Exceprt 7: First Day As A Surgeon in Malaysia

Excerpt 7:  First Day As A Surgeon In Malaysia

Tan Sri Majid had earlier reminded me in very clear terms that as head of the new Third Surgical Unit at GHKL my duties were purely and exclusively clinical. Even though that was a university unit I would have no formal teaching responsibilities. I was under the ministry, not the university; a civil servant, not a professor. My job was to relieve those academics so they would now have, in the DG’s own words, “no more excuses of their clinical load interfering with their academic duties.”

            Like most young doctors trained at university centers I had always aspired to be an academic and had planned my training accordingly, as with taking a year off for formal research, as well as publishing papers. So I was more than happy to be associated with UKM, to be with medical students and young surgical trainees despite not having a formal academic appointment.

            That Monday morning as I drove to the hospital for the first time, the thing that struck me as I was driving over Cheras Hill was the thick grimy smog hovering over the city so early in the morning. I would be spending all day breathing that dirty air! The only saving grace was that it helped block the otherwise penetrating tropical sun.

            GHKL was a huge grey five-story cement building, with a striking exterior of honeycomb cement louvers and wide overhangs to shade against the blistering Malaysian sun and torrential downpours. The complex was H-shaped (for hospital?) with the bridge-bar connecting the two wings being functioning wards. Adjacent and just before you reach the hospital was the contrasting and equally new Maternity Hospital with a completely different and equally striking exterior of a net-appearing cement façade.

            Inside I later discovered that the louvers and the deep fenestrations did their work for the wards were cool with only the fans on, and breezy. The ingenious exterior design also spared the building from the blight of many tropical structures – discolorations from molds.

            I was told that right after independence, Prime Minister Tunku Abdul Rahman had an international competition to build both GHKL and the proposed University of Malaya Medical Center. GHKL’s design by Wells and Joyce, Architects, put a premium on form and function, as well as low maintenance, reflecting the Brutalist architectural movement of the era. I was also told that the corridors were wide so they could be converted into makeshift wards during times of mass casualties, as during the race riots of 1969.

            I went straight to the Department of Surgery to see its head, only to be told that he was in the ICU with an acute asthmatic attack. The earlier sight of the dirty cloud reminded me that the poor soul would have it tough. I did not feel right to bother him. His secretary did not know who was in charge now that he was incapacitated.

            I headed to the wards and on arriving saw the nurses and doctors busy on their rounds. The bareness of the ward, with its about fifty patients, reminded me of the Veterans Hospital in Edmonton where I had done some rotations. A senior nurse in her crisp white cotton uniform and wide flat headgear broke from the group to greet me. She introduced herself as Sister Fong, the title meaning, “Charge Nurse.” After I introduced myself as the Unit’s new head she replied, “Oh, good! Now we have somebody in charge!”

            She introduced me to the group. I told them to ignore me and pretend that it was the previous day. That was easier said than executed. My presence was distracting if not disruptive even though I remained silent in the back. They were forever looking to me for approval or reassurance, a pack of puppies unsure whether to be eager or wary of their new trainer. After a few minutes, I excused myself on the pretext of attending to some administrative details. The relief on both sides was palpable, and welcomed.

            A medical officer, Dr. Zulkiflee Laidin, showed me around. Zul knew his civil service protocol well. Before I knew it, I was in the ICU meeting Datuk Menon. He apologized for not being able to show me around and that yes, the DG had phoned him earlier about me. Seeing that he had difficulty breathing even through his oxygen mask let alone engage in a conversation, I soon excused myself and assured him that I would find my way around with Zul’s help. Poor Menon, he looked like a mudfish caught in a receding tide.

            Next stop was administration. The Director was away and his deputy was in charge. He was surprised to see me but quickly recovered, adding that my unit, being the university’s, was not under his jurisdiction. Amidst the pleasantries, more to hide his embarrassment at not knowing of my arrival, he asked where I was from. After I replied Sri Menanti, Negri Sembilan, he added more as a statement, “You, member of royal family?”

            He must have thought that I was a rebel prince (what with my disheveled hair and nondescript casual attire) who had dispensed with his fancy feudal royal part to his name. There was a famous Raja Musa from my neck of the woods in Sri Menanti.

            The morning went by fast, yet I had not achieved anything. Nearing lunch time, I asked Zul where to go. Most of the consultants went home, he told me. I was not about to make the long trek back to Cheras in my father’s un-air-conditioned Ford Escort. Instead I tagged along with him to the hospital cafeteria to join the junior house and medical officers.

