Defence Policy



Malaysian take:

PM: Zahid, what is the purpose of our defence policy?
Zahid: To defend Malaysia.
PM: No, Zahid. It is to make people believe Malaysia is defended.
Zahid: The Singaporeans?
PM: Not the Singaporeans, the Malaysians! The Singaporeans know it's not.

Heh, what a joke...

The last day

1431H. Recited the prayer off my laptop. Wow, a year, just like that.

...

Finally I finished up my elective posting. Mixed results I suppose. A disaster? Maybe. Warming up before final year? Absolutely.

Memorable lines:

"Tak dapat line? Cuba lagi nanti..."

"Jangan rajin-rajin sangat, lepas lunch pergilah jalan-jalan KL eh?"

"Alright, the most important you need to go through is the clerking notes. Then the rest is quite straightforward. You're already (in the) final year, so you should know the drill,"

"Boleh tolong beli barang di Hospimart tak? Kopi dalam tin ke..."

"Oit! Apa kau buat di sini?"
"Elektif, sebulan di medical,"

Anyway, I had a great time there. Dear friendly nurses, HOs, MOs, and not to forget all specialists, thanks alot! Really.

Hmmm... working here? I'll keep my option open. It's less than 10km from where I live.


// Errr... I think its a little too much for a video about hospital.

A Gift of Life - Hadiah Kehidupan

They say that life is a gift. If so, could I have the receipt so that I can go back and change mine?
Sinead Murphy

Last year signed up for organ donation at National Transplant Resource Centre, just in case, you know, something happened. So apart from life insurance, this is something someone could benefit from me if I meet my Maker. To my horror, my name was not registered in the their system. So I signed up again at HKL when I was doing my elective.

Actually the morning before it suddenly struck in my mind; while I was cycling downtown, a bus (Metrobus in particular) might just ran over me. Heh. At least I could make someone smile when I die. What a weird logic...

"Doktor tahu, yang muslim melayu menjadi penderma sangatlah sedikit, malu kami kadang-kadang,"
"Errrrr...."
"Semua takut mati jenazah berlubang-lubang..."
"Hmmm... kena cuba pujuk lagi supaya derma..."

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Almost 2010

Why am doing it anyway?

Heh it's the endorphins. Plus there are hot showers in the ward. That's enough for me.

Then its the repetitive reminders from IKIM radio telling the masses, a healthy muslim is better than a sick one. Duh.

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// It's brand new under three twenty all-in. Rule of thumb: 'Any bike is a good bike as long as you ride it'. One set of slick tires, a helmet to reduce cranial injury (there's ongoing debate on mandatory helmet, the Aussies versus Scandinavians, please check it out), a rear pannier for my rucksack, a metal bell to warn the traffic that I'm close by, and a lock to prevent theft. That's all you need.

Honestly, I'm not really optimistic about it when I'm working later. Plenty of excuses and reasons. Ok, perhaps its limited to weekends.

Anyway, I've come to the final week. Electives in HKL has never been this convenient, because I dictate my own pace, thru self-directing learning and, more often than not, by osmosis.

But when one gets working... errr its like fish out of water. Terkejut. Haih...

Welcome final year! Bring it on!

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// I reluctantly breath in a good chunk of soot, carbon monoxides and what have you whenever I get behind this monster. Its RapidKL counterpart dumps cleaner exhaust though. See, perhaps if I cycle for a year I will be self-appointed-exhaust-gas-connoisseur, differentiating car and motorcycle makes while blindfolded.

...

For the past few weeks, I am truly indebted to advices, warnings, and more importantly their life stories of HOs. Thanks alot. Quoting one of them - 'it's not the location, it is you that really matter'.

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// 'Melepak belakang hospital' : Haikal, Halim and Amin. The former two, Ampang, while Amin serves in QE, Kota Kinabalu. 

At the end of the day, it boils down to one question - 'why I want to do this anyway?'

And one friend I know has gone to the road less travelled by others. Cayalah!

...

Come end of year school holiday, my mailbox is literally flooded by the invites. 3-4 weddings on the same day, eventhough all located within Klang Valley, is still a tall order. But I'm really happy for them.

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// All of over Malaysia! Kota Bharu, Kuala Terengganu, Klang, Seremban, Ipoh, Jitra, Kuantan. Well not really, sans Borneo. Oh, there is another one: Singapore, at Tampines.

So again, Selamat Pengantin Baru! As of me, as usual: 'Lepas raya'.

Kg Pandan to HKL

Totally a bliss when weaving through traffic along Jalan Ampang.

Another 4 weeks to go.

Going the distance

I cycled to Batu Ferringhi from my flat this morning. Yup, in the middle of busy traffic. Hmmm... I wish Penang will set aside bicycle lanes in near future, or at least more roadsigns and campaigns telling to be considerate to cyclist. Heh. On the other hand, maybe after a while I will do some skitching when approaching a climb.

Distance covered: 40km (plotted on Google map)


View Larger Map

Fuel / source of ATP:
Pre - Chocolate Gardenia bread 60 cent, chrysanthemum tea 500mL.
Stop for refuel - nasi lemak, doughnut x 2, a glass of teh tarik, mineral water 250mL
Stop for dhuha - mesti bersyukur, masa muda sebelum tua, sihat sebelum sakit.
Post @ Kapitan cafe - mint tea, iced lime

Time: Didn't bother to time, I'm not an athlete or contesting for any competition. Just take it easy.

