Emotional Roller Coster

After spending years in the military, we have been trained to follow orders regardless of how tired one feels or what emotional state one is in. Over the years, we have learnt how to keep our emotions in check and be stoic and almost robot like all the time. Or so I thought until I was posted in the Obstetrics & Gynecology (O&G) department. 

The past 4 months saw me learning the the ropes of how an O&G unit functions. Consisting of consultants, specialists, residences, medical officers, house officers, staff nurses and midwives; each plays a specific role and man respective stations, ensuring the whole unit functions as it is designed to be. 

 

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One of the most essential part of an O&G department is the labour room. The labour room is a battlefield ruled by the midwives, they are at the forefront literally fighting for every birth. And it was there that I witness and conducted many a labour.

After witnessing so many labour, I'd describe it as watching a football game. With the mum as the home-team player, the baby as the ball and the midwives as cheerleaders (but not the pretty young cheerleaders mind you, these cheerleaders are fierce & scary).

 

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A labour is a very happening event. The mum would be lying on a special bed which can broken from waist down and the legs can be put in stirrups, she would be surrounded by midwives to "cheer" her on and a houseman would usually be present to conduct the delivery. 

 

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Once the opening of the uterus is fully dilated, at every uterine contraction, will be followed by thunderous cheers of PUSH!! DON'T LIFT YOUR BUTT!! PUSHH!! PUSHHH LOONG LONNG, DONT PUSH SHORT SHORT!! COME ON COME ON A BIT MORE! (direct translation from malay la). And on top of all this commotion, the regular thump-thump-thump from the CTG machine (a machine to monitor the heartbeat of the baby) and the intermittent screams of the mother add more melody to the ongoing symphony. The symphony of chaos.

 

 

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This whole process brings you on a emotional roller coster ride. No matter how heartless or stoic you might be, your spirit can't help but soar when all the midwives start to cheer and you see the mum pushing with everything she has and you see the descend of the baby's head slowly leaving the womb of the mother..

And your heart drops with disappointment as the mother gives up halfway and you see the baby's head go back in. And at times, you can't help but feel frustrated when the mum is whining and don't want to push.

The ride also brings you to the scary zone where your heart is beating with fear when the fetus is in distress and the mum needs to deliver as soon as possible. And not to mention the moment of waiting for the baby to cry after a delivery especially a difficult one. The silent moment where even time stand stills and seconds feels like hours and everybody fervently waits with bated breath for the cry of the baby. And at the sound of a baby's cry, joy and relief blossoms in our hearts! Never has a baby's cry sound so sweet and melodious to our ears. 

 

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But the most touching moment for me has and always will be the first time I witness a mother holding her newborn baby for the first time. The joy radiating from her face when she held her baby, her smile that said everything she just went through was worth it and the look of happiness shared between the husband and the wife was something to behold. The tender moment when the mum started shedding tears of joy with the husband made me shed a few tears too. This beautiful moment will forever be imprinted in my mind, although it might be a little blurry cause I was teary eyed. 

 

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So yeah, an emotional roller coster ride alright. A whole spectrum of different emotions of ups and downs has been experienced in the battlefield known as the labour room. This actually made me realize a few things:

1) I'm not as heartless and emotionless as I thought I was. Buried deep down inside me is still a viable heart that can feel and be touched. Over the years of training and experiences have taught me to bury it deep down and to turn it off to function efficiently. This changes nothing though, I still will function efficiently but now perhaps with a little more empathy.

2) I understand now the greatness of a mother's love. No matter how unappreciated a mother's love is, a mother will forever love her children regardless of age or distance. After carrying a child for 9 months in the womb, going through childbirth (normal or Cesarian) and breastfeeding her child, there is a special bond between a mother and child. As cheesy as it might sound, I now kind of appreciate the things my mum has done for me all these years. You might have to witness firsthand how traumatic a labour can be to understand what I'm trying to say. 

3) I think O&G is fascinating! From the moment of conception right till birth is a magical process. Biggest respect to all the O&G consultants, specialist, medical officers, staff nurses, midwives around the world helping mothers give birth. It is the highest honour and trust bestowed upon you to welcome new lives into the world. Keep up the phenomenal work!

Yours truly,

Dr Shimri

 

The Batek People

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Floating down the calm brown waters of the Tembeling River followed by some light trekking through the thick forest of Taman Negara Pahang brings you to a quiet little spot in the wild jungle. As your eyes slowly adjust to dim light, small wooden huts with leaves for rooftops seem to materialize out from the shadows cast by the tall trees.

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Here you find a tribe of dark skin people with curly hair called the Batek Tribe. It is said that they crossed the ocean many many moons ago from Papua New Guinea and settled in this resources rich forest we now called Taman Negara. 

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Living a nomadic life, they used to move their village around the forest depending on available resources. But with recent modern day aid and infrastructures, they have abandon the nomadic lifestyle and have chosen to settled down. Which in a way is a win win situation for the forest and them whereby less trees are cut down to make new houses every time they relocate and the outside world become much more accessible.

Prior to settling down, the forest was their sole source of livelihood. Dressed in tree bark clothing they coexisted with the other inhabitants of the forest, hunting with blowpipes, killing small game for meat and foraging edible plants and berries. The only contact with the outside world was when they brought their forest product to trade for rice, tobacco and salt.

But over the years, the inevitable encroachment of the modern world happened. Slowly, the traditional lifestyle is slowly forgone as the newer generation chooses comfort of the modern world over the ways of their ancestors. Why light fire with stick and stones when a strike of a match brings you instant fire. Even the art of making tree bark clothing is almost forgotten in exchange for track pants and t-shirts.

The jungle itself has evidence of modernization with pipes running from rivers to their village providing them with fresh running water and also a rudimentary sewage system. 

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But that being said, there are still certain traditions which the Batek still hold fast to. Say for example their medical practice. The Batek still have a certain fear and distrust regarding modern medicine, they perceive blood taking and injections as harmful to them. Hence, they still go to their shamans for treatment of medical ailments, child births and so on.

 Tok Batin Sena a Batek Shaman

Tok Batin Sena a Batek Shaman

The shamans do have a impressive knowledge of all the herbs and plants in the jungle. Passed down from father to son and over the generations, they have identify over a thousand plants for different uses. I had the pleasure of speaking with Tok Batin Sena a Batek Shaman who was telling me about the various herbs they have, their usage and how to locate them.

 Batek's version of Syntometrine 

Batek's version of Syntometrine 

In modern medicine, we have something called Syntometrine which is given intramuscularly to a mother right after delivery of a baby to contract the uterus and reduce bleeding. Interestingly enough the Batek has something similar which is boiled in water and drunk. The only difference is the the dosing is variable whereby they can't be certain of the therapeutic dose or the toxic level.

Speaking with the Shaman made me realize how fortunate we actually are with the advancement of modern medicine especially in the area of child birth. For us, there are several well planned and well researched guidelines in place for maternal and fetal well being; Low lying placenta = operate! Breech presentation = operate! Fetal distress = operate! Gestational Diabetes on insulin = Induce! 

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Unfortunately for the Batek, everything is via vaginal delivery regardless of the situation. When I asked Tok Batin Sena how often does maternal and fetal death occur, he replied nonchalantly about 4 out of every 10 birth. Considering that the deliveries occur in the jungle under a tree without proper monitoring and medication, I'd say they are doing fairly well. I have no idea how they cut the cord, how they expel the placenta and so on. All I'm told is that if the baby is safely delivered, he/she will be named after the tree they are born under.

 

Another one of their tradition which I find fascinating is their burial system. Instead of having grand funerals where the whole village will mourn the death of a loved one, their funerals are very quiet affairs where only few selected people are privy to the death and the others choose to believe that the deceased is away on a long journey. 

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When a death occurs, the corpse is wrapped in tree bark and is carried across a river by a small group of men. The significance of the river crossing is that the Batek believes that the spirit is unable to cross the river and is prevented from returning to the village. Once they have crossed to the opposite bank, they will look for the tallest tree in the vicinity and two men will climb the tree. Then they'll haul the body up using vines and secure it at the top of the tree leaving it decompose there.

I requested to see their burial sites but was gently decline as they consider the burial site sacred. I kind of picture a certain part of the forest with trees filled with skeletons and decaying bodies.

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There are actually several more exotic Batek traditions which I would love to photograph and document which brings me to the main point of this write up. Before I proceed, first you'll have to understand that the Batek people are caught in a limbo. Neither here or there, they live a life stuck in between the old independent way of their ancestors and a so called modern lifestyle where they rely on donations and aid to get what little modern day facilities and infrastructures they have. 

