Climbing Gunung Angsi

After a 10 month hiatus, it’s time to take out my climbing boots and go climbing! And the mountain-of-interest this time is Gunung Angsi (GPS coordinates:Latitude: 2° 42′ 0 N, Longitude: 102° 2′ 60 E). If you are free next Saturday and looking for something challenging to do, come join me!

Here are the details:

Date: Sat 6th Aug 2011

Timeline:

0700 Meet up at Seremban Centrepoint or Senawang Toll

0715 Depart for Ulu Bendol

0745 Registration & Roll Call

0800 Commence hike.

1100 – 1200 Climbers to reach summit

12 noon Descend to Base

1600-1700 Reach Base, wash up and depart

Please eat your breakfast before you come.

The important things to bring are:
torchlight, whistle, rain coat, fully charged hand phone, water (about 2-3 L), food, change of clothing.

*There is a charge of RM 5 levied by the Park.

Hope to see you there!

29072011@0805

Diminutive sheaths

I paid a visit to the Skills Unit yesterday and was rather amused to discover a small plastic packet containing these tiny rubber objects:

I jokingly asked the nurse there if they were condoms for men with diminutive….er…you know…

She laughed heartily and said “no”!

Do you know what they are?

28072011@0845

Working Smart

With the oversupply of house officers in most hospitals these days, I now have 4 house officers looking after 16 patients in the two cubicles where I conduct my ward rounds 3 times a week. By any standard, this is sweet! I mean, the house officer:patient ratio is 1:4 – definitely an enviable number.

Unfortunately number does not equate greater efficiency. No doubt the house officers under my supervision are competent – they get the clerking, blood taking, setting of intravenous lines and tracing of results done as expected. They are reasonably good at presenting what they have clerked.

They do, in my opinion, lack one quality.

They do not demonstrate the ability to think on the job.

For instance, during the round we saw a patient who defaulted his anti-TB medications 3 times in the last 1 year and was admitted for possibly another round of anti-TB medications and we fervently hoped he would complete the 6 month regimen this time. I dispensed some very firm advise to get him to comply this time, including invoking what is provided in the Malaysian law the power to detain him under custody for the entire duration of his therapy.

The house officers knew the next step would be to start him on anti-TB medications and yet no one weighed the patient! (Anti-TB dosages are dependent on patient’s weight). When I requested for a weighing scale to weigh the patient, one of the house officers went to fetch it only to discover upon placing it down by the the patient’s bedside that the scale was faulty!

I seized upon the opportunity to tell the house officers that they have to work smart. If I knew a patient would be started on anti-TB, I would have weighed the patient when clerking and examining him. And if I am asked to fetch the weighing scale, I would first test the scale at the place where it is located before bringing it.

They all nodded in agreement.

We then moved on to the next patient who I discovered had multiple left cranial nerves involvement (which were unfortunately missed by my junior colleagues because everyone had assumed the patient had a stroke and so performed only a cursory examination). I asked if anyone had examined the patient’s left ear canal and no one did. A house officer (not the same one who brought the faulty scale earlier) went to fetch the otoscope only to discover at the bedside that the batteries were dead!

It appeared that the my earlier advise on how to work smart hadn’t sunk in yet!

Sigh….

I’m afraid with this over supply of house officers, they are deprived of the conducive environment to learn to work smart and on the go leaving us with doctors who could, at best, merely perform at the most minimal level of competence and this bodes ill for the future of health care in Malaysia.

On the positive side, learning to think and working smart aren’t difficult to do, it just takes some thinking and effort, so all may not be lost.

26072011@2050

Zen and the art of lecturing

Over the weekend I was at a retreat on teaching, learning and assessment. I had signed up for the retreat for 2 main reasons:

1. Attending a workshop organized by my employer was one of my Key Performance Index (KPI)
2. I wanted to hear (and learn) what’s new in teaching, learning and assessment.

The retreat was held at the Nilai Springs Resort, a 4-star golf focussed hotel located in a remote part of Nilai, Negeri Sembilan. The place wasn’t all that bad – a bit like Malaysia really – a country with heaps of potential but badly run by incompetent people. The food was, unfortunately, quite bad (the chef wouldn’t make it past the preliminary rounds of Junior Master Chef), the facilities only so so, the lock in my room was broken, the lights wouldn’t work and the phone in the room was dead (which prevented me from ordering a in-room aromatherapy massage!).

But that’s not the issue.

I think my expectations were too high. Like many other similar workshops I have attended, we were divided into groups and were given triggers for discussions/brain storming and come up with solutions. I’ve learned from experience that this kind of workshop seldom ever resolves anything. And so at the end of the retreat, we had more questions than answers which was rather deflating.

It was also at the retreat that I made a major boo-boo by falling asleep on my chair during the lecture on “How to make your lecture more interesting”!! It was with deep mortification that I bent down to retrieve my iPad which has slipped off my lap while I was dozing off and fell with a loud ‘klunk‘ onto the floor (I bet every pair of eyes in the room that were still awake at the time was staring at me)! It wasn’t entirely the presenter’s fault. I slept badly the night before (I will not elaborate why here) and so wasn’t really in the right frame of mind to sit through a lecture purporting to make lectures more interesting!

