Thursday, February 26, 2009
This entry is meant to detail some of the events that took place with no intention of highlighting or diminishing any deficiencies/special advantages of the situation.
Also, in light of the very 'medical' nature of this entry it is understandable that those with no background in the medical field will find it difficult to empathise much less comprehend some of the issues pertaining to the index circumstance and as such any comments or opinions from such parties should be considered with that in mind.
so i was oncall again since yesterday night (which i hate to be, to be frank, but that doesn't mean that i do not give my best when it comes to patients and all... it's just... well, if you were oncall you would understand).
And at approximately 6am this morning i get a phone call from a very nervous-sounding nurse in the labour room..
from what was said on the telephone (which i shan't go into much technical detail), this were some of the anticipated problems:
1. A woman who's very well into her labour by the time she came to the hospital was unaware that her baby was in breech presentation.
Breech presentation to put it simply means that instead of the normal position of the baby's head being at the bottom (i.e. the first part of the baby's body to be delivered), it was the baby's butt.
2. Moderate meconium liquor.
Again, without dabbling too much with the details basically it is a sign of possible fetal distress or asphyxiation (i am oversimplifying... to learn more please read up from a trustworthy source).
3. CTG showing fetal tachycardia and Type 1 decelerations.
Basically, another 'not very good' sign with regards to the baby's overall status.
i rushed to the labour room with plans to arrange for an emergency lower segment Cesarean section.
anyway, cut the long story short while in the midst of arranging it the baby couldn't 'wait'!
And so, i was 'forced' to conduct my first ever breech vaginal delivery!
And without any obstetrician (specialist) around at that!
Not even the obstetrics and gynaecology medical officer (who was on the way but not there yet)!
See, in this day and age this sort of thing is hardly done because usually once a pregnancy has been confirmed to be breech presentation during follow-up, the plan would be to arrange for a C-section somewhere close to the time of delivery or rather when the pregnancy approaches 'term' meaning that the baby is mature enough. Such arrangements are made because it is deemed far safer for the baby and mother to undergo surgery... i.e. breech vaginal delivery carries with it more risks!
i prayed silently as i steeled myself to do what i had only learnt years ago in theory.
Thank God for wisdom and grace because everything went smoothly and the baby was delivered safe and sound!
The mother was fine too!
*vinod wipes the sweat from his forehead even now as he recollects the whole episode*
while, to be honest, this was probably one of those 'once-in-a-lifetime' experiences... i really do pray it only happens this once in my lifetime ;)
Wednesday, February 25, 2009
i definitely need to work more and more at peeling the veneers of my superficiality and dig deeper into building 'substance'.
Sure, through the years and through the trials and tribulations, God has been and always is still interested in my growing to become the man that he wants me to be. By His will and grace, in submission to His hands, i've seen myself 'moulded' and 'refined' (and in many ways still being moulded and refined).
However, i believe that as we grow and mature in our relationship with Him, it becomes somewhat a 'natural' progression that the concern and 'work' of building ourselves up does not solely lie in His hands.
Yes, as 'children' who needed 'milk' we needed to be therefore 'fed' and in some instances perhaps even 'forced' into situations and circumstances that would result in our betterment as an outcome...
but, i feel and think that more and more as we grow into His sons and daughters and mature to a point of desiring and needing 'meat'... more and more the whole issue of our personal choice grows in it's significance as well.
God, in my humble opinion, wants us to move from a position of just doing things because we have to, to a position of doing things because we want to and maybe even doing things because we know the good that it does for us and for others and for the glory of God.
He wants us to grow in our involvement with what He is doing in our very own lives and of course the lives of those around us.
No longer being just passive recipients but more so active participants. And by that i don't just mean busying ourselves with more to do but rather 'doing' more.
let me see if i can elaborate...
Holiness is an example.
