Let me be your ‘leggy meter

I wanna be yours.

One thing I find Londoners do better than anybody else in the country is walking. They can walk for miles and miles, at different speeds. They generally have this London style of walking – fast enough to seem busy and always getting to the next place, slow enough to not seem like they are rushing to the loo for an imminent gush.

I felt like I had to walk the same way today when I was there, just so that I wouldn’t feel out of place – after all, you’ve got to do what the Romans do. But I think all I managed to do was either being slowed down by the person in front and contemplating how best to overtake without looking like a dickhead, or being overtaken by a dickhead.

———
I am tired of wanting what I can never get.

I now truly understand the meaning of a double edged sword – a phrase first introduced to me in reality by my ex-girlfriend – it hurts, and it can never be good.

If loving someone means you’d do anything selflessly for her, you’d constantly think about her, you’d wonder what she’s doing right now when you’re not with her, you’d want to listen to her voice like it’s velvety music to your ear, you’d protect her with the best of your abilities, you’d fend for her in the toughest imaginable corner, you’d be hurt when she’s hurt, you’d feel your heart sink when she cries, you’d strive to be her armour for when she’s vulnerable, you’d work for her smile, you’d lose sleep over her megawatt laughs, you’d travel till the ends of earth to earn her heart, you’d never want to live a day without her, you’d want her face to be the last thing you see before you sleep and the first when you wake up, you’d hug her and never let go, you’d not share her with anyone else in the world, you’d make her the priority, you’d shout her name from the top of the highest mountain, you’d tell your best friends she’s the best thing that’s ever happened, you’d be contented, you’d see what happiness is because she’s the missing piece in your puzzle, you’d have boring Wednesdays to look forward to because she’s all that you ever need, then what I’m feeling is more than love.

And it is a double-edged sword when you’ve found her, and she hasn’t found hers.

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French Mustard

Assumption is the mother of all fuck-ups.

Uncertainties and doubts – they fuck you up even more.


12 years. That’s how long it’s been.

It’s funny, looking back. How life has turned out to be. I remember J.K. Rowling saying, in one of her Harry Potter books, that we are defined by the choices we make (not word for word, but that’s the gist) – I cannot agree more.

I am not going to shout to the world, but what happened 12 years ago has, to put it simply, left behind a void in my head that I have only now begun to notice and manage. I chose to remain silent and deal with it myself back then. After 12 years, I decided that it was probably time to let it all go and start living out of a cage that i locked myself in. I can feel the void collapsing on itself, although there are still days or nights where I suffer from full-on shadow effects.

In those 12 years, I’ve encased myself in an ever enlarging toxic bubble of self-doubt, self-flagellation and persecution. I felt like a damaged good – that expired product on the shelf; that soured milk; bad egg in a batch; rotten apple in a bag. I refused to let anyone in until the last few years.

Still, that look on someone’s face when I told them what happened – pity – was both patronising and unbearable. The following few seconds were the worst – vulnerable and exposed, ready for the taking. I still don’t know if I expected anything by telling people what happened, but I do know that it is a sign that I’m letting someone in.

Baby steps.

I don’t regret having remained silent 12 years ago. I chose to deal with it myself, and I’ve paid the price. If Rowling’s words were anything to go by, that choice only defines me as being fucking strong. I put my faith in the right place.

Roman shuffle

We are surrounded by people. Loved ones, family, friends, housemates, colleagues, acquaintances, even strangers. Loneliness, unfortunately, isn’t a disease that can be cured by having people around. One can feel lonely even in a crowd.

It is a vacuum. It sucks energy out of you, and leaves behind a sphere of emptiness that makes even the funniest video clip you watch on YouTube seem tasteless. Those moving images are just what they are, moving – nothing gets conveyed to you. It dims the desk lamps that you turn on so that you can read.

It is a void. A void that you think can be filled by having someone around. A void that terrifies you so bad that not having that someone around makes you feel that the clock is ticking because it just does, and all that you see, hear, smell and touch are nothing to your numbed skull. A void that takes control of your perspectives, and tells you that whatever you want, believe and worked for are nothing but a speck of self gratifying dust that floats around weightless, worthless.

