To Malaysian Politicians

Dear Malaysian Politicians,

Please stop the power chase, call for a truce and focus on the economy.

I do not claim to speak on behalf of all Malaysians, but I have strong convictions that many share my sentiments.

Our concern today is not who rules the country or heads the state governments but the looming bad economy.

Whether Barisan Nasional or Pakatan Rakyat leads, it is meaningless if Malaysians have no job to go to, no money to pay rent and no means to put food on the table.

Read more.

I totally agree with the writer. Why do our leaders keep quarrelling against each other when our entire economy is looking quite bleak?

p/s: I'm still could not understand the reason the government would like to increase the toll rates when there are many people who are suffering from the global economy crisis. Perhaps they should consider DAP suggestion to make PLUS toll free by 2016.

Second and third class patients

Depending on your social status and income, you might be admitted to first or second or third class ward in Malaysia's hospital. The different ward class could mean that your stay at hospital either be comfortable or staying in a crowded cubicle.

If I'm not mistaken, being in third class means that you have to pay for every blood test but you pay less for admission fee whereas in second class, you don't need to pay for any test/investigations since that is being covered under admission fee. Please correct me if I'm wrong.

In Australia, there is no such thing as second, third or even first class. Every patient received the same standard of medical care. The only different perhaps whether you are in a single room or in a room with 4 people. Back in Malaysia, being in third class could mean that one cubicle containing around 10 patients.

I think in Australia, they have quite large amount of resources such that they could afford to provide one television per bed and every hospital has air-conds. In Malaysia, there is only one television per ward and a ward might have between fourty to sixty patients. I guess if you are admitted to public hospital in Malaysia, you might get bored easily and don't have the luxury to see any form of entertainment.

I'm not sure the needs of segregating patients in different ward class since I thought the provision of health care towards Malaysian citizens should be universal and be standardised regardless of your social status or income. At least for those who come from higher social status, they can afford to go to private sector.

Why am I writing about this matter? This might be one of the potential improvements that could be implemented in the future, provided that the government has enough staff, resources and facilities.

News: Public unhappy with government medical services

Of losing memory

Part of being human is to have memory of experiencing bitter sweet of life. The pain of losing someone you loved, that leaves you numb and senseless for long period of time, is something that you will cherish for life. The joy of receiving good news in time of despair and the memory of comforting your friends and family; those are not something that you can buy with any amount of money.

Memory is something that differentiates us from someone else. Everyone is different and have experiencing different past life. With memory, we gained strength, wisdom and sometimes opportunity to repent for our wrongdoings in the past. It is the guidance for our present and the future. In time of darkness, we seek out our memory for hope to overcome our own obstacles. Without memory, we will be nobody and we might be thinking that we haven't done anything in this world.

This is what I've been thinking in the past few days. I have the opportunity to visit Alzheimer's Australia Victoria last week and they have managed to show me the burden of losing memory and how it affects the patient, the carer and their family.

It was so painful to see how your beloved mom or dad losing their memory gradually and slowly forgetting that you are their own children. The burden of seeing them becoming more erratic for each day that passes is something that I might not be able to cope if I were in their position.

A man's real possession is his memory. In nothing else is he rich, in nothing else is he poor

Alexander Smith
("On Death and the Fear of Dying" Dreamthorp)

Life is...

Know ye (all), that the life of this world is but play and amusement, pomp and mutual boasting and multiplying, (in rivalry) among yourselves, riches and children. Here is a similitude: How rain and the growth which it brings forth, delight (the hearts of) the tillers; soon it withers; thou wilt see it grow yellow; then it becomes dry and crumbles away. But in the Hereafter is a Penalty severe (for the devotees of wrong). And Forgiveness from Allah and (His) Good Pleasure (for the devotees of Allah.. And what is the life of this world, but goods and chattels of deception?

Be ye foremost (in seeking) Forgiveness from your Lord, and a Garden (of Bliss), the width whereof is as the width of heaven and earth, prepared for those who believe in Allah and His apostles: that is the Grace of Allah, which He bestows on whom he pleases: and Allah is the Lord of Grace abounding.

No misfortune can happen on earth or in your souls but is recorded in a decree before We bring it into existence: That is truly easy for Allah.

[Al-Hadid: 20-22]

Medical Abbreviations in Malaysia

After four weeks doing elective in Malaysia, these are some of the common medical abbreviations used in the hospital.

