29 posts tagged “reflections”
Does common courtesy and manners still matter today? Or have they given way in this "dog eat dog" world. Yeah, using vulgar language and signs are entertaining. It captures the attention and perhaps achieve the objective more clearly and faster. Some people seemed to idolize vulgarity, rudeness and brash language as though it is something great, something most people won't dare to do. So the person who does it must be brave, great and deserve to be idolized. Very "keng" as they say.
From our Member of Parliment, to even doctors, perhaps specialist and consultants too, we have seen such behaviour and language. An example of this is here. More often than not, it is spoken within an inner circle of pals. On and off we do blurt out some expletives, but is it great to make it as a habit? We have heard swearing, expletives, vulgarity uttered on a daily basis, most of the time behind close doors. The irony is that some people seemed to idolize people who uttered them, whether explicitly or secretly. What is so great about it? It is certainly easier to blurt out an expletive than to construct a courteous sentence.
I've had House Officers who came to the department, not bothering to introduce themselves to the Head of Department or their specialist and started working in the wards as though they place belong to them. Some do not even bother introducing themselves to the Sister of the wards either. For crying out loud, if you visit a friend's house, common courtesy dictates you inform the owner of the house that you are coming to visit, isn't it not?
How often do people remember to use the term "Thank you. I appreciate it"? Whatever happened to common courtesy and manners? Isn't there any other way to converse other than using expletives? Politeness may not be as entertaining as swearing but to me it indicates humbleness, softness in character and perhaps finesse. Although there are great pretenders out there, it isn't a reason not to be polite. I remember how I would receive a big slap on my face from my parents whenever I utter any languange which is remotely vulgar during my childhood. Alas we can't do that to the adults who uttered vulgarity at their whim and fancy.
However I can avoid people with only vulgarity in their vocabulary. If not I may forget how to converse in a civilized manner.
Rice, is something we may have taken for granted. In the era of MacDonalds, steakhouses, Japanese cuisine and fine dining, rice is something regarded as cheap food. It is not surprising to see people in buffets ignoring the rice and target the "expensive" food like meats and seafood instead. In the restaurant, we have often seen extra rice being asked and then not finished and left on the table.
In a country where natural resources are aplenty, yesterday I was given an insight on how a local family, as the guardian ( also known as "jaga") of a probably multi-million dollars sports complex had for dinner. The local lady was given a room (more like a store room) beneath the spectator's seat to live. 3 elderly ladies were sitting around a discarded table and heaps of discarded chairs which was used once for some VIP parade in the stadium but were now left to rot. A couple of malnourished cats roamed nearby.
The lady had plain white rice for dinner with a bowl of Maggi Mi for company. Yup, plain white rice and maggi mi as the "vegetable". Something tugged at my heart. In our country where natural resources are aplenty, and multi billion mega projects are cropped up on a daily basis, this is something that should not happen. (to me at least)
Poverty is a disease which needs to be eradicated. When our country can boast the tallest and longest and can offer ONE MILLION RINGGIT to an Olympic gold medal, I can't help but wonder about the priorities our country is taking.
What is the point of having the most sophisticated scan machines and medications when patients do not even have proper nutritious food to eat due to poverty? Who benefits more from the the purchase of medications? The patients or the middleman or the pharmaceutical company? If you ask me, proper nutrition and food has more benefit than the few hundred ringgit anti-platelet agent. Proper nutrition and food is going to help the bed bound stroke patient with horrendous bed sores more than the few thousand ringgit of antibiotics.
Poverty is endemic around here. We have read about the apparent fair distribution of the country's wealth in various forms and agendas but to me what's more pertinent is the fair distribution of opportunity. Every citizen should be given equal opportunity to better themselves rather than dishing out money to them. If lazy people do not want to work despite given the opportunity then they themselves are to be blamed. But I can't help but feel that most people here (especially locals) do not have the opportunity to better themselves as these opportunities are being siphoned by the "powerful connected" people leaving crumbs behind.
I'm sure many of our leaders' children are busy studying overseas while back at home there are so many children who are not schooling due to poverty. They have to find means to put food into their stomach instead. Some schools are in dilapidated conditions too.
With the rising price of rice, I'm not surprised if some poor village people may need to resort to eating tapioca to survive. Which reminds me of the time of the Japanese Occupation as told to me.
Poverty, is the world's most prevalent and deadliest disease. Not heart attacks. It is the greatest tragedy of all times if a person dies of malnutrition due to poverty in our country. Which I'm sure is under-reported.