Stumbled a cyclist, and he says "Good morning" before passing by and disappears into corners just before Malaysia Army Camp. A white-haired chinese, presumably in his 50s. Sorry uncle, I'm not as fit as you are.

On my way back, in front of Flamingo Hotel, an elderly security guard in white uniform waved at me and even shouted out loud, with enthusiasm - "Bagus orang muda!" (Well done young man!).

Had snake bite puncture at Jalan Scotland, 2 min to home. Urgh, I just bought this bike last 4 days ago! Insaf saya tak mahu lompat-lompat dengan basikal ini lagi. Bukannya ada spring atau penyerap hentakan. Satu kerja lagi hendak menampal tiub.

BTW, saya pernah membaca sebuah blog yang banyak berkisah tentang basikal jarak jauh, dan ada satu fakta menarik yang boleh dikongsi di sini. "An average mamat who's definitely not an athelete (couch potato) like me can cycle at least 100km a day. If the road is as flat as pancake, its even further."

That makes Penang to KL about 5 days. Hmmm... tempting...

Never mind, I'll take a flight then. Save a lot of trouble and sweat. LCCT to Jenderam is less than 15 min drive! Meanwhile, this two-wheeler can take on the train from Butterworth, all the way down to Kuala Lumpur Station - yes the oldie one.

...

What a nice theme song:


My 6th

Yes, this is the 6th, and its red in colour. 'Ruaidhri'. Heh what a name. Every single brethren before it have their own stories, and I hope this one, will have a happy ending. Perhaps with the 'ever after' part.

Now I have to justify the purchase, of course, by cycling!

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from www.bicycle-adventures.com, Penang to Pangkor
Hmmm menarik juga berbasikal jarak jauh seperti adik Johan (sekarang sudah masuk universiti agaknya)

Cerita November II

Puan Khairul Husna telah pun menghebahkannya melalui medium Facebook. Jadi, datang sajalah...

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// Hiasan ini dicetak atas kertas surih, sebelum ditampal di atas kek. Jadi ia tidak boleh dimakan.

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// Antara warga pendidik SMAPK.

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// Puan Jamaliah Rani

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// Senior dan super senior... banyak yang dah berubah (muka dan perut haha)...

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// Puan Rahimaton, guru Bahasa Inggeris, dan Mr Kanang, kini penuntut Master in Surgery di HUKM - nama sebenar beliau ialah Khairul Izan.

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// Suffian Saujana, bersama Tok Wan, dan Cikgu Zuzi

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// Sistem siaraya sekolah masih seperti dahulu, semput-semput. Jadi terpaksa sewa dari luar...

Terima kasih Cikgu!

Cerita November I

"Who knows you will be a psychiatrist later on." 
ujar Dr B-harathy, sewaktu berjumpa dengannya untuk membincangkan perihal keputusan subjek Psychiatry baru-baru ini.

Tersengih aku. Alahai...

...

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// Mengisi minyak sewaktu jalan-jalan ke Bukit Genting

Beberapa hari sudah, saya sempat pulang ke Sepang. Ditakdirkan Allah, kereta Proton Saga Biru, kesayangan ini semput-semput di tengah jalan. Sudahlah pada waktu malam. 2 kali saya terpaksa bergerak perlahan di lorong kecemasan. Asal lepas clutch, enjin mati. Jadi saya main-main minyak dengan clutch sampai lenguh kaki aku. Dalam hati, kalau transmisi automatik, lagi parah!

Syak masalah bateri, tapi agak tidak logik sebab boleh saja enjin dihidupkan sebelum bertolak. Jika alternator, sudah pasti ia mati terus, sebab palam pencucuh tidak dapat dicaj. Haih, ingat lagi bab-bab enjin Kemahiran Hidup Tingkatan 3.

Akhirnya aku berhenti di Hentian Bukit Gantang. Setelah beres solat, saya mendail nombor PLUS Peronda memberitakan situasi semasa. Masa menunggu saya luangkan dengan mengkhabarkan pada keluarga dan kawan yang saya agak lambat, dan besar kemungkinan perlu bermalam di situ.

Setelah hampir 30 minit berehat, muncul trak PLUS Peronda. Saya pun terus menaikkan bonet hadapan, mendedahkan ruangan enjin kereta. Dua Polis Bantuan pun turun. Muka segar dan bertenaga, menyatakan secara bukan lisan - "Ada apa yang kami boleh bantu?". Saya pun memperkenal diri dan bercerita...

Dan sebagai seorang penuntut perubatan saya pun 'present' kes ini. Hahaha. Provisional Diagnosis - Fuel-related problem, eg. 'choked' carburettor, fuel filter. Differential Diagnosis, spark plug not firing, alternator failure...

Sambil ralit mendengar celotehan saya, salah seorang PB (Polis Bantuan) pun membuka penapis udara (air filter), menampakkan carburettor di bawahnya. Jarinya mula merayap-rayap ke atas beberapa skru dan kabel, dan berhenti bila beliau sudah pasti yang mana satu perlu diusik. Yang seorang lagi, bermisai pun menghidupkan enjin, dan menstabilkan kelajuan enjin dengan menginjak-injak kakinya pada pedal minyak. Meraung-raung ia memecah kesunyian Hentian Bukit Gantang. Sedap juga derumannya, hmmm ini belum enjin ada turbo lagi...