 

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Without funds for proper education and training, their future out of this limbo seem pretty bleak. Generation after generation will be sucked into this blackhole, forever relying on donations and slowly forgetting their traditions and cultures. And that is where a NGO called HUGS Projects come in. Their aim is to empower the Batek people, give them a means to earn a living so that they can stand independently on their own feet hence a perfect balance between modern development and tradition can exist. 

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One of projects done thus far is the creation of the Batek Jungle Hut, a jungle chalet build by volunteers and the Batek themselves. It is equipped with functional toilets right in the middle of the jungle and fully managed by the Batek. With the money earned, they invest into the future of their children whereby they send them to schools in hopes that one day they will return with the necessary skills to serve their people better. 

My role in this is to raise awareness of the existence of the Batek people and their plight. On top of that, an opportunity to document and photograph all their traditions and cultures before they pass would be phenomenal. Things like their marriages, funerals, child birth and most importantly their vast knowledge of jungle herbs and plants.

Another undertaking to consider would be to properly document all the herbs and plants and used by the Batek. Would be a shame to let this knowledge which goes back hundreds if not thousand years ago just disappear just like that. Our one link to our prehistoric ancestors and how they survived without all these modern day comforts.

So, if you are interested to learn more about the Batek people or want to help them out, you could always drop me a message and I'll put you in contact with the right people or you could always contact HUGS Projects directly. And if you are ever planning a trip to Taman Negara Pahang, I would highly recommend The Batek Jungle Hut for an authentic jungle experience you would never forget.  

 

Yours truly,

Shimri

 

 

 

  

Vacational Cardioversion

In a blink of an eye, we are suddenly 4 months into our housemanship training. As my run in the Orthopedics comes to an end, I begin another 4 months in the Medical department. 

The past four months have been exciting alright! I spent most of my time amputating rotten toes and legs, debriding wounds and assisting to fix fractures. Working almost round the clock, our routine consists of ward rounds, ward work, clinic duty, scrubbing in the operating theatre, and being on call. 

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These 4 months have strengthened my resolve to specialize in Orthopedics in the future. The satisfaction is second to none. Broken limbs are fixed, ligaments restored and the lame walk again.

It is an indescribable feeling witnessing initially septic and very ill patients due to gangrenous feet recover after amputations. The transformation from a lethargic half dead looking patient with contorted and twisted facial expression to a fresh peaceful patient is something to behold. The joy and relief radiating from them is akin to being born again. I have had patients hugging me and thanking me for cutting off their legs. 

But as much as I enjoyed my time in the Ortho department, it does take a toll on the body. Every time I'm on call, as I work throughout the night, I am in a state of persistent tachycardia; every time I get a call from the hospital, my heart skips a beat and starts fluttering...

 An ECG of a normal heart beat. Note the presence of the P wave, QRS complex and the T wave, this what we call sinus rhythm.  

An ECG of a normal heart beat. Note the presence of the P wave, QRS complex and the T wave, this what we call sinus rhythm.  

 And this is an ECG of me after prolonged working hours. Image downloaded from www.ecgreview.com

And this is an ECG of me after prolonged working hours. Image downloaded from www.ecgreview.com

So, at the end of my posting, taking all my accumulated leave, I took a short holiday to restore my heart to normal rhythm (cardioversion). There are 2 official types of cardioversion, chemical and electrical. But neither would work in my case, only a vacation would help hence the name, Vacational Cardioversion. Best taken every 4 months.

 

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Flying to Ulaanbaatar, the capital of Mongolia and then flying to Murun, in the north of Mongolia. Followed by a 9 hour bumpy car ride into the wilderness of north Mongolia to the last accessible point by car. From there, I prepared to enter the deepest parts of the wilderness in search of the legendary Reindeer Herders.

 

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My team consisting of Dulgoon, my lovely translator; Khuvsgol and Adiya, our horse-guide and his son; Taivanaa, our cook and of course me! 

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Together we embarked on a 2 days journey on horseback up the Mongol mountains and vast Mongol plains heading towards  the elusive Reindeer people. Crossing gushing rivers, up mountains and navigating thick forest on horseback, at times I felt like in a Lord of the Rings movie. The Fellowship of the Lim with me as Aragon haha. 

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Riding across the breathtakingly beautiful plains of Mongolia, awoke the suppressed Mongol genetic structure in me. My heart soared as I traversed this hidden paradise, the only word to describe this phenomenal peace and tranquility was spiritual, not religion mind you. I can understand why people retreat to mountains to achieve zen mode and to contemplate life.

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After two days of riding and camping, we finally arrived near the border of Russia and Mongolia, a place called Tsagaanuur of the Khovsgul region.

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And there the legendary Reindeer people, called the Tsataan are found! Tsataan means those who have reindeers in Mongolian. The Tsataan live in this almost forgotten part of the world cut off from the rest of the world pitting themselves against the harsh Mongolian environment.

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Living in teepees and relying on their reindeers for food, transport and clothing. They lead a nomadic lifestyle, moving camps according to the seasons. The temperature ranges from 4˚C to 16˚C in the summer and -60˚C in winter.

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The nearest medical facility is over 5 hours horse ride away. Just imagine having a heart attack or postpartum hemorrhage, and to seek treatment you have to jump on a horse then gallop 5 hours up mountains and rivers to see a doctor. So most of the time, deaths which could have been easily prevented with proper medical care often end up with a loss of life. 

I spent almost a week with the Tsataan, staying with a kind family who treated me like their own. It was fascinating to learn their ways and to follow their daily routines. Via my camera and phenomenal translating done by Dulgoon, I managed to connect with various families and learn their stories and also photograph their lives. 

 The inside of a teepee. Notice the strips of meat hanging to be dried in preparation for food in the winter. The white stuff cooking is reindeer milk.

The inside of a teepee. Notice the strips of meat hanging to be dried in preparation for food in the winter. The white stuff cooking is reindeer milk.

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It was amazing seeing the excitement on their face when they received a polaroid photo of themselves. I get the feeling the only time they get to see glimpses of themselves is when they look into rivers or lakes. Such was their excitement to be photographed, that they dressed in their best Mongolian Deel and even were willing to ride up mountains at sunset for me to photograph them. 

 A kid running off in excitement after getting a polaroid photo of himself.

A kid running off in excitement after getting a polaroid photo of himself.

I had the time of my life doing what I do best, photographing people in their element, living in utter isolation from the rest of the world, sleeping under the milky way, riding reindeers to collect firewood, playing with the Tsataan kids, dancing among the reindeers (not me dancing lah, you don't wanna imagine me dancing)...

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Amidst the harsh life they lead, there is a certain beauty, a certain romance to it all. Like wild flowers growing on freezing mountain tops.

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Given a choice, I wouldn't mind living out there for the rest of my life and open a medical facility to cater for their needs. For the short period of time I was there, learning that I was a doctor, many came from various families seeking for treatment for minor and major ailments. Cuts, burns, mal-united fractures, decaying teeth, abscesses and even what I suspect to be a tumor..

 Treating minor cuts and burns.

Treating minor cuts and burns.

What I could do was really limited though, I treated the minor ailments with what little medicine and bandage I brought. The more major problem needed surgery and proper hospital care. 

Perhaps in the future, once I've completed my housemanship, this could be an option to be explored. Raise enough money via photo exhibitions and my violin playing (as in the money people pay for me to stop playing). Then with the money raised, organize a medical team of tough and adventurous doctors and nurses to provide the much needed medical care they need. The Malaysian army could pioneer an initiative like this seeing how they are best equipped for missions like this. 

Something to think about, no? 

You know whenever I go traveling, my greatest fear is leaving something behind. So, to prevent that from ever happening, I have a checklist I always go through before moving to the next place and when packing. Even throughout the day, I'd be running the checklist in my head just to check and double check I have everything with me. Passport checked, camera checked, wallet checked, handphone checked.... then only would I be satisfied. 

But for all my checklist and diligent checking and double checking, I still managed to leave something behind during this trip. Something I never thought I'd leave behind...... my heart.

Part of me has fallen in love with the wild untamed beauty of Mongolia, the warm hospitality of the Mongolians. Forever shall I yearn to return to the vast Mongolian plains and feel the wind in my hair as I gallop across the mountains. Henceforth, nothing will compare with the beauty offered by Mongolia and everything else will seem dull and colorless. 

