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M. Bakri Musa

Seeing Malaysia My Way

My Photo
Location: Morgan Hill, California, United States

Malaysian-born Bakri Musa writes frequently on issues affecting his native land. His essays have appeared in the Far Eastern Economic Review, Asiaweek, International Herald Tribune, Education Quarterly, SIngapore's Straits Times, and The New Straits Times. His commentary has aired on National Public Radio's Marketplace. His regular column Seeing It My Way appears in Malaysiakini. Bakri is also a regular contributor to th eSun (Malaysia). He has previously written "The Malay Dilemma Revisited: Race Dynamics in Modern Malaysia" as well as "Malaysia in the Era of Globalization," "An Education System Worthy of Malaysia," "Seeing Malaysia My Way," and "With Love, From Malaysia." Bakri's day job (and frequently night time too!) is as a surgeon in private practice in Silicon Valley, California. He and his wife Karen live on a ranch in Morgan Hill. This website is updated twice a week on Sundays and Wednesdays at 5 PM California time.

Sunday, September 22, 2019

Excerpt # 35: Geeting Reacquainted With My Old Culture

Excerpt # 35:  Getting Reacquainted With My Old Culture
M. Bakri Musa (www.bakrimusa.com)

I told my parents about my planned transfer to JB. They were surprised, and disappointed. To them, there must be more to it. As Sharif had earlier noted, nobody would voluntarily seek to be transferred out of KL and be off the radar screen of the decision makers. Even after I explained the quirks of the Malaysian civil service code that a transfer meant a promotion, they were still not convinced.

            My parents remembered only too well their experience early in their careers when they were posted from one remote village to another as punishment for their less-than-deferential attitude towards their superior. This particular superior was several bureaucratic steps above my parents. In the normal scheme of things, he should have had minimal impact on my parents’ careers except for the fact that he happened to be a member of the royalty and resided in our village. Even if he were not to be my parents’ superior, tradition would have required them to pay homage to him.

My father failed to do that. He was brought up in Rantau, a village some forty miles away, tucked amidst the colonial tin mines and rubber estates with their abundant immigrant workers. Paying tributes to local feudal chieftains was alien to those folks, and that rubbed off on my father.

            Remembering that, my parents wondered whether I had transgressed against something or somebody important in KL. I reminded my parents that JB was far from an ulu(remote) posting, in fact, quite the opposite. In the end, they accepted my explanation.

            Busy with my work, I did not have much time to visit my old village or catch up with former high school classmates. After all, I would have a lifetime ahead of me to renew old friendships. I did visit my old village to pay homage to my grandparents’ family. My paternal grandparents in Rantau died when I was young, my maternal in Kampung Tengah while I was in Canada. My maternal grandmother died following a fall and grandfather, of prostate cancer. During his last year of life, he was hospitalized often at the new University of Malaya Hospital for pain relief, a particular burden with that disease. My uncle related to me that my grandfather would never tire of telling his doctors that he had a grandson studying in Canada to be one of them. He died the year I graduated from medical school.

            Terms like “grandparents,” “uncles” and “sisters” are used in a very loose sense in Malay society. My grandparents’ sisters and brothers are all grandparents to me; likewise, those who are or seemed to be a generation older than me (fewer and fewer these days!) are uncles and aunties, and those only slightly older, abang or kakak(brother or sister).

            Once in a fancy restaurant in Malaysia I was addressed as “Abang!” by the Malay waitress. I laughed considering that she was so much younger than me and I had a full crop of grey hair to boot! I responded that since she had addressed me asAbangand not as Pak(Uncle), or worse Tok(grandfather), she would get an extra tip! Perhaps she was angling for that all along.

            Abangis also how a wife addresses her husband; a lady, her lover.

            My two years at Malay College in Kuala Kangsar for my Sixth Form excepted, I left Malaysia straight from my village. My time away also coincided with tremendous changes in the country. I missed all that. Thus when I returned I still had my old Malay village persona, in particular the distinctive Negri Sembilan loghat(dialect). Meanwhile in the villages, that was fast receding together with the rapid development of the country.

            Thus when I visited my old village and began speaking in the old dialect, the villagers took a double look. The incongruity of a modern young man who had travelled the world for years yet still retained the archaic village lingo! Meanwhile those who had spent only a few weeks in KL and on returning back to the village pretended to have forgotten their loghat,. That would be akin to a Southerner who had spent a summer in Boston and on returning had forgotten his Southern drawl, or pretended to!

            I had been away for well over a decade and during the most transformative period of my life. I was very aware that I could have forgotten some of the old village niceties and courtesies. Conscious of that, I had my brother Sharif and his wife Zainab accompany my wife and I whenever we visited the village to make sure that we, especially me, did not create any social and cultural faux pas.

            When we visited my maternal grandmother’s youngest sister, the only surviving member of her generation, I was stunned to see her look so old and bent over. I remembered her as a beautiful youthful lady, with straight posture, very unlike her oldest sister, my grandmother, who was stooped. In fact, that was her nickname, Wan Bongkok (stooped grandma). I asked my granduncle how long my grandaunt had been like that.

            “Like what?” he replied.

            To him the change in her posture had been so slow that he did not notice it. If he did, it was but a normal sequence, the natural attribute of being old. I explained to him the thinning of our bones as we get older (osteoporosis), more so in women, and with that the risk of bone fractures, especially of the hips, which probably caused my grandmother’s demise. The exaggerated stoop in my grand-auntie could be due to compression (wedge) fracture of her spinal bones.

