These is my schedule for the next few climbs over the next 6 months or so. If you of you are interested, do join me. They are also posted on my side bar.
20 Mac 2008 – Gunung Angsi
12 Apr 2008 – Gunung Datuk
01 May 2008 – Gunung Angsi
07 Jun 2008 – Gunung Datuk
02 Jul 2008 – Kundasang
And come early Mac 2008, I might make a trip to this place! 
Thurs, 310108 @ 1416
I walked out of the clinic in disgust yesterday.
I was seeing a 40+ year old Chinese man who some one diagnosed with ‘Chronic Alcoholic Liver Disease with Portal Hypertension’. It was tedious because for one, he took more than 10 minutes after I pressed his number, to appear in my room. It was because his abdomen was so bloated that he found it difficult to walk.
And then after he has seated himself comfortably in the chair, he told me “Doctor, please be patient with me, let me tell you my story” !!! And thereafter he launched into his life story beginning from 1993!
He was an ex-iv drug abuser, he worked in a pub those days and because of his work, he drank hard liquor all the time mainly to entertain the guests.
What piqued my interest was the fact that he said he “worked at the pub for only 7 month”! Thereafter he said he went to Singapore to work and gave up drinking altogether. I was left wondering if 7 months of drinking alcohol was sufficient to affect his liver to such an extent.
In the year 2000 (after I’ve listened to 1994 -1997, 1998, 1999′s stories), he began to have abdominal discomfort and he went to many GPs who all told him he had “gastritis”, until one GP noted he was jaundiced and diagnosed him with alcoholic liver disease and referred him to the hospital. He was still labeled as such in the hospital, being admitted a number of times for bleeding varices. Each time, they told him his liver was damaged by alcohol.
In August last year he was admitted again, this time for abdominal swelling. Some one took his blood to test for HIV, Hepatitis B and C then. When he was discharged, he was given a follow up at the clinic which he came faithfully. When he presented at the clinic, he was again told that his liver problem is due to alcohol. His results was not traced.
Then last December, he was admitted again for the same problem. This time, he was discharged at night (according to him) and was not given any medications! He had to eat whatever spare medications he had at home. His blood result taken in August was again not traced.
Yesterday when I finally managed to cut short his story (he was pretty long winded), I asked him what his biggest concern was. He said, he was upset that he was not given any medications on his last admission and that he was asked to go home at night! He said “No patient I know has ever been asked to leave the hospital at night!”
I decided to trace his HIV, HBV and HCV results. I asked the nurse to do it and after about half an hour later, I asked the nurse again and I was told the attendants who are supposed to do it are not around and are totally un-contactable. I waited another half and hour and finally decided to just do it myself.
I walked to the Pathology lab, introduced myself (they were a bit shocked that the one addressing them was not a house officer nor an attendant) and requested for the results. The whole walk+tracing results took less than 10 minutes.
The patient was HCV positive!
His liver condition was due to Chronic Hepatitis C rather than alcohol which everyone has been assuming all these while.
I explained his condition to him as best I could, and told him of my plan (tumor markers to be sent, an ultrasound to be ordered (none has been done for him) and a referral to the Hepatologist). He was appreciative and smiled broadly when I wished him ‘Xin Lian Quai Ler’ (Happy Chinese New Year!) when he got up to leave.
What disgusted me was the utter apathy - from the attendants to the nurses and doctors. It’s not that I mind walking to the lab to trace results but if every one would just do their work, then patients can be seen to faster and managed better. If the attendants could do my job, I’d gladly trade places with them. It’s liberating to be able to walk about freely when the clinic is in full steam.
Now I am pondering if I should write an official letter of complaint. I wonder if any of them bosses read my blog! 
Disgustus maximus totalis !!!
Fri, 310108 @ 0701
Last Saturday I joined some people (who also went for the Gunung Datuk climb) to walk up Bukit Kepayang, a small hill located near Seremban 2. The trail from the foothill to the top is about 1.5 km long. On top there are 2 temples, located on opposite ends of the hill. One is a Chinese temple while the other is an Indian shrine.
Compared to Gunung Datuk, this ‘climb’ was easy-peasy. I hardly sweat! But I guess it’s as good as any place to get some early morning exercise done and to keep up the stamina for the big climb in July!
The Indian shrine at the top.
View of Seremban town from the top.
Another view from the top. I must say it’s not really fantastic.
This Saturday I’m bringing my son with me. Anyone wants to come along?
Thurs, 310108 @ 0700, on call! Gaargh!
To some people it might be considered terribly “sui” * to have a mouse dying on you, just days before the Chinese New Year, which happens to be the Year of the Rat!
Well, one of mine did just that. It went sorta dysfunctional yesterday.
