Pakistan Day 1

CREST Team Malaysia leaves for Karachi 755am. Courtesy of Pakistan International Airlines, all our relief supplies accommodated except for 12kgs. In total 14 cartons of blankets, winter clothing and children’s toys.


In-flight service by full-grown bearded male stewards! Great service, abundant food.

Team tired and slept most of the way.

Towards end of flight, all team members seen to be doing planning, writing notes on tasks, learning essential Urdu, brushing up medical skills, and meditating on the Word.

Joan and I read Psalm 23 to each other – especially struck by ‘valley of the shadow of death’ as we pictured Balakot in all its destruction.

Arrived Karachi, harassed a little bit by airport officials and touts, but finally cleared to Islamabad. Lost one piece of luggage there – mostly our medical supplies and equipment!

Received by Chaman Nadeem, national coordinator of HCF (Hospital Christian Fellowship) who is our guide for the next few days.


Unloaded all our supplies at a house in Islamabad and caught 4 hrs sleep in Skyway hotel in Rawalpindi (twin city of Islamabad).

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Pakistan calls

Newsflash: Joan and I have signed up to join CREST in a medical mission trip to Balakot, Pakistan for the earthquake relief efforts. We are going from 26 November till 10 December 2005.

Since the earthquake in October, many communities in the mountain ranges around Balakot have been left homeless to fend for themselves against the cold. The death-toll stands above 80,000 and threatens to rise in the winter. Water-borne diseases, skin infection, and psychological trauma are the commonest medical problems apart from the need for shelter and warmth.



We have been informed that we will fly into Islamabad or Peshawar, and proceed to our base camp at Mushafarrabad at the foothills. We will make daily trips into the mountains, part by road and part on foothills to go into villages where we setup medical camps. After our ‘virgin entry’ into these villages, most of which have not had any aid, much less encounters with Christians, other teams may follow up with shelter and reconstruction work. From reports of a team gone before us, the needs are overwhelming but the people are highly receptive. Apart from landslides and the occasional aftershock, our safety seems to be quite assured as the Pakistani have high regard for Chinese and the military is very protective of aid workers. Praise God for that.

We ask for your prayer support for the entire mission team, our safety and wisdom in interacting with the people. Please pray also for our parents, who we know will be very anxious. If you would like to commit yourself to being a prayer partner for this mission trip, please do reply to us as we will be much encouraged to know of the people praying for us while we are up there.

I hope to bring back lots of photos/videos, and information on how we can contribute if you are interested. There is an adoption program also where sponsors can adopt families and sponsor their rehabilitation.

Addicted to work?

I hadn't realised how addicted I am to my job until this long Deepa-Raya break. It was a week of celebration for me - of NO TRAFFIC, GOOD FOOD and all the TV I could watch without my eyes popping out.

Let me see - I watched 3 episodes of HOUSE (the TV series), House of Wax, Guess Who, and The Longest Yard. All were fun. In fact HOUSE has made me want to study medicine all over again; this time not to pass exams but for the sheer pleasure of grappling with the mysteries of human life and disease. House of Wax was,...well, overrated and under-horrored. Guess Who was surprisingly more interesting and engaging than most romantic comedies of late. And The Longest Yard was simply hilarious. By the end of the week, I was going out of my mind, rearranging furniture and making my own cables!

Anyway, I was only too glad to get back to work yesterday and be in operating theatre again. The north-pole chill of OT and the musical beeps and hums of machines makes for a second home. Am I addicted to work? Is this a good thing or a bad thing? I'm sure it's a bit of both. Tomorrow the students will be back in class for more torture and my clinic should be in full swing on Thursday...

Sigh... The joys of work.

Education for the soul

My Scripture reading today was Numbers 20. The tragic chapter where Moses & Aaron are sentenced from ever entering the Promised Land. Next to Adam & Eve getting banished from Eden, this must be the second most heart-wrenching moment in the Pentateuch. Moses venting his frustration, Aaron following suit, both of them receiving their sentence, Aaron degarbed... There is a pained silence in that chapter that shrieks of a tragedy too grave to put in words.

But the lesson is so clear. In this journey, on this side of heaven, God is interested most in my faith. And by faith I don't mean a mental approbration of a set of doctrines, but a deep visceral belief that God saves and provides. I'm beginning to see that wilderness periods are potentially the most precious of times. They make or break us. Sometimes I choose rightly, sometimes I don't. But my faith is being built from the ground up.

Do I believe enough to do just as He says, and only as He says - no more, no less. No need to give God a helping hand or take extra precautionary measures, just in case?

