$50 bucks for what????

That was the reaction I got.

Now that winter's in full swing and it's too cold to do any outdoor activities, we've started our badminton season. 3 games so far.

Perhaps we don't think twice coz we're getting paid in USD. Or perhaps there just aren't many courts here. But my friend back home hit the roof when I told him we pay almost RM200 per 2/hour session for the court rental. And the court doesn't even come with its net; we had to borrow one.

Guess it's one of those things we take for granted back home. Plenty of free outdoor courts. Heck, we could even play in our backyards.

I suppose we're all getting phat anyway, so it's worth it.

(I'm so out of shape I limped to work today after last night's game)

My tree's finally up. Put up the Christmas lights outdoors too, and did most of my X'mas shopping. Can't believe how time flies; doesn't seem like that long ago when I last blogged about this time of year.

Though I bitch about the winter, I really DO like this time of year. The white snow coating the ground and trees, like icing on cake. People are friendlier, warmer, more patient. The radio stations have begun playing Christmas songs. Friends seem closer. And I get a lot more nostalgic.

Think about friends past, and friends now. Weird friends. Like one of my buddies here who for the longest time (until 2 years ago) thought that Santa Claus and mommy were having an affair in that song, I Saw Mommy Kissing Santa Claus. He's a nephrology trainee now. But I hate to think what that did to his childhood. Shudder.

First loves. Failed loves.

Patients we healed, and perhaps even cured. And patients we lost.

Family. Those gone, and those new. For some reason, this year I've been thinking about my late Grandpa a lot. He passed away in his sleep, while I was away in Canada for undergraduate medschool. Though we never talked much due to the language difficulties, I think he was immensely proud of us. I wish I could have said a proper goodbye. Or to tell him the family's doing well. Though somehow, I have a feeling he knows.

Thanksgiving

Happy Thanksgiving everyone.

Though I'm not American, and don't really understand this celebration, I celebrate anything that gives me a day off work. And thankfully this year I'm not on hospital service, hence the words 'weekends' and 'holidays' actually have meaning.

Thanksgiving, as I understand it, something to commemorate the turkeys discovering the New World and having the Indians over for pretzels and booze, which the pilgrims made from fermented socks. Something like that.

Anyway. Besides being thankful for having a day off work, I'm thankful for other things too. For my beautiful white Jaguar XJ220. For the mansion I live in. For the 4 gorgeous Playboy bunnies I call my girlfriends. Oh wait. That was just a dream.

Seriously though. I'm not quite sure I deserve all these blessings (and more), but I do give thanks for the wonderful things in my life now. For the strange sequence of events that led me to my career here in this amazing medical center. The opportunity to do what I love doing at work. For my incredible family whom I miss so much. My supportive, sometimes crazy, always funny friends here in Rochester and in Chicago, who make my work, and this small town, so much more liveable that it almost feels like home. For my dear friends back home, in UK, NZ, whom I no longer get to see, with whom I share so many warm memories and good times that they're still very much part of me even though we're so far apart. For my health. For my wealth (all fifty-dollars-ninety-five cents of it). And most of all, for the love of my live, Veronica.

Before

After

Too much free time

So, apparently I have more readers now. Why people are keen to read my blog, I haven't the foggiest idea. Perhaps only to mock my pathetic life.
But anyway. Thanks to the wonders of sitemeter, I have been able to track the numbers.
So, who ARE you people? From Chandler, Arizona. Edinburgh. Moscow. Numerous from Malaysia, Singapore. Leave me a note, or something.
Also able to see the referral source. Which led me to find some blogs that linked me. People I've never interacted with.
Kembang only, especially when I found this one blog (thanks for inflating my ego):

Waaaah. The Pro's. I'm included in that list. What an honour, man (who cares if I didn't deserve it? I crave all sorts of attention, being as histrionic as I am). Then again, maybe you meant The Pros. As in, Vagus is shamelessly prostituting himself. Which wouldn't be inaccurate, although most prostitutes are good-looking. And I look like I ran into a reinforced concrete wall when I was a kid.
Anyways. So that got me thinking about how I could increase readership. I could blog about my sexual conquests (except I'd be making stuff up). Perhaps if I changed my blog design. Kinda like that other cyber-narcissist (but looks a lot better than me). Maybe something like: I'm making myself sick. I'll go take my pills now. Or, perhaps I could emulate one of my favourite blogs.

