, i fervently believe doctors of satisfactory level.

After posting this, I'll probably be in "Extreme Danger".

Some macha would probably want to whack me for good now.

Luckily, I can defend myself with some tae-kwan-do.


Insider II: Moscow Medical Academy Student

Sad but true.

I am a medical student from Russia as well.

Best part is, i or rather WE did not choose to come here.

We are all scholars sent here by either JPA or MARA.

If you were to google "Moscow Medical Academy" it is ranked by UNESCO as the second best medic Uni in the world.

DO NOT be fooled by this. Cuz i was one who was fooled as well.

Only after i landed in Moscow did i know that "2nd best in the world" is specifically granted to the Russian Medium of this medical school.

We Malaysians are doing the English medium...& i must say it's an utter shame that the Government actually spent millions of tax payers money to send us all here to study medicine.

The teaching facilities/methods of the English medium here is way below par...way below that of a 3rd world country even.

Some classrooms here even resemble the ones we have in our kampungs in rural areas such as Sabah & Sarawak. (so much for sending us here all the way to Moscow to EXPERIENCE this!)

For your information, this so called Moscow Medical 'Academy' DOES NOT even have a campus to begin with. Classes are scattered all over Moscow. (eg:Klang,PJ,Subang,Kajang,etc.).

We students are forced to travel everyday via Metro, or by foot or bus to attend classes. Also, there are many a time when we would have traveled so far to attend classes only to be told once we've reached there that classed are canceled!

The Government could have spent the money more wisely to educate us all in M'sia/Singapore/India. We get paid almost USD700 per month which i believe is a huge amount of tax payers money.

However, i doubt we will bring back much knowledge to be able to help the patients back home.

While there are some of us who save & spend the money wisely due to the high cost of living here, there are a huge majority of private & sponsored students who come here juz to ENJOY.

FREQUENT Alcohol parties, weekend getaways, world tours, & shopping sprees are very common among students here.

The lifestyle of many Malaysians changes tremendously once they came here. They behave even worse than the "Mat Sallehs" here. Malaysian girls here for instance would walk around ever so skimpily leaving nothing to the imagination (even during winter!)

Watever happen to the MALAYSIAN CULTURE?

Many here have even lost their virginity at the young tender age of 18 or 19 simply because a guy or girl can walk in ever so easily into the rooms of the opposite sex. Believe it or not,we have heard SEX sounds even!

Many Malaysian medical students behave as though they have no self dignity or watsoeva. (However, they potray the best behaviour once they land in Malaysia like as though they are the best Malaysian angels...sadly, we all know their true colours when they are here in Moscow. HYPOCRITES!!!).

These Malaysians are surely to be huge dissapointments to their families as well as to the nation.Exams & studies are the LEAST priority/favourite of many who are here. I wonder why did some people choose to study medicine in the very 1st place.

Let me also give u an insight of the education system here. You want to know why the majority of Russian grads are so incompetent & useless?

Well,1st & foremost we can get away with cheating ever so easily during tests & exams. You may ask how. Many students here aren't bothered about being honest for themselves. Many juz merely do the bare minimum of studying & copy their friend's answers or directly from the books during tests/exams. These students fail to realise that they are only cheating themselves.

The one who helps with the cheating is also going to lose out in the end once he/she is out of medic school & into the real working world. Another method which works really well for the girls is simply to shed some crocodile TEARS during tests/exams & instantly the lecturer/tutor would grant her a mere's still a pass u know (better than a fail). How is this fair to some students like me who slog day & night mugging & studying extremely hard with the simple intention of graduating as competent doctors?
After all, these cheaters would be graduating with a MD certificate as well & turn out to be the bad apples in the healthcare system in Malaysia & thus leading Senior Doctors to generalise & say that ALL Russian Grads are INCOMPETENT!

Does anyone have any idea how frustrating this is?

Many students who sit for exams/tests earlier would simply snap a photo of the different set of questions & answers & then distribute it to the rest of the students who have yet to sit for their exams.

