Sunday, November 10, 2013


No, I'm not moving my blog, though it's likely that the posts updated here will get more and more irregular, still, I'm keeping this blogspot for personal use.

Do pay visits for some clinical psychology, mental health and psychiatry related posts:

It does reflect a lot regarding my work, my patients and mental health in Malaysia in general. I'm currently focusing on writing clinical case studies of various psychiatric illnesses. 

Wednesday, September 11, 2013

A Letter to a patient

Dear Mr Chong,

This morning I was calling a few patients checking how they have been and trying to answer any question they may have. When I was calling this woman whom I usually called her house numbers as she didn't have a mobile phone, somebody else picked up, and told me she's no longer living. She committed suicide yesterday. The lady answered the call was her daughter. I didn't ask anything further, ended the call after sending my condolences.

It took me at least 5 minutes till I managed to type the note then tell my colleagues what happened. One of my colleagues guessed it straightaway before I opened my mouth, she must have seen it on my face. I keyed in "Deceased" on her profile and informed doctor much later.

I carried on with my work. Then later of the day I was calling you and realized that your phone was temporarily unavailable. I called your girlfriend and finally she picked up, telling me you were fine taking the medicine. About an hour later you rang me from Singapore, and when I said I was just checking how you were getting on, you said you were going to commit suicide. I know you, although only for 3 days now, I knew you were just joking, so I asked by what method you're planning. You laughed, I'm released. I was updated with your current condition, I know you're doing very well, coping well too. Afterall you weren't depressed, just some anxiety and palpitation problems.

This is part of my work. Sometimes a few people tell me they're suicidal within a day, I learn to judge well to make sure everyone stays alive, then happy if possible. I didn't take you seriously, so I didn't tell you that you shouldn't really be joking about committing suicide.

11 Sept 2013

Saturday, July 06, 2013

What's wrong with the children nowadays?

I have an in-law who teaches English in a secondary school, and is a discipline teacher. She recently got her car a recorder as her car was scratched (not just hers, but quite many other teachers' cars too). So this recorder is like a car CCTV that records everything including sound as long as there is battery power supply.

Yesterday a prefect approached her and told her that her car was scratched again! She went to check and decided to check the recorder when she got home. So hours were spent and my brother and she found the culprit. Although not exactly clear, it did quite convincingly suggest who did it. 

It was the prefect who came to report the incident. 

He is only form 2 this year. He got straight As in his UPSR. He came from a highly-educated family. He is the only child at home. He gives hands to his teachers when they need help (e.g. he helped my sister-in-law to carry bags and stuff from the car to the office). 

If it wasn't the CCTV would anyone ever think that it was him who did it?

Why a so-called good student like him did this? Something wrong the boy himself? with his teacher(s)? with the parents? with the education system? with the society?

My in-law could only think of the other day where she told him off during an assembly as he was doing homework which wasn't what students meant to be doing, what say a prefect who should set as a role model.

Really? I found it quite difficult to actually believe that a 14-year-old boy was this "advance" in playing psychological trick and had this kind of mind set where (1) he intended to revenge or sent some kind of message to my in law? (2) he did it and then reported it, most likely believing that nobody would ever know it was him?! 

We can imagine that how much it would hurt this boy if the video is published, so we thought about ways to protect him. I think we would rather have some really "bad students" who did it, so that they can be punished straight away knowing they wouldn't really care anyway (I mean it shouldn't bring harm to the bad students in long term). But for a "good" student like this, any minor punishment we thought it is (e.g. having him to resign from being a prefect) can lead to severe consequences, or even affecting the rest of his life... So as long as he knows he was wrong, parents would be notified and no punishment would be given. I think this is a better way, although I do think parents should now give a lot more attention (and love?) to this boy, understand him psychologically and his mental development, perhaps he really needs some proper counselling or psychological treatment. 

