Paying respects to Sayas 365 days a year

by prof. nyunt wai

Paying respects to Sayas 365 days a year : day 1

(posted on Oct 24, 2006)

As a buddhist, every night before I retire, I kow-tow 6 times in
obeisance of the 6 gems (the 3 gems + mum + dad + sayas.), If I'm
not too sleepy or tired, I try to form the mental image of each gem
before kow-towing. Since there are so many sayas, I assign each day
for paying respects to a particular group of sayas stratified
according to class (kindergarten to PG classes) or disicipline
(surgery and surgical specilties, basic sciences etc). Whatever our
religion, we can keep in touch with our sayas by reserving a few
seconds each day (even while driving) for them – to think about them
and to appreciate their impact of teaching or scoldings or slave
drivings on our lives. Even briefly reliving those magic moments
with our sayas will be a form of tribute to them. In fact posting
messages about our sayas (e.g. recent blogs on Lt. Col. Myint Aung,
and Major Maung Maung Myint) is one way of showing our gratitude to
them. As for my ritual of paying respects to Sayas 365 days a year,
tonight (day 1) is reserved for my kindergarten teachers. Since my
memory's bad (and is getting worse), all I can recall is one sayama
teaching me how to write "wa-lone". She was getting impatient and
frustrated because every time she demonstrated the conventional
method of writing it, I kept on writing it in the reverse way
(clockwise vs anticlockwise). I was also baffled because I couldn't
understand why she's sticking to one way while the alternative way
also produced the same result with equal speed. Had she explained to
me the concept of conventionalism in understandable terms while
appreciating my alternativity, I might have given in. What really
happed was that she finally gave up teaching me "wa-lone" writing
(might be thinking either I was too thick or too rebellious). Thank
you sayama (couldn't recall her name nor how she looked like) for
teaching me not only how to write "wa lone" but also the importance
of explaining the underlying reasons for why you should do something
in teaching and of accepting/ respecting the alternative view
points. Such was the very foundation of my education that I was
severely repulsed by sarcastic remarks such as "are you or I the
teacher?", or "hey hey, he's going to write a new textbook!". Even
then, I thank these sayas or sayamas for demonstrating to me(at the
expense their dignity) the "what not to dos" in education. I
respect even the sayas whom I dislike for they had taught us not to
be like them (anti-role modeling). After all, I accept that no body
is perfect.
Best wishes to all sayas with four "Nar"s (cetana, myitta, wathana,
anit nar)
Yours respectfully.



Paying respects to Sayas 365 days a year : day 2: My Anatomy sayas

(posted on Oct 25, 2006)

According to my roster(adjusted at the last minute), day 2 obeisance
tonight goes to Anatomy sayas : Sayamagyi Norma Saw, Sayagyi Nyo,
Saya U Aye Cho, Sayama Daw Khin Oo May, Saya U Kyi Win and Sayama
Daw Than Yi, among others. In particular I am going to pay special
respects to Sayagyi Nyo (Prof. Maung Maung Nyo) as Saya continues to
teach and illuminate me up to the present moment. The six gems is
just my private working definition that conveniently quantifies the
number of kowtowing. I give my father and mother individual
separate kowtows as they deserve more than that. If parents and
sayas belong to the same category as the 3 gems, why can't they be
regarded as gems also?. Whatever are my convictions, I shouldn't
have used the term 6 gems publicly for it can cause confusion among
non-Buddhists and some Buddhists as well. This has been indirectly
pointed out by Saya and I am very grateful for that. Although I
can still visualize Sayamagyi Norma Saw's wizardry in explaining
embryonic developments, all that is worthy of recalling from my 2nd
MBBS days in Anatomy came from Sayagyi Nyo. Just two things: One
day Saya approached our dissection table, and asked us "how many
branches does the internal carotid artery have? Before we could
respond, Saya uttered just one word, "none" and moved away.
Another thing was during one of his lectures on prostate gland. What
struck me was Saya's openness in discussing the sexual consequences
of the enlarged prostate. Up to this day, Saya is still helping and
guiding us whatever and whenever he can. His encyclopedic knowledge
and his sharp, honest and frank views are highly palpable in his
prolific postings. And Saya is kind enough to have written an
article on me in one of the files in this alumni site. It was

because of Saya's initial information (and the subsequent help of
Drs. Kyin Win and Peter) that the whole new wonderful world of AMIM
opened up for me. I am very much indebted to you Saya. Long live
your highly productive professional life!
Yours respectfully,
Lifelong pupil NW (Bbr)


