DAY 1998-2012

Feb 21 - Mar 7

1) This post marks 2,000 days since I first began my journey as a medical student. While there were no fireworks or partying to celebrate the longevity of my blog, there have been a few other milestones that make this post that extra bit special. 

2) To start off, we had our final posting in medicine last week. Previously, we had spent two weeks of our medicine rotation in Hospital Taiping. I don't recall visiting Taiping often while growing up, but being in a different environment (after so long in Penang) was certainly very refreshing. We had our sub-internship week in Taiping as well - to observe, assist, and perform whatever procedures or examinations which we could. Overall, Taiping was both fun and surprisingly quite relaxing for us. Unfortunately, we weren't able to explore the city as much as we would have liked, mostly due to the rising number of Covid-19 cases at the time.

3) I would be remiss not to talk about exams. At the end of our medical posting was an OSCE examination. Initially scheduled for May, this was brought forward to the beginning of March due to changes in our schedule. In order to standardise the OSCE stations with those of the surgery examination, the time in station was reduced from 7 to 5 minutes, with only 1 minute for discussion. While some may be relieved owing to having less time with the examiners, I personally did not, as I felt the reduced time for examination would disrupt our overall flow and thought process.

4) Regardless, we finished our final medical OSCEs yesterday. As with most exams, I knew I could have done better, but I had already given my absolute best. Now that we're done with medicine (at least until May when we have our written papers and long case exams), we can focus on our final rotation - surgery. In my mind, surgery is more labour intensive than medicine, mostly due to us having clinical sessions every day from 8-12, with afternoon online classes thrown in for good measure. At the end of the day, I keep telling myself that this is indeed the final rotation of my six-year long journey, and that gives me the motivation to see this through.

5) Here's to the last two months till our final examinations. And with that, I'll end my blog post here. Thank you very much for visiting as always, and have a nice week ahead. Cheers! 

And that's a wrap - final medicine rotation complete!

L-R: Helmi, Omar, Lilin, Myself, Sean, and Kuhan

Taiping Hospital - one of the first hospitals in Malaysia and the first to introduce the "Roentgen Ray Apparatus", otherwise known as an X-ray machine!
Interesting, the first X-ray taken here was of a pomfret - very clearly detailing all the little fish bones

Ordered the char kuey tiao "special" from Restoran Doli

A bit pricey at RM17 but the next picture explains why...

I counted 36 shrimp from just one packet of noodles!

Taiping is a literal food haven. This is one of our favourite stalls - Sri Annapoorana Curry House.

L-R: Sean, Lilin, Helmi, Omar, Kuhan, Myself

Absolute feast of a meal for just RM10!

The fried bitter gourd is one of their specialties, but really everything is just so delicious

If only I can take credit for that detailed description of the examination of the peripheral nerves of the upper limb

Rachel seems to really know where the best food spots are - this is Habee's Kitchen

The milky noodles was delightfully rich and savoury, and went really well with the generous helpings of fried fish

Another feather in our cap :)

DAY 1848-1862

Sept 24 - Oct 8

1) For the past two weeks, things have been getting better - both for our country and for us as medical students. The average number of new Covid-19 infections per day has fallen by over 7,800 over the last three weeks, with today being the fifth consecutive day the cases were below 10,000. Considering at our peak, we were averaging well over 20,000 cases per day, I would call this a huge milestone. Indeed, things are looking much brighter now, as there are plans to lift the ban on interstate travel in the next couple of days, once  90% of the adult population have been vaccinated.

2) As for us medical students, we have been informed regarding the re-opening of campus on the 18th onwards. This is a very timely update as well, since we are now in final year, and usage of the library and other facilities will definitely help us through our final stage of medical school. For the past two weeks, my group has resumed clinical training in the orthopaedics outpatient clinics. As mentioned before, we have not been allowed in the wards yet, due to the high number of cases. But in the coming weeks, I am hopeful that at some point we'll be allowed back, as more Covid-19 wards are reverted back for normal use. 

3) Having completed our two weeks of orthopaedics posting (for Semester 9), we now have another two weeks in the surgery outpatient departments (SOPD), after which we have two more rotations - in medicine and public health, respectively. Having done half our the public health module in Semester 6 (Year 3), we will now complete the remaining half during Semester 9, and we will sit the final examination for Public Health as well. Next year, Semester 10 - our final semester - begins. We only have two large modules, medicine and surgery, which includes sub-internship (i.e. pre-housemanship) training as well. Barring any hiccups, there will be one last round of examinations at the end of Semester 10 - these are the final examinations for medicine and surgery. Thus concludes medical school in a nutshell.

