Happy Independence Day

Vagus Says:

As we celebrate our 49th independence day, let us take a moment to reflect on what we've achieved, and where we are going. Although we've certainly achieved a lot in the last half century, we Malaysians cannot take things for granted. We need to realize that Malaysia owes its success to all its citizens; no one race is is more important than the other.
However, if we search the deepest parts of our soul, many would admit to thinking otherwise. I suspect many harbour feelings of envy, competition or resentment, to be exposed occasionally when hotheaded political leaders speak before thinking. For how many of us truly consider ourselves to belong to the Bangsa Malaysia? Instead, as noted on our drivers license, or IC, or even school report cards, we are either Bangsa Cina, Melayu, India or others. Political parties, schools, universities, even some medical centers (Pusat Rawatan Islams, Chinese Maternity Hospitals, etc) are racially divided. It's all a sore reminder that we're different, and that our practices promote disintegration.

As my American colleagues quite accurately put it, we practice controlled racism. Where skin colour matters in issues of politics, education, economics and every integral part of our nation's machinery. From buying a home, to even reporting a burglary. When political groups are divided by race, looking after one's race becomes an interest even before that of the nation as a whole.
Some argue that affirmative action (aka 'special rights') is still needed to safeguard the rights of certain races. However, we need to take a step back and ask ourselves, if affirmative action over 50 years of independence and 2 generations still has one race lagging behind others; is this truly something of benefit, or is this merely a crutch for people to walk with? For, if the latter is the case, one may become so dependent on the crutch that one is unable to ambulate without it.
The concept is simple. Protectionism, whether we apply it to race, or the car industry (take Proton for example), or education (pseudomeritocracy via the matriculation courses), in the long run does more harm than good. It decreases competition, efficiency, productivity; promotes laziness, inflation, corruption and abuse of power. It weakens a group, and makes it so comfortable that it strives less. As Charles Darwin put it, it's all about survival of the fittest. If you artifically promote the weak and not teach it to be strong, that species never betters itself, and outside of its protected bubble that species will never thrive. Recently, a leader reprimanded a group for relying too much on handouts. In the same papers, some groups were accusing a state leader for marginalising and not giving enough to a race. No one wants to admit; if you're gonna keep handing out candy for free, why should I work for it?

"I don't care if your company does better work. All I'm interested in is helping my people, even if it costs more. If your company wants this contract, sell away your shares."

To think that this blatantly racist comment was said at an official business meeting of a certain industry. Such is a consequence of protectionism and segregation. And our PM is wondering why our projects are delayed or incomplete, cost so much or are of poor quality.

Even young people these days have this overpowering sense of entitlement, being born with a silver spoon. Even though they were born in the same country, on the same soil, to the same citizens, in the same hospital, as I. My blood boils when I recall that Malaysian Studies class in college (something private colleges have to do these days); the teacher had a humorous way of poking fun at the subtleties of the Chinese, Malays and Indians. Until this one chap who got offended stood up and shouted at the 'Cinapeks' that we should consider ourselves "damn lucky that they let us stay here." Like my grandpa swam over from China illegally. How does that make me feel? Like a 2nd class citizen in my own country.
We talk big about 'towering' over others, or being 'glocal' (a word some politician coined, of being global yet local), but yet Malaysia is never seen as a serious competitor in the international world of research, medicine, education and the arts. Looking south towards our neighbour who is a younger nation than we, we wonder why we lag behind so much when we should be the older sibling, showing them the way. We wonder why most foreigners have heard of Singapore, but not of Malaysia. Why is it surprising? When we can't compete within our country without bias, how can we compete internationally? Thus we come up with fancy slogans and words to convince ourselves everything is fine and dandy.
Don't get me wrong; I love my country, its people and cultures. I miss it dearly, and for this reason I wish to see things improve. Being patriotic sometimes doesn't mean singing the anthem louder, or faster, or forcing people to hang flags on their homes. It isn't shutting up and accepting things as they are, for if we do not admit our faults, we can never improve on them. Sometimes the patriot is the one who truly puts the welfare of his nation above those of his personal biases and agenda. I'd like to see more patriotic leaders like that. Perhaps it is time for us to face reality, and to be up to the challenge.
Happy Merdeka Day, my fellow Malaysians.

