Journey to white water rafting

This post titled the "journey" instead of white water rafting itself because the whole journey to Sungai Padas took us 12 hours while we got to raft for only an hour. However, it was a pleasant journey, something that I have never experienced.

.

The bus ride to Beaufort Train Station took us 1.5 hours before we got into the antique train which average speed was about 20km/hour. You know those trains which produce smoke and honk "too-too" every now and then? Yup, that's the one! The bumpiness was to the extend where I could feel my internal organs oscillated up and down and the intervertebral discs were compressed on each bump. The train passed through hills and trees, villages and river. Kids from the kampung wooden houses would run to the door side and waved to the passengers as soon as the train passed by. There were a few opened compartments in the train whereby passengers were free to sit without any safety precautions. I enjoyed sitting there though with the cooling breeze and drizzle :)

.

In Beaufort train station with 3 other AIMST students before rafting. From the left: (back) Patricia, Devarani, Sakthi, Visa, Mark. (front) Siew Li, Seow Fan, Ching Mun.

.

The antique train.

Settled at the opened compartment. On the left is Sungai Padas, the rafting site.

There were these native Kadazans who had plenty of gunny sacks of the materials used to roll tobacco with them. They were eating in the train and conveniently threw the plastic, container, fruit's skin etc. out from the window. A while later, they started to chew sireh and some other stuff (tobacco or ?marijuana). As time went by, they stood up to dance along with the bumpy train rhythm, sang song and cuddled one another. It might be the sireh and stuff made them euphoric. Though it was quite entertaining during the long 2 hours ride, I wondered how is their offspring going to be like if this is how they live. It is only when they are determined enough to leave their old life styles that they can keep in pace with this developing world. Ironically, if everyone else leaves to a developed place, the culture and custom of certain ethnicities will not be retained and preserved.

And here we were, enjoying the short one hour of raft.

Post-rafting snap with the guides.

I had fun! As a result, I got nearly 30 multiple insect bites all over body and itch badly.

The beauty of sun set

We would never get bored by going to the beach repeatedly. It has been the forth time of us visiting 2 beaches in 5 days. The beauty of it can't resist us from spending our time in Tanjung Aru beach before we found a more beautiful one in University Malaysia Sabah itself.

.

Marvelled at how beautiful the scenery is, with few snaps of the setting sun. Won't be snapping the next time I watch sun set. Would like to concentrate to watch its every movement and the gradual fading ray.

.

I am loving it! Looking forward for a better scenery during island hopping next week :)

Sabah here I come

Being on top of the cloud for the first time, I was more excited than the others despite the sleepless night on the day of departure. Deva, Sakthi, Siew Li, Seow Fan and I were moving on to our selective in Kota Kinabalu for the next 5 weeks. And here we are for the third day :)

.

We are pretty much settled in a corner double-storey-house in Taman Fortuna which is only 5 minutes drive to Queen Elizabeth Hospital. It takes only 15 minutes drive to Tanjung Aru beach from our place. Thanks to Kai Fei for being able to lend us his car. It has made the exploration of new places and nice eating places easier for the past few days. All 5 of us have the same affection of gradually in love with this place regardless of the slightly higher cost of living.

.
Attachment to QE Hospital started today, I should read up something for tomorrow's clinic by right. Feel so lazy. My mind is all set to just have fun. Somebody motivate me please...
.

We are up for water rafting this Saturday. I can't wait! Woohoo~

Family dinner

Decided to prepare a steamboat dinner with the following worth celebrating events in my resident:
1) Successful spring cleaning after a few weeks
2) The completion of my IJN attachment
3) My brother’s brought forward birthday celebration
4) Farewell for me leaving to Sabah

The cost of preparing by our own actually came out to be almost the same as dining out for a buffet steamboat. Not forgetting the tedious preparations and cleaning up after eating, must really think twice before the next dine in celebration. As host, we had been running around serving the guests. However, it was the process of making and the joy of serving made us think that it was worthwhile. It’s either we enjoy serving or eating.

Leaving to Sabah in a few hours time. Feeling weird. A mingle of excitement and sadness.

