THE END

I cannot conjure any more emotions from inside me to continue writing in this blog.

Too many memories lingering around it dating from its early conception, that evokes a mixed emotions of happiness and sadness.

The only right thing to do now is to lay it to rest.

Thank you to all of you fine people who have given valuable feedbacks and advices throughout my good and dark times. From the bottom of my heart, I truly appreciate it.

Final words,

Not everything is meant to have a happy ending.

Especially a fairytale of a beautiful princess, a green smelly ogre and a pink panda.

THE END

3/1/09 - 12/12/10

****

A Good bye

Chasing Pavements is the first song she ever gave me, that was 2 years ago. She asked me what I thought it meant. My reply was hasty and all wrong in retrospective. I told her it is a love song. Perhaps because it reflected on how I felt. I was infatuated head over feet.

Tonight after browsing wikipedia, I finally knew what the song really meant and the storyline behind the video clip. Interesting I thought.

During the long night drive back from my hometown tonight. I heard again Chasing Pavements along with other songs that we shared during the first year of our friendship.

It made me realise about something.

I realise that I am still missing that special person I once knew.

Once upon a time, she inspired a lot of things in me. How her smile made my day and made me through any given weekdays. That includes creating this new blog, which at that time symbolised a new chapter in my journey. Those were the best times of my life.

Although she is still around. But deep inside I know she is no longer the same person I met at the bus stop in Baker Street. Her eyes have stop gleaming the way they used to when we first met.

Tonight, I finally realise that I haven't got the chance to grieve when she left.

I felt the need to express some kind of farewell to that special person here in my thought, in this special place.

The final closure.

It ends just like the way it began. With the very same beautiful song.

It sounds just as mesmerising as the first time I heard it.

Goodbye my sunshine.

As if you have a choice

I have been a thinking a lot lately.

Including closing this blog for good.

It has a fine and fair share of my life these past 2 years.

What it needs now is a closure.

I bet everyone needs that.

In the end

The past is there for a reason.

Don't look back at it in anger.

Treasure the past as it has made you the person you are today.

As everything happens for a reason.

Experience is what you get, if you did not get what you want.

Remember, God has better things for you.

Always have faith in Him.

My eyes are wide open.

My lips are partly open.

As I inhaled deeply.

I feel peace with myself.

It is the best feeling in this whole wide world.

I am no longer worry about the future.

The sum of your life

I've been thinking. Tomorrow it will be twenty-eight years to the day that I've been in the service, twenty-eight years in peace and war. I don't suppose I've been at home more than ten months in all that time. Still, it's been a good life. I loved India. I wouldn't have had it any other way. But there are times when suddenly you realize you're nearer the end than the beginning...

... And you wonder, you ask yourself, what the sum total of your life represents. What difference your being there at any time made to anything.

I don't know whether that kind of thinking's very healthy, but I must admit I've had some thoughts on those lines from time to time.

-- Col. Nicholson

The Bridge on the River Kwai

****

That classic movie scene has made me thinking...

Have my existence in this world bring any positive difference to the lives of people around me?

Have I been a good man?

I'm in love (again)

I love Monday morning.

The smell of freshly brewed black coffee at the nurses counter.

The yelling and shouting of few delirious elderly patients with pneumonia.

The sight of new drug overdosed young patients with charcoal-stained ryles tube stucked up their nose and hanged near the greater curvature of their stomach.

The chaotic scene of running housemen taking up blood and filling in radiology forms.

The nebulous yet sweet scent of ulcerating diabetic foot ulcers from bed 1 to the unmistakable malaenic odour in the last bed at the end of the ward.

How can one not love Monday!

3am... somewhere in KL

BEEP ! BEEP ! BEEP !

What aa... what's dat?

Silent.

Darkness.

BEEP! BEEP! That sound again....
whadda .. where am I .... oh it's the damn pager

I stared at the screen ... #3652

Reaching in the dark I almost knocked the phone over. Bugger.

"Yaa, who's thiiiss..? " My half asleep voice was hoarse due to a gallon of Malibu dream earlier.

"Hey u gotta come to ER stat! I got a guy here who drowned himself by drinking too much water, and i can't intubate him " a desperate female voice echoed on the other line.

