Delightful Days in Ipswich

One early summer in 2011, a quartet of students were flown 6557 miles across the continent from Malaysia to the United Kingdom to ultimately find themselves in the small, strange town of Ipswich, one of the oldest town in England where the locals spoke in a queer medieval English accent and the bus stops face the opposite side of the road. These are the students of the arts of healing, or medicine as some call it. They were sent to this peculiar town with the trust of their Professors to learn the ways of curing ailments associated with the ear, nose and throat, commonly known in abbreviation as ENT. Although they went on separate voyages from Malaysia to this foreign land, along their stay in Ipswich they would stay close when it comes to their intellectual endeavours inside the four walls of the hospital named after the town itself: Ipswich Hospital, where stories of birth, growth, decline and death were confined into. The long hallways of the hospital were lined with glass windows and dozens of artwork by an artist by the name of David Poole, and each morning they would make their way past these hallways to the east side of the hospital, where their morning feast awaits. Devouring the typical menu consisting of fried eggs, hash browns and bread as fast as possible, they would then rush towards the opposite side of the hospital and ascend to the second floor where the square one of morning rounds is.

As opposed to the hospital they were used to back in their homeland, there was no dedicated ward for ENT patients in Ipswich Hospital. The patients were scattered in different wards around the hospital, compelling them to travel from one ward to another, making out their typically British names: Stowupland, Somersham, Framlingham, Brantham and Martlesham to name a few. Wards to wards, patients were found one by one by this flock of gleeful doctors and upon reaching their beds, their elated moods would be tuned down to suit the patients’ temperament. Curtains were drawn around the bed, temporarily delineating them from the rest of room, allowing transactions of confidential information about their illness to take place, followed by questions, answers and advice, which would all be simmered down into two opposing conclusions: ‘you can go home now’ or ‘you need to stay a bit longer’. Customarily, compliments would be given to the doctors for the former, and complaints for the latter. Along their way to see another patient, the doctors would also discuss deliberately among themselves in quiet chatter about further plans for the latter case. One by one, the patients were seen, greetings were exchanged, compliments and complaints were gathered, and patients were sent home, until they eventually arrive at the clinics, marking the end of the morning rounds and the beginning of consultation hours.

Arrival upon the clinics on the South side would usually be greeted by pleasant and courteous nurses, most memorable was the one by the name of Celia, who has a way of saying ‘good morning’ in a cheerful manner to which the students would have a difficult time not to reply with a fairly equal amount of cheer. Their path would temporarily separate here as they reach for different doors numbered one to four, finding themselves in a small room with a large window which the nurses would slide downwards to let the refreshing summer air in, a big table for the deliberate work of the doctor, a small sink for the killing of germs, and numerous other doctor’s tools of trade. Laid in a perfect triangle were 3 chairs of different shape and size. The smallest and most ordinary of them all was for the students to sit and listen, the larger one that swivels around was for the doctor to sit and talk, and the largest one with hand rests, which when tilted fully forms into a bench, was for the sick one to be treated. For hours, the doctors would attend to the patients while the students listen attentively to doctor-patient conversation.

The gap of time in between patients was the only time for the students to ask questions to the doctors and vice versa. With names such as Hilger, Yung, Baska, Satish, Raj, Ogunniyi, Qureshi and Anjayi, it is not difficult to swerve away from medical themes and ask the doctors where they were actually from, followed by the question of ‘where the doctors of actual English descent have gone to?’, but the students feel that it is not a fitting question to ask, for the fear of being accused of chauvinism. Sometimes, the patients can be quite amusing but laughers were held as long as the patients were still in. Once out the door, they would burst out in laughter at the punched nose, ear plugs left in the ear, or the small toy left in the child’s nose. Sometimes the doctors can be quite amusing too. Once a doctor point out to one of the student that her dress was too long, when in fact she was wearing the traditional Malay dress ‘baju kurung’ which was meant to be that long. This happened for hours, until noon where lunch calls for a break, and in the evening they would either go on with the clinics or they would scrub into inky blue surgery attire and enter the operating theatre where miracles happen by the minutes.

Such were their daily endeavours in Ipswich that it became a routine for them to gain knowledge this way, every day. Without them realizing, it was nearly the end of their venture in the foreign land. On their last day, they spent time taking photos, hoping to capture the good memories together with these lot of joyful people. But nothing compares to the memories that will replayed again and again later in their minds . One of the students who had this sheer love of cafés experience went to a perfect one he found by the pier. He admired the glow of the evening sun and the sight of boats docking in and sailing out of Ipswich. Sipping coffee, listening to the likes of Jack Johnson, Kings of Convenience and Damien Rice, he lets his mind meditate. Suddenly each and every moment, even small things, feels much more meaningful. Soon he will be home, shouldering more responsibilities and living more expectations. But none of those worries bothered him. He was in a state of total detachment. For a moment, he was in a total peace of mind. Like a painter, come whatever, he thought, he will take time to close his eyes and paint this feeling of tranquillity and continue to live the life he was bound to live. 

