Goodbye Song

this will be my last post from Song. will be transferring back to sibu tomorrow and will be starting my training in surgery.

i first started work in Song on July 3rd, 2010. and how time flew by. the past one year had been a real great experience. i did not regret one bit coming here. its one of the best decision i've made in life. i guess it pays to listen to your heart and let God lead you.

when i first came here, the people here were just my staff. soon we became friends. and now we depart as family. MA Ambrose, MA Edmund, MA Brooke, MA Saong, Chief Salin, Matron Alice, JM Winnie, Jm Margeret, Jaie, James, Usop, Harris, Nurul, Kujor, Merom, Lisa, Hafzan, Dr Wong etc....they all made my stay here a memorable one. im truly blessed to have crossed path with them in this life. without them and all my staff in KK Song, i wouldn't have achieved or done all that i've done here.

working here in Song made me realised why God wanted me to be a doctor. some people go though their whole life searching for the meaning of life and never finding it. im one of the lucky few who knew what my calling was, and was blessed enough to be living that calling in life.

now i journey on to the next phase of my life. i know somewhere in the future i would be entering politics. for the immediate future,  im not sure whats in store for me. neither do i know whether i will be good in surgery. im just gonna work hard and try to make a difference and let God handle the rest.

you never know....i might just come back to Song again

"We do not remember days. We remember moments."
Cesare Pavese

VHT to Sungai Iran

this simply has got to be one of my most tiring excursion ever. went for another VHT (village health team) trip and this time we were travelling along Sg. Iran. Sg Iran is slightly bigger and longer compared to Sg. Lijau. the furthest longhouse will take up to 2 days to reach.

My team (L-R) PPK James Senabong, PPK Merom, JM Jaleha, Me, JM Winnie. MA Ambrose taking the picture.

prior to our trip, it had been really hot and not a single drop one rain fell for more than 3 weeks. because of that the river water was really shallow. so for most of the journey, we had to drag our boat along the river bed. and the boat aint light. it weighs somewhere around 200+ kg, not including all our stuff. for every 1 minute that we sat on the boat, 5 minutes or more were spent pulling it. what would have normally took 45 minutes ended up taking 3 hours plus to reach.

Pulling (berpatak) our oversized longboat

this was the routine for the next 4 days. pulling our boat from one longhouse to another. we were physically drained. my staff told me they had never experienced such shallow waters before. how we could still see patients after that amazed me. we visited 7 longhouses and i saw a total of 115 patients. most were for NCD (non communicable disease) screening and hypertension follow up. thank god there weren't any serious or emergency cases for me to handle. wouldn't know how to transport the patient to Song with those water levels.

At Rumah Muchin. No electricity available, so had to use a portable lamp to work cause night was  approaching

in between those physical endeavours, we took breaks along the river bank to have our lunch. or we went into the jungle to look for wild vegetables or using nets to catch fishes in the river for our food. or when we are just too tired to move, we just soaked ourselves in the cold river water for some much needed rejuvenation.

Rumah Empali

all the longhouses that we visited do not have electric supply and rely solely on generator sets for electricity. they would have to make fortnightly or monthly trips to Song to get diesel/petrol for their generators. there was one pintu in a longhouse which ran out of diesel and they couldn't go to Song to get it cause of the shallow water. they are an old couple and their frail bodies just dont have the strength to drag their boat for hours end to Song. so they depend on the goodwills of their neighbours or just live in darkness. 

Soaking our aching muscles 

on the 2nd day, we could only reach up to Rh. Medan which was almost 4 hours from our last stop. my initial target was to reach all the way to Rh. Sari (the furthest longhouse along Sg. Iran) which took another full day to reach. but because of the water level and the size of our boat, i was advised to abandon that plan. as we journey further up river, the water level gets shallower and shallower. at that time, i didnt think anyone one of us would have been able to physically made it all the way Rh. Sari without collapsing midway.

Mobile clinic at Rh. Medan

by the time we reached Rh. Medan, which was the 2nd furthest longhouse (Rh. Sari was another 4 hours away), i was really hot, tired, hungry, itchy all over and irritated. i was thinking to myself, "why the hell must these people choose to stay in such a deeply remote area and make life difficult for everyone?"

Net fishing at Sungai Wei for dinner

so i put that question to one of the folks at the longhouse and she replied me with this, " Doktor, bukannya kami mau tinggal jauh-jauh macam ini. kalau ada pilihan, siapa tak mau tinggal kat pasar (iban word for town). Senang bah. semua pun ada. tapi kalau kami tinggal kat pasar, susah mau cari kerja. barang semua mahal.mana ada duit. mana ada tempat untuk tanam sayur. walaupun tempat kamik ini jauh, tapi tanah ini semua kamik punya. boleh tanam padi, tanam sayur, ternak ayam. boleh pergi hutan untuk memburu. boleh tangkap ikan dari sungai. ini semua tidak perlu duit. kamik orang miskin doktor. kalau tinggal kat pasar, memang tidak dapat hidup."