I recognized the voice, it belongs to Linda, one of my close buddy in the emergency room whom I got a short fling with many years ago. Sounds like she got herself in a shitty position, and unless u're in an ER's toilet, that's never a good thing.

"Gimme 2 sec, I'll be there, remember whatever u do make sure u can ventilate him" I reminded her what she already knew.

A 300m dashed to the ER at 3am is never recognised as an extreme sport, but 2 shakes of a lamb's tail later I arrived at the crime scene and only to find it as bloody as hell.

"The tube just won't go in" Linda's voice shaken, I sensed the agony and frustration reflected in her light brown eyes.

BP 75/40....Pulse rate 30/min ! - someone yelled in the background.

"Start chest compression. 1 mg adrenaline & 1 mg atropine IV bolus" my voice widely awaken now while positioning myself near the patient's head relieving Linda.

I snapped the laryngoscope's blade open and shoved it down into the man's throat, hunting for his vocal cord - but the view was obscured by his own frothy tracheal secretion.

"Suctionnn pleasse"

PSSRRRRFTTTTTTT !!! The yonker suction made a screaming noise while suctioning a 1/4 litre of secretion resulting in a clear view of Mr Vocal cord.

Thank God it's a Cormack Lehane I and with a bit of magic from cricoid pressure that Linda gave.. steady steady... my right hand maneuvered the ETT tube and gently tuck it home beyond the cord.

"He's in V. tachy... no pulse" She yellled.

I grabbed the defib paddle, charged it to 200 Joule... "CHARGEED! CLEAR !"

*ZAPPPPP!!!* -- no response --

CPR continued with multiple boluses of adrenaline.

"He's in V. Fib".

"CHARGED! CLEAR !"

-- no response --

"Agaiin!" No movement.

Flatline.

It's been over an hour since we started work on him. His pupils were fixed and dilated, no spontaneous breathing, BP was unrecordable.

Pulseless.

We decided to call it.

"Time of death 0414"

Linda broke the bad news to the family.
Silent. Followed by anguished cries from his loved ones.

Apparently, this 30y old guy overdosed himself with illegal drugs 3 weeks ago resulted in liver and kidney failure. He was treated for 2 weeks and was discharged well a couple of days ago.

However, despite advice from his doc he overloaded himself with water up to a point where his recuperating kidneys can't take it anymore and he went into acute pulmonary oedema (wet lungs) as if he had jumped into a river and drowned himself. For some reasons, he was determined to end his life.

Appparently, the first attempt was not a cry for help after all.

I went back to my on call room to sleep off any residual morning I had left.

Moments passed.

BEEP ! BEEP! BEEP !

Resuscitated

I have always believe that prioritizing my personal life over career would be the most logical step in pursuing the absolute happiness.

After all what is the point of having a successful career without a companion,

the love of your life whom could also be your best friend & yeah you name it...

the whole enchilada.

It has always been about the pursuit of winning the girl of my dream.

Reality finally hits home... hard.

Think I gonna give my career another second shot.

After all it is the only thing I have left in this world.

Destination anywhere

As I laid on my back staring at the beach.

One thing came to my mind.

It has been a

Statistics

If you don't want to be part of a statistic, avoid 3 things:

1. Divorce

2. Smoking

3. Speeding

Food for thoughts.

Go figure.

To be the best in what you do

The seminar on hypertension last night made an impact on my grey matter.

Seeing a German professor who'd travelled across the continents to share his opinions with us opened up my eyes on certain aspect of this life.

How do we become the best in what we do for living?

My take on this...

First, we need to identify what is IMPORTANT in our life.

Then we need an 'end result model' that shows us exactly what it looks like once we are there.

By God, we need to be inspired.

I've always considered myself as a family man, and should put priority on my family matters over my job.

A family of my own?

What am I talking about.

Come to think of it, I don't even have a sweetheart.

Then it came to me like a clear blue sky.

The only LOGICAL thing to do now is first to sort out my career, before everything else.

Before I even start a family of my own.

Overwhelmed

I'm tired these days.

Too much work at the hospital.

Patients... many of them with chronic illness.