Beberapa pelayan kedai buah-buahan di situ mula mengerumuni kereta saya. Memanjangkan leher, mencelikkan mata dan memasang telinga dengan semangat inkuiri yang tinggi. Salah seorang darinya berbisik-bisik, dan telingaku dapat menangkap : "Ini mesti carburettor tersumbat... biasalah Proton... kalau kereta lagi baru memang masuk bengkel terus... kena tarik dengan 'tow truck' jawabnya".

Setelah beberapa minit enjin itu hidup, akhirnya ia stabil. Ya, ia sudah panas. Saya pun dikhabarkan yang carburettornya 'tercekik' atau tersumbat. Jadi petrol tidak dapat disalurkan dengan baik ke dalam kebuk pembakaran. Alamatnya semput-semput. Asal lepas minyak enjin mati.

Kemudian, kedua-kedua Polis Bantuan yang budiman memberi jaminan yang saya boleh sampai ke Kuala Lumpur malam itu juga. Phew!

...

Aku gembira betul sebab dapat bersua dengan kawan-kawan, bermula dengan Syafiq Ayman, yang kini menjadi MO di Hospital Port Dickson. Selepas itu kami menjamu selera di The Curve (Lengkung?).

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// Johan, yours truly, Syafiq Ayman, dan Asyhraff

Esoknya, Ahmad, Amin, Mujaheed dan Syafiq Sidqi di Al-Rawsha. Letaknya di Jalan Damai, berdekatan dengan Masjid Damai.Terkenang jalan-jalan di Timur Tengah dulu-dulu...

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// Ahmad dan Amin

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// Nasi Ayam Mandy bersama Mujaheed

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// Syafiq Sidqi meneguk Teh Pudina

Kemudian saya bertuah dapat bersua kembali dengan Muhammad (nama popular di sekolah dulu, Matbond) yang kini berkhidmat di Bank Negara. Beliau memberitahu ada kemungkinan tahun hadapan IMF akan menjadi destinasi seterusnya (dipos oleh Bank Negara). Turut hadir, Nurudin Sharoof, yang kini bekerja di salah sebuah bank. Mereka berdua banyak bercerita bagaimana sepatutnya graduan muda menguruskan duit gajinya... sambil membuncitkan perut di medan selera Pavillion dan di kedai kek kepunyaan bekas PM kita, 'The Loaf'.

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// Matbond - banyak tips-tips...

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// Nurudin Sharoof - kaki fotografi juga, dan masih pakai filem lagi!

...

Alumni SKTN. Adem pun ada mengkhabarkan yang pihak sekolah memerlukan sokongan alumni untuk program Darjah 6 pada masa hadapan. Hohoho, jika tiada aral melintang, saya pasti akan turut serta.

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// Adem Rono, Cikgu Anuar Sadat, dan Abdul Muhaimin

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// Adli Shahrul. Kini menjadi 'orang minyak'.

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// Azam, arkitek muda. Muhaimin, House Officer di Hospital Ampang. Yours truly.

Semoga di masa hadapan, ada usahasama dengan mereka. Yeay!

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// Jaraknya dari rumah di Ampang hanyalah 2.5km. Ramai kenalan bekerja di sini : Halim, Muhaimin, Aizad, Wan Aliaa, Huda, Haikal & Hidayah.

ps : Aisemen Hadi, foto hang tak dak pulak. Lain kali eh?

...


Balik ke KL kali ini berpeluang juga dengan melepak dengan Azlan Abn. Haha.

POPPH

Itulah singkatan untuk Paediatrics, Obstetrics & Gynaecology, Psychiatry and Public Health.

Terus terang, inilah masa terindah di PMC. Sayangnya ia sudah tamat, dan tahun akhir bakal belayar tidak lama lagi, setelah elektif nanti.

Saya sudah pun mendapat tawaran elektif di Hospital Kuala Lumpur, dalam Medicine, dan juga Surgery.

Peluang yang ada:
- Learn how the system works from HOs.
- Improve liaison tricks (mainly attitude) - HO is part of team comprising consultants, specialists, MOs, other HOs, matrons, nurses, and PPKs. 
- Repolish faded skill - history and presentation, and outline of management
- Cycling to Hospital Kuala Lumpur - its only 8km away from my home in Ampang. Hmmm... am I game for it? By the way, the distance is about 2.5km from my flat to Penang Hospital. Huh!


...


My type:


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Let's rekindle back the good old days back in Dublin when cycling was a routine! Well, that's how you do it when you're a student, and cheapskate :-)

Slogan penyedap hati - Mari berbasikal ke hospital....

Asleep at the wheel

House officers (HOs) falling asleep at the wheel is not a myth. Several colleagues of mine already related to me their horrifying experience.What a nightmare...

Hmmm... I think I can forget about riding bikes then. If I lose control, even for few milliseconds, I'd be history. Tomorrow's headline would be - 'HOs falling asleep to death while on motorcycle'. That's not good, after years and monies spent on me. More importantly, I am not ready yet to die! Amal tak cukup...

