Excerpt # 67: Disappoints All Around

Excerpt #67:  Disappointments All Around

M. Bakri Musa (bakrimusa.com)

            When we returned to JB from our brief trip to Seremban, it was with a gnawing and unsatisfying sense of a mission unaccomplished. The purpose of our trip was to tell my friends and family of our decision to leave. I had accomplished only half, with Badri, Ramli, and Nik Zainal, but not with my family.

            Malaysia being a land of holidays, the next one came only a few weeks later, the first-term school break. My family from KL and Seremban would be visiting us. “To go shopping in Singapore!” was their excuse. Their unstated purpose was to persuade me not to leave. Meanwhile I was consumed with planning for the upcoming medical convention.

            We always looked forward to our family gatherings and kenduris. It was a time for the cousins to be together. The joys and rambunctiousness of the young were infectious. It would also be extra special this time as we would be hosting it, and for the first time in our JB house. The only one who would be missing was our father. He stayed back because the last time they left their Seremban house empty, it was burglarized. He did not want to risk that again.

            We had our part-time maid who was from the adjacent village help us with the cooking. She was happy to meet my extended family. Up till then she could not quite place me. Now that she saw my relatives she could; I was just another Malay with a large extended family, just like hers. It comforted her that I still had my village mores and courtesies. She could now relate better with me and us. That she was about the same age of my mother helped. I too helped in the kitchen, and that surprised her. I guessed because she was only in the house for a limited time during the day, she had never seen me in the kitchen, which of course was the expected behavior of Malay or Asian men generally. That was the first time she saw our house look like a typical Malay one, with kids running around, people in sarongs laying around on the sofa and the floor, and the sound of chili pounding and smell of balacan in the kitchen.

            At night, even though we had three spare empty bedrooms, everyone slept kampong-style sprawling on the carpet in the living room downstairs. Good thing that the trees I had planted months ago were now tall and bushy enough to afford some privacy!

            With everyone caught in the party mood they forgot or chose to ignore the primary purpose of their visit – to persuade me to change my mind about leaving Malaysia.

            Then it started. I did not know how. Perhaps my sister Hamidah triggered the discussion when she commented that if I were to leave, they would not be able to visit JB and have this kind of kenduri in my house again. She had been praying that if I did leave it would be to our planned dream house in PJ. My mother added that her prayer too was that the next kenduri would be in PJ at my new house. They had all been impressed with the design that I had showed them earlier. They had not realize that a traditional house made of wood could be so beautiful and modern. Then she added that if funding were to be the issue, the family would chip in so we could have our dream home and Karen would be happy!

            That was it! I knew they meant well but I felt like a cripple getting the sympathy of others. I told them that I could and was happy living within my current income. Further I could live anywhere, and Karen and the kids too would be happy as long as I was. We could live in the village; I could even survive the jungle, I told them. During the war, we survived under the most trying circumstances. Canada, and Karen, had not spoiled me or made me soft.

            I told them that Allah had given me this talent and skills. That it was not to be utilized in Malaysia did not detract its value. I then used Ramli’s argument – I did not wish to tolak tuah (refuse God’s bounty), seeing that my talent would that much more appreciated elsewhere

.

            My mother interrupted me. She could not care how successful I was, if it were not in Malaysia, it would not mean much to her. Then she jumped over to hug me, sobbing, “We just don’t want you to leave!”

            With that everyone too started crying, including me, but I tried to control myself. Things became emotionally charged with everyone hugging me and my eyes soon became moist again. I saw Karen in the corner of my eyes sitting up on the stairs with  Mindy and Zack and their cousins. She had no idea what was going on but seeing my tears she knew something very major had happened.

            She later related that she wanted to come down and hug me with my mother but could not because of the crowd on the stairs. The only time she saw me in tears was way back when we were expecting our first baby and the obstetrician told us that it had major abnormalities and he had wanted guidance from us on the further course of action. In the end, Allah spared us that burden as our baby did not take its first breath after delivery.

            I controlled myself by joking, reverting to our old kampung dialect and telling everyone that this was a holiday kenduri, not a funeral. I told them that while everyone at the hospital would call me a doctor and a specialist, I assured my mother and all, that to her I was still an obedient kampung son. As such I would never go against my mother’s wishes. If she did not want me to leave, then I would not. I kept repeating that more than a few times to reassure everyone.