Still, I did learn something.

I learned that there are 3 levels of lecturers:

Level 1: the lecturer delivers nothing and audience learns nothing.

Level 2: the audience thoroughly enjoys the lecture given but comes out learning little.

Level 3: the audience achieves the knowledge that the lecturer desires for them to achieve.

Level 3 is the a bit like the Nirwana of lecturing – where, at the end of the lecture, knowledge suddenly falls on hitherto dull minds and transforms them into enlightened beings!!

I suspect my level of lecturing is probably around 2-ish.

I hope to learn and reach the next level…..hopefully before I get tired of lecturing.

25072011@1443

Flying Emirates

When I returned from Melbourne, I flew Emirates. I was lucky to get an economy class seat for a relatively cheap rate during a sale while I was in Melbourne. I reckoned it would be an appropriate self-reward after a 9 month stint in Melbourne and flying in budget carriers most of the time!

I was pleasantly surprised! I loved the uniform of the friendly cabin crew! They were so unique! I wasn’t really expecting much but my experience within the plane (it was on a connecting flight to Dubai with a brief stopover in KLIA) far exceeded my expectations.

The seats were very comfortable with more than enough leg room and when I placed the back of the seat into a recline position, I was thrilled that the entire seat shifted forward slightly to give better back support and comfort! At the back of every seat was attached a personal TV in which were loaded more than 200 movie titles, hundreds of songs and documentaries. The ear phones provided did not feel cheap and they were comfortable. For a small fee, I could even send emails or text messages form the comfort of my chair using the console in front of me.

Each seat was equipped with a very comfortable small pillow and blanket. Throughout the flight drinks and snacks (such as instant noodles) were provided when requested without charge. The meals were excellent and when the main lights were turned off, I was again thrilled because on the ceiling of the cabin were hundreds of tiny twinkling lights which simulated the open night sky with thousands of stars! And if one can’t sleep, one can always view the outside of the plane thanks to two cameras mounted, one at the cockpit giving you a view of what the pilot sees and the other under the belly of the plane giving you a view of the clouds below or the land when the plane flies low enough.

Awesome isn’t it?

There was bad experience which marred the otherwise experience with Emirates and it happened at the check-in counter. I was carrying around 4KG of excess weight (the baggage allowance was 30 KG) which I was hoping Emirates would be generous enough to overlook.

The lady who attended to me was less than friendly (she was more friendly to others before me) and when she discovered my overweight baggage, she firmly ordered me to “step aside there and repack your things sir and then rejoin the queue”. She would not listen to reason and she claimed that the plane was FULL and therefore could not accommodate any extra baggage. She would not listen to my request to see her after repacking my stuff and not rejoin the long queue.

Now wanting to create a scene, I left the counter and went off to a corner to repack my things. I had intentionally gone early to the airport in order to check in early. By the time she ordered me to repack the queue has stretched to a very long one and I had to queue all over again from the back in order to check in again.

That day I had to dump almost 5 KG worth of perfectly good clothing into the bin. I felt very bad about throwing the clothes away but it was either that or the chocolate and candies for my kids and some souvenirs I bought for friends which collectively weighed around the same weight. I managed to check-in the second time round with another personnel without incidence. To pay the fine for 5 KG worth of clothes would have cost me AUD 150 and not worth the value of the clothes.

What really irked me was these two matters:

1. There was a caucasian lady behind me during the first time I queued up who had 3 huge bags and a BICYCLE! She voiced out to me her concern that her baggage were excessively overweight! And indeed it was! I later learned that her baggages were 11 KG overweight! But guess what?! They let her passed the check-in, without so much as a fine!!! It made my blood boil!

2. When I got into the plane, I discovered that, contrary to what the lady at the counter told me, the plane was not full at all. In fact between the guy next to me and I were 2 empty seats! The flight was not even half full by my estimate.

The Emirates staff at the counter had lied and was dishonest. Her lack of integrity cost me to throw away good clothing. I also felt discriminated. People like her should have no place in the service industry.

I hope someone from Emirates read this and do something about these bad apples.

Will I fly Emirates again (assuming I have the money for it!!)? Most definitely! But I hope I won’t meet that lady at the counter again!

21072011@0840

Egoistic people

I was taking 3 medical students for their end-of-posting exam today when our discussion was interrupted by an announcement over the hospital’s PA system. The voice of an evidently bored-to-death person was heard after the customary chime:

“Assalamu alaikum dan selamat sejahtera kepada Datuk-datuk, Datin-datin, Doktor-doktor, tuan tuan dan puan puan sekalian. Dimaklumkan……”

In English, the opening statement would be equivalent to:

“Peace be upon you and (gasp!) peace be upon you to the ‘Knights and their spouses’, doctors, sirs and madams. Please be informed…”

It’s a bad direct translation, I know. One shouldn’t be surprised that the ‘peace’ salutations had to be repeated twice because only in this country is the arabic term reserved for the exclusive of Muslims. In Malaysia, the title ‘Datuk’ is similar to ‘Knighthood’ in the UK which is conferred by a royalty, usually for services rendered whereas ‘Datin’ is the title one gets simply by being the spouse of a ‘Datuk’.