How is this helping anyone? Can u even call this an EXAM?

Does it fit the definition of an exam?

So,can u imagine wat kind of Doctors we're producing here?

A bunch of cheaters, liars, & irresponsible future doctors! That's the TRUTH!

Now, no wonder countries like the UK refuse to accept Russian Medical grads for their Postgraduate courses.

Simply because we have never even sat for a PROPER exam per say throughout our 6years of study here.

Look at the UK universities/colleges, do they even allow any student of theirs to bring in PDA's, camera handphones, bags, books into the exam venue?

Do they allow any exam candidate to communicate with another fellow candidate once the question paper has been distributed?

Do students know the exact sample of questions & answers prior to the exams?

HELL NO! These only happen in good old Mother Russia!

So, Wake up people!!!

So, to those of you all who are planning to send any of your offsprings to Russia for a Medical Degree, please, im begging you, think again.

You're not only going to lose your money, but also perhaps the good name & dignity of your family.

This is merely an opinion of mine & not directed to insult, degrade or humiliate anyone. I believe there is nothing wrong in sharing my opinion.

POTS’s disclaimer: Posting the two testimonies above does not in any way imply that I agree wholeheartedly with the writers’ views. However, I sincerely applaud the two brave souls for having the courage to concede weaknesses when they are present and to go against the tide of mob rage.

Following the above post, medical student Ken Lui alleged that his identity was stolen by an impostor. I have removed the relevant details. The posting remains for discussion sake.

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Tuesday, March 24, 2009

Career Guidance with P.O.T.S

Aspiring doctor Joanne read my UMS posting and exclaimed:

Oh my god! I have just made my application to UMS! Can i know how long is the study duration fot medicine? How many years do i need to endure? XD

This is my humble reply.

Dear Joanne,

Thank you for reading and inspiring this post.

I apologise sincerely if I have inadvertently created a negative impression even before you are in University Malaysia Sabah (UMS).

The medical program in UMS is five years, just like all other local public universities.

The process of learning and training to be a medical doctor in UMS have gotten more difficult in the last one year due to the closure of the Queen Elizabeth Hospital.

I was told that medical students are now dispatched to Sandakan, Tawau and Kota Belud since some disciplines have shifted their services to the hospitals there.

Anyway, I think your best source of information should not be a socio-political blogger but someone who has gone through the UMS medical program.

Instead of enlightening you about the life of a medical student and doctor, I would instead advise you to think carefully before jumping into the medical bandwagon.

Be a doctor only if you are really interested in medicine and not because your parents are.

Asian families are still very stuck in the conventional thinking of going for professional careers if their children do well academically.

In all honesty, I think we need more smart and creative people outside the circle of medicine.

I might not have said this years ago when I just completed my STPM, but the truth is this – there’s a whole lot of interesting careers out there apart from medicine.

If you are artistic with an imaginative mind, you can always go into filmmaking and wildlife photography. You can produce photo essays for Time magazine or capture scenes of a honey bear enjoying a sunbath for the National Geographic Society. After all, we need to immortalize all these wonderful creatures of God in digital media before the China Chinese devour them all.

If you are into music, do consider a career in the genre of trance. You just might taste worldwide fame not unlike prominent deejays such as Chicane, Darude and Fatboy Slim. Stay out of jazz though. I find it super gay.

Medicine should very much be left to boring and bored souls like myself. Or maybe medicine turned me into a boring and bored person.


Oh yeah, don’t forget sports and athletics. I doubt Datuk Lee Chong Wei and Datuk Nicol David ever regretted choosing their career paths. Just don’t choose football and lawn bowling though. The first is reserved for mentally-challenged intravenous drug users while the second is just plain lame.

Just between you and me, I am constantly dreaming of the life that could have been if I were a professional skateboarder.

The food business is always lucrative and rewarding, even in times of economic crisis. I have already garnered enough capital to open up my very own aquaculture farm. I am still on the lookout for a potential UMNO crony since land is increasingly scarce and in high demand. Do consider the vegetarian food sector. You will be amazed how some people are willing to fork out ridiculous cash just to bite into a shrimp-looking tofu that tastes like, well, tofu.

