4th year Medicine in Malaysia
05.05.2010 38 °C
I have kind of avoided any real talk of my studies for a number of reasons. I think partly because I don't want to bore the non-medical readers and because I haven't actually been studying all that much. That caught up with me in a bang when I had a pile of overdue assignments all due at once. Hello coffee, goodbye sleep.
So here is a rundown on the past 12 weeks of my psychiatry rotation, anyone thinking of studying here might like to read this.
There is a psychiatric ward at the hospital next door, but it is only for women. They claim this is for staffing and safety reasons, as psych patients can be promiscuous and are susceptible to abuse. This ward and the outpatient psych clinics accounted for the first 6 weeks of my rotation and the teaching was quite good. The strange reality is that there is no male equivalent ward, so what happens to them you ask? They get sent to Permai!! This has to be said in a Frankenstein voice followed by evil laughter to really do justice to the psych asylum that is Permai. There is something really creepy about that place.
It was built by the Brits 80 years ago and was used as an asylum to lock up the "crazy" people. Psych patients really had no other options back then and it reminds me of the place that Yahoo Serious got sent to in Young Einstein. Anyone else remember that? It is built like an intimidating prison with around 50 HUGE wards all seperated by solid concrete sheltered walkways. The place could get bombed and you would still feel safe, in fact it did get bombed. The Japs took it over during WW2 and performed biological experiments on the patients and probably anyone else they could find. It was considered a place of torture at that time and strangely enough, the main form of transport around the expansive Permai grounds are still Japanese bicycles. There are now permanent "residents" living in some of the wards and I believe the total number is somewhere near 1000 patients, half of the original building capacity. All are wearing the green Permai issue "prison clothing" which just adds to the overall creep factor.
I spent the next six weeks wandering around Permai and talking to the patients. It wasn't long before a stroll down one of the 3 kilometre long walkways would see patients swarming to each window I passed calling "hey Australia, come in doctor". The few female wards were even worse because they are definitely promiscuous patients and they don't see many white people. "Are you single doctor?", I would stupidly answer yes just to get the response "so I still have a chance then" along with a rub of my arm and a slap on the butt. The nurses in hysterics behind the counter did not help the situation. This wouldn't be such a problem if the same lady wasn't seeing the devil with bat wings and a pair of white sneakers run around the room. And no, I didn't make that bit up.
The forensic ward holds all the murderers behind barbed wire, yes murderers. And was suprisingly easy to access for a student in a white lab coat. No questions asked, security just assumes you are a doctor and you can just wander in. Sure the patients are sedated to the point where their eyeballs are floating into their forehead, but this just makes them look even meaner. I didn't stay in there for long. One thing I did learn, if a criminal gets aquitted by a court because he is clinically insane, he doesn't go to a better place than prison.
I wonder if this asylum might be one of the last of its type in existance. The sheer volume of patients gathered in the one place from all over Malaysia is just incredible and has been a great learning experience. No developed country would ever allow such a place to continue operating and even the Malaysian government is building a replacement. Whether this is for the welfare of the patients or because they can make money from the land is unclear. What is clear is that the demolition will take a very long time.
Here are a few photos I put together. The murals were presumably painted by a patient and I found the depiction of a mentally retarded patient particularly disturbing. Even more so that they have left it there. Although the confidentiality and privacy laws in Malaysia are seldom adhered to, I still couldn't bring myself to photograph any patients. Use your imagination. Next time, I will write about the GP clinic.
In more painful news, my motorbike was a lemon. I say was, because it is no longer mine. I rang the seller to inform him of the news that his mechanic had ripped us both off and the bike needed to be sent back. After not getting any reply, I sent him a message alluding to the fact that I know where he lives and his life would not be very pleasant from now on if he didn't do as I asked. The guy had already seen me really angry when he failed to deliver the bike so I think he was really scared, because he has taken the bike back and refunded my money. You guys all know that I wouldn't have really done anything right? Right.
I guess he knew the police wouldn't help him, because they don't actually seem to do anything at all here in JB. Oh wait a minute... I did see them escorting a yellow Lamborghini up the highway on the weekend. I presume the Sultan was up for a joy ride so the police went along and cleared the road for him, like all good police do. And I thought the police in Australia were bad because they use capsicum spray on innocent people.
On a brighter note, I was invited to my fellow workmate Elroy's home in Singapore. I spent a few nights with him and his family eating the various sights across Singapore. It did originally seem that Singapore shared very little in common with its larger asian neighbours, but even though 40 years of clever governance has changed a culture, they still eat like Malaysians.
I walked out on to the jetty one night and looked at the horizon crammed with lights across the ocean wondering what country was so close off the South coast of Singapore. Must be Indonesia. No, they were ships. 100s maybe 1000s of them. Looked like a country to me. I don't know what they do with all those boxes but Singapore is about 40 x 20 kilometres in size and the 2 little bridges into Asia can't support that much cargo. I figure they just play musical boxes and just pick them up and put them down all day. They obviously make a pretty dollar doing it too, and they know how to spend it wisely.
I was lucky enough to see the government house on a rare open day. Fortunate coincidence, and the building had all the gifts from around the world on display. Amazing jewelled carpets from India, a beautiful white gold dagger from Brunei and even Thailand gave them an awesome golden elephant. So what amazing gift did Australia have on display? A wooden box with a gum leaf on top. Ha ha ha. The cheapest gift there by far. No photos allowed, but I laughed.
So now I am back in Malaysia and studying paediatrics. Yep, little kids. It seems more interesting already. I still have no bicycle and no motorbike either, but it was refreshing to deal with someone honest enough to return my money. Sure I had to threaten him with viloence, but the end result is still the same.