tag:blogger.com,1999:blog-849760634759096212024-03-13T10:47:43.465+08:00Randomly JYSimRandom - without definite aim, purpose, method, or adherence to a prior arrangement; in a haphazard way.JYSimhttp://www.blogger.com/profile/14019206630494448815noreply@blogger.comBlogger371125tag:blogger.com,1999:blog-84976063475909621.post-14280987811956477892014-08-12T22:00:00.001+08:002014-08-12T22:04:16.929+08:00The Fragrant HarbourBack in June in the midst of community rotation, I was having difficulty occupying my extremely long weekends in a new and relatively small town and very few acquaintances. It was like going into retirement suddenly - a typical workweek is less than 4 days and all of my friends, whom are mostly physicians, too, are busy slaving in the hospital. One weekend I find myself stranded with about 4.5 days off. My brain screaming from boredom and the summer heat, I found myself planning random trips to nearby countries. Thank God SoonKhen is just next door in Hong Kong and Cathay Pacific has last minute tickets for slightly more than USD 200, a call to reservations and I'm scheduled to leave in 2 days.<br />
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On Cathay Pacific flight 565 bound for Hong Kong on a cloudless summer afternoon<br />
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Rolls-Royce engines<br />
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Hong Kong airport!<br />
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Central MRT station in red tiles<br />
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Overlooking Hong Kong island on the ferry crossing to Kowloon</div>
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Every city should have a promenade and a skyline. Sadly Taipei doesn't.<br />
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I love MRT station names in Hong Kong and their coloured tiles. Now I understand why Cathay Pacific has a tile wallpaper in their lavatories.<br />
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Took the (very crowded) tram up to Victoria peak the next day<br />
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Traveling solo means having to depend on fellow travellers to take your picture.<br />
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We can easily spot British influence on the Commonwealth - wide, orderly streets, lots of windows, and easy pedestrian walkways<br />
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The promenade again in daylight<br />
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A fellow Mainlander took this picture for me.<br />
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<br />JYSimhttp://www.blogger.com/profile/14019206630494448815noreply@blogger.com3tag:blogger.com,1999:blog-84976063475909621.post-45076960130015050792014-06-28T12:17:00.003+08:002014-06-28T12:17:48.991+08:00Community Rotation a.k.a. Summer VacationFor our one-year post-graduate training (PGY) mandated by health authorities, 2 months are dedicated to community rotation which serves to familiarise us with community health resources and health disparities on a community to regional level. Translated to laymen language, it's essentially 2 months of <strike>vacation</strike> local clinic visits, emergency medical transport, home and institutional care facilities, local health policies, and a community health report. Simplified further: it's spending 2 months away from the wards!<br />
I scheduled my <strike>vacation</strike> community rotation for the final 2 months of PGY-1 to make full use of summer as well as to settle the complicated mission of re-applying for a work visa upon switching jobs in August. Also moving into the hustle and bustle of Taipei and procuring furniture for the new house, it's less of a vacation compared to my fellow colleagues - one of whom plans to conquer all the mountains in Taiwan and the other renovating and renting out his newly bought apartment.<br />
Anyway, summer is too tempting to be wasted and each of us have our own plans making full use of the 2 months.<br />
For a start, my parents were here earlier this month for my sister's commencement. As I'm on, ahem, community rotation, I picked up my parents from the airport with my free airport transfer gratuitous of Citibank. My parents' flight was delayed for an hour thanks to Hong Kong air traffic control. Just as I was about to file a complaint to Cathay Pacific, my sister's classmate told me her parents' flight was delayed for 6 hours, arriving Taipei at 2 am with their bags completely soaked. I hope they have travel insurance.<br />
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My family and my sister's classmate<br />
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President Ma's best wishes to all graduates. Strange I did not receive any congrats during my graduation. English translation as follows: I was informed of your school's commencement for MinGuo Year 103 (2014) will fall on June 7th and would like to extend my best wishes and blessing to all graduates. I look forward to seeing you persisting the school's excellent motto into our workforce along with (a chain of politically-sophisticated, hope-instilling but empty words). President Ying-jeou Ma.<br />
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Summer is not so nice in Taiwan due to the heat and humidity. But it's good to be spending time outdoors before I start my <strike>imprisonment</strike> residency in September.<br />
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JYSimhttp://www.blogger.com/profile/14019206630494448815noreply@blogger.com0tag:blogger.com,1999:blog-84976063475909621.post-64686529646820492032014-04-19T15:34:00.001+08:002014-04-19T15:43:36.772+08:00The Kinship of SorrowI was on surgical floor duty on March 8, 2014. It was an ordinary morning with everyone anxious to go home early when a random swipe on Twitter starts an infinite roller coaster of emotions.
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MEDIA STATEMENT released at 7.24am/8 Mar 2014 - MH370 Incident - <a href="http://t.co/z8YfOEPlja">http://t.co/z8YfOEPlja</a><br />
— Malaysia Airlines (@MAS) <a href="https://twitter.com/MAS/statuses/442090797224050688">March 8, 2014</a></blockquote>
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It was learned that MH370 from Kuala Lumpur (KUL) to Beijing (PEK) has "lost contact" shortly after departure with 227 passengers and 12 crew onboard.<br />
As a fellow Malaysian and frequent flyer of Malaysia Airlines, one's heart missed a beat. While preparing for the worst, we repeatedly prayed to God Almighty that it be a minor error, that no souls were lost, that the incident would end safely. Worldwide, #MH370 and #PrayforMH370 were trending on all social media as netizens wake up not expecting a sophisticated Boeing 777 would simply vanish into thin air.<br />
I can only imagine the agony and frustration of family members later that day as irresponsible social media users spread false information about the missing aircraft. Stuck on Al Jazeera English (our hospital router blocks all other news sources, AJE is the one our IT department apparently missed) for the next 20 hours, helplessness developed into fear and anger as numerous questions were raised about appropriate actions - why was the authorities informed so late? Why are there false travel documents? Why was the transponders turned off? Possibly even deliberately? We were haunted with newsflash of agonised family members at both PEK and KUL as journalists rush to the story and endless theories like sharks smelling blood.<br />
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The days that followed were as heartbreaking as it was confusing for all. Amidst the shorthanded and inexperienced Malaysian authorities fumbling with the initiation of search and rescue operations, our ASEAN neighbours, Australia, UK, and many more nations joined in the search in what is possibly the worst (and most clueless) air disaster in decades. As days went into weeks, family members of multiple nations began demanding answers from our authorities, which we scarcely have. Chinese families staged protests, pressured diplomats, went on the media, and even started a nationwide boycott fuelled by the void of information about their loved ones on board. Others, such as Maira Nari, daughter of chief steward Andrew Nari channels her loss with great composure and integrity on Twitter.