Money is also abundant in share and currency trading. My cousins are driving fancy cars and feasting in vegetarian outlets way beyond my salary as a doctor, and they are not even vegetarians.

Of course, it’s not all about the money.

Sometimes it’s about the karma and divine retribution.

One can serve the church and God too. You would need a certain degree of vocal prowess and eloquence to thrive in the ministry. Success will come soon enough and it ain’t only in the form of heavenly treasures. Just don’t molest the altar boys and get caught doing so.

When all else fails, you can always go into Malaysian politics. If someone like Muhammad I-Speak-No-English Taib can amass millions without a useful academic qualification, so can you. There might be a window of opportunity in Bukit Lanjan soon. There, you can’t say I didn’t tell you so.

After this long winded reply, if you are still keen to do per rectal examinations for life as a medical doctor, I will still cheer you on and welcome you on board.

Rest assured if you are somehow not up to the mark in clinical practice, you can always join Dr. Rikki in the logistics of quality healthcare.

All the best.
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Ukrainian CPR, Russian Life Support and the Boris Yeltsin Classification of Heart Failure II: The Reign of Chaos

I resuscitated another corpse today. By the grace of God, old Pak Abu was revived.

More than a successful resuscitation effort, it was a failed murder attempt.

The perpetrators behind the latest assassination plot were none other than our Malaysian medical graduates from Russia.

I was only a nonchalant passer-by.

Drama and blood and gore were the last things on my mind.

Yet the sight of a soul in distress was inescapable.

Some people have an uncanny the ability of selective vision to ignore that which is unpleasant to the eyes.

I unfortunately do not possess such a gift.

If I come across a man (or woman) gasping for breath trying to remain alive with the little air they can inhale, I can’t turn around and pretend I see no evil.

Now Pak Abu was obviously struggling to breathe, so much so that he was already unconscious and cyanosed with no heart beat.

I caught the first house officer and made a very quick enquiry about Pak Abu.

“Oh, he’s just sleeping,” was her reply.

It was then that I flipped and threw a fit – a memorable, record-breaking grand mal seizure even by my own standards.

“THE PATIENT IS NOT SLEEPING! HE IS DYING!” I snapped, throwing the house officer into a state of panic and disarray.

Any human being with a minimal amount of common sense could have come to the conclusion that Pak Abu was in critical condition.

I supposed that was why his Filipino caretaker stood by and did budge not an inch away from Pak Abu.

While the staff nurses and doctors left Pak Abu to die miserably, Aminah the Filipino illegal immigrant with no skilled training or formal education did the most sensible thing she could think of.

It was also the only thing she could do in the absence of assistance and professional help.

She pumped precious oxygen into his failing lungs while the Russia graduates left Pak Abu to rot.

Aminah is paid RM 60 per day. That’s RM 2.50 per hour for twenty four hours of cleaning and feeding and diaper-changing with no designated lunch time or off-days in between.

In contrast, a house officer educated for six years in a Russian medical school earns RM 4800 per month, excluding food and on-call allowances.

In the process of a rowdy resuscitation – somewhere in between 1 m of adrenaline and 360 Joules of defibrillation, I grilled the three irresponsible and blatantly negligent house officers one by one.

They did not know the basic A, B, Cs of resuscitation.

They have no inkling what an oxygen face mask is.

They have never performed chest physiotherapy and suction before.

They couldn’t tell a Ryle’s tube from an endotracheal airway or even plaster the latter decently in place.

Sometimes these Russia and Ukraine graduates give answers that can really leave one stumped in disbelief and a locked open jaw.

Do Russians turn blue and stiff and icy cold with no heart activity in sweet slumber?

Do Ukrainians have a normal blood pH of 7.28?

The list goes on.

Very bluntly, it’s a serious issue of aptitude and attitude or rather, the lack of both.