Allow me to end with a big shout out to the oldest and most trustworthy tour company in Mongolia, Juulchin Tourism Corporation for helping me organize this successful trip. Alone, I wouldn't have been able to do it with the time constraints I had working as a houseman. They arranged all the ground transport, made all the necessary arrangements for me to get in contact with the Tsaataan and all in all ensuring the whole trip went smoothly. I highly recommend them if you are ever planning a trip to Mongolia!

Yours truly,

Shimri

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Diamonds!

Million and million years ago, when planet earth was young and green and when dinosaurs roam the earth freely, tiny elements called carbon were buried in the soil. Over the years, those carbon get buried deeper and deeper and deeper... 

 

So deep the carbon goes that it comes close to the core of earth where the temperature is searing hot and the pressure tremendous! Studies have shown that the pressure exerted is over 300 000 pounds while the temperature is over a 1000˚C.

 

Interestingly enough, after an extended time of exposure to the extreme heat and pressure, the carbon slowly transform from a worthless piece of carbon to a shiny glittering sparkling element called diamonds!

 

About a week ago, after years of military training, 339 cadets officially passed out from the National Defence University of Malaysia as proud young officers. Similar to the carbon, the cadets first joined the Defence University as clueless naive teenagers. Walking around innocently, expecting things to be all sunshine and smile. They are quickly brought to reality as they are subjected to all kinds pressure (academically, emotionally, mental and physically) and extreme heat (literally! Imagine marching for hours under the hot Malaysian sun). Overtime, the weak is rooted out leaving only the best of the best, and those best of the best similar to the carbon will be transformed to diamonds at the end of the day. 

So my whole point is that each and every cadet officer in the National Defence University of Malaysia are pieces of highly selected carbon waiting to change into diamonds. The Malaysian Armed Forces using specific and specialised selection methods has identified and hand picked you to be moulded and shaped in something valuable. Remember that not everything changes to diamonds under pressure and heat. Even after centuries of exposure to heat and pressure, a piece of shit remains a piece of shit albeit a little flatter and blacker.  So hang in there, carbon! Be proud that you have been chosen to undergo this challenge and make the best of this opportunity!

 

 

On a more personal note, I'm glad to say that I have finally fully recovered with minimal scarring. Am on my two feet once again and am ready to take on the world! Thank you for all the prayers and well wishes, they truly meant a lot to me in this down time of mine.

My violin learning is going very well too. Been practising day and night while I was recovering back in Melaka much to the dismay of my neighbours. Perhaps one of the reason why I recovered so fast was due to the desperate prayers of my whole neighbourhood. Praying I recovered ASAP and get back to work, relieving them of the relentless screeching and scratching that sounds like a cat dying. Haha. 

 

I even took a few self portraits just in case Malaysia Philharmonic Orchestra called. Now all that is left is just to learn how to play. So till then!

Sincerely,

Second Lieutenant (Dr) Lim Shimri

The Tunnel of Darkness

I've always prayed that I would be the luckiest guy in the world. So lucky that I would win that 1 in a million lottery ticket and be a multi-millionaire!

This year, seeing as how my birthday was coming, I prayed extra hard. But somehow somewhere along the line, my prayers were misinterpreted. On my birthday, instead of becoming a multimillionaire,  I was diagnosed with the rare 1 in a million Steven-Johnson syndrome (SJS) secondary to either a viral infection or some new protein shake I tried. 

Steven-Johnson syndrome (SJS) is an autoimmune disorder whereby my immune system misfires and attacks my own skin instead. A layer of my skin called the epidermis dies and peels off while the mucous membranes necroses too and sloughs off. 1 in 4 patients die and being blind is one of the many side effects.

 Image taken from www.diseasesforum.com. Notice the sloughing of skin which is typical in SJS.

Image taken from www.diseasesforum.com. Notice the sloughing of skin which is typical in SJS.

 Image taken from www.diseasesforum.com. Notice the blistering rashes in the torso and arms which also is typical in SJS.

Image taken from www.diseasesforum.com. Notice the blistering rashes in the torso and arms which also is typical in SJS.

 

I spent over 10 days hospitalised covered in blistering rashes over my body and face. The worst part was the mouth, lips and tongue which were covered with open bleeding ulcers. Every twitch of the tongue brought a new wave of pain to my already overloaded sensory system, what more drinking and eating. It was so painful that a nasogastric tube was considered to feed me as as the agony was mind throbbingly overwhelming.  

 A picture of a healed ulcer on my tongue. My mouth was filled with ulcers like that.

A picture of a healed ulcer on my tongue. My mouth was filled with ulcers like that.

 

The cause of my SJS was initially thought to be an atypical presentation of herpes zoster (chicken pox) infection. However, the presentation was so atypical that Herpes Simplex virus was thought to be the cause instead. So my diagnosis was Steven-Johnson Syndrome secondary to Herpes Simplex infection. I hated that diagnosis from the very beginning.

Herpes Simplex virus is a sexually transmitted disease. And with that diagnosis carries a stigma, an implication, nay! An accusation that I've been naughty and this whole episode was my fault! I resented that diagnosis with what little energy I had. I probably would have minded it less if I really had been naughty but I was innocent and I knew it! But good thing further blood investigation revealed that Herpes Simplex wasn't the cause thus relieving me from this allegation. So now we are back to square one, what was the cause of my SJS?? It is of tantamount importance that I know the cause so I can prevent another episode. 

 Blood results ruling out Herpes.

Blood results ruling out Herpes.

 

I would describe this horrendous ordeal as being in a endless pitch black tunnel. All the uncertainties, the doubts, the worries and above all the pain envelops you, squeezes you, entangling you and ultimately crushing you. 

Being no stranger to pain and adversity, I gritted my teeth and tried doing the necessary but the act of gritting my teeth caused too much pain so I did the necessary without gritting my teeth. 

I disciplined myself to drink, to swallow medication, to clean the ulcers and to cleanse the rashes in hopes of getting better. But the walk in the tunnel of darkness is a painful and lonely one, I was at times at the verge of lying down and allowing the darkness to consume me.

 

 

But thank God for my lovely mother and sister. They were like a flower of light in the darkness, guiding me on my way to resurrection. They came all the way to the hospital and took care of me. They helped bath and feed me, they helped make honey water to sooth the ulcers in the mouth and all in all help make the recovery so much better. 

Also, all the visits, messages, cards and calls from my friends, juniors, colleagues and relatives meant a lot to me. I was so touched that all of you cared and went all out to provide moral support. It was the thought of all of you that prevented me from giving in to the pain and illness.

 

 

The doctors and nurses of Hat Mizan and also the professors and lecturers of the Faculty of Medicine and Defence Health played an extremely important role in my road to recovery. They ensured I had the best possible care available, making sure that all the side effects of SJS were dealt with promptly. They were like angels guiding me to the light at the end of the tunnel, allowing me to hope and aspire once again. 

 

 

As much as I wondered what I did to deserve this illness, I too wondered what did I do to deserve such kindness. Everybody went all out to make things better, from my mum and dad, to the cleaners in the hospital, to friends and relatives, to even doctors from different departments. From honey, to get well cards, to mangosteen juice, to gingival gels and to home made soups, I am truly indebted to each and everyone of you!

 

 

 Picture credit to Mr Hairul Ismail.

Picture credit to Mr Hairul Ismail.

This whole ordeal put me out of action at the most important time of my career, my commissioning. After 7 years of med school and military training, this commissioning is supposed to be the climax, the highlight of our journey where we officially become proud military doctors of the Malaysian Armed Forces. The commissioning is the epitome of military grandeur, the Agung himself will be present to bestow our ranks on our shoulder. This day of celebration has long been awaited, this day where we dress in our smartest uniform strutting around with our heads held high and proud; The day where we look to our parents with joy exclaiming that we did it! Oh what a day of celebration... And to think that I'd miss it :(

 

 

The commissioning is the mark of a beginning. A beginning where we begin our careers as beautiful fit young strong enthusiastic competent doctors. But instead I'm bestowed with disfiguring scars from the SJS to start off my career..

The Kübler-Ross model postulates the 5 stages of emotion terminally ill patients go through which includes denial, anger, bargaining, depression and lastly acceptance. I can't say I went through all stages but I definitely was angry initially, WHAT THE HELL DID I DO TO DESERVE THIS?!! OF ALL TIMES, WHY NOW?! WHY ME?! 

But after some time, I arrived at the acceptance phase. The Lord gives and the Lord takes, so I suppose in the grand scheme of things, this makes sense in a way, who am I to get angry. I have decided that I refuse to let these scars define me, whether they remain permanent or not, come what may, I shall continue to strive and live life with a gusto of joy and enthusiasm!

