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M. Bakri Musa

Seeing Malaysia My Way

My Photo
Location: Morgan Hill, California, United States

Malaysian-born Bakri Musa writes frequently on issues affecting his native land. His essays have appeared in the Far Eastern Economic Review, Asiaweek, International Herald Tribune, Education Quarterly, SIngapore's Straits Times, and The New Straits Times. His commentary has aired on National Public Radio's Marketplace. His regular column Seeing It My Way appears in Malaysiakini. Bakri is also a regular contributor to th eSun (Malaysia). He has previously written "The Malay Dilemma Revisited: Race Dynamics in Modern Malaysia" as well as "Malaysia in the Era of Globalization," "An Education System Worthy of Malaysia," "Seeing Malaysia My Way," and "With Love, From Malaysia." Bakri's day job (and frequently night time too!) is as a surgeon in private practice in Silicon Valley, California. He and his wife Karen live on a ranch in Morgan Hill. This website is updated twice a week on Sundays and Wednesdays at 5 PM California time.

Wednesday, August 28, 2019

Reflections On Merdeka Day: Mahathir's Halfway Leadership

Reflections On Merdeka Day:  Mahathir’s Halfway Leadership
M. Bakri Musa (www.bakrimusa.com)

During the polio epidemic of the 1950s, ingenious engineers created the iron lungs and saved many lives, while skillful surgeons crafted nifty operations and salvaged countless paralyzed limbs.

            Those advancements, though impressive, were what physician Lewis Thomas referred to as halfway technology. True technology came when Salk and Sabin produced their vaccines. Halfway technology is not only expensive but also does not address the basic problem.

            Likewise with leadership; there is the true version and then there are the many halfway varieties. Halfway leadership too does not solve problems; in fact it compounds them. It is also expensive both in terms of the direct damages inflicted as well as in the lost opportunities.

            Malaysia was blessed with a few true leaders during her first half. Tengku Abdul Rahman inspired the multiracial population, hitherto (and still is) suspicious of each other, on a single pursuit – the country’s independence – and successfully negotiatedfor it. Thus the nation was spared its war of independence and Malaysians today are unabashed admirers of their former colonizers.

            Economist Ungku Aziz leveraged the powerful religious aspiration of Hajj to make Malays save. In the process he ushered them into the modern economy, making Tabung Haji one of the region’s biggest financial institutions. Chief Justice Tun Suffian elevated the country’s judiciary to be the envy of the region.

During Malaysia’s second half, Mahathir’s leadership dominated, from 1981 until he retired in 2003. Then in May 2018, at 92, he toppled the ruling coalition that he once led. Its leader, Najib Razak, was Mahathir’s protégé and chosen successor. The irony!

A visitor today would be impressed on landing at Kuala Lumpur’s gleaming international airport. The smooth, undulating freeways into the city, beautifully landscaped, make you feel as if you are still in the First World. The glut of five-star hotels adds to that aura.

            Impressive though those may be, they are but halfway developments, showy artifacts of modernity. They cannot hide the stark realities that often intrude, like hideous acnes through thick makeup. Malaysian schools and universities for example, are an embarrassment. Minister of Education Mahathir initiated the decline in the late 1970s. Later as Prime Minister, he greased the slide.

Mahathir was also instrumental in the state’s massive involvement in Islamic affairs. Today the religious bureaucracy exceeds the Papal one in budget, personnel, and most pernicious of all, power. While the Pope could only influenceCatholics, Malaysian state-employed ulama controlMalays, in activities as well as thoughts.

This huge and sinister religious serpent that Mahathir created is now striking back. Witness the current raging and unnecessary controversies over a radical, Indian-Muslim dropout physician-turned- preacher, and the introduction khat (Arabic calligraphy) in schools. Both do not contribute to the economy. On the contrary, they come in the way of improving it.

