(Not exactly) Newsflash: KKM Semakin Tenat.

Seriously guys… it wasn’t exactly a newsflash that MOH is understaffed, under-budget, over-worked and basically functioning sub-optimally due to all of those reasons. The same issues have been plaguing MOH since I started working in 2011 (and also long before that, I am sure). And naturally, with the way our economy is doing, the state of hospitals and health facilities in MOH has been progressively worsening since then.

And what a surprise (NOT!) that THIS time, it isn’t the mengada-mengada, manjalitis Millennials who are saying these things. These things come from the professional opinion of our country’s National Audit Department! When they say it, they have credibilities. People started sharing the news (which is not exactly news) all over the social media, flooding my newsfeed with their own take and opinions on the news. But when the junior doctors say it…. well, we can brush them off as manja dan mengada-ngada, kan? (Okay, I better stop the direction in which my composition is currently heading. Haha. I have promised myself that I am done championing the issue of junior doctors. I am already a senior now and I have my own issues that I care about to fight for. But old habit dies hard, LOL! I have always believed that as a group, we are only as strong as the weakest link. And therefore, we must empower our junior doctors so that they can be as, ehem, great as us the seniors. But heck, the juniors can learn to fight their own issues especially if they believe they are right. I have my own stuff as a senior doctor that I am unsatisfied about! LOL.)

If you look at the comments section, you will notice some of the commentators saying something to the effect of “Dahlah memang tak cukup staff. Yang ada pun, bukan semua functioning! Ada yang bermasalah… asyik EL, MIA dan ada yang mempunyai masalah peribadi hutang dengan Along sampai Along mai cari kat tempat kerja and mengamuk kat sana. Exit policy buat perhiasan agaknya!” (Love your comment, there!)

Another LOVELY comment:

“Aku tak tau la susah mana sangat exit policy tu tapi yg aku tau ada ex-staff klinik aku ada kes polis pun masih kekal lagi kerja dekat PKD aku tapi dibayar gaji hari. Depa sanggup buat laporan berjela2 utk tatatertib and bayar gaji hari tapi tak sanggup nak buat laporan utk pecat org. depa punya “busy” tu macam tiap2 bulan ada kes pecat org“

Another comment which I personally LOVE :

“Bukan saja masalah tak cukup pekerja… tapi ada yg tak function. Ada yg kerja cincai, salai-balai, tak bersungguh buat kerja, lembap…. dan ada yg jahat terhadap pesakit!Kalau aku jadi org admin dah lama aku buang dan terminate org2 bermasalah mcm ni. Kalau nak kerja, buat cara nak kerja. Berdisiplin mai kerja, dress appropriately pakai uniform kerja, professional layan pesakit dan PAP! Jgn sampai benda basic routine pun nak kena ketuk every day and nak kena cakap byk2 kali. Org2 yg baloq liat macam ni memang tak layak kerja dgn KKM. Ramai lagi menunggu masuk kerja. Inilah waktunya yg paling sesuai untuk kita terminate pekerja2 lembab dan membebankan jabatan. Sebab berlungguk lagi menunggu nak dapat kerja!”

Soooo many of my friends had the same view as above! We REALLY vented out while sharing the news in the social media.(Seriously, we cannot stop millennial doctors using social media anymore! One day the millennials will become the leaders and saying things in social media will no longer be taboo! Instead, it will become the mainstream. Trust me… you can see the trend already.)

We are FED UP of the admin people not doing something concrete to these toxic, cancerous, pathetic excuse of a human being who are degrading the morale of the rest of our MOH staff by their despicable (sometimes criminal) behaviour! Not just to their own colleagues but sometimes even to the patients! (I won’t say much if  you are bad to your colleagues. Kawan-kawan sekerja kau tu memang deserve your bad behaviour sebab depa tak pandai nak defend diri sendiri dan lawan kau balik sedangkan diorang mampu nak buat kalau diorang betul-betul nak! They deserve the headache of dealing with your problematic behaviour and your unnecessary EL/MIA/laziness if they do not have the spine and are TOO MUCH OF A COWARD to report against you. But if you are UNJUST to my vulnerable, defenceless, involuntarily warded patients, I will personally make it my life mission to deliver your punishment even if I have to charge you through the legal channel. I swear it! I have even warned my own staff that if I EVER see them using ‘ubat kampung’ on my patients, I will go after them myself! Because my patients are vulnerable and they are MY responsibility. I WILL GO AGAINST YOU if I see your unethical or criminal behaviour WITH MY OWN EYES. The responsibility is mine to report on you if I see your ‘ubat kampung’ with my own eyes! If I can’t get you through the admin channel, I will get you through the legal channel! I don’t care whether the charge will stick or not… but police report WILL be done against you if any form of punishment failed to be delivered using the hospital admin channel. Whether or not the charge will stick… is the job of the police and the DPP. But making the report is MY responsibility and MY prerogative and IT WILL BE DONE if the admin people fail to give a suitable reprimand and punishment against you.) 

So the admin people, please listen to the plight and woes of your clinical colleagues. Please take action against the person who has had multiple, repetitive complaints being lodged against him. (one complaint may be due to personal issues! But if multiple behavioural issues with multiple complaints?? Takkan nak brush off lagi?) Because even if we may not say things in front of you, we will certainly vent in the social media by hiding behind the sharing of ‘current issues’. Hahah. And the public will come to know all about it.

***

COURTESY STIGMA

One week ago, again my Facebook newsfeed was exploded by the scandalous news that a private psychiatrist had allegedly sexually harassed his own patient. To be fair, we need  to know both sides of the story before we come to any sort of judgment.

But, I was disheartened by some of the comments that I read in Facebook regarding this case.

Even doctors had said something to the effect of “Psychiatrists pun sama macam pesakit depa.” And another one had said “Psychiatrists pun ada mental health issues,” (What? You think Cardiologist cannot get heart disease? Oncologists cannot get cancer? Wake up to the real world, genius!)

Have you guys heard of the term ‘courtesy stigma’, first defined by the sociologist Erving Goffman in 1963?

Courtesy stigma is basically ‘stigma by association’ in which the stigma is extended to the people who are close to the stigmatized group. For example, family members of mentally ill patients are often affected by courtesy stigma. “Kakak dia ada Schizophrenia. Tak payah lah kawan dengan dia.” or “Padanlah dia suka marah-marah. Ayah dia pun bipolar. Like father, like son.” (even if the person has an absolutely valid reason to be angry at you, you will somehow relate it to the person’s mentally ill family member.)

And courtesy stigma also affects psychiatry doctors. Trust me, we in psychiatry know this VERY WELL. Some of our own doctor-friends will say things like, “Psychiatrist boleh faham patient mental sebab depa pun mental.” and disguised their offensive sentence as a joke.

Well, I am having none of that! None of my friends will ever dare say things like that to me because I call out on it STAT! Right there and then I will challenge their statement and shred their reasoning to pieces. And they learn to behave well with me next time. See? I am a staunch believer and practitioner of behaviour modification. Your bad behaviour will be called out and punished stat! I don’t put up with crap. Welll… not for long, at least!

So, I wrote my own comment in the Facebook thread by saying:

When a prominent ortho surgeon was accused of multiple counts of sexual harrassment, we do not generalize all ortho surgeons “gatal” the lot of them.

Anyone can behave unethically and despicably. And we shouldn’t overgeneralize a group over any misdeed done by a few in that group.

Please don’t say nonsensical things like “psychiatrist are also like their patients” or that “some psychiatrist have mental health issues”.

A lot of doctors have mental health issues across all fields. Some have anger management issues as well, making life hell for their subordinates. Some were depressed while undergoing their master programs. We in psychiatry have seen all of them. We know mental health issues are prevalent in any field.

Some of the other doctors have spouses or children who are affected by mental health issues…. because their parents are only concerned about being good doctors rather than being a good parent/daughter/son/sister and they delegate the job of caring for their own family to others.

Anaesthetists also have a higher rate of suicide. What funny jokes can we crack about that? Access to lethal means of suicide is a known risk factor for anyone who is depressed. But depression or other mental health illness can happen to anyone.

Stop this stigmatization and overgeneralization. Cognitive errors are so unpalatable when they come from doctors who are supposed to have an enlightened mind.

I was gratified to see that many had liked my comment even though I wasn’t expecting them to. Having a lot of people read this comment of mine and liking it means that people understood and supported what I had written. So at that particular time, I have at least educated some people into not stigmatizing us. Small steps… but everything big starts with something small, right? I have done my part. I have spoken up.  In some other place and some other time, another person will speak up over the same issue and do their own part in reducing courtesy stigma. Slowly and surely the stigma will be reduced by these collective small steps. In fact, it is already reducing! The number of junior doctors queuing up in the waiting list to become Psychiatry MO is quite high, these days!

In fact, I was informed by one of my readers that my blog is one of their point of reference when they are trying to research on psychiatry career pathways! So, if my blog has done nothing else, it has at least promoted the field of psychiatry to some junior doctors. The popular campaign by RCPSYCH to #ChoosePsychiatry is also gaining momentum in the other side of the world.

The number of junior doctors choosing to train in psychiatry is at an all-time high, according to the latest statistics.

New figures from Health Education England reveal a 92 per cent uptake in England, Scotland and Wales, with 446 of 483 available places taken by junior doctors wanting to specialise in mental health.

This compares with a 69 per cent fill rate in 2017, when only 337 accepted one of the 491 places on offer.

The dramatic increase follows the Royal College of Psychiatrists’ #ChoosePsychiatry campaign, which launched in 2017, and has worked to increase the number of junior doctors choosing psychiatry as their speciality.

The figures also reveal a significant improvement since 2018, when 480 junior doctors accepted one of the 613 places on offer – a 78 per cent fill rate.

Record levels of investment in mental health services by the government and the NHS has helped increased public awareness to unprecedented levels, making psychiatry a more attractive career path.

Dr Kate Lovett, dean of the Royal College of Psychiatrists, said: “Psychiatry is an incredibly rewarding career and these figures are exciting news for patients as well as the specialism.

“The College’s #ChoosePsychiatry campaign has helped drive this dramatic rise in junior doctors choosing psychiatry as their career path. 

ETHICS & LEGALITY IN PSYCHIATRY

As psychiatry doctors, ethics is one of our core subjects and is supposed to be our strength and our specialty! It is REALLY sad if we are the ones who cannot practice it properly. When ethical issues involving psychiatrists appear in the social media, it is especially disillusioning and disappointing.

We used to think that doctors are generally kind, helpful and ethical. But these days, that impression can no longer be taken for granted. Remember the case of the prominent Ortho surgeon who had sexually harassed his housemen? We all had wondered regarding how his criminal behaviour could be ongoing for so long? Aren’t MOST DOCTORS ethical? So, why do MOST OF THEM become the ENABLERS of criminal behaviour? We started to wonder and cast blame when the shit hit the fan.

“Kenapa specialists lain pun tak bersuara?” 

“Kenapa tak ada siapa buat police report?”

“Kenapa Pengarah Hospital tak buat apa-apa sedangkan dah banyak complaints?” 

I am sure, AT THAT TIME, they would answer things like, “Nak ambil tindakan kena cukup bukti.”  OR, “He is too powerful. Dah buat report police pun tak boleh nak buat apa.” OR “HOs sendiri and victims pun tak berani nak ke depan buat laporan kat dia. Budak-budak Master pun bawah dia juga… nanti depa takut tak pass master.” 

They justified their inactions and silenced their conscience!

Suddenly, ONE FINE DAY, it took only ONE PERSON to decide to contact the mainstream media (THE STAR) to give her side of the story. Maybe she was thinking, “To the hell cukup bukti ka dak! Yang pasti, aku nak benda ni keluar juga!” Sebab once dah keluar, barulah siasatan akan berjalan untuk cukupkan bukti! Masalahnya bila benda dok hushed up tak keluar-keluar sampai ke sudah… sampai bila bukti nak cukup?

So things that used to be swept under the carpet (BERTAHUN-TAHUN berlalu tapi TAK PERNAH CUKUP BUKTI sebab tak pernah siapa pun teringin nak siasat habis-habisan dan ambil tindakan) tiba–tiba senang ja terbongkar dan siasatan boleh berjalan.

Bila keluar berita yang “pakar-pakar Orthopaedic di hospital tersebut akan dipindahkan” (mungkin sebab pakar-pakar tersebut dilihat seperti membenarkan dan membiarkan penganiyaan berlaku) tiba-tiba ada yang mahu complain pula! “Kenapa kami kena pindah? Sedangkan kami tak terlibat! Kami tak bersalah! Kami tak tau pun kejadian sexual harassment tu semua!”

Amazing! Orang di hospital lain pun boleh tau pasal your notorious HOD…. macam mana kau di hospital tu boleh tak tau? What wilful ignorance is this?

You deserve the punishment of being transferred out! When you are neutral and not taking sides in the face of oppression, you are actually a co-conspirator to the act! Your silence in a situation of injustice means you are siding with the side of the oppressor! To quote Finaz Yunus, (the host of Analisis in TV Al–Hijrah) we have to “BE TRUTHFUL! Not Neutral!” and this is ESPECIALLY important in the case of human rights!

So, in my opinion, you deserve to be punished (mobilized and transferred out of the hospital) if you had known what had happened and yet you had silenced your own conscience and let the heinous crime persist indefinitely!

So the take home message is: Bukti memang takkan cukup AT FIRST. Tapi, tugas siapa untuk cari bukti once orang dah complain? Tugas KITA lah! Tugas admin! Tugas polis! Tugas DPP!

Kalau admin malas buat kerja dan nak brush off complaints by saying things like “Ada cukup bukti tak? Dia ni dah counselling belum? Korang dah pernah minta explanation letter kat dia ke belum? Dah pernah bagi warning letter ke belum? Dah pernah pergi kursus-kursus untuk pekerja bermasalah ke belum? Bla bla bla..Dia ni dah lalui this procedure and that procedure ke? Kalau benda2 ni tak buat lagi, tak boleh ambil tindakan lagi!” Aduh! Sampai menyusahkan pula pakar-pakar yang dah lodge complaints…. and the problematic worker will continue his problematic behaviour till kingdom come! Well, orang lain mungkin akan give up or just internalize learned helplessness in dealing with problematic staff. Tapi kalau aku kat tempat orang yang complain, aku takkan diam! Orang yang setakat ada problem EL/MIA bolehlah nak suruh counselling ke and whatnots…. tapi kalau kesalahan menyalahi undang-undang dan ada kes polis dan sebagainya (like being accused of sexual harrassment/rape/assault)… aku akan laksanakan gantung kerja dulu sementara siasatan penuh dijalankan! Once you are cleared, you can come back  to work! But this is a HEAVY accusation, and you should be suspended until you are cleared!

In psychiatry, every single thing we do from patient admission, to medication, chemical restraint, physical restraint and seclusion/isolation are governed by the Mental Health Act! We are bound by the law in our clinical practice.

One of the shameful anecdotes in the Malaysian Psychiatry history! When a mentally ill patient dies in custody, the pounding headache is real!

 

But it is no secret that mentally ill patients are very vulnerable to being abused by our own staff or by the police officers who had made the arrest. Sometimes they are abused to their deaths as in the case of the article above. And this can happen anywhere, especially in the third world countries where patients’ rights are not that well-advocated.

