Author: VC Thong

Have I not known, the value of pride.

Little did I comprehend, the extend of one would do to protect his. In the face of own values and will, pride seems to matter more. I’m not sure how much I do though, never did ask myself that question, because in a way, I think I have none to begin with, because I have, in multiple occasions, discarded them, trading them for skills, knowledge, and reputation. For I find those holds more value.

Still, people are worried, I totally get that. During the Chinese war between Chu and Han, Han Xin, a skilful general was executed after his king won the war and established his dynasty, simply because the general, although won all the battles for his king, he was prideful. He boasted about his ability to command the army better than his king, and able to live up to his own words. So, worried that this general may become a possible threat in the future, the king ordered his execution.

Such a shame, he could have enjoyed being a well-respected veteran, instead he was pierced with bamboos and hung beneath a bronze bell, died in agony.

Aside from the history lesson, I have been thinking about this character, Sun Wukong, the monkey king. Mythology mentioned that he was invincible, ruthless, skilful, almighty. He was able to turn the heavens upside down, trashed Hell to the brim of collapse, and attained immortality. Just when he thought he was truly invincible, he was punished by Buddha, imprisoning him under layers of rock for 500 years.

500 years later did he found absolution? No, immediately upon his release, he was put under a command of a mortal monk, tricked into wearing a golden restrainer headband, and tasked to protect the team to journey to the west for a book.

Sorry, I’m not a religious person, so I tend to wonder: What happened after they got the book? So the heavens granted them positions as Gods, so what?

Sun Wukong never would have wanted the position, by giving him the Godhood, is it truly an absolution? Or another soft- imprisonment for being all powerful? Who is the real benefactor? He is the good guy when he wears the golden headband, what happens when there’s none?

How prideful those questions are indeed, assuming one’s intent even when he has succeeded in his task. Here’s my answer to those questions (which I believe was what the Monkey King thought about when he put on the headband. He would have found it there and knew it was intended for him all along, given his ability):

I am tired of holding on things which has no value for myself. Here’s my pride, you can have it, just so that I can be a better person.

Sitting in my office, staring at the busy room full with unfinished tasks and books, a feeling of nostalgia kicks in, making me write this in an early Monday morning.

Another year, another first of January, another cycle of ordeal, another meaningless celebration, where most of us find the previous one unfulfilling, and hope for a better year by partying, putting up fireworks in the middle of the night.

I for one, know for a fact that nothing changed, my KPI stays the same, or made bigger, my work is the same, my salary stays the same, and my family’s gotta eat. There will be another 365 days of 24hours, where opportunities lie in wait for me, requiring no less hardwork and determination as before.

Call me pessimistic, I’m not buying into the “next year will be better” promise. Fireworks or not, I will do better, because the are people depending on this.

However, I do realise one thing changed, and I’m not sure how to feel about this.

It struck me recently my previous nanny, one whom brought me up as a toddler, who hand-sewn my first white labcoat and praised me every Chinese New Year, has passed on. God rest her soul, for she is the kind and caring mother-like figure to me, who gave advice to me when I absolutely needed it, and brought me to who I am today.

Another realisation is that my grandmother, who was the one caring for the big old house, who prepared my favourite CNY meals, is now sick and frail. I will not be able to taste her cooking anymore, and to help her with her chores anymore, fully knowing the extend of her illness.

That sent my mind wandering in an early Monday morning, were usually organised and calm, into a stream of greyish thoughts about life. The morning coffee’s aroma turned bitter today, but it is no less welcoming, because for today, I feel that I need some bitterness to clear things up in my mind.

I noticed that I am going by each year knowing that as the number grows, people that cared for me will need to go. As I grow, they are wilting away, watching, and more often, pinning for the moment to spend more time with us. They will never ask, because they cared for us so much that the idea of being a burden will never be entertained. They chose to watch and hope, all for our best.

For this, I am contempt, that it is just a part of growing up, to know that we were just a part of a bigger system of life, where everything we do is to pass on our knowledge, love, care, and possession to the next one. Looking at my children, their carefree faces when asleep, I finally knew why my predecessors did what they did. Fully knowing the sacrifices, the heartbreaks, and consequences, they still chose to continue on. In the end, we are mentoring the future, showing them whether our methods work, and support them with love and care through their hardships in life.

This, I can work with.

My dearest mentors, I’m grateful for everything you have left me with: your memories, your love, and your wisdom. I will carry them, hone them, and pass them on to others who need it. I will be your conduit to the years beyond your bounds, to reach grounds where you hope for me. May your legacy and your vision lives on.

As the years go on, there will be a time where I will lose all my supporting pillars. When that time comes, I should have became someone else’s, as mine will be the embodiment of every single one before me, living within myself, their memories, their love, their hope, , their wisdom, and their souls.