Yeah, I get these bouts of reflections quite often. Thinking whether the career path that I've chosen is the correct path. Whether I'm still passionate in this field any longer. Honestly I don't know.
I cannot fathom how can some doctors in public hospitals go to work everyday doing rounds at 7am each day, seeing patients, then rush off to clinics to see patients again till past lunch, then doing a second round in the evening before going back AND THEN going for locum at night! In addition to the weekend locums!! They will be seeing patients every minute of their breathing lives. I think it's unhealthy and I just cannot bring myself to do that. Perhaps monetary reward is a very strong motivator to some people. But monetary reward is not about passion (maybe some people are passionate about money and what it can bring hahaha), it's about the necessity to survive and thrive in the rat race. Which is absolutely necessary, btw.
Passion is something you'd do without any rewards. You'd do it because you loved doing it. Not because someone asks you to. Not because you have to. But you want to.
I don't think I want to sacrifice every minute of my breathing life listening to complaints and ridiculous demands, plus practising defensive medicine to prevent lawsuits even if the monetary reward is good. My soul will wither away little by little. And I cannot live without a soul.
Nope, I need to breathe in the smell of flowers and fresh grass, to listen the endless waves at the seaside, to glance at the bright eyes of a dog, to pat its head, to feel the wind blowing against my cheeks, to have a great conversation. They are the food of my soul. Yeah right! - the only odour you'll smell in KL is the haze.
What would you do with passion? I keep thinking to myself again and again...to find the answer. I'm determined to move towards it even if I have to pay the price.
In the mist of the frantic rat race, where the survival of the fittest prevails, I would often stop to ponder what is the meaning of life. Not because I cannot compete and win. I've been there, I've done that, since school days. Does winning the rat race give any meaning to life? Coincidentally a friend forwarded me this poster.
Competition is part of life. It's not about personal satisfaction. It's about survival. I keep reminding myself. More so in an Asian country.
But is survival is all there is in life? Are we no more than ants struggling to survive for example? Hmm...tough question.
Decades ago, perhaps a lady would be esctatic in receiving a rose and card during courtship. (I might be wrong here hehehe). If one were to do that today, chances are you're not gonna get any second chances. (Cheapskate would be the term used ). Cold hard cash or its equivalents will definitely work better nowadays hehehe. That's life in the rat race man.
Perhaps I should stop being so sentimental and get slapped hard again. Happens when my birthday is not far away and I'm moving another year closer to meet my maker.
Btw I shall be joining a squash competition soon against some great guys. It's not for money, fame, recognition or status. It's for personal satisfaction. That's the kind of competition I like hehe ;)
Is it still rewarding to be a doctor? Does it still bring personal satisfaction? Is being a doctor still regarded as a noble profession? How does the community regard the medical profession nowadays? (We all know about the monetary satisfaction part :( When a mechanic increases his charges by 30% - here it's no big deal but if doctors increases their fee by 30%, prepare for a national backlash ).
Some of these questions will haunt many doctors time and again. The times when we question our decision to stay in the ever litigatious, hostile and ever unthankful environment. How many times can one recall a deceased family thanking the doctor nowadays for trying his best ? ( may not be the best in the world, but probably his best under the severe limitations - whether in knowledge or facilities ). More often than not the deceased family nowadays would be finding fault if any negligence had occurred and whether some $$ can be made from it. Thanks to the adverse publicity of the medical profession by the press and the increasing borderless internet world. ( When can the public realize that some fantastic experimental therapy in USA is not offerred in the remote jungles of Borneo for instance?)
When the medical student excitement of a diagnostic problem is hampered by bureaucracy and limitations of the real world. Why do clinicians need to convince the radiologist about the need for a scan for instance? Or to convince a pathologist that the particular blood test is required? These are supposed to be supportive services for the clinicians...not a hampering services for the clinician. Why does this happen? Probably because funds/facilities are limited...clinicians have to compete with each other to get that elusive supportive service.(To be fair, some doctors ask for tests unreasonably too). It is understandable under the circumstances but is it understandable for the sick patients or their relatives? Problem arises for clinicians when the request is denied and sometimes as a result, a diagnosis cannot be reached conclusively. When the patient dies without a conclusive diagnosis, questions will arise from relatives why this and that wasn't/cannot be done !!! Aah...and then that familiar complain will come.