People dying everyday.

Chapter 3: The next level

Beneath the fabric of human behavior. You will come across variety of colors...

...Ah bollocks!

Lately I have been writing the same stuff over & over again

It's time to move on.

It is time to dance!

Beating

I sat quietly in a hidden corner with a wide view of people walking in & out of Ikea. The tall hot mocha with no cream lingered on my taste bud refused to be swallowed as a whole down my dry throat.

60% of them came with their families and kids.

30% were with their significant others, like lovers, you know the type.

9% in groups of friends.

1% was sitting quietly in a hidden corner sipping his tall hot mocha with no cream.

Is my heart still beating?

It is hard to tell as I last saw it hanging in my living room earlier.

View from the top

I have a confession.

I'm beginning to lose faith in this so-called modern society.

In which some of the 'bizarre' ways of human-relationship have become an acceptable social norm.

Where people are judged better by the things they own or if they look in certain ways, or behave in certain 'manners'.

I have also become more skeptical on the institution of marriage. Although it is a Sunnah Nabi. But its values & qualities have deteriorated markedly in these last few years. The steep rise in divorce rate in Klang Valley is scary. Being married does not mean anything to everyone, anymore. There is nothing left out there that can protect its sanctity. Dishonesty in relationships are everywhere.

It brings me to one final conclusion.

People lie, hence as a general rule they cannot be trusted.

The only thing that matters in the end is not what was spoken, but the actions that follows.

Revisiting Zihuatanejo

At some point of your life, you would wish for a place where you do not leave any footsteps behind. Hoping to avoid that resonance of echoes that reminds you of the void inside, which you are going to carry with you once you leave your heart at the door.

I am looking for my Zihuatanejo.

****

Andy Dufresne: When you get out from this prison, I want you to go to a place called Zihuatanejo. You'll have to cross the Mexican border.

Red: What's down there?

Andy Dufresne: You'll see. You know what the Mexicans say about the Pacific?

Red: No.

Andy Dufresne: They say it has no memory. That's where I want to live the rest of my life. A warm place with no memory. Zihuatanejo.

Addendum

It's been a cold morning.

As I'm sitting alone in the MO room.

Waiting for this silence to break.

Waiting for that on-call phone to goes off.

Back to square one.

Back to reality.

It's too quiet.

I'm beginning to like it, that it scares me a bit.

Eyes wide open

It is now no longer matter to me as I have seen and heard enough to know the truth.

I knew a painter named Picasso who told me he was once approached by an intelligent lady with a face of an angel whom wanted to buy one of his drawing which was a portrait of a man. The piece was not that expensive but it has certain sentimental value to him.

Then as she took out the money out of her purse, she said:

"Hmm the man in the painting is all right, but he isn't tall enough, the thighs are too small, he has rather a small face and definitely not as good looking as the men in other paintings I have in my collection."

"Gosh how did you reply?" I got curious.

"It was easy, I splashed black paint over the drawing and told the lady ~ don't worry about it, it is now no longer for sale"

He chuckled.

Things you can do without

For you ladies out there.

Have you ever got caught up in a state?

I am sure you have.

Awful isn't.

For example, you got all dressed up for some event.

Went there with your male best friend.

Then out of no where he commented that his mate's girlfriend is waaay better looking than you.

Thought that he was just teasing you, you asked him back.

To which he confirmed that he is not kidding.

But you did not deny what he said.

Coz deep down you know that is the truth anyway.

Everybody at the table knew that.

The world knows that.

That's not the point of this story.

What bugs you is that why on God's earth he needs to remind you of that.

Okay let's talk about something more important & substantial in this life.

Hmm like how to prognosticate a man with an unstable angina using the TIMI score.

Future

Couple of things are in my mind.

It all began with the hunt for a place that I could call home. This is not something that we do everyday or on a regular basis. So this would be my latest obsession for the few weeks or so.

This will certainly changes things as I know it. The next 30 years of this life course will definitely take a whole new level of direction.

Shall I pack my bag and return back to live nearby my parents? Bought a house there and work for a teaching university hospital somewhere in the east coast. Have a family of my own there, grow a farm with a dozen of cows and goats.

