Monthly Archives: December 2011

SIMS FAIL!


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The other day, I was browsing through the ‘Top Apps’ on my iPad’s Application app when I chanced upon a new game which seemed to have zoomed right up to the top of the chart, surpassing even Angry Birds and Smurf Village!

The game was the SIMS FreePlay.

Now, I have heard of the SIMS before mainly from my nephews-in-law and also my daughter who was hooked upon it once upon a time on the home computer before the CD-ROM got fried. Those days I paid scarce attention to it but I often wondered how the game could be so addictive and how my kid could be stuck with the game for hours on end.

Curiosity got the better of me and so I touched the ‘Download’ button. It wasn’t long before I was ‘looking after’ a SIM whom I named ‘Jimbo’ (I know, not very creative of me). The rules were simple. I get to determine the personality of my SIM-man! I also get to ‘dress up’ my SIM-man in a wide array of outfits, hair and eye color, facial hair or not etc. Jimbo, naturally was a ‘GEEK’ (there wasn’t any personality called ‘Obsessive Compulsive Disorder‘ which would be most fitting for an ID physician!). I was to help satisfy all the needs of my SIM-man namely the need for food, hygiene, rest, toilet business, entertainment and social life. How hard could that be?

As it turned out, it was rather hard. It wasn’t long before Jimbo-the-SIM-man transformed from an energetic geek to a lethargic and stinky bloke. I haven’t figured out how to feed, clean and rest my SIM-man and so Jimbo did not shower, eat or sleep! There were also pools of organic excrement on the kitchen floor and the garden outside my SIM-man home because I couldn’t get Jimbo-the-SIM to the toilet in time! Bleh!

I got all that sorted out soon enough (which shows an old dog can indeed learn new tricks!) and Jimbo-the-SIM was back to his old energetic, fed and clean geek status.

It wasn’t long before I was asked to add another SIM and I added another bloke who moved in next to Jimbo-the-SIM and I named him Tom Riddle (again, not very creative, I know). The next task was to get Tom and Jimbo to socialize with each other. I do this by making them do stuff like: be friendly, be funny, be-whatever…

It was around this point that things got a little out of hand and before I know it, Tom and Jimbo were in a ‘Budding Romance’ status! *face-palm*

Luckily, at this time, my daughter discovered I have SIMS-FreePlay on my iPad and after the initial shock and fussing (on discovering my 2 Blokes were in a budding romance!), quickly and ecstatically,  put things right by simply touching the ‘Clear Game’ button and starting all over again. :)

Sheesh….I didn’t realize the SIMS game mimics the world so realistically! LOL!

Education gone awry


Come January, my daughter will be going to a new school to start her secondary education. Yesterday we made a trip to the school to purchase all that are needed for the new school year – books, uniform, wrappers, etc.

What greeted us at the entrance of the school were these 3 gigantic signboards:

Good grief!

These signboards epitomize what is ailing the education system in this country. Do you agree with me?

iFail


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Some one asked me yesterday what is so good about the iPad. Nothing gets me more excited than being asked to describe my newest and best toy to date!

Before long I was waxing lyrical about how wonderful and good the device is. I spoke of how, with the iPad, I literally have the world wide web on my finger tips! How looking up medical information is a breeze especially when your colleague who doesn’t have a smart phone disputes your knowledge on a subject matter. How I could take minutes of meeting and send them off before the chairs on which the participants of the meeting sat on have the chance to cool down after the meeting.

I went on and on and on. I felt like I was an Apple sales person making a sale pitch! I felt like a guru on the verge of converting a new disciple!

The person listened to me with rapt attention, totally mesmerized by the possibilities with an iPad.

Finally as I was winding down my monologue on the iPad, the person looked at me with eyes full of wonders and said:

“Yes! I think I will get an iPad!”

But before I could congratulate the person on the momentous decision, the person added:

“So, which brand of the iPad should I buy?”

*face-palm*.

Not Proud


I think sufficient time has lapsed and now I can relate this story, which highlights a not-so-proud moment in my career.

She was semi-conscious when I first saw her. Some one brought her to the ED and left. Apparently she suffered a seizure some time in the early hours of the morning. She laid quietly on her side, quite unaware of the few of us who had just entered the room.It was quite obvious that she was oriental. She was still in her teens, 15 or 16 perhaps. Her shoulder length hair was dyed peroxide blond and with streaks of pink and orange. Her eyes were accentuated with deep dark eyeliners. She wore fake eye lashes. Her lips were painted with a ghastly heliotrope colour. She must have drooled earlier because there were lip stick smudges on her face.