Waves crashes onto the beach, pushed by another, who cares free,

Knowing none the end will be, knowing none sacrifices mean,

Once it knows and gives chase, but the front will never cease.

The one later will never catch the former, as it was never meant to be.

Same water, same beach, the cycle repeats.

But will the wave grow? we shall see.

Love built me, Wisdom guided me, and Memories live within me,

I will make it matter, if chances be.

But I am merely mortal, where life fleets,

Should I fail, if time wishes be,

May I pass them down to the next, as they will replace me.

So your memories within me lives on, till eternity.

That will be my new year resolution.

It has been awhile since the last post. I’ve been busy, really busy. Switching from being a clinician in the health ministry to being an academician in the education line does has its challenges. Compared to the routine of managing healthcare, now I have to think about how to teach, how to generate new knowledge, how to treat patients, and more recently, how to run a department the new place entrusted me to take care of. To ensure the progression, I have enrolled in Master research study, hoping to one day secure my own PhD, and constantly looking for opportunity to engage with other academicians to learn their ways of bringing in new knowledge and innovations, in order to contribute to mine. I’ve lost count of how many proposals I wrote for the past 6 months. Of course, those are on top of the constant worry of myself able to be a good father, a good leader for my small family.

Sleepless nights, exhausted to the soul. It feels as if I’m back to my psychiatry training days, with more responsibility and uncertainties. I guess I just couldn’t help myself huh? To always look for ways to get out of my comfort zone.

Jun Cheng my boy, I’m sorry for the delay. You came into our lives in April 15th 2024, yet I was not able to sit down and give u this post. Here you go, here’s what your name is about:

“承于天，立于地，使于命，就于人，

能者包容万象，俊杰胸怀天下。“

“Bestowed by the heavens, stand firm on your feet, proceed with your destiny, and succeed with your being.

The abled accepts all, the fine pursues for the world.”

You came into this world without much of an ordeal. Your mom didn’t even have to stay long in the hospital. Probably because she has gotten better at the task or we chose to pay for everything this time, got a consultant doctor for you who is the best in her art. You are strong, fast, fearless, and cute. Never gotten sick, always laughing at us, and cries in a way that sounds almost like a roar when you are yearning for our attention or hungry. I’m sure you will be someone incredible in the future.

Now, let me tell you and your brother something about this world you came into. I have started teaching, and students have come for me for advice, psychiatry or life lessons alike, but I would have you two understand in detail, about how your father, me, view the world. You may develop a different perception as you grow up, or maybe even myself might change as I grow older, but I hope you would understand a few important points, so that you will not wander and wasted your talents and potential, in this wonderful world I live in, where I found full of possibilities.

First off, your mother and I love you with all our hearts. Should you find yourself difficult to move on, or lonely, or need to feel the warmth of a home, we will be there for you. Don’t get me wrong, I said the world is wonderful, but not without its own challenges and hardships. As your father, I will subject you to those, to experience, learn, adapt, and excel in the way you see fit. We will not be able to accompany you through your whole life, because you will soon be busy with your own life, and we will grow so old that we might not recognise you anymore. So in a way, we hope that you will continue to survive, weaving through the obstacles, while enjoy your life even without us. To do that, you will need to learn, and the best way to learn, is always out of your comfort zone. Remember this my boys, those who don’t learn in time, might never get the chance to, and will not be able to handle the situation when it hits hard.

When you got tired of learning and climbing the stairs of life, just come home. Me and your mom will be here. After a nice meal and rest, I will chase you out, to have you continue your journey of what we call life.

Second, just so happens that you two are boys. You will become men, of your family, your job, and most importantly, your word. I may not know how to raise a daughter, but I can assure you two I know how to train a man. Being a son of your grandfather of a soldier, and a grandson of your incredible great-grandfather, who both went through greatest and lowest a life can offer, I have written some of my own stories of manhood to tell you as you grow up. Now may be too early for you to know those so I’ll save them when you are ready. The gross idea is this: as a man, your life is not only your own. You will need to one day subject yourself to the needs of those around you, be it your family, your colleagues, your bosses, and the best yet, your own passion and belief. A man’s worth is always about how much he can shoulder, not talk. You will hear a lot of successful stories of others, but if you really pay attention to them, for your own learning purpose, its never about how ‘high’ their achievement is, it’s always about how ‘low’ they got before the success. So, talk less my sons, do more, subject yourself to challenges, chase the opportunities. Listen to the world, so you can know what you can do for its betterment. Your worth is never determined by yourself, but those around you. So accept them, be kind to them, while always improve yourself. Don’t waste your time to keep on tell others about how you did it. They have their own life to figure out their own methods. There’s no need to be the reason for them to blame you if it didn’t work for them as it did you.

Again, if you got tired of being a man, just come home and be our son for a while. After a nice meal and rest, I will chase you out again, for you to continue to prove yourself a man.