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I know he'll come home safely, cause he has to see my future together with my mom. :'(<br />
— Maira E. (@Gorgxous_) <a href="https://twitter.com/Gorgxous_/statuses/442208750783303680">March 8, 2014</a></blockquote>
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Daddy. It's almost 24 hours. When will you be back home? I'll be waiting, all of us are. Goodnight, daddy. :')<br />
— Maira E. (@Gorgxous_) <a href="https://twitter.com/Gorgxous_/statuses/442336931784163328">March 8, 2014</a></blockquote>
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Daddy. You're all over the news and papers. Come home fast, so you could read them! Don't you feel excited? :'D <a href="http://t.co/Jc4TzMSKym">pic.twitter.com/Jc4TzMSKym</a><br />
— Maira E. (@Gorgxous_) <a href="https://twitter.com/Gorgxous_/statuses/442501300408680448">March 9, 2014</a></blockquote>
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Goodnight, daddy. See you soon. We'll be waiting. :')<br />
— Maira E. (@Gorgxous_) <a href="https://twitter.com/Gorgxous_/statuses/443386496054071297">March 11, 2014</a></blockquote>
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God loves you more, daddy.... God loves them more. :')<br />
— Maira E. (@Gorgxous_) <a href="https://twitter.com/Gorgxous_/statuses/448099186328629248">March 24, 2014</a></blockquote>
Across a nation divided over a recent high court sentence and political stance, Malaysians unite in praying for missing MH370 in an unprecedented scale and momentum. People of all color and creed were one in their daily prayers - that the aircraft be found soon and its passengers and crew safe and sound.<br />
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Over the weeks we gradually started to accept the fact that the aircraft and all its passengers are "lost", it united aviation photographers from around the world to pay a <a href="http://michael-raisch.squarespace.com/malaysia-airlines-flight-370">tribute</a> to something forgotten all the while - the aircraft herself. Unsurprisingly 9M-MRO on her last flight as MH370 had a fruitful 12 years in service, bearing the flag of Malaysia across exotic nations during Malaysia Airlines' better times. I particularly loved a black-and-white 9M-MRO landing in KUL on January 30, 2014 - one of her last landings back home, which the photographer aptly titled "Oscar, you're 'home'."<br />
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As search operations continue against an uphill battle in the Southern Indian Ocean after the aircraft has gone missing for more than a month, we continue our prayers for the quick salvage of wreckage and revelation of truth for all involved. As a Malaysian this tragedy has struck me as deeply as it has struck families and staff of Malaysia Airlines. My family has flown Malaysian for innumerable years for better or worse and has always trusted her on safety, reliability, and the professionalism of her crew. It is a harrowing tragedy that struck close to home and has reminded us of loving each other more. Through flowing rivers of sorrow, it has doubtlessly united people of different races and ideals, taught us more about tolerance, and befriended people that would otherwise never cross paths.<br />
Wherever you are, we hope you're in a better place, MH370.JYSimhttp://www.blogger.com/profile/14019206630494448815noreply@blogger.com1tag:blogger.com,1999:blog-84976063475909621.post-91445305599159981652014-01-31T19:12:00.001+08:002014-01-31T19:15:18.869+08:00The Decision to Come Home for Chinese New YearSome of the disadvantages working overseas, aside from earning a foreign currency and able to stand as a bystander when our comedian government does something stupid, is having to play the "home / no home" game during Chinese New Year. Being in Taiwan, Chinese New Year is the pinnacle of peak travel season which means air tickets are sold almost twice their original price. As students with a fixed semester schedule, you purchase your flight tickets well in advance while avoiding the hot dates. However, after starting work, applying a day off during Chinese New Year is like trying to give birth to an elephant with a human pelvis - a stand-in must be found to relief your duties, lots of negotiation on the on call schedules, and train tickets typically sold out within seconds must be acquired by whatever means. Any lapse of this chain of events would mean spending Chinese New Year alone overseas.<br />
The on call schedule of our hospital is fixed only a month in advance. So by December I was calling my January and February departments for details which were still sketchy. <strike>I literally had to hold them at gunpoint for them to give me leave</strike>. We had mutually respectful discussions and I was rather disappointed to find our Chinese New Year leave would only be 4 days in total. Anyhow, anticipating the short break due to lack of residents, I deliberated on whether or not to come home for Chinese New Year.<br />
As my travel agent gleefully typed into her computer unleashing a record high price tag of NT$ 22000 round trip from Taipei to Penang (with a transit), my senior at the ED repeatedly reminded me he gets paid NT$ 20000 per 12-hour session of emergency duty at a rural community hospital. I had numerous sleepless nights and asked around on what will my first Chinese New Year abroad be like.<br />
Gradually the department of obstetrics and gynaecology, where I will be rotating in January, completed our duty schedule. They did a good job avoiding all my blackout dates but I learned I will be on call the night before my intended flight. This means I will be working until 8 am while my flight departs at 12 noon at Taoyuan International Airport, if I am flying Cathay Pacific, the cheaper option.<br />
Worried that I might not make the flight (Hualien to Taipei is 2 hours by train; Taipei to Taoyuan International Airport is another 50 mins by bus), I even tried Malaysia Airlines which happily sold out its economy class a month in advance. I decided to treat myself to business to be told the entire price would be NT$ 26000, enough to feed my family of 4 for a month.<br />
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My travel agent, the always aggressive Ms. Tsai must've checked the empty slots until even the computer hates her. Over the course of 3 weeks we managed to downgrade our fare class to around NT$ 20000. She must also hate me because I often Line her in the middle of the night to ask her to check if there's any cheaper seats. One fine day she finally broke and screamed at me to pay up before she goes to psychiatry. The final price is NT$19900 with a PEN-HKG sector in premium economy. I can't remember it was because economy was sold out (more likely), or there was only a slight price difference for a wider seat and more privacy.<br />
Next comes applying for leave during a period when the hospital is most stretched out of human resource. For this I decided to employ a tactic from Sun Tzu's Art of War - distraction and dissemination of attention. I would talk about something happy like our year-end bonus while maliciously slipping in my leave application and needing a stand in. After 4 to 5 trials and employing some hypnotic skills along the way, my partner finally agreed to stand in for 3 days while I'm off making my leave up to 6.5 days in total including traveling.<br />
If I leave Hualien after call duty at 8, I will be in peril of not boarding my flight home given the short margin of error. Arriving in Taipei at 10 and taking the bus will probably see me at the airport at around 11:20 for a 12:05 flight which is cutting it very close for an international flight. I finally decided to take the earliest train out of Hualien which is 6 am. The 2 hours of call duty I owe my friends to cover up for me as evidenced here.<br />
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On call personnel: Intern Dr. Huang with PGY Dr. Sim. Please call PGY Dr. Wang or Dr. Guo after 5:30<br />
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After a monthlong battle for tickets, leave, and stand ins with an array of seditious acts, lies, and drama worthy of an Academy award, I finally board the very chaotic flight home to Penang as one-third of the world's population scramble to be home for reunion dinner. I must say it is worth it to be home for the festive season, no matter the price.</div>
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Happy Chinese New Year to all!</div>
JYSimhttp://www.blogger.com/profile/14019206630494448815noreply@blogger.com5tag:blogger.com,1999:blog-84976063475909621.post-20603205477015189392014-01-07T22:21:00.001+08:002014-01-07T22:23:37.730+08:00Vulnerable when Unpowered My MacBook Pro will be with me for 3 years come April. It is an extremely well-travelled laptop during its short lifespan - completing my lengthy journal report while transiting in Narita, sending happy pictures of me and Dr. Drazen, editor-in-chief of the New England Journal of Medicine from Boston to my family, checking my residency application status while vacationing in Bali, and blogging from New York.<br />
It is easy to forget how convenient life has become when so much could be done by pressing the on button and navigating billion dollar investments with a stable internet connection. However, we usually take the power / battery for granted as life gets too easy for us.<br />
For Macbook users, you'll be familiar with the MagSafe adapter which Apple fanatics love to call the "tofu":<br />
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My "tofu" is as old as my MacBook Pro now and I must confess I did not take good care of it, especially so when I travel. As the laptop gets up to 8 hours battery life on a single charge, I usually chuck the tofu into a checked luggage and only see it after we're settled at our destination. During the period, the luggage usually went up and down 14576 steps, into 34 puddles, and got smashed along with 287 other luggages in a temperature of -97^C under your comfy cabin on the airplane.<br />
After 3 years my tofu has finally decided to quit me last Saturday. The usual assuring green or yellow LED did not light up when I happily plug it in at my duty room. Convinced that things designed by Steve Jobs would not fail, I plug it into another outlet. I must imagine the green dot so hard I think my retinal cone cells almost revolted against my grey matter for the hallucination. No green. No yellow. Just plain blackout.<br />
With the remaining battery, I troubleshot my problem from the Apple Support website. First, make sure your power supply is working - blimey, I always thought Apple users were smarter than that. As I was plugging into a hospital-grade uninterruptible power supply I'm positive there is sufficient electrons to kickstart a laptop. Or else the 50 ICU patients wouldn't still be breathing.<br />
Second, unplug your adapter and let it rest for 60 seconds. Replug.<br />
I must have tried no. 2 at least 60 times. During the final frantic moments I almost wished electricity would pass through me while I hold on to the computer. I don't mind being electrocuted as long as I can get onto Facebook!<br />