And if the clinician suggests the patient pays to get the supportive services/treatment in the private sector, the patient will ask why must he pay for such a service when is available in the public hospital !!! If it's that urgent, he should be entitled to that service in the public hospital for free!! Worse still the patient may think that the clinician is in cahoots with the private services/sector. It's a losing battle from the start for the clinician. It's a "can never win" situation in my opinion.
The brunt of all sides, from the "unsupportive services" to the administration to the discontented patient will fall to the clinician. Hospital administrators will always need to cut costs, limitating the clinician's choice of investigation/treatment while at the same time expecting the clinicians to fulfill "customer" satisfaction! What bullshit! It's like telling the clinician "You can't have this or that and that also because we don't have the funds but make sure you still treat the patient well (with what?) and still make him happy". Welcome to the real world! Costs of healthcare and patient's expectations have escalated. Public hospitals and doctors will bear the brunt of it.
Is it still rewarding to be a doctor? Do you expect doctors to be still enthusiastic? To add salt into injury, probably a mechanic charges more for his "consultation" than a GP doctor is allowed to.
Times have truly changed.
On one usual day at the squash courts, I was greeted by a small "Miao!". A small malnourished kitten appeared below the seats looking at me with its big eyes. I was never a fan of cats but this kitten seemed well, cute. It jumped up near my bag and curled itself. At first I was apprehensive in petting it on its head (read; toxoplasmosis), but finally my heart gave in. It was so cute and just wanted someone to show it some affection. I pinched its neck and lifted it up. From then on, every time I come to the squash courts, the kitten would just follow me.
It was malnourished but it has these wonderful big eyes. It was happy. It ran everywhere with curiosity, without fear. Under the chair, above the chair, into the courts, along the corridors etc. There was a plastic plate nearby with some dried rice, obviously someone has been feeding it.
I just wonder if it would be happier living well fed but living within 4 walls, or be free but eating crumbs.
Too bad I didn't bring my camera - will try to take some pics next time.
I knew one day I would have to leave this place. A place which I spent 8 years of my life. I knew sooner or later I would have to leave, even though I'm not sure where I'll be going yet.
A letter recently came confirming my move in the not to distant future. A mixed feeling of sadness and hope. Can't describe the feeling. I remembered the very day I reported for duty her with a friend. Each of us just came with a bag with some clothes, fresh from med school without any expectations of what lies ahead.
I have grown the love this place. The people..the land, the sea, the greeneries. Especially the people. I can still remember the smile of some of the staff which greeted me then and still do till now. People whom are unassuming, sincere and helpful. I can remember the very staff who has helped me along the way from my first days of housemanship. Some of them have moved on, some are still around. They still do remember me too :)
However as time goes by, some newer staffs are moving towards "big city" (ala KL) like attitudes. Just do your job, take care of yourselves only, don't bother about things which don't concern you and most importantly do what's necessary only to prevent yourself from getting blamed. Thanks to globalization and more frequent contacts with "big city" people, I'm not surprised. In fact one of my ex-specialist colleague who went to a district hospital swears never to return to a "big city" hospital. However that is another story.
Where in Malaysia where I can hop on to a ferry within 15 minutes of leaving my house and in 30 minutes time find myself in an island resort?
Where in Malaysia where I can have supper beside the sea with the sea breeze blowing at my face?
Where in Malaysia where I can go and buy a cinema ticket to see Indiana Jones without prior booking and lining up for less than 10 minutes?
Where in Malaysia where I can drive to work and reach in 10 minutes time with parking still available?
Where in Malaysia are the nurses so helpful and at least still have some respect for doctors?
Where in Malaysia where you know almost every staff in the hospital and can (most of the time) get things done by a smile and a wink ;) ?
Where in Malaysia there is still some trust between patients and doctors? (which is slowly changing thanks to the "efforts" in importing sand and exporting diamonds)
Where in Malaysia where there is so much space and greenery?
Where in Malaysia where people don't talk about race and religious supremacy (yet)? And eat pork and drink beer beside another person without that person being offended and harassed by religious police (yet)?
And where in the world can I play squash with a great bunch of guys in the marvelous courts free of charge at anytime I want???
Change is inevitable I believe. Even this eden is not going to last forever. The local population is slowly but surely being "diluted" in their own very state by the powers that be. Very soon it'll be no different to KL. But I'll saviour every moment I still have here.
My heart will remain here for a long time to come. I'll love to return here one day but we can't have everything and there are obligations to meet.