A couple of days ago, while trying to repeat some Scripture to myself, I found I couldn't say 'In God I trust, whose word I praise' with any amount of sincerity. There is way too much unbelief within. Does God really meet all my emotional, vocational, financial needs?

How much of my decisions and actions are predicated on this unbelief? There is much unbelief to repent of, and much transforming work to be done in my heart. A work accomplished only by receiving His love in the deepest recesses of my soul. This 'wilderness' I'm in isn't the first and certainly not the last. But in each episode, I pray that the soul-education that God is offering is not lost on me.

Career Wilderness

My current university job has been a great trial for me in a paradoxical sense - I am under-worked. I feel my research talents are wasted, opportunities to develop surgical skill is denied, and overall I have little to contribute in my current capacity. My hope of moving to our designated hospital where I may have the freedom and opportunity to fluorish has been dashed over and over again.

And all this, over the past year and a half, has plunged me into pits of depression - doubting my own worth and progress in life. I am only in my mid-30s and I feel like I'm ready for retirement!

In that context, I read today something from Rachel Remen. She says, 'Many times we can put them (suffering) behind us and get on with the rest of our lives. But.. some things are too big or too deep to do this, and we will have to leave important parts of ourselves behind if we treat them in this way. These are the places where wisdom begins to grow in us. It begins with suffering that we do not avoid or rationalize or put behind us. It starts with the realization that our loss, whatever it is, has become a part of us and has altered our lives so profoundly that we cannot go back to the way it was before.'

I am beginning to move from denial to acceptance. Life needs rebuilding and redefining. I want to believe that this period of career wilderness is refining me in ways I can't see. That God is chiseling ruthlessly away at my ambition, my drivenness and my restlesness. I am forced to ask, what IS really important to me and to God? Am I what I do, or do I do what I am? I am forced to face my deep unbelief that God could be in control and pry my controlling fingers into open hands. I am forced to confront my fears of becoming obsolete, irrelevant, useless, a vocational failure.

I believe that suffering/hunger is grace. I believe this wilderness is a gift to embrace. It is the panting without which the deer would not seek a stream. It is in my wilderness that I am compelled to ask the most important questions: who am I and who is my God?

My soul, find rest!

My soul, find rest!
Find rest in God alone.

Alone,
Not with your thoughts

Alone,
Not with your ambitions

Alone,
Not with your books
or PC
or projects

Alone,
Not clawing at things to achieve
Things to hold
People to impress

Alone,
It's so hard isn't it?
Are you afraid,
There is nothing there?

Do not fear
Being alone
For alone is where I am
And where you are is where God is

Mary and Martha slugs it out

I see so much of myself in the Martha depicted here – craving for attention, exhausted without it, presenting my best work, vying for merit. And then appaled to have Jesus point a finger at Mary, not in condemnation, but to show me that it is the ‘better way’ Oh man, had I known...

The Mary within continues to wage war with the Martha in me. Or rather my inner Mary continues to be bashed by my type-A, engine-driven Martha, accusing: Why do you sit around and do nothing? What have you achieved today, this week, this month? Are you getting anywhere? How can you be so inactive when there are so many needs around you? Don't just sit there, do something already! With that kind of inner drivenness playing out all day, it's no wonder I exhaust myself so easily. On the other hand, even when I am drained, I do not know how to rest.

I journaled on Saturday:
'If not for the discipline of a weekend review, I won't even have realised how much and why I am in severe unrest and plummetting into unhealthy habits.

Here I am at the end of the week, insomniac and weighed down by false guilt. And I'm not letting up - I still feel like I need to do more, find more to do, feel so unaccomplished...

But look at the week:
- you operated on a mycetoma
- you ran a busy clinic
- you've written 2 chapters of your book
- you've read a few papers
- you met with and counseled 2 people
- you took two bedside teachings
- you ran once in the morning
- traffic has been murderous
- you brought your parents to Serdang

You are so driven and so addicted to the adrenaline, your insight/memory is clouded. All you can feel/see is your need to DO SOMETHING. You are not how many articles you write, how many classes you take, how many poeple you meet, or how much weight you lose. These are the guidelines I use to live a healthy life, but they do not constitute who I am. I am who I am. And God loves me as I am.

If there is a time you need to STOP and DO NOTHING - IT IS NOW!

COME AWAY. STOP FROM YOUR WORK. FIND YOURSELF AND GOD IN YOU.'

Jesus says to the Martha in me: "Yoke Yeow, Yoke Yeow, you are worried and upset about many things, but only one thing is needed. Choose what is better, and it will not be taken away from you."

There comes a point every day, and at the end of every week, that I must hear that firm voice and cease. Disengage my gears, detach from the work, and declare a time of Sabbath rest. A time to just BE. Reaffirm I am who I am, apart from and before the work.

