Tuesday, August 13, 2024

something to brag about

 

The trip to Bangkok ended happily eventhough I performed poorly, but yet… a bronze for the senior division pacified my uneasiness….

3 medals in 7 days…. Well, something to brag about for the next few days for me.

the no1 is a local police officer, the 2nd place is my team mate, a retired sergeant major cum engineer




Wednesday, July 31, 2024

The bump......

 

It had been 4 years since I actively involvement in shooting competition. There are 2 bodies that organized airsoft shooting event on this island. The defense association and the practical shooting association. The PSA is a member of the IPSC and had been well known through a serial of movie “Double tap” and “Triple tap”. I had been deeply attracted by the movie but was unable to assess the PSA as whenever I inquired about the entry procedure and training, the head would always gave the answer, “ you come over and play for a few rounds before you joined”. Unlike the IPSC in HK where introduction course would be held and admission would be done after the course.

I just don’t have the extra time play a few rounds before I officially joined. However I did purchased a whole piece of gear from CR speed belt, magazine carrier with Ghost holster. That was of course almost 18 years ago.

4 years ago, I had found this course organized by the defense association and I had joined the course with Xian. I got by Glock and Xian got his 1911. I had shot a few matches after the course and was wrongly assessed with a DNF during a tier III game. It was major setback as I was not familiar with the rulebook and some #$%## safety officer had wrongly given me a DNF instead of a all miss….

I had translated the rulebook(prohibited of course as it only recognized the English version[however I am pretty sure there was a Italian version around somewhere]) and share it as an unofficial learning tool.

My shooting skill sucks as I had switched my interest to revolver after the tier III match. Shooting REV was a frustration as the tools was poorly design and inaccurate. My skill improved but however since there was only a handful of participants, only the best man won. As a senior aged shooter, getting a placement with prized was never feasible for me. Shooting real steel was another impossible dream as the tours available would take up at least 6-7 days.

Last year, my club’s master had informed me that he had found a short trip in Thailand which only last 4 days. 1 day training and 1 day competition + 2 days of travelling.

I lost my mind and signed up…Ving had however pushed Yun to join me in the event.

It was an amazing trip, Yun, a newbie to the sport, had conquered her fear and completed the race.

I finished the race while struggling to adjust myself with the recoil and trigger control.

One of the mates had shared his secret about airsoft to real steel transition; ---- to get an airsoft with great recoil and trained!

He recommended the GHK. I immediately placed an order with the upgraded version while on my way back from Bangkok.

The training process was lagging initially while I struggle with the trigger control and grip to overcome recoil.

After months of training in the attic. I finally had a breakthrough and started to advance.

The club had organized another trip in August and I had refrained myself from joining any real steel tour I think it would be fun to go with the big group.

My training result finally came into test when I joined the tier II match nearby; I made it and was bumped from marksman to sharp shooter…..



Tomorrow, I would be heading north and taking another flight to BKK as 2 days later I would participate in the tier i real steel IDPA challenge  ……


Monday, July 22, 2024

hunch....

 

An obese patient was referred down south for shortness of breath. Patient was found out to have elevated cardiac enzyme and referred to us to rule out myocarditis.

The patient had arrived hours later. He appeared to be severely obese and dyspneic even with oxygen use.

Upon examination, he was noted with mild wheezing and I had ordered a series of examination. A quick bed-side sonography was done and it was non-conclusive of any disease. An inhalation was ordered while waiting for the reconfirmation of cardiac enzyme. Patient was stable on oxygen supplement despite of hypoxia state shown on the monitor.

It was a routine workup however I was uneasy with his state as he had been inpatient for 2 days down south.

I had done a good history taking and found out that he had been a carpenter for his life and on and off attack of wheezing was noted with no major admission history.

The diagnosis of myocarditis was however not my primary diagnosis. I decided to do a CT scan as the mismatch of symptom of shortness was breath versus whatever test we had done.