Anyway, that’s not the issue. The guy on the PA took forever to say what he had to announce and when he repeated the whole announcement again the 2nd time round, all 4 of us switched off and continued with our discourse.

I told my students that one of the thing that I found endearing while working in Melbourne was the casualness of my working colleagues. I didn’t have to address them by their titles (Prof or Doctor). We called each other on a first name basis. I miss that kind of casualness. Despite the casualness, there was no loss of respect. Everyone knew their place but they did not gloat over it. It took me a while to adjust to this work culture when I first arrived in Melbourne but it wasn’t long before I was calling all the professors by their first names.

Here, I know of some titled people who would balk at not being addressed ‘properly’ and some would even take offense and accuse the offenders as being uncouth and uncultured. I know of some titled people who would only respond if addressed properly. Mind you, to pronounce the whole title every time you want to address a titled person can be quite a mouthful.

Imagine saying, “Yang Amat Berhormat, Dato’ So and So….” (Most Esteemed Sir Knight..) every time you want to initiate a conversation!

There are also others who, because they carry a title, believe that they are automatically entitled to certain privilege that lesser mortals should not enjoy – for instance, claiming certain parking lots as being their divinely conferred right and would actually make a big fuss if their precious parking lots are occupied by people who arrived to work a lot earlier than them! (This is all hypothetical, of course. Don’t read too much into it).

No doubt, people who have rendered great services ought to be honored but some times, I do wish some of these people would get off their high chair and mingle with us, mere untitled mortals. It’s actually quite nice being untitled!

Btw, I am happy to be addressed on a first name basis as long as there is mutual respect.

Cheers!

Jimbo out!

20072011@2151

Jimbo’s Sperm-shaped Stethoscope

When I lost my stethoscope a number of years ago and before I got the Littmann cardiology stethoscope (which cost half a kidney to buy), I got one of those Littmann stethoscope made for nurses. I liked it for a number of reasons:

1. It’s relatively cheap (RM 150 at the time) and so if I lose it I won’t feel the pain too much.
2. It comes in a variety of colours unlike traditional stethoscope that usually comes in boring black, blue or gray.
3. It’s lightweight so it doesn’t feel like having a ton of brick over my neck.
4. It has excellent acoustics – in my opinion, it’s as good as any high-end stethoscope (my lecturer used to point out that how good a stethoscope is depends on what’s in between the ears!)
5. And it has a unique tapered end instead of the traditional round-shape. The idea was to make it easier for the nurses to insert the stethoscope under the blood pressure cuff while measuring the blood pressure.

The last point, of course, makes the whole stethoscope an item of curiosity and a conversation piece. Whichever way one looks at it (at least in my opinion), it does look like the head of a spermatozoa! LOL!

It does have its drawbacks though. As a habit, after every bed side teaching session, I would ask the medical students to recall one new knowledge they have gained from the session. Yesterday after spending close to 2 hours teaching medical students about multiple myeloma and pneumonia, all one student could recall was my sperm-shaped stethoscope.

Sigh….

19072011@0730

Lamest of them all

I have seen some of the excuses offered for non-performance of some laboratory tests requested like ‘sample leaked’, ‘inadequate sample’, ‘machine out of order’ , ‘wrong container used’ and ‘sample not received’.

More often than not, the fault lies not with the people in the laboratory but rather with the people who collected the samples.

But I think this one takes the cake for the lamest excuse ever:

I’m gonna try and get the laboratory people to call the clinic when they next encounter this unique problem so the clinic can call patients urgently for another sample of their blood rather than have them print this out and me reading it 2 weeks down the road with the patient sitting in front of me and I have to tell the patient I do not have his/her latest result and that we need another sample, causing much unnecessary delay.

18072011@0730

KFC FAIL

A friend sent me this news on the scandal that hit KFC quite recently.

My last KFC meal was in Sydney when I went there for a visit over Easter. It was horrible! I was looking forward to a nice meal of KFC in Malaysia (we have better tasting chicken than the ones in Australia) but after viewing the videos, I think I will stay away for a long long time.

You can view the original article with the apology from KFC here.

15072011@0737

Jimbo’s ‘violent’ blog

Yesterday a number of people informed me about something that I already knew:

My blog has been blocked.

Again!

This time, by an institution of higher learning, which is a bit of a shame actually (I mean, what higher learning are we talking about when we are not open minded?!)

What is laughable of course was the fact that this blog was categorized under ‘Violence’!! LOL!

I am absolutely clueless to the ‘violent’ nature of my blog, save maybe for my support for a clean, just and transparent election in Malaysia, if this could be considered as violent.

And if my support for a something that I truly believe in results in this blog being blocked, so be it.

The Aussies would say, “up yours”!

14072011@0947