4) It has been a really long ride, certainly made longer by my research year abroad. But at the end of the day, I keep telling myself that it will all be worth it. And with that, I'll end my blog post here. Take care, stay safe and stay happy. Cheers!

Dinner with my good friend Sim @ Sushi Tei, Gurney Plaza

A lovely view to the sea

Chicken katsu curry for dinner :)

This is my first dine-in at Gurney Plaza Food Hall in months. 

Feels great seeing people coming back.

Saba meal deal for lunch. Cheap as chips for just RM10 (~£2)!

DAY 1822-1847

Aug 29 - Sept 23

1) This is the longest I've gone without a blog update - and for good reason. I've been waiting for the end-of-fourth year results to come out. What initially started out as a one week wait turned into two, then three, and finally just shy of a month since our last exam, we finally received our results this morning, during online class no less. I can just imagine some of my friends just zoning out of the lecture in order to check our results mid-lesson - I know I did.

2) For the past four weeks, we have had online classes on medicine and surgery, which are our fifth year modules. It has been rather difficult for me to find motivation to study for fifth year, especially when we didn't even know if we passed fourth year or not. Honestly, I was mentally preparing for the worst - as I knew I did not do well in a few modules. But without getting into too much detail, I was so incredibly lucky to pass fourth year! And suddenly, the stress and anxiety of waiting a month for our results seemed to just melt away. 

3) So the next (and final) step is fifth year - which is divided into Semester 9 and 10. Semester 9 has three modules which the students rotate through i.e. surgery, medicine, and public health. However, there have been problems getting us medical students back to the wards, as our main teaching hospital (Penang General Hospital) has no more teaching wards. This is due to the fact that most of the wards have been converted into COVID-19 wards, which is off-limits for medical students.

4) Nevertheless, we are scheduled to return to clinics beginning next Monday. It will be a slightly different experience, as the clinics see different patients compared to the wards. The main difference being that patients seen in clinics are generally in a more stable condition as they do not require ward admission. But there is still hope, as we are likely to utilise another teaching hospital (Taiping Hospital) after our first two weeks of clinics. Currently, there is a lot of uncertainty regarding the resumption of clinical teaching. Hopefully, this is sorted out as soon as possible, so that we may graduate and move on in life.

5) The coronavirus pandemic has really turned the world upside down, and on a personal note, has affected our clinical exposure with patients. Hopefully, we will be able to make up for this deficit and become safe and competent healthcare professionals in the end. On that note, I'll end my blog post here. Thanks very much for visiting, and have a great day. Cheers! 

On a side note - I've received my second dose of vaccine!

This means I'm fully vaccinated, and just in time for our return to clinics too :)

The sign reads, "I've been vaccinated. You should too!" - which is really good advice

DAY 1746-1759

Jun 14 - 27

1) So this week I got my first dose of vaccination! This may sound like a thing of the past for those in other countries, but in Malaysia, vaccination uptake has been very slow. Thankfully, in recent times, vaccination rates have been increasing exponentially, with the latest data showing at least 15% of the population having received their first dose. 

2) My vaccination appointment was at the SPICE Convention Centre, so I carpooled with my good friend Daniel (who coincidentally had a morning appointment as well). My appointment was an hour earlier, so I thought I would wait for him after I was done. In the end, they allowed him to be vaccinated at the same time, so we could go home even earlier. The entire process was very quick and efficient. All we had to do as we progressed through each station was to keep showing the staff our app ("MySejahtera") which contained all our particulars, and our identification card. 

3) After about 15 minutes, we were led into the actual stadium, where multiple booths had been set up for mass vaccination to take place. I was asked if I knew which vaccine I was getting (the AstraZeneca vaccine), and whether I had any allergies or previous reactions to anything. The staff then briefed me about the vaccine and asked me if I had any questions. Next, I sat outside the booth waiting for my turn to get vaccinated. The doctor went through the same quick screening, and then proceeded to show me the syringe containing 0.5mL of AZ vaccine. 

4) Before I knew it, the contents had been injected into my left deltoid, and it was all over - I did not feel a thing! The last part was to wait for 15 minutes in the waiting area (just to monitor for any immediate reactions). Daniel came right after me, and we both left without any reactions. All in all, it was very smooth-sailing and uneventful. Barring a little tenderness over the injection site, I have had no reactions/ adverse complications since getting vaccinated. Before leaving, they gave us a card with our next appointment (within 3 months), which would complete the two doses necessary for immunity. Half way there, half more to go then.