Paying respects to Sayas 365 days a year : day 3: Prof. Mya Tu

(posted on Oct 26, 2006)

Two people were entrusted with the responsibility of opening a new
medical school. With a blank cheque in hand, they toured Medical
Establishments in North America and UK studying their medical
education systems. When the school materialized in 1963 as Medical
College 2 (now UM2), it was equipped with latest instruments
including closed circuit TV system and brand new polygraphs( that
can measure and record many physiological paramenters including
ECG). With one polygraph for every 5 students and one
tutorial/practical teaching staff for every 10 students, the
teaching then was world-class. The founders were Major Ko Ko Gyi
and Prof. Mya Tu. The latter also founded the Department of Medical
Research where most of my Masterate studies were undertaken. The
first PhD in Physiology from Myanmar and the first full time
Professor of Physiology in Myanmar, Saya is still the father-figure
not only to us, the physiologists, but also to many including the
founder of the AMIM, Dr. TOKM (Dear Jennifer Painfree NNY, when saya
TOKM wrote "my father Prof. Mya Tu lives only 3 minute-drive away,
he was writing figuratively, and perhaps equating Saya with his
parents according to the concept of five anandaw-anandas). Being my
mentor, I have many things to say about Prof. Mya Tu, but I will
stick only to a few (for details, please refer to one of the AMIM
files –Who's Who in Health and Medicine in Myanmar). What still
strikes me with awe is the undiminishing energy and enthusiasm with
which Saya (at 79, and despite a history two coronary bypass
operations) is undertaking one project after another. Having
completed two (the Who's Who, and the Family Tree), Saya is now
working on the musical notes. "Strife for the ideal, Never tolerate
sloppiness" is one of Saya's advices. For if you tolerate a little
sloppiness, people will get more and more sloppy to the detriment
of the quality of the work. I hope I have at least tried to follow
Saya's advice. With best wishes for your health and happiness.
Yours respectfully,


Paying respects to Sayas 365 days a year: day 4: the “M4”

 (posted on Oct 28, 2006)

About 2 years ago, Saya M4 visited me at my office at UM1 Late-khone
campus. to enquire about the recommended texts and other books in
Physiology for the 2nd MBBS Course. Seemed Saya's going to coach
his grandson himself. We chatted a while but Saya never mentioned
what I was expecting- the name of his grandson and would-be pupil
of mine, and I never asked. We met later on several occasions but
again no mention was made of the matter. He could have rung me
anytime. But he didn't. Only when I read his obituary in the papers
did I come to know the name of that grandson (in final part 1
already). What's so special about this? Well, as the head of
Department, I had come across many people asking me (directly or
through the intermediaries) to "look after" so and so roll numbers
(for guardianship or favoritism? – the motives may vary, but when
this was done during the promotion examination then it amounted to
threat or bribery. To do what shouldn't be done-be it out of
affection (sandar-gadi), hatred (dawthar-gadi) fear (bayar-gadi), or
ignorance (maw-har gadi)-(Sayagyi Nyo- I hope I got this time right
with the enumerations) is the four "agadis", the roadmap for
corruption. Saya M4 (the ENT specialist Major Maung Maung Myint who
passed away a few months ago) did not take advantage of the position
of being my beloved saya. He spared me the stress of warding off
these agadis. Though gone, Saya's integrity remains unspotted. May
the soul of this good-natured, jolly and uncorruptable Saya rest
in peace. (the other M4 then was Major Myint Maung Maung- the OG).
With respects,


Paying respects to Sayas 365 days a year: day 5: the fragrance of the fiery rose
 (posted on Oct 29, 2006)