An addendum:

With regards to the newspaper reports about UMNO Youth again protesting about the neglect of Malays in Penang, if you learn to stand on your own two feet and not wait for someone to feed you, perhaps you won't allow yourself to be neglected. And why is it that we never hear you say anything about the neglect or injustice to the other races? Hmmph.

Happy Birthday! (to me)

*This will be an 18-SX post. Mainly because I'm old enough now. And I wanted to quote some messages I got verbatim*

It's been 22 hours. I'm still surviving, nothing bad yet.

My lungs still breath the humid air. No MI-related chest pains yet. Eyes still chinky-squinty needing the same prescription glasses. Still have a headful of (thinning) hair. And as far as I can tell, my genitalia's still functioning normally.

So, being 30 isn't as bad as I had feared (so long as I don't wake up tomorrow morning bald with my male appendage dead and wilted on the hardwood floor beside the bed).

This has been a swell birthday. I got a ton of birthday wishes via SMS, emails, voicemail (thank you all so much)(if you haven't, it's still not too late). From dear friends who miss me so much, the messages retrieved from my voicemail:

"Oii cibai. Where the hell are you? Calling to wish you happy birthday lar!"

"Fucker. Happy birthday!"

"Where the shit are you? So difficult to reach. Cheh..."

I feel so loved.

Got a beautiful gift basket from dear old sis, in collaboration with mom and dad. She even paid for it using MY credit card. Bwahaha. Okay, in all honesty, this was after her card was rejected because it was foreign-issued. She promises to pay me back. It's the thought that counts dear sis!

And then, aside from the wonderful surprise from Kris, she got me my dream car!!! A Honda S2000! The poor dear went around looking for a white S2000 but couldn't find one. But this colour suits me fine.

But seriously. I thought about this last night as I had dinner with friends. How one truly feels blessed, to be surrounded by dear, dear friends and loves ones. To have a wonderful family even if they're far away. Because, compared to this, all the riches in the world mean nothing.

Thinking about what I've accomplished in my 30 years, I feel lucky too being here. How a tubby homesick kid from a small town in Malaysia ended up in this hospital is beyond comprehension. I think luck, fate and the powers that be, have more to do with it than me. While I feel privileged and honored, I remind myself that I can't take credit for it. I recall that famous line.

If I have seen farther than others, it is because I have stood on the shoulders of giants

And the giants who carried me this far, carry me still. My family who believed I could always reach higher than what I thought. My dear friends, old and new, near and far, who molded and shaped me into the person I am. And, the person fast becoming my primary source of energy, my dear Kris.

Thanks all, for a wonderful birthday.

Choppers!

What a surprise! Like every other 30 year old boy I know, I'm fascinated by things that fly. Being here, more so the medical airlift helicopters that come and go. I've drooled over the flightsuits that my emergency medicine colleagues get to wear, and the fact that they get to fly in 3 of our choppers. I've never personally had the chance to go up to the helipad though. The most fun thing I get to do is stick needles into patients' necks.

So, as a birthday surprise, Kris made quite a few calls and planned something for me. Only I didn't know what she was up to.

"Make sure you be able to go at a moment's notice."

Go? Go where? And so today we went. As she took me towards the hospital, I had no idea what she had in mind; I thought it was going to be some boring personalized historical tour or something. Until I looked up and saw one of our choppers. And realized it was that! Got a 45-minute personalized tour of the helipad, choppers. I was like a 5 year old kid at the toystore.

Boy, was I thrilled. The timing couldn't have been better; one chopper landed while another took off while we were there. Took a ton of pictures although a dead battery almost killed things. But the flight nurse was kind enough to give me some of theirs.

Suddenly, my job didn't seem all that interesting anymore.

A Wedding

Ushered at a friend's wedding today. JC and CC. Beautiful couple, some good friends. It was a beautiful day for a wedding. We had the ceremony in this quaint historic church an hour away. All the while, I was trying to not trip on the carpet and fall (I did not), or step on the toes of any of the ladies I ushered up to their seats (I did, just once)

It was funny how the bride's mother had an interest in setting me up with some pretty little Chinese girl because she thought I was this single Cantonese-speaking doctor (no one else at the reception spoke to her in Chinese). In fact, a year ago she asked CC for my picture so that she could circulate to her friends with single daughters. So I complied, and sent her a picture of a chimp in drag carrying a microphone (I kid you not). Luckily when I met the bride's mother this time, she didn't say anything about that picture.

