Friday, April 4, 2014

Candid Moments

Sometimes it does not take a great photo to remind you of a great moment. That is why I think there is beauty in classic film cameras or polaroids. You can only have like 24 photos in a film roll, and unless you are willing to spend a lot on films, you have no choice but to be prudent on your shots. You would take the most candid and spontaneous moment in time. No taking a bunch and deleting the bad ones, no redoing shots, no photoshops . One single photo. One single moment. Miniaturized into a piece of glossy paper. That is why you see a lot of shut eyes, blurry motions, glares and stuff. But those imperfections...they themselves tell a story. Digital cameras and all its editing softwares makes us look too perfect, sometimes to the point of being artificial. It is not wholly a bad thing, though. But I miss the times when we look ugly in film but do no not care to delete it because it has already been printed.

Anyway, back to candid shots, I took this picture below spontaneously, almost like a reflex. Like, who would take a picture of a dull fuel station? I totally forgot about this photo because it pales in comparison to the more amazing photos I took hours after this was taken: upclose shots of hyenas, lions, hippos and wild buffalos. But somehow, browsing through my pictures in Africa months later, I found this picture and it reminds me of the most exciting thing: the journey. This was taken on the way from Johannesburg to Kruger Park. We had to stop at this fuel station in the middle of nowhere. It was so sunny I bought ice cream and remembered eating them while watching a pack of buffalos crossing the dirt road.

Yes the safari is amazing, but one of the most exciting part of traveling is the journey, where you don't know what to expect in front of you, your head is filled with ideal images you found in traveling books and online travel guides, and also with plans on what to do once you've reached your destination. I also get the same feeling when the flight is taking off. It always feels like a start of an adventure, no matter where my destination is. I guess it is true, that in traveling or in life achievements, what we cherish most is not the destination, but the journey to get there. The struggle. The climb.

Thursday, April 3, 2014

The Time In-Betweens

I used to look forward for things to end. Like in high school I look forward for SPM to end so I can study medicine. In pre-clinical medical school I wish for pre-clinicals to end so I can practice clinical medicine. In clinical medicine I wish to graduate fast so I can become a doctor. However, once I have started working I realize that my eagerness for things to end has slowly fade away. A big part of it has to do with the daily routine of rushing here and there and the next thing you know the day comes to an end. A smaller part of it has to do with the fear of growing old. Time flies really fast when you are working 'in the zone'.

Now I just wish for time to pass by slowly. I no longer look forward for things to end. Housemanship may be considered a tough period of a doctor's life but I don't wish to rush though it. I wish to live in the present, enjoying life as it happens to me. There is so much things to do when we're still young. If I keep a mindset of wanting everything to end: finish Housemanship to become Medical Officer fast. Finish 2 years of Medical Officership to go into Master's program fast. Finish Master's fast to become specialist fast. Do subspecialization fast. The list will never end and the next thing I know I will find myself sitting in a clinic with a distended tummy.

Recently I've learned that creative endeavours, like writing in this blog does not necessarily happen when you have tons of time. It happens during the short periods between busyness. When you know you are going to be busy, you will try to find the time in-betweens. Like here I am, 5 a.m. and writing. I am still struggling to find the time in-betweens to do non-medical stuff, but I am trying. Creative endeavours are important, but it is important to make it in-between your daily job before it can flourish as an independent endeavour. As far as motivational speakers ask you to just jump and follow your passion to fully focus on what you're truly passionate about, it may take some time.

I am talking about a job in general, not focusing on the medical career. This is partly due many Malays that I see quitting their daily job to open an online shop or painting or playing in a band and stuff. Then realise it couldn't sustain them financially, and went back to their former job. A daily job gives you the security of a sense of belonging, a medium to keep in touch with people, and of course the financial security for you to keep a focused mind while you are doing your creative work. So keep your job, do things in-between, and when you're art has flourished, when people start buying your stuff like banana fritters and you become confident it can sustain you financially, then you make the jump.

My mom would read this and worry if I would quit medicine and go painting someday. But nah, this is just a general advice for people who are considering to make the jump in career too soon. I am just finding time in-between my shift duty to write more. I admire Atul Gawande, a surgeon in the USA whom wrote 3 books in between his surgeries, which all I read with much respect towards his thoughts.