I aslo tried my hand at net fishing...caught myself instead.

at times like these i feel like a real arse. this just proved that despite being educated, people (in this case me) can still be very ignorant of the plight of others because we see the world only in our own dimension and logic. people sometimes find it very hard to open their minds and hearts to the views and plight of others. unless and until we undergo a paradigm shift in the way we think we will continue to be blinded by our own folly and discrimination. that day, i learnt an important lesson from that simple ulu woman.

Hiking to Rumah Melina along Sungai Wei....Ambrose and James not sure which part of the  river bank to  climb up.

on the final day, we visited Rh Melina. Rh Melina is situated along Sungai Wei which is a tributary of Sungai Iran. our boat was to big and heavy to travel through this river. so we had to hike along the river and the jungle for an hour to reach the longhouse. this hike was harder compared to the hike in Sg Lijau cause the under growth was much thicker and the river bank was very very slippery due to its soft  sandy soil. 

Rumah Melina

we did eventually reach Rh Melina in one piece. its just a small longhouse with probably 12 pintus. after we were done, the longhouse folks started to take out their tuak and ijok. needless to say, i got drunk. very drunk. seeing that i honoured him by getting drunk at his longhouse, the tuai rumah (head of the longhouse) volunteered to send us back to our boat using his smaller sampan. thank god for that. if i was to walked back, i dont think i would have survived to write this piece.

Me and the people at Rh. Melina....very intoxicated

Ngiling Bidai

At Rumah Jipon

had a very quiet gawai this year. i thought since i was in song i would be able to experience gawai celebration even more intensely cause song is situated in the interiors. horrors of horrors, instead of taking shots after shots of tuak and ijok, i was seeing patient after patient from 730am till 11pm even though it was a public holiday.

Ngiling Bidai

so i wrote off gawai 2011 as a disappointment. until i went to rumah jipon during my last VHT )village health team). apparently there is this celebration called "Ngiling Bidai" which is to celebrate the end of gawai. Ngiling bidai literally means "to roll over the matt" and it signifies a new beginning for everyone.  

They gave me this traditional head gear to wear

so happen that day the folks at Rh. Jipon were planning to have their "Ngiling Bidai" on the same day as our mobile clinic. there are 25 "pintu" or rooms at Rh. Jipon and we are supposed to drink at every pintu. and at each pintu we were suppose to fold over a mat. once you fold the mat, its customary for you to down a shot of tuak in addition to the tuak being served earlier at each pintu.

Smoking the local "cigar." pretty strong stuff

i was kind of the guest of honour for the event. so i was given the privilege to fold the mats. never in my life (or ever will again) have i folded so many mats. i think i folded something like 18 mats that night.

River snail for supper

so you can imagine how much i had to drink that night. fooo..... never had so much tuak in a single night before. surprisingly i did not get drunk. i was high but not drunk. it must be all the oily food that they served at each pintu.

Playing their traditional music

among the foods served are home made cookies, fried eggs, river snails, chicken soup, fried mee, cucumber soup etc. needless to say, i gobbled everything down....except for the snails. never could suck the damm thing out from the shell.

Ngajat

i also tried the local tobacco that one old guy was smoking. i must say, its as strong as some cigars i've smoked. if not stronger. because of its intense smell, the locals here use to smoke it to ward off insects while working in the field or jungle. 

At one of the pintu

once we've finished with all the pintus, it was time to sit down to enjoy some local music and dance. the folks started to dance their traditional dance called the "Ngajat." they tried to convince me to Mengyajat as well, but i rather focused on my drinking. god knows i cant dance even if my life depended on it. 

Good company = Great time

all in all it was another good experience. the sincere hospitality and friendliness of the people here never cease to amaze me. if only more were like them. really looking forward to next year's gawai.

Standard Chartered KL Marathon

Part of the 12000 people running the 10km

FINALLYYYY!!!! i did go for the Standard Chartered KL Marathon 2011 run. well, i didn't run the marathon la, just the 10.6km as planned. 2 weeks leading to the run had shin splints of both my legs. was worried i wasnt going to able to run cause i cant even run past 2km before a shearing burning pain develops on both my shin.

Runners running towards the finishing line

i made my way up to KL anyway and stayed at a crappy 3 star hotel. woke up at 430am and had half a chicken puff and 500ml of water. then i was off. took the monorail to Hang Tuah station and then hoped onto the LRT to Masjid Jamek. after that had to walk for around 20 minutes to Padang Merbok. many other runners were doing the same as well. by the time i reached there and after all the warm up i was all sweaty and smelly.....and so was 12,000 other runners.