5) The rest of the day (and week) was uneventful. I had missed the whole morning session that day, so I had to take down notes from my friends. Thankfully, I will not be missing any more classes after this (until my next vaccination of course!) And on that note, I shall end my blog post for today. Thanks very much for tuning in as always, and have a great week ahead. Stay safe and stay healthy, cheers!

The card reads "I've been vaccinated!"

Daniel and I, waiting for our turn to register :)

Translation: I've been vaccinated - you should too! :)

That's exactly how the COVID-19 vaccine looks like 

(not to scale of course XD)

DAY 1733-1745

Jun 1-13

1) This week has been a particularly rough one for me. To start off, I had an eczema flare-up for the past week, which really affected my concentration and sleep. Besides, there was a sudden complete black-out in my apartment. Also, my internet wi-fi decided to give up on me when I needed it badly, and finally, my phone decided not to charge properly. When taken individually, these seem like quite trivial matters (which indeed they are), but when you consider that most of us medical students at RUMC are already at the brink of anxiety and depression having to study for exams they have no idea how to prepare for, then it is easy to see how this may be the straw that breaks the camel's back. 

2) Regardless, the week has ended on a particularly high-note: my article on motor neuron hyperexcitability, which I co-authored with Dr. James Bashford (my supervisor from my MSc course) has been published! I still remember writing sections of this paper during my two-weeks quarantine in Tune Hotel, KL shortly after my return from UK. There was no chair to use in my hotel room, so I had my laptop propped up on two spare pillows as I hunched over, reading papers and making notes for the article. And today, just shy of a year later, this very article has been published in Clinical Neurophysiology, a high-impact peer-reviewed medical journal. 

3) In other news, Malaysia has extended its nationwide lockdown for yet another two weeks. Infection rates have indeed been dropping, with yesterday recording just 5,793 cases (compared to 9,020 cases a week ago), and the highest number of recoveries, at 8,334 discharged. For us medical students, this means more online lectures and self-directed learning. I have also registered for and received my appointment date for the COVID-19 vaccination next week (June 21). Compared to many countries, Malaysia has been slow in mass vaccination with only 4% of the population being fully vaccinated, but things look to be speeding up. My grandfather recently had his second dose, and has had no symptoms whatsoever. 

4) That's all for this edition of my blog. Thanks very much for visiting as always, and have a great week ahead. Cheers! :)

P.S. If you are interested, here is the link to the journal article:   https://doi.org/10.1016/j.clinph.2021.03.053

Title: Demystifying the spontaneous phenomena of motor hyperexcitability

https://doi.org/10.1016/j.clinph.2021.03.053

Saying goodbye to Ice: senior turned classmate turned senior again

Safe trip back to Thailand! :D

Thanks for the birthday cake Rach!

Hope you had a great one :D

DAY 1719-1732

May 18-31

1) Since my last post, the COVID-19 situation in Malaysia has reached a critical state - the usage of ICU beds nationwide is now at 104% (that's not a typo) capacity, while COVID-19 hospital beds are at 85%. This means that soon enough, Malaysian doctors will be forced to make the tough call over which patient should be prioritised for an ICU bed. Penang General Hospital is overwhelmed - many wards have been converted to COVID wards and the hospital is now running 4 ICUs to cope with the patients who require more intensive care/ ventilation. In line with this, the Ministry of Health has made the very wise (if long-overdue) decision to impose a full nationwide lockdown (similar to the first lockdown we had when COVID-19 first hit our shores), for the next two weeks. Essentially, all businesses and schools are closed, as well as any dine-in at restaurants. Yesterday, the number of infection was at an all-time high of 9,000, although today has seen a sharp decline, with "only" 6,999 infections. However, we cannot afford to be complacent - we currently have the unenviable record as the country with the highest infection rate. 

2) A few days ago, we were informed of the changes that this lockdown would have to our education - clinicals have been completely cancelled, and replaced by ever-changing online schedules. At the start of the semester last year, our elective period was 8 weeks, and I had been very fortunate to be selected to represent my university as a bilateral exchange student to the National University of Singapore (NUS). After all the necessary preparations, this was completely scrapped, and the electives shortened to 4 weeks. We were once again required to look for elective opportunities, and only locally this time (amid fears of another lockdown). Once MCO 3.0 rolled along, this was cut to just 2 weeks, and then it really was not worth seeking out another elective placement. True enough, electives have now been cancelled entirely, and all the time, money, and effort spent in securing those placements - all for nothing. But you can bet your last dollar I'm adding the NUS elective to my CV. 

