Crybaby's Lair: April 2017

Finally got my ID card!

This is my first post in 2017 and quarter of the year has gone by. I still have intentions to continue blogging but just that I have busy with work and hardly have the mood to write. One of my friend asked me if my blog is already dead and that spurred me to finish up this draft that’s been sitting on my desktop for months. So, this is an update on my life.

Somewhere in October, my parents came over for a visit. We did a day trip to Kapit, a town that is only accessible by boat up the mighty Sg. Rajang. The boat ride took 3 hours and Jewel, the nyonya was waiting for us by the jetty when we arrived. I was attracted to the mural painting of Orang Utans brushing their teeth just across the jetty. We only managed to spent a couple of hours roaming the small busy town before catching our return boat ride back to Sibu. The boat services start daily from 5:45 am till 3:30pm if I remembered correctly. They only operate when there is daylight to avoid stirring the boat into logs floating in the river. The biggest attraction Kapit got to offer is their huge busy central market. Many villagers from the interior come and sell their goods in the market and therefore you can get a huge variety of things from there especially exotic animal meat and wild fruits or vegetables. As they say you reap what you sow, you eat what you catch. I saw fresh water fishes in bright yellow, civet cat, wild boar head three time the size of my head. I think you will need a pretty big pot to cook that head! On the contrary, the Chinese community there are mostly Hokkiens and not Foo Chow like in Sibu or Sarikei. Before heading back to Sibu, we stumbled upon an old vintage Tukang Gigi shop. He was out that day and we only managed to speak with his daughter in law who operates the other half of the shop selling stationary. She told us he is currently in his eighties and still making dentures for occasional customers who seek for his service. I wanted to get to know him, know his stories, how he shipped that heavy cast iron dental chair to Kapit and maybe in the future I can buy over his vintage dental posters once he retires for good.

1st class seats with powerful aircon blasting at us for 3 hours. They were screening Tarzan on the TV.

Crossing the speedboats carefully or else into Sg. Rajang I go

My favourite mural painting

Roasted Civet Cat anyone?

Small and compact town

Getting your haircut done beneath the staircase is an in thing okay!

The Tukang Gigi Shop

Sam in Kapit too

Kapit's Busy Jetty

Last November I joined the Malaysian Endodontic Society Annual Conference for the second time! I was super excited the week before, looking forward to drench in some Endo lectures. I pulled along Phyllis, my fresh graduated junior to join me. There was noticeably less junior dentist this round compared to the year before. Here are some highlights I picked up in the conference.

From Dr. Jaruma Sakdee who concentrated on Dental Trauma from endo perspective: Don’t promise anything for trauma case! Keep calm and expect the unexpected. Every case will be unique. She also highlighted that genetics can play a role in the body response and prognosis. Far too often, patient will seek for some sort of guarantee from their clinicians but it’s crucial not to be overconfident. The ‘under promise, over deliver’ rule applies and we can at most cited the percentage found in evidence base and reassure the patient that you will try your best for their sake.

From Dr. Mike Gordan: He brought to light the expectation for the road ahead as a dental specialist, there will be more observation in clinical cases, you will begin to find out what work and what don’t work as day by day new material and instruments are being introduce in the market. He did stir my interest to find out more on CBCT artifacts and that sometimes we shouldn’t just blindly rely on technology for our diagnosis. As he pointed out using the Scintillating Grid Illusion, you can’t always believe what your eyes are telling you.

I also like this slide of his below which reveal the opinion of different discipline of dentist handling the case scenario presented.

What do you see from the radiograph?

Dr Marino Sutedjo also presented on controversies in endo (ninja vs sumo access opening; disinfection vs. medication; endo as a focal infection causing illness?) with evidence based point of view to keep us intact and sound of why we are doing what we are doing in endo field.

Other concepts like Minimal Invasive Endodontics and 25.04 prep were relatively new approaches I took home with me from the conference lectures. I was also fortunate to join a quick 15 minutes hands-on using the Wave One Gold file and the GuttaCore on an acrylic block. I was also glad to pick up the composite polishing disc kit that I was looking for so long from the trade booth.

Met Dr Vikram. To the right, Phyllis.

December month had been pretty happening for me. I went to Kuching twice over the span of one week and took the Christmas week off for a family trip in Harbin China! My clinic organized a study tour to some of the dental clinics in Kuching and I tagged along. For those who know me well know that I was really hoping to get a posting in Kuching but the Lord had other plans for me. I’m not going to complain but Sarikei has been pleasant so far. The Sarikeians are easygoing type of patients, fairly easier to handle than the demanding urbanites of the bigger cities. My patients are mostly Ibans and Foo Chow Chinese so I’m practically conversing daily in Malay and Mandarin. Sometimes I have to mix up my Malay with some Bahasa Sarawak or Iban to get an effective communication with my patient. This year I hope to travel and visit places towards the north of Sarawak: Mukah, Dalat, Bintulu and the Barrio Highlands.

Sg. Sarawak

Damai Beach with our not-sexy-back

Study tour at KP PetraJaya

Compulsory Photo with Santa Cat of Kuching though Phang and I were soaked in drizzling rainwater

Town mice talking photo with beautiful Christmas Tree infront of the Spring

I just like the store name

Sibu's Vintage Cinema

Entering the working world also brought much self-realization for me. From time to time, I find that I am lacking in this aspect and that skills, failing to be the ideal clinician I wish I am. I try to grow myself by reading up articles, to keep up the new techniques and materials in the world. It is like I’m chasing after a fast-moving bullet train, and am I limited by my time, finances and energy. Currently I’m into my 4^th week of Hospital Specialty Posting. The past 7 months in primer care I have been involved in providing basic dental treatment in the local government dental clinic as well as involved in school dental project for a month.

My School Dental Clinic Setting

Treatment Needed

Giving a talk at the school hall

Definitely, there are advantages and disadvantages of working in the government set up. Sometimes I feel frustrated and wasted; so many things could have been done than worrying over paperwork and statistical returns. There is unending emphasis over quantity over quality. As compared to my peers working at other parts of Sarawak, I do get leeway to perform many things that aren’t allow elsewhere (as a first-year dental officer) and I am grateful for that. Having said that, many a times I do get upset that I couldn’t provide a total holistic care for my patient. It might be due to time, lack of resources or manpower. I will still strive hard to provide the best for them within my capabilities. Also, I’ve been observing around me the manifestation of human natural and how sometimes it is your convenience that matter over patient’s well-being. Whatever happen to oral health awareness and prevention strategies. And being in that environment daily one can easily get influence and conform to that common practice if you don’t stand back and reflect daily.