            She showed me all her medications, for diabetes and high blood pressure. Diabetes was a dreaded disease to the villagers, conjuring images of amputated legs, debilitating strokes, and being tethered to a kidney machine for the rest of your life.

            I told them while that was true of a minority, for most they could have a normal lifestyle but for some adjustments. Chronic diseases like diabetes and hypertension are different from acute ones like pneumonia or appendicitis where with antibiotics or surgery you would be cured. Diabetes could be viewed more as our decreased tolerance to sugar (among other things), just as we have decreased tolerance to physical activities as we get older. With such maladies, medications are but only one, albeit a very important component in the overall management.

            I must have given too long a dissertation, for soon my brother nudged me and whispered that what my grandaunt wanted most was not a long lecture but to be examined by me. Prompted by that I took out my blood pressure cuff and stethoscope. I measured her blood pressure, listened to her heart and neck arteries for any bruit to suggest disturbances in the blood flow that could predispose her to a stroke. They were all normal, and she was pleased when I told her of my findings.

            Sharif commented that not often would a villager get such personal attention from a doctor – a specialist at that – and at her home! Only sultans and sultanahs had that rare privilege. My grandaunt laughed; I had made her feel special. Then Sharif teased her to make sure that I did not hand her my professional bill on my way out.

            I always used such occasions less being a doctor and more a teacher, which the word “doctor” meant in its original Latin. When my grandaunt indicated that her current set of medications was the one that finally agreed with her, I used that incident to tell those present that doctors do not always get it right the first time. As such, when something is not quite right, we should not hesitate in going back for a reassessment.

Next:  Excerpt # 36: A Cool Christmas In Hot Malaysia
From the author’s second memoir, The Son Has Not Returned. A Surgeon In His Native Malaysia, 2008.

Excerpt # 36:  A Cool Christmas In Hot Malaysia
M. Bakri Musa www.bakrimusa.com

Sunday, September 15, 2019

Excerpt #34: The Power of Prayers

Excerpt #34:  The Power of Prayers
M. Bakri Musa

Like my friend Ramli, I too was on a scholarship for medical school but unlike him, mine was sponsored by the Canadian government. Nonetheless the terms of our bonds were identical. Again unlike him, I had the opportunity of working during the summer holidays while still drawing my stipends. I had invested those extra earnings instead of taking expensive trips home. Thus I was able to buy out my scholarship obligations when I graduated.

            I had to, for the Malaysian civil servants in their usual presumptuousness to know what was best for Malaysia and for me, had demanded that I return home immediately. For my part, I was in equal measure determined to stay behind and begin my specialty training. Iknew better what was best for me and also for my country. I would bring more value to Malaysia if I were to return as a surgeon instead of only an MD. I had read somewhere that there was only one Malay surgeon in the country at that time, the late Dr. Syed Al Hadi. Indeed, when I finished my training five years later, I doubledthe number of Malay surgeons!

            I remember one cold winter weekend in Canada when it was too miserable to go outside, I occupied myself reviewing my investments and admiring those golden bonds and stock certificates. It struck me that those were merely pieces of papers. I knew what they signified and their power in real life, nonetheless they were still fancy papers. Besides, my investments were financing the Canadian economy. So why not put them in Malaysia and thus benefit her economy?

            The next day I liquidated most of my investments and wrote a cashier’s check for my father with instructions for him to use the funds as he saw fit. I told him those were my savings from my many summer jobs over the years.

            A few weeks later I received a reply thanking me and assuring me that the money would be put to good use. Alham du lillah! Praise be to Allah! Nothing beyond, nor was any expected.

            A year later upon graduating from medical school, I came home for a visit. It was right after the May 1969 riot. With my parents’ concern over my safety, I spent most of the time with them in the village. One quiet evening my father mentioned to me about the money I had sent him earlier, and what a savior it had been for him. He had been surprised and wanted to know how I managed to have such savings while still being a student. He was also curious as to what prompted my sending the check at that particular time.

            I reminded him about the long summer holidays and of students working during those breaks. For someone who was a traditionalist and who thought that being a student should be a fulltime and year-round endeavor, that surprised him. As to what made me do it, I answered that he could make better use of the money. But why at that particular time? I had no answer to that.

            That check may have been written by me, he replied, but it was Allah who guided me. He then related how he and my mother were in a severe financial squeeze at that time. My brother, who was then in Australia, was sick and needed money as there was a snag in his scholarship from Malaysia. He was penniless, having exhausted the savings he had brought from home. He wrote desperate letters home but my parents were helpless. They had no money left, having spent it replanting their rubber acreage and paying for their new house in Seremban. The builder however, had declared bankruptcy before completing it, leaving my father holding the loan but no house, and those trees were now ready to be tapped but he had no funds to buy the necessary tools. No banks would lend to a villager. Besides, my parents had just retired.

            Paralyzed, all he could do was pray that Allah would show him a pathway out of his crisis. He said that he and my mom would go the mosque in the middle of the night to pray to seek His guidance. Then out of the blue my check arrived! Part of the money he sent to Sharif and the rest to buy tools for tapping his now-matured rubber trees. With the income from the latter, his cash flow, as the accountants would put it, improved.

            I was disappointed that my parents did not apprise me of their problems. My father’s rationale was that I was in medical school, a grueling undertaking in itself, and he did not want me to be distracted by problems at home.