            The calmness and certitude with which I uttered those words calmed everyone, especially my mother. I glanced at Karen. She was quiet; she did not understand nor follow what I had said. Even if she could speak Malay, she still would not have understood me because I spoke in the distinctive archaic village dialect.

            Later in the privacy of our bedroom she asked what I had said to calm the family. I repeated what I had said. “Did you mean it?” she asked.

            “Yes!” I affirmed.

            “Then the kids and I will be with you!” If there was any trace of disappointment in her voice, I did not detect it.

Next Excerpt 68:  A Royal Banquet

Excerpt From The Autor’s Memoir, The Son Has Not Returned, 2018.

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Excerpt # 66: Recalling Fond Memories

Excerpt # 66:  Recalling Fond Memories

M. Bakri Musa (www.bakri musa.com)

            There is never a good time or way to drop bad news on a dear friend. That was how I felt when I visited my friend Badri Muhammad. As soon as I was settled on his living room sofa of his home on the UPM campus in Serdang, I told him of my decision. He snapped up straight, slapped his thigh and cried, “No way!” Then shaking his head and with both palms supporting his forehead, added, “Why?” more as a rhetorical question. He knew the answer; we had been comparing notes and commiserating whenever we got together.

            His Karen was calm. “I’m sorry it didn’t work out for you, Bakri!”

            As I went through by now my all-too-familiar laundry list of frustrations, he interjected. Had I received that university appointment, it would be no better, he said. The only thing that kept him going was his students, especially his graduate students. He could not leave them. His mentioning of his students brought forth fond emotions with my own interns and medical officers. Then there was the heartfelt gratitude from that surgical technician in Batu Pahat.

            I also had many fond memories of my grateful patients and their families. One that still remains vivid was the boy whom Mahmud and I did the first Duhamel operation in Malaysia. When I first saw him, he was emaciated and with a distended belly. His parents related how he had been constipated since birth. They knew something was very wrong with their son. Yet they were seen by no fewer than half a dozen doctors and were told that there was nothing wrong.

            I saw a similar patient at the Montreal Children’s Hospital. He had Hirschsprung disease, where a segment of the large bowel is devoid of its nerves and thus paralyzed or functionally blocked. I remember when I did a rectal examination, there was an explosive release of the blockage, with stool and gas shooting across the room. I wanted to replicate that demonstration for my trainees and medical students, with the parents’ permission, of course.

            The parents were so relieved when I told them that there was indeed something wrong with their son and that we would be able to do something about it.

            For the demonstration, I gathered my team of house staff and medical students around and then asked who among them believed that there was nothing wrong with the boy. Everyone agreed that there was something very wrong. Yet I reminded them that six doctors had examined the patient earlier elsewhere, and all had said that he was fine.

            I told my young doctors and medical students that the most important skill a physician could have, and the most difficult to develop, is to be able to tell what is normal and what is not, when someone is sick and when he is not. You may not have the right diagnosis but knowing that something is not right would be a major first step. It would also be wiser to admit that you don’t know or have not yet found the right diagnosis than to say that nothing is wrong with the patient, unless you know for sure that is the case.

            For that dramatic clinical demonstration, I picked the smallest intern, a lady. I thought she would have the smallest finger to do the rectal examination on the boy. Sure enough, as soon as she pulled out her digit, there was an explosive expulsion of gas and stool, much to her embarrassment! I had earlier apprised the parents, so they were not embarrassed but instead joined in the laughter even though it was at their son’s expense. It was a rare and precious teaching moment.

            Like me that many years ago in Montreal, those present on that day would never again forget that dramatic manifestation of Hirchsprung disease.

            That boy did well after surgery, rather two surgeries. Because of his poor nutritional status, I had to do the procedure in two stages. It was gratifying to see a limp bloated boy develop into an active boisterous youngster. His parents were so grateful that every time they came for his follow-up visits, they would bring me the choicest durian from their village.

            The first time they brought the fruit I shared it with my staff as there was no point bringing it home. To Karen, the smell of durian reminded her of an outhouse of a not well-maintained summer campground. Seeing that I did not bring the fruit home but instead shared it with my trainees, on the next occasion, they brought two, with specific request that one was for my wife and kids. Alas, they did not know that my wife had yet to acquire the taste. To her, unlike to the natives, durian was anything but the king of fruits or the fruit for kings, or queens!