AFNT – Anterior Fontanelle NormoTensive
AGE – Acute Gastro Enteritis
ARF – Acute Renal Failure
BE – Base Excess
CBD – Continuous Bladder Drainage (Fancy phrase of saying putting up a urinary catheter)
CBS – Capillary Blood Sugar
CKD – Chronic Kidney Disease
CLD – Chronic Liver Disease
DFU – Diabetic Foot Ulcers
DIL – Death In Line
DRNM – Dual Rhythm No Murmur (This is used to describe cardiovascular examination findings)
EES - Erythromycin ethyl succinate
EMCS – Emergency Caesarean Section
FTSVD – Full Term Spontaneous Vaginal Delivery
JE – Japanese Encephalitis [PDF]
KIV – Keep In View
NNJ – Neonatal Jaundice
OA – Orang Asli
PCM – Paracetamol
PD – Peritoneal Dialysis
SCR – Subcostal Recession
SGOT - Serum Glutamic Oxaloacetic Transaminase. Another name for AST (Aspartate aminotransferase)
TCA – To Come Again. Example TCA eye clinic 6/52
TRO – To Rule Out
UFEME – Urine Full Examination Microscopic Examination
UGIB - Upper Gastrointestinal Bleeding

p/s: Most of these abbreviations are quite different from the one we used in Australia.

The Coat of Professionalism

The person with the stethoscope is coming closer. The fear starts to build up. The pain gradually become more painful as that person is getting closer to them. The pain from needle is too much to bear with. The fear is too intense for them to handle. Then out of nowhere, they start to cry and try to run away from that person.

This was a common situation that I faced everyday while doing my elective in paediatrics back in Malaysia. Children are too afraid of anyone wearing stethoscope and will always associate them with needles. Any attempt of even touching them or putting the stethoscope on their chest will result in an endless crying and this may lead to futile effort to examine them.

Sometimes, we have to struggle with the children while the parent holding them down for us to check their heart and lung function. An outsider may saws this act as quite cruel but it was necessary for their own health.

Every doctor working in Malaysia has to wear white coat. The main reason behind this is to show the so-called professionalism. Every male doctor has to wear tie as well and this is certainly not suitable in hot humid environment in Malaysia.

The only department in the hospital that does not follow this code of conduct is paediatrics (a branch of medicine that looks after kids). White coat is the main source of fear to the patients. At least by not wearing white coat on the ward, this may help to reduce their anxiety. Nevertheless, any doctors or nurses for that matter, will always be associated with needles injection and most of the kids will developed intense fear towards the health professionals.

As a medical student who is trained in Australia, it was quite amusing for me to see everyone working in the hospital to wear white coats. Doctors, nurses and medical assistants have to wear white coat every day. I would not argue with this regulation if all the hospitals in Malaysia is fully air-conditioned but this was not the case.

In Australia, doctors are not required to wear white coat and it is not compulsory for male doctors to wear tie. Nurses have their own uniform but it is not white in colour . I guess we can be professional even without the white coat.

According to google, professionalism is defined as

• the expertness characteristic of a professional person
• professionalist - A person or organisation that supports a professional attitude
• an occupation, vocation or high-status career, usually involving prolonged academic training, formal qualifications and membership of a professional or regulatory body

clearing up alerts

Right now, I am reading all the alerts in my Google Reader. There are thousands of alerts that need to be clear up. This is the result of not accessing my Google Reader in the past two months.

I subscribed to all of my friend's blogs and it was surprising to read what have happened in the past two months. Few of them quit blogging for good and few of them stop temporarily.

It was interesting to see what have happened in the blogging world. Most of the blog that I subscribed to are Malaysian bloggers and it was fun to see how each blogger responds to each issue happening in Malaysia.

Each person is entitled to their own opinion and despite all of their differences, I learn to respect their own opinion. After all, no one is perfect in this world. If we are able to tolerate each other, and spend time to listen to each other problem, we are one step closer in achieving unity and peace

Manglish

I spend two weeks of medical rotation and two weeks of paediatrics as part of my elective in Hospital Ipoh, Perak. This hospital is roughly about 40km from my home and I was driving to and fro everyday.

This post I would be writing on the language used among doctors in Malaysia. Manglish, that is the mixture of Malay and English; is the most widespread language spoken by doctors.

After four weeks spending time in Ipoh, I never able to speak in Manglish. I was the only medical student who are doing elective in each department and thus, every doctor questioned which university I was from since I don't speak in Manglish.

I find it quite difficult to speak in Manglish. It is akin of breaking up the language and mixes it with another language. For someone like me who has been striving to improve my English, this is a step backward.

I am planning to work in Malaysia next year. I believe that within few years of working as a doctor in Malaysia, I would be able to master Manglish but my aim of improving my English will be diminished slowly.

RAPP

I arrived at Melbourne on Sunday morning. My semester starts yesterday. Today is my second day.

My first rotation is RAPP (Rehabilitation, Aged Care, Palliative Care and Psychiatry of Old Age). My second rotation would be Emergency Medicine and Rural followed by Psychiatry. Each rotation is 6-weeks long.

After two days in the current rotation, I believe that this rotation is not that helpful and wasting my time. It was boring and made me too sleepy. If this is the pattern throughout this semester, I think I should work part time. At least I will get money instead of wasting time doing something that is not interesting.

update

I have finished my 4-weeks elective last week. It was interesting yet boring towards the end. I will be writing more about that later.

I could not believe my eyes when I read the news that Melbourne had high temperatures more than 40 C last week and Australian Open was held at the same time. It must be like oven over there. Hopefully the temperature will be a little bit cooler when I'm back to Melbourne this Sunday.