It is a disease. It debilitates you, and makes you reliant on other things just so that you can feel better about yourself. You become hopeful, and that is all you’ve become. You are like a distressed damsel that sits on the windowsill and cries for help, but actually does nothing to help yourself. It’s a disease that no magic pills can cure. It is so harmful that once the barriers around your heart are taken down and you let someone in, it makes you believe that that someone is the person that answers all your questions, solves all your problems and is able to fill the void and block out the vacuum.

Yes, there are people around you. People that care about you, love you and shower you with praises and kindness. But loneliness poisons your heart and numbs it, rendering it impermeable to these tenderness that would otherwise release you from the vicious circle.

When the sun goes out and darkness of the night creeps in, you feel the cold even in the warmest house.

Loneliness is when you lay bare in your skin and you get attacked by all things negative. That is when you get tested. There is a limit to how much a vacuum can do; there is a limit to how deep a void can be; a disease that doesn’t kill you will only let you live with a stronger self and a clearer perspective.

Perhaps now is the time to block out the vacuum, fill the void with a much assured self, and battle the disease with a strong will for better things, better life.

Love yourself, because nobody else will if you don’t.

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Coffee Black

It’s been two months since I started working in the NHS. Apart from being glad that I’d made the decision to come over to start a new life, I haven’t really got anything else to say.

As far as my personal life is concerned, I face dead-ends at every corner I turn.

It’s frustrating when you meet someone, develop feelings that you shouldn’t, and you get caught in a situation where the circumstances are not right.

They say, your heart wants what it cannot have.

Edge of a cliff

It’s been two days since I left. Now that I am back here in this land where I don’t feel I belong, there is an indescribable void that persists throughout every breathing second.

I can hardly sleep at night – it’s the jet-lag, they say – and when I close my eyes, I see a multitude of uncertainties, fear, hopelessness and despair. It’s funny that I see them rather than feel. It’s probably because I am currently incapable of having any emotions.

I feel like screaming till my lungs collapse, but I cannot find within myself the strength to do so. Perhaps it is pointless to scream because reality is what it is.

Decisions made in the past are now what I am living.

Perhaps one day, things will be better.

Until that day comes, if it ever does, oh God, how am I to go through the days that lead to it?

White-washed jeans

The boiling point of water is a hundred degree celcius. That is when water turns from liquid into gas. It happens when the bonds between water molecules gather enough energy to break free from each other.

The turning point of life is uncertain. It is when life takes a different direction. It can happen at any time. It can happen long before we realise it. It can happen before we want it to. It can never happen no matter how hard we try.

If life was chemistry, there would be a certain formula. But life wasn’t chemistry.

Our beginnings are only the same

Exactly one week ago, I sort of excitingly began the dreaded four-month rotation in paediatrics. Excitingly? You might ask. Well, I am practically useless when it comes to paediatrics so I was excited because I knew I had to go into the rotation with an open mind.

An open mind is like a bottomless glass, it fills itself endlessly with anything and everything – as opposed to a closed mind, which is comparable with a bottom’s-up glass that can never be filled with anything.

And with an open mind, I came to a realisation when one of the specialists, whom I have now developed great respect for, gathered several of us in the ward to have a chat after we reviewed the last patient, who was admitted for suspected child abuse.

She shared her thoughts on many things, and they were all centred around the role of paediatrics. I must admit that the chat was inspiring and it stirred something within me, almost like a passion (although my true passion lies, nowadays, in sleeping). She drew the curtain and I saw light (figuratively, as the curtains were indeed already fully drawn).

Paediatrics deals with the most vulnerable group of the society. The patients range from premature infants to adolescents. It deals with lives from the very beginning, as soon as they leave the safety of the womb. These tiny beings have the adults to care for and nurture them, and to provide for them. As they form the most vulnerable group of the society, and yet they are also the ones with the most potential, paediatrics has a role to play in ensuring that they receive the best possible chances in life.

Realisation dawned upon the few of us in the chat circle when this specialist reminded that ultimately, whether or not the society becomes healthy as a whole depends on the functionality of a family unit, into which the vulnerable young enter. As the family unit is able to provide for the young in all dimensions, the soul of the young takes care of itself. Otherwise, it degrades into a misshapen gnarl that will be forever trapped in the downward spiral of neglect, crimes and social ills.