So I went and got myself a new rodent! I got a red one since it’s CNY (soon)!
Ain’t she a beauty? And the wheel kinda glows sleepily in different hues. Cool!!!
Wed, 300108 @ 1143
sui: Chinese for ‘bad luck’.
It’s so nice to be told that “some one gave you flowers!” the moment you walk into the ward in the morning.
No la, it’s not from any secret admirers or stalkers, rather, it’s from a patient’s relative. I’m not sure what it is for but isn’t it’s nice and lovely. Sure made me feel appreciated and light-hearted!
I’ve decided to leave it in the ward for everyone to enjoy (oops, I forgot to remove the tag!).
Wed, 300108 @ 1137; today isn’t so bad after all!
In less than a month, I have received 2 complaints from 2 patients. The nature of their complaints was their dissatisfaction at the way they were treated by the doctors.
The first was a HIV+ patient who was admitted for chronic diarrhoea. Because he was earlier diagnosed with pulmonary TB and was started on treatment a couple of months earlier, he was anxious to know if his chest findings on x-ray has resolved. An x-ray was ordered by me when I reviewed the patient but I was not there to review it. Being anxious, he asked the ward doctor twice in a day regarding his x-ray. He must have annoyed the doctor with his persistent pestering because the reply he received was this:
“Don’t tell me what to do! I am doctor! You are a HIV POSITIVE patient. You will die soon anyway!”, all said in a loud voice within earshot of everyone else in the ward.
The patient, being shocked beyond words, and deeply humiliated, asked for an AOR (at own risk) discharge from the hospital even though he was not well yet at the time.
The other incident occurred last weekend. A middle aged gentleman was admitted for decompensated alcoholic liver disease (he presented with swollen legs and ‘balls’). He has already been in the ward for about a week and his symptoms were subsiding but he wanted to be well faster. So, he asked the on call house officer what could be done to make his swellings go off faster. This was the reply he got:
“Your liver is all damaged. I think you had better count your days. There is no cure for you. It’s because you drank so much. You will die soon.”
Technically I wouldn’t fault the doctor for what she said because they are all true (well, not quite because there is an option of liver transplant) but I feel perhaps it could have been said with a great measure of sympathy and compassion.
I think it’s high time medical schools start teaching students the ropes of effective communication. Sigh…
Wed, 300108 @ 0700; I really dislike Wednesdays.
“Sweeper”. That’s another new word I learned on that day. I was asked this question by some one as we were about to start summiting the mountain: “Jimbo, do you want to be the ‘sweeper’?“.
I went like “Huh? What exactly are they expecting me to sweep on the way up?!”. Then some one explained that a ‘sweeper’ is one who will stay at the rear end of the team, to make sure that no one is left out and that everyone reaches the top safely. “Ugh, arr… no, maybe next time.”, I answered. I felt a bit guilty rejecting the ‘offer’ but it was my first time up that mountain and I wanted to see how fast I can ascend it. A bit selfish, I think, in retrospect.
Anyway, back to the story.
Previously on Gunung Datuk Part 2: Jimbo was delusional at the end of the story; he was having heated conversations with himself; seeing supposedly near-extinct living things deep in the jungle, cursing fallen logs and sign boards nailed on trees; and also meeting up with four beautiful barely-clad Amazon beauties! All of that were the effect of severe fatigue and dehydration. Now, to continue with the story:
After a bit of rest, I regained my senses. The Amazon babes, regretfully, were nowhere to be seen anymore.
Sigh.
For any of you who wish to climb the mountain next time, just remember this, when you come across rocks and boulders, and I mean, a lot of them, you know you are quite near the top. Nearing the top, the flora and fauna give way to huge boulders and rocks.
This is another one of the plateaus where we rested a while. I was “team-number-4″ (in the tradition of the ‘Amazing Race’). However, when I reached this place, the 3 fellas who were in front of me were nowhere to be seen! They had moved on and climbed right up to the peak and to rest there! (So much for the buddy system). The route to the top is just around the bend on the pic above, on your left. It took me 1.5 hours to reach this place which, I am told, is a very good time as it usually takes (again I am told) about 2 hours to reach here.
The rest of the team soon reached this plateau. And me, being a newbie in the group, was ‘honoured’ with a cup of hot coffee! The place was chilly and the cold and so, a quarter cup of hot coffee was much welcomed and it tasted far better than any Starbucks coffee I ever had!