Perhaps as a 'young' believer and maybe new in our faith, we found keeping ourselves holy 'solely' God's responsibility. We entrusted ourselves to Him to keep us from temptation and 'prevent' us from succumbing to it by His grace... hoping secretly that we'll be safe from ever having to face some of these 'challenges' and praying that our lives will be 'temptation-free' so that we'll never have to come to terms with them and risk failure.
But, as we grow i believe keeping ourselves holy becomes just as much our responsibility.
Of course it's true that if not for God and the Holy Spirit and the enabling overcoming grace and power of Jesus that works within us, we will all fall flat on our faces... but still the choice to exercise that power and appropriate our faith rests very much in our hands... and i sincerely believe God wants us to grow more and more 'comfortable' with that whole fact.
He's raising up a generation that KNOWS Him.
Knows who He is.
Knows His heart and what He wants.
Knows who they are in Him.
Knows what to do and why in the light of giving Him glory and pleasing Him.
i sometimes feel that we (myself included) forfeit our mental faculties when it comes to our lives in relation to God (much to God's dismay) and reduce ourselves to becoming 'reflex-action' disciples... which is an oxymoron in itself because disciples don't just do something because they were somehow 'supernaturally wired' to do so... disciples have LEARNT and DISCIPLINED themselves to do so. So instead of choosing to do the right thing because we've learnt and commited and 'discipled' ourselves to Him... we wait to see how we feel about it and to see if it all comes 'naturally'.
We somehow come under the false notion that obedience is 'automatic' and so when faced with challenge, opposition and temptation, we wait for 'autopilot' to kick in when in actual fact there is no such thing.
My mind goes to David who despite being the one who was after God's heart and who was 'passionate' for Him... fell in adultery and even resorted to murder later (mind you, not as a young boy but as a fully-grown man and King at that).
My mind also goes to Jesus who despite being the Son of God (if anybody should have had 'autopilot' mode it would have been him) and yet it has been clear in the Word that he was not exempt from any temptation known to man. In fact, it was also documented how he faced the devil and his temptations head on and overcame... not with signs and wonders... but with the knowledge of who God is.
Hebrews 5:14 (New Living Translation)
"Solid food is for those who are mature, who through training have the skill to recognize the difference between right and wrong."
so i tell myself... come on step up to the plate and start 'getting more involved'... 'doing' more about my own faith and walk with the Lord.
time to get under my skin...
Monday, February 23, 2009
i sure hope so.
of course there is the issue of how immediate is 'immediate' (especially taking into consideration the 'track record' of the ministry thus far when it comes to me) but still...
i'll take whatever i can get ;)
Sunday, February 22, 2009
i've already had a certain level of respect for him after reading some of his replies and viewpoints in the newspaper not too long ago.
But, after reading his book (which is actually more like a collection of his letters and articles previously published)...
my respect and admiration for him and more so what he stands for has been renewed.
His sense of justice and 'fair play' as well as sincere interest in the virtues and higher principles of law pertaining to democracy and freedom are noteworthy to say the least.
Through his writings it becomes increasingly apparent that he really has a sincere and passionate sense of patriotism... in that he really desires to see this country progress, in all aspects and to grow to become the mature thinking society and nation that we should be.
It's definitely inspired me to look at and consider the issues facing our country more seriously and with more sincerity.
It's sparked a similar sense of patriotism to see and contribute to this country's development in more ways than just economically.
This is our country and perhaps it's about time that we step up to the potential and possibilities of making this nation all that it can be...
a vibrant economy,
a centre of research and technological advancement in the region,
but perhaps most of all, a mature and intellectually developed nation that's exemplary in it's pursuit for peace, understanding and unity in it's diversity.
Tuesday, February 17, 2009
yesterday i finally fulfilled my long-kept desire (well, actually only over the past few months after noticing kites flying in the sky everytime i walked home from the hospital) of flying my very own kite! =)
of course, at first it was pretty embarrassing since i attempted to do so right outside the compound of my house, where there literally was no wind... and all i could find myself doing was run around in circles trying to get my kite to go up when all it would do was come crashing down right after ;)
*vinod shakes his head at the sheer recollection of how silly he looked!*
To which, after numerous attempts, my dear wife out of sympathy suggested that we go to the beach instead.