Then comes some key combinations which would reset your whatnot - something similar to Clt-Alt-Del on Windows - still not working. Finally, I booked an appointment for an Apple genius to call me. Apple tried to charge me NT1,790 for the call but thank God there was a "I just bought OS X Mountain Lion" option allowing me a free call. I managed to save 2 weeks' living expenses for a family of 5 in the Philippines.<br />
5 minutes later an Apple genius with a fake Mainland Chinese accent called. I explained to him the steps I had done. After a series of questions like what temperature is the room now and did you drop your adapter into hot soup, the genius told me the problem probably lies in my tofu and advised me to go to the nearest Apple store, which is 119 km away from my current location.<br />
With 4% of power remaining, I checked the Apple Store for a new adapter. Apparently if you think a call costing 2 weeks living expenses for a family of 5 is exorbitant, an adapter would likely feed an entire zoo.<br />
Like Sandra Bullock in Gravity (2013), with the computer screen blurring every 3 seconds and apocalyptic warning signals flashing away, I went to Ruten, the Taiwanese version of Ebay, and found the same product for half the price, including delivery. With 1% power to spare, I clicked "purchase" before the laptop went into a deep coma.<br />
The following day, I <strike>forced</strike> politely asked my junior for his adapter to infuse some much needed electrons into my baby which is barely breathing (sleep indicator of MacBooks resembles breathing patterns).<br />
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I must admit hearing the "puck" sound when the cable attaches magnetically to the laptop is like God speaking himself that morning. When I plug on, the familiar yellow bulb flashes on - even utopian Shangri-La seems slum-like when compared to the warm glow of electrons flowing through. My MacBook is saved!<br />
After 2 days, my own adapter arrived. As I lay the old tofu to rest, it seems almost a joke to me that while our computers may produce medicines that cure cancer or save the planet, they are still just a metal casing made from recycled Cola cans when unpowered.JYSimhttp://www.blogger.com/profile/14019206630494448815noreply@blogger.com2tag:blogger.com,1999:blog-84976063475909621.post-82645567684747845772013-10-29T21:53:00.001+08:002013-10-29T21:53:08.191+08:00Still Hanging There<div class="separator" style="clear: both; text-align: left;">
Just to remind all of you I'm still alive, kicking, and will be back with posts very soon.</div>
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<br />JYSimhttp://www.blogger.com/profile/14019206630494448815noreply@blogger.com0tag:blogger.com,1999:blog-84976063475909621.post-16914452259425865462013-09-15T22:01:00.003+08:002013-09-15T22:01:49.483+08:00Foreign Family CaregiverLike most middle class Malaysian families, I grew up with a family maid. We used to call them <i>kakak</i>, or sister in Malay. Like the African American ladies in "The Help" they cooked, cleaned, took care of the children, the elderly, and even buy groceries and manage the pantry. Throughout my childhood we had at least 5 <i>kakaks</i> from Indonesia. All of them worked for at least 2 years and returned home for good after their lease was done. Our last <i>kakak</i> was with us for the past 5 years from 2008 to February 2013. She subsequently returned to Bali, bought a store, and sold ice to hotels and tourists.<br />
Growing up, we were extremely grateful to all our <i>kakaks</i> for shouldering all the housework and upkeep of our family - our sweat stained school uniforms, all the windowpanes in our airy home, breakfast, lunch, dinner, and endless guests and relatives frequenting our house. We spoke Malay but they eventually knew Mandarin from our daily family conversation.<br />
After I started working in Taiwan, I had endless opportunities to work alongside lots of foreign caregivers of our patients. Unlike Malaysia, Taiwan has very strict regulations regarding foreign caregivers - they could only care for the elderly or severely disabled evaluated by specialist physicians approved by the Ministry of Health. As a result of a regulated cap, foreign caregivers in Taiwan usually have experience taking care of bedridden patients as well as the ability to speak and understand Mandarin.<br />
At the end of one's life in bedridden state, these <i>kakaks</i> are their full time companions. Most other family members just pop in once in a while or may not even show up during the patient's hospitalization.<br />
Taking care of a bedridden patient can be extremely depressing. Unlike babies which are tender and sweet, these patients might have nasty bedsores, pus-oozing wounds, foul-smelling phlegm to suction every 4 hours, and an endless list of medications to give at different times of the day. Imprisoned by their foreignness and round the clock demands, they maintain a minimal social life through text messaging or unlimited call plans. One could easily spot them chatting away on the phone or texting during their free time. Sometimes they got so engrossed they would ignore us during rounds. Their mastery of Mandarin varies and hence communication could get fiery when they aren't up to standards, especially in matters of hygiene.<br />
On two occasions during the past month, however, their genuinity touched a cord in me. Our first <i>kakak</i> was caring for this bedridden old lady who was admitted for massive pleural effusion. On the night of her chest tube insertion, she accidentally removed the tube during one of her nightly delirious episodes. I went in to check if the patient is okay and found this angry <i>kakak</i> scolding the old lady for being impulsive and trying to slowly kill her by disrupting her sleep every 30 minutes.<br />
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3 days later, the old lady's consciousness took a turn for the worse. She was barely breathing and bloodwork finds severe hypercapnia partially corrected by positive pressure ventilation. Afraid of the inevitable, I called the family members for advanced directives and DNR. After the entire proceeding was over, I found the <i>kakak</i> quietly sobbing away along the corridor while firing away text messages.<br />
"Are you okay?"<br />
"It's my fault...I shouldn't have been so harsh on her."<br />
"You took care of her for so long and did a very good job. It's hardly your fault. It's the natural way of life."<br />
She went back into the old lady's room even more emotional than any of her family members.<br />
The second <i>kakak</i> was a bubbly Indonesian girl who speaks very good Chinese. She had been taking care of Mr. Lin for 2 years and provided me with a detailed account of his present illness on admission (family members busy elsewhere, again). On his fourth hospitalization night, Mr. Lin accidentally choked while drinking some milk and was struggling for breath when I was called. After doing all the necessary workup and prescribing antibiotics while praying everything works out, I found the bubbly <i>kakak</i> in the same state as the previous <i>kakak</i>, as if all of them were programmed to tear up, cry, and text their friends about the conditions of their patients.<br />
"Two years and he was doing very well..."<br />
She was right. Mr. Lin had hardly any wounds, no bedsores, was clean every day I see him, and looks well-nourished.<br />
"It's not your fault. It was an accident. You were great in taking care of him so well," I tried to comfort her.<br />
While their emotionless family members went home to sleep in their snug beds, these <i>kakaks</i> are the ones who changed their granddad's diapers, patiently feeds 5 meals to their grandmother every day, cleans and bathes their parents in vegetative state, freeing up valuable time and energy for us to do the things we think are important. When they are hospitalized, they are the ones who slept on the minuscule sofa (convertible into a chair during the day), and had to tolerate the noisy and claustrophobic wards. When their patient is in critical condition, they joined in to pray, possibly to a different God, but for the same patient. At the end of the day, their daily keep is not just about money anymore. The bedridden granddad has became <i>kakak's</i> own parents.JYSimhttp://www.blogger.com/profile/14019206630494448815noreply@blogger.com3tag:blogger.com,1999:blog-84976063475909621.post-46781252992236518462013-08-18T19:43:00.002+08:002013-08-18T19:43:29.748+08:00Predicting DeathIt was 5:30 am and my fourth call night in a monotonous string of calls every third night. Work fatigue was kicking in and stress hormones running high as the phone rings after a long silence through the night.<br />
"Are you fully awake?" the nurse asked.<br />
"Go on," I replied with my best effort to mask the groggy voice.<br />
My patient in 667-2, Mr. G had a pulse of around 200 beats per minute and experiencing severe chest pain. He suffers from metastatic colon cancer and was admitted due to septic shock treated with broad spectrum antibiotics. He is losing a slow battle against cancer as the malignant cells had metastasized to his bone, lungs and liver. During his current hospitalization, DNR, palliative care, and advanced directives had been discussed with him and his family more than once. He had explicitly expressed the desire not to continue any form of IV drugs as they limit his out of bed mobility and elicited severe pain when the nurse changes the catheters every 3 days. As a result of his request, his antibiotics were switched to oral form but evidently that didn't work very well. He was again in shock this morning.<br />
As I approached him he was breathing laboriously through a non-rebreathing mask with his hands clutching his left chest. His heart racing against stresses exerted by infection foci in his lungs and spine as well as the pain from cancerous cells eroding away the bones. His extremities were cold and clammy with very weak pulses. Blood pressure is 80/40 mmHg.<br />
"Mr. G, how are you feeling?" I asked.<br />
"The pain on my chest is very bad. Can I have some morphine to make it go away?" He said.<br />
I ordered 10 milligrams of morphine while trying to evaluate my situation.<br />
Mr. G had passed the point of no return. While I can try to convert the heart rate back through pharmacologic methods or defibrillation (cardiac shocks), it wouldn't last very long as he is still in septic shock and his current antibiotics isn't strong enough. Ultimately every medical effort would drain his hopes of dying comfortably at home surrounded by his family.<br />
Mr. G mumbled something inaudible.<br />
"Come again please?" I asked while lowering my ears against the hissing of his mask.<br />
"Can I go home, please?" He asked.<br />
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I gathered his family by the window. The easterly sunshine had just penetrated the darkness minutes ago casting a warm golden hue into the ward.<br />
"I think the end is near. I'm so sorry but I don't think we can do anything further here," I said.<br />
"How much longer do you think he has, doctor?" His daughter asked.<br />
