Odysseys of George

I was shocked to see there were two unread sms on my iPhone this morning. In the hurry of getting to work, I forgot to check these messages and only had a look at them at about 10am. Gosh! Was I shocked and saddened.

In my carrier, I have met many people. My patients are all dear to me, they have all thought me something either directly or indirectly and not just about medicine, but the art of medicine and also life, this especially so with my elderly patients. However, some patients become closer than just patients and over the course of time, they almost are like family or a very close friend. This post is about one of them, a lady whose strength, determination and perseverance and above all her ability to smile and laugh in times of pain and suffering thought me a lot about life and love.

It was about 5 years ago. She was in her 40s and already on a wheelchair. I was a new specialist just a few months after graduation. She was wheeled in to my clinic by her sister. She smiled – a smile that was welcoming and yet cynical. I welcomed her with the usual greeting and proceeded to ask her as to why she came. Before we knew it, we were talking and she was telling me a story that I felt sorry for. A year before our first meeting, she had an emergency procedure which ended up with her having to carry a stoma bag to pass motion and an amputated right leg. She was diabetic and also hypertensive. She came to see if she could get her stoma reversed.I could understand why the stoma was a burden as it was sited poorly and she had difficulty taking care of it herself thus requiring her sister to help. She did not like the feeling of dependency. After 3-6 months of assessing her heart, her fitness level, her independent ability and seeing her determination, I agreed to reverse the stoma. She understood the high risk involved and bravely she signed the consent form. The surgery went well and she recovered well. She was able to attend functions and managed to built her self confidence all over again. She dressed better and the smile was a story of content happiness. She never fails to come for her follow up and she always wishes me via sms or calls on my birthday and on Christmas day. She would also remind me of all the important Malayalee celebration days for which I blogged before. She always kept in touch even after I have left that hospital for over two years. Early this year, she started to have problems again but this time it was more related to her female reproductive organs. A few days ago, she had difficulty in breathing and was admitted to a hospital. Yesterday night at about 1130pm, she took her last breath……………………….

“Ms Kana has passed away” was the sms that was staring at my face!!!!!

My heart felt heavy, my eyes started to tear. I called her sister and spoke to her. I decided to see her for the last time. She has always come to see me, now it is my turn. I wished it was not for this. I wished I saw her prior. I will miss her, her laughs and her smile. I will miss her wishes and her reminder of festivities. I saw her lying there on a table, they were doing their religious rituals for the departed. The ladies then dressed her up in her favorite dress. She looked contented. I hope she was. She was then placed in the coffin and was brought to the crematorium. I left. I wished I knew she was unwell. She would normally call me when she was unwell — maybe she was too weak to do so, maybe she knew and did not want to let me know. We did speak about death before — that was 5 years ago before the surgery — she looked at me, then looked at her sister and then looked down at the floor before looking back at me and said, “I’m ready. If it is my time, at least I would be no more a burden for my sister and siblings.Let God decide.”

As you showed me strength, I learned to be strong,
As you showed me determination, I learned to be determined too,
As you showed me love, I began to understand love too,
And with your smile, it made me smile even more.

Thank you for being my patient and a friend.

If you had to choose to let go of a particular sense, which would it be?

It all started when a friend of mine related a true story. There was this girl who was having problems with her nose — so much so that there was no relieve despite anything or any treatment she took. So, eventually the ENT surgeon told her of a particular procedure that may settle her problem at the cost of her losing her sense of smell. She agreed. The procedure was a success but she is now unable to smell anything.

My friend was sad to hear this story and it got me thinking. We have five sense – smell, sight, taste, touch and hearing. Medically, sight is probably the most developed sense in humans, followed closely by hearing. We use these senses without giving a thought of its individual importance until we lose them. But if you were asked to which of these sense was most important to you and which is the least or willing to give up, what would it be?

For me, I would put them in these order — sight, hearing, touch, taste and smell, with sight being the most valuable. What would yours be?

I came across this while surfing through MMR blogpost. Even before reading it, I had sensed that this would be something that would move me.

As I read the first paragraph of the post, I immediately realized that this was something long due and very appropriate – A tribute to the late Tan Sri T.J.Danaraj, the founder of the medical faculty University Malaya. A visionary man who had managed to have an impact on me even though he never thought me.

We stand on the shoulders of Giants is a teaching blog dedicated to the late Emeritus Professor T J Danaraj, the foundation Dean of the University of Malaya Medical Centre. The blog is moderated by Dr. Wong Yin Onn.

I remember presenting about this great man, during my batch Deepavali Festival as a tribute to him. We felt that little was done to honour this man, so much so that many present UMMC medical students hardly even know him.

I end this with a letter he once wrote which I copied from that very blog. An encouraging note to all……….

Dear …….,

T.J. Danaraj

TJ Danaraj

It was 1992, goodness, a good 16 years ago, I took my first steps emulating all my sisters walking into the halls of fame in this prestigious or maybe once prestigious university in the country and perhaps once upon a time, in South East Asia, University Malaya.

As I walk these steps, a mental slide show begins to reel. It starts with me in Standard Three, when I remember my teacher, asked the class who wants to be a doctor and why. Strangely, 5 of us lifted our arms and out of that 3 of us have somehow manage to achieve it. A smile arched across my face as I vividly remember telling my teacher I love blood! Goodness she must have thought I was mental!