Her face was pock marked with acne which could still be seen beneath the thick layer of make-up. Her clothes were typical for those worn by girls her age – very short black skirt and an ill-fitting blouse with frazzled edges. Her nails were painted dark purple.

She was not a pretty sight.

“This patient was brought in by some one who left. She had a generalized tonic-clonic seizure 3 hours ago and now is in post-ictal phase. It was her first seizure and by the time she came to the ED, the seizure had resolved. CT brain showed multiple ring enhancing lesions suggestive of cerebral toxoplasmosis. Her oxygen sat is only 82% on room air and she needs oxygen supplementation. Her chest Xray showed bilateral hilar infiltration suggestive of PJP pneumonia. We can’t get much history out of her because she is still drowsy and also because she doesn’t speak English very well.” The resident rattled on….

“She probably has HIV infection”, some one in the team said. We all nodded in agreement.

A rapid test for HIV confirmed our provisional diagnosis. Her CD4 count was well below 200 cells/ml which was very low – indicating her suppressed immunity and hence her susceptibility to opportunistic infections.

The next day, we met her father, who has flown more than 5000 km to see her.

“I do not want her to be treated!”

That was the first sentence he uttered after the preliminary introductions during our meeting with him. We were stunned! What father would want his daughter to go without treatment? Isn’t he aware that his daughter is in a life-threatening situation?

“I just want to take her home and take care of her”, pleaded the father, with tears streaming down his face.

My own reflection at the time (and I am not proud to say this) was that the father was an absentee father who did not bring up his daughter well. His daughter probably got mixed up with the wrong company and somehow got infected with HIV. She probably was engaged in illegal activities or immoral activities (I made the smug assumption) and that’s why she dressed like that. And now the uncaring father just wants to prevent his daughter from receiving treatment and in his ignorance wants to take her home to try traditional means of therapy.

That was my thought at the time.

And I was so dead wrong.

As it turned out, the father was one of the foremost experts on HIV in his country! He and his wife, because they were childless, chose to adopt this girl whom they knew had the HIV infection as a baby. They brought up the child as best they could under the circumstances and used their medical expertise (they were both doctors), treated the girl with the best available therapy. She grew up well, got an education and as with many girls her age, decided that she wants to dress and behave her own way. She started to default on her therapy. First line drugs failed and was replaced with second line drugs and then that too failed and third line drugs were used. She was in the country to study English. By then she had defaulted all her medications.

The father cried out for his daughter not to be treated because he knew there were no more treatment options left. It was the cry of despair, not the cry of an uncaring father. His only wish was to spend the last days with his dying daughter in his home country.

The patient got better with treatment for PJP and Cerebral toxoplasmosis – well enough for her to eventually board the flight home with her daddy – back home to where she will eventually spend the last days of her life, in the care of the person who loved her most.

I was deeply humbled by the experience and I learned some valuable lessons.

I must not judge a person by external appearance.
I must not make assumptions without proper probing.
I appreciated a father’s sacrificial love for his one and only daughter.
I want to be a better father and a better physician.

Anal-lyze this


I received this email from a Semester 6 student who voiced his concern regarding one of the patients he has been following up: (edited)

A young female patient who has underlying SLE, Autoimmune hemolysis, takayasu disease of left subclavian artery and now being hospitalized for treatment of her pneumonia.

She has a significant risk for Thrombosis -and the ward Dr have issued the blood sample for it on the 1st of this month – but it was recently rejected under grounds of “insufficient clinical picture”. I haven’t seen the lab form myself, but I think anyone could have seen that having SLE, AIH, and recent stenting of subclavian artery has sufficient justification for a blood coagulation study right?

Does this happen often?
What is the reason for the lab personnel to become so anal about the “clinical picture” that was supposedly “insufficient”?

It pains me to see that her test results get delayed and she has to be pricked again – its hard enough to obtain her blood, and recently she has been very reluctant to have her blood taken due to the fact that there needs to be many attempts until the HO succeed. Is there anything we could do to curb the pain?

Herein lies a very common problem that I have often encountered. Unlike those days when a doctor can just fill up a lab form ticking off the investigations the doctor wanted, nowadays, for some blood tests, the ‘lab people’ wants some kind of history or ‘clinical picture’ to be entered into the form as well! And per chance that this was not done, the blood sample would be rejected outright!

For instance, those days, when I wanted a CD4 cell count level, I just fill up a form, write the diagnosis as RVD (retroviral disease – a synonym for HIV infection), sign it and shoots it off with the blood sample.

