Wednesday, June 28, 2006

It's tagged as the biggest gathering of endocrinologists in the world. I believe it. Hosted by 12 hotels. Easily over 10000 participants. And there is a daily conference newspaper AND conference TV news, telecast to participating hotels and shuttle buses. Fark....

Part of the exhibition hall at the Boston Conference and Exhibition Center

I've noted at least 7 research abstracts from Singapore. Ran into the Singaporeans presenting their research. It was great hearing the 'lahs' and all. I must say, looking at their presentations, I'm impressed by the research they're doing over there. Some pretty interesting and high-powered stuff. Also met some Malaysians there who were attending.

The conference might have been in session, but these international participants were still able to keep up with the World Cup games!

On Monday, I had the most expensive meal I've ever eaten in my life. I hope to never exceed this again. Some REALLY swanky restaurant that took your credit card numbers when you phoned in to make reservations. For every person in your party that doesn't show up, they charge US $50! Fifty farking moolahs per head!! Don't play play. Dress code- Suits were suggested. My meal alone cost US$95. One measly glass of Riesling $15. KNNCCB! I was afraid that if I'd sneezed on the napkin they'd slap me with an extra $12. I bet they charge $8* for you to take a leak (*tap water and paper towels not included). Even with our supergenerous travel budget this was pretty steep. The food was excellent. French-European. But, like the smalltown ah beng that I am, I came out thinking how much more satisfied (and full) I'd be if I had a RM 6 nasi lemak ayam.
My presentation went well. The gist of it, a case of ectopic ACTH producing tumor from a bronchial carcinoid. Teaching points: 1) when you see some ridiculously high numbers like a 24-hour urinary free cortisol of 10,340, it's likely gonna be an ectopic; 2) CT and MRI are the preferred imaging modalities. Octreotide and PET scan appear to have a limited roles; 3) these things can stay occult for years.

Downtown Boston. The old and the new; a contrast

Christian Science Church and reflecting pool, Boston

Statue of Benjamin Franklin at the Old City Hall, Boston's historic Freedom Trail

Overall, a great conference albeit a bit tiring. I attended more talks and symposiums than I expected to, but it was an excellent learning experience listening to world experts speak. Finally got back to Minnesota today. Had lunch at the airport TGIF before I catching my connecting. Felt very uncomfortable, having a head bust of Yoda above my table. Damn thing was creeping me out.

Tuesday, June 27, 2006

So, apparently expatriates don't want to settle down in Malaysia because they're all horny buggers, and want a 2nd wife, but Malaysian women are dissing them (see The Star). So instead of risking living a solitary life with only one mate, they live in Thailand and the Philippines instead, able to marry another (loose) woman and mate all the time.
So our infinitely wise minister tourism minister of Kelantan says.
Whoever he's paying to get his research done, should be shot. Or at the very least, have his balls basted in honey and made to sit on a kerengga anthill. It's embarassing, really, as a Malaysian, to have to read such nonsensical and backward words, coming from a community leader. I'm ashamed. And I'm offended for the women of Malaysia. Offended for the women of Thailand and the Philippines as his words imply they're 'easier to get'. Offended for expatriates who might be reading the local papers.
Me thinks that's just a convenient excuse. The truth is simpler. We turn people away by our bad and inefficient ways, red tape, corruption, discriminatory and otherwise backward thinking. Precisely the kinds of childish stunts these idiots pull.
Can we really move forward if we think like that?
Addendum: Do you know that the reason Malaysia has trouble attracting foreign-trained specialists to return is that us foreign-trained docs like to mate with 400 pound women with C-cup busts and wooden peg legs, and we'd rather not have to marry our regular-sized fully-limbed Malaysian women?
(there, now do I sound intelligent enough to be a politician? Maybe I should run for parliment)(obviously the last paragraph was meant to be facetious. In case I inadvertently offend anyone aside from the good tourism minister)

Sunday, June 25, 2006

A venting post

My migraine's acting up, and this caught me in the right sort of mood, kinda like things leading up to the perfect storm:
So after my last post, someone complained that I should stop commenting about not seeing Malaysians here. The sense I'm getting is this 'dude' was offended.

look dude, stop repeatedly commenting about not seeing any malaysians..not everyone else is as fortunate as you to be over here. perhaps you would like to sponsor someone from home?