Recently was on call, saw the numerous patients who are/were being artificially ventilated for various reasons. Among the reasons were inoperable metastatic lung cancer, liver failure with cirrhosis, progressive/untreatable lung disease and hypoxic brain damage.Their prognosis is worst than dismal at best. I really don't know if the patients really want to go like this. Is this really how they want to be "treated" or to leave this world? In any case they have no choice - not over here. Are we "treating" their family members rather than the patients? The world is a stage...
What would the patients say if they can or are allowed to make their own decisions? In any case, it would be over-ruled by the family members on the premise that the patient is not mentally alert or in right frame of mind to make that decision. Who wants to have a heated argument with the family members of a DYING patient? And with the sequelae that follows...
The best way is to have a living will - a legally binding document which cannot be over-ruled by the family members. To state how they want to be treated if they have a terminal/life threatening condition. Alas this is a very alien concept here. In any case, any living will has to be voluntarily produced by the family member or a legal officer - which may be with-held or destroyed too.
It is very disconcerting to see terminal dying patients having tubes shoved into their lungs, their stomach and urinary tract. And members of the public/relatives ( who can tell who is who? ) going in and out of the ward, peaking here and there - like watching a bloody blockbuster movie. And they love seeing CPR being done - like it's an entertainment show. The healthcare personnel will appear "uncompassionate" if they ask the "relatives/visitors" to leave to attend to/ resuscitate the patient. Some of the healthcare personnel are harassed and scolded by these relatives too. And like Murphy's law, these patients WILL deteriorate during visiting hours when the ward is like a fish market. Some visitors will just REFUSE to leave because they say IT'S THEIR RIGHT TO BE THERE DURING VISITING HOURS. And they will just stand around looking at the "drama" involving other patients. Bloody B***tards !!
So are you going to stand there arguing with the visitors or resuscitate the patient? Your choice.
Ventilated patients gasping for their breath, sedated or even already unconscious are being poked daily for bloods, their every bodily functions being "taken care of" artificially. Swollen limbs, bed sores, bruises, haematomas everywhere. Faecal smell permeates the whole ward every time a pampers is changed. Until the patient's heart finally stop, inevitably.
Is this how you want to die?
If I have no realistic chance of a meaningful life,
Please spare me the indignity of a prolonged painful death,
Kindly do not shove tubes down my every orifice,
Please do not inflict more pain by poking me daily for bloods,
And above all, do not hook me up to a machine while I die.
Just returned from a conference in KL. A good break from the daily grind. Well almost... THE relative of THE patient just kept calling me almost daily ( at 10 pm too! ) although I'm on leave and far far away. And even though I specifically told THE relative I'm not anywhere in the STATE nor working at the moment and that the doctor in-charge will attend to whatever problems the patient might have. See what happens when your handphone number falls into the hands of patients or their relatives?
Anyway the break gave me any opportunity to re-examine myself which sometimes takes a back seat during hectic times. While staying at the golden triangle area aka Bukit Bintang/Lot 10/Hard Rock Cafe area, I can't help but observed the happenings around the area. Shopping complexes were everywhere. The area was full of tourists, roadside sellers, people "lepaking", touts, pimps, party goers etc. The various night clubs were packed to the brim. Patrons with BMWs and Mercedes parked outside while numerous GROs roamed inside. They don't even need to encourage patrons to go inside as the clubs were bursting to their seams already. Money seemed to flow around like water. A meal at Hard Rock Cafe costs a bomb and a simple "wanton mee" at a restaurant cost around RM7. Whoa!...what do patrons here do for a living man? Printing money ah?
I asked myself, is this the life young city folks yearn for? Is this what young people flocked to the city for? Not me. I'm so relieved to return to my "jungle life". I think if I ever go back to KL I might get drowned. Sometimes country folks don't realize they are so lucky. Even if they lacked money, they have more wealth than their counterparts in the city. More meaningful life, closer friendships/families and probably better health. And country folks will never go hungry should they work at their land for crops and livestock. I've yet to see anybody survive on eating money !! With the rise in food prices around the region which resulted in protests and riots, inflation will soon follow. Life in the city, even for the middle class would be tough.
I'm is still hoping to get a farm of my own...
Returned home from work and rushed to take these magnificent photos of the sunset. The dusk was brilliant after a short drizzle. As minutes ticked away as I drove crazily towards the seaside, so did the sunset. The sunset did not wait for me. It is as though the sunset was telling me that time waits for no man. Life is ticking by...