Perhaps I need to get one of these - Volvo 240 class. What an old banger. It's quite a tank, and you can get it second hand with tip-top condition well under RM8k cash. Tak perlu hutang-hutang. Being a Volvo, rest assured it is safer to fall asleep in one these. Bear in mind, beyond 50mph any car would crashed beyond recognition and definitely cause injury and god forbid, fatality. We human are not designed to take up so much toll, meaning that our internal organs would have been squashed into a blob of meat. Quoting Jeremy Clarkson - Speed doesn't kill! Suddenly becoming stationary - thats the killer.

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// Volvo 240 class Wagon version

Despite it being a huge petrol guzzler, thanks to 2-litre engine, note that its built like a tank, with plenty of spaces inside. Heh, you can even put your whole wardrobe if you want to. HOs, typically busy, surely will benefit this feature. So no need to go home and get dressed to join social function/teh tarik/makan malam/ceramah. You can even to go straight balik kampung!

Extra links:
How safe is an old Volvo?
How safe is an old Volvo? (continued)



Well the cheaper alternative would be playing your favorite tunes on the stereo and turn up the volume to the max!

Apa cerita Padang dan di medan?


Ini cerita Padang.

Summary from video:
-Right after the earthquake, a surveillance team was dispatched immediately to, as the name suggest, survey the whole affected area. Helicopter view / Bird eye view. Liaise with local authority and UN. Are the healthcare facilities still intact? Telecommunications? What about transportation - airport, seaport, river, roads connection from nearest town? Electricity? And most importantly, clean water supply. Basically they have few forms to be filled / paperwork which eventually evolve into a report. Then everyone can lend their hand... and work as a team.

-They need cash. Why? Because they can reach the nearest town, in this case, Medan, to stock up and set up a supply line to Padang. Bulky items like tents and blankets can be procured locally, or if there is no logistic connection to the nearest town like what happened in Acheh earthquake and tsunami 2004 whereby the aftermath was so bad that the leading roads were compromised, perhaps airlift and sealift is the best choice.

-Allow me to share a bit: Last year I managed to get a briefing from Maskargo about the peril of freighting all the rations to disaster locale. That's what happened after Sichuan earthquake back in 2008. Tonnes of rations were airlifted to airports in Guangzhou but no receiving party ie. no logistic connection. Plus, no proper documents for the customs. Basically no liaison with local humanitarian agency. Consequently, Maskargo has to transport it back to KLIA or left them to rot at the airport. Lots of money and effort were wasted... Haiya...

...



Ini pula dari medan.


Banyak lagi berita di sini dan sini.

Simpan dulu dalam laci


1. Tengok wayang
Memali_big_std

Remembering Memali: a Freedom Film Fest 2009 Competition winner

Thursday, 24/09/09 - 14:50PM Filed in Blog by zedeck | Views: 1185 | Comments: 0
Tags: 
KLKuala LumpurMalaysiaFreedom Film Festdocumentaryhistory

Past winners of the Freedom Film Festival (FFF) Film Competition include some stellar work. Look at Fahmi Reza's rousing Sepuluh Tahun Sebelum Merdeka, which explores a pre-Independence independence movement so buried most of us didn't know it existed.
Don't know whether the 2009 winners are any good, yet - but they certainly look intriguing. The poet, artist and dreadlocked Rahmat Haron's Al-Fatehah Memali, for example, has a great premise: it's a memorial of the 1985 Memali Massacre, through the eyes of two singer-songwriters.
Hang on. Memali?
Pay attention: on 19 November 1985, hundreds of police personnel, under then- Home Minister Tun Musa Hitam, laid siege to Memali, Kedah, on the grounds that a deviant Islamic sect, lead by one Ibrahim Mahmud, had infected the village.
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The authorities wanted to arrest Ibrahim - a scholar who had previously appeared on national television to lecture on Islamic matters - under the Internal Security Act (ISA). He resisted. Revered by the local population, the confrontation between the police and Ustaz Ibrahim's followers ended in bloodshed: 14 civilians and 4 policemen dead.
Sound interesting? We got Rahmat to tell us more about his film:
~
Where did the idea for Al-Fatehah Memali come from? Why, out of the many forgotten Malaysian histories, choose Memali in particular?
I still remember watching RTM, when I was 8 years old, on that day. The images were so strong. They made me think: why were there heavy police deployments, with armoured vehicles, M-16s, the FRU? Were Ustaz Ibrahim Libya (as he was known) and the villagers of Memali so dangerous?
The government accused them of being deviant Islamic militants who wanted to overthrow the government. But this was without evidence. The police wanted to arrest Ibrahim under the ISA - as if there's no other way to detain him but to use the ISA. That means the government of that time had no valid reason to charge him in an open, free and fair trial.
Does your film intend to address the fact that so little of us know what happened there?
For me, I'm looking at Memali from the human rights perspective. The fact is they were not only religious martyrs, but martyrs who died in defence of human rights and democracy - to oppose ISA, even they have to sacrifice their own lives in the hands of the powerful.
There has been no Truth and Reconciliation Commission for the incident. There was a Parliamentary White Paper and an RTM1 documentary about the event - to present official versions as the only truth.  The court case following the massacre was settled out of court, after they wanted to subpoena Tun Dr Mahathir Muhamad. The family of the 14 who died were given some RM20,000 - that was the price of their dignity.
Looking at Memali again will test the seriousness of the Najib administration - or any future administrations - that pledge to serve the interest of the people.
Why is the film angled from the perspective of singer-songwriters Meor and Black?
For me, this was the easiest way to put things together. They are my personal friends and I'm a big fan of them. Black wrote a song about Memali, titled Syuhada MemaliMeorcomposed the music. I like this song very much.
Even though the song was already completed before the idea of Al-Fatehah Memali came about, in this film I'm trying to tell the story of how Black and Meor unraveled the incident, while composing their song.
In the course of making this film, you spoke to residents of Memali. What was the most interesting personal story that you heard, while working on the film?
The story told by Puan Solehah Husin, the wife of Ustaz Ibrahim Libya. She told us about what happened, moments after Ustaz Ibrahim was shot. She didn't get emotional while telling us the story, at all - without a single teardrop.
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I think that was amazing. Maybe her religious convictions taught her to be patient and calm. If I was a survivor of that event, I'd be crying and howling about all those grievances.
~
(Want to hear Puan Solehah's story? Al-Fatehah Memali premieres at Freedom Film Fest 2009 on Saturday, 3 October, 7pm, at The Annexe Gallery in Central Market. The FFF's KL leg runs from 2 to 4 October.)