This huge Islamic beast sucks up precious resources that could have been used to tackle pressing social problems, like rampant drug abuse, uncontrolled HIV infections, and the epidemic of abandoned babies. Those appalling social pathologies disproportionately inflict Malays. In their pursuit of Heaven, those religious types believe in first making Muslims endure Hell on earth.

As for Tabung Haji, it had to be bailed out recently. For the judiciary, a high-profile attorney was once caught on videotape aggressively lobbying on the phone the then Chief Justice. Among that lawyer’s clients was Prime Minister Mahathir.

Mahathir tolerated corruption; a necessary lubricant for a creaky bureaucracy, he rationalized. That attitude, and the culture it nurtured, produced today’s unbridled venality, with former Prime Minister Najib and a dozen of his ministers and aides now facing criminal charges of corruption. Mahathir of course absolved himself of any responsibility.

Mahathir was and still is a halfway leader. He is ensnared by what the young Nigerian writer Chimamanda Adichie termed “the trap of a single story.” Mahathir’s self-fabricated sole narrative remains unchanged:  Malays are stupid and lazy; Chinese, wily and greedy.

Nor could Mahathir overcome that subtle and crippling Malay cultural trap of terhutang budi(debt of gratitude). His earlier support for Najib had nothing to do with the latter’s talent (Najib had none) but an expression of that old sentiment. In early 1970s Najib’s father, then Prime Minister Razak, resurrected Mahathir’s crumbling political prospects.

At 94, Mahathir has not much time. He ignores his most crucial assignment – to ensure a peaceful and predictable transition of power. He is back to his trademark destructive trait – fomenting unnecessary confusion and divisive uncertainty, especially with respect to his possible successor.

True leaders believe in their followers. When their initiatives fail, those leaders would reexamine them and formulate new ones, not blame their followers. Mahathir revels in stereotyping and blaming them.

In his book Robert Kuok, A Memoir, the author quoted Deng Xiaoping at their only meeting. “Mr. Kuok, they all say I am the one that is bringing this huge and rapid development in China. They are wrong. When I opened the door for China, they were all pushing me from behind. They are still pushing me.”

A variation on Lao Tzu’s theme – when a true leader’s work is done, the people would say, “We did it ourselves!”

What Deng did not reveal, as evident from Ezra Vogel’s biography of the man, was that there were many who opposed Deng’s opening of China. His wisdom was in notlistening to or heeding them. That’s true leadership, discerning and then encouraging the wise instincts in their followers, and ignoring those less blessed.

Mahathir panders to and exploits the raw emotions and base instincts of Malays. His championing Islam is not to emancipate Malays, as the Prophet did to the Bedouins of the 7thCentury, but as a political tool, and a very dangerous one. Likewise with Malay special privileges; Malays are fed the illusion of success and reflected glory with the opulence of their sultans and UMNO elite, their rent-seeking spoils sold as “entrepreneurial success.”

Mahathir Version 2 is no enhancement. He is still obsessed with iron lungs and weakened limbs. He does not see the need for a vaccine, much less work on one. Today’s slew of UMNO leaders indicted for corruption is only one malignant manifestation of Mahathir’s halfway leadership. His once much-hyped Vision 2020, is just that – hype. Not a word from him now. It was never a vision, only a slogan.

Mahathir’s last hurrah was in ejecting Najib and his Barisan coalition. Malaysians are grateful for that. That gratitude however, is not without bounds, and Mahathir is determined to breach that, thus betraying the trust Malaysians gave him in the last election. He is back to his old spiteful self, provoking controversies and then blaming others for stirring them up.

Mahathir wants to burden Malaysia with another Najib-caliber successor in Azmin Ali. Time to stop Mahathir. Besides, if he could not achieve his goals when he led the nation for 23 years and when he was much younger, there is little hope for him now that he is nearing 95. Time to disabuse the man of his Messiah delusion.