But long before the rest of the team reached, I did turn the corner and took a look. I was thinking perhaps I could try and scale the last 10 meters or so on my own to the top. What I saw was this! Perched against the rock surface were these 2 steel ladders which were held in place by only nylon ropes! *Gasp !!!*
I climbed up the first metal ladder and I felt like I was going to slip and fall, landing on the rocks below and die of severe internal bleeding. There were hardly any space to place a foot or a hand! I could almost see myself, at the bottom of a deep pit, too hurt to yell for help, every bone in me broken and bleeding from every orifice. I imagine seeing my entire life story pass by me in a jiffy and I regretted not maxing out on my credit card!
A cold blast of wind soon brought me back to realilty and I found myself still hanging on to the first ladder, knuckles white grasping onto the cold hard steel rungs.
The second ladder was tied to the next rock and there was only this little space between the ladder and the 15 feet or so drop into a chasm on the right! I stood there for the longest time, debating within me whether I could do it or not. I have an inane fear of height. Even staring down a balcony from a tall building makes me woozy. I looked around me, while making the decision…
There were huge boulders all around me, stacked upon each other for perhaps hundreds or thousands of years! “Why should they slip now?”, I asked myself. “Why not? You could be climbing and one of these rocks could just slip and land on you and you will be flatter than a pancake!”, another voice inside me quickly responded. Yet another voice said, “What if there is an earthquake? They won’t find your body in a million years, your kids will starve, your wife will be grief stricken, your students will miss you (yeah, right !!!), your mum will grief forever, your dog will pine for you….”!! Hey, wait a minute, I don’t have a dog!
I looked to the right and downwards and there was this chasm, just staring back at me. I couldn’t see its bottom (not from where I stood anyway) and it looked ominous!
I looked to the left and there were these 2 huge boulders. I looked everywhere. There was no other way up except via the 2 dreadful ladders. The wind was cold and strong. I felt my knees buckle. My palms sweat great drops of perspiration despite the cold.
That’s when courage failed me….
I remember telling myself, “it’s not worth killing yourself trying to scale the last bit”. I also remember telling myself that perhaps I should just forget about climbing Mount Kinabalu in July. There were some people on their way down the ladder and they asked what I was loitering there for. I told them I found it difficult to summon enough courage for the last bit of the climb. The usual replies were: “You think this is hard? Wait till you climb Kinabalu! It’s a thousand times worst than this!”
Good grief! “Yeah, thanks a lot for the encouragement buddy. I really needed that!” Pah!
And so, with my tail in between my legs, I made the slow descend from the 1st ladder and waited at the plateau for the rest of the team to arrive. Part of me was cursing myself for the lack of courage while the other part was congratulating myself for making a wise decision not to kill myself on those rocks.
I felt really bad…
To be continued.
Wed, 300108 @ 0811
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There’s an air of solemnity and gloom prevailing at the moment where I work. Everyone seems to have a ton of burden on his or her shoulders. The furrows on the foreheads are deeper and more in number, there are bags under the eyes, the hairs unkempt, the shirts unironed, the shoulders sagging just that little bit more and the eyes are kinda glazed over and unseeing. (And I haven’t even begun to describe how the STUDENTS look!)
We have fever!!!!
I mean exam fever, of course.
Yup, next month is EXAM MONTH! Gaargh! And that means, mega headache, for staff and students alike. Moods run foul, and conversations are kept to a minimum. Everyone is on the edge. Adrenals are exhausted.
How I long to skip February and get to March immediately! Rats! (pun intended) The CNY is in February!
Anyway, because of the fever (which will probably take a month to subside), the ‘Patient of the Week’ and ‘Xray of the Week’ Series will be suspended till Mac 2008.
Meanwhile, to all my students: All the Best! Study Hard! Jia-You! Semoga Berjaya!
If it’s any consolation, I passed my MBBS! I don’t see why you can’t!!
Mon, 280108 @ 1552
I think GOD had very little land space to work with when He created Mount Datuk. I mean how else can one explain the fact that right from the very beginning, the incline of the mountain is so steep?! None of the gentle upward sloping of Gunung Angsi. Instead you are hit from the very beginning with a gradient of at least 60-70 degrees! And that spells work, a lot of hard work and torture on the knees, heart and lungs!
It’s steep looking up. It’s always steep looking up, this goes on forever and ever.
That’s my ‘buddy’, he is supposed to look out for me, in case I keel over and die. Considering that he is about half my age, I think I was pretty okay, keeping pace with him, being constantly behind him by only a few meters.
It’s also steep looking down. The steep climb just went on forever and ever (actually it was like about 25 minutes or so, but it felt like eternity). I could hear my heart go ‘thump, thump, thump’! Heck, I could even hear the ‘click’ in my heart (yeah, guys, I have one!). I was tachypnoeic, tachycardic, sweating like a pig and my body cried for rest! The only thing that kept me going was the thought of being left behind by the rest of the gang.