Lastly, be humble. You will meet someone great, greater than yourself, your father, even your imagination. Judge their greatness not by their wealth, not by their appearance, not by their fame, but their contributions. Your teachers will be one of them, because they taught you and gave you knowledge. The street cleaners, sewage workers, and rubbish collectors are one of them, because they keep your living space nice and clean. Your classmates and colleagues are one of them, because they cheer you up and support you while you carry out your duty as part of a society. So treat them well, try to understand their struggles, so you may a part of this wonderful big family. The greatness of a leader is always by his team. In other words, you will only be great if others allow you to be. There are people who always ask why do others keep interfering with his pursue of happiness. Well, the answer can be simple and cruel at times: maybe they haven’t allow others the reason to help him, thus voiding themselves the room for growth. Caring and respect comes both ways my son, remember that. Never demand respect from others, it has to be earned, usually by you respecting others first. I have never seen anyone asked others to respect him and gotten what he wants, you can take my word for it.

So when you got tired of bowing down, being humble to others, come back home. I’m sure your mom and me, even when I won’t admit in front of you, that we will be happy to hear you boast about your greatness and your ambitious thoughts, as long as you live by your words to continue to be humble to others.

Welcome to this wonderful world and this ordinary family my sons. I hope you can keep up, because I’m not stopping, not yet.

It’s the same feeling all over again.

4 years, or is it 5 years ago? When I was tasked to be the platoon leader in a night ambush simulation operation during my Potential Officer Course, I told my teammates during the operation briefing: “The Dr. Thong you befriended or knew just before is not here now. You are with the other version, who only knows the mission and the mission alone.” The reason I said that is because I knew the operation would be tough. It was a battle of endurance, where the team was tasked to hide in the Malaysian Jungle, where the temperature drops to the point of freezing while the rain pours, without light or warmth. All sorts of creepy crawlies wandered on the muddy ground around us, with mosquitoes enough to cause me to have an allergic reaction the day after. During the operation, I did not sleep, kept my eyes on the enemy route, ate sparsely, talked less, act only as needed. Hell, I even addressed my close friend who I regarded as my dear brother by his rank.

Sure enough, the team became more alert, organized, and disciplined. We went through the night holding the wits about us, but barely. Lots fell sick during and after, including myself. Despite the hardship, the operation went well, I protected my teammates, and we survived the night with our morale intact. It was a successful ambush simulation.

Well, that was 4 years ago, and it was in the military. Thinking back, I’m not sure that I would condone that method now as an educator. I’m not sure too that I knew the delicateness of leadership. I suppose it’s fair to say I have learned a few things over the past few years on my own accord, by throwing myself to the edge of the country trying to run a small department while looking for ways to discover myself.

I have learned, but recently I am having that feeling again, that “The other Dr Thong” is creeping up on me.

It has been an eventful month. Following my recent resignation from the Ministry of Health, and joining the line of education as a lecturer at Universiti Malaysia Sabah, much has transpired requiring my undivided attention:

1. Enrolled into a Master of Science program and started a Clinical Trial

2. Appointed Head of Department of Psychiatry Department

3. Adjusting my role as an educator to the future young doctors

4. Expecting my second son to be born in April

5. My grandma fallen critically ill back in Semenanjung

Those are the ‘titles’, I don’t want to go into details about how each of the problems weighs on me. I leave it to the reader’s imagination.

I am currently on my flight back to Kota Kinabalu, leaving Kuantan, where my grandmother is. Heading back to my pregnant and expecting wife, my naughty 1-year-old son, and my newly appointed job. I am staring at the night sky as the plane pulls itself to the darkened clouds, and a thought comes to me:

“What are you doing? Your grandma is still sick in the hospital! She is such an important person in your life. Why are you leaving?”

That’s why I pulled out my iPad and wrote this post. It is sort of a reality check for me and you, to know that I am still aware of my actions, and maybe telling you who read this to try to understand my point of view about the current events.

I know, a lot of people have been worried about my health recently, both mentally and physically. There have been many voices of concern from people at work or my family, to take care of myself. If even my hardcore mom tells me the same, that’s when I know the concerns are very real. I am aware that I am tired to the point of not realizing exhaustion, at times auto-piloting myself through my problems and tasks. Thankfully, I was greeted by my mother’s maid’s specially prepared bed as soon as I arrived at my parent’s house, and collapsed on it for these past 2 days while being physically hundreds of miles away from my usual responsibilities.

Still, for those who are worried, thanks, I will, because I have a job to do.

I know, that the road ahead will be challenging and treacherous. I may have bitten off more than I can chew. The tasks required of me are going to pile up, as the university hospital is now still in development and the department still has lots to catch up on, as my Masters Program would require me to commit my time to research work, or as my second born will require his father’s care and presence. Still, I’m not a person who makes commitments into excuses. I don’t plan to fail in things I have decided upon myself. I just hope that you reading this post, understand that I may require help in performing the task above, but not constantly reminding me that I might fail, because I know clearly what “are” at stake, and I’m prepared to see them through the end. So please allow me to do them, because I have a job to do.

