Still here

We took an evening stroll down the Tonle Sap river at Chroy Changvar today. The exact same place I described in this blog post where I wrote about ‘the kind of day I wish to live all my life’. Well, guess what? 3 years later, I still get to live that kind of day, but with more fun company with my wife and son by my side. We’ve been spending the last 4 months in Phnom Penh, with some periods of time back in Malaysia (our visa only lasts for 1 month per entry), and so far, it has been a pretty fun stay!

Walking along the Tonle Sap river

I am here for my doctoral thesis project to enable value-based health care at HBB Clinic. For that, I implemented a cloud web-based electronic medical record (EMR) that I had developed myself (learned coding from scratch, JavaScript to be precise – React.js to be even more precise). I had to develop it myself because currently there’s no EMR that captures all the data needed to assess value of care all in one system - including clinical data, patient-reported outcomes, activity-based costing and timing data. 

Screenshot of sample patient from my EMR

Phnom Penh might not be the most convenient city to live in, but I guess it is the activity that we do here every day that made the stay more meaningful than living in a big city with a better amount of resource. There is a different kind of satisfaction when you wake up in the morning and know exactly what to do and being aware that every decision will make an observable difference. Another huge plus-point is being able to do all this while being flexible with our time - very important for a family with a one-and a half year old!

I usually wake up early to make sure I wake up before Umar does. I could get a solid couple hour of work done at this time. When Umar wakes up, we get ready for breakfast. Kamaliah usually prepares breakfast while I take Umar for shower, but sometimes we just get ready for the day and go to a nearby ‘Mamak’ restaurant when we miss eating ‘roti canai’ and ‘the tarik’.

While here, Kamaliah manages a hearing care center called HCC, started by my family a year ago. She’s in charge of 3 full time staffs working there, so sometimes she will have meetings with HCC staffs in the morning, so we depart to HBB later in the afternoon.

Prof Sharaf, Malaysian Orthopedic Surgeon and long-time family friend, visits HCC

So, I am back to doing what I was doing 3 years ago, in charge of the 5-staffed HBB Clinic. HBB is around 30 minutes away from HCC. We always go there together. At HBB, I help the staff use the newly implemented EMR, listen to their suggestions, teach them a bit on value-based care and do meetings to discuss about HBB in general while Umar plays with the cat and Kamaliah looks after him. Sometimes, we get visitors from Malaysia, so we take them for a tour around Phnom Penh and HBB.

Teaching the staff to use the EMR

During this time, I also oversee a renovation of the clinic. It has been 4 years since the clinic was launched – it’s time for a new look!

Before

After

Before

After

In the late afternoon, we take walks, sometimes along the river like today, sometimes in shopping malls, or if we’re too lazy to walk we’ll just hangout at one of the new hipster cafés or Boba tea joints. The shopping mall is Umar’s favorite place because he gets to play at the indoor play area called ‘Kidzoona’ which has all sorts playing props.

Umar playing doctor-making-burger

We are almost at the end of our stay in Phnom Penh. While I won’t say that it is absolutely the best times of our lives, it is certainly a valuable moment that we will cherish. I mean, life is Boston is good, it has everything (thanks Amazon) and access to knowledge and learning is unbeaten anywhere else in the world. But I can’t be totally flexible with my time because of class, meetings and appointments. Nothing beats life back home in Malaysia too. Nothing can replace the satisfaction of being close to your families and being home where you truly belong. 

But living here in Phnom Penh is a unique experience, where most of it has to do with the amount of time we get to spend as a family. While doing work, we get to see every second of Umar growing up, learning new things. Everything we do involves the whole family. It hasn’t been all smooth, Umar has his tantrums and we get totally exhausted some days, each of us had times when we got really sick. But all in all, it is very unlikely that we will forget the times spent here. With HBB Clinic being here to stay, I guess we will always be coming back.

Kamaliah's 27th Birthday

One morning not a long time ago, as I was preparing to go to class, I heard Kamaliah say:

“Semalam abang tengok ratio lelaki:perempuan untuk predict anak kita boy/girl lagi ke??” (Were you looking at the male:female ratio to predict our baby’s gender again??).