Mahathir should exit gracefully. Entice him with whatever it would take. Award him whatever title he craves and shower him with all the luxuries he desires. A lifetime corporate jet privilege and rent-free penthouse suite at his favorite Petronas Towers would be much cheaper than the damage he is inflicting and continues to inflict on Malaysia. If those do not work, not-so-gently remind him of the sorry fate that awaits the many Third World leaders who overstayed.

Malaysia deserves a true leader as she enters her 63rdyear of Merdeka.

Sunday, August 25, 2019

Excerpt #31: Mooting A Surgical Training Program

Excerpt #31:  Mooting A Surgical Training Program
M. Bakri Musa (www.bakrimusa.com)

Apart from getting more than my share of female doctors, my unit also had more of those who were not interested in surgery. Despite that I did not encounter many personnel issues. I can recall only two, and for very special reasons.

            One was an intern, a Taiwanese medical school graduate. At first I attributed his difficulties to language. However, I had no problem with the UKM students. Despite my intensive coaching, he was not making much progress. In the end I had to recommend that he repeat the rotation, a rare occurrence.

            A few days later I received a phone call from a senior hospital administrator about “a little problem, lah!” He wanted me to retract my earlier adverse recommendation. This intern (or rather his family) was well connected with the Minister of Health, my superior told me. When the implied threat did not work, it was made more explicit. Still, I resisted.

            True to form, a few days later I received a call from the Minister himself. In his half-English and half-Malay, interrupted by frequent “I say” and “Ayah!” he finally blurted out that my negative evaluation was unacceptable. Our ensuing conversation reminded me of the haggling at an oriental bazaar, except that it was not funny in any remote way. Unable to agree on a final term or price, I shifted tactic. I flattered him, by telling him that I was only a junior consultant and that surely he, as minister, could easily overrule my recommendation! That ended our very unpleasant conversation.

            A few weeks later the intern asked whether he could repeat his rotation with me! Either he was a masochist or that he agreed with my assessment. Obviously his family friend the Minister decided not overrule me.

            The other problem I had was with a medical officer. He was one of those not interested in surgery. I reprimanded him because he abandoned his patient in the emergency room while he was off for his Friday prayers. He retaliated by signing up to be a physician for the upcoming Hajj pilgrimage without first telling me, except at the last minute when he had to get my permission. I refused to grant him that. He was furious. For a while I thought he would become violent towards me. Instead he threatened to report me to the religious authorities. When that did not faze me, he warned me that I would rot in hell for preventing him to undertake his pilgrimage!

            The following day he made a formal request to withdraw from my service. I granted that right away even though that meant we would be short-staffed on an already overstrained service.

            That medical officer, and a few others like him in my unit, was a crying shame. It was also a significant lost opportunity. The rich resources (rich in terms of “clinical materials” or patients) of the hospital could be better used to train future surgeons instead of merely meeting the statutory requirements of new doctors. Those bureaucrats at the Ministry of Health and the UKM Dean of Medicine notwithstanding, Malaysia was desperate for surgeons.

            Earlier I had broached the idea of initiating a formal surgical residency training program with Mahmud, UKM’s Chief of Surgery. He was supportive. As he was busy with the undergraduate program, together with his lack of experience with such matters, he could not offer me much help. He was however, willing to pave my way to meet important players who could. One was Tan Sri Majid.

            So that August during Hari Raya, Mahmud and I went to Majid’s “Open House” to plead our case. We decided to go late as most visitors would come early when the food would be fresh, warm and plenty.

            When we arrived at his plush residence in the exclusive neighborhood of Bukit Tunku, the crowd was already thinning, as we had anticipated. The Tan Sri recognized Mahmud right away, and with more than a little bit of prompting on my part (“The surgeon from Canada; the one you mistook for the Egyptian Ambassador”), he remembered me.

            I reminded him of the country’s severe shortage of surgeons generally and of Malay surgeons specifically. That grabbed his attention; he guided us to a private corner of his house to continue the discussion.