"I can't be sure but given his unstable hemodynamics and very rapid heart rate, he should tire very quickly. As we discussed previously he wishes to go home for this and I think we should respect his decision."<br />
The family took a while to decide while I waited by the nursing station. Ordering more morphine shots to relief the pain and shortness of breath.<br />
"He might still struggle for a while still," The nurse commented while preparing shots of the opioids.<br />
"How come?" I asked.<br />
"Just...my experience," she said.<br />
After gathering more family members, rushing here in the early morning light still in pyjamas, they decided to respect Mr. G's wishes to go home. I hastily wrote more prescriptions for morphine and prepared all required documents while the daughters called an ambulance to transport Mr. G home. Within the hour the hissing oxygen mask and silently ominous family was gone and 6W resumed its morning rituals. I said a silent prayer while washing up preparing for the day ahead. Please, God, let him pass painlessly.<br />
Before morning reports I told my supervisor about Mr. G. He agreed with the nurse that I may have discharged the patient too early and he may be suffering even worse pain and shortness of breath at home now.<br />
"But how do we know how long a patient has left?" I asked.<br />
"That is truly a difficult question to answer." Dr. Pan said.<br />
At 4 pm I received a call from his family physician. It turns out the patient is still alive at home and in great pain. I felt a great pang of guilt as Dr. Zheng told me he was much better as soon as he arrived home. Dr. Zheng felt that the discharge might be too hastily decided and the family not properly taught on how to handle Mr. G's pain.<br />
"Usually if he is in a hospice ward, the nurses will teach family members to administer morphine for the patient. I understand 6W is an acute ward and you don't have such resources, though."<br />
Dr. Zheng said Mr. G and his family understood the circumstance when I decided to allow them to return home, believing it would all end by sundown as I told them. And they do feel more comfortable at home.<br />
"Maybe we could teach them ways of managing his symptoms and allowing them a few days to learn and practice before discharging them 'the next time,'" Dr. Zheng added.<br />
"I will definitely do that," I replied, feeling very guilty. I had predicted the death of a patient way too early and discharged him home for needless suffering. I felt sorry for Mr. G because he could've stayed longer and took more morphine to relief his pain and shortness of breath. Maybe we could've converted his heart rate back to normal, maybe he just need some adenosine, maybe, maybe, maybe.<br />
After several days swimming in guilt, I finally came to the conclusion that while I might not have done the right thing for Mr. G by discharging him too early, I most certainly respected his wishes to go home. I might not have communicated the things I can do for him here, though they are honestly very limited. If I were to be in Mr. G's shoes, I would most definitely want to go home, too. I thank Dr. Zheng for supplying Mr. G with all the analgesics he needs and hope his family members forgive me for a somewhat rash decision I made that fateful morning. I still have a lot to learn on predicting deaths and I hope Mr. G forgives me from wherever he is now. I hope he is in peace.JYSimhttp://www.blogger.com/profile/14019206630494448815noreply@blogger.com3tag:blogger.com,1999:blog-84976063475909621.post-74794943801691494082013-07-31T22:00:00.002+08:002013-07-31T22:00:59.842+08:00Leaving the Student TitleJust thought my readers should know I took and will possibly pass my Taiwanese medical licensing exams last weekend after a prolonged period of (procrastinatory) preparation at home and back here. I will be pursuing my first post-graduate year tomorrow until end of July next year.<br />
This marks the start of my 8th year in Hualien and official end of medical school which I shall miss dearly. As life gets busier and work more hectic I doubt I shall have as much time as before to write but I promise I will keep up whenever and wherever I have the opportunity. Thank you for your readership all the while which I treasure, and I look forward to bringing more content for everyone in the future.JYSimhttp://www.blogger.com/profile/14019206630494448815noreply@blogger.com3tag:blogger.com,1999:blog-84976063475909621.post-69197465056764796742013-07-19T20:29:00.002+08:002013-07-19T20:39:38.545+08:00A Tale of Two CitibanksI am starting work in August. Wait, I'm starting work in August?!<br />
That means I can start earning money, buy a car, buy a house, invest in stocks and derivatives, become a millionaire through insider trading, build my black market empire, kill a few villains, and retire gracefully. How exciting!<br />
But, all that starts with a bank account. And one has to choose one's bank carefully. Some nasty local banks like the one our hospital is using now has no branches out of Hualien and is a pain when performing interbank transactions. The other national "commercial" bank charges astronomical rates for trust funds which I had no excess money to buy, and has very steep rates for telegraphic transfers if I were to send money back home to Mum and Dad. So I figure it's time to set up my third account.<br />
After some research I found Citibank Taiwan has the best deals for cross-border transfers and convenient cash withdrawals internationally. I had enjoyed free overseas withdrawals with my Malaysian Citibank account, allowing me to avoid some ancient form of currency called traveler's cheques and my money being sucked up by some dubious bureau de change in the middle of Timbuktu. With my Citibank Debit and ATM, I just present myself to a Citi ATM, enter my PIN, and get local cash with no extra charges. That's what I call a bank who understand my needs *wears sunglasses and drive away in a Porsche*<br />
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So after I went back to Taiwan I presented myself to a nearest Citibank in Taipei to open an account. The first bank I went into asked if I have a job.<br />
"That's weird, why does having a job has anything to do with opening a checking account?" I thought. I honestly replied that I am currently unemployed but will start work in August. She said it would be much easier to return in August for the account as local regulations restricts unemployed foreigners from opening an account.<br />
"But I studied and graduated here. I've been in Taiwan for 7 years!" I argued.<br />
"Well, our bank doesn't allow unemployed foreign nationals..." she reiterated.<br />
Thanks to my tough upbringing, I did not give up. Upon exiting the Citi branch, I visited another branch several MRT stops away. This time the officer was even worse.<br />
"Where do you live currently?" She asked, "as local regulations dictates we can't allow non-locals to set up account in locations out of their area of residence, I'm afraid we can't do anything for you."<br />
This excuse is even more bizarre than the unemployment excuse. I didn't feel like putting up a fight because she might call security and throw me out of the building, but I knew<b> they were reluctant to set up an account for me because I am not a Taiwanese national</b>. <b>I am dangerous and could potentially turn into an international money launderer</b>. However, I felt I was being mistreated as I deserve to know the true reason behind all the hazy and inconsistent excuses that they use to reject my application.<br />
So I contacted a senior and friend of mine, Nathan, who happens to be Malaysian and has a Citi account in Taiwan. He was extremely kind to me and pulled his strings to get his banker to open an account for me. Minutes after texting banker Raymond of Citibank Zhongshan branch, he called me to arrange a meeting and asked me politely to bring some documents along.<br />
On the specified time and day, I went to Citibank Zhongshan branch and was greeted by 3 front desk ladies who escorted me into a Citigold cubicle and offered me drinks. The cubicle is equipped with a computer station, desks, stationaries, brochures, recliner, potted plants, and soft music. It actually feels more like a spa waiting room than an office. I cannot imagine the irony behind all this when barely a week ago I was practically asked to leave their branch on the grounds that I am a perilous criminal.<br />
Raymond greeted me very politely and explained that Zhongshan Branch is Citi's second largest branch in Taiwan (the largest being Xinyi), and that only they are authorised to set up accounts for extraordinary people like me. I do feel really special by then as Nancy poured me freshly brewed green tea.<br />
A lot of signatures ensued while Raymond explained how I could buy their trusts and forex products in future when I have "power to invest." Good! I thought. This is a bank who wants me to become a millionaire! I was given my account book, ATM card, and 3 passwords engraved in my brain after an hour and Raymond handing me his name card and made me promise to call him if I need a credit card in future. I think I shall do that as he is very hardworking, proactive, and seems like someone who won't mind me laundering some illicit money.<br />
So now I'm a proud holder of 2 Citi accounts. It's just another couple of months before I start to build my empire. Anyone interested should give me a call at 1-800-LAUNDERING.JYSimhttp://www.blogger.com/profile/14019206630494448815noreply@blogger.com1tag:blogger.com,1999:blog-84976063475909621.post-27762348021621997792013-07-07T07:56:00.002+08:002013-07-07T07:56:55.617+08:00Things I Shall MissLeaving Penang again tomorrow for an unspecified amount of time until my next return, hopefully around Chinese New Year. As a student one used to enjoy long, carefree vacations but not anymore as a responsible, working adult. I guess I shall get used to missing these things very soon but as a Penangnite, the quaint, compact island is always ingrained in you wherever you go.<br />
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<br />JYSimhttp://www.blogger.com/profile/14019206630494448815noreply@blogger.com1tag:blogger.com,1999:blog-84976063475909621.post-80799619999328177602013-06-24T10:20:00.003+08:002013-06-24T10:20:57.579+08:00Downgraded Bangkok Trip part 2While planning my trip I decided not to stay my entire 5 days in Bangkok even though it is a city with many sights and sounds as I get tired with city grime fairly quickly. The decision proved to be right as I sprained my ankle on my second day and got a nasty cold on the third. With fever and a stuffy nose limping through the streets of Bangkok, I looked forward to escaping the city to Ayutthaya 90 km north of the metropolis.<br />
Ayutthaya was the second Siam capital after Sukhothai. It was founded around 1350 AD when King U Thong went there to escape a smallpox outbreak in Lop Buri. By 1700 AD the city houses around 1 million residents with no less than a dozen of monasteries and reliquary towers in full golden glamour. However, in 1767 the city was sacked by Burmese forces in part of the Burmese-Siamese war. Countless artefacts were destroyed when Burmese army robbed and subsequently burned the city which flames lingered for 3 months. As a direct result, the one could imaginatively piece together Ayutthaya's glamorous past through its red brick ruins, headless Buddhas, and vast monasteries scattered around the city which earned it a UNESCO World Heritage Site.<br />