Not until something happens to your children, always be so alert with how they are growing up. Is results everything to them? What's the most important values that we should be implementing to our next generation? What do successful and happiness stand for? 

Saturday, June 22, 2013

Genuine Suicidal Attempt or Attention Seeking?

She was told by the doctor to come to the clinic to collect her medication and for an injection, after seeing the doctor in the hospital.

When she got here she looked like she was on the phone, but nobody heard her talking at all. Staff told her to come in to the treatment room. She gave no response, made no eye contact – as if she was so concentrate on a spot in the air. Then she walked towards the door, went out, and stood by the stairs. She looked down to the lower floors. A colleague said, “she isn’t going to jump down is she?” I was going to say “Is she looking for someone downstairs?” but before I even completed the sentence, her feet were already in the air, hanging her body on the rail. we all ran out. She didn’t do it fast as her left hand was still holding the stairs handle/rail. So one of the colleagues managed to grab her legs, another her arm.

She was brought in. She continued to say that she wanted to leave, and of course she wasn’t allowed. It took some time till she was injected and given stat dose. The doctor came from the hospital to see her.

It appeared to be something related to drugs, she seemed to be taking illicit drugs, and according to her, she will be charged for distributing drugs (or bringing drugs in from another country). She said she was innocent.

She calmed down later as the stat dose kicked in. Family member was contacted to bring her home. I’m not sure how she is right now, I hope people will all stay away from illicit drugs. 

If it was one of our busy days we wouldn’t have noticed and managed to stop this. Though we doubt if she really wanted to commit suicide, or she really just needed some attention and help maybe. Because of how the stair is designed, it wouldn’t be possible for anyone to jump down straight from 4th to ground floor (other than a small baby).  She could only fall to the third floor, though her head would have landed on the stair case below. I’m sure she was aware. So attention seeking through a suicidal behaviour?

Sometimes when it comes to mental illness (and I guess many chronic physical illnesses), family members get fed up and lose their patience after a period of time, due to the time, money and attention needed to care about the patient, but also the stigma that come with it. But without any support from close family and friends, it’s almost impossible for someone to completely recover from mental illness…

Tuesday, June 18, 2013

Confidentiality Awareness

"What? You are just going to fax the letter over like that?" I asked, as my colleague was going to fax a letter regarding one of our patients to the patient's company. The company requested it, and the patient was aware - he came to sign a consent form (ah wow such thing exists?!) but he isn't allowed to even look at the letter. So yea, he gave consent for us to disclose his illness to his workplace, without quite knowing what his doctor wrote about him.

"Yes! The patient isn't allowed to read it so we can't give the letter to let him bring to the company! I'm just going to call to make sure that they get the letter" (they? who?!)

I guess most of us know where a fax machine is placed in an office in most companies. Usually anyone who walks past it can check and look at the incoming fax. Chances are the fax may then be passed from one to another (in a larger company, maybe office boy, secretary, some other "caring" colleagues). I feel so bad that this was done. I don't blame my colleague or anyone in the clinic, but the whole awareness about confidentiality issue in Malaysia is just low, very low. When I was trained in the UK, confidential used to be such a big issue. In the uni we had one whole 5 credits module about ethics and confidentiality; At work, we had one whole hour training about protecting patients and staff confidentiality.

Having watch this, I will be so careful to sign any "consent" form in the future. I mean we all as patients or service users or some kind of participants should understand where those private information about ourselves is going and what they are used for. Remember you always have your rights, don't be afraid to fight for them. It may take quite some time till we actually get there like in many developed countries, but it will not happen if nobody is fighting for it.

I hope people in the practice gain more awareness and give more respect too. Imagine this was you, would you be happy that your some sort of medical/financial report or ability test etc is passed around in your workplace or among some unknown people? 

Sunday, June 09, 2013

Morbid Jealousy

There was this young beautiful girl, who from the age of 16, got into her first relationship with a working guy. She then became so obsessed, and had the delusions that the boyfriend was flirting with other girls, having an affair with others etc. She skipped classes, and went to her boyfriend's working place to "watch over" him, see what he was doing, who he talked with...