Or shall I just stay put in Klang Valley, which means I might as well grab that condo and live happily overlooking the hills at sunset (presence of a female companion is optional).

... with a cup of hot milo of course!

The night of the living scrubs

8pm Resus room:

A newly-wed young lady with dysuria. Jari di inai masih merah. All radiant but dehydrated with hypotensive, her urine looks dirty. Looks like another case of a honeymoon cystitis. Treatment: A good dose of antibiotics and... err take it easy ma'am and yes you too sir.

1am Private wing:

A VIP with an elective admission had a sudden surge in BP. There is nothing that a 'genuine' smile and an amlodipine 10mg od cannot fix.

4am Dengue Haemorrhagic Fever:

A 40 year old housewife, flushed out, abdominal distention, bibasal lungs crepitation fortunately no postural hypotension and good capillary refill. Gave her a 1 pint of dream over 1 hour and that bring the Haematocrit down nice and easy.

5am:

Kroooohhhh.... krooohhh krooohhhhh (apnoea) cough cough... wroooohhhhh wroooohhh

Chill before use

Modern medicine does not have the cure to all diseases under the sun. Where mainstream medicine fails or does not work, we will admit it.

I have great respect for complimentary or traditional method of healing. Acupuncture is one them.

My concern lies with traditional drugs which do not go thorough scientific research and stringent regulation in checking their safety for mass consumption. Some of the active ingredients have incredibly high dose it could cause renal failure. One of my nurse developed heart failure secondary from taking traditional weight loss pill.

In contrast, any mainstream drugs that is reported to have 'safety concern' will be recalled even after it has been released to the public.

Having said that a lot of modern drugs are extracted from plants, and they are wonderful! For example, an oral anti-diabetic drug called metformin is extracted from a plant called Galega officinalis.

PS: I got no hidden agenda nor that I have any shares or benefit from any sales of the so called modern drugs. My only interest is your health.

Traditional mistake

Everyone must refrain from taking traditional medication. Most of them contain 'steroid-based' ingredient, which although in short term can make you feel 'healthy' but it also can surpress your own natural steroid (mineralcorticoid) production by the adrenal glands (those little glands sitting on top of your kidneys).

Once you shut down your own steroid supply, your body would not be able to cope at times of stress (infection, inflammation etc).

I have seen many of these patients admitted in 'collapsed' state. Low blood pressure, lethargy or even unresponsive and death.

Come on, don't you think it's ridiculous that the so called ' one traditional' pill can cure everything under the sun.. from lesu, buasir, sakit jantung to mengetatkan apa-apa yang dah longgar.

Chapter 2: Relationship

The momentum in a relationship between two lovers is not really about chemistry...

...it is mostly biology and physics.

Chapter 1: The wrong blog

A man once told me...

that the worst nightmare for a man could have would be nothing other than 'falling in love with another man's woman'...

... to want something that he couldn't ever possibly have. But he could try and win her if he must. He could apply the concept of "All is fair in love and war" -- Francis Edward Smedley (1818 - 1864).

If you expect me to agree with him,

you are reading the wrong blog.

Defeat

Lesson was not well taken, unfortunately for me.

There will be times in a man's life when he arrives at a junction that warrants him to make that decision to either fight for what he thinks is right, or to give up.

"I decided to give up.

I resign.

I resign from everything."

Door

God works in a mysterious and yet full of surprises.

When he closes one door for you.

He will open another.

He wants to teach us the lesson of never giving up.

A doctor's heart

"A 35 year old doctor had a heart attack, right.

His heart stopped, before they revived him back.

Now was he unlucky to have wasted 1 year out in rehab.

Or is he lucky to have had that rare opportunity...

... to sort out who is important in his life."

Everything else is not important

Rule 1: Treat people like how you would like to be treated.

Rule 2: Look at rule 1.

Rusty

Sometimes all we need is a little change in perspective. In the presence of a new company it could change the way you perceive how much your life has changed in the last year or so.

Last night I had the pleasure of being reminded on how crap I was after nearly 15 year-hiatus from the table. My moves were pretty rusty but to my surprise not thaaat bad that I managed to beat an opponent 6 years younger.