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On the way to Ayutthaya, stop by Bang Pa-In Royal Palace, the summer palace for the Royal Thai family for a quick stroll. Commissioned by King Chulalongkorn after his visit to the west, one would be fascinated by a mock-Tiber landscape sitting side by side with a Chinese temple beside a Victorian mansion. It is definitely one of a kind.<br />
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Then we enter Ayutthaya to find countless ruins like these. My first stop was to Wat Phra Si Sanphet which used to be the royal palace in Ayutthaya. Now partially restored but still retaining its major red brick facade, it isn't difficult for one to imagine the glorious days of the past before the atrocities condemned by the Burmese.<br />
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The atmosphere was strangely peaceful despite its violent past. I think the Thais did a good job preserving the ruins while not overdoing it.<br />
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I visited several other temples the following morning. Wat Mahathat, also unofficially the temple of headless Buddhas, houses up to a hundred Buddha figures all beheaded by Burmese army during the raid.<br />
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There is, however, a mysterious sandstone Buddha head wedged in the roots of an ancient Bodhi tree in the premises. Some say it was abandoned by the Burmese after finding it too heavy to carry back home. The Buddha looked extremely peaceful despite its displacement, smiling even, at the numerous tourists who took pictures with it every day.<br />
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It would be a fancy glittering Buddhist destination had not the Burmese destructive behavior 300 years ago.<br />
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I stayed at iuDia By The River in Ayutthaya for 1 night. Voted the best boutique hotel in Ayutthaya, this establishment boasts itself with a riverside pool overlooking the historic park which was even more delightful at night.<br />
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I wouldn't mind staying an extra few days.<br />
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Then it's back to the hustle and bustle of Bangkok. With my ankle less swollen and fever subsiding, I am glad I found a great deal in Holiday Inn Bangkok Silom previously and checked straight into my 15th floor club room for my last day here.<br />
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Breakfast on my last day in Bangkok.<br />
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Thai people are born with natural smiles and servitude making them one of the most hospitable people on Earth. Coupled that with the natural beauty and culture of the nation making them one of the best budget holiday destination. I should thank Mum for her suggestion of a nearer to home destination that I thoroughly enjoyed and have high desire of returning. Nevertheless, as with all other developing nations, the government should take great effort in addressing the wealth gap, general welfare, and cultivating environmental awareness among her people as too many countries had gone down the road of unsustainable overdevelopment and suffered irreparable consequences.JYSimhttp://www.blogger.com/profile/14019206630494448815noreply@blogger.com0tag:blogger.com,1999:blog-84976063475909621.post-5933827779241937722013-06-20T09:44:00.000+08:002013-06-20T09:46:39.892+08:00Downgraded Bangkok Trip part 1I usually pay my tuition after Chinese New Year, allowing me ample time to ask my parents for money during the festivities and paying up after the vacations. However, this year the school requires us to pay up before the Chinese New Year. I scrambled and saved just enough and paid away before flying home.<br />
"Oh, you paid your fees already?" Mum asked.<br />
"Yup!"<br />
"In that case I'll take the money to invest in stocks,"<br />
"Eerm...ooookay?"<br />
A graduation trip didn't pop up my mind back then, so I didn't protest. After we're back from vacation my classmates started planning graduation trips. I always wanted to go to Istanbul, being the convergence of Asia and Europe as well as Islamism and Christianity. Coincidentally a group of classmates are going as well.<br />
"Can't you go somewhere more budget?" Mum haggled "There are plenty of places nearer you haven't visit."<br />
She has a point. I've been to Europe and US twice but hardly anywhere in South East Asia.<br />
Coming from Penang (with our filthy beaches), I figured a beach destination is just another waste of money and time. Culture - h'm - Bali or Bangkok - Mum and Dad had been to Bali before, so I'd best avoid an old couple's destination. And a web check of tickets to Bangkok costs merely RM 500 return with excellent timing on Malaysia Airlines. So my vacation plans was essentially downgraded from Istanbul to Bangkok. Nevertheless, it was a blessing in retrospect as not long after my graduation several demonstrations erupted in Istanbul.<br />
After several weeks of hotel bookings and trip planning, my classmates (who were going with a tour) decided to extend their stay to accompany me for 2 days. How sweet of them.<br />
Having settled my air tickets and Holiday Inns, I was reluctant to plan my itinerary until the day before departure. Thanks to Lonely Planet and Wikitravel I drew up a rough plan for my 3.5 days in Bangkok and 1 day in the ancient Siam capital, Ayutthaya.<br />
Part 1 will cover the first 2.5 days in Bangkok.<br />
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Holiday Inn Express Bangkok Siam, with a room at a perpetual 12^C. But its central location, free WiFi, great breakfast, and affordable price made up for the arctic climate.<br />
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Located right behind the hotel is Jim Thompson's House, an American businessman's collection of mansions in the Thai capital.<br />
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Went to the Grand Palace the following morning. The palace is so full of Chinese and Korean tourists it's easy to confuse where you are. The heat and humidity aren't much help either. Within 30 minutes my jeans and shirt are all soaked through. It would be much nicer to go in shorts and sandals but Thai customs forbid it.<br />
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A short ferry hop across the Chao Phraya brings us to Wat Arun, less touristy, more rustic, and much more monastic.<br />
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Spices and dried seafood on sale.<br />
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Afternoon tea at Erawan Tea Room by Hyatt Bangkok<br />
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The offerings are quite ample given the price at this five-star establishment. They did, however, missed a scone and a dish entirely which they replaced instantly on notification with lots of apologies.<br />
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After tea, we went for some shopping until leaving Siam Paragon at 7 pm for our 8 pm show at Siam Niramit. Unbeknownst to us this is still rush hour in Bangkok. We were overcharged by almost 60 baht by a taxi driver and almost missed our show. Still, like dubbed by its commercial, Siam Niramit is a must see whenever you're in Bangkok.<br />
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On my second day I went to...what's the name again...Wat Ratchandatdaram Worawihan. Never mind the name, it's an awesome temple with lots of meditation spaces and a great roof built in the Rattanakosin style.<br />
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And finally, my travel partners.<br />
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JYSimhttp://www.blogger.com/profile/14019206630494448815noreply@blogger.com1tag:blogger.com,1999:blog-84976063475909621.post-65556799854722513052013-06-07T15:20:00.004+08:002013-06-07T15:20:46.202+08:00The Insanity That is GraduationOur original graduation date was on June 7th. Thanks to some logistical problem it was brought a week earlier to June 1st. This actually means we were still working the day before graduation and some on-call interns are to attend graduation (or commencement), in overnight scrubs.<br />
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After some serious lobbying and negotiation with the school and hospital, they agreed to let us go 12 hours earlier, that is at noon of May 31st.</div>
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We didn't waste another moment of free time and signed off with the greatest efficiency by 10 am of May 31st. However, as I am following Mum and Dad back to Penang for a month, I still had plenty of packing to do and meticulous planning for studying the boards the upcoming month. Thank God for Malaysia Airlines' increased baggage allowance (30 kg), I was able to haul most of my books back home.</div>
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Commencement came and went in a daze under the scorching June sun, followed a day later by a graduation party where I almost fainted in suit and tie under the humidity. 3 days later I'm back in Penang sweating myself to dehydration reviewing all the awesome pictures of the insane week.</div>
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We were very fortunate to have our babysitter and aunt accompanying us for the ceremony.</div>
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Some pictures of graduation party and friends who I shall miss dearly for many years to come.<br />
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JYSimhttp://www.blogger.com/profile/14019206630494448815noreply@blogger.com0tag:blogger.com,1999:blog-84976063475909621.post-38423567696694955112013-05-25T21:01:00.000+08:002013-05-25T21:01:24.867+08:00Facing the Truth About GraduationThe date of graduation draws nearer as I mark off my call nights one by one, it is inevitable to have gatherings after gatherings with the different groups of people that I have bonded over the years. Depending on the subject of my dinners, I either end up broke, or enjoys a free meal with my teachers. With classmates we usually go dutch with the bill, but just to think of parting with some of my closest friends after July breaks my heart.<br />
Whether I liked it or not, I will have spent 7 years in Hualien come September. I did not like this place when I first arrived. I thought Hualien was boring, gloomy, sleepy little town with no prospects. Not very much changed since then. However, Hualien began to grow on me. Whenever I wear myself out in Taipei or lost wondering in a foreign city, I start to miss the familiar food and humidity of the mountainside town with towering, lush mountains facing the pacific (once in San Francisco I actually mumbled out loud "I live just across the ocean,"). Under a mix of circumstances I decided to stay for an additional year. The sadness of leaving is delayed but I doubt I'll have an easy time not missing it when the time arrives.<br />
