Modern Art

I tried my hand at modern art today. Wanted to bring out my sensitive, new-age side. I call this creation of mine, The Idiot.

It's an original. What do you think?I just can't understand why they can't build proper, sturdy phones nowadays. And of all people, from Nokia, the brand I've used for the last ten years.

Why can't the stupid phone be built strong enough to be run over by a car?? I mean, I'm not bloody asking for something that can withstand an 18-wheeler, or a 200-megaton nuke. I'm just talking about Veronica. A Honda Accord Coupe.

(obviously I'm blaming the phone for my own stupidity)

Anyway. Apparently dropped my phone as I got out of my car last evening (had to make an urgent visit on that sick patient of mine). Then, came back, and went out for Memoirs of a Geisha. So I guess when I parked my car again, I ran over it.

Wait, so it was Zhang Ziyi's fault. Maybe if I write her, she'd buy me a new one?

Found it this morning under the car.

Bah. Just when I thought I had extra spending money this month despite blowing dough on that laptop. Had to buy a new one stat in preparation for the many new year wishes from all my imaginary female fans.

(By the way, I no longer have the phone numbers of my friends abroad. If you're reading this, can you kindly email me your numbers again? You know who you are)

Sometimes in medicine, we have this bad habit of blaming ourselves. Or maybe it's just me, I don't know.

I saw this patient last month for osteoporosis. Probable parathyroid adenoma. But being the wiseass endocrinologist that I am, I noted too he had a goiter (actually it was quite large, funny how no one noticed earlier). And he had a couple of dominant nodules.

So I sent him for an ultrasound guided biopsy. He was supposed to see me late afternoon for follow-up. But came early because he was in pain.

Neck was swollen to twice its size. Did a quick bedside ultrasound. Hematoma. I had him sent to the ER for impending airway obstruction.

The next thing I know, he's in the OR, and for a time, they were considering a tracheostomy.

The stupid thing is, in all probability, those thyroid nodules will be benign. But in the meantime, he was placed in a potentially life-threatening situation.

I was pretty disturbed by this most of the night, and angry at myself.

We did things by the book. And, when one finds a nodule in the thyroid, a biopsy usually IS indicated. And bleeding and hematomas do happen, no fault of the interventional radiologists. But, sometimes that adage is true; if it ain't broke, don't fix it.

We did nothing wrong; conversely, we probably did the right thing but things just didn't fall into place. So why do I still feel like it was my fault?
I wish I never found that lump in the first place. If only I just rushed a bit and thought to myself, no, he's here for osteoporosis, I don't care about the rest.

Thankfully, when I visited him late at night he was doing alright. A trach wasn't necessary.

Malaysia Boleh!

A fifth of a million Ringgit.

Not to fund a medical student. Or feed several families. Or aid a disaster.

No. To drape a flag over a pyramid.

WTF??? Tutankhamun himself would turn over in his grave.

Anyway. The Star published my letter. But they obviously thought I was too long-winded (hey, I was irritated, ok?).

My original below:

I don't have anything against wanting to put Malaysia on the map. However, I fail to see how spending RM200,000 on a flag to drape the pyramids would show to the world anything other than how we like to waste resources and show off.
Believe me, I consider myself a patriot, but to me this is yet another attempt to show off 'Malaysia Boleh' without a specific goal.
Perhaps some would consider a fifth of a million Ringgit a small sum of money, but think about how that could fund education, or feed how many families.
Stunts like these, or having the longest this or tallest that, would no more produce 'towering Malaysians' than a scholarship to educate the truly deserving, the academically talented but poor student.
Perhaps only to fool ourselves, despite our driving habits, rude customer service, inefficient public services, that we are towering over other countries.
And to think that my family's taxpayer dollars are funding this!

The Whip

It all started with this report in The Star last week:

KUALA LUMPUR: Women’s groups are against proposed changes to a Bill which
appears to enhance Muslim men’s rights in cases of polygamy and make divorce
simpler for them.
The Bill is expected to be tabled in the Dewan Negara tomorrow. Some women senators told The Star that they would object to the Bill or vote against it.

And then, a day later:

KUALA LUMPUR: Women senators who have been up in arms against the controversial family law Bill, which they say will lead to erosion of their rights, will have no choice but to vote for it.
All talk of breaking ranks to vote against the Bill dissipated after Minister in the Prime Minister’s Department Datuk Seri Nazri Aziz spoke to them in small groups before talking to a group of 25 senators, including the 19 women.
Anxious to ensure that Barisan Nasional senators toe the line, he warned that he was invoking the Whip (are they f*cking kidding me??) and ordered the 19 Barisan women senators to vote for the Islamic Family Law (Federal Territories) (Amendment) Bill 2005 when it comes up for debate today.