At the finishing line

so imagine this.... 12,000 sweaty people all cramped up like sardine at the starting line. shoulder touching shoulder. then group stretching and warm up starts. and everyone was asked to stretch their arms by lifting their arms up...... CAN YOU IMAGINE THE SMELL??? i felt like i was in some damm ikan masin factory man. and you cant run away cause wherever you turn, there is a sweaty hairy armpit starring back at you. i swear to God some ppl probably fainted before the race started. never felt more relieved to hear the starter gun going off.

Post run ice treatment and massage 

there were a large number of lady runners at the event as well. some of them need to be told that there is something called a sports bra. so it was no surprise that during the run i noticed to my right: bouncing boobies. to the left: bouncing boobies. to the front: my bouncing tummy.

Cheer leaders 

worried about the pain at my shins acting up, i just decided to take it easy at the start and run at a slow pace. thankfully was able to run relatively pain free for most of the race. started picking up my pace only at the 8km mark. started feeling real tired at the 9km mark but once i saw the finish line, it was a 400m sprint to the finishing line. when i reach the finishing line, i almost puked twice. thank god nothing came out. that would have been a embarrassing sight.

It was a carnival like atmosphere at the runners' area after the race

my official finishing time was 1:11:08, ranking 607 out of the 4926 runners in the 10km Men open. was hoping to hit below the 1 hour mark. but considering that i hardly ran 2 weeks before the race its still ok la. i guess to improve my running time i need to loose more weight, pace myself better and improve my running technique. all can be achieved with more discipline and training.

Not something you want too see after a hard run

so next stop will be the Standard Chartered Singapore Marathon this 4th December 2011. i've already signed up for the half marathon with a few other friends. looking forward to the next challenge. 

VHT to Sungai Lijau

Just got back from a VHT (village health team) visit to Sungai Lijau. this was my first trip with the VHT team. there are 2 longhouses in the Sungai Lijau area, Rumah Jipun and Rumah Manja. Rumah Jipun is the furthest and it used to be a FDS (Flying Doctor Service) area but the FDS service to this area had been stopped  around 2 years ago for some reason.

Me and my team at the beginning of the hike. MA Abu taking the picture.

we took a perahu panjang from Song to Sungai Lijau. the journey took around 30-40 minutes. Sg Lijau is a very small river. we couldn't travel very far in via the river due to the low river water level. so we had to park our longboat by the river bank and hide our engine by the bushes and hope no one steals it. or else kantoi...

Hiking through a hilly terrain.

from there, we had had to hike through the jungle for 1 1/2 hours through a hilly well beaten path. thank god there was no thick under growth. the hike itself was not too difficult but if you are not physically fit it can be quite a challenge. i was told one of my JM had cried when she hiked to Rh. Jipon last time. there were certain areas where it was a bit scary. you will be walking exactly at the edge of the hill with the path no wider than half a meter. and the ground is made up of stones covered with moss making it very slippery. if you slip and fall, it will be a 30-40 foot drop into the river. i was a bit scared myself. i was carrying a knapsack at the back and at the front (look like a pregnant mother) and was unable to see clearly where i was putting my foot with each step. but it was great to hike in the jungle....shady sky, cool air, birds chirping, crossing multiple small streams.

Taking a break during the hike.

through the jungle and stream and suddenly out of no where, there stood Rh Jipon. the old longhouse was made of wood and was very dilapidated. the new one has been under construction for the past 2 years. construction has come to a halt due to financial difficulties (increasing petrol prices, inflation and what not). because of logistic and financial problems, the folks here make their own bricks and plywood using stone and sand from the river and trees from the jungle. the only thing they buy are cement, tiles and paint. and the only time when they can buy these things is after a heavy rain fall when the river water rises enough for the sampan and its cargo to go through. 

Rh. Jipon under construction

like many other longhouses in the interior, the younger generation has all left for bigger cities for better paying jobs, leaving behind the older generation and their grandchildren. they only come back during gawai. the folks here hunt and farm for a living. every morning at 4am, the old folks here hike through the jungle to sell their produce at the market in Song. if there was a medical emergency or if there is someone who is very ill, they would have to carry him/her through a make shift stretcher or give him a piggy back ride through the jungle to the river. and bear in mind, these are old people.   

Health screening for the longhouse folks.

saw around 30 plus patients in the longhouse. mostly are hypertension and complaints of body ache. also had a NCD (non communicable disease) screen and picked up 11 new cases of HPT. we had a makeshift clinic in the "ruai" of the longhouse. i will be seeing patients in the middle and we had maternal/child health on one side and the dispensary on another side. not used to seeing patients while sitting cross legged on the floor. had cramps after that hahaha... 

Make shift clinic. Thats me in the middle. The dispensary is on the left by the blue wall and the  MCH  SN on the right.

after work, it was time to relax. took a bath in the river with the rest of my male staff. it was nice and refreshing to bathe in the cold clean river water. at night we had "Ngiling Bidai" festival which was too marked the end of Gawai. will write about that in another post. 