I have this to say to you. It's not meant to offend. And not in the least bit targeted at the hardworking HO/MO physicians. But it does reflect my disappointment that the MOH isn't more proactive in encouraging intellectual and academic growth. Yes, I do think the MOH should pay. Most institutions do subsidise or sponsor their doctors if they get their work accepted; it's a form of reward. We talk big all the time about wanting to grow and wanting to be a leader in some fields. Well, it's not gonna happen if no one does anything.
Perhaps if we spent less money making bridges to nowhere, or purchasing submarines we don't need or making huge-ass flags to drape on and desecrate other countries' treasured landmarks or sending delegations of politicians and their families to 'learning trips' to Europe, will we have some money to promote intellectual growth.
But I have to say this to you too. The thing that irks me the most is how you come to my website, my virtual abode, and lecture me one what to write about, and what not to write about. I'm assuming you're a physician or at least a medical student, and so one can assume that you have some common sense. So please don't act like someone's forcing your eyelids open with toothpicks and making you to type out the URL only to have to come and complain about things you don't like seeing.
That's dumb. And plain bad manners. You don't visit your in-laws' house and complain their tea sucks. Get your own damn blog.
And no, I have a girlfriend now, so I'm not sponsoring anyone. Not even if you're Amber Chia herself. Well. Maybe negotiable...

Tuesday, June 20, 2006

Seen at clinic today...

This motorized wheelchair* was seen parked on the hallway of the clinic. I had to laugh when I saw the sign. I just had to take a picture with my phone.
Not sure why this patient was being seen in endocrinology, but I'd bet she (or he) would do well. She's got a sense of humor; that's important. And she's feisty. I like that in a patient.
*(yes, most disabled patients here use motorized wheelchairs. Most facilities in all cities are handicap-friendly, makes it easier for them to get around. Makes you realize how uncivilized or behind Malaysia can be when that politician said years ago that we couldn't afford to make Komuter stations disabled-friendly)

Friday, June 16, 2006


i·ro·ny n. An expression or utterance marked by a deliberate contrast between apparent and intended meaning.
Example: Obese woman coming to the Diabetes Clinic, BMI* (Body Mass Index) of 40, chairman of a chocolate company, hemoglobin A1c 8.6%, who doesn't exercise, drinks 2 cans of regular Coke daily, and comes in wearing a T-shirt with the words 'It's Candy Time!'
I tried to keep a straight face. Until I got to her chest to listen to her heart with my stethoscope. And saw the words on her shirt. We shot each other a look, became red in the face, and just burst out laughing. She had forgotten today's appointment was with the endocrinologist, and had worn that shirt.
Example of what not to do (kinda like being caught for speeding while wearing a shirt that says "Save the Doughnuts. Shoot the Cops" )
*BMI: Weight in kg/(height in meters)²
25-29: Overweight
>30: Obese
Along those lines, kinda amused by the issue of the lack of sugar in Malaysia. Some politicians have even stooped as low as to sell sugar to the public to reassure us cane sugar is aplenty (cheap PR stunt if you ask me). As many has pointed out, this reflects our taste buds' love affair with all that is sweet. The Almighty Lord Glucose.
All Hail.
That's a fact: Malaysians as a whole (and this is where I fully pledge my allegiance) have a sucky lifestyle. We hate to exercise. I can count with one hand the number of friends I know who exercise regularly to stay fit (EXERCISE= NOT five push ups a day!). People my age with huge beer bellies (myself included). My own family fools itself into thinking drinking lots of sweet guava/orange/apple juice is good, because 'it's just fruits' and is good for you (yea, with all that added glucose).
We love to eat ourselves to death. I still fondly remember the milo-ais at Siang Malam, my favourite mamak haunt; the secret to a good drink is to have an inch of condensed milk and an inch of milo at the bottom of the glass. You could float a spoon on it.
They say you can't get high from mamak foods, unlike the evils of an orange spiked vodka lime of bars. Well, the sugar high you get from the mamak drinks is probably worse. I bet people were running blood glucoses of over 400 mg/dL. Like the surgeon general's warning that comes on the cigarette packs, there should be something similar on the glasses:
The sugar content in this drink will likely make you bounce off walls.
We could give Starbucks a run for its money.
But really. Maybe the truth should be told. There is absolutely nothing wrong with excess glucose. Glucose is energy. Sweetness is good. Sugar is good. A bad diet, lack of exercise, do not cause diabetes. In fact, there is no such thing as diabetes. And this is not a pathetic attempt by an endocrinologist to ensure job security.