Let's talk about a giant leap of faith.

Anyone knows where we can do sky-jumping in Malaysia?

The cancer who stole Aidilfitri

I went inside the ward and negotiated my steps along the corridor. My peripheral vision caught the sight of a nurse who called me in less than 4 minutes ago. I could sense the sadness engulfing the place.

I knocked the door and entered the dimly lit room. There was a man lying on the bed with a woman sitting beside him.

"He just died a while ago" Sarah, my medical officer whispered to me.

I looked at his medical notes.

"33 years old. Pancreatic cancer"

(for a brief moment, Randy came to mind)

He was about my age, I thought.

As I walked away, I noticed a familiar-looking old man on TV had just finished making the Raya announcement.

Homebound

It it that time of the year where tiny folded papers are thrown onto the table.


I held my breath in suspence as my right hand reached out for my fate.


This is a vital process come every Aidilfitri.


Slowly... I unfolded the crumpled paper in front of me...... The four letter word caught my eyes...




As this off duty soldier on a ship homebound tomorrow.


Someone had to stay back and guard the fort.


SELAMAT HARI RAYA FOLKS !!

Fallen

For every great tragedy needs a fallen hero.

Funny, I thought.

Yes, at first I don't mind being that guy.

Samson and Achilles did it.

Their sacrifices were larger than life.

Mine would probably be a tiny little white dot at the back of an elephant's ass.

The trick to not caring too much, is to care less.

A beautiful crap.

I can't wait for puasa to be over.

The thought of sipping a venti cup of frappulicious strawberry coffee in Starbuck at 4pm with an airport book in my hand is so delightfully tempting.

On the other hand, I'm tired of being a side B. Time to stop the audio cassette.

It ain't a music if it is full of shit.

Dark sky

This morning I dreamt of standing in a balcony overlooking the city skycrapers with KLCC in sight.

The sky was dark.

A storm was approaching.

It scared me.

Out of no where, a massive giant tornado, easily a class 5, appeared in front of me.

My dream has no longer become a gentle solace.

The boy I knew

My patient died today at the tender age of 15 years old.

I didn't have the chance to say goodbye.

Deep inside I felt the tears were building up.

I could not cry.

I could not find an outlet to let out my anguish and frustration.

Randy Pausch. What I learned from him.

In the end.



... all of us will eventually leave this world. It is going to happen. Maybe an hour from now, or maybe in 5 years time.



More important than figuring out our 'expiry date', is how we are going to fill that count down moment in our lives until our time is up.



Is it too late to change who you are? To get what you want in life?



The answer to that is easy.



No, it is not too late. As long as you know who you want to become.
Not changing your look. Or changing your clothing fashion sense. Those are not important.



We are talking about SUBSTANTIAL matter here.



I have come to realize recently in identifying what is important in my life.



What do you want to do with your life?



List them up.



And do it.



Make it happen.



But don't wait too long. Because one day you may find out that you have lesser time than you think you have.


Thank you Randy.

The golden moment

It is that time of the year when we are all usually become sleepy by 3pm. Ecstatically happy at sunset. Bombarded periodically by acute post-prandial narcolepsy from then onward.

At 7.38pm - all the oncall fellah and some who are not on call - would gather around at the MO lounge equipped with the accoustic mode of singing bellies.

Lovely atmosphere. We share food and laughter.

This is much better than breaking fast at a 5 star hotel alone.

This is life at its best.

Home sweet home

A quiet on-call night like this is rare to find. It is like a pearl lost in the ocean for thousand of years waiting to be discovered by a lonely diver.

I'm longed for serenity.

I am home.

The way things are...

As the future slowly unfolded to me with every passing second, I find that the path is clearer than I could have ever envisioned it before.

Every relationship matures in its own unique way.
Not all romance should ended up as marriage.


Some relationship would be better off evolve into a long lasting friendship which in a way is a happily ever after ending too, considering the benefits it brings to both parties.


I learned that lesson the hard way.

But, it is a life-lesson that I wouldn't trade for anything.

Although the way things are right now, was not the way I wanted it to be.
But it is the way things should be.

It is the right way.