They are a living testimony to the rotten state the Malaysian Medical Council has put us all in.

How many more must suffer and die before they put in place a mechanism of evaluating the competency of trainee doctors?

As it is already, irresponsible and dubious doctors are commonplace in the system.

The disciplinary action and remedial steps however are few and far in between.

The end-of-posting assessments, log books, annual SKT appraisal and incident reporting are nothing but an exercise in vanity.

Anyway, I visited Pak Abu today.

He gave me a reassuring nod of wellness.

Here is one soul that successfully slipped away from the Russians.

How many failed to?
Read more!

Monday, March 23, 2009

Ukrainian CPR, Russian Life Support and the Boris Yeltsin Classification of Heart Failure

I resuscitated a corpse today. Needless to say, I failed.

Ukrainian CPR, Russian Life Support and the Boris Yeltsin Classification of Heart Failure

I resuscitated a corpse today. Needless to say, I failed.

I pumped air and fluids and drugs into a man who was already dead.

Ahmad (not his real name) was stiff as a log by the time I was referred to him, more of a cadaver than a human being in distress.

It was not difficult to see why.

The first house officer was breaking his ribs instead of pumping his heart.

His counterpart had no experience in setting an intravenous cannula ever before.

The third of the trio simply stood by – an idle spectator in the midst of chaos. He should have brought some popcorn with him instead of a stethoscope.

The three had one thing in common – they graduated from medical schools in Ukraine and Russia.

I don’t blame the house officers for the patient’s death.

I blame the deceitftul agents that lured parents into parting with their hard-earned money to pay for a medical education in Russia and Ukraine.

I blame Malaysian parents for coercing and sometimes forcing their offspring to pursue a medical degree despite clear suggestions that their children might not make successful doctors.

I blame the universities that make Malaysian students labor for six years in a foreign land learning a foreign language only to end up as clueless, incompetent quasi-doctors.

I blame the Malaysian Medical Council who for reasons best known to them, accorded unconditional recognition to institutions that are way below par.

I blame the healthcare authorities for allowing half-baked medical graduates to roam about causing immeasurable harm and untold horror.

I blame the public for creating and perpetuating this erroneous impression that the medical profession is highly lucrative and glamorous.

Regular followers of national events will recall the controversy surrounding Crimea State Medical University (CSMU) back in June 2005 where the Malaysian Medical Council (MMC) decided to abruptly derecognize the medical school.

This was done so despite earlier recognition and accreditation by the Malaysian Ministry of Education.

Worse, some of the CSMU students were actually government scholars sent over there on tax payer’s money.

After many unruly and loud parliamentary debates, during which a deputy minister was suspended and a barrage of racist remarks were fired by Nazri Aziz, all students already in CSMU then were finally allowed to practice medicine in Malaysia upon graduation.

The flip-flop decision by the Malaysian Medical Council has proven to be a very costly mistake.

At present, hundreds of medical graduates from Russian and Ukrainian universities especially CSMU are out without a leash in our government hospitals.

Most of them don’t know pharmacology or physiology.

Most can’t perform simple clinical procedures like urinary catheterization and intravenous cannulation.

Most can’t deliver acute care to a patient in distress.

They are not well-versed with common medical terms and classifications.

In short, they are a different breed altogether.

The Malaysian Medical Council should be ashamed of itself.

So should all the politicians who campaigned fiercely for unconditional recognition of the CSMU graduates back in 2005 without first understanding the issue in depth.

The MMC should have stuck to its guns and derecognized CSMU if it truly believed in the provision of a safe and sensible healthcare. These graduates from Ukraine and Russia could have been given a grace period of retraining under close observation.

If they prove to be incompetent and fail to meet the minimal standards, they could have been retired from service. It’s how the rules of employment work in most parts of the world.

Instead, they were made instant doctors.

In the process, ill patients were made into instant victims.

What we need urgently now is a way to address these obvious shortcomings among these house officers before they become medical officers and make lethal and illogical decisions.