2. Elektif di HKL. Sambil-sambil bermastautin di Ampang, boleh saya hadir ke program-program. KL banyak acara, tinggal hendak memilih yang mana satu.
3. Jalan-jalan Borneo. Saya kepingin jumpa kawan lama dan saudara-mara di sana.
4. Book shopping therapy. Hmmm... the battle between ebooks (read on big LCD) and print version is getting intense!

Farewell O & G

It is simply the best rotation!

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// The obsolete protocol. Don't worry, we students always keep it updated - lots of criss-crossing here and there!

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// Prof F-eeney, and the lady from Exam office, S-harla in nice Indian dress.

Favourite and memorable quotes:

A minute you spend on O & G is twice as worth you could on Paediatrics, Psychiatry or even Public Health!
Prof F-eeney on the very first day, mentioning about heavier wattage given to O&G

If you see a husband in labour room, usually it is their first baby.
Prof F-eeney during Obstetrics morning rounds

The thinnest book is the one to read, while the thick ones are for reference and best left on someone else's shelf, not yours.
Dr K-ieran (while showing his Impey) during revision classes

While I was examining this lady a little while ago, I managed to observe fetal movements. Now, the examiner definitely wouldn't disagree with you, would he?
Prof F-eeney's tutoring on how to present clinical findings.

Where is your other friend? H1N1? 
Dr S-omas on missing groupmate

You know, diet control is the way to go in managing diabetes in pregnancy.
Dr A-nil

I have nothing to disagree about your history. It's superb!
Dr K-ieran after case presentation. Well he always said that.

Hey I think you can be a politician. You completely DID NOT answer my question.
Dr J-erilee during evening tutorial

What!!! Pink branula? You think it is nice to match with the hospital gown ka? You. Go and take all the branulas in different colours. I'll show you what's the difference between green, blue, chocolate, grey and whatever colour you have.
Dr A-nil during Obstetrics morning rounds

A picture worth a thousand words. Now where's my whiteboard marker?
Dr M-aha before beginning her lecture

In infertility case, the most worried party would be the mother-in-law, not the mother.
Dr A-zmy's cynical comment on Infertility tutorial

More photos : http://picasaweb.google.co.uk/abadisufaat2/OGEOB

Oh very young

The first song that hooked me up was 'Wild World'. It was many many years ago, I think back in primary school. One day I noticed the tunes on radio before I turned to my mum asking who is the singer, as she was born in that era. Cat Stevens is Yusuf Islam.

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Moonshadow is coming. I wonder when this musical is going to our shores? Perhaps at KLPac? Heh I can only dream...

...



Oh very young
What will you leave us this time
Youre only dancing on this earth for a short while
And though your dreams may toss and turn you now
They will vanish away like your daddys best jeans
Denim blue fading up to the sky
And though you want them to last forever
You know they never will
You know they never will
And the patches make the goodbye harder still

Oh very young
What will you leave us this time
Therell never be a better chance to change your mind
And if you want this world to see a better day
Will you carry the words of love with you
Will you ride the great white bird into heaven
And though you want to last forever
You know you never will
You know you never will
And the goodbye makes the journey harder still

Oh very young
What will you leave us this time
Youre only dancing on this earth for a short while
Oh very young
What will you leave us this time

Ramadan & Syawal

Ramadan

Quoting from Bingregory.com:

The most depressing fact about Ramadan is to find out how many of your problems are not caused by the Satan.

Several objectives were achieved. Phew. I need to do more tadabbur ie. comtemplate about the meaning of the verses, rather than boarding the express tajwid bullet train.

...

Shawal
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// Haji H-assan bin Haji Abdul Salam.

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From Aidilfitri 14302009
// The crowd

What a blast! More cousins than ever, and apparently more on their way to this very world. The whole battalion will be larger next year.

Alas, by next year insha Allah I'll be working, so donating few duit rayas will be a new routine for eid. I will not be too generous though, as children are not supposed to handle too many ringgits in their pockets. Either they will spend on rubbish or the parents will collect tax from them to pay for the bills.

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// The daddys

Huh, I sense a strong smell of hypocrisy here. Back in my time, the minimal bounty would be in the range of few hundreds. Well, probably due to me being the early generation of the Haji Hassan's grandchildren. If you can relate to the law of supply and demand, you'd get it. Now, there's plenty of them - at least 65 and I've lost the count. Heh.