I know, that today may be the last time I could have spoken to my grandma. I’m not that idiot of a doctor to know the most probable outcome. Left Frontal Temporal infarct with hemorrhagic transformation, right hemiplegia, hypoactive delirium, loss of gag reflex, sepsis with leg cellulitis, underlying atrial fibrillation, the list goes on and on. The fact that I was able to still speak to her and have her looking back at me drowsily today is already a medical miracle. I’m not going to bargain for more at this point. It’s just that I too have responsibilities that I can’t abide. Rather than staying back and simply hoping for another miracle to happen, I chose to do what my grandma would have wished me to do: protect my family, protect my job, and pursue my dream.

Don’t be mistaken, it was not a pleasant nor preferred decision, it was just another bitter but better choice to make in these difficult moments as a person with responsibilities. I may be suppressing my emotions, or I may be coping with whatever defense mechanisms I have going on, thanks for the clarification, but please let me do my job.

As the flight continues into the darkness of night, I sit quietly listening to my thoughts, mindful of the tantrum and yearning for any sort of relief. No matter how far I look, there is no clearness of answer, like the scenery just outside of the window I’m leaning against, void with an endless unknown. I may be jumping from one problem to the next. I just hope I chose the right solvable ones to work on.

But I know, somewhere beyond the darkness lies the brightness of the sun and stars. Even if the flight continues endlessly, there will be a dawn that brings colours across the horizon.

And there I envision my grandma’s beloved face, smiling at me, knowing that I have done what she would have hoped me to do.

The circumstances feel familiar, but I don’t think I will need “the other Dr Thong” anymore. Because I’m sure that I’m better than him already.

My consultant psychiatrist mentor once told us in a meeting: “Those who want to be a psychiatrist must watch the latest Joker movie!”

I couldn’t agree more.

After watching Joaquin Phoenix’s award-winning Joker, I am both amazed and glad. The latter is because finally, someone out there has managed to go in-depth into the bizarre character of Joker and link everything of his behavior to legitimate mental illnesses. The movie even managed to spread awareness about mental illness by poking at the topic of stigmatization. So how realistic is the movie Joker? Is it possible to bridge evil and mental illness? If so, how would the law decide who deserves the punishment?

To answer the first question: One straight answer- it’s very real. Allow me to walk you through the movie, from a psychiatrist’s point of view.

The movie starts by showing Arthur working as a clown while shedding his tears. Let’s back up, as we clinicians like to view things chronologically. My starting scene would be when Arthur is born, as even the birth conditions are vital to our diagnostic process. There was no information about his biological mother as it was written in the scene that he was abandoned, and adopted. When Arthur found his mother’s medical record, it shows that his adopted mother has bizarre behavior, psychosis, narcissistic personality. Another impressive detail is that her interview session with the officer, while she was detained, shows her lack of emotion, a blank stare, as she is preoccupied with something. She was speaking irrelevantly, and as we psychiatrists term it, her affect was blunted. With these clues, I would say poor Authur has grown up with a schizophrenic mother with a narcissistic personality disorder. This is actually bad news, while schizophrenia is a severe mental illness with its subject disturbed by hallucinations and delusions, the combition with narcissistic personality disorder makes it dangerous. Narcissistic personalisty disorder is a twisted form of lifestyle and view that others are inferior compared to oneself. Its characterised by self-absorption, grandiosity, and lack of empathy towards others. Narcissism is also a unique predictor in criminal behaviour. One may ask, why would then someone like that ended up adopting a child, or even allowed to? My suspicion, is that there may be a secondary gain involved, such as an attempt in getting a form of social aid. Back then, they may not have a well established screening policy for adoptive mothers, allowing the system to be taken advantage of.

We may say Arthur’s tragedy begins there. The beatings he suffered caused trauma to his brain. That sets up the core character of the Joker: the pathological laughing. In the movie, Arthur handed out a card when he couldn’t control himself laughing in the bus, telling others that he has a condition, hoping others would understand. So, is it true? that it is a legitimate condition? for someone to laugh uncontrollably? Yes, it is true, and it’s called the pseudobulbar affect. In psychiatry, its also tern emotion incontinence, for someone to have difficulty restraining from laughing or crying. It often result of certain brain damage, such as trauma to the brain, which cuts off our brains ability to control autonomic reponses like laughing or crying. On personal note, I have the opportunity to review 2 cases of petient with such condition, both instead of laughing, are having difficulty with crying uncontrollably. They both were in great distress, as they told that they were constantly being misunderstood even by their families, calling them ‘crybaby’. If crying can cause so much problem, imagine what a person who can’t control his laugh would go through? It must be constantly worrying for Arthur to interact with others, knowing he might unintentionally offend them.