Friday, March 28, 2014

Life of a Houseman

I could not even begin to describe how my life has changed tremendously for the last one month. My current and previous work is nothing like one another. I used to work 40 hours a week, from 9 to 5 in Geneva. Even if I go to the gym in the WHO building, it still counts as working hours. Even my 30 minutes nap after lunch in the 'Quiet Room'! Little could I imagine back then that I would now be working more than 85 hours a week, waking up at 4.30 AM everyday, drive 20 kilometres to work, arrive around 5.30 to 6 AM, and work non-stop till 8 PM. That's more than 12 hours a day.

Life back when I was a medical student was even much easier. We go to lectures and teachings. No class? Go to sleep. It is true that working as a doctor and studying medicine is a whole different thing. Medical school is all about medicine. Full stop. Working as a doctor, half of the time involves non-medical stuff like dealing with patient's family, implant company agents, police officers, wardens in the nearby Sungai Buloh prison, lawyers, private investigators, SOCSO agents, and once I have to even deal with SYABAS, a water supplier for one of their employees who they believe is faking or exaggerating his illness. It's a crazy world, this doctoring world.

I was overwhelmed in the beginning, thinking 'what the heck, is this really what I want to do all my life?'. During the start of my work, when I was tagging, the job seems so daunting that I wake up with anxiety and nausea everyday. As taggers, we have to know all 28 cases in the ward, expected to present them at any time during ward rounds, without looking or refering to any notes. The task was gargantuan, and we have to stay until 10 PM everyday, which is the earliest (usually we won't be able to go back until 11 or 12 PM because of more work), and come to work at 6 the next day. That left like 3 to 4 hours of sleep everyday. I did that for 19 days, until I finally got off-tag. It was really a tough time for me.

But I always believe that we can get used to anything if we expose our brain long enough to the new challenges. Our brain rebels when there is too much new information coming in all at the same time. It needs time to digest things. It has been a month and my brain has started to accept this new working environment. I no longer wake up feeling anxious and nauseous. I begin to take more responsibilities, managing clinics, scrubbing in to operating theatres, attaching to the emergency department. Work is still stressful especially in the morning before ward rounds, but the stress goes downtrend as the day goes to an end. At the end of the day, nothing beats the feeling of driving back home feeling good you had a patient's sugar or blood level controlled just by putting a sign on the drug prescription, you sutured close a gaping wound nicely and stopped the bleeding, you nicely trimmed some fingers that went into a cutting machine, and inserted a steel rod into the legs to temporarily help with fractures. It is a truly satisfying feeling.

I no longer have doubts if this is what I will be doing all my life. It can be fun, but we can't see it while we are in the middle of the hectic working hours. It is time like this current moment, where I have a half-day off and working night shift tomorrow, that I can take a step back, think about what I did for the past one month, remember all the things I went through, that I feel it is worth being a doctor. For me, if a work is too much it becomes stressful. But if a work is too little it becomes depressing. I remember times where I had a whole day to write just a single report, but it becomes so depressing because I kinda have a mental block when there is too much time and I don't know what to write. I start writing 2 hours before the deadline in the end and feel depressed again feeling that I could have done a better job. Working in the hospital, you never have free time to be depressed about work. It's stressful, but it's a positive stress. All the work is done in the ward, when you go back you pass over your patients to the night shift doctor, and you go home not needing to worry to much because you believe your patient is in the safe hands of your colleague.