Ulu Sungai Lijau. Crystal clear water.

next day we were off to Rumah Manja which was a 20 minutes hike from Rh. Jipon. Rh Manja is a smaller longhouse with even lesser occupants. didnt see many patients here, only 20. most of the younger people here working and staying in Song.  

Rumah Manja

no festivities here cause they just had someone who passed away and the entire longhouse is in mourning for 2 weeks. we were told too remove whatever chains, bracelets or ear rings or else we would be liable to a fine RM16 as stated in the "Buku Hukum Adat." to indicate that there that the longhouse is in mourning, they hang a white clothe with a tied bowl in the middle of the cloth and hang it at the entrance to the longhouse. 

Clinic at Rh Manja

the journey back was real tiring. it did not rain the night before we left. and the water level was low....very low. our longboat was stucked on the river bank. we had to carry and drag it out. after that we had to push the boat through the river in what the local call "berpatak." so it was "satu, dua...TARO!!! satu, dua TARO!!!..." it took us 10 minutes to reach from the river mouth to our location the day before. but it took an hour plus or so before we could reach the part of the river that was deep enough to use the engine. by the time we got backed to Song, we were all half dead. still it was a good experience. looking forward for the next VHT trip to another river. 

Quotes

"Freedom is not worth having if it does not include the freedom to make mistakes."

Mahatma Gandhi

Quotes

"The only thing necessary for the triumph of evil is for good men to do nothing."

Edmund Burke

Life and Immortality

had  a drowning case yesterday. she went back to her kampung in chemanong along ulu katibas for gawai. she was out swimming in the river with the rest of her family. suddenly her father realised she was missing. 10 minutes later, her dad found her at the bottom of the river bed.  

she was only 6.

even in death, she still looks like a sweet and cute little girl. that for her life to be taken at such a young innocent age would seem so tragic and unfair. one moment happily swimming with her loved ones. the next moment, gone forever. i can imagine how hard it must be for her parents and brothers to comprehend her death as they gathered around her crying. 

but then, God works in mysterious ways. 

her death reminded me of my very own immortality and the things that matter in my life. after all, i was swimming in the very same river only 2 weeks ago. your life can just be taken away from you at any time.  

kind of makes me more determined to live out my dreams. makes me more determined to appreciate and focus on the better things in my life rather than to be bogged down by nonsensical trivial matters.

God determines when you are born and when you die. in between, the choices in life are pretty much your very own to make. 

Football Final distraught

had always been a Mancherster United fan. i still remembered vividly that night when they won the champion's league final in 1999. i was watching it in my mom's room. it was the only room with Mega TV (bet you cant even remember what the hell that is). what a night. just when you thought all hope was gone and then the come back equaliser and that deep into injury time goal that won them the Big Ears for the first time in since 1968. i was screaming so loudly that my mom threw the tv controllers at me. 


i've missed the subsequent finals in 2008 and 2009 because i was on call on those days. so when  Man Utd qualified for the finals against barcelona for this year's edition i was bloody determined not to miss it. 


the morning of may 28th was spend stocking my fridge with beers and cabinet with keropok.  had my Man Utd jersey (the one when they won the treble) out and all ready. two 18,000 watt speakers (borrowed from the clinic) were installed  to my tv...if you cant go to Wembley, bring Wembley to you. i even skipped my jogging routine that day cause i didnt want to tire myself out for the 330am game.


so i was all set for the big finals. and then my phone rang at 8pm....with the "Bad Day" tune by Daniel Powter....which means my MA is looking for me. fucking cibai.... it had to happen. it had too...


40+ year old lady suddenly collapsed at a family function. GCS was only 7. so had to intubate her and i had to escort her to Sibu. 


but all is not lost....i had a sudden flash of genius (doesn't happen very often). i can still bring my Astro card with me and watch it at Sangeetha's place (where i usually bunk when im in Sibu). she has an Astro decoder at her place. i felt like a genius. crisis averted.


so there i went.....night cruise along the rejang river then followed by a spine breaking bumpy ride from kanowit to sibu hospital. by the time i had settled everything at sibu hospital, it was nearly 12am. 


rushed back to sangee's place all excited with my moment of genius. got into her house and....WHERE THE FUCK IS THE ASTRO DECODER!?!?!?!?!? well, maybe she kept it somewhere after cleaning the house (no harm being an optimist). so i called her.


me: sangee, where is the ASTRO decoder?
sangee: oh, ivy took it back to kl when she got transferred. 
me: WHAT!!!!
sangee: aiyah, dont worry. im getting it installed. they say will come next month.
me: NEXT MONTH!!!!!
sangee: yeah. dont worry.


this woman obviously doesn't know there is a final going that night. so i called john.


me: john, sleeping ah.
john: no dei.
me: you watching the game tonight? are you on call tmrw?
john: im on call tmrw but you can come over and watch the game if you want. what time isit?
me: 330am.
john: ahhhh...you come only la. can can....


