C H A N G E

"No one can make you feel inferior without your permission"

- Eleanor Roosevelt

***





"If not now, when?"

- Hillel

This is how I'm going to end 2008. With a commitment to overcome my personal weakness in my interaction with other human beings.



I have identified many flaws in my immature attitude and irrational behaviour over these years. The weakness that founded my action came from my own lack of communication awareness and respect of other people.



Stephen R. Covey in his book 'The 7th habits of Highly Effective People' discussed the concept of being a PROACTIVE person.

Being proactive means that one is responsible over his actions. Responsibility that breed from 'response-ability' or the ability to choose one's response. His behavior for a given situation is based on his values, principles, and core belief; and not pressured by his immediate feelings to surrounding or people' influence over him.



He is not effected by the so-called 'social weather'. His mood and thus the way he feels and reacts is not based on social circumstances, but as a result of his own conscious effort. Whether people being nice or bad to him does not precondition his attitude toward others.

Of course there will be hiccups along the way, a brief moment of errors. The road ahead is not all rosy and easy. But in the end challenges are designed by God so we can overcome them.

***

Welcome to 1430 H and 2009 AD.

Silent night

Whatever it is... I hate insomnia. Coz time stood still at midnight tonight.

Countless trains of thought passed through my cerebral tracts in a repeat slow motion.. I hope they will derail and stop bothering me. They even keep me pondering at the possibility of whether the sun will ever rise up again the next morning.

Tonight I learn not to put up my hopes too high... coz If I fall I'd probably be too screwed up to get up again.

Then the only logical thing to do is to learn how to fall. Wouldn't that be practical.

"Yes yes.. my dear pink panda - time for your bedtime story... yes don't worry Captain Kangaroo is gonna be fine"

A glass of emotion

Haematology rotation is full of drama. More than any other discipline out there. In the past 2 months I've seen a lot of human emotions expressed be it jubilant, sadness and even tense. I befriended quite a few of them too. In a way it reminds me of paediatric haematology when I first started out 5 years ago.

Case 1: M is a your typical 20-year old next-door-girl, diagnosed with Hodgkin's lymphoma in 2006. She only had the 1st chemotherapy cycle when apparently the only one who knew about her illness was her father died of heart attack not long after. Since no one else knew about the nature of her cancer, she missed the follow-up and the rest of the treatment until she was seen again by me in 2007. These days whenever I saw her. I'd say "Hi M, stay cool" and she would giggled and laughed. She completed her final chemotherapy cycle last week and in pretty good shape.


Case 2: Z is a 42 year-old widow with 4 kids has acute myeloid leukaemia (AML)which is resistant to all chemo regime we tried, currently battling severe infection complicated with hyperviscosity syndrome. She's still holding on even though her blood pressure can be labile at times. She looked at me from behind her 'high flow oxygen mask' with a fatigue look on her face, thanking the team for trying our best. Deep inside, I tried holding back my tears.







Case 3: Few weeks ago I spent a lot of time tried to re-convince a woman that her mother who has Chronic myelocytic leukaemia (CML) need to be started on Imatinib which can work wonder in CML. Instead she & her siblings opted for her mom to be on 'pil minyak kuda'. The daughter look annoyed when I showed her blood results from other patients who responded to the treatment.

What amazed me is that this woman is a university graduate working with government. When I asked makcik, she said "entahla nak, makcik ikut mana yang molek jer".. though I knew she wanted that Imatinib.

Two days later, the daughter called me up -finally agreed to my suggestion. That alone kept me happy for the rest of the week. However one thing I realise now, is that "Common sense is neither thought in University courses nor it comes with paper degree"

Bill and Ted misadventure

Last Friday me and Happydoc went down to Melaka for a conference entitled "Managing cardiovascular risk". Both the event and the accommodation were at Renaissance Hotel which was cool since it's a 5 star hotel so supposedly "all the good stuff in life" could come in its package.

The thing I love about waking up in a hotel for a conference is because at that moment of time it feels like I'm doing something else for living such as preparing for a huge boardroom meeting. Taking a hot shower while listening to a British chap on BBC news on the telly. Neatly pressed suit and a crisp white shirt readily hanged and me taking my own sweet time sipping that cup of hot strong coffee while watching Melaka folks minding their own business.

However to my surprise the so called 5 star hotel didn't come with a free Wifi or broadband. They instead charged a whooping $21/hour or $52 for the whole day. What a rip-off, we could even get a Wifi for a $10 coffee at sbuck. And all I need was to check a few important emails or perhaps any offline message which would take no longer than 10 mins.