Monday, June 12, 2006


hyp·o·crite (noun): a person who professes beliefs and opinions that he does not hold; phoney or pretender.
Example: An endocrinologist at Lipid Clinic, who munches on cupfuls of caramel popcorn moments before he goes in to see a patient with hyperlipidemia
(I bet I still had corn kernels sticking on my teeth as I began nagging them about a healthy diet)

Sunday, June 11, 2006

While it's really nice to be working as an endocrinologist in a world-famous medical center, earning a good salary and driving a nice car, right at this moment, at 1120pm when I'm reviewing some papers on Multiple Endocrine Neoplasia type 1 and suffering from a case of the munchies, I would KILL for a decent plate of mamak mee goreng.
I miss home.

The Evolution of Palm

I've been a PDA user for the last 7 years. Started with a humble second-hand Palm III. Only 2 mbs of memomy, monochrome LCD.

1999- Palm III
2000- Palm III xe
2002- Palm m 505
2005- Palm TX
2006- My Left Palm, papers and Post-It® notes

The Palm III worked okay, but with very limited nonexpandable memory, had very limited uses. Also, Playboy pinups Anatomy diagrams don't look too good on monochrome. So, like every person with an XY genotype (well, okay, phenotype too. Can't picture the softies being into gadgets) LP and I were just itching to buy a new Palm, the IIIxe. 8 Mbs! The fun we could have! And like proper medical student dorks (we were in our clinical year then) we had our palmpilots strapped to our belt. The only things missing from geek arsenal was the pocket protector and inch-thick glasses.
Alas. That love affair didn't last. Two years later, when I was doing clinical teaching back home, it just did not turn on. Dead. And mercifully, as loved ones usually do, she decided to go quietly in the night. No goodbyes. No chance for the rest of us to see her take her last gasps of air, painfully wheezing. Adjustments to the battery, the typical give-it-a-knock failed to revive her. Not even cardioverting her with 200 J would help.
But no fear. I was working then, and was able to go out and buy a new palm, no questions asked. The m 505. My very first colour PDA. I 'sold' my nonfunctional Palm IIIxe to a medical student for a cup of coffee (had made it clear it wasn't working; they'd have to pay for the repairs themselves). And maybe that guy's voodoo is better than mine: the stupid thing started working immediately after he took it. Baah. I must say, the m 505 (which my sister gleefully inherited from me for free!!) I bought was the most reliable. Served me well for those few years.
Then ambition and greed overcame me again. I felt I needed an upgrade. Something with wifi and bluetooth. Hence, the TX. And the TX fiasco. Returned the first unit in a month. The unit would freeze badly when I tried using the wifi. Would be quicker for me to stroll to McDonald's and get a breakfast McMuffin, walk to a cyber cafe and log on, than to wait for the browser to work. Got a replacement unit prompty, and thought my troubles were over. But no. This one's touchscreen is possessed, I swear. The damn cursor would fly all over the place, sometime even to the very edges of the screen, when I placed my stylus somewhere else. It got so bad that for the last 2 weeks I just left my freaking palm in my bag, and resorted to yellow post-it notes. Just check out the video (that line, or cursor, is supposed to be exactly where you touch the screen).

A patient with ventricular fibrillation would get less squiggly than that!
So I called them again, and since it's well within the 1 year warranty, will have them look at it and repair it. Honestly I've about given up. I'm this close to chucking this somewhere and just paying $200 for a Tungsten E2. 200 bucks ain't worth all the trouble.
When I called them the nice lady was trying to guide me through it, "have you tried a soft reset?" etc. After listening to her instructions for 3 full minutes, I told her, "Lady, I have used palms for the last 7 years. This is my 4th. I've tried EVERYTHING! Now gimme the dang repair address!" (Ok, I was more polite. But it would have been nice to say that for once)
So, stay tuned for more.

My dream Palmpilot would be like a Swiss army knife of sorts. Hidden gadgets that would snap out. Polished shiny silver. And it would have a supermodel on the wallpaper that would sing praises of you whenever you were down in the dumps (not unlike that chocolate ad: You are a bouquet of man-liness..)