The previous night, we were surveying on Google for the best strollers around (still contemplating between Nuna and Uppababy). Somewhere along the way Kamaliah fell asleep, and suddenly I find myself pulling up graphs for the Malaysian population’s gender ratio and the predicted age-dependency ratio. The next morning, when Kamaliah saw all these graphs on her Macbook, she immediately knew what I was up to (it was not her first time seeing those graphs).

Kamaliah will tell me that I am lame for predicting our child’s gender based on the latest ratio (107 males : 100 females), and for worrying too much that the high dependency ratio in 2050 will cause our child to be burdened by high taxes to finance healthcare for the old population (a positive argument for national health insurance).

Such a pity marrying someone who’s so much into health economics! Kamaliah learned these less useful things from me, but on the other hand, what I learned from her is so so much more. Let me name a few. Kamaliah taught me to cook good Malaysian food. One of our favorite do-together thing now is our cooking! You see, I was hopeless before, but Kamaliah persisted in teaching me and now I can cook Malaysian food…not that great as her…but edible. I also always enjoyed going to the Asian grocery with her, and her eyes will lit with excitement and she will go “Abang, abang, abang tengok ni!” for every single item she found that is made in Malaysia.

Another thing I learned from Kamaliah is to replace ‘screen time’ with ‘people time’. We spend so much more time together these days, and we had a lot of weekend adventures together. We went whale watching, strolled through Salem in the midst of Halloween season, watched our very first Broadway theatre in New York, went seafood hunting in Cape Cod, and drove through the roads to New Hampshire to admire the beauty of autumn foliage. One of best sayings we also learned from the whale-watching tour guide is that “sometimes people spend too much time looking at these whales on their phone screens that they forgot to enjoy the majestic experience of being in front of these big creatures”. Since then we put our phone down, enjoyed experiencing one of the largest animal on earth in front of our eyes, and do not care much anymore about likes and comments on social media. We’ve practiced living in the moment since then. It is so much fun when you have one person you can share all these great memories with. One like and live comment from her is all I need.

However, all of these learning could not beat the exciting lesson of being future parents! We can’t wait to welcome our baby into this world. During our last doctor’s appointment, we can already see our baby move his/her hands. It was so surreal, and literally changed my perspective on life. For the first time it feels so real that we will be having someone who is totally dependent on us, everything we decide, everything we do will affect him/her. People say that once you have children, everything you do, you will have them in mind. I guess we can start to feel that.

Happy birthday Kamaliah, my wife, my love. Thank you for being so strong, patient and supportive. I pray to Allah to always keep you within his blessings, each hour and every day, and be the light that guides you, each step along life’s way. Thank you for all the great times, and let’s look forward to growing up (and old) together as parents, insyaAllah!

Our First Wedding Anniversary

Last weekend Kamaliah and I celebrated our first wedding anniversary. We spent time on a private island north of Pulau Kapas in Terangganu. The trip was much more of a honeymoon than the one we had last year in Cambodia, which we end up seeing patients at their houses instead. People say the first year of marriage is the hardest, I guess because as in any process of learning, the beginning is the toughest part. It was even tougher because 2016 was a year of drastic change for me. Several months after we got married, Kamaliah found out that she was pregnant. Not long after, Hospitals Beyond Boundaries shot to international prominence. She was there in New York when it all happened. Kamaliah had to bear the brunt of me shifting attention from her to the public which constantly barrage me with questions, interview requests and speaking engagements.

Upon returning to Malaysia, we received the distressing news that our baby's heart was no longer beating. It was such a hard thing to accept. At that same time, I was so occupied with prior speaking engagements and interviews, something that I regretted. I remembered the day she miscarried, I came back at night from a talk, and saw her crying on the bed. I was lost for words, and we only spent the night in silence, hugging each other till morning.

I still regret that I didn't spend my time at her side during the moment that she needed me most. But Kamaliah still stood by my side, and was always my number one supporter. She was always there to cheer me up with her wide smile. From the first day I met her, I've always had it in my mind that she is a person with an infectious smile. People just couldn't help smiling when they see her smile. She brings cheer to every room she enters, and I am blessed to have her exuding cheerfulness into every seconds of my life.