Lincoln was depressed?

Soo Inn writes in Learning from Lincoln that the great president of the US of A struggled all his life with depression, but that depression gave him clarity, creativity, and humility.

SI also shares: 'as one who has made his own short sojourn into clinical depression I cannot see how I would wish that experience on any one... The reality is that we now live in a fallen world where pain is a given. Quoting Eugene O'Neil, Shenk reminds us that “Man is born broken.” Post Fall, pain is a given. A wise and loving God now uses that brokenness for His higher purposes. Today, we live in a society that sees pain as an enemy to be removed as quickly and as efficiently as possible. I understand this desire. Pain is no fun. It's just that sometimes we remove pain too quickly, before it can deliver its message.'

Thank you for that, Soo Inn. As someone who suffers recurrent low-grade depression, I couldn't agree more. I am constantly faced with a choice: to fight the pain or to embrace it. To pour my energies into palliating it, or do the surgical work of dealing with its root causes.

I accept that on this side of heaven, the agony of living cannot possibly be eradicated. Instead pain can show me my greatest needs/weaknesses and keep driving me forward in my journey to God. Befriend your pain, Nouwen would say. Let it show the way.

As surgeons, we understand that more than anyone else. Pain brings the patient to us. The nature of pain guides us to the pathology. And the goals of treatment is not mere pain-relief but cure, by surgical removal if necessary. There are instances, even, where pain-relief is cruelly deprived of the patient - in fear of 'masking' the disease process. In the same spirit, I read yesterday Yancey's summation of the book of Job: 'God is more interested in our faith than our pleasure.'

Lincoln was depressed? It's good to know we're in good company!

Were I Not Alone

Were there not loneliness
I would not know
How alone
I am without you
And whom I’m lonely for

Were not the pain
Of longing
So intense, so painful
I would not know
How much I have not you

Were I not alone
I would not know
From whence I came
Where I go
And Whom I’m made for

SUDOKU addiction

I can't believe it.. I've succumbed to the latest craze all over the world - SUDOKU. Since I found a Palm version last night, I haven't been able to put it down.

The rules of the game couldn't be simpler: 'Enter digits from 1 to 9 into the blank spaces. Every row must contain one of each digit. So must every column, as must every 3x3 square.Each Sudoku has a unique solution that can be reached logically without guessing.'

If you're game for it, try it at Websudoku.com. If you're having trouble and need some powerful weapons for problem-solving, go to Sudoku solver. And if you need to carry it on your Palm for boring meetings and hours-long traffic jams, download Andrew Gregory's free version.

WARNING: This game is HIGHLY ADDICTIVE and is known to cause insomnia, blurred vision, mumbling-to-self, and missing-your-trainstop syndrome.

Don't say I didn't warn you...

The Tent Enlarges

I've revived my photo blog, something I used to do way back in 1999 for the original TENT (which had 9 different secttions!!)

Anyway just to get it going, I did some simple snapping at home today, allowing things to just leap out at me and 'arrest me' so to speak.

The first was just a branch of dead leaves blown in by the wind. I felt a bit like that - drained on the weekend, just wanting to get a little life back in my vine.






The second shot was of a boquet of flowers given to me by my wife on my birthday (that was months ago.) It's drying up nicely now but the colors were still very much intact. I've given it a color spot on black and white tones. Just to say that the kind of beauty infused into a gift like that, never fades...

A Stopping Place

I've just returned from a retreat at Frasers' Hill where I was both retreat leader AND participant. It was a very insightful experience for me - both helping others come into a place of rest as well as finding rest and healing for myself. So throughout the two and a half days I would share a few thoughts, lead in the practice of a spiritual discipline, and then settle into reflection and contemplation myself.

The beauty of doing it this way was that we were all journeying together. No one was really the 'guru' or the 'leader' who had all the answers. I wasn't put on a pedestal. We could all be real and see our common struggles breaking through our restlessness to find rest in God.

So after three days of crisp, cold air, birds singing, trees rustling in the wind, bright colored flowers and amazing food, and much time in God's felt presence, I return to the mad city. The paradox is I am deeply refreshed and energized on one level, and also drained and exhausted on another level. I know I'm going to need a few days of quiet and being alone to recover my own space and pace.. If I give in to the seduction of adrenaline (I'm so charged up right now, let's jump into another project!) I will surely raze myself to the ground.

So the invitation to find rest resounds right now and I must not fail to here it and enter it. I need to just stop awhile, not do anything, find stability within before I move on again.