Revivify

I think the coolest things on earth are those which are both:

1) Simple
2) Elegant 

I tried to redesign my blog to fulfill those two criteria. After a whole night tinkering around, I think this design would do. I'm also happy that I can now post uncompressed high resolution photos like the one I took up there. Guess you will see more pictures on this blog from now on. So why the sudden change? If you have been my follower since before the advent of Facebook, when Friendster was still the 'in' thing, you might realize this design is quite similar to the blog I previously had on Friendster. I missed that blog. I had a few posts there, and I had this sudden idea of reading what I wrote there again, just to see how my writings have evolved over the years. But to my disappointment, Friendster is now nothing more than a gaming website, and all the blogs written there has vanished into cyberspace oblivion. There goes my teenage memories.

I think that is the nature of social networking sites. You will never know if someday Facebook will no longer appeal to the young generation, replaced by Google+ or anything better, and all the things that you have written there will be lost. Poof. Just like that. I reckon that blogs are a better way of keeping stuff online, because even if blogspot.com is gone, I can always get my own domain and transfer the same contents into that new domain. I guess I will work more on this blog from now on. It gives me some kind of relief that my significant memories are stored here. Just in case I forget someday

On Taking Time

‘Damn these city people, never know how to take their time!’’ 

I’ve always realized that most of the things The Professor said were agreeable with me. But that curse was one of the most agreeable. We were at some traffic light in Amsterdam when the lights just turned green, and just as the Professor was kicking in the gears, the car behind started honking deafeningly. 

‘’Where is he going so fast anyway? There are more traffic lights in front!’’, he asked me. A rhetorical question. I just shrugged. The car drove past us, and a few meters later we were next to him again, side by side before another red light. ‘’See?’’ The Professor said, satisfied that his prophecy was fulfilled. He was about to give him the looks, but his son warned him ‘’Careful dad, we might end up in a fight here’’.

His son has lived in Amsterdam for quite some time. He knew how the city people would react. The Professor has always lived in the outskirts, or in small towns where people are less aggressive and had more time. Living in Kuala Lumpur since I was born, I consider myself a city people, but I couldn’t agree more with the Professor’s philosophy about people always rushing around and getting nowhere. Two days spent in his house was enough to show me that. 

The Professor is the author of several books in ENT, which are used as textbooks in medical schools around the world, he is invited to almost all the prestigious ENT society meetings and conferences in the world, he has a happy family with equally successful children in different fields (one was a ballerina who’s internationally recognized, the other was an economist for one of the largest bank in the Netherlands, and others I couldn’t recall), and he made some important discoveries in the field of ENT. Yet, his life seems so simple, seems to always have ample amount of time, sometimes you just have to wonder how did he became so successful. He has a beautiful garden full of flowers and every morning he would smoke cigarette (okay, this one is not a good example) in his garden and admire its beauty. Then he would come in, have an espresso, turn on some jazz or blues music and sit to read. When some idea sinks in his mind he would get up into his study to write. Then he would get to work. On evenings he would take his dog for a walk around the neighbourhood. At night he sometimes cooks for his family.

His favourite mode of transport is walking, second by boat (you can get to anywhere in the Netherlands through the canals) and lastly by car, and his car is the smallest Volvo I’ve ever seen (about the size of a ‘Smart Fortwo’), and he likes that car because it is convenient and doesn’t takes much time finding for a parking space and getting it serviced. I loved his sense of simplicity.

Boats are common mode of transport in the Netherlands
Jazz might be a good choice to unwind

One of the evenings, as we were sipping coffee by the garden, he asked me about my plans after medical school. I told him the usual script, finishing medical school, undergo housemenship for 2 years, go on becoming an MO, then a specialist. ''Well that’s not very clever’’, he said. I wasn’t surprised, I got used to the way Dutch people tell things: direct and straight to the point. ‘’You’re still young, you know, there’s so much time left for you’’. He told me to learn something new. ‘’You can work when you’re older, but now at a young age is where you learn and let the creativity spark. You have much more energy’’. This idea might be so foreign to us, but that is how things are in most western countries. They take time to learn something new, take a year off to write, do research, get another degree not related to the ones before. I am not saying it’s the right way to do things, but it is very different from our culture of rushing from one phase of life to another. Finishing medical school ASAP, then finish houseman ASAP, get a specialist training ASAP, but in the end where are we going? Maybe taking a year off to work with some NGOs at the most desperate of places is more satisfying, or writing a monumental book that people will read long after you die, or do research that makes science forever indebted to you.