How ironic is it that every time we look at a newborn, it is a reflection of our society. How it will grow is very much dependent upon how well we assume our roles as educators, carers, law enforcers, civil servants, doctors etc, and how well adjusted we are to changes through time.

When we read in the news headlines of a child being raped, or of a nation being invaded, or of a country shattered by insurgencies, or of a group of people being marginalised and oppressed, perhaps we should ask ourselves: have we failed our roles, starting from the family unit, into which the vulnerable young enter?

Cameron

Christmas at an Altitude

After having completed a four-month basic training in general medicine, I found myself missing the department at the thought of having to go into paediatrics for the next four months. Well, I do admit that I enjoyed myself tremendously in the department. Medicine is fascinating, and that just makes it harder for me to decide between general practice and medicine.

Work in the hospital or in a practice? I am interested in both, and they are very different to each other. I never thought that when it comes to making a decision on my career path, I have to basically think about what kind of life I ultimately want. Right now, GP is tipping the balance.

Anyway, Christmas 2013 is slightly different because, I can obnoxiously say, I treated everyone at home excluding mummy to a nice mini vacation in Cameron Highlands.

It is also different because it happened on Boxing day instead of Christmas.

It was a vacation that I very much looked forward to because I needed a good break from the exhausting (but enjoyable) work and I just wanted to get out of the Klang Valley.

I hate to admit that Cameron Highlands is slowly losing its charm as an idyllic highland holiday destination because there are developments going on almost everywhere along the way up and there’s plenty of people. I would prefer it to be quiet and tranquil, like how it used to be when I was a small child.

I once thought of owning an obnoxious home in Cameron Highlands overlooking a valley surrounded by lush green forests, where fog covers the basin (is that what you call it) up till mid-height in the morning and the chilled air feels fresh and smells of serene green.

Not anymore.

There are still some pretty sceneries but I think if nothing is being done now to halt development (yes, stop destroying the forest), these sights will soon be gone.

View from the hotel apartment.

First step in tea-making. Can’t remember what it’s called. Grinding? Rolling? The aim is to squeeze juices out of the leaves, I think.

Thank you Lord for a wonderful time.

 

Me

Rarity

Of late, I find myself in the company of thoughts.

Not thoughts of any kind. But thoughts on self, family, future, and possibilities.

I wonder if I am the only one who thinks about things like this.

Sometimes I wonder if I hadn’t chosen to do anything and just let things unfold, what would my life be?

 

Demyelinating the soul

I once heard that we should never set a negative tone at the beginning of whatever it is that we’re doing. But I’m afraid that I’m going to disappoint, because I haven’t got any ounce of positive energy left in me at this particular point of time.

Work is exhausting. And anybody who has done or is doing the houseman programme in Malaysia knows that it is demanding, and at times demeaning. It’s much worse if you are the ‘housemen leader’. On the surface, it sounds like a great honour. The truth is, you’re just shouldering more than just laborious intern work. You have also got to worry about administration stuff, as far as your fellow housemen are concerned.

Right now, I feel like there’s nobody beside me to listen to me.

So here I am, blogging to the whole wide world, expecting nothing but an outlet.

dying gaul

Being analytical is exhausting

dying gaul

After watching the first and second episodes of the newest season of Grey’s Anatomy, I started to wonder why my life in the hospital isn’t like what’s depicted in the series at all.

Of course, that’s drama and I’m in reality.

But dramas are based on reality, even though they are the exaggerations of it.

Somehow, though, I find reality much more unfathomable and terrifying than anything I’ve ever seen on telly. It’s probably because of this inherent acknowledgment that scenes in films or dramas are entirely fictional, which means that however gory or terrible it seemed on screen, it never really happened. So we are okay with them.

Ironically, reality can be much worse and you do hear people go “it’s almost like I’m watching a scene in a horror movie”. That’s because when something terrible actually happened, our mental faculty cannot comprehend it. It is in a state of shock, trying to shift from what we thought would never happen (only on telly) to what we already perceive as having happened already.

It’s just like death, and the varying degrees of its tragedy.