Some white fungus I saw on the way up. It was during one of my self-proclaimed pit-stop for some water and lots of oxygen!
Islands of White in a Sea of Green?!!!
After about 25-30 minutes of relentless climb over steep terrain, we came to this spot which kinda plateaued out a little. Here is, or rather, was, the remains of what used to be a hut for resting. Not sure what happened to it.
I met a blood sucker here (no, I don’t mean members of the local district council). It’s a leech, and a mighty big one, aitelya!!! It was obviously looking for blood and the way it moved was creepy! Very very creepy.
Another shot of the leech. Let it be known that I’ve never been bitten by a leech despite years of trekking and camping. I guess I’m lucky. I remember once when I went to the National Park (Taman Negara) for a camping trip and we were all so terrified of leeches that after every hike, we would rush back to the dorm and strip down and look for leeches! I even had a patient who presented with hematuria (passing blood in the urine) and when a cystoscope was done for him, there was this big fat juicy leech attached to his bladder wall! Apparently he went swimming in a river and this blood sucker swam right into him, literally! Ugh!
Ah, the rare and almost extinct Polycrapus hocuspocus !! You can tell that by this stage of the climb I was a bit delusional and having early signs of hypoxic encephalopathy.
And then I see this sign and I went: “Aiyoh, Still have to climb ah?!!! Loh Miang ah”. I think it was at this point that I was actually having a conversation with myself and I remember saying to myself: “Jimbo, I don’t think we can do this. I think we are almost at the end. We are just going to dehydrate and die out here. Ashes to ashes, dust to dust. It’s time to give up the spirit. Forget about climbing Mount Kinabalu in July this year. We’ll never make it. Blah, Blah, Blah!!!”
When I came upon this I actually got angry. I was angry that no one bothered to cut across this log that has fallen over the trail and blocked the way. I was angry that no one built an escalator or something so the climb wouldn’t be so hard. I was angry that I have to straddle over the log (it’s a rather obscene posture, I tell you) to get over to the other side. I was angry that the top is nowhere in sight!
And I was totally banana-ed by this sign nailed to a tree. ‘Mempisang’, what the heck is that? I didn’t see any bananas anywhere! You can tell I was 50% delirious by then.
And then all of a sudden, one can see boulders! Big big ones. I could also hear the rustling of leaves overhead as the strong and cold wind rushes through the tree branches, stirring all the leaves in unison. ‘Whish, whish, whish…’ , it went; and I thought I was in heaven!
OMG! I WAS in HEAVEN!!!! For lo and behold, in front of me were these four bootylicious Amazon Beauties! I didn’t know where they came from and why there was a road there with proper walls and gates! I don’t know why they were wearing so little clothes in the middle of the jungle. Who cares! They were purring in unison “Hey big guy, whatcha doing up here? Wanna come and play?!!”
“You bed bet I would!!! , I was salivating like a lunatic!
You can tell that at this stage Jimbo had probably lost the last marble in his head…. (severe hyponatremia, hypokaleimia, hypoglycemia, hypo-whatever-else-emia, hypoxia and hypercapnia all set in at the same time!)
To be continued…
Mon, 280108 @ 0700
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I joined a group of seasoned climbers from a local church on the 19th Jan 2008 to summit (this is a new word for me; basically it just means to climb to the top) Mount Datuk (or Dato’). The mountain is one of two in Negeri Sembilan, the other being Gunung Angsi, which I summited (there’s that word again!) in February last year.
The drive from Seremban to the mountain foothill was about half an hour at a leisurely speed of 80 km/hour (I wasn’t driving, otherwise it would be a lot faster!). We had to drive on a narrow road cutting through rubber plantations to reach the foothill.
There was this sign to welcome us. In order to climb the mountain, you need to register with the officer there and pay RM 3 only.
I am told the place had undergone some major renovations late last year, so it was all nice and spruced up.
In case you are wondering how the name of the mountain came about, here is a signboard giving a brief history of the place. IMHO, the name ‘Datuk’ is a misnomer, because no Datuk, whether biological (meaning, grandfather) or political (meaning, crooks, slimeballs, VIPs) will be able to ascend the mountain without say, a helicopter! More on that later.
There is a sign board with Malay poetry written on it at the point of entry to the climb. I am not sure what it means. Perhaps it’s meant to encourage would-be climbers or it might be a warning (like “die of dehydration and mountain sickness all ye who enters here!) or whatever. Anyone of you can enlighten me?
This is the lane where it all began. It’s a short walk downhill to a little sequestered pond where picnickers would gather and enjoy the cool ambiance and the sound of the rushing stream. It also gives climbers a false sense of security because from then onwards, it’s all UPHILL!
To be continued…
Sun, 270108 @ 0700
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