Excerpt 21: Only Too Brief An Academic Association

Excerpt # 21:  Only Too Brief An Academic Association

M. Bakri Musa (www.bakrimusa.com)

It was not with much enthusiasm that I took my hospital’s Deputy Director’s suggestion to meet with the Dean of UKM’s medical school. My lack of enthusiasm was not without foundation. Years earlier while in Canada I had written to the then UKM’s Dean of Medicine, thinking that being a new medical school my prospects would be better there. No reply. I had also written to the University of Malaya. Similar results.

            The UKM Dean’s office was at the Malaysian Medical Association building across the street from GHKL. I entered a darkened office, the lights dimmed, and curtains fully drawn. Behind a huge desk that was remarkable for its bareness sat a stocky Malay man with dark glasses.

            “I am allergic to the sun!” he said when I could not help but stare at his wearing sunglasses in a darkened room. I suppressed my laughter with some success, managing only a detached smile. Allergic to the sun, in tropical Malaysia?

            He told me that he was called in from retirement to “run this place” because the inaugural dean had some trouble with corruption. I was surprised.

            I introduced myself. He was nonplussed and just continued staring at me. I was expecting some questions about my training and experience, but nothing was forthcoming. Only silence. I was getting uncomfortable.

            Then, “Why are you here?”

            I had interrupted the siesta of a slothful monk, and was taken aback. I thought my deputy director had spoken to him about me. More in desperation, I blurted out that I was looking for an academic job.

            “Was there an ad?”

            “I beg your pardon?” not believing what I had just heard.

            He repeated his question. I replied no.

            “Wait for the ad. Then apply!”

            Only a few months earlier I was told that the country did not need surgeons except in such places as Kuala Lipis. Now I was being told that its new medical school also did not need one.

            That was my briefest interview ever, if I could call it that. I should have been disappointed, but I wasn’t. It is not a disappointment when you expect it. It was more a relief. I concluded during our very brief encounter that I should not and would not trust my future to this nincompoop.

            The man, Dr. Wahab Ariff, was a former public health doctor. The last time he examined a patient was probably when he was an intern. As for academic experience, he had none. His mindset was civil service. His superior had not told him to recruit surgeons, so he did not. He was there only to keep the seat warm.

            My surprise was that the authorities had given him the awesome responsibilities of setting up a new medical school. I wondered who was the greater fool, he or the one who appointed him?

            That distracting minor detour aside, my routine at the hospital remained unchanged. Take care of patients, teach medical students assigned to my unit from both UKM and UM, and guide the interns as well as medical officers. As for the third leg of the three-legged stool of modern medicine that I was trying to create at GHKL – research – I had introduced the rudiments of clinical inquiry to my trainees by assigning them each some small clinical projects. There was no shortage of clinical materials at GHKL, including the rare birds.

            Once I did a stomach biopsy and the results came back as “eosinophilic gastritis.” I asked one of my senior trainees about the condition and she replied, “Oh yes, we see quite a few such cases!”

            Good, I replied, and then asked her to expound on it. She could not. I told her to look up the literature and report back. To her surprise there was not much written about it either. I assigned her to follow that and similar cases and document in full the clinical history and presentations, as well as perform further necessary diagnostic tests.

            That case served many useful lessons for my trainees. Seemingly common cases may not be so, nor have been adequately studied and documented. We must remain inquisitive and not be so ready to accept pat answers or the conventional wisdom.

            Every one of my trainees had a little project or two. By the end of the year, three of them had published scientific papers. Freda Meah wrote on traumatic small bowel injuries in blunt trauma; Yusha’ Wahab on a sub-variety of injuries associated with wearing seat belts, and another series with ventral hernias. Those were case reports rather than true clinical research. Nonetheless they provided a good exercise in reviewing the literature as well as scientific writing.

Zulkifli Laidin’s clinical research was on the effect of prophylactic (preventive) preoperative topical antibiotic infiltration on surgical wound infections in acute appendicitis. As our unit was a busy one, it did not take us long to acquire a respectable publishable series. Zul showed that the technique did indeed reduce wound infections. This was at the time when the use of prophylactic antibiotics was frowned upon. Today it is standard practice; not to use one would be considered substandard if not negligent.

I too had started on my own research project, on the immunology of parasitic infections, in particular amebiasis. In the short few months I was GHKL, I saw more than a few cases and was intrigued by their myriad manifestations, from self-limiting diarrhea to severe enterocolitis and from self-healing “tumors” (ameboma) to fulminating liver abscesses. I was also certain that none of the major research centers in the West were engaged in this study. So I had this wide new field open to myself.

            The beaming smiles of my trainees when they saw their names in print for the first time made all their hard work worthwhile. I had the same elation with mine and assured them that the joy did not diminish with subsequent papers. Each was an accomplishment in its own unique way.

Next:  Excerpt 22: More UKM Matters – Misplaced Expensive Priorities

Excerpted from the author’s second memoir:  The Son has Not Returned. A Surgeon In His Native Malaysia, 2018