“They are free to debate and speak their mind, but when it comes to a vote, they have to follow,” Nazri told a hastily called press conference. The Bill must go through. No question about that,” said Nazri, who is in charge of parliamentary affairs.

The 19 women senators were lined up against a contentious Islamic Bill, which having been unanimously passed under protest, eroded their rights while enhancing the men’s.
On the eve of the debate, Minister in the Prime Minister’s Department Datuk Seri Nazri Aziz invoked the whip, compelling the women senators to toe the party line. They did. Each said that despite her conscience, “I am a loyal party member and will obey.”

So that's the concept of democracy in Malaysia, huh? We have a Cabinet who gets to decide which bills to pass, however, although it's in theory a vote, members are told to 'toe the line' and vote for whatever the powers-that-be want. And in this case, apparently something about making it easier for men to practise polygamy.

So maybe I sucked in GP during A-levels. And didn't take political sciences in undergrad. Would someone then explain to me how this can be considered democracy?

Especially for a chauvinistic and controversial topic such as this. Wow. This would set our mindset back a couple of centuries. MCPs, every farking single one of us.

Merry Christmas!

The city's all decked out in Christmas lights. That crazy house is at it again.

Merry Christmas, folks.

So I bought a laptop for my kid sister who's leaving for medschool soon. I wish I had MY brothers buying me toys like this when I was in school.

Anyway. It's ironic that it's made in Malaysia.

So, let's see... made in Malaysia, sent to the USA, and then I'm gonna bring it back to Malaysia to give it to her, who will bring it to Canada when she begins in April.

That thing's getting more miles than me.

Anatomy of a Torture

This is really pissing the crap outta me.
Am now getting at least 10 spam emails in my primary mailbox. How they got me, I don't know. Maybe I shouldn't have registered at those animal porn sites. Oops. Did I just say that out loud?

Viagra. Cheap watches. F*ck friends.
Bargain university degrees.

That got me thinking about what I would do to those ^&^%$# shitheads if I ever got my hands on one. Whoever buys stuff from those sites anyway? Bloody idiots can't even speakie Englezh.

• Perhaps shove an electrode up their asses and flip on the switch? Then again some might enjoy it. After all that's how they make bulls ejaculate (No, Ms Param, I didn't forget my A-levels biology).
• Inject extra-strength minyak angin into their jewel sacks? And use a 15-gauge needle, no less.
• Stick an extra-large urinary catheter up their urethras, AFTER I've coated it in salt.
• Tape their eyelids open, tie them to a chair, and make them watch reruns of Friends all day. Dubbed in Tamil and played at 2x regular speed.
• Have them listen to Nanny Fran sing Macarena 24 hours/day.
• I'd probably enjoy slowly shoving their fake Viagra pills up pee-tubes. One by one.

What is the price of Loyalty?

Got this in the mail today. Points to ponder.

What IS the price of Loyalty?

X'mas Party

So we organized a party over the weekend. Partly as a Christmas party. Partly as a farewell for some dear friends who will be leaving Rochester to return to Singapore. OC, a cardiac surgery fellow, who's done with his stint here. Incidentally, we were able to twist his arm into promising us a free coronary bypass when my Malaysian diet takes its toll, and my heart attack hits me at 50 (OC: What's the warranty on your bypasses? 5 million beats or 5 years, whichever comes first?).

It was great fun, a time to celebrate the friendships we've made here, people I've learnt to call family; and to reflect on how life, fate, has brought us to this place, to this career. LP and I were reminiscing about how things began, and painfully realized that we started this journey eons ago (we started medical school in 1996, and we're STILL training). So when I see young med students (yes, YOU!) talking about how they're about to finally graduate and be done, I tell them, Dude, you have no freakin' idea. You're just beginning. Bwahahaha.

I gave my gifts away too, mainly because some were not going to be here next week. I'm still unsure what that idiot friend of mine was insinuating by giving me that Chippendale calendar. But I got back at him too:
Overall, a fun party (But dammit, that bloody mistletoe didn't work!).

Malaysian Restaurant

Heard about this Malaysian restaurant, Satay2Go in Apple Valley, about an hour away from here. Apparently, it's been around for 3 years, but we only found out about it a couple of weeks ago.
Omigosh, I must say, the food that we tried was darn good. True, it was just a small hole-in-the-wall, mom-pop operation and not a huge restaurant, but man, that was the best hor fun I've had in this part of the world.
My drool glands were working overtime when I looked at the photos of their dishes. I think some elderly man slipped on my drool and fell. And they even had pretty good siew-pau. You know it's pretty good when a Seremban boy says that. (Then again, I've been away too long)
Anyways, now that we've discovered this place, I'm certain we'll raid it regularly. Owners are a nice couple from Penang. They had the most hilarious menu though.