            With the current set up at our unit, we could with minimal difficulty produce six surgeons annually, I told him. We could double or even triple that number in five years with the co-operation of the other units. He was skeptical that I could find that many qualified candidates, especially Malays. I assured him otherwise and that with my limited exposure thus far to young local doctors, I already had no fewer than a dozen excellent candidates who had expressed their interest to me. If I were to scour the countryside, I was sure to find many more. Then there were those now studying abroad like his son in Australia. He smiled at my reference to his son. I was also not so subtly reminding him of our earlier conversation not so many months ago.

            Tan Sri Majid was impressed. He was surprised that the bottleneck would not be in finding qualified candidates as he and many others had thought, rather in providing the opportunities. I was now into the nuts and bolts of my proposal when he had to excuse himself. He apologized profusely as he had a planned golf outing with a very important person. He asked that I pursue my project and apprise him of the progress.

            Buoyed by his endorsement I was a ready to charge, like a bull that had just been released out of its pen. The next day I went to the hospital’s deputy medical director for the list of incoming house staff. What list? “I would be lucky to get one when they arrived,” he smirked, “just like your arrival here!”

            I laughed even though the joke was on me. That was my introduction to the Malaysian bureaucracy at the nitty-gritty level. I already had intimations of that on my initial visit to the Ministry of Health, the search for my promised government quarters at Lake Gardens, and my encounter with the UKM dean. Nonetheless the import did not register on me then. After all my presence at GHKL proved that those bureaucratic hurdles and inertia were not insurmountable.

            Between my busy schedules and the runaround at the ministry, it took me weeks to secure my appointment with the appropriate officials, and that was only after I threatened to go over their heads directly to Tan Sri Majid. At first I was told that I could not get the list of medical students now abroad. I would have to ask the Public Service Commission (PSC). As for local students, I would have to go to the PSC too for them. I could bypass that by going to the dean’s office of the two local medical schools.

            If I could not get the list of those medical students, how about those interns and medical officers now outside of KL? I could not get them either. Only the ministry had the authority over where they would be assigned, not me. Once they were assigned to GHKL only then would they fall under the hospital’s authority and I could make the arrangements at that level.

            I protested that surely as a surgeon I would be a better judge who would be the most suitable candidates instead of passively waiting for them to be assigned to me. I could not persuade those civil servants. Those were the rules of the civil service, its “GO” or General Orders, its “Ten Commandments,” except that they ran into thousands of pages.

            Frustrated, I told them I would go directly to Tan Sri Majid. It was at that point that I was told that he had just retired. My hopes were deflated, my dream of a surgical residency program shattered. Only much later did I realize that even in retirement the man still carried much weight, and not just in healthcare.

            Although Tan Sri Majid’s successor, a certain Raja Ahmad Nordin, could not see me (he had just assumed office), nonetheless I would be able to meet with other top ministry officials. My hopes were again resurrected.

Next:  Excerpt # 32: Hitting A Bureaucratic Brick Wall

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

Sunday, August 18, 2019

Excerpt #30: Sex And Corruption

Excerpt #30:  Sex And Corruption
M. Bakri Musa (www.bakrimusa.com)

Sex and corruption, the two go together. One day I noticed that the soup served to my patients was nothing more than spicy hot water with pieces of vegetables floating. Sister Fong commented that the food quality had been deteriorating for some time. Everybody noticed that but nobody did anything about it.

            One morning on the pretext that I was finding my way around, being new, I wandered into the kitchen, unannounced. The grocery truck had just delivered its supplies, or making a show of it. The staff reacted to my presence like a herd of deer that had smelled or seen a tiger in the neighborhood. They all perked up, frozen, staring towards me with their eyes wide open. It was obvious they were not used to being visited. I greeted them in Malay and introduced myself as the new surgeon, wanting to know the workings of the hospital. I sought out their supervisor.

            I made innocent queries like where the best place to buy meat, the going price, and complimented him and his crew for having to cook for so many. “It’s like having a big kendurievery day!” I remarked. I used simple village language with my comments and questions, as well as put on my humblest Malay mannerisms to make them feel at ease. Yet they all maintained their guard throughout.