Some die almost instantly, even before resuscitative procedures can be carried out. Some die unexpectedly, even though what we have picked up never pointed towards that direction. Some die quietly, without anyone around, not even their own family. Some die peacefully, some die not so peacefully. Some come as a shock; some come as a closure.

But for doctors like me, it’s what we deal with everyday and sometimes it does numb us. Guiltily, I feel apathetic after having seen a couple of deaths. My colleagues and superiors say it’s normal, it’s a defence mechanism, it’s how our emotions react to protect ourselves from the dire consequences of a downward spiralling depression. Yet, I still feel guilty.

Not guilty because of what could have been done to delay death. But guilty of having to witness deaths that could have been more dignified. Many patients that I have seen dying in the hospital shouldn’t even be there in the first place. Their family members shouldn’t have to share their final moments with the dying (or dead) in a ward filled with strangers who secretly wished that they didn’t have to go through what they were seeing. The dead could have been brought home earlier, to breathe a familiar air and to leave in a comfortable surrounding, to see their own home for one last time.

If only anyone of us had the courage to step up earlier to allow that final dignity. If only we had the courage to admit that our interventions were not working and it is time to let nature take its course. If only anyone of us had the balls to release our patients, whom we knew were not going to make it, back to their homes instead of incessantly hooking them with wires to monitors and intravenous lines and poking them with needles.

In those final moments, how relevant are those monitors to tell us that the patient is in the last few minutes of his or her life?

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Words breaking through the wall

“Is it the wind that is in motion, or is it only the flag that is moving?”
“One day you will realise that there is no wind, and the flag does not move. It is only the hearts and minds of men that are restless”.

To have memories, happy or sorrowful, is a blessing, for it shows we have lived our lives without reservation.” – Tan Twan Eng

Exquisitely written, The Garden of Evening Mists never failed to capture my interest from its first sentence to its last. While reading the novel, I found myself always wanting to know what was going to happen. Changing between the past and present, the author successfully wove stories from different times in the main character’s life to bring the entire novel to a grand, satisfying end. It was no wonder  that it got shortlisted for the Man Booker’s Prize. And I am proud to know that he’s a Malaysian.

Even before the Education Blue Print is being implemented, doubts of its success have already filled the air. I have plenty to write about the dire state of education in Malaysia, but I am not in the right frame of mind to talk about it just yet. Work and the relentlessly discouraging atmosphere at work just suck me dry of all high spirit, day in and out. And that in itself is a story for another day, when the time is right.

As when I finished the book, I realised that it had stirred something deep within.

The theme that repeats itself for countless times in the novel is that our past shapes who we are, whether we know it or not. The main character endured physical tortures and mental afflictions while she was captured and put in a camp during the Japanese occupation in Malaya. And those were the things that made her determined, for the next thirty years of her life, to find justice and punish those who had a hand in the torture of Malayan men and women in the camps. The loss of her sister in the camp gripped her throughout the rest of her life and she was never released from the ghost of having to honour her sister in some way, until she was struck by a degenerative brain disease that made her question the point of it all. Somehow, the disease became a turning point in her life, and although morbid and harsh, it was her release.

The theme echoes the plans and ambitions I have and how they are all moulds from my formative years. It seems that everything that I am now working towards points to filling those moulds so that eventually a shape composed of my dreams and ambitions is formed. When that happens, I now find myself asking, what will I feel about the entirety of it.

I suppose that is what all of us have to find out for ourselves when we have finished the shapes of ambitions moulded by us during our formative years.

Deep, I know.

Static wings

It’s always like this, isn’t it?

Time is relative. When you’re doing something that you enjoy, hours feel like minutes; when you’re doing something that you loathe, seconds feel like a never ending drag in a vicious loop.

So is memory. It’s relative to time, but somehow obscure yet conspicuous. Something that had happened in the distant past can feel like something that had only just happened a moment ago; whereas something that had happened yesterday can feel like it was ages ago.

So is emotion. It’s relative to everything else. Its lability or stability is relative to your control, the environment, the time, the people involved. On a particularly busy day at work, you may feel uplifted because it is bright and sunny outside and your colleagues are being exceptionally helpful; on a quiet day at work, you may feel downright disgruntled because the air-conditioner is expelling something foul-smelling and your superior wants you to edit some horrible work done by an incompetent, overpaid clerk that was let off early because he was that useless.