One year spending time with her, I realized that unconsciously, my life priority has slowly changed. If I can summarize everything she has taught me the past one year to one word, it would be: "humility". Being the super ambitious young man I used to be, it took a strong woman like her to change me. For the first time in my life, I find great satisfaction in fulfilling the need of someone other than myself. I begin to think as a couple, no longer as my own self. At a time that I thought I was "oh-so-human-look-at-me-I-am-humanitarian', she taught me what being a real human is all about. About sharing, caring about those who are close to us on top of caring for strangers, and knowing that no matter how amazing your life achievements are, it would be depressing if there is no one for you to share it with.

Kamaliah, I would like to thank you for holding on and teaching me what the real important things in life are. Thank you for being such a great wife, and I am looking forward to the years and experiences we'll forge ahead as husband and wife. Happy first anniversary to us, love you to bits!

Happiest Day of My Life

I remember every time I go to an old relative's house, wedding pictures were always the ones that is kept displayed in the bedroom, most likely on the vanity table. Those pictures were a window to a time period when they look really beautiful, and we'd say "lainnye muka atok masa muda!". Some of their spouses died when I was really small, and the pictures were the only way for me to see how they look.

These digital age, we rarely get our photos printed, we always say we'll print them someday, but in the end never get the time and energy to actually go to a print shop and frame it. Someday, all those photos will be gone when our laptops breakdown...even the ones we thought will be safe in Cloud drives will disappear along with the login passwords that will be lost to dementia or death. In the end, physical printed photos will be the only evidence that we once lived.

I don't know if I will ever go out to print another picture, but if I never did, this photo is enough to represent the life that I had lived...Someday, if I get to live long..if my grandchild or great grandchild sees this picture, I just want them to know, that what they see, is a snapshot of the happiest day of my life.

Me Before You

Earlier this month, my wife pleaded to watch the movie Me Before You, an adaptation of a novel by the same title by Jojo Mayes. Although I was not always fond of book-to-movie adaptations (a cynical outlook that proliferated throughout the years precipitated by movie adaptations such as World War Z, Dreamcatcher and The Great Gatsby), I yielded to her persuasion and decided to give Me Before You a try. A smile settled across her face, her eyes creasing with pleasure as I told her we were finally going to see the movie.

To my surprise, I actually enjoyed the movie, with some conversations in it stuck in my mind long after the credits finished rolling. A dialogue that made me reflect was towards the end of the movie, when Lou, who was taking care of Will, a young man progressively paralyzed from an accident (although not medically plausible, unless he suddenly caught Guillain-Barre syndrome, succumbed to a spine cancer or his spine decided to spontaneously degenerate at a young age), asked a question along the lines of “where would you wish to be if you were still healthy?”

Will, who was a wealthy young banker, was portrayed as an avid traveller and an adrenaline junkie before he met with the accident. I expected him to answer things like skydiving in New Zealand, surfing in Hawaii or scuba diving in the Great Reef Barrier, but his answer perplexed me:

"Paris. I would sit outside a cafe in Le Marais and drink coffee and eat a plate of warm croissants with unsalted butter and strawberry jam. I want to be in Paris as me, the old me, if I shut my eyes now, I know exactly how it feels in that little square. I remember every sensation”

I could instantly relate to what he said.

I guess that when our basic ability was taken away, the activities that seemed presumptuous and routine, were the ones that we miss doing the most. Not skydiving, not scuba diving, not wall climbing. When we are left paralyzed in a wheelchair, the thought of not being able to do simple things like having a cup of coffee in a café without the hassle of trying to fit behind the table, having someone to carry us up the curb, or the stresses brought by being unable to charge our electrical wheelchair because the plug won’t fit French electrical socket made us miss the person who we used to be most.

Although I abjured the movie’s devastating ending that sort of advocate assisted suicide, I am glad that my wife brought me to see this movie for its message of gratitude. I pray we would all stay away from such debilitating disease, and still be able appreciate the little things in life and be thankful for what we have.

The scene from the movie reminded me of my time in Geneva. After work, I would sit outside a cafe in Le Grand Rue, a cobbled-street alley in between teetering apartment blocks, to drink hot coffee and eat a plate of warm crepe with chocolate, banana and peanuts. It's one of the place I keep visiting when I closed my eyes.