If there is a notion that busyness equals success, The Professor is the epitome of its fallacy. Maybe, in this modern world people always equate busyness with productivity. The busier you are (or you may seem) the more productive you are. Watching The Professor living his daily life begged me to differ. Some people strive so hard but are not going anywhere. Perhaps they are trying too hard doing insignificant things. Or maybe struggle too much in preparing things, but when the real moment that really counts: an interview, a presentation, or even a date, they falter. 

In economics, there is a law called ‘The Pareto’s Law’ which states that, for many events, roughly 80% of the effects come from 20% of the causes. In business, researches shown that in most companies, 80% of their sales come from only 20% of their products (cash cow products, as business people call it). Taking these principles into daily life, 80% of successes in life can be attributed to focusing on the 20% of efforts. Some people call this ‘The Law of Least Effort’. 

How many times have you a heard about students who seems to know everything crumbled in exams? Maybe they focused on the 80%, but neglected the 20% really matters: The gist of the theoretical knowledge that can be uttered flawlessly during presentations and exams. Or perhaps they neglected to simplify their knowledge into meaningful words for a stressful peri-exam brain. Or maybe about the story where someone tries to satisfy each and every one of her friend and fans but in the end neglected the 20% of people who really matter in their life? Or about the people who work so hard every day but ends up with a heart attack for failing to include exercising and eating healthy food into the crucial 20% of his life?

Identifying the 20% of things we need to put our efforts into is not easy, and differs from person to person. Someone might say that writing contributes to 80% of their success while they only spend 20% of their time doing it. Some say it is it includes reading, attending courses, spending time with family, exercising or joining a cause. I guess it all comes down to prioritization. Once you’ve identified the 20% if things to be prioritized, you will find that you actually have an abundance of time. Spend time on the 20% of things that matters and the rest will come by itself. May you become one of the most successful and happy people on earth

For The Professor, his 20% is writing and researching. His papers and books made him well-known all around the world. He realized that, and continued to focus his energy on that small portion of overall time. Hence, he has more time doing leisurely things with people he cares about. 

As we arrived at Schiphol Airport in Amsterdam, he walked me to the departures. ‘’Well, it was nice having u to stay with us’’ he said. I don’t know how to thank him enough, but told him I appreciate his courtesy very much, and we waved goodbye. As he walked away, I can imagine him going back to his laid back life, taking his time, sipping coffee, having a laugh with family and friends, and some time when ideas arrive, he will be up in his study to write yet another masterpiece.

Trying out some shoes at Zaanstad's wooden shoe workshop
 

Bounce!

For the last two weeks, I essentially did two postings in one. With only one working ear, the other one discharging fluids, and did I mention my head is producing a constant ringing sound out of nowhere? There’s no big deal skipping classes more than a week in high school, but in medical school, a week is equivalent to a semester in high school. Plus, I am in my short postings where one posting lasts for only 2-3 weeks. I was admitted for more than a week, and by the time I get back to class my ophthalmology posting was ending and I have to go on with anaesthesiology. At first I thought of just going ‘the hell with it’, and repeat the whole semester. With constant headaches and vertigo, I even considered repeating the whole year! But I knew I’m better than that. I’ve been through some crazy things in life. Though nothing has been more painful than this (since the eardrum is one of the most innervated organs in our body, a perforated eardrum rated 9/10 on the pain scale, similar to having a heart attack, but of course less painful than giving childbirth), I can’t let this bring me down.

 

So I held on. Staying in the operating theatre learning anaesthesiology morning till evening, and continue with ophthalmology clinics till sunset, and continue writing case write ups for both postings at night. Filling log books for both postings, alternating between ophthalmology clinics looking into 20 pairs of eyes and presenting each one to the consultant, then enter the operating theater to observe spinal taps, dural taps and whatever else taps there is in this world. Then there's the mini clinical examination for ophthalmology and Basic Life Support examinations for anaesthesiology. Hell, I don’t even know how I did all those things in just two weeks. Well, there are nights where I just broke down into depression and ask the usual question of 'why is this happening to me?'. But to think of it, many great things also happened to me in the past, and how come I didn't ask 'why is all of these great things happening to me?' Everything that is sent down to me, whether it is a great thing or a disaster, is from the Almighty. Who am I to choose only the great things and fret upon the bad? I have to accept all that is given, good or bad, because I believe, in the end, everything that He sent down to me is for my own good. I just don't realize it yet. So to be fair, I just bounced. 

I am supposed to be in Denmark right now for the IFMSA General Assembly and in Hong Kong last week to do my presentation on Health Economics that I worked my ass off preparing for months. Both are burned now since my ears are busted and I can't ride a plane for some time. Well, they say that you can't always get what you want. But I will never stop trying, I will grow through this pain to be stronger and better than ever