It is our responsibility as a psychiatry doctor to make sure that our staffs are ethical and follow the law in how they handle our patients. Mentally ill patients have their own rights. If they cannot speak up for themselves, we must look out for them!

One of my friends had said that she had heard some talks of how “ada staff masuk cell dalam wad purposefully untuk pukul patient.” in one of the hospitals she used to work at. I won’t be at all surprised if some of our staff might have unnecessarily roughened up or abused our patients.

But, that is CRIMINAL BEHAVIOUR, okay! And if I see such a behaviour with my own eyes, I will give them hell!

I personally had sternly warned my own staff, “Kalau saya nampak siapa-siapa pukul pesakit tak pasal-pasal, saya akan report! Saya akan siasat! Saya akan ambil tindakan undang-undang kalau admin tak nak buat tindakan tatatertib dan orang lain tak nak buat apa-apa! Kalau pesakit unmanageable, inform saya. Kita boleh bagi ubat, atau sedation, boleh chemical restraint atau physical restraint. Tak perlu nak kasar dengan diorang pun! Tapi macam mana kita nak bagi sedation kalau korang tak report? Dan macam mana korang nak report kalau korang tak monitor patient betul-betul? So kalau patient buat perangai, jangan nak lepas geram kat diorang kalau korang yang tak buat kerja monitor patient. Kalau korang monitor betul-betul dan inform MOs betul-betul, dah lama doctors bagi intervention tanpa perlu nak kasar-kasar! Kalau pesakit aggressive sekali pun, pergi mana breakaway technique yang dah belajar tu? Pesakit aggressive sebab dia sakit. Yang kita tak sakit ni, apa alasan kita nak aggressive?” 

I make myself clear and my stand is rock-solid, unshakeable! If things happen behind my back, I might not be able to punish you because I do not know about it. But if I, myself, is a witness to your criminal behaviour against my patient, I will go all out to make sure you get your just dessert by the admin. And if the admin brushes off my concerns, I will use a legal channel to punish you! I will do it because I have the freedom and the means to do it! And most importantly, I have the WILLPOWER to do it!

Some people think that, it is necessary to hush things up untuk ‘jaga nama hospital’. Silap besar! What happened to Hospital Sungai Buloh once the conduct of the notorious Ortho surgeon became well-known, huh?!

The truth has a way of coming out! Instead of being known as “the admin who had done nothing when multiple complaints had been lodged”, be the admin who had done something worthy of your position by lodging your own complaints against him to the DG and MMC! Say to the DG and MMC “I have concerns about this specialist. I receive reports from HOs that he has been sexually harrassing them.” You MUST do your part. The outcome of your complaint is a secondary consideration! But you must do your part, first!

My principle is clear: I don’t owe my loyalty or my allegiance to any department, hospital or ministry. I owe my loyalty and my allegiance to the truth only. I owe my obedience to God, religion and my own personal principles, FIRST! Anything else is always secondary! Kalau kau salah, kau salah! My report against you had nothing to do with where I work at! I want my department and my hospital to be known as “jabatan/hospital yang akan jaga etika terhadap pesakit dan sanggup report staff sendiri kalau staff memang salah” rather than being known for lack of ethics or under the carpet dirt-sweeper! Because I believe that IN THE END, the truth will come out someday, somehow, someway… because the sunnahtullah is like that! And my lacking in action today will be the shame of me one day. I am accountable for what I see, what I hear and what I do about it. Even if the outcome might not be what I want and the perpetrator might go free, I have done what I should in my own capacity within my own limitations and that’s all that matters! 

THE LEGAL CHANNEL IS ALWAYS THE RIGHT CHANNEL

We always tell our staffs not to use the social media and we encourage them to complain using the right channel (which is usually incompetent and slow and broken). Kalau admin tak buat tindakan sepatutnya through the right channel, then we should go through the legal channel! (The legal channel is ALWAYS the right channel, anyway). Imagine what will happen once the legal channel is taken? Well, of course media akan hidu and things will become viral anyway. So remember, the legal channel is always an option! It is YOUR RIGHTS as a Malaysian citizen. And your job does not bind you from taking legal actions against anyone who had broken the law. The hospital admin CANNOT punish you for taking a legal action when they themselves fail to deliver a fair outcome out of your complaints.

And the bonus is, the legal channel can also be the viral channel. Imagine the headlines, “Houseman lodged a police report against nightmare specialist” Haha!

Remember this incident, guys? It was only last year! The HO took a legal channel (which is always the right channel, as a Malaysian citizen) and the issue became viral!

So, my recommendation to any victim of injustice is this: It’s okay if you cannot use the social media since it is not allowed for you to do it. If you are asked to use the right channel, go ahead and use it as your first line action. But if your admin FAILS to give you justice, you must go through the legal channel. And trust me, the legal channel will be the viral channel, anyway! Because the media will pick it up! So, yup… you get what you want at last!

Unfortunately, most people will not want to go through the hassle of taking any legal action, especially if the criminal behaviour is directed towards others rather than themselves. Well luckily, I am not most people. Once I am angry enough, I will fight to the end. If my warning is not heeded by my staff, I will strike on my own if the admin is too slow in doing their job. I will take a legal action. I am not used to learned helplessness and I will never make myself get used to it when it comes to dealing with dysfunctional staff with criminal-like behaviour.

***

THE STANDARD

Before I end this post, I want to ask my dear readers to ponder the concept of justice and redha. Because trust me, even so-called religious people get confused at times!

My dear readers,

In our daily interactions with others in the society, the standard that is outlined by Allah for us is JUSTICE! That’s why in Islam we have judges and the justice system (Syariah: Hudud, Kisas, Takzir etc). It is not the place of ANYONE to tell you “Redha sajalah anak you kena bunuh. Kalau  you marah pun, bukan boleh dapat balik anak you. Tak payah nak siasat, panjang-panjang cerita! Maafkan saja pembunuh tu. Redha kan dapat pahala! Redha kan Islamik.”

NO! NO! NO!

Instead, in our daily interaction with OTHERS – with our fellow human beings – we must always be mindful of justice because that is THE STANDARD that Allah had DEMANDED of us! You should instead say, “Allah had enjoined us to be just! Allah will punish us for failing to do justice! It is our responsibility to see it delivered no matter what!”

However, in our relationship with Allah, the STANDARD is redha! You should not question Allah, “Why are You not fair to me? Why do You let my son be murdered! Is this fair of You to allow him to be killed when my son is a religious Muslim and a good person?”

No! No! No!

Instead, in our relationship with Allah, we must always be mindful of redha! “Ya Allah, apa saja yang terjadi, aku redha! I submit to your wisdom.”

Redha and justice are NOT contradictory concept! You can be “redha anak dah tak ada kena bunuh” even as you demand that justice be done for your murdered son. Your demand for the justice system to deliver justice for you has NOTHING to do with how redha you are with what God has fated for you.

Justice is your standard with fellow human beings and with the administrative system in this dunya! Redha is your standard in your personal relationship with Allah! They are two separate (but related) concepts!

(Not delivering justice is BELOW standard. Demanding justice is THE STANDARD… and it is THE MINIMUM STANDARD expected of us by God. Choosing to forgive your oppressor is ABOVE standard. But you cannot make any inference regarding level of redha, faham tak? You might choose to forgive your oppressor, but deep inside, you are still NOT redha about what Allah has fated for you! Yes… that can happen, ok? You can trick other non-educated civilians into forgiving crime by manipulating the concept of Redha while ignoring the concept of Justice, but you cannot trick me! Because when I tak puas hati, I read up! I know my stuff! Manipulate me at your own peril.)

Please be clear about this. And try to lead your life according to THE STANDARD (of Justice and Redha). Even as you may not do it perfectly hundred percent of the time. At least, TRY!

Until next time, my dear readers! Much love and may Allah bless all of us.

Revising The Islamic Education Syllabus. It’s High Time.

Recently my Facebook newsfeed exploded with a piece of controversial news involving Ministry of Education (again. Hahha). Some keyboard warriors among netizens have lambasted Teo Nie Ching, our Deputy Minister of Education, for allegedly sticking her nose into the Islamic Syllabus of Muslim students in Malaysia. Racial slurs could be read in every other comments on Facebook, it was positively nauseating.

To those who are still in the dark regarding what has been going on, let me just give you a short update of the matter just to give you guys a heads-up (please google the news further for more details).

The Ministry of Education, via the National Education Advisory Council (Majlis Penasihat Pendidikan Kebangsaan /MPPK)  had launched a national survey to revise and upgrade the Islamic Education Syllabus for Muslim students in Malaysia. Our Deputy Minister of Education, Teo Nie Ching, had then innocently shared the link to the news via her social media. Suddenly, the netizens blew the matter out of proportion by accusing her, a non-Muslim, of trying to stick her nose into the Islamic Education. The UMNO/PAS politicians and supporters started to politicize the matter with religious and racial themes in their fear-mongering campaign against PH.

Maszlee Malik defended his deputy by saying that “Kaji selidik tersebut dikeluarkan di laman web Kementerian Pendidikan, kemudian Nie Ching kongsikan maklumat tersebut di media sosial beliau. Ada orang tangkap layar dari media sosial beliau dan timbulkan isu bahawa timbalan menteri mahu campur tangan isu Pendidikan Islam, itu tidak benar dan tidak timbul isu campur tangan,”

In other words, Teo Nie Ching was only sharing on her social media of the latest initiative by her ministry (because she works there, okay?). It just so happens that the latest initiative by the ministry (in which she is THE DEPUTY MINISTER) is about our Islamic Education. However, because she is a non-Muslim, she was accused of sticking her nose into the Islamic education of Muslims. *sigh* 

There haven’t been many occasions in which I was supportive of the Ministry of Education. But in the matter of revising the Islamic Syllabus for Muslim students in Malaysia, I am all cheers! I think, it is high time we have a deep and conscientious thought about what sort of Muslims we want to produce in this country.

I have said it before, and I will say it again now. I learned MUCH MORE and in GREATER DEPTH about Islam when I was in Australia (by my own initiative and with my seniors in usrah) than what I had learned in 11 years of FORMAL Islamic education in school. Our Islamic Education syllabus in Malaysia is very superficial, focussing more on ritual than it focusses on creed (akidah); emphasizing more on superficial memorization than in-depth understanding; rewarding shallow knowledge than higher-order-thinking skills (HOTS/KBAT).

11 years!! of formal education was wasted on me! I found it so difficult to question things that I didn’t understand in the religion because it was so taboo to appear to doubt what was taught to you. Because it was a tacit understanding that questioning things that you don’t understand would somehow reflect badly on the strength of your iman. So, I just performed the rituals of prayers and fasting without any real “penghayatan” about what being a Muslim meant.

Want to know what I mean? Read on!

***

Question #1: Who creates God?

Don’t kid yourself! Don’t deny it! Everyone – including YOU, my dear readers – MUST have thought about this question at some point in their lives. But most of us swallowed it and brushed it off, didn’t we? Because some of us were told “Kalau kita tanya banyak sangat perkara-perkara ghaib, iman kita tak kuat. Benda ni kena percaya sebab rukun iman.” And then we were told to mengucap and say astaghfirullah for having doubts.  I had asked this question to adults since I was 8 years old.

But could the adults in my life answer my question to my satisfaction? Not really.  They would say something like “Mestilah Allah tak diciptakan. Kalau Allah tu diciptakan, Allah bukan Tuhan lah.”

Oh ok… so you are answering my question based on YOUR DEFINITION of God. I see.

But I wasn’t satisfied. You told me only JUST NOW that “semua benda di dunia ini diciptakan.” So, wasn’t it natural for me to just ask, “Jadi siapa cipta Tuhan? Kan semua benda di dunia ini diciptakan. You just told me that!” And now? You couldn’t answer it yourself! Or you think your previous answer satisfied me? Well, it didn’t! But because I could sense your discomfort and your disapproval, so I put off questioning you further.

I learned eventually to brush it off and bury my doubt deep inside my heart. Even when I was just a child.

But how long could I bury it? On and off it would bother me again and again. And I said astaghfirullah again and again! (And I believe this is the case for many Muslim kids as well. I was not alone, here. But because I am the ruminating, over-thinking type, hahha… it bothered me more than others, perhaps. I certainly knew that even my Kak Long had wondered the same thing and I had discussed this with her as a kid, and then later as a young adult. So jangan kata aku sorang yang tertanya-tanya benda ni! Mustahil aku sorang yang wonder pasal benda ni. This is basic akidah yang FORMAL EDUCATION di sekolah TAK MAMPU address dengan baik! Basic akidah, weh!)

Until at one point, I couldn’t bury the question anymore. After my friend passed away at the age of 18 from a car accident, I was so shocked to the core that I felt like I could not postpone answering this question any longer. It MUST stop bothering me once and for all.

So I did my research and somehow (Alhamdulillah) I happened to pick up a book by Harun Yahya entitled Timelessness And The Reality of Fate and I devoured the book in 2 days. From the very first few chapters of the book, I got the answer already. The answer that I had been wondering about since I was 8 years old… it was hidden in this 97-pages-thin, ordinary-looking  book! Amazing! The best, most-worthy book purchase I have ever made in my entire life to date!

I couldn’t recall the specific words of the explanation but it basically goes something like this:

“In order for anything to be created, it must be in the system of time. ‘Before and After’ only exists in the system of time. The system of time itself is created by God. God is not bound by the system of time. So, it is scientifically impossible by the law of physics to ask a question of who creates God because the system of time existed after God had created it. In fact, the question is unscientific and irrelevant.”

See? The book even talked about the science of physics when it discussed the system of time. Siap dengan quotes by famous scientist and physicist of the world! Barulah convincing! It makes sense! I could accept it easily enough! Think about it! Malam dan siang adalah masa kan? Macam mana nak wujud malam dan siang kalau matahari dan bumi pun tak wujud lagi. Planet, bintang-bintang dan matahari pun tak wujud lagi, macam mana bumi nak beredar untuk menghasilkan peredaran masa atau malam dan siang itu? So, everything must be in place first (the whole universe, the planets and the stars, must be created by God first! The system of time must be there first before you can ask who creates what! The creator exists BEFORE the creation. The creation exists AFTER the creator. But BEFORE and AFTER are the terms in the system of TIME. And the system of TIME did not exist until God created the universe, including the earth and the sun. This is what we mean when we say God is beyond creation. That is why when you ask who creates God, the question is unscientific! Your question is unscientific because that is THE LIMIT of the science of creation in this physical world.)

Now, ask yourself: Boleh ke ustazah sekolah rendah dan sekolah menengah ajar macam ni? Can they explain as comprehensively and thoroughly as above? Boleh tak depa address BASIC matters of akidah sampai student puas hati? Mana mungkin boleh kalau ustaz/ustazah sendiri jahil fakta sains! Lepas tu membuat ‘insinuations’ yang orang yang bertanya itu yang kurang iman! Padahal, mungkin mereka yang tidak pandai jawab! (Sorry if I sound emotional. This is a raw topic for me! Sampai sekarang, aku tak boleh terima orang-orang agama yang jahil kemudian berlindung dengan imej agama untuk MEMBULI orang yang hanya bertanya untuk kepastian. Tiba-tiba dijawabnya kita kurang iman!)

 

Question #2: How do we know Islam is the right religion? 

Again, don’t lie to yourself. I am sure EVERYONE must have thought about this at some point in their lives!