            It was obvious that my presence was a damper on their gathering. I tried to start a conversation, but to every query came monosyllable answers.

            Then an old classmate from my Kuala Pilah and Kuala Kangsar days, Ramli Ujang, came over to join us. Even though we were classmates and thus graduated from medical school at about the same time, Ramli’s career took a detour for a few years in the army. Ramli was thus still a medical officer, in dermatology.

            His familiarity and informality with me broke the ice. Soon we were in animated discussions on Canadian medical education and specialty training, as well as life in Canada generally.

            Lunch time was (still is) a long affair in Malaysian officialdom, from 12 to 2 PM. Many went home for lunch or had it at the hospital cafeteria and then sneaked in a short siesta. Towards the end of our discussion the cafeteria was empty but for us.

            Ramli and I retreated to my new office, two old friends making up for lost time.

Next:  Excerpt #8:  A Much Needed Reorganization

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

Excert #6: Seduced By A Promise Of A Chalet At Lake Gardens

Excerpt #6: Seduced By The Promise Of A Chalet In Lake Gardens

            My stipulation for living quarters threw a nasty grind to the DG’s otherwise smooth gear shift that morning that would have landed me a coveted slot at GHKL. He made a few phone calls to try to be back on smooth track. I could not figure out what he was saying in those ensuing conversations, with such bureaucratic terms like permanent establishment, superscale positions, and gazetted officers being bandied around. Then in the end he wrapped his palms against each other as if he was washing his hands as he continued in his loose conversational style with me.

            “There are a few chalets at Lake Gardens. Nice but small, for diplomats in-between assignments. I’ll get one for you but that won’t be till next week.” The current occupant was scheduled to leave soon to open Malaysia’s new embassy in Beijing.

            We were back on track again. To say that I was elated would be a mild statement. Meanwhile he continued with his small talk, about his son, a medical student who was coming home from Australia that afternoon for the holidays. The intercom buzzed a couple of times but he ignored it. He was now into his younger days as a medical student in Singapore and as a state surgeon in my home state of Negri Sembilan (“You have a great ruler there, well educated!”). His eyes glazed in the distance as he again recalled his visit to America in 1963.

            He was proud to be the first Eisenhower Fellow that made possible the visit. “The first from Malaysia, you know!” Not the first Malay, the first Malaysian, he added with evident pride.

            His reminiscing helped settle my giddiness, what with his unexpected sudden offer of a prestigious appointment at GHKL and coveted quarters at Lake Gardens to go with it. His and my revelries were interrupted when his secretary intruded with a note. He apologized for having to end the conversation and escorted me out. As I exited I noticed a distinguished-looking gentleman waiting on the sofa where I had sat earlier.

            He was the Egyptian ambassador. My appointment had been squeezed in.

            I was bubbly on the drive home to Seremban. After I related what had transpired to my mother, she hugged me, “You have to sell yourself. You don’t have to boast to do it!”

            Late that afternoon Sharif phoned. As I was relating what had happened, he cut in. “Take the offer, now!” He went on to advise me that the most important thing was to secure a slot in KL so I would always be on the radar screen of the powers that be. If I were to be sent to the ulu (interior), I could forget my future.

            That brotherly advice notwithstanding, I continued with my jual mahalstrategy. The prospect of living in the beautiful Lake Gardens area had seduced me. The following week I phoned the DG’s secretary. There was a snag. The diplomat who was supposed to be deployed had decided to stay put. I phoned again a few days later. Again, no progress on the lodging front. At that point I decided, as per Sharif’s earlier advice, to take the GHKL appointment without the housing.

            Sharif offered us to stay with him and his family at Cheras, and we did. In reality there was no other choice. By this time my sister-in-law Zainab Mat Akhir, an Australian-trained accountant and a former Colombo Plan scholar, had bonded with Karen. As Karen and I were still living from our suitcases, that move to Cheras was easy. My father also let me have his old Ford Escort. He and my mom could use the bus, he assured us, just like in the not-so-long ago days.

            I was grateful for my brother Sharif and Kak Nab (Zainab) for letting us bunk with them. Nonetheless I still had to swallow quite a bit of self-pride. Only a few months earlier we were in our own nice suburban Canadian home, our babies having their own bedrooms, and we were busy looking for a lakeside summer cottage. All that had now changed. We thought of the monumental changes in our lives during the past few weeks, and the future that would promise.

            The surgeon side of me was excited and looked forward to being back in the operating room, and in a major hospital at that, where I belong. I have always enjoyed operating, and I had been away from operative surgery now for months, and was feeling the withdrawal. I could hardly wait to be operating again!