After the event we decided to rush back to KL. Funny thing happened as we were approaching Linggi exit when all of sudden Happydoc's sweetheart started to moan and making weird noises. We stopped at the roadside and discovered that the cambelt was totally stretched out thin and bits of it shredded into pieces. Then the battery went flat and we got stuck for nearly 1 hour. It was so ironic that I end up laughing my arse off every 10 mins which didn't amused Happydoc at all.

Luckily PLUS men answered our SOS and jumpstart the battery. Trying not to push our luck with a worn out cambelt we continued at 50km/hr and reached KL by 1am - that's almost 4 hours from Melaka to KL. Tiring.. yes but I reckon that me and my buddy had some good quiet time by the roadside that night.

Moral of the story is "it's not the distance of a journey that counts but whom you share it with what really matters".

Sunshine

England is forever known for its bad weather. No surprise there since fish & chips is considered as the greatest invention the country has to offer to the world. I guess there isn't much you could expect for from the land where Tun Lancelot lost the holy grail to the Lady of the Lake and the last worldcup was won 42 years ago.

However a recent report from the NOrthern SHeffIeld Weather CenTer (NO SHIT) has observed a bizarre weather phenomenon in the city of London where the sunlight activity has increased by 25% since last September making the sunshine brighter than ever since the last 100 years.

Even more mysterious is that by using advance binary system, NO SHIT postulates that this amazing sunshine trend will moves along the equatorial line and hit Kuala Lumpur by October next year.

I am looking forward for it.

Hopefully the weather change will brighten our day.

... and I'm certain these flowers would agree with me.

Happy ending

A friend of mine introduces me to a Brit singer called Adele... a google in the youtube lead me to this charming song, check it out: Chasing pavements.



Which brings me to a theory that every story/life deserves a happy ending. Life is too short to be painted with melancholic colour. Many of us give up too soon on the idea that 'happily ever after' can be applied outside Walt Disney's movies. Well hang on there! I ain't talking about prince charming with his white donkey either. That would be the joke of the week.

I'm talking about living this life in its simplicity. No complication. Let all the hatred by-gone. No friends with hidden agenda, no colleagues-turned Lex Luthor. Again that doesn't mean that MPPJ will stop charging our annual cukai pintu. The Federal highway potholes are still gonna be there forever.

The change must come from within us. I wanna be a better person. I realise the only thing that I can change is me. Not my hospital's insane parking lot system. Not Pak Lah's weak governance or the fact that Obama is gonna kick McCain's arse back to Arizona.

But it has to be within my own capacity since the only legitimate jurisdiction that I have is myself. And the wind of change is here.. it's blowing.

CSI: Bad to the bone

The chilly air greeted us in creepy manner that morning. Happydoc had just moved out his car from the front porch when I noticed a strange looking white object which was hidden underneath his car now staring back at me.

I took a few brave steps closer, and suddenly I felt a shiver came down my spine like a bolt of lightning on a broad daylight.

"Meromaaanngg buluu pakcik"

We examined it carefully and it looked like a piece of human mandible (jaw bone) cut in half. Unlikely to be from dogs, because the canine tooth was not sharp and long enough.

"Perhaps a stray dog dug it from a shallow grave and dumped it here" Happydoc thought loudly.

"Hmm it could easily came from a young adult of between 14 - 17 years of age old... (dramatic pause)... possibly asian female" I summed up the final diagnosis.

Suddenly I felt the the spirit of Hardy Boy's enters my body (err in Happydoc case - maybe Nancy Drew's). Dang! what are we gonna do now?? After some serious consideration we came up with 3 options:

1. If this is a human bone - we need to send it to the police, they may come and turned Happydoc's house into a homocide crime scene. What would the nice 20's something-girl next door think?

2. Show it to our forensic colleagues at the hospital for confirmation - then if yes.. send it to the police.

3. Throw it into the neigbour's compound and it now became their business. Muahaha!

Finally we decided if this really belonged to a human victim. Then the owner deserve a justice and a proper burial. So we handed the bone to the nearest police station and surprise! surprise! Those folks were unsure but promised to confirm it with their experts.

The very next day I called them up for answer.. and creepy enough they said it belonged to a certain mammals of a yet undetermined origin...

"Who are you... who? who? who?"

Mentor

A wise man once said that a great teacher does not teach but to inspire others. This is exactly how I feel toward this man who has inspired many generations of doctors in this hospital.

He is an internationally renowned physician who has dedicated his life to mankind through his clinical work and research.

Although I didn't have a direct opportunity to be his student, but many of my teachers were once thought by him. So one way or another I feel indebted to him.