I was only a demonstrator with a service of one year but I was
assigned to deliver a series of lectures (on muscle) to the 2nd
MBBS students. All demonstrators in our department had to give
lectures. Such was the staff training system of Prof. May May Yi (Ma
Ma Rose), the Head of the Physiology Department, IM2.
It was only 7.30 in the morning but the downtown bus stops were
already swelling with students and staff from schools, universities
and colleges located along the Pyay and Insein Roads (the academic
rush hour). With all the binding (or rather standing) sites
saturated, the buses seemed to become scary of the crowds (enforced
queuing system complete with railings and barbed wire existed only
in cinema halls). These mobile tins of packed humans slowed down
only momentarily at a very respectable distance away from the stop.
Even then the deceleration was just enough for people to get down
(or rather get jettisoned). Having exceeded the transport maximum,
the public transport system became almost impossible. I got
desperate, as I had to give a lecture at 9 am in Mingaladon.
Luckily I caught a taxi (back in early 70s, taxis were few and far
between in Yangon) and when I reached the Department it was 2
minutes past nine. I rushed up the stairs where I was greeted by the
students coming down. They said Sayamagyi .had dismissed the class
because the lecturer failed to arrive on time. Such was the staff
management system of Prof. May May Yi, a renowned disciplinarian
and a methodical perfectionist (When I became the Head at the
same Department decades later, I had to stick the following note in
the meeting room: "Punctuality is the art of waiting for those who
are unpunctual". What a shame!)

With the assurance "I know you can handle it", Ma Ma Rose gave me
the task of taking discussion sessions with some postgraduate
doctors. I was then a demonstrator (less than 2 years in the
service) with no postgraduate training. I had to read up day and
night, visiting libraries and searching books and journals. That's
one of the means by which Prof. May May Yi recruited and groomed
would-be physiologists.

While preparing for the student practicals ("the vagal escape"), we
demonstrators had difficulty finding the vagus nerve of the
toad. "Why not seek Sayamagyi's help?" someone suggested. Ma Ma Rose
came down upon our request, and in no time, she isolated the vagus
(as if she had been doing this all along) and left without saying a
word. Ma Ma Rose indeed was a deft experimental physiologist.

How would you react if someone break (albeit inadvertently) your
china (dinner plates) en masse? One morning, a peon of Ma Ma Rose,
did just that (it was the practical and viva voce examination time,
and Ma Ma Rose must have brought those for giving lunch to the
examiners). She did not scold him nor utter a word. Such was her

I am greatly indebted to my mentor Ma Ma Rose for giving me such
wonderful training. Being a great teacher, educationist,
administrator and social activist, the fragrance of Ma Ma Rose
travels far and wide. But when it comes to principles and
discipline, I'm sure Ma Ma Rose will make no compromises.
With deep respects,


Paying respects to Sayas 365d/yr: day 6:the Rose Map to Effective Teaching  

(posted on Oct 29, 2006)

 My elder brother tried to teach me English once or twice (out of
sibling obligation, I suppose) when I was in primary school. When
it came to the meaning of the word "impossible", the examples he
gave me were so numerous (e.g. it's impossible for roosters to fly
up up and away, and for the bitches to lay eggs, and for……….) that
it became almost impossible for me to know what impossible actually
meant. That episode taught me that giving too many examples or
comparisons to clarify a point can be confusing and
counterproductive. Prof. May May Yi's lectures underscored that
point. Clear, concise and never congested, her lectures were never
hurried yet never overshot the allotted time. She used the minimum
of words that have maximal impact. This applied also to her
diagrams. I had attended many of her lectures not only out of
obligation (the back row in the lecture theatre is preserved for the
teaching staff) but also because it's always fascinating for me to
learn how others approach the subject. Furthermore, it was our
common experience that the students tend to remember the clinical
examples or personal experiences we gave; and tend to forget the
concepts and principles for which these examples were given. But had
I really learned the lesson ?
The mechanism underlying the process of glomerular filtration is
essentially the same as that of interstitial fluid formation, except
for some points. Since ISF formation had been taught in the
cardiovascular system, I thought it might be a good idea, by way of
integration, to begin my lecture on glomerular filtration by
recalling the ISF formation. I was drawing a diagram to depict ISF
formation when someone handed me a note. It read " Drop the ISF
formation part." and signed "May May Yi". It was at that moment that
a rooster and a bitch flashed back into my mind. Ma Ma Rose had
been there at the back row monitoring her staff's performance. A
hands-on training in medical education. If I have become a better
teacher, I owe a lot to Ma Ma Rose.


