I’m still not done talking about Shanghai, though it’s now more like a distant memory. I just want to show you some nice pics I took when I was there in March. I promise this is the last of the lot.
Okay, that’s it!
Aren’t they lovely? Makes me wanna go back there again (besides the glorious shopping experience, of course). 
Sun, 180508 @ 0700
You know how the best laid plan can go seriously sour? Murphy’s law dictates that if something can go wrong, it will.
That’s what happened yesterday on what was supposed to be my ‘rest, relax, rejuvenate’ trip up Cameron Highland.
The start of the journey was delayed because I had to try and sort out some problems related to some student’s research project (it didn’t get sorted out), next, just when I was about to hit the highway, a call came from my MO informing me a patient who was earlier admitted to the ICU for another problem has developed gangrene of 3 of his fingers (probably secondary to an arterial line insertion) which the vascular surgeons in KL declared as ‘dead’ and recommended ‘amputations’.
That’s fodder for a medicolegal suit! I asked the MO to get the consultants involved.
The trip up to Cameron was uneventful except for the fact that my daughter developed high fever and became very sickly.
When we got to Brinchang, at about 7 pm, we were given wrong directions and ended up being pretty lost. We finally hit camp past 8 pm, tired, hungry and I was in an unpleasant mood. Well meaning friends and church members tactfully kept a safe distance.
After dinner, we went out to town to buy some medications for my kid. The first clinic I approached did not have what I needed. I felt increasing frustration as I headed off on foot to look for the only other clinic in town.
I finally found it and it was about to close. I asked the nurse at the counter if I could buy some medicine. She looked at me as if I was asking for morphine or cocaine!
I explained that I am a doctor and that I actually know what I am doing!
The doctor-in-charge came out and after finding out what I wanted, and why, she looked up to me and said in a cheery voice with a sweet smile: “Welcome to Cameron Highland!! How was your trip here?”
I replied, “It was pretty bad” and explained that my kid was very sick. She let me have what I wanted and refused to let me pay for them!
As I walked back to my car, hand clutching the precious medications, I felt in my heart, the first gladsome feeling of grace from God for the entire awful day. A quick prayer of thanks was uttered and a small smile came on my face- the first in the last couple of hours.
Things weren’t rosy because my kid later proceeded to vomit all over her sweater, bolster, pillow, blanket and bedsheet when we got back. The night’s sleep was fitful. My wife was miserable and tired and so was I. We didn’t sleep much. We talked about going home the next day if the kid didn’t get better.
Thw day broke. And so did the high fever. She looked and felt better. We decided to stay on. My heart is lighter today than it was yesterday. Perhaps I could get the rest, relaxation and rejuvenation after all.
Sat, 180508 @ 1700
That’s the term used to describe the act of wearing 2 condoms during coitus. There are many reasons for this. One being to lessen the sensation on the penis, which would, theoretically anyway, delays ejaculation which may be helpful in men who have premature ejaculation (the movie, American Pie, comes to mind! Heh heh!).
The other , of course is to prevent unwanted pregnancies. This of course defies logic. I mean if 2 condoms prevent pregnancy better than one, wouldn’t you think the condom makers would be selling their products in TWIN PACKS?!!
And the 3 rd reason is this:
I was told by one of my patient’s wife (he is HIV+ while she is not) that her family doctor advised them to use the double barrel method to prevent transmission of the HIV virus from her hubby to her.
Evidence based?
Evidently not.
I did a bit of googling and came up with these links:
2. Dear Sugar
3. A youtube video on GayHealth.com
I tried looking in the UNAIDS website but they are silent on this matter. Personally, I’ve been advising my patients to use single condom during sex. The trick is to use it CORRECTLY!
Sat, 170508 @ 0700
I got an unexpected sms from one of my students this morning while I was doing the rounds. It brought a smile on my face. I plain forgot that today is teacher’s day.
The sms went like this:
Dear Dr,
Thanks for being wonderful in all ways that count,
For giving guidance in just the right amount,
Thanks for all the caring, for all the thoughtful things you do,
And on this special day, special thanks just for being a teacher we value!
Have a happy teacher’s day!
Awwwww…..
So sweet.
Makes me remember all my wonderful teachers who made me what I am today.
Thanks.
Fri, 160508 @ 1245
Happiness is seeing my patient who almost died (he was the one I alluded to in an earlier post) walking into my clinic this morning for his review.
No longer confined to his wheelchair, he is now able to get up and walk short distances; the pressure sore on his back has healed, he has put on 2.5 kg in the last one month, some color has returned to his cheeks, the previous discharging ulcer on his neck is showing signs of healing and is no longer actively pouring out sickly green pus. The anti-HIV and anti-TB medications are doing their miraculous work in him.
He wore a big smile when he greeted me. His mum who came with him had the sweetest smile.