This is by no means an irrational stigma or witchhunt.

Medical graduates from local universities should not be spared as well.

I am not blindly biased in favor of local graduates for which I am one myself.

Bottomline is this: Malaysians deserve to demand proper healthcare from the government they elected.

It’s not too much to ask, or is it?
Read more!

Thursday, March 19, 2009

It Doesn't Mean A Thing

Seriously, it doesn't matter.

It doesn’t matter if you were Malay, Indian or Chinese or Kadazandusun, we all bleed red.

It doesn’t matter if you were as charming as Megan Fox or just better-looking than Shrek, age catches up with us all and death will soon beckon.

It doesn’t matter if you had millions of ill-gotten gains stashed away in a Swiss bank or just some meager loose change in your jeans pocket, we brought nothing into this world and can bring nothing out of it.

It doesn’t matter if you were born with so-called royal blood or raised without education in the slums, no human should be immune from valid criticisms and the rightful course of law.

It doesn’t matter if you were an avid follower of the sarcasm in South Park or a long-time Star Wars loyalist, Indiana Jones 4 sucked big time and will leave a bitter, disappointing aftertaste.

It doesn’t matter if you were a pious Seventh Day Adventist or just a really likeable liberalist-atheist, bak kut teh tastes damn good and that’s final.

It doesn’t matter if you were an extreme skateboarder or a bed-bound cripple, you are pretty screwed if that Russian house officer did not replace your foreskin after inserting a urinary catheter.

It doesn’t matter if you adore animals and hate the Jews, grief hurts and cuts very deeply indeed.

It doesn’t matter if you were a born loser in love or the lame winner of Akademi Fantasia, cats are cats and to them you are just human.

It doesn’t matter if you were an anonymous blogger with an open identity or a loudmouth politician with deep, dark secrets, the truth will prevail sooner or later.

It doesn’t matter if you were the son of a former racist prime minister or a dead Mongolian beauty blown into shreds, the Lord God will judge us all.

It doesn’t matter if you were a closet pedophile serving the Catholic Pope or a reluctant jihadist stranded in the tumultuous Middle East, Jesus loves you and I am trying to too.

Read more!

Monday, March 9, 2009

Four Braindrains And A Rotting Driftwood

Farewell, my dear friends. I know you will excel as immigrants once again...

SMS message from POTS:
So how are your Lion City plans? Any progress?

Reply from Dr. Bee:
On-going. Now waiting for contract n registration with Singapore Medical Council. Most likely will leave by end of June. Join us.

Come July, Malaysia will lose four very capable, talented and diligent doctors.

Dr. Aye, Dr. Bee, Dr. See and Dr. Dee are four medical officers who have served the people of Sabah to the best of their ability.

Despite proving their worth and passing the preliminary stages of their external exams, they have been denied an opportunity to pursue further training in the specialty of their interest.

“Be patient,” Dr. Aye and Dr. See were told.

With the sudden extension of housemanship to two years, there was seemingly nobody to replace them in the districts of Sabah till 2010 and even then, there is no assurance that they will be transferred to a proper training center.

“Be understanding,” Dr. Dee was told.

Despite fulfilling his years of service in Sabah, Dr. Dee was denied a transfer back to his hometown in Peninsular Malaysia. The state of Sabah is supposedly facing a healthcare crisis of immeasurable severity and all transfers back to Peninsular Malaysia are frozen indefinitely.

Strangely though, the local and national news agencies are virtually hushed on this matter of political interest. As the saying goes, their silence is deafening.

“We will not stop you from resigning,” Dr Bee was told.

The Malaysian Ministry of Health demonstrates its stupidity and ignorance with words such as these.

It goes to great length to preserve rotting driftwoods like Dr. Rikki but has no qualms practically pushing astute clinicians across the Tebrau straits.

Our bright and enlightened neighbours at the south cannot be faulted for jumping at the opportunity to welcome and receive these four Malaysian ‘rejects’.

The unwanted citizens of one racist nation become the priceless assets of a capitalist city.