            Then I saw a big beef carcass being carted away to another van. I asked in as casual a manner as possible whether the hospital had another kitchen elsewhere. There was a scurry of embarrassment with the director asking the man where he was going with the meat and that it should put it back in the refrigerator. The man was startled by this apparent departure from the usual routine.

            Later at lunch time I went up to the ward. That was the day when my patients had more than just watery soup in their bowls!

            The dead too were not spared from corruption, or at least their families. The relatives of one of my deceased patient sought me out because they could not retrieve his body from the morgue. The attendant said that I had not released it. For a fee, he could “persuade” me to speed up the process. Sensing something smelly, I escorted them to the morgue to claim the body. Again, I received the now familiar deer-in-the-presence-of-tiger look on the part of the morgue workers.

            Public facilities like hospitals are underfunded. Combined with corruption and you have a major problem. I was stunned to see disposable items being reused with minimal cleansing and sterilizing. The nasogastric tubes used for my patients were stained and friable, having been reused once too many times. I solved that problem by taking a pair of scissors and cutting all the tubes removed from my patients. That way those tubes would never again be reused. The nurses were horrified by my actions! There was no budget for such necessary consumables. My rationale was that those patients were already sick, and with their reduced immune system there was no need to increase their risk to infections.

            Granted, many disposable medical devices today could be reused as they are robustly made. However, one must be assured of the re-sterilizing processes and their quality control. Even with modern sterilizing techniques of American hospitals, I still react with horror when my colleagues use a gastroscope for a colonoscopy! There have been many reported cases of diseases being spread through contaminated instruments.

            With the top honcho of the hospital busy chasing skirts and sexually harassing his subordinates, the management of the hospital suffered. If you do not have talented managers and executives to begin with, or if they are plain incompetent, mediocrity would be the consequence, if not disaster. Corruption was only one manifestation. The other was deteriorating facilities from lack of maintenance.

            One day I looked up at the air vent in my office and saw the edges were black. The vents had not been cleaned for ages. I wiped the vents and was stunned at the grit. I asked the janitor to show me the filters. He did not know what I was talking about. With my pestering, he finally called the engineer from the JKR (Public Works Department). The hospital did not even have its own dedicated engineers.

            After many attempts he finally pried open the air-conditioner panel. Phew! What a mess! Even he coughed when he removed the filters. One of the nurses commented that no wonder she had to go out every so often to catch her breath while working inside!

            Those soot-filled filters and gritty vents were emblematic of the maintenance culture, or lack of one, in Malaysia. Next to GHKL was the huge Maternity Hospital. During my entire time at GHKL, that maternity hospital’s operating suites were shuttered because the ventilation system was contaminated. Its patients had to be transported by ambulance to GHKL for surgery. Imagine a patient needing immediate C-section. Yet there was no sense of urgency to fix the problem.

            Now whenever I am in a public building in Malaysia I always look up at its air vents. If they are black, I do my waiting outside.

            During my tenure at GHKL I did not feel at all that I was on a crusade to clean up its mess. I was merely trying to correct the glaring deficiencies that were adversely affecting my patients. However, one morning the jaga kreta“boy” (parking lot attendant) who had been washing my car, greeted me with a look of concern. My immediate reaction was that I had been chintzy with my tips.

“Tuan Doktor . . .” he stammered and then paused, not knowing how to proceed. He hummed and hawed, in rhythm with the shaking of his head. “I hear lots of good things about you from the nurses and young doctors,” his raised eyebrows and wavering voice betraying his compliments.

“I mean, uh, I’ll watch no one would slash your tires,” he mumbled on!

I got his message! Somehow I was not at all concerned, perhaps the naivety of an innocent newcomer. I did not at all feel threatened. After all I was not trying to disturb the hornet’s nest, only clearing the cobwebs that came in the way of my patients.