3) Speaking from a medical standpoint, it is difficult for me to envisage all of this going away anytime soon. First, vaccine uptake has to be sufficient to ensure herd immunity (to protect those who are vulnerable and/ or are unable to receive the vaccine). Second, we need enough time to build up that immunity, so it is not feasible to just remove our masks the moment we have been vaccinated. Third, there is a possibility of booster shots being required in the future, as lifelong immunity is unlikely after just two shots. Fourth, there is a chance of seasonality in COVID-19, a bit like the influenza virus which spread seasonally each year due to a phenomenon called antigenic shift. In the case of COVID-19, we are seeing variant strains and even hybrids of these strains of virus in the community, making it all the more likely that infection rates may never disappear completely, but instead remain endemic in local areas. This may not be the news that everyone wants to hear, but it is something that we have to keep in mind.

4) But I would much prefer to end on a more positive note, which is that pandemics do end. The 1918 Spanish flu ended. The H5N1 influenza pandemic (Avian flu) ended. The 2003 SARS pandemic ended. Undeniably, at some point in time (in the very near future, I hope), the COVID-19 pandemic will end. Then it will become a thing of the past; a story to regale our children and grandchildren with. For as the old saying goes - this too, shall pass. And with that, I end my blog post here today. Stay safe, stay healthy, and stay strong in this most trying of times. Take care, and have a great week ahead. Cheers!

Okay, so this cat has decided to call my front doorstep home :)

DAY 1705-1718

May 4 - 17

1) Malaysia is currently undergoing its third iteration of the Movement Control Order (stylised as MCO 3.0). While initially limited to a few key states, the MCO has since been expanded nationwide due to new coronavirus variants with higher infection rates, increasing constraints on the capacity of the public health system, and suboptimal compliance of the standard operating procedures (SOPs) amongst the general public. This includes a blanket ban on inter-district and inter-state travel, to last until June 8th. 

2) So what does all this mean for us as medical students? Well, all education has switched from face-to-face to online. This has put a halt to our clinical training in hospitals and wards. For now, our learning is conducted via lectures and online tutorials, with new timetables being circulated every now and then to accommodate the latest updates from the Ministry of Health. 

3) Group B (my group) is in their final rotation for the year, obstetrics and gynaecology (O & G). Assuming no changes, we have one week after this rotation before having to sit for our exams. Having the constant reshuffling of timetables and disruptions to our learning is not ideal, but I agree that it is necessary and in our best interests. On a positive note, the MCO extension gives us more time for self-study and revision, which can only be a good thing given our upcoming exams.

4) Just yesterday the fifth years finished their final year medical exams - a massive congratulations to everyone! I'm sure the coming weeks will provide a much-needed break for most of you, and richly deserved indeed. I've been really lucky to call many of you my friends, and I look forward to seeing where you will go from here. All the very best in your future endeavours :)

5) Yesterday was also Teacher's Day - a very special day where we showcase our appreciation to all the teachers out there. As a secondary school student, there was a particular poem by Malaysian poet Usman Awang that I really enjoyed, called "Sajak Guru O Guru" (lit. "Teacher Oh Teacher"), and which is commonly read during Teacher's Day celebrations. Here is a particularly poignant stanza from the poem (in the original Malay Language and then translated by yours truly into English):

Jika hari ini seorang Perdana Menteri berkuasa
Jika hari ini seorang raja menaiki takhta
Jika hari ini seorang Presiden sebuah negara
Jika hari ini seorang ulama yang mulia
Jika hari ini seorang peguam menang bicara
Jika hari ini seorang penulis terkemuka
Jika hari ini siapa sahaja menjadi dewasa
Sejarahnya bermula oleh seorang guru biasa
Dengan lembut sabarnya mengajar tulis baca.

English translation: 

If today exists a Prime Minister come to power
If today exists a king ascending the tower
If today exists a President of a nation proper
If today exists a noble scholar
If today exists a lawyer upholding one's honor
If today exists a famous writer
If today exists someone who became wiser
Their story started with the humble teacher
Teaching in calm collected demeanor

6) I liked the poem so much that I actually committed it to memory, in anticipation of our SPM Malay Language examinations back when I was in secondary school. Unfortunately, the theme "Teachers' Day" did not come out for our exams that year. Nevertheless, I've never forgotten my teachers, not even those from primary school. Hopefully, I'll be able to come back and meet up with some of them in the near future. And on that note, I shall end my blog post here. Thanks very much for tuning in, and hope you have a great week ahead. Take care and stay safe, cheers!