Thank God for her brilliance and compassion ;)
*vinod recalls how his wife was shaking her head and smiling while doing her best to keep herself from bursting out in laughter at the sight of her dear husband making quite the fool of himself*
It was wonderful!
The beach really is the best place to do this sort of things ;)
And wasn't it just oh, so therapeutic!
Nothing like seeing something 'dancing' in the sky to it's own apparent tune... unaffected by the hustle and bustle below... nonchalant and naive of the 'forces' that it's actually subject to up there amidst the clouds and birds of the air.
Bold, yet beautiful.
so to those who've never ever indulged themselves in this 'gem' of a past time (you know who you are...hehe)
Go fly kite!
Sunday, February 15, 2009
all this while i've made do with just my own style of typing which isn't too bad but pales in comparison to the proper technique.
i guess it was easy to make excuses for myself before but i finally gathered the courage to grit my teeth and make the conscious effort of typing the right way ;)
it's definitely a handy skill to say the least and in view of all the future work i foresee myself doing on the computer (even now the the load is growing)... it's going to really be a valued skill.
besides, it looks 'super-cool' when you're able to type at the speed at which you're thinking... or almost ;) and on top of that without looking at the keyboard!
if that's not a good enough reason, i don't know what is ;)
sure, my hands are hurting from all the previously 'unused' muscle groups and it's taking me way way longer too...
no pain, no gain ;)
p/s: i wrote this whole thing 'properly' ;)
Wednesday, February 11, 2009
Perhaps more so in the suburban and rural areas -which i happen of course to be working in, although i do at the same time have to say that 'civilisation' i realise is very much an issue of mentality because i've met my fair share of patients and their families or significant others who are very urbanised indeed but have the mentality and perspectives of cavemen!
Just to set the record straight there is such term (unless i coincidentally made up a term that happens to exist somewhere in the lost annals of the law) as "consent-by-proxy", so to speak.
Of course, there is the concept of a parent or guardian giving consent when it comes to children and those below the legal age but that is because of the fact that these individuals are deemed not entirely capable of making an informed decision on their own so as such the responsibility lies in the hands of those who are more able (i.e. parents/guardian).
And in other cases where the patient or the individual patient is unable or incapable due to whatever reason to give informed consent as in for example the case of certain mental disabilities and the like the next of kin or even a person appointed by a governing body (in some instances even a court of law) thereby gives the power of making such decisions to that person instead.
And in other cases still (which i think is exclusive to healthcare and the like) in which decisions are made on behalf of the patient or victim in situations that can be life-saving where the doctor (usually the case) makes the decisions and is given sort of an 'implied consent' to carry on with a particular procedure in the best interests of the person in order to prevent death... there is that concept of someone taking the liberty of giving consent on behalf of the recipient.
However, that's not what i'm talking about cos' in all these cases the concept is valid and even necessary.
What i am talking about is the frequent (well, disturbingly often at least) occurrences of patients who are themselves fully able of making informed decisions on their own and yet resort to and leave themselves at the 'mercy' of their husbands/uncles/aunties/even boyfriends who most if not all of the time do not know any better. And to make matters worse, are not experiencing the brunt of the pain and suffering and threat to life that the patients themselves are subject to.
Let me give an example and simplify it in as much as i can.
i recently was attending to a patient, a relatively young lady, who quite simply was in kidney failure.
She was already experiencing all the complications as a result of her problem but when i urged her to undergo dialysis which in her case is life-saving and could translate to many more years added to her life her response was... i need to discuss with my husband.
Now, i totally understand the need to include spouses and even family in the healthcare of patients and in fact in some cases it is even more warranted because it involves them inevitably in terms of lifestyle changes, logistics, emotional and mental strain and even finance.