Recovering back in my hometown, as my vision slowly starts to clear and the scars start healing, I have had ample time to think and ponder, And a few things I have learnt throughout this particular interesting journey of mine:

1) I now know what kind of doctor I wanna be. I'm going to be that doctor who brings people out from their tunnel darkness, the one that shows them the light at the end of the tunnel. I have been there and I know the importance of doctors like that, a doctor who has the ability to recuse people with their knowledge. And to do so requires years of training and sacrifices to be a master in whatever field I choose, which I'm prepared to do.  

2) I learnt kindness. The way people went out of their way to help me and thus I have resolved to do the same. My motto in life henceforth would be "Give". I've taken so much and perhaps it is time to give.

3) I've learnt humility. I have never agreed when people say "Inshallah" or "If God is willing" I shall achieve so and so. I believed that if you want something, all you have to do is put in the effort. Why would the permission of some deity count for anything, perhaps only as a excuse when one fails, one may say it wasn't God's plan. But I have realised the errors of my ways, there is higher power at work and it is time I learnt how to submit to Him. No more being foolishly arrogant thinking that I have control and that my life is infinite. 

4) I'm going to learn how to play a violin. Nothing to do with my illness, just something I plan to do. So good luck future roommates or housemate. Be glad it isn't singing I decided to learn.

So see you all when I debut in the Malaysian Philharmonic Orchestra! If God is willing la haha. Till then.

 

Yours truly,

Shimri

 

 

 

Light in the Night

Beneath the proud cocky swagger, the crisp sharp uniforms and the shiny boots of officers, there lies hours and hours of preparation. Many a nights are spend ironing our uniforms and shining our shoes to the break of dawn.

Polishing shoes is an art, almost like Picasso painting a master piece. But instead of using paint and brushes, our instruments include a bottle of polish, a piece of cloth and some water. 

Using the cloth, a small dip of polish with a dap of water, the polish is applied to the shoe in a circular motion. In circles we go, all over the shoe until the shoe is positively gleaming. 

Sounds relatively easy isn't it? I thought the same many years back when I first learnt how to polish my shoes. But in reality, polishing shoes is a pain in the neck, like an ulcer on the butt.

Most of the time, you apply the polish and in circular motions and you go and you go and you go... but instead of becoming shinier, the shoe becomes duller and duller. Until a certain point, your shoe is as dark as a black hole, anymore polish and all surrounding light including yourself would be suck into the shoes, lost to time forever.

After generations of polishing shoes, various methods have been created to decrease the time taken to get the shoe to shine. Some use fire to melt the polish beforehand, others use a special polishing cloth but the most effective and time saving method of all is passing the shoes to a junior. Miraculously, the shoes is always retuned gleaming and shining with no effort.

I have over the years came up with my own method of polishing shoes. Simple and effective, I try to spend as little time and effort shining shoes. However, one question that has always bugged me is why must shoe polishing be done at night. And recently I got my answer.

 

''Twas was during the early morning hours as I was huddled with the other cadets officers with a cloth and a shoe in hand when the epiphany hit me with a symphony.

I was sitting polishing my shoes covered in a heavy blanket of drowsiness, trying to get my shoes to shine so I could catch some sleep. But the more I shined, the duller it seem to get. Instead of taken a high sheen, I could see the map of the world made up by the dullness. If I looked really closely, I could even see the KLCC right in the middle of Kuala Lumpur.

After hours of polishing, the shoe still remain dull and I finally got so desperate that I threw up my hands and looked to the sky praying to the Gods to help me. As I looked up, I noticed that the ceiling looked dull and fuzzy too.

Then it dawned on me that the dullness was caused by drowsiness, every thing looked dull and fuzzy, not just my shoes. I quickly went to wash my face and freshen up.

When I return to my shoes, I was almost blinded! An explosion of light seem to radiate from my shoes, illuminating the whole room and nearly burning through my retina with the intensity of the shine. So shiny were my shoes that it could have served as a beacon of light in a lighthouse warning ships away from shore.

The glistening pair of shoes sat innocently by my bed where I left it, reflecting what little light that was in the room and multiplying it by 13 times, resulting in a pair of shoes that shimmer with a brilliance that could penetrate the deep darkness of the blind so that even the blind could see my shoes; and will blind anyone who gaze upon my shoes without protection.

Hence, I finally understand why polishing shoes must only be done at night under the protection of drowsiness. Else we all would be an army of blind men.

-The End-

Circ-ception

The whole function of the Malaysian Armed Forces is based on the concept of circles within circles. Hundreds and thousands of man are systematically divided into many small military units called sections which will in turn combine to form bigger and bigger groups. Below is a short GIF demonstrating the concept of circles within circles in the Army.  

All those circles will make up the Army, there will be similar circles in the Navy and the Air force. Together they make up the Malaysian Armed Forces.

It is similar to many round baskets of onions arranged in circles in a round shaped Pasar Malam, whereby the Pasar Malam is the Armed Forces and the rings in the onions represents the small units.

 Picture from Google Image

Picture from Google Image

 

To ensure that the that whole Armed Forces is functional, it is essential that each and every circle works smoothly. Each circle has a specific role to play and to perfection must their role be carried out.

Once a certain part of the circle is not functioning, the whole system goes into haywire. 

Hence, to prevent that from ever happening, the military through years of research and studies has came up with an ingenious system. A system to ingrain military discipline into each and every soldier so that commands are followed without fail. 

The ingenious system is simple yet very effective. It consist of a thousand and twenty five ways to stimulate nociceptors. A whole spectrum of pain and discomfort has been discovered and used to the fullest by the military. 

To prepare to be part of the circles in the Army, we the first batch of recent medical graduates from UPNM have been sent to the Army Academy for basic military training before we start our housemanship. Our training is not exactly what the infantry man go through but only a fraction of it seeing as how our main role would be doctors in the future. 

Being exposed to basic military training, I have a new found respect for our fellow infantry officers. Never did I realise the amount of training an infantry officer has to go through. They are expected to be competent is various fields such as military tactics, map reading, weapons, signals and the list goes on and on...

The days are filled with hours of physical training, tactical warfare exercises, marching, shooting and not to forget fatigue duty (unarmed labour such as sweeping roads and cutting grass).

With the amount of time spend doing fatigue, an officer would hold a doctorate in road sweeping, a masters in drain cleaning and a PHD in grass cutting by the time they are commissioned. 

Once a full fledged military officer is commissioned, one can be assured that they have been fully trained in all aspects. Fit as a bull, strong as an elephant and proud as a lion.

 Picture credit: Iqbal Hakim

Picture credit: Iqbal Hakim

 

Personally, I find the instructors here to be on a different level. Their military knowledge and enthusiasm to teach is remarkable, almost never seen before.  I also find the training to be quite an experience. Not exactly the most comfortable but fascinating nonetheless. Amidst the exhaustion and hectic schedule, there are short glimpse of beauty and certain moments that make everything worth it. Moments like retreating into the night as explosions fill the air, waking up during a misty morning and seeing soldiers slowly materialize out from the surrounding trees and bushes....

 Picture credit: Muhammad Adam bin Shaharudin

Picture credit: Muhammad Adam bin Shaharudin

 Picture credit: Iqbal Hakim

Picture credit: Iqbal Hakim

 

Yours truly,

Shimri                                                                                                                                  

 

 

 

 

 

 

End of The Line



6 years ago, I boarded this freight train that took me on a ride of my life. 




On this journey, I've met countless people who has inspired, motivated and influenced me in one way or another. Of note, fellow travellers who partook in this journey with me, scaling unknown heights, achieving the unachievable and defying the norm.

Medical cadets of Intake 2010

Together we are creating history. We are at the forefront, spearheading the birth of a whole new generation of medical doctors. A generation of doctors fully trained in the aspects of medicine and military. 

It has been quite a journey, a long bumpy ride but fascinating nonetheless. This particular ride has only one stop and the stop is coming up fast! All the years of studies and preparation comes down to this last one stop, the end of the line.

And what happens after depends on these last 13 days. Pray to all the Gods out there, pray for strength, discipline and the clarity of mind for us to focus and consolidate all we have learnt and face the Final Professional Exam. Pray that we not only excel but excel phenomenally!



All the best my friends!




God is Watching


High up in the mountains, a vast forest of pine trees and the occasional horse feces found me camping by a gushing angry river with freezing cold waters coming from a melting glacier.





