Health Management in the New Normal

 

Mum celebrated her 89^th birthday in September 2021, a ripe old age where she has earned the right to relax and to enjoy her retirement.

 

Mum reads the daily news from a hard
copy of the newspapers

She still potters around the garden and reads the daily news the traditional way, from a hardcopy of the newspapers. If she came across an interesting bit of news, she would read it aloud to me. And even though I had already read it from other sources, I would acknowledge and respond to her about it.

 

In spite of treatment and medication, mum’s right knee still aches from the wear and tear of old bones and ligaments, most likely chronically damaged due to the nature of her work.

 

To stand up and walk, mum now needs the help of a walker frame to steady herself. Even with excruciating pain, she is brave and remains determined to stay mobile and independent.

 

Sometimes when her painful knees caused her discomfort, she would reminisce about a time when these same pair of legs used to take her on her daily duties, walking through narrow paths in kampungs and New Villages, uphill and downhill, to visit patients and to attend to baby deliveries in and around Masai.

 

Mum likes to potter around in the garden

While watching television or in the course of conversation, something she saw or heard might trigger off some thoughts and she would relive her past life by telling me (again!) about a time when she worked in Government service as a district midwife.

 

It was always good to listen to mum when she shared her reflections about her job that put her on-call 24-hours, 365 days a year, because nobody knew exactly when a baby was due to be born.

 

The world for the elderly would drastically shrink when their work life and social circles ceased to exist, so they tend to only talk about topics close to their hearts.

 

In the prevailing pandemic and lockdowns, the world for the elderly further shrunk with less physical contact with family and friends, and while video chats were a welcome compensation, it was not the same as in-person meet-ups.

 

Mum uses a walker frame to
steady her steps

Aware that it was necessary to let mum relive her old days, I patiently lend an ear to hear her out even though they were familiar and often retold experiences.

 

In my story, My mum the midwife (NST, Johor Buzz, Nov 2008) I brought to light the important role of a midwife, who was responsible for two lives – that of the mother and newborn – often in very challenging circumstances. 

 

I remember in the dead of night, when we were snug in bed, someone might wake us with a call, “Mee-see!” and mum would respond to her call of duty to go with this caller to help deliver a new baby.

 

Mum said sometimes the caller was just a youngster riding a motorbike and she would head out into the night, riding pillion with him. [In the districts, young people learned to ride motorcycles while they were not yet old enough to obtain a license.]

 

At that time, some villages were only accessible by boat so mum had to walk on a rickety jetty to climb into a sampan to cross a river to reach the villager’s house.

 

Looking back with a shudder, mum marveled that she was fearless when duty called but in fact, she was in a precarious position because she could not swim and only trusted God for her safety each time she left home for a case.

 

An unforgettable experience was when mum attended to a patient who lived in a kampung house built on stilts. When mum was ready to leave, she stepped out of the house directly into flood waters, and she had to wade her way out from the kampung.

 

Another shocking experience was when mum arrived to see a patient with a parang lying next to her. While she felt intimidated to see such a long-bladed knife there, mum proceeded to sterilize her patient to prepare for the birthing.

 

Just as the baby arrived, mum was stunned when the parang was used to crack open a coconut above the patient’s abdomen for the coconut juice to splash down in some archaic ritual, an act which also quashed mum’s effort to sterilize the patient…

 

These and other exciting experiences are familiar to me but when mum reminisces about them, often repeatedly, it was a way for her to reaffirm her value and contributions to the community at a time when she was strong and capable.

 

Mum's appointment card with
Klinik Mahmoodiah, marked 
with DEFAULTER in 2016

After helping to bring hundreds of babies into the world, mum has certainly earned the right to relax in her retirement. Now a pensioner, mum has regular health checks at Klinik Mahmoodiah, the outpatient clinic where she consults and receives a prescription for her ailments.

 

Over the years, we have faithfully kept all her appointments except once in 2016 when we were travelling and for this failure to keep her appointment, mum was very upset to see that she was labelled a DEFAULTER on her appointment card.

 

I could understand her distress because it was typical of the elderly, particularly retired Government servants like mum, who would choose never to default on any appointment with the clinic.

 

While my sister and I have been cautious and hesitant about bringing mum to the clinic for her health review appointments in the lockdown periods, we still managed to do so safely, twice in the past 17 months.