In fact, inilah caranya orang-orang dari agama lain boleh menemui jalan untuk memeluk Islam. Sebab mereka sendiri bertanya dalam diri mereka sendiri, is my religion the real truth? And then they did their research until they come across Islam.

Ini adalah NALURI (instinct!) yang Allah kurniakan kepada SEMUA manusia supaya manusia mengenali diri-NYA. Just because you are born as a Muslim, DO NOT EVER THINK that you have real faith! Your faith doesn’t mean a thing if it was never challenged. Your faith may not be true  if you’ve never had  to answer the challenge and come to your own conclusion. That’s why we are tested in this life… to TRIGGER us to seek REAL CONVICTION and REAL BELIEF (the death of my friend was MY trigger. I have met people whose trigger would be different. It might be ‘divorce’… it might be ‘cancer’… it might be bankruptcy…. it might be ANYTHING) Kalau kita hanya mengikut arus just because we were born into Islam (but we were never really convinced in the first place) what good is that belief? Apa beza kita dengan orang-orang yang dilahirkan dalam agama lain? Kita pun hanya mengikut agama nenek moyang juga kan (it just so happens yang agama nenek moyang kita Islam)…. sedangkan belum tentu kita betul-betul percaya.

Allah tests us until we can find Him. So regardless of what religion you were born with, you are not given a free ticket to Paradise. You WILL BE TESTED as a proof TO YOURSELF whether or not you have put in the effort to come to real faith. You yourself will know whether or not you truly believe or if you are simply following the tide of societal pressure! You will know what is in your own heart and you are accountable for it!  Allah says in Surah Al-Ankabut: 2-3 “Do the people think that they will be left to say “we believe” and they will not be tried? But we have certainly tried those before them, and Allah will surely make evident those who are truthful and He will surely make evident the liars.”

I guess the verse is asking… Adakah kamu berfikir kamu hanya akan dibiarkan menyatakan “Aku orang Islam” sedangkan belum tentu hati kamu betul-betul percaya? Sebab kamu tak pernah jawab apa yang bermain di fikiran kamu! You brushed off your doubts! And you think everyone is supposed to blindly believe like you?

 

Jadi semua ujian yang datang dalam hidup kita adalah untuk TRIGGER kita bermuhasabah dan menjawab the important questions in our lives! Please take the opportunity to answer those questions!

There is NO PLACE for blind belief in Islam! We are asked to do inductive reasoning when we are learning the religion! This is Quranic method in pondering the questions of faith! Al-Quran encourages us to question stuff! So jangan kau pula pandai-pandai nak menghalang orang lain bertanya kalau kau sendiri tak pandai jawab! Siap nak label orang yang bertanya tak kuat iman!

So, how do we know that Islam is the right religion? Well, by studying comparative religion! Of course! There is always a course of Comparative Religion / World Religion/ Theology in any university, even in the Western countries! If you can spend YEARS studying to become a doctor to complete your dunya, can’t you spend one semester of learning comparative religion for your akhirat? Sometimes, you can even do it informally by reading books on world religion during your free time. Tak payah pun nak masuk formal class bagai. Learn about other religions and compare between them! Sheikh Ahmed Deedat had done such a splendid job when it comes to comparing Islam and Christianity! In fact, that was how I had come to be convinced of Islam as the religion intended by God for his slaves. I read The Choice by Ahmed Deedat when I was 18 years old.

You yourself must go through this journey of discovery. No one could do it for you. Every one of us has their own unique journey in discovering faith and spirituality. This is why one of my favourite YOU TUBE videos are conversion stories. My personal favourite was the conversion story of Yusha Evans and I recommend it to all my readers.

Now ask yourself: could any ustazah/ustaz in your previous school tell you in details regarding why Islam is the right religion compared to Christianity? Were you convinced? Or did the ustaz or ustazah never really answer your question? Or perhaps, you yourself never question it? Again… this is BASIC CREED. Kalau benda tu pun tak settle, no wonder lah kita asyik takut anak-anak kita murtad. Isu penggunaan nama Allah di kalangan Kristian di Sabah/Sarawak jadi havoc sampai pecah alam. Padahal memang kat Middle East orang Kristian guna nama Allah juga. Kita kat sini sibuk-sibuk nak halang orang Kristian guna nama Allah…sebab takut anak-anak kita cepat keliru!

Macam mana SEBELAS TAHUN belajar akidah  di sekolah, masih boleh keliru? Allah itu satu VS Allah itu tiga! Beza kan?? Apa yang nak kelirunya?? Yang kelirunya adalah sebab ORANG DEWASA pun keliru tak reti nak ajaq anak-anak depa! Tu pasallah takut sangat! In fact, kita sepatutnya fikir yang orang Kristianlah yang keliru! The WHOLE WORLD associates the word ‘Allah’ with Islam… orang Kristian di Malaysia la yang patut lebih keliru bila nama Tuhan mereka adalah sama macam Tuhan orang Islam.

Bila kita lokek ilmu dan lokek hujah, kita akan sentiasa rasa takut dan terancam! Dan bila kita lokek ilmu dan lokek hujah, semua pertanyaan tiada jawapan. Alih-alih suruh orang lain jangan tanya dan tuduh orang yang bertanya tak kuat iman! *facepalm*

Did you know that in the Quran, we are taught to do inductive reasoning? Allah always asks us to look at specific examples in order to reach a conclusion. He asks us to look at the moon. Look at the sun! Look at the mountains and the seas. Look at the signs in the human embryology. 

Prophet Ibrahim (a.s) did inductive reasoning before concluding that his GOD was NOT the sun, the moon or the stars. He had explored one option after another and then another before he finally arrived to his conclusion. Just like our revert brothers and sisters had  to go through one religion after another and then another before arriving to Islam. 

“Those who listen to all statements, and then follow the best of it. These are the ones whom God has guided, and these are the ones possessed of minds.” (39:18)

Question #3: Why Is Quran Considered As A Miracle? 

This question was one of my struggles in understanding the religion.

Your ustaz or ustazah would ask you to memorize a few ‘skema jawapan’ talking about language style of the Quran which ‘proves’ that Quran is a miracle.

And in my mind, I was like “Kat mana yang hebat sangat bahasa Quran ni sampai jadi miracle dan mukjizat? Boleh tak bagi contoh? Ayat mana dalam Al-Quran yang miracle sangat ni sampai penyair-penyair Qurays boleh terpaku dan speechless? Awat aku tak rasa apa pun? Boleh tak elaborate dan bagi contoh?! Convince me, please!” 

Your ustaz would also teach you to write “Al-Quran ini mukjizat kerana ia tidak boleh ditiru. Ramai orang yang tidak berjaya menandingi gaya bahasa Al-Quran walaupun telah dicabar untuk melakukannya.” And then, the answer stops there. Adoi!!

I was like, “Okay…. boleh tak bagi contoh siapa orangnya yang cuba attempt nak bertanding dengan gaya bahasa Al-Quran? Is it Ka’ab Bin Malik? Abdullah Bin Rawahah? Both of them were great poets, right? Apa ayat yang diorang produce? Kat celah mana yang diorang kalah? What is the criteria yang diorang kalah tu bila dibandingkan dengan Al-Quran? Ada hakim ke yang dilantik untuk judge gaya bahasa siapa yang menang?” 

Faham tak? Look at how I overthink stuff? hahha. Jadi adakah aku akan puas hati dengan jawapan-jawapan one-liners yang superficial macam tu? Sedangkan banyak lagi soalan tak terjawab dalam kepala otak aku ni. Hahha.

Do you get it? There is just NO DEPTH!! in our learning of the religion! I was a student who DID NOT UNDERSTAND in which part of the Quran yang kau cakap gaya bahasa hebat sangat ni? Aku baca translation of the Quran dan aku rasa macam biasa saja. (I have since come to know how difficult it is for translations to convey the beauty of a text’s original language. For example, can anyone translate a Malay pantun into English while maintaining all the rhymes and the rhythms? No, right? The beauty of any language will be lost in translation. The language miracle of the Quran can only be appreciated in its original Arabic language. But there are other aspects of miracles in the Quran. For example, there are medical and scientific aspects of the Quran too!) 

As a student at that time, pelajaran agama adalah pelajaran SURE DAPAT GRED A punyalah! Because so simplistic punya skema jawapan, anyone can get an A in it! We students devoted MORE TIME for Biology, Chemistry, Physics and Add Math because they were more complicated and interesting dan belum tentu dapat A. Hahha.

But with pelajaran agama, hafal sikit-sikit, pakai common sense sikit-sikit… terus dapat A. Mudah macam makan kacang! When the fact is, learning arts (including religion/theology, history, political science and philosophy) requires inductive and exploratory reasoning involving the understanding of contexts, nuances and depth! BUKAN simple one liners!

But after years of learning to brush off my doubts, I followed the tide of peer pressure by simply burying my questions deep inside my mind!

So when did I FINALLY find the answer?

Well, I found the answer regarding why Quran is a miracle at the age of 20+ when I was listening to the lecture of Nouman Ali Khan in You Tube about The Miracles of The Quran. The video clip only lasted for two hours! Two hours! And that was enough to answer YEARS of wondering to myself about the miracles of the Quran! Below, is one of the examples of the video produced by Nouman Ali Khan’s team regarding the language miracles of the Quran. If you have time, you can watch the lecture yourself. It is very good, (better than the one I listened to years ago) because this one is illustrated.

I also learned about the Quran from books like Medical Miracles of The Quran written by Dr. Sharif Kaf Al-Ghazal.

So, can you see HOW PATHETIC is the Islamic syllabus in our formal education?? How unhelpful the syllabus was in perfecting my aqeedah and my understanding of basic Islamic principles!

Perfect the Aqeedah FIRST! Simultaneously, you can also learn the technical stuff of ibadah, muammalat, munakahat, syariah etc etc. But the Aqeedah is always a priority!

Look, there’s a reason why the Prophet PBUH spent 13 years perfecting the Aqeedah alone in Makkah! Because that is the most important thing! Only in Madinah did the Prophet proceeded with the teaching of the Syariah! Once your aqeedah is settled, the rest would be easy!

 

Question #4: All the questions I had about illogical Israilyat stories that were told to me. 

I had talked about this so many times in the past! About the fake story of Hassan Al-Basri & A Beautiful Woman and also about the bogus tale of Siti Mutiah! Hahha. So, I am just not going to elaborate on this further. But it highlights my point that MOST ustaz/ustazah are not equipped with enough knowledge to soothe our thirst for real conviction. They do not address our confusion and our sense of incredulousness.

If you are going to be ‘guru agama yang mengajar budak-budak aliran sains’, you better know how to present your content! Science students are taught to QUESTION stuff!

If you are passionate teachers, your target SHOULD NOT be to finish the syllabus cincai bocai! Your target is to make sure your students understand and are convinced by your presentation. (Tu pun kalau kau memang nak jadi a great teacher lah! Otherwise, no use for me to elaborate further). You must encourage questions among your students and you must equip yourself with knowledge too! Teach beyond the syllabus! Read stuff! Relate your religious contents with current issues and scientific phenomenas! Buatlah homework sikit…. you are teaching the religion! How much pahala will you get if because of YOU, your students attain real faith that goes beyond getting an A in Pendidikan Islam!

***

So, below are my ideas of how religious syllabus should be revised.

1)Ask students to do a critical essay on any topic of aqeedah. An essay! A CRITICAL ESSAY! NOT simple one liners! 

2)Give them reading tasks that requires them to summarize, review and state their own opinion. 

-suggested topics for their reading tasks include comparative religion, theory of evolution, Richard Dawkin’s The God Delusion.

2) Review You Tube videos of comparative religion and encourage voicing out of questions and doubts. 

3) Invite doctors, engineers, professors and physicists to talk about verses in the Quran that relate to their respective specialty! Show the students that religion is NOT SEPARATE from the practical aspects of worldly life! Show your students that religion is RELEVANT and PRACTICAL! 

***

Examples of exam questions and assignments at the secondary school level could be something like these:

Question 1:

It has been a widely popularized propaganda that Islam was spread through the edge of the sword. By using your knowledge of the Quran, your knowledge of the world history and the Islamic History, write a CONVINCING commentary to dispute this preposterous libel.   (Not less than 2000 words)

-this question requires the student not only to know the Quran alone, or the history alone. It requires the student to know BOTH;  and then to integrate those different knowledge and connect them together to produce a good essay. They must provide evidence and quotes by historians and ulama as well to get an A. 

This is one of my favourite books to answer the above question. Full of references. Written by a Non-Muslim some more!

Question 2:

By using your knowledge of The Quran, The Bible and the History of Pre- and Post- Council of Nicaea, discuss the concept of trinity in Christianity.

-The question makes it clear that the students need to know some basic knowledge regarding what trinity is all about; what the Quran says about Trinity (this requires the student to know specific Quranic verses that talk about trinity); what the Bible says about Trinity (that means the student must memorize some biblical quotations allegedly alluding to trinity); and what happened during Council of Nicaea.

-After knowing the basic knowledge, the students then need to apply those knowledge and try to connect them together and arrange them into points of natural sequence so that the essay would look good and professional.

-In short, it requires application of knowledge and critical thinking! KBAT at its best! Not simply memorize and vomit the memory into paper. Takkan matematik dan sains saja nak KBAT! Adakah pelajaran agama tak penting untuk KBAT??

 

Question 3:

An Atheist came to you and declared his conviction that there is no life after death. How do you convince this atheist to the contrary? You are allowed to use your knowledge of The Evolution Theory, your knowledge of biological science and your knowledge of philosophy to produce your argument in not less than 1000 words.

-Whoa. Imagine if religion is being taught this way at school! The ustaz/ustazah will give you this question for homework with next week as a deadline. So, students are required to do proper research into Evolution, other aspects of biology as well as philosophy….and the challenge is how to connect all these knowledge into a religious article. The students actually have to put serious hard work and energy in researching and then thinking about these topics in order to produce a good essay.

-The ustazah can discuss the answers to this essay in a very interesting lesson.  For example, she may invite the school biology teacher or a philosophy lecturer from outside to sit in the class and discuss all the points together.

-How INTERACTIVE and INTERESTING Pendidikan Islam would be if it is being taught this way, can you imagine?

***

We have to revolutionize our education system of memorizing without thinking. It is imperative for Muslims to recognize that we should change and it has to be done from NOW, starting from the teaching of our youngsters at school.

After going to Australia and experiencing a dramatic change in how knowledge is supposed to be taught, I must admit that I became HYPERCRITICAL at our education system and I have a tendency to always question first whatever is being told to me if it sounds dodgy to me. I have promised myself many years ago that I will NEVER AGAIN believe in something that sounds weird regardless of who says it until I do my own research. Which is kind of why, even in learning psychiatry, I prefer to explore knowledge by myself rather than going through the master system. It might be harder, it might take longer, I might have to spend some of my own hard-earned money…. but I still prefer it that way. (I was asked by one of my colleagues while discussing psychiatry “Afiza, kau kena psychoanalyze kenapa kau tak suka psychodynamic.” I didn’t answer anything but in my mind I was like…. aku tak perlu nak psychoanalyze kenapa aku tak suka psychodynamic. Aku dah tau kenapa aku tak suka. Because some of the dodgy-sounding stuff in Freud’s psychodydnamic REMINDS me of the same dodgy stuff I had to swallow as a child because I was told it was part of the religion and part of being a good Muslim. And then it turned out that actually, they were wrong! And now you are trying to sell to me that accepting some of the ridiculous theories in psychodynamic is part of being a good psychiatrist?! Come on! Don’t kid yourself! There are MANY psychiatrists who DO NOT BELIEVE in psychodynamic, themselves. In fact,  Dr. Jeffrey A. Lieberman, the President of American Association of Psychiatry from 2013-2014 had written a SCATHINGLY CRITICAL analysis of the history of psychodynamic in America in his book “Shrink: The Untold Story of Psychiatry”. He wrote about how the theories WERE FORCED UPON THEM by their previous seniors and anyone who even attempted to question psychodynamic at that time was being bullied into submission rather than being given a proper well-thought out answers! Sebiji macam apa yang berlaku dalam pelajaran agama di sekolah! So, aku tak payah pun nak psychoanalyze kenapa aku tak suka psychodynamic! Aku dah tau pun! Hahah. One day, in a separate post, I will Insya-Allah write further regarding how I developed transference reaction towards psychodynamic. Hahah) 

It’s time we begin a much-needed paradigm shift. 