Happy Teachers' Day 2021

To all the teachers out there, thank you for being so kind and inspiring!

DAY 1637-1651

Feb 25 - Mar 11

Night has arrived, 

Another day survived,

The medical student returns late.

Dinner has gone to waste,

For they only long to taste, 

That warm embrace of their own bed.

In stress they thrive,

In sickness they strive,

For attendance equates to proficiency,

From dawn to dusk, 

They put on a mask,

To shield others from their own deficiency.

Exams are a priority, 

So say the majority,

The mindset of a student is resolute,

Like modulus in mathematics,

Or temperature in thermodynamics,

Their conviction is thus absolute.

From students to doctors in a flash,

From scratching their heads, to treating the rash,

Repeating to themselves that old lie,

That this will all be worth it before they die.

Years of stress have taken their toll,

The once bubbly figures have lost their soul,

The cost of their dreams was their own health,

Have they never learnt that health is wealth?

Pre exam week lunch with my friends @ Baby Sumo Restaurant

(l-r: Rachel, Myself, Sharifah, Afifah)

Dinner with my cousin Eo @ Arashi, Gurney Plaza

Thanks so much for the wonderful meal!!

DAY 1623-1636

Feb 11-24

1) These past few weeks have been rather uneventful, as might be expected given the current pandemic climate. Seeing as there is not much going on in my day-to-day life right now, I thought I might write on a topic that is clearly on everyone's minds right now i.e. vaccination. Specifically, I want to briefly discuss the reasons behind vaccine hesitancy, and how one's decision not to vaccinate may affect the wider population. 

2) Vaccines train your immune system to create antibodies, which are useful in fighting off infections (i.e. bacterial or viral). They consist of either killed or weakened (attenuated) forms of germs, so they do not cause the disease or put you at risk of its complications. As the saying goes, prevention is better than cure. However, not everyone wishes to vaccinate their child, hence the recently-coined term "vaccine hesitancy". As future healthcare practitioners, it is important to understand some of the driving factors behind vaccine hesitancy or outright refusal, so that we may be better prepared to educate the patient and their families.

3) One of the main reasons for vaccine refusal is due to alleged safety concerns. It is no surprise that in the age of the internet, information regarding vaccines is readily available at the click of a keyboard. Moreover, when we consider that the mass media (TV, radio, news), as well as hearsay from family and friends, could also deliver information about vaccines, it is easy to see how the public could be bombarded with information - making it difficult to make a well-informed decision regarding vaccines. One of the main challenges in promoting a healthy discussion on vaccines is the effect of mass media sensationalism. News outlets are much more likely to report and sensationalise a rare, unforeseen side effect of a vaccine, than they are to report the countless other patients who are protected from the disease as a result of that same vaccination. 

4) Let's consider the infamous example of scientific fraud - the supposed association between vaccines and autism in childhood. One faithful day in Feb 1996, now-disgraced ex-doctor Andrew Wakefield was hired to write a journal article on "vaccine damage" in young children (google "Lancet MMR autism fraud" to learn more). His study used just 12 (!) children to "prove" that the MMR vaccine caused them to develop autism. Not surprisingly, he lost his license to practice as a doctor in the UK. Sadly, the damage had already been done. Widely considered "the most damaging medical hoax of the 20th century, it led to a sharp drop in vaccination rates in the UK and Ireland. Following the initial claims made in 1998 (when the results were published), multiple large epidemiological studies were undertaken. Reviews of the evidence by the Centres for Disease Control and Prevention (CDC), US National Academy of Sciences, the UK National Health Service, and the Cochrane Library, all found no link between the MMR vaccine and autism. Physicians, medical journals, and editors have described his actions as fraudulent and tied them to epidemics and deaths worldwide. 

5) So why was his fraudulent research so impactful? Two reasons - firstly, because people generally prefer a good conspiracy theory. There is real science behind why conspiracies are so widely believed - namely i) the desire for understanding and certainty; ii) the desire for control and security; and iii) the desire to maintain a positive self-image. A thorough discussion on this can be found via this link (https://www.psychologytoday.com/intl/blog/talking-apes/201801/why-do-people-believe-in-conspiracy-theories) Secondly, because we are pattern-seeking mammals - we look for patterns and associations where there are none. A popular saying in the field of biostatistics is "correlation is not equal to causation". Just because two things happen at the same time, does not mean that one causes the other to happen. For example, if research were to show that during the summer months, there was an increase in ice-cream consumption, and during this same period, the number of people struck by lightning increases - can we reasonably say that eating ice-cream is a cause of getting struck by lightning? Similarly, if you did a study on children who have autism and you found that they did indeed get vaccinated as a child, can we reasonably say that the vaccines must have caused them to develop autism?