The CT scan was ordered once his renal function test was out. He had multiple clot in his pulmonary vessel.

I had explained the test to the patient and his daughter and I was surprised that they were not unfamiliar with the disease. A further digging had found out that the patient’s son had pulmonary embolism at a very young age (14-15 years old). He was referred up to National Taiwan University Hospital and a genetic was done and found out that he had a specific gene that causing PE at a very young age. The pediatrician had advised everyone in the family to undergone the genetic test however no one bother.

A thorough history my ass….I grumbled to myself. You don’t ask they don’t answer. We had always asked family history about seniors in the family but not youngling.

The strange part was nothing suggestive of PE despite of the CT findings. The cardiac echo did not show right ventricle enlargement, the EKG12L was normal and the only hint was the mismatch of clinical findings. A few of my colleague had asked me why did I suspected the patient had PE and I told them that clinically I couldn’t get a diagnosis which can explained the pt’s SOB.

Well, a clear example that AI won’t be replacing this medical job in the near future….sometimes is just a hunch that lead to a diagnosis….

Tuesday, July 9, 2024

QM run....

 

The new roster had made a lot of event possible. As Ving wished to go back for QM festival; an arrangement was made and I had started the flight ticket sourcing again. I had tried to strike CKS from my list of departure as soon as the sourcing started. The trolling over the net was uneventful as there was no seat available at the peri QM period. When I almost given up the no CKS thought; seats had started to emerge on the double A site. However Ving’s senior had yet to make up their mind on the date of QM ritual. It was a difficult choice for me as the cheap seats which emerged would be selling like hot cake and it would not be long before I lost the chance of grabbing them. Urging the seniors to make a decision would be impolite moreover Ving is considered as outsider as she had married a guy which is not from the family. So I had to make a intelligent guess regarding the date. From my experience, the Seniors were folks that like to hang “laws” by their mouth, meaning that they would like to people complied to their idea/opinion by talking about tradition that set up by their ancestors.

So I had to think like them to predict how the date would be set. For Chinese, the most important reference book is the Yellow Calendar – the one book that calculates everything according to tradition. It would record suitable task to performed task on any specific day. If the date is BIG GOOD, then you could do whatever you like. If the date is noted as BIG DANGER, then you could only do the necessary like seeing a doctor and all the important task (like praying ) would be barred.

The choice was actually simple as the QM fell on Thursday and there were only 2 date to decide of, the pre QM Sunday and post QM Sunday.

According to the Yellow Calendar, the pre QM Sunday is BIG GOOD and the post QM Sunday is BIG DANGER. The choice was so simple, no one would choice a big danger day for such a major ritual….So without hesitation, I bought the ticket. It was darn cheap less that RM1k per piece to and fro with first row extra leg room seat with the AA.

It was a short trip for us and I have to bring my parents up north to visit my aunts and uncle; two rituals and a to and fro trip up north within 5 days.

Everything seems smooth until 1 week before the journey.

My bro in law had told me that those Seniors had decided to set the date on post QM; and immediately the 3 letters word started with “W” flashed through my thought…

It disrupted our plan and Ving had addressed her dismay and I was the smart ass who got it up to my face…

Since the ticket could not be refunded and no seat was available for the available date, we had to settle with it.

The journey had started a usual post call flight. I came back from a night shift; grabbed my pre-packed baggage and headed to Smallport airport.

The flight landed uneventfully and we had had our dinner at the Oriental Kopi. The costly fried noodle and curry was good, the coffee with qinchao was another plus. Satisfied meal which was costly.

We reached my bro in law house after 10 and I had gotten a good sleep after the long journey.

We headed down south with the double F from Subang the next day. It was a pleasant stay and we had a family dinner at a Japanese restaurant selling don buri at Aeon mall nearby.

The flight touched down on time and I had joined my parents late that night.