So in the end...yeah, being a houseman doctor isn't so bad. The only thing I still resent is the inability to confirm and convince to your non-medical friends when you will be free. I have always been asked for appointments and meet-ups for either HBB or just catching up. It is so hard to confirm a date where you'll be free because we work on weekends and our day-off can fall on any day and changes every week. It sucks, but otherwise, life's OK ;)


Sunday, February 16, 2014

Mountains Beyond Mountains


My favourite paragraph from Tracy Kidder’s Mountains Beyond Mountains. To be honest, I never expect to be working at the ‘HIV Central’ of Malaysia. I always thought that I will be posted to Kuala Lumpur General Hospital. But God has better plans for me. I could not even believe I am saying this, but after 10 month being away from clinical work, I am longing to start again. I enjoyed working at the WHO HQ in Geneva, global public health is still my passion and it will always be, but the field is so vast, and I feel that I need to carve out my own niche, and infectious diseases, the biggest threat to public health, is one of the things I am most interested in. If I look at the public health figures I look up to most, they are physicians first, leaders in public health later: Mahathir Mohammad, John Snow, Paul Farmer, Rudolf Virchow, to name a few. I truly believe that by diagnosing diseases of a person, it will shape your mind and way of thinking to diagnose diseases of society in unfathomable ways. In Rudolf Virchow's words, "Politics is nothing but medicine on a larger scale". So come tomorrow, "ID says treat. Love, ID".

Saturday, January 4, 2014

2013: Take It and Go

The past couple of weeks have been so refreshing. I wanted to use the word awesome but I think the words has been too overused last year so I am going to save it for an appropriate event, like, seeing auroras or volcano blasts or things like that this year. My department was on holiday for almost 2 weeks since it is an international organization, everybody gets back to their home countries for Christmas. Since it is easy and quite cheap to get anywhere around Europe on the train, I decided to do a bit of the tour.

The first place I went to, my friend and I met this young couple living in a small ski town in the Alps. We had the chance to see their house and hitch a ride with them to the train station. To be honest, we couldn’t really converse very well since their English is not that good, but from the little bits of conversation, I gather that they are very content with their lives, and that fascinates me. It is such a beautiful place to live, really, surrounded by mountains, lakes and lush landscapes, and they leveraged on that by living simply and being in touch with nature. For one thing, the house was built by their father, on his own, brick by brick. They have good internet but prefer to stay off social media and they fill their time taking long walks on weekends instead, hiking, cycling, skiing, and the likes of that. Many times during our conversation, they would tell how proud they are to live in the small village, away from the hustle bustle of the city. I have wanted to tell them yes, that makes their attitude totally different from the people in the nearest city we were in. I don’t think anybody in the city would be kind enough to let us hitch a ride to the train station and let some strangers see their house. There is just too much paranoia in the city.

 It makes me miss the times when I live such simpler lives too. So I gave it a try, one morning in Zurich I went off all social media, deactivating Facebook and Twitter, and just let my feet take me anywhere I see attractive. Being so used to uploading photos every time I see anything interesting and updating every thought in writing, I seem to struggle at first not to reach for my phone. But then, later a sense of freedom starts to overwhelm me. Walking through the old cobble-stone alleys of Zurich, I no longer see the beautiful scenes mostly through a camera lens, but instead with the perfect view of my eyes. Camera lens never do justice towards the beauty of nature anyway. The city, the old buildings, the lake, with the background of the majestic snow-capped mountains, I sat at a high point in the city and be still in the moment, observing life below me pass by, thinking these are the moments in my life that I feel most alive. It is true. These are the moments when I have full gratitude to the Creator for letting me live another day.


The renewed sense of freedom was so good that I felt I could stay this way for awhile, at least until the end of my holidays, since many of my work, especially with my NGO depends heavily on social media. So I still stayed off until I decide to write this entry, early new year, 2014, where my work starts again tomorrow. I have seen a lot of things in 2013, travelling across continents back to back. Doing things I never thought I would. But one thing I learn about doing things out of your normal circumstances, is that the ‘out of ordinary’ thing, now becomes the ordinary. I am not sure if that is a good thing or not, but it actually puts me at peace. It is not like losing interest and excitement in life, as if coming down with depression, no. It more like looking back, still couldn’t believe you did all that, smile and not talk about it unless being asked to. I think that is one way for a wise person to be humble. Do extra ordinary things when you are young, so you don’t grow arrogant with inflated sense of self-importance when you are older. Because you have done all of it when you are young, and it doesn’t mean too much to you anymore, that you don’t have to talk about it 24/7. Yeah, I like that idea. I am going to be content, say 2013 was a great year, and leave it there. In the words of Russell Peters when imitating the Indian culture: “Take it, and go”.