 

As the virus variant continued to rage on with rapid infections, mum stayed safely at home and we kept a strictly No Visitors policy to avoid any contact and threat of infection.

 

Dr Low Wei Shyong during his
house-call in March 2021

In March 2021, when mum was feeling out of sorts, we had no alternative but to invite a private practitioner to make a house-call with a request to examine mum and take blood and urine samples for tests to better diagnose and treat her condition.

 

When grandmother was still with us, our family doctor at Kelinik Woo & Hong made house-calls to see her and we continued to consult with Dr Low Wei Shyong, who took over the practice in this clinic.

 

Dr Low made this house-call to see mum and with his professional and pleasant bedside manner, mum had a very comfortable consultation with him.

 

The next morning, I was at the clinic to collect mum’s prescription. And when mum’s blood and urine test results were ready, Dr Low discussed it with my sister and I over the telephone before I went to collect the hard copy of the report from his clinic.

 

I presented Dr Low with my 2017 
Bestseller, My Johor Stories: True
Tales, Real People, Rich Heritage

In this meet-up with Dr Low, he spared a few moments for me to share with him a little more about mum and her life as a former midwife, how she probably earned her aches and pains from squatting in awkward positions to help deliver babies from mothers who were lying on the floor of their kampung houses…

 

It was also my pleasure to present the good doctor with a copy of my 2017 Bestseller, My Johor Stories: True Tales, Real People, Rich Heritage, for him to read about, My mum the midwife, our life in Masai in, Going back to Masai-chusetts and about dad in, My mentor, my dad.

 

Dr Low explained that due to the pandemic, he has adopted a New Normal to do more phone consultation and tele-medicine with patients. And as he got better acquainted with us, I was comfortable to reach him for phone consultations for mum.

 

When the doctor gave the all-clear that it was safe for mum to receive the Covid19 vaccination, we proceeded with the process for mum and in May, I had the pleasure to inform Dr Low that mum was fully vaccinated.

 

In his reply, Dr Low complemented me on my book and told me that he was reading my stories in his clinic, in between patient consultations. He said and I quote:

 

“My Johor Stories is a delightful read! Short, bite-sized stories which, as a Johorean, I can relate a lot to. Very soulful, especially the stories about your dad. He was so disciplined and loving to his children.”

 

Dr Low making his first ever
car-call from my parked car

In August, mum had an appointment at Klinik Mahmoodiah to draw blood for tests and prepare the results for her six-monthly health review in the following month.

 

As daily reports of new infections were still ranging high, my sister and I were reluctant to bring mum to the clinic for this appointment. Because it was necessary to get mum’s test results for the doctor to review and prescribe, we decided to seek Dr Low’s help.

 

This time, instead of a house-call, we arranged to meet him half-way. To avoid contact with others in the clinic, the good doctor agreed to see mum in my car, parked outside the clinic. This turned out to be Dr Low’s first car-call.

 

The next morning, I sent a sample of mum’s urine over to the clinic and a week passed before Dr Low reverted with the results of mum’s blood and urine tests.

 

As Dr Low congratulated us on what we were doing to manage mum’s health and well-being, it was indeed a comfort and relieve to learn that there was nothing alarming in the findings.

 

Weeks passed and the date for the doctor’s appointment to review mum’s health at Klinik Mahmoodiah was fast approaching but the number of new infections in Johor Baru continued to stay dreadfully high.

 

As we kept a close watch on the number of new infections around us, we also observed that mum was keeping in good general health.

 

As the appointment date drew closer, my sister and I made the decision to not let mum go to the clinic but to present a copy of her blood and urine test results and show the record of her daily Blood Pressure readings to the doctor, on her behalf.

 

This is truly an unprecedented time in history and it was important to reassure mum that it was all right for her not to be physically present at the appointment, but that I would go on her behalf. (I did not say it:) So she would not be labelled a Defaulter.

 

In a prior phone call to Klinik Mahmoodiah, I explained to the nurse that I would be going for the appointment on behalf of my mother.

 

It was also an unprecedented situation for them because she paused to seek a colleague’s view before she came back to the line with a dull phrase like, “Tak tahu lah apa doktor kata…”

 

That afternoon, I went to the clinic on behalf of mum armed with a Que-sera-sera attitude, ready to face whatever was ahead in my encounter with the doctor.