Paying respects to Sayas 365d/yr: Day 7:The Heart of Gold 

(posted on Nov 1, 2006)

 "Saya, why are you buying those Russian OG books? I asked. Without
failing to make his trade-mark generous grin, Prof. U Shwe Tin
answered: "Because if someone fires questions to me, I need to know
from which launching pad he's firing". So saying Saya, a renowned
Professor of Obstetrics and Gynaecology, left the IM2 bookshop with
a handful of books. Saya's attitude was a stark contrast to
another clinician whose response to my question during one of his
lectures was a sarcastic "hey..hey..that's a new finding. We must
write a new textbook!! ". My launching pad then was an American
textbook which this clinician did not seem to have come across.
Not only that, sayagyi U Shwe Tin had big strong skilful hands for
surgery (some students lovingly called Saya, "Gold Finger"), and a
big heart for his students and patients. Saya was the chairman of
the IM2 magazine committee and I was the member when the first
magazine was published in 1968. To quote Dr. Winston Chu (message
no.5259): "…. U Shwe Tin, whom I hold dearly in my heart as well as
in my memories. …. was the best clinical teacher in and out of the
operating room and his FRCS in addition to the FRCOG was indeed very
impressive. ….. I never forgot the expertise and the simple way in
which saya taught us (me) He was so very good at breaking down the
lectures into several fundamental components that to this day I can
still recite the types of abortions as well as the late pregnancy
hemorrhages, the stages of labor …… I am truly proud and indebted
(to him) to have been his student, although I did not become an
ObGyn".(end of quote; Saya Win Htin, hope you don't mind the
excerpt). What more could I add?
Back in the mid-70s, I was somewhat radicalized
(autoradicalization, I suppose). For instance, I did not pay homage
to my superior (the boss) during Thadingyuts because I was afraid
doing so might amount to a disguise for seeking favours. (The ritual
of paying respects to my Sayamagyi at IM2 began only after I was
transferred to IM1). I regarded throwing big parties and holding
grandiose ceremonies a mere waste of money, and above all,
everybody's time. Ironically, my wedding ceremony was held at the
Inya Lake Hotel. A few years later, Prof. U Shwe Tin and I were
riding together in a car. Some of my friends were also with us,
chatting. All of a sudden Saya said, "you know Ko NW, if it were
someone else's wedding, I sure would have turned around and gone
home straight away". Saya was referring to my wedding. A bit late,
Saya had to take a table outside the main hall when Saya should have
been at one of the reserved tables. At that time I was so
preoccupied with my radical ideas that I failed (or did not care) to
take seriously these matters into consideration. My naivety and
ignorance were to blame. The damage had been done. All I could do is
ask Saya's forgiveness. I hope Saya had already forgiven me for
With deep respects,
P.S. Saya was reported to have died on the operation table while
undergoing cardiovascular operation on Monday, 10th March 1981
(according to IM2 Annual Magazine, 1981, p. 149). In Who's Who in
Health and Medicine in Myanmar (2003), the date was given as July 4,



Paying respects to Sayas 365d/yr:Day 8: Letting Go

(posted on Nov 2, 2006)

Q: I feel that if I let go of "I" and "mine", I would lose my
identity. How can I exist if I let go of everything? Won't I become
cold and unfeeling? It sounds scary, like living in a vacuum.
Ans.: You have to understand that what you lose is merely an
illusion. It never was. You empty the mind of illusion about self.
Just let go of the illusion. In fact, you are not losing anything.
You just remove an imaginary screen before your eyes. In the
process you gain wisdom, or panna. From the wisdom unfold the four
virtues of unconditional love, compassion, sympathetic joy and
equanimity. These virtues manifest themselves as concern, humanness
and sensitivity to others. When you have pinna you can fully
experience the beauty and warmth that is within all human
relationships. That is why letting go is not losing your illusory
ego. You are uncovering a great treasure.
( from the book "Living Meditation, Living Insight. The Path of
Mindfulness in Daily Life" by Dr. Thynn Thynn. 2nd edition, 2003.).
I met the author in person only once when I was on night duty as a
house surgeon in the Central Women's Hospital, and she was the
assistant surgeon for that shift. She did not teach me anything that
night. But later on she introduced me to Zen Buddhism through her
book written in Burmese (banned shortly after it was published). Now
through the articles in another book (vide supra) she again teaches
the readers how to build up a solid foundation of mindfulness as a
way of life rather than as a practice separated from daily
living. "My family is my meditation" she declared. "It is mostly
through my family that I have learned to practice what I preach. It
is the family that compels me to sharpen my wits, to train and
retrain my own mindfulness. In fact, my family is my greatest
challenge and training ground".
Dr. Thynn Thynn is now a retired physician turned Dhamma teacher.
Her focus is on gaining balance and spiritual insight through
keeping mindfulness alive in the midst of our busy daily lives.
(I'm sure the AMIM site has become a good training ground for
members who wish to practice mindfulness).