The battle is far from over but small measures of victory have been won.
And for that I’m grateful, to God, for giving me the privilege of being part of this man’s journey back to health.
Fri, 160508 @ 1225; Jimbo and family will be leaving for his church family camp up in Cameron Highlands, for some much needed rest, recreation and rejuvenation. I could smell the mountain air already…
Previously, in ‘A Bad Legacy’, a man with HIV+ passed away, leaving behind his wife who is also HIV+ and 4 children. Due to a young doctor’s inexperience, the man’s death certificate bore the dreaded diagnosis: HIV+. This oversight started a series of unfortunate events, including the wife and children being ostracized by both sides of the family, her losing her job, her 2 elder children had to quit school and the insurance agency where the man’s life policy was bought from refused to release any money to her and finally, the insurance agency covering a house they bought in both their names refused to release the house to her.
Things looked a bit brighter nearing Christmas 2007 when the Malaysian AIDS Council (MAC) agreed to provide some financial assistance to her 2 younger children until they reach the age of 13 years old.
Now the story continues:
Since then, much water have passed under the bridge. The widow found a new job as a kindergarten teacher, her 2 elder children are taking night classes and working as mechanics in the day; her 2 younger children receives RM 80 each per child per month from the MAC (previously I thought it was RM 200 per child but apparently they have downsized the amount a bit).
The tussle with the insurance agencies continued to be the proverbial ‘thorn in the flesh’.
First they asked her to obtain written medical reports from all FOUR specialists who have treated her husband (!) ~ a move which defies logic as all 4 specialists (including Jimbo) have seen the same patient in the context of the same clinic and therefore demanding for 4 separate reports was either an act of sheer ignorance or plain stupidity. Furthermore, each report from a specialist would have costs the widow RM 80! Jimbo and another specialist wrote the reports FOC while another 2 declined to write the reports.
Next, another letter came from the insurance people requesting for copies of the deceased’s lab reports, specifically asking for his HIV status report. Copies of the reports were made and given to the widow.
Last week, the widow came to Jimbo’s clinic. It was an unscheduled visit. This conversation took place:
She: Good morning doctor.
Jimbo: Good morning! How are you? What can I do for you?
She: Doctor, I hope you can do me a big favor.
Jimbo: What is it?
She: The insurance agent has asked me to come see you. She said that if I can get a letter from you stating that my husband’s HIV report cannot be found in the hospital record, they can settle the insurance problem quickly.
Jimbo: I don’t understand. I thought I already gave you the copies of the report. How can I now say they are not found?
She: Actually I did not submit the reports to them. They now want a letter from you saying my husband HIV report cannot be found.
Jimbo: Are you asking me to lie?
She: Please doctor. It has been more than 8 months since my husband has passed away. This problem is a big headache for me. Life has been very tough. They won’t let me have the house. Please help me.
Jimbo: I know what you mean. I will help you to the best of my ability but this I am afraid, I cannot do. I’m really sorry. It would go against whatever principle I have. I’m really sorry. I can’t write the letter.
She: I know. It’s okay. I am just trying to see if I could get the letter. Thank you anyway.
She got up and left the clinic.
I felt very empty then. I felt that I have failed her. The whole system have failed her.
The question is, would you have done it any differently?
Fri, 160508 @ 0700
I saw this on the floor of the on call room bathroom this morning as I was meditating on the throne. A blob of green and something wavy, almost like a Treponema.
EeeeewwwwWWWW! I’m not going to elaborate.
I’m so dead tired. Had a relatively-no-so-quiet call and a sleepless night followed by the ward rounds this morning, 2 bedside teaching sessions, 2 referral patients to see, 1 meeting with my research students, 1 meeting with others in a newly formed research committee, and 1 teaching session. I had about 10 minutes for lunch in which I gobbled something organic (I can’t remember what I ate).
I am so exhausted, I could sleep till next year.
I wonder if I could stay awake to watch American Idol tonight!!!
Thurs, 150508 @ 0700; doctors-over-30 should not be made to work like this.
“Why do you do what you do? What keeps you going?”
That’s the question I have been asked, four times in the last 2 months. They were asked by different people and in different situations. Let me tell you about them.
1. The Brother-in-law
This man was the brother-in-law (BIL) of a patient who was referred to me from a private hospital. The latter was admitted in that hospital for severe shortness of breath and was treated as having pneumonia. After spending 8 days there and exhausting their finances, he was transfered over. When I saw him, he was near death. It was quickly established that he has HIV and pulmonary tuberculosis.
The first sentence that his BIL said to me that night when I was on call was: “Doctor, how come you are so calm?” I replied: “If I panic, no good will come out of it”. (I was actually wondering if it was real calmness I projected or pure apathy!).