However, in some case where there is no other option really and time is not on our side, the urgency and severity and most of all the potential benefit demands a complete response especially from the patient in question.
Still, i let her go back and discuss the issue with her husband.
To my dismay, she later on came back to me with the reply that they (or rather her husband) has decided that it is not necessary.
Sorry, did i miss something?!
Is your husband the one with kidney failure?
Is your husband the one suffering through the complications that ensue?
Is your husband going to suffer from eventual heart failure and death as a result?
of course i didn't say all this out loud. But i made sure that i got the idea across that the patient herself had to deal with her own problem and consent to it and not wait on 'every word that proceedeth' out of the mouth of her husband because she's 'paying' for it.
i know the Bible talks about the body of the wife belonging to the husband and vice versa but i believe that it means to say that the spouse must love and take care of their partner's personhood and even physical body as if it were their very own.
In some of these case i see, it's the direct opposite.
They seem to be harming the person instead of helping them!
i would go so far as to say that some of them are literally killing the very persons they are supposed to love and care for.
It's sad really.
Tuesday, February 10, 2009
"KOH LAY CHIN A sad state of affairs where everybody pays "
HOW weary it is. This is the season for glory and glitz -- that is, if one were to cast their eye westward. In the shining centres that are Hollywood and London, everybody is in the mood for the great win. It is trophy season, where actors and musicians cross their fingers for that hard-earned victory.
For the winners at the Golden Globes, Oscars, Grammys and others, this means more public adoration and critical acclaim. And thank God for the entertaining performances, all-round glamour and sweet successes at these award shows.It is a welcome sight indeed, a distraction, if you will, for over here in Malaysia, everyone is pretty much on a losing streak. All corners of the political divide are paying the price, whether deserved or not. As the bedlam of Perak still continues to exasperate, let us look at the list of people who have lost something in the process.
Jelapang assemblyman, former DAP member and now independent Hee Yit Foong has lost her credibility and the respect of her constituents. Indeed, her loss is such that even her family members are said to be paying the price for her decision.And the other two defectors, Behrang and Changkat Jering assemblymen Jamaluddin Mohd Radzi and Mohd Osman Mohd Jailu?
The two have lost all trust, and those who seek to take them under their wing would know full well the value of what they are getting.Bota assemblyman Datuk Nasarudin Hashim will forever be known as the man who did the quickest political gostan (10 days), and starting the frog-leaping that brought down Perak's Pakatan Rakyat government. Freedom of association may be one thing, but the manner in which these four conducted their swaps is another. Good luck to their future political ambitions, if the voting rakyat will let them have any.
But there are others who are paying a price, no matter which way you look at the Perak fiasco. The Sultan of Perak, Sultan Azlan Shah, and his son, Raja Dr Nazrin Shah, hitherto the golden royal household, beloved and respected by all Malaysians, suddenly found themselves at the centre of a very public heartbreak. Whether deserved or not, the esteemed sultan's decision on the issue shocked the many supporters of the Pakatan government in the Silver State and beyond, and left them wondering about the rejuvenated pillar of power and moral authority the royals seemed to promise.
For all his Sept 16 bravado and boasting, opposition leader Datuk Seri Anwar Ibrahim has tasted the bitter sting of defection. He has been blamed for his obsession with bringing Barisan Nasional MPs into his fold, and no less than DAP stalwart Karpal Singh has even asked for him to step down as Pakatan's head.The ultimate cost indeed is Pakatan's loss of Perak administration, just about a month short of what would have been their first anniversary.
But Barisan Nasional also pays in this recent turn of events. They may have regained a state, but at what cost? Allegations of poaching with promises of millions have been rife. So have criticisms about the abrupt "takeover", complete with the shooing of former Perak menteri besar Datuk Seri Mohammad Nizar Jamaluddin and his team from their offices.