            “Never underestimate the power of prayers,” he counselled me.

            So what made me decide to review my savings that one cold winter evening and then liquidate them and send the money home? It must have been my parents’ prayers.

            After that visit and seeing that he was trying to finish his dream home in Seremban, I gave him the leftover of my savings after I had paid off my scholarship obligations.

            That was the last time my parents accepted any money from me. When I had my first job in Malaysia, I gave him part of my check, more as a tradition of homage offering, but he returned it. I now had a young family, time to save for them and not to worry about my parents, he said. His and my mother’s journey of life was nearing the end; they could see the shore on the other side. Nothing much could happen to them in between, Insha’ Allah(God willing!). Mine was just beginning. Who knows what high seas and strong winds I would encounter; so be prepared and not worry about them.

            I had received many good advice over the years but none matched the wisdom and clarity of the one that my village schoolteacher father imparted to me on that day. As for his offering his pension checks to me many years later so I could build my dream house in PJ, he wanted to reciprocate my earlier gifts to him.

Next:  Excerpt # 35: Getting Reacquainted With My Old Culture
From the writer’s second memoir, The Son Has Not Returned. A Surgeon In His Native Malaysia, 2018.

Sunday, September 08, 2019

Excerpt #33: A Change of Direction

Excerpt # 33:  A Change Of Direction
M. Bakri Musa (bakrimusa.com)

That following Monday morning I was back at the Ministry. This time I told the officer in as calm, flat and controlled voice as I could garner that I wanted to be out of KL by yearend. My message took a while to register. People did not ask to be transferred outof KL; they lobbied hard to get there.

            Just to make sure that he did receive my message, I rephrased it. I told him that I was not tied to the government. All I needed was to give 24 hours’ notice and I would be gone.

            That grabbed his attention. I had been in the government service for less than a year. I could not by statute enter private practice. That meant I would be leaving the country. There had been plenty of recent headlines of professionals leaving Malaysia, enough that even the Minister of Health commented on it at that meeting of specialists earlier in the year. I was sure the official was very much aware of that as he was now much more accommodating.

“Give us a few days.”

            The next week I was back. The mood was different this time; all smiles from the same officer. There was good news. The Trengganu state surgeon had just resigned (to emigrate?) but I would be too junior to be posted there. Besides, that position was “Superscale F” and I was not yet even Superscale of any alphabet. It would have meant a major double promotion, first to Superscale G (the lowest) and then to F. Not possible, by GO.

            Instead they offered that position to the junior surgeon in Johor Baru (JB). Since it would also be a promotion for him (from Superscale G to F) the official assured me that he did not anticipate a negative response. Nonetheless I should await this surgeon’s decision.

            Two days later I received a phone call from the Ministry. Sensing its sensitive nature, I took the call in the privacy of my office. Yes, that JB surgeon had agreed to his transfer and I would be taking his place in JB. Since it was late in the year, my transfer would not be until after the Chinese New Year, the following February. I was not about to quibble for a few weeks’ delay. I had never been to JB before. The furthest south I had been on the Malay Peninsula was Muar when my family visited my brother who was posted to his first teaching job there.

            Soon after, my secretary knocked on my door and tiptoed in. “Are you leaving us?” as she put her fingers to her lips and closed the door behind her.

            How did she know? That call was from the ministry’s establishment officer. That could only mean a promotion and transfer. I confirmed her suspicion and added that it won’t be until the new year.

            The next morning at clinical rounds I was confronted with somber faces. I confirmed their very first query, trying hard to be casual as if it was expected and routine, adding “It won’t be till months from now!”

            That morning’s rounds went fast; the spark was gone. They were in no mood to discuss the cases at length. Later at coffee break I tried to be as upbeat as possible, spinning my leaving as a promotion and an opportunity to see another part of the country. They knew that I was faking it. While not a lie, it was not the whole truth either.

            That afternoon Mahmud came to my office and like my secretary earlier, he quietly closed the door behind him and gestured with his finger that he wanted a private conversation. Before he could ask what had happened, I apprised him of the situation, making no reference to my disappointment with the Ministry. He confessed to his jitteriness about our teaching program without my being around. I assured him that the unit now was not like it had been in January when I came in. Now it had three surgeons, and I reminded him of his earlier announcement of another one who would be coming early the next year. Satisfied, he assured me that I would love JB but reminded me that it was a royal town. He must have sensed that I was not enamored with matters royal. Or perhaps he truly remembered me from our Malay College days in Kuala Kangsar, also a royal town. I was among the few who purposely avoided functions on campus involving royalties.

            A few days later Ramli dropped by. He waited till late in the afternoon when no one was around. He was my best friend in school. You do not lie to your best friend, present or past. I unloaded on him my frustrations. He told me that he could have predicted the Ministry’s reaction towards my program proposal. To those guys, Ramli sniffed, if they didn’t think of it, then it could not be worthwhile. As for the promised promotion with my transfer, don’t count on it, Ramli warned. I would be stuck with my timescale pay for at least five years. He knew the “GO” inside out.

            Ramli confided that he was just buying time till his bonds with the government was fulfilled. He was a scholarship student; he had to serve seven long years. He had a couple more to go.

            I may have successfully rationalized my decision to leave GHKL to protect my ego, but there was no denying that my move would take me further away from my cherished aspiration to be an academic surgeon.