            Another memorable patient had a prolapsed tumor out of his rectum. I asked my medical officer to reduce it (put it back in) so we could plan an elective operation and spare him the necessity of a temporary colostomy (artificial opening on the abdominal wall for the stool to come out), not an appealing prospect. Tried as she did, she was unsuccessful. No surprise there; she being a female and inevitable question of modesty on my patient’s part prevented him from relaxing his sphincter.

            I took over. I tried all positions but still was unsuccessful. He was not relaxed enough. In a last-ditch effort, I asked him to prostrate himself as with praying and to take deep breaths as well as recite any prayer to calm himself. He did, reciting some verses of the Koran, and I could feel his abdomen and sphincter become relaxed. After a few attempts I was successful, much to his and my relief. We later went on to do a one-stage surgery without the need for a colostomy. He was grateful. As for the credit, I do not know whether that should go to the power of the Koranic verse, his self-control at relaxing his sphincter, or my digital dexterity!

            On his discharge, he gave me a three-volume translation of the Koran. “For your wife, doctor!” We still have it!

            When Badri related to me how he felt about his students, I understood him. I felt the same about my patients and trainees. I too felt that I was abandoning them, not a pleasant feeling or thought.

            When we left, Badri again expressed his disappointment. He wished things would have worked out differently for me. A true friend, he nonetheless wished me well. For my part I asked him to visit my parents often with his children as those visits meant a lot to my parents. Adam and Su reminded my parents of our Mindy and Zack. They were of comparable ages.

Next: Excerpt #67:  My Family’s Attempt To Dissuade Us

Excerpt From The Autor’s Memoir, The Son Has Not Returned, 2008.

Excerpt #65: Our Wrenching Decison That Wound Disappoint My Parentns

Excerpt #65:  Our Wrenching Decision That Would Disappoint My Parents

M. Bakri Musa (www.bakrimusa.com)

            At our first dinner in Seremban my parents brought up the topic of our dream home. A year earlier when we told our architect that we were moving to JB, he told us that would pose no problem as he was from JB and went home often. He could bring us up to date on the progress of our project on his frequent visits home. We had also shown – and often – those blueprint drawings to my parents.

            That unanticipated enquiry about our dream home sidetracked my carefully-laid strategy and talking points. Almost as a reflex I answered that it was on hold, which it was. Their immediate response was why. They warned us to build it as soon as possible as the longer we wait, the more the prices for supplies and labor would go up. They recalled their experience with building their house many years earlier.

            Nonetheless their bringing up the topic of costs provided me an opening to bring up my “non-promotion.” With my current salary, the dream house was a “no go,” I told them.

            My parents knew me well. My non-promotion could not be due to my non-performance. There must be other reasons. Their immediate suspicion - and worry - was whether I had problems with my superiors, or heaven forbid, with members of the royal household. Having assured them otherwise on both fronts, I told them of the five-year rule of the civil service. It was at this time that they realized that I was earning much less than my brother Adzman and brother-in-law Fadil, both civil servants on the administrative side and both very much younger than me but much higher in the pay scale of the civil service.

            They realized the unfairness of the situation. When Sharif, Adzman, and Fadil later came home, the discussions naturally focused on my civil service status, meaning, my low pay. Sharif knew nothing of the intricacies of the civil service but both Adzman and Fadil confirmed what I had related about the unyielding five-year rule.

            When my parents heard that, they grasped the implication right away. I would be leaving, at least the government service if not the country. Their immediate reaction was to plead with us not to. Later when Karen and Zainab were away from the house, we again discussed my future. My parents wanted to know whether Karen was unhappy with living in Malaysia. I had to assure them over and over that Karen was adapting well and that I was the one frustrated and unhappy with the way my career had unfolded.

            I sensed that they were not yet ready to receive my decision. More to the point, I was also not ready for the anticipated emotional battle that would surely ensue were I to tell them then of our decision to leave Malaysia. Not wishing to disappoint them, I again put the matter aside. What a relief it was to do so!