Next:  Excerpt #31: Exploring A Surgical Residency Program

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

Monday, August 12, 2019

Excerpt # 29: Sex Rears Its Ugly Head

Excerpt #29:  Sex Rears Its Ugly Head
M. Bakri Musa (www.bakrimusa.com)

As I had more than my share of young female house officers in my unit, it was inevitable that sex would soon rear its ugly head. One morning, a young house officer stopped me as I was about to enter my office. Could she see me “in private,” was how she put it. Something about her tone and body language said that I would have a problem ahead, and a very big one.

            After the usual pleasantries and she was comfortably seated, she clamped up! Good! It was nothing after all. Great relief!

            Then I remembered my old village courtesies. Do not accept the first two refusals or demurrals. Keep offering or prompting. Sure enough, after my third prompting she let out, with tears streaming down her cheeks. I felt nauseous; I did not want to hear more. She had come to me, her superior, to seek my help, and I did not know what to do. I remembered a couple of my female classmates and colleagues back in Canada who had been harassed by the faculty and nobody helped them. They suffered in silence.

            My first reaction was to call Karen. Then I remembered that Karen had met her before. She (my trainee) would be embarrassed by that.

            When you don’t know what to do or how to proceed you revert to being very professional and clinical, to hide behind your pseudo detachment. Did you tell your husband? Yes. What was his reaction? Angry and helpless. Both were vulnerable in their own separate ways. Why not kick her tormentor where it would hurt him most? Laughter! Great, at least some release of the tension!

            As she continued on I felt less as a departmental head with a major personnel problem, more a young ram whose ewe was being “disturbed” by an old goat. Her harasser was not just any old goat. He was the senior-most physician, with a string of royal titles to his name. There could be severe consequences if I were to cross him.

            Then I remembered my alpha dog posture with the Ministry of Health official and how easily he cowered to me. I decided to be the alpha ram. My youth and physical vigor would intimidate the ageing Don Juan and his dwindling testosterone. I had read Jane Goodall’s accounts of chimps where the old bull would simply move away instead of risking a challenge from an upcoming male.

            By the time she finished pouring out her fears, I was no longer her superior or she one of my trainees. I was now into the raw brutal sexual imagery and energy of the animal world. In my most reassuring masculine voice, I told her that I would take care of the problem, mano a mano.

            She stopped crying, the power of the comforting voice of an alpha male! Then as an afterthought she told me she did not want to jeopardize my career on her account. I scoffed at her concerns! Far from being threatened, I felt emboldened.

            That evening I discussed the problem with Karen, in particular my decision to confront the old man. She was all for that. Missing in our discussions was the thought of possible adverse consequences to my career should this character were to fight back. That thought or fear never crossed our minds. We both felt that I should do the right thing. Helping my trainee was the right action.

            The next morning I went straight to her harasser’s office. I asked his secretary whether he was in, and when she replied that he was, I went right in after the perfunctory knock on the door. She was taken aback at my aggressiveness, especially my being very junior and a new staff member at that. Once in I turned around to close the door behind me.

            I saw in front of me a mousy old Indian man crouched in his oversized chair behind his equally oversized desk. I looked around and saw pictures on the wall of his being honored by the various sultans. I ignored those and stared him straight in the eye.

            After an appropriate intimidating silence on my part, I said in a calm but firm voice, “You have been bothering my girls!” I had my arms folded across my chest while standing ramrod straight. He offered me the chair but I ignored the courtesy and remained erect, my body that is.

            He avoided my stare and darted his eyes from one corner of his desk to the other. Then I walked towards his desk and he retreated slightly in his chair. I recognized that submissive body language. I leaned over and pressed my two fists on his desk, the knuckles facing him.

            “Stop it!” I paused. Then, “Or you will regret it!”

            At that very moment I felt physically much larger than he was, accentuated with his now slumped body in the oversized chair. In actuality he was only a little smaller and shorter than me, but with my standing over him, it amplified our otherwise minimal size differential. With that I walked out. Just before I opened the door, I turned around.