From the movie’s setting, I would say it was set in the 80s when psychiatry is still young in its field. Back then there was a movement, urged by WHO to de-institutionalize, or as others term it- releasing those who were living in mental asylums, based on safeguarding human rights as well as reducing the economic burden of mental illness. However, as we have seen in the movie, the effort was not well planned out. When Arthur went to meet his case manager (I’m not sure whether she was a psychiatrist, if she was, she would be a very bad one), she was only asking routine questions like ‘Are there any voices’, or ‘Have you been taking your medicine’. There was no therapy done, no empathy in her approach, and no support of any form given to Arthur. Nowadays, knowing the impact of de-institutionalizing the mentally ill, even in Malaysia we are advancing in psychiatry rehabilitation, giving out social support such as supported employment, home visits, and social skill training for the mentally ill in the community. Without those, as we can see, Arthur is struggling to hold a job, got exploited by others, and is stigmatized for his illness.

Now comes the hard question, is evil a mental illness as well? There is a debate about this. Evil, in psychiatry, is often associated with a condition we called antisocial personality disorder, which is characterized by a person’s lack of empathy towards others. They live a lifestyle that disregards the safety of others, breaking the law without any remorse for their actions. Interestingly, it was found that a family that has a member with antisocial personality disorder is more likely to have a child with the same condition. Also, childhood abuse and neglect, with erratic parenting styles are associated with high risk for developing such condition. Normally, people with such condition would start to commit truancy even since adolescent age. Arthur, as in the movie, lacks support in him having this condition as he has been a law abiding citizen until his living circumstances worsened, pushing him to commit violent acts towards others. Maybe, is that Arthur has always been trying to supress himself, but as he chose to embrace his illness with a maladaptive manner, that’s how he became ‘evil’ turning into the ‘Joker’.

So, here comes the important question: If mental illness can be associated with evil, how do we decide justice? How will our justicial system judge these people when they commit a crime? Will they receive punishment the same as a healthy person? The answer is both yes and no. Yes, they will face justice, they would still be tried in court and faces the hammer of the law. But, there is a catch, they will require a formal assessment by a forensic psychiatrist, who would determine if the act of crime is in fact directly caused by their illness so severe that they have no way to know the nature of their action. If so, they would still be kept in an asylum, until the day they are pardoned by multiple government parties. If not, they would face the punishment same as everyone else.

For example: If a schizophrenia mother c mother murdered a child, the result of hallucinating that the child is a demon, without the knowledge that she is killing someone, or committing the crime during the act itself, she would be deemed insane and kept in an asylum until pardoned. However, if she knows that a child, and she did it anyway without seeking help first, even with her illness she will be punished.

Also, any act following the usage of alcohol or illicit substances, as well as personality disorders are not accepted for insanity plea.

So, tragic as it may be for Arthur, he will still be punished for his actions. As his deluded mind told him that he was manipulated by the talk show host Murray, resulting in him killing the host, he did not seek help, he chose not to take his medicine, and he is aware of his action of breaking the law. As a psychiatrist, I would testify him being ‘sane of mind during the time of the act’. The rest, such as the courts decision on whether is he guilty, is up to the jury and the judge.

I hope this post would create some awareness in the community about the burden of mental illness. Arthur did not choose his childhood and illness. Although he committed a crime, it can be a result of how he was being treated by society. Sidelined, disregarded, blamed, abandoned… those are the real difficulty faced by my patients. Even now the modern era, the struggle continues. The only way forward, as I see it, is for the public made aware, that mental illness is, after all, an illness. Nobody wants to be afflicted by it. We, the clinician, will continue to advocate for them, for that is what we sign up for: to protect and care for our patients.

It’s been 2 months that I’m away. Sorry things got a bit bumpy, messy even.

How I wish I could turn back time, to know the cost of my foolishness. Being away from you clouded my vision, made me lose sight of what is important, made me almost walk a path of destruction, where there’s no return.

But thank you, for being there as soon as I’m home. Looking at you froze at the sight of me, I knew I’m away for too long. You no longer recognise me, who previously you will laugh when I’m near you, and reach for me whenever you want to. It tore my heart apart, when I know I have to repeat the process of allowing you to know me again.

U grew up so quickly. It was only 2 months ago we would be worried that u will trip when u crawl, or needed our help to stand or climb up or down a ledge. Now u move with ease, reaching heights that I remember you couldn’t.

It took you 4 days to know me again, and give me the pleasure of holding you in my arms. Still my heart is heavy, knowing that I will leave you again at day 6, because of my job.

“You have to make sacrifices now, boy, for the sake of your family,” my dad said when I’m alone with him in his car, after I left you for my job, again.

Looking back, maybe I was not clear to myself what it means to be a father to you, but I sure hope I can do better in the future, your future. Now, I just wish to be there, more than anything.