The bad news is he is currently unwell, the old enemy that he fought and defeated has returned and want a rematch, which I believe he will not give in or give up that easily. With Aidilfitri is around the corner, things would be even more challenging for him and the family.

Be strong now Prof, now more than ever.

We are with all the way.

alone@aidilfitri.com

Happydoc is a newbie in our hospital, having just joined the masters programme last June, he was considered a junior. His stylish hair, boyish look and nice taste in the clothing department reminds me of the once locally famous 4u2C group.

But oh boy! I was totally wrong about him, after knowing him later did only I realised that he has strong experience in internal medicine having gone through all the major postings in GHKL.

So superdoc has helped me a lot during my rough period in these last few months. Perhaps he's one of the few good soul out there whom willingly want to befriend a crooked chap like me.




On another note, I must say this would be a lonely Aidilfitri for yours truly. I thought I could be happy again this Raya... but i guess that my wish would just have to wait this time... which may be forever. I finally realised that in life.. it's not what we want that matters. And above all the ironies in this world one thing stays true -- sometimes we can't always get what we want.

I have to live with that now.

Lastly but surely not the least Selamat Hari Raya to all my readers
... may all your wishes come true.

The hunter became the hunted

First came the abdominal pain.. then the purging! The man laid with eyes wide open the whole night literally restless on his queen size bed. Every single joints and bones within him felt twisted and burned to ashes. Not to mention the hourly visit of chills & rigor which clamp down his muscles while making his mind seem cease to exist.

Thinking it was just a viral food poisoning he stayed at home the morning after, tried to shake it off with oral hydration salts and lot of water. Which was an error in judgement because by afternoon his condition deteriorated which left him with no choice but to drag himself out and drive all the way to the hospital.

Upon arrival at the emergency dept, a newbie triage medical assistant made a 'diagnosis of probable dengue fever' hence advised him to go someplace else for blood checking. He proceeded by ticking the 'normal' checklist box without examining the patient. However the triage machine detected a rapid pulse rate of 120/min with a low BP of 100/60 whereas it should be 120/80.

The patient was then put in an observation ward with 1.5 litres IV drip went in over 5 hours, however the repeat BP later was even lower at 80/40. Then the man started adjusting the IV drips himself made it running faster.

At 9pm the senior doctor 'on call' came down to the A & E and started 1 pint gelafundin fast and having assessed it lack of response he finally said...

"Frapp, we gotta admit you upstairs".

So there i was, admitted into my own ward.. and put in the very bed where I did resuscitation on another patient about a month ago. Things started to feel different after I got my first dose of IV antibiotics called rocephin. The recurrent chills & rigor decided to shy away for good. Six days later , I was discharged home...with a different perspective on life in ward as a patient.

To all staffs & my friends, thank you for everything.

***
The CSI folks in the lab finally found the culprit from my sample... an uncommon 'Gram -ve bacilli' from the vibrionacea family named called P. shigelloides. I hope they burned in my gut.

Persoanal probe-lem

I watched Dark Knight last night and phew! As far as comic superheroes on silver screen goes, this would rank as one of the believable one.

You see, batman is just a normal dude who train himself to be at peak human physical performance. And being obscenely rich he fund himself with lotta cool toys to fight the bandits of Gotham.

Perhaps if I'm that rich I could even transform myself being a superhero. Why not? Then all I need to work on is a slick superhero name... hmm I wonder if these would cut it:

1. the stethoscope


2. the spatula man


3. the syringe
   
4. .... the scalpel-man?

The next step is to find a tailor to change my whitecoat into a tight white spandex. I'm sure Jln Masjid India has some extra material that I could use... not too mention a 'bling bling' add-on would be nice too!

Then I would need a supervillain to beat the shit-out in order to show my heroism prowess to the PJ-folks. He would definely has a cool name too like ''the cholera' or even better 'the chlamydia'! Which of course would be the alter ego of some prick from the BN frontrunners who have evil hidden agenda like lying to the Malaysian public about fuel hike etc.

Hey who knows it could be Khairy or Hishamuddin whom of course would be armed with his longgg keris to compensate for something else. If I'm lucky maybe the Keadilan would field me as its candidate in the next General election.

Oh crap then I better not get any persoanal (pun intended) aide or else the BN would pin me down with some wild sexual allegation!

... "Look! It's a bird.. no it's a plane.. no! It's the Proctoscope-man!!"

C4 satuu!

It seems like Malaysians are tired of our current politicians' shenanigan and tomfoolery acts. I tried to stay away from blogging about these people - frankly speaking I'm tired of hearing their childish remarks to each other. Not to mention their condescending attitude towards certain quarters of general public. They think we're fool!