But, no. Although I probably DO sometimes look like a chimp in drag, I've found someone without CC's mother's help, thank you very much.

The reception was held in the hall of the conservatory at a nearby park. Surrounded by the lush greenery, two reflecting pools with water lillies. It was gorgeous.

Kris found out that I don't dance. In fact, most guys I know would rather have a nail driven through their toe just to get out of dancing. Dancing for many guys, really, is just killing time before you take your date home to ahem, bed them.

"Honey, when can we leave and go home to, uh, make out?"

And then, there are guys who dance those early 80's breakdance moves. The ones whose dates leave early. But naturally, at every party, there's always the guy who likes dancing, and dances well. He knows how to twirl and spin the girls, and in the process, makes them look good dancing. Those are the guys you'd love to hate.

Me, when I do dance, I dance like an ataxic elephant with 3 peg legs and an eye patch in the throes of a seizure. But I suppose, with some alcohol, anyone can be like Travolta. But maybe I had a little too much to drink, no?

The Price of Health

Today, I played the role of a social worker.

This is one thing I dislike about playing doctor: Money.

Medications, and the service of medicine, ain't cheap. And when you put that together with a patient who is financially desperate, makes for a difficult, sometimes heart-wrenching situation. You learn about the best way to treat a disease in medical school and residency, but they don't teach you how to treat a patient who can't pay.

True, some pharmaceuticals have drug-assistance programs to help these patients, but these things don't always work. Case in mind, this one patient with a macroprolactinoma who for the last one year has been receiving free medications after they accepted my explanations for medical necessity. But for some reason, when it came time for a renewal, I was told by the hotline rep today that things were 'on backorder' and may take months to arrive. How long, he couldn't say. But strangely enough, he suggested that while they didn't have any to give to my patient now, my patient could try purchasing it from a pharmacy. So it was phonecalls to the drug company, to the patient, then drug company, then our social services, then their local doctors, and then dictating another letter of medical necessity to the drug company for the patient.

What IS the price of health? Would I be willing to pay $800 for 6 weeks worth of medications, or risk having that tumor in my head grow and potentially make me lose my vision, or make my nipples discharge milk?

Or, as we so often see in the hospital, would I be willing to bankrupt my family for a surgery that may prolong life only for 5 years or so? Or save the eyesight in my one good eye? Would I wish for my family to spend $200,000 on my hospital bill if I were to be admitted for sepsis in the context of terminal cancer?

After all, being doctors we aren't usually called to deal with these things. We just order the tests, often unbelievably expensive ones, or give them the prescriptions, or bill them for our time (admittedly, I've been guilty of billing less than I can if the patients are financially challenged). Often we don't think twice when we so conveniently click 'Sella MRI' on the computerised order form. It just takes me 3 mouseclicks.

When they run into problems with money, we're often not the ones they talk to. It's usually the nurses or the social workers or pastors.

Sometimes, it makes me feel guilty to think that I've committed a patient to an expensive medication or procedure. Because, after all, maybe he can live with that tumor. Maybe it's not worth the money. Maybe we could cut corners and do that MRI every 2 years instead of every 1. Because for some patients, the money makes a big difference. Something I see frequently at the local Free Clinic; patients not checking their blood sugars as suggested in an attempt to make the glucometer strips last longer, or taking half the recommended pills to stretch things. No such things as X-rays, or MRIs, even comprehensive blood tests. You just have to make do with what you can. Because, God knows the patients can't pay for it.

Not optimal care, but such is the harsh reality for these patients. Because if I were in their shoes, between a single MRI scan of my head that means mumbo-jumbo to everyone except my doctors, and being able to pay for my daughter's school textbooks, the choice is clear.

I hope that patient gets his cabergoline soon.

Boys Boys and Girls with too much time

Question: What do you get when you mix Coke, Mentos, one cardiac nurse, an endocrinologist, a neurologist, a nephrologist and 3 oncologists?