And I hope Dr. Maszlee and the National Education Advisory Council will deliver an exciting change in the teaching of Islamic Education in Malaysian schools. May Allah guide us all.

I leave you guys with a very famous video of Muslim spoken words regarding the meaning of life. Another one of my all-time favourite You Tube videos. I especially love the final part of the video that says, “If you disbelieve, READ!” I myself found real conviction through reading the books that I had mentioned above. This is why I always advocate for people to READ! In fact, I find it VERY LOGICAL that the first verse of the Quran that was revealed to the Prophet PBUH was Iqra’! Read! This is one aspect of the Quran that is so appealing to a reader like me.

So, enjoy the video, guys! Until next time. Much love and may Allah bless all of us.

Addendum:

P/S: I just had a phone conversation with my Kak Long about this particular issue. She told me that just a few days ago, Aayra, my 5 year old niece had asked her the exact same question of who creates Allah! Kind of proves my point that this question is a natural progression of a growing mind and it will come to every one of us, sooner or later. My Kak Long tried to answer the question to Aayra’s satisfaction but she could see that Aayra was not convinced even though Aayra did not ask further. One day, I will lend my Kak Long the book Timelessness And The Reality of Fate. And her task is to simplify the answer to Aayra in a way that would make Aayra understand.

Most Eventful Ramadhan & Eid

Assalamualaikum, guys. I hope it is not too late for me to wish all my blog readers Eid Mubarak and Taqabbalallahu Minna Waminkum. May Allah accept all the good deeds from you and from me. Amin.

I have always loved the month of Ramadhan since I was a child. This year’s Ramadhan, however, was quite eventful for me. But I still treasure it, nonetheless.

In the middle of Ramadhan, I had to sit for my CASC exam and oh boy, it was like walking through a journey of a treacherously thorny path for me. At the end of the exam, I was drained and exhausted with a heavy feeling in my chest about all the possible (imagined or otherwise) mistakes I might have committed. My apprehension was made worse by the post-exam discussion session that we had self-torturously embarked on among ourselves. (Worst idea ever to have a post-exam discussion! Only worsen my fear) During that discussion, I came to realize that some of them had done this CASC a few times in the past… one candidate had even done it for 5 times. And they were so good and so experienced but they still failed… and I am just a newbie. I knew my chance of passing was very slim. But I didn’t want to lose hope just yet.

After I got back from CASC exam, my mind was perhaps too preoccupied… I missed a step and fell down the stairs at my parents house, spraining my left foot. But because I had only just returned from exam leave, I didn’t feel like I could get an extended MC just for a sprained left foot even though this felt like the worst sprain I have ever experienced in my life. So I went for my first post-exam on-call with a crutch. It was a terrible on-call, not just because of the amount of the on-call cases, but mainly because I noticed how everyone was staring at me when I walked with a crutch along the hospital corridor. Not exactly the best feeling ever.

I felt so self-conscious that I decided to not use the crutch anymore the day after. Luckily, by my next on-call, the pain got much better and I could weight-bear already, albeit with a funny gait. It wasn’t the most fun experience I have ever had.  Adeh. I ended up spending the rest of the Ramadhan at my parents’ house instead of returning to my own place because my left foot was still too painful for me and therefore any help I could get with free meals preparation would be much appreciated. (Muchas gracias, mamita and papito! Your ever loving daughter loves you) The good thing was, I got to spend a lot of time with my parents in Ramadhan and buka puasa meals tasted much better (And it’s also great because it’s been a long time since I last feel like an only child. LOL.)

I went through the middle part of Ramadhan feeling like I was going to have to start collecting more money for my next CASC attempt. At one point, I decided to stop worrying about the result and just focus on getting the best out of Ramadhan first. Priority must be set straight, I had to firmly tell myself.

I had a good Raya celebration on the 1st and 2nd day of Raya with my family and friends.  As usual I had a ‘beraya & bermaafan’ session with my parents, my sisters and their husbands (This year, tak cukup korum. Two of my siblings celebrate raya at their in-laws’ houses.)

And we also had our annual outdoor #OOTD Raya pose. Haha. There were a lot of ridiculous pictures of us acting like cheaply-paid models, displaying  baju kurung in an outdoor photoshoot session. 😛 I will only be showing you a few here. The rest look too ridiculous for public consumption. *facepalm*

 

On the 2nd day and 3rd day of Raya, I went out with two of my good friends. Because these two don’t know each other, I had to arrange to meet them separately.  These two are among the ‘wajib jumpa time raya’ people for me, despite the fact that I do meet them quite frequently throughout the year, anyway. I also attended a few open-houses organized by colleagues and friends. All in all, I really kept my promise to socialize more after exam. I did it! Haha.

 

But on my 3rd day of Raya, the anxiety about exam came back because it was the day my exam result was going to come out. I placed all my tawakkal in Allah because I knew I didn’t do as good as I hoped to do in the exam. I told myself that I would accept whatever result that I would be getting.

***

Dear readers,

I was quite disappointed that I did not pass my CASC exam. In order to pass the CASC exam, there are TWO criterias that must be met:

1)you must reach the passing mark

AND

2) you must not fail more than 4 stations out of 16 stations.

The passing mark is 62.7. My mark is 63.3%. So, I did reach the passing mark but I failed more stations than I should. That happened to a few of us. And there were also some of us who only failed 2-3 stations but unfortunately did not reach the passing mark. It was the most disappointing thing that could ever happen to a candidate… when you made it in one criteria but did not make it in the other. Gosh, so disappointing. Overall, around 47% of the candidates had passed. The rest, including yours truly, will have to prepare for another CASC attempt.

I was disappointed. But I accepted it (because what else can I do right? LOL)

I gave myself 24 hours to grieve properly. And then I told myself that I must get over it, stop feeling sorry for myself and start to DO SOMETHING (as in, study again, of course! What else, right? Gosh… so exhausting! But the truth is, the most exhausting part is remembering the money I had burned for this exam. Ouch! The pain is real! A lot of us MRCPsych candidates are struggling financially. That is one major stressor for all of us.)

But I couldn’t even grieve properly because I had relatives to entertain and my mom needed my help in the kitchen. Actually, come to think of it, that’s a good thing because it stopped me from ruminating over my result. Because my result had come out during the festive season, I had to be less self-absorbed and focus on helping my mother to entertain the guests.

I still remember how I had reacted when I failed my Add Maths as a Form 4 student back then. That was the first time I had ever failed at anything. It was such a HORRIBLE feeling back then. I was so self-absorbed, refused to talk and just ruminated for a few days straight LOL. But maybe it is a sign of maturity now that I could simply put aside my disappointment and responded to my environment properly, be sociable and just entertained guests like nothing really disappointing had recently happened to me. If I were still my old self, I would probably just shut myself in my room and ignore everyone after announcing to my family that I want to be by myself. I would  then pick up some fiction and simply escape reality by reading the story of another person’s life hahha. Yup… that was me as a teenager! (But I am so much better now, ehem, I think. Perhaps because as I grew older, I have come to realize that most things that I used to care about was not as important as I made it out to be. It is nice when things go your way. It’s good when things are calm and rosy. But when things don’t go your way, you are going to have to deal with it, respond accordingly and persevere. But, this is easier said than done. Because first of all, you have to calm the tumultuous turmoil in your chest. And that is HARD, my dear readers. But again, you have to do what you have to do!)

It is no use to deny that the weight of disappointment is always gonna feel heavy in your chest. But the point is not to let it overwhelm you. Keep your balance.

The day after I got my result, I felt like cancelling the plan I had made with another good friend of mine to meet up with her. I haven’t caught up with her for 2 years though we always keep in touch through whatsapp messages. She is one of my best friends during housemanship and now she is already a Paediatrician. But I just didn’t feel like going out the day after my disappointing exam result. Just wasn’t really in the mood. But then…  I told myself, “Afiza, you had wanted to meet up with her for so long. Just because you fail an exam, why should you change your plan? It doesn’t make it right for you to cancel a plan that you had committed to. Both of you had set aside a specific time to meet up and she had probably cleared her schedule for this reunion…. is it okay to break a promise just because you are disappointed? Buck up, girl! You are better than this!” 

I know it is not okay to cancel a plan that we had SO CAREFULLY laid out with each other many days prior. (Because both of us were always so busy to meet up properly, before. We doctors are not really spontaneous people and every get-together is NEVER a spur-of-the-moment thing.) And really, I also wanted to meet her. I knew she was going to be a breath of fresh air that I was going to need. So, I decided to go and see her in Sungai Petani as we had planned.

 

And I am really glad I did that. The force of her insightful wisdom was what I really needed at that time. She is one of the wisest person I have had the fortune to know. She shared with me her own struggle when she was studying to become a Paediatrician and now she’s already doing her gazettement. She really did lift up my spirit in that 3 hours I had spent talking to her. I am so lucky that I am surrounded by inspiring people like her. It makes it easier for me to emulate their spunk.

So, can you see now why I feel like I’ve had such an eventful (or stressful) Ramadhan and Eid? Haha. It was like I was thrown into a roller coaster whirlwind of feelings and emotions in this particular year of Ramadhan and Eid. Feeling blissful and happy about Ramadhan and Eid in one moment, and then feeling anxious about results in the next moment. In one moment, I would feel thankful that I get to experience Ramadhan and Eid one more time this year, and then in the next moment I would feel sad about not passing the exam. I couldn’t even cry properly because even though emotionally I feel sad but intellectually I knew that I have so much more to be thankful for that it wouldn’t make sense for me to complain about anything. I would be an ungrateful slave if I complain about petty stuff when He had given me so much throughout my life. How He had guided me in the past when I was lost  by throwing me into the midst of the kind and wise people I had met in Australia! How He had blessed me with comfort and love from the people surrounding me. How He protected me even when I didn’t deseve it!

Even now, I can feel the wave of love coming from family and friends when I am feeling disappointed and defeated. That is indeed a blessing.

 

Alhamdulillah for great family support and friends with positive outlooks. Anything more that He decides to give me would only be a bonus and I realize that. Passing an exam should not be anyone’s main focus in life, right? (But oh, it would be so nice to have passed. Really, I cannot deny that. But I am putting stuff into proper perspective in order to bounce back and fight another day. I am gonna beat  the crap out of you, CASC! Haha. Insya Allah).

Now, it’s time to resume my studying and prepare for the next CASC exam.

Wish me luck and please pray that I will have the strength and fortitude to go through the exam again.

Until next time, my dear readers. Much love and may Allah bless all of us.

 

 

 

Truly Non-Partisan

Last year, while I was working as a PACA for PH, one of my batch-mates had jokingly said, “Afiza, kau ni kalau Tok Det kentut pun kau cakap merdu.” in our batch’s Whatsapp’s group.

I laughed inwardly. I admit, that I was pro-Mahathir ever since I was in primary school. Everybody who knows me, knows that! I read books about him “Mahathir Di Sebalik Tabir” when I was only 12 years old. I have since read many versions of his biography. And I have also read his autobiography “Doctor In The House”.  I haven’t read the book “Dr. Mahathir’s Selected Letters To World Leaders” yet, but I am planning to. I have a lot of other books about him at my bedside, waiting to be read. And Insya Allah, I will get to it, now that the exam is over.  So, yes, I freely admit that I am his fan.

But I am not blind to all his faults. I just happen to think that he is the smartest leader Malaysia has ever had, and if I am to take any chances, I am gonna root for Dr. M rather than Najib, UMNO and PAS.

That’s all.

And believe me, even if Dr. M was never in the picture during GE14, I would have voted for PH rather than Najib. Dr. M had NOTHING to do with me supporting PH. I hated Najib long before Bersatu was formed. To me, Najib was an evil kleptocrat who had abused his power shamelessly and openly. Nothing would ever induce me to support BN at that time, with or without Dr. M opposing Najib.

But the involvement of Dr. M in PH just strengthened my resolve to work harder for PH to win.

That’s all.

And after reading the book Billion Dollar Whale excellently written by the journalists Tom Wright and Bradley Hope, I am even more convinced that I had made the right choice in GE 14. May 9 2018 is still gonna be one of Malaysian’s greatest success story, just like The Dawn Raid saga.

***

When I just got back from Australia, my father had registered my name into Puteri UMNO. I wasn’t keen to be a member of any political party. After going to Australia, I had developed more critical thinking in how I think about politics and I had stopped supporting UMNO or any particular political party. Instead, I prefer to look at issues and debate them in my mind, looking at the merits of the issue itself…. and not from which party the issue comes from. But as a, ehem, filial daughter I obeyed his wish and registered myself into Puteri UMNO. In fact, all my sisters did. (But we managed to avoid attending meetings and such even as my father sometimes wanted us to. Hahha. I have perfect excuses because as a house officer, I was too busy to attend political meeting anyway.)

My father has always been very “bersemangat” about politics, about patriotism and about fighting to increase the socioeconomic status of the Malays. Talks about politics and economy is our small talk in the family, (believe it or not) because my father has his own business and my brother-in-law is an entrepreneur. So, in the business world, people talk about politics a lot! They know stuff about government deals that had gone wrong and fishy things that ordinary people like us don’t really know. We also like to talk about education because my elder sister is a lecturer and my two younger sisters are passionate teachers. (So you bet that I have very strong opinions about our education system. In this blog I wrote about education quite a bit!) Otherwise, we will talk about medicine and health because I am a doctor, my youngest sister is a dentist and my own beloved mother is a retired staff nurse. Or else, my siblings and I will talk about the latest fiction we had read. (This explains why I am not good at small talk. Even my small talk is serious. Hahha. This is why I have a blog. I have a lot of opinions. And my opinions are strong ones too… not exactly suitable for a nice, relaxing dinner conversation in a social setting. So, my blog is where I write them all. And yes, I write them on Facebook as well. Because I believe, social media is a good place to advocate for causes we believe in. And I use Facebook a lot when it comes to political advocacy. I used to want to become a journalist, and writing in blog or on Facebook feels natural to me when I feel strongly about something.)

After my father got fed up with the blatant corruption in UMNO, he quitted UMNO and joined Parti Peribumi Bersatu. Again, he encouraged all of us to join the party. But this time, none of us did.

My father is the sort of person who believes that we must belong in some ‘society’ or ‘party’ in order to fight for issues we believe in. “Kalau tak, kita fight pun tak ke mana sebab kita tak kuat.”

Well, he has a point.