Childhood Food Meme

Ok, I admit. I'm a meme virgin. In fact, I still don't know what it means. Issit pronounced mèh-mee (like what you call that old phat woman pimp) or do you pronounce it meme? Like: What do landmines do? They meme.
Anyways. I was tagged by Felicity. No, I grew up in Seremban. And, being a true-blue missionary school student, devoid of any female influences (aside from family), my childhood was filled with mainly junkfood:

1) Luncheon Meat

Ah. Ma Ling luncheon meat. And which schoolboy did not grow up on this? A processed meat made of pork, tendons, tripe and whichever poor factory worker who was unfortunate enough to fall into the blender, my brothers and I consumed this by the cartons. School lunch was usually slices of this on bread. Also used generously in fried whatever else. I went crazy when I found this in one of the Asian stores here the other day.

2) Mamee

It was THE junkfood of its era. You could eat it on its own, or empty the enclosed sachet of MSG into the pack before eating it, or, like what we did, order a 40-sen bowl of laksa from the school canteen , and when we were done, get extra soup and dump this pack in for a 2nd meal. Clever huh?

3) Grandpa's pancakes

No pictures here. But my late grandpa used to make us his pancakes. Nothing special in terms of taste, I've probably had much better pancakes in the recent years, but this was homemade! By Ah Kong. Made to order. Usually when we were hungry at breakfast time. He'd have the music of his old chinese opera blaring on the radio when he'd make this. Some lady singing about constipation, I suppose, hearing how high-pitched and pained her voice was. Maybe she ate too many pancakes. But yea, this brings back warm memories.

4) Curry Puff

Need I say more? Damn, this is making me hungry. Anyone know of any good curry puff recipe???

5) Dingdang

Ok, I admit, I didn't particularly like this. But the toys! You get toys with this 50-sen snack. Which is an overstatement considering it was just a pack of 8-or-so chewy stool-like bits of chocolate covered biscuits. And no, I'm still not sure why there's a picture of Doraemon AND Popeye on the box. Maybe Doraemon was Popeye's pet? Or perhaps he had a thing with him, behind Olive's back? Geez, junkfood can be so bad for you.

So that's it. And no, I won't tag anyone else with this.

It's beginning to look a lot like Christmas...

At least 8 inches of snow today. Heavy, damp snow. Good for snowballs and snowmen. Bad for shovelling, bad backs. Also bad for stupid people who use snowblowers, who stick their fingers into the machine to clear the compacted snow after they shut off the engine. Vincent, my hand-surgeon friend from S'pore, saw a lot of mangled hands here last winter.

One UGLY snowman. Believe it or not, he's wearing a real Armani tie. Was one of my favourite ties, until I was stupid enough to not believe the washing instructions. DRY CLEAN ONLY. Yeah, right, I thought. And totally ruined it.

Snow angel. Don't think the harp and halo's convincing anyone though.

The Tim Allen Story

Gaaahh!!!
I was on the cardiology floor seeing a patient today. Ran into a nurse friend, and started talking about how things were on that floor last December when I was cards SMuRf. Talked about the memorable patients, especially the ones waiting around for a new heart.
And then she told me the bad news. Seems that Mr. A, the guy who was related to Tim Allen, had a traumatic brain injury in his 40s. And tended to confabulate (without malice, he just believed his stories). And so it seems that he made up this whole thing about him being Tim Allen's cousin. And his wife, not wanting to upset him, went along with the whole charade.
Which means, my priceless book, the one autographed by Tim Allen, is now just a book with some scribbles by a crazy patient! Gaaahhhh!

And my world comes tumbling down.
Damn, this patient was convincing. And the problem was, although I didn't see Timmy and no one I know actually saw him directly, there was talk of nurses who know nurses who saw him on the floor that day. Kinda like Elvis sightings. But then again, we not infrequently get VIP/actor visitors to our hospital. Heck, even the Presidents come here.
I suppose I should have suspected something amiss when the person who wrote it misspelt 'stitches'. Then again, I thought to myself, he's just an actor, who knows, maybe he can't spell.
I suppose if nothing else, it's still a souvenir of an otherwise funny patient. Good story to tell my grandkid.
But I was hoping that I could sell that darn thing on Ebay when Timmy won his Oscar. Or died. Or gets busted for cocaine again.

Bah!