Paying respects to Sayas 365d/yr:Day 9: Anatomy of the Love Tunnel

 (posted on Nov 3 2006)

The baby had come out, arms and legs moving about, except the head.
The mother was screaming and begging for help. At his wit's end, the
young doctor got hold of the baby's legs and pulled out as hard as
he could until a few cms were added to the baby's crown-heel length
and the moving tiny arms went limp. Having lost the tug of war and
the baby's head still stubbornly refusing to show its face, the
mother (with the dead baby's body dangling about) was rushed to the
divisional ("tine") hospital 20 miles away. The specialist there
asked the young doctor whether he had palpated the abdomen of the
mother. He admitted he hadn't. When he did so, he felt in the
suprapubic region a mass(the baby's head) much larger than the size
of a football (or soccer ball – the one that's being shot at the
goals in Premiership or Champion Leagues matches). It was a case of
hydrocephalus, and just a single needle was needed to end the
ordeal. The specialist drained the CSF (by spinal tap), and out
came the deflated head.

While reading the above (episode 8) in "Sayawin sit sit phyit chin
de` (want to become a medical doctor in its truest sense) and other
stories by Dr. Soe Aung, MBBS(Mdly, 1985), MMedScOG(IM1 1993), MRCOG
(UK, 2000) (Dear saya Ko Htin Aung, this Dr. Soe Aung could not be
OG Dr. Soe Aung who retired last April; and a happy anniversary
wishes to you and Ma Shwe), I couldn't help remembering my beloved
anatomy Saya Prof. Aye Cho who once said, "women are the best goal
keepers in the world; they never let the ball in". Because Saya's
always cool and wears a smile (befitting his name), it's hard to
tell whether the statement was made in jest or in reference to the
morphometrical aspects of reproductive anatomy and its dynamics.
After reading Dr. Soe Aung's story, I came to realize that women
also refuse to let the ball out, particularly if its too big, in
absolute (as in this case, which is rare and needs deflation) or
relative (cephalo-pelvic disproportion) terms. After all, it is the
exit from passage (normal vaginal delivery) that matters, and
proper ante-natal care is crucial in making the journey through that
passage safe.

With deep gratitude to my sayas Prof. Aye Cho (for his humour),
Prof. Shwe Tin (see day 7: the heart of gold) and Dr. Daw Khin
Myint Myint (who imprinted in me the importance of antenatal care by
failing me in the class test because I failed to mention ante-natal
care in the management of labour) and other ObsGyn teachers, to
Prof. Myint Myint Aye for reminding in this Alumni site not to
forget clinical skills, to DrTOKM for recommending the book, and to
the author Dr Soe Aung for creating such a wonderful book.

Sincere regards,



Paying respects to Sayas 365d/yr: Day 10: Saya Gyan and Saya Mone

(posted on Nov 5 2006)

I loved and enjoyed Thingyan, and looked forward to it so much that
by January 1st, I found myself starting counting down the days to
Thingyan. That was back in the 1950s. I loved watching people
rehearsing dances, short plays, and than-gyats (the grandfather of
present-day hip hop music?). As Thingyan drew closer, my heart beat
faster as pandals sprang up— make-shift water-throwing man-dats,
beautifully decorated stands for water dousing and entertainment,
and prizing-giving pavilions in which various thingyan troupes in
decorated cars or floats lined up to compete. (Multi-tiered
fortresses with dozens of water hoses and water canons offering
free services for car-and-human washing were nonexistent those
days). Thingyan was then ushered in by flowers, be they in the
earthen pots ("atar-oh"s) or on the branches of paduak and ngu
trees. We used an assortment of water throwing devices --from
squirt guns, portable manual water pumps (brass "pyoots" which Brad
Pitts might find fascinating), used condensed-milk tins ("khwet-
sotes"), silver bowls(for ladies), buckets and fire hoses (for
gents). Water throwing and playing (mostly among ourselves) with
occasional skirmishes with the wandering gangs form other wards in
the morning, resting at noon in the shades of the mandats
enjoying the dances and than-gyats of competing troupes; resuming
water-playing in the evening (sometimes reveling in a car with the
elders, waiting in long queues to get drenched ), and again enjoying
than-gyat competitions and entertainments late into the night. The
cycle went on for the next 2 days. When thingyan ended, I began
suffering from post-thingyan syndrome. Where had all those water
dousing and merriment and pandals gone? Where were those mote-lone-
yay-baws(floating-dough-balls)? Why did sounds of tone-chan-chan,
tone-chan-chan go silent? People went on with the usual business as
if thingyan had never taken place. I felt uneasy, deprived,
feeling "har-tah- tah- something's terribly missing (as though
someone you cherished so much stayed with you for a few days and
then suddenly disappeared). I was then too young to know the cause
of this syndrome.