Their bickering routine on papers started to sound like an episode in Dynasty or Knots Landing.. yes I'm that old.

To digress, one of our national's shocking news from last year that has lost its way to page 10 in Malaysian papers is the infamous case of Attantuya Shaariibuu murder. After the homocide, her lifeless body was exploded with C4 bomb...

Phew! I tell you C4 is one nasty bugger. You don't want to get near any of that yellow stuff within 2km radius.

It is so wicked that it got itself into hollywood culture:

1. Blows up Nakatomi building and John McClane's ass out of the sky in Die Hard.

2. Strapped to the bank hostages in Hancock

PS: The moral of the story is do not date politician. Period.

These days

Life felt different these days. Breathing has become a conscious effort at some point of most days, which made me afraid to go to bed at night. Just in case I forgot to breath while I'm sleeping. Paranoia loves company.

Last sunday I bought my 1st ever notebook ASUS Z99 SR - a Centrino powered 2.2 GHz, 2 RAM, 250 hard disc with 128 dedicated graphic card. Anyhow I spent half day in Low Yatt which by 8pm I found myself hurried along Bukit Bintang shoplots with empty tummy. A chinese girl in a Komono suit handed me what look like a dinner menu leaflet.

Slightly excited and without looking at the leaflet I asked her.

"Halal ke?"

She threw me a confused look.

I looked at the leaflet and to my embarassment it said:

"FISH SPA for RM29 per 1/2 hour - let them massage your feet"

Someone had forgotten the drum roll.

Sentimental value

1. I recently realise that I can track all those songs that I grew up listening to, at youtube. Such a sentimental moment as there are certain songs that define certain period of ourlife. Like those ads on radio - songs that were popular on the airwave during your first falling in love or first ever break-up. Check out the bad ass hair style of Bad English back in the 80's. Rockk kapak satuu kurang manis!


2. I noticed of a late that I'm doing a lotta self-talk (dlm hati le.. nanti kene cap kuda terbang pulak). Which I haven't done so for many years since I left medschool. Apart from human interaction at the hospital - I've been spending a lot of time alone with my thinking cap on and a glass of frappucino in my hand.

3. On another note, I came across a book penned down by a US surgeon named Atul Gawande practicing at the famous 'Brigham and Women's Hospital @ Boston' - entitled COMPLICATION. Which made me realise what was written there mimic 95% of my own experience when I was a junior doc with fresh pimples on my face.

Especially the 1st chapter on performing 'central line' which means piercing the neck with a 14-gauge metal needle (that's a hugeee one) into the biggest vein that run a course near the top of our lungs, in order to insert a flexible plastic tube which have to be positioned exactly at the outskirt of the heart.

That of course brings about to some potential complication such as puncturing the lung or hitting a big neck arteries called the carotid. Boy if that happen - someone gonna yell "We got a spurterrr!"

Smileeee. U just got cannulated big time!

"Medicine is an incomplete science with an ever changing frontier practiced by fallible beings on another fellow men.
To withold treatment would do unjustice to the suffering and preventable death.

But certain treatment process in itself is filled with certain mishap and unforeseen side effect that could cause another type of harm to the human body. Which if happen... we got sued. So God help us all"

- drfrappucino

The darkest hour

Oh, why you look so sad?

Tears are in your eyes

Come on and come to me now

Dont be ashamed to cry

Let me see you through

cause Ive seen the dark side too

When the night falls on you

You dont know what to do

Nothing you confess

Could make me love you less

Ill stand by youIll stand by you

Wont let nobody hurt you

Ill stand by you

So if youre mad, get mad

Dont hold it all inside

Come on and talk to me now

Hey, what you got to hide?

I get angry too

Well Im a lot like you

When youre standing at the crossroads

And dont know which path to choose

Let me come along cause even if youre wrong

Ill stand by you

Ill stand by you

Wont let nobody hurt youIll stand by you

Take me in, into your darkest hour

And Ill never desert youIll stand by you

And when...

When the night falls on you, baby

Youre feeling all alone

You wont be on your own

Ill stand by you

Ill stand by you

Un-kodak moment

You ever came across an absolute embarrasing moment resulting in an utter silence like 'malaikat lalu'? These two happened today:

Awkward moment 1
A female waitress slipped and nearly fell while serving drinks to a family with 4 young kids ranging from 2 to 15 years old. She yelped out loudly 'B**** mako' - loud enuf to be heard by everyone in the restaurant. RATING: 5 seconds of silence.

