Excerpt #62: Planning Our Future

Excerpt #62:  Planning Our Future

M. Bakri Musa

I related to Karen what had happened with my meeting with the State Medical Director, and apprised her on the implications of my “non-promotion” on our home budget. Despite our reduced house rent in JB, no car payments (we were using my brother-in-law Nik’s car), and overall frugal lifestyle, we were still slowly but surely depleting our savings. Come January our daughter Mindy would be in preschool, a major looming expense. We had been counting on my promised promotion to at least halt if not reverse our financial flow.

            Karen however was less concerned with our bank balance, more with my mental health. She had noticed that all I did recently on coming home was complain about the country’s politics, the obstinacy of the bureaucracy, and now concerns about my personal safety should I run afoul of the royal family and other assorted big shots. The horror of my colleague’s 24-hour banishment only a few months earlier remained fresh in our minds. Not too long before that the Chief Minister, one Othman Saad, had made an unannounced visit to the hospital with a pair of scissors in hand looking for young male doctors with long hair!

            The Chief Minister was aping Singapore’s Lee Kuan Yew, a leader known to be intolerant of the “hippie” hairdo and had been known to station barbers at immigration check points to his island, ready to clip long unruly locks. I wished Othman Saad would have emulated instead Lee’s brilliance, efficiency, and intolerance of corruption.

            At least when I was in KL, Karen reminded me, I would talk of the interesting cases I had done, the papers I was submitting for publication, and the compliments I had showered on my trainees for their excellent performances. We were also looking forward to building our dream house in PJ. Now all I did was bitch about everything. She was worried that was eating into me. The only respite from my constant carping was when we were at the club house. Somehow seeing the kids in the pool, and my doing laps were therapeutic and relaxing. We were now spending more time at the clubhouse than at home. Not a healthy sign.

            My old friend and former high school classmate in KL, Ramli, was right; he knew more about the “General Orders” than all those bureaucrats. He had warned me earlier not to expect any promotion until I had served at least five years. Seeing that his words now rang true, it was time to do some serious thinking about our future.

            My dream was still an academic career. However, more than six months after I had submitted my application to the University of Malaya, I still had not received even an acknowledgment. A job there would be perfect. I could continue with my teaching and resume my clinical research. I could even indulge in basic research with the excellent laboratory facilities they have there. With our dream home right across the street from the campus, I could even walk to work. I could yet achieve my dream of being a Professor of Surgery before forty.

            I made some discrete enquiries about my application and was surprised to learn that there was no vacancy after all. That senior academic who was contemplating going into private practice had changed his mind.

            Well, at least I received an explanation for the non-acknowledgment of my earlier application.

            The only option left was private practice. In less than a year I would have put in my mandatory three-year government service and could then secure my private practice license. That was a more endurable wait than the five to be promoted to “superscale” in government service.

            Private practice, in particular private surgical practice, was then viable only in Penang and KL. I had no desire to go to Penang as I had no connections there, family or otherwise. As for KL, it was still a “closed shop.” Opportunities in JB or elsewhere were nonexistent unless I would be satisfied with office practice doing minor surgery under local anesthesia, as with circumcisions. Every Muslim boy has to have that done, a huge and lucrative but not professionally challenging market.

            Soon after my arrival in JB, a colleague who had just retired but was called back into service approached me. He and a few other local colleagues were planning to build a private hospital in JB. Would I be interested?

            He could not give me much details as it was still in the delicate and sensitive negotiating and planning phases. He did intimate that the group was headed by another recently retired physician, a distinguished clinician and well connected, having served as a personal physician to the sultan and had received multiple royal titles. That should ease the application through the bureaucratic swamp.

            I was impressed with the clinical side. However, setting up a hospital was more a business decision. I would be more impressed with an MBA than an MD. Those clinicians, distinguished though they may be in their specialties, were all former civil servants. They had spent their entire adult careers in the civil service receiving regular checks. Giving out paychecks was a completely different and far more challenging proposition. I was not confident that they could make the transition. I also could not get much information on the crucial financial and management aspects.

            I had also been approached earlier by another group from KL who was also planning a private hospital in JB. I did not know whether they were part of the same endeavor, and I could not very well reveal one group to the other. If they were to be separate, that would complicate matters; two competing entries into a new untested market.

            I was attracted more to this second group. It included two of my former colleagues at GHKL, one a surgeon who happened to be my senior at Malay College but qualified as a surgeon after I did, Dr. Ismail Nur. He had joined me in KL through UKM shortly before I left. He had completed a fellowship in Japan on the new and innovative technique of removing retained gallstones endoscopically, that is, without resorting to open surgery (ERCP-Endoscopic Retrograde Cholangio-Pancreatography). He showed me slides of the cases he had done. I was impressed. He presented his series at the College of Surgeons meeting that year, the first in the country to have successfully performed ERCP, therapeutic and otherwise.

            The other was a pediatrician, Dr. Malik. I had the highest regards for him both as a clinician (he was a gold medalist at his medical school abroad) as well as a person. He was with UKM, and once told me not to bother with the university. He was just biding his time before entering private practice.

            I was attracted to this second group for another reason. Both Drs. Malik and Ismail were young; they had not yet been acculturated into the destructive civil service mentality. Beings Malays I thought they would have a better chance because the government was encouraging us to enter the private sector. They would also be more dynamic and entrepreneurial.

Next:  Excerpt # 63: Contemplating Private Practice In JB

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