Life wasn’t a bed of roses. I wasn’t the best in class only getting the idea of studying in Form 4, I trailed and toiled and somehow rolled together with the best in my school till I somehow manage to breathe the air of this prestigious hall. Must be my mom’s prayers, I believe. She used to pray for us before we sat for our exams but for me it was different – whenever she prays and tells me all will be well, it would not be. Thus she stopped saying anything but continued praying — I must say I believed in that more than what I studied.

From a prestigious school to a prestigious university, all I could feel was of pride. It was not too long afterwards, that I realized that medical school was a total different ball game. As i stepped into the Dean’s office for the interview, I was asked why choose medicine and I was silent as if to question why not. I looked at the aging professor, and said, ” I always felt like doing it, no second thoughts, but perhaps the most obvious reason was that I would love to help people.” I smiled as I exited the room.

Now 16 years forward, I find myself in constant asking of that very same question. Somehow, this simple question does not seem to be the easiest to answer truthfully. With changing times, more financial strain, difficulties in progressing in the profession, this question truthfully is difficult.

Then, a few days ago, I saw my patient and I realized something. She was a young lady in her 40s with young kids, suffering from Oesophageal cancer. Oesophagectomy (removal of the oesophagus) is a surgical procedure with high morbidity and mortality and thus many shrug away at doing this. The surgery was done 10 days ago. A few days ago, she was already walking about and having soft diet with no major complaints. As I walked towards her, the first thing I realized was the smile she presented to me. That was the biggest present any patient can give their doctor, a smile in return. I was flushed with enthusiasm and I realized that the answer to that very question has never changed. Nothing could be above that smile she gave me, not even the powers above that deprive me of going further for I have already gone a little further. After working for 11 years, still a young doctor and surgeon in comparison, I have learnt to many things and yet has still much too learn. Medicine is a of progressive learning and the best teachers are your patients and not the textbook.

Well, I have been waiting for this and now I manage to go for the 26th July performance. That would be the only day I would be free to catch and of course the highlight for me was to catch Mia Palencia.

The venue was at Plaza Mont Kiara. The layout was acceptable. It was packed when I reached there with the center area just in front of the stage being left empty. Many photographers took this to their advantage as I grow in jealousy to see them aiming their delicious gadgets (DSLR) and having the time of their life taking shots .

The music I felt was too loud at its bases. The crowd was there quite obviously for Mia Palencia because by the end of Phunk Mob performance which was for me was a little lack of the jazz soul, most had left and the audience picked up again just before Mia Palencia came back on stage at 11.15 pm. Bassgroove 100 played just before Mia came on stage and they were good but with the anticipation and the warm and humid environment, the audience was geting restless a little. Things were not the same the day before as many reviews said that the 25th performance was fantastic and so was the turnout. It was also too hot and humid for the musicians who were drenched in sweat just about 10 minutes into their performance.

Mia Palencia

I did my share for the local jazz industries by buying Mia’s and Karen Nunis’s albums. No matter what, personally I think this was of good effort and should be done regularly. Jazz awareness is still quite infantile in Malaysia but that is also because jazz is a lot about the feelings and moods of the musicians and harmony between them, which is also why not many people take to jazz easily. Even for me, there are some forms of jazz that is difficult to like. Hmmm….. maybe I should do some research on jazz then…..hmmm.

Sultan Abdul Hamid Collegians can stand proud again as this prestigious school once again stand above all to celebrate its 100years.

The celebration activities actually started in Jun last year with a fund raising dinner held at PWTC organised by SAHOCA on the 3rd of November 2007.

Tomorrow, there would be a THE 100 YEAR ANNIVERSARY HUNT.

The SAHOCA Treasure Hunt 2008 with the theme “ Jom Sambut 100 Tahun Kolej” was initiated by SAHOCA Selangor/ Kuala Lumpur to motivate ex-collegians in the Klang Valley to make a journey to Alor Setar and partake in the festivities organized in conjunction with the 100 years Kolej celebration and events.

The starting point is the Car Park B, One Utama Shopping Kompleks, Petaling Jaya and he finishing pint is the Kolej School Hall, in Alor Setar.

The flag off will be at 7.45am on the 24th July 2008 and the closing time of arrival is at 5.00pm at Kolej Hall, Alor Setar.

PROGRAM FOR TREASURE HUNT 2008 – ( 24th July 2008. )

7.00 am
Gathering at Car Park B, One Utama, PJ
7.15 am
Final Briefing by Hunt Club, Organiser
7.45am
Flag- Off by VIP Hunt will traverse North South Highway and into Kedah – Entry into Alor Setar is the North Toll PlazaTreasure Hunting around Alor Setar with relevance points of interest to Kedahan and ex Collegians

5.00pm
Hunt Closes at Kolej Hall, Alor SetarAfternoon Tea at Kolej Hall
6.30 pm
LCD Answer presentation and Prize Award
7.00pm
Event Ends

On the 26th of July, would be the Centenary Celebration Day.

For a walk down the memory lane, check out Down Memory Lane

As for me, I would have to miss it. I am on call tomorrow and would have to work on Saturday too.
However, I have a facebook group that I have created which have managed to bring together many of us. Hopefully the group can do more that just be online.