As the sun set after a long, long day, I sat at a pre-identified spot to photograph the stars as they slowly lighted up the sky. The spot was on a bridge spanning across the river where I could photograph the milky way over the gushing river.





To call that particular bridge is the overstatement of the year, if not the century. The bridge was nothing more than a piece of old withered flimsy log placed carelessly across the river. Walking across the "bridge", one can experience first hand the movement of the tan, sin & cos wave.

And so, on that very bridge I sat with my camera attached on a tripod as the darkness of the night slowly enveloped me. 

You know how the wind blows up in the mountains? Bitter cold wind comes in sudden strong gusts buffeting you left and right. Hence, I was dressed in multiple layers of warm clothing to keep warm. 

Truly enjoying myself, I photographed absolute beauty and I remember thinking: "I wouldn't mind doing this for the rest of my life." And it was at that very exact moment, an enormous gust of wind came blowing, buffeting me and wobbling the "bridge".

And in front of my very eyes, my camera together with the tripod fell right into the river!

I was stunned for 1.342 seconds and when I recovered I immediately used my torch to pierce the absolute darkness, trying to at least catch a glimpse of my camera in the rolling and gushing river. And by some miracle, I saw it floating not 10m from where I stood. At that moment I knew I had only 2 choices, to jump in the river or to bloody jump in. 





The million of stars hanging out in the sky that night were surprised to see a guy dressed in layers of thick clothing suddenly plunging into a freezing mountain river in the black of the night. But with all the crazy things the stars have seen humans do, they probably didn't think much of it.

The moment I jumped into the river, the layers of clothing absorbed so much water that the weight dragged me underwater for a moment. It took all my strength accumulated since birth, to bring my head to the surface and stay afloat.  

The short moment I was underwater was enough to disorientate me. Using the North Star to reorientate myself, I started my search for the camera. 

Banging into rocks and boulders as the current swept me down river, I used my torch to desperately try catch a glimpse of the camera. And lo and behold! I suddenly saw it washed against some rocks not far from me. Using the light from my torch to illuminate the direction I had to head to, I swam toward the camera as if a crocodile was after me.

According to Murphy's Law, "Anything that can go wrong, will go wrong, at the worst time possible." And so it was at that moment my torch that is waterproof and shockproof decided to be neither. Thus, in pitch blackness I swam in the direction of the rocks and blindly stretched out my hand....

The feeling of bliss and relief when my hand closed around the leg of the tripod is indescribable. I myself couldn't believe that I actually manage to get back my camera. The way I felt then is probably best summarise with the following picture:




So swimming one hand against the current, I manage to get back to the shore and fell down totally exhausted. Lying on the shore, freezing my butt off and bruised all over my body, it occurred to me that it probably wasn't the smartest thing to do jumping into the freezing river in the middle of the night all for the sake of a camera.





Throughout the years of my life, I've done a fair share of stupid things, things that wouldn't be done if I actually stopped and think for a moment. My name "Shimri" means God is watching. I think that the only reason I manage to survive thus far is because God is watching over me and I'm pretty sure he is entertained over the years by my various stupid antics.





Not surprisingly, my camera is not working anymore after its swim in the river. Tried immersing it in uncooked rice when I came down the mountains. After a week of immersing it in uncooked rice, it managed to revive the camera but it went kaput after a while. Thus bringing my journey in photography to a temporary halt. The good thing is that I bought insurance for the camera so I'll be getting a replacement soon. 

So till then.. :)

The Pilgrimage



Two months ago, I flew to the north of India for my elective posting in Apex Hospital Pvt Ltd. With state of the art facilities and a wide array of specialties, Apex Hospital was supposedly the best Hospital in Jaipur.


Image from Apex Hospital website

For the following few weeks, I was attached to the orthopedics department with the privilege of observing the many orthopedics problem which plague the Indian population. The cases seen were more or less similar to the ones seen in Malaysian with the only difference being that diseases that are almost eradicated and rarely seen in Malaysia are still very at large in India. For instance, tuberculosis (TB). 

Such a vast amount of the population is infected that various presentations are seen instead of the normal pulmonary symptoms. Poor management and even poorer compliance has resulted in the birth of a strain of the bacteria known as the Totally Drug-Resistance TB which makes treatment of TB an enormous hassle.




Most of my time was spent either shadowing the doctors or assisting in the Operating Theatre. With my vast vocabulary of Hindi and an even vaster English vocabulary of majority of the patients, communication between the patients and me involved many blank stares and confuse expressions. With all the hindi being spoken, it did feel a little like in a Bollywood movie. At times, I half expected everyone to drop everything and start dancing and singing. 


Of all the cases I saw in India, one that really left an impression was this particular case:




An elderly Indian woman came to the emergency department with a grossly distended abdomen. The swelling has been there for almost 2 weeks and 1 day ago she developed severe debilitating pain in the abdomen. The pain was so severe that she couldn't eat and drink nor could she defecate or pass flatus. She even had trouble breathing and moving without feeling crippling pain. 

After a series of investigations, the doctors diagnosed her with a strangulated umbilical hernia. Which means part of her intestines or in this case a large part of her intestines has protruded through the umbilical opening in the abdominal muscles and has been strangulated by the small opening causing the intestines to necrose and decay. If you notice the dark patches on her abdomen, those are signs that the intestines have started to turn gangrene. 

Back in Malaysia, this situation would have been an emergency! The patient would have been sent with all haste to the operating theatre and an emergency surgery would have been done to try save the patient's life. The patient wouldn't have survived the night without the surgery and even with the surgery, the patient only had a 50% survival rate. 

But what happened was after the doctors explained the situation to the patient and the family members and strongly advised for an immediate surgery, the family members decided to hold an annual grand meeting. 

So after the minutes of the previous annual grand meeting was read and the proper greetings were given, the debate on the best course of action to take started. And after hours and hours of debating they finally came up with a verdict...

They decided not to do the surgery and instead wanted to seek for alternative medicine or more specifically they wanted to bring the patient for a pilgrimage in hopes that God or some other higher power would grant them mercy and heal the patient. 

And that did not make sense to me at all! I mean, the pathology of her condition is crystal clear and the treatment even clearer. Why would one decided not to do the surgery and put one's life in the hands of some unknown deity??

I was extremely curious at what this pilgrimage was all about and wanted to see what kind of pilgrimage was this where terminally ill patients would rather go for the pilgrimage than seek proper treatment. 

I asked around and got to know that the pilgrimage was to a Holy Lake high up in the mountains found extremely north of India. And thus I packed my bags and headed north, extremely north.




I rode buses when they were available, hitched hike when there was none. For days I travelled across unfamiliar lands, meeting people of foreign cultures and eating what I could carry in my bag. In this fashion, I arrived at the foot of the mountain where the Holy Lake was said to be found. 




Braving the cold, the desolation and the exhaustion, I followed the footsteps of the strangulated hernia patient up the mountain. 



Carrying all my photography gear (camera, lenses, flash, light stands, soft box, umbrellas), tents, sleeping bags, warm clothing, books and food, my bag weighed at least 25kg. I kind of realised I over packed when the weight of my bag fractured both my clavicles, dislocated my shoulders and herniated my intervertebral disc. 

So lugging all that weight for days, I painstakingly made my way all the way to the Holy Lake, which was high up in the mountains where the air is thin and cold.



The thing that strikes you the most when you arrive at this holy alpine lake is not the beauty, not the cold nor is it the exhaustion. Don't get me wrong; it is breathtakingly beautiful and freezing cold! But the thing that strikes you the most is the silence. A heavy cloud of silence, so quiet that you not only hear your every heartbeat but you hear right down to the cellular level. Every single ATP being produced by your mitochondria is clearly heard... 

And it was in this blanket of silence when I finally understood why the herniated patient chose to come for this pilgrimage instead of undergoing the surgery.




The destination itself wasn't the main point of the pilgrimage nor was getting healed any part of purpose of the trip. Instead the journey to the Holy Lake was what made the whole pilgrimage what it was. Many a days were spent walking high up in the mountains, above the clouds and living off the land. 





They hunt with the mystical eagle hunters, drink from cold mountain springs and sleep under the stars. 





And when they arrived at the Holy Lake, they can finally die in peace after savouring pristine unspoilt beauty of nature, the very best this world has to offer. And through this experience, they have truly lived at least once before they pass on from this world. 
What better way to leave this world?