            We were now back to celebrating the family get-together. Before we left for JB, my mother again appealed to me to explore other opportunities in the country. Regardless how the government treated me, Malaysia still needed my services, was her counsel. My father was less sanguine. He understood my dilemma. He remembered only too well early in his career of what it felt like to be yanked around by officialdom and not being appreciated. He had no choice but to grit his teeth and bear it.

            During that break, we made a side trip to GHKL to meet up with some old friends. We also wanted to visit the Badris at UPM to apprise them of our plans. I did not want them to hear the news through the grapevine. At GHKL I met with Dr. Nik Zainal. An interventional cardiologist, the first in the country, Nik and I were classmates back at Malay College. When I told him that I would be leaving, he had to support his head with both hands as he looked down, dejected and disappointed.

            “Oh, no! Not you!” as he shook his head many times while looking down.

            I was about to enumerate my long list of frustrations when he raised his right palm to stop me. He knew them all too well; he too had to put up with them. Somehow, he told me, since my return he felt emboldened that together we could break down this massive brick wall that was the Malaysian officialdom. He felt that he could count on my support. Now with my leaving, he did not wish to bang his head against the wall anymore. It would be futile, and painful. My departure would suck the energy out of him, he kept telling me over and over. To say that he was disappointed would be a severe understatement. We could do so much together, he pleaded. He was the sniper who was now deep in enemy territory and smelling victory, when his fellow commando gave up. Now alone and sensing his own vulnerability, he wondered if his mission was worth it.

            When we were still in medical school (he in Australia) we both heard of Malaysia’s plan of establishing a cardiac center. We were excited; he would be the cardiologist and I, the surgeon. We would work well together and make a great team.

            I wrote to the Malaysian authorities indicating that I was confident of being selected into the cardiac surgery residency of my medical school. That program was highly regarded. My confidence was not unfounded. My grades aside, the program was headed by Dr. John C Callaghan, a man of many firsts in heart surgery. He did the first successful open heart surgery in Canada back in 1956 at our university hospital, and designed the first pacemaker when he was at Toronto. Callaghan was also unique in that he saw his mission beyond his country. He wanted to help the world. As a result, his residency program actively sought foreign doctors to train. The absence of Canadian trainees in his program was noticeable and thus became the subject of many complaints from young local doctors. Callaghan was not at all perturbed. Those less charitable to him would suggest that his gesture was less a magnanimous one, more to feed his ego. Callaghan was always abroad being feted by the likes of the President of Ecuador and the Shah of Iran.

            When I heard of Malaysia’s plan for the heart center, I wrote to the Ministry of Health apprising them of where I could possibly fit in. Of course I did not receive any reply! I wrote to my brother-in-law Ariffin to follow it up. Yes, the authorities did receive my letter, and no, it was not for me to decide whom the government would send for further training. Wow! I did not realize then that there was a glut of young Malay doctors whom they could choose from! Nonetheless Ariffin suggested that I come back as soon as possible after my graduation so I could be chosen as the candidate.

            That episode should have been my first lesson (and intimations of future hassles) in dealing with Malaysian bureaucracy! As for my being a cardiac surgeon, after a stint in General Surgery, I was smitten by its bug and decided to stay as such.

            As for Nik Zainal, a few months after I left Malaysia, he too resigned from government service to start his private practice. Years later when I met him, he thanked me for leaving. Otherwise, he said, he would still be in government service banging his head against the immovable wall. Now with his thriving private practice, he was tolerant of the bureaucracy. Money is still the best lubricant, as well as salve.

            Ramli’s reaction could not be more different. “Get out of here while you still can!” he told me. He was surprised that I had even returned. He stuck it out because had no choice. He was biding his time. Once in private practice he could indulge in his other passion, politics. He had already sent out feelers to the UMNO folks in our home state.

            “Why did you come home?” he asked. “You had great opportunities there!”

            Why tolak tuah (refuse the bounty of Allah?) and put up with the frustrations at home, he wanted to know. Ramli gave me a much-needed different perspective. That boosted my confidence in our decision.  Ramli’s remarks reminded me of my not very pleasant encounter with that doctor-bureaucrat when I visited the Ministry of Health for the first time when I just returned from Canada. To him, only flunkies and those bonded by the government would return from abroad.  