They are not the first and certainly won’t be the last.

My four dear friends, I wish you all the utmost and the best in your future undertakings.

I know you will all excel in all that you pursue.

And yes, I do envy your freedom and liberation from idiocracy like the SKT and SLAB programs.
Read more!

Kota Marudu, Sunday. The Land Beneath the Winds is set to tap into the lucrative health tourism industry. If realized, the inaugural project would generate an estimated revenue of RM 67.69 million for the state in 2009.

Healthscare and Nutrition Minister Datuk Liow Tong Lai made the announcement after an unannounced visit to the Kota Marudu Hospital here on Sunday.

“I have seen with my own eyes the potential that Sabah offers in terms of healthscare services. The medical and surgical care here is unprecedented and unique. There is no other way to describe it. Sabah healthscare is genuinely of international standard and on par with Zimbabwe and Somalia,” Datuk Liow said.

Future director of the state healthscare department, Dr Rikki agreed wholeheartedly.

“Datuk Liow has indeed seen with his own eyes. We have Burmese surgeons and Iraqi physicians, Russian house officers and lots of Filipino patients. No other state hospital can claim to be more international than us,” Dr. Rikki added.

The Healthscare Ministry in Kuala Lumpur has appointed Kinabatangan MP Dung Mokhtar to oversee the implementation of the pioneer Sabah State Tourism Project.

“Like the Healthscare Minister, I not only saw with my own eyes but have analysed the situation in Sabah as well. The Queen Elizabeth Hospital and Kota Marudu Hospital will be ideal for this project,” Dung explained.

Details of the various packages up for offer are yet to be finalized.

For accommodation, potential clients can choose between the standard rusted bed and the more economical makeshift canvass bed.

To enjoy greater camaraderie, patients can opt for the backroom where the space between two beds is a mere 30 centimetres.

“You can hear your neighbour’s fart and even smell it. If you have TB and are coughing your lungs out, the neighbouring bed can rescue that precious pulmonary tissue,” a medically-enlightened Dung elaborated.

Meals served in the health tourism project will display strictly Malaysian flavors. Breakfast comprises sliced bread and plain water. Lunch and dinner will be pure porridge served with boiled fish or steamed chicken.

“With such mouth-watering servings, I am sure that the ill and debilitated will recover in no time and once again be in state of a positive nitrogen balance,” Dung added.

Dung Mokhtar brushed aside concerns regarding the welfare of patients’ caretakers and next-of-kin.

“They can sleep on the floor and the many benches around the hospital if they want. We will not stop them,” Dung promised. Read more!

Friday, March 6, 2009

Dr. Rikki II: The Rise of Driftwood

A sense of déjà vu came over me. The hunched figure with a greying crown seemed so familiar.

The furrows on his forehead were like anyone else’s but somehow extraordinary for some reason.

Was he an ill patient that I once treated and have now recovered to full health?

Perhaps he was just another Sabahan with common features of a limited gene pool.

Dr. Rikki II: The Rise of Driftwood

It wasn’t the best time to be distracted.

The patient was severely ill and on her way for a brain scan in the Sabah Medical Center. Her vital signs were just barely acceptable and would require my close and total attention for the next hour or so. It is never easy to be jolted out of more secure environment in the ward and into an ill-equipped Malaysian ambulance.

Yet the face that I just glanced at in a flash refused to depart from the corner of my mind.

A sense of déjà vu came over me. The hunched figure with a greying crown seemed so familiar.

The furrows on his forehead were like anyone else’s but somehow extraordinary for some reason.

Was he an ill patient that I once treated and have now recovered to full health?

Perhaps he was just another Sabahan with common features of a limited gene pool.

I’m sure he was more than that. I am quite sure that at one point of my life I was by choice or by force, interacting with this native patriarch on a regular basis.

Something about him must have left a deep, lasting impression in me way back then.

I tried to attach a name to the face and maybe place the person in a regular environment.

An attire of some sort might help. So will a tie, a lab coat and maybe a stethoscope too.