            Many years later I would read Portrait Of A Thousand Smiles:  Academician Tan Sri Dato’ Seri Dr. Salleh Mohd Nor, the autobiography of the distinguished former Head of the Malaysian Forestry Research Institute. He related his own frustrations in dealing with the local bureaucracy. It took him over ten long years before he could free his institute to become a statutory body, free from the strictures of the civil service and the stranglehold of those petty, incompetent civil servants.

Freed from the constraints of the civil service, Tan Sri Salleh was instrumental in producing over 100 PhDs in his field, a productivity unmatched even by local universities. Of even greater significance, most of them were Malays.

Reading his book, I was humbled by the man’s unbelievable patience and enviable endurance. Likewise today I cannot help but feel a tinge of envy on seeing Datuk Jefri Abdullah’s success with his Neuroscience Institute at USM in producing dozens of Malaysia’s neurosurgeons.

Both Malaysians have not only distinguished themselves with their sterling “resume virtues,” they have also accomplished what must surely be legendary “obituary virtues,” to use New York Times’ David Brooks’ phrase. What a legacy!

Next:  Excerpt # 34: The Power of Prayers
From the writer’s second memoir, The Son Has Not Returned. A Surgeon In His Native Malaysia, 2018.

Monday, September 02, 2019

Excerpt # 32: Hitting A Bureaucratic Brick Wall

Excerpt # 32:  Hitting A Bureaucratic Brick Wall
M. Bakri Musa (www.bakrimusa.com)

Recognizing the critical importance of my upcoming meeting with top Ministry’s officials to interest them on my proposed surgical training program, I deliberated on my approach. I was less concerned with the facts; those were compelling enough to anyone with some sense, rather the tone and manner of my presentation. Should I be soft, humble and low key, with cap in hand begging for their favor, or should I be forceful, asserting my points with confidence so as to convince them with no questions asked?

            In short, should I approach this meeting the Malay or Western way. I tried the soft Malay approach on my first day at the ministry and ended up with an uluposting in Kuala Lipis. When I did it the Western way, I was rewarded with an immediate interview with the top honcho and a much sought-after posting at GHKL.

            The choice was clear. So at the meeting, I addressed the officials in English, politely and with minimal formal greetings or drawn-out salutations as I would have to, had I spoken in Malay. Taking their silence to mean that they were ready for business, I went ahead with my presentation. Again, silence. I took that to mean acceptance, or at least non-resistance. After finishing, I asked them if they had any questions, and they still remained silent.

            I took that also to mean agreement. After all what I was proposing would not involve any additional resources or increased funding, merely rationalizing and making efficient use of existing ones, as for example having medical officers assigned to my unit only those who were interested in surgery. So I continued.

“Here’s what I need!”

            Then the problems began! To every request, they had an argument why they could not help me, reverting to the familiar “GO” or General Order. After about the fourth or fifth denial, I’d had it. In a fit of exasperation, I turned to the senior-most official, “Sir, you don’t understand what I am striving at here.”

            Leaning forward and with my right elbow on his desk and my index finger pointing at him, an unmistakable display of rudeness in Malay culture, I told him that even if he and his colleagues in the Ministry were to give me their full enthusiastic support and provided me with all the resources, I would still have to work my ass off to make the program work.

            “Today we bitch about the pathetic lack of Malay surgeons. This program would remedy that. Yet you guys block me. You can have it!” With that I packed up my papers and walked out to their stunned silence. Well, at least silence, I wasn’t sure they were stunned.

            At the door, I turned around and gave my parting shot, “Twenty years from now you’ll still be bitching about the lack of Malay surgeons!”

            Today, forty years later, they still are!

            That afternoon I could not find my usual enthusiasm. My teaching rounds were flat. My students and trainees recognized that but said nothing.

            On the way home I felt so tired and dejected that I forgot my usual routine of picking up pisang gorengby the roadside stall. When Karen was ready with our tea, there were no fried bananas to go with it. With or without the treat, Karen sensed my dejection. Her immediate thought was that I had lost a patient at surgery. She was relieved when I told her it was not that.

            Karen had sensed my frustrations building up during that past few weeks. I was finding the little irritations becoming intolerable. The traffic was getting worse. With my non-air-conditioned car, it seemed that I was always behind a soot-belching truck, with the diesel smell soaking into me. The heat would get to me; the humidity soaking my shirt. I would come home drenched and exhausted.

            My earlier little disappointments like the brush off from the UKM dean and my pitiful salary increase a few months earlier now loomed large. Whenever I came home Karen would wonder what brick wall had I crushed my head into that day.

            Uncontained frustration snowballs on its own momentum. Or to use a local metaphor, a muddy shoe picks up more mud. Even if there were to be some positive news or developments, those would now be interpreted in their potential negative light. The dark clouds muted everything. It would be worse for any bad news; they would be magnified even more.

            At about this time the government announced a new ruling. New doctors would now require three years of mandatory service before they could enter private practice, instead of the then current two. I felt that the new ruling targeted me specifically as it was backdated to the beginning of the year instead of applying only to incoming doctors. I felt trapped. The added year now seemed an eternity.

            A year should in the normal scheme of things not be a factor but it was to me, as it meant a 50 percent extension of my mandatory period. By now I did not trust the government. It could just as easily extend that requirement even further to five years and again make that retroactive. Before long I would be trapped by inertia.