Mission completed

Time flies. I have completed my 3 weeks attachment in IJN (National Heart Institute) in a blink of eye. Two weeks was spent in cardiology while another week in cardiothoracic surgery. It was a good experience indeed as this attachment has changed my perception towards Malaysia’s health care system a little.

Attitude
Hospital staffs like doctors, nurses, guards or even cleaners are there with servants' hearts. They smile to greet the passer by daily. I hardly see any sour face or screaming at patients which is a common scene seen in general hospitals. Things are explained clearly to the patients to ensure compliance and patient's needs are met as much as possible. Supportive hospital staffs play a role in aiding patient's disease progress. The effective patient-staff relationships can be shown by loads of thank you cards on the notice boards and tokens of appreciation on the wall along the corridors.

Efficiency
Patients who are for further investigations are scheduled as early as possible. Tests like stress ECG and echocardiography are performed immediately if necessary and the results are interpreted on the day of consultation itself. Invasive investigations such as angiogram or biopsy are done within few days without delay. Besides that, doctors are divided into teams of 3 or 4 and each team has their own allocated patients. Team work makes things easier as they lighten one another’s burden by working together to see patients for ward round or clinic.

Social welfare
To my amazement, the funding of IJN is good. All patients who can’t afford the cost of admission or treatments get subsidized either completely or partially. For prescription wise, the best drugs with the least side effects are prescribed to the patients without having considered the cost of the drugs.

I am grateful to Dr. Kevin who supervised me through out my attachment. He is a dedicated and cheerful doctor who had inspired me by the way he treats people. I enjoyed following his clinic, ward round or emergency cases. Cardiology is now my considered specializing field after gynaecology. I don't mind working in IJN in the future though the food there seriously needs some improvements. By the way, he walks extremely fast! I am pretty much trained up for brisk walking now :p

Thanks for treating me as a part of the team. It’s truly a blessing to the people having you as doctor. All the best for your future undertaking!

Friendship forever

As I was younger, I used to write autograph during those school leaving days. The phrase “friendship forever” is one of the commonly used. It innocently expressed my desire of wanting to befriend somebody till forever. As I grew I began to use it less and less. Rather it is replaced by barely “keep it touch”. The definition of “friendship forever” changes with time as I move from place to place.

Having stayed away from home for a while, this home coming made me realized the friendships that I thought could last forever extinguished by distance, busy schedules or getting attached to another half. The quality of the friendship is no longer the same. We couldn’t share our lives as much as we used to. Words have no chance to be spoken, emotions left unwinded. We are no longer transparent to one another. Knowing 天下无不散之宴席 (there’s never a feast but the guests have to depart), I feel sad on losing the intimacy we used to have.

Life consists of many transition phases. Each phase brings about new people or new environment. God must have been testing my ability to adapt. The next transition might be just around the corner. I am uncertain whether the friendships I own at this moment will last forever. At least there is something I can do for sure, is to treasure you for whom you are for now.

Thanks for being a part of my life, my friends. Do keep in touch always!

Familiarities

6.30am, school children walking to-and-fro. I parked my car near my ex-primary school. Got down, walked to a nearby coffee shop for breakfast. Had a glance, the school has expanded with a few new buldings. The gate is built bigger and higher. It is no longer the same old school crafted in my memory.

.

I stepped into the coffee shop. The coffee shop which I used to go regularly to catch breakfast before I was sent to school. It had been a while since I last visited. A long while, says 12 years.

.

Alone. I chose a corner seat, sat on a shabby, heavy wooden chair. The same chair that required me to pull with all my strength 12 years ago. And now I can easily drag it moving. The arrangement has not changed much. The char kuey teow stall is still there. Wan tan mee uncle has gained weight. And the chee cheong fun granny still looking young. The price remains RM0.40 per piece.

.

I munched on my fried bee hoon while observing the customers came one after another. A few tables were occupied by school children with their mothers. The bages on their uniforms were familiar. So as the two pony tails. Every scene recollected the memory that was stored long ago. I sat at almost all tables before and each table spoke its own story. I remembered my mother loved the iced lime tea. My siblings and I would loyally go for milo or barley.

.

The shop owner noticed a new comer. She approached me and asked where I from and where was I heading to in such an early hour. I answered accordingly. She was surprised when I said I met her before when I was young.