But, I still don’t want to belong to any party. I stuck by my decision to ONLY support anything or anyone based on the merits of their arguments rather than because “aku ahli parti tu. So aku kena setia pada parti.” 

Look, I am a loyal person. But I am loyal to the truth. I don’t want any kind of ‘artificial’ sense of obligation that ties my hands from saying what I really think.

So, these days, when I started to post in Facebook about certain government policies I disagree with, some people started to say, “Tu la… dulu kau undi PH sangat. Siap jadi PACA lagi. Sekarang, baru tau yang UMNO tu lebih banyak memberi manfaat kepada orang Melayu.”

Ugh! Gosh, penat cakap dengan orang macam ni sebenarnya. They just didn’t get it! They fail basic critical thinking.

I worked for PH during GE 14 (even when I was NOT a member of any of their party components) because I was ANGRY at Najib and at those spineless, coward UMNO politicians who did not dare to throw Najib out of leadership when his corruption was so obvious! I cannot condone that kind of evil kleptocracy to continue indefinitely in Malaysia. To me, regardless of the perceived incompetence of the current government at the moment, I would not do it any other way even if I could turn back time. UMNO must lose the election in order to uproot all the corruptions in the government and clean the system. In the next GE 15, if PH did not govern well, we can vote for BN again. In fact, I would rather we change government every single term so that any kind of corruption would be quickly uprooted every 5 years. When one party becomes too arrogant  for having been in power for too long, the rakyats will suffer. Monopoly in ANY sector is a fertile breeding for corruption and abuse of power. If we change people in power often, and there is no monopoly in who gets to be the government, they would know that their position is NOT secure and they will be more careful about making unjust policies and bullying the rakyats in the future. Because they know Malaysians now vote not based on political party and races, but based on the merit of the issues and policies. So, they will work harder to come up with good policies if they want to stay relevant!

Please understand that just because I was a PH PACA that doesn’t mean I am going to support PH no matter what the issue is! So there is no need for you to say annoying things like, “Tu la…. sokong lagi PH.” What the heck? Why is it so hard for them to understand? In politics, we choose the lesser of two evils by evaluating the information that we possess at THAT PARTICULAR POINT IN TIME. Susah sangat ke nak faham? When the election is over, there will always be issues and we continue to use our GOD-GIVEN BRAIN to evaluate those issues and come up with our own opinion. Get it?

I am not the sort of person who would stick to one party. I am non-partisan. Tolonglah merdekakan fikiran dari politik kepartian. Free your mind and use your intellect to evaluate on any issue instead of blindly supporting people just because they come from your own race or your own party.

***

The truth is, lately I have been quite disappointed with Dr. M and ALSO with Dr. Maszlee in particular. And with Dr. Mujahid… Gosh the kekanda is not even worth mentioning! And let’s not even mention Kesavan Subramaniam, the Sungai Siput MP, who is now facing the accusation of having sexually harassed one of his political aide. This is so sick!

Let me enumerate below what are the issues I have been feeling upset about for the past few weeks.

1)Dr. M labelled Dr. MAZA as ‘pekak’

I was upset when Dr. M labelled Dr. MAZA as ‘pekak’ just because Dr. MAZA had said that Islam is being threatened under PH. Look, whether or not it is true that Islam is being threatened under PH, there is absolutely no call for you to label someone as ‘pekak’. If you disagree with someone, you rebut their points one by one! Simply labelling people when you disagree with them is a form of cheating…. it shows that you are too lazy to come up with a counter-argument and simply take an easy way out! I hate that in anyone! And to think that Dr. M did this, I was so disappointed.

If you listen to the clip above, Dr. MAZA came up with a lot of reasonable arguments regarding the unjust treatment subjected to Ustaz Zamri Vinoth. Therefore, if Dr. M disagrees with Dr. MAZA, he should have just answered on the issue without resorting to labelling Dr. MAZA as pekak! I expect more from Dr. M than this!

Below is my frustrated Facebook rants against Tun M.

2) A DAP Senator  suggested for Malaysia to open an embassy in Israel. 

Nga Hock Cheh, a DAP senator, had – out of the blue – suggested that Malaysia should open an embassy in Israel, knowing full well that we don’t have ANY diplomatic relation with Israel.

What a stupid political move! Do you really want to be ‘kerajaan satu penggal, oh wahai PH? Malay Muslims will never vote PH again if you say something like this multiple times. Our patience has been stretched thin already! Prioritize your agenda! How does opening an embassy in Israel would advance you, politically? Are you so eager to alienate your Malay supporters? Do so at your own peril, I tell you.

GE 14 has shown that the rakyats can topple down the government that has overstep their boundaries. The Israel issue is a clear, indisputable boundary!

Nasib baik kau cepat sedar dan tarik balik kenyataan tu! Perhaps, you are trying to test the water, hmm? Don’t bother. When it comes to the issue of Israel and Palestine, our stand is CLEAR and it will NOT budge!

3) There was also another nonsense suggestion to erase the status of religion in our IC. (For WHAT?!)

Some factions in DAP believe that stating your religion in IC is the cause of disunity in the country! Hahaha. What a joke.

You want to know what cause disunity in this country? YOUR insistence to maintain the existence of vernacular school is the MAIN reason Malaysians are not united. It is the main reason Chinese patients always request for Chinese doctors… because they can’t speak in Malay or English despite being born in this country! It is the main reason why some insensitive Chinese can have the audacity and the temerity to speak in their mother tongue when there are Indians and Malays in the group too. It is the main reason why Malay and Indian HOs in Penang had complained that their rude consultant had spoken in Chinese and effectively alienating HOs of other races in teaching rounds! This is why a lot of doctors in Penang GH had said that Chinese doctors (not all) in Penang are mostly racists!

4)Questionable move by Youth And Sport Ministry to bring BTS into the country.

This is something I just cannot understand. Previously, mere days after winning the GE 14, Nurul Izzah had said that she wanted to bring Radiohead into Malaysia. (I don’t even know who is Radiohead, by the way). And now, Syed Saddiq wants to bring BTS (a Korean group) for a concert in Malaysia in an effort to promote the country.

Look, I am the sort of person who are not into anything Korean. Never really into their dramas or their songs or their culture in general. I seriously don’t know ONE SINGLE name of their actors or actresses.

Until the BTS issue came up in the social media.

I wrote a very lengthy Facebook post about this too. My stand is clear. I don’t think government should be seen to be so eager in supporting trivial, ‘picisan’ stuff! As a government, we should be seen to be focussing on serious stuff! Let the commercial people and the free market decide whether or not BTS should come to Malaysia. Kerajaan tak payah nak beriya-iya support. Doing that is such a stupid political move… the conservative Malays would not vote you anymore! Get it?

You shouldn’t make any statement supporting ‘lagha’ stuff happening in the country because it just looks, oh, so BAD when a politician is seen to be behaving like a fanatic enthusiast of foreign artists! Just be neutral and let the entertainment people bring them in if there is market for it! BUT YOU! MUST! STAY! CLEAR! OF TRIVIAL, PICISAN STUFF! Think about your credibility as a leader, PLEASE!

5)The Education Ministry Is Just Not Doing A Good Job! 

From the very beginning, I had expected the Education Ministry to ABOLISH vernacular schools, reform the education system and gradually phase out the Bumiputera quota once vernacular schools are abolished. We need our future generation to be UNITED by one similar common background before we can talk about stopping the quota system.

Instead, among the first crazy thing we heard upon winning GE 14 was for the government to recognize a Taiwan-based UEC qualification! This is like throwing more confusion into an already chaotic education system!

I also had my own opinion about the move that Tahap 1 students not having to take exams because apparently, it is better to focus on manners and akhlak first. As though they cannot be learned simultaneously! But that’s just me. Maybe a lot of people out there prefer for their kids not to have exams. But I am the sort of person who wants some sort of benchmark to gauge the students’ understanding of the syllabus. So, I basically disapprove of this backward move because I don’t think learning manners and akhlak cannot be done simultaneously with academic learning. But I am not going to hold this against Education Ministry because I know how polarized the opinions on this are.

But to my dismay, from the very beginning the Education Ministry was seen to be focussing on trivial stuff. Like the wearing of black socks and shoes. Like the implementation of cashless business interaction at school. WHY???? Por que?? Aku tak faham! Why do the kids need to be cashless in school when outside the school, they NEED TO LEARN TO USE MONEY anyway! Where is the rationale in this action? (And my cynical brain is also asking, whose company benefits from this system? Who is the company who will be installing the machine necessary for cashless business interaction at schools?) 

Nowadays, Dr. Maszlee has received criticism right, left and centre! He has nothing to lose if he just says “We will abolish vernacular schools. The standard 1 batch who first enters the new education system will no longer be subjected to any quota system when they are applying for matriculation, 10-11 years from now.” 

Two things will happen when he says that:

1)The kiasu Chinese (baca elok-elok. Aku cakap pasal Chinese yang kiasu sahaja. Bukan semua Chinese, ok? But kiasu Chinese.) will no longer dare to ask for quota to be abolished because THEY ARE NOT READY TO GIVE UP THEIR VERNACULAR SCHOOLS either.

2) He puts himself in a strong position to bargain for a quid pro quo. He comes across as someone who is interested in the unity of the people and willing to sacrifice the quota pula tu! He would seem reasonable and smart and willing to compromise for the future good of the nation! And when THEY insist not to abolish vernacular schools but at the same time still demanding for abolishment of the quota system, they would seem selfish and uninterested in national unity!

But what did he do instead? He said  something to the effect of “Quota should be there because even job openings are discriminatory. Private companies only hire mandarin-speaking candidates.” Gosh! Is he saying that one act of discrimination justifies the use of another act of discrimination?! “Oh sebab hangpa discriminate kami dalam pekerjaan, so kami discriminate korang dengan quota lah.” OMG…. no wise politician will say something like that!

Politicians should have basic debating skills, in my opinion.  Rather than comparing quota with job discrimination, you should compare quota with vernacular schools…. because the existence of quota is part of Hak Bumiputera. And if Bumiputera have to sacrifice their rights, then the non-bumiputera must also sacrifice their vernacular schools. Barulah comparable kat situ, faham tak? Barulah kau tak kena bash! Dan kalau kau kena bash pun, at least it will be for a WORTHY statement and a WORTHY move!

Now people are bashing him so badly in the comments section in Facebook and most of them are Chinese. See, YB? You are already unpopular as it is. Alang-alang dah tak popular dan masih asyik kena bash, might as well you simply take the most unpopular action of all by abolishing vernacular schools. Tak perlu nak jaga hati sesiapa… kau memang dah tetap tak popular di kalangan kiasu Chinese.

In fact, being unpopular now is a form of freedom for you. You can do what you believe as right because you know that catering and pandering to people is useless anyway. They still won’t like you. So chin up, and be firm! Just execute!

 

***

If I had become a journalist, I am sure I will be the kind hated by politicians in BOTH the opposition and the government. Because I am TRULY NON-PARTISAN.

I will applaud your good move. But I will also scrutinize all your mistakes and crucify you in my article. It’s a good thing that I am not a journalist. It makes for a more peaceful life.

As a doctor, I am exactly the same. There are times when I will keep my opinion to myself because it’s just not worth it to argue over something trivial. But I do have my red buttons. Push them at your own peril! Most of the time, aku tak ada masa nak gaduh dengan orang. I have fictions to read, book reviews to write, studying to do, housechores to complete and I have a blog to update and articles to pen. And I also have to socialize and catch up with friends, reply Whatsapp messages and emails… so that they don’t think that I have forgotten them. Aku banyak kerja… tak ada masa nak cari gaduh.

But I have pet peeves. Okay?

And I have certain issues I am not willing to compromise. I don’t like discrimination within medical field. If you discriminate certain groups with your snide ‘budget bagus’ remarks, I will retaliate on their behalves or on my own behalf. I don’t like it if you try to discriminate my psychiatry department by sending us staff of questionable calibre, hiding behind ridiculous easily shredded reasoning! If you try to justify the bullying of HOs, I will get back at you and break your arguments point by point. If you try to ‘sound alim’ by telling people to ‘redha’ in order to cover up your own cowardice to fight on issues, I will make sure you know exactly what I think about it! Sebab aku paling pantang orang budget alim dan bagi bad impression tentang agama, padahal kau pengecut dan kau tak reti langsung nak berbahas secara ilmiah! If you are unjust in your statement (like Dr. M was towards Dr. MAZA), I will give you a taste of your own medicine so that in the future, you will think twice before giving out such statements.

And another of my pet peeves…. is of course, politicians and their crappy statements!

And my favourite topics are books, comparative religion, philosophy, cats, education, psychiatry practice and the health system.

So any issue that touch on any of these things, I will talk or write about them. If I had touched someone’s nerves when I talk or write about any of these topics…. well, oops, sorry! Lain kali kalau nak cakap, fikir dulu yang ada orang macam aku yang boleh membalas dan menjawab. Jangan ingat semua orang malu-malu kucing nak face you off.

Otherwise, I am content to mind my own business and just read a book! So please, give a wise comment when you talk about things like these with me. For your own well-being, please use a bit of your own critical thinking when talking about politics to anyone. Because if you happen to talk to me, I will scrutinize and rebut your argument point by point if I think your stand is wrong. If you cannot have a free mind, then you can NEVER understand people who DO HAVE a free mind and do not support any particular party just because it comes from any particular race. We generally avoid people like you. But if you are the ones who come to us criticizing our political stand… that’s ok, you can do that. But expect my rebuttals because I don’t keep my silence.

I leave you guys with a video by Dr. MAZA regarding how a Muslim must make a stand in their lives. We are committed to what is true and what is just. Anything less than that is not acceptable if we are a Muslim.

 

P/S: Alhamdulillah I fulfilled my promise to come up with 2 blog posts in May. Haha. 😉

Playing Verbal Fluency Game With My Nephew (And I Lost)

Salam Ramadhan guys,

I hope it is not too late for me to wish everyone a blessed and productive Ramadhan. Just hang on for a moment while I wipe away and clear out all these dust and cobwebs in my website. 😛 Been awhile since I last clean up around here. Adeh!

Gosh…. it’s been quite some time since I last update my blog. I have been super busy with studying. I always promise myself that I will write in my blog AT LEAST once a month. Just because writing is therapeutic for me. And because I want to prevent Alzheimer’s Disease by exercising my mind in a mental gymnasium of creative written expression. Haha. But obviously, I have failed to write anything in the month of April. So here I am… planning to make it up by promising myself to write 2 entries in the month of May. Hopefully, I won’t break this promise too. (Gosh, I need to step up!)

My exam is next week, peeps!  I have come to the stage of tawakkal already. I have accepted that I will never be able to cover everything and I am gonna forget stuff. I am just human, after all. I accept that we can only try our best and the rest is in Allah’s hands. I will try not to be so neurotic towards the end of my exam preparation, ehem! Just ‘enjoy’ the exam , right? (Yeah, right. Haha. I am not THAT positive, yet. I can NEVER enjoy exams, darn it! ) 

Please pray for me, folks. I need all the prayers and good wishes I can get. And the best part of this is, we are in the blessed month of Ramadhan…so hopefully, all of our prayers will be granted by Allah. I remember how I took my final high school exam (SPM, of course) in the month of Ramadhan too. And Alhamdulillah, me and most of my friends got straight As for it. So, I hope I can repeat the same feat for my final specialist CASC exam in this Ramadhan too. (But I have come to know that the passing rate for CASC exam is only 50%. So, there is only 1 in 2 chance that I can make it. Oh, is there a glimmer of light at the end of the tunnel? LOL.)