Don't ask how did I spend it. It's classified under OSA.

Anyway, I am grateful to be with my family this time around. Plus the extended ones. Second cousins. Third cousins. Wow. The family tree is really huge, as most of the mothers are grandmultiparous. Alhamdulillah.

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// The mothers

ps - Sans fireworks, the Eid is kinda dull. Adult supervision should do the job, instead of this cute little creatures risking their arms and legs (its expensive because of its illegal by law) just to have more fun. Wait a minute, they can't be bothered anymore - there are plenty of electronics for them, so I better bring back PS3 or Wii next year!

Kesah Ajang Cerita Kita - Tukar Tiub

as per Tuan Isham at tukartiub.blogspot.com

KESAH AJANG CERITA KITA

adalah dikesahkan
ajang pun dilahirkan

lalu ajang dibesarkan
lalu ajang disekolahkan
lalu ajang diuji dan dipereksa
lalu ajang lulus ujian

gembiralah satu keluarga
gembiralah ajang se ajang-ajnangnya

ajang pun belajar lagi
diuji dan diperiksa
ajang pun luluslah

ajang pun dilamar bekerja
maka bekerjalah ajang
berbaris dan beratur dijalan raya
bangun dari tidor untuk menjual tenaga

sebulan sekali menerimah upah
lalu ajang membeli tv
untuk rehat dan bersenang hati

setiap hari beratur berbaris dijalan raya
bangun untuk menjual tenaga
dihujung minggu ajang berehat buntang mata menonton tv

duit terkumpul lagi
lalu membeli kereta sebelum mencari bini
berbaris beratus dijalan raya
bagun dari tidor untuk menjual masa dan tenaga
agar dapat bayar hutang kereta dan rumah sewa

lalu ajang pun berbinilah
bangun pagi berasak asak menjual tenaga
untuk membayar kereta dan rumah sewa
lalu ajang dan isteri menjadi cerdik
tak perlu bayar sewa kalau rumah dimiliki
lalu mereka berhutang lagi
untuk membayar kereta dan hutang bank
lalu mereka bangun pagi
berasak asak di jalan raya untuk memburuh
dan mengumpul duit nak jadi kaya

adalah dikesahkan
anak pun lahir dan dibesarkan
lalu anak di anjangkan sekali lagi
lalu anak diajar agar dia pun bangun pagi
bangun berasak-asak dijalan raya bersedia cekap
bijak pandai untuk menjadi hamba kepada kerja

akhirnya anjang tua dan hendak mati
anjang terlantar dikatil
lalu anjang teringat
sebuah buku cinta yang dibelinya tetapi lupa tidak dibaca
lalu anjang teringat sekuntum bunga mawar
yang dia terlupa baunya
lalu anjang teringat sebuah pantai landai
sebuah tasik permai sebuah gunung berhutan
saekor burung belibis terbang menyambar

lalu dia teringat gesekan biola
dan tiupan seruling sawah dan gaung
hutan dan pacat

ajang memanggil anak datang
ingin menyampai pesan
lalu mereka pun berkumpul
ajang hanya sempat berkata – jangan jadi bodoh –
semua tercengang semua hairan
mereka menangis
ajang telah hilang ingatan.

ajang mengulangi lagi – jangan jadi bodoh – lalu anjang mati

esoknya anak dan isteri bagun pagi pagi
berasak asak di jalan raya entah apa hendak dicari
mengulangi hidup berpusing-pusing
tak pernah sedar diri
hilang ingatan jadi injin bangun pagi
untuk beli kereta rumah dan tv

The way forward

Today my teacher showed a powerpoint on the projection of 'Doctor to Population' in Malaysia, much to everyone's surprise after his lecture on Endometrial cancer. Wow. Putting it simply, Malaysia will begin to produce doctors excessively by 2014, thanks to almost 20 med schools and more or less 400 recognised institutions gazetted by Malaysia Medical Council (MMC).

Well, it depends on how do you set the ratio up. Mind you, more medical centres will be built to correlate with Malaysia's ever growing population - yes I know our family size is getting smaller in comparison with our parents' heyday.

On the other hand, it allows us medical graduates to permeate and diversify even further, instead of solely focusing on pure healthcare ie. medical officer in hospitals and clinics (talking about becoming specialist, subspecialist and subsubspecialist). There's alot more opportunities out there, right?

Hmmm.... its just a degree anyway, a gate to lifelong learning - as illustrated by him : 'learning from womb to tomb'.

By the way, currently there is a ongoing debate on healthcare reform in the States. Things got pretty heated until few made noises (and smear campaign) against the 'socialised medicine' practiced by many Europeans. I wonder how is it going to be here in the future...

Ramadan

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Azam Ramadan kali ini agak ringkas, of course recycle azam tahun lepas:

-Khatam POPPH
-Khatam al-Quran, balik-balik terlepas 1-3 juzuk...
-Buka puasa di masjid, surau dan hospital
-Tambah kualiti dan kuantiti majlis ilmu
-Shopping buku lagi (sambung azam tahun lepas)
-Habiskan buku yang telah dibeli tahun lepas (wow mati aku)
-Banyak muhasabah dan buat tindakan


Bukan setakat cerita alkohol di Selangor

Mari kita tonton video ini:



While on an official visit to a Middle East sheikdom to finalize a major contract for a UK firm, the Minister manages to get himself into trouble on several fronts. Learning that the country is dry, he arranges for liquor to be available on the sly. When they are presented with an expensive 17th century antique bowl, Mrs. Hacker gets Bernard Woolley to get the object valued at less than £50 allowing her to keep the gift. When the Minister learns that bribes were likely paid to obtain the contract, he insists that there be a full public inquiry. A little reminder from Sir Humphrey sets things straight.