Next:  Excerpt #7: First Day As A Surgeon In Malaysia

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

Excerpt #5: Meeting The Big Chief

Excerpt #5:  Meeting The Big Chief

            By the time we returned late Sunday from our weekend diversion at Port Dickson, my thoughts were clear and focused. I was determined to take Sharif’s advice, meaning, spend some time in KL to meet the key decision makers. The next morning I was off to KL again, this time wearing my yellow suit, what Karen called my Canadian Pacific Airline outfit, that being the color of its cabin crew uniform. When the Jamaican salesman at Henry Singer Clothiers said that only I could wear that color, as a white man would look washed out while a black would be mistaken for a gigolo or a pimp, I bought both, his sales pitch as well as the suit. He was an awesome salesman! Had he known that yellow was also the Malay royal color, he would have thrown that in too!

            I rehearsed my expected ‘impromptu’ conversation with that doctor at the ministry, anticipating his every negative response. I also practiced my crisp Canadian accent.

            I had hardly finished asking the receptionist that I wanted to see her superior when she replied, “Yes, Sir!” and disappeared to return quickly with him.

            She addressed me as “Sir!” I was expecting her to chide me for speaking in English.

            Likewise the officer; I was expecting all sorts of excuses as with the previous week. Instead, after a few phone calls he secured for me an appointment with the Director-General right away. Sharif was right; be assertive.

            When I arrived at the top floor office of the DG, the secretary directed me to a comfortable sofa in the well-appointed suite. She brought in tea in exquisite china, together with some delicate British crackers. Wow!

            Only the week before I had felt rejected, not worthy of any attention from even the lowest civil servant. Now I was treated like the returning prodigal son, but unlike in the biblical version, I did not at all feel unworthy of the attention lavished upon me.

            Soon a visitor exited the office followed by the Director-General extending a final handshake. I had not met Tan Sri Majid Ismail before but recognized him from his many pictures in the papers. Years earlier when I was in high school he had made headlines for being the rare Malay Queen Scholar. He was also the first in the country to qualify as an orthopedic surgeon.

            He came forward to shake my hand in a firm grip, very unlike the soft palm-sliding Malaysian manner, while his other grasped my left elbow in a warm familiar way. He apologized for making me wait. Imagine!

            “So, you are the surgeon from Canada!”

            I corrected him saying that I was a local boy. From there on our conversation was warm, smooth, and cordial. He recalled with visible fondness his earlier visit to America as an Eisenhower Fellow back in 1963, and how much he admired the American (and also Canadian) system of specialist training. Soon our conversation turned clinical.

            “How many gastrectomies have you done?” Satisfied with my answer he went on. “How about AP resections?”

            He also asked about my research experience. In passing I told him that I once read his paper on the spontaneous rupture of the patella tendon from topical steroid injections, one of the first few reported cases. He smiled.

            Then, . . . “I have theposition for you,” as he leaned back, “. . . at GHKL!”

            I perked up. I wanted to hear it right! He went on to say that the recently-appointed Professor of Surgery of the newly-established medical faculty of the Universiti Kebangsaan Malaysia (UKM-National University), one Hussein Salleh, had absconded to Australia. The university’s surgical clinical unit at GHKL was now stranded, and the university was desperate.

            “I worked very hard to get him the professorship,” Majid looked exasperated as he related his experience with this Hussein Salleh. “As soon as he got it, he ponteng! Phew!” as he waved his hand in the air.

            This Hussein Salleh had used his newly-acquired professorship to pave his emigration to Australia. I could see Majid still scaling his tongue against his upper teeth to get rid of the residual bad taste.

            “Could you handle the assignment?” He stared straight back to me with his piercing eyes made even more exaggerated through his thick black-horn glasses. After I assured him that I could, his next question was when could I start.

            “Anytime!” I responded. Sensing that I now had the upper hand, I decided to be more hesitant, to as we say in the village,jual mahal sikit(lit: hard sell; fig: play hard-to-get). “As soon as I have a place to stay!” not as an afterthought but a deliberate contingent requirement.

            He paused, rubbing his chin. “Hmm, that could be a problem.”

Next:  Excerpt #6: Seduced By The Promise Of A Chalet In Lake Gardens

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

A Nation Deceived

Excerpt #4:  A Nation Deceived

It had been a hectic and far-from-pleasant week despite attempts by my parents to make us, especially Karen, comfortable. Tun Razak’s death had cast a gloom on the entire nation. My being posted to Kuala Lipis only made the mood worse despite my earlier spin at viewing that as an exotic sojourn.