6) As with all medications and surgical procedures, there is a possibility of unwanted complications. For instance, when you take Panadol (paracetamol) for that chronic headache, there is an increased risk you might develop kidney and liver problems, and at higher doses, it may precipitate massive stomach bleeding and severe, life threatening skin reactions, including Steven-Johnson Syndrome, or toxic epidermal necrolysis. Yet we are quite happy to continue taking Panadol, and other over-the-counter medications on a regular basis. So what gives? The answer is simple - we weigh the risk-to-benefit ratio of these medications. The above complications I mentioned are incredibly rare, and usually occur in really high doses. So let's now compare the risk-to-benefit ratio of vaccinations.

7) Vaccines are no different to other medications - they come with their own side effects. Most of these are self-limiting, meaning they resolve by themselves without any further treatment. These include local symptoms, such as swelling, redness, and pain at the site of the injection, as well as general symptoms such as a headache, fatigue, and a mild fever. Quite a lot of people get worried when they see their child being feverish and less active after getting a vaccine. This is understandable, but at the same time, we must remember that having a temperature is a sign that the body is improving its immune defenses! At slightly higher body temperatures, our cells and enzymes are able to work more efficiently, producing more antibodies and at a higher rate, to fight off infection. Now let's consider anaphylaxis, which is a severe, life-threatening allergic reaction that rarely occurs after vaccination. In the US, a grand total of 10 cases of anaphylaxis were reported after over 4,000,000 doses of Moderna COVID-19 vaccines were administered (https://www.cdc.gov/mmwr/volumes/70/wr/mm7004e1.htm). No deaths were reported. This means that your chances of getting an anaphylactic shock after vaccination are quite literally a million to one (to be exact, it is 2.5 per million population, but I'm not about to argue semantics here). Now before someone says even a million to one odds is still too high when it comes to human lives, let's consider the alternative - not vaccinating. Based on the same report, there have been a total of 24,135,690 cases and 400,306 deaths due to COVID-19 in the US. When you compare 400,000 deaths due to COVID-19, against the 0 deaths attributable to the vaccine, then perhaps vaccines may not sound as bad as some people make them out to be...

8) One of the main reasons to vaccinate your child is to provide herd immunity. You may have heard of this before, but basically it's the idea that when a sufficient percentage of a population is vaccinated against an infectious disease, the whole population (including those who are not vaccinated, for various reasons) will be protected against the disease. So why should we care about providing immunity to others who would not vaccinate? To put it simply, there are a group of individuals who simply cannot receive a vaccination as their immune system is too weak (we call them immunocompromised). For example, individuals who have cancer, full-blown AIDS, or are on radiotherapy, chemotherapy, or are transplant recipients. These patients are sadly more susceptible to infectious diseases and yet are ineligible to receive the very vaccines that will provide them protection against these diseases. Instead, they rely on you and me to vaccinate ourselves, so that we may collectively achieve herd immunity, thereby indirectly protecting them from the disease.

9) Some parents may also wonder why vaccines do not completely prevent the infection - i.e. you can be vaccinated against tuberculosis (via the BCG vaccine) and still develop pulmonary tuberculosis in later life. So what's the point of vaccines then? Well, I like to use the analogy of a seatbelt. A seatbelt on its own does not prevent an accident from happening, but in the unfortunate event of an accident, the seatbelt could well save your life, by preventing you from getting hurled out of the vehicle. Similarly, vaccines may not be 100% effective in preventing a dangerous illness from occurring, but it i) significantly reduces the likelihood of it happening, and ii) in the unfortunate event that you do contract the disease, it reduces the severity and duration of the illness. Having said that, vaccines in general are highly effective. For instance, after receiving the second dose of the MMR vaccine (which protects against measles, mumps, and rubella), 99.7% of vaccinated individuals are immune to measles. Similarly, the varicella (chickenpox) vaccine is between 85-90% effective in preventing all varicella infections, but 99.9% effective in preventing moderate to severe chicken pox. 