If I were terminally ill, I would make the same choice. I would rather travel one last time and witness unparalleled beauty instead of lying on the operating table with the probability of dying and the last thing I see would be the doctor's face.



What will your choice be?






Living with the Mentawai

Situated deep in the dense muddy jungles of Siberut island, a tribe of people known as the Mentawai is found surviving and thriving in the jungle. The Mentawai were once head-hunters, using poison arrows and long cruel looking knifes to go about their hunts.



Over the years, as modernisation and religion is slowly introduced, they have become more civilised and more accepting of outsiders but no less ferocious.




Taking a 12 hour ferry ride from Padang, Indonesia to Siberut island and another 2 hour boat ride upriver into the jungles, one would arrive at a certain part of the jungle inhabited by the Mentawai people. 




Instead of forming settlements or villages and living together in the jungle, each Mentawai family consisting of the parents and children will build a wooden house and fend for themselves. The closest neighbour would be at least 45 minutes to an hour trek away. 


Braving the hardships of the jungle, I stayed with the Mentawai people for a week learning their ways  and observing their rituals. What I've seen and learnt has given me a totally new perspective of life and also answered a question I always had since I was a child.


"Why did Tarzan learn to swing from the tree-tops?"

The answer to that particular sophisticated question would be because the jungle floor is extremely muddy! I kid you not, I was practically swimming in waist-deep mud just to get from point A to point B. 


Having Sagu as their staple diet and the occasional meat, most of the children here suffer from Kwashiorkor disease (a form of malnutrition caused by inadequate protein). Children with distended bellies are seen running about looking like pregnant mothers.




Once a fortnight, a saina (domesticated pig) would be slaughtered and dinner that night will be a grand affair! Although most of the Mentawai has been converted to either Islam or Christianity, forms of animal-worship can still be observed. Say for instance, during the slaughter of the saina.



Before a knife is plunged into the neck of the saina, a ritual is done whereby the saina is blessed with a prayer chanted in Mentawai language and flowers stroking the head. Half way through the prayers, the saina is quickly stabbed and as its lifeblood flows out, the light in it's eyes fades..




While waiting for the fire to start, the saina is gutted and the children went ecstatic waiting for the upcoming pork for dinner.




Dinner was indeed a grand affair, or rather as grand as it could get in the jungle without electricity. Dinner was eaten with much gusto and many smiles which became broader as I gave out my portion of boiled pork seasoned with salt.




Through a translator, I asked one of the Mentawai father if given a chance, would he uproot his family, leave the hardships of the jungle and move to a city. He blatantly said no! "The forest has provided for his father, his father's father and will continue to provide for his sons and generations to come. They know every tree, every rock and every vine. Food, medicine and materials can all be procured in the jungle for free. Why leave the beautiful jungle and go to a city where everything is controlled by money..." he passionately said in Mentawai language. 

Before it was translated, I already knew the answer just by seeing the fierce proud gleam in his eyes as he described the jungle and also by observing the tender lovingness in the gestures he made to emphasise that the jungle is part of his family just as much as it is part of him. That is what that defines him and makes him a Mentawai!




Yours truly,
Shimri


Thought for a Rainy Day



"Come to me, all you who are weary and burdened, and I will give you rest"
                                                                        -Matthew 11:28-



I recently completed a trek across the mountains of Kashmir known as Markha Valley Trek. The trek was nearly 90km long with passes of 5200m above sea level. We walked for days carrying our bloody heavy backpacks through freezing cold and scorching heat.




Reaching a village where one can have a simple cup of water to quench our paper-dry throats and a place to rest our weary legs is like finding an oasis in the wilderness, a temporary respite from the sufferings of the trail.

The extreme relief and gratefulness one feels upon given rest after being weary and burdened is indescribable. It is tantamount to........ I don't know, nothing? Words can't describe the feeling. One just feels at peace, sheltered and safe albeit only for a moment. 




Here is a fascinating thought though:

Is finding religion similar to being given rest when one is weary and burdened?



With all the sins and evil in the world, an unbeliever stumbles upon religion and finds peace and serenity. He is at peace knowing there is some higher power at work and there is a better place somewhere when all is done. So he prays with a joyful heart and worship fervently.


Or, is religion more of a blind leap of faith?



We do what we are told because some ancient man told us many thousand years ago to do this and to that. Hence, we robotically do what ever we are told, blindly but with faith that we are doing the right thing. We feel no joy, no tranquility, no nothing. The only thing we feel is perhaps a small sense of achievement at fulfilling our responsibility. 


Or, is religion some horse-crap after all?

Just an excuse for wars and genocides. Something created to divide mankind and to allow them fight one another.


The answer? I don't know. You tell me....



All Dogs Go To Heaven



When I was 12, I had a dog named Blacky that I absolutely adored. She had a jet black coat of short fur, pointed ears, lean tone muscles and snow white feet. I fed and sheltered her despite protests from my mum who feared dogs. I remember stealing slices of ham and chunks of chicken from the fridge to feed her as often as I could. 

I even brought Blacky on my daily evening runs where we would terrorize the neighborhood cats. We worked out this system whereby I'd spot the slunking cats then pointing in that direction I'd shout: " GO GO GO GO!!" Blacky would then start barking and charging enthusiastically in the direction I was pointing regardless if she saw a cat or not.

The poor innocent cat seeing a crazy barking dog charging in it's direction will flee trying to escape revealing it's position. This is the moment Blacky would be waiting for. She would run even faster chasing after the cat and nipping it at its heels. The cat would be chased up a tree or somewhere inaccessible then Blacky would come trotting proudly back to me with her head held high, tail wagging so fast she looked like she had 9 tails. These were the moments she lived for.

Unfortunately, on days I couldn't bring her cat chasing, she would become restless, chasing anything or anyone passing my house. This posed a threat and danger to the public so long story short, my dog was shot by the Malacca City Council in front of my eyes. I was devastated by the death of my dog and hated dog-catchers passionately! 


The scene of my dog being shot replayed in my head for many years




The year 3 medical cadets of UPNM recently started our Community Medicine posting. My group was attached to the Pest Control Department of Kuala Lumpur City Council. One of the many jobs of the Pest Control Department is dog-catching. Thus, we tagged along a team of dog-catchers to round up stray dog in Kuala Lumpur area. 

The Kuala Lumpur City Council uses the looping method to catch dogs. A few men armed with long iron poles that has a loop of rope at one end will corner the dog and try to loop the dog around the neck. It is like a lasso but with a iron pole instead.



Driving around Kuala Lumpur in vans, the dog-catchers start their hunt for dogs.



Once a group of stray dogs is spotted, the hunt begins! The dog-catchers will alight the van at different locations surrounding the dogs. Once everybody is in position, they will then systematically close in and capture the dogs. At least that is what the plan is..

The stray dogs are no fools I can tell you that. Throughout the years, they have learn to look out for the coming of the dog-catchers. I don't know if they memorised the smells of the dog-catchers or they watch out for men carrying sticks or maybe they recognise the van's engine frequency. But once a dog spots these dog-catchers, a long howl is heard: "AAAWOOOOOOOO!" And as if that was the warning call, all the dogs would suddenly start running in all direction.

The dog-catchers will then choose one dog and chase after it. If the dog is lucky, it gets away. Else the poor thing would be caught and compounded.





But with so many men chasing down one dog, capture is most of the time inevitable.


The captured dogs will then be brought back to the dog compound where they'll be kept for a week to see if anybody comes and so call "bail" them out. If no one comes, the dog would then be put up for adoption for 3 days. 



After 3 days, if no one adopts the dog, the dog will be put down in the most humane way possible that ensures the dog dies without any suffering.


Death by lethal injection

The carcass will then be incinerated with temperatures of 850˚C leaving only ashes to be buried.





Most of the captured dogs won't be reclaimed and will eventually face death and I think the dogs realise it too. You can see it in the way the dogs react when people approach their cage. 

Some look at you with the most adorable eyes, pleading to be adopted!





Some start barking and howling: "Let me ooouuut"!!




Others snap and snarl, determine not to beg for mercy and would rather die with pride.




But there are some that will undergo transformation as people approach their cage. They literally transform to a devil, eyes flashing green, teeth bared and hackles all raised up. The message is clear: If I'm going to die, you are going to die too.




I know it looks cruel killing all these stray dogs, I too initially thought so. How dare these bloody bastards kill my dog?!!

According to World Health Organisation (WHO), the definition of health is the state of complete physical, social and mental well-being and not merely the absence of disease or infirmity.