            My father was conflicted on whether I was still his teenage son whom he could order around or a young surgeon deserving of some awe and respect. He occasionally addressed me as “Tuan Doctor!” but seeing that I did not respond, reverted back to the familiar “‘Bai!” My mother stuck to ’Bai. To her I was still her young boy to whom she had waved a long, tearful goodbye some thirteen years earlier, and now desperate to make up for all those precious lost times. She was noticeably restrained however, in ordering me around in Karen’s presence. I in turn was very effective in using that as a convenient shield.

            This Kuala Lipis posting was not what we had expected. That Friday, as we had promised before we left Canada, Karen phoned her parents. She broke down during the call and had to hand the phone to me as she could not continue. Her earlier excitement of a new adventure had now given way to a terrible homesickness. I did my best on the phone to reassure my in-laws. It helped that the call was expensive and thus had to be brief. Ruth maintained her composure. Her parting words was a pleading “take good care of my baby and grandchildren.”

            Karen and I were not the only ones down in the dumps that week. The day before, the Tun’s body arrived at Subang Airport from London. The place was packed and the grief palpable. His funeral was, as expected of a much-loved leader, somber. The mood was amplified by the live coverage. Everyone who could not go to the airport were glued to the television sets, at home, in the restaurants, and community centers. The whole nation was in despair. It was the suddenness and unexpectedness that shocked the nation. Malaysians had not at all been prepared for the tragic news.

            I felt detached through it all. That surprised me for I had admired the man. He had after all inspired me to return! Engulfed in my own turmoil, the Tun’s death was more disappointment than sadness. That soon turned to anger as details of his malady became known.

            He had been sick for years, stricken with leukemia. He had kept that secret, from his family as well as the nation, right till the very end. Even when he took the final trip to London for his desperate and ultimately futile treatment, there was an elaborate ruse to disguise and hide it from the public. This despite his obvious emaciation. Hard to believe that his fellow cabinet ministers, top civil servants, and others close to him did not notice this dramatic physical deterioration in the man. You did not have to be a doctor to know that there was something wrong–and mortally so–with him. Yet he was able to deceive everyone right to the day he left Malaysia by sneaking through Singapore on the pretense of a routine visit.

            

            As details of that and other deliberate deceptions later emerged, I became angry. He had not taken Malaysians into his confidence. Now his demise had caused so much pain. The Tun’s keeping his fatal illness a secret was not an act of courage or favor but the contrary.

            When you are in the doldrums, indulging in one bad thought would in quick order degenerate into other more sinister ones, with subsequent contemplations even less charitable if not downright ugly. I wished Allah would let the Tun have a final look on earth and see the grief he had inflicted upon his people. He could have lightened that burden had only he had taken them in his confidence. We Muslims are very accepting of death.

            My thoughts flashed back to my childhood days in the old village. I remembered my cousins and others being taken out of the English school we attended, opting instead for the new Malay stream. They had fallen for the sway of the nationalists. My father managed to dissuade some of them. “We should not listen to what our leaders say, instead follow what they do,” he advised them. The Minister of Education at that time was Tun Razak. While he was exhorting the Malay masses to send their children to Malay schools, he was surreptitiously sending his, all of them, to English schools, and in England to boot.

            That was Tun Razak’s first deception. He succeeded very well. No surprise then that others would follow, until the ultimate one that January.

            Years later my cousins whose parents had kept them in the English stream would never cease to express their gratitude to my father. On the other hand, a friend whose parents had taken him out of English school, on Tun Razak’s exhortations, on meeting me later (now a surgeon) would only comment that my father had been wiser than his!

            Tun Razak was the man who inspired me to give up my career in Canada and return home. Now the best my country could offer me was a slot in Kuala Lipis District Hospital, and without an anesthesiologist!

            I was directing my anger on and disappointment to the man. He was now the focus of my conflicting emotions. How on earth did I end up in this predicament?

            The sparkles of the fond memories I had of the late Tun were now dimmed but I still harbored a tiny reservoir of goodwill for the man.

            To escape the turmoil within me, or more correctly, to distract myself, I decided to take the weekend off to go Port Dickson. We pretended that the last week or two had been but a bad dream and that we were back at Honolulu and extending our stay there. Although the amenities at the Rest House in Port Dickson were far from those at the hotel we stayed in Waikiki, nonetheless our brief make-believe diversion was therapeutic.

Next:  Excerpt #5: Meeting The Big Chief

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