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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