so took a power nap. woke up at 300am and msg john. no reply. buggar must be still sleeping. didnt want to call and disturb him since he was on call after the game. so i resigned to watching the replay at 1pm. if cannot watch live at least the replay pun jadi la...


at 830 my good friend andrew tan messaged me. now andrew is a liverpool supporter. if he sms me at 830am on a sunday morning, it has to be something to do with the final. 


so i purposely ignored the sms and replied him, "did not read ur msg cause i haven't watch the fnal yet and i dont want to know the score. got emergency last night. planning to watch the replay at 1pm."


send....


there, now he knows and wont tell me anything bout the score. 2 minutes later i got a reply from him. i clicked on his msg and there it was written "barca 3, man utd 1."


........speechless........


when i go back to melaka in June, with God as my witness, someone is gonna get real hurt. 


SOMEONE.....

My time in Song....maybe its time to move on

At KK Tekalit with a Hypertensive patient

Just got back from another week long medical trip up Katibas river. This was my third and most likely last trip up there. I’ve already applied to be transferred back to Sibu hospital. Heard that it will go through somewhere in july or august. But knowing how bureaucratic JKNS (Jabatan Kesihatan Negeri Sarawak) can be, i won’t be surprise if im transferred later.

I’ve been here for 10 months now. I know I volunteered to come to Song in the first place but a big part of me tells me that my time here is up. My long term goal is to be a surgeon. I realised I’m not the type of doctor who can sit in a clinic the whole day. It bores me.

Another reason is that I feel I’ve done all i can do to improve the health care here. This place probably needs a new MO with new ideas and direction to make health care here better.  Remaining here would just mean I’m holding up in my comfort zone and I wouldn’t be able to progress anymore.

         Got caught in a tropical thunderstom on the way from Tekalit to Bangkit. No choice to continue in the rain. My yellow arse was freezing out there.                                                

When i was first transferred here, the clinic didn’t have much despite it being such a beautiful clinic. We have patients up river in the ulu areas that have not seen a doctor in their entire life. There was no X-ray or organism culture facility. No infusion pump, no CTG, no ARM stick. The MAs didn’t have a proper guideline on how to follow up on hypertensive and diabetic patients. There was a gross lacking of emergency drug. We had a 10 year old speedboat with an equally old engine which breaks down after a single emergency trip.

All these are vital for a clinic such as KK Song since we have no road access to any hospital.  If there was an emergency and we can’t transfer the patient due to engine boat failure or bad weather, all these instruments are necessary to make a diagnosis and keep the patient alive and stable until transfer to a hospital.

I remember a case where a patient collapsed in my clinic in the middle of the night. We had to start her on inotropic support to increase her blood pressure but we didn’t have any dopamine or dobutamine. All we had was adrenaline but we had no infusion pump to administer the drug. So we had to inject 5 ampules of adrenaline into a pint of normal saline and titrate it that way. It was a rather crude and unorthodox way to do things but what choice have i got. I just wanted to save her in any way possible.  Her BP and heart rate went up and down depending on the position of her hand and IV line. We wasted a lot of time as well looking for another speedboat because the clinic’s speedboat broke down again after transferring a patient few hours before that. We finally managed to get a speedboat from a logging company. Unfortunately, we didn’t manage to save her. She passed away at the wharf while we were about to transport her. 

Had a time of my life at the waterfall in Sungai Engkaroh, near Bangkit.

Now, we have most (I stress on the word MOST) of the instruments that we need, we are able to provide better health care to the people here. We have a new speedboat (albeit a very small one) with a new 80hp engine. The old boat has been send for a very much needed servicing in Sibu. We have yet to receive our Xray machine but my boss has confirmed with me that Song will be receiving it in the new future. Guess the new MO and people of Song will benefit from it.

We have also started on a 3 monthly mobile medical to Ulu Katibas specifically targeting poorly controlled hypertensive and diabetic patients who are financially poor and can’t come down to Song for follow up. We use the 4 Klinik Kesihatan (Tekalit, Bangkit, Engkuah and Chemanong) as a focal point for these patients to gather and see me. Patients with good BP and glucose control will be seen by the MAs.

In the first visit, i saw a total of 210 patients with 90% of them for poorly controlled blood pressure and diabetes. In my most recent visit, i saw only 135 patients with roughly around 85% for poorly controlled blood pressure and diabetes. The number of MO cases has reduced but MA cases still remain the same. That means just after 2 medical camps, we were able to reduce the number of poorly controlled hypertension and diabetes patients by 60%.

The beauty of mother nature. I've fallen in love with Sarawak and cant get enough of her natural beauty

We also started taking blood specimen on the 2^nd visit onwards to check for their renal function. We managed to detect 8 cases of renal impairment and those patients were informed of their condition and are under close follow up in Song. Those who need specialise care were referred to Sibu for further management.