Fight the flab

I've been eating without thinking and neglecting exercise for a couple of months now. Chomping my way steadily up 3kgs since I dared look at the scales. Yesterday I started running again and clocked my slowest speed ever in 2 years! 6.6kph for a distance of 5km. That's from a high of 11kph... Sob!

Today, I decided I will start counting again and logging my exercise and intake.

Input today: 2240cals! (from a kong-fu chau for dinner, and McD's double cheeseburger for lunch) Bad, bad, bad. I'm going to try to get back to a sub 1500cal day in order to lose 1kg a week.

Just to remind us how much a Double Cheese-burger McValue meal can set you back, these are the figures:

Double Cheeseburger = 480cals

Coke = 210cals

French Fries = 453 cals

Eat that all... 1143cals! Doesn't leave much space for anything else does it?

Anyone who needs an Excel worksheet (based on Asian foods) to calculate his input vs. output plus a chart to boot, contact me and I'll send you one! Join me on the crusade against obesity! Say TAKNAK GEMUK!

Only One Way

Expressed in many ways, the Word (in Psalm 33-34)continues to assert that there is only one way worth following, and that is God's. Conversely, our short-sighted humanistic purposes he 'foils' and 'thwarts.' We are reminded not to place any confidence in the things that will ultimately fail, like the 'size of his army', 'great strength' of the warrior' or the speed of a 'horse in hope of deliverance.'

No amount of power, ability, influence, possesion can protect you and buy you safety, solace and peace of mind. The psalmist urges us to do the only right thing, and that is 'in him our hearts rejoice, trust in his holy name, put our hope in Him'.

Psalm 34 also reminds us that on this side of heaven, there is no guarantee of a triumphalist, whoopsy-daisy life of comfort. In fact, 'a righteous man may have many troubles'(!) 'But he delivers him from them all.'

That is the thrust of living on hope. It is always a forward looking life. One that does not waste energies in trying to build or recapture a little Eden for ourselves here on earth. But instead is willing to courageously put our hope in a future glory, joy and comfort. This world is truly not our home, we're just a passing through.

In response to another piece of scripture: "Teach me to do your will, for you are my God; may your good Spirit lead me on level ground." Ps 143:10


Your will,
Not my own
Your thoughts
Higher than mine
Your lead
I shall follow

Not the will of man
Not my selfish dreams or foolish ambitions
Not the pace of the world
Only YOUR will

For you are my God
No other God and no other shall I follow

Getting away

Decided on a whim to get out of the city and look down on it, at it, away from it, just not be in it, for a while. And oh what a wonderful experience it was. We drove up the Hulu Langat hills, and just less than 10km from where the road leaves Cheras is this small clearing where we can plant ourselves and just stare at KL city in all its madness.

It was great just to feel apart from it for a while. And the continuous chilly breeze was lovely too. That's what I call regaining sanity. And in an act of saintliness, I lifted my hand in benediction, 'All you mad people in the mad city,.. God bless you.'

Take a close look at this picture and you can see two planets - Jupiter above and Venus below - shining down on the city. The only celestial lights you can see with our level of light pollution..

The Levitical Mystery

The instructions to the priesthood and prescriptions for correct temple protocol found in the book of Leviticus is laborious and wearisome to work through. It is hard to understand the God of the New Testament who is one of grace and freedom encumbering the Israelites of the Old with such huge burdens and near-impossible legalism.

But there are the occasional hints that clues us in on the basis for such elaborate institutions. Like Lev 17:11, where the LORD declares that 'the life of a creature is in the blood, and I have given it to you to make atonement for yourselves on the altar; it is the blood that makes atonement for one's life.'

Or this paradoxical declaration at the end of Lev 22, after a long list of what makes a sacrifice acceptable or unacceptable, a priest clean or unclean: 'I am the LORD, who makes you holy and who brought you out of Egypt to be your God.' Imagine that - to say that after all that has been done, none of it makes you holy - only He does.

The shedding of blood. A perfect sacrifice. The imputation of righteousness. It's all there and more.

I get the impression that the whole concept and institution of an atoning sacrifice is being systematically programmed into the consciousness and culture of the Israelites. And a perfect sacrifice at that. Truly this is God at work in history - hinting at the future when one such perfect sacrifice will come. Encrypted in this codec of levitical practice is every facet and nuance of Christ's atoning work on the Cross. It is a depth worth plumbing for such gold.

Much Ado About MDs

It seems like there's a new wave of M.D. shows on TV. With the demise of Chicago Hope and E.R., and only Becker surviving the times, we now have two brand new, swanky doctor shows - SCRUBS and HOUSE.