Some ordinary classmates had became daily work partners for me since clerkship. We became a network of friendly opposing extended families with frequent gossiping and scandal spreading typical of couples who are forced to stay together for 7 years. 7 years - not an easy feat for people you don't like, but never enough time for the people you cherish. Nevertheless, it is only remarkable to watch how everyone grew to become better individuals as we recall our very first impressions of each other - the naive, raw, and boundless ambitions of doctoring which are subsequently trimmed, robbed, or even buried alive by a stifling national health system. No doubt some of us still retain the passion of servitude and treating the sick, but whether the fire is still alive at the end of residency remains to be observed.<br />
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For those who knew me from the very beginning of blogosphere, many knew coming to study in Taiwan has never been part of the plan. It was more of an accident. A happy accident that transformed my life into what it is today.<br />
I have many regrets that I shall carry with me through graduation. The most notable being participating very little in co-curricular activities during my early university life. As a result I constantly try to encourage younger juniors to be less studious and just enjoy life as it is. And I'm so glad most of them struck a good balance between work and play.<br />
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Being in Hualien can exclude you from many transformative events happening elsewhere. The few inspiring individuals we met over the years nevertheless contributed to sculpting into what we are today. From brotherly residents to respectable professors and power people, they fill hospital corridors with memories of nervous morning conferences, sleepless call nights, rushed lunches, and aimless banter to kill time before 5:30 pm.<br />
It will be a huge leap out of the comfort zone after graduation. Meeting new people, shouldering extra responsibilities, and keeping up with more work in lieu with a mature medical professional in the making. Sadly for Taiwan, not everybody looks forward to it. But for now I think I shall just rejoice with the thought of my MD degree within grasp in the following week!JYSimhttp://www.blogger.com/profile/14019206630494448815noreply@blogger.com0tag:blogger.com,1999:blog-84976063475909621.post-64902722854368323972013-05-10T22:07:00.000+08:002013-05-10T22:13:13.628+08:00It is Always Darkest Just Before the Day DawnethAs a Malaysian I am proud of my country which has enjoyed peace and prosperity over the past 57 years. Despite our disparities of race and culture, we were able to overcome most differences to build a place we called home. And under the protection of our motherland, generations of Malaysians flourished.<br />
However, the democracy we enjoyed has slowly come under threat. During the last Malaysian general elections, despite obtaining the lesser of the popular vote, the ruling coalition managed to form a government with almost two-thirds majority against the opposition with the popular vote but failed to form a ruling government. This is attributed to gerrymandering and vote rigging as evidenced by multiple sources and irregularities in the electoral process.<br />
It was an extremely sad day for Malaysians - to see our decision hijacked by a government who later blamed their poor performance on a "Chinese tsunami" and repeatedly told the people they have been misled and brought on a joy ride by the opposition, which majority of the people voted. Facebook became a dark and angry place while other social media were flooded with accusations and petitions to return fragments of democracy to her people.<br />
I was on call in general surgery on voting day and stayed up very late to follow life streaming results. As I saw seat upon seat being loss with a marginal majority to a party whose interest is no longer among the people but in power and money, I was speechless but not surprised. Our current government has ruled for more than half a century and acquired power beyond a reasonable check and balance process. However, I was speechless because this government had actually made the decision to sacrifice the better good of the people and nation for its own benefits.<br />
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I slept very poorly that darkest night in Malaysian history. Not because I was on call. I was praying to God Almighty to please save Malaysia from another 5 years of corruption, money politics, and self destruction. While lunching in the operating room lounge the next day, I actually can't stop tearing thinking how older generations of Malaysians might not live to witness a new Malaysia they dreamt and were promised about.<br />
As despair and darkness clouded Monday, I read some random comments on Facebook and realised even though we were robbed of our democracy, this elections has only united us better. Across the globe, Malaysians, regardless of race, gathered to hold peaceful protests demanding answers and explanations. In Malaysia itself, Malays voiced out against Najib's "Chinese tsunami" while the Chinese population were unfazed by having no cabinet ministers representing them, citing "if we are truly Malaysians, we should be taken care of regardless of race."<br />
This is unprecedented in our history of race-based politics manipulated by the current government. 10 years ago having no Chinese or Indian cabinet minister would be unimaginable for the minority population. Yet after May 5 we became more resilient. We started demanding answers from our government and election commission. We matured into responsible, democratic citizens. We learned the importance of check and balance and a two-party system. We became better Malaysians.<br />
<b>So to all Malaysians, whether you voted or not on Sunday, congratulations on learning this valuable lesson. This is our first step forward on a long road to a mature nation. We mustn't be defeated by a night of fraud as the future is upon us. And God will always be with the righteous until truth prevails.</b>JYSimhttp://www.blogger.com/profile/14019206630494448815noreply@blogger.com0tag:blogger.com,1999:blog-84976063475909621.post-55734728881323336472013-05-03T22:04:00.003+08:002013-05-03T22:08:56.058+08:00Voting My Absentee BallotThe 13th Malaysian General Election will be held on May 5th, 2013. For Malaysians residing overseas who registered for absentee ballots, we cast our votes a week earlier at the nearest Malaysian embassy or foreign office. As I completed my registration back in February, I was told to present myself to the Malaysian Friendship and Trade Centre (MFTC) in Taipei last Sunday.<br />
On arrival, there were crowds of helpful Malaysian students stationed near the entrance offering assistance for those unfamiliar with the procedure. They were dressed neutrally and bore no symbols or signs of any political party. At the lobby of the office, three MFTC officers checked us in by striking out our names and requesting our signature. We were then told to queue to enter their 8th floor office.<br />
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We were told the office they occupied was small and can only accommodate 4 voting booths. Hence the 20-minute wait in the lobby. The atmosphere was quite pleasant with mostly students exchanging small talk and discussing study plans.</div>
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After we were invited up their office, another MFTC officer verifies your identity and hands you your ballot papers sealed in an envelope. "Affairs of His Majesty The King" with "Election Commission of Malaysia" printed.</div>
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We can collect the ballot papers and vote there right away or leave and vote at a place of our choice with a legal witness. For those unwilling to vote at the office, you'd have to bear the costs of hiring a witness and sending your ballot papers back to the EC.<br />
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We unseal the envelope in front of one of three witnesses provided by the MFTC who cross-checks your name, identity number, and ballot serial number on both the parliament and state ballots. Somehow I don't feel my votes were confidential given that my ballot serial number is printed on my verification letter which must be attached with my ballot. However, as the witness explained we were to put our ballots in another sealed envelope which will be handled confidentially, I think the procedure is barely acceptable.</div>
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I voted in an empty booth, put all the papers in their respective envelopes, sealed them, and drop them into a large gunnysack hung right at the exit of our voting room. And I completed my first voting as an honourable citizen of Malaysia.</div>
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As mentioned in my previous post, your vote is your choice on behalf of your country. It represents what you believe in and who you give that mandate to govern and manage our country. It is our integrity, our democratic right, and our future. To all fellow Malaysians, <b>please make every effort to vote on Sunday</b> and may God bless our motherland.JYSimhttp://www.blogger.com/profile/14019206630494448815noreply@blogger.com1tag:blogger.com,1999:blog-84976063475909621.post-15727374635921688612013-04-26T20:55:00.003+08:002013-04-26T21:09:46.523+08:00Kindness of Strangers Part 2Several days after the last post, two bombs detonated 12 seconds apart near the finishing line of the Boston Marathon. Its aftermath shocked the world with news that trail even until today. Like many other acts of terrorism, the world is never again a same place after such tragedies and we can only pray for the innocent souls of those lost fighting against it.<br />
The Boston bombings stirred up a mixed feeling inside me. I went to Boston twice and loved the city for her charm and history. In fact, last summer I spent nearly an hour at Copley Square, the main venue of the bombings. It definitely sent a chill down my spine to recall the beautiful afternoon now.<br />
On my flight back from Boston last summer, I chance to sit next to a Vietnamese American working as a firefighter in Boston. He was what you'd call a typical American jock - extremely muscular, wears deodorant, and packs bags of snacks up the flight "because airline meal portions are so small". Amidst his confident physique, I can tell this is his first time on a flight - right after settling in he began to fiddle with the reading lights, seat pockets, coat hanger, and tray table. It was a brand new Boeing 787 (they are still airworthy back then) with sophisticated seats. After his 10-minute inspection he sighed "they thought about everything, didn't they?"<br />
I helped him with his earphones as airlines use a two-pronged jack instead of the regular iPod one-pronged jack. Then he started talking to me about his family of two boys and her wife. "Aren't they the most beautiful thing you've ever seen?" showing off their pictures on his iPhone.<br />