Part 2
Part 3

Hacker: Are you saying that winking at corruption is government policy?
Sir Humphrey: No, no, Minister! It could never be government policy. That is unthinkable! Only government practice.

Hacker: You're a cynic, Humphrey!
Sir Humphrey: A cynic is what an idealist calls a realist.

Salvaging Precious Data

Image
Hard drives fail just like any other appliances. If you browse thru the specs, often it says something like MTBF 100k hours. That's 'Mean Time Before Failure'. Unfortunately extreme condition and prolonged operation makes 'aging' of hard drives accelerates.

Now the problem is, how to salvage all data residing inside the failed drive?

Since I'm avid Mac OS X user, I'd recommend DiskWarrior. However, my effort to recover my precious has yet to bear any fruits...

Pengajaran: Rajin-rajinlah backup dengan burn DVD!

Alleycats - Soal Kahwin

Tahun ini banyak sungguh jemputan yang diterima.



Dengar ini teman-teman
Kata-kata buat pedoman
Kalau salah oh maafkan
Dalam hati jangan simpan

Ku bicara soal kahwin
Bukan soal main-main
Kalau ada keinginan
Fikir dulu sebelum lakukan

Orang kahwin,kita kahwin
Orang senang,kita berhutang
Dari itu sabar-sabar
Agar tidak kau berlapar

Selalu adanya penceraian
Kerana tiada bersefahaman
Atau fikiran belum matang
Sudah ingin nak berumah tangga

Kalau sudah ada jodoh
Apa hendak di katakan
Tunai saja keinginan
Berpandukan keimanan

Hai nak muda,hai perawan
Hidup ini, bukan sehari
Cari jalan,meyakinkan
Agar tak menyesal nanti

Apa yang tak ingin ku melihat
Hari ini kahwin esok bercerai
Bagiku kalau terjadinya
Ramai akan menjadi janda

Lagu ini hanya lagu
Untuk hibur bukan mengata
Yang tersinggung maaf saja
Kami hanya insan biasa
Maaf saja (oh maafkan)
Maaf saja (oh maafkan)

Rumah Warga Emas

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//Rumah Orang-orang Tua Permatang Tok Gelam

Minggu lepas terpapar editorial British Medical Journal berkenaan rumah warga emas. Sewaktu latihan di Jabatan Psikiatri dahulu, acapkali saya bertemu pesakit sebaya dengan datuk dan nenek sendiri. Perasaan terus menjadi lain macam...

"Seorang ibu boleh menjaga 10 orang anak, tapi tidak semestinya 10 orang anak boleh menjaga seorang ibu."
, pesan kebanyakan guru-guru di sekolah bergema di kotak fikiran.

Dalam surah at-Tin juga disebut yang manusia dicipta oleh Allah sebagai "makhluk yang terbaik, dan kemudiannya berubah mengambil tempat sebagai ciptaan terendah". Ulamak Ibnu Kathir menghuraikan maksud ayat tersebut sebagai peringatan tentang hari tua kita. Semasa kita masih kecil, ibu-bapalah yang menjaga makan-minum, memakaikan lampin dan selainnya sehingga kita membesar. Kitaran itu akan kembali sewaktu jika mencecah usia emas nanti. Fisiologi kita bakal melangkah ke era degeneratif - kita pulang ke alam kanak-kanak, dari segi jasmani, akal dan rohani. Bahasa mudahnya, 'nyanyuk'.

Pada suatu hari yang lain, seorang pesakit pernah merintih mencerita yang anak-anaknya berebut hartanya. Terus terdiam dan kelu lidah saya ketika itu...

.....

Published 4 August 2009, doi:10.1136/bmj.b2683
Cite this as: BMJ 2009;339:b2683

Editorials

Do not-for-profit nursing homes provide better quality?

Possibly, but current evidence is too weak to prove a causal association

In the linked systematic review (doi:10.1136/bmj.b2732), Comondore and colleagues assess the relation between profit status and the quality of care in nursing homes and conduct a meta-analysis of four quality measures.1 The association between profit status and the quality of health care has been controversial for decades. The controversy stems partly from theoretical ambiguity and partly from lack of definitive empirical evidence. In theory, not-for-profit healthcare providers may provide a higher quality of care because their mission might include quality and because they do not need to divert resources to shareholders and taxes. On the other hand, for-profit providers may feel greater pressure to compete on price and quality, and this may result in higher quality care that is also more efficient. Unfortunately, rigorous testing of these competing theories is limited because it is impractical to conduct randomised controlled trials of profit status. Methods to mimic randomisation in observational studies (for example, instrumental variables2) are not always viable. Thus, empirical evidence cannot determine with certainty which theory is closer to the truth.