 

The reception counter at Klinik Mahmoodiah

At the clinic reception when I presented mum’s appointment card, the nurse asked where mum was and if she was bed-ridden.

 

As I explained that I had the relevant reports for the doctor to review, she was rather blunt and unsympathetic but I kept my cool.

 

Then she wrote in Red, Wakil Ibu, on the Registration Number and passed this small piece of paper to me with a reminder me to bring the patient in for the next appointment.

 

Filled with relieve, I proceeded to the next counter and gave the young man this Registration Number to collect mum’s clinic record card.

 

When he passed mum’s card to me along with the Registration Number, he told me to go to BILIK 4 even though the chop in Blue on the Number read as, BILIK 2.

 

As I approached BILIK 4, I realized that it was where the patient’s Blood Pressure would be taken. Since I was not the patient and I had the record of mum’s daily BP readings ready, I proceeded to BILIK 2 where I dropped mum’s appointment card into the small box fixed at the room’s entrance.

 

My Registration Number with the words,
Wakil Ibu written on it

Through the glass panel on the room door, I saw it was still dark inside and guessed that the doctor was not in yet. After all, it was then just about 2pm, so I sat down to wait until mum’s name was called.

 

Moments later, the door of BILIK 3 opened and a doctor – from the white lab coat he wore, I guessed he was a doctor – came out and collected the patients’ cards from the small box outside BILIK 2.

 

When he picked a card and called out my mum’s name, I responded and was ushered into BILIK 3. There were three others inside this room, all wearing white lab coats.

 

Incidentally, these past two days I was working on the manuscript for my Book Three and had reviewed the draft for my story on the first Intensive Care Unit (ICU) in the Johor Baru General Hospital, the former name of Hospital Sultanah Aminah.

 

To share this story, I also included a historical reference to the hospital’s Officers’ Ward or First-Class Ward, a building that was once the residence of the sister of Sultan Abu Bakar, Ungku Khatijah, built in 1928 on a hill known as Bukit Cengkih or Clove Hill after a clove plantation here.

 

When the First-Class Ward was relocated to the new extension of the main hospital in 2009, this building was used as the Hematology Ward and part of the Monash University Malaysia campus for the Jeffrey Cheah School of Medicine and Health Sciences.

 

Then when I entered BILIK 3 and saw the other three young people clad in white lab coats, I safely concluded that they were trainees in the Monash University Malaysia campus for the Jeffrey Cheah School of Medicine and Health Sciences here.

 

The doctor who ushered me into the room, invited me to sit down on the patient’s chair while the young lady trainee took her place at the desk as the consulting doctor.

 

When the doctor asked for my name, I started to explain that I was not the patient but was there on behalf of the patient. He still wanted to know my name and when I told him, it was like a confirmation because he had already recognised me from my voice. [We were fully masked and wearing face shields.]

 

“I’m Dr Ho,” he declared as I turned to look at his name tag which read, Dr Ho Loon Shin, and I too recognised him because I had forgotten that he was a Lecturer with the Monash University campus here.

 

Meanwhile Dr Ho gave me a glowing introduction to the three trainees and told them about our mutual friend, the late Michael Parry, who was his Headmaster in their school in Kulai while Dr Ho was then the Head Prefect.

 

With the introductions done, Dr Ho stepped away from the desk while I proceeded to consult with the young lady trainee in our roles as patient and doctor.

 

When I presented her with mum’s blood and urine test results and record of BP readings, Dr Ho went into teaching mode and helped to evaluate the details page by page for the benefit of the three trainees. [A copy later attached to mum’s record.]

 

Even though I entered the clinic with deep apprehension, everything changed when Dr Ho took me into BILIK 3 where I met with the three trainees, How Eng Han and Lim Wai Kit, both from Kuala Lumpur, and Ewurama Akroma Dontoh, the young lady from Ghana, Africa.

 

It was truly an unexpected encounter in an unprecedented time but an encouraging experience for me because mum’s health and well-being were evident from the findings in the test report.

 

Once again, I was reminded that God is always faithful and good.

 

Deeply grateful for being accommodated in the New Normal, I the Wakil Ibu, left the clinic with a prescription for mum and her next appointment fixed for January 2022.

NOTE: My Johor Stories series of books are available from MPH bookstores nationwide and online from mphonline.com