            When you are caught in a thunderstorm in the darkest of night, lightning becomes not a curse or a harbinger of worse things to come, rather a moment of brightness that would enable you to see your surroundings even if only for a brief moment so you could get your bearings. I remembered how dejected I was after my first visit to the Ministry of Health that many moons ago. Then the sudden elation and sense of adventure. I would be a Peace Corp volunteer, not a returning native son.

            I was not ready to give up on my native land, or roll over to ease the bureaucrat’s job as I did when I first went to the ministry and they pronounced me good only for Kuala Lipis. Instead, I took my brother Sharif’s advice and had fought back. My reward was a posting at GHKL.

            The current setback notwithstanding, I refused to let those civil servants set my agenda. I would control it. Malaysia should be big and generous enough to have a slot for her native son somewhere. I just have to be diligent in searching for that and be prepared that it may not be in KL. There was no point in being at GHKL and be on the radar screen of the powers-that-be if you were to be mistaken not as a bright promising blip but a glint of dust on the monitor. I refused to accept the fate thrown to me by those civil servants. I was determined that my future be in my own hands, with Allah’s guidance.

            That weekend Karen and I again pondered our future. We went through this once before we were married. Oh, how we agonized! We had planned our wedding the summer she graduated. However, I would graduate a year earlier and had considered doing my internship in United States and continue with my residency there. That would mean being separated from Karen for a year just before our wedding. We did not relish the thought. We compromised; I did my internship in Canada.

            Karen felt that moving out of KL meant giving up my cherished dream. She remembered how I used to imagine my articles in various journals with the footnote, “Professor of Surgery, University of Malaya, Kuala Lumpur.” She recalled the many discussions we had on how best to prepare myself for an academic career. Now she was disappointed those dreams of mine (and hers too) would be shattered.

            Then, a glimmer of hope. I had heard rumors of a senior academic surgeon at the University of Malaya retiring to enter private practice. A few weeks later I saw an ad in the papers for that opening and submitted my application, just like the dean of the other medical school had reminded me earlier. I also wrote my Canadian referees to alert them.

            In truth, I was not terribly worried about my future. If my native land did not need my talent, I have the whole wide world. Karen however, was worried that my family would blame her if we were to return to the West. It did not help that whenever she phoned Canada (which was rare as it was so expensive) she would always end up crying. That upset my parents very much; they viewed that as their failure to make their daughter-in-law feel at home.

            After much soul searching, that weekend Karen and I decided that I should leave GHKL. I wanted to be as far away as possible from those obstructionist and hidebound civil servants lest they would infect me with their warped values. Another big reason was that should I decide to leave Malaysia, I would have had the opportunity to see more of my country. I had never seen much of it before I left for Canada. I was also getting fed up with the traffic and congestion of KL.

Next:  Excerpt #33: A Change of Direction

From the writer’s second memoir, The Son Has Not Returned. A Surgeon In His Native Malaysia, 2018.

Wednesday, August 28, 2019

Reflections On Merdeka Day: Mahathir's Halfway Leadership

Reflections On Merdeka Day:  Mahathir’s Halfway Leadership
M. Bakri Musa (www.bakrimusa.com)

During the polio epidemic of the 1950s, ingenious engineers created the iron lungs and saved many lives, while skillful surgeons crafted nifty operations and salvaged countless paralyzed limbs.

            Those advancements, though impressive, were what physician Lewis Thomas referred to as halfway technology. True technology came when Salk and Sabin produced their vaccines. Halfway technology is not only expensive but also does not address the basic problem.

            Likewise with leadership; there is the true version and then there are the many halfway varieties. Halfway leadership too does not solve problems; in fact it compounds them. It is also expensive both in terms of the direct damages inflicted as well as in the lost opportunities.

            Malaysia was blessed with a few true leaders during her first half. Tengku Abdul Rahman inspired the multiracial population, hitherto (and still is) suspicious of each other, on a single pursuit – the country’s independence – and successfully negotiatedfor it. Thus the nation was spared its war of independence and Malaysians today are unabashed admirers of their former colonizers.

            Economist Ungku Aziz leveraged the powerful religious aspiration of Hajj to make Malays save. In the process he ushered them into the modern economy, making Tabung Haji one of the region’s biggest financial institutions. Chief Justice Tun Suffian elevated the country’s judiciary to be the envy of the region.

During Malaysia’s second half, Mahathir’s leadership dominated, from 1981 until he retired in 2003. Then in May 2018, at 92, he toppled the ruling coalition that he once led. Its leader, Najib Razak, was Mahathir’s protégé and chosen successor. The irony!

A visitor today would be impressed on landing at Kuala Lumpur’s gleaming international airport. The smooth, undulating freeways into the city, beautifully landscaped, make you feel as if you are still in the First World. The glut of five-star hotels adds to that aura.

            Impressive though those may be, they are but halfway developments, showy artifacts of modernity. They cannot hide the stark realities that often intrude, like hideous acnes through thick makeup. Malaysian schools and universities for example, are an embarrassment. Minister of Education Mahathir initiated the decline in the late 1970s. Later as Prime Minister, he greased the slide.

Mahathir was also instrumental in the state’s massive involvement in Islamic affairs. Today the religious bureaucracy exceeds the Papal one in budget, personnel, and most pernicious of all, power. While the Pope could only influenceCatholics, Malaysian state-employed ulama controlMalays, in activities as well as thoughts.