That's it.
My flight's all set. I'll be coming back February 12th at 11.15pm. That's right, I'll be home for Valentine's day. Though as usual, short trip only. This time 13 days.
So, can someone say 'Bloggers' Meet'?
Ahem. Anyone wants to take the doctor out the doctor to take her out for Valentine's day dinner?
(Edited to conform to acceptable social norms)

Bad Days

Was talking to a friend who had a bad day. We all have that. The ones we think about and perhaps even blame ourselves on a bad (read: PMS) day. Like every job, we all have bad days, except unfortunately ours as doctors usually involve patients dying.

Mine?

Well, I have recurring memories (and nightmares) of that sick patient dying from a tension pneumothorax. Despite the surgeon's attempts with the chest tube.

Or that young guy with the pancreatic cancer whose family refused to believe there was no hope.

Or how it felt to have those ribs cracking under my hands when I did CPR on that dialysis patient.

Or that man who clotted off his mechanical mitral valve and went into cardiac arrest.

Or that GI bleeder who was just gushing out blood from the rectum as fast as we were forcing the transfusion in. I stained my scrubs with her blood that night, as she was dripping onto the floor at one point.

Or that ICU monitor alarm that sounds like a horn, that goes off at that moment when the patient decides to die. Did some consults in the CCU this week; that sound still gives me the shivers.

On days like that, you just wanna come home and curl up in bed and not talk to anyone. And just drink yourself to sleep.

Because life (and death), has to go on.

A Picture is Worth a Thousand Words

And so it begins

Gaaahhhh!!!
It's snowing! Bleh bleh, hack hack hack.
Guess it was unavoidable. Like death and taxes. And we were lucky in that it didn't snow before Halloween.

Just light snow for now; most of it will be gone by tomorrow since the temperature's above freezing. But you know this is just the beginning.

Though, I have to say. Nothing beats a white Christmas. With lights. Hot choc or eggnog. A tree. Carols.

Goodbye

I just can't take it anymore.

I'm sorry.

I'm sure you never planned it this way. Neither did I. But it's clear, we just don't get along. And sometimes, instead of prolonging the pain and suffering, it's best to go our own way, and to find others.

The way you've become so unreliable. Breaking down when I needed you most. Freezing up.

Yes, I do love how you look. And how you feel on my hands. But this just isn't worth it anymore.

I'm sorry.

I'm sending you back to Palm to have you exchanged for a new one.

Will keep you readers updated. I just had to send it back. After having to reset it 30 times since I bought it, I figured this wasn't normal. We'll see if the replacement Palm TX is more reliable. I'm just concerned that because this is so new on the market, this is an inherent problem with them all. A colleague seems happy with his TX though. So perhaps my new one will work better.

Here we go again

Wow. Brilliant.
The cops now have to wear badges.
"Saya Anti Rasuah"
And it's not even optional, '... or face the wrath of the top brass...' so the Star says.
Firstly, if I was a cop... I'd be deeply insulted by this move. It's kinda like us doctors being made to wear tags like:
"Please remind me to wash my hands after I check your rectum"
or
"I hate vancomycin-resistant enterococcus" (antibiotic resistant superbug)
This is yet another example of a simplistic yet likely useless approach to combating a problem. We have this habit of starting all kinds of 'campaigns' when we have a problem.
I remember my SPM days in school. My BM tuition teacher gave us tips on essay-writing.
"Start a 'kempen' "
Kempen anti-dadah. Kempen kebersihan. Kempen anti Aedes. Kempen AIDS. Kempen Beli Keleta Ploton. The list goes on.
There was this recent article about this politician who organized a Dengue campaign/talk in some mall in KL. And was disgusted by the poor turnout. Duh. Unless you're U2 or something, don't expect a crowd to come listen.
The point is, how far will these steps go? How interested are the people, in showing up and listening, first of all? How effective is a simple 2-inch plastic badge? Unless if it was a 20-inch shocking pink badge.

"Oooh. That policeman has an anti-bribery badge. Maybe I shouldn't offer him money to 'settle' my speeding ticket...."

Simplistic, shallow answers for all of life's problems.

The root of the problem is deeper, I think. It comes down to our values, and our sense of what's right and wrong. Which is reflected in our other habits such as driving and honesty.

The answer? I'm not quite sure.

I DO know though, that I hate dirty cops. I remember that time, when was in form 5 when my girlfriend and I had a major argument, and had to find somewhere to talk it out. And so, we were at the Lake Gardens (corny, but true), talking. Her crying. And these 2 stoopid cops came-a-knocking. And threatened to take us to the Balai for 'suspicious activity' unless we settled on the spot.

Farking assholes. I hope they rot in hell with that RM50 that they stole from 2 kids having a fight.