Stop being that hole (the one near perineum)

Dear Salvatore Ferragamo,

Do you know fungus? I know them very well. I deal with fungus on a daily basis. They sometime kill my patient (if the bacteria can't finish the job that is).

Although they can be beautiful in microscale. And in a different life they could end up as a cheesecake.

The ugly truth is budyy.... you are like a fungus.

You dump your girlfriend, because you can't change what you are.

A thing that you claim prevent you guys from being together.

Yet you linger around her. All charming. Phone calls. Show up at her house at 5 in the morning. Acting like her boyfriend. And you became jealous when she's with another guy.

To me, you are just like a little boy.

Immature and selfish.

My advice:

If you be cannot be with a girl for whatsoever reason.

And you and her cannot remain in any lesser than a romantic relationship AKA Just friends.

And you very well aware that she is so DEEPLY IN LOVE with you.

That she is weak enough that she cannot continue her life without your love.

Then my boy, do what is right.

Just be a man.

Just walk away and leave her alone.

Let her continue with her journey and peacefulness she deserves.

She has suffered for too long from your little mind-fuck game.

I can't bear seeing my friend in that state.

Salvatore,

I wish you would stop being that annoying 'unremovable' fungal at the back of a nasopharyngeal cancer patient's tonsil.

How I wish you are a candida.

So I could get you an Amphotericin for your birthday.

Owh well it's none of my business anyway (apart from that you're hurting my friend). But then again she seems to enjoy your warmth and presence still.

Well Good Luck.

I'm out.

Disclaimer:

This is a work of fiction (and yes Elvis is very much alive in Memphis, and pigs can fly).

... Plus, Salvatore can very well be Salvalingam.

Age of innocence

Lot of people talk about 'one day' concept. That one day they'll do this and that, go here and there. Empty talk just won't do it.

Just fucking do it. Oh yea don't say fuck, it's not good. Unless you really mean it.

Today is filled with a list of difficult cases which might be a relapse lymphoma, refractory myeloma and maybe just maybe (if I lucky enough) a case of sakit perut from an expired coca-cola. Damn fizzy.

As a result, I'm empowered by lot of negative energy today. Felt like I was going to explode into million of minuscule particles trapped inside a freaking hot jar colliding into each other - until I generate enough energy which will finally combust into a ball of fire.

Maybe one day. Who knows?

As for today.

I just gonna be me. Maybe I'll go back in time and be that 8 year old kid again. Stress free.

Whadaheck... playing "shoot 'em cowboy" with some schoolkids while stucked in a jam wasn't such a bad idea after all.

Relation-ship

Given time, everyone will change and show their true colours.

I think I've said this before.


But is it true that once we grow tired of that person, we will have lower threshold of losing our nerve and let out our anger on him/her? Rhetorical question.


A lot of men (and women of course) out there who appear calm and collected at their workplace and hold back all the work-related stress and frustation, only to let it out on their families at home.

Are we taking granted people we claim we care for?

To them it is SAFER to unleash all of those anger and negative emotions to their love ones, knowing well enough that they will never leave you. As oppose to let it out on your boss and risk of getting fired.

My take on this.
If we never scold a stranger over a trivial matter, on a basis of basic courtesy and respect for another human being.
Then we should never do the same to our friends & families.

After all these are the people who actually care about us.

Class of 2010

The new batch of medical students have just joined us for their clinical training. A TRANSITION where they start to use what they learn from books and apply it in the real life. They are young, vibrant people with innocent yet eager mind. They will kinda follow your ward round with 150% attention. The word 'Sorry doctor' comes out from their mouth every single minute when they think they've given you the wrong answer.

It could easily boost one's ego when you're surrounded by these students (Muaha ha evil laugh ha ha!!). It would certainly be wise to think carefully before you open your mouth, because they will jot down every single thing that you say into their little notebook.


I usually tell them to be polite, but never show that you are vulnerable or weak, and most important thing is to show that you are matured students (err even that one, they would write down... huh?!)

But as time passes by, these guys will eventually progress to the final year and with a blink of an eye, they graduate and become your peers...

... and of course start to lawan taukeh with you "in your face" kinda style.