The nursing home sector is no exception to this controversy. Comondore and colleagues report that existing studies predominantly favour not-for-profit nursing homes, in that 40 of 82 studies showed significantly better quality in non-profit making homes. The meta-analysis favoured such homes for two of four outcomes; differences between the other outcomes were not significant. An important benefit of this review is that the authors were able to compare these results with similar reviews they conducted on hospitals and dialysis centres, both of which also showed higher quality in not-for-profit organisations.3 4 What is most remarkable about the results, however, is the inconsistency of the findings. Three of the studies reviewed showed significantly better quality in for-profit homes, and the remaining 39—almost half—were equivocal.

The inconsistency of the findings probably reflects the challenges of using observational data. No review or meta-analysis can overcome the empirical limitations common to all the studies reviewed—we still do not know whether not-for-profit status is the reason for higher quality of care. In other words, if a for-profit nursing home became not-for-profit, would its quality improve? The authors note this caveat, but it is worthy of greater consideration in terms of practical implications.

The lack of causal evidence is particularly problematic in that most of the studies were conducted in the United States, where the relation between nursing home profit status and payer mix is unique among healthcare sectors. Whereas not-for-profit status is normally associated with a community oriented mission, including care for the indigent, which would justify the tax exemption status, not-for-profit nursing homes in the US tend to focus on the clinically more severe and financially more lucrative end of the payer spectrum.5 For-profit facilities usually have a less lucrative payer mix and take on a larger proportion of (indigent) Medicaid beneficiaries. Thus, it could be argued that differences in quality stem from differential revenues rather than mission or diversion of resources to shareholders. Indeed, not-for-profit nursing homes with large Medicaid populations often provide a similar level of quality to that of for-profit homes.6 7 It could be that inadequate risk adjustment confounds the association, because for-profit and not-for-profit nursing homes tend to have different populations in terms of clinical needs.

The degree to which this uncertainty over causality matters depends largely on perspective. To prospective nursing home residents, their families, and care providers concerned about placement in a high quality nursing home, not-for-profit status may act as an indicator of high quality care. The reasons for higher quality in not-for-profit homes are largely irrelevant. Consumers already seem to be guided by this indicator,5 8 although it should be supplemented with personal experience in visiting the home and monitoring care.

From a policy perspective, the uncertainty over causality matters a great deal. It is not at all clear, for example, that banning for-profit providers from the nursing home sector would raise quality. It might, but many factors other than profit status have been strongly linked to the quality of nursing home care, such as the proportion of residents on Medicaid and the extent of poverty in the surrounding neighbourhood.7 Facilities that change profit status will probably maintain these other characteristics. Thus, if differences in quality between for-profit and not-for-profit nursing homes stem at least in part from differences in revenues rather than mission, eliminating for-profit homes may do little to eliminate differences in quality.

Experimental data—data from a situation in which nursing homes are forced to change profit statusare needed to increase our understanding of the causal association between profit status and the quality of nursing homes. Comondore and colleagues note that many European countries with historically public, not-for-profit, healthcare systems are now considering privatisation. Although current evidence is too limited to inform the potential effect of such a policy change on quality of care, the policy change itself could provide useful experimental data.

Cite this as: BMJ 2009;339:b2683

R Tamara Konetzka, assistant professor

1 University of Chicago, Department of Health Studies, 5841 S Maryland, MC2007, Chicago, IL 60637, USA

Research, doi:10.1136/bmj.b2732


Competing interests: None declared.

Provenance and peer review: Commissioned; not externally peer reviewed.

References

  1. Comondore VR, Devereaux PJ, Zhou Q, Stone SB, Busse JW, Ravindran NC, et al. Quality of care in for-profit and not-for-profit nursing homes: systematic review and meta-analysis. BMJ 2009;339:b2732.[Abstract/Free Full Text]
  2. McClellan M, McNeil BJ, Newhouse JP. Does more intensive treatment of acute myocardial infarction in the elderly reduce mortality? Analysis using instrumental variables. JAMA 1994;272:859-66.[Abstract/Free Full Text]
  3. Devereaux PJ, Choi PT, Lacchetti C, Weaver B, Schunemann HJ, Haines T, et al. A systematic review and meta-analysis of studies comparing mortality rates of private for-profit and private not-for-profit hospitals. CMAJ 2002;166:1399-406.[Abstract/Free Full Text]
  4. Devereaux PJ, Schunemann HJ, Ravindran N, Bhandari M, Garg AX, Choi PT, et al. Comparison of mortality between private for-profit and private not-for-profit hemodialysis centers: a systematic review and meta-analysis. JAMA 2002;288:2449-57.[Abstract/Free Full Text]
  5. Spector WD, Selden TM, Cohen JW. The impact of ownership type on nursing home outcomes. Health Econ 1998;7:639-53.[CrossRef][Web of Science][Medline]
  6. Konetzka RT, Spector W, Shaffer T. Effects of nursing home ownership type and resident payer source on hospitalization for suspected pneumonia. Med Care 2004;42:1001-8.[CrossRef][Web of Science][Medline]
  7. Mor V, Zinn J, Angelelli J, Teno JM, Miller SC. Driven to tiers: socioeconomic and racial disparities in the quality of nursing home care. Milbank Q 2004;82:227-56.[CrossRef][Web of Science][Medline]
  8. Chou SY. Asymmetric information, ownership and quality of care: an empirical analysis of nursing homes. J Health Econ 2002;21:293-311.[CrossRef][Web of Science][Medline]