Such disparagement will be the foul-smelling, uninvited guest that BN will have to bear with when the new Umno leadership comes into play in March. Both sides of the political divide have yet to realise that nobody likes a show-off, or a display of gloating.Last but not least, the rakyat pays too. We lose time, money and attention that would be better used on more important things; not the least the mammoth preparations necessary to meet the global recession. We must be one of the few nations now completely engrossed with politicking while the rest of the world quiets down to a murmur to focus on the nitty-gritty of the economic slowdown.
Thus in this sad state of affairs, everybody pays. What can we do besides watching the trophy season to beat this weariness? Perhaps we can all turn to Rudyard Kipling.
In his inspirational 1895 poem If, he urges us to "keep your head when all about you are losing theirs and blaming it on you", and to "trust yourself when all men doubt you, but make allowance for their doubting too".
He writes of not dealing in lies, and not giving way to hate. Of treating Triumph and Disaster, "those two impostors, just the same", and to start again when you have lost everything.
Kipling ends his memorable piece with: "If you can talk with crowds and keep your virtue, or walk with kings nor lose the common touch, if neither foes nor loving friends can hurt you; If all men count with you, but none too much, if you can fill the unforgiving minute with sixty seconds' worth of distance run, yours is the earth and everything that's in it, and -- which is more -- you'll be a Man, my son!"Perhaps If could supplement the fifth principle of our Rukun Negara -- "Courtesy and Morality" -- which has been given short shrift of late.
well said, well said.
Sunday, February 08, 2009
So judging from how this whole issue of me having never sat for SPM and in particular SPM BM has been revealing it's ugly head every now and then i decided to give it another go and see if i could sit for it.
i figured, maybe the last time i went through the ardous process of trying to get it sorted out and they (as in the Ministry of Health) turned around and finally said i don't need to sit for it and should sit for another BM proficiency exam that they conducted (which i did sit for and passed) ... maybe they got mixed up and left me with the short end of the stick.
So here's what i did.
i called the Jabatan Pelajaran Negeri Labuan and found out, with a sincere intention to apply and get this problem over and done with.
The lady who picked up was quick to reply that the forms won't be out till March and that i could apply then and sit for the 'July' paper... only that now it's no longer termed as such but rather it's called a 'REPEAT' paper.
To which, me, using my God-given common sense replied, "Well, i didn't sit for SPM at all. Can i still sit for the REPEAT? Would it be a problem?".
She paused and said she'd check.
A minute later she asked me how old i was (don't know what that has got to do with it).
5 minutes later she comes back and tells me that i can't sit for just the SPM BM paper since i've never sat for SPM at all. Instead, she gives me the option of sitting for at least 6 subjects of SPM to be able to sit for the BM paper! (actually come to think of it that's about exactly the same response i got the last time i inquired while i was back in KL..only that it took them much longer to give me a definite answer)
You mean i practically have to sit for the entire SPM (i think 6 subjects is the bare minimum right?) to be able to sit for the SPM BM paper???!!!
So the Ministry of Defence denies me my application based on the fact that i don't have an SPM BM credit and now the Ministry of Education says i have to sit for the entire SPM to be able to even qualify to get the SPM BM credit... and the Ministry of Health asked me to sit for an exam that seems to have no particular use or bearing elsewhere (whether it even has a bearing within the Ministry of Health has yet to be definitely determined too)!
Thanks but no thanks.
Have i ever mentioned that i'm 'amazed' at just how beautifully our government system works sometimes?
*vinod rolls his eyes as far back as he possibly can*
Thursday, February 05, 2009
And their answer is NO.
Reason: i don't have SPM BM
*vinod slaps his forehead in disbelief*
And this too in the light of a recent statement by our Prime Minister himself urging the public to consider a career in the military in view of their desperate need of manpower.
Looks like beggars can be choosers.
On a much more positive note:
At least it's clear which direction God wants me to go in (or not go in for that matter).
He does know best ;)
In years (or maybe even months) to come, i'll look back on this and smile and thank God for closing this 'door'.
i can't help but 'laugh'
Seriously, what's with all these defections and 'party-hopping'???