10) "So what if I do not vaccinate my child? It is a risk I am willing to take." Well, let's consider some of the aforementioned diseases. In the neonatal (newborn) ward, one of the saddest cases to come across is a baby born with congenital rubella. Typically, these babies are born blind in both eyes (due to bilateral cataract) and deaf (bilateral sensorineural deafness) in both ears. They have a 50% risk of heart abnormalities, including a "hole in the heart" (patent ductus arteriosus), and are prone to infections of the layers surrounding the brain (meningoencephalitis). When you consider that this disease is completely preventable (by ensuring that everyone including the mother is vaccinated with the MMR vaccine), perhaps it's easier to understand the pain that healthcare workers go through when they see yet another implication of vaccine refusal. 

11) Also, let's try to remember that it was barely fifty years ago when patients with polio, most already paralysed due to the disease, were strapped for the rest of their lives to huge industry-sized horizontal cylinders called "iron lungs" (just google it), with their entire body up to their neck encased in this metal contraption with only their head sticking out - just to be able to breathe. Since being eradicated (in the US at least) due to the success of a nationwide vaccination programme, polio has since made a resurgence in other countries, including Malaysia, the Philippines, and most of sub-Saharan Africa. Similarly, measles, once considered eradicated in the year 2000 due to mass vaccination, has seen a resurgence in the United States, with over 1,200 cases confirmed by the CDC in the year 2019. 

12) So what can we do to educate the public regarding vaccines and their use? First and foremost, as healthcare practitioners, do not brush off the parents' concerns. Acknowledge and empathise with them. Try to understand how they must feel, overburdened with information and a sense of guilt and uncertainty in deciding what is best for their child. Secondly, do not demonise or condemn those who refuse to vaccinate their children. Instead, point them to reputable and verifiable sources of information, such as the Centre for Disease Control and Prevention (CDC), World Health Organisation (WHO), and your country's own Ministry of Health. Thirdly, as a parent, talk to your healthcare provider. They will have firsthand experience in counselling parents regarding vaccinations, so they should be able to answer most of your questions. 

13) Given the current situation, we are in desperate need for mass vaccination against the COVID-19 virus, so that we may return to a semblance of normalcy once everyone develops immunity. Let's all do our part to ensure that we remain protected, and by extension, that we protect our loved ones, and those around us, from this pandemic. I would like to leave you a quote by Jeffrey Kluger, editor-at-large for TIME magazine, " Vaccination saves lives. Fear endangers them. It's a simple message parents need to keep hearing". And with that, I end today's blogpost. Thank you for visiting, take care, and stay safe. Cheers! 

DAY 1607-1622

 Jan 26 - Feb 10

1) It has been a good while now since my last post. Usually, I would have quite a lot of interesting material to share on my blog after such a long period of time. However, due to the fact that we are all in lockdown, and clinical sessions have not yet resumed, there is nothing really exciting going on in my life right now.  Meanwhile, we have received news that clinical teaching will resume on the 22nd, which gives us some time to relax revise.

2) I have been spending the past week revising data from my previous dissertation. It has been a long week for me, having to sift through and conduct further analyses on what seemed to be lines of never-ending data. Thankfully, I have managed to complete the bulk of the analyses, and I shall now wait to discuss the next steps with my supervisor. 

3) At the start of the new year, a lot of us would been led to believe that we would witness a sense of normalcy from the current COVID-19 pandemic. That has very clearly not been the case. While numbers have been dropping in most countries, it is clear that mass vaccination will take a while to implement, and even longer to build up immunity in the general population i.e. herd immunity. This could take anywhere from months to a year. Therefore, it is important to maintain social distancing, practice good hygiene, wear a mask, and obey local public health guidelines. 

4) Having said that, the situation in local shopping complexes and other small businesses is really quite depressing. Just the other day, I walked to Gurney Plaza to get some groceries and stock up for Chinese New Year. Around 80% of non-food outlets were closed, and of the food outlets, no dine-in was permitted, with takeaway being the only option. For added measure, all the chairs and tables in these outlets had been tied up to prevent any dine-in customers. In general, the whole complex looked empty, safe for the  Grab/Food Panda delivery drivers who were queuing to pick up items for home deliveries. 

5) It is quite clear now that I would not be returning home for CNY. There is just too much uncertainty with when I might come back for clinics. At the very least, I will be fully occupied with things to do throughout this continued lockdown - mostly revision if I'm honest haha. That's about it for this edition of my blog. Hopefully there will be more exciting posts in the weeks to come. Have a great week ahead, and stay safe and healthy. Cheers!

Beautiful Chinese New Year decorations @ Gurney Plaza :)

Too bad there were so few visitors to admire the lovely decorations...