It was an early push off the next day and I had to cover a trip from Kulai to KL by noon and stopped by Seremban on the way down south and ended up in Malacca for a night stay. A drive with no assist for more than 500km? Would be a great challenge for me since I had Fefe for the past 2 years.

It was an early push off and we managed to cover the whole journey without hiccup. We landed at Malacca later in the evening and I had mistakenly booked a service apartment which was crap. It was near the Portuguese settlement (bad choice because I wanted a stay nearby so that we could reach the restaurant easily after we arrived). The food at the restaurant was excellent with fresh squid and crab served. The price was reasonable and definite and must for a next visit.

We had also had satey chelup at the Mcquek before we retreated to the apartment. The apartment is well furnished but yet poorly managed. The check out was worst as we had to wait till 9 am before the management is opened.

The trip back to Kulai was uneventful.

The next day we had gone to Kota Tinggi for the Kiang Kee BKT.

Hokkien style BKT around the southern area. The score should be a 90% but yet 10% deduction for the distance; 80% is good enough but I would think twice before I taste it again…The road was windy and roller coaster like…the up and down slope added the difficulty to drive.

Anyway, I missed the museum as we had a tight scheduled to follow. We visited my grand father for the QM ritual that afternoon.

We slept in the Tune hotel later that night as we had flown the last flight out from Senai with double A.

We were lucky as the Tune hotel served early meal during the fasting month. An enjoyable breakfast and I picked up some snack at the salty fried pancake store along the way to check in.

I had a variety of good food, a long drive that proven my capability and my first QM visit after the urn run. Smack for choosing the wrong date was still acceptable.

However the story continued as below…

-       The whole group visited their ancestor

-       The ritual was performed and at the end of the ritual a cast of divination block was done…

-       There was a continual double down for more than 10 times[rare odds really]….until some of the seniors decided to kneel down and asked for permission….and finally approval was given just before the rain pour down heavily..

 

My conclusion---

Stupid move of picking a bad date letting the whole group to bad luck, and the ancestors were angry with it…

The great one had been always looking after me and did not put me in that kneel down embarrassing situation…. Praise the great one…

Tuesday, July 2, 2024

the change ....

 

Making referral and receiving referral were 2 different things.

Making referral was a sign of showing weakness and receiving referral were a declaration that we are capable.

Well, some of those at the tertiary center would be too authoritative and would treat referral doctor as junior or incompetent one.

I had met rude surgeon who had asked detailed questions that made the referral look like a resident reporting to the tutor. I hated that and I sworn that not to present such stupid/arrogant attitude toward my comrade while receiving any referral.

But yet sometimes, you would get some referral which was…..


I received a call sometimes back in which an elderly male was referred for chest pain and elevated cardiac enzyme. Routinely, we would ask the relevant unit to upload the EKG12L to our LINE chat. The EKG uploaded later had however shown prominent STT elevation over the inferior leads and the patient should be diagnosed as STEMI undisputedly. I quickly called them up and asked them to prep the patient and PCI would be performed as soon as the patient arrived. Never bite on your colleagues no matter how incompetent they were, however you do feel odd when receiving some referral….the southern tip of this island is a very secluded area; manpower drain was the norm and even surgeon who is not well train in medicine had to take the stand in ED.

We were facing similar situation since few months ago.

The management had decided to split the roster arrangement into 2 parts. The ED roster would be done by the HOD and the ward roster would be done by the admin head.

The previous roster was actually manipulated solely by K. He would try anything to filled up every hole on both the roster. However, there were always rules to follow. No continual shift of more than 12 hours, no overlap shift covering both ED and ward. Our shift was a mess as we need compromised our shift to enable K to covered most of the shift upstairs. No kidding, K was doing 15 shifts in ED and 12-13 shifts upstairs. Severe violation of working restriction however we are not considered as labor and nothing to shout about.

The reshuffling of roster making was a great news to us. Our shift was prioritized and our roster looked nicer. We were getting streak of off days and night shifts instead of getting intermittent off shift which burnt off half of our vacation.