Well, we have to do what we have to do, don’t we?

But whatever the outcome is, I will accept it, move on and act accordingly. I can always take it another time if I can’t make it this time. That takes the pressure off my shoulder somewhat. (But, ah… if only money grow out of trees, I will be one heck of an avid gardener. LOL. This exam cost me almost RM11,000 in exam fees and preparation course. And that is excluding my flight ticket and accommodation. *sigh*)

Such is life, folks. Not everything is a bed of roses. Even roses have thorns. We take risks, face the consequence, move on and persevere. Well, life is like that. Like riding a bicycle, people say. You can’t keep your balance if you don’t keep moving (well, unless it is an exercise bike… which is stationary anyway. In which case, the purpose of moving is to lose weight rather than to keep your balance. Which reminds me, that I haven’t exercised for awhile now. *sigh*)

And that is why, ready or not, I must take this exam. Keep on moving. Maintain my balance.

 

While revising my academic materials, I was reminded of how I had played ‘verbal fluency’ game with my nephew one year ago. (To those who don’t know, verbal fluency is one of the cognitive test administered for frontal lobe assessment in the clinic). I laughed in the middle of studying this part of cognitive exam because I remember how I had lost to my 6 year old nephew in this verbal fluency game.

Guys, ageing is real! I lost to my 6 year old nephew that day, you know! God, the horror of it! Of course, to Eshan, I had said, “I only pretend to lose to make you happy,”

Of course, he didn’t believe me. Haha .

So please play this game with your family members as a form of mental exercise to prevent Alzheimer’s, ok! This is one of my favourite games to play with my nephews and nieces (because I am too afraid to play Scrabble or Chess with them… the shame will be too great if they defeat me in those too. Haha. Eshan and Aayra are making me feel my age so acutely. Seriously, guys… not even kidding.)

 

 

In that video, all of us were wearing purple for the wedding of my younger sister. We were all exhausted after entertaining all the guests and the kids were bored, so we decided to play this game while waiting for our Asar prayer. Yup, we left our parents in the ceremony hall to entertain the guests themselves. *walk of shame* #IKNowIamBad 

My parents were pseudo-cool about it…. they didn’t mind me and my siblings’ disappearance act a’la Houdini in the middle of a wedding. LOL. They are so used to it and have become habituated to their children’s lack of social skills. We always avoid socializing more than the absolute necessary amount. Haha. (But they did say, “Nanti korang juga tak kenal saudara-mara. Asyik tak mau sembang dengan orang.” Hahha. But then… I blame my father’s genetic. He is even worse than me when it comes to small talk. My mom is the only one who is good at it in our family.)  I didn’t even know most of the guests anyway. And making small talk with people I don’t know is one of the things that I dread. Not that I have social phobia or anything like that… hahah. I just don’t like crowds and noise too much.

And verbal fluency game is more fun anyway! LOL.

 

Notice how I went blank a couple of times and Eshan just couldn’t wait to count to ten as fast as possible so that he could win. Hahah. He is more competitive than my Kak Long ever was.

In the second video, even Aayra (my 5 year old niece) was helping me. Oh, the shame. (What was wrong with my frontal lobe, guys?!)

I swear, after exam is over, I am going to time myself for 1 minute and practice coming up with as much words as possible so that I can beat them in the next battle. Practice makes perfect, right? Raya is coming soon and they are gonna ‘balik kampung’ to my parents’ house…. so we can have the next battle during Raya. We will call it Aidilfitri Verbal Fluency Contest, si? #AndJustWaitEshan #MakNgahWillMakeAComeback #MakNgahWillDefeatYou 

For the record, I know what bison and walrus are (I know how they look like in the kids dictionary hahha), I just don’t know what they are called in Malay (excuses, excuses LOL) But ah… I have such a smart nephew and niece. I have to step up my game and be careful not to lose to them in the future. Adeh!

One day, I am gonna organize a verbal fluency test in Malay….. Eshan and Aayra will not defeat me in that one. Because my Malay is better than theirs (I hope!)

***

I leave you guys with a reminder (especially for myself) to enjoy this Ramadhan and make the best of this month with prayers and excellent good deeds (exams not withstanding). May Allah strengthen our faith and make us among the righteous in the hereafter. Amin.

Until next time. Much love and May Allah bless all of us.

Heartbreaking News In New Zealand

When I first found out that there was an ACT OF TERRORISM being committed at two mosques in Christchurch New Zealand on Friday resulting in 49 Muslims killed and many others injured, I was devastated.

I had  to stop my studying for awhile and just devoured the news that were spreading like bushfire in my Facebook newsfeed. I wanted to cry. But I couldn’t. My eyes just refused to cooperate to tear up. So, I was left with deep heaviness in my chest instead. I know that the heaviness will go away if I just cry. (This is my problem. It is always difficult for me to cry. I think if I could just cry, I can relieve this ache in my chest.)

I have been to Christchurch when I was a medical student. I went there  with my housemates for a holiday during the first semester break of my 4th year of medical school. We enjoyed our New Zealand trip very much because New Zealand is just such a beautiful country. I never thought that this tragedy could happen in New Zealand because my impression was New Zealanders were much more tolerant towards ‘other’ people compared to their Australian counterparts. They are more progressive in terms of giving their indigenous people (the Maoris) their rights and privileges. The rights of the Maoris in New Zealand are better preserved and protected than the rights of the Aboriginals in Australia.

So when something heartbreaking like this happened in Christchurch, I just could not process it!

And then I found out that the evil perpetrator behind this massacre was an Australian who has a Neo-Nazi political leaning.

Well…. I love Australian people. Most of them are lovely and kind. But some of them can be such racist rednecks! Five years in Australia taught me all I need to know about white supremacy and racism. My experience in Australia shaped me into the kind of person I have become now. I am a person who is super-sensitive to any form of racism or supremacy or ‘budget bagus’ group. You can judge anyone as an individual if you are so inclined. But don’t overgeneralize the whole group because of any mistake done by some individuals in that group. I COULD NOT tolerate that EVER. Muslims living in the West post 9/11 would understand the kind of suffering we had to endure when we were all painted with the same brush. To them, either we were evil terrorists or oppressed Muslim women! Either way, we were treated with suspicions and being looked at as inferior just because we wore the hijab outside the house.

I remember how I felt like I had to prove myself as a Muslim medical student in Australia. I had to do MORE to get the same kind of respect or esteem that the Australians effortlessly enjoyed. As an introvert, it took some adjustment for me to push myself to be extra-friendly, to be outspoken in tutorials, to join group discussions, to mingle with people (now doing these things is much easier for me these days… especially the outspoken part. Haha)  I had to do all these extra efforts in an attempt to contradict the degrading narrative of what being a Muslim woman was perceived to be (when actually, I really preferred to keep quiet and just went home and read my books). Whenever I couldn’t answer any question in the tutorial group, I felt so embarrassed (more embarrassed than I would have been if I were in Malaysia) because I felt like I was feeding the stereotype that Muslim women are stupid by my inability to come up with a sensible answer. I felt like I had to say something (anything!) in the tutorial even when I had nothing to say. I felt like I had to fill up my speech quota of the day in order to appear fully switched on and involved in the tutorial discussion. I felt that way after finding out that some tutors had complained to the admin that “the Malaysian students are too quiet and not participating in the tutorial discussion”. So during each tutorial session, I doubled my effort to appear extrovert because apparently, the more you talk, the more intelligent people think you are. *rolled eyes* (And yes, Australians are very extrovert! And so, people who are too quiet would be thought of as less intelligent or less capable) So, I strove harder in order to contradict the stereotyped image of what being a Muslim woman was. My sweetest moment was when my assignment on Health Equity Selective was being put up on my uni website (in our students blackboard page) as an example to the juniors in the batch below mine on how to write a Health Equity Selective project in the category of Psychiatry.  Me, an International student whose English is only a second language, got the opportunity to display my assignment as a guidance for the juniors to emulate when doing their psychiatry Health Equity Selective… I was over the moon! (Yup, I had chosen Psychiatry for my Health Equity Selective project. I have been interested in Psychiatry since I was a medical student and had chosen that field for my elective.) I was over the moon because I felt like I had proven a point. It was like, I was saying “See… a Muslim student is not that stupid. If we don’t talk as much in our tutorial session, it is because some of the things are obvious already… that it is not even worth mentioning. And English is our second language… it takes more energy for us to come up with any sort of conversation compared to you guys. If we are a bit slow in articulating our thoughts, that is only to be expected, isn’t it? Besides, we just don’t feel the need to stand out all the time.”

My Malaysian juniors were like “Kami bangga sangat tengok Health Equity Selective Kak Afiza masuk dalam blackboard. Malaysia boleh gitu!”

I laughed.

I am proud of my juniors too. I was proud whenever I see my Malaysian juniors were more well-adjusted and had assimilated better with other Australian students compared to us, the seniors. The juniors learned from our own mistakes and put more effort in making Australian friends. They experienced less criticism that “the Malaysian students do not mingle with people. They like  to keep  to themselves and don’t put in any effort to assimilate with the whole batch”.  As the years progressed and we started getting more Malaysian students among our junior batches, I thought, we were doing such a good job of portraying that Muslims were not as bad as what were shown in the media. Slowly but surely, I felt like the stereotype against Malaysian students were eroding. My heart burst out with pride when I saw how Malaysians were very heavily involved in our university Islamic Society (I myself was the treasurer of University of Newcastle Islamic Society at one time) and we were always the front-liners when it came to interacting with non-Muslims at the Islamic booth during Islamic Awareness Week. Compared to the Saudi or other Middle Eastern Muslims, Malaysian leadership shone bright in the Islamic Society. (Perhaps because our command in English was better than them). We could answer controversial questions about Islam quite well while guarding the booth. All in all, we were making pretty good progress.

But it could get pretty tiring. Always having to prove yourself over and over again is tiring. Whenever there were new incidents of terrorism and bombings in the Western world, I felt like all our hard work to prove that Muslims are good people were completely undone. And we had to do it all over again. Prove ourselves all over again. It was exhausting. Mentally and physically draining.

But I never regret any of it! Because the struggle that I had gone through made me who I am today. There is beauty in the struggle that we have to face in order to live up to our Muslim identity and Muslim ideals when we are living in a non-Muslim country. Looking back, I was my best self in spirituality when I was a medical student in Australia. Because of the struggle I had to face in Australia, I was more conscious of God and more connected to my religion than I ever was in Malaysia. I invested more time to learn about Islam properly (partly because I had to prepare answers for the questions that non-Muslims liked to ask). I was my most patient self when I was in Australia… because I was carrying the image of a Muslim and I did not want my bad behaviour to tarnish the name of my religion. In Australia, I had a purpose GREATER than my own self because I had to be a small ambassador to my religion! So despite all the struggles and the difficulties, I was very motivated. Our social support were the usrah-attending seniors who kept reminding us to be good, to do good, to strive for the hereafter and not just the dunya. (This is the part of myself that I miss the most, now that I am in Malaysia. I miss the Afiza who was nice. Because the current Afiza is not so nice! Hahah. Somehow, after coming back from Australia, I have retained my outspokenness but have not retained being nice. Perhaps because Malaysians are not always nice too….they are not always ethical…they don’t have values of respect or punctuality or cleanliness or efficiency…. they can be lazy…  they can trample on your rights… and if I am too nice and not outspoken enough, I will be oppressed. And I don’t want that.)

***

Allah had planned my life so beautifully, Alhamdulillah.

At 18 years old, I was grieving the death of my friend. Looking back, maybe I had an existential crisis at that time because I was so shocked by the fragility of life. That my friend could die at such a young age! I wondered, what was this life all about? For two years, I was wondering to myself about existential stuff, but afraid to vocalize them out for fear that they would label me “tak kuat iman”. And then Allah sent me to Australia where I met religious people who could answer all my questions. Alhamdulillah, my existential crisis resolved then. I became a firm believer. I came across someone in Melbourne who answered my questions patiently, systematically… scientifically, even! Suddenly, I felt a sense of spiritual awakening that I had never experienced before that summer, which was my first summer in Australia. I knew then that Islam is logical; that it makes sense! If things do not make sense, you must double-check whether it is truly religious in the first place. I was ecstatic and grateful for all that I had learned that summer.  It is nice to have real faith!  (I was so relieved! Finally, the horror of the Israilyat stories I had to swallow in KMB can be vomited out once and for all without feeling any guilt. That’s why I will always love Australia, the place where I had experienced an exponential growth, mentally and spiritually! There would never be a time when I think of Australia without a sense of nostalgia. It’s just not possible. Some of the things I had learned in Australia STILL influence my behaviour until now!)

I believe, some Muslims would have an existential crisis after witnessing this current heartbreaking incident. Some of the family members of the deceased might experience what I had experienced during the period of grieving. They would start questioning… why are there so many dreadfulness in this world? Why do people do evil things? Why didn’t God do something about it? Why didn’t He intervene? Why is this world so unfair? Why was I even created? What am I supposed to do in this life? Is Islam really the right religion? How do I know that? What if I am in the wrong faith… what will happen to me when I die, then?

They might have all these questions as they deal with the death of their loved ones. And hopefully, they will go through the cognitive process of finding the answers… and finally be at peace in their faith. You cannot bury these questions and silence your conscience. Repressing your doubts will not help you find peace. You must actively engage with your intellect and answer the questions that you have about the religion, about faith, about life after death. Otherwise, you will always be in doubt. And it won’t be real iman. You will not experience true peace that comes with firm belief. You will not feel confident to take any action, to speak up, to do what you believe is right… because you are not even REALLY sure if God is real and that He will help you out of any trouble.

So, don’t bury your internal existential crisis or your philosophical conflict. Answer them! Seek and you shall find! And believe me, what you find will be beautiful and priceless!

 

***

My Facebook status on the act of terrorism at the two mosques in Christchurch.

I have been busy preparing for my CASC exam these days. As usual, I am at my most neurotic self while preparing for exams, LOL. I would start thinking about how much money will be lost if I fail my exam. I would start thinking about “ah, aku dah tak larat nak study! I just want to be a chronic MO.” Hahha.

Sometimes, I mourn my lack of time for fiction reading. It is ridiculous how much I sweat the small stuff.

I forgot that there are other more important things in life other than being a nerd and passing your exam. I forgot that my fiction-reading are trivial, picisan stuff! Stuff of amusements and ‘main-main’.

In other parts of the world, people are fighting for their lives!

On the same day that the mosques in  Christchurch were attacked, Israel had also launched series of airstrikes across Gaza! We have thousands, if not millions, of our Muslim brothers and sisters in various parts of the world undergoing physical and mental suffering… all at the same time! And I am worried about exams? And about reading fiction? Gosh, Afiza… you are preposterous!

Sometimes, I have to admit, I can be really stupidly ridiculous. I am done worrying about trivial stuff! Because there’s more to life.

