Borrowed Hours

Please click the photo above to play the daily videoNearing the weekend, and you can feel it in the shoulders before the calendar admits it. Thursday has a particular texture, close enough to Friday to taste it, far enough away to be cruel about it.

The haze was back this morning, which felt frankly unsporting. It rained the night before, properly and at length, and I’d gone to bed with the reasonable expectation that the air had been washed clean. Apparently not. The rain did its best, the haze simply waited it out. There’s a lesson there about persistence, though I’d rather not learn it from smoke.

I got to work early, partly by choice and partly by necessity. A colleague is away on holiday, so I’m covering, which means my usual load plus theirs, folded neatly on top like an extra coat in a heatwave. I don’t begrudge it. Holidays matter, and someone will do the same for me when it’s my turn to vanish to somewhere with better air. But covering has its own quiet weight. You’re minding someone else’s patients, someone else’s loose ends, all while trying not to rearrange the furniture in their absence.

And then there was my own full clinic as well, because the day had clearly decided generosity was the theme. The timer earned its keep again. I’ve stopped feeling self-conscious about it. A man with a countdown on his desk looks either very organised or slightly unhinged, and on a day like today, I was happy to be mistaken for either.

In the afternoon I headed to Sunway for a talk. Driving across the Klang Valley mid-afternoon is a kind of meditation, if your idea of meditation involves brake lights and quiet muttering. Sunway itself always feels like a small city that got ambitious and never stopped building, which I mean as a compliment. There’s an energy to it I rather like, even when I’m too tired to match it.

Dinner was included, which is one of those small details that shouldn’t matter as much as it does. After a long day, not having to think about food is a genuine kindness. Someone else decides, someone else serves, and all you have to do is turn up and eat. I’ve come to believe that a well-organised dinner is the true measure of any event. The content can be excellent, but if you send people home hungry, nobody remembers the slides.

It ran late, as these things do. By the time I got home the day had long since used up whatever reserves I’d brought to it. Tired is the honest word. Not the dramatic kind, just the ordinary, earned sort, where the body is ready to stop well before the mind agrees to.

There’s a certain satisfaction in a day like this, though I’d only admit it once rested. Two loads carried, one talk attended, one dinner I didn’t have to cook. The weekend is close now. Close enough that I can almost see it, haze permitting.

No free lunch

Little did I realise the impact of the economy crisis to the usual running of my Department. The Medical profession has always in one way or the other share a connection with the Pharmaceutical companies. In a certain way, they can be a player in Continuing Medical Education (CME) program amongst the Medical fraternity. Without their endowment, many of the Medical conference would cease to exist. Honestly speaking, they are essential to Medicine.

They take the gamble in Medical research. Even though the rake billions when the drug they develop became a hit, they also foot up the bull if they tank. It can be a huge gamble. The Medical profession can't afford that. They also invest a lot money in the clinical testing of the drugs, making sure that the theoretical therapeutic properties of the drug translate into day to day use. There was no point having a drug that work on paper but kill us the moment we swallow them.

I observed that since the turn of the year, the sponsorships from the Pharmaceuticals was slowly drying out. Yes, I got my usual share of diaries and wall calendars for the year, but the feeling was palpable. Take today for example, out Department CME went by without the presence if the Pharmaceuticals. That translated to no free lunch. It was not that I was desperate for them - the lunch was becoming generic lately anyhow - but it was nice to have lunch on the go while listening to some talks and presentation. As it turned out, we had to delay the session so that the MOs were able to catch some bite.

The Economy crisis has hit the Department. Upon looking at the bookings for CME sponsorship, we were usually booked up many months in advance. It turned out that there were bow few empty slots .......

Afternoon lunchtime lecture - Note to self, food + lecture = zzzzz

Kenneth Lee from Genzyme talking about use for ATG in transplant conditioning and aplastic anaemia.

Posted via email from Stamp up those photos!

H1N1 hitting UMMC

Prof Aw in his H1N1 Address, originally uploaded by Haris Abdul Rahman.

We have to face the fact that the pandemic is going on. No point hiding away or pretend that everything is hunky-dory. At the same time, there is no point going overboard on pandemic that has been on the horizon for some time. A couple of academic staffs and another couple of doctors are awaiting further tests, while another two patients are in ICU, presumed due to H1N1. It is a serious matter, but the panic surrounding the whole situation may prove to be just as if not more dangerous.

Yesterday, one of UM alumnus, Prof Aw Tar-ching gave a talk on the steps taken in UAE where he is working now. It was clear, in a country that depends on tourist traffic, a panic will hurt the economy hard. He outlined that the most important thing we have to do now is to have a consistent and accurate portal for information dissemination. What is happening now is more of sporadic, knee-jerk like statements from the powers that be on this policy and that. It will just create confusion. Or even worst, it in itself may give the public a sense that the government is also panicking behind the scene.

Remember, consistent and accurate information .... I think that is what we need .......

Lesson from Singapore

Morning Talk by Prof Ho from Singapore NUS, originally uploaded by Haris Abdul Rahman.

We wouldn't like to admit it, but there are things we could learn from our Southern neighbour. And we are not just talking about how to make a sitcom here.

This morning, the Faculty received a visit from a Professor from NUS in Singapore. He basically told us the story of how the healthcare system in Singapore been undergoing a major revamp since the turn of the millenium. And it all started from a realisation of something very obvious.

First, Doctors were leaving for Private practice in droves and that needed stopping. Second, the only real advancement can only be made if backed by R&D. In short, there are investment needed to be made into the health system, and it is not to build the biggest hospital with no specialist, or to purchase a CT machine to be hidden in a basement. The money should be channeled directly at the target. Increase the Faculty members pay packet, spend the money for research opportunity for these Faculty members and spend the money on proper human resource development, not on just some 'modal insan' mambo jumbo.

It all started with a simple questionnaire distributed to all doctors at one of the main hospital, asking what they detest most about their job and what it the main reason why they are still at it. The main reason why they want to leave is 1) the pay is a lot better outside, 2) limited career prospect for advancement. The next thing they do was realign the services, and change the hospital demography of the island down into 4 'district' hospital and 2 University Hospitals, the '4 plus 2' plan.

At the hospital, to promote career development, the Faculty Members were introduced into 4 career tracks, ranging from pure Clinicians to mainly Researchers. The promotion criteria will be aligned to each career tracks and everyone knows exactly what is required of them. At least what it sounded on paper. In en updated survey, they seems to be looking at early success. The staff retention rate looked good and their research output is also on the rise. The feedback from the Medical Students and patients also seems better than before, but Prof Ho himself felt that it is too early to paint any conclusions.

I find the talk fascinating and Prof Ho has plenty of insight to offer us. Realistically however, with a more intellectual population (and politicians) and smaller, and more compact geography, these major rethinking is much easier to implement in Singapore. The fact that the Minister of Health also tended to be medical doctors does help! The fact that they realised that something was wrong in the first place, quickly proposed a solution and implemented it is something that I admire. If only we can have similar strive for a goal, any goals, than there is hope for my beloved 1Malaysia.