This huge and sinister religious serpent that Mahathir created is now striking back. Witness the current raging and unnecessary controversies over a radical, Indian-Muslim dropout physician-turned- preacher, and the introduction khat (Arabic calligraphy) in schools. Both do not contribute to the economy. On the contrary, they come in the way of improving it.

This huge Islamic beast sucks up precious resources that could have been used to tackle pressing social problems, like rampant drug abuse, uncontrolled HIV infections, and the epidemic of abandoned babies. Those appalling social pathologies disproportionately inflict Malays. In their pursuit of Heaven, those religious types believe in first making Muslims endure Hell on earth.

As for Tabung Haji, it had to be bailed out recently. For the judiciary, a high-profile attorney was once caught on videotape aggressively lobbying on the phone the then Chief Justice. Among that lawyer’s clients was Prime Minister Mahathir.

Mahathir tolerated corruption; a necessary lubricant for a creaky bureaucracy, he rationalized. That attitude, and the culture it nurtured, produced today’s unbridled venality, with former Prime Minister Najib and a dozen of his ministers and aides now facing criminal charges of corruption. Mahathir of course absolved himself of any responsibility.

Mahathir was and still is a halfway leader. He is ensnared by what the young Nigerian writer Chimamanda Adichie termed “the trap of a single story.” Mahathir’s self-fabricated sole narrative remains unchanged:  Malays are stupid and lazy; Chinese, wily and greedy.

Nor could Mahathir overcome that subtle and crippling Malay cultural trap of terhutang budi(debt of gratitude). His earlier support for Najib had nothing to do with the latter’s talent (Najib had none) but an expression of that old sentiment. In early 1970s Najib’s father, then Prime Minister Razak, resurrected Mahathir’s crumbling political prospects.

At 94, Mahathir has not much time. He ignores his most crucial assignment – to ensure a peaceful and predictable transition of power. He is back to his trademark destructive trait – fomenting unnecessary confusion and divisive uncertainty, especially with respect to his possible successor.

True leaders believe in their followers. When their initiatives fail, those leaders would reexamine them and formulate new ones, not blame their followers. Mahathir revels in stereotyping and blaming them.

In his book Robert Kuok, A Memoir, the author quoted Deng Xiaoping at their only meeting. “Mr. Kuok, they all say I am the one that is bringing this huge and rapid development in China. They are wrong. When I opened the door for China, they were all pushing me from behind. They are still pushing me.”

A variation on Lao Tzu’s theme – when a true leader’s work is done, the people would say, “We did it ourselves!”

What Deng did not reveal, as evident from Ezra Vogel’s biography of the man, was that there were many who opposed Deng’s opening of China. His wisdom was in notlistening to or heeding them. That’s true leadership, discerning and then encouraging the wise instincts in their followers, and ignoring those less blessed.

Mahathir panders to and exploits the raw emotions and base instincts of Malays. His championing Islam is not to emancipate Malays, as the Prophet did to the Bedouins of the 7thCentury, but as a political tool, and a very dangerous one. Likewise with Malay special privileges; Malays are fed the illusion of success and reflected glory with the opulence of their sultans and UMNO elite, their rent-seeking spoils sold as “entrepreneurial success.”

Mahathir Version 2 is no enhancement. He is still obsessed with iron lungs and weakened limbs. He does not see the need for a vaccine, much less work on one. Today’s slew of UMNO leaders indicted for corruption is only one malignant manifestation of Mahathir’s halfway leadership. His once much-hyped Vision 2020, is just that – hype. Not a word from him now. It was never a vision, only a slogan.

Mahathir’s last hurrah was in ejecting Najib and his Barisan coalition. Malaysians are grateful for that. That gratitude however, is not without bounds, and Mahathir is determined to breach that, thus betraying the trust Malaysians gave him in the last election. He is back to his old spiteful self, provoking controversies and then blaming others for stirring them up.

Mahathir wants to burden Malaysia with another Najib-caliber successor in Azmin Ali. Time to stop Mahathir. Besides, if he could not achieve his goals when he led the nation for 23 years and when he was much younger, there is little hope for him now that he is nearing 95. Time to disabuse the man of his Messiah delusion.

Mahathir should exit gracefully. Entice him with whatever it would take. Award him whatever title he craves and shower him with all the luxuries he desires. A lifetime corporate jet privilege and rent-free penthouse suite at his favorite Petronas Towers would be much cheaper than the damage he is inflicting and continues to inflict on Malaysia. If those do not work, not-so-gently remind him of the sorry fate that awaits the many Third World leaders who overstayed.

Malaysia deserves a true leader as she enters her 63rdyear of Merdeka.

Sunday, August 25, 2019

Excerpt #31: Mooting A Surgical Training Program

Excerpt #31:  Mooting A Surgical Training Program
M. Bakri Musa (www.bakrimusa.com)

Apart from getting more than my share of female doctors, my unit also had more of those who were not interested in surgery. Despite that I did not encounter many personnel issues. I can recall only two, and for very special reasons.

            One was an intern, a Taiwanese medical school graduate. At first I attributed his difficulties to language. However, I had no problem with the UKM students. Despite my intensive coaching, he was not making much progress. In the end I had to recommend that he repeat the rotation, a rare occurrence.

            A few days later I received a phone call from a senior hospital administrator about “a little problem, lah!” He wanted me to retract my earlier adverse recommendation. This intern (or rather his family) was well connected with the Minister of Health, my superior told me. When the implied threat did not work, it was made more explicit. Still, I resisted.