This weekend has been swell. Good friends, old and new, good food, good weather, a barbeque with a bottle-full of lighter fluid and limitless supply of booze. Recipe for a 3-alarm fire. Kinda like Charlton Heston in The Towering Inferno. You wouldn't think that we were a bunch of 30-or-so year old physicians and other professionals. One year, Nick zinged part of his eyebrows. This year, there was this loud whoosh and a mushroom cloud when TS lit the pit.

And then, someone told us of this urban legend about Coke and Mentos. And that's when trouble started.

Answer: Click below to find out.

P/S: Isn't Smirnoff vodka supposed to be flammable if you spit it onto an open fire?

The difference between brothers and sisters

Scenario 1: Brother upset
A: (Telephone call) Oi. Cheer up lar. Not the end of the world. Other fish in the sea.
B: Hmm. Oklar.
Price: $0.13

Scenario 2: Sister upset
A: Woi. Cheer up lar.
B: How?? How to study. Waahhhh I wanna go home. Sob sob sob.
A: Don't lar. It's ok.
B: No it's not ok. Why did I decide to study medicine? Wahhh. Sob sob sob. Wanna go home.
A:
A bouquet of flowers and balloons later...
B:
Price: $55

Happy National Day!

Happy National Day.
Wait, you say. Wrong date. Nope. Apparently I'm now an honorary Singaporean.
We had a Red-White party today to celebrate Singapore's National Day, the day they seceded from Malaysia and subsequently accomplished so much that it makes us look bad (just kidding, folks!).
Anyway. Kris was even motivated enough to look up Singapore on Google, and made cookies with the country's flag.

It was great. You can alway tell that it's gonna be a swell party when the cops show up 10 minutes into the party starting.

No kidding. She's a real cop. And those are real handcuffs. Just check out her yellow Tazer. And no, we didn't bribe her. We're Singaporeans, remember?

(I'm not gonna say why she came. We'll see how creative your imaginations can be. My only hint: No, it did not involve gerbils)

So, Nick started emailing me in Malay. I thought it would be interesting to reply in like, to see how well I could still write in that language, seeing that I've been gone 8 years now.
What I meant to say:

Dear friends,
Nick and H are thinking about coming over this weekend. If they do come, we could do a BBQ. LP, is your wife here yet? It's been a while since we last saw her. Also, you have yet to meet Kristin yet, no? Moreover, this weekend your cousin TS's girlfriend will be flying in, so we could have a nice gathering.
Nick, if you and H come, you can crash at my place. LP and CW too. Don't worry about space. At the worst, we can crash at Kristin's place; she's got a nice apartment. Or, the boys can sleep in the bathroom. Let me know if you're coming.

P/s: My Malay's f*cking rusty, need to practice!

What I came up with:

Rakan-rakan sekalian.
Nick dan H sekalang sedang fikir mahu mari hari Sabtu dan Ahad. Kalau mereka mari, boleh buat barbeque lar. LP, lu punya wanita, oops, isteri sudah datang ke Amerika tak? Sudah lama tak nampak. Lu pun belum jumpa saya punya teman Kristin kan? Lagipun, minggu ini lu punya bodoh saudara TS punya teman wanita akan datang juga. Jadi boleh mengadakan jamuan lar.
Nick, kalau lu dan H datang, boleh tumpang kat kami punya rumah. LP dan CW juga. Ada tempat tidur lar, tak perlu bimbang. Kalau tak cukup, boleh tumpang juga kat Kristin punya apartment, banyak besar and cantek. Atau, kami jantan boleh tidur dalam tandas.
Beritahu kami lar, kalau datang atau tidak.

P/S: Bahasa sudah puki-karat, mesti latih!

My BM teacher Puan Noraini would have been so proud.