(I'm not saying all cops are bad. I'm sure they're doing Malaysians a good service. I'm sure there are straight-shooters who are not dirty. I just haven't met one yet)

Addendum:

Here you go. The recent Star story about abuse and theft by the police. Or maybe they weren't wearing their name badges?

Signs you're getting old..

Some of my good buddies are celebrating their birthdays this month (November seems to be a popular baby-popping month, doesn't it?). So this is specially for them. Thanks for keeping me sane in this place/job!

• You refer to 20-year olds as 'those kids'
• You quit counting your grey hairs but start counting your cholesterol
• Exercise is.... straining to get that last piece of poop out
• You comtemplate picking up cigar smoking, because you know smoking's too late to kill you anyway
• Your dream car isn't that sporty coupe anymore, but a family-sized minivan
• Your idea of a great time out is coffee with good friends
• You find Diane Keaton extremely sexy
• You have friends on Viagra, and you don't find that funny
• People use only one candle on your birthday cake
• Between an extra hour of sleep and nighttime sex, you pick the extra hour

Chest 2005, Montreal, Canada

Basilica Notre-Dame

Waaahh. I didn't want to leave Montreál!!

Not with the great food there, and the babes. Omigod (lau nua lau nua) the French Canadian babes. I forgot that a Body Mass Index of 35 is abnormal, after having been in MN for 3 years.

It was a weird feeling coming back to Canada. I graduated in 2001, and my last trip back was to Vancouver in 2003 when I presented a paper on pulmonary hypertension. Seeing all the familiar signs- Tim Horton's, where we spent hours snacking on past-midnight doughnuts and hot chocolate after we were done studying; Zellers; the 'Sortie' exit signs (I swear, if a fire breaks out in a hotel, masses of people would die from the confusion). Also, being Montreal, obviously the French influence is greater. Hence my nosebleeding from looking at the French Canadians.

It's interesting how although this is still part of Canada, the culture and language is so different that it feels like a different country. Firstly, all the signs are in French. More than half the TV channels in the hotel are in French.

I mean, have you ever tried watching Star Trek: The Next Generation in French?

Imagine it like Hokkien: "Oi, Riker, ee-lang Klingon ai-see ar? Kannineh, lai thau wah lang eh pae-ki? Sak si ee-lang"

And so many locals here can't speak conversational English. Weird.

This was a big conference. Not exactly sure about the turnout, but I'd estimate it to be close to 5,000 people. In this huge exhibition hall, Palais de Congres de Montreál. Went through the program book hoping to find some visitors from home, as there are hordes of international physicians from India, Japan, Korea etc. Thrilled to see at least 10 research papers from Singaporean authors being presented here. However, I must say that I was disappointed not finding a single Malaysian paper. Not that I'm wanting to compete with anyone or anything like that. Just that this gets you thinking, are we doing something wrong? Is there a lack of emphasis on academic medicine in Malaysia? On research? Probably. We're busy trying to cope with the housemanship issue. Singapore, on the other hand, appears to be more proactive in wanting to expand its knowledge. For example, Singapore sends several doctors to my hospital every year (funded by Singapore) for a 1-2 year fellowship, so that they may bring their new knowledge back to apply it there. The only people I've met who were 'sent' by Malaysia are these 2 Pakistani physicians initially funded by IJN. Who incidentally, are not planning to return (the masses of Malaysian doctors here, got here on our own accord). Anyway, I digress.... Back to the conference.

My presentation went well. Had been a nervous wreck for the last 24 hours. Half expected to be grilled to death by the audience. But no, they were nice.

"Severe Hyperammonemia from a Urea Cycle Disorder Presenting in Late Adulthood"

And no, they didn't make me present in French (they wouldn't want me to use MY french).

Won the award for Best Oral Presentation under the Nonpulmonary Critical Illness category, which was a nice bonus. The manuscript was submitted for publication a few days ago; hopefully that gets through. Pretty good paper too, if I may say so myself. Ahem.

After the presentation, was able to meet up with a friend from KL who's doing medical school in Montreal. In fact, back during those days, she was a student of mine. Very glad that she's doing so well here, applying for a residency in anesthesia. Then again, am not too surprised; she was one of the brighter students, good head on her shoulders. And has grown into a rather attractive young woman too (ahem, if you're ever reading this, it's a compliment). It was great to be able to catch up on things, and to get updates on where everyone went.

Got to sightsee too. Went to Mont Royal, with great view of the city. Basilica Notre Dame, where Celine Dion got married. And Chinatown.... wow. Great food.

Had a great time here. It was nice to be able to return, even for just 4 days.

Merci, Canada. I'll be back someday...