During these visits we also have informal CMEs (continuous medical education) for the MAs in the clinic so that they can better pick up red flag symptoms and signs and refer the cases to me early so as to prevent the patient from deteriorating further.

We also invited the dental team along with us. It’s always more fun to have the dental team around. The bigger the group the merrier it is. There was once case where a patient had been suffering from a toothache for 4 years but he couldn’t afford the RM20 fare to go down to Song to have his tooth extracted. When it was finally removed he was so dam happy and he was later cursing the tooth for the pain all these years. What a sight....

I guess another reason i want to go back is because i want to be a surgeon eventually. Seeing diabetic and hypertensive patients who refuse to take their meds days in and day out irritates me. I feel claustrophobic stucked in the clinic all day long. And looking at how my friend from the same batch as me and my juniors getting better and better in surgery makes me feel kind of left behind. The desire to go back and make up for lost time is strong. 

This is the life man. Just lying there and fishing without a care in the world with the sunset as your companion,  the breeze caressing your face and the melody of a running river in your ears. 

But at the same time there is a small part of me who still wants to stay for just a little while longer. I just found out i failed my MRCS exam. Will be re-sitting the exam in September. I’ll definitely have more time to study here than when i go back to sibu.

Another reason is that ive came out with a new idea. There are many other smaller tributaries along the rejang river  which stretch for kilometres with few longhouses deep in it. To travel to those longhouses one would need to travel by longboat and if the water level is low, you are required to push the boat for an hour or two. 

Im planning a medical trip to Sungai Lajan next month. The furthest longhouse(Rh. Jipon, what a name)  is 4 hours from Song. Need to take a 2 hour boat ride followed by 2 hours of hiking in the jungle to reach that longhouse. This is a pilot project. If i feel there is a need to conduct such a clinic, then will do so once every month for each river under Song KK. but can only carry out the project if im still in Song.

All up to God how long he wants to keep me here. 

Running....

i first started jogging when i was 14. it was in preparation for my school's annual cross country run. ever since then, i've always had this magnetism of sort for running. i jogged frequently during my teens. i remembered my best 10km was 48minutes when i was 17 years old. when i entered high school, my running became less. when i was in medical school it was even lesser. i ran only sporadically and my weight ballooned. 

after med school i had 6 a months break and i started running again. from a physical fitness stand point of view, i felt great. my resting heart rate was 62/min. 

but once i started work, i fell again to the routine of making excuses for not running. my running became sporadic again. i would be running hard for a month and once im able to run 8km (my psychological barrier) non stop, i ease off the peddle and stopped running for months only to struggle through everything again. 

when i started my district posting i was round and i weighed in at 87kg. i was told i dont look good cause im over weight but i dont really care for such vanity. but when i see ppl in their 20s getting hypertension and soldiers in their 30s getting a heart attack, it spooked me out. my own father had a heart attack in his early 50s and went for a triple by-pass surgery. i told myself im not going to die of a heart attack until my children graduate from college. 

so thats when i started running again. and dammit, it feels good....

there is something special about running. when you run there is this feeling of freedom that grows inside of you. to me running is more of a mental challenge than a physical one. when i run, it just ME against MYSELF.

when you can hear your own heart pounding and laboured breath and every inch of your body shouts out to you to stop, thats when mental strength kicks in. you force every aching muscle and joint in your body to push on and when you finally do reach your target distance, you feel a sense of liberation. of freedom..... 

you feel liberated cause you know you have what it takes to go beyond your own worst enemy....yourself. and that you are not a slave to your own earthly mortal body. it kind of gives you a weird sense of euphoria. i dont know if this is what they call a "runner's high."


running is also a good stress reliever. whenever im bothered or angered by something or when i loose a patient, i go for a long run. its a good outlet to release all those negative energy deep inside you. rather then let rip those pent up negative energy at some innocent loved one, i just run it off.  i found it has helped me cope with my short fuse better.

i read somewhere last year that only 1% of the world's population has completed a full marathon. that was when i decided running a full marathon is one of the few things i want to do before i die. Emil Zatopek (1952 Olympic marathon gold medallist) said, "If you want to win something, run 100 meters. If you want to experience something, run a marathon." 42.2km of non stop running is going to be one hell of a mental challenge and i intend to achieve it by 2012.

the Sibu mini marathon was the first open competitive 10km run in my life and i was happy i did it in 1 hour (despite weighing 82kg). next stop is the KL Standard Chartered 10km run on 26th june. hopefully can dip below 50 minutes. 

if everything goes to plan and i stay injury free, planning to finish the half marathon (21.1km) at the Standard Chartered  Singapore Marathon 2011 on 4th December 2011.

"You have to make the mind run the body. Never let the body tell the mind what to do. The body will always give up. It is always tired in the morning, noon, and night. But the body is never tired if the mind is not tired." 

