Excerpt # 41: An Easy Transition

Excerpt #41:  An Easy Transition

I had a warm welcome from everyone at GHJB[1], in particular my senior colleague and fellow surgeon, Mr. A R Bhattal. He had a more practical reason for welcoming me; he was tired of covering two busy surgical units!

            He assured me that I should have no problem transiting to the local scene. “Unlike KL, we don’t have big egos here!”

            He added that I was lucky to have an excellent team of interns and medical officers. He mentioned Yahya Awang and Suraya Hussein, medical officer and intern respectively. I knew Yahya’s older brother, Hussein Awang, a urologist at GHKL. He had wanted me to join his kidney transplant team after he had heard about my research experience in Canada. I was tempted to, but considering that I already had so much on my plate, declined it. I could not justify joining his team when we had so many patients with incarcerated hernias, bowel obstructions, and ruptured appendicitis to take care.

            Suraya was Prime Minister Hussein Onn’s daughter. You would not know that from her demeanor on the wards. One morning during our usual robust rounds early during my tenure there, I came down hard on her over what I thought were her shoddy clinical notes. She tried to correct me a couple of times as I read them to the group, but I ignored her. Likewise her fellow interns who tried to rescue her.

At the end after my very pontificating–and condescending–“I don’t want ever again to see that caliber of clinical notes . . .” comment, she responded in a cool, calm voice and a winning smile, “I wanted to tell you that I forgot to remove my page of scribbles. My actual notes are behind that.”

I read her finished notes, taking my time.

“Yes, this is what I want on all my patients!” I did not know whether I succeeded in hiding my utter stupidity and embarrassment. It was a good thing that the ward floor did not have a hole, or I would have crawled into it and stayed there!

            Earlier, Bhattal must have sensed my lack of reaction to his introduction, for he added, “They are nice kids, really, unlike children of other big shots!”

            He alluded to my teaching program in KL and expressed his hope that I would continue with it. He would give me his full cooperation. GHJB used to have a national reputation for its post-graduate medical training program under Dr. Lim Kee Jin, an internist. With his retirement a few years earlier, that program fell apart. Bhattal hoped that I would resurrect it, this time focusing on surgery. I took that to be a compliment; I was comforted by his confidence in me.

            My transition to GHJB indeed went without a hitch. The hospital director was extra effusive in welcoming me. He complimented me on my publications. “Unprecedented in the history of our hospital for a staff member to have papers published! Not even Datuk Lim had any!” he gushed. He expressed his hope that one day while he was still there to read in the medical journals, “From the Department of Surgery, General Hospital Johor Baru.” Well, at least he was different from that medical director at GHKL. Bhattal was right; they did not have big egos at JB.

            My next courtesy visit was to the head of medicine. He had just taken over from the legendary Lim Kee Jin. Lim’s replacement wanted everyone, especially me, to know that he was more than capable of filling in that big shoe, and then some. That visit was pleasant enough but l was fortunate that he did not pick up on my lack of enthusiasm to his frequent name-dropping.

            Bhattal next introduced me to the head of anesthesia, but not before giving me some editorial commentaries. The man was very competent and ran a very tight ship, he told me. If I were not to interfere with his domain, I should be fine. Fair enough; that applies to most individuals.

            I had an instant rapport with this anesthesiologist, Dr. Poopathy. He apologized that he had just retired and was holding the fort until the new chief arrived. Whatever rules he had in place could become inoperative with the new head. Perhaps his retirement and now being called back to work but minus all the administrative and other headaches had mellowed him. He could now focus on his clinical work.

            Dr. Poopathy was more than just any anesthesiologist. He was one of the country’s pioneer formally-trained ones. Prior to him, Malaysian anesthesiologists were the products of “quickie” British training, sporting the Diploma of Anesthesia. Dr. Poopathy was a Fellow of the Faculty of Anesthetists of the Royal College of Surgeons (FFARCS).

            Later I met the radiologist, another Dr. Lim. I went to his department to check on a patient’s films. We introduced ourselves and exchanged pleasantries.

            “I’m embarrassed to show you these shitty films,” as he put them up, his earthy language matching his casual attire. His machines were so ancient, he said, that by the time he could demonstrate the pathology I could have figured it out clinically. He was right about the quality of the films, nonetheless he went over them with me.

Then, focusing on me, “Let’s see, you graduated from Canada, trained there, and have practiced there. Now you’re here!” He leaned back in his chair. “What madness brought you here?” he laughed.

            He said that he had submitted numerous proposals to upgrade the department under the various Malaysia Development Plans but to date nothing had been done. Only promises.

            I was glad if not relieved to discover that I was not the only one bitching about the government. That was reassuring.

            Looking back, I was pleased that Bhattal had taken his time to introduce me all around. That was what I missed in KL. I didn’t blame Datuk Menon, the surgery chief, for he was in the ICU when I reported to work there.

            Bhattal went beyond and apprised me of the local social scene. An avid golfer, he told me about the Tasek Utara Golf Club and its many wonderful non-golf activities such as its Friday-night movies, swimming pool, and fantastic dining. Good for the family, he assured me. As a civil servant I was entitled to a vastly discounted membership, subsidized by the government. He encouraged me to join, and I did. He was right about the facilities. The club was my as well as my family’s savior while in JB.

            I had minimal difficulty duplicating what I did in KL. My trainees in JB were just as smart, diligent, and enthusiastic. Unlike in KL, this time I paced myself in part because we did not have as many young trainee doctors as there. I had only one weekly seminar, alternating the combined basic science and clinical surgery. The pathologist declined to participate in my conferences. He was already swamped with his regular responsibilities, was his excuse. I was fortunate that Yahya would be sitting for his FRACS (Australian surgical board), so he and Hew, another trainee contemplating his FRACS, were the major impetus behind my teaching program.

            We had our seminars on the top floor, the site of the now defunct Post Graduate Medical Institute. It still had a functioning staff, the sole medical librarian. She willingly accepted the new responsibility. With her old mailing list, she helped spread the word around about my surgical seminars. At least I now had some clerical help, unlike in KL.

            GHJB may be a large hospital but it did not have a cafeteria. There were many makeshift hawker stalls of doubtful hygienic standards along the adjacent streets. As the seminar would be at lunch time (to accommodate everyone time-wise), we would have to provide lunch, otherwise we would waste precious time with everyone trying to grab their own meals. How to fund that?

At first I wanted to have the drug companies sponsor the meetings, but that meant I would have to scramble every week to find a sponsor. Besides, it did not seem right. In the end, I decided to have everyone chip in RM10 at a time. When the funds got low we would chip in again. Since we always had an influx of new interns throughout the year, we had a constant inflow of fresh money. There were no free loaders. During the year we all had to chip in no more than two or three times.

            Our JB seminars soon developed a local following. The presence of the other specialists as well as the town’s practitioners enhanced the quality and appeal. My expanding the topics beyond the purely surgical gave it wider appeal.

            One of my medical officers presented a topic on surgical immunology, the same one Zul presented in KL a year earlier. At the end of the seminar one of the consultants, Dr. Ravi, an ENT specialist, came up to compliment me. He had just returned from Britain to take his FRCS examination and had enrolled in its basic science course there. He gushed that my presentation was far superior. I corrected him that it was not mine but my medical officer’s.

            “Come on lah, Bakri,” he teased in disbelief and then went ahead to ask me a question on the presentation. I pretended not to be sure of the answer and turned to my medical officer. He gave an impromptu full dissertation on the topic. That convinced my colleague!

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

Next:  Excerpt # 42  Dealing With A Federal Medical Bureaucrat

---

[1] Now the Sultanah Tun Aminah Hospital