Over the years the girl got into various relationships, because of how beautiful she is, guys get attracted, and when she becomes attached, she also gets really obsessed and possessive, especially when the guy having any contact with other girls, despite how faithful the guys were. The girl slowly realized this a problem, and consulted a psychiatrist. Over the years she also gained insight with her problem -- a condition now called "morbid jealousy".

Morbid jealousy is a psychiatric condition where the person holds strong belief that his/her partner is being unfaithful without any convincing or "solid" evidence that this belief is true. It tends to happen over and over again no matter how many partner this person changes and how "innocent" the partner is.

It is getting to quite a common condition nowadays. As we would probably all expect that conditions like anxiety disorders and depression would be a lot more common, now probably every 1 in 10 people with a psychiatric condition comes to the clinic due to this problem, although most of them may not understand this as their problem (but only think that they can't sleep, get anxious easily, feel unhappy, got no appetite, is bad-tempered, gets agitated easily... which can simply appear as anxiety depression).

Here it's important to clarify that morbid jealousy doesn't apply when actually you find some convincing evidence, or when you are just feeling a bit insecure whether your partner gets a bit too close to someone (yes, just a bit insecure, which does not affect your life that much, and problem may simply be solved after you speak calmly with your partner), or when it's just part of a more sensitive type of personality.

For the patient's partner to come to understand that their partner has this problem would be helpful to the patient, and being understanding, considerate, supportive and patient to the patient will be significant to the process of recovery. 

Friday, May 10, 2013

Kita Kawan Mah!

I used to live in the UK for 6.5 years. And most people who first met me would always have thought that I came from China, when I shake my head, "Korea? Japan? Philippines? ..." was what I usually was asked. I would say I come from Malaysia, though I'm the third generation there, my grandfather is from China. Chinese is my ethnicity, but Malaysia is my nationality.

I may explain further, say if I'm watching Olympics games and the Chinese is playing the Malaysians, I'd definitely support the Malaysians. When there's no Malaysian playing, I MAY support the Chinese. So in other words I see my nationality more importantly than my ethnicity, not forgetting the roots and values of my ancestors.

I went to Chinese kindergarden (2 years), Chinese primary school (Sekolah Jenis Kebangsaan, 6 years), Chinese secondary and high school (private, 6 years) in Malaysia. Then I left Malaysia for another 4 years undergraduate and postgraduate studies in the UK. I do grow up not having many non-Chinese friends, not understanding much about the non-Chinese cultures, having lots of stereotypes about the Malays and Indians (as a psychologist I'd say "stereotype" is a way of categorising, until it goes too far and leads to...). I can think of a few Malay friends I met from ELS Subang, and two Indian friends I have during my time in the Uni in UK (they are from Malaysia). Among all these girls and boys, 100% of them are kind and nice, the kind that I'd say can either be my moderate good friend or even good friends.

Until that day our PM calls it the "Chinese Tsunami", until the day Utusan Newspapers asks "Apa lagi Cina mau? (What else does Chinese want?)". I know Chinese Tsunami isn't true statistically and factually myself, but I don't know what I can do about that feelings of upset. You can't really defend especially when you think people have all thought that you are guilty. Till I start reading some status updates on facebook shared by friends. They are written by Malays, by Malaysians to be exact, defending this isn't chinese tsunami, explaining how LGE ended up in prison defending someone of not his race, saying DAP didn't win any seats from UMNO other than the one by LKS (so there isn't such saying that Chinese is taking over the country bla bla blah), praising how far Chinese has learnt that we can no longer rely and believe in BN, saying we are all just one family i.e. a Malaysian family, saying they would boycott some mainstream papers for trying to differential us as different races, showing pictures of people helping others of different races in BERSIH and 508BLACK etc etc etc.