For as long as I can remember… everytime I was overwhelmed by my study, some sort of tragedy would be breaking news and made me realize that my struggle was not significant at all in the general scheme of things. For example, in 2010, while I was preparing for my final General Medicine exam, the Turkish ship Mavi Marmara, which was a civilian ship bringing aid to the Palestinians, was attacked by the Israel Navy in May 2010. The attack by the Israel Navy was bravely resisted by the civilians on the ship; nine activists died and many were wounded. I was worried sick about my exam at that time. But after reading about what had befallen the Mavi Marmara ship, I had felt similarly ridiculous as I am feeling now for being too worried over small stuff when people are fighting for something greater than even their own lives!

I composed a poem for Mavi Marmara at that time entitled FORGIVE MY SCOWL which I had uploaded into the poetry section in this blog. I composed that poem after taking a pause from studying my General Medicine notes in order to clear my muddled head and to lift up the overwhelming heaviness in my chest.

This is also why I am taking a pause from my CASC studying and writing this post today. To clear my head. To lift up the heaviness in my chest. Because I just couldn’t cry. Because to compose a poem, it would take a much greater mental strength than I possess. Because I am too mentally exhausted by all the bloodshed.

I pray, that all Muslims would unite together and peacefully respond to this sad calamity in a positive way. I hope, there will be no revenge bombing by Muslims because it would only make matters worse for our brothers and sisters in the West. Trust me, I had enough experience of how terrible it is to be in the West when so-called Muslims commit an act of terrorism somewhere. (Nak masuk lecture hall keesokan hari pun rasa nervous! Rasa malu! Belum lagi rasa takut kena attack bila terpaksa jalan berseorangan.) Please, no revenge bombing targeting innocent people, be it Muslims or non-Muslims. Please, no more bloodshed.

***

I leave all my readers with a reminder to live in this world like a traveler or a stranger. Because, really… isn’t that what we are? Until we reach our final destination, we are only a traveler along the path of life. Hopefully, we will find something precious and beautiful along the way.

Values For A Balanced And Well-Ordered Life

When I was an IB student in KMB, part of the World Literature component that we had to study was the novel The Great Gastby, authored by an American novelist, F. Scott Fitzgerald.

Though at that time as a teenager I was not that enamoured with this magnum opus of F. Scott Fitzgerald, the FIRST TWO SENTENCES of this novel had stayed with me until now.

In my younger and more vulnerable years my father gave me some advice that I’ve been turning over in my mind ever since. 

“Whenever you feel like criticizing any one,” he told me, “just remember that all the people in this world haven’t had the advantages that you’ve had.”

We had to analyze the novel as a student. And I just kind of wrote in my literature analysis that we shouldn’t be judgmental towards other people because we don’t know what other people have gone through in their lives to cause them to behave a certain way now. By the way, I got an A for my literature analysis of The Great Gatsby at that time. But all I wrote in my essay was some wishy-washy namby-pamby crap that I feel embarrassed to be recalling now.

Trust me, I have changed my mind. I think the longer I am in psychiatry, the more objective I become about things that I read and what I should tolerate and not tolerate. Or maybe it is just the effect of me being older and wiser.

I believe that what happened to you in your past DO affect your life now…. but only up to a point. Whether or not you let the past haunt you, it is ON YOU. It is YOUR DECISION.

If I could go back in time and do the literature analysis all over again, I would probably change  the tune of my essay and write something like this instead: “We all have different life story. OF COURSE none of us will have the same kind of advantages and disadvantages. That’s just life. It doesn’t mean you can excuse yourself when you do something bad or maladaptive. Instead of wallowing in your disadvantages in life and comparing how other people’s lives are much more advantageous than yours, you should move forward and think about how you could make your life better, isn’t it? Mr. Gatsby deserved what he got in the end! He should have moved on a long time ago and stop pining for a married woman.”

Trust me, I have no sympathy for the great Mr. Gatsby.

***

As a psychiatry MO, I am going to be honest and admit that I have favourite cases and favourite patients. I mean, that is only natural. That’s why we have subspecialty, right? Because we don’t always like all types of cases even though we DO see and manage them all to the best of our ability.

And, let’s face it. We do have favourite patients, don’t we? We don’t discriminate our patients in terms of treatment and resources but there are certain patients we like to see MORE than others. That’s just human.

So, what sort of patients do I like? Well, I like patients who help themselves because it makes it all worthwhile. Because without the patients helping themselves, there is nothing much I can do to help them that would work long term. We can psychoeducate till kingdom come, or do daily home visits, or call them every day to update on their progress, or we can repeatedly give them compliant therapy…. over and over again…. but nothing will stick long term until they accept their illness, and make THAT VITAL DECISION to take the meds and perform all the non-pharmacological measures we tell them to do. My whole investment in effort and time to make  their mental health better depends LARGELY on the fact of whether or not they themselves will do what I have told them to do! I can do my best… but it won’t work if THEY don’t do their best. We are not going to be there for them 24/7. And we shouldn’t have to. Part of the responsibility should be shouldered by the patients themselves and their family members.

So yup… I do have favourite patient’s family members too. The more cooperative the family members are, the bigger the smile that I bestow towards them as a form of greeting at the start of the conversation. LOL.

It is kind of disheartening sometimes. When the reward for our hard work (seeing the progress of our patients is a reward) depends on the patients themselves taking that leap of change…. it can be disheartening because some of them just refuse to take that leap.

So when patients (or their family members) ask me about their prognosis or if they will ever get better, I said truthfully “You will get better. Not all conditions can be cured… but they do get better. But how much better you get depends on YOU.”

And that’s the problem. And that’s also the solution.

YOU are the solution. Regardless of your background! Regardless of your advantages and disadvantages in your past! Regardless of what had happened to you in the past and the present, YOU are the solution to your own problems. Make that decision to take your medication. Make that decision to not let your past determine your future. Make that decision to put some effort in doing all those lifestyle changes! Make that decision to do your CBT homework! Make that decision to feed your thoughts with positive self-affirmations as you were taught to do in your CBT sessions. Make that decision to practice that deep breathing exercise and the relaxation techniques taught to you. Do it for you!

Because I cannot do it for you.

***

What are the values you must internalize in order to move forward DESPITE your past and  your disadvantages?

Because trust me, if everyone can behave badly by citing random disappointing things that had happened in their lives as the cause of their depression/borderline personality/ antisocial personality/addiction, then everyone can get away with crimes because “oh, it is not my fault. I had a deprived and disadvantageous childhood, you know”.

“Oh, I murdered that guy because he reminded me of an ustaz in a Maahad Tahfiz who had sexually abused and sodomized me when I was younger! It’s not my fault. Don’t judge me if you don’t know my past.”

But when you are arrested by the police and subsequently sent to be evaluated in Hospital Bahagia Ulu Kinta, we will only determine whether or not you were of sound mind when you had committed that murder and whether or not you are fit to plead! Regardless of whatever bad past experiences you had, we are only going to be interested in the soundness of your mind! We are only interested to know whether you knew what you did was wrong and contrary to the law! That’s it! We might be interested in your past… but only up to a point. The court may take note that you used to have a disadvantageous childhood… but you will STILL be punished. It is only right for you to be punished. Your bad past will not suffice in the court of law to justify your crime!

Facts! Reality!

Regardless of whatever childhood adversities you have experienced, by the age of 18 you will be treated like an adult in the court of law! You would be assumed to have had the maturity of an adult and you are accountable for your own action. You cannot turn around and blame your parents when you are addicted to drugs… because your siblings who are NOT addicted to drugs ALSO have the same parents as you! The judge in court will not entertain wishy-washy, sappy sob story of an excuse like that! Even in Islam, we are accountable for our sins at the age of puberty! The reality should not be distorted to adjust to YOUR subjective experience! Instead, regardless of whatever bad experiences you have had, you must make the effort to adjust to the reality. If anyone can be excused based on ‘subjective’ experiences of childhood disadvantages, then that’s it! There should be no law and order. Everything must be grey and blurry, then!

Likewise, the reality is such that when you behave in a counter-productive manner or in a socially inappropriate manner, most people will reject you. Regardless of your past! People who are going to deal with you day in and day out are not going to care about how difficult your past was after a certain point! Their sympathy can only go so far. So the onus is on YOU to rise above your past and change your behaviour if you want to lead a fulfilling life. And we are here to help you do that. But you must be willing to put in some effort without always blaming others for every single thing that goes wrong in your life.

In Psychiatry, we also learn that there are certain risk factors that predispose someone to having depression or other mental illness. But some people do cope well with life despite having those risk factors! How come?

So my take home message is  this: Your past DO affect you… but ONLY up to a point! You are not totally helpless against your past! Because the rest of your life is determined by what you are going to do now in moving forward.

And you can turn over a new leaf by internalizing certain values in your life that I am going to enumerate below. Please take note that I am not disregarding or invalidating all your past experiences and all the injustices that had happened towards you. I am just giving you a way to move forward.

Effort

“Doktor, ingat senang ke nak usaha? Pesakit depressed memanglah tak larat nak exercise, nak buat behaviour activation semua. Bila doktor cakap kena usaha… macam stigmatizing. Ada doktor suruh pesakit kencing manis usaha supaya pancreas diorang keluarkan insulin? Tak kan…”

“No, I won’t tell type 1 diabetic patients to put in an effort to force their pancreas to produce insulin. However, I do tell them to put in an effort to take their insulin, to control  their diet, to exercise and keep a healthy lifestyle. And this is what I am telling you to do too. It is not stigmatizing. It is factual.” This was my answer to the patient (who also had some component of personality on top of her depression). Very matter-of-fact, very reality-based.

To be honest, I NEVER like the ‘mental illness stigma’ poster that compared depression with diabetes. It is so inaccurate, and we should stop saying “Jangan stigmatize pesakit depression. They cannot help their behaviour. They lack serotonin. Just like pancreas orang yang ada diabetes tak boleh keluarkan insulin, orang depressed pun tak boleh keluarkan serotonin. When you tell depressed people to put an effort, it is a stigma! You don’t tell diabetic patients to produce insulin, do you?”

Ugh! Gosh! I cringe inwardly whenever I hear misleading things like that.

I agree that we should not stigmatize mental illness! But I disagree about depressed patients not having to put in any effort in dealing with their depression! Asking people to put in some effort should not be construed as stigmatizing! In ANYTHING we do in life, effort is vital! In ANYTHING!  Stop trying to tie our hands from telling our patients to put in some effort! What do you want me to say then…. tak payah usaha langsung?

As a Muslim, Allah will not help us without us putting in our effort! To Muslims, that’s a fact! I am not going to distort reality just to align myself with the content of a bad poster. I am not going to distort facts just to appear FALSELY empathetic and sympathetic when the reality is different! If we cannot tell them to put in some effort, then how about asking them to go to occupational therapy? Doesn’t that require some effort? How about asking them to attend their CBT sessions or their psychotherapy? Doesn’t that require effort for them to do their homework?! How about asking them to practice deep breathing exercise and do some physical activities? Doesn’t that require effort?

The only condition that doesn’t require your effort is when you are in a state of coma! You don’t tell ICU patients to put in any effort, sure! But for the rest of us, the requirement for a good, healthy and balanced living is our effort. The faster you internalize this idea, the faster you will improve your life, Insya Allah.

So, please! Please stop promoting mental health awareness by comparing depression with diabetes! That’s like comparing apples and eggs. They are not even in the same category! (at least, comparing apples and oranges can fall under the category of fruits! But apples and eggs are two different categories altogether, get it?). For one thing, there is no component of the ‘mind’ in the Pancreas! There is no intertwining interpersonal conflicts and ongoing social stressors in the development of Type 1 Diabetes! So Type 1 Diabetes patients really cannot change anything much in the way they behave to help their condition. But this is not the case in depression! So, how is this a good and fair comparison? Neither the diabetic patients nor the depressed patients are treated fairly by this comparison.

And Wallahi, this comparison should cease to exist! (Adoi, penat! Too much emotion has been invested in writing about this alone, LOL. Pheww!) 

To quote Kevin MD: 

Diabetes is a disorder of insulin metabolism. Insulin is produced in the pancreas. The (depression-diabetes) analogies disregard the intimate intertwining of brain and mind. For the pancreas, there is no corresponding “mind” that exists in the realm of feelings and relationships.

I prefer to compare depression with having a fractured lower limb in terms of how effort would improve your outcome. “Katakanlah awak mengalami kemalangan jalan raya dan kepatahan kaki lalu tidak boleh berjalan.  Lalu, saya pun beri kepada awak tongkat untuk bantu awak jalan. Sudah tentu berjalan dengan tongkat dengan kaki yang patah lebih susah berbanding sebelum kaki awak patah. Tetapi tongkat itu serves its purpose untuk bantu awak bergerak walaupun memerlukan lebih banyak tenaga. Tapi jika awak masih duduk di kerusi dan tidak mahu berjalan walaupun sudah diberikan tongkat, maka tongkat itu langsung tak berguna! Bila awak duduk dan baring sahaja, ini akan membawa risiko mendapat bedsores dan secondary infection yang lebih teruk lagi. Apabila saya berikan awak tongkat dan suruh awak berusaha untuk berjalan, tak bermakna saya menidakkan kemalangan yang berlaku dan kesakitan yang awak alami kerana patah kaki. Tetapi saya bantu awak untuk move forward WALAUPUN ya, saya akui awak kemalangan dan ya, saya akui awak memang sakit dan patah kaki. But the tongkat is here, isn’t it? Are you gonna take it and walk or are you going to just sit down, not using the tongkat and instead repeatedly go back and forth questioning why the accident had happened to you? And why aku patah kaki dan orang lain tak patah kaki? Because think about it….How is that going to help you? Now… let’s get back to your depression. I am giving you your medication and I have scheduled CBT sessions for you with our clinical psychologist… will you take it? When I told you to put in some effort to do all these measures, to try to go to work… I am not denying your depression and I am not saying it is going to be easy! It is hard! Of course going to work while being depressed is ALWAYS going to be much harder than going to work without any depression… that goes without saying! However, now I have given you some medication, and you will be seeing our clinical psychologist for CBT sessions….these things are the tongkat! Yes, it is still harder to go to work compared to when you were not depressed… but now, going to work is becoming more achievable, isn’t it? Compared to when your depression was not treated at all, now even though it is STILL hard… it can be achieved right? Just like it is still painful for a man with a broken leg to walk with a crutch, but at least with the crutch, the man with a broken leg can now walk, isn’t it? Will you at least try first?”

Most patients who already have some spark of optimism inside them can relate with the ‘patah kaki’ analogy FAR BETTER than the diabetes analogy, in my experience.

Really… I am not a vague, wishy-washy person. I am always the ‘bottom line’ kind of person! I want to know the truth, the reality, the actions that I need to do and what is the possible outcome I can expect. And therefore, I don’t like to comfort people with half-truths. I do adjust my style of giving away the real truths to my patients depending on their personality and the appropriate context…. but I am not gonna give them empty words of comfort. I am not gonna tell them it is okay when it is NOT okay. I am gonna tell them, “What happened is not ideal but what are you gonna do about it? Let’s face it and deal with it! It will be hard but it can be done. I will help you… but again, it will only work if you help yourself because a lot of things require effort on your part!”

And most patients recognized the truth and they gravitate towards it! The sunnahtullah is such that deep inside, all of us want to know the truth. And when we give the truth to them, it builds trust because they know that this doctor is not lying and pretending to care about them! Sure, some of them don’t like to hear the truth and they might hate us for awhile. But the seed of doubts regarding their actions has been planted in their minds…. and eventually they will think and evaluate the matter again.