.

Life has changed so much. Every person, everything. Felt so comfortable with the familiarities. I miss those time. I miss my mother.

.

Stayed in the past for 15 minutes. Rushed off.

Decisions that kill

It was stressful. The second day of cardiology attachment started with ward round in Coronary Care Unit with 2 doctors and 1 nurse. I reached before the specialist and introduced myself to the doctor-in-charge.
.
“Good morning, I’m Ching Mun from IMU. May I join your ward round, doctor?”
.
So the first patient was seen without the specialist. Half way talking to the patient, the doctor turned to me and asked again for my name. He looked at my name tag and scribbled on the bed ticket:
.
“S/W Dr. Ng Ching Mun” (S/W: Seen with)
.
Oh my… Perhaps I didn’t introduce myself as Medical student from IMU. Felt so uneasy and didn’t know how to correct him that I’m not a doctor yet! The specialist came there after and his name was written in the subsequent patients’ bed tickets instead of mine *allayed*.
.
This was not the major stressors. Being the only Medical student there (Deva started with cardiothoracic surgery first) means I have to answer all questions directed to me. There were only 2 questions for me today and I answered 1 wrongly and couldn’t answer the other one at all. It simply means I need to read and practice more.
.
Going into the main point, many think doctor is a noble occupation. Well maybe it is. A quote from the Spiderman remains vividly in my mind:
.
“The greater the power, the greater the responsibility.”
.
I testified that verse again.
.
Patient A, a known case of heart disease on warfarin with INR of 4+ who was last seen well and active. A doctor tried to correct his INR by giving Vitamin K to prevent bleeding tendencies. However, a thrombus formed as a result of the attempt. He complained of sudden abdominal pain. Laparotomy showed bowel infarction due to blockage of vessel by the thrombus and resection was done. He passed away of sepsis lastly.

.
Patient B, a dentist who complained of pain and numbness on her left upper limb. She was diagnosed with subclavian artery stenosis and had a stent done. A rare complication of broken stent occured. The vessel leaked to develope aneurysm which compressed her laryngeal nerve affecting her voice quality and ability to speak. She was treated with antibiotic for 2 weeks due to infection. To prevent the aneurysm from getting bigger, another stent was inserted to block the blood flow from aorta and thus the blood flow to her left upper limb was impaired further. The pain progressed from bad to worst. She was depressed.

.

There is no absolute right or wrong in Medicine. Patient A might be at risk of massive bleeding if INR was not corrected. And nobody expected patient B would get worst after treatment. One can suggest a treatment plan with his points going for while the other can say no with valid reasons.

.

Patient C, an elderly in her 80s with a previous coronary artery bypass graft presented with chest pain. She was subjected to either bypass again or treated medically. The doctor chose the latter, and secretly told me that the chances of her dying of heart attack is high based on his experience. She might leave anytime. It is still better than to die in an operation theater.

.

It striked me the most when one patient submissively said:

.

"Doctor, it's all up to you. You decide what is best for me."

.

Medical students can make mistakes and fail exam, but medical doctors can't afford to decide wrongly and loss life.

.

Greater power comes greater responsibility.

The first week of holidays

I had a week of complete book-free holidays. Didn’t do much except to sleep and surf. I was like a tensed up balloon which air was being released abruptly. Leaving behind an empty skin which couldn’t fly high. Feel helpless looking at my days just passed unproductively…

Today I started to spring clean my house’s kitchen. The spring cleaning was supposed to be done for Chinese New Year but it was delayed for the sake of my exams. Half a day was spent to just clean up half of the kitchen. I guess I’ll get muscle ache from the endless wiping. Another half to go. Tiring. The end result was quite satisfying though :)
.

Starting my elective in IJN (Institut Jantung Negara) tomorrow. I’m so unprepared! Got to adjust my odd sleeping hours and get myself back to studies. No more procrastinating!

To be achieved during this holidays:
1) Study the bible
2) Have a consistent quiet time
3) Read up heart diseases
4) Spend time with friends and family
5) Start working out, though feeling demotivated after I failed to reserve a place for KK mount climbing :(

Tomorrow is going to be better!