I was wondering "were these Malays of majority?", maybe there were only like 5% of the urban Malays who think so?! I don't have Malay friends whom I can ask... As time passes, our so-called PM and some mainstream medias continue to give unjust racial comments which were upsetting, I started to see more and more non-Chinese raising their voices, including those from BN and some NGOs. I also spent some time reading the comments of those statuses defending for my race written by somebody non-my-race. The majority of the writers' friends agreed with them, though perhaps 5-10% didn't, and even scolded these writers for not defending their own religion, benefits, races and children etc.

So I learnt that they were probably majority, at least the majority of the urban Malays. OK, now stop saying Malays, Chinese, Indians, Ibans and whatsoever... Because of "him", we are more united as Malaysians. I probably wouldn't have realized this for a long long time without him... I remember way before the election day, I have myself said to an Indian tenant of my father's shop that "there are good and bad people in all races". Now I've confirmed myself after the election, that there are good chinese, good malays, good Indians, bad Malays, bad Indians, bad Chinese.. all the good ones should be united to defend the bad ones...

Though, I'm not saying that I've "removed" all my stereotypes about others, but I am going to try to accept that we all live, study, work, and do things differently (so some people work harder, some people lazier, some are more arrogant etc), as long as it's legal, I'm also going to try stopping these prejudice of other races, because for once I now know they would extend hands of help despite our ethnicity, and for once I'm hoping our next generation will grow up with far less prejudice and stereotype. 

Monday, May 06, 2013

The day after the 13th General Election

I was weeping a little going to bed last night (or should I say 2 o'clock this morning), feeling hopeless and helpless, wondering whether the day would ever come to us Malaysians at all... wondering why wouldn't those people Ubah with us... wondering whether it's possible to fight all these ____ tactics...

Perhaps we were all too naive, thinking the process of democracy took only 10 years (or less). Especially when the results first opening, it all looked so positive, we were all so excited. Ubah yes?! Ini kali lah?!!! The Lim father and son (Kit Siang and Guan Eng) have been fighting for long, and I believe they never give up, and will never give up. So are many other opposition leaders (though in Penang, Selangor and Kedah, they aren't opposition). This is only my first vote, why should I give up? I weeped, I wiped my tears, I slept the sadness off and today I'm feeling much hopeful again...

Statistically, 5.5 millions people voted for PR, how many voted for BN? 5.2 millions. Ah but BN won. What does this reflect? (Think...) In 308 parliamentary, BN 140 vs PR 82, in 505, BN 133 vs PR 89. That's a gain of 7 parliamentary seats for PR this time round. In 308 state seats, BN 344 vs PR 161, in 505, BN 275 vs PR 230. Hey ladies and gents, that's +71 new state seats!

I hope people see some improvements there, some hopes, some positive changes. Now we learn from "mistakes". If we know there'll be electricity failures, each counting agent should prepare torch light (according to my brother they did, but there wasn't any failure in their area...). If we know there will be more hantu (ghosts), we will get more Taoist masters and Bomoh to catch them.

There's always solutions. There's always hopes. There's always tomorrow. It may take a long time, but as long as we keep fighting, democracy will be with us.