            “Think about it!” My parting shot.

            Back in the comfort of my office I felt good, like a real man should. It was easy. All I did was act like one. I had uttered only four crisp sentences, three more and each considerably longer than Cesar’s terse Veni, vidi, vici(I came, I saw, I conquered!).

I had no idea whether that would work. More to the point, while I hoped that my strategy would work, I was not in the least worried that this slimy character would use his power to go after me. He was but a rat.

            A few months later my trainee greeted me with the good news that her husband had his promotion. She was scared that her husband’s career would be the price she would have to pay. No, she had not been bothered anymore. I was relieved even though I had expected that her tormentor would cower and retreat. Those who prey on the helpless, be they female subordinates or the poor and powerless, are cowards at their core – bullies.

Next:  Excerpt #30 Sex And Corruption
From the author’s second memoir, The Son Has Not Returned. A Surgeon In His Native Malaysia, 2018.

Sunday, August 04, 2019

Excerpt #28: A Much-Welcomed Lighter Workload

Excerpt # 28: A Much-Welcomed Lighter Workload
M. Bakri Musa (www.bakrimusa.com)

Towards the latter half of the year UKM had a second surgeon, Dr. Bahari Habib. He had just passed his FRCS (Edinburgh) the previous year. He graduated together with Mahmud, the departmental chief, from the University of Malaya, and had attended the prestigious Penang Free School.

            My first introduction to Penang Malays was at Malay College in 1961 when I joined its Sixth Form. That school was (and still is) exclusively Malay. Imagine my surprise to see on my first day there so many ‘Indian’ students. I made an unpardonable boo boo thinking that they were Indians who could speak Malay. My friend Ramli corrected me, and just in time. That experience notwithstanding, when I met Bahari that day I spoke to him in English because I thought he was Indian. Only when he responded in Malay and referred to me as “Hang” (you) in the distinctive Penang Malay dialect did I realize my error.

            Seeing that Bahari was just back from Britain, I had him coast along for a while. Later at the end of the week, we agreed that he, Mahmud, and I would get together to discuss our clinical supervisory arrangements.

            Even before the week had ended, he had asked through Mahmud for the meeting. Earlier, the nurses had intimated to me that Bahari was not happy that I was “running a one-man show.” At our meeting however, Bahari, being a Malay, was very polite and even deferential. It was not fair for me to carry all the load, he said. That sounded much more pleasing to my ears!

            Not being on the faculty, I was very much aware of the sensitive nature of my position in the university’s unit. Tan Sri Majid had emphasized that to me at the very beginning. Always cognizant of that advice, I made sure that Mahmud was in the loop throughout. I also wanted his help and co-operation.

            It did not take long for Mahmud to excuse himself saying that what I was doing in the Unit was new and foreign to him. He had never been exposed to such formal teaching programs when he was at the University of Malaya or in Britain. That did not surprise me as I had a few fellow trainees back in Canada who had been through the British system.

            Like Mahmud earlier, I let Bahari pick his clinical as well as teaching load and responsibilities that would suit his time and interest. He chose the basic science seminar and the Clinico-Pathological Conference (CPC). As for clinical load, he picked the women’s ward.

            My practice with the CPC had been to choose the appropriate cases and then give the list to Professor Kutty the day before so he could be prepared. I would also assign the interns who would be presenting the clinical details. I apprised Bahari of my routine and he seemed to have understood me.

            On the appointed morning, Kutty reminded me that he had not received the list. However, he was not one to be easily distracted. List or no list he went ahead with the cases he had on hand. When he asked for the clinical details, as Bahari had not assigned anyone, we wasted much time asking for volunteers among the interns.

            After the presentation, Kutty cornered me with a look of concern seeing that we had departed from our routine. Things were not in their usual smooth flow. He asked if everything was okay with me and my family. He thought that I was distracted by some personal family events. I assured him otherwise and said that Bahari was now in charge of the CPC. He rubbed his forehead with his right palm and whispered, “Doc, we had it going so well! Why change now?”