The impact was striking as the ward roster had left many blank spot and boss and some surgeons who did not do calls had to fill in. K was unable to continue his fill out all the spot plan and sought to find other locum elsewhere.

The management had however tried to barred him to do extra locum which frustrated K. K had complaint to me on a few occasions. I had sensed that his intention to leave and finally talk to the management. I told him that the south would gladly take over capable big gun like K and we would lose him in very soon should the barring measurement continue. The plead was heard and K was happily ever after.

The first and second month was chaotic for the ward roster. Last minutes call and overlapping had started to emerged as it was the only solution to the situation. By the third month, the management had totally given up and over lapping and continual shift (aka alternative unit nonstop shift for indefinite hours) started to exist. 

The gate to Hxll had finally opened; now, more than 30 shifts are applicable to a single person as arrangement of back to back calls which continued stay for 72 hours in the hospital had started to exist.

Over relaying on a single person to make up the ward roster would be a disaster when the person quit, as for me…none of my business…

The roster was pretty sweet for most of us and I had lots of streak vacation to plan for activity….

Monday, July 1, 2024

2024 1st fight final leg part 2.

 

The flight arrived at CKS in the afternoon and we had picked up our car at the carpark. We headed north and the traffic was smooth as most of residents were travelling south back to their hometown for CNY eve. We managed to check into the hotel without hazard and after a brief rest we had roved around the street of T city heading to YiLan Ramen for our CNY eve dinner. The plan was smacked when we saw the door shut with a notice in front of the gate. Nothing to curse as it was CNY, a family day. We had to walk back with the thought of getting something from the convenience shop. Along the road, we came across Yoshioya (donburi shop) which was still operating. The shop was filled with foreigner, Asian and Caucasian…. Stomach was fed and we walked back toward the hotel.

The next morning, we had a late start as the event would be starting around noon. We woke up had grabbed some food along a coffee shop. It was CNY D1 and we had to take whatever was there. We travelled to the venue with MRT and met other church member before we entered the main hall. The event ended late in the evening and I had prebooked a table at a steak house nearby the hotel.

The Tex-Mex joint offered great food and we retreated to the hotel later.

The second day event started early with the holy communion. It ended later at noon and we arrived back to the hotel by 1pm. We had meal at the Kurai sushi shop next door before we headed down south.

It was a long journey; we encountered heavy traffic as it was D2 of CNY aka wife go back home day.

We reached home after 8 hours of driving; double the time than usual.

It was grace for me…. everything was properly arranged; I couldn’t bare to think the deep sxxx that I would be in should anything go wrong.

I praised the great one again…  

Thursday, June 6, 2024

 

I had told Ving that there would be no harm if we gathered with our parents during the CNY prior to departure of my 1st flight. The meaning was different and we could enjoy festival time which was different in nature.

The plan was however altered as Ving had found out that there was this Global Chinese Conference organized by the church this year during CNY. Ving asked me if we could go back and attended this gathering during the CNY.

Yun was still stuck with her study and it would be a trio journey for us again. Ving would take the early start with Xian pushing from K city to KLIA 4 days before I head north for a flight to the Lion country. Xian and Ving would later take a flight down south with the Firefly and we would fly back together to CKS at CNY eve. We would then participate the global conference in T-city and headed back south on D2 of CNY.

4 flights for me to book and I need to worry about another trip up north from Kulai to KLIA2 via land(apparently fully booked of flight) on CNY eve -1 days. The 3D2N lodging in T city around the CNY was another challenge as it was very close to the venue and the option leftover was limited.  

All the booking was done within a five days window after multiple loops of checking and rechecking.

Makan tak kenyang , tidur tak nyenyak was best description of my life after my return from the 1st flight.