The time long, the memory dire, the emotion fizzy.

The time wispy, the memory bright, the emotion electrifying.

It’s all relative.

Boat-ride to Manukan Island.

‘See not with your eyes, hear not with your ears, feel not with your senses’

“Only know you’ve been high when you’re feeling low”

Entrance, exit. A beginning, an end.

Thank you, Elisha, for having me in this wonderful coastal city.

A picture speaks a thousand words. Here’s a picture of words. So it’s words of a thousand words.

 

Kota Kinabalu

Land beneath the wind

A rather beautiful coastal city.

I have never actually thought that I’d one day set foot on East Malaysia. But life has always got its plan and who am I to go against the flow?

Here I am, in Kota Kinabalu for a couple of nights.

First impression of this place: beautiful, laid back and somewhat intriguing.

The locals are a very polite bunch of people and even on the phone they sound like they want your company.

First order of the day is to meet this monkey before going to other places (read: helping her do some of her way overdue errands).

This monkey is so tiny.

I haven’t updated this blog in a while. It’s probably time to write a few more posts before I go back to being suffocatingly busy in the medical department in Klang.

Side note: Congratulations to self for having completed four months of training in the Surgical department, in spite of all the arrogant personalities.

 

Befallen

Fear not, for I am with you; be not dismayed, for I am your God; I will strengthen you, I will help you, I will uphold you with my righteous right hand. – Isaiah 41:10

Ever since I first stepped foot into this male trauma ward, I have been taking care of this young chap from Vietnam. He had a terrible road traffic accident, and sustained a severe head injury that has since rendered him unable to speak or move. He was very weak, and the part of his skull where a piece of bone was taken out to relieve the pressure in his brain caused by a large amount of bleeding cannot be mistaken by anyone who would stomach the sight of him – his brain bulges through that rather massive gap, underneath scalp scarce of hair.

You might think that I am going to tell you a sobbing story of how a Vietnamese boy, optimistic of his future in Malaysia, became trapped in the most unfortunate twist of fate that he ends up struggling between life and death in a foreign country where only a handful of people speak his language.

If you had thought so, you were wrong.

I am going to tell you, to the best of my abilities, about his mother, who has been relentless, tireless and always hopeful.

The first time I saw her, my heart sunk. She was a short, tiny woman with rough, short fingers telling of hard work and a hard life. She stared at me warily during the first moments of my examining her son. Hair tied up in a bun, she smiled at me warmly after I finished examining. “Are you his mother?” I tried to confirm. She nodded vigorously and began talking ferociously in Vietnamese. Understandably, it made no sense to me, but that did not stop her. She used hand gestures, motioned at the lifeless-looking boy and herself, and patted her own chest several times.

Ownership, hers. Her son.

I did not know where to proceed. I flipped through the case notes. There were plenty of CT scan reports, doctors’ notes, medical summaries, lab investigation results, observation charts, drug sheets, and progress notes. One word hung staggeringly loosely in my head: bad.

Obviously, she didn’t have a clear idea of what was happening. She looked at me, and I looked at her. I began gesturing using my own hands to try to convey a message, to ascertain her understanding of the entire situation. She looked as if she understood me when she nodded her head vigorously, again.

I had to take that as some sort of an answer.

Every time I began my day (or night) in the ward, I would start with her son. And she would be there. Some days, her son would have fever, and she knew it wasn’t a good sign of anything. On one occasion where I taught her how to properly tepid-sponge, I learnt a great deal more about her. Although stubborn (I told her repeatedly not to drape wet cloth over the surgical wound on the patient’s scalp but she did it anyway), she was quick and she followed my other instructions. She religiously freshened the cloths, for days on end, until the fever settled.

One day, when we told her that she could feed her son tiny sips of water, she beamed.

Eager and over-enthusiastic, she literally fed him one cup of water in one go. It was a surprise that the patient, whose ability to swallow we were unsure of,  could take it all in without any signs of regurgitation or aspiration into the airways (by the way, there was a tracheostomy tube in the neck).

At one point, there was a series of sunny days (if you would allow the expression) in that corner of the ward where she and her son were, as the temperature plateaued at 37 and all the vital signs were looking good. He began to follow instructions and there were life and awareness in his eyes. The first time it happened, she was incredibly happy and grateful.