The image seems complete now, except for a voice and some movements.

Ladies and gentlemen, presenting… Dr. Rikki?

Dr. Rikki?

The 46-year-old house officer?

The prince of the soil who lived off a MARA medical scholarship for ten years only to return as a ward jester starting 2 mls of Ryle’s tube feeding and one pint of third generation cephalosporin for maintenance fluid?

What the heck is he doing back in the hospital?

Wasn’t he sent to an apex university somewhere in Kelantan to repeat his final year of medical school?

He passed?

He passed!

He passed and he’s back!

I met Dr. Rikki again a few days later. Very casually, we exchanged greetings and I enquired about his current posting.

“Oh, I decided I didn’t like clinical medicine. I’m in management now - Quality Assurance Unit in the state health department.”

Had I not been on flat ground, I would have fallen back in utter disbelief and absolute astonishment.

I am not against providing a lifeline for doctors who are incompetent in clinical practice.

One has to feed a family, and Dr. Rikki is no exception.

If my ageing brain has not failed me, Dr. Rikki could hardly spell ‘A-O-R-T-A’ to refer a patient with severe chest pain.

So pray, tell, how on earth can anyone with minimal command of the English language be placed in administration and specifically one that implements quality control measures?

Is it any wonder Sabah is perpetually in such dire straits?

Read more!

Monday, February 23, 2009

An Open Apology To The Health Minister

Dear Yang Amat Berhormat (YAB) Datuk Liow Tiong Lai,

I am sincerely sorry for my unwarranted outburst in my previous letter.

Your kind intentions have been severely misinterpreted.

I am utterly sorry if I appeared to belittle your credentials and leadership capabilities.

I can see now what an ignorant nincompoop I have been by accusing so very unjustly.

Dear YAB,

I realise now that you had far-sighted goals when you closed down our operation theatres and wards. In line with global medical education and training, you wanted the doctors in Sabah to be well-versed in acute care and emergency healthcare services.

Therefore, you abruptly but wisely witheld all non-emergency surgeries like colon cancers and enlarged prostates. You knew that one day these tumors would grow and spread and cause potentially irrversible severe systemic upset. That is the perfect time when we doctors will finally get the opportunity to provide acute care.

I am also apologetic for accusing the Minisry of deliberate feet-dragging in building a new general hospital for Sabah. In fact, I am losing sleep over my unfounded allegations that cronies of the state and federal government are reaping indecent profits from the current health crisis.

I should have known better. Malaysia is after all, not spared from the global economic turmoil. We should be more thrifty and save our funds and billions of ringgit for projects of greater public interest, like the national space program and the many buy-elections ahead.

Oh, how were you misunderstood! A thousand apologies from me!

Dear Datuk,

I was also uninformed and ignorant of your noble mission to improve palliative services in Sabah and the country as a whole. Why should we doctors perform complicated and heroic surgeries trying to cure cancer and degenerative diseases? After all, there is a oft-repeated medical slogan that clinicians should ‘cure sometimes, relieve often and comfort always’. If only I had known that you were a staunch believer in palliative care, I would not have bombarded the Ministry with such contempt.

From now on, I will stop pleading the Ministry of Health for more operating theatres, recovery wards and medical staff trained in life-saving clinical work. I will instead persuade cancer patients against surgery and opt for palliative care instead. I will encourage my colleagues to do the same although I can’t guarantee that they will do the same. They are very stubborn and determined doctors, you see – not unlike me when I wrote my first letter to you.

Dear most honorable and esteemed Minister,

After today, I will based all my clinical judgement on bedside assessment instead of relying on x-rays, CT scans and various blood results. I realise now that you were only trying to make us into more astute clinicians when you seemingly neglected Sabah by not providing us a CT scan and various diagnostic lab tests.

Lastly, my most respected and magnanimous Health Minister, I apologise from the bottom of my heart and beg for pardon for my excessive sarcasm in this second letter.

I am after all, a product of the system.

Read more!