There was this case I met 5 days before the journey. A middle-aged handicapped man was run over by a car and sent into the ED by EMT. I was complaining to the Great one about unfairness treatment to the patient. He was a patient with CP and walking difficulty. Apart from that, he was also deaf and had to read lips for communication. I was expecting internal bleeding secondary for pelvic fracture while doing the FAST echography. However everything was negative, he had only sustained some pulmonary contusion on the CT. I had asked the young police chap who came for investigation about the mechanism of injury. The video clip extracted from the nearby CCTV was stunning. The patient was crushed under the wheel of an SUV while heading to the train station after his work.

I did further inquiry after the patient’s father came. They did not have any specific religious belief though. I knew only the Great one could show such grace and I was curious why he had done so…..

I shared the case few days later with Yun and during the conversation, I finally realized that the miracle was actually directed toward me; The Great one just wanted to tell me, he is always along my side. A strange way to present himself, but It was the response from him that pacified me.

I felt peace afterward and stopped to worry about the journey. 4 days after Ving and Xian arrived at KLIA2. I started my drive up north. It was a warm morning and I managed to secure everything in the house and double check all the windows and doors before I hit the road. I stopped by at clear water R&R and bought some biscuit/snack. The temperature had dropped below 20C and I had put on my jacket while I wandered around the R&R. It was a brief stop, I continued my journey and reached DaYuan by noon. I had stopped by a food joint hoping to get some bread so that I could eat during the flight but all I could only settled with Taiwanese bread which I did not favor of.

I parked my car at a private parking lot nearby the airport as I had failed to book a lot at the airport parking area. It was winter holiday then and peak season for travelling.

I had arrived early and the counter of Scootair was still closed. I was lucky enough to find a corner around waiting area and taken a good nap before the counter checkin begun. The security check and document check was smooth and I was still able to find a seat at the dining area for a quick lunch. The red wine beef stew with rice was up to the standard but yet my anxiety prevailed.

Scoot was considered as low cost carrier and the menu offer nothing special and it was very expensive so I decided to skip the meal at 30000ft (reason that I bought the bread). The flight was a smooth one and I landed at T3 on time. 

My sis in law and mother was waiting for me and it took us about 1.5 hrs to arrive back home.

As I promised myself during my last trip for a nice BKT; I had brought my parents down south to JB to have a trial at the Hockien style BKT at Skudai. Sub-par to my standard but yet still acceptable, no fish prawn also ok la .

Ving and Xian arrived the same night and we spent 2 uneventful days around Kulai. The Trip to Kota Tinggi was postponed due to flood and rain. It was a place that I had fantasied for a long time. I wandered if I would I have a chance to visit the place in the future…

During the stay, we had visited a Malay night market nearby and I found that Malay food providers had greatly improved since my day in KK. Apart from the traditional food/cake, I had seen many new type of food added to their sale. I was lucky to lay my hand on the famous coconut shake and lots of goodies...

One thing that haven’t change; Chinese were still unable to mixed with Malays around the southern part of the peninsular; we were the finger countable Chinese that patronized the market

It was a short stay for us and we had a pre CNY eve family dinner at a Teocheow restaurant before we left; special food but yet not my cup of tea. It was the first time I had eaten such dishes and I thank my bro for setting it.

My sis in law had booked a minivan for us that evening and we left Kulai at 4pm.

The driver sprinted the Granvia like it was it’s last cruise. We managed to arrive at KLIA2 Tune hotel by 8pm even with the jam and 2 stop at R&R during the journey. One of the most expensive ride I had paid(incl the surcharge for CNY) but yet it was the only option that I had as no flight was available on that day.

After check-in to Tune hotel; we had wandered to KLIA2 seeking for dinner.  We had stopped by the food court and I had ordered mee mamak goreng from the food stall manned by Indonesian. I can assured you that it was the best mee goreng mamak that I had for the last few years.

The Tune hotel breakfast was a satisfying one and we managed to have a last tap of Malaysia yummy before we headed for the check-in. The first part of the daring trip ended when we boarded the flight….the next thrilling part awaits us at the other side of the world.