10 signs you're getting old

1. Between sex and sleep, you pick sleep
2. Your food groups are Fiber, Low-Cholesterol and Low-Salt
3. You no longer laugh at your friends taking Viagra
4. All your sentences begin with "When I was your age..."
5. You grew up on Atari & Betamax, while Ipods scare you
6. You feel like a pedophile for oogling at that 21-year old supermodel
7. You spend 15 minutes stretching for a 10 minute workout
8. You start worrying about karma and the afterlife
9. Peeing takes you 3 minutes
10. The local boyscouts use your eyeglasses to start campfires
11. You have more hair at the buttcrack than at your scalp
12. You can't count anymore

I admit, I'm scared shitless.
In a way, it's surreal. In a bad way, that is. Almost like that feeling of disbelief that you're in the police lock-up for mooning your hairy ass at the President.
Yes, I turn 3-0 in less than 20 days.
Shit. Thirty years old.
In the larger scheme of things, 30 isn't old. And I'm doing pretty well health-wise and profesionally for someone my age. But farkdammit (phrase stolen from Piffles), I can no longer say I'm "in my twenties." At one time in my life, it seemed like all the babes (Ms. Malaysia, actresses, models etc) were older than me, in their mid 20's. Suddenly, they're all much younger, and you almost feel like a dirty old man drooling at the likes Amber Chia (I swear I have no Michael Jackson tendencies).
I'm no longer a 'young man'. Far from my sexual peak (they say everything goes downhill after 18). Can no longer pass off as a student for discounts on stuff.

Doesn't help when your dad and late grand-dad had as much hair as Yoda. I used to tease him about using wax & polish for his head instead of hair gel (sorry, dad!). I suspect I'm headed down that path too.
Wearing an earring when you're 20 is cool. Wearing on when you're older makes you look like you're going through your midlife crisis. Especially when your plates proudly proclaim Sugarboy.
And now, they no longer check my ID for age when I buy booze. Had dinner with Kris at this Italian restaurant a few weeks ago. The idiot waiter asked her for her ID, and casually ignored me. I gave him such a look that if looks could kill he'd be 6 feet underground and rotting in 10 seconds. I glared at him so intensely that he did ask to see mine at the end. That's my Superman laservision for you.
I suppose there are perks to being older too. I can walk into a car dealership and say I wanted to testdrive their S2000, and people wouldn't look at me like I couldn't afford it. I could chat with older people like they're my friends. I have more credibility with my patients; for the longest time they saw me as a medical student because they thought I was 21. Your woman feels safe with you (falsely so). And, seeing how many Malaysian men in their 30's have beer bellies and are out of shape, all you need is to have minimal amounts of muscle and you'd stand out amongst the crowd.

(Yea, cheap thrill. This self consolation isn't working).

As someone once said: Growing old is mandatory. Growing up is optional. Now excuse me while load up Halo 2 on my Xbox.

Back to the Dark Ages

Just try to ban me.

I dare you.

Brought to you by yet another harebrained idea of a soon-to-be police nation.

After all, what else haven't we banned? We're becoming less and less of a nation (despite trying to fool ourselves into thinking we're a 'towering society'). Let's see. We've banned:

• Certain unsuitable names
• Suicide, kissing and some hugging scenes from films
• Movies (Daredevil, Austin Powers, Zoolander, Bruce Almighty)
• Plays (Election Day)
• Black metal music
• Even cartoons (Prince of Egypt)
• Late night karaoke
• Even tried to ban late night mamak
• Botox
• Certain kinds of clothes
• TV ads (not enough local content)
• Hugging in public
• Holding hands

And now they want to police blogs? For cryin' out loud. A blog is simply a 'web log'. Nothing more. I doubt my patients come her for medical advice. It is not meant to be a credible source of news. Some use it as an online diary, some to display their creative writing, while others to share information. The very nature of blogs makes it less than reliable when it comes to facts, and our leaders should know it before they waste their resources on a witch hunt like this. Will my kid sister be arrested if she blogs about how she dislikes her headmaster?

To ban my blog because it may "compel the public to lose faith in the nation's economic policies" borders on communism . If I, as a Malaysian citizen, have doubts in my country's economic policies because of its biased, corrupt or discriminatory practices, it is within my right, my freedom of speech, to say so. The impetus then, would be on the government's part, to prove me wrong by showing us otherwise. Not to ban those who voice real concerns.
Otherwise, we would be no different from China during the era of Chairman Mao, when everyone had to sing only praises of the party.

Wawasan 2020? Wake up; not at this rate. Precisely why other countries are advancing at such an astronomical rate, while we just sit in the dark room trying to convince ourselves how much we 'tower' over others.