After the water festival, came the festival of lights (tazaungdine).
Because we had moved to west Yangon, we were now in the very heart
of tazaungdine festivities. Buildings, roads and streets were
illuminated with multicolored light bulbs. U Ba Gyan Street Cartoon
Shows (as Winston, Stan and other alumni had recalled),14th street
still-performances depicting srories from the ten Zat-taws, stage-
shows along Lanmadaw and Kyone-gyi streets, and anyeint pwes in
almost every street. I enjoyed the festivities till 2 or 3 in the
morning. When the festivities end, darkness returned, and again I
suffered from post-tazaungmone syndrome. This time I was mature
enough to realize that I suffered because I enjoyed these
festivities so much. Saya Gyan and Saya Mone had taught me a
lesson: "The more you are emotionally or physically involved in
something, the more you will suffer when that something is no longer
there ("swal lan" --> the` kywan".). So at the two Sayas' advice, I
had been trying not to get too emotionally involved in or attached
to anything or anyone, including my own ego. I have to, because I
don't have a wooden heart.


Paying respects to Sayas 365d/yr: Day 11: Bomhu Lao

 (posted on Nov 6 2006)

Dear Max Kyi,

Thank you for your information (message 1899) on the demise of one of
the foremost orthopaedic gurus of Myanmar, Lt. Col. Robert Lao(aks. U
Mya Si). (the other guru was Sayagyi U Ba Pu). Bomhu Lao (as he was
fondly addressed by us) taught us orthopaedics at the DSGH. He was so
good-natured and obliging that even as medical students, we felt very
much at ease with this Colonel Commandant. One day we was operating on
the soft tissue- the gluteus muscle in search of a broken needle. We
were expecting his blame on the M.O. who was so careless as to break
the needle while giving I.M. injection. But he just commented that it
was a very unfortunate event- both for the doctor and the patient. May
the soul of this good-natured surgeon and teacher rest in peace.



  Paying respects to Sayas 365d/yr: Day 12: The Ethical Rat Trap-1

 (posted on Nov 8 2006)

I've been trying not to get caught in the Ethical 3Qs (quagmires)
simply because I don't want to let loose the lid of Pandora's box.
However, since the piper's music with intonations of earnest
goodwill and sincerity has become so enticingly desperate and urgent
(re: msg no. 6071) that the sacrificial animal is now obliged to
jump into the quagmire (though the rat does not think evading
these questions on ethical issues is unethical or inhuman) by way
of paying respects to ALL the SAYAS (past and present, young and
old, in all fields --clinical, research, education, administration, public health) whose incorruptible integrity and
ingenuity in handling ethical dilemmas have been a beacon in today's
black moral wilderness.

Q no. 1-What would you do if someone practising Medicine is
unethical and hurting patients? If that person is known to you as a
classmate, friend, teacher or mentor or the one dear to your heart or the one
you trained or helped?