            That afternoon I went to see Bahari to go over again with him how I did it before. When I finished, he disagreed. “No, that’s spoon feeding.”

            He argued that the preparations should be the trainees’ responsibilities; they should take the initiative, not him. I reminded him that these students were used only to the passive one-way lecture-style teaching of their undergraduate years but not to our graduate-level, seminar-type active learning environment that I was trying to cultivate. He grasped my point and in the end asked me to take the conference back until he would be prepared leading it.

“That’s too much work. I can’t do it now! I just came back from Britain and had hardly unpacked.”

            That little hiccough aside, our clinical and teaching programs proceeded as before. Soon the Royal College of Surgeons of Edinburgh had their oral examinations at our hospital. Among the candidates, four were from our unit, two for Part I and two for the final Part II. During the months before the examination, I tailored my teaching rounds accordingly. Zul and Yusha sat for Part I; for Part II, Freda and the Indian registrar, who would be sitting for her umpteenth time. She was on the government service, the other three, UKM. I told everyone that at the program where I trained, it was expected for all candidates to pass at the first crack. I also told them that I expected to maintain that track record locally.

            After the examination, I met my candidates; they were all beaming. None of the questions surprised them as I had asked those very same questions or variations thereof many times before during our rounds. When the results were announced later that day, all four of my candidates passed, including the perennial test taker!

            I knew much earlier in the day that my candidates had done well. Datuk Menon, one of the examiners, came by to congratulate me right after the last session and wanted to know what I had done right. He told me that the British examiners too were impressed with my candidates. I told Menon that he should congratulate my trainees as they did all the hard work. I had also met one of the British examiners. He had inquired where I was trained in Canada. When I replied the University of Alberta Hospital in Edmonton, he beamed and exclaimed, “Walter’s program?”

            That “Walter” was Walter C McKenzie, the legendary Dean and Professor of Surgery. By the time I started my residency training, the program was under the equally sterling leadership of Robert Macbeth, McKenzie’ immediate successor.

            No matter how you analyzed my candidates’ results, they were impressive. Both veterans and first-time takers passed; their only commonality was going through our program.

            It was a tradition at my old Canadian training program to take our instructors to a celebratory dinner after the examination results were released. I wanted to replicate the tradition locally but with a twist. With four successful candidates and their spouses, that would be quite a bill. I compromised and invited only Freda and her husband and billed it not as a celebration for her passing the examination but as welcoming her as a fellow full-fledged attending and faculty member. I also invited Mahmud and his wife, Sharifah, also a fellow faculty member.

            It was an elegant formal dinner-show at the Hilton, then thehotel in KL. The menu was Western, with the steaks specially flown in from Colorado, but the show was local, traditional Malay dances. Karen enjoyed the show and dinner very much, her first and wonderful introduction to local culture. Even the steak was on par with Alberta’s.

            With Freda now a full-fledged surgeon, my load was further lightened. We could now run an extended training program. The success with the FRCS examinations buoyed me, quite apart from enhancing our unit’s reputation among the house staff.

            The first and second surgical units were headed by senior distinguished surgeons. No surprise that they received the best house staff. The ones sent to my unit, the UKM candidates excepted, were generally those not welcomed in the other two. As a consequence, I had more female house staff members than could be accounted for by chance alone. During ward rounds I looked like a sultan with his harem tagging along. I also had a disproportionate share of house staff members who were, shall we say, more interested in psychiatry.

            That reference to harem was not incidental. With more than my share of pretty young female doctors, sex would be an inevitable problem, and it was, though not in the pattern I would have expected. Resolving it taxed me in more ways than I could have ever imagined.

Excerpt # 29:  Sex Rears Its Ugly Head
Excerpted from the writer’s second memoir, The Son Has Not Returned. A Surgeon In His Native Malaysia, 2018.