Wednesday, June 07, 2006

Cultural exchange

The problem (and the joy ) of having an American girlfriend is the language and cultural barrier. You can be cussing at the pesky bugs and the smell of gardening manure in your native tongue, but if you time it right and have the right intonations and facial expression, can have her thinking that you're admiring the daisies and enjoying the blessed warmth of the summer sun. But since she's such a trooper, I've been teaching her some key Malaysian words and phrases. Words she can use to impress my parents (Wow, Auntie Vagus, your fried rice is damn c*bai good-lah!).
So far, words I'm hoping to teach/have taught:

  • Kwai poh /kwai loh
  • Pang sai/Lau sai
  • Leng lui
  • - lah!
  • Ham sap
  • Tandas
  • Lor mai kai

Still some ways to go before I can work up to pukima, KNNCCB or even CB or KKC. After all, I wouldn't want her to know that her boyfriend's lastname in Chinese is 'penis'. That would make for unreasonably high expectations for the future. (On a personal note: yes, I suffered terribly during those cruel years in elementary school when my mates called me KKC unceasingly).

And someday, I'll teach her to drive like a Malaysian: driving on the left side of the road, perpetually talking on the cellphone while driving, music turned up to >100 decibels, sudden turns without using the indicator, frequent use of the international handsign of peace and friendship ( ).

But she's a fast learner; am sure Kris, my young padawan will be fine.

Anyways. Feel free to make suggestions about vital Malaysian phrases and words she needs to learn. And of course save some for me to use if she goes shopping with my credit cards.

Saturday, June 03, 2006

The Race Ride

Can't. Feel. My. Legs.

The biking was awesome. Couldn't have asked for a better day; sunny clear blue skies, not a cloud in the sky. It had rained last year.
Overall, just under a hundred people, raising over $20,000.
In the typical Malaysian kiasu-ism, although this wasn't a race, I was zipping past people, or impatiently waiting behind roadhoggers fellow cyclists until I could pass. Must. Finish. First. And I did, though no one except me was keeping count. 51.5 km of cycling through southeast Minnesota, taking us from the city to the outskirts to rural roads to farmlands and back.

Km 0-10: (This is a cinch. Maybe I should have signed up for the 50 mile ride instead of the 32.)
Km 11-20: (KNCCB. What can't that person ride faster? Dang it I'm gonna overtake)
Km 21-30: Thighs and back start to ache.
Km 31-35 uphill: Butt muscles start to twitch and threaten to cramp. And no, this was not from what I ate last night.
Km 36-40: (Gaah. What is that smell?? Oh. Manure)
Km 41-45: Starts hallucinating. Sees recurring images of a cool, lush desert wadi. With a char kuey teow stall beside it. And a Heineken van.
Km 46- Finish: (Gotta be number one. Gotta be number one. Gotta be number one) (And I think I did finish number one in my group. Though this wasn't a race)
Total distance: 51.5 kilometers. Total time: 2 hours 4 seconds.

I gotta say I was disappointed that all we got at the finish line were two elderly people on lawnchairs ringing their bells to welcome me back (Bless their hearts. They volunteered, after all). True, there was a big organizer's hut and volunteers and even the local radio station people. But, where was the ribbon through which I ride? The cheerleaders with their pompoms (one of the 60-year old ladies did wave her pompom at me I guess)? The mayor with a medal for me? Publishers with their book deals for me. Mothers with their daughters and marriage proposals in tow??
I bet Lance Armstrong would never have put up with this.
Okay, that last part was a joke. This was a great, no, AWESOME day. A day when people got together to raise funds for a good cause. And you, my readers, contributed so generously (thank you, really) though I did have my doubts about your motives (to help diabetics, or to see me topless?).
A promise is a promise, and since I exceeded my goal of $200, you get a topless picture (just remember to throw up into the toilet, and not your keyboard).

Thursday, June 01, 2006

2 more days. The training's going well. Since last August, have done 822 kms, hoping to hit 1000 before the end of this year.

The 32 mile bike trip will be this Saturday morning. Tire pressure, checked. Gears oiled. Bike computer, checked. Helmet, checked. Gloves, checked. Nut-choking biking tights, checked. Cheerleaders, checked. Looks like I'm set to go.

So far, my efforts have raised $160. Remember, you have a few more days to donate to a good cause. And you get a topless picture if we hit $200.

Wish me luck. And send a search party if I don't come in to work on Monday. And remember, my blood type is O.

Latest Update: $185. Need. Fifteen. More. Dollars.