"Where are you heading to?" I asked.<br />
"Vietnam. Hanoi to be exact. I'm visiting my sister whom I haven't seen for 7 years. She doesn't know I'm coming."<br />
"Must be a very nice surprise then."<br />
"Yeah, I called her husband to pick me up from the airport."<br />
"How long is the entire journey?"<br />
"Eerm...almost 24 hours I guess. I leave Boston at 11 am and arrives in Hanoi before midnight local time."<br />
He later requested a beer to which the Japan Airlines stewardess replied "do you want Kirin, Suntory, or Asahi?" (all Japanese brands) We stared at each other and back at Ms. Nakagawa with a blank face. She later gave us 3 cans each to sample. I hope they didn't run out by the end of the 13-hour flight.<br />
He was a nice seatmate who offered me plenty of snacks throughout the flight while I helped him with the touchscreen television. I regretted not taking down his name although I am bad with names. Even if I did I'd forget them right after I collected my baggage or leave the airport.<br />
A few days after the bomb incident he suddenly came back in my mind. As a Boston firefighter he is almost certain to be involved in the series of explosions or the rescue efforts later. I saw the pictures of the casualties and was relieved he wasn't one of them. I hope he and his beautiful family are well, and that they get to visit Vietnam again soon, together.<br />
For most people a bomb going off somewhere might not affect you at all. For others it means a loss of a parent, child, or loved one. If we believe in love, we must remember that no human being have the right to end another's life. They are loved and so are you.JYSimhttp://www.blogger.com/profile/14019206630494448815noreply@blogger.com0tag:blogger.com,1999:blog-84976063475909621.post-30660704081838298882013-04-13T21:50:00.002+08:002013-04-13T21:51:04.182+08:00Kindness of Strangers Part 1Just to break the monotony of hospital life, I decided to write a little about the kindness of strangers I've encountered throughout my travels abroad, just to remind me that some, if not most people out there are good in nature and isn't trying to <a href="http://edition.cnn.com/2013/04/12/world/asia/taiwan-train-evacuation/index.html">blow up a train with 600 people</a> as happened recently.<br />
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<u>Bordeaux, France - 2008</u><br />
In the summer of 2008 I spent one month in Bordeaux under the care of the Nocart family. Under a bilateral agreement between the Taiwanese and French Medical Students' Association, a local medical student will provide lodging for me while I leave a sum for a Frenchmen in exchange to Taiwan. It so happens the medical student hosting me is traveling in Taiwan when I'm there and we never actually met. I'm completely under the care of his mum, Claudie, and brother, Alexandre. In short, they were complete strangers to me.<br />
Things started to go wrong at Kuala Lumpur International Airport. My Paris-bound flight was delayed for 2 hours awaiting the arrival of 20 passengers from Jakarta. We were an hour late into Charles de Gaulle and the queue for the TGV was horrible from all the morning arrivals. Three hours after arrival, I manage to get a ticket to Bordeaux, but the train was 2 hours later than my intended arrival. I tried calling my host but it went into voicemail (it was 7 am local time). Unable to speak a single word of French and wresting my baggage through Gare du Nord, I gave up and jumped on the southbound train seconds before it departs.<br />
On arrival at Bordeaux, nobody is waiting for me. After 15 minutes in the empty station, jet lagged and tired, I went to the Tabac and brought my first and only French phone card. Just as I started dialling the number, a petit but energetic lady jabbed my back.<br />
"You? Sim?"<br />
And so I was saved from living on the streets in Bordeaux.<br />
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We went home, had a sandwich, and through broken English and hand gestures she said she needed to go to work. The house was then completely mine. I fell into a 16-hour slumber and woke up at 8 am the second day ready to go to work.<br />
When I come home later that day, the key into my apartment isn't working. I tried slotting it in from various angles but it just wouldn't work. Just as I picked up enough courage to go talk to someone (in French), a hunky, moustached Frenchman approached me and shook my hands.<br />
"Hi, Sim! It's so nice to meet you!"<br />
You can imagine I'm more than startled. Do the French have the ability to tell your name from your face?<br />
"Oh, we saw you fell asleep when we came back yesterday. I am Alex, Nicolas' brother."<br />
And so began our friendship celebrating its fifth year this July.<br />
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Part 2 to continue...JYSimhttp://www.blogger.com/profile/14019206630494448815noreply@blogger.com0tag:blogger.com,1999:blog-84976063475909621.post-92006993477713911832013-03-31T14:40:00.000+08:002013-03-31T14:42:46.797+08:00Routines in the SICUMedical care is surrounded by routines - fresh bloodwork every morning, nasogastric tube care, bed baths etc. Somehow in a forest of routine nursing work, our internal system, aided by whatever miracle drugs physicians prescribed, have the intrinsic ability to heal itself from all the chaos and assaults of disease.<br />
On the other hand, family members of ICU patients have their own set of routines. They only get to visit from 10.30 to 11 am and 6 to 6.30 pm everyday. These precious 60 minutes become a treasured moment for families. Especially so when the patient's conditions are deteriorating and the end is imminent.<br />
Every morning after ordering routine tests for my patient I would write the morning's progress note standing beside the bench on SICU-39. At 10.30 am sharp family members would be allowed in. All donning the pale yellow overalls as a feeble attempt of infection control, they would stand beside their beloved's bed and start their daily routine.<br />
This wife of SICU-39 is there every morning, repeating the same words like a recorder - "it's me, Yun Ling is with me today. Can you hear me?" "We are waiting for you to come home. The grandchildren can't wait to see you again." "If you hear me, will you blink your eyes?"<br />
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After several minutes of unresponsive soliloquy, Mrs. SICU-39 will take out her expensive Samsung mobile phone and play recordings of her grandchildren's message. This is the most heartbreaking part of their visit.<br />
"Granddad, I'm Xiao Xiao. Take care of yourself and come home to us soon!"<br />
"Hey <i>ah gong</i>, I am Xiao Xiao's classmate who visited last week. Get well soon and <i>jia-you jia-you jia-you</i>! [translated: I give you my wholehearted support]"<br />
My eyes will invariably swell with tears after several rounds of <i>jia-you jia-you</i> but I try to remain composed and refrain from leaving. Before they leave, I'd always nod and smile to Mrs. SICU-39 in recognition of her resilience. We became nodding acquaintances over the course of several days.<br />
One day, after finding her husband in worse shape than previous days, she walked over to me.<br />
"I think he's taking a turn for the worse."<br />
I am not obliged to talk to families as I am not yet a licensed practitioner. However, there is no one with authority around.<br />
"We started a new medication this morning. We'll continue to monitor him over the weekend for any changes. It will take about 2 to 3 days for the drugs to take effect."<br />
She looked at me in the eye and said, with speckles of tears in her eyes, "it's ok if he doesn't wake up anymore, we all knew you (the medical team) did your best."<br />
Her revelations broke my heart even worse than Xiao Xiao and her classmate's recitations. She loved him so much but had just realize things could never be the same again. It must take her a great amount of courage to utter "it's ok" - to let go of her routines, her struggles against the fragility of life.<br />
Every person has the ability to love and be loved. To be given the knowledge to salvage love is certainly an honor. Yet at times like these, we could only do our best. At the end of the day, what matters most is whether you did your very best.<br />
And I shall miss Xiao Xiao's voices soon.JYSimhttp://www.blogger.com/profile/14019206630494448815noreply@blogger.com2tag:blogger.com,1999:blog-84976063475909621.post-64288725590574310812013-03-21T21:42:00.001+08:002013-03-21T21:43:54.786+08:00Thank You Sir Arthur Conan DoyleFor creating Sherlock Holmes and Dr. Watson. And thank you BBC for making it into an awesome TV miniseries.<br />
I know, it's almost 3 years since Season 1 and an entire year since the end of Season 2. I'm late in the bandwagon, but like anybody else I thoroughly enjoyed every episode and character.<br />
A few weeks ago I mentioned I feel for both Dr. Watson and Sherlock. They are like two parts of my multiple personalities. I will elaborate further here with my similarities with Dr. Watson and Sherlock:<br />
<br />
John Watson<br />
<ol>
<li>We both keep a blog for simpleminded people. And I think it's a reason why it's popular. In fact, you can visit Dr. Watson's blog <a href="http://www.johnwatsonblog.co.uk/">here</a>.</li>
<li>We share caring personalities for people that mater to us.</li>
<li>As with Watson, I am more comfortable in a supportive role instead of a major crime-solving lead</li>
<li>We have high standards of moral integrity</li>
<li>We work rather rigidly</li>
</ol>
<br />
Sherlock Holmes<br />
<ol>
<li>We are more intelligent than ordinary people *ahem*</li>
<li>We get irritated when people distract us while we are thinking</li>
<li>We are impatient with other's slow thoughts</li>
<li>Right at the end of the spectrum in social skills, when circumstances requires it</li>
<li>Cannot stand boredom</li>
</ol>
Actually, I'm so bored waiting for Season 3 now that I almost re-watched all 6 episodes to find any clues for Sherlock's fake death. This one scene from Season 1 Episode 3 describes my feelings most aptly right now.<br />
<br />
<iframe allowfullscreen="" frameborder="0" height="360" src="http://www.youtube.com/embed/hPCnsex4Wlg?rel=0" width="640"></iframe>
<br />
Shouldn't you be studying instead of spending all your evenings watching the same miniseries? You ask. Well, I had my ways of surviving in the challenging field of medicine. The truth is I am always so tired after coming home I simply can't face taking out my books and see words fly around me anymore.<br />
So just as a reminder to study and read more until I graduate, here's my favourite character with an important message.<br />
<br />
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<a href="http://2.bp.blogspot.com/--NcxBsWadFQ/UUsOJfWQjnI/AAAAAAAAC_4/wfjVlx55_WM/s1600/You-should-sherlock-30095676-1248-702.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="358" src="http://2.bp.blogspot.com/--NcxBsWadFQ/UUsOJfWQjnI/AAAAAAAAC_4/wfjVlx55_WM/s640/You-should-sherlock-30095676-1248-702.jpg" width="640" /></a></div>