Sorry, just a while more. I will be there soon, I promise.

It’s been awhile. While contemplating my options about my future, I read back the novel i wrote for you, hoping to find some clarity, maybe a wisdom that may have been forgotten within my memories of you.

Grandpa, I have always look up to the sky whenever i faced with huge obstacles, may it be my housemanship, my professional exams, or diverting paths life choices, hoping that you are watching over me, granting me that small hope that it will be alright. I’m not a religious person, but for you, i make that exception, because I know, if you are alive, you will answer me by saying the most simple words I need to hear:

“It will be fine.”

“I’m sure you will win.”

“Good boy, you can do this.”

I’m scared, grandpa. I am not as good as you think. I may have taken on something that I am not able to accomplish. Hundreds of miles away from my family, I may have made a decision to test my worth, but at the same time creating more obstacles for my wife and child.

Yes, you have a great grandson now, grandpa. He is alot like you and me. Bad temper, and relentless in asking for our own demands.

Reading back what I have wrote for you, I still can’t get rid of the feeling that I may have not understand you well enough. The things you did, the words you chose, and the way you made your choices. They are not the best choice I know, but did you ever spend time reflecting them? Or are you aware of it but choose to not tell us to spare us from the damage?

Am I a bad person if I chose not to follow my father’s footsteps? Am I doomed to fail if I don’t do so? What if I chose to go a very different path than you or my dad? Will you still be watching and smiling amongst the stars? Proud of your grandson? For my ultimate aim is to ease suffering for whoever walks into my clinic? Despite my own?

Your son is formidable, i would say more, way more than you, or me, should I carry on this trend? Or it’s an illusion casted down by you, your son, towards your grandson?

I’m broken, grandpa. By your choices, by your visions of the world, and by the hopes you left behind in your legacy.

Help me, for I think, that despite your actions, you meant well for everyone, that you chose to endure the sufferings for those you cared. And I, will be the last person to be understood that even will I burn in the depths of hell, I will never stop giving up hope and laughter to the people who come to me for just the wish to be happy again.

You made me smile throughout my childhood, grandpa. I wish to do that for the people of the world.

Watch me from the stars. I will be there when the times comes, and share with you my walk through the world over a glass of beer, which I never got the chance to. I’m not a superstitious man, but I know you are wondering why I did what I do. I just hope you will be patting on my shoulder and tell me again:

“You did the best you could,”

“You have grown well”

“I’m proud of you.”

I miss you, grandpa. I really do.

“贤明雄志壮才俊，万象功成就于恒。”

“Wisdom, clarity, might and ambition strengthen the talented and charming,

All occurrences and achievements are done by will of perseverance.”

Naming of Thong Jun Heng – “唐俊恒”

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I thought I have enough room here forever, but not sure whether it’s the walls closing in on me, or it’s me who is growing bigger?

Time and time again I hear these noises and voices. It sounded like they are talking to me, telling me stories, keeping me entertained. Usually, it’s a soft womanly one, but there’s another deep voice, whenever it appears, the woman will sound happy as well. Strangely, when that happens, I feel somehow excited, at peace even.

Argh, without me realizing the place has gotten too tight on me! I have no room to move anymore!

Hmm? The one deep voice sounds so near this time, I can feel it, this time its different! It seems like there’s something on the other side of the walls! I want to see what is on the other side!

What if I just kick the wall a little…

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“Hubby! My water broke!” My wife suddenly jolts out of bed, and storms into the toilet.

It was 1 am midnight. I was in a deep sleep, a well needed rest after 2 days of travelling from Kota Kinabalu, to Kuala Lumpur, and finally back to my pregnant wife in Kuala Lipis. It was a rush, as i predicted that it won’t be long before the baby checks-out his mother’s cramped up womb, and into this beautiful world, where he will have bigger legroom to explore and grow.

I was tired, but that quick sentence from my wife sends my brain into alert mode. Realizing the time has come, I quickly prepare us both and drive to the hospital. We did not wake anyone else on the way out, because there’s nothing to be panic about, yet.

After a brief assessment by the labor room night shift houseman, contraction closely follows and my wife is warded for good. I quickly settle my wife in the ward, bring her personal belongings, and call it a night. It is already 4 am when I lay down on my bed. Although I hardly get any good sleep due to anxiety, I keep my eyes closed as I will need the strength tomorrow, for my wife and future son.

25/07/2022, 8am, I am awakened by a call from the hospital, to ask me to stand by outside the labor room, for my wife is already being pushed there.

The time is nigh, and I realized I bought everything to prepare for this moment except pampers. There’s no time to visit the stores anymore, I quickly dress up myself, ask for my mother-in-law’s help to buy the necessary, and rush to the labor room’s front door and wait.

9am, nothing.