            True to form, a few days later I received a call from the Minister himself. In his half-English and half-Malay, interrupted by frequent “I say” and “Ayah!” he finally blurted out that my negative evaluation was unacceptable. Our ensuing conversation reminded me of the haggling at an oriental bazaar, except that it was not funny in any remote way. Unable to agree on a final term or price, I shifted tactic. I flattered him, by telling him that I was only a junior consultant and that surely he, as minister, could easily overrule my recommendation! That ended our very unpleasant conversation.

            A few weeks later the intern asked whether he could repeat his rotation with me! Either he was a masochist or that he agreed with my assessment. Obviously his family friend the Minister decided not overrule me.

            The other problem I had was with a medical officer. He was one of those not interested in surgery. I reprimanded him because he abandoned his patient in the emergency room while he was off for his Friday prayers. He retaliated by signing up to be a physician for the upcoming Hajj pilgrimage without first telling me, except at the last minute when he had to get my permission. I refused to grant him that. He was furious. For a while I thought he would become violent towards me. Instead he threatened to report me to the religious authorities. When that did not faze me, he warned me that I would rot in hell for preventing him to undertake his pilgrimage!

            The following day he made a formal request to withdraw from my service. I granted that right away even though that meant we would be short-staffed on an already overstrained service.

            That medical officer, and a few others like him in my unit, was a crying shame. It was also a significant lost opportunity. The rich resources (rich in terms of “clinical materials” or patients) of the hospital could be better used to train future surgeons instead of merely meeting the statutory requirements of new doctors. Those bureaucrats at the Ministry of Health and the UKM Dean of Medicine notwithstanding, Malaysia was desperate for surgeons.

            Earlier I had broached the idea of initiating a formal surgical residency training program with Mahmud, UKM’s Chief of Surgery. He was supportive. As he was busy with the undergraduate program, together with his lack of experience with such matters, he could not offer me much help. He was however, willing to pave my way to meet important players who could. One was Tan Sri Majid.

            So that August during Hari Raya, Mahmud and I went to Majid’s “Open House” to plead our case. We decided to go late as most visitors would come early when the food would be fresh, warm and plenty.

            When we arrived at his plush residence in the exclusive neighborhood of Bukit Tunku, the crowd was already thinning, as we had anticipated. The Tan Sri recognized Mahmud right away, and with more than a little bit of prompting on my part (“The surgeon from Canada; the one you mistook for the Egyptian Ambassador”), he remembered me.

            I reminded him of the country’s severe shortage of surgeons generally and of Malay surgeons specifically. That grabbed his attention; he guided us to a private corner of his house to continue the discussion.

            With the current set up at our unit, we could with minimal difficulty produce six surgeons annually, I told him. We could double or even triple that number in five years with the co-operation of the other units. He was skeptical that I could find that many qualified candidates, especially Malays. I assured him otherwise and that with my limited exposure thus far to young local doctors, I already had no fewer than a dozen excellent candidates who had expressed their interest to me. If I were to scour the countryside, I was sure to find many more. Then there were those now studying abroad like his son in Australia. He smiled at my reference to his son. I was also not so subtly reminding him of our earlier conversation not so many months ago.

            Tan Sri Majid was impressed. He was surprised that the bottleneck would not be in finding qualified candidates as he and many others had thought, rather in providing the opportunities. I was now into the nuts and bolts of my proposal when he had to excuse himself. He apologized profusely as he had a planned golf outing with a very important person. He asked that I pursue my project and apprise him of the progress.

            Buoyed by his endorsement I was a ready to charge, like a bull that had just been released out of its pen. The next day I went to the hospital’s deputy medical director for the list of incoming house staff. What list? “I would be lucky to get one when they arrived,” he smirked, “just like your arrival here!”

            I laughed even though the joke was on me. That was my introduction to the Malaysian bureaucracy at the nitty-gritty level. I already had intimations of that on my initial visit to the Ministry of Health, the search for my promised government quarters at Lake Gardens, and my encounter with the UKM dean. Nonetheless the import did not register on me then. After all my presence at GHKL proved that those bureaucratic hurdles and inertia were not insurmountable.

            Between my busy schedules and the runaround at the ministry, it took me weeks to secure my appointment with the appropriate officials, and that was only after I threatened to go over their heads directly to Tan Sri Majid. At first I was told that I could not get the list of medical students now abroad. I would have to ask the Public Service Commission (PSC). As for local students, I would have to go to the PSC too for them. I could bypass that by going to the dean’s office of the two local medical schools.

            If I could not get the list of those medical students, how about those interns and medical officers now outside of KL? I could not get them either. Only the ministry had the authority over where they would be assigned, not me. Once they were assigned to GHKL only then would they fall under the hospital’s authority and I could make the arrangements at that level.

            I protested that surely as a surgeon I would be a better judge who would be the most suitable candidates instead of passively waiting for them to be assigned to me. I could not persuade those civil servants. Those were the rules of the civil service, its “GO” or General Orders, its “Ten Commandments,” except that they ran into thousands of pages.

            Frustrated, I told them I would go directly to Tan Sri Majid. It was at that point that I was told that he had just retired. My hopes were deflated, my dream of a surgical residency program shattered. Only much later did I realize that even in retirement the man still carried much weight, and not just in healthcare.

            Although Tan Sri Majid’s successor, a certain Raja Ahmad Nordin, could not see me (he had just assumed office), nonetheless I would be able to meet with other top ministry officials. My hopes were again resurrected.