For the unacquainted, SCRUBS revolves around a few interns with overactive imaginations, hip lives, and a great zest for people. In short - a myth. But, hey, who among us MDs don't wish our lives were a little like that. I liked today's episode on Astro, actually, where a dying patient taught an intern that it was ok to rest.

That he needed to give himself permission to go lie on the grass and relax for awhile. We MDs do become so obsessed and entrapped in our work sometimes as not to be able to see the bigger picture or to find ourselves apart from it.

HOUSE, on the other hand, glorifies a team of diagnosticians whose expertise is solving the unsolvable cases. Those that, in our real life hospitals, normally go quietly unsolved. Labelled 'SEPTICEMIA' or 'M.I.'. These guys however, come up with high flung diagnoses like cerebral cysticercosis, or colchicine-poisoning. I understand that the whole point of this series is that - the diagnostic genius of Dr. House and his dream team. What is unrealistic is how these guys run ALL the lab tests themselves! From gene sequencing to viral antibody titres! That's really taking it too far.

What I DO like about it, is the FED-UPness of House (which is true of all of us after seeing one patient too many) and the METICULOUSNESS of his problem-solving. I've seen more than one technique that we actually employ in real life, being used. One is the acronym for pathologies - he uses MIDNIGHT (for metabolic, infective, degenerative, neoplastic, etc.), and the other is the Venn diagram for looking for the disease that accounts for ALL presenting symptoms. Also the mention of Occam's razor was very gratifying to me - the simplest explanation is most likely the correct one.

As doctors we may pooh-pooh the idealism, unreal-ness, or far-fetchedness of some of the stories, but let's not deny that in some way it validates our lives as human beings. That's what I like about these shows - they portray us frail, vulnerable, and confused like everyone else. And even if it doesn't change public perception, I hope it helps us to accept ourselves better.

Perfect Discovery

I'm so proud of what I've done with SALIVATE, my food indulgence blog. Not that many people actually go to it to look for places to eat. Not that I've reviewed that many places. It's just that the ROJAK shot looks so damned good there, I salivate when I look at it. And I've been able to put in a map and satellite photo to show how to fly in also. Now that's an achievement! Hah.

Good friend Fook Meng from Melaka congratulated me for finding the 'places off the beaten path'. Precisely why it was such a wonderful experience for Joan and I. Truth is we were driving around the cemetery, a little lost, looking for a place to park when the two stalls just sprang into view. We screeched to a halt on a whim, and my, what a wonderful discovery it was! The backdrop of a cemetery, the simplicity of the 2 stalls, the magnificence of the food, and the chance find made it all a perfect moment for us. One of the simple highlights of our journey to Melaka last week.

A shared home

The words 'You are not your own, you were bought at a price' - is both convicting and liberating.

It condemns the runaway arrogance of absolute self-rule. My life is not for me to run as I wish and to do with any way I so please. I am not my own. I belong also to someone else.

On the other hand, the success and outcome of my life isn't squarely on my shoulders either. I am not solely responsible. The burden isn't all mine. I am not my own. I belong also to someone else.

What joy to be called a temple. A tabernacle. A home. To be a heart/body that is a shared space with the One who transforms it, enlivens it and nurtures it together with me. I want to be a space always full of love, warmth and truth, and a space always available to others.

Whose earth is it?

Everyone has strong feelings about the shroud we are under. Take away our blue skies and majestic skyline and fires begin to burn in the hearts of Malaysians.

Only until recently did the government end its secrecy on the API - by which time, undeniable and unconcealable hazardous levels has already been superceded. But API or no API, we are all choked, and we are panicking. Like smoking rats in a cage, with nowhere to run, the frenzy is palpable. It's not just a haze in the sky, it's confusion on the ground as well.

How long will this last? How is it affecting my health? Should I stay home or go to work? Is it safe? Will there be an emergency? Should I think of moving out of the city?



We can blame Indonesia and demand for compensation. Lame apologies are useless right now - we want action! Then we find out that Malaysian plantations are partly responsible for raging flames across the Straits.

This morning my wife and I drove through thick smog. The sky was slate gray. The majestic twin towers, usually sparkling with glory were reduced to ghostly shadows. And there were hardly any cars on the road - (a glad thanks to PM for his quick call for an emergency in some parts, and the closure of schools throughout Klang Valley). This is what a nuclear winter would look like - if we survived to see it, that is - I remarked to my wife.

If this was a sign, a wake-up call, it is to tell us that our environment is frail and extremely vulnerable. The carrying capacity of our air is so exhausted that the slightest disturbance will tip us into this gray winter. It is also to tell us that when it comes to caring for planet earth, political boundaries have no meaning. We are responsible, and all of us are responsible. If we never appreciated it enough to protect it - we must now.