George S. Patton, U.S. Army General, 1912 Olympian.

10km run on my bday

i never really was a birthday type of person. never did like big dinners or surprise party where im the center of attraction. makes me feel awkward. as long as my closest of friends and loved ones remember it and and im able to have a small simple dinner with them, im pretty happy. to me the perfect birthday is to sleep in till noon and then have a heavy hearty breakfast in bed and then go right back to sleep without any interruption.

i know....i sound like an old uncle.

so this year for my 29th birthday, i dont know what the hell i was thinking when i signed up for a 10km run when i have not ran the 10k since i was 17. i've started running again lately but the most i ran was 8km. i dont know why i did it. maybe it was due to the urging from a close friend. maybe i've gone nuts from the boredom in Song. maybe i wanted to see if i could still do it.

whatever it was, i was regretting it the night before the run. my friends had a birthday cake cutting for me the night before the run. before i blew out the candles, i did not wish for a million dollars or a threesome with sexy screaming Japanese twins or a PS3 + HDTV. i just wished to god that there will be a thunder storm in sibu the next morning so that i can sleep in.

when the alarm rang at 530am, there was no thunder or spliter splater sound of falling rain accompanying it. just the cockadoodledoo of a very irritatingly punctual and hard working rooster from my friend's neighbour's house. i was cursing myself for watching Thor at 11 pm and only sleeping at 230am.

managed to dragged myself out of bed and went through my toilet routine which consist of face washing, teeth brushing, butt scratching and chocolate making. put on my shorts and singlet with my bib number A224 and i was off to the run with 2 other friends.

we were told to be there by 645am for the registration. we reached there at 630am only to find out that "YOU DON'T NEED TO REGISTER" and the run only starts at 845am. so was banging balls for 2 hours.

finally at 840am, the organiser called for the 10km run participants to gather at the starting line. the next thing i know, everybody suddenly started running. there was no "on your marks, get set, go" or blaring of a horn gun. they just started running....must be Singaporeans running also.

since this was my first 10km run in years, i started off slowly. wanted to pace myself. so i was pretty much last in the initial stages of the run.

the running route was through a plantation road. once you reached 5km, you turn back and head back towards the starting line.when i was at the 3-4km mark, the leading pack (some army dudes) was already at the 6km mark. wat caught my eyes was a 60+ year old apek was among them. about 20 mins before this race, he ran and won the 7km category in 30 mins.

my ego when "pfffeeeeetttt..."

anyhow, i trudge along anyway at my own pace. slowly but surely, i was catching up with the rest of the crowd in front of me. the last 3km was difficult. it was more of a mental rather than physical challenge. gotta admit, that apek kind of inspired me to finished the race.

i eventually did finished the race at 31st (out of 60-70 ppl) placing with a time of just under 1 hour. i was surprised with the time. i thought i would finish at around 1hour 10mins. so in the end i was pretty happy with the race.

but next year, im still going back to sleeping and breakfast in bed....hopefully with sexy screaming Japanese twins.

Reflections

well....im 29 now.

i can still remember the time when i was still sucking on Dumex from a milk bottle like it was yesterday. or how my dad used to chase me around the house with a rotan when i was still wearing my kiki-lala shorts and t-shirt. how time has fly.

so much has happened in my life since then. some good. some not so good. a few highs and a few lows. but all happened for a reason.

i've fallen in love. i've fallen out of love. had my heart broken. broken the heart's of others as well. had known the beauty of waking up next to a loved one. and also experience the loneliness and sorrow of rejection and betrayal.

reflecting back on the past 29 years, there were many turning points in my life. each turning point in my life was preceded by an event of intense pain, hardship and sorrow only to be followed by a life changing realisation of what it all meant.

i think the greatest turning point was when my dad fell ill and passed away when i was 15years old. that one single event had the largest impact on my life. it was that one event that shaped my entire life and made me who i am today. i would not be who i am today if it was not for my dad's death. that day, December 15th 1997, was the day i took my first step to becoming a man.

my dad's passing left me feeling sad and fearful of what the future may hold. but above it all, regret was the feeling i felt the most. i regretted not being closer with him. i took for granted that he will always be there. at 15years old, i had yet to experience death of a loved one. the greatest regret in my life is not being there with my father on the day he fell ill and never regaining consciousness cause i rather hang out with my friends. i carry that regret till this day with me. that experience taught me that the lives of our loved ones are on borrowed time and that we have too treasure them while they are still around.

do you know how it feels to come home from school and see your mom crying in front of a stack of bills and not knowing what to do....my dad's death left a big void that needed to be filled. i had to step into that role for the sake of my younger siblings. i took my first job when i was 15. i started making important family decision at age 15. it was then that i learned that every action has a consequence. because of that, i think a lot before i make any decision. and i dont make any decision when im emotional cause experience taught me that its the worst possible time to make any important decision. i guess maybe its cause of this that i think too much. thats what my closest of friends tell me.