11 am, the nurse tells me it’s only 3cm. I returned home and brought my Nintendo. Monster Hunter does good in calming my nerves.

After soloing some dragons, I grow bored in the cramped-up Volkswagen and decide to sit on a bench near the labor room.

1 pm, I made a new friend of an expecting father, telling me all sorts of exciting tales of being a father of 3, going to 4. I then slowly walk to the canteen for my quick lunch. There’s nothing except plain rice, one piece of chicken breast in curry, and a flaming hot sambal belacan.

Well, I still gotta eat, what the heck right? I’m fine with that.

As soon as I put my plate on the cashier, the labor room called and asked me to quickly be there for my wife, for it was already 8cm. I quickly shove half of the food into my throat, there’s no time to pay attention to its taste nor finish another half, and jog my way to the labor room, past its counter, and into the partition where my wife is.

I have conducted many labors in the past, 6 years ago to be exact, when I was doing my houseman-ship, I have many times seen the unspeakable (for many men, who have no idea how nasty labor can be and shocked by the sight of it) and has grown numb to the situation. Still, seeing my wife in that state does bring heartache. She is groaning silently in pain, hoping only for it to end quickly.

We held hands, as her womb slowly pushes our son’s head through the narrow path, expanding the surrounding bones and muscles. Her grip is so strong it almost crushes my thick palm. Knowing what is going to happen, I soothe her with a calming voice and appearance, hoping it can lower the pain.

When the time comes, I hand it over to my O&G colleagues, praying that they are well experienced and my wife is in good hands. I will spare the critical moment, as it involves a lot of pushing, groaning, blood, and tears.

As soon as my wife’s pain stops, he is born, my very own son, who I believe will take on the world, stronger, smarter, and better than his father will.

My eyes linger with tears of joy when I hear his cry for the first time, loud and fierce, as I visualise him to be for months.

I shall name him “恒”， for I believe that he will know the value of perseverance, and shines bright like a burning sun, bringing warmth to those around him.

Thank you, dear wife, for bringing him into this world, and thank you, my son, for just being born.

What comes next is weeks’ worth of ‘baby cry on-calling’, a venture of neonatal jaundice with phototherapy, taking my own baby’s blood, a revelation by my parents that they know less about taking care of a baby than I do, and enjoying a 5-star ward in KPJ Kuantan while my baby is being suntanned. But that is a story for another time.

After 2 years of housemanship, and 4 years of training/ Medical officer routine, I have reached the part of my career where I can get my own parking spot- yes, it’s a big perk. Try to find a place to park your car in any governmental hospital every morning, you will understand.

“With bigger power, comes greater responsibilities.” Uncle Ben and Spider-man said that in their movie, but I did not see the weight of those words before I reach my new working place.

Hospital Mesra, situated side of the city of Kota Kinabalu, it’s one of the 4 governmental mental institutions in Malaysia. Compared to those in the Peninsular, it is considerably smaller. On the day I report for duty, I was greeted by a swift and pleasant orientation process, met my new polite a boss, and granted time for myself to get myself comfortable. As I walk up the hillside for the first time, I was shocked by how quick i’m able to finish my tour around the hospital. All it took was a 5 minute walk I have reached the rear fence, with every wards visible from the slope.

“Well, it won’t be too hard to get myself familiar right?” I thought with confidence, greeting every staffs walking up as i passing by. “6 months of gazettement, learn everything I can, get friendly with everyone, make no enemies. How hard can that be?”

It did not take long for me to scold my underlings for the first time. All it took is a negligience from them.

“Be careful, try to stay on their good side if you don’t want to have a bad comment in your review later!” Concerned, my colleague warned me on the first week of my arrival, for my own good I guess.

Another week passed by, another victim of my anger. This time, is because of an overstepping of boundaries by a colleague from another hospital.

It was huge, even my friend from the eastern coast heard about the news on the same day, and came asking what made me shoot a fireball so hot it scorched the gentle soul of the mentioned person.

Well, just to clear up the confusion, I don’t like people telling me what I am supposed to do in my hospital when that person is not even working in my workplace. We answer to our own bosses, and there’s a system of how we function based on the current needs and situations. How will you feel when there’s some stranger telling you how to manage your own house?

Things have been similar since then. Now, I may have become the most feared, strict, and meticulous psychiatrist in my beautiful hospital. Truth be told, I am comfortable, knowing that there now exist a balance among the specialist. My other colleagues are quite friendly and lenient towards our subordinates, so I now become the person who makes them vigilant. They will be more cautious in their work whenever I am involved, which is what a doctor should do.

From my experience, there’s just a fine line between fear and respect. The military taught me well in that aspect, which is:

“You don’t need to be “liked” for the mission.”

“if it saves your comrades, do it for the mission, even if it makes you the bad person in their eyes.”

My consultant once said in a meeting, “If I allow an incompetent doctor to pass his examination, indirectly I allowed him to endanger the lives he is supposed to treat!”