Nowadays, in addition to the above, I must also do the following:

1. Write a short description of the ‘clinical picture’ and in the description, the word ‘HAART‘ must be written. I had a number of samples rejected because the word ‘HAART’ was not written! Nowadays I either write “an RVD patient on HAART” or “an RVD patient NOT on HAART” in the form, just so that the sample will not get rejected. It’s pointless to try to point out to the lab people that not all HIV infected patients are on HAART and but ALL of them need their CD4 count done regularly.

2. The form must be written in duplicates!

Frankly I seriously doubt what I write for the ‘clinical picture’ part is ever read by anyone and personally, I feel a little offended that a lab personnel who does not see patients nor have the training to decide on a patients’ management has the authority to reject your lab request based on a ‘technicality’ and cause so much of problems and discomfort for the patients.

On the flip-side, these added requirements such as writing ‘case histories’ and requiring forms be in duplicates or triplicates may be measures instituted to curb wanton and unnecessary blood investigations requests and perhaps to cut cost but surely there must be a better solution that this than to allow a lab personnel to overwrite sometimes life-saving lab investigations requests simply because some details were not filled in!

The student sent me another email later on to lament the fact that the rejected lab investigation cannot be repeated now because it has become irrelevant because intervention has been started for the patient. In his word:

“It’s like doing blood cultures after antibiotics have been started!”

Personally, I think they are just being anal.

My Christmas Wish List 2011


My dearest Mrs Santa,

It’s that time of the year again when everyone kinda wind down and take a break from the craziness of the preceding months. This year my annual request letter letter is a little late compared to last year’s mainly because I have been so busy since coming back from Melbourne ~ you know, same pay, same position, more responsibilities!

Anyway, I am not here to gripe. This isn’t the season for complains but rather the season to reflect and be thankful for the blessings one has received.

I would like to say a big thank you for these 2 things:

1. The lust-worthy beautiful poster you sent me a few weeks ago. Your new attire totally suits your personality well and enhances all your undulations perfectly! I have taken the liberty to add some text into a photo capture of the poster and pasting it here for you to see.

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The poster now is displayed prominently on the ceiling just above where I sleep ~ it helps me sleep and induces such awesome dreams!!! Even the nightmares were beautiful! I often wake up feeling strangely satisfied and contented. ;)

Thank you so much! I sincerely hope I’m the only guy in the world you sent this poster to (excluding the old fart, Mr Santa of course).

2. Last year, I made a very humble request for TWO iPads and really, it was made in jest because the chance of me actually getting them was pretty remote ~ mainly because I didn’t have the money. But, a miracle happened or rather should I, say two miracles happened! I am sure it must have been the work of your dainty lovely sexy long fingers, turning the wheels of fate for it wasn’t long before I received the iPad (which went to my wife) and I received my iPad2 just before returning from Melbourne to Malaysia!

Contrary to my earlier statement about the iPad being a glorified iPhone and that I didn’t really have a good justification for wanting one, you must have thought otherwise! Now my iPad has become the numero uno of all my computing needs.

I mean, life would be so much more dreary without Angry Birds and Smurf Village, wouldn’t it?

I must say, you are one wise bootylicious girl! You know exactly what a man wants! *smack! wink!*

And there are so many things to be thankful for:

1. I successfully completed my stint in Melbourne (although my desperate attempt to stay on did not materialize – the janitor job at the hospital was taken by a Vietnamese fella, Subway and Maccas turned me down as they thought I was overqualified and they weren’t hiring in China town, Melbourne!) :(

No worries, some day I shall return there! There’s always Plan B and Plan C.

2. My daughter did very well in her UPSR exam, scoring a whopping 5As and thus could keep her dog (whose life hanged in the balance up till results day because the prerequisite for keeping the critter was that she would score 5As!). Naturally I was disappointed (about keeping the dog) but no daddy would be disappointed for long with such wonderful news. Those days when I was her age, ‘A’ was not in my vocabulary. Actually my vocabulary started mostly with ‘D’ or ‘E’.

3. My son turns 8 today and it was tough for him not having a paternal figure around when I was away but things have more or less gotten back on track since I came back. I hope to bond with him more and teach him stuff that only a daddy could teach. :)

4. And my wife? She is as awesome as ever and it’s hard to believe that although we are in our 5th decade of life, we (or at least I) still behave like we are in our teens! (Psst…the little booklet on ‘How to keep Santa deliriously happy 364 days a year’ that my wife received from you really helped! We didn’t know whipped cream has so many possibilities!!!)