I didn’t see him again till 2 months later when it was nearing time for the patient to be discharged. Some how the patient survived and was making the long slow and painful path to recovery. I sat together with the BIL and explained my plans for the patient. At the end of the conversation, he asked me that question: “Dr, why do you do what you do? What keeps you going?”
2. The Medical Students
These 2 students sat with me in stunned silence as I spent about an hour talking to a sobbing homemaker, first by telling her that her hubby has HIV, then explaining to her how the virus is transmitted and finally, to tell her that no matter how angry she is, she is all her hubby has for support now. She sobbed and sobbed and sobbed; then recomposed herself, thank me and walked out the clinic door to her hubby who was waiting outside (he couldn’t bring himself to tell his wife all these).
I felt drained after that.
Then the students asked, “Why do you choose to do what you do?”
3. The Master Student
He was the next person to ask me, when I began my attachment in UMMC again after being away for 1.5 years. He came up to me while the ID clinic was at its end and he asked., “Dr. J, why do you choose to do ID?”
I asked him, “Why? Are you interested in doing ID as well?”.
He averted my gaze when he replied, “Actually I am interested in ID but I know I won’t be able to make a lot of money if I choose ID”.
I said, “Yeah, if making money is your primary concern, I’m afraid ID is not for you. I don’t think you can make much money being an ID physician”.
Funny, at that point, I almost felt what Jesus felt when he had the conversation with the rich young ruler (Luke 18: 18-23)
4. The Church Member
“J, can I ask you for a favour?”, asked a church member after the church service one day.
*Spider senses tingling like crazy* ~ “Trouble!!! Prepare to deflect all arrows!”
“Can you speak at the coming church family camp?”
*Mega-spider sense headache* ~ “Errrr, what about?”, I asked.
“Oh, just talk about your work, what you do, and why you do it”.
“Why?”, I asked.
“So that others can be encouraged”, he replied.
There is that question again! Four times in less than 2 months.
Frankly, I haven’t really thought much about it, you know, about why I do what I do. Money is definitely not the reason, as can be seen in conversation no. 3 above. Status and glamor are out as well (ever heard of any glamorous ID physicians or one with a Datukship??!!!)
I sincerely do not think that my story will inspire, much less, encourage anyone.
I enjoy doing what I do. I find immense satisfaction in doing it.
The church camp is this weekend! And I am given 10-15 minutes to talk. I better cook up a story real fast!
I could think of one reason though….
Anyone who knows me well, knows that I am constantly hungry, in the physical sense. I have to eat every 2 hours in order to stave away any hypoglycemic symptoms. If I stay hungry, I would have a massive migraine to contend with. And that makes me a lousy candidate as a Christian. Fasting as a discipline would be unimaginable! If I were a Moslem, I would be a miserable one because I would not be able to fast the entire month of Ramadhan! (I truly admire my Moslem friend’s ability to fast).
So, to seek an alternative, here is the fast I observe:
“Is this not the fast that I have chosen:
To loose the bonds of wickedness, to undo the heavy burdens,
To let the oppressed go free, and that you break every yoke?
Is it not to share your bread with the hungry,
And that you bring to your house the poor who are cast out;
When you see the naked, that you cover him,
And not hide yourself from your own flesh?
Then your light shall break forth like the morning,
Your healing shall spring forth speedily,
And your righteousness shall go before you;
The glory of the LORD shall be your rear guard.
Then you shall call, and the LORD will answer;
You shall cry, and He will say, ‘Here I am.’ (Isaiah 58: 6-9)
I guess, in the final analysis, I do what I do with the hope that when it finally comes to my turn to be in need, I may, at that time, find some measures of mercy and grace.
I think I shall tell them at the Family Camp this weekend to just read my blog here! That shouldn’t take more than 2 minutes!
Thurs, 150508 @ 0700
After mountain climbing for the last few months, I have been itching to try something new. Some one asked if I would like to participate in the Port Dickson International Half Marathon which will be held on the 25th May 2008 at 7.00 am.
I am told a half marathon entails running (or walking) for 23 km. I was a bit wary initially but became more positive somewhat when told that I can opt to run the 11 km instead (which would make it a Quarter Marathon!).
So, I am in!
Would you like to join me?
You can register at the following venues: (please bring along a photostated copy of your IC)
1. Jusco Seremban 2 (17th May 2008 )
2. Tesco Seremban 2 (18th May 2008 )
Wed, 140508 @ 1400
This is an announcement for the next climb, which is Gunung Datuk in Rembau on this Saturday, 17th May 2008. For those of you who are interested, please gather at the Agape Church compound by 7.15 am on that day. For a list of stuff to bring and directions to the church compound, please click here: Stuff to bring and Direction to Agape Church.
Wed, 140508 @ 0700; on call - bleh!
PS: Jimbo won’t be joining this climb as he has to go elsewhere. Jimbo is also itching to climb other mountains in Negeri Sembilan. Any recommendations?
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