Frankly just as a matter of basic principle i find it embarrassing. It only proves the level of maturity or should i say the lack thereof of our political leaders and representatives.
Everything appears so self-centred and ego-driven.
Where's the sense of responsibility?
Where's the sense of representation?
Where's the sense of accountability?
Where's the sense? (period)
i mean when these individuals were elected into power i believe they were not just given the opportunity and privilege to hold their respective posts only because of their individual personal traits but more so for the vision of the group or political party they represent.
And they're supposed to believe in that cause and call to a collective effort themselves (i mean, they joined the party out of their own free will right?).
It's pretty obvious that the contrary is true.
The only agenda on these individuals minds are but to serve their own interests.
i mean come of it...
As it is the world is facing an economic meltdown and every country is bracing itself for the brunt of what may come... and here we are, still playing the game of who's in who's team!
If anything, the current challenges that we're facing as a nation especially in the light of the vulnerable and frail global economy should only drive us to focus our efforts collectively towards tackling these very impending predicaments and prepare in advance and as best as we can for the betterment of our people and nation as a whole.
But here we are... jumping parties like it's a game of hop-scotch!
So i guess instead of securing ourselves in the face of economic instability our leaders are just planning to add to it by shaking our already rocky political boat!
it's not just a betrayal to the party they represent but a betrayal and insult to the citizens of this country who voted and had their trust invested in them!
i pray that in due time (in fact sooner than later) our leaders will find in themselves the wisdom and courage to look beyond themselves.
i pray let the original purpose and intentions that these leaders had as they started out (i'm sure they all started out well intentioned) be revived in it's sincerity, integrity, altruism, honour and nobility especially in the face of such trying times across the globe.
And i pray that they remember that the power they have is a power given...
given by the rakyat... and so may their decisions and actions be becoming of that privilege and responsibility entrusted to them.
My lowly 2 cents.
Monday, February 02, 2009
i think it’s an absolute wonder how people can come up with melodies and lyrics to accompany them right off the top of their heads.
i mean talk about creativity and being original! Can you possibly get more inventive than that? i honestly don’t think so.
Amongst the various art forms, music has got to be one of the most outstanding (at least in my opinion… and I’m hardly the music enthusiast).
i mean how does someone come up with something that not only sounds different but is pleasing to the ear and relates to the soul.
Most if not all of the other art forms make use of what’s already there.
Paintings are mostly based on something that’s seen either at present or sometime or other. Even if it’s imagined, surely there’s some point of reference isn’t there (if we’re absolutely honest with ourselves)?
Sculptures needless to say are about the same.
Even sketches, plays and the like make use of various points of reference… usually permutations of a myriad of experiences and things that the writer himself has been exposed to.
So essentially these art forms are just exagerrations and alterations of ‘stuff’ that’s already there. Twisted copies if i may be so blunt to call them.
That’s not to say they’re not beautiful and breathtaking in their own right.
Still, music is different.
Where’s the point of reference?
i mean you don’t hear songs when you’re walking through the park or you’re working at the office or your lying in bed (unless you have your radio or iPod or something of the sort turned on).
And if you say you’re point of reference is other songs… then you’ll just end up producing something that sounds just like them… not even a twisted copy but just a copy.
Ya sure, you may have influences and all that but bottom-line the finished product (especially the really good ones) sound like nothing anybody has ever heard before.
Maybe my fascination is more pronounced because i don’t have a musical background at all. i’ll embarrassingly admit that i’ve actually tried to ‘compose’ a song (more like come up with a tune) some time before and it was one the most difficult things i’ve ever attempted to do! No joke!
It bewilders me. Just where do these songs come from?
Does God in His good pleasure suddenly drop these tunes into peoples heads straight down from heaven?
Is it a mere stroke of genius?
Enlighten me… somebody.
Having said that, i guess it's pretty obvious that i have the utmost respect and admiration for those among us who are 'song-composers'. My hat's off to you ;)