"Hey buddy, that's just a car-key... Hang on i wonder if it has tuna flavour on it - curious... curious"

Awkward moment 2
I was about to leave a surau when a blind man asked if I'd seen his water bottle. I saw one next to a wall and while walking to get it, I accidently asked him for a confirmation"yang hijau ni ke pakcik?".
I felt like 'can someone please get me a rope'.

Dang!

This ain't a love song

Where does this road would lead me to?

I have made a decision on this part of my life which may not have a turning point. I may not live that long...

...but for whatever that left of it, I think it's time to pick up the broken pieces and move on. This is as real as it gets in this life.

As I reflect on this journey that I've made so far, there are definitely few things which I am not so proud of... and this would probably top the list.

Would you ever forgive me?

This ain't a love song.

I should have seen it coming when the roses died
Should have seen the end of summer in your eyes
I should have listened when you said good night
You really meant good bye

Baby, I thought you and me would stand the test of time
Like we got away with the perfect crime but
We were just a legend in my mind
I guess that I was blind

Remember those nights dancing at the masquerade
The clowns wore smiles that wouldn't fade
You and I were the renegades, some things never change

It made me so mad cause I wanted it bad for us baby
Now it's so sad that whatever we had, aint worth saving
If the love that I got for you is gone
If the river I've cried ain't that long
Then Im wrong, yes I'm wrong, this ain't a love song

If the pain that I'm feeling so strong
Is the reason that I'm holding on
Then Im wrong, yeah I'm wrong - this ain't a love song

I cried and I cried
There were nights that I died for you baby
I tried and I tried to deny that your love drove me crazy

If the pain that Im feeling so strong
Is the reason that Im holding on
Then Im wrong, yeah Im wrong - this aint a love song
Yes, Im wrong, yeah, Im wrong - this aint a love song

Reality bites

I rarely go shopping at pasar tani ever since I came back from atas laut 5 years ago. Hey don't get me wrong.. I absolutely love it , cumer the 'fresh' scent of fish etc etc sometime sting my nose. What an embarassing thing to say! Considering that I used to work at pasar malam for 3 - 4 years during my highschool days. Seems like this 'mat salleh celup' is stuggling conforming to his root... tak malu betoi!

They stole quick glance at each other several times - how sweet.

So strolling at Penchala pasar tani today is seriously doing some good to my internal homeostasis - balancing my disturbed 'chi' from too many shopping @ pavillion/the gardens. A different walk of life.

To digress, not all kids would have an easy years growing up.. it's a tough world out there - Palestine, rural places in Bangladesh and India to name a few. Kids working as labour in cotton factories or begging on rural streets, you know stuff we read in Time mags while sipping our nice hot mocha @ starbucks.

For example what would this young boy could acquire during his formative childhood years if he's literally picking up shoes from the box and arranging them on that table under the hot scorching sun... he could easily be around 4 - 5 years old.

When i did it I was like 16 - 18 years old. So that was character building if not anything else. I mean forget about National service.. although i don't mind lay my hands on those M16. Huh! Men, we easily distracted eh!

30' something

Just had my birthday last week, a plain simple one - nothing fancy, no cakes or balloon etc etc.

It makes me to think lately that in life sometime you're allowed to do certain thing only once in your lifetime. Life is not a dinner buffet and you'll not allowed for second helping.

So be certain that what you're going for is what you really want in this life.



On another note, I watched a DVD last night called '2 days in Paris' written/directed by Julie Delpy, the same French chick in 'before sunrise/sunset' (http://drfrappucino.blogspot.com/2006/11/before-we-were-young.html).

This film in a way could be the alternate version of the 'sunrise' movie.. the one if Celine had met Jesse in Vienna 6 months later and end up being lovers.

Movie quote ".. this is almost basic... i don't even know you'

Crap etc

New year came with a bang.

Any New year resolution this time around? Well not much I guess as far as I'm concern let just say I prefer to be a more realistic chap rather than having some idealistic crap jogging around my cerebral track.

The fact that nothing is certain or safe these days, especially if you're checking into 'the K' hotel in Batu Pahat, which ironically I just checked out at 1pm today (... was there to attend a wedding mind you).

Couple of things to keep in mind:

1. Friends come and go but your family stays around.


2. Never rely on your bank savings accounts (... or those belonging to your spouse too).


3. No matter how certain you are on your life right now, always - always have a PLAN B tucked somewhere inside your spender.
   

Hmm is this post too early to contain such a pessimistic view on life, well don't mind me - I'm just being as realistic as my ageing vertebral bones.