Shall I begin my answer with a question? Since being unethical
(something to do with the value system) and hurting patients
(malpractice which may amount to criminal conduct) are two separate
issues (as Saya Winston has pointed out; re: message# 6106), the
emphasis is on which? On not being ethical, or on malpractice, or
on both (unethically hurting patients)? Anyway, let me draw on some
of my experiences: (1) Many years ago, a township medical officer
did surgical sterilizations on some women villagers without waiting
for the approval from the medical board. According to him, he did
this in good faith to relieve their poverty and promote maternal and
child welfare and without charging cash or kind. But someone (out of
moral duty or rivalry?) reported to the authorities and he got
dismissed from the service. He was bitter up to this day because he
felt his empathy and good will were not considered in passing the
verdict. Obviously he was unethical (by the value system of that
era) but there was no harm done to the patients. He became a G.P.
Had he been allowed to stay in the service, I believe he would have
saved many lives in the districts as he was a competent surgeon (as
attested by another A.S. who got surgical training from him). (2) As
a house surgeon, I participated in a vaginal hysterectomy done on an
obese middle aged Indian lady. The uterus came out along with a
baby in it. From the reactions from the OGs, I know something's
wrong. But should I report this? A case of negligence? If I
should, to which body? Where's the hot line? What would be the
consequences? I'm sure these OGs had learned their lesson. They
should be allowed to continue contributing their services, which
they did excellently for many years. (3) When I was promoted to a
bigger medical school, I came across a very senior faculty member
who at the start of a practical examination (a single practical
question for 3 hours) went from table to table to whisper the
answers (certain values) to selected students. I was dumbfounded and
thought of reporting this to the authorities. Had I followed my
impulses, I don't think I would still be in the teaching post since
that faculty member had connections—it was just a matter of "looking
after" the children of some powerful people in high places. So my
answer to Q1 is: I will report provided the time and atmosphere are
right and if it makes a difference. If not, I will resort to other
means such as peer persuasion. I don't think "silence is golden"
here. Silence or indifference stinks.

Sincere regards,
Bloggobattered rat


Paying respects to Sayas 365d/yr: Day 13: The Ethical Rat Trap-2

 (posted on Nov 10 2006) 

Dear Dr Shwe Zin Tun and alumni,

Sorry I had to take a break as struggling out of one quagmire was so

Q no. 2-The Doctor in Question is the Pioneer of medicine and saved
many thousands of lives. Is that OK for that reputed physician to
kill one and harm some maliciously or unintentionally or out of
sloppiness or incompetence or for whatever reason? Is ONE too many
or too little?

In this Q, I could see Dr. Jackal suddenly turning into Mr. Hyde. Be
it murder, manslaughter or grievous hurt, there are criminal laws to
handle the cases individually. The law (or the people) does not take
into account the previous good deeds (cf. Richard Nixon and
Watergate). For some, flirting only once is enough to turn years of
love into hatred (though Bill Clinton survived the marriage as well
as the presidency). So for me, one is just one-- no more, no less.

Bloggobattered rat


Paying respects to Sayas 365d/yr: Day 14: The Ethical Rat Trap-3

 (posted on Nov 10 2006)  

Dear Dr Shwe Zin Tun and alumni,
Now the final quagmire (haw- hair, haw -hair).

Q no. 3-The last but I feel most important Q is what would you
do about it? How can you help change the practice to help the
public,patients and then your fellow physicians? How would you
approach it? Is Status Quo acceptable? Is 'Do Nothing OK 'because
it happens everywhere? Is 'Do Nothing' acceptable because it doesn't
affect me or has never been affected?

Let us go back to the case where a stroke patient died during the
so called brain surgery. The relatives had collected and paid kyats
1000 000 (if I remember the number of zeroes correctly) to the
private hospital only to find out upon unbandaging the head (for the
ritual of bathing the body) that he deceased had not been operated
upon. Three points arise from this case-based approach: (1) Who
among the relatives had enough conscious, education or the presence
of mind (and the most important of all, the time, money, resources,
and connections) to stand up to the hospital? (2) Even if there were
one, how would he/she execute it? Delay the cremation or burial
until the police and responsible people from the hospital arrived ?
(3) Even if some of the Alumni members had formed a support group
to fight for the case, where was the evidence? None if cremated.
Exhume the body if buried? It boils down to the fact that until and
unless there is an ethics squad (something like Kyaw Thu's funeral
charity services) which could arrive at the scene of malpractice
within minutes (upon calling the 24 hour hotline), I `m afraid
there is very little we can do about such cases. On the other hand,
shall we turn blind eyes and ears to the bad practices of some
clinicians because they had to do it for their children's education
(abroad at top institutions)?. What a lame excuse! Educating one's
children's at the expense of patients' suffering and even lives is
shameful, degrading and deplorable. But do we have the mechanisms to
stop this? Doing nothing is not OK but apathy on the part of the
public as well as the majority in the medical establishment is a
great hindrance to apropriate preventive, punitive or remedial
measures, and no amount of drastic action can change the people's
indifference as had been demonstrated by the failure of the twin
tower attacks to make people a little bit more sensitive to
Palestinian or Arab (or whichever) cause.

Bloggobattered rat(so tired, z z zzzzzz zz)