The gratitude was clearly evident by her subsequently stopping me in a corridor to hand me an envelope with some Vietnamese words written on the front. Google translate said it read something along the line of “dedicated doctors”. Inside the envelope was a 50 ringgit note. I returned it to her the following day.

The bad days and good days in the ward also saw her switching from being an anxious mother to a relaxed woman never devoid of smiles. She was persistent, and she still is. Some mornings, I could catch her whisper Vietnamese that sounded like prayers into her son’s ears. Such an occurrence would be even more frequent on a bad day.

I don’t know when, but there came a time when she would speak to me in Vietnamese every time she saw me, as if I could understand everything she said. I would nod, try to make sense of what she said, and then I would shrug my shoulders, to which she only repeated her sentences with even more hand gestures and bigger movements. As comedic as it sounds, I sometimes understood what she was trying to say and I would reply her in repeated movements and simple English words like “okay, now, no, better, don’t, cannot” with the accompanying signs (a cross for ‘no’, a frantic waving of the hand for ‘cannot’).

One night, my colleague and I had to juggle between two wards. I wrote my mobile number on the whiteboard in the ward, which, by the way, is meant for staff only, and went downstairs to the other ward. Within half an hour, I received a text. It didn’t make sense to me because it was in Vietnamese. I shook my head, finding the entire situation an odd combination of comedy and helpless frustration.

I did not reply her.

———

I will be going to work tomorrow night. And I hope it will be the first of endless good nights and days for the mother and son.

———

Don’t mistake me for using this story to maim the soft part of your soul. This story that I told, to the best of my abilities, is to show you the resilience and strength of a mother looking after her neurologically disabled son in a foreign land. She inspires me in many ways, and I hope she does the same for you in some way.

And on this Father’s Day, I pray for my father’s health. And I pray for the best in God’s will for my patient and her mother.

Psychologically pathological

“That question is not for you to ask. It’s for a specialist to ask.” He darted a gaze so full of disgruntlement that the entire ward might be disinfected of the nastiest bugs.

I stared at him in disbelief, but behind a smile that I hoped would project shame rather than a hidden fury. “Your job as a house officer is simple – you’re my clerk. And questions for your level are like ‘how do I diagnose a breast cancer?’, not the question you asked earlier.”

He beamed in the most disgusting way I have ever seen. Knowing that there was nothing I could do at that point, I swallowed the ball of anger and looked down to peer at the case notes, pretending to be suddenly interested in somebody else’s illegible scribbles.

This is one of the examples why working as a house officer in this country makes me feel like I am not living in the twenty-first century. Also, it is one of the things that convinces me even more that arrogant and self-indulgent fools should not be allowed to be a doctor in the first place.

let there be light

Patience in turmoil

“For I know the plans I have for you,” declares the Lord, “plans to prosper you and not to harm you, plans to give you hope and a future.” – Jeremiah 29:11

I watched a video on YouTube. It was a recording of Ben Fogle giving his speech at a Peace One Day conference. He talked about the transatlantic rowing boat race that he took part in several years ago. He reflected on the experience and shared his thoughts, and the take home message was that if you set your mind and body on something, you will be able to achieve it.

And while I was watching that video, I heard a text tone. I didn’t bother getting up to reach the phone because I wanted to finish watching the video clip. It was a very motivating speech. I must admit.

As soon as the video ended, I staggered across the room to get to the mobile. I was very anxious because I rarely get texts nowadays. It was from a good friend’s mum, who said she was praying for me and the exact bible verse was Jeremiah 29:11. At that particular moment, I felt peaceful, grateful and touched, all at once. She must have heard about my current predicament. She is such an angel.

The thing is, I realise, things never turn out the way you want them. They just turn out the way they are, and how you choose to feel about them depends on your expectation. Sometimes, you feel disappointed because they turn out to be the exact opposite of what you wanted, or worse. Sometimes, you feel delighted because they are exactly what you wanted, or better. Still, they are the realities and you cannot change them. You can only move on.

So I have been thinking that whatever I do now, and whatever I want and plan, I will let the outcome be decided by my Lord. He knows it best.

Amen.