Next:  Excerpt # 66:  Recalling Fond Memories

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

A Hectic Christmas And New Year

Excerpt # 64:  A Hectic Christmas And New Year     

M. Bakri Musa (www.bakrimusa.com)

I had an extended holiday from Christmas to New Year. I could not get a break for Hari Raya Haji but had no difficulty securing a long one for Christmas, and in Muslim Malaysia!

            We decided to take time out from contemplating our future to enjoying the moment. This could be our last stay in JB and Malaysia; we might as well enjoy it to the fullest. We re-visited the beach resort of Desaru to savor its fine sands, and the fishing village of Kukup for its seafood delicacies.

            I was anxious to complete my two clinical projects, or at least have all the data collected. To speed that up I was now very much involved, and that consumed much of my time during and after work. I had my briefcase with me wherever I went so I could pore over my notes. The kids and Karen could be playing on the swings on the playground but I would be busy reviewing the charts.

            As if that would not occupy me enough, Bhattal co-opted me to be the on local committee to host the upcoming Annual Meeting of the Malaysian Medical Association that April, an assignment that took quite a chunk of my time. It however accrued much benefits to me as I had the opportunity to interact with many of the private practitioners in town. The city was unique in that the private doctors had good relationships with their counterparts in the government service. There being only one social club in town, the Tasek Utara Golf Club, helped. They were also very generous to me and my family, perhaps knowing that we government doctors had measly pay! My distant memory could recall only two of the private practitioners, Drs. Nawawi and Adam Liew.

            With Malaysia’s abundance of public holidays, a full five-day working week is the exception; the norm being extended weekends. The really long weekends are at Christmas, Chinese New Year, and Hari Rayas. The Chinese and Christians may be minorities in Malaysia, but only in numbers, not influence. Chinese New Year is no more exuberantly celebrated than in Malaysia. Don’t even bother getting anything done during that holiday as the country would be paralyzed.

            During that extended Chinese New Year holidays in early February of 1978, barely five weeks away, would be the time I decided to apprise my parents of our future plan. My strategy was to tell them in the same manner that Karen and I arrived at our decision; first my non-promising career prospects at home as exemplified by my “non-promotion,” the lack of openings at both UM and UKM, our decision to leave government service, and then the best opportunities for private practice, whether in JB, KL, or Canada. Finally, the decision we took.

            For that holiday, we drove up to Seremban, this time taking the inland route through Segamat and Gemas instead of the usual and faster coastal one through Muar and Malacca. It said something about how much of a stranger I was in my native land as I had never been through those towns before. As expected, the roads were not crowded; in places, deserted. However, we did not feel unsafe. Our only worries were what if our car were to break down along those deserted stretches. A decade or two earlier such a journey would have been unthinkable or reckless as the country was then under the Emergency, with armed communist bandits roaming the countryside with impunity. Segamat and Gemas in particular, were very “hot” and “black” areas.

            We took our sweet time savoring the country scene of lowlands of rice fields and hills with thick jungles on each side. We stayed at “Rest Houses” along the way, much like the old colonials did. Those Rest Houses were government-owned establishments catering to earlier colonial civil servants when they made “outstation” visits. It was a quaint way to explore the country. The only modern aspect to our travel was our car and the paved roads. For Karen, it was the first time to see and smell rural Malaysia as a deliberate journey and not merely passing through towards our destinations.

            The Rest Houses in Segamat and Gemas were not air-conditioned and their mosquito nets stained, not from dirt but lack of use. The bed sheets were the old thin frayed white cotton. The only good thing was that they was not stained like the mosquito nets. That would have turned off us. As for the pillows, they were flat and far from fluffy. Those went along with the sagging beds.

            The services we received were way below what those early colonialists had experienced, at least from what I could glean from their journals. There were no restaurant facilities; we had to drive to town for our meals. No surprise then that we were the only guests at both rest houses. The flip side to that was that we had the establishment, in particular the playground, all to ourselves, to the delight of the kids.

            That slow leisurely road trip along the backroads of Malaysia up to Seremban was a much needed break for me. It was a time-out of sorts for me, to get off my roller coaster life of the past year and half. I savored it. I was only too aware that soon we would have to make a monumental decision that would impact our future as well as of the family.

Next Excerpt #65:  The Wrenching Decision To Disappoint My Parents

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