Which brings me to the last part of my letter; what shall I wish for this year? Frankly, at this point in time, there isn’t a lot of stuff that I would want but here are some that you might want to whisper into Santa’s ears on my behalf when he slumps exhausted and drifts off into dream land after some nocturnal acrobatic  activities:

1. An Emperor Massage Chair, like the one below. I tried one the other day in Jusco Seremban and it was awesome. Why, I felt like I was cradled in your wonderful warm and loving bosoms! The price tag was RM 13,888! ~ way over what I could afford!

2. I love my Black Beauty but I have had it for years. It is still performing well although the built-in Bluetooth and DVD-burner no longer work and I am rapidly running out of disk space. It is also agonizingly slow to start-up (heck, I could do the laundry while waiting for it to start!) and so, just in case it dies on me anytime between now and next December, can you get Rudolph to hop over and deliver to me a Mac Book Air? Nothing Android or Windows for me, TQVM. :)

Hmmm, I think that’s about all I will ask specifically for this year. Of course the usual stuff that I always want are still on the list – you know, stuff like:

1. Health and wealth for all my loved ones (and me!)
2. Shopping vouchers and freebies (for the wife and me!)
3. My sour and non-communicative neighbours might just be a little friendlier and that the guy will stop venting his angst on my poor plants!
4. Lots of toys for my son
5. My daughter will go through the hormonal upheaval of puberty and teenage years unscathed.
6. A new government, perhaps? (*Gasps!*)

And of course, World Peace.

Thank you Mrs Santa. You have been so generous and kind!

Signing off now with heaps of love and kisses!

I’m sending you this poster for Christmas ~ it might even help inspire Santa to join a gym! (my personal one where I will be wearing my new red thong will be sent in another mail! ~ red thong included). *wink*

Merry Christmas and a Happy New Year!!!!

The Call


Yesterday while working in my cubicle, while daintily observing the rules of working in a cubicle-farm, I received a phone call from a woman (Phone number: +60 3 7626 8899 – call and ask her out for a date if you are into obnoxious rude females) who claimed to be representing the Hong Leong Bank.

Right from the start, I could tell the person from the other end of the line was an Ah Lian for she could barely string a sentence in English without sounding like a drowning dolphin trying to say “I am drowning” in Japanese.

She: Harrow? Is this Jimbo? (name has been changed …for the sake of change)

Me: Yes, speaking.

She: Ha? Is this Jimbo ar?

Me: Yes, this is Jimbo speaking.

She: I want to tell you hor, your credit card debt is way overdue. You owe us ar….around RM 7,400. Please pay immediately, thank you, bye! (She hissed the words in a hypothyroid voice).

Me: *WTH!* Excuse me?! What are you talking about? I don’t have a credit card with Hong Leong Bank! How can I possibly owe you any money?

She: What?! You sure or not? Our system here hor said you owe us money. You better pay la. Don’t joke like this! Your IC number is XXXXXX-05-XXX4 right?

Me: Hello?! Yes that is my IC number.

She: Then correct la, you owe us money. Our system here have your details.You don’t play a fool like that la.You not receive our statements and lawyer warning letter meh?

Me: *Double WTH!!* You are very rude!! What is your name? Do you think I have all the time in the world to joke with you about these things?! (I said in a rather loud voice, breaking all the rules of cubicle dwelling! One KPC-colleague later asked me if I was fighting with some one on the phone!)

She: Ah….oh sorry sorry…I not mean liddat! Liddat hor, I think you got identity stolen already la….you better sort this out yourself quickly! You go make report! You get back to us and you pay money okay?!

Me: Huh? Excuse me…you are the one who claim I have a credit card with you when I don’t have one, you claim I owe you money and now you claim some one stole my identity and you want me to sort it out? You sort it out for me. It’s your problem, not mine!

She: No, no…you have to sort it out. You go make report because the credit card is in your name.

Me: Oh?! So, if i now issue a credit card in YOUR name and I go spend money with it, you go and sort it out yourself, correct?!

She: Err…wait ar wait ar……*click*

That woman hung up on me!!!! I now hex her with dysmenorrhoea for 6 months at least and may her ovaries atrophy to the size of peanuts!

Gaargh!!!

I immediately called a friend of mine who is an employee with the bank. She later called back to confirm the following:

1. I indeed do not hold a HL Bank credit card and hence do not owe them any money.

2. There has been a rash of similar cases lately involving such calls and the aim was to con people out of their personal details by instilling fear into them.

It was all a con. Imagine what would have happened if I happen to have a credit card with the bank!

I am very concerned that my personal details, including my IC number can be so easily accessed by unscrupulous people! :(