These uncared and uncontrolled stray dogs cause lots of social problem. Damaging property, threatening safety of the public and can even spread diseases. These stray dogs make people anxious and worried all the time and even cause many a sleepiness nights due to the barking.

Therefore, to ensure a city is clean, healthy and suitable for human habitation, you now see why rounding up all these stray dogs are essential?

If and only if the definition of health included political well-being.... rounding up corrupted politicians would have been so much more satisfying. 


Our 4th Anniversary

I know I am more than a few days late but anyway, 22nd May 2014 marks the 4th year since I reported to the National Defence University of Malaysia to pursue my Medical degree. In conjunction with this special date, here is a poem I wrote to celebrate and also to commemorate our journey together thus far. No offence is meant and if I do somehow offend you, my sincerest apology is offered in advance. So, here goes my so called "poem":

University Pertahanan National Malaysia is my university,
we go by the motto of duty, honour and integrity.
Similar to any institution of credibility,
we have our moments of pride and also ignominy.

The latter is none other than our famous Rid Tee.
Disorientated as he might be,
please do not call him a bloody babi,
for it is a great insult to the swine community.





Throughout these 4 long years,
sweat, blood and tears has become no stranger.
Extreme suffering of the body has somehow become meagre,
we all have become a little stronger.





Tough and stressful it might be, joy and laughter do happen occasionally.
And it usually comes after a nice steaming bowl of mee curry.








Annoying patients out of their sufferings are what we do best.
To the extent where patients even shout: "Just let me bloody rest!"





Many a night are spend in the hospital,
with nothing to sustain us but apples,
in hopes of gaining knowledge that dazzles.





The true meaning of unity is found in the army,
not some "1-Malaysia" slogan which rings empty.





I know our walk to be a doctor is not easy,
Pray we'll have the strength to finish the journey completely.






Pray also we will one day be generals full of competency,
planning and improving the Medical Corps properly.





Lastly,  I hereby present you with Intake 2010 Medical Cadets of the National Defence University of Malaysia.


-The End-

A trip out to Sea

During the Golden Era of Melaka, the muddy waters of the Straits of Melaka was not only teeming with merchants ships but located just beneath the surface, abundant schools of fishes of all kind roamed freely and happily.




Numbering in thousands and millions, the fishes seemed infinite in numbers, allowing a booming fishing business. Fishermen strutted proudly around the dock, occasionally throwing a proud glance at their fleet of fishing boats that made the navy green with envy.

Now, fast forward a few years and we come to present day Melaka. An obvious decline is seen due to incompetent and corrupted leaders. Lousy leaders isn't my topic of the day though, but rather he is:



Meet Pak Cik Awi, a 47-year old fisherman who has been fishing in the Straits of Melaka the past 11 years. He's a father of 4 children and works his butt off to provide for his family. Every morning, as soon as the tide is in, he goes out to sea in his tiny little sampan hoping to return with a boat full of fishes.




But the opposite is usually true. After spending hours under the scorching sun, casting and retrieving his fishing nets, he gets nothing but dead leaves, rubbish,



and also miserable tiny fishes.



Long gone are the days where every cast ends up with a full boat of flipping and jumping fishes. With all the land reclamation process going on in the Straits of Melaka, the once infinite fishes has become finite, even bordering upon extinction.

Determined not to return home empty handed, Pak Cik Awi ignores his aching back and sore hands, feverishly casting and retrieving his net, hoping and praying to at least catch a fish that is worth something. 



Fortune must have been smiling upon Pak Cik Awi that day, for after long last, his patience and hardwork finally paid off. The treasure every fisherman in the Straits of Melaka is hoping to catch is the Pomfret fish (ikan bawal). Selling at RM 60 per kilogram, catching a few of these fishes would have been worth all the hardwork at sea.



Well, Pak Cik Awi didn't catch a few but at least he manage to get one before he had to return to mainland as the tide was going down rapidly. Now his family doesn't have to go hungry for that night plus he can afford to buy petrol for the next trip out to sea. Real fortunate huh?





I wonder what happened to the former glory of the fishermen? How did it come to this?



My 2 Cents


Being in an environment where the mind is believed to be in total control of the body, I've seen various occasions where extreme feats of greatness are achieved through pure will power alone.

Photo credits to Pet S. Salvador


Be it mentally or physically, anything, even perfection can be achieved with the right amount of determination. 




After years of disciplining and training our bodies, through pain and sweat, a bond is formed between our bodies and us. The body becomes a trusted companion, something we rely on, trusted to never fail us. The body and us against the world. 

At least that was what I believed until I was posted to the hospital.



Here in the hospital, the ultimate betrayal is witnessed many times over. The betrayal of the body. 


The body you thought would be there with you till the very end suddenly decides to turn against you, growing something sinister, something that eats you up from within, something that renders you paralysed for the rest of your life.  

So much for mind over body huh? How can that tumour be controlled with sheer determination? That damn infection running through your nervous system halted with will power?




You know the moment when one learns he/she has only a few more months to live? It is heart-breaking. Extremely so. Coming from one who doesn't usually like to express feelings, you can trust me on that. 

There are many reactions upon reception of the bad news. Some burst out laughing, hoping with every fibre in their body that the doctor is playing an April fool joke. Slowly, as they realised it isn't April yet, the tears starts flowing amidst the laughter. 


Others literally break down, wailing and crying, looking stunned and devastated upon the betrayal of their beloved body.



After witnessing all these betrayals, I have come to one conclusion: live life to the fullest while the body is still on your side. Go climb that mountain, jump off that plane, marry the love of your life, run that marathon, write that book, volunteer for social services or whatever. Just as long as you fulfil as many dreams and goals as you can. Thus, when the betrayal comes, you can actually calmly sit back with your legs crossed and know that you have had a good run.





My uncle who is paralysed waist down due to a bout of poliomyelitis during his childhood once told me:


" Life is short enough to enjoy but too long to suffer" 
                                                         -Lim Sow Seng-



Simple yet deep; beautiful and sweet. So yeah.. let us use that short time to the max just in case we may have to suffer later on.


Yours truly,
Shimri 


The Upward Plunge Part 2

Day 2: Pairo- Lantang Village




Faithfully following behind the retreating back of Mann our guide, he led us ever onwards to the snowy caped mountains.

After staring at Mann's bag for hours, I slowly came to memorise every single detail of the bag, every meticulously patched up tear, every faded stain. The image of the bag was so firmly etched into my mind that I see it every time I close my eyes, even dream about it when I sleep. Mann should have been carrying my medical books, that way I could have memorise the whole book instead...

So with Mann leading the way, me slightly behind him and Aiman covering up the rear, we walked across the Langtang trek of the Himalayas. 




Just as I was thinking how our journey is somewhat similar to the journey of Frodo in The Lord of The Rings ( Mann being Sméagle, Aiman being Sam and me being Frodo), I dislodged some stones sending them rolling down a hill alarming a flock of birds which took flight immediately. It was a magical moment as we stood on top of a hill surrounded by the serene mountain view and engulfed in a cloud of birds, at least it was magical until the shit started dropping..




As the sun started sinking behind the mountains, we arrived at Lantang Village hungry, weary and cold. The village made up of many small houses with chimneys smoking was a very welcomed sight. The smoke means fire and fire means warmth and food. 




The whole village was already in shadows as we walked towards our chosen tea-house to spend the night, except for a field nearby where the last rays of the sun still shone. 

In that last ray of sun, I saw a small young boy dancing, spinning and tumbling around. He looked so happy, so care-free, laughing as he danced, screaming as he spun and fell. 




I wanted to capture that tender moment but as I approach the boy, he quickly disappeared back into his house.



Dinner that night was a cold affair. 

Even with a heater burning red hot trying in vain to heat up the dining area, everyone was shivering as we huddled round the heater gulping down hot tea and wolfing down our Dhal Bhats (a local rice dish).

Remember the dancing young boy? Well, apparently he and his family were staying next door to us. It was so cold that they came over to share the fire and have dinner together. 

After dinner I took out my iPad and let the dancing boy and his brother have a go at some of the games I have in my iPad. They were mesmerized.. 




I could see their exciment as they figured how to beat the games. The brother concentrated especially hard while playing a game that even a blob of mucus slowly dripping out from his nose went unnoticed. 



These mountain folks seem to have nothing, no televisions, no computers, no overpriced apple products, no nothing. But in reality, these people actually have everything. 

They have the purest form of joy by enjoying simple things in life like dancing in the sun, they get the highest satisfaction achieved by pitting themselves against mother nature and excelling, they enjoy the blues skies, the high mountains....