Those words are embedded inside my mind, burned even, into my soul.

The person who upholds the law or the system will never be liked. Nobody ‘likes’ a judge, a police, or a warden. They have to create a level of fear, for others to know that there will be trouble if they mess up. Being a doctor who leads other doctors does make me realize, that if there is no pressure, and everyone can just do what they like, there will be no improvements, and worse, my patients will be in danger.

Since my other colleagues are so friendly and caring, why not I take on the role of the “enforcer”, since I have been trained so well in that role for my whole life?

To keep my worth, I know I have to be better than those I’m trying to lead. Respect only will be earned if I can do what they couldn’t, that I can do it right, and that I will show them how to do what I do (provided that they wish to learn of course). All my mentors have taught me well on that: to keep on learning, always do the right thing, and never compromise on the quality of care for my patients.

“The eyes don’t see what the mind doesn’t know.” Another quote from my mentors in neuropsychiatry. Being a psychiatrist, we must see what others neglected, find what others missed, and we should advocate for our patients even if the whole world doesn’t understand their illness.

If I upset a few doctors along the way, while being able to ensure the safety of my patients and uphold my responsibility and oath as a clinician, I will gladly do so.

I’m content, for now, I’m able to understand my teachers and mentors in the field, who scolded, mocked, and insulted me, but at the same time taught, trained, and motivated me to be who I am.

Thank you, my teachers. May our passion to heal others burn bright illuminating the hearts of others.

Time has passed since i written anything on the blog. I would say I got distracted from my usual creative self by many other major events occurred for the last few months. I got married, worked hard and passed my exams, gaming profusely as a compensation for the time lost during my exam days, went through the hassle of progressing the next step of my career, and of course, working.

Why I started writing again in a sleepless night? Because today, I find myself worry of the uncertainty ahead.

After 4 years of struggle with my training program as a specialist trainee, I finally passed my MRCPsych membership exam. In between the period I went through the tough times of long COVID ward postings, workplace transfers, loneliness and self doubt. Those actually did a toll on my concentration to the exam preparation effort. Fortunate enough, my new work place is filled with wonderful colleagues and that has enabled me to regain my motivation, and I managed to pass the exam right on the time of the day I’m supposed to complete my 4 years training.

I was happy, top of the world even, to know that I finally did what I set out to do since my housemanship. My life felt complete, I’m advancing in my career, married to the woman who gives my happiness all the time, my workplace is awesome, and my family is proud of my achievement. To top it off, I am finally doing something I like to do- being a psychiatrist.

Everything was so perfectly fine until the faithful day, when I attended the psychiatry training board committee interview.

It is the time when the leaders in the field meet us, to talk about our path forward as a specialist. Without much of a discussion, I was being told that they might send me to the other side of the country, across the sea, to the eastern state of Sabah.

Don’t get me wrong, I’m not complaining. Not yet at least. I know the implication of such a decision. Spending years in the field, meeting so many great teachers and bosses have taught my one thing:

Experience doesn’t come cheap. Often, those who paid the great price may have learned to treasure it more, and will gain more.

To tell the truth, after the interview I started searching the net for other opportunities. Overwhelmed by emotions, I couldn’t even have my lunch that day.

But looking at my wife, who just sit quietly and smiled beside me, my rational thoughts finally able to reach in:

“I can’t leave, there’s so much here for me. I have come too far to walk out!”

“Fine then, I’m young, I’m here to learn. I want to be the best. So there are price, but I have been familiar with the trade. Everything worthy is to be earned, it’s less if it was given.”

I know that too well. Maybe that is the problem. So I said, “Yes, I’ll do it.”

It took them 2 months to prepare my transfer. Remember the hassle I mentioned? I can’t reveal much about the emotional turmoil I went through simply due to the incompetence of a certain agency (Not my department of course, we are all wonderful people). For a whole month I have to make hundreds of mostly confusing and unanswered calls, even visit them in person to find out about the progress with no avail. Then, I was struck by the news of I have to move myself to the furthest part of the country in just 5 days. Much can be said about the possible reason behind such a nonsensical act, but I can’t reveal much other than summarise it into a simple phrase:

“Power with incompetence equals idiocity.”

So here I am, trying to figure out how to empty my rental house, move my things back to my hometown, complete my transfer documents, and bid farewell to my family and friends in 5 freaking days.

I have never feel this much pressure for time, not since my army days. At least during those times we are running for our lives, not due to some people whose job is to sit behind a desk and organise a team of young-to-be-leaders of the medical field, not knowing how to call me herself to inform about the placement, misplacing a career-and-life-changing letter, and tell me that she don’t have my phone number to begin with, which can be easily found if she actually spend some time calling my hospital and ask for me!

Now I am more motivated to reach the top of the ladder, just to stop these disasters from happening to others.