Next:  Excerpt # 32: Hitting A Bureaucratic Brick Wall

From the author’s second memoir, The Son Has Not Returned. A Surgeon In His Native Malaysia, 2018.

Sunday, August 18, 2019

Excerpt #30: Sex And Corruption

Excerpt #30:  Sex And Corruption
M. Bakri Musa (www.bakrimusa.com)

Sex and corruption, the two go together. One day I noticed that the soup served to my patients was nothing more than spicy hot water with pieces of vegetables floating. Sister Fong commented that the food quality had been deteriorating for some time. Everybody noticed that but nobody did anything about it.

            One morning on the pretext that I was finding my way around, being new, I wandered into the kitchen, unannounced. The grocery truck had just delivered its supplies, or making a show of it. The staff reacted to my presence like a herd of deer that had smelled or seen a tiger in the neighborhood. They all perked up, frozen, staring towards me with their eyes wide open. It was obvious they were not used to being visited. I greeted them in Malay and introduced myself as the new surgeon, wanting to know the workings of the hospital. I sought out their supervisor.

            I made innocent queries like where the best place to buy meat, the going price, and complimented him and his crew for having to cook for so many. “It’s like having a big kendurievery day!” I remarked. I used simple village language with my comments and questions, as well as put on my humblest Malay mannerisms to make them feel at ease. Yet they all maintained their guard throughout.

            Then I saw a big beef carcass being carted away to another van. I asked in as casual a manner as possible whether the hospital had another kitchen elsewhere. There was a scurry of embarrassment with the director asking the man where he was going with the meat and that it should put it back in the refrigerator. The man was startled by this apparent departure from the usual routine.

            Later at lunch time I went up to the ward. That was the day when my patients had more than just watery soup in their bowls!

            The dead too were not spared from corruption, or at least their families. The relatives of one of my deceased patient sought me out because they could not retrieve his body from the morgue. The attendant said that I had not released it. For a fee, he could “persuade” me to speed up the process. Sensing something smelly, I escorted them to the morgue to claim the body. Again, I received the now familiar deer-in-the-presence-of-tiger look on the part of the morgue workers.

            Public facilities like hospitals are underfunded. Combined with corruption and you have a major problem. I was stunned to see disposable items being reused with minimal cleansing and sterilizing. The nasogastric tubes used for my patients were stained and friable, having been reused once too many times. I solved that problem by taking a pair of scissors and cutting all the tubes removed from my patients. That way those tubes would never again be reused. The nurses were horrified by my actions! There was no budget for such necessary consumables. My rationale was that those patients were already sick, and with their reduced immune system there was no need to increase their risk to infections.

            Granted, many disposable medical devices today could be reused as they are robustly made. However, one must be assured of the re-sterilizing processes and their quality control. Even with modern sterilizing techniques of American hospitals, I still react with horror when my colleagues use a gastroscope for a colonoscopy! There have been many reported cases of diseases being spread through contaminated instruments.

            With the top honcho of the hospital busy chasing skirts and sexually harassing his subordinates, the management of the hospital suffered. If you do not have talented managers and executives to begin with, or if they are plain incompetent, mediocrity would be the consequence, if not disaster. Corruption was only one manifestation. The other was deteriorating facilities from lack of maintenance.

            One day I looked up at the air vent in my office and saw the edges were black. The vents had not been cleaned for ages. I wiped the vents and was stunned at the grit. I asked the janitor to show me the filters. He did not know what I was talking about. With my pestering, he finally called the engineer from the JKR (Public Works Department). The hospital did not even have its own dedicated engineers.

            After many attempts he finally pried open the air-conditioner panel. Phew! What a mess! Even he coughed when he removed the filters. One of the nurses commented that no wonder she had to go out every so often to catch her breath while working inside!

            Those soot-filled filters and gritty vents were emblematic of the maintenance culture, or lack of one, in Malaysia. Next to GHKL was the huge Maternity Hospital. During my entire time at GHKL, that maternity hospital’s operating suites were shuttered because the ventilation system was contaminated. Its patients had to be transported by ambulance to GHKL for surgery. Imagine a patient needing immediate C-section. Yet there was no sense of urgency to fix the problem.

            Now whenever I am in a public building in Malaysia I always look up at its air vents. If they are black, I do my waiting outside.

            During my tenure at GHKL I did not feel at all that I was on a crusade to clean up its mess. I was merely trying to correct the glaring deficiencies that were adversely affecting my patients. However, one morning the jaga kreta“boy” (parking lot attendant) who had been washing my car, greeted me with a look of concern. My immediate reaction was that I had been chintzy with my tips.

“Tuan Doktor . . .” he stammered and then paused, not knowing how to proceed. He hummed and hawed, in rhythm with the shaking of his head. “I hear lots of good things about you from the nurses and young doctors,” his raised eyebrows and wavering voice betraying his compliments.

“I mean, uh, I’ll watch no one would slash your tires,” he mumbled on!

I got his message! Somehow I was not at all concerned, perhaps the naivety of an innocent newcomer. I did not at all feel threatened. After all I was not trying to disturb the hornet’s nest, only clearing the cobwebs that came in the way of my patients.

Next:  Excerpt #31: Exploring A Surgical Residency Program

From the author’s second memoir, The Son Has Not Returned. A Surgeon In His Native Malaysia, 2018.