#505 #lainkalilah #nevergiveup #PRU13 #GE13 #democracyneverdies

Saturday, May 04, 2013

As a Proud Malaysian

今天的馬來西亞氣氛很奇怪 奇怪大概是自己的心理作祟吧
因為明天會是馬來西亞的投票日 也就是大選
還參加了三場政治講座 看過我其中敬佩的雪州議長鄧章欽 (決定忍著不再說他躺著都會贏) 曾經的副首相如今的反對黨領袖安華 還有公正黨署理主席 Azziz Ali (個人相當喜歡這人的風格管他甚麼種族) 等等不下十人...
每天用心看星洲 (你或許想問我這報紙怎麼還讀得下去 每翻兩頁就一大版BN/MCA/Najib 的新聞 這就是我厲害的地方 我都跳過與它們有關的新聞資訊廣告...) 還有追蹤facebook, tweeter 的消息
公平的說句 其實網絡上的極端人士很多 很不理智 很不humane (用華語我會說"不像人" 所以還是寫英語好) 也很野蠻... 事實的真相也不容易知道 就靠我們自己去判斷 而不是一味的吸收與憤怒批判... 不簡單 很不簡單...
但是許許多多的事實擺在我們的演前 卻不難讓我們發現 就算手中握有一票 也唯一在這個時候我們才像真正的"老闆" 可是面對黑暗的政治手段與 manipulations 我們能做的事情卻這麼的少...
原本我並不想在這個時候寫有關大選的Blog 一方面我是個有話直說的人令一方面我不想被抓 -_- 可是今天我真的不想再看報紙了 看那毫無新聞自由的報紙 完全被管制的報紙電台電視...

寫了這麼多 只想說要是明天是一場公平的選舉 我支持的清廉公正公義的一方是會贏的 這是我堅信的 只可惜 它公平嗎? 透明嗎? 值得相信嗎? 沒動手腳嗎?

不管結局如何 至少我參與 也會去盡我身為公民的責任早些出門投上一票 並盡量確保自己投的不是廢票...
不是這樣嗎 參與了 出了一份力了 要是結果不如所願 也只能說這世界或許本來就沒有那麼不公平的事
因為馬來西亞已經是這麼一個沒天災又富有天然資源的國家 要是還出現了公正廉明的領導人 不就太幸運了...
(也順便補充說明其實我真的挺生氣符合資格卻又沒登記成為選民的人或者不去投票的人 可是其實我自己也是 只是我沒登記卻已經成為選民 比起那些登記了卻被除名的我還是要幸運得多吧?! 又是黑暗唉)

話說回來 我也不是真的那麼支持某政黨某聯盟的人

只是我學會兩線制的好 我想完全不貪的官員 做久也會貪 也會懶 也會攬權濫權...
完全不貪的一定很少 只是現在這群勇士 很大部份都是受了高深教育的專業人士醫生牙醫律師大學講師成功企業家 etc etc 那麼賺的行業還犧牲自己和家人出來參政 可以想像他們迫切想改變的心 所以自然比某些人抵抗誘惑的能力強多了吧...

願明天的馬來西亞是 光明 和平的

The content in the links below may not represent the blog owner's view.
People trying to reach it to CNN
Pledging governments of some other countries to stop their people from intervening the Malaysian's election (which should really be a election that is completed by only Malaysians!)

P.S. 沒想到英國回來後寫的第一篇竟然是政治有關 還用了久違的中文...
#五月五 #PRU13 #GE13 #inikalilah

Tuesday, January 29, 2013

Leaving people I love

I'm probably the person who has the most leaving dos done from work, and it's been going on for over two weeks now. Tonight is the last night, we were out for drinks, I wasn't even sure if I was drunk (just 2 pints, so I shouldn't be) but it did appear to be so for them. 

I hate leaving. I stood out there after they walked me home, I just stood there and cried. I was sad because I am leaving these people that I love, but I'm even more sad because I see tears in them. I kept saying this isn't the end of it, but by heart we all know, at one point of our life some people may appear to be so important and special to you, but 10 or 20 years later (if not less) when you look back, they are just part of the memory, part of the history. 

Though one thing that I always do, I keep people in my heart. I reserve places for different people, big and small places. And nothing changes this, not even time. 

I never knew it could be so difficult, or I may have done done a different decision. The saddest part is life will move on, the things that you cry about today, no longer matters some days later. Sad, isn't it? No? I don't want these people to just be in my memory. That ain't good enough. Tell me think about them and have a smile on your face? This ain't good enough. I want to see them, and smile. 

Nothing I can do to change. I will let go one day. What's worse, one of them is going to drop me off in the airport tomorrow...