DAY 1593-1606

Jan 12 - 25

1) As our country battles a third wave of COVID-19, most states have been placed under a fresh lockdown, initially for two weeks, then subsequently extended for an additional week. During this time, all our clinical rotations have also been suspended. In the midst of all this, there are two factions - those who feel that further lockdown is essential to contain the number of clusters daily; and those who feel that any further lockdown will severely cripple the country's already weakening economy, in particular the small and medium enterprises (SMEs). I can see the arguments for both, and I'm personally on the fence on this. But at some point, difficult decisions will have to be made, which will not please everyone.  

2) Personally, I've enjoyed the two weeks' reprieve from having to wake up early to attend clinics. This is an ideal opportunity for me to (hopefully) catch up with my revision. The downside to this "extra" bit of revision time is that we will now either have less holidays or less study time before our exams. That's assuming that we still get to graduate in time, of course. The way things are going, it is really hard to tell what will happen in the coming weeks. 

3) In the recent weeks, my email inbox has been inundated with emails from potential medical students/ school leavers who are interested in finding out more about medicine at RUMC. It has given me great satisfaction to be able to help these aspiring doctors decide if medicine is for them, and to share my own experience as a medical student. Before entering medical school, I had a few close seniors who were extremely patient in answering my many questions, so in some small way, I think of this as giving back. 

4) A week ago, the landlady came over with the maintenance staff to take a look at my bathroom. For the past few weeks, the toilet had been leaking from one of the pipes. Luckily, with some help, we were able to locate the source of the water (it was very well concealed behind the tank cover). As they did not have the necessary tools to fix the leak there and then, we made an appointment for the plumber to come again. All in all, the repair took just under an hour. I'm very glad as I had initially been told that it would take at least two visits.

5) That's basically it for this edition of my blog. Sorry there is nothing more interesting to read, but then again, these are some really strange times... As always, thanks very much for visiting my blog, take care and stay safe. Cheers! 

We need to stay strong and remain hopeful, and look out for one another :)

DAY 1579-1592

Dec 29 - Jan 11

1) Just like that, the nightmare that was 2020 has passed. That doesn't mean things will get any better, but with a new year comes new hope. Some of us will have made our New Year's Resolutions, while others may not. I don't have any particular resolution, other than to continue toiling about with my studies. I'm currently just past the half-way point in family medicine, and I'll be sitting for the end-of-rotation examinations in two weeks. No pressure then.

2) Exam stress aside, family medicine has been very interesting. Our 10-day break for Christmas was very useful for me, as it gave me time off to rest and recuperate, as well as revise some much-needed medicine and surgery notes. Given the recent increase in COVID-19 infections in Malaysia, we will have to wait and see if there are any changes implemented to our current movement control order, which may have an impact on our studies and exams. I guess we'll find out tomorrow evening.

3) When I was younger, I loved reading about space and astronomy - of quasars, supernovas, and supermassive black holes. Of course I was not able to understand most of it, but recently I've begun watching videos on YouTube, and it has piqued my interest again. Everything from the theory of the universe, how life began, and how we measure the age of the universe etc - all easily assessible and explained in layman terms. 

4) Another aspect of science that I've always enjoyed is evolutionary biology, specifically that of humans. Those days, it was always a search for the "missing link" - that transitional fossil that describes the intermediate form that separates modern humans from our anthropoid ancestors. Nowadays, we know that evolution is neither linear nor progressive (i.e. it is branching), and so the term "missing link" has fallen out of favour, replaced by the newer term "last common ancestor". Again, some excellent videos are available on YouTube explaining this in more detail - I just find them fascinating.

5) There's nothing really new going on in my life right now. The main objective is to finish off our family medicine rotation in one piece, and then transition to the next rotation (i.e. ophthalmology) before our Chinese New Year break. Until then, I should probably get back to revising haha. Thanks very much for visiting my blog as always, and have a great week ahead. Cheers! 

Welcome to Cat Beach!

(We took a nice detour during our posting at Teluk Bahang Health Clinic to visit this gem of a location)

I don't know anything about cats but here's a contented-looking one XD

These are all stray cats that have been put up for adoption :)

One of them even decided to get close to me XD

At the entrance to the very aptly named "Cat Beach"

Here's a close-up photo of my left retina, taken during one of the clinic postings

(it's a normal eye XD)

Lunch with Sharifah and Rachel @ Oldtown Kopitiam :)

As quickly as they appeared, the Xmas decorations have been taken down and replaced by the Chinese New Year ones

Compulsory face shield, for extra protection against the current pandemic...

A huge thanks to Melvin and Melissa for the lovely cake and banter! :')