Centre Point

Lunch at Centre Point
(N01°28.861', E103°45.793', Elev:39m)

My usual lunch at 10 minutes drive from work place.

Petai Sambal Chicken

Dinner + supper @ Ong Shun Seafood Restaurant.

Petai Sambal Chicken Rice, RM 5.00

What is the different between doc and pharm?

John Updike (a patient himself) once wrote, " I am silvery, scaly. Puddles of flakes form wherever I rest my flesh. Lusty, though we are loathsome to love. Keen-sighted, though we hate to look upon ourselves. The name of the disease, spiritually speaking, is Humiliation". (Fitzpatrick)

My patient was very upset today, so did I. He had a severe flare of his skin condition.

My heart sank because at the beginning of the consultation, he just threw all his anger toward me. But, why me? What was my fault?

I was upset because, I had already tried my best to help him, but there were lot of things beyond my control.

He is a young man, just began to have his business expanding, opening second branch of his shop. He has a lot of commitment at home and in his business, in addition to his whole live burden having to have an incurable skin disease.

Sometimes, I tried too to understand the reason when he could not keep up to his appointment.

His disease was well controlled on regular topical treatment.

However, one of the reasons he had worsening of his skin condition because he did not get enough topical cream that he was supposed to get.

The pharmacy had run short of that cream for the past 1 month and I was still wondering what took them 1 month that long, yet the supply problem was not sorted out.

To make matter worse, he could not source those cream from the private pharmacies as none of them in this region had it.

This man was so emotional today. He expressed how embarrassed he felt till he dared not meet his customers for the past one week.

Judging from his skin condition I could not dare imaging how his social life has been, with all those red and angry lesions and flakes all over the house and the bed.

So, basically I spent most of the time trying to explain the reason why the pharmacy could not provide the exact amount as I wanted him to get.

There were lot of things really beyond my control.

So my job was to prescribe and it was the pharmacist's job to dispense.

What can a doctor do when he has the gun but he has no bullets? The bullets are with the pharmacists.

Sometimes, how I felt the patient should strip in front of the pharmacists and beg them to see how extensive his skin lesions were and at least, they were more compassionate to consider giving him enough supply as prescribed.

So, you see, the difference between the doc and the pharm is, whenever a patient is angry or frustrated due to matters not of the doc's will, the doc has to basically "swallow the dead cat".

This is because pharmacies don't see patients as the way doctors see them as.

P/S: Sorry, this post is not intentionally meant to 'step' on pharmacists, but if you feel offended, then, sorry.

Close shop

One of the 'landmark' building in the south.

What at big contrast to the KL LowYat IT mall.

Almost devoid of human life.
Probably people here are not very IT-savvy, or do they prefer to go across the strait?

BN DP

A friend send me a link to this very funny video.



From: Kav.

Moon cake festival

What did I do on the Mooncake festival day?

Having piece of mooncake.

I was helping my friend in the clinic while they went out for 'dating'.

Some kiddies performing in the public.

Kind of interesting seeing these youngsters performing without having those stage fright.

Boleh

It has been almost half the period where I am currently posted, the south most of the country. Before this, I have never stepped a foot out, and the land across the strait was the first foreign land I adventured out.

Before this I have heard so much about the country that banned chewing gum, especially on how clean they are.

The above picture was taken last week when I paid a visit to my cousins who stayed across. Never could I had imagined how actually close we were and when the fact that how foreign I would have thought they were been.

My uncle and family are actually staying across as near as from Seberang Jaya to Gelugor.

I am so impressed with the environment over there. A city that is very well planned and everything is so organized. Their government low cost flats look more like our luxurious condominium here. Their compound and streets are so clean that I almost ask myself, am I hallucinating? Their transportation is very accessible and efficient.

The sales assistants in the shopping complexes and the waiters in the restaurants are very courteous and polite. Although they may be a bit 'Kiasu' but you see most of the people there are very law-abiding citizens. People queue for their turn and one is almost sure that you won't get cheated by taxi drivers.

In short, you almost feel at ease without even having to worry about safety and crime.

Here is the border where thousands of people move in and out in a day. The fact that we are actually the same kind of people by culture even though we are separated by that piece of concrete link.

But as one passes by the check point, one could see the 'sudden' change of scenery, to that of a dirty, rude and chaotic picture.

One thing for sure, you won't see this in Singapore.

Yeh, cause we are in the Bolehland, and everything is 'boleh'.

Parkir

Learned new word.

Parking in Bahasa Malaysia is "Parkir".

Traveling

District visiting yesterday.

Across

Checking out prices across the Strait.

Aspire One AOA110: SD599 (x2.3) = RM1377.

EEE PC 901: SD698 (x2.3) = RM1605.

Sunset across the causeway.

SaDingDing

While window shopping at Tebrau, I came across one CD album which was extensively been promoted in a book shop. Curiously, I spent the next 30 minutes listening to this New Age album and I was intrigued by her voice and style of music.

Her voice sounds like Dadawa+FayeWong.

Curiously, I Google-search her name and found some interesting videos:





Shanghaiist.

Sad tragedy

Just not too long ago, HPG community was shocked by the passing of our kind doctor, another tragedy happened in Pg Anesthetic department on Wednesday. I was shocked to find out from friends that another Pg anesthetist was found dead in the on-call room. It was widely reported in the Chinese dailies but not in the English papers. Even though I am no longer in HPG, I am very sad because we lost yet another good young doctor with so much bright future ahead. She is a good friend of Dr. Chen too.

RIP.

Where to publish?

One of my consultants used to tell me, if I have an article to publish, I better choose the most appropriate scientific journal to publish. This is because, if I have a very good article, I should publish it in the international journals that are well-read by many people in the world.

Unfortunately, the well-read and renowned journals all require subscription, which could be quite expensive. It is also most frustrating when one searches the PubMed for related articles, most of time, we can only get the abstract. Many articles require subscription or need to be purchased for a price.

I strongly believe that medical education should be shared and easily accessed freely. It therefore makes more sense that if I have an interesting case or study to publish, I would want it be made available to all people to read.

Advance in internet and information technology has made information especially medical related researches be obtained within seconds with the click of the mouse. We therefore see thousand of articles been uploaded every minute.

With the concept of 'free access' in mind, many authorities have turned their publications into 'open access', which could be read freely by anybody who has internet connection.

I feel, this concept should be the objective in mind when we want to disseminate information.

Talking about free access, let us see what our neighboring countries have adopted when come to publishing their researches or scientific reports in medical journal. The Singapore Medical Journal and Journal of The Medical Association of Thailand are available freely online and are downloadable in PDF format.

I am rather disappointed that in the era of global competitiveness, our own Malaysian Medical Journal is only circulated among members, while the online version is only available in the abstract form.

Another point to note, while the Singapore Medical Journal and Journal of The Association of Thailand are publishing their journals monthly, our Malaysian Medical Journal is still making its appearance quarterly. What more disturbing is, I usually receive my copy after few months by postage.

No wonder, we are loosing many of our good writings to the foreign journals.

Take a look at the latest publication of Singapore Medical Journal (August 2008). Our own Dr. Ong HT from Penang has a good review article on "Cardiovascular outcomes in the comparative hypertensive drug trials: more consensus than controversy".

I wonder, in Bolehland everything is 'boleh', but why Malaysian Medical Journal 'tak boleh'?

Therefore, if you have a good article to publish, which journal would you choose to publish?

For me, I would go for those with 'open access'.

Here are the LIST of open access journals from BioMed Central (BMC).

Good place to publish your case reports:
Cases Journal.
Journal of Medical Case Reports.