But patients who STILL persisted in playing the victim card (usually a personality component is involved here), will continue to deteriorate. And my heart sinks.

As a psychiatry doctor or a therapist, among the first thing we should do (after allowing them to ventilate and express their distress), is to get them to internalize the value of effort! We will not get anywhere if they still persist that they are victims of their past and therefore they will always be ill and flawed because their past can never be changed and therefore there is no use for them to put in any effort.

That is really such a tragic way to think about life. We must pull them out of that mindset before anything can ever change. But unfortunately, it is STILL their decision to change their mindset! At the end of the day, we can only do so much to help them. The ultimate outcome lies in their decision. 

 

Having A Growth Mindset

The opposite of having a growth mindset is having a fixed mindset. The worst thing that can happen to anyone is to have a fixed mindset. Having a fixed mindset would wreak havoc in your life because you have basically internalized learned helplessness. Learned helplessness is bad, folks! With learned helplessness, people can be driven to suicide because they believe nothing they do will ever change the situation and there is just no hope left. 

 

Biologically, we learned about brain plasticity which is the ability of our brain to change through life with our experiences and our training! It correlates perfectly with the value of having a growth mindset.

From the psychological point of view, Piaget’s theory of cognitive development talks about how our mind and our mental schemas are always adapting and accommodating…. for the rest of our lives. So we are not always stuck in our bad childhood memories. Provided you put in some effort, you can overcome your disadvantages! 

While I do think that me hearing out your feelings and allowing you to ventilate your problems do help to de-stress you while you are facing your crisis, I am more interested to know what you are going to do about overcoming your limitations in life? That’s the BOTTOM LINE always.

With a growth mindset, you will have a positive and optimistic outlook in life because YOU JUST KNOW that whatever it is that is happening to you, you can master the steps that you need to take to overcome the challenges! You just need to grow your mind by expanding your horizon with new skills, new set of positive thoughts and new set of behaviours. When you have a growth mindset, you know you can learn and re-learn and un-learn your way into a better coping mechanism. 

You won’t say things like “Dah aku memang macam ni. Family aku dulu ajar aku macam ni. Memang dah tabiat aku. Memang aku tak boleh nak ubah… nak buat macam mana?”

I am not saying that it is easy to change your habits! A person with a growth mindset ALSO might be resistant to change because they are already comfortable with their own habits and personality. But when it is important for them to change and adapt (perhaps, there is something at work that they have to be in-charge of that requires a new set of behaviours and habits), they will make themselves change their habits and behaviours because they know that the only constant in life is change! And if they have to do it, then they have to do it!

So, will you continue to practice? Will you continue to study and acquire knowledge and skills for the betterment of your future? Will you be willing to put in some time and effort (goes back to effort, doesn’t it?) to do what has been taught to you during your CBT sessions so that your new skills slowly become second nature and would be automatically activated in the future with much less effort than what you have to put in now?

You will do it, when you have a growth mindset.

If you have a fixed mindset… don’t worry. This is the beauty of the concept of having a growth mindset. You can unlearn that fixed mindset NOW, and start to learn to have a growth mindset.

Having An Internal Locus Of Control

In psychiatry/psychology, locus of control is defined as the degree to which people believe that they have control over the outcome of events in their lives, as opposed to external forces beyond their control.

If you have an internal locus of control, you believe that events that happen to you is the result of your own doing rather than the external forces outside your control. For example, when you have an internal locus of control, you would believe that you had passed your exam because you had studied hard and went to all the lectures and tutorials that were given at the uni and because you had prepared accordingly. You did not think it was the external factors beyond your control that had made you pass. You did not think that it was just luck or because other people were doing even worse than you or because the teachers like you better than your other classmates. You are less likely to conform to your surroundings when you have an internal locus of control.

If you have an external locus of control, you believe that you had no control over the events that had happened to you and there was nothing you could do to influence the turn of events. For example, you believe that you would never pass the exam because the subject was too hard and the lecturer did not like you. So there was nothing you could do to pass your exam. You believe that the result of your exam somehow depends on all other external factors except your own effort. Having an external locus of control makes you more likely to conform to expectations and environments because you want your life to progress smoothly.

In general, when it comes to motivation and drive, having an internal locus of control is much healthier than an external locus of control. 

However, having too much of anything is never good. Having a much too internal locus of control can also cause you to blame yourself and will make you feel unnecessarily responsible for something that you could never help. And that can also predispose you to depression. See the diagram below to see what I mean regarding imbalanced locus of control and why it would be bad to have too much of either.

 

The key word here is balance and reality check! I have mentioned before that I like the truth! I like reality check! Those are the two words I use a lot with my patients. You are entitled to your feelings and you have a right to them because it is YOUR feelings…go ahead and have them. But at the end of the day, your feelings do not necessarily reflect the reality. And if adjustments need to be done, your feelings must be compromised to give way to the truth or the reality! You must start learning to feel the right thing! (yes it can be done!) Because your feelings, even though you have a right to them, are subjective. But the truth and the reality are the objective facts! It will make your life much easier and less turbulent if you can learn to feel the right thing. 

As Muslims, we know that things that happen to us are decreed by Allah. But because we don’t know the decrees of Allah yet (I don’t know whether I will pass my exam or not, for example) we are ORDERED by God to put in some effort to attain what we desire. So the locus of control is balanced here. You are neither too sad nor too happy about things that happen to you in this life. Because you know that whatever bad or good things that happen to you have already been decreed by God and eventually anything bad and good will simply run its course! It will pass! There will be a next challenge to conquer and then the next, and the next…. until you breathe your last air! Bad events hurt… but give it time. Put in some effort, work at it again! Continue! Persevere! Feed that internal locus of control.

And when a disappointing outcome arrives… recognize that some things are out of your own control but it does not nullify your effort at all. It’s just life!

For example, someone passing their viva is a combination of effort, studying and doa (internal locus of control) and examiner factor, your health issues during the time of exam, and the type of case  you get (external locus of control). That is the reality! Nothing in life is TOTALLY in your control. And nothing in life is TOTALLY under the control of the external forces. Perhaps, when you realize this fact, your feelings about anything will be in moderation.

Read Up

I suggest that people take up reading as a hobby. Not because it is my hobby and I am very much in favour of that habit (haha… mungkin ada juga komponen biased sikit. Because I will always think that reading is superior to any other hobby hahah… so yup, ada biased sikit) but because it is the one good hobby that will benefit anyone regardless of gender, social status, and whatever past experiences you have had.

Even if you read commercial fiction like Harry Potter, you will feel like “Wow…. this kid could fight the evil Lord Voldemort by the virtue of his effort and perseverance. Setakat kena marah dengan consultant, that is nothing to be scared about. I will turn up to work and finish my housemanship regardless of how bad I kena marah. I can overcome this!” Hahha. Okay… that is an extreme example. After all, Harry Potter is a fictional character and most people don’t try to relate their lives with fictional characters to sooth their feelings. So, you might not think that reading Harry Potter can ever motivate a disillusioned houseman (though actually it works with a lot of ardent readers out there! It certainly works with me!)

But you can also read biography/autobiography of really inspiring people. Autobiography books are real-life events! In my last blog post, I talked about the biography of Muhammad Ali and how inspiring he was. If you are a Muslim, you can read the seerah of our Prophet and his companions (I have mentioned before that Umar Al-Khattab is my favourite superhero). Read about the history of Jerusalem and the oppression committed by Israel towards the Palestinian people who are still persevering and fighting for justice and freedom (Netanyahu is worse than Lord Voldemort, okay!). Read the biography of Mahatma Gandhi and Nelson Mandela and the sort of sacrifices they had to make for the sake of freedom and social justice.

I am not saying that reading protects you from depression or neuroticism. But it broadens your horizons, knowing that people are always struggling sometime, somewhere. You get to live the lives of many people through reading, and you get to find out how all these various people cope with their own mistakes and  their own troubles (After all, the best way to learn is to learn from other people’s mistakes and troubles…. rather than making the mistakes and having the troubles yourself, right?).

If you just read (the right material), you will have a better coping mechanism. It improves your logical thinking and your abstract reasoning which will make it easier for your therapist to work with you. Some of your CBT homework require some reading too. You are more likely to do it if you already love reading.

If you don’t like reading, don’t worry. Focus on getting a growth mindset, first… and then you will know that you can adapt your brain into loving to read… and it WILL benefit you.

For Muslims, it is no coincidence that the first verse that is revealed by Allah to our beloved Prophet Muhammad (PBUH) is to read! Iqra’, remember? Get some knowledge! Internalize the values that you read and use it as your guidance in making any decision! Our parents can only teach us so much… because they have only their own experiences to tell you about. Their way of doing things and their experiences may not be applicable to you. And so, we read in order to experience the lives of many people so that we can have a big arsenal of weapons to choose from whenever life strikes us hard. 

This is the first verse of the Quran that was revealed to our beloved Prophet Muhammad (PBUH)!

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And as a therapist, sometimes we need to set up boundaries with our patients. We have to let them experience the consequences of their own behaviour. We should not be enabling and reenforcing their bad behaviour by always giving in to their demands for attention and validation when what they are doing are obviously wrong and maladaptive.

They have to stick to their appointments and learn to deal with the consequences of being late to their  CBT/Psychodynamic session. When they throw a tantrum, we should ignore them until they are willing to behave well and until they can state exactly what sort of problems they want to discuss with us in a rational and calm manner. Behave like an adult and we will treat you like an adult.

Some patients will manipulate their counsellors or their therapists or their doctors. It is important that we recognize that behaviour and not accidentally rewarding them.

A few years ago, I myself had terminated a therapeutic relationship with one patient when he had thrown a tantrum at the nursing counter in order to see me. My late HOD, Dato’ R, happened to be at the counter at that time and managed the situation by telling him that I was covering addiction clinic and he must see other doctors. The patient should have come during his allocated appointment time but he didn’t.  He had come earlier than his scheduled appointments so many times in the past and I had told him not to do it. I told him that he had to learn to deal with his feelings by the techniques that had been taught to him. And I told him that he should go to the ED for any emergency that crops up in between appointments. I was hoping that by making myself less accessible, he would learn to deal with his distress by himself using the techniques that had been taught. But he still didn’t.  A few days later, he came to  the clinic again (again, without an appointment) and I decided to see the patient one last time to terminate the therapeutic relationship. I told the patient that what he did at the nursing counter a few days ago was unacceptable and I think he should see other doctors. I was very firm. You must follow the rules, or bear the consequences. After I terminated the therapuetic relationship, he did not see any specific doctor since then and was placed in the general pool for any doctor to see. As far as I know, there is no issue since then.

One day, I happened to bump into him at the supermarket. He was polite and did not try to detain me when I said that I need to excuse myself to finish shopping. That was a huge improvement! A few weeks later he came to the clinic, and he had requested to see the doctors in room 2 (happened to be my consultation room on that day). The clerk at the counter was firm and said “But you didn’t follow appointment. Pergi bilik 5. Lepas ni kalau nak request doctor mana, datang on time.” And he abided by that instruction without insisting to see me in Room 2. Very good behaviour that he had displayed there! So, I have made a decision that if he ever comes on time later on and requests to see me, I will grant him his wish as a reward for his much improved behaviour.

I am very particular about time and sticking to agreed rules and negotiated terms. That is one of the ways I know that the therapy is working. I have an aversion to being manipulated and controlled. I don’t like it and I won’t allow it in my therapeutic relationship with my patients. On this, I am very firm. I don’t think it is healthy to be there for your patient 24/7.

At what point is your patient going to be able to learn to think for themselves and  solve their own problems if you are always there to be depended on whenever they are in crisis? Once we have agreed on the negotiated rules and terms, we must stick to it. Early in the treatment, there might be some adjustments and hiccups along the way. But by the time the adjustment period is over and the patient is still crossing all sorts of boundaries… then a serious talk must be conducted to establish what is okay and what is not okay in this therapeutic relationship. Any more crossing of boundaries is no longer healthy for either party and perhaps we should pass the case over to our colleague.

And that’s what I did.

Maybe as I grow older and mature into the profession, I might learn differently about what to expect and what to tolerate with regards to therapeutic relationship with my patients, but being controlled and manipulated and being forced to give in to that kind of behaviour will not be something I will passively tolerate. I don’t think that will ever change about me.

On the other hand, another patient of mine who had successfully internalized the values of effort, and having a growth mindset and having an internal locus of control (unfortunately she STILL hasn’t internalized the values of reading, haha) had successfully managed all her crises in the 3 months when I was not around in the clinic (because I was doing my forensic attachment in HBUK at that time). When she saw me shortly after I returned from HBUK, she had said “Doktor tau tak dalam masa 3 bulan ni banyak sangat benda jadi kat saya. Tapi saya boleh handle sendiri, doktor. Doktor tau tak saya dah berhenti kerja yang dulu. Waktu tu saya sangat stressed dan nak sangat jumpa doktor… tapi nurse kata doktor pergi attachment. So saya pun pendam sajalah and handle sendiri. Alhamdulillah, sekarang saya dah dapat kerja baru. Dan gaji saya lagi bagus dari kerja saya yang dulu.”

I was overjoyed that she could handle things for herself. I said to her something along the lines of “Bagus! Memanglah semua masalah kena handle sendiri. Kalau saya ada pun, apa saya boleh buat? It’s your job, it’s your life… you have to make your decision and stick to it and then put in the hard work. And then, there will be another challenge… and you will handle it again just like you have handled it in the past. These things will continue for the rest of our lives.  Memang awak boleh buat pun. Congratulations! Lepas ni bolehlah bagi appointment 3 bulan sekali pula.” I teased.

“Dua bulan dulu lah, doktor!” 

I laughed. “Saya tak ada tiga bulan hari tu, awak okay jer! Pernah dengar tak, necessity is the mother of invention? Bila benda dah jadi dan kita terpaksa handle sendiri, waktu tu lah kita discover our real abilities. The situation NECESSITATES us to grow! We must start creating opportunities for you to handle crises yourself in between appointments. You can do it! In fact, you have done it when I wasn’t around!”

I cannot wait until I can give her a four monthly appointment. Hahah. Yes, she is one of my favourite patients. Because she internalized those values I had listed above, she is much better now. So, I like seeing her because I feel like all the time spent in my session with her was not in vain. Not wasted. But eventually, it is our responsibility to make sure our patients can be confident to let us go. One day, I might have to move elsewhere, work in another state. I am not going to be there for them 24/7. It is an unrealistic expectation to be placed on any doctor or any therapist! And I refuse to do it for any of my patients. It is kinder in the long run that we maintain boundaries and make them self-sufficient. It is the kindest thing you can do to anyone…. to provide them with a fishing rod instead of a limited supply of fish of uncertain duration. That kind of uncertainty will create unconscious distress in them because they will always be wondering “Can I survive without my therapist?”

So, I have told her that next time, we are going to try for a 3 monthly appointment regardless of whether or not she feels ready. She just smiled… because she knew I always do what I said I would. Or maybe it was a smile of someone who is confident enough not to worry too much any more.

Why worry when everything has been written and all you have to do is to go through it and do your best until you breathe your final breath.

I leave you guys with one of my favourite songs by Sami Yusuf. This song teaches us that when it comes to dependency, there is only ONE entity that we REALLY cannot live without… and that’s the way it should be in this life. That’s the reality. All the dramas in your life should take a pause to acknowledge this fact once and for all. And trust me, you will be happier for it.