<br />JYSimhttp://www.blogger.com/profile/14019206630494448815noreply@blogger.com1tag:blogger.com,1999:blog-84976063475909621.post-46711288138975633602013-03-09T21:12:00.002+08:002013-03-09T21:13:05.698+08:00A Symbol of ResistanceLike it or not I have been in Tzu Chi University for 7 years. It is not exactly a blink of an eye - there were good and bad times - and I'll be leaving school in 3 months' time! How exciting is that!<br />
Given Tzu Chi University is barely 20 years old, 7 years is a big feat and things were certainly a lot different from what it used to be when I got in here. One significant change has to be the student identity cards.<br />
The school changed the design of our student IDs twice over the past 5 years. The first design was the original design (herein termed "original") that I got when I enrolled. It was nothing special but it contained everything important from your IC number to parent name (for what I could never comprehend). At the back of the card, the bar code is HUGE and hence very easy to scan when entering the library, paying for food etc. In short, original is a respectable, functional, and reliable student ID which I had cherished for more than 6 years.<br />
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How did I end up with two student IDs you ask? Well, seeing that I'm about to graduate, I decided to keep my ID as a momento and declare it "lost". After NT$ 150 and 3 working days I got our new second generation student ID which is hideous and silly (herein termed "new").<br />
First of all, the English fonts bearing the name of the school made it looked like a kindergarten. This card contained no information at all except your name, school number, and your faculty at the left corner which is easily neglected. Then we come to space utilisation - what is the use of all the empty spaces between my name and my faculty?<br />
At the back of the card, the bar code is half the size compared to original which makes it very difficult to be detected. Then there were rows and rows of useless articles dictating the laws and bylaws of student identities according to the Ministry of Education.<br />
A novel function of new is an RFID chip embedded inside the card. So instead of waving helplessly for the bar code to be detected, you just swipe it over an RFID detector while paying your food. However, as student meals are subsidised (or so they say), it only allows one payment per meal. Poor students like me who eat ourselves into the red every semester can no longer rely on other students to pay for food. I resisted switching to new when they made the overhaul but seems like my resistance is futile now that I'm about to graduate.<br />
I am only glad I kept original with me during all those tough years of medical school. Now when I graduate I can return this hideous new ID and keep original as a symbol of resistance from all those years of poverty and hard work.JYSimhttp://www.blogger.com/profile/14019206630494448815noreply@blogger.com0tag:blogger.com,1999:blog-84976063475909621.post-28648568238641319782013-02-25T21:08:00.001+08:002013-02-25T21:08:10.993+08:00Postal Voting RegistrationAs the Malaysian government is nearing her 5-year term and on the verge of being dissolved for fresh general elections, I am anxious about how I can exercise my right as a citizen to vote when I'm overseas and unable to return.<br />
Turns out it is really easy.<br />
The Election Commission of Malaysia is currently accepting registrations for postal voting of Malaysian voters residing overseas.<br />
If you fulfil <b>all</b> conditions listed below, you should register as soon as possible:<br />
<br />
<ol>
<li>Malaysian citizen</li>
<li>Registered voter: check your status <a href="http://daftarj.spr.gov.my/DaftarjBM.aspx">here</a> by entering your NRIC</li>
<li>Residing overseas <b>except</b> Singapore, southern territories of Thailand, Brunei, and Kalimantan, Indonesia</li>
<li>Had been in Malaysia for more than 30 days during the past 5 years before parliament or state council has been dissolved</li>
</ol>
All you need to do is print out a copy of <a href="http://www.spr.gov.my/images/stories/pdf/Borang_1B.pdf">Borang 1B</a>, fill it in BLOCK LETTERS, and return it via one of the following:<br />
<ol>
<li>Email to upup@spr.gov.my</li>
<li>Fax to +603-8881 1201 / 1202 / 1187 / 1192</li>
<li>Mail to: </li>
</ol>
<blockquote class="tr_bq">
Suruhanjaya Pilihan Raya Malaysia Aras 4-5, Blok C7, </blockquote>
<blockquote class="tr_bq">
Komplex C Pusat Pentadbiran Kerajaan Persekutuan 62690 Putrajaya </blockquote>
<blockquote class="tr_bq">
(Attn: Unit Pengurusan Undi Pos Luar Negara)</blockquote>
You will have to decide which Malaysian High Commission the Election Commission should send your ballot papers to for you to receive them. A full list can be found <a href="http://www.spr.gov.my/images/stories/pdf/Nama_dan_Alamat_Pejabat_Perwakilan_Malaysia_di_Luar_Negeri2edit080213.pdf">here</a>.<br />
For more information, please visit SPR's website. The above information was translated from Bahasa Melayu to English from SPR's featured bulletin <a href="http://www.spr.gov.my/index.php?option=com_k2&view=item&id=34%3Apengundian-pos-di-luar-negara&Itemid=189">here</a>.<br />
<br />
Lastly, it is your right as a citizen to vote. Please exercise your right as a democratic citizen in deciding the future of our country and children.<br />
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<ol>
</ol>
JYSimhttp://www.blogger.com/profile/14019206630494448815noreply@blogger.com5tag:blogger.com,1999:blog-84976063475909621.post-42369033596830098272013-02-19T15:13:00.001+08:002013-02-19T15:17:38.285+08:00Till the Next Chinese New Year in Penang<div class="separator" style="clear: both; text-align: left;">
Feeling really grateful for being able to spend almost 3 weeks back in Penang this Chinese New Year, which is up to 3 times longer than most of my classmates' break. I did it with a lot of lobbying and under the table tactics that I would not share with you in broad daylight *mischievous evil laugh*.</div>
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Anyway, it might be a very long time till the next CNY back in Penang given that I will start my PGY year in August and continue with peds residency after that.</div>
<div class="separator" style="clear: both; text-align: left;">
After 7 continuous years of spending CNY in Penang while in medical school I shall welcome something fresh next year. Whether it will be a lonely meal in Taiwan or doing calls in a chaotic festive hospital, I shall cherish happy moments from an easier time. After all, this is part of the professionalism required from us, and I hope to rise to the challenge.</div>
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<br />
Come to think of it all festive season is about friends and family. It is all about spending time with them and showing how we care. In other words one doesn't need any festive season to visit or talk to a relative if you truly care for them.<br />
This year is special because lots of high school friends are back awaiting government posting while my cousin's wedding dinner was held during CNY week. Needless to say it was a crazy week for all of us. I am only glad it was all over now but was more than happy to had spent quality time with my uncles and aunts, schoolmates, and parents.<br />
The past few months had been rather confusing for me. Indeed I mentioned I needed time to think about my future this holiday. I am glad all that is (roughly) sorted out now with help from lots of beloved family and friends. I will save that for future posts if the opportunity arises.<br />
The next 3 months in surgery will certainly be tough but it is the last quarter till graduation. Thereafter I will have a 2-month study break which I will spend half of the time in Penang, again. It will be a new journey from then on and with mixed feelings I look forward to it.JYSimhttp://www.blogger.com/profile/14019206630494448815noreply@blogger.com0tag:blogger.com,1999:blog-84976063475909621.post-47239551273190184642013-02-14T11:29:00.000+08:002013-02-14T11:35:39.569+08:00New Year ConversationsIt's the season you have a love-hate relationship with - from the bumper to bumper crawl downtown before the actual new year to the leftovers and bully talk of the sinister aunt - it is Chinese, or rather, Malaysian Chinese at their best. With social media dominating our very lives nowadays, no longer do they need to depend on gossiping for your marital status or annual salary. They rub salt right on the wounds.<br />
"I heard you lost your job? Why's that?"<br />
"You broke up with your girlfriend of 10 years? She's an angel, it's absolutely your loss!"<br />
Nevertheless, the meeting up with old friends, <i>ang pau</i> from generous relatives, and gourmet food that you get to savour only once in a year is like the morphine that saturates one's mesolimbic system urging one to return for more every year.<br />
It is also the time of the year one must watch out for fatigue and overeating from entertaining guests. Add greedy friends inviting you for endless rounds of poker and blackjacks in order to siphon money off your yearly earnings, this can made for a very tiring season.<br />
Anyway, with that in mind, the best way to ward off nasty elements like these would be to practise moderation and learn to say no despite of the odds.<br />
<br />
"Eat more, boy! You're too thin!"<br />
"No-<i>lah</i> auntie, It's because I'm sitting right beside you. Heard of Einstein's Theory of Relativity?"<br />
<br />
"When are you getting married? You should learn to be responsible now that you have graduated!"<br />
"Oh no auntie, I wouldn't want to rush into a broken marriage like yours. That's why I'm not married yet."<br />
<br />
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<br />
Same rule applies for the friends who boast of their six-figure annual salary and hilltop bungalows. Being about the same age as you, a little sarcasm won't spoil the fun.<br />
<br />
"This Alpha Romeo of mine takes only 4 seconds from 0 to 60. I wanted the Ferrari which takes only 3.6, but she is too much of a fuel guzzler."<br />
"I feel bad for the brakes, Penang having a jam every 3 blocks or so. I hope the brakes can get you down from 60 to 0 in 4 secs. I wouldn't like to burn paper money for my friends yet, not when I haven't made my first million."<br />
<br />
"Gucci bags are so expensive this year I decided to get Coach."<br />
(singsong voice) "So sad they didn't make First or Business you have to end up in Coach."<br />
<br />
With my conversation principle, I can guarantee you'll be guest-free by next year's Chinese New Year. Imagine all the savings you will enjoy - no heart-stopping artery-clogging fat-laden CNY cookies, no mandarine oranges, no guests who overstay their welcome etc.<br />
Last and not least, the festive season is all about family and friends, so don't spoil somebody's fun by showing off your latest gadget from Mars or space-technology suits. After all, they are probably all made in China and nothing to be proud of after 3 months.JYSimhttp://www.blogger.com/profile/14019206630494448815noreply@blogger.com2