my dad was admitted to a private hospital for his illness. he was in the ICU for 10days before he passed away. my family was financially above average but we were by no means rich. he had no insurance. and we had trouble finding money to pay for his medical bills. and he just had a heart surgery which cost almost rm100k. mom kept dad in a private hospital cause the mentality was that private hospital was better than a public hospital. and she felt a debt of gratitude to my dad, so she had to give him the best there is. the hospital will call everyday stalking for money. each day in the ICU cost more than RM4k. i can still remember how my mom had to borrow money from friends and how she had to hound the bank. or how she cried when she couldnt find enough money when the hospital called and told her that the hospital cant keep my dad if she cant pay. i felt anger and outrage. but most of all, i was overwhelmed with hopelessness. powerless to do anything for my father.

that event made me the doctor i am today. that was when i knew how it felt to be poor and not being able to access medical care. i understood what hopelessness meant.that was the day when i knew what kind of a doctor i wanted to become. i told myself i would be a doctor for the poor and needy and give hope to those who have none. lack of money should never be an excuse for not having access to the best medical treatment available. everyone deserves a chance at living. rich or poor.

there were many more life changing events in my life. and along the way, ive made many mistakes. i've hurt many dear ones with my words or actions. but whatever mistakes i made, i learnt from them and it made me a better man.

sometimes, mistakes just cant be avoided no matter how hard you try. till this day (and more often this past few months), i frequently ask myself whether i will regret the decisions that i make today.

then i realised, the truth is"NO ONE KNOWS!!!"

you cannot see into the future to guide your decisions. you can only make them with a sincere heart and the best of intentions and hope for the best. if it turns out to be a mistake, then learn from it and move on. no point holding on to a regret. its better to have lived a fulfilling meaningful life full of mistakes rather than living in the shadow of fear and not experiencing life to the fullest.

after all, mistakes are part of life. its mistakes that make us human after all.

what is a regret,

nothing but a distant memory,

hoping to be a reality

(justine tan, dec 30 1997)

this occurred while i was on a holiday....

had a 25y old guy coming to the clinic breathless and barely able to speak. from his sign language, my MA (medical assistant) figured that he trying to tell him that he was chocking on something.

when he opened his mouth, the MA saw a fish's tail sticking out from his throat and still flapping. the fish's head was all the way in the throat.

the patient was immediately send to Sibu via speed boat then by ambulance. upon arrival, he underwent an emergency surgery of the neck to remove the "foreign body."

apparently this guy has a habit during fishing, where he will keep the fish he caught in between his lips....alive. well guess this fish didn't like that very much and tried killing him by diving into his throat and spread open its fins which contains multiple small hooks/pins like structure.

heard the guy got discharged from the hospital yesterday.

lucky fool....

a 50+ year old lady came to see me in the clinic (conversation was actually in hokkien which was more hilarious)

lady: lokun (doctor) ah, i want some sleeping pills.

me: sleeping pills are controlled medication. i cant just simply give it out. why do you need it for?

lady: every night cannot sleep leh...

me: why? is there some personal matter or problem bothering you?

lady: aiyah, something like that.

me: what is it about?

lady: no need to talk bout it la. very pai seh (shy).

me: if you dont tell me i cant h help you. are you feeling depressed?

lady: cheh, no no no. its not like tat.

me: then what is the problem?

lady: its my husband la. he every night ohh, sure will disturb me. and i cant sleep because of that.

me: husband disturbing you?? what seems to be the problem?

lady: he wants to have sex lor. every night also want to do. but i dont want to. i lau (old) already la. la bin boh tam liow (all dry already inside). hair down there also dont have already.

me: so you want the sleeping pills so that you can sleep even though he "disturbs" you??

lady: oh no. the pills are for him.

me: nabe...(the hokkien in me had to come out). does he want to take it?

lady: i dont know. most probably not. but dont care la...

me: but what if he doesnt want to take it?

lady: aiyah doctor you just tell him its a new hypertension medication for his stroke la. kau tim la like tat.

*hope my sex and marriage life dont end up like that. i still want to do it when i'm 80.

to free with nothing to do. so decided to read my old blog postings from 2005. comparing myself then and now i realised that i still believe in the same principles till today. im still passionate bout certain issues close to my heart.

the difference is that, i used to see the world in a much lighter light. i could make every darn embarrassing or difficult situation into a joke. and i wrote with much more humour and a sense of keenness. i laughed my head off at reading what i wrote 5 years ago and how i perceive certain events.

what i write now aint that funny anymore. most are depressing actually.

i guess somewhere along the way i lost that inner person that resides within me. have to stop taking life to seriously.

gotta to believe in my motto again, "life is full of shit. you just gotta to learn how to see the joke behind each one."