Do you ever get that feeling, that things you do, things you hold close to your heart, things you consider to be your trademark trait, could be construed to be something wrong? Something that may be misundertood. Or insulting. Or taken advantage of.
You kinda do something out of sheer goodwill. Or because it makes you happy. And then it backfires. And you're wondering why you bothered in the first place.
You kinda realise that maybe your idea of kindness, or generosity, or friendship, is pathological. Be it doing favours for someone. Or offering a place to stay to people you don't know well, but give the benefit of trust to anyway . Or giving gifts. Or taking calls. Or helping refer a patient to a consultant, even if that wasn't why she was here to see you in the first place.
Don't mind me. I'm probably just bitter because I had to wake up at some unholy hour on a Sunday morning to round on my patients.

What is this?

This is an 18-SX entry... be forewarned. Ok, here's a quiz. Who can guess what this quaint little piece of object is?

Is it:

(A) Kristin's new necklace?

(B) A caterpillar with tattoos?

(C) Baby toy?

(D) Xmas tree deco?

(E) Ball-o-meter?

And the answer is: (E)! The Orchidometer, or Ball-O-meter, something I use frequently at work when evaluating hypogonadism. For such a simple device (string-of-pearls) it's bloody expensive.

These things seem to come in streaks.

A vast majority of my thyroid nodule patients have benign disease. Very occassionally, the biopsies turn out to be cancer.

This week, it was 2 in a row. 2 patients I biopsied last week. Papillary thyroid carcinoma.

I remember the days when I was an intern. If the first patient of the night had a-fib with RVR (atrial fibrillation with rapid ventricular response) you knew your next few would have the same thing. Ditto for NSTEMIs. Or CHF.

I suppose, in endo, PTC has relatively good prognosis. Unlike the other cancers out there, thankfully. And it was just serendipity that these were came to be discovered. I just hope I didn't ruin someone's Christmas season.

Back on the inpatient service now, and will be oncall for the next 2 weeks. Some very interesting cases, not the usual stuff; insulin antibodies, adrenocortical carcinoma.

Question: What do eskimoes do when it's cold?

Answer: Sit round a candle.

Question: What do eskimoes do when it's very cold?

Answer: Light it.

Dear Santa

Dear Santa,

Before you finalize your list this year, I think it would be crucial for me to clarify some details with you, lest you are misinformed by your elves. Who knows how convoluted gossip can be.

• I wasn't winking at that blonde nurse the other day. I just had some err... eye irritation. A grain of sand in the eye. After all, who hasn't experienced a sandstorm in Minnesota?
• I did not imbibe all that whiskey and beer for the sheer pleasure of it. No, no, Santa, your (incompetent) elves misunderstand. I was merely sparing my friends from the evils of ethanol. Kids shouldn't be left alone with these things.
• I swear, there was a tarantula on that lady's der·ri·ère. Why else would one brush it? Those elves! Always so quick to jump to conclusions!
• That officer was mistaken. I wasn't driving at 110 mph. It was 10 mph! But me, I didn't want to hurt his feelings pointing that out, that he may need a new pair of glasses. In any event, I was rushing to the hospital to treat an emergency case that I, and only I, knew what to do. Countless families were saved from the TahilalattehOkurangmanisitis Disease. But, it was a team effort (my nurses did help) so I hesitate to take credit for it.
• I really did wash my hands after using the toilet that day for a Number Two. And contrary to the accusations of that nurse, was NOT eating a coney dog and reading Maxim when I was in there.
• I have no idea what happened to all that chocolate ice-cream in the freezer. However, I recall having read about the association between UFO sightings and the mysterious disappearances of frozen desserts.
• I never lie. Not, sir, not me. Ever. Not even if my life depended on it.

Therefore, Santa, I hope you, in all your wisdom, do not get fooled by these malicious lies that were obviously made up by people envious of I. But, being as forgiving as I am, will not hold it against them that they look like chickenshit while I've been mistaken for Michaelangelo's David. After all, who can blame them? It's hard to not envy perfection.

So, Santa, I hope you take all this into consideration when you plan your list. And remember, I'm wanting that BLACK iPod nano. And my thong size is 30.

Images of Winter

Took these pictures today. It's a winter wonderland out there; been snowing for the last 24 hours, and we got at least 6 inches already. Got this from a patient of mine last year.

Think I overdid the Christmas shopping this year. Just got carried away. But then again, I have a lot to be thankful for, wonderful friends and companions here who bring so much joy to this place. I guess I'd rather have more friends to give presents to, than none.
Before I saw snow, never could quite understand how snow could look like crytalline in structure. You know, those starry designs kids drew. But they really are! Miniature stars. Each one unique. Gawd, I love the snow (except when I have to shovel).

3 weeks to Christmas. Better start behaving, or else Santa might not bring me what I want.