What wouldn't I give to have what they have..


The Upward Plunge Part 1

Paul Salopek once wrote:

               "Walking is falling forward. 

                       Each step we take is an arrested plunge, a collapse averted, a disaster braked.
                 Walking becomes an act of faith."


For the past one week, Aiman and I plummeted across part of the Himalayan mountain range in Nepal. We walked the Langtang trek and conquered a 4985m peak called Tsergo Ri.







Day 1: Kathmandu- Landslide




That is the view outside my window as we embarked on a 7 hour bus ride from Kathmandu to Syabrubesi. The road leading to Syabrubesi is extremely narrow, barely being able to fit one small car but used as a two-way highway for trucks, lorries and buses.

The road barely qualifies as a road, with rocks and boulders becoming the layering for the road instead of tar. That makes the journey a 7 hour bumpity-bumpity ride.

Some parts of the road are destroyed by landslides, making the narrow and bumpy road even narrower and bumpier. At parts like these, the bus trying to manoeuvre across the debris tilts precariously over the edge of the mountain. In reaction, some passengers lean desperately to the opposite side, trying to rebalance the bus and prevent a tumble straight down the cliff; while other passengers get down on their knees and start praying to all the gods known to human mankind.

The driver oblivious to the dangers of the road and the distress of the passengers, drives with one hand and his other holding a cigarette, as he sings along the nepalese songs blasting out from the speakers.





Either by the skill of the bus driver or the prayers of the passengers or the desperate leaning of the other passengers, we actually arrive at Syabrubesi in one piece, unhurt and unharmed.


Aiman, a fellow medical cadet whom I jokingly call the "fart-man" (in return, he calls me the bloody China-man) suggest we start hiking immediately instead of spending the night at Syabrubesi.




We turn to our hired local Nepalese guide, Mann, asking his opinion. 

Mann has an easy manner and an easier smile which seems to be permanently stuck on his face. He is always smiling! Be it in the cold or even during extreme hunger and tiredness.  



Mann has various sayings that he claims are Nepalese sayings. For example:


      "Chicken curry, no hurry."

      "Slowly slowly, catch the monkey"
      "Apple pie, don't shy"
      "Nepal= Never Ending Peace And Love

And not all are innocent and pure:

       "Japan= Jumping And Pumping All Night"
      "Fanta= F*** And Never Talk Again

Along the way he came up with more and more sayings, making me doubt they are Nepalese sayings but rather self-made up rhymes. 



So, asking his opinion if we can start hiking, he replies with a smile on his face: "No problem!" And thus, our upward plunge along Langtang trek towards Tsergo Ri begins!





Our aim for the day is to reach a village called Pairo. Carrying our backpacks and a big smile on our faces, we walked along Langtang River, saturating ourselves with the beauty of God's creation.




After 2 hours of walking, we arrive at our destination where we were quickly allocated rooms to spend the night.







In Nepal, a particular tribe of people staying high in the Himalayas are renowned for their mountaineering expertise. Seemingly immune to the cold and the effects of high altitude, they are regarded as elite mountaineers, the best of the best. Serving as guides at extremely high altitudes, these people form the backbone of expeditions conquering Mount Everest. This tribe of people are known as the Sherpa people.

As the sun started sinking, the rising crescent moon found us crowded round the kitchen fire trying to warm ourselves. Just as we were about to get warm, the kitchen door was thrown open letting in the cold frigid air. Two figures quickly huddled in and came to share our fire...




They introduced themselves and ordered dinner. I kind of forgot their names hehe (my apologies, I suck at names). But one of them is a Sherpa and the other is a man from China training to be a professional guide. So they were there to practise ice climbing at one of the many snowy capped peaks along Langtang trek.

After we all had dinner, the Sherpa started telling stories about his various expeditions up Mount Everest. The Sherpa had a hypnotic way of telling his stories, he had everybody in the kitchen sitting at the edges of the chair trying to catch his every word as he recounted his experiences. 

His stories painted a picture in my head where I am standing proudly at the top of Mount Everest with the Malaysian flag in my right hand....... 

With the fire dying and dreams of conquering Everest, I wished everybody goodnight and head to bed to rest and prepare for our hike tomorrow.


A starry sky seen under Nepalese prayer flags
.

A Glimpse into Our Life

The one activity that keeps the soldiers fit for war is none other than physical training, or better known yet as PT. Never before has a session of PT been photographed and shown to the outside world but today, today I had the privilege of photographing an entire session of 2010 medical cadets doing their PT. So, presenting the ladies:






And gentlemen:







At the break of dawn, with the early morning Muslim prayers echoing through out the still morning mist, we get out of bed and prepare to go for our PT.




It all starts with a little stretching,




Which then quickly excaltes to sprints,



Push ups and so on...





As the morning progressed, we found ourselves crawling and rolling in the field,





Going through various exercise designed to strengthen and toughen one up.




The ladies do the same exercise as the guys, making our ladies very scary.




The intensive and strenuous exercises drives every single medical cadet on the field to exhaustion, except that one Chinese bugger running around taking pictures.




With military training instead of holidays during our semester break, a generation of future army doctors is slowly and painstakingly created. A generation where all are fit and strong. 




Capable of running any distance ordered,




And being able to carry their own weight and more,





But most importantly, a generation of peace loving military doctors are born. Where a nation's peace and security is priority. 


Peace!


Yours truly,
Shimri

Sulphur mines at Kawah Ijen

My brother, uncle and me recently made a trip to East Java, Indonesia in search of a long lost Javanese legend.

We rode over mountains,



Crossed endless deserts,



And ventured into unknown roads,



Till we found at long last, the last living man who remembers this sacred Javanese legend.



The legend goes something like this:

Once upon time, in a land far far away. There lived a small chic by the name of Chicky-chicky-micky-micky. He stayed with his mother and his many brothers and sisters.




One day, he decided to go for a walk alone in the woods.





As he was walking, a curious sight caught his attention.





He was so excited, he ran as fast as his tiny legs could carry him back home to tell his brothers and sisters.






Upon hearing the news, they all rushed to see this sight.





The sight which interest them was this new building which never was seen before in this land.




They entered the building out of curiosity and that was the last we ever heard of Chicky-chicky-micky-micky and his siblings.



-THE END-





Ok seriously, we went to East Jawa to visit Mount Bromo and the Sulphur Mines at Kawah Ijen. I have to say the sulphur mines were pretty interesting.

This sulphur mine is located in the crater of a volcano called Kawah Ijen. We had to ascend the volcano then descend into it's crater to visit the mines.




Standing at the top of the volcano and looking down the crater, the sight of the mines coloured yellow by the abundant amount of sulphur and swathed in a thick choking sheet of smoke greeted us.



We quickly descended despite warning signs prohibiting us from going down.



In the mines, a dozen iron pipes channel molten sulphur from beneath the depths of the volcano to the surface.



The liquid sulphur will solidify, forming solid stones of sulphur.



The miners will then break up the stones of sulphur, collect the broken pieces of sulphur, put them in a basket then carry them down the volcano.

A miner breaking up the sulphur 


A basket of sulphur waiting to be carried down

I'm astounded at how the miners can actually carry the basket of sulphur weighting at least 90kg and manoeuvre across the treacherous pathways of the volcano.



I tried lifting the basket of sulphur and I tell you it is heavy. It is so heavy it hurts. I barely could take one step, let alone make my way uphill. 

The bamboo resting on my shoulder dug into my clavicle, exerting such force that my clavicle threaten to snap at the weight of the bloody basket of sulphur. 





I managed to speak with a local miner named Poniman, who has been working here for the past 17 years. He braves the the suffocating sulphuric smoke, the crushing weigh upon his shoulders and the treacherous pathways just to earn a little money to feed his family. 



After so many years of carrying the this heavy burden, his body has adapted to allow him to perform his job. Notice the hypertrophied trapezius muscle to protect his clavicle from the obscene pressure exerted by the basket of sulphur. Notice also the bruising around the shoulders and the yellowing of his teeth and sclera. 

The ravages of sulphur mining

Seeing the miners being able to go about their work cheerfully despite the heavy burden they carry, even teasing and helping one another as they slowly made their way down the volcano made me realise that I have officially lost the right to complain about life. No matter how bad or tough I think my life is, it can never be as hard as these sulphur miners. 

I mean what are long working hours or parade which takes 3 hours compared to this lifestyle?

Henceforth, if I ever start to complain, please give me a full cup of water with a cover and ask me to shut the full cup.